As an important setting for the administration of vaccinations, the reasonable setting up and standardized management of vaccination clinics will enhance immunization service quality, public satisfaction, and improve the vaccination rate to protect people′s health. In recent years, various provinces in China are continuously promoting the standardized construction and management of vaccination clinics. However, the level of standardization management remains unbalanced, and the capacity of vaccination services needs to be further improved. This paper reviews the standardized management process of vaccination clinics, summarizes the practice and achievements in various regions, and analyzes the challenges and issues during these processes, to provide reference for improving the standardized management level of vaccination clinics in the future.

As an important setting for the administration of vaccinations, the reasonable setting up and standardized management of vaccination clinics will enhance immunization service quality, public satisfaction, and improve the vaccination rate to protect people′s health. In recent years, various provinces in China are continuously promoting the standardized construction and management of vaccination clinics. However, the level of standardization management remains unbalanced, and the capacity of vaccination services needs to be further improved. This paper reviews the standardized management process of vaccination clinics, summarizes the practice and achievements in various regions, and analyzes the challenges and issues during these processes, to provide reference for improving the standardized management level of vaccination clinics in the future.

Objective To analyze the mechanism of Huangwu Ganfu Ointment in relieving pain of knee osteoarthritis(KOA)based on network pharmacology;To verify it in animal experiments.Methods The active components of Huangwu Ganfu Ointment were obtained by TCMSP database,PubChem database and SwissADME platform,the effective components were screened,and the targets were obtained from SEA database.KOA disease-related targets were obtained from GeneCards,OMIM and other databases,and the intersection targets were obtained.A effective component-target-disease network was constructed using Cytoscape 3.9.0 Software.Protein-protein interaction(PPI)network was constructed by STRING database and core targets were screened.GO and KEGG enrichment analysis of intersection targets were analyzed using DAVID platform.The KOA rat model with cold and damp syndrome was established,and the intervention of Huangwu Ganfu Ointment was carried out.The efficacy was observed and the core target expressions were detected.Results Totally 104 effective components were screened from Huangwu Ganfu Ointment,and 59 potential targets were obtained for treating KOA.PPI network interaction analysis obtained the important targets of IL6,IL1B and PTGS2.KEGG enrichment results showed that Huangwu Ganfu Ointment may involve 84 signaling pathways such as IL-17,TNF,TRP and NF-κB in the treatment of KOA,most of which were related to inflammation.The results of animal experiments showed that Lecuesne MG scores increased in the model rats(P<0.05),and paw withdrawal threshold(PWT)significantly decreased(P<0.05).Compared with model group,PWT in Huangwu Ganfu Ointment medium-and high-dosage groups were significantly recovered,and synovitis Krenn score decreased(P<0.05).The Mankin score of cartilage tissue of Huangwu Ganfu Ointment high-dosage group decreased(P<0.05).The contents of IL-6 and IL-1β in all Huangwu Ganfu Ointment groups decreased(P<0.01).Huangwu Ganfu Ointment medium-and high-dosage groups could down-regulate the expression of TRPV1 protein(P<0.05,P<0.01).Conclusion The mechanism of Huangwu Ganfu Ointment in alleviating the pain of KOA may be related to reducing inflammatory response,reducing the release of inflammatory factors of IL-1β and IL-6,alleviating inflammatory pain sensitivity of KOA,and down-regulating the expression level of TRPV1.

