Construction of multi-level medical training platform system in clinical skills simulation training center / 中华医学教育探索杂志

This study mainly introduces the exploration of the construction and management of multi-level medical training platform in clinical skills center of the Affiliated Hospital of Yangzhou University. Through the construction of a multi-level clinical skills training platform, a reasonable hierarchical training program is formulated by taking the clinical basic skills training platform and the clinical specialist skills training platform as the basic core teaching content. This program adopts various ways to improve the teaching quality, effectively promote students' ability of clinical practice step by step, meet the needs of different levels of medical personnel in different stages, scientifically and effectively cultivate the high-quality medical personals, and give full play to the role of hospital clinical skills center in medical education, which lays a good foundation for the continuous improvement of teaching quality in hospitals.

The status quo and demand analysis of multi-level pre-job training for clinical nursing teachers / 中华医学教育探索杂志

Objective:To investigate the status quo of multi-level pre-job training for clinical nursing teachers and analyze their training needs, so as to provide reference for the design of pre-job training for clinical nursing teachers.Methods:A cross-sectional survey method was used to investigate 172 clinical nursing teachers in a tertiary general hospital in Harbin from April 2020 to June 2020 with multi-level pre-job training mode. The status quo of pre-job training and the training needs of teachers were analyzed. SPSS 17.0 was used to process the original data statistically.Results:Among the 172 respondents, 138 teachers (80.2%) were under 35 years old, and 133 teachers (77.3%) had a bachelor's degree or less; 89 teachers (51.7%) confirmed that hospitals or departments would carry out pre-job training in a planned and organized way, 10 teachers (5.8%) said that hospitals or departments had never organized training, 41 teachers (23.8%) had never participated in pre-job training, and 80 teachers (46.5%) had participated in pre-job training 1-3 times. There were 5 duplicates in the first 8 training contents of in-hospital training and in-department training, including knowledge of common diseases, nursing procedures, communication skills, hospital rules and regulations, and teaching methods. The total score of training demand was (154.51± 40.35) points, and the overall demand rate was 81.3%, which was at the high level. The dimensions with the highest scoring rate were legal system and humanistic literacy, with a scoring rate of 83.0%. The dimension with the lowest score was teaching management, with a score of 74.9%. The scoring rate of training needs with the highest points won nine items respectively on students' basic quality (self-supervision, willingness to learn, professional quality, etc.) (84.7%), training of legal knowledge (84.4%), incompatibility of drugs commonly used in department (84.3%), nurse etiquette (83.3%), nursing risk prevention (83.1%), evaluation methods of student education (83.1%), nurse-patient communication skills (83.0%), nurses and patients medication observation points of commonly used drugs in the department (83.0%), and effects of commonly used drugs in department (82.9%). Among the top three training forms, 84 students (48.8%) received online learning, 74 students (43.0%) received lectures from experienced teachers in hospitals, and 72 students (41.9%) received experience exchange and sharing seminars.Conclusion:The talent structure of clinical nursing teachers in this hospital is relatively young, and the first education level is low. Therefore, the pre-job training of clinical nursing teachers should be strengthened vigorously. The awareness rate and participation rate of pre-job training are average, so we should strengthen the release of training information from various channels, improve the awareness rate of training activities, clarify the encouragement or reward measures to participate in pre-job training activities, and improve the participation rate of training activities. Pre-job training content is repeated at every level, with a gap between the training needs of teachers in clinical nursing teaching. It's suggested that the teaching hospitals combine with their training objects of training needs, take the online-offline mixed mode of training, reasonably plan training contents as a whole at all levels, avoid training content repetition and waste of teachers, and organize teachers to timely exchange and share experiences.

Presidential communication approaches and the impact on public health: a comparative analysis of three South African presidents' communication on AIDS and COVID-19

The HIV response in the African continent over past decades demonstrates the potency that the words and actions of political leaders have in either expediting or impeding the implementation and adoption of preventive measures at the individual and community levels. The article explores the health communication approaches employed by two South African past presidents (Thabo Mbeki and jacob Zuma) in responding to the HIV epidemic, and contrasts these with the communicative approach of President Cyril Ramaphosa during the COVID-19 pandemic. Approached from this understanding, this article provides a comparative analysis of the communication approaches of these three presidencies across the two pandemics, and considers the variously trusted sources of top-down, government-driven and bottom-up, community-informed approaches to health communication. Critical lessons that emerged in South Africa during the HIV epidemic regarding the need to include communities in communicating about risks and behaviour change have not been adopted into the COVID-19 response. Political leaders are not best placed to communicate about these issues, and, in the context of pandemics, there is a clear need to reconsider top-down communication approaches that are designed without the participation of communities and ignore the interconnected nature of health and other social determinants of health.

