Table of Content

01 January 2023, Volume 39 Issue 1

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Treatise

Correlation study on professional burnout，professional identity and career success of clinical pharmacists in grade-A tertiary hospitals in Nanchang City

TANG Zhen, LIU Yan-hua, LI Gang, ZHANG Zeng-zhu, XU Lan

2023, 39(1):  1-4. 

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Objective To explore the status quo of professional burnout，professional identity and career success among clinical pharmacists in grade-A tertiary hospitals in Nanchang City，and to analyze the correlation between them. Methods From December 2021 to April 2022，a convenience sampling was used to conduct a questionnaire survey among clinical pharmacists in a grade-A tertiary hospital in Nanchang City，including general information，professional burnout，professional identity and career success. Results The professional burnout A score of 141 clinical pharmacists was （37.73±9.46）points，and the professional burnout B score was （23.05±6.66）points. The professional identity score was （87.52±13.44）points，and the career success score was （32.95±5.66）points. Professional burnout A was negatively correlated with professional identity，career success and various dimensions（all P<0.01）. Professional burnout B was positively correlated with professional identity，career success and various dimensions（all P<0.01）. The results of multivariate analysis showed that age，gender，professional identity and career success were the main influencing factors of professional burnout（P<0.01）. Conclusion Managers of clinical departments should pay attention to the professional burnout of clinical pharmacists，and adjust their job burnout and improve their work quality by enhancing their professional identity，career success and other aspects.

Study on changes of inflammatory factors in patients with pneumoconiosis and its relationship with carotid atherosclerosis

LI Ai-juan, HUANG Shi-yi, MENG Chun-yan, PEI Sheng-fei, CAO Xiang-ke, QIAN Qing-zeng

2023, 39(1):  5-8. 

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Objective To investigate the changes of inflammatory factors in patients with pneumoconiosis and its relationship with carotid atherosclerosis. Methods Totally 119 patients with pneumoconiosis were selected in Linxi Hospital of Kailuan General Hospital from September 2015 to September 2021 as observation group，including 73 patients with stageⅠ，29 patients with stage Ⅱ，17 patients with stage Ⅲ. Totally 51 healthy people were selected in same period as control group. All people were detected the items of interleukin-6（IL-6），C-reactive protein（CRP），Homocysteine（Hcy） and cystisin C（Cys C），and neck ultrasonography（intima-media thickness，IMT）. The changes of inflammatory factors in patients with pneumoconiosis were analyzed，and the relationship between inflammatory factors and carotid atherosclerosis were analyzed. Results The levels of inflammatory factors and IMT in patients with pneumoconiosis（stageⅠ，Ⅱ and Ⅲ） were [（16.29±3.17）ng/L，（7.91±1.26）mg/L，（13.84±3.97）μmol/L，（1.79±0.43）mg/L，（1.05±0.24）mm]，[（27.62±5.42）ng/L，（15.68±3.09）mg/L，（25.93±6.01）μmol/L，（3.52±0.84）mg/L，（1.28±0.19）mm]，[（48.07±8.35）ng/L，（38.64±6.37）mg/L，（46.78±7.25）μmol/L，（5.80±1.02）mg/L，（1.67±0.32）mm]，respectively，which were higher than those in control group[（5.98±1.04）ng/L，（2.23±0.85）mg/L，（5.61±1.12）μmol/L，（0.81±0.16）mg/L，（0.86±0.13）mm]（all P<0.01）. The levels of inflammatory factors（IL-6，CRP，Hcy，Cys C） and IMT in patients with pneumoconiosis stage Ⅱ and Ⅲ were higher than those in patients with pneumoconiosis stageⅠ（all P<0.05）. The levels of inflammatory factors（IL-6，CRP，Hcy，Cys C） and IMT in patients with pneumoconiosis stage Ⅲ were higher than those in patients with pneumoconiosis stageⅡ（all P<0.05）. The levels of inflammatory factors（IL-6，CRP，Hcy，Cys C） in pneumoconiosis patients with IMT thickening and plaque were higher than those in pneumoconiosis patients with normal IMT（all P<0.05）. The levels of inflammatory factors（IL-6，CRP，Hcy，Cys C） in pneumoconiosis patients with IMT plaque were higher than those in pneumoconiosis patients with IMT thickening（all P<0.05）. When there were IMT thickening and plaque，the levels of inflammatory factors（IL-6，CRP，Hcy，Cys C） were positively correlated with IMT（all P<0.05）. Conclusion The patients with pneumoconiosis have high levels of inflammatory factors，who may be prone to carotid atherosclerosis.

Expression of long noncoding RNA CUST-49525 and CUST-40243 in K562 cytotoxicity induced by 1，4-benzoquinone

LIU Xiao-dong, HUANG Yun-fei, TIAN Wei

2023, 39(1):  9-14. 

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Objective To detect the expression changes of LncRNA CUST-49525 and CUST-40243 in the process of cytotoxicity induced by 1，4-benzoquinone，provide the basis for the later study of their regulatory role in cytotoxicity. Methods K562 cells were exposed to 0，10，20 and 40 μmol/L 1，4-benzoquinone for 24 hours，and the morphological characteristics of the cells were observed under optical microscope. CCK-8 method was used to measure the cell growth. Cell cycle distribution and apoptosis were analyzed by flow cytometry. The expression of LncRNA CUST-49525 and CUST-40243 was measured by real-time fluorescence quantitative PCR. Results After K562 cells were exposed to 1，4-benzoquinone for 24 hours，the number and morphology of K562 cells were obviously changed under microscope. Compared with the control group，the relative proliferation rate of K562 cells in 20 and 40 μmol/L dosage groups decreased significantly（P<0.01）. 1，4-benzoquinone in each dose group could induce cell apoptosis in a concentration-dependent manner（P<0.01）. Compared with the control group，the G1 phase proportion of K562 cells in the 20 and 40 μmol/L dosage groups increased（P<0.01），while the S phase proportion decreased（P<0.05）. The results of real-time quantitative PCR showed that compared with the control group，the expression levels of LncRNA CUST-49525 and CUST-40243 in K562 cells in 20 and 40 μmol/L dosage groups increased（P<0.01）. Conclusion LncRNA CUST-49525 and CUST-40243 are abnormally expressed in the cytotoxicity of K562 cells induced by 1，4-benzoquinone，and they may be involved in the regulation of cytotoxicity，but their specific mechanism needs further study.

