Comparative analysis of Aedes albopictus surveillance index in Yangpu District， Shanghai / 上海预防医学

ObjectiveTo analyze the interannual fluctuation， seasonal fluctuation， habitat distribution and the correlation of the 3 monitoring indicators of Aedes albopictus in Yangpu District of Shanghai from 2017 to 2021， and to provide a scientific basis for A. albopictus control and rational use of the indicators. MethodsThe density surveillance data of A. albopictus recorded by Breteau index （BI）， Path index （PI） and the mosquito ovitrap index （MOI） from 2017 to 2021 in Yangpu District， Shanghai were compared. Microsoft Excel 2019 software was used for data summary and SPSS 25.0 software was used for statistical analysis. ResultsFrom 2017 to 2021， there were two months with BI>5， and the PI were all above the density control level of Class C， and there were nine months with MOI≥5. In 2017， BI was higher than in the other four years， with statistically significant differences （all P≤0.001）. MOI in 2017 and 2020 was higher than in 2019 （P=0.029， P=0.004） and 2021 （P=0.005， P=0.001）， with statistical significance. MOI for different types of habitats varied significantly， with a statistically significant difference （P=0.004）. A linear correlation was observed between BI and PI （r=0.462， P=0.010）. ConclusionBI， PI and MOI are used simultaneously to reflect the density of A. albopictus in Yangpu District of Shanghai. However， these three monitoring indicators show poor linear correlation. Comprehensively considering the scientific aspects of monitoring methods and seasonal fluctuations of indicators， it is suggested that MOI should be used as the main index to evaluate the density of A. albopictus. In the MOI， attention should be paid to factors such as the distribution of the habitats， the standardization of operating methods， and quality control， which are essential for enhancing the reliability of the MOI.

Analysis on the Educational Value and Inheritance Path of the Westward Relocation Spirit: Taking Medical Colleges and Universities as an Example / 中国医学伦理学

As an important part of the spiritual pedigree of the Communist Party of China, the "westward relocation spirit" has profound theoretical value and practical significance for the ideological and political education and career planning of contemporary medical students. Therefore, through detailed interpretation of the educational value of the "westward relocation spirit", this paper analyzed the inheritance path of the "westward relocation spirit" from the four levels of state, society, schools and individuals, in order to cultivate medical students to form a correct grass-roots employment consciousness, and coordinate the contradiction between social development and personal needs. It provides a clear direction for shaping the "new successor of westward relocation" under the command of the Party and comprehensively improving the modernization of medical students’ service at the grass-roots level.

A Study on the Cultivation Path of Professional Spirit of Medical Students into Ideological and Political Courses in Post-epidemic Era / 中国医学伦理学

In the post-epidemic era, medical workers have more responsibilities and the medical environment is becoming increasingly complex, so more exquisite medical technology and higher-level professionalism are needed. In the post-epidemic era, medical students’ cognition of the value of life itself, their reflection on the ethical relationship between life individuals and their understanding of the ethical relationship between freedom and responsibility make it more significance to strengthen the cultivation of professional spirit. The ideological and political course is the key course to implement the fundamental task of cultivating people with virtue. Integrating the professional principle education of "Life is the highest", highlighting the philosophical thinking education and strengthening the great anti-epidemic spirit education in the ideological and political course is an effective way to cultivate the professionalism of medical students in the post-epidemic era.

Research on the Communication Path of Traditional Chinese Medicine Culture from the Perspective of Industry-University-Research Collaborative Innovation / 中国医学伦理学

Traditional Chinese Medicine (TCM) is an indispensable carrier of traditional culture for China to embrace the world. During the 14th Five-Year Plan period, the state proposed to "comprehensively promote the building of a healthy China, attach equal importance to TCM and western medicine, and vigorously develop the cultural industry of TCM". Promoting the development of TCM cultural industry needs scientific and innovative approaches. This paper explored how to realize the communication path of TCM culture from the perspective of "Industry-University-Research". Based on the analysis of the current situation of TCM culture communication, taking Shandong University of Traditional Chinese Medicine as an example, this paper integrated technology, human resources, resources, environment and information and other collaborative innovation elements to effectively gather, and explored a new way for the collaborative development of TCM communication with enterprises, schools, scientific research institutions and et al, aiming to further help TCM culture go abroad.

