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The contents of general practice discipline construction comprise of orientation, team development, personnel training, scientific research, teaching base establishment and management of the discipline, etc. At present, the weakness in above aspects of general practice discipline construction is still the major challenges in most of the primary healthcare institutions. Our experiences in last 10 years shows that the application of Leicester Assessment Package can effectively promote the general practice discipline development for primary care institutions.
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Objective:To develop the interpersonal emotion regulation questionnaire for healthcare workers and examine its reliability and validity.Methods:Based on the theory of social regulatory cycle (SRC), literatures review and semi-structured interview were used to form the item pool of the scale.Through expert consultation, project analysis and the exploratory factor analysis, the scale items were screened, and the interpersonal emotion regulation questionnaire for healthcare workers was initially formed.The convenient sampling method was adopted to select 619 healthcare workers from multiple hospitals in Anhui province to conduct the formal survey to test the reliability and validity of the questionnaire and confirmatory factor analysis (CFA) using the SPSS 24.0 and Mplus 8.0 software.Results:There were 18 items and four dimensions including emotion identification, motivation, regulation strategy and implementation strategy process in the interpersonal emotion regulation questionnaire for healthcare workers.The results of CFA showed that the questionnaire fitted the data with well construct validity.The correlation coefficients between each dimension and the scale were 0.830-0.932.The Cronbach’s α coefficient of the overall questionnaire was 0.962, the split-half reliability was 0.880 and the test-retest reliability was 0.786.The score of total questionnaire was significantly positively correlated with the score of emotional intelligence ( r=0.680, P<0.001) and empathic ability ( r=0.554, P<0.001), and was significantly negatively correlated with the doctor-patient relationship ( r=-0.353, P<0.001). Conclusion:The interpersonal emotion regulation questionnaire for healthcare workers has satisfactory reliability and validity, which can be used to measure the ability of interpersonal emotion regulation in healthcare workers.
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OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors （PPI） on the blood concentration and the risk of invasive fungal disease （IFD） in patients with malignant hematological disorder. METHODS In accordance with the random number table method， 40 patients with malignant hematological disorders who were admitted to the hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group （20 cases） and observation group （20 cases）. The control group received Posaconazole oral suspension alone， while the observation group received Posaconazole oral suspension combined with PPI. The incidence of IFD， attainment rate of blood concentration， the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients， and blood concentrations of posaconazole on 7th， 14th， 21st， and 28th day after posaconazole application were compared between 2 groups； the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group， and the attainment rate of blood concentration in the observation group was significantly lower than control group （P＜0.05）. There was no significant difference in the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients and the incidence of adverse events （P＞ 0.05）. The blood concentration of posaconazole in the observation group was significantly lower than control group on 7th day of medication （P＜0.05）； there was no significant in blood concentration of posaconazole between 2 groups on the 14th day of medication （P＞0.05）. CONCLUSIONS Posaconazole combined with PPI can reduce the blood concentration of patients with malignant hematological disorders， increase the risk of IFD. Clinical practice should try to avoid the combination of the two or use them under the guidance of therapeutic drug monitoring.
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Objective:To explore the value of HDlive Flow in prenatal diagnosis of the velamentous placenta.Methods:A total of 2 723 pregnant women underwent prenatal ultrasonography in the second trimester and delivered at Zhejiang Provincial People's Hospital from January 2019 to January 2020, and 48 of them were diagnosed as having velamentous placenta confirmed by postpartum clinical and pathological examination and were included in this retrospective analysis. Two-dimensional echocardiography-color Doppler flow imaging (2D-CDFI) and HDlive Flow were both performed during the prenatal ultrasound examination. The sonographic features of velamentous placenta by HDlive Flow were summarized and the prenatal detection rate between two methods were compared using Chi-square test. Results:The incidence of velamentous placenta was 1.8% (48/2 723) in our hospital. Out of the 48 enrolled cases, 45 were diagnosed by HDlive Flow with a detection rate of 93.8% (45/48), three of them were complicated by vasa previa; the other three cases were misdiagnosed as battledore placenta. There were 38 cases diagnosed by 2D-CDFI with a detection rate of 79.2% (38/48), which was lower than HDlive Flow ( χ2=4.360, P=0.037); the other ten cases were misdiagnosed as battledore placenta. The sonographic features by HDlive Flow were as follow: (1) Umbilical cord attached to fetal membranes outside the placenta in 41 cases with the umbilical vessels distributing along the fetal membrane in a mesh pattern; (2) In three cases, the umbilical cord insertion was located on fetal membranes at the edge of placenta; (3) One case was shown that umbilical cord and the branches of umbilical vessels were inserted into the placenta in a "λ" shape. Conclusions:The anatomy of the umbilical cord, umbilical blood vessels and placenta can be directly shown under HDlive Flow, which can improve the prenatal detection rate of the velamentous placenta.
