Objective: With the development of society, people's requirements and standards for nursing work continue to improve, under the premise of nursing human resources are relatively insufficient, nursing work from nursing skills to service attitude to ensure quality, this standard brings great work pressure to nursing staff, in addition, the increasing medical disputes, It increases the risk factor of personal safety attack in the workplace of nurses, and further increases the psychological pressure of nurses, thus increasing the incidence of job burnout of nurses. Methods: A multi-stage random sampling was adopted to conduct a questionnaire survey among 1049 nursing staff on December 1, solstice and December 30, 2015. The current situation of nurses' job satisfaction, stressors and job burnout and its influencing factors were analyzed. Results: 1) The total score of nurses' job satisfaction was 91.52 ± 17.99 points; 2) The total score of nurses' work stressors was 86.52 ± 21.95 points; 3) The total score of nurses' job burnout was 38.44 ± 7.55 points; 4) The aspects of patient care, management and interpersonal relationship were significantly correlated with nurses' burnout (P < 0.001), and the total score of job satisfaction was positively correlated with nurses' burnout, while the total score of job satisfaction was negatively correlated with nurses' burnout. There was a significant correlation between job title and nurse burnout (P < 0.001). Conclusion: The job burnout of nurses is related to nurse satisfaction and work pressure. The problems of management and interpersonal relationship, title, total score of job satisfaction and patient care are the main problems of nurses' job burnout.

ABSTRACT:As an international tourist center, Hainan province includes both imported and local COVID-19 cases. This study aimed to investigate the clinical characteristics and outcomes of COVID-19 patients in Hainan, China.COVID-19 patients hospitalized in Hainan affiliated Hospital of Hainan Medical University in January to March 2020 were retrospectively assessed. Routine blood tests, blood gas analyses, and computed tomography imaging were performed within 24 hours. Virus nucleic acid was detected every other day. The patients were divided into local resident and traveler groups, and differences in clinical data as well as leukocyte, lymphocyte, and neutrophil levels were analyzed.A total of 70 patients aged 51.23 ± 13.54 years were assessed, including 16 local residents and 54 travelers. Of these, 55 cases (78.6%) had fever, 47 (67.1%) had cough and sputum, and 9 (12.9%) had chest dyspnea; 60 and 10 cases were mild/common and severe/critical, respectively. Sex, basic diseases, smoking history and drinking history, Charlson Comorbidity Index, symptoms, time of onset to admission, clinical severity, white blood cell count, lymphocyte count, neutrophil count, oxygen inhalation, mechanical ventilation, glucocorticoid therapy, treatment, admission to ICU, hospital stay, and mortality were similar between the 2 groups.The warm and humid climate of Hainan does not seem to significantly affect patient features and outcomes from COVID-19. Unnecessary travel to tourist areas should be avoided.

Objective: To investigate the effect of cognitive behavioral intervention on nurses with PTSD by using cognitive behavioral intervention. Methods: The subjects were selected by randomized control method, and the PTSD nurses were divided into control group (n = 30) and intervention group (n = 30). The intervention group used cognitive behavioral intervention; the control group did not use cognitive behavioral intervention. Nurses with PTSD in the two groups completed the basic situation survey, medical coping questionnaire (MCMQ) and anxiety self-rating form (SAS) psychological scale one month later. Results: There was no significant difference in MCMQ and SAS scores between the two groups before intervention (P > 0.05). After intervention, the scores of MCMQ and SAS in the intervention group were compared with the scores of MOCQ and SAS in the control group. The scores of the control group after intervention were significantly higher than those of the intervention group, with statistical significance (P 0.05). It shows that cognitive behavioral intervention therapy has the effect and value of improving the psychological status of nurses with PTSD. Conclusion: Cognitive behavioral intervention therapy combined with psychology for nurses with PTSD can effectively relieve their stress level, relieve their mood, and improve their positive coping ability and work efficiency.

雾计算是云计算的延伸概念,可以使计算和存储功能更接近应用程序和医疗信息数据源.提出了一种基于雾计算的区块链医疗数据管理架构,医疗数据所有者的元数据存储在私有区块链上,支持搜索和防篡改功能,并允许雾节点以分布式方式执行授权过程.案例研究表明,与其他方法相比,本研究所提出架构可以缩短患者医疗数据访问时间,满足可靠性和互操作性要求,为病历资料管理理论和实际应用提供借鉴.

