Table of Content

01 May 2026, Volume 42 Issue 9

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Treatise

Risk factors and prediction model construction of re-acute exacerbation of coal workers' pneumoconiosis patients combined with chronic obstructive pulmonary disease

CHEN Xiaoli, LI Xueqin, ZHAO Fangfang, ZHAO Liangliang, WANG Yan

2026, 42(9):  1153-1157. 

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Objective To investigate the risk factors of re-acute exacerbation of coal workers' pneumoconiosis patients combined with chronic obstructive pulmonary disease（COPD） and further construct clinical prediction model，so as to provide the reference for early detection of high-risk groups of re-acute exacerbation and formulation of targeted prevention and treatment programs. Methods Totally 228 coal workers' pneumoconiosis patients combined with COPD diagnosed and treated in Jincheng General Hospital from January 2020 to June 2023 were retrospectively included and grouped according to whether acute exacerbation occurred again within 12 months after discharge or not. The single factor analysis and multi-factor analysis were used to analyze the independent risk factors of re-acute exacerbation of coal workers' pneumoconiosis patients combined with COPD. The risk prediction model of re-acute exacerbation of coal workers' pneumoconiosis patients combined with COPD was constructed，and the prediction efficiency analysis was performed. Results There were 80 cases with re-acute exacerbation within 12 months after discharge in 228 patients，with the incidence of 35.09%. The results of univariate analysis showed that the course of disease，the number of acute exacerbations in the past 12 months，the score of COPD self-assessment test，and forced vital capacity may be related to the re-acute exacerbation of coal workers' pneumoconiosis with COPD（all P<0.05）. The multivariate Logistic analysis results confirmed that the course of disease ≥10 years，acute exacerbation ≥2 times in the last 12 months，COPD self-assessment test score ≥10 points and lower forced vital capacity were independent risk factors for re-acute exacerbation of coal workers' pneumoconiosis with COPD（all P<0.05）. Using a disease course of ≥ 10 years，a history of ≥2 acute exacerbations within the past 12 months，a COPD self-assessment test score of ≥10 at discharge，forced vital capacity，and a Logistic regression model P-value to predict the probability of recurrent acute exacerbations of coal worker pneumoconiosis with COPD，the receiver operating characteristic（ROC） curve prediction was performed，and the areas under the curves were 0.771，0.724，0.714，0.726 and 0.919，respectively. Conclusions The re-acute exacerbations in coal workers pneumoconiosis patients combined with COPD may be related to the disease course，the number of acute exacerbations in the past 12 months，the score of COPD self-assessment test and forced vital capacity. The data model constructed by using the above four factors has shown good efficacy in predicting the recurrence of acute exacerbations of patients，which is worthy of further analysis in our work.

Investigation on occupational hazard factors in a new dry process cement production enterprise in Guangxi

HUANG Chunyuan, HUANG Ji, FU Songwen, ZHOU Benjian, NIE Chuanli, OU Junrong

2026, 42(9):  1158-1162. 

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Objective To investigate and analyze the occupational hazard factors present in a new dry process cement enterprise in Guangxi，providing detailed evidence for strengthening occupational disease prevention and control. Methods Occupational hygiene surveys and occupational hazard factor detection methods were employed to collect relevant data，and the results were analyzed and evaluated. Results The individual dust compliance rate in the cement enterprise was 100.0%，the fixed-point dust compliance rate was 90.0%，the individual noise compliance rate was 100.0%，the fixed-point noise compliance rate was 66.7%，and the compliance rates for other chemical toxins and physical factors were all 100.0%. Conclusion The main occupational hazards in this new dry process cement production enterprise are dust and noise. It is necessary to improve the protective facilities for dust and noise in the workplace，implement occupational health monitoring，and protect the health of workers.

Analysis of occupational hazards in a typical waste household appliance dismantling enterprise in central Shaanxi

WANG Tingjuan, WU Ruixian, ZHANG Mingzhu, QI Zixuan, XING Yafei, QI Baoning

2026, 42(9):  1163-1167. 

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Objective To understand the occupational hazards present in a typical waste household appliance dismantling enterprise located in central Shaanxi Province，and to propose effective prevention and control measures to protect the health of workers. Methods In accordance with national legal standards and requirements，an on-site investigation and professional testing were conducted from December 2022 to January 2023 at the workplace of a typical waste household appliance dismantling enterprise in central Shaanxi Province，the results were calculated，analyzed，and evaluated. Results The main occupational hazards in this enterprise were dust and noise. The concentration of other dust at the material handling post on the air conditioning line in the production workshop was 9.4 mg/m³，and at the dismantling post on the washing machine line，it was 9.9 mg/m³. The calculated equivalent sound level over 40 hours for the dismantling workers in the production workshop（washing machine line） and the dismantling and feeding workers at crushing station 1# and 2# in the crushing workshop（washing machine line） exceeded 85 dB（A）. The noise intensity at the 2# feeding post in the crushing workshop was the highest，with a maximum value of 100.5 dB（A），exceeding the standard by 15.5 dB（A），which does not comply with occupational exposure limits. Conclusion This enterprise demonstrated exceeded standards for both dust and noise，indicating a significant occupational hazard. The production enterprise should actively implement effective measures to improve ventilation，dust removal，and noise control to ensure the occupational health of its workers.

Analysis on current situation and influencing factors of occupational stress among grassroots public health personnel in a City of Guangdong Province

WANG Shuyu, RUAN Tanfeng, CHEN Hao, HUANG Yiping, LIU Haozhong

2026, 42(9):  1168-1173. 

