Association between Working Hours and Anxiety/Depression of Medical Staff during Large-Scale Epidemic Outbreak of COVID-19: A Cross-Sectional Study

Objective@#This present study aimed to investigate the relationship between working hours and anxiety/depression mood of medical staff in China during COVID-19 epidemic. @*Methods@#The cross-sectional interview study was conducted during the period between February 14th and February 29th, 2020. A total of 291 Chinese medical professionals were recruited from 4 cities and participated in the study. @*Results@#In 291 participants, 116 (40.0%) medical staff experienced anxiety and 151 (51.8%) underwent depressed mood. In male, the level of GAD-7 and PHQ-9 scores increased with the elevation of working hours per day (WHPD) (β=0.579, p=0.003 and β=0.943;p=0.001) respectively. In female, nonlinear relationship mode was demonstrated. The levels of GAD-7 and PHQ-9 scores increased with the elevation of working hours when it was above 5 hours (β=1.432; p0.05). @*Conclusion@#During the COVID-19 epidemic, we found a strong correlation between the psychological mood and WHPD. The correlation followed different modes in male and female medical workers. Enforcing an upper time limit of WHPD may help decrease the risk of pandemic-related psychological problems in medical workers.

Association between Working Hours and Anxiety/Depression of Medical Staff during Large-Scale Epidemic Outbreak of COVID-19: A Cross-Sectional Study

Objective@#This present study aimed to investigate the relationship between working hours and anxiety/depression mood of medical staff in China during COVID-19 epidemic. @*Methods@#The cross-sectional interview study was conducted during the period between February 14th and February 29th, 2020. A total of 291 Chinese medical professionals were recruited from 4 cities and participated in the study. @*Results@#In 291 participants, 116 (40.0%) medical staff experienced anxiety and 151 (51.8%) underwent depressed mood. In male, the level of GAD-7 and PHQ-9 scores increased with the elevation of working hours per day (WHPD) (β=0.579, p=0.003 and β=0.943;p=0.001) respectively. In female, nonlinear relationship mode was demonstrated. The levels of GAD-7 and PHQ-9 scores increased with the elevation of working hours when it was above 5 hours (β=1.432; p0.05). @*Conclusion@#During the COVID-19 epidemic, we found a strong correlation between the psychological mood and WHPD. The correlation followed different modes in male and female medical workers. Enforcing an upper time limit of WHPD may help decrease the risk of pandemic-related psychological problems in medical workers.

Survey and analysis on professional identity of nursing students in different nations before clinical practice / 中国实用护理杂志

Objective To investigate the status of professional identity of Xinjiang nursing students and analysis on the differences in different nations and educational levels, so as to provide the basis for nursing professional identity education. Methods By cluster sampling,a total of 626 nursing students of two schools in Xinjiang were surveyed by general information questionnaire and the Professional Identification Scale for nursing students. Results Theprofessional identity level of Xinjiang nursingstudents was in the medium level scored 62.13 ± 12.54. The highest level was Uighur nursing students scored 67.76 ± 10.9, followed by other national nursing studentsscored 59.44 ± 12.99, the lowest level was Han national nursing studentsscored 56.41 ± 11.25 (F=69.654, P<0.05). The highest level of professional identity was secondary school studentsscored 66.71 ± 10.96, followed by junior college studentsscored 59.33 ± 8.23, the lowest level was undergraduate studentsscored 57.32 ± 12.54 (F=49.815, P < 0.05). Conclusions The professional identity of nursing students is not high,and were affected by many factors. It is suggested that nursing educational workers should take various measures to implement nursing students professional emotional education. Nursing teachers should possess higher level of professional identity,and guide students to set up the correct professional identity in various angles.

