Evaluation on professional competencies and development of teachers for health in primary and secondary schools in Shanghai / 中国学校卫生

Objective@#To evaluate the self awareness of professional competencies and its development of teachers for health in primary and secondary schools in Shanghai, so as to provide a reference for development of professional competencies and future specialized development.@*Methods@#A survey was conducted among 1 722 teachers for health in primary and secondary school by the professional competency questionnaire.@*Results@#Most of the teachers for health had bachelor s degrees (65.6%) and junior professional titles (43.4%), the full time teachers accounted for 66.5%, the percentage of teaching health education courses was 69.8 %, 7.7% took part in the formal class of schedule; the two top scorers were the dimension of "professional ethic as a teacher" and "school public health prevention and control" (4.68±0.43, 4.55±0.47); the two lowest scorers dimensions were related to school health education with increasing standard deviation (3.96±0.66, 3.91±0.65); the mean of self rated competency of the 6-14 years working experience group was slightly higher in all dimensions, that of 15 years or above group was lower than 6-14 years group in the total system and the dimensions of professional ethic as a teacher and emergency handling of accidents, and in responsing specific health problems dimension, the mean of 15 years or above group lower than that of 1-5 years group ( P <0.05).@*Conclusion@#The entry threshold of teachers for health in primary and secondary school is a critical consideration; Teachers competency preparations are satisfying in professional ethics and school public health prevention/control; meanwhile, the overall health education competencies were insufficient, and noticeable differences in the competency level among teachers are observed. It suggest drawing up entry qualifications and professional standards for health education teachers to guide the teacher s learning and improvement, calling for facilitating the professional promotion of teachers at the government s policy level.

Relationship between phosphorylation of GSK-3β and high glucose-caused abolition of cardioprotection induced by sevoflurane postconditioning / 中华麻醉学杂志

Objective:To evaluate the relationship between phosphorylation of glycogen synthase kinase-3β (GSK-3β) and high glucose-caused abolition of cardioprotection induced by sevoflurane postconditioning.Methods:H9c2 cells were incubated in normal glucose (5.56 mmol/L) DMEM culture medium or high glucose (33 mmol/L) DMEM culture medium.The cells were divided into 8 groups ( n=24 each) using a random number table method: normal control group (group NC), normal glucose-cultured hypoxia/reoxygenation (H/R) group (group NH/R), normal glucose-cultured sevoflurane postconditioning group (group NS), normal glucose-cultured GSK-3β inhibitor SB216763 group (group NSB), high glucose-cultured group (group HC), high glucose-cultured H/R group (group HH/R), high glucose-cultured sevoflurane postconditioning group (group HS) and high glucose-cultured GSK-3β inhibitor SB216763 group (group HSB). The model of cardiomyocyte H/R was established by subjecting cardiomyocytes to 3 h of hypoxia followed by reoxygenation.Immediately after onset of reoxygenation, cardiomyocytes were exposed to 2.4% sevoflurane for 30 min in Ns and HS groups.Before the beginning of reoxygenation, GSK-3β inhibitor SB216763 was added to the culture medium with the final concentration of 10 μmol/L in NSB and HSB groups.At 3 h of reoxygenation, the apoptosis rate was determined by Anexin V-PI flow cytometry, the expression of GSK-3β and phosphorylated GSK-3β (p-GSK-3β) was detected by Western blot, superoxide dismutase (SOD) activity was measured using xanthineoxidase method, and lactic dehydrogenase (LDH) activity and malondialdehyde (MDA) content were determined by colorimetric assay. Results:Compared with group NC, apoptosis rate, LDH activity and MDA content were significantly increased, and SOD activity was decreased in group NH/R and group HC, expression of GSK-3β was up-regulated, and expression of p-GSK-3β was down-regulated in group NH/R, expression of p-GSK-3β was up-regulated in group NS, and expression of p-GSK-3β was down-regulated in group HC ( P<0.05). Compared with group NH/R, apoptosis rate, LDH activity and MDA content were significantly decreased, and SOD activity was increased in group NS and NSB groups, and expression of GSK-3β was down-regulated, and expression of p-GSK-3β was up-regulated in group NS ( P<0.05). Compared with group HC, apoptosis rate, LDH activity and MDA content were significantly increased, SOD activity was decreased, expression of GSK-3β was up-regulated, and expression of p-GSK-3β was down-regulated in group HH/R ( P<0.05). Compared with group HH/R, apoptosis rate, LDH activity and MDA content were significantly decreased, and SOD activity was increased in group HSB ( P<0.05). Conclusion:The mechanism by which high glucose abolishes cardioprotection induced by sevoflurane postconditioning is related to inhibiting phosphorylation of GSK-3β.