目的 对海口市老年人进行为期1年的口腔健康干预,分析干预效果.方法 采用分层随机抽样法,在海口市美兰区随机抽取2个居委会作为调查点.每个居委会随机抽取65～74岁常住老年人口120人,分别为干预组(接受3次口腔健康检查、3次口腔健康教育和1次口腔基础治疗,同时根据个人需要提供个性指导)和对照组(不予任何处理).结果 干预前,干预组总龋病患病率和填充率与对照组比较差异无统计学意义(P>0.05);干预后,干预组总龋病患病率与对照组比较差异无统计学意义(P>0.05),干预组总龋病填充率显著高于对照组(P<0.05).干预前,两组牙龈出血、牙结石、牙周袋(≥4 mm)、附着丧失(≥4 mm)检出率比较差异无统计学意义(P>0.05);干预后,干预组牙龈出血、牙结石、牙周袋(≥4 mm)检出率显著低于对照组(P<0.05).结论 健康教育和基础治疗的干预方式可以有效地改善了老年人的口腔健康状况,对改变老年人口腔就诊行为起到一定的作用.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的通过分析干预实施后贫困地区实验组和对照组生活质量的差异情况,对干预效果进行评估,为提高海南居民的生活质量及脱贫攻坚提供参考措施。方法于2019年1月采用典型抽样方法,抽取海南省琼中县新林村（实施远程医疗干预）281人为实验组,乐东县番豆村（不实施干预）156人为对照组,共437人。采用SF-36量表对研究对象进行评估。结果实验组在生理功能、情感职能、精神健康与对照组差异有统计学意义（P &lt;0.05）;生理职能、躯体疼痛、总体健康、活力、社会活动,差异无统计学意义（P&gt; 0.05）。多重线性回归分析结果显示,是否干预（β=7.36）、年龄（β=–6.81）、是否喝酒（β=–6.04）是贫困地区居民生活质量的影响因素。结论居民生活质量受年龄、喝酒史、是否干预等因素的影响;实施互联网+医疗助力远程医疗服务可以有效改善贫困地区居民生活质量。</span>

The results were analyzed by unconditional logistic regression.The analysis results showed that the positions entered into the regression model (OR = 2.339); the expected retirement age (OR = 3.280); and delayed retirement can better solve the pension problem (OR = 0.553).Retirement can relieve child financial pressure (OR = 0.217), emotional exhaustion (OR = 0.913) and social opportunities (OR = 1.132).The OR of job title, expected retirement age, and social opportunities is greater than 1, and the others are less than 1.Conclusion: The most expected retirement age for nurses is 50 to 55 years old, and they are more inclined to retire early.Factors affecting the willingness to postpone retirement include position and expected retirement age.Postponement of retirement can better solve pension problems.Postponement of retirement can alleviate child financial pressure, social opportunities and emotional exhaustion.

Currently, most studies on the factors affecting sleep quality have used logistic regression or multiple linear regression to identify such factors, there are same drawbacks in these methods, the structural equation modeling (SEM) can compensate for these deficiencies. A total of 2341 students from three universities in Hainan, China, participated in the cross-sectional survey. The Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. A self-administered questionnaire was provided to collect data for the symptom checklist-90 (SCL-90) and the internet addiction test (IAT), as well as other potential or hidden factors affecting sleep quality. SEM was used to estimate the important factors affecting sleep quality, and to explore the particular contributions of the identified factors. The types of hidden factors affecting sleep quality were, in descending order, psychological (0.308), behavioral (0.289), physiological (0.250), and environmental (0.019) factors. More specifically, higher scores on the SCL-90 (0.780) caused the biggest difference in sleep quality, followed by health status (0.601), the frequency of late sleeping (0.574), internet addiction (0.530), and the dormitory environment (0.470). The results provide reliable means for the improvement of sleep quality among college students.