Analysis on clinical characteristics of occupational pneumoconiosis complicated with pleural effusion

LIU Chen, WANG Rui-bin

2023, 39(1):  15-18. 

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Objective To explore the clinical characteristics of occupational pneumoconiosis complicated with pleural effusion，accurately understand the risk factors of pneumoconiosis complicated with pleural effusion and poor survival. Methods The clinical data of 30 pneumoconiosis patients with pleural effusion（observation group） and 30 patients without pleural effusion（control group） in the Yunnan First People's Hospital from May 2018 to October 2020 were collected，and the clinical characteristics of the two groups were compared. Results There were statistically significant differences between the observation group and the control group in the clinical features of the highest body temperature[（38.11±0.82）℃]，chest pain（73.3%），dyspnea（53.3%），pneumoconiosis stage Ⅱ and Ⅲ（80.0%），CT pleural effusion（90.0%），and biochemical indexes such as C-reactive protein [66.98（20.18，127.22）mg/dL]，D-Dimer[1.78（1.12，5.74）mg/L]，CD4⁺T cells[325.00（201.05，382.99）cells/μL]，blood oxygen saturation（0.72%），antithrombin Ⅲ[（107.95±12.01）%]，prothrombin time[（13.86±1.56）s]，plasma fibrinogen[（4.74±1.98）g/L]，vital capacity[（2.89±0.56）L]，forced expiratory volume in the first second（FEV）[（2.19±0.45）L] and FEV/forced vital capacity[（48.15±5.02）%]（all P<0.05）. The multivariate logistic regression analysis showed that C-reactive protein，antithrombin Ⅲ，prothrombin time，chest pain，dyspnea，and pneumoconiosis stages were the main clinical features for predicting pleural effusion. Conclusion The pneumoconiosis complicated with pleural effusion indicates more serious disease classification and deterioration trend，which should be given more attention and more timely and accurate diagnosis and treatment.

Investigation on occupational hazards in Chongming District of Shanghai

MA Wen-di, WANG Jin-xiang, ZHANG Biao, DING Yue-hua, ZHANG Zi-yu

2023, 39(1):  19-23. 

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Objective To understand the current situation of occupational health of enterprises in mining industry，manufacturing industry，electric power，gas and water production and supply industry in Chongming District of Shanghai，get the basic data of occupational hazards in Chongming District，and provide basis for formulating occupational disease prevention and control strategies. Methods By using the Occupational hazards status survey form designed by the National Health Commission，a major investigation team was set up to make a thorough investigation of the occupational health status of enterprises in Chongming District of Shanghai in 2020. Results Among the 778 enterprises in Chongming District，632（81.20%） were toxic and harmful enterprises，760（97.69%） were small and micro enterprises，766（98.46%） were manufacturing industries，and metal products were the main industries. The exposure rate of large and medium-sized enterprises was higher than that of small and micro enterprises，and the difference was statistically significant（P<0.05）. The exposure rate of manufacturing industry was higher than that of electricity，gas and water production and supply industry，and the difference was statistically significant（P<0.05）. The reporting rate of enterprise hazard factors，the entrusted detection rate of enterprise hazard factors and the implementation rate of occupational health monitoring decreased from large to small according to the enterprise size，and the differences were statistically significant（all P<0.05）. Conclusion Chongming District should focus on small and micro enterprises and the shipbuilding industry， urge enterprises improve the occupational health management，strengthen supervision，publicity，guidance and intervention for different enterprises，and assist enterprises to develop healthily and orderly.

Evaluation of occupational hazard control effect of VOCs treatment unit transformation project in a petroleum refining enterprise in Guangxi

WANG Feng-jiao, WANG Dan, ZHANG Li-fang, GUO Hang, JIA Zhuo-hao, DONG Ding-long

2023, 39(1):  24-28. 

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Objective Through the evaluation of occupational hazard control effect of volatile organic compounds（VOCs） treatment unit transformation project of a petroleum refining and chemical enterprise in Guangxi，to provide a basis for the prevention and control of occupational hazard factors of the enterprise. Methods From March 2021 to June 2021，the on-site investigation and detection of occupational health were conducted，to evaluate the control effect of occupational hazards in the enterprise. Results The occupational hazard factors produced in the production process mainly included hydrogen sulfide，benzene，toluene，xylene，solvent gasoline and noise. The test results show that the qualified rates of the measured occupational hazard factors were 100%. The allocation of occupational disease prevention facilities，personal protective articles and emergency rescue facilities met the requirements of relevant national laws and regulations. No occupational related abnormalities were found in occupational health examination. Conclusions The risk of occupational hazards of the project is classified as general. The leakage accidents are easy to occur due to pipeline and valve leakage or equipment wear during normal production. The regular inspection，maintenance or replacement of filler is confined space operation，which may lead to acute poisoning accidents. Therefore，after the project is put into operation，various emergency rescue measures should be strictly implemented，and occupational health management should be strengthened to ensure the occupational health of operators.

Occupational fatigue status of nursing staff in a tertiary hospital in Suzhou City and its relationship with sleep quality and mental toughness

SHEN Yong-ying, XU Wen-juan

2023, 39(1):  29-32. 

