An Analysis of the Lifestyle and Mental Health Status of Adult People Living in Dhaka City: A Cross-Sectional Study in Post COVID-19 Era

Introduction: The Novel Coronavirus or COVID-19 affected all the megacities of the world and made the mental health and lifestyle of people paralyzed. According to different studies, such difficulties were different in scale in different cities depending on the demographic attributes of the people. This phenomenon has created the essence of the current study to examine the health conditions in terms of their mental health, lifestyle, and demographic attributes during and immediate past of the COVID-19 era. Method: It was a cross-sectional study covering the people of Dhaka City Corporation. For this purpose, a multistage sampling method was applied, under which the respondents were selected randomly and a self-administered structured questionnaire was used to collect data. The questionnaire was developed based on the DASS 21, as it was suitable to measure the components of mental health in the form of depression, anxiety, and stress. Descriptive analysis and cross-tabulation were applied to find out the association between dependent and independent variables, whereas, a chi-square test was performed to examine the hypothesis. Finally, multivariate analysis was done to find out the risk factors. Three logistic regression models were developed for three dependent variables. Result: The findings of the analysis revealed that the lifestyle of people had severely influenced the components of their mental health conditions during and immediate past of COVID-19 in the Dhaka City Corporation, which varies to some extent depending on the demographic attributes of those. Conclusion: The above findings are statistically significant enough to conclude about the essence of taking preventive measures regarding mental health issues in the future. However, the limitations of this study-keeping it within the urban areas and the educated people, have also created the venue for future researchers to move with their research endeavors in the rural areas nationwide and thus generalize the results.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Spatial variation of health risk of groundwater for drinking water supply in Mingshan County,Ya'an City,China

Rural drinking water safety is a growing concern in China. This study investigated the health risk of pollution of groundwater for the drinking water supply in Mingshan County, Ya＇an City, in Sichuan Province, China, using 46 samples from the years 1991 to 2010. Carcinogenic, non-carcinogenic, and total risks were assessed by the model recommended by the United States Environmental Protection Agency （U.S. EPA）. Thematic maps of the risks caused by single and multiple factors were generated from inverse distance weighting interpolation （IDW） and the geostatistical analysis functions of ArcGIS. The results show that the carcinogenic risks caused by chemicals in groundwater for drinking water supply are low, within the acceptable interval for risk management. However, non-carcinogenic risks are high and the number of sampling sites with risk values exceeding the standards amounted to 29. Non-carcinogenic risks of Cr6＋, nitrate, fluoride, and Fe at sites 43, 46, 50, 64, 67, and 74 were the sources that caused high total health risk. This study reveals the risk level of groundwater quality and orders of treatment of pollutants, and provides a scientific basis for groundwater management in this area.

Acceptability of Immunization against COVID-19 by the Populations of the Kasenga State Health Area in the Uvira Health Zone, DR Congo

Introduction: COVID-19 was an emerging disease putting all public health systems in countries around the world in a state of emergency. To be able to prevent its spread and morbidity and mortality, several appropriate strategies were necessary, such as vaccination. The latter has been the subject of controversy. The objective of the present study is therefore to evaluate the factors associated with the acceptance of this vaccine within the population of the Kasenga State Health Area. A result which will shed light on future strategies to be put in place for possible new vaccines. Methodology: Is a prospective and analytical cross-sectional study conducted over a period of approximately 1 month from January 5 to February 5, 2024. A survey questionnaire in Kobotoolbox was useful for collecting data. STATA software was very important for us in analyzing the data collected. Results: Prevalence of vaccination against COVID-19 among the population of the Kasenga State Health Area is 37.5% (28.4 - 45.6). The study revealed that reluctance is observed among most of the population for different reasons, including, first and foremost, the deliberate aspect of not wanting to take the vaccine (46.6%) and rumors that this antigen is dangerous and harmful (32.9%). 72.5% of respondents believe that the COVID-19 vaccine is a fabrication, unhealthy and that the disease itself never existed. The study proved that there was a statistical relationship between age (p = 0.001) and adherence to vaccination. And the refusal of respondents to recommend the vaccine to loved ones was a factor associated with non-adherence to vaccination (OR = 7.901, 95% IC [3.028 - 20.615], p = 0.000). Conclusion: Vaccination against COVID-19 was not well accepted by the population of the study site. Raising public awareness and involving community leaders and political-administrative authorities, which has not been done well, would play an important role in the good perception of the disease, of the vaccine and therefore in its adherence.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

