A comparative study on the human resources deployment of public general hospitals in Pudong New Area / 中华医院管理杂志

Objective:To compare the actual situation and measurement data of human resources deployment in public general hospitals in Pudong New Area, so as to provide a data basis for further optimizing the human resources deployment plan.Methods:The Pudong New Area Health Statistical Information System was used to collect the staffing information and business data of 9 public general hospitals in Pudong New Area, Shanghai in 2019. On such basis, the numbers of officially budgeted positions and actual positions were calculated. Descriptive analyses of the data were performed to compare the theoretical and actual quantities by paired t-test and Wilcoxn signed-rank sum test. Results:The actual number of officially budgeted positions of the 9 hospitals was less than the theoretical number( Z=-2.55, P=0.011), while the actual number of positions was less than that of theoretical number( t=3.36, P=0.010). The proportion of the officially budgeted position shortage at tertiary hospitals(72.77%)was higher than that of secondary hospitals(36.94%). The proportion of position shortage at tertiary hospitals(16.14%)was less than that at secondary hospitals(38.78%). Conclusions:Area-owned general hospitals are in shortage of human resources, while secondary and tertiary hospitals have different needs for human resources. The actual situation of a hospital should be comprehensively considered to develop an optimal deployment plan for human resources.

Therapeutic effect of nape cluster acupuncture combined with swallowing function training on post-stroke dysphagia / 中国针灸

OBJECTIVE@#To observe the effect on swallowing function in patients with post-stroke dysphagia treated with nape cluster acupuncture and the immediate effect of acupuncture at Fengchi (GB 20).@*METHODS@#A total of 60 patients with post-stroke dysphagia were randomized into an observation group and a control group, 30 cases in each one.On the basis of conventional western medication treatment, swallowing function training was applied in the control group, once a day.On the base of the treatment as the control group, nape cluster acupuncture was applied at Fengchi (GB 20), Tianzhu (BL 10), Wangu (GB 12), Lianquan (CV 23), Panglianquan (Extra), Jinjin (EX-HN 12) and Yuye (EX-HN 13) in the observation group, once a day. Additionally, pricking blood was applied at Jinjin (EX-HN 12) and Yuye (EX-HN 13), 2 times a week. The treatment was given 30 min each time, a week as one course and 4 courses were required. Before and after treatment, the standardized swallowing assessment (SSA) score and video fluoroscopic swallowing study (VFSS) score were compared in the two groups. The ultrasonic diagnostic device of swallowing and surface electromyography were used to observe the immediate effect on swallowing related muscles of acupuncture at Fengchi (GB 20).@*RESULTS@#Compared before treatment, the SSA scores were reduced after treatment in the two groups (<0.05), and the change of the observation group was larger than the control group (<0.05). Compared before treatment, the VFSS scores were increased after treatment in the two groups (<0.05), and the change of the observation group was larger than the control group (<0.05). Acupuncture at Fengchi (GB 20) immediately increased the amplitude of submental muscles and infrahyoid muscles in the observation group (<0.05), the geniohyoid muscle movement time was reduced and geniohyoid muscle displacement was increased (<0.05).@*CONCLUSION@#On the base of the routine treatment, nape cluster acupuncture could improve swallowing function in patients with post-stroke dysphagia. Acupuncture at Fengchi (GB 20) could immediately affect swallowing related muscles, improve muscle amplitude and reduce swallowing time.

Screening of MYH7 gene mutation sites in hypertrophic cardiomyopathy and its significance / 中华医学杂志(英文版)

