Objective:To give some suggestions on the policy optimization of the establishment of National Hygienic City from the perspective of policy system.Methods:Policy documents were searched in WanFang Database and websites of ministries and commissions directly affiliated to the State Council with the key words of hygienic city, and analyzed by using the content analysis and quantitative analysis, based on the theory and perspective of policy tools and the two-dimensional analysis framework.Results:Among the 161 policy documents, supply-based, environment-based, and demand-based policy tools accounted for 6.83% (11/161), 83.85% (135/161), and 9.32% (15/161) respectively. Policy planning, policy implementation, policy supervision, and policy evaluation tools accounted for 10.56% (17/161), 63.35% (102/161), 21.74% (35/161), and 4.35% (7/161) respectively.Conclusion:The government should reduce its dependence on environmental policy tools, especially strategic measures, and attach importance to the use of supply-based policy tools and demand-based policy tools. At the same time, it should pay attention to the formulation of more practical policy tools in the process of policy evaluation.

Objective:To give some suggestions on the policy optimization of the establishment of National Hygienic City from the perspective of policy system.Methods:Policy documents were searched in WanFang Database and websites of ministries and commissions directly affiliated to the State Council with the key words of hygienic city, and analyzed by using the content analysis and quantitative analysis, based on the theory and perspective of policy tools and the two-dimensional analysis framework.Results:Among the 161 policy documents, supply-based, environment-based, and demand-based policy tools accounted for 6.83% (11/161), 83.85% (135/161), and 9.32% (15/161) respectively. Policy planning, policy implementation, policy supervision, and policy evaluation tools accounted for 10.56% (17/161), 63.35% (102/161), 21.74% (35/161), and 4.35% (7/161) respectively.Conclusion:The government should reduce its dependence on environmental policy tools, especially strategic measures, and attach importance to the use of supply-based policy tools and demand-based policy tools. At the same time, it should pay attention to the formulation of more practical policy tools in the process of policy evaluation.

AIMS: This study focused on the newest evidence of the relationship between forest environmental exposure and human health and assessed the health efficacy of forest bathing on the human body as well as the methodological quality of a single study, aiming to provide scientific guidance for interdisciplinary integration of forestry and medicine. METHOD: Through PubMed, Embase, and Cochrane Library, 210 papers from January 1, 2015, to April 1, 2019, were retrieved, and the final 28 papers meeting the inclusion criteria were included in the study. RESULT: The methodological quality of papers included in the study was assessed quantitatively with the Downs and Black checklist. The methodological quality of papers using randomized controlled trials is significantly higher than that of papers using non-randomized controlled trials (p < 0.05). Papers included in the study were analyzed qualitatively. The results demonstrated that forest bathing activities might have the following merits: remarkably improving cardiovascular function, hemodynamic indexes, neuroendocrine indexes, metabolic indexes, immunity and inflammatory indexes, antioxidant indexes, and electrophysiological indexes; significantly enhancing people's emotional state, attitude, and feelings towards things, physical and psychological recovery, and adaptive behaviors; and obvious alleviation of anxiety and depression. CONCLUSION Forest bathing activities may significantly improve people's physical and psychological health. In the future, medical empirical studies of forest bathing should reinforce basic studies and interdisciplinary exchange to enhance the methodological quality of papers while decreasing the risk of bias, thereby raising the grade of paper evidence.

Objective: To explore the influence of caregiver burden on quality of life among caregivers for patients with lung cancer in Beijing. Methods: From August to October in 2017, 336 caregivers for patients with primary lung cancer from a large tertiary hospital were recruited to this survey by convenient sampling method. The Caregiver Reaction Assessment (CRA) and the WHO Quality of Life-BREF (WHOQOL-BREF) Instruments were used to evaluate the caregiver burden and quality of life. The demographic characteristics were evaluated using Pearson chi-square or Fisher′s exact tests. In addition, using the 4 dimensions of quality of life scale as the dependent variables while the 5 dimensions of caregiver burden and demographic variables as the explanatory variables, we conducted the multiple linear stepwise regression analysis (the defaults were 0.15 for FORWARD and BACKWARD). Results: The scores of family caregivers′ esteem, impact on schedule, impact on finances, impact on health and lack of family support were 4.30±0.47、3.55±0.74、3.10±0.91、2.60±0.78、2.32±0.73, respectively. Regression results showed that demographic factors, including marriage, occupation and relationship with patients and impact on health, caregivers′ esteem and impact on finances dimensions of caregiver burden were the factors which influenced the quality of life of caregivers. Conclusions The caregiver burden in patients with lung cancer is mainly focused on impact on schedule and finances. Impact on health, finances and caregivers′ esteem (seven items were reverse-scored) are significantly negatively correlated with quality of life of caregivers.