City Health Examination in China:A Methodology and Empirical Study

National urban planning,construction,and management levels have undergone qualitative changes in China since 2000.Nonetheless,problems caused by rapid urbanization are becoming increasingly prominent.The concept of the city health examination appears to tackle these problems and is being gradually implemented,starting from the implementation of a national strategy and leading to the concrete practice of high-quality urban development.This paper elaborates on the basic philosophy and theory of the city health examination,briefly explains indicator selection and aims,and comprehensively illustrates examination methods.It then describes the empirical research that operationalized the dataset collected from a satisfaction survey administered during the 2020 city health examination.It aims to provide a reference for the standardization,specialization,analysis,and application of the results of the city health examination in China;this may help promote a smooth elimination of‘urban diseases’and allow for the development of high-quality livable cities.This research shows that city residents are generally more satisfied with the landscape features,ecological livability,and security resilience;it also shows that residents are generally more dissatisfied with traffic issues.Residents with different characteristics showed different satisfaction levels toward different indicators.Residents were also shown to be more sensitive to innovation vitality,ecological livability,and health and comfort in considering whether to stay in their current city.

Current situation and human health risk assessment of fluoride enrichment in groundwater in the Loess Plateau:A case study of Dali County,Shaanxi Province,China

This study aims to investigate the mechanisms and health risks of fluoride enrichment in groundwater in the Loess Plateau,China.By taking Dali County,Shaanxi Province,China as an example,this study obtains the following results through field investigation and the analyses of water,soil,and crop samples.(1)The groundwater can be divided into two major types,namely the Quaternary pore-fissure water and Karst water.The Karst area and sandy area have high-quality groundwater and serve as the target areas for optional water supply.The groundwater in the study area is slightly alkaline and highly saline.Meanwhile,high-fluoride groundwater is mainly distributed in the loess and river alluvial plains in the depression area of the Guanzhong Basin and the discharge areas of the groundwater,with the highest fluoride concentration exceeding seven times the national standard.(2)Fluoride in groundwater mainly originates from a natural source and human activities.The natural source refers to the fluoride-bearing minerals in rocks and soil,and the fluoride from this source is mainly controlled by natural factors such as climate,geologic setting,pH,specific hydrochemical environment,ion exchange,and mineral saturation.Human activities in modern life can be further divided into industrial and agricultural sources primarily.(3)The health risks of fluoride contamination are very high in the Loess Plateau,especially for children compared to adults.Meanwhile,the risks of fluoride exposure through food intake are higher than those through drinking water intake.The authors suggest selecting target areas to improve water supply and ensure the safety of drinking water in the study area.Besides,it is necessary to plant crops with low fluoride content or cash crops and to conduct groundwater treatment to reduce the fluoride concentration in drinking water.These results will provide a theoretical basis for safe water supply in the faulted basin areas in the Loess Plateau.

Exploring China's Western and Central County Systems Performance Measured by Outcomes Framework Scores-A Cross-sectional Survey of Routine Healthcare Data

This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider satisfaction.Health outcomes were assessed from four secondary indicators：infant mortality rate;maternal mortality rate;under-5 child mortality rate;and the incidence of Class A and Class B notifiable diseases.Financial risk was assessed using two secondary indicators：the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System（NCMS） insurance scheme,and the rate of NCMS funds utilization.The assessment of satisfaction was made using two secondary indicators：the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health systems.Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.

The Model of Health Poverty Alleviation in Poor Mountainous Areas in Southwest China: A Case Study of "5 + 5" Model of Health Poverty Alleviation in Xundian County

Carrying out health poverty alleviation and ensuring the security of basic medical care for the poor are important contents for China to implement the strategy of targeted poverty alleviation and win the battle to get rid of poverty. Xundian Hui and Yi Autonomous County in Yunnan Province is a national poor county integrating ' nationality,poverty,mountainous area and old revolutionary base area'. In recent years,based on the actual situation,Xundian County has explored an effective way of health poverty alleviation. It has effectively prevented the phenomenon of poverty caused by illness and returning to poverty due to illness,and effectively ensured that Xundian County has successfully achieved the goal of getting rid of poverty. Xundian County finally got rid of the shadow of ' poverty' for more than 30 years to become one of the first batch of counties in Yunnan Province to get rid of poverty. This paper makes great efforts to analyze and summarize the specific methods,main achievements,successful experience,lessons and reference about health poverty alleviation in Xundian County. At the same time,it also studies and analyzes the main problems existing in the model,and puts forward the corresponding measures and suggestions,in order to provide a reference for health poverty alleviation in other poor areas.

