Objective:To construct a standard index system for the outpatient job competency of midwife, and to clarify the midwives' abilities when providing outpatient services, so as to improve the midwives' core competencies and service satisfaction.Methods:A research group was established in December 2018. On the basis of literature review and survey of midwives' outpatient needs in the early stage, referring to expert opinions, and taking job competency theory as the theoretical framework, the standard index system for the outpatient job competency of midwife were initially constructed. From December 2018 to March 2019, convenience sampling was used to select 24 experts from different ClassⅢ Grade A hospitals of Beijing, and the Delphi method was used to conduct 2 rounds of expert consultations.Results:Among 2 rounds of expert consultations, the effective recovery rates of the questionnaires were all 100.0% (24/24) , the positive coefficient of experts was 100.0%, and the coefficient of authority of experts was 0.786. The Kendall coordination coefficients of the 2 rounds of correspondence were 0.030 and 0.400, respectively ( P<0.05) . The final construction of standard index system for the outpatient job competency of midwife included 4 first-level indicators, 9 second-level indicators and 24 third-level indicators of knowledge and skills, professional quality, health education ability, and ability to improve the quality of professional services. Conclusions:The standard index system for the outpatient job competency of midwife is scientific and reasonable, comprehensive in content, and strong in specialty, which can provide a reference for the training and assessment of midwife.

Objective:To investigate the status of cancer-related fatigue in lung cancer patients and its related influencing factors, thus to provide reference for clinical active intervention and improve the quality of life of patients.Methods:In this study, interviews and questionnaires were used to collect patient-related data.Seventy patients with lung cancer from January 2016 to January 2019 in Zhuji People's Hospital were selected in this study, and relevant information was collected and analyzed.The relevant influencing factors of cancer-related fatigue was analyzed.Results:The survey showed that the average score of cancer-related fatigue in lung cancer patients was (5.71±1.96)points, which was in moderate status, the behavioral dimension fatigue score was (5.95±2.38)points, the emotional dimension score was (5.48±2.37)points, the sensory dimension score was (5.46±2.38)points, and the cognitive/emotional dimension score was (4.79±2.11)points.Age, serum albumin level, surgery and anemia were the influencing factors of cancer-induced fatigue in patients with lung cancer( P<0.05). Sleep disorders, anxiety, depression were positively correlated with cancer-induced fatigue in patients with lung cancer( r=0.642, 0.350, 0.192, P=0.000, 0.000, 0.000). The average quality of life score of lung cancer patients was (84.14±6.52)points, which was negatively correlated with cancer-induced fatigue and functional areas, and positively correlated with symptom areas, insomnia and diarrhea( P<0.05). Conclusion:The cancer-induced fatigue of 70 patients with lung cancer in Zhuji People's Hospital is in moderate status, and the main influencing factors are age, serum albumin, surgery and anemia.The survey can provide a reference for subsequent clinical intervention for lung cancer patients.

Objective To observe the effect of Huolisu oral liquid combined with mirtazapine tablets on the expressions of NE and 5-HT in the patients with depression,and explore the therapeutic efficiency. Methods 75 patients with depression were randomly divided into a study group with 43 cases,which were treated with Huolisu oral liquid and mirtazapine tablets and a control group with 32 cases,which were only treated with mirtazapine tablets The Hamilton depression scale(HAMD)score, serum NE,and 5-HT were detected in the patients before the treatment and 4 and 8 weeks after the treatment separately. Results Before treatment,there were no statistical significance in HAMD score,serum depression NE and 5-HT(t=0.501, 0.520, 0.611,P>0.05). After treated for 4 and 8 weeks, compare with the control group, HAMD score was decreased(t=1.829、2.263, P<0.05), serum 5-HT was increased(t=2.119, 2.870, P<0.05),and NE was increased in the study group(t=2.264, 2.705,P<0.05). Conclusion Huolisu oral liquid combined with mirtazapine tablets can significantly decrease HAMD score,and increase serum NE and 5-HT level. The treatment can improve the depression symptoms in the patients with depression obviously.

Objective To evaluate the serum organochlorine pesticides residues levels in breast cancer pa-tients with different estrogen receptor(ER). Methods 93 patients of breast cancer from Fengnan districtand 65 pa-tients from Tanghai county in Tangshan were selected,whose ER were detected by pathology and serum organochlo-fine pesticides (DDTs and HCHs) levels were detected and compared with gas chromatography/electron capture. Results The orders of detection rate of HCH isomer in breast cancer patients in two areas were β-HCH >δ-HCH > α-HCH >γ-HCH. The orders of detection rate of DDT isomer in breast cancer patients in two areas were PP'-DDE > PP'-DDT > OP'-DDT > PP'-DDD. The serum levels of β-HCH, PP'-DDE in breast cancer patients in two are-as were positively correlated with age (r=0.272 ,0.330 , P<0.01) or BMI (r=0.312,0.187, P <0.01, <0.05). There were statistical differences in the serum β-HCH,δ-HCH,PP'-DDE levels between the estrogen receptor posi-tive breast cancer patients and the estrogen receptor negative breast cancer patients in two areas (P<0.05 for each). Conclusion The serum organochlorine pesticides residues levels in breast cancer patients with positive es-trogen receptor are higher than that with negative estrogen receptor, implicating that breast cancer is dependent on es-trogen. The cause of breast cancer is likely due to estrogen-like effect of serum organochlorine pesticides residues.

Objective To investigate the relation between hepatic function of mothers and prognosis of fetuses in intrahepatic cholestasis of pregnancy(ICP).Methods 166 patients with ICP were retrospectively studied.Results The incidences of meconium passage and fetal distress were perfectly high in mothers of high serum transaminase and bilirubin.The birth weight and Apgar scores of neonate were related to the levels of bilirubin and we could predict the fetal prognosis by analysis of mother's serum bilirubin level.The serum total bile acid(TBA) levels and other hepatic indexes were not related to the incidences of meconium passage and fetal distress.Conclusions The fetal prognosis of mothers with high-level serum transaminase and bilirubin is bad,so they must be taken great aware of.The prognosis of fetuses can be bettered by cesarean section at proper time.

Objective To summarize the cl inical characteristics and imaging features of psittacosis. Methods The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed . Results The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dis sociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of ne utrophils might be increased. The chest X-ray and CT scan showed air-space co nsolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were a lso present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittac i. Erythromycin was effective in all 3 patients. Conclusion Although the appearance of psittacosis on clinical findings and chest X-r ay and CT scan is not characteristic, psittacosis can be diagnosed with the comb ination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging f eatures of psittacosis is helpful in differential diagnosis.