Objective To investigate the current status of ethical sensitivity among oncology nurses and explore the influencing factors in 13 Grade IIIA hospitals in Foshan to provide guidance for formulating effective intervention measures.Methods From July to September 2023,a cluster convenience sampling method was used to select 574 oncology nurses from 13 Grade IIIA hospitals in Foshan City,Guangdong Province as the research subjects.A general data questionnaire,the Chinese version of the nurse moral sensitivity questionnaire(a revised moral sensitivity questionnaire,MSQ-R-CV),the caring behaviour inventory(CBI),and the Chinese version of emotional intelligence scale(Wong and Law emotional intelligence scale,WLEIS)were used for the cross-sectional study.Univariate and multivariate linear stepwise regression were used to analyse the influencing factors.Results A total of 574 questionnaires were collected,of which 524 were valid.The total scores of ethical sensitivity,caring behaviour,and emotional intelligence of oncology nurses were(44.57±7.63),(125.86±17.95)and(86.82±14.37),respectively.Results of multivariate linear stepwise regression showed that working years in oncology departments,whether participated in medical ethics and took narrative nursing training,the total score of caring behaviour and the total score of emotional intelligence were the influencing factors of oncology nurses'ethical sensitivity(all P<0.05),jointly explained 70.5%of the total variation of ethical sensitivity(F=94.253,P<0.001).Conclusion Oncology nurses in Foshan demonstrate a medium-level of ethical sensitivity.Nurses who have≤20 years of working experience,lacking the training in medical ethics and narrative nursing within the past three years,exhibiting a shortage of caring behaviour and possessing a low emotional intelligence are more likely to exhibit low ethical sensitivity.Nursing managers should prioritise the nurses in this category with appropriate measures to enhance their ethical sensitivity.

Objective:Analyze the impact of smoking on the mortality and life expectancy of residents in Tianjin in 2019.Methods:Use mortality case-control study method to collect all cause of death cases of residents in Tianjin in 2019 for analysis. After adjusting for the 5-years-old age group, education level, and marital status, the smoking attributed deaths from different diseases of different genders, smoking attributed deaths in different age groups, and their impact on life expectancy were analyzed.Results:The total number of deaths in 2019 was 75 254, with 42 201 males (56.1%). Among male deaths, 3 215 (9.9%) were attributed to smoking, of which 2 157 (50.2%) lung cancer deaths were attributed to smoking; The risk of lung cancer death among smokers was 3.075 times higher than that of non-smokers (95% CI: 2.812-3.364); Among the 33 053 female deaths (43.9%), 1 396 (5.8%) were caused by smoking, with 744 (29.1%) lung cancer deaths attributed to smoking. The age group with the highest number of deaths attributed to smoking for women was the 75-<80 years old age group, followed by the 70-<75 and 80-<85 years old age groups. The age group with the highest proportion of deaths attributed to smoking for men was the 55-<60 years old age group. In addition, smoking accounts for more than 60% of deaths in the 60-<65, 45-<50, 55-<60, and 65-<70 years old age groups. In 2019, the loss of life expectancy attributed to smoking deaths among all residents in Tianjin was 1.13 years, with a loss of 1.15 years for males and 0.57 years for females. The expected life expectancy excluding deaths caused by smoking was 82.92 years, 80.77 years for males and 84.61 years for females. Conclusions:Smoking remains one of the important risk factors for death among residents. Promoting effective measures to reduce smoking rates is an effective way to increase life expectancy.

Objective:To evaluate the effect of tobacco control in different public places after 10 year implementation of Tobacco Control Regulations in Tianjin, investigate the tobacco exposure and tobacco hazard awareness of local population, and provide evidence for the implementation of tobacco control policies and measures.Methods:Data were collected in the tobacco control surveys in Tianjin in 2012 and 2021. On-site observation was used to evaluate the implementation of tobacco control measures in different public places in Tianjin, and face-to-face interview was used to collect the information about passive smoking exposure and tobacco-related knowledge awareness of local residents aged ≥15 years in Tianjin.Results:From 2012 to 2021, the posting rate of smoking free signs in medical institutions was high (100.0%), the posting rate in schools, government offices increased to 100.0%, but posting rate in taxis decreased obviously. The placing rate of tobacco control materials in medical institutions, public transportation waiting places and internet cafes decreased, while the placing rate in other places increased. Except for taxis, the places where people were found to be smoking decreased. The passive smoking exposure in public places and workplaces decreased from 43.2% to 26.6%. The public awareness that smoking can cause stroke increased by 11.3%, but the public awareness rate of smoking causing heart disease decreased and lung cancer by 7.7% and 7.2% respectively. The awareness rate of passive smoking causing heart disease in adults, lung disease in children and lung cancer in adults decreased by 21.8%, 22.1% and 9.1%, respectively.Conclusion:Since the implementation of the Tobacco Control Regulation in Tianjin, the passive smoking exposures have been reduced, but the environment layout of smoking free places, especially the health education about tobacco hazards, needs to be further improved. It is suggested to strengthen the promotion and supervision of tobacco control to create a smoke free environment.