Analysis on the All Media Communication Path of Traditional Chinese Medicine Culture under the Background of the Epidemic Prevention and Control / 中国医学伦理学

As an important part of China’s excellent traditional culture, Traditional Chinese Medicine (TCM) culture contains rich philosophical thoughts and has made important contributions to human health. The advent of the all media era has provided an opportunity for the full effect communication of TCM culture. On the basis of clarifying the scientific connotation of all media, this paper analyzed the dilemma faced by the all media communication of TCM culture under the background of the epidemic, and explored the all media communication path of TCM culture from four aspects: new ecology of content, new system of technology, new model of management, and new targeting of audience, so as to improve the communication, guidance, influence and credibility of the all media of TCM culture.

Influencia del tiempo psicológico y el autocontrol en el malestar psicológico en adultos argentinos / Influence of psychological time and self-control on psychological distress in Argentinian adults

Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

Suporte Familiar, Traço/Estado Depressivo e Motivos para Viver em Usuários da Atenção Primária/Secundária / Family Support, Depressive Traits/Conditions and Reasons For Living in Primary/Secondary Care Users / Lo Apoyo Familiar, Rasgos/Condiciones Depresivos y Razones Para Vivir en Usuarios de la Atención Primaria/Secundaria

A depressão pode ser desenvolvida, agravada e/ou prevenida em função de alguns fatores como suporte familiar e motivos para viver, além da possibilidade de ser concebida como traço e estado depressivo. O objetivo principal desta pesquisa foi testar um modelo teórico preditivo (path analysis) do suporte familiar sobre traço/estado depressivo e sobre os motivos para viver, em uma amostra de 123 participantes, composta por dois grupos: pacientes do CAPS-AD e da ESF e, posteriormente, verificar as diferenças desses aspectos na amostra estudada. Foram aplicados uma ficha sociodemográfica, a Escala Baptista de Depressão - Adulto (EBADEP-A), Inventário de Percepção de Suporte Familiar (IPSF), Escala de Traço e Estado Depressivo (ETED) e Escala Brasileira de Motivos para Viver (BEMVIVER). O resultado da path analysis indicou que os motivos para viver são explicados pelo estado e traço depressivo e pelo suporte familiar. Os pacientes do CAPS-AD, tinham maiores níveis de sintomatologia depressiva e estado depressivo do que o grupo do ESF. Pacientes do ESF apresentaram médias maiores de suporte familiar e motivos para viver. Conclui-se que investir em estratégias que potencializem os motivos para viver e o suporte familiar podem reduzir os riscos de sintomatologia depressiva.

Depression can be developed, worsened and/or prevented depending on some factors such as: family support and reasons for living, in addition to the possibility of being conceived with a depressive trait and state. The main objective of this research was to test a predictive theoretical model (path analysis) of family support on the depressive trait/state and reasons for living, in a sample of 123 participants, composed of two groups: patients from the Psychosocial Care Center- Alcohol and Drugs (CAPS-AD) and the Family Health Strategy (ESF) and verify the differences of these aspects in the studied sample. A sociodemographic form, the Baptista Depression Scale -Adult (EBADEP-A), the Perceived Family Support Inventory (IPSF), Trait and Depressive State Scale (DTS) and the Brazilian Scale of Reasons to Live (BEMVIVER) were applied. The result of the path analysis indicated that the reasons for living are explained by the depressive state and trait and family support. CAPS-AD patients had higher levels of depressive symptoms and depressive state than the ESF group. ESF patients presented higher means of family support and reasons to live. It is concluded that investing in strategies that enhance the reasons to live and family support can reduce the risks of depressive symptoms.

La Depresión puede desarrollarse, agravarse y prevenirse dependiendo de factores como: apoyo familiar y razones para vivir, además puede de ser concebido con un rasgo y estado depresivo. El objetivo de esta investigación fue probar un modelo teórico predictivo del apoyo familiar sobre el rasgo/estado depresivo y las razones de vivir y verificar las diferencias de esos aspectos en la muestra estudiada, de 123 participantes compuesta por dos grupos: pacientes del Centro de Atención Psicosocial - Alcohol y Drogas (CAPS-AD) y la Estrategia de Salud de la Familia (ESF). Se aplicó un formulario sociodemográfico, Escala de Depresión de Baptista - Adulto (EBADEP-A), Inventario de Apoyo Familiar Percibido (IPSF), Escala de Rasgo y Estado Depresivo (DTS), Escala Brasileña de Razones para Vivir (BEMVIVER). El resultado del análisis indicó que las razones para vivir a ser explicadas por el estado y rasgo depresivo y por el apoyo familiar. Los pacientes CAPS-AD tenían niveles más altos de síntomas y estado depresivo que el grupo ESF. Los pacientes ESF presentaron mayores medios de apoyo familiar y razones para vivir. Se concluye que invertir en estrategias que potencien estas razones y apoyo familiar puede en la reducción de los riesgos de síntomas depresivos.

