The development of health-promoting hospitals is an important part of the Healthy China Initiative， facilitating the transformation of medical institutions from a primary focus on medical and surgical treatments to a patient-centered approach prioritizing public health. To promote the scientific， standardized， and sustainable development of health-promoting hospitals， the Shanghai Municipal Center for Health Promotion， together with Shanghai General Hospital and other institutions， has jointly developed the Standards for the Development of Health⁃promoting Hospitals （Standards） in accordance with the principles of scientific rigor， feasibility， and advancing with the times. The Standards outlines the requirements for the development of health-promoting hospitals across four aspects： organizational and institutional guarantees， creation of a healthy environment， implementation of health education and promotion， and evaluation. It is applicable to all levels and types of public medical institutions in Shanghai， and can also be referred to and implemented by other medical institutions. The introduction of the Standards is of great significance for promoting the formation of a long-term mechanism in health-promoting hospitals. This paper introduces the basis， principles， main content， precautions， and implementation suggestions of the Standards. Taking into account relevant policies and standards， it interprets the technical aspects in the process of developing health-promoting hospitals， which is helpful for medical institutions and their management to better understand and apply the standards in their work.

OBJECTIVE To establish a method for the determination of propofol concentration in human plasma and apply it in patients with lymphedema. METHODS The concentration of propofol was determined by UPLC-MS/MS after protein precipitation of plasma samples using thymol as internal standard. The sample was eluted on a Kinetex C18 column with a mobile phase consisting of acetonitrile （A）-water （B） for gradient elution at the flow rate of 200 μL/min. The sample size was 5 μL， and the column temperature was set at 40 ℃. The sample chamber temperature was 15 ℃. Using multi-reaction monitoring mode， the ion pairs for quantitative analysis were m/z 177.0→161.2 （propofol） and m/z 149.0→133.1 （internal standard）， respectively. The above method was used to determine the plasma concentration of propofol in 6 patients with lymphedema. RESULTS The linear range of propofol was 50-5 000 ng/mL （r＝0.995 0）. RSDs of within- and between-batch precision were not more than 8.08%； no endogenous interference， carryover effect， or dilution effect was observed in blank plasma. The extraction recovery ranged from 89.80% to 93.73%， and matrix effects were within the range of 97.93%-101.73%. RSDs of the stability test were all lower than 3.27%. During intraoperative TCI 2-30 min， the plasma concentration of propofol in 6 patients was maintained in the range of 1 865.3-6 056.2 ng/mL， and the propofol was almost excreted within 4-8 h after operation. CONCLUSIONS The established UPLC-MS/MS method in this study can achieve the determination of propofol and a simple and fast sample pretreatment process without derivatization； it is proved to be suitable for the concentration monitoring of propofol in plasma samples of patients with lymphedema.

ObjectiveTo investigate the current situation of health communication carried out by medical institutions in Shanghai through new media platforms such as WeChat， Weibo， Toutiao， Douyin， Kuaishou， Bilibili and WeChat Videos， and to propose targeted measures. MethodsBased on the systematic collection of new media accounts of medical institutions in Shanghai， and through the combination of keyword screening and manual audit， health communication data of medical institutions on new media platforms were determined. ResultsData from 1 117 new media accounts of 162 medical institutions in Shanghai were collected， including 610 WeChat official accounts， 105 WeChat video accounts， 89 Weibo accounts， 18 Bilibili accounts， 198 Douyin accounts， 37 Toutiao accounts， and 60 Kuaishou accounts， totaling 111 853 posts. After keyword sorting and manual screening， a total of 66 761 health science posts were collected， with WeChat Official Accounts， Douyin， and Weibo having the top three highest number of posts. Video-based new media such as Douyin， WeChat Videos， Kuaishou， and Bilibili had a better communication impact than text and image-based new media like WeChat Official Accounts， Weibo， and Toutiao. Among them， Douyin and Toutiao were the best platforms for video and text-image-based new media， respectively. ConclusionMedical institutions in Shanghai recognize the importance of new media in health communication and have made full use of various media platforms to carry out health communication，having a certain impact on health education. In the future， medical institutions should choose appropriate platforms based on target audiences and content characteristics， fully leverage the advantages of various platforms， explore innovative communication strategies， promote the dissemination of health knowledge， and enhance the health literacy of the public.