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Objective To evaluate the current situation of occupational stress among grassroots public health prevention and control personnel in a city in Guangdong Province and analyze its influencing factors，in order to provide a basis for formulating intervention measures. Methods A typical sampling method was used to recruit 492 grassroots public health workers in November 2022. The job demand control model（JDC） and the effort reward imbalance（ERI） were evaluated using the job content scale and the effort-reward imbalance scale to assess two occupational stress patterns. Results The detection rates of occupational stress based on the JDC and ERI models were 79.88% and 66.46%，respectively. Occupational stress based on the JDC model was significantly associated with 15-<20 working years，overtime work due to infectious disease outbreaks prevention and control and routine tasks over the past 3 months，overtime due to routine tasks over the past 3 months，moderate or weak family well-being，and concerns about workplace infection risks（χ²=3.928，7.311，8.328，9.877，4.582，all P<0.05）. For the ERI model，significant risk factors included intermediate professional titles，overtime requirement of the position，overtime work due to routine tasks over the past 3 months，and high life pressure（χ²=6.651，4.575，5.308，7.760，all P<0.05）. Conclusion Occupational stresses in this population are influenced by both JDC and ERI models，with a high prevalence of occupational stress. Main influencing factors for the JDC model includes working years，overtime work over the past 3 months，family well-being，and infection concerns at work，while main influencing factors for the ERI model includes professional titles，job-related overtime requirements，overtime work over the past 3 months，and life pressure.

Analysis on mediating role of boundary elasticity in the relationship between work-family conflict and occupational burnout among orthopedic nurses

CHAI Juan, GUAN Xiaoyan, LI Guojuan, LU Lingna

2026, 42(9):  1174-1178. 

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Objective To investigate the boundary flexibility，work-family conflict and occupational burnout of orthopedic nurses，analyze the mediating role of boundary flexibility between work-family conflict and occupational burnout of orthopedic nurses，and provide objective evidence for improving the level of occupational burnout of orthopedic nurses and improving the efficiency of clinical nursing work. Methods From January to February 2025，183 orthopedic nurses from 9 grade-A tertiary hospitals in Shanghai City were selected as the survey subjects by convenient sampling method. The boundary flexibility scale，work-family conflict scale and occupational burnout scale were used to investigate the boundary flexibility，work-family conflict and occupational burnout of orthopedic nurses，and the data were analyzed. Results The boundary flexibility score of orthopedic nurses was （28.76±4.32）points，the work-family conflict score was （57.48±16.36）points，and the job burnout score was （60.76±12.28）points. The job burnout scores of orthopedic nurses with different ages，professional titles，clinical nursing working hours，average monthly income，and average monthly number of shifts were compared，and the differences were statistically significant（all P<0.05）. The boundary flexibility score of orthopedic nurses was negatively correlated with the job burnout score（r=-0.532，P<0.01），the work-family conflict score was positively correlated with the job burnout score（r=0.628，P<0.01），and the boundary flexibility score was negatively correlated with the work-family conflict score（r=-0.519，P<0.01）. Boundary flexibility partially mediated the relationship between work-family conflict and job burnout of orthopedic nurses，with a mediating effect value of 0.314，accounting for 43.01% of the total effect. Conclusion Job burnout and work-family conflict of orthopedic nurses are both at a high level，and work-family conflict can directly promote or indirectly affect their job burnout through boundary flexibility. Hospitals should improve the boundary flexibility of orthopedic nurses，reduce work-family conflict，and thus reduce job burnout.

Anti-inflammatory effect of aucubin on colitis in cadmium-exposed rats and its influence on p38MAPKNF-κB signaling pathway

YAO Xiaobo, LIU Fei, XIAO Fangyi, FENG Liang

2026, 42(9):  1179-1185. 

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Objective To investigate the anti-inflammatory effect of aucubin on colitis in rats exposed to cadmium and its effect on p38MAPKNF-κB signaling pathway，provide reference for the prevention and treatment of intestinal diseases related to environmental heavy metal cadmium exposure. Methods Totally 40 rats were randomly divided into control group，cadmium exposure model group，and low- and high-dose aucubin groups based on their body weight，10 rats in each group，half male and half female. The control group was gavaged with an equal volume of normal saline，the cadmium exposure group was gavaged with 0.5 mg/kg CdCl₂ solution daily，and the low- and high-dose aucubin groups were gavaged with 25 and 50 mg/kg aucubin solution daily on the basis of cadmium exposure. After the experiment，the colonic mucosal damage index（CMDI），disease activity index（DAI），colon inflammation scores，and colon cell apoptosis rates of the rats in each group were measured. The real time fluorescence reverse transcription and Western blotting were used to test mRNA and protein expression level of mitogen-activated protein kinase p38（p38MAPK） and nuclear factor kappa-light-chain-enhancer of activated B cells（NF-κB） in colon tissue. The enzyme-linked immunosorbent assay was used to test levels of tumor necrosis factor-α（TNF-α），interleukin-6（IL-6） and monocyte chemoattractant protein-1（MCP-1） in colon tissue. Results Compared with the control group，the CMDI（12.25±1.12），DAI（2.71±0.23），colon inflammation score（7.24±1.22），apoptosis rate[（29.54±2.99）%]，p38MAPK mRNA（4.69±0.65），NF-κB mRNA（4.27±0.48），p38MAPK protein（1.06±0.10），NF-κB protein（1.12±0.13），TNF-α[（459.14±29.24）mmol/mL]，IL-6[（541.20±33.21）mmol/mL] and MCP-1[（625.36±42.27）mmol/mL] in the cadmium exposure model group were significantly increased（all P<0.05）. Compared with the cadmium exposure model group，the CMDI（8.54±0.85），DAI（1.81±0.18），colon inflammation score（5.30±0.54），apoptosis rate[（16.24±1.23）%]，p38MAPK mRNA（3.24±0.45），NF-κB mRNA（3.05±0.33），p38MAPK protein（0.75±0.07），NF-κB protein（0.80±0.08），TNF-α[（236.41±19.47）mmol/mL]，IL-6[（302.14±25.22）mmol/mL] and MCP-1[（337.48±32.17）mmol/mL] in low-dose aucubin group were significantly decreased（all P<0.05）. While CMDI（5.24±0.56），DAI（1.28±0.09），colon inflammation score（3.22±0.41），apoptosis rate[（3.22±0.47）%]，p38MAPK mRNA（2.33±0.23），NF-κB mRNA（1.25±0.19），p38MAPK protein（0.35±0.04），NF-κB protein（0.42±0.05），TNF-α[（130.20±15.11）mmol/mL]，IL-6[（184.20±19.11）mmol/mL]，MCP-1[（209.54±22.19）mmol/mL] in high-dose aucubin group were further decreased，and those were significantly decreased as compared with lower-dose aucubin group（all P<0.05）. Conclusion The aucubin exhibits a significant anti-inflammatory therapeutic effect on colitis in cadmium-exposed rats，its mechanism is related to the significant inhibition of the activation of the p38MAPK/NF-κB signaling pathway by aucubin.