Effects of Wenyang Huazhuo Tongluo Recipe Containing Serum on Transforming Growth Factor β1/ Smad Signaling Pathway of Skin Fibroblasts in Systemic Sclerosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effects of Wenyang Huazhuo Tongluo Recipe (WYHZTLR) containing serum on transforming growth factor β1 (TGF-β1)/Smad signaling pathway of skin fibroblasts in systemic sclerosis (SSc).</p><p><b>METHODS</b>Totally 36 SSc patients were randomly assigned to Chinese medicine (CM) group, Western medicine (WM) group, and integrative medicine (IM) group according to random digit table, 12 in each group. Patients in the CM group took WYHZTLR decoction (one dose per day). Patients in the WM group took penicillamine tablet (0. 125 g each time, bid) and Prednisone Acetate Tablet (PAT 20 mg, qd). Patients in the IM group took penicillamine, PAT, and WYHZTLR decoction (in the same dosage of corresponding drugs as aforesaid). All patients were treated for one month to get drug containing serum. Besides, 10 untreated SSc patients' serum was taken as the control group. Healthy subjects' skin fibroblasts were originated from healthy skin tissue of the upper arms of 2 female patients undergoing plastic surgery. Corresponding serum of each group was added in the culture system of SSc patients' and healthy subjects' dermal fibroblasts respectively. Expression levels of TGF-β1 receptor type I (TGF-β1 RI), TGF-β1 receptor II (TGF-β1 RII), p-Smad2/3 and Smad7 protein were examined by Western blot. Expression levels of collagen type I and collagen type III (Col-I, Col-III) mRNA were examined by reverse transcription PCR. Contents of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in the supernatant of SSc, skin fibroblasts were examined by ELISA.</p><p><b>RESULTS</b>Compared with the control group, expression levels of TGF-β1 R I and p-Smad2/3 protein significantly decreased, but expression levels of Smad7 protein significantly increased in skin fibroblasts of SSc patients and healthy subjects of WM, CM, and IM groups (P <0.05, P <0. 01). Meanwhile, the expression level of TGF-β1 RII decreased in the IM group (P <0. 05, P <0. 01). Compared with the WM group, expression levels of TGF-β1 RI and p-Smad2/ 3 protein significantly decreased, but that of Srnad7 protein significantly increased in IM groups (P <0. 01). mRNA expression levels of Col-I and Col-II in SSc skin fibroblasts significantly decreased more in WM, CM, and IM groups than in the control group (P <0. 05, P <0. 01). Besides, the expression level of Col-III mRNA was significantly lower in the IM group than in the WM group (P <0.01). Compared with the control group, serum levels of MMP-9 and MMP-9/TIMP-1 ratios increased more obviously in WM, CM, and IM groups (P <0.05, P <0.01). But expression levels of TIMP-1 decreased significantly in CM and IM groups (P <0.01). Expression levels of MMP-9 and MMP-9/TIMP-1 ratios increased more in the IM group than in the WM group (P <0. 01). Expression levels of TIMP-1 decreased more in CM and IM groups than in the WM group (P <0.01).</p><p><b>CONCLUSION</b>WYHZTLR containing serum could reduce expression levels of Col-I and Col-III possibly through regulating key signal molecules, such as TGF-β1 RI, p-Smad2/3, and Smad7 in TGF-β1/Smad signaling pathway of SSc skin fibroblasts, and inhibiting transduction of TGF-β1/Smad signaling pathway.</p>

A novel thermosensitive in-situ gel of gabexate mesilate for treatment of traumatic pancreatitis: An experimental study / 华中科技大学学报（医学）（英德文版）

