Objective: To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy. Methods: Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on. Results: A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level. Conclusions China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.

OBJECTIVE To conduct a rapid qualitative study on the chemical constituents of the methanol extract in Thamnolia subuliformis (Ehrh.) W.Culb. by UHPLC-Q-Exactive Focus-MS/MS. METHODS The chromatographic separation was performed on a Waters Acquity UPLC BEH C18(2.1 mm×50 mm, 1.7 μm) column with acetonitrile(A)-0.1% formic acid aqueous solution(B) as mobile phase for gradient elution, the flow rate was 0.3 mL·min–1 and the column temperature was 30 ℃. Mass spectrometry was performed using an electrospray ionization and data was collected in negative ion modes, and the detection range was m/z 80−1 200. The chemical constituents in Thamnolia subuliformis (Ehrh.) W.Culb. were identified rapidly and comprehensively based on the accurate relative molecular and combined with literature data and reference substances. RESULTS A total of 39 chemical constituents were speculatively identified, including 9 mono-substituted phenyl rings, 11 depsides, 5 depsidones, 2 dibenzofuran, 10 lipids, and 2 others. CONCLUSION The chemical constituents in the Thamnolia subuliformis (Ehrh.) W.Culb. can be identified accurately and rapidly by this method. Among them, 3 compounds(β-resorcylic acid, usnic acid, atranorin) are unambiguously identified by comparing with reference standards, 19 compounds are found from Thamnolia subuliformis (Ehrh.) W.Culb. for the first time. This paper can provide the important basis for study on pharmacodynamic material and substitute development of Thamnolia subuliformis (Ehrh.) W.Culb..

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To provide a retrospective analysis of the levels of occupational external exposure of radiation workers in Hubei province from 2009 to 2018 in a way to prevent and control its risks.Methods:The external individual doses were surveyed for 50 070 radiation workers between 2009 and 2018 by the effort of the Hubei Provincial Center for Disease Control and Prevention. Under the relevant national standards, the external radiation doses to radiation workers were conducted by using TLDs.Results:The average annual collective effective dose to radiation workers in a 10 years period was 1.93 man·Sv, the median of average annual effective dose of 0.14 mSv ( P25- P75: 0.06-0.30 mSv), and the average annual effective dose of 0.40 mSv. The annual effective doses received by 46 562 workers were less than 1 mSv, accounting for 92.99% of the total monitored workers. The annual effective dose varied dependent on occupational categories, showing a year-by-year decline trend and staying at a low level after 2012. The relative high radiation doses were seen in nuclear medicine and interventional radiology in medical applications, non-destructive testing and well logging in industrial applications, and other types of radiation applications. Conclusions:The average annual effective dose decreased year in a by year manner and kept at a low level. This indicated that the radiological protection measures taken during the 10 years ensure the health of workers. The continuous monitoring result suggest that much more attention should be paid to such categories workers as nuclear medicine, interventional radiology, non-destructive testing, well logging and others through improving radiation protection measures.

Objective:To formulate a standardized management plan of Hemodialysis Room for patients with infectious diseases and explore the practical effect.Methods:The Beijing Ditan Hospital affiliated to Capital Medical University formulated a standardized management plan for hemodialysis room of patients with infectious diseases, which was implemented in 2017. Using convenience sampling method, 146 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January 2017 to October 2020 were selected as the experimental group, and 46 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January to December 2016 were selected as the control group. We compared the nursing compliance rate before and after the implementation of the plan, the incidence of adverse events, and the satisfaction with nursing in the two groups.Results:After the implementation of the plan, the nursing compliance rate was 97.13% (406/418) , which was higher than 89.29% (50/56) before the implementation, and the difference was statistically significant (χ 2=8.316, P<0.01) . The incidence of adverse events in the experimental group was 6.85% (10/146) , which was lower than 17.39% (8/46) in the control group, and the difference was statistically significant (χ 2=4.567, P<0.05) . The Nursing Work Satisfaction Scale score of the experimental group was (94.67±3.08) , which was higher than (91.96±2.91) of the control group with a statistical difference ( t=8.882, P<0.05) . Patients' satisfaction with nursing in the experimental group was 98.63% (144/146) , which was higher than 91.30% (42/46) in the control group, and the difference was also statistically significant (χ 2=6.201, P<0.05) . Conclusions:The explored and implemented standardized management plan for hemodialysis patients with infectious diseases has achieved certain positive results, which provides a scientific, fine and standardized nursing management strategy for the construction of systematic solutions in the future.