Analysis of the effects of PM_2.5 on gene expression in human bronchial epithelial BEAS-2B cells based on bioinformatics

HA Zhiyun, WEI Meina, WU Yanduo, WANG Bo, MA Xue, XU Haiming

2026, 42(9):  1186-1193. 

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Objective To analyze the effect of particulate matter 2.5（PM_2.5） on gene expression in human bronchial epithelial cells（BEAS-2B） using bioinformatics methods，screen differentially expressed genes（DEGs），in order to provide reference for respiratory system injury and mechanism caused by PM_2.5. Methods A dataset related to BEAS-2B cells exposed to PM_2.5（GSE158954） was retrieved from the Gene Expression Omnibus（GEO） database of the National Center for Biotechnology Information（NCBI） in the United States. The R language was used to screen the gene expression data matrix by DEGs，enrich the Gene Ontology（GO） function and analyze the Kyoto Encyclopedia of Genes and Genomes（KEGG） signal pathway. At the same time，the protein-protein interaction（PPI） network was constructed by using STRING database and Cytoscape3.8.0 software，the key hub genes were screened by MCODE plugin，and relative expression levels of DEGs were analyzed using the NCBI Gene database. Results The GSE158954 dataset included 6 samples：three controls（GSM4816385，GSM4816386，GSM4816387） and three PM_2.5-exposed BEAS-2B cell samples（GSM4816388，GSM4816389，GSM4816390）. The analysis results showed that a total of 235 DEGs were detected（P<0.05 and |log2fc|≥1 after correction）. Among them，there were 121 up-regulated genes and 114 down-regulated genes. GO analysis results showed that DEGs were significantly enriched in multiple biological processes，cell components and molecular function modules. In terms of biological processes（BP），they mainly involved processes such as chemotaxis of macrophages（AMs） and neutrophils，suggesting that they played a potential role in regulating immune cell migration；at the cell component（CC） level，they were concentrated in the plasma membrane，cytoplasm and cytosol regions，suggesting that DEGs might be involved in physiological activities related to these subcellular structures；the molecular function（MF） module showed that DEGs mainly played a protein binding function，which was closely related to their participation in many intracellular signal transduction pathways and molecular interactions. The KEGG analysis results showed that，in addition to virus related signaling channels，DEGs mainly participate in PI3K-Akt and other signaling pathways. Further screening identified 27 key genes，including PTGS2，CXCL8，CCL2，IL1B，TNFSF10，IL1A，JUN，IL-6，TLR3，TRIM21，USP18，IFIT5，MX1，EGFR，CASP1，STAT2，GBP1，SAMD9L，OAS2，PARP9，RTP4，IFI35，MX2，TRIM22，UBE2L6，SP110，and CMPK2. Most DEGs had relatively high expression levels in lung tissue. Conclusion This study reveals that PM_2.5 may mediate respiratory inflammatory responses and immune dysregulation by modulating 27 key genes（such as PTGS2 and CXCL8） and affecting signaling pathways such as PI3K-Akt. These findings provide novel insights into the mechanisms of PM_2.5-induced respiratory injury.

Study on microbial contamination status and health management countermeasures of take-away food in Nanning City from 2023 to 2024

GUO Junkun, ZHAO Long, LONG Xi, LYU Zhongqi

2026, 42(9):  1194-1198. 

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Objective To investigate the microbial contamination of take-away food in Nanning City from 2023 to 2024，and put forward corresponding policy recommendations to provide scientific basis for optimizing the health supervision system. Methods From 2023 to 2024，a total of 800 take-away food samples were collected from 13 districts and counties in Nanning City，and the microbial contamination of take-away food samples was tested. Results This time，the overall detection rate of contamination in the online take-away food samples tested was 37.4%（299/800）. There were statistically significant differences in the total number of colonies and the detection rate of microbial detection in different sample origins（χ²=23.634，22.035，both P<0.05）. There were statistically significant differences in the detection rates of Escherichia coli，total bacterial count，common pathogenic bacteria and microorganisms among different food varieties（all P<0.05）. There were statistically significant differences in the detection rates of Escherichia coli，common pathogenic bacteria and microorganisms in different months（all P<0.05）. Conclusion There still have some problems in the health status of take-away food in Nanning City，which requires the participation of multiple social parties to optimize the health supervision system，so as to promote the formation of social co-governance of food safety.

