Objective To understand the basic information of the number, classification, and distribution of radiation work units in non-medical institutions in Shanxi Province, China, and to analyze the status quo of health management and radiation protection measures for radiation workers, so as to provide a scientific basis for occupational exposure protection in non-medical radiation work units and better protect the occupational health rights and interests of radiation workers. Methods A questionnaire survey was conducted to investigate some non-medical institutions in Shanxi Province. On-site testing was carried out to determine the risk factors for radioactive occupational diseases in the selected non-medical institutions. Results In 220 non-medical institutions, there were 340 radiation devices and 2284 radioactive sources. The rate of individual dose monitoring was 92.7% and the rate of occupational health examination was 87.2%. These devices were equipped with 325 detection instruments for radiation protection, 1316 personal protective equipment, and 730 personal dose alarms. Radiation occupational disease risk factors were investigated in 101 institutions. Conclusion The occupational health management of radiation workers in non-medical institutions in Shanxi Province is generally in line with the national standards. However, there is still a big gap with the level of occupational health management in medical institutions. The health administration departments should clarify the management measures for non-medical institutions and strengthen their supervision and management functions.

Purpose/Significance To provide high-quality health information services,to promote the coordinated development of medical and educational services,and to help build a healthy China service system.Method/Process By using the methods of network investigation,literature investigation and telephone interview,the paper investigates the current situation of teaching support services of 30 libraries of medical universities and colleges in China,and analyzes the existing problems from four aspects:teaching resource serv-ices,information literacy services,disciplinary services and service guarantee.Result/Conclusion Libraries of medical universities and colleges should establish and improve the teaching support service system,strengthen discipline teaching support services,provide accu-rate health information services,strengthen regional or departmental collaboration,and innovate intelligent service modes,so as to be-come an important driving force for healthy China initiative.

OBJECTIVE To investigate the potential therapeutic effect of the sporoderm-removed Ganoderma lucidum spore tablet "Xianzhi No.3" from the perspective of immunomodulation and cardioprotection. METHODS Chemical components of the sporoderm-removed Ganoderma lucidum spore tablet "Xianzhi No.3" were analyzed by UPLC-Q-TOF-MS and colorimetric methods. Examined tablet’s effects on zebrafish models of macrophage reduction, heart failure, H2O2-induced oxidative stress in myocardial and endothelial cells, and a microglial inflammation model induced by lipopolysaccharide. Immune regulation and cardioprotective effects were evaluated through multiple indicators, including macrophage formation and phagocytosis abilities, anti-neuroinflammation ability, cardiac systolic and diastolic functions, and anti-oxidative stress injury ability in myocardial and endothelial cells. RESULTS The sporoderm-removed Ganoderma lucidum spore tablet "Xianzhi No.3" improved macrophage formation and phagocytosis, cardiac systolic and diastolic functions, reduced neuroinflammation, and alleviated oxidative stress in myocardial and endothelial cells, resulting in immunomodulatory and cardioprotective effects. CONCLUSION The sporoderm-removed Ganoderma lucidum spore tablet "Xianzhi No.3" maybe a potential therapeutic agent for regulating the immune system and protecting cardiac function.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To analyze the relationship between the systemic immune inflammation index (SII) and risk stratification of acute pulmonary embolism.Methods:The clinical data of patients with moderate to critical pulmonary embolism admitted to the emergency department of Peking University People's Hospital from January 2018 to May 2022 were respectively collected. The patients divided into a medium to high-risk group and a medium to low-risk group according to risk stratification. The SII index, simplified pulmonary embolism severity index (sPESI), general information, disease history, laboratory test results, and other indicators between two groups of patients were compared. Logistic regression was used to analyze the relationship between SII and risk stratification in patients with acute pulmonary embolism.Results:A total of 97 patients with moderate to critical pulmonary embolism were included, including 43 were in the medium high risk group and 54 were in the medium low risk group. The data of SII index, white blood cell count, C-reactive protein, and sPESI of patients in the medium to high-risk group were significantly higher than those in the medium to low-risk group (all P<0.05), and lower lymphocyte count than those in the medium to low-risk group ( P<0.05). Logistic regression analysis showed that SII ( OR=1.001, 95% CI: 1.000-1.002, P=0.027) and sPESI ( OR=2.000, 95% CI: 1.155-3.464, P=0.013) were the main factors affecting risk stratification in patients with acute pulmonary embolism. The AUC of SII, sPESI score, and their combined evaluation of acute pulmonary embolism risk stratification were 0.710, 0.625, and 0.739, respectively. The combined evaluation value of the two indicators was higher than that of a single indicator ( P=0.007). Conclusion:SII has good application value in risk stratification of acute pulmonary embolism, and the combined sPESI score has higher value.