Construction of a multi-level model for evaluating the association between the number of dust exposed workers and raw coal production / 中国职业医学

@#Abstract: Objective （ Based on the data from the ″Occupational Diseases Hazardous Items Reporting System″ hereinafter ）， referred to as the ″Reporting System″ a method was constructed to estimate the number of occupational dust exposed workers （ ） in coal mining and washing enterprises hereinafter referred to as "coal workers" at the provincial administrative level. Methods ， A typical sampling method was used to study 1 808 coal enterprises in Shanxi Province Inner Mongolia Autonomous ， ， Region Shaanxi Province and Xinjiang Uygur Autonomous Region in 2020 in the Reporting System. Based on the data of 1 217 ， ， - coal enterprises that were coal mining or integrated coal mining and washing enterprises a multi level model was established to analyze the association between the number of coal workers and raw coal production. Two scenarios were set up based on the ， enterprise scale composition ratio to estimate the number of underreported coal workers and the number of coal workers in each Results provincial administrative region was corrected. The data of the Reporting System in 2020 showed that the ranking of ， raw coal production and the number of coal workers from most to least were Shanxi Province Inner Mongolia Autonomous ， ， Region Shaanxi Province and Xinjiang Uygur Autonomous Region with a total of 1 002 842 coal workers. The random intercept ， model using raw coal production enterprise scale and their interaction terms was fitted optimally with a −2 log likelihood value of 2 005.96 and Akaike information criterion value of 2 017.95. The factors affecting the number of coal workers included raw ， coal production and its interaction with the scale of enterprises. For every 1.00% change in raw coal production the number of ， coal workers in small and micro enterprises changed by 0.62% and the number of coal workers in large and medium enterprises changed by 0.13% more than that in small and micro enterprises. The corrected total number of coal workers for the four ， Conclusion provincial administrative regions was 1 125 515 and 1 089 321 for the two hypothetical scenarios respectively.The multi level model constructed with the data of raw coal production enterprise scale and their interaction terms of four ， provincial administrative regions could estimate the number of coal workers accurately and could better correct the number of coal workers in each provincial administrative region.

MF2ResU-Net: a multi-feature fusion deep learning architecture for retinal blood vessel segmentation / 数字中医药（英文）

Objective@#For computer-aided Chinese medical diagnosis and aiming at the problem of insufficient segmentation, a novel multi-level method based on the multi-scale fusion residual neural network (MF2ResU-Net) model is proposed.@*Methods@#To obtain refined features of retinal blood vessels, three cascade connected U-Net networks are employed. To deal with the problem of difference between the parts of encoder and decoder, in MF2ResU-Net, shortcut connections are used to combine the encoder and decoder layers in the blocks. To refine the feature of segmentation, atrous spatial pyramid pooling (ASPP) is embedded to achieve multi-scale features for the final segmentation networks.@*Results@#The MF2ResU-Net was superior to the existing methods on the criteria of sensitivity (Sen), specificity (Spe), accuracy (ACC), and area under curve (AUC), the values of which are 0.8013 and 0.8102, 0.9842 and 0.9809, 0.9700 and 0.9776, and 0.9797 and 0.9837, respectively for DRIVE and CHASE DB1. The results of experiments demonstrated the effectiveness and robustness of the model in the segmentation of complex curvature and small blood vessels.@*Conclusion@#Based on residual connections and multi-feature fusion, the proposed method can obtain accurate segmentation of retinal blood vessels by refining the segmentation features, which can provide another diagnosis method for computer-aided Chinese medical diagnosis.

Research on medical insurance data sharing mode based on " City-customized Medical Insurance" / 中华医院管理杂志

With the explosive growth of " City-customized Medical Insurance" products, the voice of commercial health insurance needs medical insurance data support is increasing.The authors took " City-customized Medical Insurance" as the representative of commercial health insurance, analyzed the demands and motivations of stakeholders in medical insurance data sharing through the power-interest matrix model, and summarized the medical insurance data sharing path at the commercial insurance product design end and claim settlement end. It is suggested to strengthen the top-level design, build the implementation path of standardized sharing of medical insurance data and the operation mechanism of hospital data docking, to realize the value increment of all stakeholders.