Gabexate mesilate (GM) is a trypsin inhibitor, and mainly used for treatment of various acute pancreatitis, including traumatic pancreatitis (TP), edematous pancreatitis, and acute necrotizing pancreatitis. However, due to the characteristics of pharmacokinetics, the clinical application of GM still needs frequently intravenous administration to keep the blood drug concentration, which is difficult to manage. Specially, when the blood supply of pancreas is directly damaged, intravenous administration is difficult to exert the optimum therapy effect. To address it, a novel thermosensitive in-situ gel of gabexate mesilate (GMTI) was developed, and the optimum formulation of GMTI containing 20.6% (w/w) P-407 and 5.79% (w/w) P188 with different concentrations of GM was used as a gelling solvent. The effective drug concentration on trypsin inhibition was examined after treatment with different concentrations of GMTI in vitro, and GM served as a positive control. The security of GMTI was evaluated by hematoxylin-eosin (HE) staining, and its curative effect on grade II pancreas injury was also evaluated by testing amylase (AMS), C-reactive protein (CRP) and trypsinogen activation peptide (TAP), and pathological analysis of the pancreas. The trypsin activity was slightly inhibited at 1.0 and 5.0 mg/mL in GM group and GMTI group, respectively (P<0.05 vs. P-407), and completely inhibited at 10.0 and 20.0 mg/mL (P<0.01 vs. P-407). After local injection of 10 mg/mL GMTI to rat leg muscular tissue, muscle fiber texture was normal, and there were no obvious red blood cells and infiltration of inflammatory cells. Furthermore, the expression of AMS, CRP and TAP was significantly increased in TP group as compared with control group (P<0.01), and significantly decreased in GM group as compared with TP group (P<0.01), and also slightly inhibited after 1.0 and 5.0 mg/mL GMTI treatment as compared with TP group (P<0.05), and significantly inhibited after 10.0 and 20.0 mg/mL GMTI treatment as compared with TP group (P<0.01). HE staining results demonstrated that pancreas cells were uniformly distributed in control group, and they were loosely arranged, partially dissolved, with deeply stained nuclei in TP group. Expectedly, after gradient GMTI treatment, pancreas cells were gradually restored to tight distribution, with slightly stained nuclei. This preliminary study indicated that GMTI could effectively inhibit pancreatic enzymes, and alleviate the severity of trauma-induced pancreatitis, and had a potential drug developing and clinic application value.

A multiple regression formula for the prediction of thyroid microcarcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To establish a quantitative analysis formula for the prediction of thyroid microcarcinoma and decide the cut-off values for the recommendation of ultrasound-guided biopsy.</p><p><b>METHODS</b>The ultrasound characteristics of 830 subcentimeter thyroid nodules were retrospectively analyzed based on pathological results in this study. A diagnostic formula was developed using multivariate binary Logistic regression with the cut-off values for the recommendation of biopsy. The diagnostic values of each feature and the formula were evaluated.</p><p><b>RESULTS</b>The most suspicious ultrasound characteristics for subcentimeter thyroid nodules were solid echostructure (OR=41.97), microlobulated margin (OR=25.89), hypoechoic echogenicity(OR=10.36), no halo (OR=8.38), irregular margin (OR=4.26), taller than wide (OR=2.71), microcalcification (OR=1.92), and macrocalcification (OR=1.28). The sensitivity, specificity, and accuracy of the formula were 90.9%, 54.0%, and 72.5%, respectively.</p><p><b>CONCLUSION</b>This multiple regression formula is an objective tool for the evaluation of thyroid microcarcinoma, which can provide the cutoff values for the ultrasound guided biopsy.</p>

Antioxidant role of glutathione hormone and γ-glutamyl cysteine synthetase in hyperoxia-induced lung injury in premature newborn rats / 中华实用儿科临床杂志

Objective To explore the expression of glutathione hormone (GSH) and γ-glutamyl cysteine synthetase (γ-GCS) in premature newborn rats exposed to hyperoxia,and to study antioxidant role of GSH and γ-GCS in hyperoxia-induced lung injury.Methods One-day old preterm SD rats were divided randomly into 2 groups:hyperoxia group and air group.Newborn rats in hyperoxia group were continuously exposed to oxygen(oxygen ＞ 850 mL/L),and newborn rats in air group were exposed in room air.After 1,7,14 days of exposure,the preterm SD rats of 2 groups were killed,and whole lung of these rats were isolated.GSH and γ-GCS of pulmonary tissue homogenate were detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA).Bicinchoninic acid (BCA) was used to detect GSH protein in lung tissue homogenate.Total lung RNA was extracted and γ-GCS mRNA was detected by reverse transcription polymerase chain reaction.Results 1.The results were detected by ELISA method and BCA method,compaired with air group,the expression of GSH protein in lung tissue induced by hyperoxia was significantly increased after 1,7 days of exposure(all P ＜ 0.05),but the expression of GSH became significantly weak after 14 days of exposure (P ＜0.05).2.The expression of γ-GCS mRNA and protein level were significantly increased in 1,7 days (all P ＜0.05),but the general tendency decreased after 14 days of exposure,the expression of γ-GCS mRNA became stronger than its expression after 14 days of air group,both were no significantly different(P ＞0.05).Conclusions The changes of GSH and γ-GCS in the lung of premature SD rats induced by oxidation outbreak participate in the development of hyperoxia-induced lung injury,the activity of γ-GCS may be increased by hyperoxia,and alleviate hyperoxia lung injury in premature rats through antioxidation of GSH.

