Investigation on the current status of medication education in medical institutions in China / 中国药房

OBJECTIVE To investigate the development and current status of medication education in domestic medical institutions， aiming to provide reference and suggestions for better development of medication education. METHODS The online questionnaire survey was conducted in March 2023 to investigate the implementation of medication education in medical institutions at all levels nationwide； descriptive analysis and influencing factors analysis were conducted. RESULTS A total of 1 368 questionnaires were recycled， 1 304 of which were effective questionnaires， with the effective rate of 95.32%. The average rate of providing medication education was 73.62% in medical institutions nationwide， 76.05%， 67.68% and 73.76% respectively in Eastern， Central and Western regions， 87.11%， 60.57% and 46.32% respectively in tertiary， secondary and primary medical institutions. The commonest place and way of carrying out medication education were dispensing window and oral instructions， and both were more diverse in tertiary medical institutions， compared with second and primary medical institutions. The median annual service volume of medication education in medical institutions PUMCH-A- at all levels was 500 people； the higher the level of medical institutions， the larger the annual service volume of medication education （P＝0.023）. More than half of medical institutions didn’t have any form of compensation for medication education， which was mostly reflected in the workload of medical institutions with compensation. Grade of medical institutions， degree of information and automation were the major influencing factors of carrying out medication education. CONCLUSIONS The ratio of carrying out medication education is improved in the central region in China in recent years， compared with 2019； while that of primary institutions in all regions is at a low level and should be improved. The place of carrying out medication education should be set according to the characteristics of medical institutions， and medication education forms should be enriched as much as possible. The quantity and quality of medication education talents still need to be improved. Compensation for pharmaceutical care should be continually explored and implemented to prompt high-quality and sustainable development of medication education.

Investigation on the current status of medication education in medical institutions in China / 中国药房

OBJECTIVE To investigate the development and current status of medication education in domestic medical institutions， aiming to provide reference and suggestions for better development of medication education. METHODS The online questionnaire survey was conducted in March 2023 to investigate the implementation of medication education in medical institutions at all levels nationwide； descriptive analysis and influencing factors analysis were conducted. RESULTS A total of 1 368 questionnaires were recycled， 1 304 of which were effective questionnaires， with the effective rate of 95.32%. The average rate of providing medication education was 73.62% in medical institutions nationwide， 76.05%， 67.68% and 73.76% respectively in Eastern， Central and Western regions， 87.11%， 60.57% and 46.32% respectively in tertiary， secondary and primary medical institutions. The commonest place and way of carrying out medication education were dispensing window and oral instructions， and both were more diverse in tertiary medical institutions， compared with second and primary medical institutions. The median annual service volume of medication education in medical institutions PUMCH-A- at all levels was 500 people； the higher the level of medical institutions， the larger the annual service volume of medication education （P＝0.023）. More than half of medical institutions didn’t have any form of compensation for medication education， which was mostly reflected in the workload of medical institutions with compensation. Grade of medical institutions， degree of information and automation were the major influencing factors of carrying out medication education. CONCLUSIONS The ratio of carrying out medication education is improved in the central region in China in recent years， compared with 2019； while that of primary institutions in all regions is at a low level and should be improved. The place of carrying out medication education should be set according to the characteristics of medical institutions， and medication education forms should be enriched as much as possible. The quantity and quality of medication education talents still need to be improved. Compensation for pharmaceutical care should be continually explored and implemented to prompt high-quality and sustainable development of medication education.

Relationship between attentional bias, anxiety, depression and post traumatic stress disorder in primary and middle school students / 中国学校卫生

Objective@#To investigate the relationship between negative attentional bias and post traumatic stress disorder(PTSD) in the context of higher depression and anxiety symptoms after the outbreak of COVID 19, so as to provide scientific basis for mental health education in primary and secondary schools.@*Methods@#From March to April 2021, a total of 708 students from primary school and junior high school (grade 6 through grade 9) in Beijing,Shanxi,Hunan,Shandong,Hebei,Hubei of China were selected. The Children s Revised Impact of Event Scale(CRIES), the Attention to Positive and Negative Information Scale （APNI）and Depression, Anxiety and Stress Scale-21(DASS-21) were used in a questionnaire survey.@*Results@#A total of 242 students were diagnosed with PTSD, and the detection rate was 34.2%.The scores of intrusion and high arousal of boys（7.92±5.33,8.60± 5.41 ） were lower than those of girls（8.72±4.85,9.50±4.76），and the difference was statistically significant ( t =-2.04, -2.32, P < 0.05 ). There were statistically significant differences of negative attention bias,CRIES score, intrusion,debarb and high arousal among primary and middle school students of different grades ( F =3.57,5.99,4.45,4.60,7.40, P <0.05). Negative attention bias, anxiety, depression and post traumatic stress symptoms were significantly positively correlated ( r =0.27-0.84, P <0.05). Logistic regression analysis showed that anxiety ( OR =1.13, 95% CI =1.06-1.20) and negative attention bias ( OR =1.10, 95% CI =1.07- 1.12 ) were positively associated with PTSD symptoms in primary and middle school students( P <0.01).@*Conclusion@#Anxiety and depressive symptoms show impacts on negative attention bias and might exacerbate the symptoms of post traumatic stress disorder. Therefore, emotional adjustments can help reduce the post traumatic stress response in the post epidemic period.

