Objective To compare the external morphological characteristics and movement patterns between Schistosoma japonicum and S. sinensis cercariae. Methods S. japonicum and S. sinensis cercariae were heat-fixed, and well-extended cercariae, of 50 each species, were randomly selected for measurement of body length, body width, tail stem length, and tail fork length. The external morphological characteristics of S. japonicum and S. sinensis cercariae were compared. In addition, S. japonicum-infected Oncomelania snails and S. sinensis-infected Tricula snails were observed under a microscope and the movement patterns of S. japonicum and S. sinensis cercariae were compared. Results The mean body length, body width, tail stem length, and tail fork length were (0.16 ± 0.01), (0.05 ± 0.01), (0.14 ± 0.01) mm and (0.06 ± 0.01) mm for S. japonicum cercariae, and (0.13 ± 0.01), (0.05 ± 0.01), (0.13 ± 0.01) mm and (0.06 ± 0.01) mm for S. sinensis cercariae, respectively, and there were significant differences in terms of cercaria body length (t = 14.583, P < 0.05) and tail stem length (t = 3.861, P < 0.05), while no significant differences were seen in terms of body width (t = 0.896, P > 0.05) or tail fork length (t = −0.454, P > 0.05). Microscopy revealed that the tails of both S. japonicum and S. sinensis cercariae swung from side to side and there was no significant difference in their movement pattern. Conclusion S. sinensis and S. japonicum cercariae share highly similar external external morphological characteristics and movement patterns.

Objective To investigate the capability for distinguishing between the morphology of Oncomelania hupensis and Tricula snails and its influencing factors among schistosomiasis control professionals in Yunnan Province, so as to evaluate the interference of Tricula snails with O. hupensis surveys. Methods O. hupensis and Tricula snails were sampled from 9 schistosomiasis-endemic counties (districts) in Yunnan Province. The capability for distinguishing between O. hupensis and Tricula snails was evaluated using online questionnaire surveys and field blind tests among schistosomiasis control professionals, and the proportions of correct judgment, misjudgment and missed judgment were calculated. Univariate and multivariate logistic regression models were created using the software SPSS 25.0, and factors affecting the proportion of correct judgments of O. hupensis snails were identified among schistosomiasis control professionals. Results Questionnaire surveys and field blind tests showed that the overall proportions of correct judgments of O. hupensis snails were 56.77% (2 305/4 060) and 68.28% (1 556/2 279) among schistosomiasis control professionals in Yunnan Province, respectively. Univariate logistic regression analysis of online questionnaire surveys identified gender [odds ratio (OR) = 1.244, 95% confidential interval (CI): (1.073, 1.441), P < 0.05], professional title [OR = 0.628, 1.741, 95% CI: (0.453, 0.871), (1.109, 2.734), both P < 0.05], working duration [OR = 0.979, 95% CI: (0.971, 0.987), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 1.410, 0.293, 0.523, 95% CI: (1.103, 1.804), (0.237, 0.361), (0.416, 0.657), all P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed that the proportion of O. hupensis snail misjudgments was 1.179 times higher among male schistosomiasis control professionals than among females [OR = 1.179, 95% CI: (1.006, 1.382), P < 0.05], and 1.474 times higher among schistosomiasis control professionals in schistosomiasis-elimination areas with snails than in areas without snails [OR = 1.474, 95% CI: (1.145, 1.898), P < 0.05], and the proportions of missed judgments of O. hupensis snails were 0.284 [OR = 0.284, 95% CI: (0.225, 0.359), P < 0.05] and 0.523 times [OR = 0.523, 95% CI: (0.412, 0.664), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Univariate logistic regression analysis of field blind tests showed age [OR = 2.381, 95% CI: (1.677, 3.381), P < 0.05], professional title [OR = 1.688, 95% CI: (1.103, 2.582), P < 0.05］, working duration [OR = 0.970, 95% CI: (0.956, 0.984), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 0.262, 0.593, 95% CI: (0.188, 0.364), (0.420, 0.837), both P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed the proportions of missed judgments of O. hupensis snails were 0.263 [OR = 0.263, 95% CI: (0.176, 0.394), P < 0.05] and 0.604 times [OR = 0.604, 95% CI: (0.416, 0.875), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Conclusions Schistosomiasis control professionals in Yunnan Province have a low accuracy rate for distinguishing between the morphology of O. hupensis and Tricula snails, and gender and classification of schistosomiasis epidemics in endemic foci are factors that affect their ability to distinguish. The presence of Tricula snails causes a high degree of interference with O. hupensis surveys in O. hupensis snail-infested areas of Yunnan Province. Reinforced training for distinguishing between O. hupensis and Tricula snails is required among schistosomiasis control professionals in Yunnan Province.