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Objective To understand the occupational fatigue status and influencing factors of nursing staff in a tertiary hospital in Suzhou City，analyze the relationship between occupational fatigue status and sleep quality，mental toughness，provide a basis for making decisions to alleviate occupational fatigue in nursing staff. Methods The questionnaires were distributed to 275 nursing workers in a tertiary hospital in Suzhou City from November to December 2021，and the data were analyzed. Results The total score of occupational fatigue of 275 nursing workers was （16.36±3.54）points，the total score of Pittsburgh Sleep Quality Index was（6.63±1.98）points，and the total score of mental toughness was （90.38±13.45）points. The total score of Pittsburgh Sleep Quality Index and its various dimension scores of nursing staff were positively correlated with the total score of occupational fatigue（all P<0.05）. The total score of mental toughness and its dimensions scores of nursing staff were negatively correlated with the total score of occupational fatigue（all P<0.05）. Working age >10 years，night shift >4 times/month，never exercising，sleep quality，and mental toughness were the influencing factors of occupational fatigue status of nursing staff（B=0.685，0.896，0.754，0.683，-0.542，all P<0.05）. Conclusions The occupational fatigue status of nursing staff in a tertiary hospital in Suzhou City can not to be ignored. The factors influencing occupational fatigue include long working years，frequent night shifts，lack of exercise，sleep quality and mental toughness. Among them，the worse the sleep quality of nursing staff，the more serious occupational fatigue. The stronger the mental toughness，the lower the occupational fatigue. Managers can formulate targeted strategies to alleviate the occupational fatigue of nursing staff.

Residue analysis and health risk assessment of heavy metals in 24 Chinese medicinal materials in Xingqing District of Yinchuan City

WANG Yan, QIN Jia-qi, ZHOU Tong-ning, ZHAO Si-yuan, CAO De-yan, ZHU Mei-lin

2023, 39(1):  33-38. 

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Objective To determine the six heavy metals[arsenic（As），copper（Cu），cadmium（Cd），lead（Pb），chromium（Cr） and nickel（Ni）] in 24 Chinese medicinal materials，conduct the health risk assessment. Methods The 24 kinds of heavy metals commonly found in the Yinchuan market collected during 2020 were determined by inductively coupled plasma atomic emission spectrometer （ICP-OES） method to determine the content of six kinds of heavy metals. The data were analyzed according to WM/T 2-2004 the Green trade standards of importing and exporting medicinal plants and preparations and the 2015 edition of the Chinese pharmacopoeia（part one）. According to the theory of health risk assessment，the health risk of heavy metals to human body was analyzed step by step. Results Each element presented a good linear relationship（r>0.999），the recovery rates were 80%-120%，indicating that the method was accurate and reliable. The detection of heavy metals showed that the content of As in Dried ginger was up to 1.183 mg/kg，and there were no samples that exceeded the standard. The content of Cu in Alisma orientalis was the highest（15.962 mg/kg），and there were no samples that exceeded the standard. The content of Pb in Stephania tetrandrawas the highest（4.606 mg/kg），and there were no samples that exceeded the standard. The content of Cd in Lily the highest（1.436 mg/kg），with the exceeding rate of 23.4%. The content of Cr in Chrysanthemum the highest（15.386 mg/kg），with the exceeding rate of 64.7%. The content of Ni in Honeysuckle the highest（4.689 mg/kg），with the exceeding rate of 28.6%. The elements were analyzed separately，the HI value of six heavy metals was <1，which had little effect on human health. The analysis of comprehensive hazard index showed that the all Chinese medicinal materials are polluted by different levels of heavy metals，and the order of health risk was Honeysuckle>Ginger>Lily>Chrysanthemum>Rhizoma Chuanxiong>Alisma orientalis>Rhizoma Atractylodis macrocephalae>Bletilla striata>Radix et Rhizoma codonopsis>Chinses angelica>Rhizoma et Radix fritillariae>Licorice>Scaphium scaphigerum>Pueraria lobata>Angelica dahurica>Ginseng>Stephania tetrandra>Radix paeoniae alba >Gastrodia elata >Achyranthes bidentata>Rhizoma pinelliae ginger>Chinese yam>Radix trichosanthin>Radix asparagi. Conclusion It is more reasonable and accurate to evaluate heavy metals in 24 Chinese medicinal materials by health risk assessment based on intake，but the standard limit values of Cr and Ni in Chinese medicinal materials need to be further studied and discussed.

Analysis on surveillance results of iodine nutrition among key population in Kunshan City from 2016-2020

CHEN Lei, XU Han-bing, SUN Xiao-wen, HAN Chun-mei, HU Chao-you, LYU Guan-ming

2023, 39(1):  39-42. 

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Objective To analyze the distribution of iodine nutrition level of key population in Kunshan City during the "13th Five-Year Plan"（2016-2020），provide scientific basis for the formulation of the prevention and control policies of iodine deficiency disease. Methods By the stratified random sampling，the children aged 8-10 years old were selected according to geographical location every year，and their urine samples and edible salt samples were collected to determine the content of urine iodine and salt iodine. Results A total of 1 609 salt samples were collected in Kunshan City from 2016 to 2020. The coverage rate of iodized salt was 97.39%，the qualified rate of iodized salt was 99.49%，and the consumption rate of qualified iodized salt was 96.89%. A total of 1 084 urine samples were collected from children aged 8-10 years old，and the median urine iodine was 202 μg/L. There was statistically significant difference among different years（χ²=26.857，P<0.01）. A total of 525 urine samples of pregnant women were collected，and the median of urine iodine was 154 μg/L. The samples of urine iodine value <150 μg/L accounted for 47.81%. There was no statistically significant difference in the median urine iodine of pregnant women among different years（χ²=4.738，P>0.05）. Conclusion During the "13th Five-Year Plan"，the overall iodine nutrition level of key population in Kunshan City is at an appropriate level，but 24.72% children have excess iodine nutrition and 47.81% of pregnant women have iodine nutrition deficiency，which requires classification guidance for these two groups of people，including strengthen iodine supplements for pregnant women and reducing iodine intake for children.

