Objective:To establish an early clinical prediction model for patients with chronic liver disease who are coinfected with hepatitis E virus (HEV), and quickly evaluate the probability of severe hepatitis in patients.Methods:A retrospective analysis was conducted on 87 patients with chronic liver diseases who were hospitalized at the Third Affiliated Hospital of Sun Yat-sen University from May 2018 to September 2023. Clinical features and laboratory indexes were analyszed and patients were classified to severe (TBIL >171 μmol/L with PTA <40%) and non-severe (TBIL <171 μmol/L with PTA >40%) groups. and Independent factors identified using LASSO regression were incorporated into a novel nomogram to identify patients at high risk of severe hepatitis in the early stages. The performance of the nomogram was evaluated using the area under the curve and the mean absolute error of the calibration curve.Results:Significant difference was observed in the serum total bile acid (TBA) level between the severe group [240.00 (183.30, 268.70) umol/L] and the non-severe group [93.40 (20.10, 271.70) μmol/L, U=269.00, P=0.002]. Additionally, the levels of apolipoprotein A1 (APOA1) [0.32 (0.18, 0.48) g/L] and uric acid (UA) [156.15 (117.00, 202.00) μmol/L] were significantly lower in the severe group compared to the non-severe group (APOA1: [0.77 (0.63, 1.06) g/L, U=71.00, P<0.001]; UA: [334.05 (243.70, 401.00) μmol/L, U=83.00, P<0.001]). The researchers developed a nomogram, which incorporated two independent factors (APOA1 and UA) and an additional variable (TBA), exhibiting a strong predictive ability, with an area under the curve (AUC) of 0.963 (95% confidence interval: 0.927-0.998) and a well-fitted calibration curve. Positive and negative predictive values of 94.0% and 88.2% were calculated, and a nomogram score of 129 or greater was considered indicative of a higher likelihood of developing severe illness. Conclusions:This nomogram offers a rapid and accurate means of evaluating the probability of severe illness in patients with chronic liver disease after overlapping infection with HEV, which can accurately and effectively predict the risk of severe illness in patients.

Objective:Based on the investigation of students after the "periodic recall" examination, to discuss the role and existing problems of this kind of examination in the joint training of standardized training for residents.Methods:In March and October, 2017, questionnaire survey was conducted on the students who participated in the "periodic recall" clinical examination, and the arrangement and implementation of the assessment were evaluated by the students in terms of satisfaction, and the ability status before and after the clinical examination was assessed in person on a scale of 1-10. At the same time, the results of the two times of examinations were analyzed, and the average scores of all skills and the overall average scores were calculated to compare the differences. SPSS 16.0 was used for t test and variance analysis. Results:A total of 112 questionnaires were distributed and 99 were returned. Students' overall satisfaction with the examination arrangement was high, with the satisfaction of all items above 70%. After the examination, the students' self-assessment scores of all abilities were improved, and there were significant differences before and after the examination. There was a significant difference in the average improvement of self-assessment ability among the seven skills ( F=4.19, P=0.006). The results analysis showed that the average score of simple operation was higher than the overall average score, with significant differences. Conclusion:"Periodic recall" examination can meet students' psychological and learning needs in the tumor hospital training, with high satisfaction, which has obvious effect on improving students' simple operation skills, but weak improvement of complex comprehensive skills.

