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BACKGROUND: Hospital staff are vulnerable and at high risk of novel coronavirus disease (COVID-19) infection. The aim of this study was to monitor the psychological distress in hospital staff and examine the relationship between the psychological distress and possible causes during the COVID-19 epidemic. METHODS: An online survey was conducted from February 1 to February 14, 2020. Hospital staff from five national COVID-19 designated hospitals in Chongqing participated. Data collected included demographics and stress responses to COVID-19: 1) the impact of event scale to measure psychological stress reactions; 2) generalizedanxietydisorder 7 to measure anxiety symptoms; 3) Patient Health Questionnaire 9 to measure depression symptoms; 4) Yale-Brown Obsessive-Compulsive Scale to measure obsessive-compulsive symptoms (OCS); and 5) Patient Health Questionnaire 15 to measure somatization symptoms. Multiple logistic regression analysis was used to identify factors that were correlated with psychological distress. RESULTS: Hospital staff that participated in this study were identified as either doctors or nurses. A total of 456 respondents completed the questionnaires with a response rate of 91.2%. The mean age was 30.67 ± 7.48 years (range, 17 to 64 years). Of all respondents, 29.4% were men. Of the staff surveyed, 43.2% had stress reaction syndrome. The highest prevalence of psychological distress was OCS (37.5%), followed by somatization symptoms (33.3%), anxiety symptoms (31.6%), and depression symptoms (29.6%). Univariate analyses indicated that female subjects, middle aged subjects, subjects in the low income group, and subjects working in isolation wards were prone to experience psychological distress. Multiple logistic regression analysis showed "Reluctant to work or considered resignation" (odds ratio [OR], 5.192; 95%CI, 2.396-11.250; P < .001), "Afraid to go home because of fear of infecting family" (OR, 2.099; 95%CI, 1.299-3.391; P = .002) "Uncertainty about frequent modification of infection and control procedures" (OR, 1.583; 95%CI, 1.061-2.363; P = .025), and"Social support" (OR, 1.754; 95%CI, 1.041-2.956; P = .035) were correlated with psychological reactions. "Reluctant to work or considered resignation" and "Afraid to go home because of fear of infecting family" were associated with a higher risk of symptoms of Anxiety (OR, 3.622; 95% CI, 1.882-6.973; P < .001; OR, 1.803; 95% CI, 1.069-3.039; P = .027), OCS (OR, 5.241; 95% CI, 2.545-10.793; P < .001; OR, 1.999; 95% CI, 1.217-3.282; P = .006) and somatization (OR, 5.177; 95% CI, 2.595-10.329; P < .001; OR, 1.749; 95% CI, 1.051-2.91; P = .031). "Stigmatization and rejection in neighborhood because of hospital work", "Reluctant to work or considered resignation" and "Uncertainty about frequent modification of infection and control procedures" were associated with a higher risk of symptoms of Depression(OR, 2.297; 95% CI, 1.138-4.637; P = .020; OR, 3.134; 95% CI, 1.635-6.006; P = .001; OR, 1.645; 95% CI, 1.075-2.517; P = .022). CONCLUSIONS: Hospital staff showed different prevalence of psychological distress during the COVID-19 epidemic. Our study confirmed the severity of negative psychological distress on hospital staff and identified factors associated with negative psychological distress that can be used to provide valuable information for psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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Infecciones por Coronavirus/psicología , Coronavirus , Neumonía Viral/psicología , Distrés Psicológico , Adolescente , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/psicología , COVID-19 , China/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Prevalencia , SARS-CoV-2 , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Based on upper echelons, paradox, and social capital theory, this study extends the association of CEO vision articulation and feedback-seeking behavior with firm sustainability by identifying the mediating role of eco-innovation and top management team (TMT) boundary-spanning behavior as a moderator. By analyzing the data of mid-sized to large Chinese firms using hierarchical regression and bootstrapping-based moderated path analysis, we found that product and process eco-innovation mediates the link between CEO vision articulation and firm sustainability while CEO feedback-seeking behavior enhances firm's sustainability through product eco-innovation only. Finally, conditional indirect effects show the vital role of TMT boundary-spanning behavior in facilitating CEOs to improve the firm's long-term sustainability through eco-innovation.
