The digital transformation of China's community health management is a key step in the high-quality development of medical and health services,and is of great significance in enhancing the health and well-being of all residents.Using literature analysis,logical analysis and other research methods,it analyzes the practical foundation and constraints of the digital transformation of China's community health management,and proposes optimization strategies.It concludes that national policy,infrastructure development and social demand provide a realistic foundation for the digital transformation of community health management in China,but it also faces the problems of insufficient transformation of thinking,the concept of digital management has not sufficiently replaced the traditional concepts;the technical foundation is weak,and the construction and operation of the digital application platform started late;the structural barriers are prominent,and the lack of sound system construction leads to insufficient cooperation among the main bodies;the lack of digital standards,and the lagging operation of digital standardization of community health management;and the lack of digital standards.Management digital standardized operation lagging behind the constraints.Accordingly,it is proposed to promote the identity of the digital transformation of community health management,to build an operational space for digital community health management,to improve the digital system to regulate the activation of synergistic governance of the main body,and to optimize the supervision and guarantee of technology in digital management.

Objective:To investigate the application effect of kangaroo mother care on anxiety and parenting stress in premature mothers during hospitalization.Methods:From January to December 2018, 230 premature mothers were admitted to the neonatal intensive care unit of Ningxia Medical University General Hospital.They were randomly divided into the intervention group( n=114) and the control group( n=116). The premature infants in control group only implemented routine developmental support care.The premature infants in the intervention group was on the basis of routine developmental support care, 2 hours per day of kangaroo mother care was performed from the 2nd day incharge to discharge.Parental Stress Scale: Neonatal Intensive Care Unit and Parenting Stress Index-Short Form was performed using the 2nd day and the 14th day of hospitalization, and the two groups of premature mothers were evaluated for anxiety and parenting stress. Results:There were no significant differences in the scores of PSS: NICU((3.65±0.91) vs (3.63±0.91)) and PSI-SF((90.32±8.95) vs (90.12±7.17))(both P>0.05) between the two groups on the 2nd day of hospitalization (before intervention). On the 14th day of hospitalization (after intervention), the total scores ((2.57±0.80) vs (3.47±0.93))and each dimension scores of PSS: NICU in the intervention group were lower than those in the control group (first part (2.41±0.78) vs (3.81±0.73), second part (2.61±0.71) vs (3.14±0.83), third part (2.75±0.86) vs (3.57±1.06), fourth part(2.49±0.80) vs (3.35±0.94))( P<0.01). In addition, the total score of PSI-SF((79.09±8.02) vs (89.46±8.74)), parenting Distress((32.32±9.48) vs (37.15±9.67)), Parent-Child Dysfunctional Interaction((24.26±5.07) vs (27.34±5.26)), and Difficult Child scores((22.51±4.88) vs (24.97±5.05)) in the intervention group were lower than those in the control group( P<0.01). Conclusion:Kangaroo mother care can reduce the anxiety of premature mothers during hospitalization and help relieve the parenting stress of premature mothers.

Objective:To explore the influence of family function on the psychological resilience of mothers of premature infants.Method:Totally 2 836 mothers of premature infants who met the inclusion criteria were investigated with general information questionnaire, family APGAR index (APGAR) and Connor-Davidson resilience scale (CD-RISC) in three third-class A general hospitals and two specialty hospitals in Ningxia.SPSS 23.0 software was used for statistical analysis.Pearson correlation was used to analyze the relationship between psychological resilience and family function of preterm mothers.Hierarchical regression was used to analyze the impact of family function on psychological resilience of preterm mothers.Results:Total score of resilience scale in mothers of premature infants was (68.38±16.59) and the total score of family function was (9.07±1.53). There were 1 550 cases with good family function and 1 286 cases with family dysfunction.The total score of psychological elasticity and the score of all dimensions in the group with good family function were higher than those in the group with family dysfunction( P<0.05). The total score of psychological elasticity ( r=0.771, P<0.01) and self-improvement ( r=0.410, P<0.05), tenacity ( r=0.492, P<0.01), optimism( r=0.438, P<0.05) were positively correlated with family function.Stratified regression analysis showed that cooperation( β=1.016) and intimacy( β=0.389) were the important influencing factors of preterm mothers' psychological resilience ( P<0.05). Conclusion:Psychological resilience of mothers of premature infants is closely related to their family function.Good family function can help mothers of premature infants improve their psychological resilience and promote their mental health.