OBJECTIVE：To study the effects of chrysophanol on the activa tion of microglia and the expression of inflammatory factors in cerebral ischemia model rats. METHODS ：SD rats were randomly divided into sham operation group ， model group and chrysophanol high ，medium，low dose groups [7.88，3.94，1.97 mg/（kg·d）]，with 20 rats in each group （the number was complemented in cases of death or unsuccessful modeling during modeling process ）. Except for sham operation group ， middle cerebral artery occlusion model was established in other groups by improved thread method. After 2 hours of ischemia ， sham operation group and model group were intraperitoneally injected with 1 mL normal saline ，and each administration group was intraperitoneally injected with 1 mL corresponding drug ，once a day ，for 7 consecutive days. After last medication ，the score of neurological impairment was recorded ；cerebral infarction of rats was observed by TTC staining ，and the percentage of cerebral infarction area was calculated. The expression of Iba- 1 positive cells in ischemic penumbra of rats was observed by immunofluorescence staining. The expression of Notch- 1，TNF-α and ICAM-1 in the ischemic penumbra of rats were detected by Western blotting assay. RESULTS ：In sham operation group ，there was no infarction area in the brain tissue ，and the Iba- 1 positive cells in the ischemic penumbra were few and branched. Compared with sham operation group ，the infarction area of cerebral tissue in rats was obvious in model group ； the 052）number of Iba- 1 positive cells in ischemic penumbra were 〔ZQ2017003〕） increased significantly ，and they were in amoeba or round shape；the neurological impairment score ，the percentage of cerebral infarction area ， relative expression of Notch- 1， TNF-α and ICAM-1 protein in ischemic penumbra were increased significantly （P＜0.05）. Compared with m odel rats ，the infarction area of cerebral tissue in each dose group of chrysophanol was reduced to different extent ；the number of Iba- 1 positive cells in ischemic penumbra was decreased ；neurological impairment score ，the percentage of cerebral infarction area ，relative expression of Notch- 1，TNF-α and ICAM-1 protein were significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS ：Chrysophanol has a certain protective effect on the brain tissue of cerebral ischemia model rats ，and can relieve the nerve injury. Its mechanism may be associated with inhibiting the activation of microglia and expression of inflammatory factors mediated by Notch pathway.

OBJECTIVE: To explore the application of the autoregressive integrated moving average model( ARIMA model)in predicting incidence of occupational noise-induced deafness( ONID). METHODS: The ARIMA model was established and validated based on the number of new onset ONID cases in Guangdong Province from 2006 to 2015. Then the ARIMA model was used to predict the trend of new onset ONID cases from 2016 to 2020. RESULTS: The number of new ONID cases in Guangdong Province from 2006 to 2015 showed an exponential growth trend. The optimal model fitted with the number of new onset ONID cases from 2006 to 2015 was the ARIMA( 2,2,2) model,which better match the number of new onset ONID cases from 2008 to 2015. According to the ARIMA( 2,2,2) model,the number of new onset ONID cases in Guangdong Province will continue to have a rapidly increasing trend from 2016 to 2020. CONCLUSION: The ARIMA model based on time series matches the time trend of ONID onset,and it can be used for the prediction of ONID incidence trend.

OBJECTIVE: To analyze the epidemiological characteristics and predict epidemiological trends of occupational chemical poisoning,based on directly reported data during 2006-2015 in Guangdong Province. METHODS: The data of patients with occupational chemical poisoning reported from National Information Surveillance System for Occupational Disease and Occupational Health from 2006 to 2015 in Guangdong Province were collected. The epidemiological characteristics were retrospectively analyzed. The autoregressive integral moving average model( ARIMA model) was established and validated based on the number of the new onset cases and was used to predict the trends of occupational chemical poisoning from 2017 to 2020 in Guangdong Province. RESULTS: From 2006 to 2015,1 288 new cases of occupational chemical poisoning were reported in Guangdong Province,which accounted for 24. 4% of the total number of new cases of occupational diseases in the province( 5 283 cases). Among the new cases,the percentage of acute and chronic poisoning was 21. 7%( 279/1 288) and 78. 3%( 1 009/1 288). There was 74. 7%( 962/1 288) of organic solvent poisoning. Five kinds of new occupational chemical poisoning were found. Most of the new cases were male,accounting for 56. 7%( 729/1 288). They were mainly distributed and concentrated in Pearl River Delta Region,accounting for 95. 9%(1 235/1 288). Shenzhen,Dongguan and Guangzhou were the most three cities which had 425,325 and 209 cases respectively,all of them accounted for 74. 4%( 959/1 288). The new cases of poisoning mainly distributed in medium and small enterprises( 72. 0%),private economic enterprises( 50. 9%) and manufacturing industries(70. 5%). The number of occupational chemical poisoning diseases decreased first,and increased,and the proportion to the total number of occupational diseases in Guangdong Province showed a straight downward trend(P < 0. 01). The median age at diagnosis was 35 years old and the median work year at diagnosis was 2. 0 years,and both of them showed an increasing trend( P < 0. 01). CONCLUSION: Occupational chemical poisoning in Guangdong Province has certain characteristic of crowd aggregation and epidemic trends.

