Mediating role of depression between workplace violence and job burnout among healthcare workers / 中南大学学报(医学版)

OBJECTIVES@#Health workers are at risk of workplace violence, which can seriously affects their mental health and work status. This study aims to explore the mediating role of depression between workplace violence and job burnout among healthcare workers.@*METHODS@#From January 10 to February 5, 2019, a questionnaire was distributed to frontline healthcare workers through the wenjuanxing platform using convenient sampling (snowball sampling). The questionnaire included the Chinese version of the Workplace Violence Scale, Maslach Burnout Inventory, and Patient Health Questionnaires (PHQ-2). Descriptive statistics, correlation analysis, and mediation model tests were conducted on the cross-sectional data collection.@*RESULTS@#The study included 3 684 participants, with (31.63±7.69) years old. Among them 2 079(56.43%) were experienced workplace violence, 687(18.65%) were screened positive for depression, and 2 247(60.99%) were experienced high levels of occupational burnout. Correlation analysis showed positive association between workplace violence and depression, workplace violence and occupational burnout, depression and occupational burnout (r=0.135, r=0.107, r=0.335, respectively, all P<0.001). After controlling for covariates, workplace violence had an indirect effect on occupational burnout through depression, with a standardized coefficient of 0.25 (SE=0.02, 95% CI 0.21 to 0.28), accounting for 13.87% of the total effect.@*CONCLUSIONS@#The study highlights the close relationship between workplace violence, depression, and occupational burnout among healthcare workers, with depression acting as a mediator between workplace violence and occupational burnout. This study suggests that it is necessary to improve the communication skills of healthcare workers, increase the installation of security systems and emergency plans, use new media platforms to convey positive energy between doctors and patients, and open channels for medical consultation and complaints. It is also necessary to provide guidance for healthcare workers' depressive emotions. Addressing depression among health care workers will help reduce the harm caused by workplace violence, protect the physical and mental health of healthcare workers, and reduce work burnout.

The effect of osteoking on postoperative fracture healing of femoral neck fracture / 国际中医中药杂志

Objective:To analysis the effect of osteoking on fracture healing after internal fixation in patients with femoral neck fracture.Methods:A total of 120 patients with femoral neck fracture treated in Weifang people's Hospital from January 2017 to April 2020 were analyzed retrospectively. All patients underwent inverted triangular fixation with 3 cannulated screws after reduction. According to the condition whether they took osteoking after operation, they were divided into two groups, with 60 in each groups. The control group was treated with traction and rotation closed reduction. If closed reduction failed, open anatomical reduction was performed. The treatment group took osteoking on the basis of the control group. Both groups were observed 3 months and followed up to 9 months after operation. Bone osteotylus growth and fracture healing were evaluated by X-ray or CT. Lumbar vertebral bone density was detected by dual-energy X-ray bone density instrument. Serum amino terminal peptide of type I procollagen (PINP) and serum carboxy-terminal peptide β (β-CTX) of type I collagen were detected by double-antibody sandwich ELISA and competitive ELISA.Results:The fracture healing time of the treatment group was (13.06±2.35) weeks, and that of the control group was (17.75±3.56) weeks, and the difference between the two groups was statistically significant ( t=8.52, P<0.01). During the follow-up period, the fracture healing rate was 93.3% (56/60) in the treatment group and 75.0% (45/60) in the control group, and the difference was statistically significant ( χ2=7.57, P=0.006). The rate of nonunion was 1.7% (1/60) in the treatment group and 5.0% (3/60) in the control group, and there was no significant difference between the two groups ( χ2=1.03, P=0.309). The rate of malunion was 5.0% (3/60) in the treatment group and 20.0% (12/60) in the control group, and the difference was statistically significant (χ 2=6.17, P=0.013). The BMD of the treatment group was significantly higher than that of the same group before operation at 9 months after follow-up [(0.76±0.12) g/cm2 vs. (0.71±0.06) g/cm2; t=2.89, P<0.05]. The level of serum β-CTX at the 3rd month after operation [(186.76 ± 26.23) ng/L vs. (286.05 ± 23.18) ng/L, t=21.97] in the treatment group was significantly lower than that of the control group ( P<0.05), at the 6th month [(252.34 ± 21.58) ng/L vs. (302.52 ± 16.87) ng/L, t=14.19] in the treatment group was significantly lower than that of the control group ( P<0.05). The PINP level at the 3rd month [(37.52 ± 7.59) μg/L vs. (27.59 ± 5.36) μg/L, t=3.56] in the treatment group was significantly higher than that of the control group ( P<0.05), at the 6th month [(30.54 ± 5.63) μg/L vs. (25.63 ± 4.98) μg/L, t=2.36] in the treatment group was significantly higher than that of the control group ( P<0.05). Conclusion:Osteoking can regulate the bone metabolism balance of patients with femoral neck fracture after internal fixation, shorten the fracture healing time and promote fracture healing.

