Applying the Super-EBM model and spatial Durbin model to examining total-factor ecological efficiency from a multi-dimensional perspective: evidence from China.

Ecological efficiency mainly emphasizes the importance of balancing the relationships between natural resources, energy, the ecological environment and economic growth, which has aroused widespread concern worldwide. China's rapid economic development has inevitably been accompanied by serious resource exhaustion, environmental pollution and ecological deterioration in the past several decades, which has brought huge challenges to China's sustainable development. Therefore, establishing the evaluation framework of total-factor ecological efficiency (TFEE) and identifying its driving force have a great significance for improving China's sustainable development capabilities. First, an ecological efficiency evaluation framework is established based on the theory of total-factor analysis. Second, the super efficient hybrid distance model considers undesirable output and measures TFEE nationwide in 30 provinces and four regions during the period 2003-2017. Finally, the spatial effect of TFEE and its influencing factors are examined by using a spatial Durbin model. The empirical results show that (1) nationwide and regional TFEEs have different degrees of decline during the study period. There were significant differences among the 30 provinces and four regions. Beijing, Tianjin and Shanghai are efficient, while the other provinces have not been as effective. The TFEEs of the four regions are not effective with an ordering of eastern > northeast > central > western. (2) Moran's I index shows that the TFEE nationwide has a positive spatial autocorrelation with strong spatial agglomeration. However, the spatial distribution pattern of TFEE in China was unstable and labile. The Moran scatter plot indicates that China's provincial TFEE has not only spatial dependence characteristics but also differences in spatial correlation. (3) Most factors are bound up with TFEE to various degrees: technological progress (TP), industrial agglomeration (IG) and human capital (HC) play a positive role, while industrial structure (IS), the level of urbanization (CITY) and energy intensity (EI) play a negative role. Additionally, environmental regulation (GZ) shows a U-type relationship with TFEE. The level of economic development (GDP) and foreign direct investment (FDI) cannot have a significant impact on TFEE at this stage. (4) The spatial Durbin model results show that TFEE has a significant spatial spillover effect, and the improvement of the TFEE of a province will increase the TFEE of neighbouring provinces. The confirmed spatial spillover effects of technological progress (TP), industrial structure (IS), the level of urbanization (CITY), industrial agglomeration (IG) and human capital (HC) can significantly impact the TFEE of neighbouring provinces. Among them, technological progress (TP), the level of urbanization (CITY) and human capital (HC) can significantly improve the TFEE of neighbouring provinces, and the level of economic development (GDP) and foreign direct investment (FDI) can significantly inhibit the improvement of TFEE in neighbouring provinces.

Changes of fasting plasma glucose level before and after menopause: Research based on Kailuan health checkup cohort / 中华内分泌代谢杂志

Objective:To analyze the changes of fasting plasma glucose(FPG)level before and after menopause.Methods:Kailuan health checkup cohort was used to extract data of women aged≥18 years who participated in the first physical examination of Kailuan physical examination cohort and had menopausal age at the end of the seventh physical examination. A total of 3 749 women with 22 057 physical examination records were included in the analysis. Natural logarithmic transformation was applied to FPG, and a segmented linear mixed-effects model was used to analyze the changes in ln-transformed FPG before and after menopause. Additionally, an interaction analysis was performed to assess the multiplicative effect of baseline age and baseline body mass index(BMI)on ln-transformed FPG concerning pre- and post-menopausal periods.Results:The average age of the first physical examination for women in this study was (45.63±4.52)years, the median menopausal age was 51(50~53)years, and the median number of physical examinations was 6(5~7)times. The results of the piecewise linear mixed effect model showed that lnFPG increased from 1 year before menopause, with an average annual increase of 0.021 mmol/L, and continued to increase from menopause to 5 years after menopause, with an average annual increase of 0.007 mmol/L. LnFPG tended to be stable after 5 years of menopause. Baseline age could affect the changes of lnFPG before and after menopause, and there was a negative multiplicative interaction between baseline age ≥45 years and the time period from 6 years to 1 year before menopause( P=0.032). Women with baseline age ≥45 years had a higher average annual increase in lnFPG from 1 year before menopause to 5 years after menopause than women with baseline age <45 years( P<0.05). On lnFPG, there was a positive multiplicative interaction between baseline BMI and time segments around menopause. Compared to women with BMI <24.0 kg/m 2, obese women displayed more annual increase in lnFPG from 6 years to 1 year before menopause as well as from menopause to 5 years after menopause( P<0.05). Conclusions:Menopause has an adverse impact on FPG, with the most significant changes occurring within the period of one year before menopause and up to five years after menopause. Age and BMI significantly influence the changes in FPG before and after menopause.