OBJECTIVE：To put forward policy suggestions for the adjustment and reform of centralized drug procurement mode in China. METHODS ：The evolution process of centralized drug procurement mode in China was reviewed ，and problems were found through literature research and expert interview. Combined with the experience of drug procurement platform construction，GPO procurement and medical insurance payment control fee management in the United States and Singapore ，the reform suggestions were put forward for basic model assumption of bidding procurement based on cost control target and drug bidding procurement policy. RESULTS & CONCLUSIONS ：China’s drug bidding procurement system has gone through the stages of unified purchase and marketing ，decentralized procurement ，centralized procurement start-up and adjustment ，comprehensive implementation of online centralized drug procurement ，exploration of the integration of “two bidding ”（bidding for essential medicine and bidding for non-essential medicine ）and joint procurement ，and pilot stage of national drug bidding and procurement. At the present stage ，there are many problems in centralized drug procurement ，such as the diversified subordination relationship of the platform ，the possible monopoly of enterprise selection under the policy of “two invoice system ”，price reduction becoming the core performance index of bidding procurement ，and the suspected monopoly operation of GPO procurement exploration. The model analysis based on the goal of cost control shows that drug cost is a function of efficiency ，drug quantity and price. High price leads to high cost ，while low efficiency leads to high cost. In the future ，the goal of drug bidding and procurement should not only foucs on price control ，but also on efficiency. The function of bidding and procurement will return to the essential function of “price for quantity ”. It is suggested that a relatively independent and unified platform should be established for drug bidding and procurement in China ，and the grouped procurement mode should be gradually standardized ，the expenditure control function of medical insurance payment audit should be exerted instead of simple price reduction ，and absolute unified lowest price procurement should be avoided.

Objective:To have a better understanding of congenital leukemia by summarizing its clinical features and prognosis.Methods:This study retrospectively recruited 10 neonates with congenital leukemia treated in Beijing Children's Hospital, Capital Medical University from January 2006 to December 2018. Clinical data including clinical manifestations, laboratory examinations, treatment and follow-up were described.Results:The 10 patients consisted of six boys and four girls. In all cases, symptoms presented within 11 d after birth. The admission complaints were jaundice ( n=4), polypnea ( n=3), fever ( n=2) and rash ( n=2). Physical examinations of the 10 patients showed eight with splenomegaly, seven with hepatomegaly and seven with petechia/skin rash. All patients had significantly increased white blood cell count (from 45.8×10 9/L to 553.0×10 9/L), complicated by different degrees of anemia and thrombocytopenia. By bone marrow biopsy, two cases were diagnosed as acute lymphoblastic leukemia and the other eight cases as acute myeloid leukemia. All cases refused chemotherapy on the preliminary diagnosis. Three cases lost follow-up and six died within two months after discharge requested by their parents. One baby had spontaneous remission, but relapsed two years later. Complete remission was achieved after strict management and no relapse was reported until ten years old. Conclusions:Congenital leukemia is a severe condition with high mortality. Some cases may achieve spontaneous remission, but long-term follow-up is needed.