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Ulcerative colitis(UC)is a chronic non-specific inflammatory disease involving colon and rectum. The etiology and pathogenesis of UC are not yet fully defined. Multiple enteroscopy,and drug therapy such as steroid and immunosuppressant,can cause adverse effects on psychology in UC patients. It is found that psychological disorder is a risk factor of UC. It can affect the quality of life and social function of UC patients,reduce the treatment compliance,prolong the course of disease,and ultimately results in poor prognosis. This article reviewed the advances in study on role of psychological factors in UC.
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Objective To investigate the health-seeking behavior and related factors among hypertensive and diabetic patients contracting medical service in Beijing Fangzhuang Community Health Service Center.Methods By using stratified random sampling method, 830 contracted hypertensive and diabetic patients were selected in the study.A face to face questionnaire survey was conducted in Fangzhuang Community Health Service Center from November 2016 to January 2017.Total 800 questionnaires were completed, and the medical behavior and influencing factors of patients were analyzed.Results The first-contact rate of community for hypertensive and diabetic patients was 73.0%(584/800).The reasons for choosing community service were: near home(86.3%,690/800), shorter waiting time(71.4%, 571/800)and trust in doctors(50.3%, 402/800); while the reasons for not choosing community service were less drug varieties(76.1%, 609/800), poor facilities(32.1%,257/800)and lower technical level(11.4%, 91/800).Its influencing factors were: frequent need of accompanying for visit(χ2=5.719, P=0.012),family income(χ2=4.540,P=0.021),awareness of service scopes(χ2=64.668,P=0.000),purpose of service(χ2=19.234,P=0.000),frequency of doctor contact(χ2=9.367, P=0.001), the awareness of referral(χ2=5.736,P =0.011).Conclusion The community health service centers should take the advantage of easy access, short waiting time and patients′trust,at the same time should improve the service conditions and quality,so as to increase the first-contact rate for patients contracting medical service.
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A total of 210 female patients with overactive bladder (OAB) were divided into M receptor blockage (M,n =71),pelvic floor muscle stimulation physiotherapy (S,n =70) and combination (C,n =69) groups.After one course of treatment,the OAB symptom scores were compared to pretreatment values (P ＜ 0.05).After a second course,the overall response rate was 69％ in group S.Pelvic floor muscle stimulation physiotherapy provided excellent sustained outcomes.
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Objective Molecular targeted drugs have anti-angiogenesis and anti-tumor effects.The study was to investigate the role of sunitinib on treating metastatic renal cell carcinoma ( mRCC) and its long-term efficacy and adverse reactions. Methods From November 2007 to March 2013, 281 mRCC patients were divided into two groups according to their own willingness.102 patients in the experimental group received sunitinib 50 mg per day.Pain score, metastatic focuses before and after targeted therapies were compared.179 patients in control group was treated by immunotherapy.Kaplan-Meier survival analysis was used to draw the survival curves and Cox regression model was applied in multivariate analysis. Results There was no difference between the two groups on baseline (P>0.05).In the experimental group, 78 cases were clear cell carcinoma, with remission rate 29.4%, stablity rate 53.8%and total effective rate 83.2%after treatment;15 cases were papillary renal cell carcinoma, with remission rate 33.3%, stablity ratio 46.7%and total effective rate 80.0% after treatment;9 cases were collecting duct carcinoma, with the remission rate 22.2%, the stablity ratio 55.6% and the total effective rate 77.8% after treatment.The bone scan after 1 cycle of treatment showed 2 cases progressed(10.5%), 5 cases relieved(26.3%) and 12 cases sta-blized(63.2%), the total effective rate of bone metastasis amounting to 89.5%, the effective rate of lung metastasis 81.7%, the effective rate of liver metastasis 60.0%and the effective rate of lymph node metastasis 72.8%.The median overall survival in the experimental group was 28.9 months, 20.7 months in control group(P<0.05).Cox regression analysis showed age, tumor classification, liver, lung, bone and lymph node metastasis were prognostic factors influencing mRCC.The common averse events were white blood cells, thrombocytopenia, neutropenia and hypoalbuminemia. Conclusion Sunitinib for the treatment of mRCC can diminish the metastatic focuses , ease the pain , improve the quality of life, delay the progression of the disease, and prolong the overall survival.