Objective:To explore the mediation effects of perceived social support and work-family conflict on clinical nurses′ self-efficacy and parenting stress, and to provide theoretical basis for formulating intervention programs for parenting stress.Methods:A total of 631 clinical nurses from 8 grade A hospitals in Anhui Province were selected by convenience sampling method from August to October 2023. A cross-sectional survey was conducted with the general data questionnaire, the Chinese version of Work-Family Behavioral Role Conflict Scale, the Parenting Stress Scale for Clinical Nurses, the Perceptived Social Support Evaluation Scale and the General Self Efficacy Scale to analyze the relationship between perceptive social support, work-family conflict, self-efficacy and parenting stress and the mediating effect.Results:A total of 603 clinical nurses were included, including 9 males and 594 females, aged (35.16 ± 4.59) years. The total scores of work-family conflict, parenting stress, understanding of social support and self-efficacy were (87.10 ± 14.38), (51.00 ± 9.51), (59.91 ± 11.57) and (26.68 ± 6.27) points. The total effect of self-efficacy on parenting stress was - 0.385. The mediating paths of self-efficacy on parenting stress included: self-efficacy→perceived social support→parenting stress; self-efficacy→work-family conflict→parenting stress; self-efficacy→perceived social support→work-family conflict→parenting stress. The three indirect effects accounted for 18.69%, 53.72% and 16.87% of the total effect.Conclusions:Social support and work-family conflict have a chain mediation effect between clinical nurses′self-efficacy and parenting stress. Nursing managers can improve the self-efficacy of clinical nurses and enhance the understanding of social support to help reduce work-family conflict, so as to effectively alleviate the level of child-rearing stress of clinical nurses.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