Mediating effects of sleep deprivation between emotional exhaustion and turnover intention in clinical night shift nurses of 5 grade-A tertiary hospitals in Shaanxi Province

LI Zi-xuan, DUAN Xiao-yan

2023, 39(1):  43-48. 

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Objective To understand the current situation of sleep deprivation，emotional exhaustion and turnover intention of night shift nurses，and to explore the intermediary relationship of sleep deprivation between emotional exhaustion and turnover intention. Methods In March 2022，a total of 394 clinical night nurses from 5 grade-A tertiary hospitals were selected in this cross-sectional survey. They were investigated with the general data questionnaire，intent to leave scale，emotional labor scale，and athens insomnia scale. SPSS 26.0 was used for general data，correlation and regression analysis，and AMOS 24.0 was used for intermediary effect analysis. Results The total score of sleep deprivation in 394 nurses was （7.24±6.14）points，the total emotional fatigue score was （46.35±9.55）points，surface performance score was （22.94±5.83）points，deep performance score was （12.75±3.64）points，natural performance score was （10.66±3.40）points，and total turnover intention score was （12.73±3.21）points. There was a positive correlation between sleep deprivation and emotional exhaustion，turnover intention（r=0.714，0.747，both P<0.01）. Sleep deprivation played an intermediary role between emotional exhaustion and turnover intention，which accounting for 41.0%. Conclusions The incidence of sleep deprivation between clinical night shift nurses is higher. Emotional exhaustion can induce turnover intention，also can accelerate turnover intention through the inducing factor of sleep deprivation. Meanwhile sleep deprivation plays a partial mediating role between emotional exhaustion and turnover intention. The management department should rationalize and upgrade the management structure，pay attention to the sleep status and emotional pressure of night shift nurses，and reduce their turnover intention.

Mediating effect of resilience on problem solving ability and social support in nurses

LUO Yi-fan, FAN Jia-xin, LI Yu-mei

2023, 39(1):  49-54. 

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Objective To explore the mediating effect of resilience on nurses' problem solving ability and social support，provide evidence for improving nurses' problem-solving ability. Methods From September to December 2021，the general information questionnaire，the Chinese version of the social problem-solving inventory revised（C-SPSI-R），the 10-item Connor-Davidson resilience scale（CD-RISC 10），the social support rating scale（SSRS） were used to conduct a questionnaire survey on 397 nurses from grade-A tertiary hospitals in Shanghai obtained by the convenience sampling method. Results The score of nurses' problem solving ability[M（P₂₅，P₇₅）] was 82.00（76.00，90.00）points，the score of social support was （40.15±8.32）points，and the score of resilience[M（P₂₅，P₇₅）] was 25.00（20.00，30.00）points. The problem solving ability was positively correlated with social support and resilience（r=0.596， 0.333，both P<0.01），and the resilience was positively correlated with social support（r=0.356，P<0.01）. The social support of nurses had a positive prediction effect on problem solving ability（the direct effect was 0.190），and resilience had a partial mediating effect between social support and problem solving ability，and the mediating effect accounted for 58.8% of the total effect. Conclusion Nurses' social support and resilience have positive predictive effects on problem solving ability，so the nursing managers，nursing educators should start with the perspective of the social support and resilience to improve the problem solving ability of nurses.

The Chinese version and assessment of reliability and validity of the workplace resilience scale

ZHANG Yi-fan, ZHANGWANG Zhe-qi, WANG Meng-jia, JIA Yi-yang, SHI Wen-wen, GUI Li

2023, 39(1):  55-58. 

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Objective To translate and revise the workplace resilience scale（WRS） into Chinese version，then to assess the reliability and validity of the Chinese version of the WRS. Methods The Chinese version of WRS was formed in the light of the modified Brislin translation model. Totally 317 nurses were selected from eight military hospitals in Shanghai，Beijing and other cities by convenient sampling method from January to March 2022，then the reliability and validity were investigated. Results The Cronbach′s α of WRS was 0.956，split reliability was 0.943. Analysis of content validity of the WRS indicated that the item-level content validity index（I-CVI） was 0.8-1.0，and the scale-level content validity index（S-CVI） was 0.92. Exploratory factor analysis found that the Kaiser-Meyer-Olkin（KMO） was 0.964. The Chinese version of WRS consists of 19 items，divided into 4 dimensions： active problem solving，team efficacy，confident sense-making，bricolage，and the cumulative variance contribution rate reached 77.9%. Conclusion The Chinese version of WRS has good reliability and validity，and can be used as a reliable tool to evaluate workplace resilience for nurses.

Mediating effect of occupational delayed gratification on empathy and occupational benefits of nurses in military hospitals

ZHAO Ying, SHI Jia-xing, ZHU Xia, SHI Rui-jie

2023, 39(1):  59-62. 

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Objective To explore the mediating effect of occupational delayed gratification on the relationship between empathy and the occupational benefits of nurses in military hospitals. Methods From May to July 2019，365 nurses in a grade-A tertiary military hospital in Xi'an City were investigated by the occupational delayed gratification scale，nurses' occupational sense of benefit scale，and empathy scale，and the data were analyzed. Results The total scores for nurses' empathy，occupational delayed gratification and occupational benefits were （104.53±15.2），（23.55±3.05） and （134.80±18.09）points，respectively. The empathy and occupational delayed gratification was positively related to the occupational benefits（r=0.492，0.392，both P<0.0l）. The occupational delayed gratification played a part of intermediary effect on the relation between empathy and occupational benefits（β=0.265，P<0.01）. Conclusion The empathy affects military nurses' sense of occupational benefits not only directly but also indirectly through occupational delayed gratification，so it is necessary to improve nurses' empathy and professional delay satisfaction through various interventions in clinic，thereby enhancing nurses' sense of professional benefit.