FK866 protects polymicrobial sepsis-induced liver injury in mice / 中华危重病急救医学

Objective To investigate the effects of nicotinamide phosphoribosyl transferase (NAMPT) inhibitor FK866 on polymicrobial sepsis-induced liver injury in mice. Methods Eighty-four healthy male C57BL/6J mice were divided into four groups by random number table method (n = 21): sham group, sepsis-induced liver injury model by cecal ligation and perforation group (CLP group), vehicle+CLP group and FK866+CLP group. FK866 (10 mg/kg) or same volume dimethyl sulfoxide were given intraperitoneally into mice 24, 12 and 0.5 hours prior to CLP in the FK866+CLP group or the vehicle+CLP group, respectively. Fifteen mice in each group were used to observe the 48-hour survival after operation. The remaining 6 mice were sacrificed 20 hours after operation to harvest venous blood and liver tissue samples for index detection. The levels of serum alanine transaminase (ALT) and aspartate aminotransferase (AST) were measured by colorimetry; the levels of serum NAMPT, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay (ELISA); the mRNA expressions of TNF-α and IL-6 were measured by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR); the protein expressions of hepatic NAMPT, cytoplasmic IκBα and nuclear factor-κB (NF-κB) were measured by Western Blot. Results Compared with the sham group, the 48-hour survival in the CLP group was significantly decreased; serum and liver NAMPT protein levels were significantly increased, serum ALT, AST, TNF-α, IL-6 levels and mRNA expressions of TNF-α, IL-6 in liver tissue were significantly increased; the expression of cytoplasmic IκBα protein was significantly decreased, and the expression of nuclear NF-κB protein was significantly increased; which indicated that CLP induced NF-κB activation, inflammation and liver injury. There was no significant difference between the vehicle+CLP group and the CLP group. Compared with the vehicle+CLP group, the 48-hour survival in FK866+CLP group was significantly increased (53.33% vs. 26.67%); serum ALT, AST, TNF-α, IL-6 levels and mRNA expressions of TNF-α, IL-6 in liver tissue were significantly decreased [serum ALT (U/L): 128.94±32.48 vs. 237.24±58.61, serum AST (U/L):289.89±68.74 vs.468±82.17, serum TNF-α (pg/L): 65.17±18.74 vs.127.64±48.18, serum IL-6 (ng/L): 31.78±5.23 vs. 60.87±13.12, liver TNF-α mRNA (2-ΔΔCt): 8.37±4.17 vs. 18.24±6.12, liver IL-6 mRNA (2-ΔΔCt): 18.58±7.12 vs.34.24±6.71], the expression of cytoplasmic IκBα protein was significantly increased (IκBα/GAPDH: 0.23±0.03 vs. 0.12±0.04), while expression of nuclear NF-κB protein was significantly decreased (NF-κB/Lamin B1: 0.25±0.04 vs. 0.42±0.05), with statistically significant differences (all P < 0.05). Conclusion NAMPT inhibitor FK866 protects polymicrobial sepsis-induced liver injury via the inhibition of NF-κB activation and inflammation.

Influence of the positive endexpiratory pressure and Trendelenburg position on the right jugular vein in obese patients / 中国医师进修杂志

Objective The internal jugular vein puncture catheter had some difficulties and challenges for obese patients.Whether positive end expiratory pressure and Trendelenburg position will increase the cross-sectional area of the right internal jugular vein in obese patients. Methods Forty patients were selected for perioperative period.Male-to-female ratio was 19:21;age ranged from 43 to 69 years. ASA wasⅠ-Ⅲ, and BMI was ≥ 30 kg/m2. After induction of general anesethesia and end intubation,the patients were placed in a supine position on a level bed with the head turning to the left 20°.The transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein were measured incrementally from the lowest to the highest with PEEP 0,5 and 10 cmH2O (1 cmH2O=0.098 kPa) and the head-down position angle of 20°. Ultrasound was used to measure and record the transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein at the level of the cricoid cartilage. Results All PEEP levels increased the transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein compared with the control: (1.38 ± 0.34) cm2vs. (0.73 ± 0.30), (0.97 ± 0.26) and (1.15 ± 0.30) cm2;(1.50 ± 0.30)cm vs.(1.00 ± 0.26),(1.18 ± 0.27)and(1.29 ± 0.26)cm;(1.01 ± 0.16)cm vs.(0.57 ± 0.16), (0.75 ± 0.18)and(0.84 ± 0.16)cm,P<0.05.Six patients were excluded because the blood pressure was below 90/60 mmHg (1 mmHg=0.133 kPa) after PEEP 10 mmHg was seted. Transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein was larger at the head-down position angle 20°compared with that at the PEEP levels.The largest cross-sectional area was (1.38 ± 0.34)cm2.Conclusions The use of positive end expiratory pressure and Trendelenburg position increases transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein in obese patients.Transverse diameter, anter-posterior diameter and the cross-sectional area of the right internal jugular vein is the largest at the head-down position angle 20°, then the PEEP 10 cmH2O.Airway pressure is the largest at the head-down position angle 20°.When we set the PEEP 10 cmH2O, some patients′ blood pressure is below 90/60 mmHg. AS for the airway pressure and hemodynamic instability, we recommend using PEEP 5 cmH2O to facilitate internal jugular venous cannulation in obese patients.