ObjectiveTo observe the regulatory effect of Huangwu Ganfu ointment on transient receptor potential anchor protein 1 （TRPV1） receptor expression， macrophage polarization， and p38 mitogen-activated protein kinase （p38 MAPK） signaling pathway in synovial tissue of knee osteoarthritis （KOA） rats with yang deficiency and cold coagulation syndrome and explore the mechanism of relieving peripheral inflammatory hyperalgesia of KOA. MethodForty-eight male SD rats were randomly divided into blank group， model group， high-dose， middle-dose， and low-dose groups of Huangwu Ganfu ointment （9.3， 4.65， 2.325 g·kg^-1）， and celecoxib group （20.82 mg·kg^-1）. The KOA rat model of yang deficiency and cold coagulation syndrome was established through climate box and swimming for two weeks combined with an injection of sodium iodoacetate （MIA） in the articular cavity. After continuous administration for four weeks， the general condition of rats in each group was observed， and the pain withdrawal threshold （PWT） and joint diameter induced by mechanical stimulation were recorded. The expression levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， nerve growth factor （NGF）， and calcitonin gene-related peptide （CGRP） inflammatory factor were detected by enzyme-linked immunosorbent assay （ELISA）， and the histopathological changes of synovial tissue of the knee joint were observed by hematoxylin-eosin （HE） staining. Western blot was used to detect the protein expression of TRPV1， p38 MAPK， and p-p38 MAPK in synovial tissue of the knee joint， and immunofluorescence （IF） was used to evaluate the polarization of M1/M2 macrophages. ResultCompared with that in the blank group， the overall mental state of the model group was worse， and the autonomous activity was decreased. The body mass was lower， and the joint diameter was increased. The X-ray showed that the osteophyte at the edge of the joint proliferated， and the articular surface was obviously rough. The articular cavity was significantly narrowed， and the PWT was significantly decreased （P<0.01）. The contents of IL-1β， TNF-α， CGRP， and NGF in serum and synovium Krenn score increased significantly （P<0.01）. The protein expression of TRPV1 and p-p38 MAPK/p38 MAPK increased significantly （P<0.01）， and the proportion of M1 macrophages and M1/M2 increased （P<0.01）， while the proportion of M2 macrophages decreased （P<0.01）. Compared with model group， the body mass in the low， middle， and high dose groups of Huangwu Ganfu ointment increased to different degrees （P<0.05， P<0.01）. The diameter of the knee joint in the high dose group of Huangwu Ganfu ointment and celecoxib group decreased （P<0.01）. The recovery of PWT in the high and middle dose groups of Huangwu Ganfu ointment groups was more obvious （P<0.05）. The contents of IL-1β and CGRP in the serum of rats in each administration group were significantly decreased （P<0.01）， and the content of serum TNF-α in the celecoxib group and high dose group of Huangwu Ganfu ointment decreased significantly （P<0.05）. The content of serum NGF in the middle dose group of Huangwu Ganfu ointment decreased significantly （P<0.05）， and the synovium Krenn score decreased in the high dose group of Huangwu Ganfu ointment （P<0.05）. In addition， the protein expression of TRPV1 and p-p38 MAPK/p38 MAPK in synovial tissue decreased significantly in all groups of Huangwu Ganfu ointment （P<0.01）. The proportion of M1 macrophages in synovial tissue in the celecoxib group and all groups of Huangwu Ganfu ointment decreased （P<0.01）， and the proportion of M2 macrophages in the high dose group of Huangwu Ganfu ointment increased （P<0.05）. The M1/M2 in the middle and high dose groups of Huangwu Ganfu ointment decreased （P<0.05）. ConclusionHuangwu Ganfu ointment can mediate the polarization of macrophages to reduce the inflammatory reaction of KOA， alleviate the release of inflammatory pain mediators， and lower the protein expression of TRPV1. The mechanism may be related to the p38 MAPK signaling pathway， so as to improve the peripheral hyperalgesia of KOA.

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

Objective:To explore the chain mediating effect of anxiety and flow experience on perceived stress and mobile phone addiction in nursing college students.Methods:In December 2021, a cross-sectional design survey was conducted on 4 179 freshmen and sophomores in a nursing college in Heilongjiang Province. The Chinese perceived stress scale, generalized anxiety disorder-7, flow state scale, and mobile phone addiction tendency scale were selected separately to assess perceived stress, anxiety symptoms, flow experience and mobile phone addiction. SPSS 26.0 software was used for descriptive analysis, independent sample t-test, Spearman correlation analysis, and AMOS 24.0 software was used for mediating effect test. Results:(1) Among the 3 050 nursing students, there were 714(23.41%) students who were addicted to mobile phones. (2) Spearman correlation analysis indicated that perceived stress(27.31±9.56) was positively correlated with anxiety(7.00(1.00, 10.00), r=0.441, P<0.05), flow experience((12.00±3.40), r=0.517, P<0.05), and mobile phone addiction((42.42±13.05), r=0.476, P<0.05).Anxiety was positively correlated with flow experience ( r=0.430, P<0.01) and mobile phone addiction ( r=0.538, P<0.01).Flow experience was positively correlated with mobile phone addiction ( r=0.490, P<0.01). (3) Anxiety and flow experience played seperate mediating and chain mediating roles between perceived stress and mobile phone addiction, accounting for 26.06%(0.165/0.633), 23.54%(0.149/0.633) and 3.48%(0.022/0.633) of the total effect. Conclusion:Perceived stress not only directly affects the mobile phone addiction of nursing students, but also indirectly affects mobile phone addiction through the independent and chain mediating effects of anxiety and flow experience.