Cloning, identification and functional analysis of the goat transcription factor c-fos / 生物工程学报

C-fos is a transcription factor that plays an important role in cell proliferation, differentiation and tumor formation. The aim of this study was to clone the goat c-fos gene, clarify its biological characteristics, and further reveal its regulatory role in the differentiation of goat subcutaneous adipocytes. We cloned the c-fos gene from subcutaneous adipose tissue of Jianzhou big-eared goats by reverse transcription-polymerase chain reaction (RT-PCR) and analyzed its biological characteristics. Using real-time quantitative PCR (qPCR), we detected the expression of c-fos gene in the heart, liver, spleen, lung, kidney, subcutaneous fat, longissimus dorsi and subcutaneous adipocytes of goat upon induced differentiation for 0 h to 120 h. The goat overexpression vector pEGFP-c-fos was constructed and transfected into the subcutaneous preadipocytes for induced differentiation. The morphological changes of lipid droplet accumulation were observed by oil red O staining and bodipy staining. Furthermore, qPCR was used to test the relative mRNA level of the c-fos overexpression on adipogenic differentiation marker genes. The results showed that the cloned goat c-fos gene was 1 477 bp in length, in which the coding sequence was 1 143 bp, encoding a protein of 380 amino acids. Protein structure analysis showed that goat FOS protein has a basic leucine zipper structure, and subcellular localization prediction suggested that it was mainly distributed in the nucleus. The relative expression level of c-fos was higher in the subcutaneous adipose tissue of goats (P < 0.05), and the expression level of c-fos was significantly increased upon induced differentiation of subcutaneous preadipocyte for 48 h (P < 0.01). Overexpression of c-fos significantly inhibited the lipid droplets formation in goat subcutaneous adipocytes, significantly decreased the relative expression levels of the AP2 and C/EBPβ lipogenic marker genes (P < 0.01). Moreover, AP2 and C/EBPβ promoter are predicted to have multiple binding sites. In conclusion, the results indicated that c-fos gene was a negative regulatory factor of subcutaneous adipocyte differentiation in goats, and it might regulate the expression of AP2 and C/EBPβ gene expression.

Incidence of unintended pregnancy within 2 years after delivery and its influencing factors in China / 中华妇产科杂志

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

Down-regulation of ubiquitin specific peptidase 18 suppresses the invasion and proliferation of gastric cancer cells / 肿瘤研究与临床

Objective To analyze the expression and role of ubiquitin specific peptidase 18 (USP18) in gastric cancer cells,and to investigate the relationship between the development of gastric cancer and USP18.Methods The levels of USP18 protein and mRNA expression in immortalized gastric mucosa epithelial GSE cell lines and gastric cancer cell lines (AGS,MKN45,MKN25,BGC823,BGC803,SGC7901) were detected by using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot,respectively.The role of USP18 in the invasion and proliferation of gastric cancer cells was analyzed by using CCK8 and Transwell assays.Results The mRNA level of USP18 was lower in GSE cell lines than that in gastric cancer cells (F =794.052,P ＜ 0.000 1).In six gastric cancer cell lines,mRNA level of USP18 was relatively high in BGC823 (17.62±0.55) and BGC803 (13.52±0.50) cell lines,and low in MKN28 (1.40±0.17) and MKN45 cell lines (4.23±0.26).As for the protein level,the expression of USP18 was lowest in GSE cell line.In six gastric cancer cell lines,the expression of USP18 was the highest in more aggressive SGC7901 and BGC803 cell lines and the lowest in AGS and MKN45 cells.Compared with the control group,interference of USP18 decreased the invasion and proliferation abilities of SGC7901 and BGC803 cell lines (P ＜ 0.01).Conclusion USP18 is highly expressed in more invasive gastric cancer cells,and the downregulation of USP18 can suppress the invasion and proliferation of gastric cancer cells.

