Objective To know the rural doctors' knowledge,belief and practice on iodine deficiency disorders(IDD),as well as their capability on health education communication in Ye County,Henan Province.Methods Semi-structured interviews were conducted among 50 rural doctors in Ye County,Henan Province.Topics covered include:sales of salt purchases,daily supervision and monitoring activities of salt,the health effects of salt,the situation of rural doctors trained,the situation of rural doctors participated in health education and related recommendations.Results ①Twenty-nine of the rural doctors knew exactly the advantage of salt iodization.②Thirty-nine of the rural doctors had taken part in the half quantitative detection of salt once or twice a year and 15 of them knew the supervision activities of salt industry department.③Forty-nine of the rural doctors believed salt iodization was beneficial to health and 48 of them were willing to participate in health education on IDD.④The major ways of their acquiring health knowledge were promotional materials [54.0％ (27/50)],TV [50.0％ (25/50)],and lecture/training [24.0％ (12/50)].⑤Thirty-seven of the rural doctors had taken part in health education on IDD.They were used to use booklets [68.0％ (34/50)],promotional slogan [36.0％ (18/50)],broadcast [24.0％ (12/50)],and doctor consultation [24.0％ (12/50)].⑥Twenty-eight of the rural doctors thought the current health education on IDD was better.They hoped to reduce the price of salt,strengthen supervision,receive more training and health education on IDD.Conclusions The rural doctors remain relatively lack of knowledge on IDD.Rural doctors have the initiative and responsibility to conduct health education on IDD,but their pattern is still a one-way propagation.

Objective To evaluate the sleep and mood of patients with type 2 diabetes and peripheral neuropathy , and to explore whether the results were related to the level of interleukin-17 ( IL -17 ) . Methods 130 cases of type 2 diabetes diagnosed in Department of Endocrinology , First Affiliated Hospital of Medical University of Anhui from September 2015 to July 2016 were selected ,46 diabetes mellitus patients without peripheral neuropathy ( NDPN group ) and 84 patients with peripheral neuropathy ( DPN group ) were selected in the study.According to Toronto score (TCSS),DPN patients were divided into mild DPN group (DPN1 group,54 cases), medium and severe DPN group (DPN2 group,30 cases).The severity of insomnia and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and 17-term Hamilton's Depression Scale (HAMD-17).The serum levels of IL-17 were measured .Results The scores of PSQI and HAMD-17 in the DPN group were signifi-cantly higher than those in the NDPN group,The score was (9.74 ±2.87),(10.85 ±2.20),and (12.03 ±2.71)respectively,the differences was statistically significant ( F =7.43, P =0.001 ), and the scores of PSQI and HAMD-17 in the DPN2 group were significantly higher than those in the DPN 1 group,the scores were (6.80 ± 2.74),(7.52 ±2.49),and (8.97 ±3.22) respectively,the differences was statistically significant (F=5.73,P=0.004 ) .The level of IL-17 in the DPN group was significantly higher than that in the NDPN group ,the differences was statistically significant(F=5.27,P=0.006).There was no statistically significant difference in IL -17 between the DPN1 group and the DPN2 group.IL-17 level of patients with PSQI >10 was significantly higher than that of patients with PSQI≤10 (t=5.52,P=0.021).The level of IL-17 in patients with HAMD-17≥7 and patients with HAMD-17 <7 had no statisticallysignificant difference .Conclusion Sleep and mood is closely related to the condition of patients with type 2 diabetes and peripheral neuropathy .Sleep condition may affect the level of IL -17 and the development of neuropathy .

Objective:To analyze the characteristics of nerve injury in patients with diabetic peripheral neuropathy (DPN) and explore the diagnostic value of current perception threshold (CPT) and nerve conduction velocity (NCV) for DPN.Methods:One hundred and thirty-six DPN patients admitted to Beijing Puren Hospital from June 2017 to December 2019 were selected, and 130 diabetic non-DPN patients admitted during the same period were used as controls. All the subjects were tested by CPT and NCV. Among them, the detection of NCV included sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV). Statistical analysis was performed on the relevant indicators of the two groups of subjects.Results:The CPT values of the upper limb median nerve and ulnar nerve at 2 000 Hz, 250 Hz, and 5 Hz, the superficial peroneal nerves at 250 Hz, and 5 Hz, and the CPT values of the sural nerve at 2 000 Hz and 250 Hz were higher than those of non-DPN patients, DPN injury mainly occurred in myelinated nerve fibers in the lower extremities [60.29%(82/136)], and the difference were statistically significant ( P<0.05). The SCV and MCV of the median nerve, ulnar nerve, and common peroneal nerve in the DPN group were lower than those in the non-DPN group, the SCV abnormal rate was higher than the MCV: 55.88%(76/136) vs. 37.50%(51/136); 58.82%(80/136) vs. 41.18% (56/136); 67.65%(92/136) vs. 50.00%(68/136), and the differences were statistically significant ( P<0.05). The area under the predictive value curve (AUC) of CPT for DPN was 0.815 (95% CI 0.735 ~ 0.895). The AUC of NCV for DPN was 0.875 (95% CI 0.813 ~ 0.944). The AUC of CPT and NCV for DPN was 0.923 (95% CI 0.876 ~ 0.970). Conclusions:DPT patients have abnormal CPT and NCV, and nerve damage occurs mostly in myelinated nerve fibers and SCV. Diagnosing DPN by combining CPT and NCV is helpful to improve the detection rate of DPN.

