Because of the frequent occurrence of disasters, China's emergency medical rescue(EMR) system is undergoing a critical stage of quality improvement and capability upgrading, with an urgent need to enhance professional response capacity and management efficiency. Guangdong Provincial Emergency Hospital is the first provincial emergency hospital in China. In recent years, it has been committed to continuously promoting the construction of hospital EMR system in six aspects, and has achieved certain results. In terms of Party leadership, the hospital strengthens organizational coordination to ensure efficient implementation of decisions and establish a scientific and effective commander system. The talent cultivation focuses on improving the stability and practical competence of professional teams, and building a specialized and multidisciplinary emergency team. In organizational operation, a platform-based structure enables cross-departmental resource integration and efficient coordination. For emergency response, a response mechanism combining routine and emergency operations achieves seamless switching between routine and crisis states. For equipment support, an intelligent, modular logistics system enhances rapid response and sustained operational capability. In external collaboration, the hospital reinforces coordination with health administrative departments and mission-deploying agencies, forming a collaborative and synergistic emergency prevention and control network. The conseruction experience of Guangdong Provinical Emergency Hospital provides a replicable and scalable model for the institutionalization, professionalization, and internationalization of China's EMR system, offering valuable theoretical and practical insights for strengthening emergency response capability to emergencies.

Construction of smart hospitals is of great significance to the substantial development of medical institutions and the reform of medical and health systems and meanwhile it serves as a crucial support for the high-quality development of pub-lic hospitals.Guangdong Second Provincial General Hospital actively responds to national policies,constantly exploring standard-ized application of new smart medical technology.It has successfully built itself into a first full-scene smart hospital.Through gradually deepening the intelligent construction of hospitals,the hospital has achieved obvious achievements in hospital manage-ment such as medical services,medical resources,medical data,hospital operation logistics,and medical environment improve-ment.Their practical experience can provide references for the intelligent construction of hospitals domestically.

As the medical reform deepens,it becomes imperative for public hospitals to construct acadre of high-level,high-quality young talents and intensify the cultivation of professional competency among them for the continuous promotion of high-quality development.In response to new journeys,new situation and new requirements,Guangdong Second Provincial Gen-eral Hospital pioneered the Middle and Young-Aged Cadre Training Program.Based on this novel talent cultivation and reserve model,the hospital established a comprehensive job management system and staff employment system.With the system,the hos-pital highlighted a persistent optimization of talent teams by equally emphasizing the introduction and cultivation of talents and up-grading the talent team structure,and explored the innovative mechanisms to enhance the professional competency of young tal-ents,providing sustained impetus for the hospital's developmental construction and contributing to the realization of Healthy Chi-na and Healthy Guangdong.

Metformin is currently a strong candidate anti-tumor agent in multiple cancers. However, its anti-tumor effectiveness varies among different cancers or subpopulations, potentially due to tumor heterogeneity. It thus remains unclear which hepatocellular carcinoma (HCC) patient subpopulation(s) can benefit from metformin treatment. Here, through a genome-wide CRISPR-Cas9-based knockout screen, we find that DOCK1 levels determine the anti-tumor effects of metformin and that DOCK1 is a synthetic lethal target of metformin in HCC. Mechanistically, metformin promotes DOCK1 phosphorylation, which activates RAC1 to facilitate cell survival, leading to metformin resistance. The DOCK1-selective inhibitor, TBOPP, potentiates anti-tumor activity by metformin in vitro in liver cancer cell lines and patient-derived HCC organoids, and in vivo in xenografted liver cancer cells and immunocompetent mouse liver cancer models. Notably, metformin improves overall survival of HCC patients with low DOCK1 levels but not among patients with high DOCK1 expression. This study shows that metformin effectiveness depends on DOCK1 levels and that combining metformin with DOCK1 inhibition may provide a promising personalized therapeutic strategy for metformin-resistant HCC patients.
Animals ; Antineoplastic Agents/therapeutic use* ; Carcinoma, Hepatocellular/metabolism* ; Cell Line, Tumor ; Clustered Regularly Interspaced Short Palindromic Repeats ; Genome ; Humans ; Liver Neoplasms/metabolism* ; Metformin/therapeutic use* ; Mice ; Phosphorylation ; Synthetic Lethal Mutations ; Transcription Factors/metabolism* ; rac GTP-Binding Proteins/metabolism*