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Objective:To construct a risk identification model based on dynamic Bayesian network(DBN),and to explore its application value in the operation management of orthopedic equipment in hospital.Methods:Risk factors in orthopedic equipment management were identified based on DBN model,and risk evaluation index set was established to provide early warning and prevention for possible risk factors.12 pieces of orthopedic medical equipment in clinical use in The Second Affiliated Hospital of Air Force Medical University from January 2020 to February 2022 were selected,the traditional orthopedic equipment quality operation management method(referred to as traditional mode)and the DBN-based risk identification mode(referred to as DBN mode)were adopted for equipment management respectively.The equipment operation effects,risk incidence rates and treatment efficiency of the two modes were compared.Results:The start-up operation efficiency and equipment quality qualification rate of the equipment in DBN mode were(93.54±4.05)%and(97.51±6.68)%,respectively,which were higher than those in the traditional mode;the troubleshooting time and the equipment component damage rate were(7.14±1.64)hours and(0.48±0.11)%,respectively,which were lower than those in the traditional mode,the difference was statistically significant(t=8.862,8.228,32.994,73.047,P<0.05).The function failure rate,parts damage rate,unqualified cleaning and disinfection rate and improper management rate of equipment in 479 equipment usage data,897 operations,300 equipment disinfection records and 500 equipment daily inspection records in the DBN mode were 0.21%(1/479),0.33%(3/897),1.33%(4/30)and 2.0%(10/500),respectively,which were lower than those in the traditional mode,the difference was statistically significant(x2=21.527,12.964,3.485,6.914,P<0.05).The effective rate of 500 cases of orthopedic medical equipment treatment of DBN mode was 97.8%(489/500),which was significantly higher than that of traditional mode,the difference was statistically significant(x2=12.617,P<0.05).Conclusion:The application of risk identification model based on DBN to the management of orthopedic medical equipment in hospital can strengthen the quality of orthopedic equipment management,improve the efficiency of equipment operation and treatment,and prevent and avoid equipment risks.
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Objective@#To compare the clinical effect of breast conserving surgery and modified radical mastectomy for early breast cancer.@*Methods@#The clinical data of 100 patients with early breast cancer who received surgical treatment and completed 5 years of follow-up were retrospectively analyzed.According to the operation mode, the patients were divided into the conservative group(47 cases) and radical group (53 cases). The patients underwent breast conserving surgery, surgical treatment of modified radical mastectomy respectively.The objective response rate, the effect of aesthetic breast appearance, postoperative 5 years survival rate, local recurrence rate, distant metastasis rate, survival quality were compared between the two groups.@*Results@#The objective remission rate of the conservative group and radical group was 82.98%, 86.79%, respectively, the difference was not statistically significant (χ2=0.284, P>0.05). The aesthetic good rate of the conservative group was 91.49%, which was higher than 0.00% of the radical group (χ2=85.609, P<0.01). The 5-year survival rate, local recurrence rate, distant metastasis rate of the conservative group were 95.74%, 6.38%, 4.26%, respectively, which of the radical group were 96.23%, 1.89%, 3.77%, respectively, the differences between the two groups were not statistically significant (χ2=0.015, 1.311, 0.015, all P>0.05). The scores of physical health, mental health, social function, quality of life score of material life of the conservative group were (79.37±8.19)points, (83.56±11.21)points, (81.48±10.95)points, (83.19±11.34)points, respectively, which were significantly higher than those of the radical group [(71.58±6.23)points, (71.87±8.65)points, (70.62±9.17)points, (71.76±8.79)points](t=5.388, 5.873, 5.396, 5.666, all P<0.05).@*Conclusion@#For patients with early breast cancer, the clinical effect of breast conserving surgery is similar with the modified radical mastectomy, it can effectively improve the breast appearance and the quality of life of patients.