Occult hepatitis C virus infection in volunteer blood donors in Shaanxi province / 中国输血杂志

【Objective】 To investigate the prevalence of occult hepatitis C virus infection (OCI) in Shaanxi blood donors and characterize the occult hepatitis C virus in this cohort. 【Methods】 Between July and September of 2019, 112, 117, 46, and 75 blood samples were obtained from eligible donors, alanine aminotransferase (ALT) elevated donors(ALT>50 U/L), hepatitis B virus surface antigen (HBsAg) positive donors, and anti-hepatitis C virus (anti-HCV) positive donors, respectively. Peripheral blood lymphocytes (PBMCs) were isolated from all the samples. HCV 5′UTR was amplified from total RNA of PBMCs using reverse transcription nested PCR (RT-Nested PCR) to detect the infection status of OCI in blood donors. HCV RNA core/E2 region was amplified from HCV RNA positive samples with RT-Nested PCR to determine HCV genotypes and subtypes via sequencing. 【Results】 Two (2.67%, 2/75) cases of OCI were identified in anti-HCV positive samples, 1(0.85%, 1/117) case of OCI was identified in abnormal ALT samples, and all OCI were genotyped as 1b. OCI was not found in HBsAg positive and eligible blood donors. 【Conclusions】 Our findings suggest that OCI does exist among Shaanxi blood donors and that ALT may be useful in diagnosing OCI.

Up-regulation of miR-125b targeting Foxp3 regulates the expression of immune factors to enhance the radiosensitivity of cervical cancer cells / 中华微生物学和免疫学杂志

Objective:To investigate the effects of miR-125b on radiosensitivity of cervical cancer cells and its possible downstream mechanism.Methods:The expression of miR-125b and Foxp3 in cervical cancer tissues and cells was detected by RT-qPCR. The HeLa cells were irradiated with 0, 2, 4 and 6 Gy of X-rays. The expression of miR-125b and Foxp3 in each group was detected by RT-qPCR. After downregulation of miR-125b expression and 6 Gy X-ray irradiation, the proliferation ability of HeLa cells was detected by MTT assay, and the expression of Bax and Bcl-2 proteins were detected by Western blot. The relationship between miR-125b and Foxp3 was detected by Targetscan and Dual luciferin reporter assay. After downregulation of Foxp3 expression and 6 Gy X-ray irradiation, the proliferation ability of HeLa cells was detected by MTT assay, and the expression of Bax and Bcl-2 proteins were detected by Western blot. The effects of miR-125b on radiosensitivity of HeLa cells through Foxp3 were detected. After down-regulation of Foxp3, the contents of IL-10 and TGF-β in supernatant were detected by ELISA.Results:The expression of miR-125b in the tissues and cells of cervical cancer was significantly decreased, while the expression of Foxp3 was significantly increased. The expression of miR-125b in HeLa cells was increased after radiation in a dose dependent manner. The expression of Foxp3 in HeLa cells was decreased after radiation in a dose dependent manner. After 6 Gy X-ray irradiation of HeLa cells, down-regulation of miR-125b increased the cell proliferation capacity, significantly reduced the expression of Bax and increased the expression of Bcl-2. miR-125b targets Foxp3 and negatively regulates Foxp3 expression. After 6 Gy X-ray irradiation of HeLa cells, down-regulation of Foxp3 significantly reduced the proliferation capacity of HeLa cells, increased the expression of Bax and decreased the expression of Bcl-2. Overexpression of miR-125b can enhance radiosensitivity of HeLa cells through Foxp3.After 6 Gy X-ray irradiation, down-regulation of Foxp3 reduced the expression of IL-10 and TGF-β in cells.Conclusions:Upregulation of miR-125b enhances the radiosensitivity of cervical cancer cells by targeting and negatively regulating Foxp3, and the mechanism of that may be related to the down-regulation of Foxp3 to reduce the expression of IL-10 and TGF-β in the cells.

