Objective To investigate the geographical distribution and seasonal fluctuations of visceral leishmaniasis vectors sandflies in Henan Province in 2023, so as to provide insights into the prevention and control of visceral leishmaniasis vectors. Methods A total of 23 counties (districts) were sampled from 18 cities of Henan Province from May to September, 2023 as sandfly surveillance sites, and sandflies were captured using human capture and light trapping methods. Following morphological identification, the changes in the sandfly density were calculated at different months and in different breeding habitats. Results A total of 406 light traps were set at sandfly surveillance sites in Henan Province from May to September, 2023, and a total of 3 137 female sandlies were captured, with an average density of 7.73 sandlies/(light·night). A total of 1 494 Phlebotomus chinensis sandflies were captured, including 1 222 female sandflies, with an average density of 3.01 sandflies/(light·night), and the highest density of P. chinensis was found in Gongyi City [17.00 sandflies/(light·night)]. A total of 5 544 sandflies were captured using the human capture method, including 230 P. chinensis, and the density of P. chinensis appeared a unimodal distribution, with a peak in early July [5.81 sandflies/(light·night)]. Among different breeding habitats, the highest P. chinensis density was detected in pigpens [4.50 sandflies/(light·night)]. Conclusions P. chinensis was predominantly distributed in hilly areas of northern and central-western Henan Province in 2023, and the sandfly density appeared a unimodal distribution. Intensified monitoring of visceral leishmaniasis vectors is recommended.

Objective To characterize the species of common sandflies in Henan Province using DNA barcoding with cytochrome c oxidase subunit I (COI) gene as the molecular marker, and to analyze the genetic polymorphisms of sandflies, so as to provide insights into visceral leishmaniasis prevention and control in Henan Province. Methods Sandfly specimens were sampled from 13 sandflies surveillance sites from 2021 to 2023 in Anyang City, Zhengzhou, Luoyang and Xuchang cities (Zhengzhou-Luoyang-Xuchang areas) where visceral leishmaniasis cases were reported and in Jiaozuo and Xinxiang cities (Jiaozuo-Xinxiang areas) without visceral leishmaniasis cases reported. Genomic DNA was extracted from a single sandfly, and COI gene was amplified. The amplification product was subjected to bidirectional sequencing. Following sequence assembly, the species of sandflies was characterized through sequence alignment using the BLAST tool. The intra-specific and inter-specific genetic distances of sandflies were estimated among different areas using the software Mega 11, and phylogenetic trees were created. The polymorphisms of nucleotide sequences in the sandflies COI gene were estimated using the software DnaSP. The fixation index (F_ST) of different geographical isolates of sandflies was calculated using the Arlequin software, and the gene flow value (Nm) was used to measure the gene flow in the sandflies populations. In addition, the population genetic structure of different geographical populations of Phlebotomus chinensis was analyzed using the STRUCTURE software. Results A total of 978 sandflies were collected from 13 sandflies surveillance sites in Zhengzhou-Luoyang-Xuchang areas, Jiaozuo-Xinxiang areas and Anyang City of Henan Province from 2021 to 2023, and 475 sandflies were randomly sampled for subsequent detections. A total of 304 Ph. chinensis, 162 Se. squamirostris and 9 Se. bailyi were identified based on molecular biological detection of the COI gene, and Se. bailyi was reported for the first time in Henan Province. The intraspecific genetic distances of sandflies were 0.000 to 0.040, and the inter-specific genetic distances ranged from 0.133 to 0.161. Phylogenetic analysis revealed that each of the three sandfly species was clustered into a clade. The genetic polymorphisms of Ph. chinensis populations varied among different areas, with the highest haplotype diversity (0.966 ± 0.007) and the greatest nucleotide diversity (0.011) in Zhengzhou-Luoyang-Xuchang areas, and the lowest haplotype diversity (0.720 ± 0.091) and nucleotide diversity (0.004) in Anyang City. The dominant haplotype of Ph. chinensis populations was Pch_Hap_2 in Anyang City and Jiaozuo-Xinxiang areas, with moderate genetic differentiation (0.05 < F_ST < 0.15) and frequent gene exchange (Nm value > 1) between Ph. chinensis populations sampled from Anyang City, and Jiaozuo-Xinxiang areas. Population genetic structure analysis showed that the dominant component of Ph. chinensis populations was K5 in Anyang City and Jiaozuo-Xinxiang areas. No obvious dominant haplotype was observed in Ph. chinensis populations sampled from Zhengzhou-Luoyang-Xuchang areas, which had very high genetic differentiation (F_ST > 0.25) and little gene exchange (Nm value < 1) with Ph. chinensis populations from Anyang City, and Jiaozuo-Xinxiang areas, with K3 as the dominant component. In addition, there was no significant difference in the genetic polymorphism level among Se. squamirostris populations from the three areas. Conclusions There are Ph. chinensis, Se. squamirostris and Se. bailyi in Henan Province, and S. bailyi is recorded for the first time in Henan Province by molecular biological assays. There are different levels of genetic differentiation and gene exchange among P. chinensis populations in different areas of Henan Province.