Analysis of the effect of using integrated health education to nurse elderly patients with hypertension in institutions in poor areas / 中国实用护理杂志

Objective To analyze the effect of applying KTH [knowledge-attitude-belief practice model (KABP model), transtheoretical model of behavior (TTM) and health belief model (HBM)] integrated health education into nursing of elderly patients with hypertension in institutions in poor areas. Methods KTH integrated health education was established. Before the intervention and 12 weeks after intervention, the Questionnaire of Hypertension Knowledge, the Primary Hypertension Patients′Compliance Scale and Chinese version of the World Health Organization Quality of Life Questionnaire (WHOQOL-100) were used to investigate 84 cases of elderly patients with hypertension of four pension institutions in three poverty-stricken counties of Chaoyang city. Results After 12 weeks of intervention, the awareness rate of hypertension knowledge, compliance behavior and quality of life scores were higher than those before intervention, the complete awareness rate was 100.0% (84/84) vs. 3.5% (3/84);the high level of compliance behavior was 48.8%(41/48) vs.15.5%(13/84),the difference was significant (χ2=156.41, 86.27, P<0.01). The total score of quality of life was 86.95±5.41, higher than that before the intervention (76.93±6.60), the difference was statistically significant (t=8.662, P<0.01). Conclusions KTH integrated health education is an effective way to be applied in pension institutions of poor areas.

Biological characteristics of mesenchymal stem cells from psoriatic skinversus normal skin / 中国组织工程研究

BACKGROUND:Skin-derived mesenchymal stem cels may reflect the onset of psoriasis. OBJECTIVE:To analyze the biological characteristics of skin-derived mesenchymal stem cels in psoriasis patients. METHODS:Skin-derived mesenchymal stem cels from 30 patients with psoriasis and 20 healthy controls were isolated and cultured by trypsin. Flow cytometry was used to detect the celular immune phenotypes CD34, CD44, CD29, CD45, CD90, CD105, CD73 and HLA-DR. The mesenchymal stem cels were induced by the corresponding cartilage, osteogenic and osteogenic inducing agents, to identify the multi-directional differentiation ability. The cel proliferation curve was plotted at passage 3, and the levels of transforming growth factor-β1 and epidermal growth factor in culture supernatant were detected by ELISA assay. RESULTS AND CONCLUSION: Under an inverted phase contrast microscope, primary skin-derived mesenchymal stem cels isolated from patients with psoriasis and normal controls both exhibited heterogeneity. In the two groups, CD29, CD90, CD44, CD73 and CD105 were highly expressed, and CD45, CD34, and HLA-DR were lowly expressed. Under certain conditions, skin-derived mesenchymal stem cels were induced to differentiate into adipocytes, osteoblasts or chondrocytes. Proliferation of skin-derived mesenchymal stem cels in the psoriasis group was significantly faster than that in control group, but the final number of cels in the two groups tended to be consistent. The levels of transforming growth factor-β1 and epidermal growth factor in the psoriatic skinhad no correlation with the severity of the disease (P > 0.05). Compared with the control group, the epidermal growth factor level in the cel supernatant was significantly higher in the psoriasis group (P < 0.01), while the level of transforming growth factor-β1 was significantly lower (P < 0.01). These results showed that there is heterogeneity in the morphology of skin-derived mesenchymal stem cels from psoriasis patients, and the biological activity of mesenchymal stem cels is abnormal.

Relationship between the expression of chemokines and their receptors in the maternal-fetal ;interface and pathogenesis of unexplained recurrent spontaneous abortion / 中华妇产科杂志