Objective To predict the potential geographic distribution of Oncomelania hupensis in Yunnan Province using random forest (RF) and maximum entropy (MaxEnt) models, so as to provide insights into O. hupensis surveillance and control in Yunnan Province. Methods The O. hupensis snail survey data in Yunnan Province from 2015 to 2016 were collected and converted into O. hupensis snail distribution site data. Data of 22 environmental variables in Yunnan Province were collected, including twelve climate variables (annual potential evapotranspiration, annual mean ground surface temperature, annual precipitation, annual mean air pressure, annual mean relative humidity, annual sunshine duration, annual mean air temperature, annual mean wind speed, ≥ 0 ℃ annual accumulated temperature, ≥ 10 ℃ annual accumulated temperature, aridity and index of moisture), eight geographical variables (normalized difference vegetation index, landform type, land use type, altitude, soil type, soil textureclay content, soil texture-sand content and soil texture-silt content) and two population and economic variables (gross domestic product and population). Variables were screened with Pearson correlation test and variance inflation factor (VIF) test. The RF and MaxEnt models and the ensemble model were created using the biomod2 package of the software R 4.2.1, and the potential distribution of O. hupensis snails after 2016 was predicted in Yunnan Province. The predictive effects of models were evaluated through cross-validation and independent tests, and the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS) and Kappa statistics were used for model evaluation. In addition, the importance of environmental variables was analyzed, the contribution of environmental variables output by the models with AUC values of > 0.950 and TSS values of > 0.850 were selected for normalization processing, and the importance percentage of environmental variables was obtained to analyze the importance of environmental variables. Results Data of 148 O. hupensis snail distribution sites and 15 environmental variables were included in training sets of RF and MaxEnt models, and both RF and MaxEnt models had high predictive performance, with both mean AUC values of > 0.900 and all mean TSS values and Kappa values of > 0.800, and significant differences in the AUC (t = 19.862, P < 0.05), TSS (t = 10.140, P < 0.05) and Kappa values (t = 10.237, P < 0.05) between two models. The AUC, TSS and Kappa values of the ensemble model were 0.996, 0.954 and 0.920, respectively. Independent data verification showed that the AUC, TSS and Kappa values of the RF model and the ensemble model were all 1, which still showed high performance in unknown data modeling, and the MaxEnt model showed poor performance, with TSS and Kappa values of 0 for 24%(24/100) of the modeling results. The modeling results of 79 RF models, 38 MaxEnt models and their ensemble models with AUC values of > 0.950 and TSS values of > 0.850 were included in the evaluation of importance of environmental variables. The importance of annual sunshine duration (SSD) was 32.989%, 37.847% and 46.315% in the RF model, the MaxEnt model and their ensemble model, while the importance of annual mean relative humidity (RHU) was 30.947%, 15.921% and 28.121%, respectively. Important environment variables were concentrated in modeling results of the RF model, dispersed in modeling results of the MaxEnt model, and most concentrated in modeling results of the ensemble model. The potential distribution of O. hupensis snails after 2016 was predicted to be relatively concentrated in Yunnan Province by the RF model and relatively large by the MaxEnt model, and the distribution of O. hupensis snails predicted by the ensemble model was mostly the joint distribution of O. hupensis snails predicted by RF and MaxEnt models. Conclusions Both RF and MaxEnt models are effective to predict the potential distribution of O. hupensis snails in Yunnan Province, which facilitates targeted O. hupensis snail control.