The processing of blood with irregular antibodies and its clinical application / 中国输血杂志

【Objective】 Toexplore the viability of preparing washed RBCs ordeglycerolized RBCs(referred as frozen RBCs)from blood containing irregular antibodies, so as to provide references for formulating processing procedures of blood containing irregular antibodiestosave blood resources and reduce blood wastage. 【Methods】 Once irregular antibodies were yielded, their type and titerwere determined.The plasma was discarded, and the suspended RBCs were prepared and processed according to the standardized washing scheme.The processing effect of blood with different titers and types of antibodies was observed, and theirfurther clinical application was followed up. 【Results】 From May 2017 to July 2019, a total of 45 blood samples containing irregular antibodies were screened in our center. The overall qualified rate reached 91.1% after processing. 100%(25/25) was qualified in IgM, and 80.0%(16/20)in IgG.4samples, initially noncom for mingdue to IgG-Dwith titerranged8~16, met the requirements after one or two additional washing processes. Among them, 23 cases were issued and appliedin clinicaland noadeverse reactions to blood transfusionoccurred. 【Conclusion】 After appropriate processing, blood containing irregular antibody can be applied to the clinical to save blood resources. When the irregular antibody is IgG-D and the titer is high, the washing times should be increased, and only when there is no residual antibodycan the samples be issued to the clinical.

The effect and mechanism of tacrolimus pretreatment on cold ischemia reperfusion injury of transplanted liver in rats / 中华肝胆外科杂志

Objective:To investigate the roles of tacrolimus pretreatment on hepatic ischemia reperfusion injury (IRI) and its possible mechanism in a rat autologous orthotopic liver transplantation (AOLT) model.Methods:For 24 specific pathogen free 8-10 week male Sprague Dawley rats (220-250g) were randomly and equally divided into three groups. The abdomen of sham-operated group was only opened and closed; the treatment with tacrolimus was administered via dorsal penile vein before the experiment in tacrolimus-pretreated group; the AOLT group and tacrolimus-pretreated group were set to construct the AOLT IRI rat models. The levels of ALT, AST, tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β) in serum were tested after the reperfusion. The change of liver structure was evaluated by H&E staining. The quantitative real-time PCR (RT-qPCR) and Western blot assay were used to test the mRNA and protein level of hypoxia-inducible factor-1α (HIF-1α) and heme oxygenase-1 (HO-1).Results:The levels of serum ALT (1 332.0±52.8) U/L and AST (2 472.0±257.8) U/L in the AOLT group were higher than the levels in the sham-operated group (65.0±17.4)U/L, (222.3±45.2) U/L and tacrolimus-pretreated group (789.9±54.0) U/L, (533.4±31.6) U/L. The differences were significant ( P<0.05). And in the tacrolimus-pretreated group there were less lesions in the liver than in the AOLT group. The serum level of TNF-α and IL-1β of the AOLT group were increased than the sham-operated group and tacrolimus-pretreated group, and the differences were significant ( P<0.05). Compared with the AOLT group, the expressions of HIF-1α and HO-1 were increased significantly after the tacrolimus pretreatment ( P<0.05). Conclusion:Tacrolimus pretreatment could reduce rats hepatic cold IRI by inducing the expressions of HIF-1α and HO-1, and inhibiting the production of inflammatory cytokines.