Correlation analysis of nurses' professional attitude，self resilience，and occupational deviant behavior on current status of patient safety competence in grade-A tertiary hospitals in Tianjin

HUO Xu, XIE Wei, ZHANG Yajun, ZHANG Siai, REN Yongxia

2026, 42(9):  1199-1206. 

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Objective To understand the current status and influencing factors of patient safety competence among nurses in grade-A tertiary hospitals in Tianjin，explore its correlation with nurses' professional attitude，self resilience，and occupational deviant behavior，so as to provide a reference basis for targeted intervention measures. Methods A questionnaire survey was conducted from March to October 2024，and 600 nurses from five grade-A tertiary hospitals in Tianjin were selected as the survey subjects. The general information survey，patient safety competency nurse evaluation scale（PSCNES），Chinese version of professional attitude scale for nurses（PASN-C），Chinese version of ego-resiliency scale（ERS） and nurse workplace deviance behavior（NWDB） were used for the questionnaire survey，and the data were analyzed. Results The total score of patient safety competence among 600 nurses in grade-A tertiary hospitals in Tianjin was （124.86±27.59）points，the total score of professional attitude was （136.34±30.06）points，the total score of self resilience was （38.63±7.34）points，and the total score of occupational deviant behavior was （32.18±6.28）points. The total score of patient safety competence was positively correlated with the total score of professional attitude（r=0.632，P<0.01） and self resilience（r=0.574，P<0.01），and negatively correlated with the total score of occupational deviant behavior（r=-0.536，P<0.01）. The different educational backgrounds，job titles，years of work experience，night shifts，participation in safety training，professional attitudes，self resilience，and occupational deviant behaviors entered the regression equation（all P<0.05）. Conclusions The patient safety competence among 600 nurses in grade-A tertiary hospitals in Tianjin is at an above-average level，with education level，professional title，years of work experience，night shifts，participation in safety training，professional attitude，self resilience，and occupational deviant behavior being independent risk factors. It is suggested that hospital managers should provide nurses with multiple safety training channels，optimize the professional environment，create a good safety culture atmosphere，strengthen nurses' professional attitude and self resilience ability，further reduce occupational deviant behavior，thereby improving the patient safety competence among nurses，and further enhancing the quality of nursing services.

Multiple mediating effects of self-depletion and career compromise on the relationship between workplace loneliness and silent behavior among clinical nurses

WANG Rong, WANG Ping, HU Hui, WANG Xia

2026, 42(9):  1207-1212. 

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Objective To investigate the current status of workplace loneliness，self-depletion，career compromise and silent behavior among clinical nurses，analyze the relationship between self-depletion and career compromise in the relationship between workplace loneliness and silent behavior，and to provide a reference for constructing a workplace mental health support system for clinical nurses. Methods From October to December 2024，352 clinical nurses from three government hospitals in Nantong City were conveniently selected and surveyed using general information questionnaire，the workplace loneliness scale，the self-regulatory fatigue scale，the career compromise scale，and the nurse organizational silence evaluation questionnaire，and the data were analyzed. Results The scores of workplace loneliness，self-depletion，career compromise and silent behavior among 352 clinical nurses were （48.53±8.99），（48.51±11.21），（39.39±9.55） and （62.59±13.98）points. Workplace loneliness，self-depletion，career compromise，and silent behavior were all positively correlated（r=0.647，0.618，0.645，all P<0.01）. Self-depletion and career compromise played a multiple mediating role in the relationship between workplace loneliness and silent behavior，with the total mediation effects accounting for 38.3% of the total effect. Among them，self-depletion partially mediated the relationship between workplace loneliness and silent behavior，accounting for 13.9% of the total effect. Career compromise also partially mediated the relationship between workplace loneliness and silent behavior，accounting for 16.0% of the total effect. Self-depletion and career compromise together acted as a chain mediator between workplace loneliness and silent behavior，accounting for 8.4% of the total effect. Conclusion Clinical nurses exhibit higher scores in silence behavior，with self-depletion and career compromise demonstrating multiple mediating effects between workplace loneliness and silence behavior. Nursing managers can mitigate nurses' workplace loneliness to alleviate self-resource depletion，thereby reducing career compromise and silence behavior.

Analysis on status and influencing factors of professional identity among standardized training nurses in six grade-A tertiary hospitals in Sichuan Province

HU Yue

2026, 42(9):  1213-1219. 

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Objective To investigate the status quo of professional identity，organizational commitment and social support of standardized training nurses in grade-A tertiary hospitals in Sichuan Province，analyze the influencing factors of professional identity，and provide a theoretical basis for improving the professional identity level of standardized training nurses. Methods From August to October 2024，632 standardized training nurses from six grade-A tertiary hospitals in Sichuan Province were selected as the research objects by the convenient sampling method. The general information questionnaire，professional identity scale，organizational commitment scale and social support scale were used for investigation. The univariate analysis，correlation analysis and multivariate hierarchical regression analysis were used to analyze the professional identity of nurses. Results The professional identity score of standardized training nurses in grade-A tertiary hospitals in Sichuan Province was （109.40±15.97）points， the score of organizational commitment was （47.36±7.72）points，and the score of social support was （67.27±10.81）points. There were statistically significant differences in the scores of professional identity among nurses with different educational backgrounds，reasons for choosing nursing profession，personality characteristics，grade of standardized training，whether they had work experience before standardized training，job satisfaction，work atmosphere satisfaction，and whether they planned to be engaged in nursing profession（all P<0.05）. The professional identity score of standardized training nurses in grade-A tertiary hospitals was positively correlated with organizational commitment score（r=0.656-0.833，all P<0.05） and social support score（r=0.583-0.741，all P<0.05）. The organizational commitment score was positively correlated with social support score（r=0.575-0.695，all P<0.05）. The main influencing factors of professional identity in standardized training nurses were the reasons for choosing nursing profession，job satisfaction，job atmosphere satisfaction，whether they intend to engage in nursing work，organizational commitment and social support. Among them，organizational commitment and social support had predictive effects on standardized training nurses' professional identity. Conclusions The professional identity of standardized training nurses in Sichuan Province is at a medium level and needs to be further improved. The organizational commitment and social support are significantly related to nurses' professional identity and are important protective factors. Improving nurses' organizational commitment and social support can effectively improve the professional identity level of standardized training nurses.