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Objective:To investigate the expression of TNF-α,IL-1βand NF-κB in the cortex after traumatic brain injury in rats, in order to further explore the protective effects and possible mechanisms of mild hypothermia treatment .Methods:The forty-five SD rats were randomly divided into Sham group , TBI group, treatment group.Rats model of TBI were established via Marmarou's meth-od.The animals were sacrificed at 1 d,3 d and 5 d post-TBI.The brain tissue was taken out to measure the water content based on wet-dry weight method .The expression of TNF-α, IL-1βand NF-κB proteins were detected by Immunohistochemistry and Western blot a-nalysis.Results:Compared with the Sham group , the brain water content was increased (P<0.05), reached peak at 3 d post-TBI, the expression of TNF-α,IL-1βand NF-κB was significantly increased (P<0.05), reached peak at 1 d, sustained higher expression to 5 d post-TBI.Mild hypothermia treatment remarkably reduced the brain water content (P<0.05), down-regulated TNF-α,IL-1βand NF-κB expression in comparision to the TBI group (P<0.05).Conclusion:The higher expression of TNF-α, IL-1βand NF-κB in the cortex may play an important role in the pathogenesis of TBI .Mild hypothermia can suppress NF-κB signaling pathway , reduce inflammatory reactions , relieve cerebral edema , finally promoting brain injury recovery .
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Botryococcus braunii is a unique colonial green microalga and a great potential renewable resource of liquid fuel because of its ability to produce lipids. Due to the dense cell colonies and rigidly thick cell wall of B. braunii, the traditional Nile red method is usually of low sensitivity and bad repeatability and hard for the determination of lipid content in the cells. By dispersing the colony with ultrasonic, assisting permeation of Nile red across the cell wall with dimethyl sulfoxide and optimizing the staining conditions, we established an improved detection method. The details were as follows: after the colonial algal sample was treated by ultrasonic at 20 kHz for 20 s, 100 W transmitting power and with 1 s on/1 s off intermittent cycle, the equivoluminal 15% (V/V) dimethyl sulfoxide and 3 microg/mL Nile red were successively added and mixed evenly, then the staining system was incubated in dark at 40 degrees C for 10 min, and subsequently was measured by fluorescence spectroscopy detection with an excitation wavelength of 490 nm. Compared with the traditional method, the improved one not only had higher detection sensitivity which was increased by 196.6%, but also had obviously better detection repeatability whose characteristic parameter - relative standard deviation (RSD) was decreased from 10.91% to 1.84%. Therefore, the improved method could provide a rapid and sensitive detection of lipid content for B. braunii breeding and cultivation.
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Chlorophyta , Chemistry , Lipids , Microalgae , Chemistry , Spectrometry, Fluorescence , Methods , UltrasonicsABSTRACT
By stratified random sampling method, 10 000 residents were investigated with the questionnaire in Fangzhuang community of Beijing, 9497 valid questionnaires were collected with a return rate of 94. 97%. The results showed that two main purposes for patients to use the community health services were to seek consultation (29. 8% ) and to get prescription (28. 2% ). The three main reasons for residents to choose community health services were the convenience, less medical expenses and more clear explanation from doctors, followed by the personal trust in the doctors.
