Medical prevention center for chronic diseases in the medical consortium of Wenling city / 中华医院管理杂志

" Medical prevention integration" is the practical need of the construction of healthy China and the focus of the construction of medical consortium in the future. Taking the practice of four chronic disease specific medical prevention centers of Wenling County medical consortium as an example, the authors analyzed their practices and experience in coordinating county advantageous resources, establishing organizational structure, and implementing chronic disease specific prevention and control based on informatization. The " medical prevention integration" system constructed by this mode optimized chronic disease service content, improved service capacity and service quality, and achieved in improving satisfaction. This mode could improve the effect and satisfaction of chronic disease management, improve the prevention and treatment efficiency of chronic diseases, and practice the whole cycle health management of chronic diseases.

Study on the mechanism of diabetic nephropathy in type 2 diabetes mellitus of blood glucose fluctuation and oxidative stress / 中国基层医药

Objective To study the mechanism of diabetic nephropathy(DN) in type 2 diabetes mellitus of blood glucose fluctuation and oxidative stress.Methods 90 patients with type 2 DN were selected,included 30 cases of the normal albuminuria (DM group),30 cases of microalbuminuria (NA group),30 cases of the mass albuminuria (MA group),and during the same period,30 healthy persons in our hospital for medical examination were selected as the control group(NC group).The blood glucose,blood lipid,blood glucose fluctuation and oxidative stress were compared among the 4 groups.Results The blood glucose(FBG),postprandial 2h blood glucose(2hPG),glycosylated hemoglobin(HbA1c) levels had statistically significantly differences among the 4 groups(F=23.088,24.356,43.553,all P0.05).The mean amplitude of glycemic excursions(MAGE),mean absolute value of blood glucose(MODD),superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the 4 groups had statistically significant differences(F=37.350,216.899,21.003,93.211,all P<0.05).Correlation analysis showed that in patients with type 2 DN,negative correlation was observed between SOD and MAGE and MODD(r=-0.430,-0.523,all P<0.05),MDA and MAGE,MODD was positively correlated(r=0.534,0.624,all P<0.05).Conclusion Blood glucose fluctuation is involved in the occurrence and development of DN,the mechanism may be correlated with oxidative stress.

Relationship between occupational stress,uncertain endurance and job burnout of pre-hospital emer-gency nurses / 中华行为医学与脑科学杂志

Objective To investigate the correlation between occupational stress,uncertain endur-ance and job burnout of pre-hospital emergency nurses. Methods A total of 380 pre-hospital emergency nurses were recruited by stratified cluster sampling method.The occupational burnout scale(MBI)including emotional exhaustion(EE),depersonalization(D)and diminished personal accomplishment(PA),the In-tolerance of Uncertainty Scale(IUS),the Nursing Stressor Scale(NSS)including stresses associated with nurse expectations(NSS1),with family(NSS2),with interpersonal relationship(NSS3),with nature of work (NSS4),with patient(NSS5)and with work load(NSS6)were applied for all subjects.Results The pre-hospital emergency nurses who had worked less than 3 years got the higher EE score(33.58 ± 4.34)and higher PA score(26.98±4.31)than those who had worked 3 to 10 year(22.33±4.05,16.14±4.28,P<0.05) or longer than 10 years(21.50±4.36,16.81±4.36,P<0.05).Nurses got higher EE score(33.82±4.28,22.96 ±4.39,21.04±4.62,P<0.05),and higher PA scores(27.02±4.21,16.04±4.31,16.01±4.30,P<0.05)than the nurse practitioner or above levels.People whose monthly income were below 0.3 million got higher PA scores than those whose monthly income were 0.3 million or more(26.75±4.24,16.47±4.27,17.11±4.34,P<0.05).People who got degrees of bachelor or above had PA scores which was more than people who got de-grees under bachelor(26.33±4.36,17.24±4.28,P<0.05).Regression analysis showed that the multiplication score between IUS and NSS1 had the interaction effect with EE and D scores(β=0.33,0.33,P<0.05); the multiplication score between IUS and NSS5 had the interaction effect with EE and D scores(β=0.31,0.30, P<0.05)and the multiplication score between IUS and NSS3 had the interaction effect with D scores(β=0.34,P<0.05).Conclusion The pre-hospital emergency nurses'job burnout varies according to their length of service,job title,educational level and salary,and is also influenced by the combination of occupational stress and uncertain endurance.