Status quo and influencing factors of good death expectation of rural elderly people in Hunan Province

PENG Xin-yu, ZHANG Wan, XIA Qing, LUO Bing-bin, WANG Dong-hua

2023, 39(1):  63-68. 

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Objective To understand current situation of good death expectation of rural elderly people in Hunan Province，analyze its influencing factors. Methods From July to September 2021，433 elderly people in six villages of Hunan Province were collected by the convenience sampling method as the investigation objects. A questionnaire survey was performed by the general data questionnaire，good death inventory，self-care ability scale of elderly people and filial piety expectation scale，and the data were analyzed. Results The average score of good death expectation of rural elderly people was （3.83±0.41）points，which was at the middle level. The scores of self-care ability of the elderly and filial piety expectation were positively correlated with good death expectation（both P<0.01）. The age，education level，financial burden and the scores of self-care ability and filial piety expectation were the influencing factors of good death expectation of rural elderly people（all P<0.05）. Conclusion The level of good death expectation of rural elderly people in Hunan Province should be improved，so it is necessary to develop the intervention measures to improve the level of self-care ability and filial piety expectation of the elderly，so as to enhance the quality of life of the elderly，finally achieve good death.

Situation and influencing factors of loneliness of special hardship elderly people with centralized support in a rural area of Haikou City

TANG Yu, ZENG Cai-yun, TAN Shao-ying, WANG Tao, LI Hai-bo

2023, 39(1):  69-72. 

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Objective To explore the current situation and influencing factors of loneliness of the special hardship elderly people with centralized support in rural area. Methods From April to May 2021，91 impoverished elderly in a rural nursing home in Haikou City were investigated by the general data questionnaire，loneliness scale of university of California at Los Aageles（UCLA），patient health questionnaire depression module（PHQ-9），hamilton anxiety scale（HAMA） and 10-item connor-davidson resilience scale（CD-RISC-10）. Results 85.71% of the elderly had moderate or more loneliness. The univariate analysis showed that there were statistically significant differences in the loneliness level among the elderly in different gender，education，marriage history，frequency of relatives' visits，participation in recreational activities，depression and anxiety（all P<0.05）. The correlation analysis showed that psychological elasticity was negatively correlated with loneliness（r=-0.594，P<0.05）. The multivariate analysis showed that marriage history，participation in recreational activities，frequency of relatives' visits，depression level and psychological elasticity explained 51.20% of the variation of loneliness. Conclusion The special hardship elderly people in rural nursing homes generally have a strong sense of loneliness，and the elderly who are divorced，widowed，do not participate in recreational activities and have low frequency of relatives' visits have a high sense of loneliness，while those with low level of depression and good psychological flexibility have a low sense of loneliness.

Study on the current situation and influencing factors of vocational identity of medical social workers in Guangdong Province

GUO Xiao-fa, SUN Gang, QIAN Yi

2023, 39(1):  73-79. 

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Objective To study the current situation and influencing factors of vocational identity of medical social workers in Guangdong Province. Methods From April to September 2021，medical social workers in Guangdong were investigated，using the Guangdong medical social workers' vocational identity questionnaire，to analyze vocational values，vocational emotions，vocational skills and vocational expectations. Independent sample t-test，ANOVA and multiple linear regression were used to analyze the influencing factors of vocational identity. Results The total score of vocational identity on medical social workers in Guangdong Province was （44.89±7.19）points. The identity mean value of "vocational values" was 3.73 points，which got high degree of recognition. The identity mean value of "vocational emotions" and "vocational skills" were 3.69 and 3.47 points，which got low degree of recognition. The identity mean value of "vocational expectation" was 4.06 points，which got highest degree，and desired to improve the level of specialization. Single factor analysis shown that the stronger the belief in medical social work，the higher level of love on the vocation. With higher identification of values and concepts of medical social work，and higher personality awareness，the higher the recognition and support of the peripheral support system，the higher the job satisfaction，which was more in line with the career development plan，and the stronger the vocational identity of medical social workers. Multivariate analysis shown that the belief in medical social work had the greatest impact on vocational identity，followed by personality awareness，support and recognition of service objects，satisfaction with the cultural atmosphere of employers，number of years engaged in medical social work，social work qualification obtained，and marital status. The stronger the belief，the higher the personality awareness，the higher the support and recognition of the service object，the higher the satisfaction with the cultural atmosphere of the employer，and the better the vocational identity. The research also found thatthe longer the working years，the better the sense of identity，the higher the professional title，the lower the professional identity. Compared with unmarried people，those married had a better sense of professional identity. Conclusions The vocational identity of medical social workers in Guangdong Province is at a medium level，and the identification of vocational skills is low. It is necessary to further improve the professional skills and specialization level. The vocational identity of medical social workers is affected by many factors，including years of working，marital status，beliefs，personality awareness，recognition and support from peripheral support systems，etc.

Research on the pollution of heavy metals in the water of Shunyi section on Chaobai River and Hanshi Bridge wetland

ZHENG Qi-guang, LIU Sheng-tian, ZHU Mei-juan, LI Yong-ji, WANG Jing

2023, 39(1):  80-83. 