Analysis and practice on the " dual-channel" management mode of national medicare negotiated drugs in China / 中华医院管理杂志

" Dual-channel" management is an important management measure to solve the difficulty of national medicare negotiated drugs entering the hospital and improve the accessibility of the drugs. China clearly included some social pharmacies into the supply guarantee channel of national medicare negotiated drugs, and formed a " dual-channel" supply mode for negotiated drugs together with the hospital supply. By sorting out China′s national medicare negotiated drugs policy management documents and the management modes and specific measures in various regions and periods, this paper summarized and analyzed the progress of process management, multi-level medical security integration, remote handling, drug safety supervision, and information construction in various regions. Based on the relevant policy guidance and local practical experience, the authors explored and optimized the " dual-channel" landing management, so as to provide reference and suggestions for further improving the accessibility of national medicare negotiated drugs and giving full play to the effectiveness of medical security.

Evaluation of a multi-level quality control system in health management center setting / 中华健康管理学杂志

Objective:To explore the application and effect of multi-level quality control system (referred to as “quality control”) in health management center setting.Methods:The health management center of Hanzhong Central Hospital constructed a multi-level quality control system of “hospital-department-unit” and “department-unit-quality-controller” in August 2019. A total of 83 619 people who underwent physical examination in the Health Management Center of Hanzhong Central Hospital from August 2018 to July 2020 were selected as the subjects. 32 009 people who underwent physical examination from August 2018 to July 2019 were selected as the control group, and 51 610 people who underwent physical examination from August 2019 to July 2020 were selected as the experimental group. The timely notification of important abnormal results and the follow-up of the “four-high” population (hypertension, hyperglycemia, hyperlipidemia, and hyperuricemia) were observed. Two thousand satisfaction questionnaires and two thousand physical examination reports were collected from the institutions who had received both physical examination in the Health Management Center of Hanzhong Central Hospital for two consecutive years. The physical examination items of the above clients were basically the same. The satisfaction rate of the two groups of physical examination and the qualification rate of the physical examination reports were measured respectively.Results:The results showed that the timely notification rate of important abnormal results (99.4% vs 96.6%), follow-up rate of “four-high” population (hypertension 95.1% vs 91.2%, hyperglycemia 95.3% vs 91.6%, hyperlipidemia 94.6% vs 92.3%, hyperuricemia 92.7% vs 86.4%), satisfaction rate of physical examination (physical examination environment 94.0% vs 91.3%, service attitude 96.4% vs 91.9%, waiting time 97.6% vs 95.4%, physical examination process 98.3% vs 96.8%, professional level of medical staff 97.2% vs 95.1%), and qualified rate of physical examination report (accuracy of input information 99.5% vs 98.1%, accuracy of main examination conclusion 99.4% vs 97.3%, normative sorting 99.8% vs 98.8%, rationality of health advice 99.2% vs 96.8%) in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion:The establishment of a multi-level quality control system in health examination service can improve the timely notification rate of important abnormal results, the follow-up rate of the “four-high” population, the satisfaction of physical examinees, and the qualified rate of physical examination reports.

A method of lung puncture path planning based on multi-level constraint / 生物医学工程学杂志

Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Multi-level governance tackling the COVID-19 pandemic in China / A governança multinível no enfrentamento da pandemia de COVID-19 pela China / Gobernanza multinivel en China para el combate de la pandemia de COVID-19

Abstract This paper investigates China's leadership over intergovernmental and private actions in tackling the COVID-19 pandemic and identifies sectors, levels, and roles played. The main argument is that successful control over the pandemic depends on effective and integrated leadership at different levels. The conceptual, theoretical, and analytical framework is given by the multi-level governance theory. Through a case study, the actions adopted in China (n = 374) were mapped from reports issued by the Chinese government, the World Health Organization, and media information. Content analysis was adopted to categorize data. Quantitative and qualitative findings show different roles of actors, as well as usefulness of the multi-level governance to provide fast and complex responses required during the pandemic. In the last section, the conclusion and recommendations for future research are addressed. The lack of studies on the application of multi-level governance in non-democratic regimes especially during a pandemic indicates the relevance and contribution of this study to the literature.

Resumo O artigo objetiva investigar a liderança pública das ações, relações privadas e intergovernamentais da China no enfrentamento da pandemia de COVID-19, identificando setores e níveis envolvidos, bem como os papéis desempenhados. O argumento central é o de que o controle bem sucedido da pandemia depende da liderança eficaz e integrada das relações intergovernamentais e privadas nos diversos níveis. O enquadramento conceitual, teórico e analítico é dado pela teoria da governança multinível. Através do método de estudo de caso, as ações de enfrentamento adotadas na China (n = 374) foram mapeadas a partir dos relatórios emitidos pelo governo chinês, pela Organização Mundial da Saúde e informações da mídia. As ações foram categorizadas através da técnica de análise de conteúdo. Resultados quantitativos e qualitativos são apresentados e mostram os papéis dos atores, bem como a relevância da governança multinível diante da rápida e complexa resposta exigida pela emergência da pandemia. Na última seção são apresentadas as conclusões e oportunidades para desenvolvimentos futuros. A relevância da pesquisa também reside na escassez de estudos sobre a aplicação da governança multinível em regimes não democráticos, especialmente durante pandemias.

