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Background The contracted family doctor services are the embodiment of the implementation of the new medical reform policy, and the transformation of the grass-roots health service mode. Studies have proved that the occupational stress in medical staff was at a high level. The enhancement of professional identity will contribute to strengthen team building，alleviate job burnout, and reduce turnover intention of family doctors. Objective To investigate the current situation of occupational identity among family doctor teams in Chengdu, to examine potential influencing factors of occupational identity, and to provide a reference for promoting career development and team building of family doctor teams. Methods Multi-stage random cluster sampling was adopted to enroll study participants form 46 primary healthcare centers where family doctor contract services were implemented among 23 districts and counties in Chengdu between March 4 and 26, 2021. A total of 2 681 family doctors participated in this survey. A self-reported survey was conducted to collect participants' demographic and occupational data. The Effort-Reward Imbalance (ERI）questionnaire was implemented to assess occupational stress. The Professional Identity Scale was used to appraise occupational identity. Results A total of 2 327 valid questionnaires were collected, with a valid recovery rate of 86.80%, involving 1 715 females (73.7%) and 612 males (26.3%), with dominant age groups of 26−35 years (43.3%) and 36−45 years (30.4%), a high proportion of being married (82.8%), having college (36.0%) and undergraduate (47.3%) education, a high proportion of primary titles (66.0%) and informal work contract (66.1%). About 88.7% of family doctor team workers reported occupational stress. The average score of occupational identity was (3.68±0.62) points. There were significant differences in occupational identity scores among different professional title, work contract, working years in medical institutions, income, and effort/reward ratio (EER) groups (P < 0.05). ERR was negatively correlated with occupational identity (rs=−0.495, P<0.05）. The multiple regression model showed that occupational identity score in the non-staffed participants was lower than the score in the staffed ones (OR=0.429, 95%CI: 0.299−0.825). The occupational identity score in the participants having associate senior title or above was higher than in without professional title (OR=1.424, 95%CI: 1.194−2.328). The longer the working years, the higher the occupational identity score among the participants. The score of the more than 20 working years group was 1.820 times that of the less than 5 working years group (95%CI: 1.342−2.543). The higher the income, the higher the occupational identity score. The score of the 9001−12000 yuan per month group was 1.977 times that of the 1000−3000 yuan per month group (95%CI: 0.811−9.696) , and the score of the more than 12000 yuan per month group was 2.283 times that of the 1000−3000 yuan per month group (95%CI: 1.199−10.267）. Conclusion The family doctor team workers generally report occupational stress, and their occupational identity is at a medium level in Chengdu. Relevant managers should implement intervention measures against the main influencing factors to reduce their work tension and improve their occupational identity.
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@#Abstract: Objective To investigate the diagnostic efficacy of rifampin-resistant real-time fluorescent quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in bronchoalveolar lavage fluid (BALF) combined with peripheral blood tuberculosis infection T cell spot test (T-SPOT) and tuberculosis antibody (TB-Ab) in smear-negative pulmonary tuberculosis. Methods The clinical data of 114 cases of clinically diagnosed smear-negative pulmonary tuberculosis, 80 cases of non-tuberculous pulmonary diseases and 22 cases of smear-positive pulmonary tuberculosis in our hospital from January 2019 to January 2021 were retrospectively analyzed. The detection results of peripheral blood T-SPOT, TB-Ab and BALF GeneXpert in the three groups were analyzed. The sensitivity, specificity, negative predictive value, positive predictive value, false negative rate, false positive rate and Youden index of the three detection methods were compared. The differences in the positive detection rate of smear-negative pulmonary tuberculosis between the separate detection and the combined detection of the three methods were compared. The receiver operating characteristic curve (ROC) was performed to calculate the area under the curve (AUC). Results The sensitivity of BALF GeneXpert and peripheral blood T-SPOT and TB-Ab was 66.91%, 80.88% and 90.44%, respectively. The specificity was 98.75%, 73.75% and 41.25%, respectively; the diagnostic coincidence rates were 78.70%, 78.24% and 72.22%, respectively, which were higher than 70.00%. In the smear-negative pulmonary tuberculosis group, the positive detection rates of these three methods in the smear-negative pulmonary tuberculosis group were 63.15%, 79.82% and 90.35%, respectively, and the differences were statistically significant compared with those in the non-tuberculosis pulmonary disease group (all P<0.01). The positive detection rate of the three combined methods in the smear-negative pulmonary tuberculosis group was 96.49 %, which was significantly higher than that of TB-GeneXpert method and T-SPOT, and the differences were statistically significant (χ2=37.283, P<0.01; χ2=13.612, P<0.01); the Youden index of combined detection was significantly higher than that of single detection, and the AUC of combined detection was 0.977, which was significantly higher than that of single detection. Conclusion BALF GeneXpert combined with peripheral blood T-SPOT and TB-Ab can significantly improve the diagnostic rate of bacterial-negative pulmonary tuberculosis, providing a strong basis for guiding clinical treatment.
