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 explore the diagnostic value of a wearable flexible patch ECG instrument in arrhythmia,the alarm situation during clinical application,patient satisfaction and safety.Methods A total of 1 443 subjects wore flexible patch ECG and conventional dynamic ECG(control)for 24 h to test the validity and consistency of arrhythmia diagnosis,and counted the alarm of remote ECG and the occurrence of related adverse events during the wearing of the instrument.Results There were 987 cases of arrhythmia detected by flexible patch ECG and 992 cases by conventional dynamic ECG.The total coincidence rate of arrhythmia diagnosis was 98.7%.The mean heart rate was measured by flexible patch ECG(75.4±11.4)times/min,conventional dynamic heart rate(71.5±12.1)times/min,the intra-group correlation coefficient(ICC)of 2 instruments was 0.892(95%CI:0.537-0.956),with good repeatability.The correct alarm rate of flexible patch ECG was 100%.The incidences of skin pruritus(0.28%vs.1.32%),skin allergy,redness and swelling(0.14%vs.0.69%)and electrode strip shedding(0 vs.0.28%)during wearing the flexible patch electrocardiogram were lower than those of the conventional holter electrocardiogram(P＜0.05).Conclusion The flexible patch ECG has few adverse reactions,high comfort,good safety and clinical applicability.

This paper aims to push health scientific popular knowledge and carry out targeted patient health education for certain patients, based on the demand of health education for specific diseases and population. Taking the female climacteric health scientific popularization as an example, the authors summarized the practice of popularizing scientific education in a tertiary specialized hospital based on the cognitive level and health education needs of outpatients and the general public. A multidisciplinary health scientific popularization team was set up to communicate popular science knowledge to patients and other menopausal women in need through multi-channel and multi-platform forms. Such means include online ones, offline ones, and cooperation with various social organizations. The implementation of health scientific popularization mode meets the needs of patients and the general public. The implementation of this mode of health popularization could improve their self-health management ability and health accomplishment. It provides a good reference for public hospitals to carry out health science popularization.

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 explore the relationship between bullying among middle school students and family factors in a city of central China, so as to provide support for the prevention and reduction of school bullying among middle school students. Methods: The stratified cluster random sampling method was used to investigate the bullying involvement and family factors of 2 996 middle school students from first grade in junior high school to third grade in high school in a city in central China. Chi-square test and Logistic-regression analysis were used to analyze the relationship between family factors and bullying participation of middle school students. Results: Among 2 996 students, 390 students(13.0%) were found of having bullying behavior, and 1 127 students(37.6%) were found of being bullied. Univariate analysis showed that there were statistically significant differences in family factors such as whether she or he is the only child, father-child relationship, mother-child relationship, marital status of parents, whether the mother work away from hometown, education level of father and mother(χ2=8.88, 56.49, 30.85, 30.91, 3.89, 10.36, 11.72；25.00, 69.33, 46.76, 57.09, 3.93, 23.19, 45.49, P<0.05). Logistic regression analysis showed that the only child and mother’s education degree was junior college and below were the risk factors for middle school students’ bullying involvement (OR=1.37，1.39). Parents’ harmonious marital status and father’s not working outside are the protective factors of middle school students’ bullying(OR=0.53, 0.83).The only child is the risk factor of bullying in middle school students (OR=1.42), and good father relationship is the protective factor of bullying in middle school students (OR=0.38). Conclusion Family factors have a certain impact on the involvement of middle school students in bullying in a city of central China, and corresponding preventive measures should be formulated from the perspective of family to focus on the intervention of high-risk groups.