Objective To investigate the factors influencing the prognosis of complex intracranial aneurysms treated with pipeline flow-directed device(PED)and to develop a nomogram prediction model.Methods The clinical data of a total of 98 patients with complex intracranial aneurysm,who were admitted to the Anyue County People's Hospital or the Second Affiliated Hospital of Guilin Medical College of China from January 2021 to April 2023 to receive PED treatment,were retrospectively analyzed.The influencing factors that might affect the prognosis of patients with complex intracranial aneurysm were collected.According to the modified Rankin Scale(mRS)score,the patients were divided into good prognosis group(being defined as mRS ≤2 points)and poor prognosis group(being defined as mRS＞2 points).The clinical data were compared between the two groups,and a nomogram model was established and validated.Results In the 98 patients,poor prognosis was seen in 10(10.20％).The differences in age,history of hypertension,history of diabetes mellitus,clopidogrel resistance,Fisher classification,repeated aneurysm rupture,aneurysm location,aneurysm size,aneurysm neck,multiple lesions,and Hunt-Hess grade on admission between good prognosis group and poor prognosis group were statistically significant(all P＜0.05).Multivariate analysis revealed that history of hypertension,clopidogrel resistance,repeated aneurysm rupture,aneurysm location,multiple lesions,and Hunt-Hess grade were the independent factors influencing the prognosis of patients with complex intracranial aneurysm after receiving PED treatment.The AUC of the nomogram model in predicting the prognosis of PED for complex intracranial aneurysms was 0.849(95％CI=0.758-0.939).The predicted curves of the model group and validation group were basically fitted to the standard curves.The results of the decision curve analysis showed that the net benefit to patients was greater than 0 when the probability threshold of the nomogram model for predicting a poor prognosis of PED for complex intracranial aneurysms was 0.10-0.90.Conclusion The factors causing poor prognosis of PED for complex intracranial aneurysms mainly include history of hypertension,clopidogrel resistance,repeated aneurysm rupture,etc.The nomogram model established in this study can predict the risk of poor prognosis in patients with complicated intracranial aneurysm after receiving PED treatment.

Objective:To analyze the effect of rehabilitation nursing based on dynamic and static complementary balance theory in functional exercise of patients after total knee replacement.Methods:A simple random sampling was used to select 84 patients who underwent total knee arthroplasty in Lishui Municipal Central Hospital from June 2020 to June 2021. The patients were divided into observation group and control group with 42 cases each by random number table. The patients in the control group were given routine rehabilitation nursing before discharge, and the patients in the observation group were given rehabilitation nursing based on the dynamic and static complementary balance theory before discharge. At the time of discharge and one and three months after discharge, the functional exercise compliance (score of the Out-of-hospital Functional Rehabilitation Exercise Compliance Questionnaire), knee joint function score and balance ability score of the two groups of patients were compared, and the hospital stay and complication incidence of the two groups of patients within three months after discharge were recorded and compared.Results:Within three months after discharge, the scores of Out-of-hospital Functional Rehabilitation Exercise Compliance Questionnaire in the two groups decreased, knee joint function scores and balance ability scores of patients in the two groups increased, and the scores in the observation group were higher than those in the control group one and three months after discharge, with statistically significant differences ( P<0.05). The hospital stay of patients in the observation group was shorter than that in the control group, and the total incidence of complications within three months after discharge was lower than that in the control group, with statistically significant differences ( P<0.05) . Conclusions:Rehabilitation nursing based on the dynamic and static complementary balance theory can effectively promote the recovery of knee joint function of patients after total knee replacement, improve the compliance of patients with functional exercise, and reduce the occurrence of complications.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.

Objective:To determine any effect of repeated thermal stimulation on the viability and functioning of inflamed human umbilical vein endothelial cells (HUVECs).Methods:Well-cultured HUVECs were divided into a normal group, a model group, a thermal stimulation 5 times group (group A), a thermal stimulation 9 times group (group B) and a thermal stimulation 13 times group (group C) and cultured under the same conditions. The normal group was not given any intervention. The model group was stimulated with 1μg/mL lipopolysaccharide for 1 hour. Groups A, B and C were first subjected to 5, 9 and 13 rounds of repeated thermal stimulation, each round lasting 4 minutes at 43℃ and 1 minute at room temperature. They were then incubated for one hour at 37℃ under a 5% CO 2 atmosphere with 1μg/mL lipopolysaccharide. Cell viability and the expression of NF-κB were evaluated using methyl thiazolyl tetrazolium and immunofluorescence assays. The levels of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were determined by enzyme-linked immunosorbent assay. Results:After the intervention, the average cell viability of the model group and of groups A and C was significantly lower than that of the normal group, while that of group B was significantly higher. After the intervention, the average NF-κB expression in the normal group was significantly different from that in the others, with group B′s level significantly different from that of the model group. After the treatment, the average expression of ICAM-1 and VCAM-1 in the model group had increased significantly, while that in groups A, B and C had decreased significantly compared with the normal group. The levels of groups A, B and C were then significantly different from that of the model group. The average ICAM-1 level of group B was significantly different from those of groups A and C.Conclusions:Repeated thermal stimulation can protect inflamed HUVECs and reduce the expression of HUVEC adhesion molecules.

