Objective　To analyze and study the status quo and deficiencies in the construction of talent teams at all levels of CDCs in Hainan Province and put forward countermeasures to provide a reference basis for the high-quality development of talent team construction in all levels of CDCs in Hainan Province. Methods Using field surveys and data retrieval, spatial analysis was employed to compare the overall differences in human resource status of the provincial-level CDC and CDCs in five regional areas (East, West, South, North, and Central Hainan). The coordination between human resource allocation and development strategies was analyzed. A descriptive analysis mainly utilized CDC survey questionnaires and other research forms to explore the health human resources of the province's CDCs. Results The professional and technical personnel in the provincial CDCs comprise 1 431 individuals, accounting for 82.3% (1 431/1 739) of the total number of actual employees, which falls short of the Central Institutional Reform Commission's (CIRC) mandate that technical professionals comprise at least 85% of the total workforce (CIRC Document [2014] No. 2). Among Hainan's CDC personnel, 115 individuals are recognized as high-level talents within the Hainan Free Trade Port framework. These include one Class C talent, 22 Class D talents, and 93 Class E talents. Class A, B, and C-level talents are deficient. The majority of staff at both the provincial and regional CDCs hold bachelor's degrees. There is a significant proportion of staff with associate degrees or lower qualifications, coupled with a severe shortage of highly educated personnel. Postgraduates with master’s degrees or above account for 27.8% (65/233) in the provincial CDC, indicating low educational credentials among personnel in Hainan's CDCs. The central region, characterized by slower economic and social development, faces greater challenges in attracting and retaining high-level talent. There is a scarcity of public health professionals with interdisciplinary expertise. Some public health staff lack clinical knowledge, experience, and skills in disease treatment. Furthermore, there is a need to strengthen on-site emergency response capabilities for public health emergencies. The structural ratio of senior, intermediate, and junior professional and technical positions in the provincial CDC is 40%∶45%∶15%. The position settings are limited to ranking levels without distinction by professional category, leading to a bottleneck-type competition like crossing the "one log bridge" for technical position promotions. Conclusion　Hainan Province faces significant challenges in developing its public health workforce, both in technical expertise and management capacity. Especially under the context of the closure operation of the Hainan Free Trade Port, it is necessary to continuously strengthen top-level talent design to cultivate a favorable policy, system, and cultural environment, thereby promoting the sustained and healthy development of the province's public health career.

Objective To evaluate the efficacy and safety of rabbit anti-human thymocyte immuneglobulin(rATG)induction therapy in kidney transplant recipients from donation after cardiac death in China.Methods This was a prospective,multicenter,single-arm and interventional study conducted in China(NCT03099122).Adult patients who underwent kidney transplantation from donation after cardiac death and received rATG induction therapy(cumulative dose of 5 mg/kg)were included.Univariate and multivariate logistic regression analyses were used to identify factors associated with acute rejection(AR),delayed graft function(DGF),graft failure and patient death.The occurrence of adverse events was also analyzed.Results A total of 115 adult patients were enrolled in the study,of whom 107 were evaluable for efficacy.The incidence of biopsy-proven acute rejection(BPAR)and acute rejection(AR)was 2.8%(95%confidence interval 0.6%-8.0%)and 4.7%(95%confidence interval 1.5%-10.6%),respectively.The incidence of delayed graft function(DGF)was 13.1%(95%confidence interval 7.3%-21.0%).Graft and patient survival rates were 97.2%(95%confidence interval 92.0%-99.4%)and 99.1%(95%confidence interval 94.9%-100%),respectively.Multivariate logistic regression analysis showed that donor serum creatinine and recipient panel reactive antibodies were risk factors for DGF(both P<0.05).Common treatment-emergent adverse events(incidence>5%)included anemia(8.7%),infectious pneumonia(8.7%),and urinary tract infection(8.7%).Conclusions Standard-dose rATG induction therapy demonstrates low incidences of BPAR,AR,and DGF,and good safety in kidney transplant recipients from donation after cardiac death in China.

Objective:To explore the psychological acceptance mechanism of appropriate Traditional Chinese Medicine (TCM) techniques among patients with abnormal uterine bleeding (AUB) .Methods:Using purposive sampling, AUB patients experiencing menstruation but not yet menopausal were recruited from Zhumadian City, Henan Province, and Jiaxing City, Zhejiang Province, between November 2022 and January 2023. Semi-structured interviews were conducted, and the collected data were analyzed using content analysis.Results:A total of four main themes were identified: individualized disease perception and treatment experience; awareness and treatment experience of appropriate TCM techniques; cultural identity and influence of traditional beliefs; and the need for science communication and safety regarding TCM techniques.Conclusions:While AUB patients show a generally high level of acceptance toward appropriate TCM techniques, their understanding of both AUB and the relevant TCM therapies remains limited. Multiple factors influence patients' choices, and some concerns and doubts still persist during the decision-making process.