Objective: To study the causes and influencing factors of no seeking medical treatment among pneumoconiosis patients. Methods: Using stratified sampling method and typical survey method, we carried out the questionnaire survey in nine provinces in China including the east, the medium and the western region using a questionnaire on the seeking medical behavior pf pneumoconiosis patients and the influencing factors. The subjects include occupational pneumoconiosis cases and clinically diagnosed cases and the response rate is 94.3 percent. The data was entered twice with epidate3.1 and error detection and statistical analysis was completed with SPSS 20.0. Chi-square test was used for univariate analysis, and multivariate logistic regression was used for multivariate analysis. Results: One thousand and thirty-seven subjects were investigated with average age 55.9±11.2 years. Seventy percent of them were silicosis and 21.9 percent were coal worker’s pneumoconiosis with 67.5 percent of them residing permanently in the countryside, and 37.9 percent of their education background were primary school culture and 33.1 percent of them had junior high school culture. Thirty two point six percent of respondents had no personal income with a median monthly income of 1 200 yuan. Four hundred and thirty four of subjects hadn't seek medical treatment since they got the pneumoconiosis accounting for 41.9 percent with three hundred and thirty seven of them hospitalized directly. The reasons of no seeking medical treatment for the respondents mainly include the self-induction symptoms lighter, the high cost of treatment and cannot claiming the payment of the medical expenses, buying drugs in drugstore, thinking that no medicine can cure pneumoconiosis or no effect, complex procedures, too far away from medical institutions, no unaccompanied, needing a long time or no time, communication disorders, etc. accounting for 44.4 percent, 24.6 percent, 10.9 percent, 9.1 percent, 6.9 percent, 4.4percent, 3.2 percent, 2.9 percent, 1.9 percent, 1.5 percent, respectively. The results of multivariate analysis showed the main characteristics of subjects with restrictions to the outpatient health service utilization are as follows: demographic sociological indicators such as registered permanent residence area is western (OR_western=2.18, 95%CI:1.38-3.43) , more than seventy five years old (OR_{over 75}=6.82, 95%CI:2.04-22.9) , unemployment, temporary or permanent employment (OR _unemployment=1.90, 95%CI:1.17-3.08; OR_{temporary employment}=3.11, 95%CI:1.57-6.14; OR_{permanent employment}=2.10, 95%CI:1.18-3.74) , self-rated health score of 50 or above (OR_{self-rated-70}=2.04, 95%CI:1.18-3.51; OR_{self-rated-90}=3.00, 95%CI:1.97-5.37; OR_{self-rated 90}=2.95, 95%CI:1.74-8.07) ; with increase to the outpatient health service utilization are breath with difficulty (OR=0.57, 95%CI:0.41-0.78) , emphysema (OR=0.48, 95%CI:0.26-0.90) , hospitalized with pneumo-coniosis (OR=0.12, 95%CI:0.07-0.20) . Conclusion Pneumoconiosis patients no covered by injury insurance should be orderly included in the basic medical security system, and be given the medical treatment actively; It should be strengthened the health management for the pneumoconiosis patients and correctly guided the utilization of medical services.

Objective To study the impact of integrated nursing process in intravenous thrombolysis in patients with cerebral infarction in superacute period.Methods A total of 31 intravenous thrombolysis patients from January to December 2015 were as experimental group given integrated nursing process and 31 cases from May to December 2014 were as control group given conventional nursing,thrombolysis patients' behavioral life quality by NIHSS,dementia by MMSE and depression by CES-D before and after thrombolysis were compared.Results There was no significant different in experimental group and control group in NIHSS score,MMSE score and CES-D scores before thrombolysis;while there was statistically significance between the two groups in NIHSS scores after thrombolysis in 24 hours,in 15 days or in one month(P ＜0.05).There was no statistically significance between the two groups in MMSE scores after thrombolysis in 24 hours (P ＞ 0.05),but was statistically significant in 15 days after thrombolysis and one month (P ＜ 0.01).There was statistically significant difference between the two groups in CES-D scores in 24 hours,15 days and 1 month after thrombolysis (P ＜ 0.05).Conclusion Quality of care for the patients with acute cerebral infarction thrombolysis associates with their behavioral life quality,dementia and depression.Integrated nursing process improves their behavioral life quality,and relieves dementia and depression of patients with acute cerebral infarction thrombolysis.

