Background The mental health problems of employees in administrative organs and public institutions are highly valued.However,there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.Objective To analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region,so as to provide references for promoting their mental health and intervening in psychological problems.Methods From October 23 to 28,2022,a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique,and were assessed using Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).Results A total of 1797(58.04％)employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey.Depressive symptoms were noted in 579(32.22％).SDS scores yielded statistical difference among the selected employees of different ethnicities,types of job positions and educational levels(F=9.074,101.488,4.477,P<0.01),and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities,educational levels and types of job positions(H=49.196,17.028,160.848,P<0.01).Anxiety symptoms were detected in 711(39.57％)employees.SAS scores exhibited statistical difference among the employees with different genders,ages,ethnicities,educational levels,marital status and types of job positions(t=-4.571,F=6.648,3.950,5.243,12.008,22.253,P<0.01).Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages,genders,ethnicities,educational levels,marital status and types of job positions(H=24.361,-3.788,28.365,24.268,25.976,56.204,P<0.01).Conclusion About one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety.The depression symptoms are more severe among Tibetan people,those with low education levels and ordinary civil servants.The anxiety symptoms are more severe among employees aged 30 and below,those with low education levels,unmarried and those in technical positions.

Objective:To analyze the correlation between drug-induced sleep endoscopy (DISE), results, polysomnography (PSG) indicators, and clinical parameters in patients with obstructive sleep apnea (OSA), and to establish and validate a predictive model for tongue base plane obstruction.Methods:This retrospective study analyzed 117 OSA patients diagnosed via PSG and treated at the Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, between October 2014 and March 2022. The cohort comprised of 114 males and 3 females, with an age range of 20 to 54 years (mean age 38.1±8.4 years). Data on DISE results, PSG results, and clinical indicators were collected for all 117 patients. Logistic regression analysis was performed to identify relevant indicators, and a predictive model for tongue base plane obstruction was constructed and internally validated using the R programming language.Results:Univariate logistic regression analysis identified four independent risk factors for predicting tongue root plane obstruction: tonsil grading, N2, N3, and rapid eye movement sleep(REM) stage [ OR:0.412(0.260~0.652),1.045(1.012~1.079),0.943(0.903~0.984),0.961(0.925~0.998), P <0.05]. Multivariate logistic regression analysis confirmed tonsil grading and N3 sleep stage (12.48±12.22%) as significant predictors. A nomogram model incorporating these factors demonstrated good predictive performance, with an area under curve(AUC) of 0.82 (95% CI: 0.548-1.000), an optimal cutoff of 0.519, a specificity of 80.0%, and a sensitivity of 86.7%. Internal validation of the model in the validation cohort yielded an AUC of 0.751 (95% CI: 0.625-0.876). Conclusions:Tongue base plane obstruction observed during DISE in OSA patients is associated with tonsil grading and N3 sleep stage duration. The predictive model developed for tongue base plane obstruction based on DISE demonstrates good efficacy, as evidenced by its internal validation.

In situ and real-time monitoring of responsive drug release is critical for the assessment of pharmacodynamics in chemotherapy. In this study, a novel pH-responsive nanosystem is proposed for real-time monitoring of drug release and chemo-phototherapy by surface-enhanced Raman spectroscopy (SERS). The Fe₃O₄@Au@Ag nanoparticles (NPs) deposited graphene oxide (GO) nanocomposites with a high SERS activity and stability are synthesized and labeled with a Raman reporter 4-mercaptophenylboronic acid (4-MPBA) to form SERS probes (GO-Fe₃O₄@Au@Ag-MPBA). Furthermore, doxorubicin (DOX) is attached to SERS probes through a pH-responsive linker boronic ester (GO-Fe₃O₄@Au@Ag-MPBA-DOX), accompanying the 4-MPBA signal change in SERS. After the entry into tumor, the breakage of boronic ester in the acidic environment gives rise to the release of DOX and the recovery of 4-MPBA SERS signal. Thus, the DOX dynamic release can be monitored by the real-time changes of 4-MPBA SERS spectra. Additionally, the strong T₂ magnetic resonance (MR) signal and NIR photothermal transduction efficiency of the nanocomposites make it available for MR imaging and photothermal therapy (PTT). Altogether, this GO-Fe₃O₄@Au@Ag-MPBA-DOX can simultaneously fulfill the synergistic combination of cancer cell targeting, pH-sensitive drug release, SERS-traceable detection and MR imaging, endowing it great potential for SERS/MR imaging-guided efficient chemo-phototherapy on cancer treatment.

[This corrects the article DOI: 10.1016/j.apsb.2022.08.024.].

