OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

Objective:To develop the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and test its reliability and validity, so as to provide an effective tool for evaluating the care needs of young and middle-aged terminally ill patients for medical and nursing staff.Methods:This study is a cross-sectional study. Guided by the theory of supportive care needs, an initial scale was formed through literature review, qualitative interviews, Delphi expert consultation, and pre-survey. From July to September 2022, convenience sampling was used to select 570 young and middle-aged terminally ill patients hospitalized in the Oncology Department and Hospice Care Ward of six Class Ⅲ hospitals in Tianjin as the research subject, and a questionnaire survey was conducted on the patients. The items in the scale were selected using item analysis method. The structural validity of the scale was evaluated using exploratory factor analysis and confirmatory factor analysis. The content validity of the scale was evaluated using the scale-level content validity index and the item-level content validity index. The reliability of the scale was evaluated using internal consistency coefficient and half reliability coefficient. A total of 570 questionnaires were distributed, and 565 valid questionnaires were collected, with an effective response rate of 99.12% (565/570) .Results:A total of 18 experts completed two rounds of consultation, with an expert authority coefficient of 0.890, the Kendall's W values of 0.309 and 0.417, respectively ( P<0.05). The Care Needs Scale for Young and Middle-aged Terminally Ill Patients included 6 dimensions and a total of 39 items. Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 71.515%. Confirmatory factor analysis showed that the overall model fitted well. The content validity index at the scale level was 0.942, and the content validity index at the item level was 0.833 to 1.000. The total Cronbach's α coefficient of the scale was 0.975, and the half reliability coefficient was 0.911. Conclusions:The reliability and validity of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients are good, and it can be used as an evaluation tool for the care needs of young and middle-aged terminally ill patients.

OBJECTIVE To study the improvement effect and mechanism of Gubenanshen decoction on menopausal syndrome model rats . METHODS Totally 70 rats were anesthetized and placed on the operating table for bilateral ovariectomy to induce menopausal syndrome model . Other 10 rats without modeling were taken as sham operation group . Sixty model rats were divided into model group ，Gengniananpian group （TCM positive control group ，0.56 g/kg），Estradiol valerate tablet group （chemical drug positive control group ，0.1 mg/kg），Gubenanshen decoction high -dose，medium-dose and low -dose groups （18.0，9.0，4.5 g/kg）， with 10 rats in each group . Model group and sham operation group were given normal saline intragastrically ；administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 4 weeks. After last administration ，the plasma contents of luteinizing hormone （LH），follicle stimulating growth hormone （FSH）and estradiol （E2）were determined .The indexes of uterus，adrenal gland ，spleen and thymus were measured ；pathological changes of rat uterus were observed ；mRNA expressions of kisspenptin 1（Kiss-1），inositol triphosphate receptor 1（IP3R1）and gonadotropin -releasing hormone （GnRH）in hypothalamic tissues were detected ，and the protein expressions of Kiss -1，ERK1/2 and p -ERK1/2 were also detected . RESULTS Compared with sham operation group ，the contents of LH and FSH in the plasma of rats were significantly increased in model group （P＜0.05 or P＜0.01）. The contents of E 2，organ index ，mRNA expressions of Kiss -1，IP3R1 and GnRH and protein expressions of Kiss -1 and p-ERK1/2 were decreased significantly in hypothalamic tissues （P＜0.05 or P＜0.01）. The glands of the uterus were reduced and the cells in the lamina propria were dense . Compared with model group ，above indexes of Gubenanshen decoction groups （except for the content of E 2 in the low -dose group ）were reversed significantly （P＜0.05 or P＜0.01）. The number of uterine glands increased，and single columnar epithelial cells were arranged orderly （except for the low -dose group ）. CONCLUSIONS Gubenanshen decoction can increase mRNA expressions of Kiss -1，IP3R and GnRH and protein expressions of Kiss -1 and p -ERK1/2 in hypothalamic tissues of rats ，and activate GnRH secretion signaling pathways so as to improve the menopausal syndrome .

BACKGROUND: The previous study has indicated that lung cancer has a high incidence and mortality in China, and has caused a large economic burden. The purpose of this study was to analyze the incidence and economic burden of lung cancer by analyzing the information on the home page of discharge history of lung cancer patients in Hebei Tumor Hospital, and to provide scientific basis for the prevention and treatment of lung cancer. METHODS: The information of all of the discharges, new cases, surgical patients, age, gender, length of stay and hospitalization cost of lung cancer patients in Hebei Tumor Hospital from January 2012 to December 2019 were retrieved based on the medical record management system, and the incidence trend, gender and age distribution as well as the economic burden of the disease were statistically described. RESULTS: The number of new cases of lung cancer increased year by year, from 2,235 cases in 2012 to 5,012 cases in 2019. The number of males always outnumbered females, but the gender ratio decreased year by year, from 2.25 in 2012 to 1.56 in 2019. Among new cases of lung cancer, the proportion of surgical treatment increased year by year, from 28.14% in 2012 to 44.83% in 2019. Except for 2012, the proportion of surgical operations in female patients was higher than that in male patients from 2013 to 2019. The proportion of surgical operations in male and female patients was 23.52% and 28.07% in 2013, and 36.14% and 58.37% in 2019, respectively. The median age at the onset of lung cancer has increased year by year, from 61 years old in 2012 to 63 years old in 2019. The median age of onset in all lung cancer patients was higher in males than in females. The number of new lung cancer patients and surgical patients both showed an increasing trend with the increase of age, and both reached the maximum value in the age group of 60-69 years old. With the increase of age, the number of patients gradually decreased. The median length of hospital stay for all discharged lung cancer patients or surgical patients decreased year by year, from 10 d and 19 d in 2012 to 8 d and 17 d in 2019, respectively, while the median hospitalization cost increased year by year. It increased from 10,611.46 yuan and 38,750.13 yuan in 2012 to 17,187.15 yuan and 84,030.16 yuan in 2019, respectively. CONCLUSIONS Lung cancer is still one of the main cancers endangering the health of Chinese residents. The incidence of lung cancer is increasing year by year, and the distribution of gender and age has certain characteristics. In order to reduce the number of cases and the economic burden, effective prevention and control measures should be formulated and medical reform should be strengthened.
Age Distribution ; Aged ; China/epidemiology* ; Female ; Financial Stress ; Humans ; Incidence ; Lung Neoplasms/surgery* ; Male ; Middle Aged