Liver stiffness measured by acoustic radiation force impulse imaging in assessing hepatic functional reserve in patients with space-occupying lesions in the liver / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the value of liver stiffness measured by acoustic radiation force impulse imaging(ARFI) in assessing hepatic functional reserve in patients with space-occupying lesions in the liver.</p><p><b>METHODS</b>Sixty-three patients with space-occupying lesions in the liver were enrolled. Liver stiffness (LS) measurements with ARFI and indocyanine green(ICG) retention test were performed in the same day, and plasma clearance rate of indocyanine green(ICG-K), ICG retention at 15 minutes(ICGR15) as well as 10 effective values of LS were recorded. The correlation between Child-Pugh score, ICGR15, ICG-K, and LS were evaluated.</p><p><b>RESULTS</b>The LS measurements with ARFI failed in one patient. A strong correlation between LS and ICGR15(r=0.789, P<0.01) and an inverse correlation between LS and ICG-K(r=-0.738, P<0.01) were observed. Besides, there was a significant correlation between LS measurements and Child-Pugh score(r=0.929, P<0.01) . The LS significantly differed among patients with Child-Pugh class A, B, and C(P<0.01) .</p><p><b>CONCLUSION</b>ARFI is a simple, feasible and non-invasive method for assessing hepatic functional reserve in patients with space-occupying lesions in the liver.</p>

Efficacy of homemade hemostatics of injected gelatin matrix for immediately treating blunt hepatic trauma in canine model without additional pressure / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the efficacy of homemade hemostatics of injected gelatin matrix (HIGM) for immediately treating blunt hepatic trauma in canine model without additional pressure.</p><p><b>METHODS</b>A total of 27 commercial hybrid dogs underwent celiotomy to establish hepatic trauma model after general anesthesia. The dogs were prospectively randomized into 3 groups: the treatment group (n=9, with the direct application of homemade hemostat), the positive control group (n=9, with thrombin solution), and the negative control group (n=9, with 0.9% normal saline). Time to hemostasis and intra-abdominal blood loss were recorded, and heart rate (HR), mean arterial pressure (MAP), and hematological parameters were compared among these three groups. Gross examinations were performed 30 minutes after surgery.</p><p><b>RESULTS</b>Significantly shorter time to hemostasis [(1.20±0.33) min] and less blood loss [(47.22±8.61) ml] were observed in the treatment group than in control groups (P 0.05). No cases of bleeding occurred in any animals in the treatment group, and no signs of infection and adhesion formation were evident due to exposure to HIGM. Two cases in the positive control group (22.22%) were found to have rebleeding. All animals in the negative control group experienced visible bleeding.</p><p><b>CONCLUSION</b>HIGM is effective for controlling bleeding after hepatic trauma without the additional compression, and therefore may be valuable in field surgery.</p>

Survey study of conditions of patients with acute stroke seeking for acupuncture treatment / 中国针灸

To explore possible factors that affecting patients with acute stroke seeking for acupuncture treatment by questionnaire survey. The average age of the 202 patients was 63.14. Before the survey, only 66 patients had received acupuncture treatment, and 136 patients did not consider accepting acupuncture treatment. After the survey, there were more patients want to accept acupuncture treatment (P < 0.05). Patients expressed three major opinions about acupuncture, i.e., lack of knowledge of acupuncture, analgesia after needling, and slow effectiveness. Patients lack awareness of acupuncture and cultural identity. Therefore, it is urgent to promote awareness of acupuncture, strengthen culture identity which will facilitate the development of acupuncture.