Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective·To establish Downs cephalometric norms for the Han Chinese aged 18-25 with harmonious faces,and to analyze gender and regional characteristics.Methods·A stratified sampling approach was used to recruit participants from seven geographic regions across China.Over 30 000 volunteers were screened,and 883 participants with harmonious faces were ultimately included.Basic demographic data were collected,and lateral cephalometric radiographs were taken.Hard tissue measurements were performed with Downs analysis(using anatomical porion).The data were then statistically analyzed to compare gender and regional differences in dentofacial structures.Results·The gender differences in the four hard tissue measurements,the angle of convexity,A-B plane angle,mandibular plane angle,and occlusal plane angle,were statistically significant(P＜0.001).Females showed larger values for the angle of convexity,mandibular plane angle,and occlusal plane angle,but smaller values for the A-B plane angle,compared to males.The gender differences in the interincisal angle,L1 to occlusal plane,L1 to mandibular plane,and U1 to AP plane were not statistically significant.There were regional differences in all 10 measurements of Downs analysis,though some regions shared common features.Specifically,the northeastern,eastern,and southern coastal regions exhibited a smaller facial angle,and larger mandibular plane angle,angle of convexity,occlusal plane angle,and U1 to AP plane.It suggested that,compared to inland regions,individuals from coastal regions tended to have more retrusive chins,steeper mandibular planes,more prominent upper incisors,and more convex hard tissue profiles.Conclusion·Gender differences exist in the dentofacial hard tissue structures of Han Chinese adults with harmonious faces,primarily in skeletal measurements.Each region has its unique dentofacial characteristics,along with some common features.These differences should be taken into account in clinical diagnosis and treatment for the development of personalized and precise therapeutic strategies.

Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective·To establish Downs cephalometric norms for the Han Chinese aged 18-25 with harmonious faces,and to analyze gender and regional characteristics.Methods·A stratified sampling approach was used to recruit participants from seven geographic regions across China.Over 30 000 volunteers were screened,and 883 participants with harmonious faces were ultimately included.Basic demographic data were collected,and lateral cephalometric radiographs were taken.Hard tissue measurements were performed with Downs analysis(using anatomical porion).The data were then statistically analyzed to compare gender and regional differences in dentofacial structures.Results·The gender differences in the four hard tissue measurements,the angle of convexity,A-B plane angle,mandibular plane angle,and occlusal plane angle,were statistically significant(P＜0.001).Females showed larger values for the angle of convexity,mandibular plane angle,and occlusal plane angle,but smaller values for the A-B plane angle,compared to males.The gender differences in the interincisal angle,L1 to occlusal plane,L1 to mandibular plane,and U1 to AP plane were not statistically significant.There were regional differences in all 10 measurements of Downs analysis,though some regions shared common features.Specifically,the northeastern,eastern,and southern coastal regions exhibited a smaller facial angle,and larger mandibular plane angle,angle of convexity,occlusal plane angle,and U1 to AP plane.It suggested that,compared to inland regions,individuals from coastal regions tended to have more retrusive chins,steeper mandibular planes,more prominent upper incisors,and more convex hard tissue profiles.Conclusion·Gender differences exist in the dentofacial hard tissue structures of Han Chinese adults with harmonious faces,primarily in skeletal measurements.Each region has its unique dentofacial characteristics,along with some common features.These differences should be taken into account in clinical diagnosis and treatment for the development of personalized and precise therapeutic strategies.

With the rapid acceleration of aging in China, there is a huge need for elderly patients to have improved quality of life in the terminal stage.Palliative sedation is an integral part of palliative care and can alleviate painful refractory symptoms, and its use in patients in various terminal illnesses is being explored across the world.Attention is focused on its indications and implementation.In China, palliative sedation in clinical practice is in an early exploratory stage and relevant criteria and guidelines have yet to be established.A review of the current practice and research progress concerning palliative sedation for patients' end-of-life care in China and the rest of the world will offer insight and strategic considerations in the initial pursuit and accelerated acceptance in the future in China.