Objective:To explore the incidence characteristics of hemorrhagic stroke among residents in Tianjin from 1999 to 2018, to provide data for formulating accurate prevention and control strategies.Methods:The incidence rate of hemorrhagic stroke and its distribution in different ages, gender, urban and rural areas were analyzed by monitoring new hemorrhagic stroke cases in Tianjin from 1999 to 2018. The standardized incidence rate was calculated based on the six th national population census in 2010. χ 2 test was used to compare the incidence rate. The trend of age and trend of age were analyzed by trend χ 2 test. Joinpoint software was used to analyze the change in the annual incidence rate. Results:During the study period, hemorrhagic stroke accounted for 13.08% of all stroke cases. The incidence rate of a hemorrhagic stroke in Tianjin residents was 75.38/100 000-46.70/100 000, showing a downward trend ( Z=-28.63, P<0.01, APC=-1.45%). After adjustment of age and gender, the standardized rate was 57.93/100 000-27.55/100 000, still showing a downward trend ( Z=-54.72, P<0.01, APC=-3.38%). The incidence rate of male and female hemorrhagic stroke decreased, and the incidence rate of males in all ages and age groups was higher than that in females ( P<0.01). The age of onset is younger, and the standardized incidence rate of an urban hemorrhagic stroke in the city decreases ( P<0.01), and the city descends faster. Conclusions:The characteristics of hemorrhagic stroke in Tianjin are similar to those in developed countries. The lower age group and rural population are the key groups of intervention. The study of incidence characteristics and trends is of great significance for accurate prevention and control of stroke, reducing disease and medical costs.

Objective To investigate the clinical significance of cortactin antibody in myasthenia gravis (MG).Methods Cortactin antibody in the serum of 100 MG patients, 40 normal controls and 40 other neuroimmune diseases patients was examined by Western blotting and ELISA using purified recombinant human protein cortactin as antigen .Acetylcholine receptor antibody ( AchR-ab ) and muscle specific kinase antibody (MuSK-ab) were parallely measured by ELISA.Results Antibodies to cortactin were found in nine (9％) serum samples of 100 MG patients.Four of the nine cortactin antibody positive sera were also positive for AChR-ab.The rest five MG patients only had antibodies against cortactin ( no detectable AChR-ab or MuSK-ab).None of the control subjects (including 40 normal controls and 40 other neuroimmune diseases patients ) had cortactin antibodies.Most (7/9) of the cortactin antibody positive MG patients presented with early-onset subgroup.Patients only with cortactin antibodies did not appear to have thymoma.Patients with MG who had both AChR and cortactin antibodies showed maximum involvement of muscles and severe Osserman's classification ( three cases of type ⅡB and one case of type Ⅳ) . Conclusion Cortactin antibody may be a new antibody for MG , which can provide clues for further exploring the potential pathogenic mechanisms of the disease .

Objective To compare the long term effectiveness of tonsillotomy(TT)vs. tonsillectomy (TE)by hypercator in treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children. Methods 119 children with tonsil hypertrophy were diagnosed with OSAHS and included in the study. Among them,57 children underwent TT by hypercator and 62 TE only after preoperative laboratory polysomnography(PSG). All participants were interviewed 5 years after operation to assess the satisfaction of their caregivers,investigate the frequency of respiratory infections,the rate of tonsil regrowth and evaluate their quality of life by Obstructive Sleep Apnea-18(OSA-18). Results Some of them received postoperative PSG. All parents reported alleviation of breathing obstruction,but the postoperative satisfaction in TT group was higher than TE group mainly because of the shorter time return to normal diet. The rate of the respiratory tract infections was not increased in all cases after surgery. Four cases of children were observed with tonsillar regrowth,but no surgery was needed for further treatment. The rate of the dry throat symptoms in TT group was lower than TE group. Conclusions Tonsillotomy by hypercator can effectively eliminate the obstruction symptoms in children with OSAHS,superior to TE for its shorter recovery period and smaller oral mucosal injury and lower rate of tonsils regrowth and it is worth to clinical promotion.

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.