Preparation and evaluation of intra-articular injectable sinomenine hydrochloride-loaded in situ liquid crystals / 药学学报

Phytantriol (PT), ethanol (ET) and water were used to prepare in situ cubic liquid crystal (ISV2). The pseudo-ternary phase diagram of PT-ET-water was constructed and isotropic solution formulations were chosen for further optimization. The physicochemical properties of isotropic solution formulations were evaluated to optimize the composition of ISV2. In situ hexagonal liquid crystals (ISH2) were prepared based on the composition of ISV2 with the addition of vitamin E acetate (VitEA) and the amount of VitEA was optimized by in vitro release behavior. The phase structures of liquid crystalline gels formed by ISV2 and ISH2 in excess water were confirmed by crossed polarized light microscopy and small angle X-ray scattering, respectively. Rheological properties of ISV2 and ISH2 were studied by a DHR-2 rheometer. In vitro drug release studies were conducted by using a dialysis membrane diffusion method. Pharmacokinetics was investigated by determination of sinomenine hydrochloride (SMH) concentration in synovial membrane after intra-articular injection of SMH-loaded ISH2 in adjuvant-induced arthritis rats. The optimal ISV2 (PT/ET/water, 64 : 16 : 20, w/w/w) loaded with 6 mg x g(-1) of SMH showed a suitable pH, injectable and formed a cubic liquid crystalline gel in situ with minimum water absorption in the shortest time. The optimal ISV2 was able to sustain the drug release for 144 h. The optimal ISH2 system was prepared by addition of 5% VitEA into PT in the optimal ISV2 system. This ISH2 (PT/VitEA/ET/water, 60.8 : 3.2 : 16 : 20, w/w/w/w) was an injectable isotropic solution with suitable pH. The new ISH2 was able to sustain the drug release for more than 240 h. Local pharmacokinetics study indicated that the retention time and AUC(0-∞) of ISH2 group were increased significantly compared with that of SMH solution group and the AUC(0-∞) of ISH2 group was 6.01 times higher than that of SMH solution group. The developed ISH2 was suitable for intra-articular injection that may apply to patients in the treatment of rheumatoid arthritis.

Pulmonary surfactant homeostasis associated genetic abnormalities and lung diseases / 中华医学遗传学杂志

Pulmonary surfactant (PS) is synthesized and secreted by alveolar epithelial type II (AEII) cells, which is a complex compound formed by proteins and lipids. Surfactant participates in a range of physiological processes such as reducing the surface tension, keeping the balance of alveolar fluid, maintaining normal alveolar morphology and conducting host defense. Genetic disorders of the surfactant homeostasis genes may result in lack of surfactant or cytotoxicity, and lead to multiple lung diseases in neonates, children and adults, including neonatal respiratory distress syndrome, interstitial pneumonia, pulmonary alveolar proteinosis, and pulmonary fibrosis. This paper has provided a review for the functions and processes of pulmonary surfactant metabolism, as well as the connection between disorders of surfactant homeostasis genes and lung diseases.

Effects of dexmedetomidine with different-dose on hemodynamics during anesthesia induction in ;patients undergoing off-pump coronary artery bypass grafting / 中国医师进修杂志