Use of structural models to elucidate the occurrence of falls among older adults according to abdominal obesity: a cross-sectional study

Abstract BACKGROUND: Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES: To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING: A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS: Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS: The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION: Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

The development status and path of rare disease treatment and orphan drugs in China / 中国药理学通报

Rare diseases are a group of diseases with low incidence, complex conditions, difficulty in diagnosis and poor treatment accessibility. With the growing attention on rare diseases in China in recent years, relevant policies are gradually improved, rapid progress have been made in the treatment of rare diseases and the development of orphan drugs, but there are still challenges. Based on the development status of rare disease treatment and orphan drugs, this paper elaborates on the development path of rare disease diagnosis, and provides reference for the rare disease treatment, orphan drug development and policy formation in China.

Molecular mechanism of microRNAs regulating sorafenib resistance in hepatocellular carcinoma / 中国药理学通报

Hepatocellular carcinoma (HCC) is one of the most deadly malignancies in the world, with strong invasiveness, low cure rate, high metastasis rate and poor prognosis. Sorafenib is the most important and effective first-line drug for the treatment of advanced hepatocellular carcinoma, but its clinical efficacy is severely limited by primary and acquired drug resistance. Mi-crornas ( micrornas) are small non-coding Rnas that play a key regulatory role in the occurrence and development of hepatocellular carcinoma and the progression of sorafenib resistance. This paper summarizes the role of micrornas in the initiation and development of sorafenib resistance in hepatocellular carcinoma, in order to further understand the mechanism of sorafenib anti-hep-atocellular carcinoma, and to provide valuable theoretical basis for clinical targeted therapy and prognosis improvement in hepatocellular carcinoma.

Exploration on the Paths of Integrating the Spirit of Yimeng Red Sister-in-Law into Nursing College Students’ English Courses / 中国医学伦理学

College English courses are both instrumental and humanistic, and have become the main position for nursing students to cultivate their humanistic qualities. Integrating the spirit of Yimeng red sister-in-law into the college English teaching of nursing students reflects the new requirements of "curriculum ideology and politics" in colleges and universities, and is also an important way to implement the fundamental task of establishing morality and cultivating students. The integration of Yimeng red sister-in-law spirit into college English teaching can enhance the sense of mission and cultural confidence of nursing students, and promote them to form correct values and medical ethics. College English teachers should strive to explore methods and paths to integrate the spirit of Yimeng red sister-in-law into college English teaching, fully utilize the humanistic resources contained in textbooks, comprehensively display the image of Yimeng red sister-in-law through literary works, and use the second classroom to cultivate students’ ability to communicate the spirit of Yimeng red sister-in-law in English.

Analysis on the Social Advantages and Practical Paths of Integrating Medical Social Work Services in the Medical Field / 中国医学伦理学

There are some issues in the process of patient treatment in the medical field, such as knowledge inequality, difficulties in doctor-patient trust and interdisciplinary cooperation, disciplinary barriers, excessive diagnosis and treatment, and structural imbalance of medical resources. In response to these issues, combined with the advantages of conceptual integration, professional integration, and resource integration of medical social work, this paper proposed a practical path for integrating medical social work services in the medical field. The main paths include micro path that systematization, comprehensiveness, and personalization of patient’s diagnosis and treatment process, the integration of intermediary path that integration of disciplinary and professional perspectives, concepts, and practices, and macro path that collaboration and coordination among society, community, and healthcare systems.

Research on the Localization Development Path of Narrative Medicine / 中国医学伦理学

After more than ten years of preliminary exploration, the localization development of narrative medicine has made some achievements in theoretical research, medical education and clinical practice, but its development direction and pathway still need to be further confirmed. From the five perspectives of policy system, management mechanism, cultural background, medical education and social development trends, this paper discussed systematically and macroscopically the localization development of narrative medicine, and advocated that improving the top-level design and local policies, constructing management systems at all levels, taking root in Chinese culture, carrying out systematic narrative education and closely integrating with the development trend, so as to inspire the theoretical construction of the development path of narrative medicine in China.