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@#Objective To explore the effects of Valpar Component Work Sample on Parkinson's disease (PD). Methods From June, 2015 to June, 2017, 40 patients with PD were randomly divided into control group (n=20) and observation group (n=20). Both groups received routine treatment and occupational therapy, while the observation group accepted rehabilitation with Valpar Component Work Sample in addition, for eight weeks. They were assessed with Unified Parkinson's Disease Rating Score II and III (UPDRSII and UPDRSIII), Mini-Mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and the Parkinson's Disease Questionnaire-39 (PDQ-39) before and after treatment. Results The scores of UPDRSII, UPDRSIII, MMSE, HAMD, and HAMA, and Summary Index of PDQ-39 improved in both groups (t>2.864, P<0.05) after treatment, and improved more in the observation group than in the control group (t>2.237, P<0.05). Conclusion Combined with Valpar Component Work Sample may further improve the activities of daily living, motor, cognitive function, depression and anxiety, and then quality of life in patients with PD.
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Objective@#To develop a method that can continuously monitor duration of students outdoor activities for a long time, so as to provide data support for the relationship between outdoor activity duration and students health.@*Methods@#From April 28 to July 6, 2022, 1 168 students from a primary school in Shenzhen were selected. Fixed cameras were placed on the top of school classrooms, corridors and critical paths were used to identify student data and duration in the picture. And AI, cloud computing and other methods were used to measure students-non-classroom time instead of outdoor activity time in school.@*Results@#The average length of time spend on outdoor activities in school of the 24 pilot classes were 67.6-113.0 min, and showed a downward trend by grade ( F =42.74, P <0.05). The duration of outdoor activities among students was negatively correlated with the detection rate of myopia and overweight( r =-0.74, -0.45, P <0.05).@*Conclusion@#The data on outdoor activity time calculated by AI image recognition is basically in line with the reality. Monitoring students outdoor activity time at school through AI image recognition is feasible and popularized.
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Objective To study the alterations of renal function in patients with acute ischemic stroke and diabetes and to analyze the risk factors of contrast-induced nephropathy (CIN) after digital subtraction angiography (DSA).Methods Eight hundred and seventy-one cerebral infarction patients with diabetes who underwent DSA were selected in the Third Affiliated Hospital of Chongqing Medical University and Nanjing Brain Hospital Affiliated to Nanjing Medical University from August 2012 to August 2016.The patients were divided into diabetic group (n =178) and non-diabetic group (n =693).The alterations of renal function and the incidence rate of CIN were observed between two groups 3 days after DSA.Univariate analysis and multi-factor Logistic regression analysis were used to analyze the independent risk factors of CIN.Results The levels of estimated glomerular filtration rate (eGFR,ml · min-1 · 1.73 m-2) in diabetic group at 1,2 and 3 days after DSA(81.94 ±9.38,75.36 ±8.21,84.43 ±9.72) were lower than that in non-diabetic group (84.62 ± 10.06,79.08 ±9.84,87.62 ± 10.15,t =3.213,4.645,3.772,all P < 0.05).The levels of serum creatinine (Scr) and cystatin (CysC) in diabetic group at 1,2 and 3 days after DSA (Scr:85.63 ±9.83,92.37 ±10.07,83.43 ±9.07;CysC:1.08 ±0.12,1.35 ±0.14,0.95 ±0.10) were higher than that in non-diabetic group (Scr:81.36 ± 8.98,87.84 ± 9.85,80.31 ± 8.64,t =5.548,5.448,4.253;CysC:0.97 ±0.11,1.21 ±0.12,0.88 ±0.09;t =11.677,13.400,9.043;all P < 0.05).The incidence rate of CIN in diabetic group (25.84% (46/178)) was higher than that in nondiabetic group (7.07% (49/693),x2 =51.358,P =0.001).Multi-factor Logistic regression analysis showed allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,NIHSS score,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.Conclusions The renal function decreased significantly and the incidence rate of CIN was high in cerebral infarction patients with diabetes after DSA.Allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.
