Objective: To investigate the trends in incidence of viral hepatitis in Yuxi City, Yunnan Province from 2004 to 2022, so as to provide insights into the management of viral hepatitis. Methods: Data of viral hepatitis cases in Yuxi City from 2004 to 2022 were retrieved from the China Disease Prevention and Control Information System. The temporal, human and spatial distribution of viral hepatitis cases were analyzed using a descriptive epidemiological method, and the trends in incidence of viral hepatitis were evaluated in Yuxi City from 2004 to 2022 using annual percent change (APC) and average APC (AAPC). Results: A total of 37 430 viral hepatitis cases were reported in Yuxi City from 2004 to 2022, with an average annual incidence rate of 91.27/105, and the incidence showed a tendency towards a rise (AAPC=12.686, P<0.05). There were 29 229 cases with hepatitis B, 5 796 cases with hepatitis C, 1 451 cases with hepatitis A, 520 cases with hepatitis E and 434 cases with unclassified hepatitis reported in Yuxi City, with average annual incidence rates of 71.27/105, 14.13/105, 3.54/105, 1.27/105 and 1.06/105, respectively. The average annual incidence rates of viral hepatitis were 98.24/105 and 78.94/105 among men and women, which both appeared a tendency towards a rise (AAPC=12.415% and 12.581%, both P<0.05). The highest average annual incidence of viral hepatitis was seen among residents at age of 25 to 29 years (139.89/105), with the lowest seen among residents at ages of 0 to 4 years (11.38/105), and the average annual incidence of viral hepatitis appeared a tendency towards a rise with age (P<0.05). The highest average annual incidence of viral hepatitis was seen in Huaning County (234.24/105), with the lowest seen in Chengjiang City (26.11/105), and the average annual incidence appeared a tendency towards a rise in Xinping County from 2004 to 2022 (AAPC=21.451%, P<0.05). Conclusions The reported incidence of viral hepatitis appeared a tendency towards a rise in Yuxi City from 2004 to 2022, with hepatitis B as the main type. High incidence was seen among men and adolescents. The viral hepatitis control strategy requires to be adjusted with adaptations to high-incidence hepatitis subgroups, residents and regions.

Objective:To develop a nomogram model for screening of type 2 diabetes mellitus in a community population.Methods:From October to December, 2020, 6 028 community residents who participated in the " national health physical examination" in Karamay community with complete physical examination data and met the inclusion and exclusion criteria were selected. The physical examination data included medical history, physical examination, laboratory, and ultrasound reports. Random segmentation sampling was used to divide the population into modeling and validation cohorts, and LASSO regression analysis was used to screen for independent factors associated with diabetes diagnosis. The independent influencing factors were furthor incorporated into the multi-factor logistic regression, and the RMS software package was used to construct the column chart. The area under receiver operating characteristic(ROC) curve was used to measure the differentiation of the model. The calibration curve can directly reflect the calibration degree of the model.Results:In the modeling group, multivariate logistic regression analysis showed that age, gender(female), history of hypertension, history of hyperlipidemia, HbA 1C, urinary microalbumin, homeostasis model assessment for insulin resistance, and triglycerides and glucose index were independently associated with diabetes. OR were 1.053(95% CI 1.038-1.069), 0.681(95% CI 0.512-0.906), 1.802(95% CI 1.227-2.626), 1.789(95% CI 1.303-2.448), 10.973(95% CI 8.318-14.745), 1.002(95% CI 1.001-1.004), 2.914(95% CI 2.248-3.799), and 2.673(95% CI 2.03-3.536), respectively. The areas under ROC curves of the training set and the validation set were 0.945 and 0.955, respectively. The optimal critical value in the ROC curve was 0.178(sensitivity 0.930, specificity 0.839) in the training set and 0.201(sensitivity 0.945, specificity 0.848) in the validation set. Conclusion:The screening model of type 2 diabetes developed in this study has good accuracy, which can be used as a screening tool for high-risk population of type 2 diabetes.

