Objective To understand the status of quality control in occupational medical examination (OME) institutions in Guizhou Province. Methods A total of 124 registered OME institutions actively conducting OME in Guizhou Province were selected as the study subjects using the judgment sampling method. The evaluation was conducted by on-site document reviews, practical skill assessments, and investigation of OME practices for quality evaluation and analyzing their quality control performance. Results The public institutions accounted for 71.0% with a 41.5% of OME workload, while private institutions accounted for 29.0% with a 58.5% of OME workload among these 124 OME institutions. The overall pass rate for quality evaluation of OME institutions was 16.9% (21/124), with a total of 1 296 items failed to pass the quality evaluation. Among the unqualified items, organizational structure, quality control management systems, OME quality control, and information reporting accounted for 15.2%, 21.7%, 52.8%, and 10.3%, respectively. The unqualified rate of quality assessment items of OME institutions was 24.5% (1 296/5 288), and the unqualified rate was lower in public institutions compared with private institutions (22.4% vs 29.3%, P<0.01). The rates of the three key unqualified items, including chest radiography conclusion evaluation, audiogram calculation and conclusion evaluation, and blood lead comparison were 9.8%, 74.8% and 71.4%, respectively. The rates of unqualified audiometry operation test and chief physician theory test were 74.8% and 9.7%, respectively. Conclusion The quality of OME institutions in Guizhou Province requires continuous improvement, particularly in enhancing the abilities of audiometry operation, calculating audiogram results and conducing right conclusion, and blood lead inter-laboratory comparision.

Objective To analyze the influencing factors of self-management ability of coronary heart disease patients after percutaneous coronary intervention (PCI) and construct a nomogram model. Methods A total of 247 CHD patients who underwent PCI were selected as the research subjects, and all of them were evaluated by Coronary Heart Disease Self-management Scale (CSMS). Multivariate Logistic regression analysis was used to screen out the independent influencing factors of self-management ability of CHD patientsafter PCI, and R software was used to construct a nomogram model. The discrimination, calibration, and goodness-of-fit of the nomogram model were evaluated by receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test. Results The average CSMS score of 247 patients was (86.79±9.22), and these patients were divided into low-score group(89 patients) and high-score group (158 patients)based on the critical value of 86.79 points. There were significant differences in age, education level, monthly per capita family income, and self-efficacy between the low-score group and the high-score group (P < 0.05). Multivariate Logistic regression analysis showed that age, education level, monthly per capita family income, and self-efficacy were independent influencing factors of self-management ability of CHD patients after PCI (P < 0.05). The nomogram model constructed based on the four influencing factors found that age >70 years increased the weight by 86.2 points, education level below high school increased the weight by 87.4 points, monthly per capita family income < 3 500 yuan increased the weight by 82.3 points, and low self-efficacy increased the weight by 99.6 points. The results of ROC curve analysis showed that the area under the curve of the nomogram model for predicting self-management ability ofCHD patients after PCI was 0.842 (95%CI, 0.794 to 0.890). The slope of the calibration curve was close to 1, and the results of goodness-of-fit test was as follows: χ²=10.226, P=0.233. Conclusion Age, education level, monthly per capita family income, and self-efficacy are influencing factors of self-management ability of CHD patients after PCI, and the nomogram model constructed based on these factors has high predictive value for self-management ability.

