Objective:To construct of evaluation index system and theory-skill-humanity (TSH) model for core competence of radiation specialist nurses, to provide reference for clinical training of radiation specialist nurses.Methods:In January 2023, the draft of the evaluation index system of core competence for radiation specialist nurses was development by literature reviews and semi-structured interviews; from February to March 2023, 20 experts were consulted with 2 rounds of Delphi consultations to determine the index system and determine indicator weights based on the importance assigned by experts to each indicator.Results:Among 20 experts, 17 were female and 3 were male, aged 35-65 (46.48 ± 8.19) years old. The effective recovery rate of the questionnaires was 100.0% (20/20) and 95.0% (19/20) in the first and second round, respectively. The authority coefficient of the experts was 0.937 in the second round, the Kendall coefficients of concordance in the first-level indexes, second-level indexes and third-level indexes were 0.448, 0.407, 0.464, respectively, the difference was statistically significant ( χ2 = 53.60, 148.81, 58.18, all P<0.001). The final evaluation index system of the core competence of radiation specialist nurses included 3 first-level indicators, 11 second-level indicators and 56 third-level indicators. Conclusions:The evaluation index system of the core competence of radiation specialist nurses constructed based on TSH model in the present study has certain feasibility and practicality, which can be used as the basis for the training and evaluation of radiation specialized nurses.

Objective:To explore the status quo and influencing factors of death anxiety among middle-aged and young adult patients with chronic heart failure (CHF) .Methods:Totally 176 middle-aged and young adult CHF patients treated at Fuwai Central China Cardiovascular Hospital between January 2021 and February 2023 were selected by convenience sampling and investigated with a general information questionnaire, the Medical Coping Modes Questionnaire (MCMQ), and the Death Anxiety Scale.Results:A total of 176 questionnaires were distributed, with 170 valid responses, yielding an effective response rate of 96.59%. Among the 170 middle-aged and young adult CHF patients, 136 had low death anxiety, while 34 had high death anxiety. Multiple linear regression analysis showed that educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding) were influencing factors of death anxiety in middle-aged and young adult CHF patients ( P<0.05) . Conclusions:Death anxiety in middle-aged and young adult CHF patients is primarily associated with educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding). Clinical assessments should focus on these factors to provide timely and targeted psychological interventions.

Objective: To understand the epidemiological and spatial distribution characteristics of mushroom poisoning events in Zunyi, and to provide theoretical basis for the prevention of mushroom poisoning at the grassroots level. Methods: Descriptive analysis and spatial distribution of mushroom poisoning events reported by foodborne disease surveillance system in Zunyi were carried out. Results: A total of 525 cases of mushroom poisoning events were reported in Zunyi in the past ten years, with a total of 1 758 cases poisoning casesand 29 deaths. The occurrence of mushroom poisoning had seasonal fluctuation, mainly from June to October, accounting for 89.90% of the total. Family was the main place of mushroom poisoning, accounting for 96% of the total. Autochthonous gathering was the main source of mushroom poisoning events. Conclusion Mushroom poisoning is one of the main causes of food poisoning death. With the help of geographic information system(GIS), the distribution map of toadstools is preliminarily explored by combining environmental factors with the distribution of mushroom types.

Objective: To analyze the epidemiological characteristics of plant and mushroom poisoning events among people aged 0-19 in Guizhou Province from 2015 to 2019, so as to provide the basis for prevention and control of food poisoning events among children and adolescents. Methods: Data of people aged 0 to 19 involved in plant and mushroom poisoning incidents reported by the foodborne disease outbreak surveillance system in Guizhou Province from 2015 to 2019 were collected, verified, sorted and statistically analyzed. Results: From 2015 to 2019, there were 590 cases of plant and mushroom poisoning among people aged 0 to 19 in Guizhou Province, 1 441 people were poisoned and 5 died. In May and September, family and collective dining halls were the places with the highest incidence of plant and poisonous mushroom poisoning incidents, accounting for 90.68% (535/590) of the total incidents. Poisonous mushrooms and masanberry accounted for 71.69% (423/590) of the food poisoning causes, and 5 people died of poisoning were caused by poisonous mushrooms. Conclusion In the cases of plant and mushroom poisoning among people aged 0-19 years in Guizhou Province,preschool primary and middle school students in rural areas are most vulnerable population of poisoning, so it is necessary to strengthen the publicity and education on the prevention and control of toxic plant and mushroom poisoning among children and teenagers in rural areas, so as to reduce the occurrence of relevant poisoning incidents.