Objective To analyze the characteristics of visceral leishmaniasis cases in Henan Province, so as to provide insights into formulation of the visceral leishmaniasis control srtrategy. Methods All epidemiological data of reported visceral leishmaniasis cases in Henan Province from 2021 to 2023 were retrieved from the National Notifiable Disease Report Information Management System of Chinese Center for Disease Control and Prevention, and the epidemiological features and diagnosis of visceral leishmaniasis cases were descriptively analyzed. Results A total of 93 visceral leishmaniasis cases were reported in Henan Province from 2021 to 2023, with a male to female ratio of 2.58∶1, and including 2 imported cases from other provinces and 91 local cases. The number of visceral leishmaniasis cases peaked during the period between March and May, and between July and October. The reported visceral leishmaniasis cases had ages of 7 months to 74 years, with the largest number of cases found at ages of 0 to 9 years (26 cases, 27.96%), followed by at ages of 60 to 70 years (24 cases, 25.81%). Farmer (47 cases, 50.54%) and diaspora children (19 cases, 20.43%) were predominant occupations, and 91 local visceral leishmaniasis cases were found in 6 cities of Zhengzhou, Luoyang, Anyang, Hebi, Sanmenxia and Xuchang. The median duration from onset of visceral leishmaniasis to diagnosis was 20 days, and there were 25.81% (24/93) cases with 10 days and less duration from onset to diagnosis, 38.71% (36/93) cases receiving diagnosis at 11 to 30 days following onset, and 35.48% (33/93) cases receiving diagnosis for more than 30 days following onset. All cases were predominantly diagnosed in province- (60.00%) and city-level (28.89%) medical institutions. Conclusions The number of visceral leishmaniasis is on the rise in Henan Province, with a gradually expanding coverage. Intensified monitoring of visceral leishmaniasis cases, dogs, and vectors, dog management, sandflies control and improved individual protection are recommended to prevent the spread of visceral leishmaniasis.

To understand the current status of emergency nurses’ patient safety attitude cognition and its influencing factors, 746 emergency nurses from 34 hospitals were investigated with the revised Chinese version of the safety attitude questionnaire. The results showed that the total mean score of patient safety attitude of emergency nurses was (3.98±0.40) points, which was above the middle level. Among them, the mean scores of team cooperation, safety atmosphere, management perception, work satisfaction, working condition, and stress perception were (4.14±0.85) points, (3.85±0.81) points, (3.90±0.81) points, (3.91±0.85) points, (3.86±1.06) points, and (3.89±0.59) points, respectively. Multiple linear regression analysis showed that length of service and grade of hospital were the influencing factors of emergency nurses’ patient safety attitude (P<0.05). It is suggested that the managers should incorporate patient safety culture into the training and management of emergency nurses, especially strengthen the safety culture education for junior nurses; the secondary hospital should also focus on enhancing team cooperation training for emergency nurses and improving the working environment of them, so as to reduce unsafe behaviors in nursing work and ensure patients’ safety.