BACKGROUND@#There have been few reports of mutations in the beta-myosin heavy chain (MYH7) gene in hypertrophic cardiomyopathy (HCM), which is associated with sudden cardiac death caused by HCM. This study aimed to screen the mutation sites in the sarcomeric gene MYH7 in Chinese patients with HCM. We also planned to analyze the pathogenicity of the mutation site as well as its significance in clinical and forensic medicine.@*METHODS@#From January 2006 to June 2017, autopsy cases were collected from the Department of Pathology, the Affiliated Hospital of Qingdao University. The experiment was to detect MYH7 gene status in formalin-fixed paraffin-embedded tissues from 18 independent autopsy cases who suffered HCM related sudden death (fatal HCM) and 20 cases without cardiomyopathy. Common mutation exon fragments of MYH7 gene were amplified by polymerase chain reaction. The end-of-deoxygenation method and gene cloning method were further performed to analyze the mutation sites. Homologous comparison among mutant sites was conducted using BLAST online database.@*RESULTS@#The 1336th nucleotide of MYH7 gene at exon 14 was converted from T to G in one HCM case, resulting in the conversion of threonine (Thr) at position 446 to proline (Pro). In another case, the 1402th nucleotide at exon 14 was converted from T to C, resulting in the conversion of phenylalanine (Phe) at position 468 to leucine (Leu). Homologous comparison results showed that the two amino acid residues of Thr446 and Phe468 are highly conserved among different species.@*CONCLUSIONS@#Our results showed fatal HCM harbored mutations of Thr446Pro and Phe468Leu in the MYH7 gene. It is significant for clinical and forensic medicine to further explore the functions and detailed mechanisms of these mutations.

C_(19)-diterpenoid alkaloids from Aconitum austroyunnanense / 中国中药杂志

Eight C_(19)-diterpenoid alkaloids( 1-8) were isolated from the ethyl acetate soluble fraction of 95% ethanol extract of the ground roots of Aconitum austroyunnanense through various column chromatographies on silica gel,ODS,Sephadex LH-20 and MCI gel.Their structures were elucidated as 14α-benzoyloxy-13β,15α-dihydroxy-1α,6α,8β,16β,18-pentamethoxy-19-oxoaconitan( 1),N-deethylaconitine( 2),spicatine B( 3),leucanthumsine A( 4),acofamine B( 5),macrorhynine B( 6),aconitilearine( 7),and ambiguine( 8) based on their chemical and physicochemical properties and spectroscopic data. Compound 1 was a new compound and alkaloids 2-8 were isolated from this plant for the first time. Some isolated alkaloids were tested in vitro for cytotoxic potential by employing the MTT method. As a result,alkaloid 1 exhibited weak cytotoxic activity against three tested tumor cell lines( A-549,He La,and Hep G2) with IC_(50) values less than 20 μmol·L~(-1).

Impairment mechanisms of acute hyperglycemia in the first-phase insulin secretion in mouse / 中国实验动物学报

Objective To clarify the impairment mechanisms of acute hyperglycemia in the first-phase insulin se-cretion in mice. Methods The mouse model of acute glucose toxicity was established by glucose infusion through jugular vein catheterization. The glucose and insulin levels were assessed by IPGTT and OGTT in the mice of acute hyperglycemia and control groups. The histology of pancreatic islets was observed using HE staining and the insulin granules and other cy-toplasmic organelles were observed by electron microscopy. Results The mouse model of acute hyperglycemia was suc-cessfully established. The IPGTT showed that the blood glucose level was decreased by 87% ( 10. 3 ± 0. 33 mmol/L vs. 19. 3 ± 1. 66 mmol/L) at 15 min in the acute hyperglycemia group compared with the control group. The OGTT showed that the blood glucose level was decreased by 85% (9. 8 ± 0. 31 mmol/L vs. 18. 16 ± 1. 01 mmol/L) at 30 min in the acute hy-perglycemia group compared with the control group. However, the peak values of insulin secretion were delayed in both IPGTT and OGTT. Insulin levels at 2. 8 and 16. 7 mmol/L glucose stimulation in the acute hyperglycemia group was de-clined by 46% and 67% than the control group, respectively (P<0. 05). Residual insulin content in isletβcells was de-clined by 49% at 2. 8 mmol/L and 94% at 16. 7 mmol/L glucose infusion than the control group (P<0. 05). The histolo-gy showed irregular structure of pancreatic islets in the acute hyperglycemia group. The electron microscopy revealed that the amount of insulin granules was decreased, and more cytoplasmic vacuoles and swollen mitochondria were observed. Conclusions Acute intravenous glucose load decreases insulin content of isletβcells, leading to decrease and delay of the first-phase insulin secretion.