OBJECTIVE: To assess the value of copy number variation sequencing (CNV-seq) and karyotyping in the prenatal diagnosis for carriers of balanced translocations. METHODS: Clinical records of 135 amniocentesis samples of balanced translocation carriers undergoing simultaneous CNV-seq and karyotyping were analyzed. Chromosomal aberrations were defined as those can definitely lead to birth defects definitely, which included chromosomal numerical abnormality, large deletion/duplication and pathogenic copy number variations (pCNVs). RESULTS: The detection rates for karyotyping and CNV-seq were 4.44% (6/135) and 5.93% (8/135) respectively, and the latter had a detection rate of 1.48(2/135) higher than the former. A total of 68 fetal chromosomal translocations were detected by karyotying analysis. CONCLUSION For couples carrying a balanced translocation, simultaneous CNV-seq and karyotyping is conducive to the detection of fetal chromosomal abnormalities and genetic counseling.
Chromosome Aberrations ; Chromosome Disorders/genetics* ; DNA Copy Number Variations ; Female ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic

Objective:To analyze the status and its influencing factors of job burnout among female workers of labor-intensive enterprises.Methods:A total of 750 female workers from 5 labor-intensive enterprises in Guangdong Province were selected as the study subjects by random cluster sampling method in August, 2019. 665 valid questionnaires were collected, and the effective recovery rate was 88.67%. The Maslach Burnout Inventory-General Survey was used to assess job burnout and its influencing factors were analyzed.Results:Among 665 female workers, 429 (64.51%) found to have different levels of burnout, among which 380 (57.14%) were mild to moderate burnout and 49 (7.37%) were severe burnout. The comprehensive scores of job burnout in different age, marital status, current post working age, working time per week, personal monthly income, working system and occupational stress groups were statistically significant ( P<0.01) . There were significant differences in the score of emotional exhaustion in different age, marital status, current working age, working time per week, personal monthly income and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of depersonalization in different age, weekly work time, personal monthly income, working system and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of low individual achievement in different education levels, weekly work time, working system and occupational stress groups ( P<0.05) . Conclusion:The female workers of labor-intensive enterprises are generally have mild to moderate job burnout. The main influencing factors of job burnout are weekly work time and occupational stress.

Objective:To analyze the status and its influencing factors of job burnout among female workers of labor-intensive enterprises.Methods:A total of 750 female workers from 5 labor-intensive enterprises in Guangdong Province were selected as the study subjects by random cluster sampling method in August, 2019. 665 valid questionnaires were collected, and the effective recovery rate was 88.67%. The Maslach Burnout Inventory-General Survey was used to assess job burnout and its influencing factors were analyzed.Results:Among 665 female workers, 429 (64.51%) found to have different levels of burnout, among which 380 (57.14%) were mild to moderate burnout and 49 (7.37%) were severe burnout. The comprehensive scores of job burnout in different age, marital status, current post working age, working time per week, personal monthly income, working system and occupational stress groups were statistically significant ( P<0.01) . There were significant differences in the score of emotional exhaustion in different age, marital status, current working age, working time per week, personal monthly income and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of depersonalization in different age, weekly work time, personal monthly income, working system and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of low individual achievement in different education levels, weekly work time, working system and occupational stress groups ( P<0.05) . Conclusion:The female workers of labor-intensive enterprises are generally have mild to moderate job burnout. The main influencing factors of job burnout are weekly work time and occupational stress.

Objective To explore the effects of whole-course management model of day surgery on patient safety, satisfaction and nursing quality. Methods From January to December 2015, we selected patients with the most common six types of surgerys of day room in Xiangya Hospital Central South University as subjects. From 1st January to 30th June 2015, a total of 498 patients admitted before implementing whole-course management of day surgery were chosen in control group. From 1st July to 30th December 2015, a total of 561 patients admitted after that were selected in observation group. The differences in cancellation rate of surgery, delayed discharge rate within 24 h, incidence rate of changing deportment, incidence of complications after leaving hospital, visiting rate in emergency department within 72 h, unplanned readmission rate within 7 d, rate of follow-up and patients' satisfaction post discharge before and after implementing whole-course management of day surgery were compared. Results The cancellation rate of surgery of observation group was 5.2%significantly lower than that (11.8%) of control group (P<0.05). The delayed discharge rate within 24 h (1.8%), incidence rate of changing department (0.4%), incidence of complications after discharge (2.3%), visiting rate in emergency department within 72 h (0.2%) and unplanned readmission rate within 7 d in observation group (0.5%) were all significantly lower than those (4.0%, 1.6%, 6.2%, 1.4%, 1.6% respectively )in control group (P<0.05). The rate of follow-up and patients' satisfaction in observation group were 97.68% and (98.83±1.05) significantly higher than those in the control group [92.97%, (94.18±1.36)] (P< 0.05). Conclusions The whole-course management of day surgery can reduce the delayed discharge rate within 24 h, incidence rate of changing department, incidence of complications after discharge, visiting rate in emergency department within 72 h and unplanned readmission rate within 7 d, improve the rate of follow-up and satisfaction of discharged patients, guarantee patient safety and improve nursing quality.