Objective:At present, emergency acute heart failure unit has been gradually carried out in China. This study is to analyze the impact of acute heart failure unit on the mortality and readmission rate of acute heart failure (AHF) within 6 months after discharge.Methods:Patients with AHF admitted to Emergency Department and Department of Cardiology, Peking University People's Hospital between December 2019 and December 2020, were prospectively collected. Patients with complicated malignant tumor, stage 4-5 chronic kidney disease, automatic discharge, and incomplete medical history were excluded. The baseline data, past medical history, admission condition, and auxiliary examination were collected. After discharge, the information of oral drugs, hospital readmission and death were collected through outpatient medical records in clinical data center or telephone consultation. Patients were divided into the emergency acute heart failure unit treatment group (emergency AHFU group), emergency routine treatment group (outside AHFU group) and cardiology treatment group according to the different treatment locations. SPSS 25.0 software was used for comparison between groups, and a P<0.05 was considered as statistically significant. ResuIts:A total of 238 patients with AHF were enrolled, 28 patients died in hospital, and 210 patients were followed up. Four cases were excluded from malignant tumor during follow-up, and 6 cases were lost to follow-up. There were 40 cases in the emergency AHFU group, 67 cases in the outside AHFU group, and 93 cases in the cardiology treatment group. According to the prognosis, the patients were divided into the poor prognosis group ( n=83) and good prognosis group ( n=145). The age, sex, vital signs and cardiac function of patients in the emergency AHFU group were basically the same as those in the outside AHFU group at admission, and the proportion of patients in the emergency AHFU group using non-invasive positive pressure ventilation was higher (52.5% vs. 32.8%, P<0.05). The utilization rate of angiotensin converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor enkephalinase inhibitors, β-blockers, diuretics and other oral drugs was higher in the emergency AHFU group after discharge, and patients also had more regular follow-up (95% vs. 79.1%, P<0.05). The 6-month readmission rate (15.0% vs. 40.3%, P<0.05) and the 6-month readmission and mortality composite results of patients in the emergency AHFU group (17.5% vs. 43.3%, P<0.05) were significantly lower than those in the outside AHFU group. COX regression analysis showed that the readmission rate of patients in the emergency AHFU group was lower than that in the outside AHFU group ( OR=2.882, 95% CI:1.267~6.611, P=0.12). Compared with the cardiology treatment group, the AHFU group had higher systolic blood pressure, faster heart rate, NT-probNP level, higher proportion of NYHA grade Ⅳ and Killip grade Ⅲ cardiac function (all P<0.05). The proportion of non-invasive mechanical ventilation in the AHFU group was significantly higher than that in the cardiology treatment group (52.5% vs. 30.1%, P<0.05). After discharge, there were no significant differences between angiotensin converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor enkephalinase inhibitors and β-blockers. There were also no significant differences in readmission and mortality rate 6 months after discharge. Binary logistics regression analysis found that the independent risk factors of AHF were routine emergency treatment, age, female sex, coronary heart disease, and BUN peak. Conclusions:The emergency acute heart failure unit is an independent protective factor for acute heart failure and reduced readmission rates within 6 months and readmission and mortality composite outcomes. Older age, female sex, coronary heart disease and elevated BUN peak are independent risk factors affecting the prognosis of AHF, which should be identified and preventive measures should be taken early.

Objective:To compare the efficacy and safety of paroxetine alone and paroxetine combined with gabapentin in patients with somatoform disorder (SFD).Methods:From July 2018 to December 2020, 108 adult patients with SFD were prospectively selected from the psychological clinic of Jining First People′s Hospital. All patients were divided into the control group (52 cases) and the observation group (56 cases) according to the random number table method. The control group only received paroxetine, and the observation group received paroxetine combined with gabapentin for 12 weeks. Before treatment, at the end of treatment and at the 3-month follow-up after treatment, the levels of anxiety, depression and quality of life in the two groups of SFD patients were assessed by Symptom Checklist 90 (SCL-90), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and the Short Form-36 Health Survey (SF-36), respectively. Adverse event during treatment was recorded with Treatment Emergent Symptom Scale (TESS). At the end of treatment and at the 3-month follow-up after treatment, the therapeutic efficacy was evaluated with the patient′s Global Impression of Change (GIC).Results:At the end of treatment, GIC scores of the control group and the observation group were 3 (2-4) and 2 (1.25-3) respectively ( Z=2.081, P=0.037), and the treatment efficiency (GIC score ≤3) was 65.4%(34/52) and 83.9%(47/56), respectively, with a statistically significant difference (χ 2=4.945, P=0.026). Compared with that before treatment, the SCL-90, HAMA and HAMD scores of the two groups at the end of treatment were significantly reduced (all P<0.05); the SCL-90 somatization and anxiety factor scores of the observation group were lower than those of the control group (all P<0.05), and the HAMA somatization anxiety score of the observation group at the end of treatment was lower than that of the control group ( P<0.05). Compared with that before treatment, the scores of physical health and mental health in the two groups at the end of treatment and 3 months follow-up after treatment were significantly increased (both P<0.05), but there was no significant difference between the two groups (both P<0.05). There was no statistical difference in the total incidence of adverse events between the two groups ( P=0.085), but the incidence of vertigo in the observation group was significantly higher than that in the control group (χ 2=4.405, P=0.036). Conclusions:Paroxetine combined with gabapentin can further increase the effective rate of paroxetine treatment and improve the anxiety of SFD patients, but it has no significant impact on the quality of life, and has the potential risk of increasing dizziness, lethargy and other adverse reactions.