OBJECTIVE To explore the association of brain-derived neurotrophic factor gene (BDNF) polymorphism with the latent cognitive endophenotype of posttraumatic stress disorder (PTSD) after major natural disasters in Hainan Province, China. METHODS A total of 300 patients with PTSD and 150 healthy controls (HC) were surveyed by psychoanalysis scale to assess their cognitive functions. Polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis (PAGE) were used to detect the BDNF gene polymorphism. RESULTS In terms of the cognitive function, the scores in the PTSD group were worse than those of the HC group (P < 0.05 or P < 0.01). There was a significant difference in the distribution of BDNF genotype and allele frequency between the two groups (P < 0.05). PTSD endophenotypes were significantly different among the BDNF genotypes in the PTSD group (P ≤ 0.01). CONCLUSION There is a statistically significant difference in the polymorphism of BDNF gene between PTSD and HC groups, and the alleles are associated with the incidence of PTSD. Thus, it may be a risk factor for PTSD.

Objective: To understand the influencing factors of job burnout among nurses in Haikou 3A hospital and explore its direct and indirect effects, so as to provide a scientific basis for the work efficiency of nursing staff.Methods: Between November 2, 2015 and November 2015, using multi stage random sampling, self-administered questionnaire survey was conducted among 1049 nursing staff, using the path analysis method to study the effect of direct and indirect factors effect.Results: The total score of job burnout of nurses was 38.44 ± 7.55, high occupational burnout was 0.9%, moderate occupational burnout was 66.5%, and low occupational burnout was 32.6%.The scores of job burnout were compared among the nurses with different titles, and less achievement (F = 8.342, P < 0.001) and depersonalization (F = 3.12, P = 0.025) were statistically significant.Nurses' Job Burnout and job stressors were the first, and the canonical correlation coefficient was 0.4397 (F = 20.54,P < 0.0001), indicating that the more problems existed in patient care, the greater the degree of emotional exhaustion.The first canonical correlation coefficient of job burnout and job satisfaction of nurses was 0.3791 (F = 12.8, P < 0.0001), indicating that the better the family and work balance, the less individualized nurses were.The path analysis results showed that the 4 dimensions of job stressors (management and interpersonal problems) is positive, the direct effect of the strongest (0.219), the total effect of sort of work pressure source of 4 dimensions (0.245) > 5 dimensions of work pressure source (0.125) > title (-0.112) job satisfaction scores (-0.097).Conclusion: Job stress, job satisfaction and job title are the factors that affect job burnout.The 4 and the direct and indirect effects of job stressors are the strongest, and measures should be taken to solve these problems.

Studies have shown that the expression level of the brain-derived neurotrophic factor (also known as BDNF) is of great significance on neutron activity, which has a close relationship with the improvement of the learning and memory ability; it has effect on the physical growth and development of an individual as well. On the other hand, childhood autism is a group of serious neurodevelopmental disorders. Some literature has pointed out that the BDNF plays a tremendously important role in the pathogenesis and the treatment of neuropsychiatric diseases. In recent years, many scholars at home and abroad have done a lot of research and found that there is a close relationship between BDNF and autism. This paper therefore will give an introduction on and an analysis of the relationship between BDNF, the polymorphysis of its gene, and childhood autism based on the previous domestic and overseas literature.

To determine the consistency between CT findings and real-time reverse transcription–polymerase chain reaction (RT-PCR) and to investigate the relationship between CT features and clinical prognosis in COVID-19. The clinical manifestations, laboratory parameters, and CT imaging findings were analyzed in 34 COVID-19 patients, confirmed by RT-PCR from January 20 to February 4 in Hainan Province. CT scores were compared between the discharged patients and the ICU patients. Fever (85%) and cough (79%) were most commonly seen. Ten (29%) patients demonstrated negative results on their first RT-PCR. Of the 34 (65%) patients, 22 showed pure ground-glass opacity. Of the 34 (50%) patients, 17 had five lobes of lung involvement, while the 23 (68%) patients had lower lobe involvement. The lesions of 24 (71%) patients were distributed mainly in the subpleural area. The initial CT lesions of ICU patients were distributed in both the subpleural area and centro-parenchyma (80%), and the lesions were scattered. Sixty percent of ICU patients had five lobes involved, while this was seen in only 25% of the discharged patients. The lesions of discharged patients were mainly in the subpleural area (75%). Of the discharged patients, 62.5% showed pure ground-glass opacities; 80% of the ICU patients were in the progressive stage, and 75% of the discharged patients were at an early stage. CT scores of the ICU patients were significantly higher than those of the discharged patients. Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. The initial features in CT may be associated with prognosis. • Chest CT is valuable for the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. • The early CT findings of COVID-19 in ICU patients differed from those of discharged patients.