Analysis of monitoring results of paragonimiasis endemic in Kaijiang County of Dazhou City from 2021 to 2023

HONG Yue, WU Xiaohong, YUAN Xiaoming, PENG Huanwen

2026, 42(9):  1220-1224. 

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Objective To understand the epidemiological dynamics of Paragonimus in Kaijiang County，grasp the influencing factors，and assess the prevention and control effects，so as to provide a basis for improving public health，formulating prevention and control measures and scientific research. Methods From 2021 to 2023，monitoring data of Paragonimus in Kaijiang County were collected，reviewing the historical monitoring data and relevant literature of Paragonimus in Kaijiang County from 2011 to 2023，and synthesizing the monitoring results to make a comparative analysis. Results A total of 1 208 people were surveyed in Kaijiang County from 2021 to 2023，and the total positive rate of human anti-Paragonimus antibody IgG was 2.07%（25/1 208），of which，the positive rate of residents' antibody was higher than that of students' antibody. From 2021 to 2023，a total of 621 freshwater crabs were captured and dissected，with a positive rate of 9.66%（60/621） for Paragonimus metacercaria infection，the average weight of 30.20 g of freshwater crabs，and the total infection level of 2.45 cysticerci/crab. Compared with 2011-2013，the positive rate of human anti-Paragonimus antibody IgG，the proportion of eating freshwater crabs，playing with crabs，and drinking raw water in the population decreased significantly；The knowledge rate of Paragonimus in the population increased significantly；And there was no statistically significant difference in cysticercosis infection of crabs. The results of univariate analysis showed that playing with crabs and drinking raw water were the risk factors for IgG-positive serum anti-Paragonimus antibodies in the population（χ²=6.511，12.922，both P<0.05）. The division of monitoring sites in Kaijiang County from 2015 to 2023 was 7 level Ⅲ and 2 level Ⅳ Paragonimus infected sites. The top 3 townships with seropositivity rate of each monitoring site in Kaijiang County from 2015 to 2023 were Gantang Township，Yongxing Township，and Jiangzhi Township. There was a significant positive correlation between the positive rate of crabs and the altitude of the sampling site（r=0.904，P<0.05）. Conclusion Kaijiang County is the epidemic foci of paragonimiasis，and the risk factors for population infection still exist，so it is necessary to further strengthen the publicity and education of knowledge of paragonimiasis prevention and control，and to change the bad hygienic and dietary behaviors of the local residents.

Analysis on current status and influencing factors of self-management activeness among community-dwelling elderly patients with chronic diseases

ZHANG Shiqing, YANG Xiumu, DENG Man, XU Xuejun

2026, 42(9):  1225-1230. 

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Objective To investigate the current status of self-management activation among community-dwelling elderly patients with chronic diseases in Hefei City and analyze its influencing factors，in order to provide a reference basis for interventions aimed at promoting self-management activation among patients. Methods A cross-sectional survey design was conducted from August to November 2023，317 elderly patients with chronic diseases who visited three community health service centers in Hefei City were selected as the research subjects. The survey was conducted using a general information questionnaire，the consumer health activation index scale，acceptance of illness scale，social support rating scale，and the Chinese version of the Eysenck personality questionnaire，and the data were analyzed. Results The self-management activeness score of community-dwelling elderly patients with chronic diseases was （69.28±17.54）points. Self-management activation was significantly associated with age，education level，marital status， living arrangements，personality type，perception of outdoor environment，number of comorbidities，self-rated health，and number of hospitalizations for chronic diseases in the past year were compared，and the differences were statistically significant（all P<0.05）. The self-management activation of elderly patients with chronic diseases in the community was positively correlated with acceptance of illness and social support（r=0.787，0.615，both P<0.01）. Age，education level，acceptance of illness，and social support were significant influencing factors of self-management activation among community-dwelling elderly patients with chronic diseases（all P<0.05）. Conclusion The overall level of self-management activation among community-dwelling elderly patients with chronic diseases in Hefei City is low. In the future，primary healthcare providers can develop precise and systematic self-management activation intervention strategies tailored to patients' age，education level，acceptance of illness and social support to improve health outcomes and promote successful aging.

Development and reliability and validity testing of an intrinsic capacity health literacy scale for the elderly

LIN Jingwen, ZHU Jie, ZHANG Yining, FU Haiyan, LIU Yongbing

2026, 42(9):  1231-1237. 

