ABSTRACT
Objective:Based on Grounded Theory,the objective of this study is to explore the problems of Phy-sician multi-sited license in Zunyi, Guizhou Province from the perspective of doctors and putting forward the corre-sponding countermeasures. Methods:From January to July,2017,based on purposive sampling and Grounded Theo-ry,43 doctors from nine medical institutions in Zunyi of Guizhou Province were interviewed using semi-structural in-terview syllabus. With the help of open coding, axial coding, selective coding, multi-sited licensed Physician were integrated to explore existing problems, and putting forward corresponding countermeasures. Results:After three-grade coding,105 concepts,17 categories,7 main categories and 5 core categories of multi-sited licensed Physicians were concluded. Then, 5 lines of Physician multi-sited license were formed, including development prospect and doctors aspiration, the factors that could stimulate development, development difficulties, relative supporting poli-cies,service needs and practice condition. Conclusion:The majority of doctors are willing to carry out multi-sited prac-tice,the relevant laws and regulations,the specific implementation details,salary distribution system and the improve-ment of treatment scheme of medical negligence,the support of medical institutions,the transformation of medical insti-tutions management,the necessary medical conditions that the second place of practice should provide,the distance of second place of practice which should be fully considered,the convenience of traffic conditions and corresponding team-work support are necessary requirements to be taken into consideration to carry out physician multi-sited license.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the biomarker of manganese exposure by analyzing the relationship between manganese exposure and concentration in some biomaterials.</p><p><b>METHODS</b>The air samples were collected through the individual air sample. According to the manganese levels in the air, workers were assigned to control group, low concentration group and high concentration group, and manganese in the hair, urine, serum, blood cell and saliva from different group were measured respectively. The correlations between concentration of external manganese exposure and manganese concentrations in biomaterials, and years of employment and concentrations in biomaterials were analyzed.</p><p><b>RESULTS</b>In the high concentration group, saliva manganese was 32.17 µg/L, hair manganese was 37.39 mg/kg, urine manganese was 2.50 µg/L, plasma manganese was 29.61 µg/L, blood manganese was 14.49 µg/L, were higher than those in the control group (10.40 µg/L, 1.60 mg/kg, 0.77 µg/L, 10.30 µg/L, 4.56 µg/L respectively) (P < 0.01). The manganese concentration in the saliva was significantly correlated with airborne manganese concentration (r = 0.649, P < 0.01), with the years of employment (r = 0.404, P < 0.01), with the total exposure of manganese (r = 0.342, P < 0.01), with the manganese concentration of plasma (r = 0.303, P < 0.01) and with the manganese concentration in blood cells (r = 0.359, P < 0.01), respectively.</p><p><b>CONCLUSIONS</b>The concentration of manganese in saliva could work as a biomarker of manganese internal exposure.</p>