Multicenter epidemiological characteristics of Mycoplasma pneumoniae infection in children in Hainan Province, 2012-2020 / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics (season, age, gender, mixed infection and clinical manifestations, etc.) of Mycoplasma pneumoniae (MP) infection in children in Hainan Province, so as to provide epidemiological evidence-based medical basis for the prevention and control of MP infection in children in Hainan Province. Methods　The serum IgM antibodies of MP, Legionella pneumophila, Chlamydia pneumoniae, adenovirus, respiratory syncytial virus (RSV), Q fever Rickettsia, parainfluenza virus, influenza A virus and influenza B virus in children with respiratory tract infections (RTIs) who were hospitalized in pediatrics of many hospitals in Hainan Province from March 2012 to February 2020 were detected by indirect immunofluorescence method. The positive serum MP-IgM antibody was defined as MP infection. The epidemiological and clinical data of MP infected cases were analyzed retrospectively. Results　From March, 2012 to February, 2020, a total of 35 731 qualified pediatric inpatients with RTIs in many hospitals in Hainan Province were tested for serum MP-IgM with the total positive rate of 39.12% (13 978/35 731). The yearly positive rates of MP-IgM from 2012 to 2020 were 48.39%, 56.23%, 56.62%, 47.04%, 29.71%, 24.14%, 47.55%, 36.84% and 24.46% respectively. The positive rates of MP-IgM in 2013 and 2014 were significantly higher than those in other years (P<0.05). The positive rate of MP-IgM in summer in Hainan Province was the highest (41.34%) and the lowest in winter (35.77%) (P<0.05). MP infection occurred in all age groups, the positive rate of MP-IgM in children of preschool (51.80%) was significantly higher than that in other age groups (P<0.01), and the positive rate of MP IgM in children of infancy (15.36%) was lower than that in other age groups (P<0.01). The positive rate of MP-IgM in female was 44.77%, which was significantly higher than that in male (35.83%) (P<0.05). MP infection combined with positive IgM of another pathogen accounted for 32.63% (4 561 cases), positive IgM of another two pathogens accounted for 1.26% (176 cases). MP infection was mostly found in pneumonia (68.73%), and the main clinical symptoms were cough (84.72%), fever (51.01%) and wheezing (3.16%). Conclusions　MP is an important pathogen of respiratory tract infection in children in Hainan Province, and infection is more common in children in early school age and early childhood. Mp-specific tests should be performed to identify the pathogen in children suspected of MP infection. In the high incidence season, health education should be strengthened in kindergartens, schools and other places to prevent respiratory tract infection.

Incorporation of the YRHQ motif into CD3ζ chain enhances the antitumor activity of HER2-targeted CAR-T cells / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨在靶向HER2的CAR的CD3ζ链胞内区引入YRHQ基序对CAR-T细胞的特异性杀伤活性及免疫记忆形成的影响。方法：通过DNA合成获得包含靶向HER2的编码抗原受体H28ζ或H28ζ(YRHQ)的DNA片段，通过慢病毒载体将不同CAR的DNA片段分别转导健康人外周血T细胞，制备靶向HER2的H28ζ-CAR-T及H28ζ(YRHQ)-CAR-T细胞。扩增过程中对不同CAR-T细胞进行计数，FCM检测CAR的表达率。将CAR-T细胞分别与HER2阳性的SKOV3、MDA-MB-453或HER2阴性的MCF-7细胞共培养，LDH释放法检测其杀伤活性，ELISA法检测IL-2、IFN-γ和颗粒酶B的水平，WB法检测STAT3磷酸化水平及免疫检查点分子TIM-3和PD-1的表达，通过FCM检测CCR7、CD45RO的表达，分析CAR-T细胞的表型。结果：H28ζ-CAR-T和H28ζ(YRHQ)-CAR-T细胞扩增能力较好，体外培养7 d时扩增4~5倍。H28ζ-CAR和H28ζ(YRHQ)-CAR表达率分别为（33.3±2.85）%和（28.30±3.2）%。H28ξ(YRHQ)-CAR-T细胞的杀伤活性较H28ζ-CAR-T细胞更高（P<0.05）。经HER2抗原刺激后，与T细胞或H28z-CAR-T细胞比较，H28ξ(YRHQ)-CAR-T细胞的STAT3磷酸化水平较H28ξ-CAR-T细胞明显升高（P<0.01）；而两者间PD-1和TIM-3的表达无明显差异。未经抗原刺激的CAR-T细胞CCR7和CD45RO表达与正常T细胞比较差异无统计学意义（均P>0.05），与SKOV3细胞共培养后，与T细胞或H28z-CAR-T细胞比较，H28ξ(YRHQ)-CAR-T细胞中TEM细胞比例明显增加、TCM细胞比例明显减少（均P<0.05）。结论：在CD3胞内区引入YRHQ基序可在一定程度上提高CAR-T细胞的杀伤潜力。