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

Objective To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health(SRH)status of residents,providing a basis for a better promotion on construction of health-supportive environments.Methods The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021.With SRH level as the dependent variable,two-category logistic regression analysis was conducted to analyze the impact of the built environment in hygienic cities on the SRH status of residents.Results A total of 1,357 respondents were enrolled in this study.After controlling confounding factors,four aspects in the built environment in hygienic cities were detected remarkable influences on the SRH level of residents,including enough green space in the living area[odds ratio(OR)=1.395,95%confidence interval(95%CI):1.055–1.845],clean and hygienic living environment(OR=1.472,95%CI:1.107–1.956),residents’confidence in drinking water safety in the living area(OR=1.856,95%CI:1.354–2.544)and residents’confidence in food safety in the living area(OR=1.405,95%CI:1.027–1.921).Conclusion Regarding city construction,the government should focus more on the subjective perception of residents on built environments to build a supportive environment benefiting the health of residents.

Study on Revision and Compilation of Rainstorm Intensity Formula in Liuzhou City and County

Rainstorm intensity formula,main basis of solving urban waterlogging,is the basis of scientifically and rationally making urban drainage professional planning and drainage engineering design. In this paper,compilation of rainstorm intensity formula in Luzhai County was taken as the case,revision and compilation techniques and research methods of rainstorm intensity formulas in municipal district and administrated county of Liuzhou were introduced. According to the Design Specification for Outdoor Drainage（ GB 50014-2006,2016） and the Technical Guidelines for Establishment of Intensity-Duration-Frequency Curve Design Rainstorm Profile,historical rainfall data at Luzhai National Weather Station were sampled by using annual maximum method,and sampling time was from1980 to 2016. The period with the maximum rainfall was divided into 11 time intervals： 5,10,15,20,30,45,60,90,120,150 and 180 min. Fitting adjust of rainstorm sample data was conducted by using Pearson-III distribution curve,rainstorm intensity formula was fitted by the least square method,and calculation accuracy test corresponded with the requirement of Design Specification for Outdoor Drainage（ GB 50014-2006,2016）. Conclusions and suggestions were as below： firstly,rainstorm intensity formula was compiled and calculated according to the recommended methods of the Design Specification for Outdoor Drainage（ GB 50014-2006,2016） and the Technical Guidelines for Establishment of Intensity-Duration-Frequency Curve Design Rainstorm Profile,calculation process was normative,and calculation result error met the requirement of the specification. Secondly,sampling by annual maximum method was more suitable for the expression of periodic hydrometeorological law by taking year as reappearance period,and could cause better randomness and independence of statistical sample,and the method was scientific and reliable. Thirdly,rainstorm intensity formula compiled by taking rainfall data in national weather stations of Liuzhou and its administrated counties as the sample could be used in the scope of the local jurisdiction.

Assessment of Phytosanitary Practices in Peri-Urban Agriculture and Associated Environmental and Health Impacts in Developing Countries: Case of Abengourou City (Côte d’Ivoire)

The use of phytosanitary products remains uncontrolled and abusive in the practice of market gardening in most developing countries. However, it remains one of the potential sources of environmental contamination and public health problems. This study examines the health and environmental risks associated with the use of phytosanitary products in market gardening in the town of Abengourou in Cote d’Ivoire. Field surveys carried out among all (30) market gardener sites housed 150 farmers showed that when the products were spread, no health and safety measures were observed. Approximately 80% of the respondents did not wear gloves or face masks. Some products used were not approved for market gardening. Farmers had itching, dizziness, headaches, colds and vomiting on a regular basis when applying the products. The study also revealed the presence of empty packaging in the surrounding surface water and on the ground. In addition to producers, this type of uncontrolled market gardening likely exposes consumers to high health risks and also contributes to environmental degradation. Raising awareness among stakeholders of good agricultural practices could help promote sustainable market gardening. However, studies of the effects of products in such an environment on the health of consumers deserve to be carried out.

A Cognitive Approach to the Formalization of City and County Names in China’s Hunan Province

There were mainly six types of formalization models found in the study for 95 city and county names in China’s Hunan province,namely,the environment in a place for the place,the wish of the nomenclator for the place,the relative position of a place for the place,the resident for the place,the legend for the place,and the function of a place for the place.In the six formalization models,environment in a place for the place was the most in number,forging 47 names.Besides,the wish of the nomenclator for the place and the relative position of a place for the place came the second,taking 20 names respectively.The cognitive operation participating in the formalization was primarily single metonymy with only a few complex metonymies.Metaphtonymy could be only noted in the model of the wish of the nomenclator for the place.It was notable that single metaphor was missing in the cognitive operations.