Objective:To investigate the impacts of two anesthesia approaches on infections of immunological parameters during splenectomy in hepatocellular carcinoma patients .Methods: Sixty hepatocellular carcinoma patients were divided into two groups randomly,each groups was thirty (liver function Child-Pugh grade was A-B).Total intravenous anesthesia with pmpofol group (group A,n=30 ) and combined intravenous inhalational anesthesia with sevoflurane group (group B,n=30 ).Before induction of anesthesia , at the end of operation ,and after operation 24 hours.blood samples were collected to determined with the level of CD 3+,CD4+,CD8+, CD4+/CD8+and TNF-α, IL-2, IL-6 of hepatocellular carcinoma patients .Results: The perioperative physiological index MAP , HR, SpO2,RR each point had no obvious difference between two groups (P>0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+had no significant difference between two groups before anesthesia (P>0.05).There was no significant changes in CD3+,CD8+with two groups in all moments.Compared with the T0,A,B two groups of CD4+,CD4+/CD8+were lower (P<0.05)in T1 point,but T2 point and T0 point had no significant difference in group B .The levels of CD4+,CD4+/CD8+in group B were higher than in group A ( P<0.05 ) . Compared with T0 moment,group A and group B patients postoperative IL-6 in T1,T2 level increased significantly (P<0.05),and there was no statistically significant difference between group A and group B in all moment .( P>0.05 ) .Compared with the T0 moment,there was no significant change in group A of TNF-αlevel (P>0.05),while group B increased significantly in postoperative day ( P<0.05 ) .The level of IL-2 in each moment interval between the two groups had no significant difference ( P>0.05 ) . Conclusion: Both total intravenous anesthesia with pmpofol and combined intravenous inhalational anesthesia with sevoflurane inhibit the immune function of the patients with hepatocellular carcinoma cell immune reaction .The inhibitory effect of sevoflurane inhalation anesthesia on cell immune function is less affected .

Objective To explore the application of breast milk ( colostrum, transitional milk, and mature milk) oral care on the prevention of ventilator-associated pneumonia (VAP) in neonatus. Methods Oral care with breast milk was implemented as part of the VAP-prevention bundle nursing in the neonatal intensive care unit ( NICU) from the January of 2012 in Taihe Hospital affiliated of Hubei University of Medicine. A total of 34 cases used normal saline as oral care ( before used breast milk as oral care) as control group between January 2010 and December 2011, and 38 cases utilized breast milk for oral care (after used breast milk as oral care) as observation group between January 2012 and December 2013. Both groups were compared by the results of oral pharyngeal and tracheal secretion culture after tracheal intubation, and the incidence of VAP. Results Contrasted 32. 35%, (103. 62 ± 23. 07) h,(17. 94 ± 2. 53) d in the control group, the incidence of VAP, duration of ventilatory support, and length of hospital stays in the observation group were 10. 53%,(92. 76 ± 14. 15) h and (14. 95 ± 2. 25) d (t/χ2 =5. 183,2. 373,5. 307;P <0. 05). After using breast milk for oral care, the pathogenic microorganisms detection rate of oropharyngeal and endotracheal was 10. 53% and 7. 89%, lower than 32. 35%and 26. 47% in the control group, the differences were statistically significant(χ2 =5. 18,4. 46;P <0. 05). Conclusions Using breast milk as oral care can effectively prevent neonatal VAP, and reduce duration of ventilatory support as well as the length hospital stays.

In this paper, according to the requirement of the focused sound field measurement, a focused sound field measurement system was established based on the LabVIEW virtual instrument platform. The system can automatically search the focus position of the sound field, and adjust the scanning path according to the size of the focal region. Three-dimensional sound field scanning time reduced from 888 hours in uniform step to 9.25 hours in variable step. The efficiency of the focused sound field measurement was improved. There is a certain deviation between measurement results and theoretical calculation results. Focal plane--6 dB width difference rate was 3.691%, the beam axis--6 dB length differences rate was 12.937%.
Computer Simulation ; Numerical Analysis, Computer-Assisted ; Software ; Sound