Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

ObjectiveTo understand the use of antibiotics in inpatients and the incidence and trend of hospital infections， to explore the implementation effect of comprehensive management measures， and to provide reference for hospitals to use antibiotics reasonably. MethodsBased on the hospital infection monitoring and management system， a retrospective analysis and comparison were conducted on the use of antibiotics， submission of microbial test samples， and incidence of hospital infections among inpatients in a tertiary hospital from 2012 to 2021. ResultsFrom 2012 to 2021， the use of antibiotics showed a downward trend， from 50.82% in 2012 to 41.29% in 2021. At the same time， the use rate of restricted and special antibiotics had also decreased， and the use rate of restricted and special antibiotics in patients without hospital infection was significantly lower than that in patients with hospital infection， and the microbial testing rate was also on the rise. The annual incidence rate of hospital infection was 0.69%‒1.92%， and the annual case-time prevalence rate was 0.79%‒2.17%. The annual average rate of the above two in 10 years was 1.18% and 1.34%， respectively. The results of the exponential smoothing model also showed that the utilization rate of antibiotics was decreasing and the incidence of nosocomial infection was stable. ConclusionLarge general hospitals took comprehensive management measures to strengthen the management of rational use of antibiotics， which led to a decline in the use rate of antibacterial drugs for inpatients and an increase in the rate of microbial examination. At the same time， the overall incidence of hospital infection was relatively stable， suggesting that the comprehensive management measures of antibacterial drugs in hospitals had achieved certain results. The current measures need to be optimized in the future to continuously improve the management level of rational use of antibacterial drugs.

Objective We aimed to investigate the relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in children with Henoch-Sch?nlein purpura nephritis(HSPN).Methods We conducted a retrospective analysis of 800 HSPN children from the medical records of the First Affiliated Hospital of Henan University of Chinese Medicine.Laboratory indicators(blood routine test,urine routine test,coagulation test,liver function)and renal pathological indicators of them were collected.According to the severity of renal pathological microscopic lesions,the microscopic pattern of blood stasis was divided into three types,including choroidal discord,dead blood coagulation and intracarenal disease accumulation.The classification of renal microscopic pattern of blood stasis and the correlation between laboratory indexes and renal pathological index were analyzed by Spearman grade correlation and binary Logistic regression analysis.Results(ⅰ)There was no statistical difference of the distribution of the renal microscopic pattern of blood stasis in the different traditional Chinese medicine patterns.(ⅱ)There were significant differences in the contents or the grade of albumin and fibrinogen in the HSPN children with different microscopic pattern of blood stasis(all P＜0.05).(ⅲ)The maximum area under the receiver operating characteristic(ROC)curve between fibrinogen and intracarenal disease accumulation was 0.594(95％CI from 0.540 to 0.633,P＜0.001);sensitivity was 0.447,specificity was 0.725;the best threshold on the ROC curve of 0.172 was 3.755 g/L.(ⅳ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the scores of intracarenal disease accumulation type(r=0.176,r=0.315,r=0.656;all P＜0.001).(ⅴ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the renal microscopic pattern of blood stasis(r=0.157,r=0.377,r=0.429;all P＜0.001).Conclusion The microscopic renal pattern of blood stasis can not only reflect the severity of renal blood stasis,but also reflect the severity and long-term prognosis of renal diseases.Albumin and urinary protein grade can reflect the early stage of the microscopic renal pattern of the blood stasis(choroidal discord).The content of fibrinogen increases with the aggravation of renal microscopic pattern of blood stasis,reflecting the end-stage of HSPN,which has the correlation with the formation and severity of related indexes.Fibrinogen can be used as a laboratory indicator to assist in the diagnosis of irreversible lesionsin the renal pathology of HSPN children.