Objective:To explore the incidence and epidemiological features of workplace violence among medi-cal staffs in a Third - grade Class - A hospital in Xi'an,and to provide scientific basis for the hospital and relevant health management departments to make workplace violence prevention and control measures. Methods: Using Hospital Workplace Violence Questionnaire, a survey was conducted among medical staffs in a Third - grade Class - A hospital in Xi'an to investigate the occurrence of workplace violence over the past one year. Results:A-mong the 1174 respondents,655 suffered workplace violence in the past one year,with a rate of 55. 79％ ;the vio-lence occurred mainly in day shift and wards;the perpetrators were mainly middle - aged,male and the families of patients;69. 42％ of the respondents thought the workplace violence were unavoidable and 87. 31％ of the respond-ents considered that the top measures that can be taken to prevent the workplace violence was "the correct media o-rientation";the main coping methods of medical staffs were patience explanation and forbearance,and after suffering workplace violence,the medical staffs would feel grievances,anger,declining enthusiasm for work and even didn't want to do medical care. The main measures that the hospital had taken to prevent workplace violence mainly in-cluded the security patrol,installing cameras in wards and keeping light bright at night in working area. Conclu-sions:Workplace violence is common among medical staffs. To prevent and control hospital workplace violence,it is recommended that:① Hospital employ more security personals and should particularly strengthen security work in high - risk period,high - risk departments;②it should strengthen the training of medical staff on the prevention and control of workplace violence and strengthen popularization of the relevant legal knowledge to the client;③it should strengthen the communication and cooperation with media and promote the correct media orientation;④it should smooth the patient feedback channels and timely correct the existing problems.

Objective To investigate the current status of workplace violence among Nursing Staff. Methods The Modified Version of Hospital Workplace Violence Questionnaire was used to investigate 792 nursing staff about their experiences of workplace violence over the past one year in a third-grade Class-A comprehensive hospital in Xi′an city. Results The prevalence of workplace violence among 792 participants was 58.08%(460/792), Outpatient department, Emergency department, Obstetrics and Gynecology department, Pediatrics department were the high-risk areas of workplace violence. Day-shift was the main period of workplace violence occurred. The families of patients, middle-aged, male were the main perpetrators. 72.60%(575/792) of the respondents thought the workplace violence were unavoidable. Correct media orientation (89.33%, 707/792) was considered as the primary measure for preventing workplace violence. Patience explanation (74.13%, 341/460), forbearance (53.04%, 244/460) were the main methods for coping with hospital workplace violence. Grievances (75.38%, 347/460), anger (65.65%, 302/460), part of them even wanted to resign (21.84%, 100/460) after experiencing workplace violence were their feelings. Security patrols (81.63%, 647/792), wards installed cameras (77.43%, 613/792) and bright lights (53.42%, 423/792) in the night work areas were the main measures to prevent workplace violence that the hospital had taken to prevent workplace violence. Conclusions Workplace violence among nursing staff is common. It is suggested that hospitals and the relevant government departments should conduct further intervention research, to formulate feasible administrative riot guiding for reducing the incidence of workplace violence.