Objective To analyze the epidemiological characteristics of nosocomial Escherichia coli infection and risk factors of ESBLs-producing Escherichia coli infection in children, and to provide scientific basis for better prevention of nosocomial Escherichia coli infection in children. Methods A total of 169 children with nosocomial infection hospitalized in Handan Regional Children's Hospital from January 2020 to December 2020 were selected by random sampling method. After specimen collection, bacteria were identified by VitEK-32 identification system , and drug sensitivity of isolated pure Escherichia coli colony was identified by automatic drug sensitivity analyzer Phoenix 100. Statistical analysis of drug resistance of Escherichia coli. The clinical data of the children were retrieved from the case system by uniformly trained professionals, and the department distribution, underlying diseases, clinical characteristics, antibiotic resistance, length of hospital stay, surgery, invasive exercises and other clinical data of all the children were counted. Factor logistic regression analysis of the risk factors of nosocomial infection of ESBLs Escherichia coli in children in the hospital. Results A among of 39 strains of Escherichia coli were detected in children with nosocomial infection in children's hospital. The main specimens were 22 strains (56.41%) in sputum, 11 strains (28.21%) in urine and 6 strains (15.38%) in blood.Twenty-one strains of ESBLs Escherichia coli were detected, with a positive rate of 53.85%. Fever was the most common first symptom in 37 cases (94.87%). Children with ESBLs (+) Escherichia coli infection were significantly higher than those with ESBLs (-) Escherichia coli in age, length of hospitalization, neonates/recent use of broad-spectrum antibiotics, complicated underlying diseases, and invasive operation (P<0.05). Multivariate logistic regression analysis showed that recent use of antibiotics, combined with underlying diseases, and invasive operation were independent risk factors for ESBLs infection in children in hospital (P<0.05). Conclusion The incidence of nosocomial Escherichia coli infection in children is high, and active intervention should be carried out for children who have recently used antibiotics, complicated with underlying diseases, and invasive operations to reduce the risk of ESBLs Escherichia coli infection.

Objective:To summarize the application rules of acupuncture and moxibustion in the clinical trials for dysmenorrhea and endometriosis.Methods:The relevant articles of clinical research on acupuncture and moxibustion for the treatment of dysmenorrhea in endometriosis were retrieved electronically from CNKI, Wanfang, VIP, PubMed and Cochrane Library (Retrieved from database establishment until 31 October 2021). The clinical literatures that met the inclusion criteria were included into the database (Microsoft Office Excel 2019), and the main table and sub-table were established through Microsoft Office Excel 2019. Descriptive statistic analysis was performed by using SPSS 26.0 software. StataSE15 (64-bit) software was used to analyze the correlation between the combinations of acupoints with single acupoint frequency>5.Results:A total of 40 clinical studies were included. Of them, the top 3 acupuncture methods according to the frequency were acupuncture (11 times), moxibustion (11 times), and electro-acupuncture (8 times), the top 3 acupuncture points used according to the frequency were Guan Yuan (34 times), San Yin Jiao (26 times), and Zhong Ji (25 times), the top 3 meridians of the body acupuncture points according to the frequency were Ren Meridian (36 times), Spleen Meridian (32 times), and Stomach Meridian (22 times). According to the correlation analysis, body points of Guan Yuan, San Yin Jiao, Uterus, Qi Hai and Zhong Ji were stronge related.Conclusion:Acupuncture can effectively treat EMT dysmenorrhea with less adverse reactions. The methods are mainly acupuncture, moxibustion and electroacupuncture, mostly local acupoints, intersection acupoints and empirical acupoints.

Objective:To evaluate the guidelines on discharged health education for solid organ transplant recipients at home and abroad, analyze the characteristics of each guideline, so as to provide reference for the development of health education for organ transplantation in China.Methods:This was a guideline quality evaluation study. The guidelines on health education for discharged recipients with solid organ transplantation were searched on the websites of clinical practice guidelines, the websites of transplantation professional associations, and Chinese and English databases at home and abroad through computers. The search time limit was from January 1, 2011 to January 1, 2022. The quality of guidelines that met the inclusion and exclusion criteria was evaluated using the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) .Results:A total of 8 guidelines were included. The overall quality evaluation of the guideline was Grade A ( n=2) and Grade B ( n=6) . In terms of standardized scores in six areas of quality evaluation, the average values of scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability as well as editorial independence were 87.62% (70.37%-100.00%) , 75.46% (44.44%-97.22%) , 66.54% (43.75%-93.06%) , 90.16% (77.78%-96.30%) , 48.18% (20.83%-68.75%) and 74.13% (8.30%-97.22%) , respectively. The recommendations of the guidelines covered 9 aspects: team composition and support services, drug management, infection prevention, complication management, diet and nutrition, daily life and social reintegration, contraception and reproduction, psychological guidance and follow-up review. Conclusions:The development of guidelines for different types of solid organ transplantation varies. The overall quality of the guidelines needs to be improved and the content needs to be refined. In the future, we can learn from foreign high-quality guidelines to carry out localization practice, so as to build a health education related guideline for discharge of solid organ transplantation that is suitable for China's national conditions as soon as possible.