The Differences between County,County-level City and Municipal District in the System of Administrative Divisions in China

Administrative division is an important means of political power reorganization and management,resource integration and optimal allocation,which profoundly shapes the spatial layout of urban development in China.To clarify and compare differences between counties,county-level cities and municipal districts is the primary premise for the study of administrative division and urban development.This paper analyzes the institutional differences between counties and county-level cities,as well as counties,county-level cities and municipal districts,from the aspects of organizational structure,urban construction planning,land management,finance,taxation and public services.The research shows that the establishment of counties,county-level cities and municipal districts adapt to different levels and stages of economic and social development,and the conversion from county to county-level city and the conversion from county(or county-level city)to municipal district are both important transformation ways to change their administrative systems,which has different management system and operation pattern.At the same time,the transformation of county-level administrative region is also a“double-edged sword”,we should think about the administrative system as a whole to decide whether it should be adjusted,and effectively respond to the actual needs of local economic and social development.

2015—2022年天水市肺结核患者耐药情况及利福平耐药特征分析

目的:分析2015—2022年甘肃省天水市肺结核患者耐药情况及利福平耐药特征,为优化耐药结核病卫生政策提供科学依据。方法:采用回顾性研究方法,从“中国疾病预防控制信息系统”子系统“结核病管理信息系统”中收集2015—2022年天水市肺结核患者实验室检测结果、耐药筛查和耐药结核病诊断信息等资料,分析患者病原学阳性率、药物敏感性试验结果和耐药诊断时间等。结果:2015—2022年,天水市共登记活动性肺结核患者8458例,除外结核性胸膜炎的肺结核患者为7895例,病原学阳性率为28.32%(2236/7895),且从2015年的11.33%(177/1562)上升至2022年的61.30%(236/385),呈明显上升趋势(χ_(趋势)^(2)=1014.480,P=0.000);天水市应耐药筛查肺结核患者2360例,实际耐药筛查率为85.00%(2006/2360),从2015年的54.80%(97/177)上升至2022年的93.39%(240/257),呈明显上升趋势(χ_(趋势)^(2)=397.292,P=0.000);天水市耐药检出率为98.90%(1984/2006),利福平耐药检出率为15.73%(312/1984),从2015年的10.42%(10/96)上升至2017年的28.57%(62/217),再下降至2022年的11.34%(27/238),呈先上升后下降趋势(χ_(趋势)^(2)=27.248,P=0.000)。312例利福平耐药患者中,男性[198例(63.46%)]多于女性[114例(36.54%)];年龄相对集中在20~29岁[85例(27.24%)]和40~49岁[66例(21.15%)],且老年患者(60~83岁)比例从2016年的9.52%(2/21)上升至2022年的25.93%(7/27),呈明显上升趋势(χ_(趋势)^(2)=4.801,P=0.028);职业以农民为主[213例(68.27%)];痰涂片结果以涂阳患者居多[215例(68.91%)],但痰涂片阳性率从2015年的100.00%(10/10)下降至2022年的59.26%(16/27),呈下降趋势(χ_(趋势)^(2)=17.664,P=0.000)。耐药谱前3位依次为利福平+异烟肼+乙胺丁醇[26.92%(84/312)]、利福平[26.28%(82/312)]和利福平+异烟肼[23.40%(73/312)]。耐药患者诊断时间中位数(四分位数)从2016年的145(91,196)d逐年下降至2019年的21(12,39)d。结论:2015—2022年天水市肺结核患者病原学阳性率和耐药筛查率均呈逐年上升趋势,利福平耐药检出率波动较大,耐药诊断时间明显缩短,建议加大老年肺结核患者利福平耐药筛查力度,以减少耐药肺结核的传播。

Impact of River Water Quality on Public Health in Perspective of Asian Rivers:A Case Study of Buriganga River,Bangladesh