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Objective To understand the pollution levels of heavy metal elements in the water of Shunyi section on Chaobai River and Hanshi Bridge wetland，and provide scientific reference data for the management of reclaimed water and make-up wetland in the region. Methods The sampling points were set in Shunyi section of Chaobai River and Hanshi Bridge wetland，and the water samples were collected in April（wet season） and October（dry season） 2021 respectively. Six kinds of heave metals（Zn，Cu，As，Pb，Cd，Cr） in the samples were quantitatively analysed with the developed methods，and the heavy metals polluted levels of the two wetlands were evaluated. Results The concentrations of six kinds of heavy metals in the reclaimed water wetlands were 0.06-9.72 μg/L，which were lower than those of the national surface water Ⅲ water quality standard. The concentrations of Zn，Cu and As in dry season were higher than that in wet season（all P<0.05）. Conclusion The pollution levels of six kinds of heavy metals（Zn，Cu，As，Pb，Cd，Cr） in the water of Shunyi section on Chaobai River and Hanshi Bridge wetland were generally lower.

Mediating effect of interpersonal sensitivity on parent-child attachment and self-identity among students from two college in Shaanxi Province and Anhui Province

GUO Zhi-hui, XIA Yun-yao

2023, 39(1):  84-88. 

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Objective To explore the relationship between parent-child attachment，interpersonal sensitivity and self-identity among college students，analyze the mediating effect of interpersonal sensitivity on parent-child attachment and self-identity. Methods In November 2021，372 students from two college in Shaanxi Province and Anhui Province were collected by the stratified cluster random sampling，the questionnaire survey was conducted by the inventory of parent and peer attachment（IPPA），interpersonal sensitivity scale and self-identity scale，and the data were analyzed. Results The scores of parent-child attachment，interpersonal sensitivity and self-identity in college students were （1.81±0.39），（2.39±0.67） and （2.84±0.29）points，respectively. There were statistically significant differences in self-identity scores among students with different parenting style and family structure（all P<0.05）. There were statistically significant differences in parent-child attachment scores among students in different grade，parenting style and family structure（all P<0.01）. There was statistically significant differences in interpersonal sensitivity scores among students with different parenting style（P<0.05）. The parent-child attachment was positively correlated with self-identity（r=0.328，P<0.01），while the interpersonal sensitivity was negatively correlated with parent-child attachment and self-identity（r= -0.157，-0.517，both P<0.01）. The interpersonal sensitivity played a partial intermediate role in the relationship between parent-child attachment and self-identity in college students（β=-0.477，P<0.01），and the mediating role was significant，accounting for 22.9% of the total effect. Conclusion The parent-child attachment positively affects self-identity，and the interpersonal sensitivity plays a partial mediating role in the relationship between parent-child attachment and self-identity.

Analysis on status and influencing factors of patient safety attitude and professionalism among nursing students

DAI Wei, YE Hong-fang, XU Xiang-rong, LIU Qing-yuan

2023, 39(1):  89-92. 

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Objective To investigate the status quo of attitudes towards patient safety and professionalism of nursing students，analyze its influencing factors. Methods In October 2021，303 nursing students from a grade-A tertiary hospital in Nanjing City were selected as investigation objects. The investigation was performed by the patient safety attitude and professionalism scale for nursing students，clinical learning environment scale and perceived social support scale，and the data were analyzed. Results The total score of patient safety attitude and professionalism in nursing students was （129.04±18.64）points，the score of clinical learning environment was （176.40±23.47）points，and the score of perceived social support was （66.50±10.67）points. There were statistically significant differences in patient safety attitude and professionalism among nursing students of different gender，internship time，nursing errors，participation in patient safety training，liking degree of nursing profession and clinical practice satisfaction（all P<0.05）. The patient safety attitude and professionalism was significantly positively correlated with clinical learning environment and perceived social support（r=0.547，0.402，both P<0.01），while clinical learning environment was positively correlated perceived social support（r=0.410，P<0.01）. The clinical learning environment，perceived social support and clinical practice satisfaction were the main influencing factors of patient safety attitude and professionalism in nursing students，explaining 34.5% of total variance of patient safety attitude and professionalism in nursing students. Conclusions The patient safety attitude and professionalism in nursing students is at a high level，but needs further improvement. The schools and nursing educators can improve nursing students' patient safety attitude and professionalism by formulating patient safety training courses，improving teaching methods of teachers，giving encouragement and providing social support.

Analysis on current situation and influencing factors of pharmaceutical college students' professional identity

FENG Chun-miao, WANG Yi, JIAO Ke, WANG Hao

2023, 39(1):  93-96. 

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Objective To explore the status quo and influencing factors of pharmaceutical college students' professional identity，provide theoretical and data support for "planning model construction and application research of college students' professional identity". Methods Taking the method of convenient sampling，the questionnaire on the current situation and influencing factors of professional identity of pharmaceutical college students was designed. Totally 772 valid questionnaires were collected from pharmaceutical college students enrolled in a medical college in Shandong from September 2017 to September 2020，and the effective recovery rate was 96.75%. Results The questionnaire has good reliability and validity，and five important factors（accounting for 71%） that may affect the professional identity of pharmaceutical college students were obtained：professional cognition，professional emotion，professional behavior，school factors and social evaluation. The average score of professional identity in respondents was （2.69±0.82）points，and there was statistically significant difference in professional identity scores among college students of different grades（P<0.05）. The results of linear regression analysis showed that professional emotion，professional learning behavior，school factors and social evaluation were the main influencing factors of pharmaceutical college students' professional identity（β=0.845，0.126，0.057，-0.059，all P<0.05）. Conclusion The professional identity of pharmaceutical college students is in the lower middle level，and it is necessary to improve the professional identity of pharmaceutical college students from the aspects of professional emotion，professional learning behavior，school factors and social evaluation，and pay attention to grade differences in professional identity.

Multiple mediating effects of social support and sense of security on sexual mental health and sexual health attitude of medical students in higher vocational colleges of Sichuan Province

WU Ji-jun, RONG Xian, LIU Zhen-fan, LIU Jie, ZHANG Ji-quan

2023, 39(1):  97-102. 