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Objective To develop an intrinsic capacity health literacy scale for older adults，in order to provide a more integrated，comprehensive，and simple assessment tool for health management of the elderly，and to improve the theoretical system of health literacy with the goal of healthy aging. Methods The first draft of the intrinsic capacity health literacy scale was constructed through the literature analysis and the Delphi method. From May to August 2024，638 elderly residented from communities in Yangzhou and Taizhou cities in Jiangsu Province were selected for a survey to conduct reliability and validity analysis on the preliminary draft of the scale. Results The intrinsic capacity health literacy scale for older adults consisted of three dimensions：functional health literacy，interactive health literacy，and critical health literacy，with a total of 36 items. Exploratory factor analysis extracted three common factors，with a cumulative variance contribution rate of 70.031%. Validation factor analysis confirmed the good fit of the modified scale model. The item-level content validity index varied between 0.867 and 1.000，while the scale-level content validity index at 0.974. Cronbach's alpha coefficient for the overall scale was 0.968，and the folding coefficient reached 0.853. Conclusion The intrinsic capacity health literacy scale for older adults has high reliability，specificity，and comprehensiveness，which can provide a basis for improving the level of intrinsic capacity health literacy of the elderly and developing intervention programs.

Mediating effects of depressive symptoms between sedentary behavior and cognitive frailty in community-dwelling older adults

MA Xue, HAN Xiaoyun, SHI Xunyu, HUANG Yuwen, XIONG Yaling

2026, 42(9):  1238-1243. 

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Objective To explore the mediating role of depressive symptoms between sedentary behavior and cognitive frailty in community-dwelling older adults，providing insights and evidence for slowing the onset and progression of cognitive frailty and developing corresponding intervention measures. Methods A convenience sampling method was used to select 504 cases of older adults living in two communities in Changzhou City from February to July 2023 as the study subjects. The general information questionnaire，international physical activity questionnaire-short，5-itom geriatric depression scale，frailty phenotype and Montreal cognitive assessment scale were used to conduct the investigation. The multivariate Logistic regression and Z-test were used to investigate whether the mediating effect of depressive symptoms between sedentary behavior and cognitive frailty in older adults was significant or not. The pathways between sedentary behavior，depressive symptoms and cognitive frailty，and the 95%CI for the effect values of each pathway were investigated using AMOS 26.0 software. Results The sedentary behavior，depressive symptoms， and cognitive frailty were present in 282（56.0%），156（31.0%），and 89（17.7%） of the 504 older adults，respectively. The sedentary behavior（OR=4.464，95%CI：1.822-10.940） and depressive symptoms（OR=6.497，95%CI：2.871-14.700） were significantly associated with the occurrence of cognitive frailty among community-dwelling older adults. The mediating effect of depressive symptoms between sedentary behavior and cognitive frailty was significant（Z=2.413，P<0.05），with an effect value of 0.082（P<0.05） and an effect percentage of 24.19%. Conclusions The depressive symptoms play a partially mediating role in the relationship between sedentary behavior and cognitive frailty in community-dwelling older adults. It is suggested that community workers and healthcare professionals should not only intervene in the sedentary lifestyle of older adults，but also focus on screening for depressive symptoms in sedentary older adults，to maximize the prevention and slowing of the incidence and progression of cognitive frailty.

Level and health risk assessment of disinfection byproducts in drinking water in urban area of Wuhu City in 2024

SHEN Denghui, DING Liujun, XU Min, CHANG Qian, SONG Jian

2026, 42(9):  1244-1249. 

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Objective To investigate the concentration levels and distribution characteristics of six disinfection byproducts（DBPs） in drinking water of urban area in Wuhu City，evaluate their potential health risks to the population. Methods Totally 100 water samples were collected from source water，terminal water（excluding secondary water supply），and secondary water supply during the dry season and rainy season in urban area of Wuhu City in 2024. Using WS/T 777-2021 Guidelines for Environmental Health Risk Assessment of Chemical Substances，the carcinogenic and non carcinogenic risks via oral exposure routes were calculated. Results Except for tribromomethane，all five DBPs were detected in drinking water of urban area in Wuhu City with concentrations below national standards. The tribromomethane was the predominant pollutant，while seasonal variations in contaminant levels and rankings were observed among other substances. The total carcinogenic risks of disinfection byproducts in drinking water of Wuhu City was 2.0×10^-5-7.6×10^-5 in dry season and 1.3×10^-5-3.5×10^-5 in rainy season，and the non-carcinogenic risk was 7.2×10^-2-4.0×10^-1. The carcinogenic risks were the highest during the dry season with trichloroacetic acid and dichlorodibromomethane，and during the rainy season with dichlorobromomethane and dichloroacetic acid，while the trichloromethane contributed the most to non carcinogenic risks. Conclusion The lifelong carcinogenic and non-carcinogenic risks posed by disinfection byproducts in drinking water of urban area in Wuhu City are within acceptable levels，and it is necessary to focus on the carcinogenic health risks of exposure to trichloroacetic acid and dichlorodibromomethane during the dry season，and dichlorobromomethane and dichloroacetic acid during the rainy season，to ensure the safety of drinking water for the population.

Analysis on HPV vaccination willingness and its influencing factors in male medical students based on health belief mode

ZHANG Siyi, MA Shaowei, BAI Wei, SONG Jiabin, SONG Meiqin

2026, 42(9):  1250-1254. 