随着生活节奏的加快,互联网技术的发展,人们工作和学习的时间越来越碎片化.大学生是一个特殊的群体,其时间的管理和支配直接影响个人素质的提升和学业质量的情况,大学生时间碎片化研究引起了越来越多研究者的关注.本研究旨在梳理大学生时间碎片化的概念及其相关研究,探讨目前研究存在的问题,以期为后人的研究提供借鉴.

目的 了解医院护士月经不调的影响因素,为相关部门提供可靠的数据基础及依据,并可针对不同的影响因素做出相应的政策调整,使护理人员能够为患者提供更优质的服务.方法 2017年使用自制月经情况调查表,焦虑自评量表(SAS),应激性创伤障碍筛查量表(PCL-C)对海口市三甲医院护士进行横断面调查.结果 共发放问卷350份,回收有效问卷601份,有效回收率为92.46％.月经正常组(350人)和月经失调组(251人)每周工作时间、焦虑状况、创伤后应激障碍比较,差异均有统计学意义(均P＜0.05);工作医院、工作压力在月经正常与不调2组间比较,差异均有统计学意义(均P＜0.01);广义线性回归结果显示,影响月经的因素工作医院(海南省人民医院OR=1.682,海口市人民医院OR=1.699)、每周工作时间(OR=1.391)、工作压力(OR=2.509)和焦虑(OR=1.041)4个因素,均为危险因素.结论 相关部门应制定合理的护士工作机制,从而保障护士的身体健康,更好地为患者提供优质的服务,从一定程度上缓解医患之间的矛盾和压力.

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that plagues trauma survivors. Evidence shows that brain-derived neurotrophic factor (BDNF) may be involved in the occurrence and development of PTSD. Here we tried to demonstrate whether BDNF gene polymorphisms are correlated with neurocognitive function following PTSD in patients with hepatocellular carcinoma (HCC). This study included 102 patients with HCC complicated with PTSD, 146 HCC patients, and 152 healthy volunteers. Initially, we evaluated the neurocognitive function of the study subjects. Next, we measured BDNF G11757C and rs6265 polymorphisms by polymerase chain reaction-restriction fragment length polymorphism. The correlation of BDNF polymorphisms and BDNF level with HCC complicated with PTSD was evaluated. The results revealed that HCC complicated with PTSD showed decreased serum BDNF level and Mini-mental state examination (MMSE) score. Serum BDNF level of HCC and HCC complicated with PTSD was positively correlated with MMSE score. GA + AA allele and A allele of rs6265 increased the risk of PTSD among patients with HCC. GA and AA genotypes of rs6265 were correlated with the decreased MMSE score of HCC complicated with PTSD. Haplotype GA of rs6265 and G11757C increased the risk of PTSD for HCC, while haplotype CG decreased this risk. Lastly, the logistic regression analysis suggested that low BDNF level was a contributor to HCC complicated with PTSD, while GG genotype of rs6265 served as a protective factor. Collectively, this study defines the GG genotype of BDNF rs6265 polymorphism as a protector to HCC complicated with PTSD. In addition, these results provided a promising target for PTSD prevention in patients with HCC.

目的 调查海口市三甲医院护理人员月经不调现况及影响护理人员月经不调的因素,为相关部门提供可靠的数据基础及科学依据.方法 选取海口市三甲医院工龄半年以上的在册女护士为研究对象,使用自制月经情况调查表对其进行横断面调查.结果 纳入调查的601名护理人员中有251人月经不调,占41.76％;月经不调症状主要表现为痛经、 周期紊乱、 腰骶骨疼痛及腰腹坠疼等情况.不同年龄组护理人员月经不调率比较差异有统计学意义(P<0.05),不同科室、 职称、 护龄的护理人员月经不调率比较差异无统计学意义(P>0.05).护理人员月经期间的保养措施前三位分别是月经期间注意保暖、 保持精神愉快及注意饮食、 不吃辛辣食物.结论 海口市三甲医院护理人员月经不调情况较为普遍,尤其是青年护理人员,需加强关注.

