A survey on satisfaction of supply and demand sides of community health services in Shanghai / 上海预防医学

ObjectiveTo investigate the satisfaction of both service providers and users in community health service centers through questionnaires， and to analyze the reasons， so as to put forward suggestions for improving satisfaction. MethodsSampling was conducted in 247 community health service centers in 16 districts of Shanghai， and data were collected from employees and patients through on-site questionnaires. ResultsA total of 10 334 eligible questionnaires were collected from community health service centers， of which 7 712 were from patients and 2 622 were from employees. In 2021， the public's satisfaction with community health service centers was 96.51 points， and the satisfaction of employees was 94.08 points. The public expressed lower satisfaction with the availability of essential drugs for outpatient services， while the staff were less satisfied with their salary and benefits， work recognition， and career development. Regarding family doctor services， 73.38% of the public had signed up for family doctor services， while 23.57% of the public did not know about the family doctor services， and 16.18% believed it was necessary to improve the publicity of basic public health services. ConclusionThe public's overall satisfaction with the service of community health services is gradually increased. The basic medical services of community health are recognized by residents. Drug allocation needs to be improved urgently， and publicity and promotion need to be further strengthened. The overall satisfaction of employees is high， but further improvement is needed in terms of salary and benefits， work recognition， and career development.

The Nucleus Accumbens CRH-CRHR1 System Mediates Early-Life Stress-Induced Sleep Disturbance and Dendritic Atrophy in the Adult Mouse / 神经科学通报·英文版

Adverse experiences in early life have long-lasting negative impacts on behavior and the brain in adulthood, one of which is sleep disturbance. As the corticotropin-releasing hormone (CRH)-corticotropin-releasing hormone receptor 1 (CRHR1) system and nucleus accumbens (NAc) play important roles in both stress responses and sleep-wake regulation, in this study we investigated whether the NAc CRH-CRHR1 system mediates early-life stress-induced abnormalities in sleep-wake behavior in adult mice. Using the limited nesting and bedding material paradigm from postnatal days 2 to 9, we found that early-life stress disrupted sleep-wake behaviors during adulthood, including increased wakefulness and decreased non-rapid eye movement (NREM) sleep time during the dark period and increased rapid eye movement (REM) sleep time during the light period. The stress-induced sleep disturbances were accompanied by dendritic atrophy in the NAc and both were largely reversed by daily systemic administration of the CRHR1 antagonist antalarmin during stress exposure. Importantly, Crh overexpression in the NAc reproduced the effects of early-life stress on sleep-wake behavior and NAc morphology, whereas NAc Crhr1 knockdown reversed these effects (including increased wakefulness and reduced NREM sleep in the dark period and NAc dendritic atrophy). Together, our findings demonstrate the negative influence of early-life stress on sleep architecture and the structural plasticity of the NAc, and highlight the critical role of the NAc CRH-CRHR1 system in modulating these negative outcomes evoked by early-life stress.

Monitoring of viral myocarditis injury using an energy-confined upconversion nanoparticle and nature-inspired biochip combined CRISPR/Cas12a-powered biosensor.

The early diagnosis and timely intervention of viral myocarditis urgently require a noninvasive detection approach. Therefore, we present a CRISPR/Cas12a-powered biosensor that integrates an exceptionally efficient upconversion luminescent resonance energy transfer (LRET) with a nature-inspired biochip to determine a golden-standard cardiac biomarker (cardiac troponin I). First, a unique sandwich-structured energy-confined upconversion nanoparticle (acting as the energy donor) is synthesized to dramatically reinforce the LRET's ability. Such a structural improvement endows a relatively high quenching efficiency (as much as 93.8%) toward the surface acceptors and enhances the working adaption in complicated biological media. Moreover, a three-dimensional photonic crystal fabricated using a self-assembly of nanospheres is employed to construct a biochip interface, under which the upconversion luminescence is prominently boosted to approximately 27-fold to achieve signal amplification. Finally, the newly developed luminescence sensing method exhibits remarkable assay performance after introducing these attempts into a dual-aptamer-regulated CRISPR/Cas12a system to transduce the target. More importantly, this biosensor can primarily be a quite useful tracer tool to allow dynamic monitoring of the entire myocardial injury process in a coxsackievirus B3 infected mouse model, paving an attractive venue for medical diagnostic techniques.

Expression and prognostic significance of unique ULBPs in pancreatic cancer.

BACKGROUND: Pancreatic cancer is one of the most lethal cancers worldwide, due to the lack of efficient therapy and difficulty in early diagnosis. ULBPs have been shown to behave as important protectors with prognostic significance in various cancers. MATERIALS AND METHODS: Immunohistochemistry and enzyme-linked immunosorbent assays were used to explore the expression of ULBPs in cancer tissue and in serum, while survival analysis was used to evaluate the subsequent clinical value of ULBPs. RESULTS: Statistics showed that high expression of membrane ULBP1 was a good biomarker of overall survival (18 months vs 13 months), and a high level of soluble ULBP2 was deemed an independent poor indicator for both overall survival (P<0.001) and disease-free survival (P<0.001). CONCLUSION: ULBP1 provides additional information for early diagnosis, and soluble ULBP2 can be used as a novel tumor marker to evaluate the risk of pancreatic cancer patients.

