ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.

OBJECTIVE To understand distribution of fungi and condition of drug sensitivity to provide information for preventing nosocomial fungal infection,rational administration and approaching therapeutic strategy.METHODS CHROMagar coloration medium,API20C AUX systemic identification breed,identifying drug selected test chart of Hema-biotech BACT-IST,and susceptibility test were used according to broth micro-dilution antifungal susceptibility test(Mi-AFST) of CLSI M27-A2.RESULTS The major strains isolated from hospital infection samples were Candida albicans(60.04%)and C.tropicalis(22.22%),and mainly from sputa(69.03%),and the key departments were internal respiratory medicine(38.29%),intensive care unit(ICU)(31.91%) and senior cadre ward(16.54%) orderly.According to the sensitivity of antimycotic drugs the flucytosine(97.39%) and amphotericin B(95.27%) were relatively sensitive,the effective rate and resistance rate of antimycotic drugs were 91.00% and 44.00%,respectively,the rate of fungus detected without clinical symptoms was 10.63%.CONCLUSIONS The clinical diagnosis and therapeutic strategy are determined by clinical symptoms and laboratory results of drug sensitivity;and the prevention of fungal infection is also important.

OBJECTIVE: To observe the effects of Ru'ai Shuhou Recipe (RSR), a compound traditional Chinese herbal medicine, on 5-year recurrence rate after mastectomy in breast cancer. METHODS: A total of 300 patients with breast cancer were divided into two groups: treatment group and control group. The patients in the treatment group were treated with Western medicine and RSR, and the patients in the control group were treated only with Western medicine (the same as the treatment group). In the two groups, the 5-year recurrence rates after mastectomy in breast cancer were investigated. RESULTS: Thirty-four breast cancer patients were lost to five-year follow-up during the course of investigation, and 266 breast cancer patients went through the evaluation. The 5-year recurrence rate after mastectomy in the treatment group was significantly lower than that in the control group (P<0.05). The recurrence rate after mastectomy was influenced by positive lymph node, primary breast tumor size, clinical stage, and patients' health status. There was significant difference in the 5-year recurrence rates between the two groups (P<0.05) under the following conditions, such as the positive lymph nodes more than four, the primary breast tumor larger than two centimeters, and in the clinical stage II and III, estrogen receptor (ER)-positive/progesterone receptor (PR)-positive and ER-negative/PR-negative. The recurrence rate was not associated with the operation method and age distribution. CONCLUSION: RSR can reduce the 5-year recurrence rate after mastectomy in breast cancer.

Objective The purpose of this study was to provide practical anatomic data for the imaging diagnosis and surgical treatment of the disease of the subphrenic spaces. Methods Sectional anatomy of the subphrenic spaces on the coronal plane were investigated on 30 sets of serial coronal sections of superior abdomen of Chinese adult cadavers and MR imaging of 2 abdomen of cadavers. Results Subphrenic spaces were divided into perihepatic spaces and perisplenic spaces on the coronal plane.The space between the anterior margin of left gastropancreatic fold and the posterior layer of hepatogastric ligament is the only direct communication between the superior and inferior recesses of the lesser sac.Its communicating type is divided into three types on the coronal plane.The right layer of the gastrophrenic ligament is continuous with the posterior layer of the lesser omentum,the left layer of the gastrophrenic ligament is continuous with the right layer of the phrenicosplenic ligament and the posterior layer of the gastrosplenic ligament.Left gastropancreatic fold is continued to the left and right layers of gastrophrenic ligament upward.The bare area of stomach is located between the left and right layers of gastrophrenic ligament,its existing rate is 100%.The bare area of spleen is located among phrenicosplenic ligament,gastrosplenic ligament,splenorenal ligament and splenocoloic ligament.Its the most width exists at the splenorenal ligament.It is divided into the part of the splenic hilus and the splenorenal part.Its maximum is 2 64?1 16 cm,4 16?2 24 cm respectively. Conclusion The coronal plane is dominant for showing left gastropancreatic fold and the communication relationship between superior and inferior recesses of the lesser sac.The superior and inferior recesses of the lesser sac that may communicate with each other is 73 3 percent of all the cases studied