Resumen El artículo investiga el liderazgo público de China en las acciones y relaciones intergubernamentales y privadas para enfrentar la pandemia de COVID-19, al identificar los sectores y niveles involucrados, así como los roles. El argumento central es que el control exitoso de la pandemia depende de un liderazgo efectivo e integrado a diferentes niveles. La teoría de gobernanza multinivel es el marco conceptual, teórico y analítico. Las acciones adoptadas en China (n = 374) se mapearon a través del método de estudio de caso, a partir de informes emitidos por el gobierno chino, la Organización Mundial de la Salud e información de los medios y, para categorizar esos datos, se adoptó la técnica de análisis de contenido. Se presentan hallazgos cuantitativos y cualitativos que muestran los roles de los actores, así como la relevancia de la gobernanza multinivel ante la respuesta rápida y compleja requerida por la emergencia pandémica. En la última sección se exponen las conclusiones y recomendaciones para futuras investigaciones. La falta de estudios sobre la aplicación de la gobernanza multinivel en regímenes no democráticos, especialmente durante una pandemia, demuestra la relevancia de este estudio y su contribución a la literatura.

Interpolation Algorithm for Motion Vector Field of CTA Image and Accelerated Implementation Based on Uniform Grid and Multi-level B-spline / 中国医疗器械杂志

In order to solve the problems of slow operation speed and low registration accuracy of thin plate spline (TPS) interpolation method for motion vector field in coronary computed tomography angiography (CTA), a multi-level B-spline interpolation method (MBS) with uniform grid is proposed. On the one hand, the interpolation method used local B-spline to refine the sparse mesh layer by layer in a multiscale way to improve the accuracy of registration. On the other hand, it used the splitting matrix method to interpolate the motion vector field, greatly reducing the operation time of interpolation. The experimental results show that the proposed method can be used for CTA image registration efficiently.

The application of multi-level comprehensive model in the evaluation of medical practical teaching effect / 中华医学教育探索杂志

Objective:To evaluate the effectiveness of medical practical training with a multi-level comprehensive model.Methods:We randomly selected 100 medical undergraduates who received practical training in The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from 2017 to 2019, 20 medical education experts, and 30 teachers for a questionnaire survey using self-designed questionnaire with 3 first-level items, 8 second-level items, and 31 third-level items. Data processing and analysis was made by multi-level comprehensive model.Results:The comprehensive evaluation data (0.176 4, 0.512 3, 0.252 5, 0.058 8) obtained by the multi-level comprehensive model showed that the proportions of medical undergraduates achieving excellent, good, moderate, and poor effects of medical practical training were 17.64%, 51.23%, 25.25%, and 5.88% respectively. According to the principle of maximum membership, the final comprehensive evaluation result of the effectiveness of medical practical training was "good".Conclusion:This research has demonstrated the scientificity and feasibility of using the proposed multi-level comprehensive model to evaluate the effectiveness of medical practical teaching. In the comprehensive evaluation, the quantitative processing of qualitative indices can generate the matching score of each index in the multi-level index system. The evaluation results are intuitive and easy to analyze, thus providing the basis for the targeted improvement of medical practical teaching effect.

Determinant Factors in Cost to Feed for Long-Term Care Facilities Residents / 보건행정학회지

BACKGROUND: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. METHODS: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. RESULTS: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). CONCLUSION: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.

Investigation of"multi-level integrated training mode"of clinical thinking and its evaluation system / 中华医学教育探索杂志

With the reform of medical education ("5+3"), the clinical mentors usually need to guide three kinds of students who are at different stages of medical education at the same time. And we summed up the core concept of clinical thinking and problems in its training, such as the imperfect teaching mode, insufficient teacher teaching awareness, students' difficulties in adapting to role changes, thinking patterns, and relying on auxiliary examinations, etc. For the training targets of three kinds of students are different, we explored and constructed a "multi-level integrated" training mode and the evaluation system of clinical thinking from the building of professional thinking, lectures, heuristic rounds, multi-aspect thinking mode extension, group learning and case discussions. So far, they have made effective achievements among a small part of students, which are hopefully useful for clinical training.