Objective:To explore whether microRNA (miRNA) -181b-5p inhibits the proliferation and invasion of cutaneous melanoma cells by targeting pleckstrin (PLEK) .Methods:Bioinformatics methods were used to analyze cutaneous melanoma-associated core genes; dual-luciferase reporter assay was performed to verify the targeted interaction between miRNA-181b-5p and PLEK. Oligo RNA and small interfering RNA (siRNA) were used to regulate the expression of miRNA-181b-5p and PLEK in A375 cells respectively in this experiment, and A375 cells were divided into the following groups in detail: mimic negative control group, miRNA-181b-5p mimic group, inhibitor negative control group, miRNA-181b-5p inhibitor group, PLEK siRNA group, siRNA negative control group, miRNA-181b-5p inhibitor + control siRNA co-transfection group and miRNA-181b-5p inhibitor + PLEK siRNA3 co-transfection group. After 48-hour treatment, qPCR was performed to determine the mRNA expression of miRNA-181b-5p and PLEK in A375 cells, Western blot analysis to determine the PLEK protein expression, and Transwell assay to assess the invasive ability of A375 cells; after additional 24-96 hours of culture, cell counting kit-8 (CCK8) assay was conducted to assess the proliferative ability of A375 cells.Results:PLEK was the core gene for cutaneous melanoma. PLEK expression in the cutaneous melanoma in situ tissues was significantly higher than that in the paracancerous tissues ( P = 0.031) , but lower than that in the metastatic tissues ( P = 0.001) . Compared with human epidermal melanocytes HEMa-LP, the mRNA and protein expression of PLEK significantly increased in A375 cells (mRNA: 3.884 ± 0.156 vs. 0.997 ± 0.010, t = 18.48, P < 0.001; protein: 2.840 ± 0.301 vs. 1.029 ± 0.094, t = 5.47, P = 0.005) , but the miRNA-181b-5p expression significantly decreased in A375 cells (0.333 ± 0.042 vs. 0.967 ± 0.069, t = 7.83, P = 0.001) . Dual-luciferase reporter assay showed targeted binding of miRNA-181b-5p to PLEK. Compared with the mimic negative control group, the miRNA-181b-5p mimic group showed significantly decreased survival rate of A375 cells (48 hours: t = 7.96, P = 0.015; 72 hours: t = 7.50, P = 0.002; 96 hours: t = 7.96, P = 0.001) , and significantly decreased invasive ability of A375 cells ( t = 5.07, P = 0.007) ; on the contrary, the survival rate and invasive ability of A375 cells were significantly higher in the miRNA-181b-5p inhibitor group than in the inhibitor negative control group (survival rate: 24 hours, t =5.38, P = 0.013; 48 hours, t = 5.36, P = 0.013; 72 hours, t =7.63, P = 0.005; 96 hours, t = 5.99, P = 0.004; invasive ability: t = 7.24, P = 0.002) ; compared with the siRNA negative control group, the proliferative and invasive ability of A375 cells significantly decreased in the PLEK siRNA group (proliferative ability: 48, 72, 96 hours, P = 0.015, 0.011, 0.001, respectively; invasive ability: t = 4.93, P = 0.008) ; compared with the miRNA-181b-5p inhibitor + control siRNA co-transfection group, the miRNA-181b-5p inhibitor + PLEK siRNA co-transfection group showed significantly decreased proliferation rate and invasive ability of A375 cells (proliferation rate: 24, 48, 72, 96 hours, P = 0.042, 0.042, 0.037, 0.017, respectively; invasive ability: t = 8.52, P = 0.001) . Conclusion:miRNA-181b-5p can inhibit the proliferation and invasion of cutaneous melanoma A375 cells, likely by down-regulating the PLEK expression.