Lenvatinib down-regulates IGF1R/Mek/Erk signaling pathway in the treatment of regorafenib-resistant hepatocellular carcinoma / 中华肿瘤杂志

Objective: To investigate the therapeutic effect and mechanism of lenvatinib on regorafenib-resistant hepatocellular carcinoma cells. Methods: CCK-8 and clone formation assay were used to observe the inhibitory effect of lenvatinib on the growth of hepatocellular carcinoma cells. Flow cytometry was used to detect the apoptosis of regorafenib-resistant hepatocellular carcinoma cells treated with lenvatinib. The expression levels of related proteins were detected by western blot and immunohistochemical staining. The inhibitory effect of lenvatinib on the tumor formation ability of regorafenib-resistant hepatocellular carcinoma cells in vivo was observed by subcutaneous tumor formation experiment in mice. Results: CCK-8 and clone formation assay showed that lenvatinib could inhibit the proliferation of regorafenib-resistant hepatocellular carcinoma cells. The number of clones of HepG2, SMMC7721 and regorafenib-resistant HepG2, SMMC7721 cells in lenvatinib group (120.67±11.06, 53.00±11.14, 55.00±9.54, 78.67±14.64) were all lower than those in control group (478.00±24.52, 566.00±27.87, 333.67±7.02, 210.00±12.77, all P<0.05). Flow cytometry showed that lenvatinib could promote apoptosis of regorafenib-resistant hepatocellular carcinoma cells, the apoptosis rates of HepG2, SMMC7721 and regorafenib-resistant HepG2, SMMC7721 cells in lenvatinib group [(12.30±0.70)%, (9.83±0.38)%, (15.90±1.32)%, (10.60±0.00)%] were all higher than those in control group [(7.50±0.87)%, (5.00±1.21)%, (8.10±1.61)%, (7.05±0.78)%, all P<0.05]. The apoptosis-related protein levels suggested that apoptosis was increased in the treatment of lenvatinib. The animal study showed that lenvatinib can inhibit the growth of regorafenib-resistant cells in vivo. Immunohistochemistry and western blot results showed that lenvatinib could down-regulate the abnormally activated IGF1R/Mek/Erk signaling pathway in regorafenib-resistant cells. Conclusion: Lenvatinib can reverse regorafenib resistance in hepatocellular carcinoma, possibly by down-regulating IGF1R/Mek/Erk signaling pathway.

Comprehension of Chinese spoken garden path sentences for children with high-functioning autism / 中国康复理论与实践

ObjectiveTo explore the psychological and behavioral characteristics of understanding Chinese garden path sentences in children with high-functioning autism (HFA). MethodsFrom April to August, 2019, 35 children with HFA and 35 age-matched typically developing (TD) children were recruited by social recruitment method in the Key Laboratory of Speech and Hearing of East China Normal University in Shanghai. The Garden Path Sentence Comprehension Test was designed based on the psycholinguistic method, and the mental process and the ability of understanding garden path sentences were tested by the agent task experiment paradigm. Finally, the processing strategies and error types of Chinese spoken garden path sentences for HFA children were explored. ResultsThe score in understanding garden path sentences was lower (t = -2.941, P < 0.01), and the reaction time in processing garden path sentences was significantly longer (t = 6.132, P < 0.001) in HFA children than in TD children, however, there was no significant difference in the number of childern mastering garden path sentences between two groups (χ2 = 2.954, P > 0.05). In terms of the error types of "animate noun + verb + animate noun + 's + noun" (AVA) and "animate noun + verb + inanimate noun + 's + noun" (AVI) garden path sentences, both groups showed more errors in "pursuit of correct word order" than in "pursuit of semantically correct" (t > 2.503, P < 0.05). In "inanimate noun + verb + animate noun + 's + noun" (IVA) sentences, HFA children showed less erros in "pursuit of correct word order" than in "pursuit of semantically correct" (t = -6.523, P < 0.001), however, no difference was found between them in TD children (t = 2.024, P > 0.05). ConclusionThe processing and comprehension ability of Chinese spoken garden path sentences in HFA children aged five to seven yeas are poor. HFA children are more sensitive to semantics, and garden path sentences with semantic violations are more likely to lead to HFA children's understanding errors. In the garden path sentence patterns of AVA and AVI, HFA children appear similar sentence understanding and processing strategies as TD children. In the garden path of IVA, HFA children use a sentence processing strategy combining word order and semantics, but semantics play a more prominent role, while TD children use a more stable word order processing strategy.