Impairment mechanisms of acute hyperglycemia in the first-phase insulin secretion in mouse / 中国实验动物学报

Objective To clarify the impairment mechanisms of acute hyperglycemia in the first-phase insulin se-cretion in mice. Methods The mouse model of acute glucose toxicity was established by glucose infusion through jugular vein catheterization. The glucose and insulin levels were assessed by IPGTT and OGTT in the mice of acute hyperglycemia and control groups. The histology of pancreatic islets was observed using HE staining and the insulin granules and other cy-toplasmic organelles were observed by electron microscopy. Results The mouse model of acute hyperglycemia was suc-cessfully established. The IPGTT showed that the blood glucose level was decreased by 87% ( 10. 3 ± 0. 33 mmol/L vs. 19. 3 ± 1. 66 mmol/L) at 15 min in the acute hyperglycemia group compared with the control group. The OGTT showed that the blood glucose level was decreased by 85% (9. 8 ± 0. 31 mmol/L vs. 18. 16 ± 1. 01 mmol/L) at 30 min in the acute hy-perglycemia group compared with the control group. However, the peak values of insulin secretion were delayed in both IPGTT and OGTT. Insulin levels at 2. 8 and 16. 7 mmol/L glucose stimulation in the acute hyperglycemia group was de-clined by 46% and 67% than the control group, respectively (P<0. 05). Residual insulin content in isletβcells was de-clined by 49% at 2. 8 mmol/L and 94% at 16. 7 mmol/L glucose infusion than the control group (P<0. 05). The histolo-gy showed irregular structure of pancreatic islets in the acute hyperglycemia group. The electron microscopy revealed that the amount of insulin granules was decreased, and more cytoplasmic vacuoles and swollen mitochondria were observed. Conclusions Acute intravenous glucose load decreases insulin content of isletβcells, leading to decrease and delay of the first-phase insulin secretion.

Transformation of baicalin and wogonoside through liquid fermentation with Bacillus natto / 中国中药杂志

This experiment aimed to explore and research the process of preparing baicalein and wogonin through liquid fermentation with Bacillus natto. Active enzymes of produced by B. natto was used for the biological transformation of baclin and wogonoside, in order to increase the content of the haicalein and wogonin in the scutellaria. With the content of the baicalein and wogonin as evaluating indexes, the effects of carbon source, nitrogen source, the types and suitable concentration of inorganic salt, medium pH, granularities of medical materials, liquid volume in flask, shaking speed, liquid-to-solid ratio, fermentation time on the fermentation process were studied. The optimal process conditions for liquid fermentation of scutellaria were 1.0% of peptone, 0.05% of NaCl, pH at 6, the granularities of medical materials of the scutellaria screened through 40-mesh sifter, 33% of liquid, shaker incubator speed at 200 r x min(-1), liquid-to-solid ratio of 5:1, temperature at 37 degrees C, fermentation for 6 days, baclin's conversion rate at 97.6% and wogonoside's conversion rate at 97% in the scutellaria. According to the verification test, the process was stable and feasible, and could provide data reference for the industrial production.

Molecular typing of Leptospira interrogans strains isolated from Rattus tanezumi in Guizhou Province, Southwest of China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To identify and type three leptospires isolated from Rattus tanezumi in Guizhou Province by using three molecular techniques (PFGE, MLVA, and MLST), reveal the molecular characteristic of causative agents of local leptospirosis and evaluate these three molecular methods based on their detection resolution and efficiency.</p><p><b>METHODS</b>Three Leptospira strains were isolated from the kidney of Rattus tanezumi and cultured with EMJH medium. PFGE, MLVA, and MLST assays were applied to type the three strains isolated from Rattus tanezumi in Guizhou Province.</p><p><b>RESULTS</b>PFGE, MLVA, and MLST typing showed that the three leptospiral isolates matched with leptospiral serogroup Icterohaemorrhagiae serovar Lai. The findings of the genotyping methods were consistent. MLVA and MLST defined genotypes, whereas PFGE allowed the recognition of additional subgroups within the genotypes, and the findings of molecular typing were also consistent with those of traditional techniques.</p><p><b>CONCLUSION</b>Three leptospiral isolates from Guizhou Province matched with leptospiral serogroup Icterohaemorrhagiae serovar Lai, and PFGE, MLVA, and MLST, as reliable molecular techniques for identifying and typing of Leptospira interrogans, would contribute to the active surveillance, outbreak investigation and source tracking for leptospirosis in Guizhou Province.</p>