Objective:To explore the role of post competency oriented interactive teaching in clinical teaching of blood purification.Methods:A total of 80 interns from the blood purification center of our hospital were selected from May 2019 to August 2020, and they were randomly divided into two groups. The control group ( n=40) were taught by routine clinical teaching, and the observation group ( n=40) was taught by interactive teaching based on the post competency. They were both taught for 3 months. The theoretical and practical assessment results of the two groups after teaching, the post competency before and after the teaching, and the satisfaction with the teaching were compared. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical and practical assessment scores of the observation group after teaching were higher than those of the control group, and the difference was statistically significant (theoretical assessment: t=4.01, P<0.05; practical assessment: t=3.94, P<0.05). There was no statistically significant difference in effective communication ability score ( t=1.31, P=0.193), adaptability and coping ability ( t=1.25, P=0.216), autonomous learning and self-improvement ability ( t=0.93, P=0.356), and management ability score ( t=0.76, P=0.451). After teaching, the competency scores of the above-mentioned positions in the two groups were improved compared with those before teaching, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant (effective communication ability: t=12.60, 6.63, P<0.05; adaptability and coping ability: t=11.21, 6.44, P<0.05; autonomous learning and self-improvement ability: t=10.80, 5.78, P<0.05; management ability score: t= 12.42, 6.79, P<0.05). There were significant differences in the distribution of satisfaction with teaching ( t=6.90, P=0.007) of the two groups of interns, and the total satisfaction rate of the observation group was higher than that of the control group ( t=6.49, P=0.011). Conclusion:The application of post competency oriented interactive teaching in clinical teaching of blood purification internship can not only improve the appraisal results of interns, enhance their post competency, but also improve the teaching satisfaction.

Objective:To explore the effect of health education based on behavior change wheel (BCW) in patients with bronchial asthma.Methods:Using the convenient sampling method, a total of 100 patients with bronchial asthma who were admitted to Taizhou People's Hospital from March 2019 to July 2020 were selected as the research objects. The patients were divided into the experimental group and the control group by random number table method, with 50 cases in each group. The control group was given routine health education, and the experimental group was given health education based on BCW guidance on the basis of the control group. After 6 months of intervention, the cognitive level of asthma, inhalation therapy compliance behavior, quality of life and other indicators were compared between the two groups.Results:Finally, 47 cases in the experimental group and 44 cases in the control group were completed. The total score of disease essence, inducing factors, medication knowledge, self-management and asthma knowledge in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The inhalation therapy compliance score and inhalation therapy compliance rate of the patients in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total scores of activity limitation, asthma symptoms, psychological status, concern for one's own health and quality of life in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing based on BCW can help improve the disease cognition level of patients with bronchial asthma, promote the development of inhalation therapy compliance behavior and improve quality of life of patients.

Objective:To analyze the effect of using reflective teaching method based on quality feedback in clinical teaching of hemodialysis.Methods:From January 2019 to May 2020, 76 hemodialysis interns from West China Hospital of Sichuan University were selected and randomly divided into 2 groups. The routine group interns were taught by routine clinical teaching, and the observation group was taught by the reflective teaching based on quality feedback. The teaching time last 3 months. The thinking ability of the two groups before and after teaching and the satisfaction of the interns with the clinical teaching mode were compared. SPSS 22.0 was used for t test and χ2 test. Results:The theoretical and practical assessment scores of the observation group were higher than those of the routine group ( P<0.05). After teaching, the scores of the two groups were all increased in the dimensions of truth-seeking, analytical ability, open thinking, systematic ability, confidence in critical thinking, cognitive maturity and curiosity. And the scores of the above dimensions of the observation group were higher than those of the routine group ( P<0.05). There were significant differences in the satisfaction distribution of the two groups of interns with the clinical teaching mode, and the total satisfaction rate of the observation group was higher than that of the routine group ( P<0.05). Conclusion:The implementation of reflective teaching based on quality feedback in clinical teaching of hemodialysis can improve the teaching effect, enhance the thinking ability of interns, and improve their satisfaction with the clinical teaching model.

Objective:To explore the mediating effects of self-control and rumination between neuroticism and insomnia in college students.Methods:A cross-sectional survey was conducted among 767 college students from a university in Sichuan province with Chinese big five personality inventory-15, insomnia severity index, ruminative responses scale, and self-control scale.Results:The prevalence of insomnia was 36.6% among college students.The scores of neuroticism (9.63±3.41), rumination (22.27±5.44) and ISI (6.61±4.28) were positively correlated with each other ( r=0.281-0.389, P<0.01), while each of them was negatively correlated ( r=-0.453--0.194, all P<0.01) with self-control (60.71±9.41). Analysis of mediating effects revealed that neuroticism not only directly affected insomnia, but also indirectly affected insomnia through the mediating effects of rumination and self-control respectively. Conclusion:Self-control and rumination have mediating effects between neuroticism and insomnia in college students.