Objective:To explore the effect of supportive-expressive group therapy (SEGT) on alexithymia in patients with lung cancer.Methods:Totally 62 lung cancer patients were divided into control group( n=30) and intervention group( n=32) by coin flipping method.The intervention group received 6-week supportive-expressive group therapy and the intervention path was improved by action research method.There was no special intervention in the control group.The Toronto alexithymia scale (TAS-20) and hospital anxiety and depression scale (HADS) were used for measurement, and statistical analysis was carried out by SPSS 21.0. Results:The emotional recognition disorder (Wald groupχ 2=6.055, Wald interactionχ 2=15.157), emotional description disorder (Wald groupχ 2=5.736, Wald interactionχ 2=28.912), TAS-20 (Wald groupχ 2=7.181, Wald interactionχ 2=28.126), anxiety (Wald groupχ 2=4.905, Wald interactionχ 2=30.491), depression (Wald groupχ 2=9.580, Wald interactionχ 2=29.417) and HADA (Wald groupχ 2=8.140, Wald interactionχ 2=47.851) had significant group effect and interaction effect at the pre-test, post-test and 1 month after intervention(all P<0.05). There was no significant group effect in extroverted thinking (Wald groupχ 2=1.161, P>0.05), but the time effect (Wald timeχ 2=6.381, P<0.05) and the interaction effect (Wald interactionχ 2=6.339, P<0.05) were significant in the three time points.The group effect of emotional recognition disorder, emotional description disorder, TAS-20, anxiety, depression and HADA score at completed intervention and 1 month after intervention were significant(all P<0.05). Compared with before intervention, TAS-20((52.94±4.77) , (52.06±4.07)), emotional recognition disorder((17.72±2.23) , (17.78±1.64)), emotional description disorder((13.44±1.94) , (13.41±1.79)), HADA((14.41±2.63) , (13.75±2.97)), anxiety ((7.03±1.64), (6.84±1.51)), depression ((7.38±1.45) , (6.91±1.75) ) at completed intervention and 1 month after intervention decreased ( P<0.05), while the HADS of control group only decreased at completed intervention ( P<0.05). Conclusion:SEGT can reduce alexithymia in lung cancer receiving chemotherapy, and this intervention has positive effect on improving anxiety and depression in lung cancer patients received chemotherapy who are accompanied with emotional cognitive impairment and emotional somatic symptom recognition disorder.

Objective To establish the central tube preparation system for the blood samples from hospitalized patients in clinical laboratories and explore its application value.Methods A central tube preparation system for clinical specimen was researched and developed.The system was directly connected with the laboratory information management system (LIMS) and hospital information management system (HIMS) for monitoring and tracking management on-line with standardization,intellectualization and informatization during the whole process of collection,detection and report of clinical specimens.Results The central tube preparation system for blood samples from hospitalized patients in clinical laboratories was successfully established.The development and application of this system optimized the blood collection process,avoided incidental human mistakes in traditional blood collection process,realized the real-time monitoring of the clinical samples during the whole process and reduced the labor intensity of nurses.Therefore,the working efficiency and degree of clinical satisfaction were increased greatly.Conclusion The developed system could process the specimens intelligently,improve the management level of hospital and department and provide guarantee for standardized management of clinical laboratories.