Objective To evaluate the efficacy and safety of rabbit anti-human thymocyte immuneglobulin(rATG)induction therapy in kidney transplant recipients from donation after cardiac death in China.Methods This was a prospective,multicenter,single-arm and interventional study conducted in China(NCT03099122).Adult patients who underwent kidney transplantation from donation after cardiac death and received rATG induction therapy(cumulative dose of 5 mg/kg)were included.Univariate and multivariate logistic regression analyses were used to identify factors associated with acute rejection(AR),delayed graft function(DGF),graft failure and patient death.The occurrence of adverse events was also analyzed.Results A total of 115 adult patients were enrolled in the study,of whom 107 were evaluable for efficacy.The incidence of biopsy-proven acute rejection(BPAR)and acute rejection(AR)was 2.8%(95%confidence interval 0.6%-8.0%)and 4.7%(95%confidence interval 1.5%-10.6%),respectively.The incidence of delayed graft function(DGF)was 13.1%(95%confidence interval 7.3%-21.0%).Graft and patient survival rates were 97.2%(95%confidence interval 92.0%-99.4%)and 99.1%(95%confidence interval 94.9%-100%),respectively.Multivariate logistic regression analysis showed that donor serum creatinine and recipient panel reactive antibodies were risk factors for DGF(both P<0.05).Common treatment-emergent adverse events(incidence>5%)included anemia(8.7%),infectious pneumonia(8.7%),and urinary tract infection(8.7%).Conclusions Standard-dose rATG induction therapy demonstrates low incidences of BPAR,AR,and DGF,and good safety in kidney transplant recipients from donation after cardiac death in China.

Objective:To explore the psychological acceptance mechanism of appropriate Traditional Chinese Medicine (TCM) techniques among patients with abnormal uterine bleeding (AUB) .Methods:Using purposive sampling, AUB patients experiencing menstruation but not yet menopausal were recruited from Zhumadian City, Henan Province, and Jiaxing City, Zhejiang Province, between November 2022 and January 2023. Semi-structured interviews were conducted, and the collected data were analyzed using content analysis.Results:A total of four main themes were identified: individualized disease perception and treatment experience; awareness and treatment experience of appropriate TCM techniques; cultural identity and influence of traditional beliefs; and the need for science communication and safety regarding TCM techniques.Conclusions:While AUB patients show a generally high level of acceptance toward appropriate TCM techniques, their understanding of both AUB and the relevant TCM therapies remains limited. Multiple factors influence patients' choices, and some concerns and doubts still persist during the decision-making process.

With the rapid changes in people's lifestyles, natural and social environments in recent years, the prevalence of chronic and non-communicable diseases in China and its related risk factors have also had tremendous changes. The epidemiological characteristics of chronic and non-communicable diseases and their risk factors vary throughout the country, and the impact of unique climate, diet and lifestyle in southern China on the incidence and prevalence of chronic and non-communicable chronic diseases remains to be elucidated. Therefore, large-scale cohort study is urgently needed to provide evidence for the etiological research and management of chronic and non-communicable chronic diseases in different areas, and for the national management strategy for major chronic and non-communicable diseases. The prospective cohort study of chronic and non-communicable diseases in general population in southern China was established in December 2017. The study recruited permanent residents aged 35-74 years from both urban and rural areas in Guangdong, Hainan, Fujian Provinces and Guangxi Zhuang Autonomous Region. A big data platform of precision medicine which integrates health information with biological samples for long-term follow up has been established. A baseline database of 116 520 people aged (54.9±12.5) years, including 71 077 women (61.0%), has been established. Collecting questionnaire survey data, physical examination data, and biological samples. This paper briefly introduces the concept, design and progress of the prospective cohort study of chronic and non-communicable diseases in general population in southern China.

