Objective:This study aims to determine the risk perception, evacuation decision-making, and influencing factors related to typhoon disasters among public.Methods:A cross-sectional study will be conducted in residents of Hainan from September 2024 to January 2025. The study will employ chi-square tests, t-tests, and binary logistic regression analysis to examine factors influencing evacuation behavior decisions. Furthermore, structural equation modeling based on ordered choice model will be constructed to validate the mechanisms through which risk perception affects evacuation decision-making processes.Results:Among 517 respondents from 11 administrative districts (counties) in Hainan Province, 62.09% of the residents were willing to evacuate. The decision of public evacuation behavior was significantly related to disaster knowledge, official trust, risk perception, source of warning information and some demographic characteristics. Structural equation modeling demonstrated that warning information sources positively correlated with disaster knowledge and official trust (path coefficients: 0.363, 0.315, both P < 0.001). Both disaster knowledge and official trust showed positive correlations with risk perception (path coefficients: 0.157, 0.165, both P < 0.001), while risk perception positively influenced evacuation decisions (path coefficient: 0.137, P = 0.003). Moreover, source of warning information, disaster knowledge and official trust further positively affect evacuation behavior decision through risk perception, a key mediating variable. Conclusions:Disaster knowledge, official trust, risk perception and other factors can directly or indirectly affect the evacuation behavior of the public following the typhoon disaster. In typhoon-prone areas, it is recommended to enhance public risk perception through strategies such as authoritative training, diversified early warning channels, and improving government credibility, thereby promoting disaster preparedness and evacuation behaviors.

Objective:Using oral iron preparations as the positive control,this study explores the efficacy and safety of intravenous iron isomaltoside in the treatment of moderate postpartum iron deficiency anemia(IDA),as well as the impact of anemia correction on fatigue levels and psychological status among postpartum patients.Methods:Eighty-four patients with moderate iron deficiency anemia during puerperium who were delivered at the Tianjin Medical University General Hospital from April 1,2022,to June 30,2023,were included and randomly as-signed1∶1 to the intravenous group(37cases)or the oraliron group(39cases).Theintravenous group received a one-time infusion of ferric derisomaltose(1000 mg)within 1-3 days after delivery.In the oral group,oral iron(150 mg/day for at least 4 weeks)was administered from postpartum day 1.The improvement effect of anemia and the occurrence of adverse reactions were compared between groups.At the same time,the quality of life assess-ment[Multidimensional Fatigue Inventory(MFI)]and postpartum depression assessment[Edinburgh Postnatal Depression Scale(EPDS)]were self-evaluated by electronic questionnaire,and the degree of fatigue and psy-chological condition were compared.Results:①After treatment,6-8 weeks postpartum follow-up showed that the Hb level(129.1±6.4 g/L vs.119.4±9.6 g/L),Hb growth value(49.8±9.4 g/L vs.39.8±11.8 g/L),and Hb growth percentage(62.7%vs.49.3%)Hb increase≥40 g/L(89.2%vs.53.8%),hematocrit level(34.8%vs.29.4%),mean corpuscular volume(97.6 fl vs.92.5 fl)in the intravenous group were significantly higher than those in the control group(P<0.05).②Comparison within groups:compared with the pre-treatment,the MFI scores of the intravenous group and the oral group were significantly lower after treatment(P<0.05),while the difference between the EPDS scores of the two groups before and after treatment was not statistically significant(P>0.05).Comparison between groups:there was no statistically significant difference in MFI scores and EPDS scores between the two groups before and after treatment(P>0.05).③There were no grade 3 or above adverse events occurred in either group.Conclusions:Intravenous ferric derisomaltose is effective and safe for the treat-ment of postpartum anemia,improving hemoglobin levels more rapidly than oral iron,with similar improvements in fatigue levels and no significant impact on postpartum depression as assessed by EPDS.

Objective: To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy. Methods: Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on. Results: A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level. Conclusions China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.