Objective:To explore the clinical characteristics and etiology of children with alimentary tract hemorrhage so as to optimize the diagnosis and treatment.Methods:The clinical data of 2 054 children with alimentary tract hemorrhage in Kunming Children′s Hospital from January 2014 to December 2018 were retrospectively analyzed.Results:Among 2 054 children with alimentary tract hemorrhage, males was in 1 274 cases, females was in 780 cases, and the ratio of males to females was 1.6∶1; <3.0 years old was in 647 cases (31.5%), 3.0 to 5.9 years old was in 488 cases (23.8%), 6.0 to 8.9 years old was in 413 cases (20.1%), 9.0 to 11.9 years old was in 281 cases (13.7%), and ≥12 years old was in 225 cases (11.0%); upper alimentary tract hemorrhage was in 991 cases, lower alimentary tract hemorrhage was in 1063 cases. The top three causes of children with upper alimentary tract hemorrhage were acute or chronic gastritis/ gastric ulcer, anaphylactoid purpura and systemic serious infection; the top three causes of children with lower alimentary tract hemorrhage were intestinal polyps, anaphylactoid purpura and food protein allergic colitis. A rare causes of alimentary tract hemorrhage had Peutz-Jeghers syndrome, cavernous transformation of portal vein, Bartter syndrome, systemic lupus erythematosus, Budd-Chiari syndrome, annular pancreas, Reye syndrome, Klippel-Trenaunay syndrome, Evans syndrome and perianal angiectasia and so on.Conclusions:Alimentary tract hemorrhage is a common disease in pediatrics. With the increase of age, the proportion of children with alimentary tract hemorrhage decreased. The main causes of upper and lower alimentary tract hemorrhage are different in different age stages. In addition to paying attention to common causes, the rare causes of alimentary tract hemorrhage should be vigilant and recognized.

Objective:To translate the Anterior Skull Base Nasal Inventory-12 (ASK-12) into Chinese, and test its reliability and validity.Methods:Following the classic Brislin back translation model, the original scale was translated and back translated. A nursing expert, a doctor of Nursing, and a bilingual translator of doctoral degree adjusted and revised the scale to form the first draft of the Chinese version of ASK-12, and form the final scale through pre-survey. From July 2018 to July 2020, convenience sampling was used to select 220 patients with pituitary tumor resection via nasal sphenoid approach in a ClassⅢ Grade A hospital in Suzhou City for investigation. SPSS 22.0 was used to test the reliability and validity.Results:The internal consistency Cronbach's α coefficient of the Chinese version of the ASK-12 was 0.819, the equal-length Spearman-Brown half coefficient was 0.794, and the test-retest reliability correlation coefficient was 0.915. The content validity index was 0.9, and the cumulative variance contribution rate of the two common factors extracted by exploratory factor analysis was 54.45%, and the structure validity was good.Conclusions:The Chinese version of the ASK-12 has good reliability and validity, and can be used to evaluate the severity of postoperative nasal symptoms in patients undergoing anterior skull base surgery via the nose, which provides a scientific clinical evaluation tool.

Objective:To explore the experience and feelings of hip and knee replacement patients participating in the enhanced recovery after surgery (ERAS) model during hospitalization, so as to provide a reference for the improvement of ERAS perioperative and continuous nursing plans.Methods:From August to November 2019, purpose sampling was used to select 15 patients undergoing hip and knee replacement who were admitted to the Department of Joint Surgery of a ClassⅢ Grade A hospital in Guangdong Province for the semi-structured interview. Colaizzi's 7-step analysis method on phenomenology was used to analyze, summarize and refine the themes of the collected interview data.Results:The experience and feelings of joint replacement patients participating in the ERAS model during hospitalization can be summarized into 4 themes, namely uncertainty of information, being worried about the treatment effect, insecurity of early discharge, the contradiction between the desire to return and lack of confidence.Conclusions:Patients participating in ERAS had a short hospital stay after hip and knee replacement, and could not fully digest the information provided by the medical and nursing staff. Patients were also worried that they would not be able to cope after being discharged from the hospital. Clinical medical and nursing staff should fully evaluate the patient's readiness for discharge, provide personalized guidance, perfect out-of-hospital continuous nursing services and improve the patient's experience of early discharge.

Objective:To investigate the effects of exercise prescription on quality of life in patients with pituitary adenomas after surgery.Methods:A total of 82 patients with pituitary adenomas who met the inclusion criteria from December 2017 to September 2018 were enrolled. The control group received routine nursing care. The intervention group was given exercise prescription on the first day after surgery and 3 months after discharge from hospital. Both groups of patients completed the Health Status Survey(SF-36) before and after the intervention.Results:Before the intervention, there was no significant difference in baseline date of patients between two groups( P>0.05). After intervention, the general health dimension score (53.03±11.30) of the control group was significantly higher than the score within the group before treatment ( Z value was -4.398, P<0.05). The physiological function (86.67±7.46), physical function (66.67±29.28), role-emotional (71.30±22.75), vitality (68.33±8.78), general health dimension (61.39±10.66) of the intervention group were significant higher than the score within the group before treatment ( Z values were -4.809--2.041, P<0.05) . After the intervention, the significant difference were found in role-physical, general health, vitality, social function(77.18±15.71) and physiological health dimensions (73.75±10.00) between the intervention and control group ( Z values were -3.122- -2.467, t value was 3.044, P<0.05). After the intervention, non-function patients′ physiological function (72.06±23.19), general health (60.59±10.75), vitality (69.71±10.23) and social function (81.04±10.22) were significantly higher than the control group ( Z values were -2.832- -2.059, P<0.05). Conclusion:Exercise prescription can improve the quality of life in patients with pituitary adenomas after surgery.