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OBJECTIVE:To improve the dispersion stability in water of Tussilago farfara powder,and to improve compliance of Xiao’er feike granules. METHODS:The effects of 4 kinds of dispersion stabilizer (sodium hexametaphosphate, dextrin, PEG4000 and lecithin) on dispersion stability of suspension in water were investigated during the grinding of T. farfara using rate of absorbance change(β)and Zeta potential as index;IR spectrum of samples were characterized. Using original formulation with-out dispersion stabilizer as control,the dispersion stability of new formulation granules in water were analyzed comparatively after adding dispersion stabilizer. RESULTS:Among 4 kinds of dispersion stabilizer,β of sample prepared by sodium hexametaphos-phate was the lowest,while Zeta potential of it was the highest;compared with original T. farfara,β of T. farfara grinded with 2.5% sodium hexametaphosphate decreased by 16.8%,and Zeta potential absolute value increased by 29.4%;no new peak was found in IR spectrum. Compared with control granules,granules suspension prepared by new formulation had lower β and higher Zeta potential absolute value (P<0.01);particle size was 30 μm and no large particle aggregation was found;β was less than 5.0% within 20 s sedimentation. CONCLUSIONS:During the preparation of Xiao’er feike granules,the application of sodium hexametaphosphate in the grinding of T. farfara powder can improve the dispersion stability of granules in water and the compliance of the preparation.
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Objective To explore the suicide ideation and related factors in elderly with depressive disorder.Methods A sample of 60 old patients meeting the criteria of ICD-10 for depressive disorder and 60 normal controls were assessed by the Self-rating Idea of Suicide Scale(SIOSS),Trait Coping Style Questionnaire (TCSQ),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS) and Pittsburgh Sleep Quality Index(PSQI).Results The score of despair factor,optimistic factor,sleep factor,conceal factor and total score of SIOSS in patients with depressive disorders (6.22±3.28,2.43± 1.47,1.87± 1.58,1.17± 1.1 1 and 10.51±4.91,respectively) were significantly higher than those of normal controls(t=5.83-14.03,P<0.01).The scores of SIOSS in patients were significantly positively related with the scores of SAS,SDS,PSQI and N C (r=0.311-0.792,all P<0.05),but negatively related with the scores of PC(r=-0.761,P<0.01).Moreover,regression analysis showed that the suicide ideation was increased in accordance with serious depression,anxiety,sleep quality,higher level of education and decreased ability to positive response in elderly with depressive disorder(R 2=0.853,F=62.768,P<0.01).Conclusion The suicide ideation in elderly with depressive disorder is more serious than that of normal people,and may be influenced by depression,anxiety,sleep quality and coping style.
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Objective To assess the safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.Methods We searched database including Wanfang,CNKI,VIP,Pubmed,EMBASE,EBSCO HOST and Metstr data for all the cohort studies on the use of thrombolysis for acute ischemic patients with asymptomatic intracranial aneurysm,and ascended the correlated references listed on the articles.Meta-analysis was conducted based on the methods recommended by the Cochrane collaboration.The outcomes of the meta-analysis were intracerebral hemorrhage (ICH),symptomatic intracerebral hemorrhage (sICH),subarachnoid hemorrhage (SAH).Results Four cohort studies included 707 patients,of whom 48 patients had asymptomatic cerebral aneurysms.The risk ratio prevalence of ICH among those patients did not differ statistically with those without aneurysms (RR =1.17,95% CI 0.69-1.99,P =0.56).No statistical differences were found in both odds ratio prevalence of sICH (OR =1.70,95% CI 0.44-6.59,P =0.45) and SAH (OR =1.13,95% CI 0.20-6.27,P =0.89) between the patients with asymptomatic cerebral aneurysms and those without.Conclusion Current evidence did not indicate that the risk of hemorrhage increased in acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.