Establishment and application of TaqMan Real-time PCR for the detection of pathogenic Leptospira species / 中华流行病学杂志

Objective To develop and evaluate a TaqMan Real-time PCR method for the detection of pathogenic Leptospira species.Methods rrs gene of part fragment on 16S rRNA was used to design primers and TaqMan probe.The target gene was cloned into vector pMD19-T in order to make the standard curve and be used for quality control.To determine the specificity and specificity,DNA from Chinese Leptospira strains belonging to 15 pathogenic reference strains,21non-pathogenic reference strains,and 50 different serotypes of pathogenic isolates as well as 27 other micro-organisms were included in this study.Eight serial DNA dilutions from pathogenic Leptospira and DNA from 25 kidney tissues were detected by Real-time PCR and conventional PCR simultaneously.Results A Real-time PCR methodology was developed and optimised.All the pathogenic Leptospira gave a positive amplification.Non-pathogenic Leptospira and all the other micro-organisms were not amplified.The plasmid sensitivity of Real-time PCR and conventional PCR were 10 copy/μl and 104 copy/μl respectively.The DNA sensitivity of Real-time PCR and conventional PCR were 100 fg/μl and 1 ng/μl respectively.The kidney tissue detection of the two methods appeared to be exactly the same.Conclusion This research project successfully developed a Real-time PCR methodology with better sensitivity and specificity for the identification of pathogenic Leptospira,using the rrs gene.

Molecular typing on Leptospira interrogans isolates from Jiangxi province,by pulsed-field gel electrophoresis / 中华流行病学杂志

Objective To perform a molecular epideminlogical investigation on the types of Leptospira interrogans isolates from leptospirosis patients and animal hosts in Jiangxi province,using a pulsed-field gel electrophoresis (PFGE).Methods The extracted chromosomal DNA from leptospiral isolates were digested with restriction endonuclease Not Ⅰ and the DNA segments were separated by using PFGE.By BiOnurerics V4.0 software and 75% similarity as the standard,the obtained PFGE images from leptospiral isolates were managed to establish a digitization database and then the PFGE maps of leptospiral isolates were compared with those of reference standard strains belonging to 15 serovars in 15 serogroups of L.interrogans,for cluster analysis.Results 139 strains of L.interrogans isolated from different areas of Jiangxi province were classified into 46 PFGE types.Among the PFGE types,LepNot Ⅰ.0071,LepNotⅠ.0072 and LepNot Ⅰ .0043 were the predominant types that accounting for 28.06%,15.11% and 7.19% of all the leptospiral isolates,respectively.The PFGE maps from 84.89% (118/139) of the 139 leptospiral isolates were found to basically match those of 6 reference standard strains belonging to 6 serovar in 6 serogroups of L.interrogans.In the 118 matched ieptospiral isolates,32.37% (45 strains),15.83% (22 strains) and 15.11% (21 strains)belonged to sero-groups Icterohaemorrhagiae serovar Lai,sero-groups Australis serovar Australis and sero-group Javanica serovar Javanica,respectively.Conclusion PFGE seemed a fast,accurate and effective method for typing of L.interrogans isolates.Serogroup Icterohaemorrhagiae serovar Lai and followed by serogroup Australis serovar Australis as well as serogroup Javanica serovar Javanica were the predominant L.interrogans species in humans and animal hosts in Jiangxi province.