Objective To explore the therapeutic mechanism of blood- activating and blood- stasis- removing (BABAR) therapy for polycythemia vera (PV).Methods Ten first- visit or un- relieved outpatients and inpatients were treated with BABAR therapy for 12 weeks. Healthy volunteers served as the normal control. Before treatment and 1, 4, 8 and 12 weeks after treatment, the apoptotic rates of bone marrow mononuclear cells (BMMC) was analyzed with the TUNEL method. The expression of bcl- 2 and p53 was observed by the method of immunohistochemistry and their mRNA expression by the method of hybridization in site.Results One, four and eight weeks after treatment, the apoptotic rates of BMMC was increased as compared with those before treatment (P 0.05).The gene expression level of Bcl- 2 and p53 and their RNA expression level in the patients before treatment were higher than those in the normal control(P

Objective: To evaluate the effects of overweight and obesity intervention in the health-promoting school model and to provide reference for effective prevention and control of overweight and obesityin middle Schools. Methods: Using stratified cluster random sampling, 10 middle schools in Sanmenxia City were randomly divided into intervention group and control group. In the intervention group and the control group, one middle school and one high school were randomly selected. The students from the two classes randomly selected in the first and second grades in the four schools that were selected, the questionnaire survey and medical examination was conducted before and after the intervention to evaluate the intervention effect. Results: After intervention, the ratio of overweight and obesity of the intervention group decreased from 22.70% before intervention to 17.45%, statistical significance(χ 2=4.11, P<0.05), and the ratio of overweight and obesity of the control group increased from 22.39% before intervention to 22.91%, no significant difference(P>0.05). After the intervention, the response rates of limiting red meat, fried food and sugarsweetened beverages were all higher than those before the intervention, the differences were statistically significant (χ 2=125.73, 10.69, 208.55, 170.66, 50.01, P<0.01). Conclusion The comprehensive intervention measures of overweight and obesity in the model of health promotion school can encourage students to develop healthy behaviors and effectively prevent and control middle school students from overweight and obesity, and it is easy to form a long-term intervention mechanism.

Objective:To investigate the application of 3.0T high resolution magnetic resonance imaging(HR-MRI)in acute ischemic stroke(AIS)and the influence factors of prognosis.Methods:A total of 92 AIS patients who underwent treatment in Hainan General Hospital from January 2019 to June 2022 were selected as the research objects.All patients were treated by thrombolytic therapy,and they were divided into favorable prognosis group(mRS scores≤2 points,n=66)and poor prognosis group(mRS score>2 points,n=26)according to modified Rankin Scale after they received 90d treatment.All of patients underwent Magnetom Trio type of 3.0 T HR-MRI examination within 1 week after they hospitalized,and the changes of luminal stenosis rate,the luminal area at the narrowest point,the plaque load,T2WIsignal intensity index,T1WI signal intensity index,plaque enhancement rate and other parameters were compared.The receiver operating characteristics(ROC)curve was adopted to analyze the predictive value of 3.0T HR-MRI parameters on the AIS prognosis.Binary Logistic regression model was used to analyze the risk factors that affected the prognosis of AIS patients.Results:The difference of infarction diameter between two groups was statistically significant(x2=6.574,P<0.05).The lumen area at the narrowest point in the poor prognosis group was significantly lower than that in the favorable prognosis group,while the T2WI signal intensity index,T1WI signal intensity index and plaque enhancement rate in the poor prognosis group were significantly higher than those in the favorable prognosis group(t=-3.378,4.443,4.413,3.890,P<0.05),respectively.ROC curve analysis showed that the area under curve(AUC)values of T2WI signal intensity index,T1WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate in predicting the AIS prognosis were respectively 0.743,0.739,0.706 and 0.748.The Logistic regression analysis showed that infarction diameter>3.0cm,T1WI signal intensity index,T2WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate were respectively independent risk factors that could affect AIS prognosis(OR=3.889,257.151,105.073,4.091,1.121,P<0.05).Conclusion:3.0T HR-MRI has higher efficiency in the assessment for the prognosis of patients with AIS,which can provide guidance for the judgement of prognosis and the formulation of treatment scheme through observes the changes of a series of parameters include T2WI signal strength index,T1WI signal strength index,the lumen area at the narrowest point,plaque enhancement rate.The above parameters are risk factors that affect the prognosis of patients,which often represent the progress of patients'conditions.