Posttraumatic stress disorder (PTSD) is a common response to traumatic events. Many PTSD patients recover in the next few months, but in a significant subgroup, the symptoms persist, often for years. The present study shows that brain-derived neurotrophic factor (BDNF) gene is related to the pathological mechanism of a variety of mental diseases. Here we investigate the effect of methylation of BDNF gene and different loci on the occurrence and development of PTSD. Initially, using case-control method, 322 PTSD patients as well as 215 normal controls were selected as the subjects. Following peripheral venous blood being collected from the subjects, genomic DNA was extracted. Methylation of the cytosine-guanine dinucleotide (CpG) island in BDNF gene promoter was then modified by bisulfite and detected through direct sequencing. Methylation of CpG in BDNF gene promoter was closely related to PTSD, and the methylation level of CpG in BDNF gene promoter may serve as a biomarker for PTSD diagnosis. Types of trauma of PTSD patients may have a certain effect on the methylation level of BDNF gene promoter. Methylation level of the BDNF promoter, depressive degree score, poor sleep quality score, early trauma score, mental stress score, and trauma type were closely related to the occurrence and development of PTSD. Taken together, our data support the notion that stressful life events may directly cause CpG methylation in the BDNF promoter of PTSD patients. Stress types may be associated with methylation levels of CpG1, CpG7, and CpG18 in the BDNF promoter of PTSD patients. These findings provide a new way for the diagnosis and treatment of PTSD.

Objective To analyze the influence of oral health intervention on oral health-related quality of life for elderly people in Haikou, and to provide scientific basis for exploring effective measures for oral intervention of elderly people in Haikou. Methods A total of 240 people aged 65~74 years old in two residents, committees in Haikou were selected by multi-stage random sampling method. They were divided into intervention group and control group,with 120 people in each group. In the intervention group, examination of mouth (3 times) and oral health education (3 times) were conducted during a one-year intervention period, and individualized guidance was provided according to in-dividual needs. The control group only received the questionnaire investigation, which was not given any oral health examination and oral health education. The scores of the oral health impact scale (ohip-14) after one year was compared between the two groups. Results The total average OHIP-14 score of intervention group and control group before the intervention were respectively (15.05±5.37), (15.42±4.32);there was no significant difference in the total score of oral health-related quality of life and its four dimensions between the two groups (P>0.05). After the intervention, the total average OHIP-14 score of intervention group and control group were respectively (8.83 ± 5.19), (14.72 ± 7.94);the total scores of oral health-related quality of life, psychological discomfort, physical functional discomfort, pain and discomfort in the intervention group were significantly lower than those in the control group (P<0.01). Conclusion Oral health intervention can effectively improve the level of oral health-related quality of life, which should be actively carried out to improve the quality of life of the elderly.

Objective To investigate the correlations of four genetic single nucleotide polymorphisms (SNPs) of brain-derived neurotrophic factor (BDNF) with posttraumatic stress disorder (PTSD). Methods A total of 300 patients with sporadic PTSD and 150 healthy subjects (the control group) were selected according to the diagnostic criteria of PTSD (DSM-IV), and the genotypes of the BDNF SNPs G-712A, C270T, rs6265, and rs7103411 were detected by polymerase chain reaction and direct DNA sequencing to determine intergroup differences in the genotypes and allele frequencies; the p values were corrected with the permutation test. Results The genotypes and allele frequencies of the SNPs G-712A, rs6265, and rs7103411 of BDNF showed no significant intergroup differences (p>0.05). However, the genotype and allele frequencies of C270T showed significant differences between the PTSD group and the control group (p<0.05). Conclusion The SNP C270T of BDNF may be associated with PTSD. Individuals carrying the polymorphic T allele of C270T may be more likely to suffer from PTSD.

目的 了解海口市老人口腔保健知识的知晓情况.方法 采取自制调查问卷用分层抽样的方法分别对海口市4个区的老人进行问卷调查.结果 海口市老年人知晓度最高的前3个知识点是保持口腔卫生是防治牙病的关键;要均衡饮食,甜食易导致龋齿;每天至少刷牙2次;而对于爱牙日、牙菌斑、牙线可以清除牙菌斑和食物残渣的知晓率最低.且不同年龄、经济状况、文化程度的知晓程度不同,城乡差异大.多重线性回归分析显示进入回归方程的影响因素有个人月收入、原住址、年龄、文化程度,作用最大的因素为个人月收入.结论 老年人对口腔保健知识知晓率较低,应当加强口腔保健知识的教育,确立正确的口腔保健态度和行为,以提高老人的生活质量.