Objective To evaluate the effects of dexmedetomidine with different-dose on the hemodynamics during anesthesia induction in patients undergoing off-pump coronary artery bypass grafting. Methods Sixty patients undergoing off-pump coronary artery bypass grafting were selected, with ASA grade Ⅱ - Ⅲ, NYHA cardiac functional grading Ⅱ - Ⅲ, and left ventricles ejection fraction >45%. The patients were divided into D1 group, D2 group and control group by table of random digit method with 20 cases each. In D1 group, intravenous infusion dexmedetomidine 0.3μg/kg was given for 20 min before anesthesia induction;in D2 group, intravenous infusion dexmedetomidine 0.6μg/kg was given for 20 min before anesthesia induction;in control group, intravenous infusion the same volume of 0.9% sodium chloride was given before anesthesia induction. The mean arterial pressure (MAP), heart rate, cardiac output and stroke volume variation (SVV) were recorded before infusion dexmedetomidine (T0), before anesthesia induction (T1), 3 min after anesthesia induction (T2), trachea cannula (T3) and 5 min after trachea cannula (T4). The adverse cardiovascular events and drug intervention were recorded during anesthesia induction. Results There were no statistical differences in MAP, heart rate, cardiac output and SVV at T0 among 3 groups (P>0.05). Compared with that in control group, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that at T0, the heart rate at T1, T2, T3 and T4 in D1 group were decreased, the MAP, heart rate, cardiac output and SVV at T3 in control group were increased, the MAP, heart rate, cardiac output and SVV at T1, T2, T3, T4 in D2 group were decreased, and there were statistical differences (P<0.05). Compared with that in D1 group, the MAP, heart rate, cardiac output and SVV at T2, T3 and T4 in D2 group were decreased, and there were statistical differences (P<0.05). The rates of adverse cardiovascular events in D1 group and D2 group were significantly lower than those in control group:35%(7/20) and 40%(8/20) vs. 95%(19/20), the rate of drug intervention in D1 group was significantly lower than that in control group and D2 group:10% (2/20) vs. 45% (9/20) and 35% (7/20), and there were statistical differences (P<0.05). Conclusions Dexmedetomidine (0.3 μg/kg) is beneficial for the stability of hemodynamics before anesthesia induction in patient undergoing off-pump coronary artery bypass grafting.

Effect of controlled low perfusion pressure on expression of phosphor-Akt and phosphor-ERK following spihal ischemia-reperfusion in rabbits / 中华麻醉学杂志

ObjectiveTo investigate the effect of controlled low perfusion pressure on expression of phosphor-Akt (p-Akt) and phosphor-ERK1/2 (p-ERK1/2) following spinal ischemia-reperfusion (1/R) in rabbits.MethodsThirty-six Japanese long-ear white rabbits aged 3 months weighing 2.0-2.5 kg were randomly divided into 3 groups ( n ＝ 12 each):group sham operation (group S) ; group spinal I/R (group I/R) and group controlled low perfusion pressure (group LP).Auricular artery and femoral artery were carnulated for proximal and distal BP monitoring.A 4F catheter with a balloon at the tip was inserted into abdominal aorta.The tip was positioned 1 cm below left renal artery.Spinal ischemia was induced by inflating the balloon until the distal MAP < 20 mm Hg,and maintained for 25 min.During the first 10 min of reperfusion the distal MAP was increased to 45-55 mm Hg by partially deflating the balloon.Then the balloon was fully deflated to allow complete reperfusion.The function of lower limbs was assessed with Tarlov score (0 ＝ no detectable movement,4 ＝ normal function) at 1,3,7,28 d of reperfusion.Au the animals were sacrificed at 1 d of reperfusion in each group.The lumbar segment L3-5 of the spinal cord was removed for microscopic examination and determination of expression of p-Akt and p-ERK1/2 by immuno-histochemistry) and detection of neuronal apoptosis in dorsal horn (by TUNEL).ResultsSpinal I/R significantly decreased Tarlov scores,and increased the number of apoptotic cells and expression of p-Akt and pERK1/2 in group I/R as compared with group S.Low perfusion pressure during the 10 min at the beginning of reperfusion significantly increased Tarlov scores,decreased apoptotic index and further increased p-Akt and pERK1/2 expression in group LP compared with group I/R.The histopathological damage in the spinal cord was attenuated in group LP.ConclusionControlled low pcrfusion pressure can reduce the spinal cord I/R injury by activating Akt and ERK1/2 and decreasing neuronal apoptosis.

Cardioprotective effects of morphine on rat heart suffering from ischemia and reperfusion / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the cardioprotective effects of morphine on ischemic reperfused rat heart in vitro and its mechanism.</p><p><b>METHODS</b>The isolated rat heart was perfused in a Langendorff apparatus. Infarct myocardium was determined by TTC. Coronary flow (CF), heart rate (HR), left ventricular pressure (LVP), the first derivative of ventricular pressure (LVP/dtmax) and infarct size after ischemia and reperfusion in rat heart given 0.3 micro mol/L morphine were observed. The effects of naloxone and glibenclamide on the cardioprotection of morphine were also measured.</p><p><b>RESULTS</b>After ischemia and reperfusion, CF, HR, LVP and LVP/dtmax of isolated rat hearts decreased significantly (P < 0.01). After morphine preconditioning, HR, LVP and LVP/dtmax increased (P < 0.01) and infarct size was reduced significantly (P < 0.01), while no significant change in CF (P > 0.05). The cardioprotective effects of morphine were abolished by naloxone or glibenclamide completely.</p><p><b>CONCLUSIONS</b>Morphine can reduce ischemia-reperfusion injuries in isolated rat heart. The cardioprotective effects of morphine are mediated by a local opioid receptor-K(ATP) channel linked mechanism in rat hearts.</p>

The Measurement and Significance of DNA Content in Primary Lung Cancer / 中国医科大学学报

Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.