Effect of prenatal exposure to passive smoking on leptin of neonatal cord blood and birth weight in a rural area of Yunnan Province / 环境与职业医学

Background Previous studies have shown that active smoking during pregnancy can reduce the level of neonatal cord blood leptin, and thereby affect birth weight. However, few studies have studied the association of passive smoking during pregnancy with leptin in neonatal cord blood and birth weight. Objective To explore the effects of passive smoking in varied pregnancy stages and entire pregnancy on neonatal cord blood leptin level and birth weight in a certain rural area of Yunnan, and potential mediating role of cord blood leptin. Methods Based on a prospective prenatal cohort study conducted in Xuanwei County, Yunnan Province, a total of 545 mother-infant pairs were included in this study from early pregnancy enrollment to delivery. The demographic information and reproductive history of the subjects were collected by questionnaire. The urine samples of pregnant women in the first, second, and third trimesters of pregnancy were collected during regular prenatal examinations. Umbilical cord blood samples were collected from newborns at birth. The concentration of urine cotinine (UC) was measured by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). According to the results of UC level during pregnancy, the study subjects were divided into three groups: negative group (<LOD), low exposure group (LOD-M), and high exposure group(>M). The level of leptin in cord blood was detected by ELISA. Multiple linear regression was used to analyze the effect of passive smoking on umbilical cord blood leptin in newborns during pregnancy. Path analysis was used to explore the relationship among passive smoking during pregnancy, neonatal cord blood leptin, and birth weight. Results The average exposure rate of passive smoking during pregnancy was 87.28%, and the exposure rate for entire pregnancy was 76.88%. The median concentration of leptin in neonatal cord blood was 4.17 μg·L−1. After adjusting for maternal age, ethnicity, educational level, pre-pregnancy body mass index (BMI), gestational weight gain, parity, annual household income, infant sex, and birth weight, we found that low level (b=−3.388, P=0.001) and high level (b=−2.738, P=0.006) of passive smoking in the first trimester of pregnancy had negative associations with leptin concentration of cord blood by multiple linear model. The path analysis results showed that passive smoking in the first trimester and pre-pregnancy BMI directly affected leptin levels, and the sizes of direct effects were −0.073 and −0.087 (both P<0.05) respectively. Passive smoking in late pregnancy, gestational weight gain, premature, newborn girls, parity, and pre-pregnancy BMI directly affected birth weight, and the sizes of direct effects were −0.063, 0.191, −0.301, −0.128, −0.121, and 0.167 (all P<0.05), respectively. No mediating role of leptin was found in the effect of passive smoking on neonatal birth weight. Conclusion Passive smoking exposure during pregnancy is common among rural women in Yunnan Province. Passive smoking in the first trimester may be key in decreasing the leptin level of neonatal cord blood. Passive smoking in third trimester may lead to a decrease in birth weight. No evidence shows that leptin mediates the relationship between passive smoking and birth weight.

Establishment and application of path-based management mode of 5-HT3 receptor antagonists in chemotherapy patients / 中国药房

OBJECTIVE To establish the path-based management mode of 5-hydroxytryptamine-3 receptor antagonist （5- HT3RA） in chemotherapy patients， and to improve the rationality of medication in chemotherapy patients. METHODS 5-HT3RA standardized drug use control rules were formulated， with the help of medical intelligence and decision support （MINDS） system， path-based management was carried out for chemotherapy patients using 5-HT3RA in the form of whole-process information capture and prescription pre-review， and whole-process intervention was implemented on medication indications， usage and dosage， course of treatment， etc. The intervention effect was analyzed by comparing the changes in the use of 5-HT3RA without indication， unreasonable usage and dosage， repeated medication， unreasonable course of treatment， and per capita drug cost before and after the implementation of path-based management. RESULTS A total of 9 181 patients were included. After the implementation of path- based management， the proportion of unindicated drugs decreased by 0.48%， and the rate of unreasonable single dosage， unreasonable frequency， repeated medication， unreasonable treatment course （5-HT3RA still used 3 days after chemotherapy） decreased by 10.48%， 0.65%， 1.33% and 0.34%； per capita cost of 5-HT3RA decreased by 13.72 yuan； there were statistical significance （P＜0.05）. CONCLUSIONS 5-HT3RA path-based management mode effectively improves the rationality of medication and provides a new idea for rational clinical drug use.