Objective To detect the expression of gonadotropin-releasing hormone (GnRH) in cervical cancer and to explore the correlation.Methods A total of 68 patients with cervical squamous cell carcinoma and 45 patients with chronic cervicitis were selected.Immunohistochemistry and hybridization in situ were used to detect the expression of GnRH in cancer tissue and cervicitis.Protein and nucleic acid level were observed in patients with GnRH.Results In 45 patients with cervicitis, both GnRH and GnRH mRNA expressions were negative in cervical epithelial tissue, while in 68 cases of cervical squamous cell cancer, the positive expression of GnRH in cancer tissues was 82.36%, and positive expression rate of GnRH mRNA was 64.71%.There were significant differences in levels of GnRH and GnRH mRNA between patients with cervicitis and cervical squamous cell carcinoma (P<0.05).The qualitative expression rates of GnRH in different clinical stages of cervical cancer were 55.56% of Ib, 87.10% of IIa and 100% of IIb, and qualitative expression rates of GnRH mRNA in different clinical stages of cervical cancer were 38.89% of Ib, 70.97% of IIa and 84.21% of IIb.There were significant differences in GnRH and GnRH mRNA levels between patients with different clinical stages of cervical cancer (P<0.05).Conclusion There is a high level of gonadotropin-releasing hormone in cervical cancer, which may be involved in the development of cancer cells.

Objective To detect the expression of gonadotropin-releasing hormone (GnRH) in cervical cancer and to explore the correlation.Methods A total of 68 patients with cervical squamous cell carcinoma and 45 patients with chronic cervicitis were selected.Immunohistochemistry and hybridization in situ were used to detect the expression of GnRH in cancer tissue and cervicitis.Protein and nucleic acid level were observed in patients with GnRH.Results In 45 patients with cervicitis, both GnRH and GnRH mRNA expressions were negative in cervical epithelial tissue, while in 68 cases of cervical squamous cell cancer, the positive expression of GnRH in cancer tissues was 82.36%, and positive expression rate of GnRH mRNA was 64.71%.There were significant differences in levels of GnRH and GnRH mRNA between patients with cervicitis and cervical squamous cell carcinoma (P<0.05).The qualitative expression rates of GnRH in different clinical stages of cervical cancer were 55.56% of Ib, 87.10% of IIa and 100% of IIb, and qualitative expression rates of GnRH mRNA in different clinical stages of cervical cancer were 38.89% of Ib, 70.97% of IIa and 84.21% of IIb.There were significant differences in GnRH and GnRH mRNA levels between patients with different clinical stages of cervical cancer (P<0.05).Conclusion There is a high level of gonadotropin-releasing hormone in cervical cancer, which may be involved in the development of cancer cells.

Objective To explore the effect of different nasal feedings in enteral nutrition for elderly patients with severe brain hemorrhage. Methods Eighty elderly patients with severe brain hemorrhage were assigned into the observation group and control group according to the odd and even numbers at admission with 40 in each group. The control group was treated with graded injection nasal feeding, and the observation group was treated with continuous infusion nasal feeding. The nutrition indicators and enteral nutrition complications were compared between the two groups. Result The nutrition indicators in the observation group were better than those in the control group and the rate of enteral nutrition complications in the observation group was lower than that in the control group (P<0.05). Conclusion Continuous infusion nasal feeding can improve the nutritional status of elderly patients with severe cerebral hemorrhage and effectively reduce the incidence of complications of enteral nutrition. So it is worthy of clinical application.

Objective To evaluate the expression of peroxisome proliferator-activated receptor γ(PPARγ)and retinoid x receptorα(RXRα)in cholangiocarcinoma to explore its relation to clinicopathological factors and investigate its impact on prognosis.Methods Expression of PPARγ and RXRα was detected by immunohistochemistry in 69 cases of cholangiocarcinoma and 12 non-tumor cases.The relation of PPARγ and RXRα expression to clinicopathological parameters and prognosis was determined.Results The expression rates of PPARγ in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 59.4% and 0, respectively(P＜0.05).The expression rates of RXRα in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 78.3% and 20%, respectively.There were significant differences between the 2 groups in PPARγ and RXRα expression.PPARγ expression was associated with TNM clinical stages and lymph node metastasis.According to univariate survival analysis,PPARγ expression was correlated with poor prognosis(P＜0.05).There was positive correlation between PPARγ and RXRα.Conclusion The expression of PPARγis significantly correlated with the clinicopathological characteristics and biological behaviors of cholangiocarcinoma.PPARγ and RXRα expression may play an important role during tumorigenesis.