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Objective To investigate the status of social support，sense of security，sexual mental health and sexual health attitude of medical students in higher vocational colleges of Sichuan Province，analyze the mediating role of social support and sense of security in sexual mental health and sexual health attitude. Methods Using the convenience sampling method，856 medical students from three higher vocational colleges in Sichuan Province were investigated by general information questionnaire，social support scale，security scale，sexual mental health scale and sexual health attitude scale from March to May 2021. Results The scores of sexual health attitude，sexual mental health，sense of security and social support of medical students in higher vocational colleges were （45.843±9.166），（69.158±9.746），（60.490±10.627） and （52.542±8.365）points，respectively. The results of correlation analysis showed that there was a positive correlation between the sexual mental health and sexual health attitude of medical students in higher vocational colleges（r=0.287-0.571，all P<0.05），a negative correlation between sense of security and sexual health attitude（r=-0.274--0.679，all P<0.05），and a negative correlation between social support and sexual health attitude（r= -0.246--0.541，all P<0.05）. The mediating effect analysis showed that the social support of medical students in higher vocational colleges played a partial mediating role between sexual mental health and sexual health attitude，and the mediating effect was 0.097，accounting for 15.67% of the total effect. The sense of security played a partial mediating role between sexual mental health and sexual health attitude，the mediating effect was 0.169，accounting for 27.30% of the total effect. The social support and security played a chain mediating role between sexual mental health and sexual health attitude，the mediating effect was 0.036，accounting for 5.82% of the total effect. Conclusions The sexual health attitude of medical students in higher vocational colleges is at a medium level，which needs to be further improved. The nursing education should formulate targeted sexual education and training activities according to the differences of student groups，improve students' social support and sense of security，and improve their sexual psychological health status.

Study on present situation and influencing factors of resilience of family caregivers of schizophrenia patients in community in Urumqi

Ailipati Tailaiti, CHEN Jin-rong, NIU Min-rui, LYU Meng, WANG Hui-cai

2023, 39(1):  103-106. 

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Objective To investigate the current situation and influencing factors of resilience of family caregivers of schizophrenia patients in community in Urumqi，provide reference for improving the resilience level of this group and taking effective intervention measures. Methods Using snowball sampling method，the family caregivers of 71 schizophrenia patients from seven communities in Urumqi were selected as the research object from December 2021 to February 2022，and the general information questionnaire and Connor Davidson resilience scale（CD-RISC） were used for investigation，and the data were analyzed. Results The total score of mental resilience of family caregivers of schizophrenia patients in community was （58.24±14.89）points，among which the scores of tenacity，strength and optimism were （30.03±8.04），（18.90±5.45） and （9.31±2.10）points，respectively. The education level，per capita monthly income of family and knowledge of diseases were all factors influencing the resilience of family caregivers of community schizophrenia patients（all P<0.05），which could explain 41.3% of the total variation. Conclusion The mental resilience of family caregivers of schizophrenic patients in community in Urumqi is at a medium level，and the educational level，family per capita monthly income and knowledge of diseases of family caregivers are the influencing factors，so it is necessary to pay attention to the physical and mental health of this group in community management，and suggest strengthening community health education and taking effective intervention measures to improve the mental resilience of this group.

Analysis on research hotspots and frontiers of domestic altitude sickness based on data mining

ZONG Yong-hua, OU Xia, ZHANG Yan-fei, XU Ming-zhu, ZHANG Xue-qin, MO Ge

2023, 39(1):  107-114. 

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Objective Since the 21st century，the research on altitude sickness has achieved rapid development in China. The purpose of this paper is to explore the research hotspots and scientific frontiers in the field of altitude sickness in China，and to provide reference for the follow-up research in this field. Methods Taking CNKI database as the search object，3 797 articles published from January 2000 to July 2021 were selected. CiteSpace scientific measurement tool was used to carrying out the metrological analysis and knowledge mapping. Results The number of literature on plateau sickness was generally on the rise from 2000 to 2021. The research focuses on the etiology，pathology and clinical prevention and treatment of "high altitude pulmonary edema，high altitude brain edema and high altitude polycythemia"，as well as the exploratory research on high altitude factors. The pathological mechanism represented by "oxidative stress" and "inflammatory response"，magnetic resonance imaging of altitude sickness and altitude medicine are the research frontiers in the past three years. Conclusions The study of altitude sickness focus on the directions of clinical diagnosis and treatment，etiology and pathology of acute or chronic plateau sickness in the past 20 years. There are few literature on biochemistry，molecular genetics and environmental occupational health related to altitude sickness. In the future，it is necessary to strengthen the researches on molecular biochemistry，genetics and environmental health to promote the systematic and holistic study of altitude sickness.

Investigation and Research

Analysis on current situation and influencing factors of perceived stress among employees in Tianjin Centers for Disease Control and Prevention

YU Jie, DU Ying, CHEN Ruo-nan, LIU Wei, LI Jian, XU Ying

2023, 39(1):  115-117. 

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Objective To evaluate the current situation and influencing factors of perceived stress among employees in Tianjin Centers for Disease Control and Prevention（CDC），provide evidences for improving the physical and mental health of CDC staff. Methods From November 23，2021 to February 28，2022，the staff of Tianjin CDC were selected as the research subjects. The perceived stress level was investigated by electronic questionnaire of Chinese perceived stress scale（CPSS），and the data were analyzed. Results A total of 365 valid questionnaires were obtained，the median of overall perceived stress score was 25.00（18.00，31.00）points，among which 178 cases（48.8%） had high perceived stress. The perceived stress level of district units[26.00（20.00， 31.00）points] was higher than that of municipal units[24.00（18.00，29.00）points]. The long overtime hours and poor health status were the risk factors for high perceived stress level of the staff of CDC. Conclusion The perceived stress level of Tianjin CDC staff is generally high，the perceived stress level of district units is higher than that of municipal units，and overtime hours and health conditions are the main factors affecting the occurrence of high perceived stress.