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Objective To investigate the effects of IL-12 coexpression level on antigen expression and immune responses induced by HBsAg DNA vaccination. Methods DNA vaccine plasmid pHBV carrying codon-optimized preS2-S gene of reference sequence CHN-HBV07-C in China was constructed. Three DNA vaccine plasmids pHBV-12i, pHBV-12l and pHBV-12h were also constructed by subcloning three different IL-12 expression cassettes with various expression strengths to plasmid pHBV, respectively. Expression levels of IL-12 and HBsAg in vaccine plasmid-tranfected 293T cells were measured by quantitative ELISA. DNA vaccines were administered intramuscularly to BALB/c mice and HBsAg-specific cellular immune responses were determined by IFN-γ ELISPOT. HBsAg-specific antibodies were tested by Chemiluminescence Quantitative Immunoassay. Results The HBsAg expression level in 293T cells was 70 ng/ml when transfected by plasmid pHBV without IL-12 expression cassette, and the HBsAg level was 18 ng/ml when transfected by plasmid pHBV-12l carrying low-level IL-12 expression cassette, whereas the HBsAg level was only 6 ng/ml when transfected by plasmid pHBV-12h carrying high-level IL-12 expression cassette.Results of DNA vaccination revealed that HBsAg-specific humoral and cellular immune responses were significantly decreased in mice administering vaccine pHBV-12h carrying high-level IL-12 expression cassette. Although HBsAg-specific antibody responses in mice inoculated with pHBV-12l were also decreased when compared with those in pHBV-vaccinated mice without IL-12 expression, the HBsAg-specific cellular immune responses were significantly increased. Conclusion High-level coexpression of IL-12 may suppress the expression of HBsAg, Whereas modest coexpression of IL-12 significantly enhanced the HBsAg-specific T cell responses induced by DNA vaccination. Therefore, it is so important to balance the expression between adjuvant and antigen to enhance the immune response.
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Objective To discuss influence of nursing intervention on complications of elderly patients with lower extremity bone fracture. Methods 105 elderly patients with lower extremity bone fracture were randomly divided into the nursing intervention group and random nursing group with 52 patients in each group. χ2 test and t test were used to compare the nursing effect in the two groups. Results The incidence rate of complication and average hospitalization time in the nursing intervention group were evidently lower than those of the random nursing group. Conclusions Nursing intervention has profound significance on rehabilitation of elderly patients with lower extremity bone fractures.
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【Objective】The effect of sinomenine on human cyclo-oxygenase(COX) and interleukin-1?(IL-1?) was observed to explore the anti-inflammatory mechanism of sinomenine.【Methods】Peripheral blood monocytes(PBMC) were isolated and incubated with sinomenine.After incubation,total RNA from PBMC was extracted and the effect of sinomenine on COX and IL-1? expression with or without the stimulation of lipopolysaccharide(LPS) was observed by the method of semi-quantitative reverse transcription polymerase chain reaction(RT-PCR).【Results】Sinomenine had no effect on COX-1 gene expression,had a slight inhibitory effect on COX-2 gene expression and had a strong inhibitory effect on IL-1? gene expression.【Conclusion】 The anti-inflammatory mechanism may be related to the inhibition of inflammatory cytokines.
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Objective To observe the effect of naringin on proliferation and differentiation of 3T3-L1 preadipocyte,and to investigate its possible mechanism.Methods The cultured 3T3-L1 cells were pretreated with naringin,and then MTT method was used to detect the proliferation of the cells,oil red O staining method and spectrophotography were applied to analyze the degree of differentiation.The expression of PPAR? 2 and C/EBP? mRNA associated with adipocytes differentiation were detected by reverse transcription PCR(RT-PCR).Results Naringin suppressed the proliferation and differentiation of 3T3-L1 preadipocytes and down-regulated the expression of PPAR? 2 and C/EBP? mRNA.Conclusion Naringin can inhibit the proliferation of 3T3-L1,and can suppress their differentiation through down-regulating the expression of PPAR? 2 and C/EBP? mRNA.
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Objective To solve the problem that traditional electronic medical records(EMR) system could not be extended to patients' bedside because of the wired network connection restrictions.Methods Based on wireless transmission and data synchronization technologies in PDA,a mobile nursing station was developed.Results Such functions were realized as patient identity verification,implementation of doctor's orders and vital signs collection beside patients' bed.Conclusion Technical support is provided for closing EMR information chain and improving medical quality.[Chinese Medical Equipment Journal,2008,29(2):53-54]