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Postprandial hypotension is an abnormal regulation of blood pressure, which is common in the elderly. Due to insidious symptoms, postprandial hypotension is easily neglected by patients and medical staff in clinical practice, but it has a high degree of harm. There are many factors related to the occurrence of postprandial hypotension, including demographic factors, disease-related factors, lifestyle factors, postprandial postural factors and so on. Among demographic factors, age is positively associated with the occurrence of postprandial hypotension. Among disease-related factors, the existence of some basic diseases such as hypertension and diabetes, and the use of most kinds of anti-hypertensive drugs can increase the risk of postprandial hypotension. Among lifestyle factors, smoking is a risk factor for postprandial hypotension: while reducing the intake of staple foods, drinking large amounts of water or drinking green tea before meals may reduce the risk of postprandial hypotension. By taking different postures after meals, postural factors affect the rate of gastrointestinal emptying and then affect the occurrence of postprandial hypotension. Among the above factors, it is feasible to prevent postprandial hypotension by changing postprandial posture.
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Objective@#To evaluate the effects of tube voltage on image quality in coronary CT angiography (CCTA), the estimated radiationdose, and DNA double-strand breaks (DSBs) in peripheral blood lymphocytes to optimize the use of CCTA in the era of lowradiation doses. @*Materials and Methods@#This study included 240 patients who were divided into 2 groups according to the DNA DSB analysismethods, i.e., immunofluorescence microscopy and flow cytometry. Each group was subdivided into 4 subgroups: thosereceiving CCTA only with different tube voltages of 120, 100, 80, or 70 kVp. Objective and subjective image quality wasevaluated by analysis of variance. Radiation dosages were also recorded and compared. @*Results@#There was no significant difference in demographic characteristics between the 2 groups and 4 subgroups in eachgroup (all p > 0.05). As tube voltage decreased, both image quality and radiation dose decreased gradually and significantly.After CCTA, γ-H2AX foci and mean fluorescence intensity in the 120-, 100-, 80-, and 70-kVp groups increased by 0.14, 0.09,0.07, and 0.06 foci per cell and 21.26, 9.13, 8.10, and 7.13 (all p 0.05). @*Conclusion@#The 100-kVp tube voltage may be optimal for CCTA when weighing DNA DSBs against the estimated radiationdose and image quality, with further reductions in tube voltage being unnecessary for CCTA.
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Objective:To explore the mechanism of the influence of just world belief on depression in college students, and to explore the multiple mediating effects of hope and forgiveness.Methods:Totally 290 college students were assessed by belief in a just world scale(BJWS), adult dispositional hope scale(ADHS), Hearland forgiveness scale(HFS) and self-rating depression scale(SDS).Results:The scores of the belief in a just world, hope, forgiveness and depression were 53.90±7.83, 33.67±3.87, 109.75±12.52 and 16.84±8.41, respectively.The belief in a just world was positively correlated with hope( r=0.41, P<0.01) and forgiveness( r=0.40, P<0.01), and negatively correlated with depression( r=-0.38, P<0.01). Hope was positively correlated with forgiveness( r=0.43, P<0.01), and negatively correlated with depression( r=-0.53, P<0.01). Forgiveness had a significantly negative correlation with depression( r=-0.57, P<0.01). Structural equation model showed that the direct effect of the belief in a just world on depression was not statistically significant.The belief in a just world can influence depression by multiple mediators of hope(the effective amount=0.26), hope→forgiveness(the effective amount=0.20), and the model fitted well(χ 2/ df=1.63, RMSEA=0.04, GFI=0.96, NFI=0.98, CFI=0.99). Conclusion:The belief in a just world can influence depression by multiple mediators role of hope, hope→forgiveness.
