Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.

Objective:To assess the application effect of "internet + mobile medicine" on the process management of standardized residency training of obstetrics and gynecology.Methods:A total of 43 teachers including 14 administrators and 29 instructors who were not directly responsible for management, and 41 residents who participated in the standardized training in our base were enrolled as research objects. The data of process management were sorted by internet technology, and combined with personal wishes and casting lots, the residents were divided into two groups: the control group ( n=21) adopted traditional way while the observation group ( n=20) used mobile medicine for process management. By conducting multi-dimensional questionnaire and data comparison, we analyzed the evaluation of teachers and residents, the scores of different stage of residents, and the satisfaction of cervical cancer postoperative patients to medical care under different process management mode. SPSS 22.0 software was used for t test and chi-square test. Results:The application of "internet + mobile medicine" in standardized residency training obtained positive evaluation both by teachers and residents, and the ratio of considering "necessary" to reform the traditional residency training management mode in residents [95.1%(39/41)] and administrators [92.9%(13/14)] were both higher than that in instructors [62.1%(18/29)]. And 78.6%(11/14) of the administrators believed that cloud data management took less time. After 6 months of process management by different modes, the clinical diagnosis and treatment ability and skill operation ability scores of observation group were higher than those of control group [(93.6±5.6) vs. (89.4±5.7); (89.6±8.8) vs. (84.0±8.7)]. The "overall medical satisfaction rate" of cervical cancer patients was relatively high in both groups [100%(30/30) vs. 93.3%(28/30)], and the "very satisfied rate" of patients in the mobile medical group was higher than that in the traditional group [86.7%(26/30) vs. 63.3%(19/30)].Conclusion:The application of "internet + mobile medicine" is conducive to strengthening the process management and optimizing the quality of standardized residency training management of obstetrics and gynecology.

【Objective】 To analyze the changes of gut microbes in patients with postpartum depression so as to explore the relationship between postpartum depression and gut microbes. 【Methods】 A total of 60 postpartum subjects were recruited to participate in this study. The depression status of the participants was scored using the Edinburgh Postpartum Depression Scale (EPDS). Those with a score ≥13 were included in the postpartum depression group (PPD group), while those with a score less than 13 were included in the postpartum healthy control group (PPHC group). The feces of these 60 subjects were collected, and the fecal whole genome DNA was extracted for 16S rDNA sequencing. The data of changes in the bacterial diversity between the groups were obtained, and the possible correlation between the changes of intestinal microbes and postpartum depression was analyzed. 【Results】 The number of microorganisms in PPD patients was significantly reduced (P<0.001); the Chao1 index (P<0.001) and ACE index (P<0.001) of α diversity decreased significantly. There were also significant differences in β diversity between the two groups. Analysis of the bacteria in the groups showed that Acetanaerobacterium, Adlercreutzia, Allobaculum, Alloprevotella, Bifidobacterium, Christensenella, Escherichia, Eubacterium, Faecalicatena, Fusobacterium, Haemophilus, Intestinimonas, Lactobacillus, Megamonas, Monoglobumus, Muribaculum, Oscillospira, Paraprevotella, Streptococcus, Raoultibacter, Ruminococcus and Stomatobaculum were significantly enriched in PPHC group. In contrast, Kineothrix, Lachnoclostridium, Acinetobacter, Aquisphaera, Enterococcus, and Mucispirillum were enriched in PPD group. RDA/CCA analysis showed that EPDS was positively correlated with Prevotella, Kineothrix, and Alistipes, but negatively correlated with Lachnospira. 【Conclusion】 This study found that the intestinal flora of patients with postpartum depression was significantly disrupted, and there was a correlation between the intestinal flora and postpartum depression symptom score. Therefore, intestinal microbial markers may contribute to the diagnosis and treatment of patients with postpartum depression.

Objective:To explore the teaching effect of individualized teaching based on problem-based learning (PBL) that applied in gynecology practice teaching under the background of conflicts between postgraduate examination preparation and clinical internship for medical undergraduates.Methods:A total of 157 medical students of the five-year program who started gynecology internship and meanwhile prepared for the postgraduate entrance examination in 2018 were enrolled in the study and divided into two groups randomly. One group received traditional teaching (control group), and the other group received individualized teaching mode based on PBL (observation group). After the internship, the two groups of students were assessed for their theoretical and clinical skills, and the students' evaluation of the teaching effect was acquired through a questionnaire survey. SPSS 22.0 was used to perform chi-square test.Results:The students in observation group had statistically significant higher scores in theory and skill tests than those in the control group ( P<0.001). The evaluation of boosting their enthusiasm for internship, advancing self-learning ability, conducing to improving learning methods in the future, and enhancing clinical skills and thinking ability in the observation group was significantly better than that in the control group ( P<0.05). Conclusion:The individualized teaching model based on PBL could efficiently alleviate the conflicts between internship and postgraduate entrance examination preparation and improve the effect of gynecology practice teaching.