Evaluation and thinking on the clinical theoretical exam of phased examination for medical practitioner qualification / 中华医学教育探索杂志

Objective:To analyze the performance of clinical theoretical examination of the five year clinical medical students in a medical school, and to explore the existing problems and direction involving in the medical education.Methods:The difficulty coefficient and degree of discrimination were used to analyze the quality of this test, and F test and LSD- t test were conducted with SPSS 24.0 to analyze the mastery rate of various modules and secondary disciplines including basic medicine, medical humanities, clinical medicine and preventive medicine. Results:The overall difficulty coefficient of the test was 0.74, and the degree of discrimination was 0.37. The coefficient of difficulty of each module is more than 0.70, and the degree of discrimination is about 0.40. The mastery rates of each module were all greater than 70%, with clinical medicine being the highest and medical humanities and basic medicine being the lowest, and the mastery rate of each secondary discipline was more than 60%, with a significant difference.Conclusion:This exam is sample, the degree of discrimination is good, and the overall knowledge is well mastered. However, it is still necessary to innovate education reform and improve the teaching quality based on weak points.

Effect of ultrasonic coupling agent-soft rubber bag padding method on DWI image quality of testis / 中国医学影像技术

Objective To explore an auxiliary method to improve DWI image quality of testis.Methods Thirty healthy male volunteers were selected,and EPI-DWI and FSE-T2WI scanning with the same parameters were successively performed according to three different schemes.Scheme A:Padding ultrasonic coupling agent-soft rubber bag at the scanning position.Scheme B:Padding physiological saline-soft rubber bag at the scanning position.Scheme C:No preexamination treatment at the scanning position.FSE-T2WI (the same scheme and the same slice) was used as the reference of anatomic form,and the images were conducted by two attending doctors.The image geometric distortion,signal uniformity and anatomical clarity were scored by 5 points method.SNR and CNR of were calculated by one of the two doctors.The scoring consistency between the two doctors was evaluated.The scoring of image geometric distortion,signal uniformity,anatomic clarity,SNR and CNR of the three schemes were statistically analyzed.Results The scoring consistency of image geometrical distortion,signal uniformity and anatomical clarity of the three schemes were relatively good or better between the two doctors (Kappa=0.805,0.737 and 0.713).There were significant differences of image geometrical distortion,signal uniformity and anatomical clarity scoring obtained from three schemes (comparisons between groups and overall comparison,all P＜ 0.05),superiority:Scheme A＞ Scheme B＞ Scheme C.Conclusion Ultrasonic coupling agent-soft rubber bag padding method can significantly improve DWI imaging quality of testis.

Efficacy observation of primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy for treatment of advanced ovarian cancer / 肿瘤研究与临床

Objective To analyze the clinical effects, complications and prognosis of primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced ovarian cancer. Methods The clinical data of 64 patients with advanced ovarian cancer in Shanxi Provincial Cancer Hospital from May 2015 to May 2017 were analyzed retrospectively. Conventional cytoreductive surgery (CDS) was performed in all patients. According to the different therapeutic regimen before and after operation, the patients were divided into 2 groups, including 32 cases treated with primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy (the observation group), and 32 cases treated with intraperitoneal hyperthermic perfusion chemotherapy after operation (the control group). The clinical effect, complications and prognosis were compared between the two groups. Results The blood loss in the observation group [(512±165) ml] was lower than that in the control group [(815±186) ml]. The amount of ascites in the observation group [(716±160) ml ] was lower than that in the control group [(1 279±236) ml], and the differences were statistically significant (t= 6.890, t= 11.153 respectively, both P＜ 0.05). Moreover, the duration of surgery in the observation group was shorter than that in the control group [(125 ±15) min vs. (185 ±24) min; t = 18.572, P＜ 0.05]. The total incidence of complications and 2-year recurrence rate in the observation group were lower than those in the control group, and the 2-year survival rate in the observation group was higher than that in the control group (both P＜0.05). Conclusion Primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer has a favorable effect with less complications and good prognosis, which is worthy of clinical application.