The relationship of CPS-I, OCT and hepatic encephalopathy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the role of carbamyl phosphate I (CPS-I)and ornithine transcarbamoylase (OCT) levels in cirrhosis patients with and without hepatic encephalopathy, and to analyze the correlations between CPS-Iand OCT with the development of hepatic encephalopathy.</p><p><b>METHODS</b>CPS-I, OCT, plasma ammonia and liver function of 95 cirrhosis patients with hepatic encephalopathy and 25 cirrhosis patients without hepatic encephalopathy in our hospital from January 2008 to December 2009 were analyzed. 60 healthy controls were recruited in the control group. The differences of serum CPS-I, OCT levels among the cirrhosis patients with and without hepatic encephalopathy and the healthy controls were analyzed; the correlations of CPS-I, OCT levels with plasma ammonia and total protein in cirrhosis patients,and the correlations of CPS-I, OCT levels with Child-Pugh classification of cirrhosis symptom severity in cirrhosis were analyzed. the clinical characteristics between patients who had HE and no HE with chi-square tests were compared. Comparisons of CPS-I, OCT levels across patients based on the Child-Pugh classification were performed with One-Way ANOVA and Student-Newman-Keuls, correlation of CPS-I, OCT with other indicators were performed with Pearson correlation analysis.</p><p><b>RESULTS</b>Serum CPS-I and OCT levels in cirrhosis patients with hepatic encephalopathy were (143.3+/-48.5) U/L, (297.0+/-102.6) is multiplied by 10 U/L, which were lower than that in cirrhosis patients without hepatic encephalopathy (180.3+/-51.5) U/L, (351.8+/-109.0) is multiplied by 10 U/L (t = 2.53, t = 2.78, P < 0.01). Compared with healthy controls, serum CPS-I and OCT levels in cirrhosis patients with and without hepatic encephalopathy were all lower (t = 3.21, t = 4.16, t = 2.12, t = 3.15, P < 0.05). CPS-I was correlated with OCT, (r = 0.946, P < 0.05); CPS-I and OCT were negatively correlated with ALT and AST (r = -0.284, r = -0.239, r = -0.303, r = -0.322, P < 0.05). Additionally, CPS-I and OCT levels were negatively correlated with the Child-Pugh classification in Cirrhosis (F = 10.13, F = 20.28, P < 0.01).</p><p><b>CONCLUSION</b>The serum CPS-I and COT levels were important factors affecting plasma ammonia in patients with cirrhosis and played an important role in the development of hepatic encephalopathy.</p>

Establishment of standardized method for pulsed-field gel electrophoresis on Leptospira interrogans and analysis on their patterns / 中华流行病学杂志

<p><b>OBJECTIVE</b>To establish a standardized operation procedure for pulsed-field gel electrophoresis (PFGE) on Leptospira interrogans as well as a figure digital database to develop the Chinese representative reference strains.</p><p><b>METHODS</b>Under the characteristics of strains and referring to the other SOPs of PFGE on pathogens provided by CDC and PulseNet Asia Pacific, genomic chromosome DNA purification, restriction endonuclease digestion and the parameters for running PFGE were optimized.</p><p><b>RESULTS</b>Not I digestion patterns of leptospiral genome for the Chinese representative strains were established and partial isolates of serogroup icterohaemorrhagiae from the leptospirosis surveillance in Sichuan and Anhui provinces were analyzed by PFGE. Results showed that each of all the 15 Chinese representative strains had a unique pattern. 91.67% (22/24) of the 24 isolates identified as serogroup icterohaemorrhagiae matched to the map of the reference strain 56601 (serogroup icterohaemorrhagiae serovar lai).</p><p><b>CONCLUSION</b>The PFGE figures were clear with high resolution and the fragments were equally distributed by this standardized operating procedure so as to reveal the molecular-genetic characteristics of Leptospira interrogans. The patterns had high relativity with the serological identification and seemed to be very important for genetic analysis of strains in studying the outbreak of leptospirosis.</p>