Pain is a prevalent symptom in both cancer and non-cancer end-stage diseases, often being the most feared by patients and significantly impacting their quality of life.Hospice care aims to address physical, psychological, spiritual, and other needs of patients and their families during this stage, with a focus on alleviating pain and discomfort.Effective pain management is a crucial component of hospice care, particularly given the increasing prevalence of cancer and chronic diseases in China and the growing elderly population.To provide analgesic management for hospice patients, a thorough assessment of pain is essential to identify its type and characteristics.Treatment approaches may include etiological interventions, pharmacotherapy, interventional therapy, physiotherapy, psychotherapy, and comfort care, all aimed at achieving comprehensive pain management.The use of opioid should be carefully guided by scientific principles to minimize adverse effects and optimize pain relief, ultimately enhancing patients' end-of-life quality of life.

Objective:To explore the distribution characteristics of pathogens in adult patients with community-acquired pneumonia (CAP) and to provide basis for the diagnosis, treatment, prevention of CAP.Methods:1 446 inpatients with CAP were prospectively enrolled in a third-class hospital in Beijing in recent 5 years (from January 2015 to December 2019). Respiratory tract samples were collected for smear, culture, nucleic acid, antigen and antibody detection to identify the pathogen of CAP. Mann-Whitney U test was used for continuous variables and χ 2 test or Fisher′s exact test was used for categorical data for statistical analysis. Results:Among the 1 446 patients, 822 (56.85%) patients were infected with a single pathogen, 231 (15.98%) patients were infected with multiple pathogens, and 393 (27.18%) patients were not clear about the pathogen. Influenza virus is the first pathogen of CAP (20.95%, 303/1 446), mainly H1N1 (8.51%, 123/1 446), followed by mycoplasma pneumoniae (7.19%, 104/1 446), Mycobacterium tuberculosis (5.33%, 77/1 446) and Streptococcus pneumoniae (5.05%, 73/1 446). The outbreak of H1N1 occurred from December 2018 to February 2019, and the epidemic of mycoplasma pneumoniae pneumonia was monitored from August to November 2019. Patients under 65 years old had high detection rates of Mycoplasma pneumoniae (14.41% vs. 2.41%, χ2=74.712, P<0.001), Streptococcus pneumoniae (8.16% vs. 2.99%, χ2=18.156, P<0.001), rhinovirus (6.08% vs. 3.56%, χ2=5.025, P<0.025), Chlamydia pneumoniae (5.90% vs. 1.15%, χ2=26.542, P<0.001) and adenovirus (3.13% vs. 0.92%, χ2=9.547, P=0.002). The severe disease rate of CAP was 14.66% (212/1 446), and the average mortality rate was 3.66% (53/1 446). The severe illness rate and mortality rate of bacterial-viral co-infection were 28.97% (31/107) and 19.63% (21/107), respectively. Conclusions:Influenza virus is the primary pathogen of adult CAP. Outbreaks of Mycoplasma pneumoniae and H1N1 were detected in 2018 and 2019, respectively. The remission rate and mortality rate of virus-bacteria co-infection were significantly higher than those of single pathogen infection. Accurate etiological basis not only plays a role in clinical diagnosis and treatment, but also provides important data support for prevention and early warning.