Objective:To observe the short-term efficacy of sub-Tenon’s triamcinolone acetonide (TA) in the treatment of cystoid macular edema (CME) after cataract surgery.Methods:A retrospective study. From October 1, 2013 to October 1, 2018, 21 patients (21 eyes) with CME after cataract surgery diagnosed at The Affiliated Eye Hospital of Wenzhou Medical University were included in this study. All eyes underwent BCVA, intraocular pressure, frequency domain OCT examination. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity when recorded. A frequency domain OCT instrument was used to measure the foveal retinal thickness (CRT). Among 21 eyes of 21 patients, 9 eyes were male and 12 eyes were female; the average age was 66.38±10.88 years. The average logMAR BCVA was 0.46±0.23; the average CRT was 519.90±131.59 μm; the average intraocular pressure was 11.01±3.97 mmHg (1 mmHg=0.133 kPa). All eyes underwent a single treatment of 100 mg/ml TA suspension 0.4 ml (containing TA 40 mg) under Tenon's capsule. The average follow-up time after treatment was 32.86±20.2 days. The changes of BCVA, CRT and intraocular pressure were observed 1 month after treatment. The BCVA, CRT and intraocular pressure before and after treatment were compared by paired t test. Results:One month after treatment, the average logMAR BCVA, CRT, and intraocular pressure of the CME eyes were 0.29±0.22, 307.71±35.82 μm and 14.19±6.30 mmHg, respectively. Compared with those before treatment, the differences were statistically significant ( t=5.252, 8.166, 4.128; P=0.000, 0.000, 0.001). Among 21 eyes, 13 eyes (61.90%) of the retinal cysts in the macular area completely disappeared; 8 eyes (38.1%) were still visible between the retinal layers. Three eyes with intraocular pressure over than 21 mmHg were treated with lowering intraocular pressure and returned to normal. Conclusion:Sub-Tenon’s capsular injection of TA to treat CME after cataract surgery can reduce CRT and improve vision in a short time.

Objective To investigate the clinical efficacy of vena cava-atrium anastomosis liver transplantation (VCAALT) for Budd-Chiari syndrome (BCS).Methods The retrospective descriptive study was conducted.The clinicopathological data of 18 BCS patients who underwent VCAALT in the Zhongnan Hospital of Wuhan University (6 cases),the Third Xiangya Hospital of Central South University (8 cases) and Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (4 cases) from May 1996 to December 2012 were collected.All the 18 patients were males,aged from 29 to 61 years,with an average age of 42 years.According to characteristics and invasion extent of hepatic vein and vena cava after preoperative examinations,patients were performed different surgical procedures of VCAALT,including bridge piggyback liver transplantation (BPBLT),hanging atrium liver transplantation (HALT) and cava vena resection bridge liver transplantation (CVRBLT).Observation indicators:(1) surgical and postoperative situations;(2) typical case analysis;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to December 2018.Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative situations:of 18 patients,11 underwent BPBLT,3 underwent HALT,4 underwent CVRBLT.The operation time and volume of intraoperative blood loss were (6.0± 1.3)hours and (1 264±435)mL.One patient died of bilateral pulmonary diffuse inflammation and sepsis due to severe infection.The duration of postoperative hospital stay was (18±5) days.(2) Typical case analysis:one 47-year-old male BCS patient was detected retrohepatic vena cava plaques and thrombus and hepatic venous thrombus by exploratory laparotomy,and underwent BPBLT.A 43-year-old male BCS patient was detected hepatic and retrohepatic vena cava plaques,thrombus,concomitant cavernous transformation,and underwent HALT.A 32-year-old male BCS patient was detected plaques and thrombus with red thrombus in the hepatic vein,from right renal vein to right atrium,and underwent CVRBLT.All the 3 patients underwent VCAALT successfully with a satisfactory recovery.(3) Followup situations:18 patients were followed up for 3.0-60.0 months,with a median time of 51.7 months.During the follow-up,3 patients died of acute rejection,biliary complications and chronic graft dysfunction at 1,3,5 years postoperatively.The 1-,3-,5-year survival rates were 16/18,15/18,14/18,respectively.Conclusion Different surgical procedures of VCAALT for BCS are selected according to different situations of patients,which are safe and feasible with a satisfactory efficacy and beneficial to long-term survival of patients.

Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.

Objective:To investigate the effects of the Paecilomyces Lilacinuson extracellular polysaccharides on the phenotypic and maturation of murine dendritic cells. Methods: Imature DCs were induced in vitro from the murine bone marrow cells in the presence of rmGM-CSF and rmIL-4, and then they were cultured with different dosage of the extracellular polysaccharides. The morphological characterization was analyzed under microscopy. The expressions of the DCs surface costimulating factors and phagocytic function to FITC-dextran were detected by flow cytometry. The level of IL-12 secreted by DCs was observed by ELISA. At the same time the influence of DCs on the proliferation of T cells was determined by MTT. Results:Treating with the polysaccharides for 48 h could up-regulate the expression of DCs surface molecules,such as CD11c,MHCⅡ,CD80 and CD86,and the 400 μg/ml was the optimal dose,comparing with the blank control group, the difference was significant (P<0. 01), contrast to LPS control group that was not different ( P<0. 05 ) . The uptaking FITC-dextran ability of the DCs treated with 300 μg/ml and 400 μg/ml polysaccharides was significant lower than the unstimulated DCs(P<0. 05). At the same time the extract at different concentration could distinctly enhance the proliferation of T cells by DCs too. Conclusion:The extracellular polysaccharides could stimulate the maturation of dendritic cells and induce the production of mature dendritic cells.