Risk factors for children s blood lead levels in one city of Jiangsu / 中国学校卫生

Objective@#To understand the level and risk factor of lead exposure among children in one city of Jiangsu.@*Methods@#In northern Jiangsu Province, 373 children from 2 primary schools were enrolled and were tested for blood lead and heavy metal exposure. Lead exposure was tested in household dust of 46 children. A multivariate Logistic regression was used for lead exposure risk analysis. Spatial distribution of lead contamination in household dust was conducted and compared with the location of industrial enterprises.@*Results@#The geometric mean of blood lead in 373 children was 25.80 mg/L,the blood lead of 3 children (0.8%) was more than 100 mg/L. Pencil biting ( OR=4.26, 95%CI=1.61-10.68, P <0.05) and lead contamination in surrounding environment ( OR=2.93, 95%CI=1.24-7.34, P =0.02) was positively related to high blood lead level in children. The geometric mean household dust lead concentrations in 46 children was 302.27 μg/mg, and household with high dust lead levels were mainly located around manufacturing enterprises.@*Conclusion@#Environmental factors correlate with blood lead level in children. Efficient strategies and public health policies are urgently needed to control and prevent environmental lead pollution. Families and schools should actively carry out health education to engourage children good hygiene habits, and effectively reduce lead exposure.

Depressive symptoms and associated factors of men who have sex with men (MSM) among young people/students in a city / 中国学校卫生

Objective@#To understand HIV status and depressive symptoms among men who have sex with men (MSM) in the HIV-infected young people/social network.@*Methods@#Intervention network of local CDC was used to recruit HIV-infected young people/students in the city. A mixed recruitment method of snowball sampling and respondent driven sampling method. A MSM young people/students with HIV infection. A total of 201 valid questionnaires were collected.@*Results@#Among them, 132(65.7%) were students, 121(60.2%) were HIV-positive, 108(53.7%) had depressive symptoms. The awareness rate was 92.0%(185). Binary-Logistic regression analysis showed that HIV infection(aOR=4.06,95%CI=2.13-7.72), living alone (aOR=2.93, 95%CI=1.31-6.52) and having sex before the age of 18 (aOR=4.13, 95%CI=1.32-12.96) were significantly associated with depression, moreover, HIV knowledge was a protective factor that help to resist depression in young MSM(aOR=0.30, 95%CI=0.13-0.69)(P<0.01).@*Conclusion@#Depressive symptoms are prevalent among HIV-infected MSM young people. It s cost-effective to promote a multiple biomedical package of increasing HIV/AIDS awareness, reducing HIV infection and transmission to protect young people/students from depression.

7. 0T ultrahigh-field MRI directly visualized the pedunculopontine nucleus in Parkinson's disease patients

OBJECTIVES: The pedunculopontine nucleus (PPN) is considered a promising new target for neurostimulation in Parkinson's disease (PD) patients with postural instability and gait disturbance that is refractory to other treatment modalities. However, the PPN is typically difficult to visualize with magnetic resonance imaging (MRI) at clinical field strengths, which greatly limits the PPN as a viable surgical target for deep brain stimulation (DBS). Thus, the aim of this study is to directly visualize the PPN based on 7.0T ultrahigh-field MRI. METHODS: Five PD patients were enrolled and scanned using the MP2RAGE sequence on a 7.0T ultrahigh-field MRI scanner. Then, the MP2RAGE sequences were imported into a commercially available navigation system. The coordinates of the directly localized PPN poles were recorded in the navigation system relative to the anterior commissure-posterior commissure plane. RESULTS: Our results indicated that the PPN presented intermediate signal intensity in the 7.0T ultrahigh-field MR images in comparison with the surrounding structure, such as the hypo-intensity of the periaqueductal gray and the hyperintensity of the neighboring white matter tracts, in PD patients. The mean coordinates for the rostral and caudal poles of PPN were 6.50 mm and 7.20 mm lateral, 1.58 mm and 2.21 mm posterior, and 8.89 mm and 13.83 mm relative to the posterior commissure. CONCLUSION: Our findings provide, for the first time, direct visualization of the PPN using the MP2RAGE sequence on a 7.0T ultrahigh-field MRI, which may improve the accuracy of stereotactic targeting of the PPN and improve the outcomes in patients undergoing DBS.