Objective:To explore the distribution characteristics of pathogens in adult patients with community-acquired pneumonia (CAP) and to provide basis for the diagnosis, treatment, prevention of CAP.Methods:1 446 inpatients with CAP were prospectively enrolled in a third-class hospital in Beijing in recent 5 years (from January 2015 to December 2019). Respiratory tract samples were collected for smear, culture, nucleic acid, antigen and antibody detection to identify the pathogen of CAP. Mann-Whitney U test was used for continuous variables and χ 2 test or Fisher′s exact test was used for categorical data for statistical analysis. Results:Among the 1 446 patients, 822 (56.85%) patients were infected with a single pathogen, 231 (15.98%) patients were infected with multiple pathogens, and 393 (27.18%) patients were not clear about the pathogen. Influenza virus is the first pathogen of CAP (20.95%, 303/1 446), mainly H1N1 (8.51%, 123/1 446), followed by mycoplasma pneumoniae (7.19%, 104/1 446), Mycobacterium tuberculosis (5.33%, 77/1 446) and Streptococcus pneumoniae (5.05%, 73/1 446). The outbreak of H1N1 occurred from December 2018 to February 2019, and the epidemic of mycoplasma pneumoniae pneumonia was monitored from August to November 2019. Patients under 65 years old had high detection rates of Mycoplasma pneumoniae (14.41% vs. 2.41%, χ2=74.712, P<0.001), Streptococcus pneumoniae (8.16% vs. 2.99%, χ2=18.156, P<0.001), rhinovirus (6.08% vs. 3.56%, χ2=5.025, P<0.025), Chlamydia pneumoniae (5.90% vs. 1.15%, χ2=26.542, P<0.001) and adenovirus (3.13% vs. 0.92%, χ2=9.547, P=0.002). The severe disease rate of CAP was 14.66% (212/1 446), and the average mortality rate was 3.66% (53/1 446). The severe illness rate and mortality rate of bacterial-viral co-infection were 28.97% (31/107) and 19.63% (21/107), respectively. Conclusions:Influenza virus is the primary pathogen of adult CAP. Outbreaks of Mycoplasma pneumoniae and H1N1 were detected in 2018 and 2019, respectively. The remission rate and mortality rate of virus-bacteria co-infection were significantly higher than those of single pathogen infection. Accurate etiological basis not only plays a role in clinical diagnosis and treatment, but also provides important data support for prevention and early warning.

Objective To investigate the epidemic tendency and drug resistance of common pathogenic bacteria in the patients with infectious diarrhea,and then provide scientific evidence for the treatment of bacterial diarrhea.Methods The feces specimens were collected from 12 156 patients with infectious diarrhea in our hospital during April 1,2012 and October 31,2017.Then,they were cultured,and the obtained bacteria were isolated and identified by the Vitek 2 Compact system and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS).The serotype and drug resistance of the obtained bacteria were analyzed by the agglutination test and K-B disk diffnsion method,respectively.Results A total of 1 218 strains (10.02％,1 218/12 156) of pathogenic bacteria were isolated from 12 156 feces specimens,including 926 (7.62％,926/12 156) strains of Vibrio,96 (0.79％,96/12 156) strains of Aeromonas,178 (1.46％,178/12 156) strains of Salmonella and 18 (0.15％,18/12 156) strains of Shigella.The detection rates of pathogenic bacteria per year were 9.2％,11.9％,13.4％,7.0％,11.3％ and 7.2％,respectively,from 2012 to 2017.The detection rate of Shigella was low,but it had a high resistance to ampicillin and compound sulfamethoxazole (SMZ-TMP).Other pathogenic bacteria were more sensitive to SMZ-TMP,ceftriaxone,aztreonam,gentamycin and quinolones except ampicillin.Conclusion The main pathogenic bacterium in the patients with infectious diarrhea is Vibrio,and Shigella has the highest resistance to most drugs.The overall infection tendency is sporadic.It is necessary to strengthen the monitoring of pathogenic bacteria and their drug resistance in the patients with infectious diarrhea.

Objective To further intensify the reform of public hospitals,promote talents team building and scientific research management innovation,enhancing the overall capacity of care delivery,as well as the development of science and technology in grass-roots hospitals.Methods A series of measures were adopted to arouse the enthusiasm of personnel to conduct research and finally increase the research outcomes.Concrete measures include talent training program and scientific research man-agement innovation,construction funding assurance,whole-process dynamic management,clarification of the quantitative evaluation index,research rewards,research funding management,as well as performance management.Results After implementation of such measures,the academic atmosphere changed a lot,medical technology improved,the quality of scientific research,project application and research outcomes increased dramatically which has statistical significance compare to previous situations.Conclusions The establishment of the incentive system plays a significant role.It helps in talent agglomeration during a relatively short period of time,exploring the potential capabilities of scientific research,enhancing the core competitiveness of hospital scientific research,which provide strong intellectual support and talent guarantee for hospitals development.