Objective:To understand the present situation, law and characteristics of pesticide poisoning in Tianjin, and provide scientific basis for the formulation of pesticide poisoning control strategy.Methods:In August 2019, the related pesticide poisoning report card was derived from the China Disease Prevention and Control Information System. A total of 864 pesticide poisoning cases from 2009 to 2018 in Tianjin were studied, and the data were processed by SPSS 24.0, statistical analysis was performed by 2-test.Results:from 2009 to 2018, a total of 56 pesticide poisoning deaths were reported in Tianjin, with a case fatality rate of 6.48% (56/864) , including 166 cases of productive pesticide poisoning (19.21%) and 698 cases of non-productive pesticide poisoning (80.79%) , the difference of case fatality rate was statistically significant (χ 2=11.72, P<0.05) . With the most cases of pesticide poisoning (144 cases) in 2012 and the least (48 cases) in 2018. The cases were mainly distributed in Jizhou (312 cases) , Baodi District (247 cases) and Jinnan district (140 cases) , with a total of 699 cases (80.90%) . The time was mainly from May to August, in which non-productive pesticide poisoning occurred in each month, the concentration of productive pesticide poisoning occurred from April to August in spring and summer, and reached its peak in July and August. The age range from 35 to 44 years old was the most (188 cases, 21.76%) , and the age below 15 years old was the least (8 cases, 0.93%) . Pesticide was the most common drug type (551 cases, 63.77%) . Conclusion:The departments concerned should strengthen the education and supervision of pesticide safety, improve the farmers'awareness of harm and self-protection, so as to reduce and prevent the occurrence of pesticide poisoning in this city.

Objective:To explore the main influencing factors of leucopenia in benzene workers.Methods:The data of 514 benzene hazardous enterprises and 97 non benzene hazardous enterprises in 16 municipal districts of Tianjin from January to December 2019 were collected. A total of 16113 benzene exposed workers and 5817 non benzene exposed workers were included in the study. The occupational health examination data of workers during on-the-job were analyzed, and they were divided into white blood cell count reduction group and white blood cell count normal group. Additive interaction was used to evaluate the effects of workers' general situation, occupational history, enterprise information and benzene exposure on leukocyte count reduction.Results:The age and length of service of workers in the white blood cell count reduction group were higher than those in the white blood cell count normal group ( Z=-3.411, -4.539, P<0.01) . The detection rate of white blood cell count reduction in women was higher than that in men (χ 2=211.631, P<0.01) . The detection rate of white blood cell count reduction in workers in enterprises located in urban areas, classified as manufacturing and small and micro enterprises was higher than that in workers in suburbs, non manufacturing and large and medium-sized enterprises (χ 2=8.039, 4.232, 37.478, P<0.05) . The additive interaction analysis of the influencing factors of white blood cell count reduction showed that there was additive interaction between gender and benzene exposure, the relative excess risk ratio ( RERI) , attribution ratio ( AP) and interaction index ( S) were 3.789 (95% CI: 2.280-5.299) , 0.571 (95% CI: 0.414-0.726) and 3.045 (95% CI: 1.699-5.459) , respectively. Conclusion:The management of benzene operation in the production environment of small and micro manufacturing enterprises in Tianjin should be strengthened, as well as the personal protective articles and occupational health protection measures for female operators, so as to protect the health of operators and prevent the occurrence of occupational diseases.

Objective:To understand the present situation, law and characteristics of pesticide poisoning in Tianjin, and provide scientific basis for the formulation of pesticide poisoning control strategy.Methods:In August 2019, the related pesticide poisoning report card was derived from the China Disease Prevention and Control Information System. A total of 864 pesticide poisoning cases from 2009 to 2018 in Tianjin were studied, and the data were processed by SPSS 24.0, statistical analysis was performed by 2-test.Results:from 2009 to 2018, a total of 56 pesticide poisoning deaths were reported in Tianjin, with a case fatality rate of 6.48% (56/864) , including 166 cases of productive pesticide poisoning (19.21%) and 698 cases of non-productive pesticide poisoning (80.79%) , the difference of case fatality rate was statistically significant (χ 2=11.72, P<0.05) . With the most cases of pesticide poisoning (144 cases) in 2012 and the least (48 cases) in 2018. The cases were mainly distributed in Jizhou (312 cases) , Baodi District (247 cases) and Jinnan district (140 cases) , with a total of 699 cases (80.90%) . The time was mainly from May to August, in which non-productive pesticide poisoning occurred in each month, the concentration of productive pesticide poisoning occurred from April to August in spring and summer, and reached its peak in July and August. The age range from 35 to 44 years old was the most (188 cases, 21.76%) , and the age below 15 years old was the least (8 cases, 0.93%) . Pesticide was the most common drug type (551 cases, 63.77%) . Conclusion:The departments concerned should strengthen the education and supervision of pesticide safety, improve the farmers'awareness of harm and self-protection, so as to reduce and prevent the occurrence of pesticide poisoning in this city.