Objective To study the impact of integrated nursing process in intravenous thrombolysis in patients with cerebral infarction in superacute period.Methods A total of 31 intravenous thrombolysis patients from January to December 2015 were as experimental group given integrated nursing process and 31 cases from May to December 2014 were as control group given conventional nursing,thrombolysis patients' behavioral life quality by NIHSS,dementia by MMSE and depression by CES-D before and after thrombolysis were compared.Results There was no significant different in experimental group and control group in NIHSS score,MMSE score and CES-D scores before thrombolysis;while there was statistically significance between the two groups in NIHSS scores after thrombolysis in 24 hours,in 15 days or in one month(P ＜0.05).There was no statistically significance between the two groups in MMSE scores after thrombolysis in 24 hours (P ＞ 0.05),but was statistically significant in 15 days after thrombolysis and one month (P ＜ 0.01).There was statistically significant difference between the two groups in CES-D scores in 24 hours,15 days and 1 month after thrombolysis (P ＜ 0.05).Conclusion Quality of care for the patients with acute cerebral infarction thrombolysis associates with their behavioral life quality,dementia and depression.Integrated nursing process improves their behavioral life quality,and relieves dementia and depression of patients with acute cerebral infarction thrombolysis.

Objective To investigate the mechanism of protective effects of tumor necrosis factor receptor associated protein 1 (TRAP1) on hypoxic cardiomyocytes of rats.Methods Primary cultured cardiomyocytes were obtained from neonatal Sprague-Dawley rats (aged 1 to 3 days) and then used in the following experiments.(1) Cells were divided into group TRAP1 and control group according to the random number table (the same grouping method below),and then the total protein of cells was extracted.Total protein of cells in group TRAP1 was added with mouse anti-rat TRAP1 monoclonal antibody,while that in control group was added with the same type of IgG from mouse.Co-immunoprecipitation and protein mass spectrography analysis were used to determine the possible proteins interacted with TRAP1.(2) Cells were divided into normoxia blank control group (NBC),normoxia + TRAP1 interference control group (NTIC),normoxia + TRAP1 interference group (NTI),normoxia + TRAP1 over-expression control group (NTOC),and normoxia + TRAP1 over-expression group (NTO),with 1 well in each group.Cells in group NBC were routinely cultured,while cells in the latter four groups were respectively added with TRAP1 RNA interference empty virus vector,TRAP1 RNA interference adenovirus vector,TRAP1 over-expression empty virus vector,and TRAP1 over-expression adenovirus vector.Another batch of cells were divided into group NBC,hypoxic blank control group (HBC),hypoxic + TRAP1 interference control group (HTIC),hypoxic + TRAP1 interference group (HTI),hypoxic + TRAP1 over-expression control group (HTOC),and hypoxic + TRAP1 over-expression group (HTO),with 1 well in each group.Cells in hypoxic groups were under hypoxic condition for 6 hours after being treated as those in the corresponding normoxia groups,respectively.The mRNA expression of cytochrome c oxidase subunit Ⅱ (COX Ⅱ) of cells in each group was detected by real time fluorescent quantitive reverse transcription polymerase chain reaction.Experiments were repeated for three times.