Analysis of clinical and pathological characteristics of five cases with intravenous leiomyoma / 中国综合临床

Objective To investigate the clinical and pathological characteristics, diagnosis and differential diagnosis of uterine intravenous leiomyoma (IVL) , so as to improve the detection of the disease.Methods Five cases of IVL were retrospected, who were treated and diagnosed by clinical gross examination,morphologic features and immunohistochemical staining in Tumor Hospital of Anyang from 2011 to 2015.Results Symptoms of IVL were usually nonspecific, most patients experienced hypermenorrhea, abdominal pain or distension, and pelvic mass.Typical pathological changes were intravenous visible grey weblike or worm-formed nodules, which could be pulled out.Microscopically, the tumors were composed of mild spindle-shaped cells with rare mitotic figure and closely related to blood vessels.The tumors were positive for smooth muscle derived marker, progesterone receptor, estrogen receptor, and negative for S-100, HMB45 and CD34.However CD34 can displayed vascular endothelial cells around the tumor.Conclusion Uterine IVL is a benign tumor with malignant biological behavior, which has different clinical pathological features of leiomyoma ordinary.Surgery is the main treatment method.A satisfactory therapeutic effect can be achieved by selecting the appropriate extent of surgery.Long term follow up of iVL patients after operation is important.

Relations of the doctor-patient with psychological security and stress in operation patients / 中国实用护理杂志

Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.

Clinicopathological characterization of 1,058 cases with primary esophageal benign tu-mor in China / 中国肿瘤临床

Objective:To analyze the clinicopathological characterization of primary esophageal benign tumor (EBT). Methods:A total of 1,058 EBTs were enrolled from 500,000 cases in an esophageal and cardiac tumor biological sample and clinical information data-base of Henan Key Laboratory for Esophageal Cancer Research (1973-2015) in the First Affiliated Hospital of Zhengzhou University. SPSS 21.0 software was applied for data analysis. Results:In this database, 1,058 cases with primary EBTs among the 249,246 esopha-geal tumor patients with detailed clinical and pathological information were identified with an incidence of 0.42%(1,058/249,246). A total of 544 patients were male with an average age of 50±11 years old, whereas 514 patients were female, with an average age of 52± 11 years old. Among the 10 types of EBTs, leiomyoma was the most common type (84.50%, 894/1,058), followed by papilloma (6.90%, 73/1058). Adenoma (0.38%, 4/1,058) was the rarest type. Leiomyoma, gastrointestinal stromal tumor, and neurofibroma mainly oc-curred in male patients. By contrast, lipoma, granulosa cell tumor, schwannoma, and hemangioma mainly occurred in female patients.All five cases of hamartoma occurred only in female patients. Given the incidence of≥50%as the common standard, the common EBT in sequence in young male patients was leiomyoma and gastrointestinal stromal tumor, whereas that in young female patients was granulosa cell tumor and lipoma. The common EBT in sequence in older male patients was papilloma, gastrointestinal stromal tumor, and leiomyoma, whereas that in older female patients was schwannoma, papilloma, leiomyoma, gastrointestinal stromal tumor, and hamartoma. Additionally, lipoma, hemangioma, neurofibroma, and adenoma in male patients and neurofibroma in female patients oc-curred in older patients. The different ages of patients with EBTs (P=0.034) and leiomyoma (P=0.004) had a statistical significance. In these EBTs, leiomyoma, papilloma, gastrointestinal stromal tumor, and schwannoma mainly occurred in the middle esophagus, where-as lipoma mainly occurred in the lower esophagus. The major treatment for EBT in the present study was surgery (57.54%, 492/855), which was followed by endoscopic resection (38.01%, 325/855) and others (4.45%, 38/855). Conclusion:The incidence of EBT is low, with a couple of different histological types. Gender, age, and predilection sites are different depending on the histological types of EBTs. Surgery and endoscopic resection are the major treatment methods.

Relationship between risk stratification of cardiovascular diseases and outcome of 64-slice helical computed tomography coronary angiography / 中华老年医学杂志