Objective To investigate the relationship among Helicobacter pylori(H.pylori),CD4 positive cells and CD8 positive cells in gastric mucosa of the AIDS patients with gastritis.Methods Fiftyeight AIDS patients with upper abdominal pain were diagnosed with chronic gastritis through gastroscopy.The gastric biopsies from them were used for H.pylori detection with rapid urease test and Giemsa staining,pathology examination with HE staining,and immunohistochemistry analysis for CD4,CD8 positive cells in Gastric mucosa.And the application of flow cytometry was for the detection of peripheral blood CD4 and CD8 lymphocytes from the patients.Results H.pylori was positive in 26 cases,and negative was in 32 cases.CD8 cell expression in gastric mucosa of the AIDS patients with H.pylori positive was significantly higher than H.pylori negative patients(P＜0.05).There is no difference CD4 cell expression in gastric mucosa between the AIDS patients with H.pylori positive and H.pylori negative patients.Moreover,CD8 positive lymphocytes in gastric mucosa of those patients with H.pyloriinfection were significantly stronger than the CD4 positive lymphocytes.However,the peripheral blood CD4 lymphocytes from the patients with H.pylori infection were more than those from H.pylorinegative patients significantly(P＜0.05).Conclusion The expression level of CD8 cells in gastric mucosal tissues of AIDS patients with H.pylori infection were higher than those without H.pylori infection.The CD4 lymphocytes from the peripheral blood of the patients with H.pylori infection were more than those without H.pylori negative patients.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Objective:To explore the influencing factors of abnormal blood pressure and electrocardiogram (ECG) in occupational motor vehicle drivers.Methods:In January 2024, a cluster sampling method was used to study 606 occupational motor vehicle drivers from a transportation service enterprise in Beijing who completed occupational health examination in 2023 in Peking University Third Hospital as observation group and 596 non-occupational motor vehicle drivers as control group. The data of personal history, occupational history, blood pressure and ECG were collected, and the effects of occupational motor vehicle driving on hypertension and ECG were analyzed by multivariate logistic regression.Results:The age of workers in the observation group was (34.1±7.8) years old, and the length of service was (7.0±7.1) years. The age of the control group was (33.8±7.6) years old, and the working age was (7.7±6.5) years. There was no significant difference in age and length of service between the two groups ( t=0.62, -1.90, P=0.538, 0.057). Systolic blood pressure (133.0±14.7) mmHg, diastolic blood pressure (83.7±11.6) mmHg, hypertension detection rate of 33.0% (200/606), ECG abnormality detection rate of 39.9% (242/606). They were significantly higher than those in the control group [ (127.8±14.4) mmHg, (77.5±11.0) mmHg, 24.7% (147/596), 31.0% (185/596) ], and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that occupational motor vehicle driving were risk factors for hypertension and abnormal ECG ( OR= 1.210, 1.578; 95% CI: 1.145-1.231, 1.237-2.012; P<0.001) . Conclusion:Occupational motor vehicle driving may increase the risk of hypertension and abnormal ECG in workers.

Objective To evaluate the status and influencing factors of early ambulation in patients following postoperative gastric cancer, and provide evidence for making reasonable evaluated standard to patients.Methods Self-designed questionnaires were used to investigate the early ambulation of 108 patients following postoperative gastric cancer from June 2013 to August 2014. Results The mean time of first ambulation was(30.82±13.83)h in 108 patients, and the average distance was(13.14±14.68)meters. 51 cases completed the early ambulation and accounted for 47.2%. The results of logistic regression analysis showed that postoperative pain and postoperative fatigue could greatly affect early ambulation of patients following postoperative gastric cancer(P<0.05).Conclusions Postoperative pain intervention and postoperative fatigue management benefits to the early ambulation for patients following postoperative gastric cancer.