Comprehensive evaluation of community health services in Shanghai / 中华医院管理杂志

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

[Analysis of 994(G--> T) mutation in the plasma platelet-activating factor acetylhydrolase gene in the patients with cerebral infarction].

OBJECTIVE: To investigate the relationship between plasma platelet-activating factor acetylhydrolase (PAF-AH) gene 994(G--> T) mutation in exon 9 and the patients with cerebral infarction in Chinese Hans. METHODS: The authors conducted a case-control study including 108 patients in three groups (atherosclerotic cerebral infarction group, lacunar infarction group and cerebral embolism group) and 215 normal subjects as controls. Genomic DNA was analyzed for the mutant allele by a specific polymerase chain reaction. RESULTS: The frequency of the mutant genotype in the 102 patients with cerebral infarction was 35.19%(32.41% heterozygotes and 2.78% homozygotes), and was 38.10%(34.92% heterozygotes and 3.18% homozygotes) in the atherosclerotic cerebral infarction group, being all significantly higher than the control group's 20.46% (18.60% heterozygotes and 1.86% homozygotes)(P< 0.01); however, the frequencies of the mutant genotype in the lacunar infarction group and cerebral embolism group were 32.35% (29.41% heterozygotes and 2.94% homozygotes) and 27.27% (27.27% heterozygotes and 0 homozygotes) respectively, being not statistically different from those of the controls (P> 0.05). CONCLUSION: These findings show that the 994(G--> T) mutation of plasma PAF-AH gene may be an independent risk for atherosclerotic cerebral infarction, but not for lacunar infarction.

Analysis of 994(G--> T) mutation in the plasma platelet-activating factor acetylhydrolase gene in the patients with cerebral infarction / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between plasma platelet-activating factor acetylhydrolase (PAF-AH) gene 994(G--> T) mutation in exon 9 and the patients with cerebral infarction in Chinese Hans.</p><p><b>METHODS</b>The authors conducted a case-control study including 108 patients in three groups (atherosclerotic cerebral infarction group, lacunar infarction group and cerebral embolism group) and 215 normal subjects as controls. Genomic DNA was analyzed for the mutant allele by a specific polymerase chain reaction.</p><p><b>RESULTS</b>The frequency of the mutant genotype in the 102 patients with cerebral infarction was 35.19%(32.41% heterozygotes and 2.78% homozygotes), and was 38.10%(34.92% heterozygotes and 3.18% homozygotes) in the atherosclerotic cerebral infarction group, being all significantly higher than the control group's 20.46% (18.60% heterozygotes and 1.86% homozygotes)(P< 0.01); however, the frequencies of the mutant genotype in the lacunar infarction group and cerebral embolism group were 32.35% (29.41% heterozygotes and 2.94% homozygotes) and 27.27% (27.27% heterozygotes and 0 homozygotes) respectively, being not statistically different from those of the controls (P> 0.05).</p><p><b>CONCLUSION</b>These findings show that the 994(G--> T) mutation of plasma PAF-AH gene may be an independent risk for atherosclerotic cerebral infarction, but not for lacunar infarction.</p>

Age-related increase of plasma platelet-activating factor concentrations in Chinese.

BACKGROUND: Platelet-activating factor (PAF) is a potent bioactive phospholipid, which may be one of the determinants of atherogenesis. The purpose of this study was to investigate the relationship between the concentrations of plasma platelet-activating factor and age in a common Chinese population. METHODS: Two-hundred seventy-nine Han nation subjects (male: n=162; female: n=117) who had visited two hospitals for overall health survey, as an annual medical check-up or for other reasons by clinical examinations were recruited and divided into six age groups (21-30, 31-40, 41-50, 51-60, 61-70, 71-80 years). PAF was extracted from their plasma and purified by thin-layer chromatography (TLC). The PAF concentrations were detected by radioimmunoassay. RESULTS: The PAF concentrations (pg/ml) in plasma showed significantly age-related increase (r=0.3348, P<0.01, n=279). In the 21-30-year group, the PAF concentration was 338+/-96 pg/ml. Except for the 31-40-year group, the PAF concentrations in other four groups were all higher than that of the 21-30-year group (P<0.05, P<0.01, P<0.001 and P<0.001, respectively). CONCLUSIONS: Considering PAF is one of the key factors relevant to progression of atherogenesis, and the high concentrations of plasma PAF may therefore serve as a marker for the risk of atherosclerosis. Adjustment of the concentrations of plasma PAF correlated with aging may be helpful to reducing the prevalence rate of multi-senile arteriosclerosis occlusive diseases.