Objective:Using oral iron preparations as the positive control,this study explores the efficacy and safety of intravenous iron isomaltoside in the treatment of moderate postpartum iron deficiency anemia(IDA),as well as the impact of anemia correction on fatigue levels and psychological status among postpartum patients.Methods:Eighty-four patients with moderate iron deficiency anemia during puerperium who were delivered at the Tianjin Medical University General Hospital from April 1,2022,to June 30,2023,were included and randomly as-signed1∶1 to the intravenous group(37cases)or the oraliron group(39cases).Theintravenous group received a one-time infusion of ferric derisomaltose(1000 mg)within 1-3 days after delivery.In the oral group,oral iron(150 mg/day for at least 4 weeks)was administered from postpartum day 1.The improvement effect of anemia and the occurrence of adverse reactions were compared between groups.At the same time,the quality of life assess-ment[Multidimensional Fatigue Inventory(MFI)]and postpartum depression assessment[Edinburgh Postnatal Depression Scale(EPDS)]were self-evaluated by electronic questionnaire,and the degree of fatigue and psy-chological condition were compared.Results:①After treatment,6-8 weeks postpartum follow-up showed that the Hb level(129.1±6.4 g/L vs.119.4±9.6 g/L),Hb growth value(49.8±9.4 g/L vs.39.8±11.8 g/L),and Hb growth percentage(62.7%vs.49.3%)Hb increase≥40 g/L(89.2%vs.53.8%),hematocrit level(34.8%vs.29.4%),mean corpuscular volume(97.6 fl vs.92.5 fl)in the intravenous group were significantly higher than those in the control group(P<0.05).②Comparison within groups:compared with the pre-treatment,the MFI scores of the intravenous group and the oral group were significantly lower after treatment(P<0.05),while the difference between the EPDS scores of the two groups before and after treatment was not statistically significant(P>0.05).Comparison between groups:there was no statistically significant difference in MFI scores and EPDS scores between the two groups before and after treatment(P>0.05).③There were no grade 3 or above adverse events occurred in either group.Conclusions:Intravenous ferric derisomaltose is effective and safe for the treat-ment of postpartum anemia,improving hemoglobin levels more rapidly than oral iron,with similar improvements in fatigue levels and no significant impact on postpartum depression as assessed by EPDS.

OBJECTIVE To conduct a rapid qualitative study on the chemical constituents of the methanol extract in Thamnolia subuliformis (Ehrh.) W.Culb. by UHPLC-Q-Exactive Focus-MS/MS. METHODS The chromatographic separation was performed on a Waters Acquity UPLC BEH C18(2.1 mm×50 mm, 1.7 μm) column with acetonitrile(A)-0.1% formic acid aqueous solution(B) as mobile phase for gradient elution, the flow rate was 0.3 mL·min–1 and the column temperature was 30 ℃. Mass spectrometry was performed using an electrospray ionization and data was collected in negative ion modes, and the detection range was m/z 80−1 200. The chemical constituents in Thamnolia subuliformis (Ehrh.) W.Culb. were identified rapidly and comprehensively based on the accurate relative molecular and combined with literature data and reference substances. RESULTS A total of 39 chemical constituents were speculatively identified, including 9 mono-substituted phenyl rings, 11 depsides, 5 depsidones, 2 dibenzofuran, 10 lipids, and 2 others. CONCLUSION The chemical constituents in the Thamnolia subuliformis (Ehrh.) W.Culb. can be identified accurately and rapidly by this method. Among them, 3 compounds(β-resorcylic acid, usnic acid, atranorin) are unambiguously identified by comparing with reference standards, 19 compounds are found from Thamnolia subuliformis (Ehrh.) W.Culb. for the first time. This paper can provide the important basis for study on pharmacodynamic material and substitute development of Thamnolia subuliformis (Ehrh.) W.Culb..

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To formulate a standardized management plan of Hemodialysis Room for patients with infectious diseases and explore the practical effect.Methods:The Beijing Ditan Hospital affiliated to Capital Medical University formulated a standardized management plan for hemodialysis room of patients with infectious diseases, which was implemented in 2017. Using convenience sampling method, 146 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January 2017 to October 2020 were selected as the experimental group, and 46 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January to December 2016 were selected as the control group. We compared the nursing compliance rate before and after the implementation of the plan, the incidence of adverse events, and the satisfaction with nursing in the two groups.Results:After the implementation of the plan, the nursing compliance rate was 97.13% (406/418) , which was higher than 89.29% (50/56) before the implementation, and the difference was statistically significant (χ 2=8.316, P<0.01) . The incidence of adverse events in the experimental group was 6.85% (10/146) , which was lower than 17.39% (8/46) in the control group, and the difference was statistically significant (χ 2=4.567, P<0.05) . The Nursing Work Satisfaction Scale score of the experimental group was (94.67±3.08) , which was higher than (91.96±2.91) of the control group with a statistical difference ( t=8.882, P<0.05) . Patients' satisfaction with nursing in the experimental group was 98.63% (144/146) , which was higher than 91.30% (42/46) in the control group, and the difference was also statistically significant (χ 2=6.201, P<0.05) . Conclusions:The explored and implemented standardized management plan for hemodialysis patients with infectious diseases has achieved certain positive results, which provides a scientific, fine and standardized nursing management strategy for the construction of systematic solutions in the future.