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Objective To investigate the current awareness level of male medical students towards human papilloma virus（HPV） and its vaccine，and analyze the influencing factors of their vaccination willingness based on the health belief mode，providing a reference for developing effective health education intervention strategies to enhance HPV vaccination willingness. Methods Between April and July 2024，a self-designed questionnaire titled Survey on HPV Vaccine Knowledge and Factors Influencing Vaccination Intentions was administered to 496 male medical students in the undergraduate programme at a medical college in Xinjiang using convenience sampling，in accordance with inclusion and exclusion criteria. The data were then organized and analyzed. Results The overall average score for male medical students' awareness of HPV and its vaccine was （10.79±2.55）points. 74.20% of the male medical students had heard of the HPV vaccine，and their vaccination willingness was 57.26%. The statistically significant differences were observed in various dimensions of the health belief model and HPV vaccination willingness（all P<0.05）. Further regression analysis revealed that monthly living expenses，level of HPV awareness，perceived barriers，cues to action，and self-efficacy were correlated with male medical students' HPV vaccination willingness（all P<0.05）. Among these factors，monthly living expenses，level of HPV awareness，and self-efficacy showed significant positive correlations，while perceived barriers and cues to action demonstrated significant negative correlations. Conclusions The male medical students have an acceptable level of awareness towards HPV and its vaccine，but further enhancement is still needed，and their vaccination willingness also requires improvement. Based on the health belief mode，adopting targeted health education intervention strategies such as eliminating vaccination barriers，increasing cues to action，and enhancing self-efficacy is of great significance in increasing male medical students' HPV vaccination willingness.

Visual analysis of research on nursing burnout in China based on CiteSpace

DENG Xiaodie, YANG Kangqing, WANG Fei, WANG Xiaojun, CHENG Fang

2026, 42(9):  1255-1261. 

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Objective To carry out the visual analysis of relevant literature in the field of nursing burnout research in China based on CiteSpace software，so as to provide reference and basis for further research. Methods The China National Knowledge Infrastructure（CNKI） was used as the search source to retrieve all the relevant literature related to nursing burnout research in China， and the search time frame was set as the period of building the library to August 2023. After preliminary screening，the results were imported into Excel and CiteSpace V（6.2.R4） software for visual analysis of the authors，institutions，and keywords in the included literature. Results The final search included 1 737 papers. The number of published research papers related to nursing burnout showed an upward trend，with the highest number of published papers in 2022，which was 156. Totally 257 authors and 212 institutions were involved，the research institutions were mostly nursing schools and affiliated hospitals of various universities，and the institution with the highest number of publications was Affiliated Hospital of North Sichuan Medical College（seven papers），and the authors who tied for the first place in the number of publications were MA Yunhong and WANG Juan（six papers）. A total of 288 keywords were included in the keyword mapping，with 47 keywords appearing ≥10 times，forming 11 meaningful clusters. Among them，"burnout" "nurses" "related factors" "coping styles" were high-frequency keywords，and "mediating role" and "emotional intelligence" were keywords that have emerged in recent years. Conclusion China's related research on the topic of nursing burnout started late but developed fast，and the research hotspots mostly focused on the mediating role，mental toughness，and emotional intelligence.

Investigation and Research

Investigation of radiological diagnosis and treatment institutions in Xi'an City

ZHENG Sujin, JIANG Lihong, HAN Xiao, WU Wenjing, SUN Leihuan, GUO Cancan

2026, 42(9):  1262-1266. 

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Objective To analyze the current status of equipment configuration，personnel allocation，protective equipment，and clinical activities in radiological diagnosis and treatment institutions in Xi'an City，reveal resource distribution characteristics and existing issues，and provide evidence for optimizing healthcare resource allocation. Methods A census survey was conducted across 415 radiological diagnosis and treatment institutions in Xi'an City in 2024，including equipment configuration，distribution of radiation workers protective equipment，and regional distribution of diagnostic and treatment frequencies，and the survey data were analyzed using descriptive statistics. Results There were 1 526 radiological devices in 415 radiological diagnosis and treatment institutions in Xi'an City，including 1 349（88.40%） radiological diagnostic devices，30（1.97%） radiotherapy devices，28（1.83%） nuclear medicine devices and 119（7.80%） interventional radiology devices. The radiological diagnostic equipment was distributed across hospitals of all levels，the radiotherapy and nuclear medicine devices were concentrated in tertiary hospitals，and the interventional radiology equipment was primarily allocated to tertiary and secondary hospitals. There were 106 953 on-duty workers in 415 radiological diagnosis and treatment institutions，5 915（5.53%） workers were radiological personnel，with 62.08%（3 672） working in tertiary hospitals and only 5.66% in primary hospitals. There were 9 803 units/sets in 415 radiological diagnosis and treatment institutions，with radiological diagnostic protective equipment（6 169 units/sets，62.93%） being the most prevalent，followed by interventional radiological protective equipment（3 094 units/sets，31.56%）. In the analysis of 415 radiological diagnosis and treatment institutions，the total number of facilities in Weiyang District（57 institutions），Yanta District（59 institutions），and Chang'an District（54 institutions） leads the city. Among them，Yanta District had the highest number of tertiary hospitals（10 institutions），Weiyang District contained the largest proportion of unrated hospitals（29 institutions），and Chang'an District demonstrated the highest concentration of primary hospitals（20 institutions）. Collectively，Yanta District，Beilin District，Weiyang District，and Xincheng District contributed to more than 60% of the city's total radiological diagnosis and treatment volume. Conclusion Xi'an City demonstrates robust infrastructure in radiological equipment and protective resources，however，advanced equipment，specialized personnel，and protective resources are disproportionately concentrated in higher-level hospitals compared to primary institutions.

Health Management and Research

Analysis on current situation and fairness of financial investment in public health for disease control and prevention institutions in a city in North China from 2023 to 2024

YAN Baorun, MA Changxu, YAN Zhixiong

2026, 42(9):  1267-1271. 