Objective:To investigate the knowledge, attitude and practice of general practitioners (GPs) in Shenzhen towards managing patients with common mental health problems.Methods:It was a cross-sectional study, from September 19 to October 31, 2020, 500 GPs from 100 community health centers (CHC) in 10 districts of Shenzhen municipality were randomly selected as the research subjects by stratified random sampling; the survey was conducted by self-filled questionnaire, which included general conditions, knowledge tests of common psychological problems (generalized anxiety disorder, depressive disorder, panic attacks, sleep disorders), GPs′ attitudes to take care of common psychological problems, and GPs′ practice of caring for common psychological problems.Results:A total of 500 questionnaires were distributed and 329 valid ones were collected. In terms of knowledge, GPs had the highest accuracy of answering the characteristics of depressive disorder (97.3%, 320/329), and the lowest accuracy of case analysis of panic attacks (50.2%, 165/329). In terms of attitude, 71.1%(234/329)of GPs agreed that "common psychological problems should be taken care of",there was a statistically significant difference in attitude scores among GPs with different years of working in CHC ( Z=14.60, P=0.006). In terms of practice, the most encountered mental health problem was insomnia (91.2%, 300/329), 46.5% (153/329) of GPs would use psychological assessment scales, 52.9% (174/329) of GPs would choose direct referral, and there were statistically significant differences in attitude scores among GPs with different years of working ( Z=10.70, P=0.030) and years of working in CHC ( Z=22.14, P<0.001). Conclusions:GPs have a positive attitude in taking care of common psychological problems, but lack of knowledge and confidence. As working in CHC for more years, GPs are more inclined to care for patients with common psychological problems in practice.

Objective:To analyze a Risk Scale for Emergence Agitation After General Anesthesia in Children (the EA risk scale) into simplified Chinese and evaluate the reliability and validity in children with strabismus correction surgery.Methods:After obtaining the authorization of the original author, the English version of the EA risk scale was translated, translated back and culturally debugged to form the Chinese version of the EA risk scale. Then 279 children with strabismus correction surgery were selected from a tertiary hospital of ophthalmology in Tianjin and were investigated to validate the scale.Results:The correlation coefficients of each item and the total score of the scale were respectively 0.768 (item 1) ,0.717(item 2), 0.676(item 3), 0.634(item 4) (all P < 0.01). Content validity index of the scale was 0.920, and each item was 0.80-1.00. One factors including 4 items were identified using exploratory factor analysis, accounting for 62.052% of the total variance. The optimal cut-off value for the EA risk in children was 10, with the AUG was 0.816, specificity of 0.704, and sensitivity of 0.839. The Cronbach α coefficient for the total scale was 0.819, and the intraclass correlation coefficient value between the scorers was 0.835. Conclusion:The Chinese version of the EA risk scale has good reliability and validity. The items are concise, clear, and easy to understand. It is suitable for clinical departments as a preliminary screening tool to identify emergence agitation after general anesthesia on children with strabismus correction surgery and to assess the risk of its occurrence.

Objective:To investigate health status and home care service demands of elderly people in urban-rural joint areas in Beijing.Methods:From December 2018 to September 2019, a stratified random sampling method was adopted to select permanent elderly residents from 2 sub-districts in Liangxiang area in Beijing as research subjects. The survey was conducted using general information questionnaires, Barthel Index Rating Scale and self-made Home Care Service Demand Questionnaire for Elderly People. A total of 1 410 questionnaires were distributed, all of which were effectively recovered.Results:Among 1 410 elderly persons, 1 173 suffer from chronic diseases, with a prevalence rate of 83.2%. The top 3 diseases in terms of prevalence were hypertension (55.3%, 780/1 410) , diabetes (22.7%, 320/1 410) and coronary heart disease (22.3%, 314/1 410) . The top 3 home care service demands were psychological comfort and companionship (92.3%, 1 301/1 410) , daily care (82.0%, 1 156/1 410) and medication guidance (43.1%, 608/1 410) . There were significant differences in the nursing needs of the elderly with different ages, family monthly average income and reimbursement methods of medical expenses ( P<0.05) . Conclusions:The prevalence of chronic diseases among the elderly in the urban-rural areas of Beijing is high and the demand for home care is urgent. Nursing staff should provide more accurate nursing services and implement comprehensive management based on illness and demands for home care service of the elderly.