Objective: To explore the influence of early essential newborn care(EENC) on the development of omphalitis in preterm infants following normal delivery. Methods: A total of 184 preterm infants, admitted to General Hospital of Ningxia Medical University from January 2017 to December 2017, were retrospectively collected as EENC group. During the same period, 161 preterm infants who were born in Yinchuan Maternal and Child Health Hospital were included in the control group. Preterm infants in EENC group were managed based on the clinical practice guideline of "Early Essential Newborn Care", while those in the control group underwent routine care after birth. The incidence of omphalitis between the two groups were compared using independent-samples t test and Chi-square test. Influencing factors of omphalitis were analyzed using univariate analysis and multivariate logistic regression analysis. Results: The incidence of mild omphalitis was lower [5.4% (10/184) vs 11.8% (19/161), χ²=4.520, P<0.05], and the separation and drying up time of cord stump were both earlier in the EENC group than those in the control group [(5.5±1.5) vs (8.2±1.2) d, t=4.169; (2.6±1.4) vs (3.2±1.4) d, t=4.513; both P<0.05]. Logistic regression analysis showed that gestational age≤34 weeks (OR=1.885, 95%CI: 1.109-6.757, P=0.032), early umbilical cord clamping (OR=3.615, 95%CI: 1.372-9.381, P=0.001) and bandaging of the umbilical stump (OR=1.921, 95%CI: 1.257-11.893, P=0.035) were independent risk factors of omphalitis in preterm infants. Conclusions Umbilical cord treatment based on EENC could reduce the incidence of omphalitis by avoiding its risk factors in preterm infants following normal delivery.

Objective To investigate the effects of early essential newborn care (EENC) on body temperature and short-term clinical outcomes of vaginally born preterm infants at 1 h after birth. Methods This was a prospective case-control study. A total of 97 premature infants, who were born vaginally between 34-37 weeks in the Obstetrics Department of General Hospital of Ningxia Medical University from January 1 to December 31, 2017 and admitted to the neonatal intensive care unit were enrolled as intervention group. Another 103 premature infants, who were born vaginally in the Obstetrics Department of Yinchuan Maternal and Child Health Hospital at the same period were enrolled as control group. EENC-based treatment and management were implemented to infants in the intervention group, such as thorough drying immediately, 30 min skin-to-skin contact immediately and delayed cord clamping after birth, etc., while those in the control group were managed based on routine protocol. Chi-square test was used to compare the incidence of hypothermia, hypoglycemia and hypoxemia between the two groups at 1 h after birth. The general condition and the time of colostrum secretion were compared by two independent sample t-test. Multivariate logistic regression was used to analyze the risk factors of hypothermia. Results At last, 96 participants in the intervention group and 102 in the control group were analyzed. Compared with the control group, the intervention group showed lower incidence of hypothermia [17.7% (17/96) vs 37.3% (38/102), χ2=9.418, P=0.002], hypoglycemia [9.4% (9/96) vs 19.6% (20/102), χ2=4.142, P=0.042] and hypoxemia [14.6% (14/96) vs 28.4% (29/102), χ2=5.578, P=0.018] at 1 h after birth and earlier colostrum secretion [(18.3±2.4) vs (31.4±3.5) min, t=32.463, P<0.001]. Multivariate logistic regression analysis showed that birth weight <2 500 g ( OR=2.483, 95% CI : 1.731-3.234, P=0.025), gestational age<36 weeks (OR=1.899, 95%CI : 1.325-2.472, P=0.012), room temperature between 22-24℃in the delivery ward (OR=2.465, 95% CI: 1.279-4.754, P=0.007), no-skin contact (OR=2.958, 95%CI: 1.435-4.481, P=0.023) and rapid and simple drying ( OR=2.467, 95% CI : 1.285-4.736, P=0.006) were the risk factors for hypothermia in premature infants. Conclusions EENC can reduce the incidence of hypothermia, hypoglycemia and hypoxemia in premature infants at 1 h after birth and may be helpful for early colostrum secretion.

Objective: To understand mental health status of primary school boarding pupils in rural families, and to explore specific intervention method suitable for mental health problems prevention and intervention among those children. Methods: Social emotional education was administered through family station among 105 rural primary school students in Gaohawo central primary school in Yanchi county of Ningxia Province. Mental health was evaluated by the Mental Health Rate Scale for Pupil (MHRSP) before and after intervention. Results: The average score of mental health of children with rural boarding students was (48.00±18.56), the detection rate of total score ≥65 was 19.05%, and the detection rate of with at least one dimension≥10 points was 100%. Mental health problems in different dimension was highest in personality defects (48.57%), followed by learning disabilities (43.81%), emotional disorders (25.71%), social adjustment disorders (18.10%) and morality defects (11.43%). After the intervention, the detection rate and total score of mental health problems among rural pupils decreased significantly compared to before intervention (χ2=20.60, 6.05, 43.58, 10.99, 12.73, P<0.05), and the detection rate of learning disabilities, mood disorders, personality disorders, social adaptation disorders, and moral defects decreased significantly (t=4.00, 3.31, 3.25, 3.31, 2.54, P<0.05). Conclusion Mental health problems of primary school students in rural areas are outstanding. Social and emotional education should be the focus of parents, schools, the community, as well as government. The social and emotional education of the "family station" activity could improve mental health among primary school pupils in rural areas, which is worth further promotion.