Objective To investigate the relationship between the risk stratification of cardiovascular diseases and the outcome of 64-slice helical computed tomography (MSCT) coronary angiography. Methods A total of 470 cases suspected to have coronary heart disease were enrolled.They all received 64-slice MSCT coronary angiography, and they were divided into groups according to the range of disease, degree of calcium scoring, degree of stenosis and characteristic of plaque. Among them, 80 patients underwent both MSCT and selective coronary angiography (CAG) at one time, and they were grouped according to the range of disease and degree of stenosis. All the 470 cases were classified as five levels according to the risk stratification of cardiovascular diseases. The lesions of coronary artery in different risk stratifications were observed, and the correlations were analyzed.Results In the 80 patients who underwent both MSCT and selective CAG, there were no significant differences in the range of coronary artery diseases(χ2=3.631, P=0.067) and coronary arterystenosis (χ2=1.639, P=0.200) between MSCT and CAG. Along with the increased level of the risk stratification, there were the more ranges of the coronary artery diseases (λvery high risk. multi-vessel disease=1.09,λhigh risk. double-vessel disease=0.91, λlow-risk. single-vessel disease=1.07)and the more degrees of coronary artery stenosis(λvery high risk. severe stenosis=0.96,λhigh risk. moderate stenosis=1.03,λlow-risk. mild stenosis=0.78). The degrees of calcium scoring in different risk stratifications of cardiovascular diseases showed significantly differences (F=256.20,123.76,62.50, 98. 24,52.36,P＜0.01). There was the highest percentage of soft plaque in very high risk patients.Higher percentages of fiber plaque, calcified plaque and mixed plaque were found in moderate risk and low risk patients(λvery high risk. soft plaque=1.01,λlow-risk. calcium plaques=1.17). Conclusions The 64-slice MSCT coronary angiography could provide a basis for assessing risk stratification of cardiovascular diseases. The complicated coronary artery disease, moderate-severe calcification, more severe stenosis, higher percentage of soft plaque are found in the very high risk patients. The lower level of the risk stratification is found in patients with the less range of the coronary artery disease and less severe degree of the coronary artery calcification and stenosis. The calcified plaque and mixed plaque are found in moderate risk and low risk patients.

A study on the expression of BCSG1, S100A4, VEGF in breast neoplasm / 中华普通外科杂志

Objective To study the expression of BCSG1 ,S100A4,VEGF in human breast cancer.Methods Immunohistochemistry technique SP method was used to examine breast fibroadenoma in 40 cases,breast invasive ductal carcinoma in 62 cases ( by armpit lymph node metastasis as 2 groups) and corresponding paratumor tissues in 48 cases. Results Among the 4 groups, there was significant difference ( P＜0.05 ) in the positive immunostaining rate of BCSG1 ,S100A4, VEGF. Conclusions In the breast invasive ductal carcinoma, the expression of BCSG1, S100A4 and VEGF increased. This suggested the invasive and metastasis ability of the neoplasm enhanced. The expression were in positive correlation with tumor pathology. Combined detection of BCSG1, S100A4, VEGF expression contributes to the early diagnosis and prognostic assessment of the carcinoma of the breast.

Advances in Methylotrophy / 微生物学通报

Methylotrophy is a kind of widespread microbe which can use carbon compound as their only carbon and energy sources.It has been reported that methylotrophy can directly use one carbon com-pound to transform into their own metabolic one carbon unit,then these one metabolic one carbon units can be used as energy and carbon skeleton by organisms,which is a main part in one carbon metabolism.Because this is a novel metabolic system,it can be used in the study of biological metabolism and evo-lution.Based on the previous study about Methylobacterium sp.MB200 in our lab,here we summarized the research improvements about methylotrophy from their taxonomy,metabolism,genomics and ap-plications.

Expression of nm23, MMP-2, TIMP-2 in breast neoplasm in Zhengzhou Center Hospital, China.

BACKGROUND: In recent years, the carcinoma of the breast threatens to women's health heavily. Invasion and metastasis is the main reason that results in the patients death. OBJECTIVE: A prospective study is made in the center hospital of zhengzhou, in order to approach the expression of nm23, MMP-2 (Matrix metallo-proteinase-2), TIMP-2 (it's tissue-inhibitor of the metalloproteinase-2) in the breast neoplasm and the relationship with invasion and metastasis. METHODOLOGY: This study applied the immunohistochemistry technique SP method RESULTS: In fibroadenoma, ductal carcinoma in situ and invasive ductal carcinoma of the breast 4 groups, the positive immunostaining rate of nm23, MMP-2 and TIMP-2 have significant difference among 4 groups (p < 0.05). In the breast invasive ductal carcinoma, the expression of nm23 and TIMP-2 decreased or the expression of MMP-2 increased CONCLUSION: This suggested that invasion and metastasis is ability of the neoplasm. MMP-2 in the breast ductal carcinoma in situ appears of high expression and this suggested that the positive expression of this onco-proteins was the early incident in the genetic course of the breast cancer The unite detection of nm23, MMP-2 and TIMP-2 expression would contribute to the early diagnosis and prognostic assessment of the carcinoma of the breast.

Expression of apoptosis regulatory protein survivin in pituitary adenomas / 中华内分泌代谢杂志

The expressions of survivin and bcl-2 protiens were examined in 8 specimens from normal pituitary tissues and 38 pituitary adenomas by immunohistochemistry. The results showed that the expression of survivin was strongly associated with bcl-2 expression and abnormal expression of survivin resulted in inhibition of cell apoptosis, which might play a role in the pathogenesis of pituitary adenomas.