Objective: To observe the effects of axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata on repairing defects after radical resection of scalp carcinoma in patients. Methods: From February 2006 to December 2015, twenty-one patients with scalp carcinoma were admitted to our hospital, and the carcinoma invaded external lamina or full-thickness of skull and dura mater. After perfect preoperative examination, carcinoma and scalp tissue in 3 to 5 cm from the edge of carcinoma, external lamina or full-thickness of skull and invaded dura mater were resected and sentinel lymph nodes around carcinoma were cleaned in 3 to 4 days after admission. The postoperative defects with size reached from 11 cm×8 cm to 22 cm×18 cm. The flap transplantation was performed at the same time when quick frozen pathological examination results of resected scalp carcinoma margin tissue, skull, dura mater margin and basal tissue, and sentinel lymph nodes showed completely negative. Defects in 3 elderly patients were repaired by single or multiple axial scalp vascular network flaps, with the resected flaps size ranged from 12 cm×7 cm to 19 cm×14 cm. Defects in the other 18 patients were repaired by anterolateral thigh perforator flaps with fascia lata, with the resected flaps size ranged from 13 cm×10 cm to 23 cm×19 cm and the resected fascia lata size ranged from 8 cm×7 cm to 10 cm×10 cm. The head donor site of flap was repaired by medium thickness skin of head and back; the thigh donor site of flap was repaired by medium thickness skin of thigh on the same side. All patients gave up postoperative radiotherapy, chemotherapy, and other follow-up treatments. Results: After operation, the flap and skin in all patients survived completely, with no vascular crisis or other condition. During the follow-up for 6 months to 9 years, all patients showed good appearance except for baldness in operation area of head, with no obvious malformation in head donor site of flap and skin, no swollen external hernia in the brain tissue, and no local recurrence or distant metastasis of carcinoma. The appearance of thigh donor site of flap and skin was good, with normal muscle strength and movement of lower limbs. Conclusions Patients with scalp carcinoma were performed with radical resection of carcinoma, and axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata were applied to repair the postoperative defects, with good appearance of head operation area and no local recurrence or distant metastasis of carcinoma.

Objective To investigate the clinical effect and safety of three dimensional conformal radiotherapy (3D-CRT)for patients with cervical cancer after radical operation in stage ⅠA to ⅡA.Methods The data of 119 patients of cervical cancer in ⅠA-ⅡA with postoperative radiotherapy in our hospital were analyzed retrospectively.Of which 56 patients were treated with 3D-CRT radiotherapy (3D-CRT group),63 patients were treated with conventional radiotherapy (conventional group).The differences radiation reactions and quality of life between two groups were compared.Results The local control rate of 3D-CRT group in the first 12 and 18 months after surgery were 87.50% and 82.14%,respectively,which were significantly higher than those of conventional group(71.43%,65.08%),the difference was statistical significance(P <0.05).The survival rate of 3D-CRT group after 1 year,2 years,3 years were respectively 91.07%,83.93%, 71.43%,compared with the conventional group (84.13%,73.02%,65.08%),the difference was not statistically significant (P >0.05). Patients of 3D-CRT group were followed up for 3 years,the median survival time was 34.29 months,which was longer than the 31.08-month of conventional group,the difference was statistically significant(χ2 =4.116,P =0.042).Quality of life of 3D-CRT group (60.81 ±4.28) point was lower than that of conventional group (63.75 ±5.03)point,and the difference was statistically significant(P <0.05).The rate of early radiation reaction(rectal reaction,vaginitis)and late radiation reaction (mild or moderate radiation proctitis)in 3D-CRT group were lower than those in the conventional group,the difference was statistically significant(P <0.05 ).Conclusion The 3D-CRT has effect on the long-term prognosis of patients with cervical cancer in stage ⅠA-ⅡA,which can significantly reduce the radiation reaction and improve the quality of life of patients.