Objective:To study the therapeutic effect of liraglutide on rat models with non-alcoholic fatty liver disease (NAFLD) and its influence on the expression of fibroblast growth factor 21 (FGF21).Methods:Thirty five Sprague Dawley (SD) rats were randomly divided into normal control group (15 rats) and control group (20 rats). They were fed with normal diet and high fat diet respectively. The NAFLD rat model was established by feeding the model group for 12 weeks. After successful modeling, the model group was randomly divided into liraglutide group and model group. 600 μg/(kg·d) liraglutide and equal volume normal saline were injected intraperitoneally respectively. All rats were killed at the 16th week. Serum FGF21, alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting blood glucose (FBG), triglyceride (TG) and total cholesterol (TC) were measured; Hematoxylin-eosin (HE) staining was used to observe the pathological changes of rat liver tissue, and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of FGF21 mRNA in rat liver tissue.Results:The liver index and serum ALT, AST, TC and TG contents in model group were significantly higher than those in normal control group (all P<0.05). The above indexes in liraglutide group were significantly lower than those in model group (all P<0.05). There was no significant difference in serum FBG level among the three groups ( P>0.05). HE staining showed that there were no abnormal pathological changes in liver of normal control group. Steatosis and inflammatory cell infiltration occurred in liver cells of model group. Compared with model group, liver steatosis and inflammatory cell infiltration in liraglutide group were significantly reduced. The level of FGF21 in serum and mRNA expression of FGF21 in liver tissue in model group were significantly higher than those in normal control group ( P<0.05). The levels of FGF21 in serum and FGF21 mRNA in liver tissue in liraglutide group were lower than those in model group ( P<0.05). Conclusions:Liraglutide can effectively delay the development of NAFLD in rats, and its mechanism may be related to the regulation of the expression of FGF21.

Objective:To investigate the species and concentrations of airborne pollens in Wuhan urban area and their correlation with the number of visits of allergic rhinitis patients.Methods:Retrospective analysis of pollen dispersal characteristics and the number of patients with allergic rhinitis presenting to Tongji Hospital of Huazhong University of Science and Technology in Wuhan city from October 2017 to September 2018, as well as pollen allergen testing results of patients with allergic rhinitis presenting to the Department of Allergy during the same period. Pollen data was collected by a 1-year air sampling conducted in Wuhan City during the same period using the volumetric method. The samples were examined microscopically to identify airborne pollen species and counted, and the concentrations of various pollens were calculated. Information on patients with allergic rhinitis who came to the hospital during the same period was collected, and the correlation between pollen concentration and the number of patient visits was statistically analyzed using Pearson correlation analysis.Results:A total of 35 types of airborne pollen were collected from October 2017 to September 2018. The dominant pollens in spring were Moraceae (68.46%, 1 042/1 522), Pendula (12.22%, 186/1 522) and Cupressaceae (2.30%, 35/1 522); in summer and autumn, the dominant pollens were Artemisia (3.81%, 58/1 522), Humulus (4.01%, 61/1 522) and Ambrosia (0.59%, 9/1 522). The peak number of visits for allergic rhinitis patients occurred in March-April and July-September, both exceeding 2 200 visits and reaching a maximum of 2 545 visits. There was a very weak correlation between the number of visits and the total pollen concentration ( r=0.17, P=0.001). The average monthly pollen skin prick test positive rate of patients with allergic rhinitis was highest in March-May, exceeding 40% with a maximum of 45.73%, and there was a significant correlation between the positive pollen skin prick test positive rate and the average monthly pollen concentration ( r=0.62, P=0.031). Conclusions:Pollen species and concentrations fluctuated continuously with time in Wuhan urban area, with peak pollen dispersal in spring from March to April and in autumn from August to September. The number of visits to patients with allergic rhinitis and the positive pollen skin prick test positive rate increased accordingly during the peak pollen concentration periods.