The effect of infrared spectral analysis in analyzing of the chemical composition of renal staghorn ;calculi and its relationship with urinary tract infections / 中国医师进修杂志

Objective To explore the effect of infrared spectral analysis in analyzing of the chemical composition of renal staghorn calculi and its relationship with urinary tract infections. Methods From June 2014 to June 2016, the clinical data of 186 patients with renal staghorn calculi were collected. The stone composition were analyzed by infrared spectroscopy and traditional chemical titration, and the stones infection were detected by microbial analysis system. The relation between stones infection, urinary tract infection and stone composition were analyzed. Results The results of infrared spectroscopy and traditional chemical titration in detecting renal staghorn calculi ingredient had no significant differences (P>0.05). In 186 patients, 56 patients (30.11%) was in infected group, and 130 patients (69.89%)was in non-infected group. The abnormal urine rate, urinary tract infection rate, medistream urine positive infection rate and cotton swabs positive infection rate in infected group were was significantly higher than those in non-infected group: 73.21%(41/56) vs. 50.77%(66/130), 19.64%(11/56) vs. 3.85%(5/130), 50.00%(28/56) vs. 6.15%(8/130), 67.86%(38/56) vs. 8.46%(11/130), P<0.01. The carbonate apatite stones rate and six water magnesium ammonium phosphate rate in infected group were significantly higher than those in non-infected group: 21.43%(12/56) vs. 5.37%(7/130), 57.14%(32/56) vs. 2.31%(3/130), P<0.01. The calcium oxalate rate and uric acid rate in non-infected group were significantly higher than those in infected group:50.00%(65/130) vs. 5.36%(3/56), 24.62%(32/130) vs. 1.79%(1/56), P<0.01. Conclusions Analysis of staghorn calculi ingredient caused by urinary bacterial infection with infrared spectroscopy is simple, reliable and easy to operate. It is important for postoperative infection prevention.

The exploration and practice of concentrated training model to medical students before clinical practice / 中华医学教育探索杂志

Clinical practice, the necessary way which must be passed by medical students, is a key period of medical education and a vital part to realize the goal of higher medical education. Our hospital has taken a series of effective measures to strengthen clinical practice teaching for many years, and we are ex-ploring the concentrated training model to medical students all the time. Every year before clinical practice, the Inspection Section develops theoretical and basic clinical skills training courses, selects experienced teachers to teach, check and evaluate the training result according to students' performance in medical and teaching activities in the ward, the clinical practice syllabus and Medical Qualification Examination aims to improve medical students' theoretical knowledge, skills, medical ethics, humanity, and clinical thinking, etc. Effect evaluation shows that our training model has played a positive role in improving overall qualities of medical students and got good feedback from them.

Long-time follow-up results of phakic posterior chamber intraocular lens and iris-claw phakic intraocular lens implantation for high myopia / 中华实验眼科杂志