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Objective To analyze the current situation and fairness of financial investment in public health for disease control and prevention（CDC） institutions at both municipal and district levels in a city in North China，explore the challenges and issues faced in their high-quality development，and propose corresponding suggestions. Methods Through field research and data analysis in August 2024，the study gained an in-depth understanding of the financial investment in CDC institutions and its impact on business operations and fund utilization. The on-site visits and research were used to extract key data such as the number of staff on duty，financial investment，arrival time，and expenditures. The combination of literature analysis，on-site research，and statistical analysis methods was used to analyze the basic funds（personnel funds and public funds） and special funds for financial work. Lorenz curve and Gini coefficient were used to explore the equity of funding investment in CDC institutions of the city. Results The personnel expenses were basically guaranteed in CDC institutions at municipal and district levels in a city in North China，but there were problems with the investment of public expenses and special funds for work. Some district-level CDC institutions had tight public expenses，and even failed to meet the basic office needs. The special funds for work were not allocated in time，and the low arrival rate of funds in some district-level CDC institutions had seriously affected the development of their business work. Only municipal CDC and C District CDC provided technical services externally，and there were shortcomings in technical service capabilities and market competitiveness. In 2023 and 2024，Gini coefficients of personnel expenses，public expenses and work expenses were 0.063 and 0.223，0.346 and 0.501，0.137 and 0.178，respectively. Conclusions The fairness of funding investment in CDC institutions at municipal and district levels in a city in North China needs to be continuously improved. It is recommended to enhance financial fund communication between municipal and district-level CDC institutions，increase financial input，and improve the policy support and market environment for external services of CDC institutions，to promote CDC system reform.

Overview

Research progress on environmental monitoring of norovirus

ZHANG Jiasheng, ZHANG Min

2026, 42(9):  1272-1276. 

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Norovirus（NoV） is the primary pathogenic agent responsible for non-bacterial acute gastroenteritis（AGE） and is also a common cause of food poisoning. NoV is characterized by rapid mutation，high infectivity，and a generally susceptible population，which collectively impose a considerable economic burden on society and individual patients. Environmental monitoring of NoV is an essential component of its overall surveillance，focusing on environmental samples such as air，surfaces，water，etc.，aiming to understand the distribution of norovirus in various environments and assists in tracing the virus's transmission routes. This article presents a comprehensive review of the introduction of NoV，air monitoring，surface environmental monitoring，the persistence of the virus at various temperatures，and the monitoring of environmental sewage. The findings provide a theoretical basis for the early detection and prevention of NoV infection and for the government to formulate relevant policies

Research progress on biomarker detection techniques for occupational silicosis

GENG Jian, HUANG Xiaoxia, ZHANG Chunyan, WANG Pangyu, WANG Xianang

2026, 42(9):  1277-1283. 

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Silicosis，a type of occupational pneumoconiosis，has a pathogenesis that is not yet fully elucidated. Contact biomarkers，effect biomarkers，and susceptibility biomarkers can predict the onset of silicosis，as well as assess its progression and prognosis. Enzyme-linked immunosorbent assay（ELISA），chemiluminescence immunoassay（CLIA），polymerase chain reaction（PCR），and mass spectrometry technology are mature but require advanced laboratory facilities and equipment. "All-in-one" detection technology like liquid chip technology，microfluidic technology，and nanosensor technology simplify operational workflows and enable rapid detection，pointing to a new direction for developing occupational disease biomarker detection technologies. At the same time，the proposed prevention and control pathway of "dynamic biomarker monitoring-multi-dimensional joint screening-risk stratified intervention" offers new strategies for early warning of silicosis，personalized interventions，and optimization of public health policies. This paper provides a comprehensive review of the research progress in biomarker detection technology for occupational silicosis, aiming to serve as a reference for related studies.

Research progress on the relationship between emotional labor and empathy fatigue in nursing students

WANG Shuxian, LU Yue, YUE Tong

2026, 42(9):  1284-1288. 

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In recent years，the medical industry's requirements for nursing quality have been continuously increasing. Nursing students are facing increasing emotional labor and psychological pressure in clinical internships or work. Long-term emotional labor may lead to empathy fatigue in nursing students，which not only affects their physical and mental health，but also may reduce nursing quality and lead to job burnout. This article reviews the relationship between emotional labor and empathy fatigue of nursing students，including relevant concepts，measurement tools and existing research results. The purpose is to deeply understand the internal connection between the two and adopt effective coping strategies to create a healthier and more sustainable working environment for nursing students.

Current status and countermeasures of biological safety laboratory management research

ZHANG Yuhang, DING Lei, YU Jing, XIA Mengjie, LIU Qi, LU Yaoqin

2026, 42(9):  1289-1296. 

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The management of biosafety laboratories is an issue of wide concern to countries all over the world. In order to safeguard national biosafety，each country has formulated corresponding laws and regulations to strengthen biosafety management according to its own national conditions. As an important part of biosafety science and technology，biosafety laboratories play an important role in the prevention and control of infectious diseases and public health emergency response. Through in-depth analysis of the current management status of biosafety laboratories，a number of problems have been found，including imperfect management system，unsound hardware facilities，incomplete record-keeping and so on. In order to reduce the risk of biosafety，there is an urgent need to strengthen the management of biosafety laboratories. Specific measures include the construction of a sound and reasonable management system，strengthening the construction and inspection and maintenance of hardware facilities，comprehensively carrying out the record-keeping work of biosafety laboratories，strengthening the professional guidance and training of staff，strengthening the health care of biosafety laboratories，and strengthening the supervision of the self-inspection and effective implementation of the emergency plan. Only through comprehensive management measures to strengthen the management of biosafety laboratories can reduce the risk of biosafety and protect public health and safety.