BACKGROUND:Artificial cornea titanium scaffold has a higher complication rate in clinical usage; therefore, to seek a kind of artificial corneal scaffold with high biocompatibility is a hot spot.
OBJECTIVE:To explore the biocompatibility of the artificial cornea titanium scaffold with hydroxyapatite surface modification.
METHODS: Twenty-seven New Zealand white rabbits were enroled to make alkali burn models of the right cornea and then randomized into three groups: in experimental group, artificial cornea titanium scaffold with hydroxyapatite surface modification was implanted into the right eye; in control group, artificial cornea titanium scaffold was implanted into the right eye; in blank group, no scaffold was implanted into the right eye. At 2, 4, 16 weeks after implantation, the right corneas were taken out for pathological observation and scanning electron microscope observation.
RESULTS AND CONCLUSION:At 16 weeks after implantation, there was no difference in the number of inflammatory cels and fibroblasts among the three groups. Over time, in the experimental group, the corneal tissues, fibrous tissues and adhered extracelular matrices were increased gradualy. In addition, the experimental group had more adherent corneal tissues, extracelular matrices and better tissue healing than the control and blank groups. These findings indicate that the artificial cornea titanium scaffold with hydroxyapatite surface modification had good biocompatibility that can effectively promote proliferation of corneal cels and corneal vascularization.

Immunohistochemistry was carried out for assessment of the expression of IgG4 and IgG in 29 patients with Hashimoto's thyroiditis (HT) and 26 other patients with subacute thyroiditis,thyroid adenoma,and thyroid carcinoma.HT group were divided into IgG4 HT (10/29) and non-IgG4 HT (19/29) groups.Statistical analyses of clinical and histological characteristics were also conducted in both groups.2 cases of subacute thyroiditis were IgG4 positive (2/26).The IgG4 positive plasma cells,IgG positive plasma cells,and ratio of IgG4 +/IgG + plasma cells in IgG4 HT cases were significantly higher than non-IgG4 HT ones(P＜0.05).The serum Fl4 in IgG4 HT cases were lower than non-IgG4 HT ones(P＜0.05).After operation,IgG4 HT had a greater proportion for accepting thyroxin treatment(P＜0.05).IgG4 HT is a new-found disease which has particular histological and immunological features and would have good response for cortical hormone therapy.Serum and tissue examination of IgG4 seems to be helpful to the diagnosis of IgG4 HT.

Objective To retrospectively analyze the clinical characteristics ,pathological features and aetiology of pulmonary carcinoid tumourlets .Methods The clinical data of 10 patients with pulmonary carcinoid tumourlets in the West China Hospital of Sichuan University from April 1976 to October 2013 were collected for conducting the retrospective analysis and combining the lite‐raute review .Results Of the total 10 patients ,3 cases were male and 7 cases are female .9 cases were accompanied by bronchiecta‐sis ,1 case was complicated with lung adenocarcinoma .The clinical manifestations were lack of specificity ,which were dominated by repeated cough ,expectoration ,dyspnea and hemoptysis .The microscopic pathological examination suggested that there were differ‐ent degrees of inflammation reaction or fibrous tissue hyperplasia .All patients had no carcinoid syndrome ,lymph node and distant metastasis .10 cases received the surgical treatment .6 cases were pulmonary hypoplasia ,in which 1 case was carcinoid tumourlets complicating pulmonary sequestration .The postoperative follow up lasted for 5 - 80 months .8 cases had no recurrence and 2 cases were loss of follow up .Conclusion For the middle‐aged women patients with bronchiectasis and poor therapeutic effect ,complica‐ting carcinoid tumourlets should be vigilant ,active surgery combined with the pathologic examination is a suitable clinical decision .

Objective To investigate the training scale and social demand of nursing undergraduates in recent five years in Henan province,and supply reference for trend of talent supply and demand in future five years in Henan province.Methods A cross-sectional questionnaire survey were taken,6 nursing colleges,78 hospitals took part in the survey.Literature searching and trend extrapolation method were used to predict the demand of nursing talents in Henan province from 2011 to 2015.Results Tertiary hospitals demand more nurses with bachelor degree than secondary hospitals; the appropriate proportion of nurses with bachelor degree in all nurses was 30％～50％; besides,a predictive model equation was proposed.Conclusions The scale of undergraduate nursing should develop in appropriate ratio based on the predictive values; we should strengthen undergraduate nursing education for all-around development to adapt tertiary hospitals and community nursing trend,and the predictive model equation needs continuous emendation.