Background With the development of refractive surgery,phakic intraocular lens implantation (PIOL) for high myopia is proving its outstanding merits in short-term treating outcomes.However,its long-term safety and effectiveness were still in more attention.Objective This study was to evaluate and compare the long-term safety,stability and efficacy of Verisyse PIOL implantation with implantable contact lens (ICL) implantation for high myopia.Methods The clinical data of 18 eyes (9 patients) who received Verisyse iris-claw intraocular lens implantation for high myopia and matched 22 eyes (11 patients) who received ICL implantation for high myopia from 2009 to 2011 were retrospectively analyzed.The patients were followed-up for 2 years after surgery.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalence (SE),axial length,corneal endothelial cell density (ECD),contrast sensitivity (CS),wave-front aberrations and postoperative complications were recorded during the following-up.The efficacy index,predictable and safety index were compared between the two groups.Results There was no significant difference in UCVA,BCVA and SE between Verisyse group and ICL group(t =0.92,1.32,4.32;all at P＞0.05).Non-glare CS under the 1.5,3.0,6.0,12.0 and 18.0 c/d spatial frequencies were insignificantly different between the two groups(Z=0.782,0.956,0.495,0.874,0.293;all at P＞0.05),and the similar outcomes were found in glare CS (Z=0.985,1.254,0.896,1.652,0.492;all at P＞0.05) in postoperative 2 years.Root meas square of total high order aberration (RMSh),vertical-trefoil,vertical-coma,horizontal-coma,spherical aberration(SA),were significantly elevated in the Verisyse group compared with the ICL group (Z =4.72,4.24,3.12,3.65,2.16;all at P ＜ 0.05).The mean efficacy index was 108.49 ± 16.62 in the V erisyse group and 106.71±15.88 in the ICL group,showing a significant difference (t =0.54,P＞0.05).The mean safety index was 140.56±33.89 in the Verisyse group and 143.34±34.56 in the ICL group,with a significant difference between them (t=0.29,P＞0.05).The mean predictable index was-0.25(-0.97,4.23)in the Verisyse group and 0.98 (-1.44,1.52) in the ICL group,and the difference was significant (Z =-2.68,P ＜ 0.05).Conclusions Both Verisyse PIOL implantation and ICL implantation for high myopia are safe,predictable and effective.The vusial quality and predictability of ICL implantation are much better than Verisyse PIOL implantation.A long-term effect should be observed for the further evaluation.

Efficacy of compound trabeculectomy in the treatment of glaucoma / 中国基层医药

Objective To research the clinical effect of complex trabeculectomy in the treatment of glaucoma. Methods 80 patients with glaucoma were selected in the study.They were randomly divided into two groups. 40 patients in the control group were given traditional trabeculectomy technique,and 40 patients in the treatment group were given composite trabeculectomy.The incidence of shallow anterior chamber,intraocular pressure,one year after the formation of a functional follicles were analyzed and compared in the two groups.Results The incidence rate of shallow anterior chamber in the treatment group (6.98%)was lower than the control group(23.81%).6 months, 12 months after operation,the IOP of the treatment group was lower than the control group,and less than 21mmHg. After 1 year,the formation rate of functional follicles of the treatment group (90.70%)was higher than the control group (71.43%),the difference between the two groups was significant(χ2 =5.16,P <0.05).Conclusion The treatment effect of composite trabeculectomy for glaucoma is significant.

Metabonomics Study on Blood of Rats with Xiaoqinglong Decoction Syndrome Based on GC-MS / 中国中医药信息杂志

Objective To determine the endogenous metabolites in blood of rats with Xiaoqinglong Decoction Syndrome by using GC-MS;To provide evidence for researches on the essence of Xiaoqinglong Decoction Syndrome. Methods Totally 36 male Wistar rats were randomly divided into blank control group (10 rats), model group (13 rats), and Xiaoqinglong Decoction group (13 rats). Model group and Xiaoqinglong Decoction group were used to make the models of exogenous cold and internal fluid syndrome (Xiaoqinglong Decoction Syndrome). Rats in Xiaoqinglong Decoction group received gavage with Xiaoqinglong Decoction, while rats in blank control group received nothing. Blood of rats in the three groups was taken from the abdominal aorta and detected by GC-MS 15 days later, and analyzed by multivariate statistical analysis with PLS-DA. Results 13 kinds of biomarkers were found:lactic acid, 3-hydroxy-butyric acid, glycine, serine, lysine, dextrose, arachidonic acid and other metabolites. Conclusion Expressions of biomarkers, such as lactic acid and glycine, are energy metabolism, immune function, and inflammation, which provide material basis for researches on the essence of Xiaoqinglong Decoction Syndrome.