Objective To explore the relationship between the expression of chemokines and their receptors in the maternal-fetal interface and the pathogenesis of unexplained recurrent spontaneous abortion (URSA). Methods 8-10 weeks CBA/J female mice were mated with DBA/2 and BALB/c male mice at the ratio of 2∶1 to establish the model of normal pregnant mice (CBA/J × BALB/c) and URSA mice (CBA/J × DBA/2). Sixty mice were divided into 6 groups, with ten in each group. The mice in the normal unpregnancy group were executed for endometrial tissues; the mice in the embryonic implantation normal pregnancy group were executed for endometrial tissues at the sixth day of gestation; the mice in the embryonic development normal pregnancy group were executed for decidua and chorionic tissues at the fourteenth day of gestation. While, the mice in the embryonic implantation URSA group were executed for endometrial tissues at the sixth day of gestation;the mice in the pre-abortion URSA group were executed for decidua and chorionic tissues at the ninth day of gestation;the mice in the post-abortion URSA group were executed for decidua and chorionic tissues at the fourteenth day of gestation. The chemokines and their receptors in different tissues of the mice were determined by western blot, including the protein expression of stromal cell derived factor (CXCL12), monocyte chemotactic protein 1 (CCL2), regulated upon activation normal T cell expressed and secreted(RANTES) and their receptor CXCR4, CCR2, CCR5 in maternal-fetal interface. Results (1) The protein expression of CXCL12 and CXCR4, CCL2 and CCR2, RANTES and CCR5 in endometrial tissues of the normal unpregnant group were 0.13±0.04 and 0.18±0.09, 0.057±0.023 and 0.39± 0.08, 0.034 ± 0.012 and 0.22 ± 0.05, respectively. They were 0.35 ± 0.09 and 0.93 ± 0.15, 0.349 ± 0.056 and 0.91 ± 0.15, 0.336 ± 0.089 and 0.44 ± 0.05 in endometrial tissues in the embryonic implantation normal pregnancy group;and were 0.62±0.15 and 1.23±0.28, 0.283±0.051 and 0.55±0.09, 0.225±0.065 and 0.35± 0.07 in decidua tissues in the embryonic development normal pregnancy group. The protein expression of chemokines and their receptors in endometrial tissues in the embryonic implantation normal pregnancy group and in decidua tissues in the embryonic development normal pregnancy group were higher than those in the normal unpregnancy group, with statistically significant difference(P<0.05). Compared with the embryonic implantation normal pregnancy group, CXCL12 and CXCR4 in decidual tissues in the embryonic development normal pregnancy group were significantly higher(P<0.05), while CCL2 and CCR2, RANTES and CCR5 were significantly lower (P<0.05). (2) Compared with the embryonic implantation normal pregnancy group, CXCL12 and CXCR4 (0.20±0.06 and 0.44±0.11) in endometrial tissues in the embryonic implantation URSA group were significantly lower (P<0.01), while CCL2 and CCR2(0.451±0.133 and 1.32± 0.20), RANTES and CCR5(0.488 ± 0.137 and 0.61 ± 0.18)were higher (P<0.05). (3) Compared with the embryonic development normal pregnancy group, CXCL12 and CXCR4 in decidual tissues of pre-abortion URSA group(0.27 ± 0.09 and 0.26 ± 0.10) , post-abortion URSA group (0.25 ± 0.08 and 0.23 ± 0.08) were significantly lower (P<0.01), while CCL2 and CCR2 (0.576±0.123 and 0.92±0.15 in the pre-abortion URSA group;0.748±0.112 and 1.56±0.34 in the post-abortion URSA group), RANTES and CCR5(0.294±0.054 and 0.59 ± 0.18 in the pre-abortion URSA group;0.363 ± 0.058 and 0.78 ± 0.14 in the post-abortion URSA group) were significantly higher(P<0.05). CCL2 and CCR2, RANTES and CCR5 in decidual tissues in the post-abortion URSA group was obviously higher than those of the pre-abortion URSA group, with statistically significant difference (P<0.05). Couclusions The accurate expression of CXCL12, CCL2, RANTES and their receptors CXCR4, CCR2, CCR5 play important roles in the embryonic implantation and development. The lower expression of CXCL12 and CXCR4 protein and higher expression of CCL2 and CCR2, RANTES and CCR5 in decidua and chorionic tissues are closely related to the pathogenesis of URSA.