Objective: To study the clinical and molecular characteristics of Staphylococcus aureus(S.aureus ) isolated from neonates of Beijng Children′s Hospital. Methods: The clinical information of S. aureus infection in newborns of Beijing Children′s Hospital from February 2016 to January 2017 was collected.The molecular biological characteristics of S. aureus isolates were detected.Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus(MSSA)were identified, using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing(MLST)and spa typing were analyzed using the PCR, and the staphylococcal chromosomal cassette mec(SCCmec) type was analyzed for the MRSA isolates.Eleven adhesion gene and three virulence genes(pvl, psma, hlα )were also detected by PCR.Antimicrobial susceptibility testing was performed by agra dilution method or E-test method. Results: The total of 57 cases of neonatal S. aureus infection were collected during the study.The most common clinical diagnosis was 38 cases (66.7%) of pneumonia and 28 cases (49.1%) of skin infection syndrome (SSTI). There were 31 cases (54.4%) with MRSA infection and 26 cases (45.6%) with MSSA infection.The proportion of SSTI in the MRSA group (64.5%) and the infection of more than 2 sites (61.3%, 19/31) were significantly higher than those in the MSSA group (30.8%, 8/26 and 23.1%, 6/31). There were 16 MLST types and 29 spa types, the most common ones were ST59 (40.4%) and t437 (33.33%), respectively.The most common popular clones of MRSA and MSSA were ST59-SCCmecIVa-t437 (54.8%) and ST22-t309, respectively(11.5%). The sdrE carrying rate of MRSA was higher than that of MSSA, while the sdrD and cna carrying rates were lower than those of MSSA (P<0.05). The other adhesion and virulence gene carrying rates were not significantly different between the two strains.The multi-drug resistance rate of all strains was 61.4%(35/57). Except for lactam antibiotics, the most common resistant phenotypes of MRSA and MSSA were ERY-CLI, accounting for 74.2% and 26.9%, respectively. Conclusion The main types of neonatal S. aureus infection in our hospital were pneumonia and SSTI.SSTI and multi-site infections of MRSA infection are more common.MRSA and MSSA isolates have clonal dissemination characteristics.The most common clones are ST59-SCCmecIVa-t43 and ST22-t309, which show no significant differences in the status of carrying virulence factors between them.The multi-drug resistance rate of neonatal S. aureus isolates is higher.

Objective: To investigate the clinical manifestation, cytogenetics, gene mutations and prognostic factors of chronic neutrophilic leukemia (CNL) . Methods: 16 CNL cases, according to WHO (2016) -definition, were reviewed retrospectively. Identifications of the CSF3R, ASXL1, SETBP1, CALR and MPL mutations were performed by direct sequencing. JAK2 V617F mutation was detected by AS-PCR. Results: Of the 16 CNL patients, the median age was 64 (43-80) years with a male predominance of 75% (12/16) . The median hemoglobin was 114 (81-154) g/L, with median WBC of 41.20 (26.05-167.70) (10⁹/L and median PLT of 238 (91-394) ×10⁹/L.The median level of marrow fibrosis (MF) was 1 (0-3) degree. There was no other cytogenetic abnormalities except t (1;7) (p32;q11) , +21 and 14ps+ for each. All the 16 CNL patients harbored CSF3R T618I mutation. ASXL1 mutations were identified in 81% (13/16) , while SETBP1 mutations were confirmed in 63% (10/16) . The CALR K385fs*47 mutation was found. There was no mutation in JAK2 V617F or MPL in the above 16 patients. The median overall survival (OS) of patients presented with WBC≥50×10⁹/L at diagnosis (11 months) was significantly shorter than of WBC<50×10⁹/L (39 months, P=0.005) . Conclusion CSF3R T618I mutation was specific for CNL. The median OS of CNL patients was 24 months, and WBC≥50×10⁹/L at diagnosis was an unfavorable prognostic factor.

Objective To study the effect of nursing intervention on awake time and blood ammonia levels for patients with hepatic encephalopathy treated by dialysis therapy.Methods A total of 60 patients with hepatic encephalopathy treated by dialysis therapy in our hospital were randomized into control group (routine nursing) and observation group (nursing intervention) according to random number method,with 30 patients per group.The incidence of induced factors of hepatic encephalopathy,the clinical efficacy of nursing,and the patients' awake time and changes of blood ammonia levels in two groups were compared.Results Compared with the control group,the incidences of induced factors of hepatic encephalopathy such as infection,high protein diet,gastrointestinal bleeding,electrolyte disturbances were significantly reduced in the observation group (P ＜ 0.05);Compared with the control group,the total effective rate of nursing was obviously increased in the observation group (P ＜ 0.05);The patients'awake time was significantly decreased and the blood ammonia levels were obviously reduced on after nursing in the observation group (P ＜ 0.05).Conclusion Nursing intervention for patients with hepatic encephalopathy can effectively remove the induced factors of hepatic encephalopathy and increase the clinical efficacy of dialysis therapy.