Recombination-activating gene 1 and 2 (RAG1 and RAG2) in flounder (Paralichthys olivaceus).

During the development of B and T lymphocytes, Ig and TCR variable region genes are assembled from germline V, D, and J gene segments by a site-specific recombination reaction known as V(D)J recombination. The process of somatic V(D)J recombination, mediated by the recombination-activating gene (RAG) products, is the most significant characteristic of adaptive immunity in jawed vertebrates. Flounder (Paralichthys olivaceus) RAG1 and RAG2 were isolated by Genome Walker and RT-PCR, and their expression patterns were analysed by RT-PCR and in situ hybridization on sections. RAG1 spans over 7.0 kb, containing 4 exons and 3 introns, and the full-length ORF is 3207 bp, encoding a peptide of 1068 amino acids. The first exon lies in the 5′-UTR, which is an alternative exon. RAG2 full-length ORF is 1062 bp, encodes a peptide of 533 amino acids, and lacks introns in the coding region. In 6-monthold flounders, the expression of RAG1 and RAG2 was essentially restricted to the pronephros (head kidney) and mesonephros (truck kidney). Additionally, both of them were mainly expressed in the thymus. These results revealed that the thymus and kidney most likely serve as the primary lymphoid tissues in the flounder.

P53 and vascular endothelial growth factor expressions are two important indices for prognosis in gastric carcinoma / Las expresiones del P53 y del factor de crecimiento del endotelio vascular constituyen dos índices importantes para la prognosis del carcinoma gástrico

AIM: This study examined the correlation between P53 and vascular endothelial growth factor (VEGF) expression together with tumour vascularity and investigated their clinical significance in the prognosis of gastric carcinoma. SUBJECTS AND METHODS: Ninety-five patients with gastric carcinoma who underwent curative surgical resection were studied using immunohistochemical staining. Correlation between the expression of p53, VEGF, microvessel count (MVC) and various clinicopathologic factors were studied. RESULTS: No significant correlation was found between p53 expression and clinicopathologic factors. The rate of VEGF positivity was significantly higher in patients with haematogenous metastasis than in those without haematogenous metastasis. Both p53 and VEGF expression were associated with MVC. The MVC in p53 positive tumours was significantly higher than that in p53 negative tumours. Similarly, the same trend was seen between VEGF expression and MVC. The p53 and VEGF were co-expressed in 61 of 95 tumours (64.2%), and a significant (p < 0.01) association between p53 and VEGF expressions was demonstrated. The rate of VEGF positivity was significantly (p < 0.01) higher in the patients with disease recurrence than in those without recurrence, whereas no significant correlation was found between disease recurrence and the expression of p53. CONCLUSIONS: The p53 expression may play an important role in controlling angiogenesis by regulating VEGF expression and VEGF expression is associated closely with disease recurrence. In addition, both p53 and VEGF expression might be useful in indicating the prognosis in patients with gastric carcinoma.

OBJETIVO: Este estudio examinó la correlación entre el P53 y la expresión del factor de crecimiento del endotelio vascular (VEGF) junto con las vascularidad del tumor, e investigó su importancia clínica en la prognosis del carcinoma gástrico. SUJETOS Y MÉTODOS: Noventa y nueve pacientes con carcinoma gástrico que fueron sometidos a resección quirúrgica curativa, fueron estudiados usando teñido inmunohistoquímico. Se estudió la correlación entre la expresión de p53, VEGF, el conteo de microvasos (MVC) y varios factores clínico-patológicos. RESULTADOS: No se halló una correlación significativa entre la expresión de p53 y los factores clínico-patológicos. La tasa de positividad de VEGF, fue significativamente más alta en pacientes con metástasis hematogénica que en pacientes sin metástasis hematogénica. Tanto la expresión de p53 como la de VEGF estuvieron asociadas con el conteo MVC. El MVC en tumores p53 positivos fue significativamente más alto que en tumores p53 negativos. De manera similar, la misma tendencia se observó entre la expresión de VEGF y MVC. El p53 y el VEGA fueron co-expresados en 61 de 95 tumores (64.2%), y se demostró una asociación significativa (p < 0.01) entre las expresiones de p53 y VEGA. La tasa de positividad VEGA fue significativamente más alta (p < 0.01) en los pacientes con recurrencia de la enfermedad que en aquellos sin recurrencia, en tanto que no se halló una correlación significativa entre la recurrencia de la enfermedad y la expresión de p53. CONCLUSIONES: La expresión p53 puede desempeñar un importante papel en el control de la angiogénesis mediante la regulación de la expresión de VEGF y la expresión de VEGF está estrechamente asociada con la recurrencia de la enfermedad. Además, tanto la expresión de p53 como la de VEGF podrían ser útiles para indicar la prognosis de pacientes con carcinoma gástrico.