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Objective To explore the group-generalization first aid modeling drilling and its effects on training of first aid skills for nurses. Methods Training scheme of group-generalization first aid modeling drilling was designed. A total of 240 nurses with 2 to 5 years of service were selected to be trained in first-aid skills for 8 months. We compared the knowledge of first aid theory, manipulative skill of first-aid, the score of group-generalization first aid modeling drilling before and after training. The score of group-generalization first aid modeling drilling included 65% for personal operation and 35% for comprehensive evaluation through group ( ability to judge the change of the condition, emergency response capability, teamwork ability, communication ability, ability of writing nursing records, accident during rescue process, other abilities including medical waste handling and so on). We also compared the score of group comprehensive evaluation, the time of simulation drilling, the problem frequencies before and after group-generalization first aid modeling drilling. T test and chi square test were used for statistical analysis according to the data type. Results After training, scores of knowledge of first aid theory, manipulative skill of first-aid and personal of group-generalization first aid modeling drilling were (83. 20 ± 4. 80), (81. 96 ± 4. 89) and (86. 95 ± 6. 06) significantly higher than those before training [(78. 10 ± 8. 46), (80. 20 ± 7. 72), (76. 37 ± 10. 79)] with statistically significant differences (t= 8. 84, 2. 59, 9. 61; P < 0. 05). The score of comprehensive evaluation through group of group-generalization first aid modeling drilling was (16. 68 ± 2. 51) before training compared (22. 06 ± 2. 81) after training with a significant difference (t=13. 22, P<0. 01). The time of simulation drilling decreased from 11 minutes to 7 minutes. There was a significant decrease in the incidence of problems with significant differences (P<0. 05). Conclusions The group-generalization first aid modeling drilling effectively improves the knowledge level of first aid theory and manipulative skill of first-aid and is helpful to comprehensively enhance the ability of comprehensive first aid so as to improve the quality of emergency treatment and nursing.

To investigate the diagnosis and surgical treatment of inraspinal tumors.
The clinical data of 246 patients with inraspinal tumors who had undergone operations in the Affiliated Hospital of Qingdao University Medical Col ege between January 2010 and January 2013 were retrospectively analyzed. The treatment and prognosis of inraspinal tumors were reviewed.
262 operations were performed, with posterior bilateral laminectomy approach in 202 cases, semi-laminectomy approach in 28 cases, laminoplasty approach in 10 cases, and lateral resection of extra-vertebral canal dumbbel shaped tumors in 22 cases. The short-term remission rate of the nerve root pain reached 95.0%(133/140), and the improvement rates of the sensory disability, motor disturbance, and sphincter dysfunction were 85.6%(125/146), 86.7%( 136/157), and 84.6(11/13) respectively. The ASIA nervous function scores and grades at the last fol ow-up were significantly superior to those before and 3 months after the operation in 236 patients.
Intraspinal tumors are mostly benign. The clinical appearance of them should be watched closely, and thorough physical check-up should be performed. MRI is the examination of choice at early diagnosis. The key to improve the treatment effects is to perform operations as soon as possible.

BACKGROUND:Embryonic stem cel s have the capacity of multi-differentiation potential, and have been utilized for the therapy of acute liver injury. However, the migration and proliferation of embryonic stem cel s after transplantation remains not wel characterized.
OBJECTIVE:To track the transplanted embryonic stem cel s in repairing acute liver injury by bioluminescence imaging technology.
METHODS:Murine embryonic stem cel s (D3) were transducted with a construct composed of firefly luciferase, monomeric red fluorescence protein and herpes simplex virus truncated thymidine kinase triple fusion reporter genes by lentivirus system. Stable D3 embryonic stem cel s integrating three report genes were screened. The undifferentiated embryonic stem cel s or differentiated embryonic stem cel s from the 6-day-old embryoid body were transplanted into acute liver injury model of SV129 mouse through spleen, and the transplanted cel s were monitored by bioluminescence imaging technology.
RESULTS AND CONCLUSION:Reverse transcription PCR results showed that the expression level of Oct-4 and Nanog was not affected in embryonic stem cel s transducted with triple fusion reporter gene compared with wild-type embryonic stem cel s. The migration process of transplanted cel s was visualized by bioluminescence imaging technology. Teratomas were found in both triple fusion-embryonic stem cel s treatment group and triple fusion-embryoid body cel s treatment group at liver, and the teratoma formation could be suppressed by ganciclovir administration because ganciclovir can react with herpes simplex virus truncated thymidine kinase and trigger cel necrosis process. Histological analysis showed that teratomas comprised tissues from al three germ layers. These results demonstrate that triple gene fusion does not affect differentiation potential of embryonic stem cel s and it is risky to utilize embryonic stem cel s for cel therapy, because it affects repair of liver injury. The therapy strategy requires further improvement and real-time visualizing of embryonic stem cel s in vivo is absolutely necessary.