Evaluation of internal clinical skills assessment in five-year clinical interns / 中华医学教育探索杂志

Objective To evaluate the assessment index system of internal medicine, and to analyze the factors of practical effects on internal medicine. Methods The assessment index system of clinical skills was developed by expert group based on the clinical syllabus and objectives. Internal medicine index system was divided into four items such as history-taking, physical examination, hos-pital records and case questions. 49 five-year clinical interns who took internal medicine exams were researched. Reliability, validity, discrimination, difficulty were used to analyze the quality of assess-ment index system. Gender, teaching hospital and the preparation of postgraduate examination were used to explore the influencing factors of practical effects with independent t-test and Wilcoxon signed rank tests. Results The reliability, discrimination, difficulty of the assessment index system were 0.50, 0.15 and 0.85, respectively. The removing item coefficient of history collection, physical ex-amination, hospital records, case questions were 0.38, 0.26, 0.47 and 0.53, separately, and the discrimination were 0.18, 0.17,0.27 and 0.37, separately, and the difficulty were 0.87, 0.89, 0.79, and 0.78, respectively. The scores of assessment index system of girls were higher than those of the boys(P0.05). The students who prepared the postgraduate examination scored lower than the others(P<0.05). Conclusions The assessment index system of internal medicine is reason-able and reliable, but the assessment of case questions still needs to be standardized. Teaching hospi-tals have little effect on internship while gender and the preparation for postgraduate examination influence practice effects in internal medicine.

A comprehensive evaluation of the health services in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To establish a comprehensive evaluation system for the development of health services, and to assess the levels of health services in 2008 and 2009 in Hunan compared with seven other provinces in central China, so as to provide a basis for hygiene management decisions.@*METHODS@#In order to establish a comprehensive evaluation system, a Delphi method, a boundary value method, and an RSR method were applied, respectively, to survey indices of health service development, to screen indices, and to determine index weights. A weighted TOPSIS method was used to evaluate the development status of health services of the eight provinces.@*RESULTS@#The Cronbach's alpha coefficient of the questionnaire was 0.884, indicating a proper surface validity and a content validity. The expert positive coefficient, authority coefficient and Kendall coefficient were 93.75%, 0.8117, and 0.31, respectively. A comprehensive evaluation system, which consisted of 3 primary indices, 10 secondary indices and 52 tertiary indices, was established. The result of the comprehensive evaluation showed that the health services development of Hunan Province ranked 7th and 6th among the 8 central provinces for 2008 and 2009, respectively.@*CONCLUSION@#The established, comprehensive evaluation system has a high reliability. Health services development of Hunan Province is relatively backward among the 8 central provinces.

Nutrition and food safety and influence factors for lower grade pupils in 2 counties in West China / 中南大学学报(医学版)

OBJECTIVE@#To explore the knowledge of, attitude to and practice in nutrition and food safety, the influence factors, and to provide reference for relevant health education programs.@*METHODS@#A total of 510 randomly selected students from Grade 1 to 3 randomly selected were surveyed by a nutrition and food safety questionnaire in Huize of Yunnan Province and Zhen'an of Shaanxi Province. Multiple-linear regression was used to analyze the influence factors of nutrition and food safety.@*RESULTS@#The correct answer rate on nutrition and food safety knowledge of the pupils from Grade 1 to 3 was 74.4%. Nutrition and food safety knowledge score was 11.16±2.51, but only 7.8% of the students correctly answered "How much water should we drink every day". Students who agreed that it is necessary to learn nutrition and food safety knowledge in school accounted for 78.6% and 73.9%, respectively. At least half of the students showed correct behaviors in 7 aspects. The students who ate beans and meat daily or regularly accounted for 28.4% and 34.9%, but only 9.2% of the students drank more than 7 cups of water daily. The multiple-linear regression showed that the major influence factors were the area, grade, status of lodge and singleton.@*CONCLUSION@#Education is needed for students to form better dietary habits, especially those in low grades, non-singleton, and in board schools.