Objective:To investigate the species and concentrations of airborne pollens in Wuhan urban area and their correlation with the number of visits of allergic rhinitis patients.Methods:Retrospective analysis of pollen dispersal characteristics and the number of patients with allergic rhinitis presenting to Tongji Hospital of Huazhong University of Science and Technology in Wuhan city from October 2017 to September 2018, as well as pollen allergen testing results of patients with allergic rhinitis presenting to the Department of Allergy during the same period. Pollen data was collected by a 1-year air sampling conducted in Wuhan City during the same period using the volumetric method. The samples were examined microscopically to identify airborne pollen species and counted, and the concentrations of various pollens were calculated. Information on patients with allergic rhinitis who came to the hospital during the same period was collected, and the correlation between pollen concentration and the number of patient visits was statistically analyzed using Pearson correlation analysis.Results:A total of 35 types of airborne pollen were collected from October 2017 to September 2018. The dominant pollens in spring were Moraceae (68.46%, 1 042/1 522), Pendula (12.22%, 186/1 522) and Cupressaceae (2.30%, 35/1 522); in summer and autumn, the dominant pollens were Artemisia (3.81%, 58/1 522), Humulus (4.01%, 61/1 522) and Ambrosia (0.59%, 9/1 522). The peak number of visits for allergic rhinitis patients occurred in March-April and July-September, both exceeding 2 200 visits and reaching a maximum of 2 545 visits. There was a very weak correlation between the number of visits and the total pollen concentration ( r=0.17, P=0.001). The average monthly pollen skin prick test positive rate of patients with allergic rhinitis was highest in March-May, exceeding 40% with a maximum of 45.73%, and there was a significant correlation between the positive pollen skin prick test positive rate and the average monthly pollen concentration ( r=0.62, P=0.031). Conclusions:Pollen species and concentrations fluctuated continuously with time in Wuhan urban area, with peak pollen dispersal in spring from March to April and in autumn from August to September. The number of visits to patients with allergic rhinitis and the positive pollen skin prick test positive rate increased accordingly during the peak pollen concentration periods.

Objective:To develop scientific and practical sensitive indicators with its own characteristics for nursing quality of breast specialty.Methods:A research team was established in August 2018, which searched the databases both at home and abroad, screened and identified relevant literatures according to John Hopkins' evidence level and quality evaluation standards. A sensitive indicator framework for nursing quality of breast specialty was preliminarily formed based on the indicators involved in the literatures. In January 2019, the expert correspondence questionnaire was prepared. Twenty experts were randomly selected from the Qingdao Medical Doctors Association and the Nursing Experts Committee and received two rounds of correspondence consultations using the Delphi method in order to build, modify and confirm the sensitive indicator system for nursing quality of breast specialty.Results:The authority coefficients of the experts in the two rounds of consultation were 0.815 and 0.858; the expert authority coefficient was> 0.80; and the coefficient of variation of each indicator was< 0.30. Eleven sensitive indicators for nursing quality of breast specialty including the awareness rate of functional exercise of the affected limb and lymphedema prevention measures were developed.Conclusions:The sensitive indicators of nursing quality of breast specialty based on the Delphi method is highly practical and credible, which have distinctive specialty characteristics, may be used for the overall care quality assessment and management of breast disease patients, and provide accurate and scientific evaluation for clinical nursing work.