The current situation of occupational protection against skin/mucosa contamination among obstetrician and gynecologist / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the occurrence and protection of skin/mucosa contamination among obstetrician and gynecologist.</p><p><b>METHODS</b>By random, stratified, and clustered sampling, 219 obstetrician and gynecologist were selected. 210 valid questionnaires were collected, efficiency is 95.89%. 110 obstetrician and gynecologist come from tertiary hospitals, 100 come from secondary hospitals. A self-administered questionnaire on skin/mucosa contamination was employed to gauge the implementation of protection, types and working links of skin/mucosa contamination.</p><p><b>RESULTS</b>Of the respondents, only 14.76% (31/210) and 5.24% (11/210) adhered to proper hand washing and wearing protective glasses within nearly 1 year in practical work. Of the respondents, 73.81% (155/210) had experienced the skin/mucosa contamination during their vocation, 50.95% (107/210) occurred sharps injuries, 45.71% (96/210) occurred damaged skin contamination, and 43.33% (91/210) occurred mucosa contamination. Sharps injuries mainly occurred when abdominal operation (45.71%, 96/120), damaged skin contamination mainly occurred when gynecological examination (21.43%, 45/210), and mucosa contamination mainly occurred when midwifery (37.14%, 78/210).</p><p><b>CONCLUSION</b>The implementation of protective measures is inadequate and incidence of skin/mucosa contamination is higher among obstetrician and gynecologist. Therefore, occupational protection education should focus on different types and working links of skin/mucosa contamination. At the same time, strict supervision and management system should be established.</p>

Knowledge, attitudes and practices of combined oral contraceptives in Tianjin obstetrics and gynecology personnels / 天津医药

Objective To understand the knowledge, attitude, practice (KAP) status and relative demand to combined oral contraceptives (COCs) in medical staffs of obstetric and gynecological department in Tianjin, providing reference basis for the effective intervention measures. Methods By using random, stratified and clustered sampling approach, we selected 382 medical staffs of obstetric and gynecological department in Tianjin. A self-administered Questionnaire on COCs KAP was employed to survey the general characteristics, awareness of COCs knowledge, attitudes to COCs, service capabilities of contraceptive counseling, prescribing behavior and request of continuing education. Results The respondents showed de?fects in COCs indications, non-contraceptive benefits, relationship with cancer and birth defects. The average knowledge score was higher in doctors than that of nurses. The higher the titles and qualifications, the higher the knowledge score. A to?tal of 90.11%of respondents believed that strengthening the contraceptive guidance can help to reduce pregnancy. Strength?ening the interpretation of misunderstanding (81.04%) and enhancing the treatment and follow-up of adverse reactions (62.09%) can help to reduce stop taking. Only 25.82%of respondents could provide detailed COCs relative consulting servic?es;42.96%of obstetricians and gynecologists refused prescribing COCs for women over the age of 40 for the purpose of con?traception. A total of 93.13%medical personnel showed demand on relative training. Conclusion It’s necessary to perform continuing education to medical staffs via different intervention, so as to improve their cognitive level to COCs, ameliorate COCs relative attitudes and behavior, and help them providing better service to women of childbearing age.

Knowledge, attitudes and practices of preconception and prenatal care in Tianjin obstetrics and gynecology personnels / 天津医药

Objective To better understand the knowledge, attitudes, practice (KAP) and relative demand of precon?ception and prenatal care (PAPC) in medical staffs of obstetrics and gynecology department in Tianjin. Methods Using ran?dom, stratified and clustered sampling approach, we selected 382 obstetrics and gynecology personnels in Tianjin. A self-ad?ministered questionnaire on PAPC KAP was employed to survey their general characteristics, their awareness of PAPC knowledge, their attitudes to PAPC, their service capabilities of PAPC and their request of continuing education. Results The respondents were lacking of KAP in Calcium and Iron supplementation, alternative preconception examination and emerging prenatal examination but present good KAP in folic acid supplemen, necessary prenatal items and classic prenatal examination. Doctors′average knowledge score was higher than nurses′. The scores in primary health care institutions was significantly higher than that in tertiary and secondary medical institutions. Young and junior medical respondents showed higher awareness than older and senior ones. Most (91.21%) respondents believe that PAPC is necessary. But 86.54%of re?spondents are not confident enough to provide comprehensive PAPC services. There were 63.74%, 54.67%, 38.74% and 32.42%of the respondents who could provide special PAPC advisory of adverse pregnancy history, thyroid dysfunction, re?productive infections and diabetes respectively. The most urgent training contents include PAPC knowledge in presence of complications or risk factors, advances in prenatal diagnosis, nutrition during pregnancy and consulting skills. Conclusion It′s necessary to intervent obstetrics and gynecology personnels to improve their cognitive level to PAPC, as well as to amelio?rate relative attitudes and behavior so they can provide more scientific and comprehensive PAPC service.