Objective: To analyze the epidemiological characteristics, clinical manifestations and imaging charac-teristics of 76 cases with neonatal cerebral infarction, in order to provide evidence for the diagnosis, treatment and prognosis for neonal cerebral infarction. Method: Newborns with cerebral infarction admitted into the Neonatal Center, Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2017 were enrolled.According to neurological sequelae, the participants were divided into good prognosis group and poor prognosis group for retrospective analysis, and their cranial magnetic resonance imaging(MRI) changes and mental development were followed up. Results: The incidence of convulsion was the highest in 76 cases (73.7%, 56/76 cases), among which unilateral limb twitching was characteristic in 39.2% (22/56 cases). Clinical physical examination showed no significant positive signs in 13.2%(10/76 cases) of the patients, but middle cerebral artery involvement accounted for 80.3% (61/76 cases), and there was no abnormal discharge of electroencephalogram in 29.2% (19/65 cases) of the patients.Among 41 children (29.3%) received follow-up, 12 cases had neurological sequelae, and 15 cases (36.6%) received anticoa-gulant therapy.The median area of original damage of T2 sequence cerebral infarction was 10.3%, the median area of diffusion weighted image damage was 2.0%, and the median area of damage of T2 sequence was 1.0%.The median ratio of craniocerebral lesion damage was 8.4%.The ratios of poor prognosis were 14.9%, 4.8%, 0.5% and 14.4%, respectively. Conclusions Neonatal convulsion is the most common manifestation of neonatal cerebral infarction.Unilateral limb clonus is characteristic.The larger the infarct involvement area and the larger the intracranial lesion change area through reexamination, the poorer prognosis of the children.Early anticoagulant therapy could not improve the prognosis of neonatal cerebral infarction.

Objective: To evaluate the performance of multiplex polymerase chain reaction-based reverse line blot hybridization (mPCR/RLB) in the detection of pathogens causing neonatal bacterial meningitis and associated drug resistance genes. Methods: Clinical data and cerebrospinal fluid (CSF) samples were collected retrospectively from 80 cases diagnosed with neonatal bacterial meningitis in Beijing Children's Hospital from January 1, 2012 to December 31, 2018. A total of 100 CSF samples were obtained including 80 samples collected after admission (12 before and 68 after antibiotic treatment) and 20 recollected at follow-up. All CSF samples were analyzed by conventional culture, susceptibility test and mPCR/RLB. Differences in the detection of pathogens and drug resistance genes were analyzed by Chi-square test. Results: (1) Among the 80 first-collected CSF samples, mPCR/RLB revealed significantly higher positive rate than conventional culture [26.3% (21/80) vs 7.5% (6/80), χ²=10.025, P=0.002]. No significant difference was showed between the two methods in analyzing the 12 samples collected before antibiotic therapy (9/12 vs 5/12, χ²=1.543, P=0.214), while the positive rate in 68 samples collected after antibiotic intervention detected by mPCR/RLB was obviously higher than that by conventional culture [17.6% (12/68) vs 1.5% (1/68), χ²=13.176, P<0.001]. (2) Conventional culture results of the 20 samples collected during follow-up were all negative, but four were positive using mPCR/RLB, which were also positive previously. Furthermore, the results of both methods in previous detections were identical. (3) According to the conventional culture results, the pathogens were Escherichia coli (three cases), Group B Streptococcus (two cases) and Listeria monocytogenes (one case), while mPCR/RLB detected Escherichia coli (four cases), Group B Streptococcus (five cases), Listeria monocytogenes (four cases), Neisseria meningitidis (four cases), Haemophilus influenzae b (one case), Gram-negative bacteria (one case), Gram-positive bacteria (one case), and Listeria monocytogenes and Haemophilus influenzae b coinfection (one case) in 80 first-collected CSF samples. (4) Antibiotic susceptibility test showed that one Escherichia coli strain produced extended spectrum beta-lactamases. Drug resistance gene detection by mPCR/RLB showed that acrA, acrB, CTX-M (consistent with antibiotic susseptibility test) and TetM genes were positive in three, two, one and one case, respectively. Conclusions mPCR/RLB is of great clinical value due to its higher detection rate and better accuracy compared with bacterial culture and can also detect drug resistance genes.