Objective To explore the effect of assessment criteria in early ambulation of gastric cancer patients after surgery. Methods Totally 327 gastric cancer patients from January 2013 to March 2016 in our hospital were selected as the research object by convenience sampling method. All patients were randomly divided into the control group ( n=160) and the observation group ( n=167) by throwing a coin. Patients in the control group received routine nursing before surgery, while patients in the observation group were assessed by postoperative assessment criteria of early safety ambulation. The status of postoperative early ambulation and satisfaction degree were compared between two groups. Results In the observation group, the proportion of ambulation within 24 hours after surgery was 80.2%, and it was 46.9% in the control group (χ2=39.439,P<0.05). The satisfaction degree towards nursing work in the observation group was 95. 8%, and was significantly higher than that in the control group ( 81. 2%) . The situation of observation group with early ambulation is better than that of control group (χ2=9.115,P<0.05).Conclusions Assessment criteria of early ambulation for patients with postoperative gastric cancer is benefit for developing early postoperative ambulation and improving the satisfaction degree towards nursing.

Objective To investigate the clinical comprehensive value of finerenone in the treatment of diabetic nephropathy(DN),and to provide evidence-based medicine evidence for clinical drug decision.Methods PubMed,Web of Science,Embase,Cochrane Library,WanFang Data,CNKI and health technology assessment(HTA)official website were systematically searched to collect the systematic review/Meta-analysis and pharmacoeconomic evaluation on finerenone in treatment of DN from the inception to November 31,2023.The method of rapid HTA was used to evaluate the effectiveness,safety and economic evaluation.The innovation,suitability and accessibility of finerenone were analyzed by relevant data from drug instructions,professional websites such as the National Medical Products Administration(NMPA)and Center for Drug Evaluation,NMPA.Results In terms of effectiveness,finerenone significantly reduced the risk of the renal composite events and composite cardiovascular outcomes in DN compared with placebo and traditional mineralocorticoid receptor antagonist(MRA).In terms of safety,the incidence of adverse reactions and acute kidney injury of finerenone was similar to that of placebo and traditional MRA,but the incidence of hyperkalemia was higher than that of placebo.In terms of economy,two foreign HTA reports showed that finerenone was more economical than standard treatment.In terms of innovation,finerenone was the world's first approved non-steroidal,selective MRA innovative drug for the treatment of type 2 DN,making its efficacy and adverse reactions more advantageous.In terms of suitability,finerenone should only be taken once a day,which had good suitability in pharmaceutical properties and clinical use.In terms of accessibility,the domestic price of finerenone was lower than the international price,and it was included in the medical insurance,and the market coverage was high,it had a good affordability and availability.Conclusion Finerenone has good effectiveness and safety in the treatment of DN,but attention should be paid to the risk of hyperkalemia,and its economy requires further economic research in China.As the world's first approved non-steroidal,selective MRA innovative drug,finerenone has better innovation,suitability and accessibility.

Objective:To investigate the clinical application value of coiled tube of femoral anterolateral flap in the repair of circumferential defect after resection of advanced hypopharyngeal carcinoma.Methods:Clinical data of 42 patients with advanced hypopharyngeal cancer admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to April 2022 were retrospectively analyzed, including 41 males and 1 female, aged from 33 to 82 years old. All patients received surgical treatment, including total laryngectomy plus total laryngopharyngectomy in 20 cases, total laryngectomy, total laryngopharyngectomy and resection of partial tongue base in 8 cases, total laryngectomy, total laryngopharyngectomy and resection of cervical esophagus in 9 cases, total laryngectomy, total laryngopharyngectomy, and resection of partial tongue base and cervical esophagus in 5 cases. The postoperative circumferential defects were repaired with the coil tube of anterolateral femoral skin flap in phase Ⅰ, and the healing status of the flap, wound healing and swallowing function were observed. All cases were followed up.Results:The lengths of the hypopharyngeal defects were 7-18 cm and the sizes of the harvested flaps were 6 cm×9.5 cm-10 cm×20 cm. Flaps survived in 41 cases, flap necrosis occurred in one case, and the survival rate of flaps was 97.6%. One artery and one vein were anastomosed in 40 cases, and one artery and two veins were anastomosed in 2 cases. Postoperative cervical wound infection occurred in 5 cases, and pharyngeal fistula occurred in 2 cases. Three months of follow-up after surgery, 31 cases had normal diet, 9 cases presented with semi-liquid diet and 2 cases with liquid diet. Following up for 6-65 months, recurrence and metastasis occurred in 14 patients (33.3%), including primary site recurrence in 4 cases (9.5%), cervical lymph node recurrence in 6 cases (14.3%), and distant metastasis in 4 cases (9.5%). The 1-year and 3-year overall survival rates were respectively 79.4% and 60.5%.Conclusion:Coiled tube of femoral anterolateral flap is an ideal skin flap for repair of circumferential defects after resection of advanced hypopharyngeal carcinoma.