Research Progress and Prospect Analysis of Vascular Interventional Surgical Robot / 中国医疗器械杂志

Vascular interventional surgery is an important means to treat cardiovascular and cerebrovascular diseases, but the particularity of its working environment will bring greater radiation threat to doctors. Vascular interventional surgery robots can effectively improve the working environment of doctors and can provide more stable operations, improve the success rate of surgery. This study mainly introduces the current research status, key technologies, and future application of vascular interventional surgical robots.

Impacts of poor working conditions, occupational psychology, and enterprise risk factors on occupational injury by path analysis / 环境与职业医学

Background Occupational injuries, which can result in absenteeism, disability, or death, are closely related to poor working conditions. However, the improvement of operating conditions are often time-consuming and require significant economic inputs. Both occupational psychology and enterprise risk factors have been proved to be related to the occurrence of occupational injuries, but their roles in the influence path of adverse working conditions leading to occupational injuries remain unclear. Objective To explore the roles of occupational psychology and enterprise risk factors in the impact of adverse working conditions on occupational injury, so as to provide a scientific basis for enterprises with adverse working conditions to carry out targeted occupational injury intervention programs. Methods The survey data of 5997 manufacturing enterprises were obtained from the European Survey of Enterprises on New and Emerging Risks (ESENER) database. The data on enterprise risk characteristics, occupational injuries, working conditions, and occupational psychological factors were extracted and assigned. Occupational injury differences by enterprise categories were examined by chi-square test. Correlations between interest variables were evaluated by Spearman test. Path analysis with Bootstrap method was conducted using AMOS 26 software, and ratio of chi-square statistic to degree of freedom (χ2/ν), comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA) were used to evaluate the path model candidates. The effect size and its proportion were calculated for variables (occupational psychological factors, enterprise risk factors, and adverse working conditions) included in the final model. Results The M (P25, P75) scores of occupational injuries, adverse working conditions, and occupational psychological factors were 40 (20, 50), 50 (30, 60), and 20 (10, 30), respectively. The enterprises that reported occupational injuries accounted for 25.5% (1550 enterprises) of the total enterprises. Proportions of the enterprises that reported occupational injuries varied significantly by company scale, branch companies, temporary employment, language barriers, and establishment time (P<0.05). The results of Spearman test showed that occupational injuries were positively correlated with working conditions (rs=0.440), occupational psychological factors (rs=0.205), company scale (rs=0.307), temporary employment (rs=0.282), and language barriers (rs=0.158); but negatively correlated with branch companies (rs=−0.180) and establishment time (rs=−0.176) (P<0.05). In the path analysis, the fitness indexes of the final model were χ2/ν=2.85, CFI=0.997, TLI=0.993, and RMSEA=0.018 (90%CI: 0.011, 0.025). The indirect effect size values and constituent ratios of enterprise risk factors and occupational psychological factors in the effect of adverse working conditions on occupational injuries were 0.166 (30.01%) and 0.013 (3.13%) respectively. The indirect effect size value of occupational psychological factors in the effect of enterprise risk factors on occupational injuries and its constituent ratio were 0.022 and 6.85%. Conclusion Enterprises with adverse working conditions may control the risk of occupational injuries by offering better solutions to surmount language barriers and temporary employment, developing occupational psychological intervention and optimization programs such as improving working hours system. At the same time, large enterprises, enterprises without branches, or enterprises with a long history are the focus of occupational injury prevention and control.

The connotation, characteristics and implementation paths of nurses′ prescription rights in China / 中华医院管理杂志

It is already an inevitable choice for the innovative development of the global healthcare system to grant nurse practitioners the prescription rights, in an effort to improve the access to primary care services and clinical outcome of patients. The contradiction between supply and demand of health service in China is becoming increasingly prominent, making it urgent for nurses with prescription rights to join the primary healthcare team. On the basis of clarifying the connotation and characteristics of nurses′ prescription rights, the authors demonstrated and analyzed the demands, realistic basis and challenges of nurses′ prescription right granting, and put forward their thoughts on the feasible paths from the aspects of national system construction and local pilot exploration, aiming to provide reference for promoting the reform of nurses′ prescription right granting in China.