Objective: To analyze the rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age (18-49 years old) in China in 2013. Methods: The analysis used data obtained from the China Chronic and non-communicable disease surveillance in 2013.The surveillance included 176 534 adults aging ≥18 years old, who were selected from 302 surveillance points by multi-stage cluster random sampling method. A total of 46 674 women at reproductive age (18-49 years old) were investigated. Blood pressures were measured by electronic blood pressure monitor. After being weighted according to complex sampling scheme and post-stratification, the rate of prevalence, awareness, treatment and control of hypertension were compared by different characteristics such as age, education, urban and rural areas, and geographic locations. Results: The prevalence of hypertension among women at reproductive age (18-49 years old) in China in 2013 was 13.5%. The rate in the rural areas was higher than that in urban areas (χ²=46.23, P<0.05), which were 14.5% and 12.3%, respectively. The prevalence in eastern, central and western geographic locations were separately 13.9%, 13.2% and 13.1%, there was no statistical difference (χ²=0.56, P>0.05). The hypertension prevalence in all age groups (18-24, 25-29, 30-34, 35-39, 40-44, 45-49 years old) were 6.6%, 9.2%, 9.6%, 12.0%, 17.9% and 28.3%, respectively. The prevalence of hypertension showed a rising trend with age increasing (t=12.32, P<0.05). The awareness, treatment and control rates of hypertension were separately 25.8%, 22.7% and 7.4% in women at reproductive age (18-49 years old), which were 31.6%, 28.2% and 9.4%, respectively in urban areas; and 21.3%, 18.5% and 5.9%, respectively in rural areas. The rates in urban areas were all higher than those in rural areas (chi square were separately 18.98, 21.31, and 6.80, P values <0.05). The treatment rate of hypertension was 86.8% among who had been aware of hypertension, and the treatment rate of hypertension was 31.8% among who received control of hypertension. The treatment rate among who had been aware of hypertension in eastern, central and western locations were 89.3%, 88.3% and 79.5%, respectively. The control rates in eastern, central and western locations were 8.5%, 8.1% and 4.7%, respectively. The treatment rate among who had been aware of hypertension and control rate in the eastern and central geographic locations was higher than that in western locations (chi square were separately 10.05 and 7.25, P values <0.05). Conclusion The prevalence of hypertension in women at reproductive age (18-49 years old) was comparatively high, and the rates of awareness, treatment and control were low. The differences showed statistical significance between urban and rural areas.

Objective To understand the passive smoking exposure level and related risk awareness in adults in China in 2013.Methods A face-to-face questionnaire survey was conducted in 179 570 adults selected through multistage cluster sampling from Chinese chronic disease and risk factors surveillance sample population (2013) in 302 surveillance sites.The effective sample size was 176 179 adults.After comprehensive weighting of the samples,the passive smoking exposure level and the awareness rate of related risks were analyzed.Results The passive smoking exposure rate was 52.8％ (95％CI:51.2％-54.4％) and the rate decreased with age (x2=515.8,P＜0.000 1).The exposure rate was highest in persons engaged in commercial services (61.6％,95％CI:58.6％-64.5％).The awareness rate of related risks was 67.9％ (95％CI:65.8％-69.9％).The awareness rate was higher in urban area (77.0％,95％CI:75.0％-79.1％) than in rural area (60.0％,95％CI:57.7％-62.4％),in males (69.8％,95％CI:67.8％-71.7％) than in females (65.9％,95％CI:63.7％-68.1％).The awareness rate of three related diseases in urban residents (49.8％,95％CI:47.3％-52.4％) were higher than that in rural residents (37.9％,95％CI:35.4％-40.5％);the awareness rate of passive smoking related lung cancer was highest (88.5％,95％CI:87.5％-89.5％),followed by lung disease in children (70.0％,95％ CI:68.1％-71.9％),the awareness rate of passive smoking related heart disease was lowest (46.8％,95％CI:44.6％-49.1％).Conclusion The passive smoking exposure level is relatively high in adults in China,and the awareness rate of passive smoking exposure risks,especially heart disease,is low.

Objective: To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors. Methods: China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression. Results: The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ²=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05). Conclusion The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.