Surveillance on severe acute respiratory syndrome associated coronavirus in animals at a live animal market of Guangzhou in 2004 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of severe acute respiratory syndrome coronavirus (SARS-CoV) like virus in animals at a live animal market of Guanzhou in 2004 before and after culling of wild animal action taken by the local authority, in order to predict the re-emerging of SARS from animal originals in this region.</p><p><b>METHODS</b>Animals at live animal market were sampled for rectal and throat swabs in triplicate. A single step realtime reverse transcription-polymerase chain reaction (RT-PCR) diagnostic kit was performed for screening SARS-CoV like virus, the manual nested RT- PCR and DNA sequencing were performed for confirmation. Only specimens which tested positive for both of the N and P genes by nested RT-PCR were scored as positive.</p><p><b>RESULTS</b>In 31 animals sampled in January 5 2004 before culling of wild animals at Guangdong Province, including 20 cats (Felis catus), 5 red fox (Vulpes vulpes) and 6 Lesser rice field rats (Rattus losea), 8 (25.8%) animals were tested positive for SARS-CoV like virus by RT-PCR methods, of which 4 cats, 3 red fox and one Lesser rice field rats were included. However, two weeks after culling of animals and disinfection of the market were implemented, in 119 animals sampled in January 20 2004, including 6 rabbits (Oryctolagus cuniculus), 13 cats, 46 red jungle fowl (Gallus gallus), 13 spotbill duck (Anas platyrhynchos), 10 greylag goose (Anser anser), 31 Chinese francolin (Franclinus pintadeanus), only rectal swab from one greylag goose was tested positive for SARS-CoV like virus. Furthermore, in 102 animals that including 14 greylag gooses, 3 cats, 5 rabbits, 9 spotbill duck (Anaspoecilorhyncha), 2 Chinese francolin (Franclinus pintadeanus), 8 common pheasant (Phasianus colchicus), 6 pigeons, 9 Chinese muntjac (Muntiacus reevesi), 19 wild boar (Sus scrofa), 16 Lesser rice field rats, 5 dogs, 1 mink (Mustela vison), 3 goats, 2 green peafowl (Pavo muticus) sampled in April, May, June, July, August and November, only rectal swab from one pig was tested positive. However, of 12 and 10 palm civets sampled in November and December including five of which had been at the live animals market for 2 days, none of them was tested positive.</p><p><b>CONCLUSION</b>This findings revealed that animals being sampled in April, May, June, July, August and November of 2004, only one rectal swab from a pig was tested positive as SARS-CoV like virus, much lower than the results from the previous year, suggesting that the possibility of re-emerging of human infection from animal origins is low for the winter of 2004-2005.</p>

Distribution of virulence associated genes among strains of Leptospira / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze factors related to the virulence associated genes of Leptospires.</p><p><b>METHODS</b>Twelve putative virulence associated genes were detected by polymerase chain reaction (PCR) method in 38 reference strains, 81 field strains of Leptospira interrogans isolated from patients or animals, and 12 avirulent strains of Leptospira biflexa.</p><p><b>RESULTS</b>These putative virulent genes were widely distributed among the strains of Leptospira interrogans, but only few of them were detected in Leptospira biflexa. Gene lipL32 was detected in all strains of Leptospira interrogans. Distribution of gene lipL36 was varied significantly with detected rates from 0 to 90.91%. Gene la1608 had a positive rate of 87.50% for strains of serogroup Icterohaemorrhagiae, but was only detected in few strains of other serogroups with a range from 0 to 25.00%. Rate of detection on gene sphA was 17.65% in Leptospira interrogans, and was absent in serovar hardjo reference strain.</p><p><b>CONCLUSION</b>Results indicated that these genes might be of importance for the virulence and pathogenicity of Leptospira interrogans, while gene lipL32 might be one of the common antigens. Gene lipL36 might be involved in serogroup specificity with genetic diversity, but gene la1608 was as one of the genes with specificity for serogroup Icterohaemorrhagiae. However, serovar hadjo might hold quite different genetic characteristics when compared with the other serovars of Leptospires.</p>