Objective: This study was aimed to analyze the epidemic trend and predict the incidence trend of occupational diseases during 2006-2015 in Guangdong province, which may provide the theoretical foundation for occupational disease risk assessment and precise control and prevention. Methods: We analyzed the number of reported occupational disease cases, the constituent ratio, the average age and working-age of patients. We also performed the linear-by-linear association test of new incidence, median age and median working-age by curve-fitting method, of which the diagnostic year was set as the independent variable. Meanwhile, we designed an ARIMA model to predict the variation tendency of occupational diseases in 2017-2020. Results: (1) During 2006-2015, the total reported cases of occupational disease is 5289, including 2101 cases of occupational pneumoconiosis (39.7%) , 1363 cases of occupational poisoning (25.8%) , and 864 cases of occupational otolaryngological and stomatological disease (16.3%) . (2) The number of occupational diseases and pneumoconiosis have a straight upward trend (R²=0.851, R²=0.856) , while the number of occupational otolaryngological and stomatological disease and occupational tumor have a exponential trend (R²=0.914, R²=0.696) . The constituent ratio of occupational poisoning is decreasing, and the constituent ratio of occupational otolaryngological and stomatological disease is increasing. (3) The average onset age is 40 (33, 46) years old, and the average onset working-age is 6 (3, 11) years. Both of them have a straight upward trend (R²=0.954、R²=0.792) . The onset age of pneumoconiosis, occupational poisoning and occupational otolaryngological and stomatological disease have a upward trend. In addition, the onset working-age of occupational poisoning and pneumoconiosis have a upward trend. (4) The number of occupational diseases in 2017-2020 is predicted to be between 902-1231. Conclusion Occupational diseases in Guangdong province showed a trend of high incidence. The age and working-age of occupational diseases showed an extended trend. Therefore, our work of occupational epidemic trend may provide some bases for the occupational disease risk assessment and precise control and prevention.

Objective: To investigate the characteristics, temporal trend of silicosis, and provide basis for risk assessment and precise prevention and control of occupational diseases. Methods: Using descriptive statistics to analyze the reported cases of silicosis by SPSS 20.0 software. Reported silicosis cases, the constituent ratio, the incidence age and the working age at onset were analyzed by a linear trend test. Analyzing the variation trends of regional, industry, economic type and enterprise scale distributions by the chi-square trend test. Moreover, using Moran's I method for spatial autocorrelation analysis and trend-surface analysis. Results: (1) During 2006 to 2015, Guangdong province had reported 1, 428 cases of silicosis, mainly gathered in Foshan, Zhongshan, Guangzhou, Shenzhen, which included 1391 male cases accounting for 97.41%. And the average incidence age was 45 (39, 51) . The average working age of onset was 9 (5.5, 15) . In economic type distribution, the private economy took the main part, accounting for 59.1%. In enterprise scale distribution, it was dominated by small and medium enterprises (SMEs) , accounting for 32.4% and 37.3% respectively. In industry distribution, most cases were gathered in materials and mining industry, accounting for 32.1% and 22.9% respectively. (2) The number of silicosis cases, the incidence age and the working age of onset showed a rising trend (P<0.01) . Meanwhile, the constituent ratios of medium-sized enterprises and building materials industry were increasing (P<0.05) . The annual variation trends of regional, economic type and age distributions were not statistically significant (P> 0.05) . (3) The spatial distribution trend showed an inverted U type, which was firstly raised and then declined from south to north and from east to west. The distribution characteristic demonstrated some high-high cluster areas, including Chancheng, Nanhai, Shunde, Panyu, Dongguan, Pengjiang, and Zhongshan. While Wuhua showed a high-low outlier form (P<0.01) . Conclusion Silicosis cases, age and working age of onset were on the rise, as well as the industry and enterprise scale distributions of occupational diseases presented a certain trend in Guangdong province from 2006 to 2015. There were high-high cluster and high-low outlier phenomena in spatial distribution with spatial correlation. Therefore, our work of silicosis epidemic trend and distribution may provide some bases for the occupational disease risk assessment and control.