Objective: To evaluate the reliability and validity of a questionnaire for job satisfaction with influenza vaccine recommendation of community diabetes management doctors. Methods: Through the literature review,expert interviews and pilot survey,a questionnaire for job satisfaction with influenza vaccine recommendation of community diabetes management doctors was initially formed. Cronbach's α coefficient was used to evaluate the reliability of the questionnaire; correlation analysis,exploratory factor analysis（EFA）and confirmatory factor analysis（CFA）were used to evaluate the validity of the questionnaire. Results : The questionnaire had 23 items, which were categorized into four dimensions: working environment,job itself,general satisfaction and occupational load. The Cronbach's α coefficient of working environment,job itself,general satisfaction, occupational load and the total questionnaire was 0.924,0.884,0.937,0.891 and 0.936,respectively. EFA showed that the characteristic roots of four dimensions were all more than one,and the cumulative variance proportion was 73.82%. The Pearson correlation coefficient between each item and the total questionnaire ranged from 0.339 to 0.818, and the correlation coefficient between each dimension and the total questionnaire ranged from 0.429 to 0.872（all P<0.05）. CFA showed that the variances of parameter estimation errors were all positive,and the standard errors ranged from 0.035 to 0.099,which were statistically significant（P<0.05）;the standardized parameters between each item and dimension ranged from 0.596 to 0.939; χ2/df was 4.627（P<0.05）, the comparative fit index was 0.827,the root mean square error of approximation was 0.076,which indicated the model fit. Conclusion The questionnaire has good reliability and validity,so it can be used to evaluate the satisfaction with influenza vaccine recommendation of community diabetes management doctors.

Objective To explore the effect of application of task-based learning with experiential teaching on nursing clinical decision making ability. Methods A total of 96 nursing students were divided into experimental group and observation group with each of 48 nursing students. The experimental group used the application of task-based learning with experimental teaching, the control group used the traditional scenario simulation. At the end of the course, the final scores, skill operation scores and nursing students'evaluation of the course and clinical decision-making ability of nursing were observed in the two groups. Results The final scores, chapters related to task-based learning with experiential teaching, skill operation scores was (82.06±0.98), (12.01±0.88), (94.99±0.34) points in the experimental group, and (78.34±0.98), (9.32±0.76), (91.87±0.98) points in the control group, and the difference was significant(t=12.958, 9.872, 10.834, all P<0.01). The evaluation of teaching methods, teaching process and teaching effect was (20.06±0.98), (23.01±0.88), (35.99±0.34) points in the experimental group, and (17.34±0.98), (20.32±0.76), (30.87±0.98) points in the control group, and the difference was significant (t=5.96, 6.87, 6.99, all P<0.01).The score of clinical decision-making ability of nursing was (137.50 ± 12.61) points in the experimental group, and (123.88±9.89) points in the control group,and the difference was significant (t=5.891, P<0.01). Conclusions The effect of task-based learning with experiential teaching in teaching of nursing in vocational nursing students, enable students to transfer knowledge and experience in experience, it can improve the students' clinical decision making ability.

Objective: To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages. Methods: Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent. Results: The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (F=42.324, 10.220, 8.660, 11.254, 29.795, 31.305, 23.742, 27.738 and 34.638, all at P<0.001). The percentage of mature neutrophils in active stage BU group and quiet stage BU group were (73.10±10.21)% and (62.40±12.09)%, which were significantly higher than (54.95±6.07)% in healthy control group.The percentage of mature neutrophils in active stage BU group was significantly higher than that in quiet stage BU group (P<0.05). The percentages of non-cytotoxic T, NK lymphocytes, granular T and NK lymphocytes in active stage BU group and quiet stage BU group were significantly lower than that in healthy control group, the percentage of non-cytotoxic T, NK lymphocytes and granular T, NK lymphocytes in active stage BU group were significantly lower than those in quiet stage BU group (all at P<0.05). The percentage of immature granulocytes after treatment was significantly higher than that before treatment in improvement stage BU group (t=-2.469, P=0.036). Conclusions Increase of peripheral blood mature neutrophil was observed in BU patients, which may help to monitor the inflammatory activity of BU.