Objective:To investigate the consistency of Velum, Oropharygneal, Tongue base, Epiglottis (VOTE) scores between two surgeons with similar clinical experience in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with different degree of disease, and to analyze the influencing factors leading to the difference in score.Methods:This was a cross-sectional study. 64 preoperative drug-induced sleep endoscopy (DISE) videos of OSAHS patients during December 2014 to July 2018, from Nanfang Hospital, Southern Medical University were analyzed. The VOTE score was assessed single-blind by two similar experienced surgeons, and the Kappa value between the two scorers was calculated by the third researcher. According to the characteristics of the case, Fisher's exact test or chi-square test method was used to further explore the factors that influenced the consistency.Results:Sixty-four patients were divided into four groups according to the severity of the disease, including mild (7 cases), moderate (30 cases), severe(18 cases), and extremely severe (9 cases). The scores evaluated between two researchers were analysed for consistency. For mild patients, the two scorers were completely consistent in the configuration and degree of obstruction in the velum and epiglottis (Kappa=1). There was no agreement on whether obstruction or not, obstructed configuration, obstructed degree of the oropharynx and tongue base, and presence of velum and epiglottis obstruction. For moderate patients, the two scorers had a good consistency in the configuration and degree of the velum (0.61≤Kappa≤0.80), and there was no consistency in the evaluation of the degree of tongue base and epiglottis ( P>0.05). The consistency of the remaining obstructed conditions in the four planes was generally or moderate (0.21≤Kappa≤0.60). For patients with severe OSAHS, the two raters were completely consistent in the evaluation of palatopharyngeal and epiglottic planes for the presence of obstruction, but there was no consistency in the degree of obstruction. Although the degree of obstruction in the oropharyngeal plane can be assessed with good consistency, the consistency of whether the plane was blocked or not was generally not high. In the assessment of other obstructive conditions in the four planes of severe patients, the agreement between the two scorers was moderate or generally. For extremely severe patients, the two scorers were completely consistent in the evaluation of the velum obstruction, but there was no consistency in the degree of obstruction of the oropharynx and tongue base, and the obstruction configuration and degree of the epiglottis. The evaluation of other obstructed conditions in the four planes is good or moderate. Among the patients with severe OSAHS, the difference in the assessment of obstruction of the oropharynx was associated with tonsil size ( P<0.05). Conclusion:When physicians with similar clinical experience scored VOTE, the consistency of whether the velum and oropharyngeal planes are obstructed is related to the severity of the disease. Better consistency is observed among more severe OSAHS patients. The reason for the poor consistency of the oropharyngeal plane in severe OSAHS patients OSAHS is due to the difference of the tonsils size. For severe OSAHS patients with small tonsils, the assessment of whether the oropharynx is obstructed should be more cautious.

Objective: To investigate the risk factors of pneumonia in maintenance hemodialysis (MHD) patients. Methods: The clinical data of patients undergoing dialysis longer than three months at the Hemodialysis Center of West China Hospital of Sichuan University from July 2013 to July 2018 were retrospectively analyzed. The patients were divided into pneumonia group and non-pneumonia group. Follow-up time started from admission to the beginning of hemodialysis. All patients were followed until the patient died, or withdrawn from hemodialysis, or transferred to another center, or until the study deadline (April 2019). Baseline clinical data were compared between the two groups, and the differences in clinical data between the pneumonia group and the baseline were also analyzed. Risk factors for pneumonia in hemodialysis patients was analyzed by binary logistic regression. Kaplan-Meier curve was used to compare the survival prognosis of the two groups, and the Log-rank method was used for significant test. A multivariate Cox proportional hazard model was used to analyze risk factors for MHD patients' death. Results: (1) A total of 311 patients were enrolled in the study, in which 178 (57.2%) of the patients were male, and 75(24.1%) of the patients had pneumonia. Compared with non-pneumonia group, the pneumonia group patients were older (P=0.002), had higher level of white blood cells (P=0.001) and lower level of serum creatinine (P=0.003), albumin (P=0.001), and serum magnesium (P=0.039). There were also statistically significant differences between the two groups in the proportion of females and underlying diseases (all P<0.05). (2) The time of pneumonia occurred from the initial time of dialysis was (10.69±9.82) months. Compared with baseline values, decreased hemoglobin and albumin level were found (both P<0.01). (3) Logistic regression analysis showed male patients had lower risk of pneumonia than female patients (OR=0.438, 95% CI 0.242-0.795, P=0.007). For every 1 g/L increase in albumin, the risk of pneumonia was reduced by 6.4% (OR=0.936, 95% CI 0.885-0.991, P=0.022). Kaplan-Meier survival curve analysis showed that the difference in 5-year cumulative survival rate between pneumonia group and non-pneumonia group was statistically significant (60.6% vs 84.4%, χ²=16.647, P<0.001). (4) Multivariate Cox regression analysis showed that long dialysis time (HR=0.870, 95% CI 0.832-0.909, P<0.001) and high serum albumin level (HR=0.898, 95%CI 0.845-0.955, P=0.001) were protective factors in patients with MHD. Pneumonia (HR=3.008, 95% CI 1.423-6.359, P=0.004) was an independent risk factor for death in MHD patients. Conclusions Hemoglobin and albumin level are reduced in MHD patients with pneumonia. Low albumin level is a risk factor for pneumonia in patients. MHD patients with pneumonia have a lower survival time than those without pneumonia.