The construction of medical knowledge platform is a core value of the intelligent construction of electronic medical records. The hospital-wide knowledge base construction covers a wide range of content, including multiple healthcare scenarios such as medicine, testing, inspection, surgery, blood transfusion and nursing. This article introduced how Jiangsu Province People′s Hospital used knowledge graphs and rule engine to construct a hospital knowledge management platform, realize the integration of knowledge-based knowledge base and a non-knowledge-based knowledge base, and embed clinical diagnosis and treatment rules into the information system for different flexible application scenarios.Finally, a multi-dimensional knowledge base was formed to realize the unified knowledge information integration of various clinical expert knowledge, and to provide integrated display and decision support for all departments, as well as realizing real-time data verification, prompting and control in each link.

Purpose: Drug resistance is one of the main causes of chemotherapy failure in patients with small cell lung cancer (SCLC), and extensive biological studies into chemotherapy drug resistance are required. Materials and Methods: In this study, we performed lncRNA microarray, in vitro functional assays, in vivo models and cDNA microarray to evaluate the impact of lncRNA in SCLC chemoresistance. Results: The results showed that KCNQ1OT1 expression was upregulated in SCLC tissues and was a poor prognostic factor for patients with SCLC. Knockdown of KCNQ1OT1 inhibited cell proliferation, migration, chemoresistance and promoted apoptosis of SCLC cells. Mechanistic investigation showed that KCNQ1OT1 can activate transforming growth factor-β1 mediated epithelial-to-mesenchymal transition in SCLC cells. Conclusion Taken together, our study revealed the role of KCNQ1OT1 in the progression and chemoresistance of SCLC, and suggested KCNQ1OT1 as a potential diagnostic and prognostic biomarker in SCLC clinical management.

With the development of modern computing technology and medical physics,radiotherapy has made great progress.The theoretical basis of radiobiology seems to lag behind the clinical application of radiotherapy,which hampers the further improvement of treatment efficacy and the optimization of treatment modality.In this paper,some emerging challenges of precision radiotherapy technology to the traditional theory of radiobiology,such as radiosensitivity,dose-response curve and survival curve,linear-quadratic model,4Rs theory,as well as the interaction between cancer and microenvironment,radiation-induced second primary cancers (RISPC),will be discussed.The interplay between precision radiotherapy and traditional radiobiology theories will be addressed with the aim to potentially solve some of the challenging problems.

Objective To investigate the Mycobacterium tuberculosis infections in 2014 among Beijing army recruits, and evaluate a new method for screening latent tuberculosis infections.Methods A total of 194 army recruits were subjected to chest X-ray examination purified protein derivative(PPD) skin test, antibody detection, and interferon gamma release assay(IGRA) by ELISA combined with recombinant protein CFP10-ESAT6 and latent infection protein Rv2628.Results The positive rates of PPD skin test and antibody test were 49.7% and 15.5%, respectively.The latent infection rate of IGRA test was 22.2% in 194 cases after CFP10-ESAT6 stimulation.After stimulation of latent tuberculosis infection(LTBI) with Rv2628, IFN-γ level was significantly higher than that in healthy control group (P<0.05).The weak positive group of TST (5 mm≤diameter<15 mm) had a significantly higher level of IFN-γ than the strong positive group(diameter≥15 mm)(P<0.05),but after stimulation with CFP10-ESAT6,IFN-γ levels were not significantly different between the two groups(P>0.05).There was no significant difference between antibody negative and positive groups after stimulation by CFP10-ESAT6 and Rv2628 (P>0.05).The area under the ROC curve of Rv2628 diagnosis of tuberculosis infection was 0.84.When Youden index was 0.621,the specificity was 94.7% and sensitivity was 67.4%.ConclusionCombined detection of antigens Rv2628 and CFP10-ESAT6 specific IFN-γ values can be potentially used for differential diagnosis of active or latent tuberculosis infections.

Objective To study the performance indicators after reorganization for 10 Years in enterprise hospital.Methods The performance indices from 2005 to 2014 of a Class One Grade A hospital was evaluated by rank sum ratio.Results The reform was in the doldrums in 2005, improved slightly in 2006 and 2007, increased significantly and steadily in 2008, reached the best in 2014.Conclusion Evaluating the performance of hospital management with rank sum ratio is scientific and clear, which has certain practical value.