(3) Cells were divided into group NBC,group HBC,group HTOC,group HTO,hypoxic + TRAP1 over-expression + COX Ⅱ interference control group (HTOCIC),and hypoxic + TRAP1 over-expression + COX Ⅱ interference group (HTOCI),with 3 wells in each group.Cells in the previous 4 groups were treated as those in experiment (2).Cells in group HTOCIC and HTOCI were respectively transfected with COX Ⅱ RNA interference empty virus vector and COX Ⅱ RNA interference adenovirus vector,and then both added with TRAP1 over-expression adenovirus vector.The proliferation activity of cells was determined by cell counting kit 8 and microplate reader,and the ratio of death cells was measured by propidium lodide and Hoechst 33342 staining.Another batch of cells were divided into group NBC,group HBC,group HTIC,group HTI,hypoxic + TRAP1 interference + COX Ⅱ over-expression control group (HTICOC),and hypoxic + TRAP1 interference + COX Ⅱ over-expression group (HTICO),with 3 wells in each group.Cells in the previous 4 groups were treated as those in experiment (2).Cells in group HTICOC and HTICO were both transfected with TRAP1 RNA interference adenovirus vector,and then respectively added with COX Ⅱ over-expression empty virus vector and COX Ⅱ over-expression adenovirus vector.The proliferation activity of cells and the ratio of death cells were detected as before.Experiments were repeated for three times.Data were processed with one-way analysis of variance and LSD test.Results (1) The expression of TRAP1 was found in cells of group TRAP1,while that was not found in cells of control group.The possible proteins interacted with TRAP1 were keratin,COX Ⅱ,and an unknown protein with predicted molecular weight 13 × 103.(2) Compared with that in group NBC,the mRNA expression of COX Ⅱ of cells had no significant change in group NTIC and group NTOC (with P values above 0.05),but significantly decreased in group NTI (P ＜0.01),and significantly increased in group NTO (P ＜0.01).Compared with that in group NBC,the mRNA expression of COX Ⅱ of cells in group HBC was significantly decreased (P ＜ 0.01).Compared with that in group HBC,the mRNA expression of COX Ⅱ of cells had no significant change in group HTIC and group HTOC (with P values above 0.05),but significantly decreased in group HTI (P ＜ 0.01),and significantly increased in group HTO (P ＜ 0.01).(3) The proliferation activity of cells in group NBC,group HBC,group HTOC,group HTO,group HTOCIC,and group HTOCI was respectively 0.498 ± 0.022,0.303 ± 0.018,0.313 ± 0.032,0.456 ± 0.031,0.448 ± 0.034,and 0.335 ± 0.026,and the ratios of death cells in above groups were respectively (4.7 ±1.5)％,(24.7 ±3.1)％,(26.0±2.7)％,(13.3 ± 2.5) ％,(12.7 ± 2.1) ％,and (21.0 ± 1.7) ％.Compared with those in group NBC,the proliferation activity of cells in HBC was decreased,while the ratio of death cells was increased (with P values below 0.01).Compared with those in group HBC,the proliferation activity of cells and the ratio of death cells in group HTOC had no significant change (with P values above 0.05),while the proliferation activity of cells was increased and the ratio of death cells was decreased in group HTO (with P values below 0.01).Compared with those in group HTO,the proliferation activity of cells and the ratio of death cells in group HTOCIC had no significant change (with P values above 0.05),while the proliferation activity of cells was decreased and the ratio of death cells was increased in group HTOCI (with P values below 0.01).(4) The proliferation activity of cells in group NBC,group HBC,group HTIC,group HTI,group HTICOC,and group HTICO was respectively 0.444 ± 0.025,0.275 ± 0.016,0.283 ± 0.021,0.150 ± 0.009,0.135 ± 0.011,and 0.237 ±0.017,and the ratios of death cells in above groups were respectively (3.7 ± 0.6)％,(21.0 ±2.7)％,(20.3 ±3.1)％,(31.7 ±2.5)％,(33.3 ±3.2)％,and (19.3 ±1.5)％.Compared with those in group HBC,the proliferation activity of cells and the ratio of death cells in group HTIC had no significant change (with P values above 0.05).Compared with those in group HBC and group HTIC,the proliferation activity of cells was decreased and the ratio of death cells was significantly increased in group HTI (with P values below 0.01).Compared with those in group HTI,the proliferation activity of cells and the ratio of death cells in group HTICOC had no significant change (with P values above 0.05),while the proliferation activity of cells was increased and the ratio of death cells was significantly decreased in group HTICO (with P values below 0.01).Conclusions TRAP1 can up-regulate the expression of COX Ⅱ mRNA,and COX Ⅱ is one of the downstream effector molecules that TRAP1 mediates its protective effects on hypoxic cardiomyocytes.