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Objective@#To show development status of postprandial hypotension studies comprehensively and intuitively in order to provide a reference for nursing research on postprandial hypotension.@*Methods@#The data was from the literatures included in Web of Science database from 1986 to 2019 related to postprandial hypotension, and CiteSpace information visualization software was used to analyze the issuing country and institution, cited authors, Cited journals, keywords and cited references to postprandial hypotension.@*Results@#A total of 1 140 literatures were obtained. 187 papers were finally included after screening. University of Adelaide in Australia has the most of published articles and the most of cited authors; The cited journals mainly include international high-impact journals such as Annals of Internal Medicine and Journal of the American Geriatrics Society. Through keywords clustering, a total of 5 research hotspots were obtained, including falls, insulin, autonomic nervous system, aged cared, gastrointestinal.@*Conclusions@#Postprandial hypotension is one of the convergence points of interdisciplinary fusion. At present, preliminary results have been obtained, but the research on its mechanism is still in the exploratory stage. Falls, insulin, autonomic nervous system, aged cared, gastrointestinal are currently the main focus of postprandial hypotension researches. The prevention of postprandial hypotension has made some achievements, but there are also some risks. It is necessary to conduct further studies on more convenient and safe measures to prevent postprandial hypotension.
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Objective To explore the mediating effect of overgeneral autobiographical memory between shame and depression in college students.Methods Randomly selected 205 undergraduates were tested using Shame Scale (SS),the Center for Epidemiologic Studies Depression Scale (CES-D) and the Autobiographical Memory Test(AMT).Results (1) The total score of shame was (58.46± 12.34).The total score of overgeneral autobiographical memory was (5.19 ± 2.1 1).The total score of depression was (19.62±5.36).The correlation results showed that the sense of shame,the overgeneral autobiographical memory and depression were positively correlated with each other(r=1.99,0.48,0.28;all P＜0.01).(2)Mediation effect analysis and further Boot-strap test showed that sense of shame positively predicted depression,and overgeneral autobiographical memory partly mediated the association between the shame and depression,accounting for 10％ of total effect.Conclusion During the clinical treatment of depression,medical profession can reduce the depression caused by shame by intervening in the generalization of autobiographical memory of patients with depression.
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OBJECTIVE: To discuss the feasibility of renal toxicity screening of drugs using high content analysis technology. METHODS: Rosiglitazone was selected as the negative drug and valinomycin was selected as the positive drug. High intension HK-2 renal cell toxicity screening model was established through testing five indexes including cell number, DNA intensity, cell permeability, mitochondrial membrane potential and cytochrome C, using high content analysis technology. Aristolochic acid A and cisplatine that has obvious renal toxicity was used to validate the model. RESULTS: Valinomycin, cisplatin and aristolochic acid A has obvious renal toxicity;rosiglitazone don't have renal toxicity. CONCLUSION: High content analysis can be used to screen renal toxicity of drugs.
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OBJECTIVE Nanotechnology provides a novel strategy for the delivery of anticancer drugs. In this study, titanium dioxide coated gold nanorod (GNR/TiO2) nanostructures were used as the drug carrier for gambogic acid in order to improve its anticancer effect. METHODS Biocompatibility and cellular uptake of GNR/TiO2 nanostructures were studied in human glioblastoma U-87 MG cells. Cell viability was evaluated by ATP assay and calcein AM staining. LysoSensor Green DND-189 and Hoechst 33342 were used to analyze the intracellular location of GNR/TiO2 nanostructures. The in vitro anti-cancer effect of gambogic acid loaded nanoparticles was compared with free drug. RESULTS The results showed that GNR/TiO2 nanostructures are biocompatible, and they are localized at the intracel?lular acidic compartments of endosomes and lysosomes. The intracellular drug content delivered via GNR/TiO2 nanostructures was 6 fold higher than the free form, thus dramatically enhancing the anticancer effect of gambogic acid. Furthermore, mild photothermal therapy also showed synergistic effect with the drug. CONCLUSION Our study suggested that GNR/TiO2 nanostructures can be considered as a promising anticancer drug carrier.