Xiyanping aerosol inhalation for pulmonary infection in patients with acute stroke / 国际中医中药杂志

Objective To investigate the therapeutic effectiveness of Xiyanping aerosol inhalation for pulmonary infection in patients with acute stroke. Methods Sixty-three patients with pulmonary infection after acute stroke were enrolled and randomly allocated to either a treatment group or a control group. The control group was treated with anti-infective and apophlegmatisant on the basis of standardized stroke treatment, the treatment group was treated with Xiyanping aerosol inhalation on the basis of the treatment in the control group. All patients were treated for 14 days. The resolution times of symptom and signs, and the changes of inflammatory parameters were compared. Results The total effective rate in the treatment group was significantly higher than that in the control group (93.75%vs. 74.19%;χ2=4.510, P=0.034). The resolution times of symptom and signs, such as cough and excessive phlegm (5.94 ± 1.25 d vs. 6.73 ± 1.48 d;t=2.292, P=0.025),fever (2.72 ± 0.11 d vs. 3.25 ± 0.18 d;t=12.046, P<0.01), pulmonary rale (5.22 ± 1.15 d vs. 7.21 ± 1.21 d;t=6.693, P<0.01), and dyspnea (1.17 ± 0.49 d vs. 2.82 ± 0.61 d;t=11.855, P<0.01) in the treatment group were significantly shorter than those in the control group. White blood cell count (2.55 ± 1.02 ×109/L vs. 3.91 ± 1.25 ×109/L;t=4.738, P<0.01), granulocyte proportion (4.92% ± 1.32% vs. 6.25% ± 1.16%; t=4.738, P<0.01) and lymphocyte proportion (58.62%± 6.15%vs. 65.94%± 6.17%;t=4.716, P<0.01) in the treatment group were significantly lower than those in the control group. Conclusions Xiyanping aerosol inhalation can shorten the resolution times of symptom and signs, and improve the therapeutic effectiveness in patients with pulmonary infection after acute stroke.

Knowledge, attitudes and practices of post abortion family planning services in Tianjin obstetrics and gynecology personnels / 天津医药

Objective To better understand the knowledge, attitudes, practice (KAP) status and relative demand to post abortion family planning service (PAFPS) in medical staffs of obstetrics and gynecology department in Tianjin. Meth?ods By using random, stratified and clustered sampling approach, 290 obstetrics and gynecology personnels in Tianjin were selected. A Self-Administered Questionnaire on PAFPS KAP was employed to survey the general characteristics, aware?ness of PAFPS knowledge, attitudes to PAFPS and the occurrence of unintended pregnancy themselves, and service capabili?ties of PAFPS and request of continuing education. Results The respondents showed defects in PAFPS forms, follow-up ar?rangements and contraceptive method after abortion. The average knowledge score was higher in tertiary medical institution than that of secondary medical institutions. The score was higher in clinical doctors than that of nurses, and the higher the ti?tle, the higher the score. The 95.34%of respondents believed that it was necessary to develop PAFPS widely. But 93.55%of respondents thought that it can be difficult to carry out PAFPS as being required because of unclear service process, shortage of funds, human resource constraints, inadequate facilities and weak sense of services. The 53.36%of respondents, who had sexual life history, occurred unintended pregnancy themselves. The current defects of PAFPS were no standardized service processes, missing of medium-term and long-term follow-up, missing of collective consulting, providing contraceptives not timely and hadn′t pay attention to contraceptive advice. There were 90.68%medical personnels showed demand on relative training. Conclusion It′s necessary to perform continuing education about PAFPS to obstetrics and gynecology personnels via different intervention. At the same time, we should increase investment and make the service processes perfectly, so as to improve the level of PAFPS in obstetrics and gynecology medical staffs.

Knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin, China.</p><p><b>METHODS</b>By random, stratified, and clustered sampling, 507 reproductive health-related medical workers in Tianjin were selected. A Self-Administered KAP Questionnaire on blood-borne occupational exposure was employed to gauge the general characteristics, awareness of knowledge, attitudes to occupational exposure, implementation of pre-exposure protection, incidence of occupational exposure, and demands for continuing education.</p><p><b>RESULTS</b>Among all respondents, 63.15% (305/483) were aware of the reporting procedures and related departments after the incidence of occupational exposure. The awareness rate of classification of HIV occupational exposure was 48.45% (234/483). About preventive medication time after HIV and hepatitis B virus exposure, the awareness rates were 37.89% (183/483) and 31.47% (152/483), respectively. The average score of occupational exposure knowledge among respondents was 74.45±14.00. The multivariate analysis indicated that medical staff of obstetrics and gynecology, females, doctors and high-level medical institutions showed significantly higher awareness than urology professionals, males, nurses, and medical staff of primary health care institutions, respectively (t = 12.140, t = 5.428, t = 2.582, F = 4.218, P<0.05). Of the respondents, 93.17% (450/483) and 94.41% (456/483) thought that washing hands properly and wearing protective glasses were effective methods for the prevention of occupational exposure, but only 15.94% (89/483) and 3.93% (19/483) adhered to proper hand washing and wearing protective glasses within nearly one year in practical work. Of the respondents, 60.46% (292/483) had experienced the occupational exposure during their vocation, and 95.65% (462/483) needed respective trainings.</p><p><b>CONCLUSION</b>The awareness of occupational exposure among reproductive health-related medical staff is lacking, especially in preventative medication and reporting procedures after the incidence of occupational exposure. The implementation of protective measures is inadequate and incidence of occupational exposure is higher. Therefore, continuing education is necessary to improve the knowledge and attitudes towards occupational exposure in medical staff. At the same time, strict and effective supervision and management system should be established.</p>

Prediction and intensive care of malignant middle cerebral artery infarction / 国际脑血管病杂志

Mortality of patients with malignant middle cerebral artery infarction (mMCAI) is as high as 41％ to 78％ with the conservative treatment in the intensive care unit.Malignant edema caused tentorial herniation is the most common cause of resulting in the death of patients.Some evidence supports the hemicraniectomy for the treatment of patients with mMCAI.The patients must receive supportive and adjuvant therapies before surgical decision making.Therefore,the prediction and intensive care of mMCAI have a very important significance.This article reviews the predictive factors and intensive care of mMCAI.

Clinical Features and Influential Factors of Therapeutic Efficacy of Reflux Esophagitis in Elderly Patients with Type 2 Diabetes Mellitus / 胃肠病学

Background:The prevalence rate of diabetes mellitus ( DM ) associated with gastroesophageal reflux disease ( GERD)is increasing recently,and the relationship between DM and GERD has become a research hotspot. Aims:To study clinical features and influential factors of therapeutic efficacy of reflux esophagitis( RE)in elderly patients with type 2 DM(T2DM). Methods:Two hundred elderly patients with RE diagnosed by gastroscopy from March 2011 to October 2013 were enrolled,and divided into T2DM associated with RE( T2DM)group and RE group. The clinical features, endoscopic findings and therapeutic efficacy of the two groups were analyzed,and the influences of DM course and control of blood glucose on efficacy of RE were also analyzed. Results:The main manifestations of RE were extraesophageal symptoms,typical esophageal symptoms were less common. The overall efficacy rate decreased with the increase of endoscopic grade of RE,however,extraesophageal symptoms improved significantly. With the prolonging of DM course,the endoscopic grade of RE was increased,and the control of blood glucose was worse. The overall therapeutic efficacy was significantly reduced with the prolonging of DM course in patients with well controlled blood glucose. Conclusions:Extraesophageal symptoms are common,endoscopic grade of RE is worse and blood glucose is difficult to control in elderly T2DM patients associated with RE. DM course and status of blood glucose control have influences on the therapeutic efficacy of RE.

Knowledge, Attitudes and Practices of Sexually Transmitted Diseases in Reproductive Health-Related Medical Professionals in Tianjin / 天津医药

Objective To understand the knowledge, attitudes, practices (KAP) and relative training demand of AIDS and other sexually transmitted diseases (STDs) in reproductive health-related medical professionals in Tianjin. Meth-ods By using random, stratified and clustered sampling approach, 507 reproductive health-related medical professionals were selected in Tianjin area. A self-administered KAP questionnaire on AIDS and other STDs was used to collect the data included in the general condition, understanding of AIDS and other STDs knowledge, attitudes to AIDS and syphilis patients, occupational exposure of medical staffs and request of continuing education. Results The score of STD knowledge was (75.59±12.15) in respondents coming from the secondary medical institutions, which was significantly higher than that of ter-tiary medical institutions (70.11±10.07) and primary health care institutions (67.62±12.20,F=15.817,P<0.001). Multiple-factor analysis showed that there was a higher cognitive level for STD in professionals working in the department of obstetrics and gynecology and women’s health care (β=-3.765,P=0.048). A total of 86.34%respondents worried about HIV or syphilis infection due to occupational exposure. Only 25.88% respondents expressed a willingness to provide medical services for AIDS and syphilis patients. About 60.46%medical staffs experienced occupational exposure. Only 13.04%respondents were familiar with emergency treatment and reporting procedures while occupational exposure occurring. The 94.62%medical per-sonnel showed demand on relative training. Conclusion It’s necessary to perform continuing education to medical staffs via different intervention, so as to improve their cognitive level and attitudes to AIDS and other STDs, and help them provid-ing better service to the patients and the public.