Objective To investigate the security and efficacy of one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by uniportal-video-assisted thoracic surgery(VATS) to cure patients with myasthenia gravis(MG).Methods A number of 131 patients with MG who underwent resection of thymic tissue and clearance of mediastinal fat by VATS in one single center from February 2009 to December 2013 were selected in this retrospective study.76 patients underwent unilateral resection of thymic tissue and clearance of mediastinal fat by three portal VATS from February 2009 to March 2012 and 55 patients underwent one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS from April 2012 to December 2013.The time for operation,the bleeding volume during operation,the volume of postoperative drainage and drainage time,the improvement of symptoms,the postoperative pain,hospital stays and the occurrence of myasthenia gravis crisis were compared between the two groups.Results The general condition and pathological type did not have significant statistical differences between the two groups.The operating time in the uniportal-VATS group was significantly longer than that in three portal VATS group,but the pain was lighter,and the hospital stay was shorter.There were no significant differences between groups in terms of blood loss,postoperative drainage time,and volume of drainage.The follow-up was from 32 to 90 months,and 118 (90.08％)patients completed the follow up.94.5 ％ of the patients in uniportalVATS group acquired complete stable remission(CSR),while it was 84.2％ in three portal VATS group(P ＜ 0.05),and the uniportal-VATS group had lower rate of myasthenic crisis (P ＜0.05).Conclusion One stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS is safe and effective with shorter hospital stay and less pain,and it can get higher CSR and less myasthenic crisis,its efficacy is superior to traditional three portal VATS.

Objective To explore the relationship between self-management behaviors and family function among elderly pa-tients with diabetes in community in order to provide evidence for community nursing of diabetes.Methods A total of 670 elderly patients with diabetes were selected with convenience sampling household survey method and investigated with the family Adapta-tion,Partnership,Growth,Affection,and Resolve(APGAR)and the Summary of Diabetes Self-Care Activities(SDSCA).Results The family functions total score of the elderly patients with diabetes in community was (6.95±2.91),the self-management behav-iors total score was (20.06±5.80),among the self-management behaviors the score for exercise was the highest and blood glucose monitoring was the lowest;family function had remarkable positive relation with the total score of self-management behaviors a-mong elderly patients with diabetes in community(r=0.156,P <0.05).Conclusion There is a correlation between the self-man-agement behaviors and family function,good family function is conducive to the improvement of self-management behaviors for the elderly patients with diabetes.

Background and objective Despite undergoing curative resection, the 5-year survival rate for stage III non-small cell lung cancer (NSCLC) patients is less than 25%. hTere is a need for biomarkers for prediction of survival and guiding individual therapy. MiR-155 is one of most commonly upregulated miRNAs in malignancies, and regulates multiple pro-oncogenic pathways. We aimed to investigate the prognostic impact of miR-155 in resected stage III NSCLC patients. Methods Tumor formalin-ifxed, paraffn-embedded (FFPE) from 162 resected stage III NSCLC patients were collected. Total RNA including miRNA was extracted, and qRT-PCR was used to determine the expression of miR-155. Results Spearman rank correlation test showed a positive correlation between miR-155 expression and nodal status (r=0.169, P=0.032). MiR-155 expression had a signiifcant prognostic impact in the total cohort (P<0.001), in squamous cell carcinomas (P=0.002) and in adenocarcinomas (P=0.003). In N0-1 subgroup, miR-155 expression did not have a signiifcant prognostic on overall survival in univariate analysis (P=0.319). In N2 subgroup, miR-155 had a negative prognostic effect on OS in univariate analysis (P<0.001). Cox regression analysis revealed that miR-155 expression was unfavorable prognostic factors of OS (RR=2.311, 95%CI:1.479-3.611, P<0.001). Conclusion High expression of miR-155 represents a valuable marker of poor clinical outcomes in patients with stage III NSCLC.

Objective To assess the efficacy of vancomycin flush solution for prevention of catheter-related infections in oncology patients. Methods Randomized controlled trials(RCTs) were searched and identified from Cochrane library, PubMed, EMBASE, CBM, CNKI and related journals were also scanned. In accordance with inclusion and exclusion criteria, we evaluated the quality of the included studies by Jadad scale and analyzed the data of catheter- related sepsis, catheter colonization, exit- site infection by RevMan 5.0. Results We included 5 randomized controlled trials (400 patients). Meta analysis showed that there were statistical differences between vancomycin- heparin mixture and heparin solution on the incidence of catheter-related sepsis, catheter colonization, but no difference was found on the incidence of exit-site infection. Conclusions The current evidences show that contrast with heparin flush solution, van comycin - heparin flush solution can significantly reduce the incidence, of catheter - related sepsis and catheter colonization. But vancomycin-heparin flush solution was more effective, and the results should be further confirmed in prevention of Gram-positive bacterial and fungal catheter-related infections or in non- neutropenic patients. Before draw the conclusions, further high-quality, large scale, double-blind randomized controlled trials are still needed.