Objective To construct a 3D ResNet deep learning model based on multi-parametric prostate MRI(mpMRI),and to observe its value for automatically identifying the main MR sequences.Methods Totally 1 153 sets pre-biopsy prostate mpMRI data of 1 086 patients who underwent ultrasound-guided prostate biopsy in 3 hospitals were collected and divided into different image datasets,i.e.T2WI,diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)maps with a total of 5 151 images.Then the images were categorized into non-fat-suppressed T2WI(T2WI_nan,n=1 000),fat-suppressed T2WI(T2WI_fs,n=1 188),high b-value DWI(DWI_High,b-value≥500 s/mm2,n=1 045),low b-value DWI(DWI_Low,b-value＜500 s/mm2,n=1 012)or ADC map(n=906),also divided into training set(n=4 122),verification set(n=513)and test set(n=516)at the ratio of 8∶1∶1.After preprocessing and augmentation,a 3D ResNet model for automatically identifying image categories was trained and optimized in the training and verification sets,and its classification efficiency was evaluated in the test set.Results The identifying accuracy,sensitivity,specificity,positive predictive value,negative predictive value,F1 score and Kappa value of the obtained model for automatically identifying categories of images in the test set was 0.995-1.000,0.990-1.000,0.998-1.000,0.990-1.000,0.998-1.000,0.995-1.000 and 0.994-1.000,respectively.Conclusion The obtained 3D ResNet deep learning model could effectively and automatically identify the main sequences of prostate mpMRI.

Objective To develop a 3D V-Net deep learning segmentation model based on multi-center data,and to evaluate its value for automatic segmentation of prostate on T2WI and apparent diffusion coefficient(ADC)maps.Methods Totally 2 894 sets of multi-parametric MRI data of 2 673 patients with clinically suspected prostate cancer from 3 medical centers within 1 month before biopsy were retrospectively collected.Finally 5 974 sets axial images were enrolled,including 3 654 sets of T2WI and 2 320 sets of ADC maps.Prostate contours were manually annotated layer by layer on axial T2WI and ADC maps,and the left-to-right,anterior-to-posterior,superior-to-inferior diameters and volume of prostate were measured and taken as reference standards.The images were divided into training set(n=4 780,including 2 907 sets of T2WI and 1 873 sets of ADC map),verification set(n=601,including 384 sets of T2WI and 217 sets of ADC map)and test set(n=593,including 363 sets of T2WI and 230 sets of ADC map)at the ratio of 8:1:1.After preprocessing and augmentation,3D V-Net was used to construct and train the segmentation model based on training and verification sets,and the segmentation performance of the model was evaluated in test set using Dice similarity coefficient(DSC),Jaccard coefficient(JACARD)and volume similarity(VS),respectively.The parameters measured with the model were compared with the reference standards,and the correlations were explored.Results Compared with the corresponding ADC maps,DSC,JACARD and VS of the model for automatic segmentation of prostate on T2WI in test set were all higher(all P＜0.001).The left-to-right,anterior-to-posterior and superior-to-inferior diameters of prostate measured with the model on both T2WI and ADC maps were all larger than the reference standards(all P＜0.001),while no significant difference of the volume was found(both P＞0.05).All parameters measured with the model on T2WI and ADC maps were positively correlated with reference standards(rs=0.794-0.985).Conclusion 3D V-Net deep learning model could automatically segment prostate on T2WI and ADC maps with high accuracy,and its efficiency based on T2WI was better than that based on ADC maps.

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

Objective:To explore the impact of negative perfectionism on academic procrastination, as well as the mediating role of anxiety and the moderating role of negative cognitive emotion regulation strategies.Methods:In December 2022, a cross-sectional survey was conducted on 4 178 students from a medical college in Heilongjiang Province. The Zi negative perfectionism questionnaire, procrastination assessment scale-student, generalized anxiety disorder-7, and cognitive emotion regulation questionnaire were used to conduct the questionnaire survey, and 4 004 valid questionnaires were recovered. SPSS 26.0 statistical software was used for common method deviation test, descriptive statistics and correlation analysis, PROCESS macro program was used for mediation and moderation effect analysis.Results:(1) The scores of nursing students' negative perfectionism, anxiety, negative cognitive emotion regulation strategy, and academic procrastination were (120.48±23.40), (12.75±5.36), (44.82±11.20), and (42.95±14.30), respectively. (2) Negative perfectionism was positively correlated with anxiety ( r=0.311, P<0.01) and academic procrastination ( r=0.113, P<0.01). Academic procrastination was positively correlated with anxiety ( r=0.190, P<0.01) and negative cognitive emotion regulation strategies ( r=0.260, P<0.01). (3) Anxiety played a partially mediating role between negative perfectionism and academic procrastination, with direct effect and mediating effect accounting for 49.11% (0.055/0.112) and 50.89% (0.057/0.112) of the total effect, respectively. (4) The effect of negative perfectionism on anxiety was moderated by negative cognitive emotions, and the predictive effect of negative perfectionism on anxiety was stronger in nursing college students with high negative cognitive emotion ( β=0.231, P<0.001). Conclusion:Among nursing college students, negative perfectionism can predict academic procrastination through anxiety, and cognitive emotion regulation strategies moderate the predictive effect of negative perfectionism on anxiety.