Application of Competency-based Education in Traditional Chinese Rehabilitation Therapy / 中国康复理论与实践

@#Objective To explore the effect of competency-based education on course of Traditional Chinese Rehabilitation Therapy.Methods 2 sophomore classes of rehabilitation technology were as the control group and the reform group. The control group was taught with traditional model, while the reform group were taught with the competency-based education. The achievement of these groups were compared. Results There was not significant difference in the theoretical test, but was in the skill test and questionnaire score between the groups (P<0.05). Conclusion The competency-based education can improve the performance of students studying Traditional Chinese Rehabilitation Therapy.

Cloning, molecular characterization and expression of acireductone dioxygenase (ARD) gene from Salvia miltiorrhiza / 中国中药杂志

<p><b>OBJECTIVE</b>To study the acireductone dioxygenase (designated as SmARD) gene of Salvia miltiorrhiza through bioinformatics and characterization of its tissue expression and response expression on stress in shoot.</p><p><b>METHOD</b>SmARD gene was obtained by sequencing cDNA library constructed by us. BLAST was used for alignment, ORF finder software was applied to find open reading frame, prosite was used to analyze the protein characterization. Semi-quantitative RT-PCR was used to detect the gene expression level.</p><p><b>RESULT</b>The full -length cDNA of SmRAD was 688 bp long with a 591 bp ORF (open reading frame) that putatively encoded a polypeptide of 196 amino acids; with a predicted molecular mass of 23.27 kDa. The deduced amino acid sequence of SmRAD of gene shared high homology with other known RADs. Semi-quantitative RT-PCR analysis indicated that SmRAD was constitutively expressed in roots, stems, flower and leaves of S. miltiorrhiza, with the high expression in roots. In addition, SmRAD expression level under different stress condition was also analyzed in root, including signaling components for plant defence responses, such as methyl jasmonate, salicylic acid and ABA, as well as drought, cold and salt abiotic stress. The expression of SmRAD was suppressed by water deficit treatment for 3 d, 150 mmol x L(-1) NaCl, 4 degrees C cold and 100 mmol x L(-1) ABA treatment for 1 d, but induced by 100 mmol x L(-1) MJ and 10 mmol x L(-1) ETH.</p><p><b>CONCLUSION</b>A novel SmARD gene was cloned from S. miltiorrhiza. This study will enable us to further understand the role of SmARD in the defense response under different abiotic stress and in synthesis of active cmpounds in S. miltiorrhiza at molecular level.</p>

Inhibitory effects and mechanism of ursolic acid on the proliferation of rat aortic smooth muscle cells / 中国药科大学学报

Aim: To observe the effect of ursolic acid(UA)on the proliferation of rat vascular smooth muscle cell(VSMC)induced by high-level glucose and explore its relationship with p38MAPK signal transduction pathway.Methods: The proliferation of VSMC induced by high-level glucose(25 mmol/L glucose)was adopted as model,the inhibition of UA on the proliferation of VSMC was measured by MTT assay,and the expression lev-els of phospho-p38MAPK was detected by cell-based ELISA as well as the expression of c-fos protein was exam-ined by SABC method.Results: UA(20 μmol/L and 40 μmoL/L)inhibited glucose-induced proliferation of VSMC(P <0.05).Compared with the group subjected to glucose induction,UA decreased the expression levels of phosphorylated p38MAPK(P < 0.05),and also inhibited c-fos expression.Conclusion: UA suppressed glucose induced proliferation of VSMC,which might be related to the suppression of the activation of p38MAPK signal transduction pathway,and thereby down-regulated c-fos expression.