Objective To investigate the correlation of serum urate and gout with calcific aortic stenosis.Methods Patients aged over 60 years admitted into our hospital from July 2009 to January 2019 were retrospectively analyzed.A total of 230 patients were diagnosed as calcific aortic stenosis according to clinical history and transthoracic echocardiography(TTE),and enrolled in the aortic stenosis group.During the same period,460 age-matched patients without aortic stenosis confirmed by TTE were randomly recruited in the 1 ∶ 2 case-control study.The correlations of calcific aortic stenosis with serum urate and gout were analyzed.According to the differential pressure across the valve leaflets assessed by TTE,patients with calcific aortic stenosis were divided into 3 subgroups:the mild stenosis subgroup(n=42),the moderate stenosis subgroup(n=79)and the severe stenosis subgroup(n =109).Relationships of serum urate and gout with different degrees of calcific aortic stenosis were analyzed.Risk factors for the degree of calcific aortic stenosis were analyzed by Logistic regression analysis.Results Serum urate level was higher in aortic stenosis group than in control group [(401.8±139.7) μmol/L vs.(320.7± 106.2) μmol/L,P＜0.05].And the proportion of patients with gout was higher in aortic stenosis group than in control group[11.3％ (26 cases) vs.5.0％ (23 cases),P＜ 0.05].Multivariate Logistic regression analysis indicated that serum urate (OR =3.47,95 ％CI:2.24～ 5.38,P ＜ 0.01) was an independent risk factor for calcific aortic stenosis,while gout (OR=1.41,95％CI:0.74～2.71,P =0.30)was not.There was no correlation of serum urate and gout with the severity of calcific aortic stenosis among the three subgroups(P＞0.05).Conclusions Serum urate level is significantly increased in patients with calcified aortic stenosis.Serum urate is an independent risk factor for calcified aortic stenosis,but has no relationship with stenosis degree.The correlation between gout and calcified aortic stenosis still needs to be further explored.

Objective: To analyze the rule and characteristics of school food poisoning incident in Guizhou Province during 2011-2018. Methods: Data of school food poisoning incidents were collected from the Foodborne Disease Outbreak Surveillance System in Guizhou Province during 2011-2018 and statistically analyzed. Results: A total of 78 cases of food poisoning occurred in schools in Guizhou Province during 2011-2018. Among the 1 506 cases, 869 hospitalized and 1 died. May was peak time for school food poisoning. Most of the incidents (83.33%, 65/78) occurred in the school canteens. Plant origin products (50%, 39/78), especially spoiled rice, were the most common types of food poisoning in school(16.67%, 13/78). Conclusion Primary and secondary school students were the largest group for school food poisoning in Guizhou province. It was necessary to strengthen the supervision and management of school canteens and surrounding places, as well as to improve the food safety awareness of food operators and students, preventing similar incidents from happening again.

OBJECTIVETo explore the impact of electroacupuncture (EA) on the protein expression of adenosine receptors in the heart of the rats with myocardial ischemia (MI).

METHODSThirty healthy male SD rats were divided randomly into a control group (=6), a model group (=12) and an EA group (=12). We ligated the left anterior descending artery (LAD) for MI model in the model group and EA group, and exposed the heart after opening the chest without ligation in the control group. EA, 2 Hz /15 Hz and 1.5-2 mA, was applied at bilateral"Neiguan"(PC 6) in the EA group for 20 min, once a day for continuous 5 days. No intervention except grabbing and fixation was used in the control group and model group. We applied 2% TTC staining to observe the infarct size of myocardium, colorimetry to analyze serum lactic dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), radio-immunity assessment to detect cardiac troponin T (cTnT), Western blot to evaluate the adenosine A1 receptor (A1AR), A2aAR, A2bAR and A3AR.

RESULTSAfter treatment, myocardial infarction of (27.56±3.24)% was obvious in the model group; the myocardial infarction in the EA group was (21.04±3.61)%, with statistical significance (<0.05). The expressions of serum LDH, CK, CK-MB and cTnT levels in the model group increased compared with those in the control group (all<0.01), and the expressions of LDH, CK, CK-MB and cTnT levels in the EA group decreased compared with those in the model group (<0.05，<0.01). The A1AR expression in the model group was not different from that in the control group (>0.05), and A2aAR、A2bAR、A3AR expressions decreased (<0.05,<0.01). A2aAR and A2bAR expressions in the EA group increased compared with those in the model group (both<0.01), and there was no statistical significance between A1AR and A3AR expressions (both>0.05). .

CONCLUSIONEA may achieve cardioprotective effect by regulating the expressions of A2aAR and A2bAR in myocardial tissue, which induce the corresponding signal cascade for reducing myocardial infarction area.