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″Herb-Pairs″, also known as pair drugs, refers to a prescription consisted of two relatively fixed traditional Chinese medicine, is the most basic, most simple and most common form of medication prescription in traditional Chinese medicine compound compatibility. It is not a random combination of two herbs, nor is the simple accumulation of efficacy, but the simple and delicate experience of ancient Chinese medicine practitioners. As a bridge between single drug and prescriptions, it is the embodiment of the regular and dialectical connotation. Therefore, research on Herb-Pairs has always been the most basic and most important entry point for compound compatibility studies. However, the interaction between herbs and herbs is an effect with a downside as well as benefits. The beneficial herb-herb interaction in Herb-Pairs include mutual promotion, mutual enhancement, mutual restraint between two drugs and counteract toxicity of another drug. And the harmful herb- herb interaction in Herb- Pairs includes mutual inhibition and antagonism. All of these interactions areby means of affecting the metabolism of components to play a therapeutic effect. Using the pharmacokinetic-pharmacodynamic (PK-PD) binding model, the combination of drug metabolism and pharmacodynamics can further elucidate the influence on effect caused by drug concentration and metabolism, which can help elucidate the mechanism of drug action. Consequently, in this review, the herb-herb interactions in terms of pharmacokinetic were summarized to elucidate rule of TCM compatibility.
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Objective To analyze the epidemiologic characteristics of epidemic hemorrhagic fever syndrome (EHF) from 2004 to 2010 and provide scientific basis for formulating control measures.Methods Epidemiological data of EHF between 2004 to 2010 were obtained from the“National Disease Surveillance Report on Management Information System”,and the population data were from the“National Disease Surveillance Information Management System for Basic Information Report System”.Descriptive epidemiological methods was used for statistical analysis.ResultsA total of 173 cases were reported in Qian'an from 2004 to 2010.From 2004 to 2010,the cases were 86,67,12,1,0,1,and 7 cases,respectively,and the rate were 13.12/10 million ( 86/640 249 ),10.42/10 million (67/642 688 ),1.86/10 million ( 12/645 124),0.15/10 million (1/647 983 ),0(0/650 720),0.15/10 million( 1/653 839),and 0.11/10 million(7/657 380),respectively.The overall rate was 3.86/10 million(25/648 283) of population.From 2004 to 2008 the incidence reported declined rapidly,then increased slowly after 2009.The cases were found intensively in winter(November - next January) and spring season (february - may).The incidence in the age group of 10 - 45 was higher than that of other age groups,and the total number of cases was 82.08％(142/173).The incidence in males( 114 cases) was higher than that of females(59 cases).Occupational distribution mainly to peasants and students,which accounted for 87.86％ (152/173).Conclusions Epidemic in the city declines rapidly follows by a slow recovery,suggesting that in the future surveillance,mice-killing and protection of vulnerable population should be strengthened.
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The present research was aimed to investigate the relationships between the single nueleotide polymorphisms (SNPs) of CACNA1S gene 11 exon and thyrotoxic hypokalemic periodic paralysis (THPP)in the people of Han Nationality in Sichuan China. 100 male subjects were divided into four groups in this study, i.e., 22 patients with THPP, 23 patients with hypokalemic periodic paralysis (HPP), 33 patients with thyrotoxicosis but without hypokalemic periodic paralysis (NTHPP), and 22 healthy (control group) subjects. The sequences of the CACNA1S gene exon 11 polymorphisms, for the four groups respectively, were analysed by the SNPs method with polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and DNA direct sequencing. A meta-analysis of three additional studies was also performed. Three SNPs of exon 11 of the CACNA1S gene (C1491T, T1551C, C1564T) were present in all the four groups. The polymorphisms C1491T and T1551C were present in both homozygotes and heterozygotes, while the C1564T polymorphism was present only in heterozygotes. The genotype frequencies of variants at C1491T and T1551C were not significantly associated with TPP (dominant model: P=0.530 and P=0.568; allele frequency model: P=0.563 and P=0.568). A Meta-analysis yielded combined odds ratio (OR) for TPP of 2. 12 (95% CI: 0.80-5.60) at C1491T, 2.90 (95% CI: 0.71-11.78) at T1551C, and 1.61 (95% CI: 0.36-7.26) at C1564T with the dominant model. These results suggested that three SNPs of CACNA1S gene exon 11 definitely could exist but could not be associated with TPP people of Han Nationality in Sichuan.