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This study was aimed to explore the mechanism of Xin-Feng capsule (XFC) on pulmonary function of Sjogren's syndrome (SS) rat model based on the TGF-β1-ERK1 signal pathway. A total of 50 SD rats were ran-domly divided into the normal control (NC) group, model control (MC) group, hydroxychloroquine sulfate (HCQ) group, radix paeoniae alba (total glucosides of paeony capsules, TGP) group, and the XFC treatment group, with 10 rats in each group. Except the NC group, the complete Freund's adjuvant (CFA) and the same rat sub-mandibular gland antigen induced method were applied to each rat after metatarsus injection on two feet and CFA after sufficient emulsification of 0.2 mL submandibular gland protein mixed antigen induced SS. The water drink-ing quantity, body weight change, pulmonary function, ERK1, TGF-β1 protein expression and serum cell factor (IL-17, IL-4) changes were detected in each group. The results showed that compared with the NC group, the body quality and serum IL-4 of MC rats were obviously decreased, and the water drinking quantity, submandibu-lar gland / lung index, submandibular gland pathological score, ERK1, TGF-β1 integral and IL-17 were increased (P < 0.01 or P < 0.05), and the pulmonary function parameter was decreased (P < 0.01 or P < 0.05). Compared with the MC group, the body quality, pulmonary function parameters FEF50 and MMF of the XFC group were in-creased, the IL-4 expression was increased, the water drinking quantity, submandibular gland / lung index, sub-mandibular gland pathological score, serum IL-17 expression, ERK1 and TGF-β1 integral were decreased (P <0.01 or P < 0.05). Compared with the HCQ group, the body quality and IL-17 were significantly decreased in the XFC group (P < 0.01), FEF25, FEF75 and MMF were increased (P < 0.01 or P < 0.05). Compared with the TGP group, the lung index and IL-17 were decreased in the XFC group (P < 0.01 or P < 0.05). It was conclud-ed that the lung function of SS rats was declined, which is closely related to the activation of TGF-β1-ERK1 sig-nal pathway. Traditional Chinese medicine of XFC is able to downregulate the TGF-β1 expression and to restrain epithelium-mesenchymal cell transformation, in order to inhibit ERK1 phosphorylation activation and proliferation, decrease immune inflammation, in order to improve SS and lung function.
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Rheumatoid arthritis (RA), as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA.
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Objective To observe the changes of lung parameters,the ratios of B and T lymphocyte attenuator(BTLA) and serum cytokines in patients with knee osteoarthritis (KOA),and explore possible molecular mechanism of them.Methods Forty-seven cases of knee osteoarthritis from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from 2011 October to 2012 July were analyzed in this study.Pulmonary parameters were detected by spirometer; B and T lymphocyte attenuator(BTLA) was detected by flow cytometry ; Interleukin (IL)-1β,IL-10,matrix metalloproteinase-9 (MMP-9),tissue inhibitor of matrix metalloprotease-1 (TIMP-1) were detected by ELISA;ESR was determined by Westergren method ; hs-CRP was determined by the automatic biochemistry analyzer.Results (1) Compared with NC group,levels of FVC,FEV1,FEV1/FVC,PEF,MEF25.75,MEF50,MEF25,CD3 + BTLA+ T cell,CD4+ BTLA+ Tcell,IL-10,TIMP1 were significantly decreased,IL-1 β,MMP9 were significantly increased.(2)Correlation analysis showed FVC was negatively correlated to Lequesne MG,symptom classify quantization scores,course,MMP9,while positively related to CD3+ BTLA+T cell,IL-10,TIMP1 ;FEV1 was positively correlated to CD3 + BTLA+T cell,CD4+ BTLA+T cell,TIMP1,while negatively correlated to course ; MEF50 was positively related to CD3+BTLA+T cell,CD4+ BTLA+T cell.Conclusion While articular cartilage lesions occurred in KOA patients,the lung function was also declined.The mechanism may be associated with the declination of expression of BTLA,which can cause up-regulating of IL-1 β,MMP9 and down-regulating of IL-10,TIMP1,thus leading to immune dysfunction and abnormal immune response.Those may induce airway injuries and result in lung function decline finally.
