ObjectiveTo understand the level of medical narrative competence among hospice care practitioners in Shanxi Province， explore its influencing factors， and provide references for carrying out targeted training and improving the medical narrative competence of the medical and nursing staff. MethodsUsing convenience sampling， a total of 102 medical and nursing staff from hospitals providing hospice care in Shanxi Province were recruited as the research subjects. Questionnaire surveys were conducted with the Self-Designed General Information Questionnaire and the Self-Rating Scale for Medical Narrative Competence as the research tools. Univariate analysis and multiple linear regression analysis were adopted to explore the level of medical narrative competence and its influencing factors among hospice care practitioners in Shanxi Province. ResultsThe total score of medical narrative competence among hospice care practitioners in Shanxi Province was （158.19±19.69）. The mean scores of all dimensions were ranked from the lowest to the highest as attention and listening， understanding and response， and reflection and representation. Univariate analysis demonstrated that working years in hospice care， daily communication frequency with patients， weekly communication duration， degree of colleague care， professional recognition， job satisfaction， and familiarity with narrative medicine constituted the influencing factors for the level of medical narrative competence among hospice care practitioners （all P<0.05）. Multiple linear regression analysis showed that working years in hospice care， degree of colleague care， and familiarity with narrative medicine had statistically significant effects on the medical narrative competence of hospice care practitioners （all P<0.05）. ConclusionAdministrators of hospice care should prioritize medical and nursing staff who lack familiarity with narrative medicine， have low degrees of colleague care， experience short working years， and possess low professional recognition and job satisfaction with hospice care work. Targeted training should be strengthened for these individuals to improve their medical narrative competence level， thereby enhancing the quality of hospice care services.

Objective:To understand the levels of selenium and T-2 toxin in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province.Methods:From July 2018 to February 2019, in five cities (counties) of historical critical Kashin-Beck disease areas, namely, Ma'erkang, Rangtang, Aba, Ruo'ergai and Hongyuan, one township was selected, respectively, and then one village in the historical critical disease area and one village in non-disease area were selected from the selected townships. Hair samples from 30 children aged 6 to 12 years old were collected to test selenium content in each village. Staple food samples of 10 households were collected to test the selenium and T-2 toxin contents in each village. Ten soil samples were collected from each village to test the selenium content.Results:The medians selenium of children's hair in the diseased and non-diseased villages ( n= 180, 120) were 0.260 0 and 0.330 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 6.319, P < 0.01). In Ma'erkang and Hongyuan, the medians selenium in the diseased villages were lower than those in non-diseased villages ( Z = - 3.327, - 4.939, P < 0.01), and there were no statistically significant differences between the diseased villages and non-diseased villages in Rangtang and Ruo'ergai ( P > 0.05). The medians selenium of staple food in the diseased and non-diseased villages ( n = 110, 70) were 0.005 8 and 0.018 0 mg/kg, respectively, and the diseased village was lower than non-diseased village ( Z = - 2.263, P < 0.05). In Ruo'ergai, the median selenium in the diseased village was lower than that in non-diseased village ( Z = - 2.306, P < 0.05), and there were no statistically significant differences between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Hongyuan ( P > 0.05). The T-2 toxin contents in staple food were all less than detection limit (1 μg/kg) in the diseased and non-diseased villages ( n = 103, 65). The soil selenium contents in the diseased and non-diseased villages ( n = 60, 40) were (0.045 3 ± 0.021 5) and (0.065 8 ± 0.045 4) mg/kg, respectively, and the diseased village was lower than non-diseased village ( t = 2.672, P < 0.05). The soil selenium content in the diseased village was lower than that in non-diseased village in Hongyuan ( t = 14.838, P < 0.01). There were no statistically significant differences in the soil selenium content between the diseased villages and non-diseased villages in Ma'erkang, Rangtang and Ruo'ergai ( P > 0.05). Conclusions:The overall selenium level of children's hair is at a medium level (0.25 - < 0.50 mg/kg) in the historical critical disease area of Aba State of Sichuan Province, the selenium levels of staple food and soil are at a deficiency level (< 0.025, < 0.125 mg/kg), and the diseased villages are lower than non-diseased villages. No T-2 toxin is detected in staple food.