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Adult , Humans , Male , Base Sequence , Calcium Channels , Genetics , China , Ethnology , Chromosomes, Human, Pair 11 , Genetics , Exons , Hypokalemic Periodic Paralysis , Genetics , Molecular Sequence Data , Polymorphism, Single Nucleotide , Thyrotoxicosis , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To Explore the effect of oblique preputial island flap for the treating of hypospadias.</p><p><b>METHODS</b>Fifty-one patients were performed one-stage urethroplasty with oblique preputial island flap to repair hypospadias.</p><p><b>RESULTS</b>All cases resulted in a good contour of the penis without any redundancy and a normal anatomic position of slit-shaped urethral meatus. The urination was perfect. Six patients occurred complications (3 cases of urinary fistula, 3 cases of meatal stenosis).</p><p><b>CONCLUSION</b>With extensive scope of materials, reliable blood supply of skin flap, satisfactory appearance of shaping penis and few complications, one-stage urethroplasty with oblique preputial island flap is an effective method to repair hypospadias of penile type and penile-scrotal type.</p>
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Adolescent , Child , Child, Preschool , Humans , Male , Hypospadias , General Surgery , Penis , General Surgery , Surgical Flaps , Urethra , General SurgeryABSTRACT
Objective To study the inhibition effect of leech extract on HepG2 cells. Methods Human hepatocellular cancer cell line HepG2 were treated with different concentrations of leech extracts which were extracted by method of freeze-thawing with liquid nitrogen and contrasted with that by method of water extracting and ethanol precipitating. The inhibition effects and cell morphous were examined by MTT assay and Acridine orange (AO) fluorescent staining method respectively. Result The 6～15 mg/mL drug concentrations of leech extract by method of freeze-thawing with liquid nitrogen had an obvious inhibition on proliferation of HepG2 cells in a dose-dependent manner, and the effect was better than that by method of water extracting and ethanol precipitating (P
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<p><b>OBJECTIVE</b>To obtain related pharmacodynamic data for the clinical experiment by observing the sexual activities of male rats after using sildenafil ciltrate through stomach irrigation.</p><p><b>METHODS</b>Forty male Sprague-Dawley rats were distributed into 4 groups with different dosages (control with distilled water, low dosage: 0.08%, medium dosage: 0.24% and high dosage: 0.72%). After the male Sprague-Dawlay rats were mated with their female counterparts in pairs, the latent period of chasing, the frequencies of chasing in 60 minutes, the latent period of intercourse and the frequencies of intercourse in 60 minutes were recorded.</p><p><b>RESULTS</b>Compared with the control, the frequencies of chasing were significantly increased and the latent periods of chasing were significantly shortened in both high dosage and medium dosage groups after using sildenafil (P < 0.01); The frequencies of intercourse in 60 minutes were significantly increased and the latent periods of intercourse were significantly shortened in all the groups after the use of sildenafil.</p><p><b>CONCLUSIONS</b>The sexual activities of male rats treated with sildenafil were significantly activated.</p>
Subject(s)
Animals , Male , Rats , Dose-Response Relationship, Drug , Phosphodiesterase Inhibitors , Pharmacology , Piperazines , Pharmacology , Purines , Rats, Sprague-Dawley , Sexual Behavior, Animal , Sildenafil Citrate , SulfonesABSTRACT
<p><b>OBJECTIVES</b>To investigate possible abnormalities of the sperm neck in eight infertile painters observed by transmission electron microscope.</p><p><b>METHODS</b>Spermatozoa from 8 infertile painters (21-32 years old) were observed by transmission electron microscope.</p><p><b>RESULTS</b>The abnormalities of the connecting piece could be divided into 6 types, among which the anomaly of the connecting piece concomitant with a true nuclemalamic condition was the most serious.</p><p><b>CONCLUSIONS</b>The abnormalities may be related to expression obstacles of nuclear genome and mitochondrial genome, and to anomalous cellular signal transduction during spermiogenesis as well.</p>