Water pollution is one of the current global problems.So many countries are suffering from this problem specifically most South Asian and Southeast Asian countries,and Bangladesh is one of those countries that are suffering from water pollution.Furthermore,the city of Bangladesh,Dhaka is one of the most densely populated cities in the world and overpopulation is showing a negative impact on the water quality now.Most of the rivers are very polluted around Dhaka city because of anthropogenic causes.This study focused on Buriganga river pollution and its impact on public health.This study intended to find out the major cause of Buriganga river pollution and the health status of the community living beside the Buriganga river.Also the study identified all the common diseases which people are suffering from around the Buriganga river area.Then the study compared the results with other southeast Asian countries so that it can make the relationship and can make it easier to understand the current situation of water pollution on public health in East Asia and Southeast Asia regions.During the research work,it was noticed that the Buriganga river is very polluted due to human activities.The transportation system,fishing,and waste canals from industries become the primary reasons behind Buriganga’s current condition.Also irresponsibility of both the environmental department and civil society is the major factor in Buriganga river pollution.The hygienic level was also not in a good condition because so many wastes like plastic materials and other daily use materials were thrown out into the river.That’s why public health conditions around the Buriganga river become vulnerable nowadays.So policies have to be implemented from the right perspective and the institutions have to be strong enough to handle all the issues regarding the Buriganga River.

Research on the Evaluation and Early Warning of Ecological System Health of Resource-based City

资源型城市在为中国的工业化进程做出了巨大贡献的同时,城市的生态系统健康也出现了许多问题,对城市生态系统的地理环境和生物种群造成很大影响,甚至造成一些资源型城市生态系统的失衡和崩溃.论文以突变理论和城市生态系统健康理论为依据,首先建立了资源型城市生态系统健康评价指标体系,然后基于突变理论,构建了资源型城市生态系统健康的突变模型,并以邯郸市为例,进行了实证分析.以期对资源型城市的生态系统健康状况进行监测,当其出现较大扰动时进行预警,以保证资源型城市的生态系统健康,为实现资源型城市的可持续发展提供参考.

石家庄市县域科技创新与经济发展耦合协调关系时空演变

选取石家庄市13个县域单元作为研究区域,构建科技创新能力和经济发展水平评价指标体系,计算评价指数,测算两者的耦合协调度,使用ArcGIS绘制空间分布图,深入剖析科技创新能力、经济发展水平以及两者耦合协调关系的时空演变特征。研究发现:全市县域科技创新能力和经济发展水平呈现较强的正相关性,且都在2010—2017年间提升速度较快,而在2019年之后提升速度呈减慢的趋势。2010—2021年经济发展水平指数均高于科技创新能力指数,但后者提升速度高于前者,表明石家庄市各县域科技创新能力滞后于经济发展水平,但科技创新能力的发展势头较好。2010年以来,全市县域耦合协调度呈现上升趋势,但耦合协调度与科技创新能力和经济发展水平的变化趋势相似,即2018年之前的提升速度要快于2018年之后。2021年,全市县域耦合协调度等级为“勉强协调发展”,协调发展水平较低,有待进一步提升。

基于SERVQUAL模型的基层医疗卫生服务质量评价研究

目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多因素二分类logistic回归探索筛查服务质量差距的影响因素;借助IPA象限图呈现居民对社区卫生服务中心的SERVQUAL模型各维度服务质量重要性的分布情况。结果:问卷各项条目的服务质量差距均为负值,服务保证性和移情性维度的服务质量差距得分最高,分别为-0.47±0.59分和-0.47±0.65分;服务有形性维度的服务质量差距得分最低,为-0.40±0.55分。年龄、收入情况和慢病年限是服务质量差距的影响因素。结论:当前基层医疗卫生服务质量与居民的期望之间存在一定差距,基层医疗卫生服务机构应重视对低年龄、高收入和慢病病程较长的居民的服务需求。

基于数字医疗的现代化城市医疗体系构建对策研究——以我国天津市为例

新型冠状病毒感染疫情对全社会的冲击和影响暴露出城市公共卫生健康体系及治理能力现代化的不足,我国卫生健康事业的发展面临新的挑战。推进数字医疗、构建现代化城市医疗体系是贯彻落实健康中国战略、推进我国现代医疗事业发展的重要抓手,是国家综合实力的重要体现,是经济社会发展进步的重要标志,是提高人民健康生活品质的重要途径,对于实现资源整合、优化就诊流程、降低运营成本、提升服务质量、提高工作效率和管理水平有着重要意义。本文从国内某直辖市二、三级医疗机构信息化建设现状分析出发,着眼于如何顺应时代发展需求,打造智慧型数字化医院,寻找科学解决方案,规划未来发展定位,为数字化医疗领域的政策与规范制定提供依据,以更好地为卫生行政部门、公立医院管理者服务,为政府决策部门提供医改的新思路。