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Objective To explore the clinical effect of high intensity focused ultrasound(HIFU)combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer.Methods A total of 106 patients with primary liver cancer were divided into two groups:50 cases were treated with TACE,and the other 56 were treated with combination of HIFU and TACE.The changes of AFP levels and the size of tumors after three months treatment were analyzed and compared with each other.The survival rates for one,two and three years were calculated with Kaplan-Meier method and compared between the two groups.Results In the two groups,AFP decreased significantly after treatment,but the combined group was superior to the other in AFP decrease.In the combined group,the 1-,2-and 3-year survival rates were higher than those in the TACE group with 82.3%,60.8%and 39.2% vs 68.0%,42.6%and 21.0%respectively(P<0.01).No serious complications were seen,such as burn of skin,bleeding,gastrointestinal perforation. Conclusion The use of HIFU combined with TACE in the treatment of patients with primary liver cancers is feasible and safe.The combined group is superior to simple TACE for the management of primary liver cancers,and the former is more effective in decreasing AFP level and improving survival rates.
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Turbidimetry was used to examine the inhibitory effect of Xanthoxyin on adenosine diphosphate (ADP)-, arachidic acid (AA )- and thrombin-induced platelet aggregation in rabbits. In-vitro experiment showed that Xanthoxyin 0.037,0.l85,0.924,9.240,92.40?mol. L -1 , can significantly inhibit ADP-, AA- and thrombin-induced platelet aggregation. The inhibition rates were 22.4%-70.l%,l5.3%-68.2% and 25.8%-74.6% respectively. In-vivo experiment showed that Xanthoxylin (ig. 5 mg/kg) cand also inhibited ADP-, AA-and throbin-induced platelet aggregations. The inhibition rates were 2l.0%,35.7%,50.9% and 32.7% in ADP-induced group,23.2%,46.3%,52.4% and 4l.6% in AA-induced group, and 26.7%, 44.5%,6l.6% and 54.2% in thrombin-induced group respectively l5,30, 60 and 90 minutes after ig. Xanthoxylin.
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Objective Try to discover the safe and effective inhibitors of lymphangiogenesis. Methods Lymphatic endotheial cells from pig thoracic duct were isolated and cultured. The observation of specimens by LM and EM was made. The control group, endostatin and PF-4 experimental groups were set. Methods of the scraped line and MTT were used to examine their inhibitive effect on the lymphangiogenesis. Results The P value is
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Objective To study on the curative effect of DDP and Tegafur plus radiation for advanced cancer of esophagus. Methods 148 Patients with advanced cancer of esophagus were randomized into two groups(each 74), one group were accepted radical radiotherapy followed by DDP and Tegafur (chemoradiotherapy group),the other group were accepted radical radiotherapy only (radiotherapy group), radiotherapy in both groups was similar (60 ~ 65 Gy/6~6.5 W with routine fractionation). Results The effect was 81.1 % in radiotherapy group and 90.5 % in chemoradiotherapy group, the difference in effect was no statistically significant (?2=2.719, P =0.09), The 1, 3 and 5-year survived rates were 43.2 %, 16.2 %, 9.5 % respectively in radiotherapy group and 71.6 %, 33.8 %, 21.6 % respectively in chemoradiotherapy group. The survival rates in chemoradiotherapy group were all higher than that in radiotherapy group, the difference in effect was statistically significant(?2=8.684, P