Geographical variation and related factors in prediabetes prevalence in Chinese adults in 2013 / 中华预防医学杂志

Objective@#To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes.@*Methods@#Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level.@*Results@#The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level.@*Conclusion@#The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.

Emotional intelligence training intervention among trainee teachers: a quasi-experimental study

Abstract Background: Emotional intelligence (EI) has often been linked to improvements in professional performance. Indeed, generic competencies related to EI have been included in university curricula. However, learning EI involves significant time and effort on the part of students, and this may hinder the acquisition of specific content for each degree. In this study, an intervention to develop EI in higher education students is described and evaluated. Methods: The intervention consisted of eight group sessions performed in a regular course aiming to increase EI. The sessions included strategies and training on perceiving and understanding one's own emotions and others' emotions, identifying and understanding the impact one's own feelings in adopting decisions, expressing one's own emotions and the stress experienced, and managing both one's own emotions and emotions of others. Participants were 192 students studying for a Master of Primary Education degree. A quasi-experimental nonequivalent control group pretest-posttest design was adopted. The effectiveness of the intervention was evaluated using multi-level analyses. Results: The results showed a significant improvement in the EI of students in the experimental group compared with the control group. Conclusions: This research demonstrates that it is possible to develop EI in higher education students, without hindering the acquisition of specific content competencies and, therefore, without interfering with their academic performance and without overburdening students with work outside the classroom. Trial registration: The experiment has been registered in the Initial Deposit of the Spanish Center for Sociological Research (CIS). 7/6/2015. http://www.cis.es/cis/opencms/ES/index.html.

The tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea ;syndrome / 中国医师进修杂志

Objective To observe the tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Twenty-three patients were enrolled. According to the different obstructive level, the different operations were chosen to complete upper airway reconstruction in contemporaneous operation group (group A, 13 patients). In the simple palatopharynx level obstructive group (group B, 10 patients), bilateral tonsillectomy and H-UPPP was chosen. Results The operation time in group A was significantly longer than that in group B:(121.0 ± 35.4) min vs.(80.7 ± 25.3) min, P0.05). Conclusions Individual therapeutic schedule for OSAHS patients should be formulated. Operating the different obstructive levels simutaneously, which would solve upper airway occlusion and complete the upper airway reconstruction at the same time. No more adverse events happen, compared with the simple palatopharynx level obstructive group, though the operation time may be longer.

Multi-level analysis of oral health and its influencing factors in 12-year-old children in Chongqing / 第二军医大学学报

Objective To understand the status of oral health and its influencing factors among 12-year-old children in Chongqing, so as to provide evidence for setting up the intervention policy of oral health for children. Methods The data obtained from “the assessment on the comprehensive intervention effect for oral health among children in Chongqing” in 2015 were used in the present study; multi-level logistic regression model was used to analyze the status of oral health and its influencing factors among children in Chongqing. Results The prevalence of dental caries among 12-year-old children was 45. 5% (922/2 025) in Chongqing, and the status of oral health was clustered at school level (Ωu=0. 412, P=0. 091, α=0. 1). Multi-level logistic regression analysis indicated that the gender, sugar or chocolate intake once a week and above, and “whether children recognizing that oral health is very important for their life” were the individual variables affecting the dental caries incidence in 12-year-old children, and the difference between urban and rural schools was its background variable (P<0. 05, α=0. 05). Conclusion The gender, cognition to oral health, behavioral habit and the difference between urban and rural schools where children study are important factors influencing the oral health of 12-year-old children in Chongqing, and pertinent measures should be taken to improve the oral health among children.

Effect of Cognitive Behavioral Multi-level Intervention on Post-stroke Depression / 中国康复理论与实践

@#Objective To investigate the effect of cognitive behavioral multi-level intervention on post-stroke depression. Methods 160 patients with post-stroke depression in our hospital from February 2013 to February 2015 were divided into control group (n=80) and obser-vation group (n=80). Both groups received conventional medical treatment and nursing care. The observation group received cognitive be-havioral multi-level intervention nursing care, including personal psychology, behaviour and joint relationship. Self-rating Depression Scale (SDS) was assessed, and the serum level of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α(TNF-α) were mesured before and after treatment. Results After treatment, the score of SDS was lower (t=2.705, P<0.05), and the levels of IL-1β(t=8.182), IL-6 (t=2.883), TNF-α(t=2.604) were lower in the observation group than in the control group (P<0.05). The incidence of depression was also lower in the observa-tion group than in the control group ( χ 2=6.144, P<0.05) after 6 months follow-up. Conclusion Cognitive behavioral multi-level interven-tion could effectively prevent post-stroke depression.