Objective:To explore the main influencing factors of leucopenia in benzene workers.Methods:The data of 514 benzene hazardous enterprises and 97 non benzene hazardous enterprises in 16 municipal districts of Tianjin from January to December 2019 were collected. A total of 16113 benzene exposed workers and 5817 non benzene exposed workers were included in the study. The occupational health examination data of workers during on-the-job were analyzed, and they were divided into white blood cell count reduction group and white blood cell count normal group. Additive interaction was used to evaluate the effects of workers' general situation, occupational history, enterprise information and benzene exposure on leukocyte count reduction.Results:The age and length of service of workers in the white blood cell count reduction group were higher than those in the white blood cell count normal group ( Z=-3.411, -4.539, P<0.01) . The detection rate of white blood cell count reduction in women was higher than that in men (χ 2=211.631, P<0.01) . The detection rate of white blood cell count reduction in workers in enterprises located in urban areas, classified as manufacturing and small and micro enterprises was higher than that in workers in suburbs, non manufacturing and large and medium-sized enterprises (χ 2=8.039, 4.232, 37.478, P<0.05) . The additive interaction analysis of the influencing factors of white blood cell count reduction showed that there was additive interaction between gender and benzene exposure, the relative excess risk ratio ( RERI) , attribution ratio ( AP) and interaction index ( S) were 3.789 (95% CI: 2.280-5.299) , 0.571 (95% CI: 0.414-0.726) and 3.045 (95% CI: 1.699-5.459) , respectively. Conclusion:The management of benzene operation in the production environment of small and micro manufacturing enterprises in Tianjin should be strengthened, as well as the personal protective articles and occupational health protection measures for female operators, so as to protect the health of operators and prevent the occurrence of occupational diseases.

Objective: To analyze the characteristics and influencing factors of new occupational diseases in Tianjin from 2008 to 2017, and to provide scientific basis for the formulation of prevention and control measures for occupational diseases in Tianjin. Methods: In 2018, data on the new occupational disease in Tianjin from 2008 to 2017 were collected from the China Disease Prevention and Control Information System. Statistical analysis was performed on the basic situation, the nature of the company, and the distribution of the industry. Results: A total of 5201 cases of occupational diseases were reported in Tianjin from 2008 to 2017, mainly including pneumoconiosis (92.37%) , followed by occupational poisoning (2.88%) , and the third occupational ENT disease (2.31%) . The male cases were higher than females, with a median age of 56 years and a median of 20 years of service. The most reported area was Hedong District (26.86%) . The economic type and scale of the cases belonged to state-owned large and medium-sized enterprises. The industry is mainly composed of non-metallic mineral products, and there are significant differences in the composition ratios of its economic type (χ²=19240.00, P<0.01) , enterprise size (χ²=3883.00, P<0.01) and industry (χ²=52050.00, P<0.01) . Conclusion Pneumoconiosis, occupational poisoning and occupational ENT diseases are the key prevention and control occupational diseases in Tianjin city. It is necessary to strengthen the prevention and control of occupational diseases in large and medium-sized state-owned enterprises, and to respond to occupational disease hazards in such key industries as the manufacturing industry so as to protect the health of occupational groups.

Objective: To clarify the association between occupational exposure to wood dust and chronic obstructive pulmonary disease risk by a meta-analysis. Methods: A systematic search of the studies was conducted using 3 English databases (Pubmed, Embase, and Cochrane library) and 3 Chinese databases (CNKI, WanFang, and VIP) before March 2019. The following key words was used: 1) wood, 2) hardwood, 3) softwood, 4) saw, 5) dust, 6) chronic obstructive pulmonary disease, 7) chronic obstructive airway disease, 8) lung function. A quality score was evaluated by Newcastle-Ottawa Scale, NOS (Wells, 2012). Pooled effect value with 95% confidence interval (CI) was calculated using fixed-effect model (Heterogeneity test I²<25%) or random-effect model (Heterogeneity test I²≥25%). Meta-regression was used to explore heterogeneous source. Sensitivity analysis was used to verify the stability of the results. Publication bias was assessed by Egger＇s test. Fill and trim method was used to correct the pool effect value with 95%CI for studies which wit publication bias. The TSA threshold was calculated by the O＇Brien-Fleming loss function in the TSA data. The studies were evaluated based on the accrued information size (AIS) . Results: A total of 9 studies were included in the analysis. The occupational exposure to wood dust was not significantly associated with increased chronic obstructive pulmonary disease risk (ES=1.01, 95%CI: 0.856-1.194). TSA showed that the cumulative Z-value curve neither gone beyond the traditional (Z=1.96) threshold line, nor exceed the TSA threshold, but has reached the expected amount of information. This result was consistent with the meta-analysis. Conclusion This study does not yet consider that COPD is associated with occupational wood dust exposure.