OBJECTIVE: To establish a comprehensive evaluation system for the development of health services, and to assess the levels of health services in 2008 and 2009 in Hunan compared with seven other provinces in central China, so as to provide a basis for hygiene management decisions. METHODS: In order to establish a comprehensive evaluation system, a Delphi method, a boundary value method, and an RSR method were applied, respectively, to survey indices of health service development, to screen indices, and to determine index weights. A weighted TOPSIS method was used to evaluate the development status of health services of the eight provinces. RESULTS: The Cronbach's alpha coefficient of the questionnaire was 0.884, indicating a proper surface validity and a content validity. The expert positive coefficient, authority coefficient and Kendall coefficient were 93.75%, 0.8117, and 0.31, respectively. A comprehensive evaluation system, which consisted of 3 primary indices, 10 secondary indices and 52 tertiary indices, was established. The result of the comprehensive evaluation showed that the health services development of Hunan Province ranked 7th and 6th among the 8 central provinces for 2008 and 2009, respectively. CONCLUSION The established, comprehensive evaluation system has a high reliability. Health services development of Hunan Province is relatively backward among the 8 central provinces.
China ; Health Services ; standards ; statistics & numerical data ; Humans ; Surveys and Questionnaires

OBJECTIVE: To study the health service development in Hunan Province, and to find out the advantages and disadvantages, and to make tentative specific suggestions. METHODS: Comparison was made in Yunnan, Hunan, and Zhejiang Provinces in 4 major areas: health institutions, personnels, facilities, and funding. RESULTS: The overall health service of Hunan Province was good: The health resources increased, the allocations were reasonable, and the health expenditure decreased. Some problems appeared, such as backward primary health, shortage of medical talents, inefficient use of hospital beds, deducted government investment, increased business income, and large urban-rural gap. CONCLUSION There is urgent need to further develop health institutions and increase personnels, particularly improving the primary health care and making use of traditional Chinese medicine; improving the management of hospital beds to increase efficiency, increasing financial support to reduce the patients' burden, and ensuring the need of rural health care.
China ; Delivery of Health Care ; trends ; Health Services ; economics ; statistics & numerical data ; Health Services Administration ; Humans ; Rural Health ; economics

Objective To study the differences in retinoic acid receptor γ(RARγ) mRNA expression levels in blood leukocytes between antipsychotic-free and antipsychotic-naive schizophrenic patients and healthy control,especially in different genders. Methods Forty-three acute schizophrenic patients who were antipsychotic-naive or antipsychotic-free for at least three months (male = 34, female = 9) and 39 age- and sex-matched healthy subjects (male =25 ,female = 14) were included for blood leukocytes expression of RAR γ mRNA ,using real-time PCR technique. Results Kolmogorov-Smirnov Z analysis showed a significant increase of RARγ mRNA (P =0.041) level in blood leukocytes of pooled schizophrenic patients(0. 027 ± 0. 003) than in the healthy subjects (0. 020 ± 0.002). The elevation was mainly found in the female patients (0. 030 ± 0.003). Within-sex analysis showed that the female schizophrenic patients showed a trend increase (P = 0. 166) of RAR γmRNA expression compared with the male patients (0. 026 ± 0. 001) and exhibited greater RARγ mRNA expression (P = 0. 014)when compared with the female healthy subjects(0. 018 ±0.004). Conclusions The present findings showed an abnormal expression of leukocyte RARγ mRNA level in antipsychotic-free and antipsychotic-naive schizophrenia especially in the female patients. Blood RARγ markers could add to the diagnosis and individualized pharmacotherapy of schizophrenic patients ,especially the female patients.

Promoting information exchange is the major function of the information system for postgraduate students which was aimed at improving the efficiency of management,facilitating scientific management,accelerating information transportation among users and enhancing utilization of information.The idea of management,design and implement of the information system for postgraduate students based on Web were described in this paper.

According to the design of medical specialist system and the features of Cancer Prevention and Treatment in China, suggestions of Oncologic specialist training were proposed as following. Applying the training by phases is suitable, the conceptions, principles and protocols for Comprehensive treatment and standardized treatment are core contents for the Oncologic specialist training process, which should be carried out in tumor hospital prior to general hospital, the special therapy for the special disease is the aim of Oncolngic specialist training.