Objective To assess the reliability of auto-shimming line width (LW) and water suppression rate (WS), and the correlation between them. Methods GE Signa Excite HD 3.0T system and eight-channel torso phased-array coils with PRESS sequence were performed in 38 volunteers. Liver spectra were collected with TR of 1500 ms, TE of 30 ms, VOI of 2 cm×2 cm×2 cm, NSA of 64 times. Spectroscopy routine auto-shimming pre-scanning program was executed and the values of LW and WS were recorded. Then another spectroscopy routine auto-shimming pre-scanning program was performed repeatedly and 38 groups of data were obtained totally. Intra-class correlation coefficients (ICC), coefficient of variation (CV) and significance test were conduced on 38 groups of LW and WS data. Spearman rank correlation analysis was used to assess the correlation of LW and WS. Results ①The ICC of LW and WS was 0.862 and 0.961 (both P＜0.0001), respectively, while the value of CV was 0.20, 0.18, 0.09 and 0.08, respectively. Significant difference was not observed; ②The value of correlation coefficient was -0.659, -0.485 (both P＜0.0001), respectively. Conclusion ①The reliability is excellent for in vivo liver 3.0T 1H-MRS and WS appears relatively stable; ②Indexes of LW correlate with WS moderately, and it seems the smaller the value of LW is, the easier to achieve higher WS.

Objective To characterize the effect of the ~1H-MRS scan parametem, including the type of coil, TE,NSA and VOI, on shimming, water suppression, spectral signal to noise ratio(SNR)and the stability of the baseline of liver in vivo. Methods ~1H-MRS of liver in vivo was performed prospectively on GE Signa Excite HD 3.0 T system in 46 volunteers. Point-resolred spectroscopy(PRESS)sequence with built-in body coil and eight-channel torso phased-array coils was applied. After the localized scan,the first PRESS sequence with a TR of 1500 ms,TE of 30 ms. VOI of 2 cm×2 cm×2 cm and NSA of 64 times was acquired using eight-channel torso phased-array coils.(The first PRESS sequence parametem was deemed as A).Then,the sequence was repeated with alteration of the three parameters including the type of coil,TE and size of VOI.(Changed parameters deem as B).The data were analyzed with the Wilcoxon matched pairs signed test.0 mark:A is similar to B,1 mark:A better than B,-1 mark:A worse than B.Results SNR(-1 mark 0 pair,0 mark 1 pair,1 mark 10 pair,Z=-3.162,P=0.002)was better in data(n=11)with eight-channel torso phased-array coils(A)than that with the built-in body coil(B),but the autoshimming line width with eight-channel torso phased-array coils were inferior to those with built-in body coil (-1 mark 8 pair,0 mark 2 pair,1 mark 1 pair,Z=-2.511,P=0.012).SNR was better in data(n=13)with TE of 30 ms(A)than that at the sequence with TE of 90 ms(B)(-1 mark 2 pair,0 mark 0 pair,1 mark 11 pair,Z=-2.496,P=0.013).whereas baseline stability was,poorer in the former(-1 mark 10 pair,0 mark 2 pair,1 mark 1 pair,Z=-2.333,P=0.020).SNR at the sequence(n=10)with VOI of 2 cm×2 cm×3 cm(B)was better(-1 mark 6 pair,0 mark 4 pair,1 mark 0 pair,Z=-2.449,P=0.014)than that at the sequence(n=29)with VOI of 2 cm ×2 cm × 2 cm(A),but poorer(-1 mark 0 pair,0 mark 5 pair,1 mark 5 pair,Z=-2.041,P=0.041)auto-shimming line width was shown. By comparison the sequences with NSA of 128 times(B)and NSA of 64 times(A),the former could provide better spectrum SNR(-1 mark 21 pair,0 mark 7 pair,1 mark 1 pair,Z=-4.264,P=0.000).Conclusion It is more easy to achieve a homogeneous bo magnetic field using a small size of VOI and builtin body coli.The sequence with VOI of 2 cm ×2 cm ×3 cm.NSA of 128 times is recommended for clinical use. Increase VOI and NSA are helpful to improve SNR. Longer TE is helpful to improve baseline stability.