Overview

Research progress of subthreshold depression in college students

DUAN Hai-zhen, CAO Mei-juan, HE Xin

2023, 39(1):  118-121. 

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Subthreshold depression is a mental sub-health state，and its incidence rate is much higher than that of depression.College students are still in the stage of development and perfection due to their physiology and psychology，which makes them a high incidence group of subthreshold depression，resulting in serious damage to learning，life and social functions.Timely discovery and treatment can improve the symptoms of subthreshold depression of college students，thus further reducing the incidence rate of depression.This paper summarizes the concept，connotation，theoretical basis and evaluation tools of subthreshold depression，deeplyanalyzes the influencing factors of subliminal depression of college students，and summarizes the intervention methods，in order to provide reference for effectively promoting the physical and mental health and all-round development of college students，reducing the incidence rate of subliminal depression，and effectively relieving the symptoms of depression.

Effects of radio-frequency electromagnetic fields on Alzheimer's disease

JIANG Yu-rong, WU Xi-nan, ZHANG Sheng-qingyu, LI Zhi-qiang, SHU Xiao, WU Hui-xin

2023, 39(1):  122-125. 

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Radio-frequency electromagnetic fields（RF-EMF） are widely existing in production and life，which act on the body with non-thermal effects. Different biological effects may occur through long-term RF-EMF exposure. The brain is one of the target organs that sensitive to RF-EMF exposure. RF-EMF exposure may alter learning and memory function. The effects of RF-EMF on learning and memory function are still debated. In recent years，studies have found that prolonged exposure to RF-EMF is associated with the onset and progression of Alzheimer's disease（AD）. It may improve learning and memory function in AD by affecting β-amyloid（Aβ） levels and other responses downstream of the Aβ pathway，activating autophagy and inhibiting apoptosis in the brain of AD，which may have a protective effect on neurons. At present，the research into AD is still in its infancy and the causes and effective treatments for AD have still not been identified. Studying the effects of RF-EMF exposure on AD may provide new leads for AD-related research. The article review the effects of RF-EMF on pathological changes and cognitive function in AD and provide a basis for AD-related research.

Research progress of person-centered dementia care methods for nursing staff in nursing institutions

CHEN Hai-wen, SONG Jie, ZHANG Nan, LIU Lin, LU Xiao-han, GONG Xiao-ju

2023, 39(1):  126-130. 

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With the aging of the population，the prevalence of dementia is increasing year by year. The increasing number of people with dementia and its complicated care management have become a social problem urgently to be solved in the global health system. At present，there is no effective treatment for dementia，socorrect nursing approach may improve the quality of life of dementia patients. Due to the decline in cognitive and language function，dementia patients generally have wrong perceptions and expressions in daily life，and caregivers tend to adopt reality-oriented dementia care. However，person-centered care is a basic element of dementia care practice，which not only helps to relieve patients' mental and behavioral symptoms，improve their quality of life，and promote their health and happiness，but also helps to reduce the pressure and burden of caregivers and promote positive care practice. The article reviewed the research progress of the person-centered dementia care，assessment tools，form，the present situation and influence factors of nursing institutions' nurses at home and abroad in implementation of person-centered dementia care，put forward the further relevant qualitative research and intervention research in China，so as to provide reference for managers of domestic elderly care institutions to take effective measures for improving nursing staff's level of person-centered dementia care.

Research progress of health-promoting behavior in patients with coronary heart disease

YU Liang-meng, YANG Qiao-fang, XIN Ju-hua, LIU Chang, MA Ping-ping

2023, 39(1):  131-135. 

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The high incidence of coronary heart disease and high mortality rate seriously harm the health of individuals，but also increases medical expenditure and increases the social burden. The health behavior of patients with coronary heart disease is the main factor that affects the occurrence and development of their disease.Good health-promoting behavior reduces disease relapse rates and mortality. Paying attention to the health promotion behavior of patients with coronary heart disease is one of the current research focuses and hotspots. The article summarize the research progress of health-promoting behavior in patients with coronary heart disease，so as to provide reference for formulation and implementation of effective health behavior intervention measures in clinic.

Research progress on factors and protection of blood-borne occupational exposure of nurses in emergency department

ZHANG Shuang-fei, CHENG Jin-tao, YUAN Meng, HUANG Xiao-hong

2023, 39(1):  136-139. 

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The emergency department is one of the high-risk places for nurses to have blood-borne occupational exposure. Due to the particularity of work，emergency nurses become the high-risk group of blood-borne occupational exposure，and the health problems caused by blood-borne occupational exposure cannot be ignored. The article review the forms，related factors，health hazards and protection of emergent nurses' blood-borne occupational exposure，so as to strengthen the self-awareness of protection of nursing workers，reduce the incidence of emergent nurses' blood-borne occupational exposure，and effectively protect the health and safety of nurses.

Research progress on stigma of mental illness among health care providers

XIE Xiao-shu, XIE Li-li, WANG Dong-hua, DENG Xiao-yu, PENG Xi-ya, CUI Ting

2023, 39(1):  140-144. 

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At present，stigma of mental illness among health care providers is a hot research topic in sociology and psychology in the world. The attitude of health care providers towards mental illness is not positive and enthusiastic in the public perception，and even biased，which will do great harm to both patients with mental illness and health care providers themselves. The article review the research on mental illness stigma of health care providers，discuss the measurement tools，related factors and intervention strategies of mental illness stigma of health care providers，and provide theoretical basis for the intervention of mental illness stigma of health care providers，so as to reduce the stigma of mental illness of health care providers in China，improve the comprehensive quality of health care providers，and reduce the harm of mental illness patients in the process of seeking medical treatment.