Development of health service in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To study the health service development in Hunan Province, and to find out the advantages and disadvantages, and to make tentative specific suggestions.@*METHODS@#Comparison was made in Yunnan, Hunan, and Zhejiang Provinces in 4 major areas: health institutions, personnels, facilities, and funding.@*RESULTS@#The overall health service of Hunan Province was good: The health resources increased, the allocations were reasonable, and the health expenditure decreased. Some problems appeared, such as backward primary health, shortage of medical talents, inefficient use of hospital beds, deducted government investment, increased business income, and large urban-rural gap.@*CONCLUSION@#There is urgent need to further develop health institutions and increase personnels, particularly improving the primary health care and making use of traditional Chinese medicine; improving the management of hospital beds to increase efficiency, increasing financial support to reduce the patients' burden, and ensuring the need of rural health care.

Effects of pre-operation medical intervention on conversion of atrial fibrillation by valve replacement in patients with rheumatic heart disease and atrial fibrillation / 中国综合临床

Objective To evaluate the influence of preoperation medical treatment on recurrence of atrial fibrillation(AF) in valve replacement postoperative patients of rheumatic heart disease during in-hospital and other risk factors. Methods One-hundred and eight patients with rheumatic heart disease and AF that underwent valve replacement postoperative patients were randomly divided into 2 groups: the treatment group (n =54)and the control group (n = 54 ). The treatment group were treated with ranipril, felodipine and simvastatin for 1 month and other conventional preoperational treatments before operation . The control group were only treated conventional preoperational therapy. Occurrence of AF postoperation were observed during inhospital. Results The occurrence of atrial fibrillation of the two group was no difference( 35.85% vs 41.51%,P = 0.55) immediately after rebeat. There was significant difference in the occurrence of atrial fibrillation of the 2 groups within 24 h post-operation ( 47.17% vs 69.81%, P = 0.02 ) . Logistic regression showed that intervention before operation had significant effect on the occurrence of AF( OR =0.39,95% CI: 0.17 -0.86,P =0.018) ,as well as the diameter of left atrium (LAD) ( OR= 4.28,95% CI:1.12 - 18.23, P = 0.018 ),pulmonary artery pressure(PAP) ( OR = 3.28,95% CI: 1.14 - 12.25, P = 0.01 ), duration of atrial fibrillation (AFD) (OR = 4.19,95% CI: 1.15 -14.22,P = 0.011). ROC curve showed that the best cut-off of LAD was 46.5 mm to predict AF,with sensitivity of 73% and specify of 85% ;the best cut-off of PAP was 48.5 mm Hg,with sensitivity of 75.6% and specify of 80.3% ;the best cut-off of AFD was 7. 5 months,with sensitivity of 76.1% and specify of 88.3%. Conclusion The recurrence of AF can be effectively reduced during hospitalization by the preoperational triple treatments for patients with rheumatic heart disease successfully underwent valve replacement operation , which is also beneficial for maintenance of sinus rhythm after operation.

Ordinal regression analysis on influence factors of health literacy in middle-aged and elderly people in Hunan province / 中华老年医学杂志

Objective To explore the influence factors of health literacy in middle-aged and elderly people in Hunan province.Methods With multi-stage randomized cluster sampling, people aged 45 years and over were selected from both urban and rural areas of six geographical regions of Hunan province, using the China residents health literacy questionnaire developed by Chinese Health Education Center, by face to face survey to get data. The influence factors were analyzed retrospectively with univariate and ordinal regression analysis.Results The 1158 persons were investigated and the valid questionnaires were 1154, the effective recovery rate was 99.7%. Univariate analysis showed that there were significant differences in heath literacy among different degree of education, age, gender, marital status, income, region and occupation (all P＜0.05). The results of ordinal regression analysis Showed that the major influence factors were degree of education, income,age and occupation.Conclusions The people at low levels of education or income should be concerned about health education and health promotion strategies.