Objective:To provide a retrospective analysis of the levels of occupational external exposure of radiation workers in Hubei province from 2009 to 2018 in a way to prevent and control its risks.Methods:The external individual doses were surveyed for 50 070 radiation workers between 2009 and 2018 by the effort of the Hubei Provincial Center for Disease Control and Prevention. Under the relevant national standards, the external radiation doses to radiation workers were conducted by using TLDs.Results:The average annual collective effective dose to radiation workers in a 10 years period was 1.93 man·Sv, the median of average annual effective dose of 0.14 mSv ( P25- P75: 0.06-0.30 mSv), and the average annual effective dose of 0.40 mSv. The annual effective doses received by 46 562 workers were less than 1 mSv, accounting for 92.99% of the total monitored workers. The annual effective dose varied dependent on occupational categories, showing a year-by-year decline trend and staying at a low level after 2012. The relative high radiation doses were seen in nuclear medicine and interventional radiology in medical applications, non-destructive testing and well logging in industrial applications, and other types of radiation applications. Conclusions:The average annual effective dose decreased year in a by year manner and kept at a low level. This indicated that the radiological protection measures taken during the 10 years ensure the health of workers. The continuous monitoring result suggest that much more attention should be paid to such categories workers as nuclear medicine, interventional radiology, non-destructive testing, well logging and others through improving radiation protection measures.

OBJECTIVE：To put forward policy suggestions for the adjustment and reform of centralized drug procurement mode in China. METHODS ：The evolution process of centralized drug procurement mode in China was reviewed ，and problems were found through literature research and expert interview. Combined with the experience of drug procurement platform construction，GPO procurement and medical insurance payment control fee management in the United States and Singapore ，the reform suggestions were put forward for basic model assumption of bidding procurement based on cost control target and drug bidding procurement policy. RESULTS & CONCLUSIONS ：China’s drug bidding procurement system has gone through the stages of unified purchase and marketing ，decentralized procurement ，centralized procurement start-up and adjustment ，comprehensive implementation of online centralized drug procurement ，exploration of the integration of “two bidding ”（bidding for essential medicine and bidding for non-essential medicine ）and joint procurement ，and pilot stage of national drug bidding and procurement. At the present stage ，there are many problems in centralized drug procurement ，such as the diversified subordination relationship of the platform ，the possible monopoly of enterprise selection under the policy of “two invoice system ”，price reduction becoming the core performance index of bidding procurement ，and the suspected monopoly operation of GPO procurement exploration. The model analysis based on the goal of cost control shows that drug cost is a function of efficiency ，drug quantity and price. High price leads to high cost ，while low efficiency leads to high cost. In the future ，the goal of drug bidding and procurement should not only foucs on price control ，but also on efficiency. The function of bidding and procurement will return to the essential function of “price for quantity ”. It is suggested that a relatively independent and unified platform should be established for drug bidding and procurement in China ，and the grouped procurement mode should be gradually standardized ，the expenditure control function of medical insurance payment audit should be exerted instead of simple price reduction ，and absolute unified lowest price procurement should be avoided.

Objective:To have a better understanding of congenital leukemia by summarizing its clinical features and prognosis.Methods:This study retrospectively recruited 10 neonates with congenital leukemia treated in Beijing Children's Hospital, Capital Medical University from January 2006 to December 2018. Clinical data including clinical manifestations, laboratory examinations, treatment and follow-up were described.Results:The 10 patients consisted of six boys and four girls. In all cases, symptoms presented within 11 d after birth. The admission complaints were jaundice ( n=4), polypnea ( n=3), fever ( n=2) and rash ( n=2). Physical examinations of the 10 patients showed eight with splenomegaly, seven with hepatomegaly and seven with petechia/skin rash. All patients had significantly increased white blood cell count (from 45.8×10 9/L to 553.0×10 9/L), complicated by different degrees of anemia and thrombocytopenia. By bone marrow biopsy, two cases were diagnosed as acute lymphoblastic leukemia and the other eight cases as acute myeloid leukemia. All cases refused chemotherapy on the preliminary diagnosis. Three cases lost follow-up and six died within two months after discharge requested by their parents. One baby had spontaneous remission, but relapsed two years later. Complete remission was achieved after strict management and no relapse was reported until ten years old. Conclusions:Congenital leukemia is a severe condition with high mortality. Some cases may achieve spontaneous remission, but long-term follow-up is needed.