Construction of a competency evaluation model for health managers based on grounded theory / 预防医学

Objective@#To construct a competency evaluation model for health managers based on the grounded theory, so as to provide insights into the training and evaluation of health managers.@*Methods@# From December 2022 to March 2023, health managers with three years and more of working from health management center of a tertiary hospital, a health management enterprise and a university with a top-tier ranking for the major of "Health Services and Management" were invited, and a semi-structured interview on competency was conducted based on grounded theory. Coding techniques were applied to analyze the interview data, including open coding, axial coding, selective coding and theoretical saturation testing using NVivo12 software. Based on the coding results and drawing inspiration from McClelland's "Iceberg Competency Model Structure", a competency evaluation model for health managers was formulated.@*Results@#Twenty-one health managers participated in the study, including 8 participants from the hospital, 7 participants from the enterprise and 6 participants from the university, 14 females, 17 participants with 3-10 years of working, and 6 participants with the rank of associate senior professional title or above. The interview yielded 5 main categories, from which the competency evaluation model for health managers was developed with five dimensions: professional development, health management capability, communication and coordination, humanistic care, and personal traits. professional development and health management capability constituted the overt competencies of health managers, while communication and coordination, humanistic care, and personal traits formed their implicit competencies. @*Conclusions@#The competency evaluation model for health managers constructed in this study includes explicit competency and implicit competency, which is expected to serve as a reference for the effective selection and cultivation of health managers.

Physical activity among senior primary school students on weekends in Beijing / 中国学校卫生

Objective@#To analyze the duration and influencing factors of moderate and vigorous physical activity(MVPA) on weekends for primary school students in grades 4 to 6 in Beijing, and to provide a reference for formulating health education and promotion measures.@*Methods@#Multi stage stratified cluster sampling method was used to randomly select 2 515 students from grades 4-6 in 14 primary schools in Beijing, and a self administered questionnaire was used to record MVPA on weekend, social demographic characteristics, other related health behaviors and knowledge. Multivariate Logistic regression analysis was used to explore the influencing factors of MVPA on weekends.@*Results@#The prevalence of insufficient MVPA on weekends in Beijing was 63.54 %, and the prevalence was higher among girls (69.92%) than boys (57.81%) ( χ 2=39.65, P <0.01). Multiple Logistic regression analysis revealed that girls ( OR =1.74), living in rural areas ( OR =1.41), participants attending general schools ( OR = 1.34 ), from divorced family ( OR =1.46), and short sleep duration ( OR =1.50) were more likely to fail to meet the MVPA recommendations( P <0.05).@*Conclusion@#It is quite common that no sufficient weekend MVPA among senior primary school students, among them, the outer suburbs and schools with relatively weak teaching resources are the key places that need attention, and girls are the key groups that need attention.

Current advances in research of semaphorin 3A:a potential target for the treatment of nospecific low back pain / 中国骨伤

Nonspecific low back pain is closely associated with afferent nerve ingrowth into degenerated IVDs and increasing the inflammatory response. Members of the class 3 semaphorins signal their response through two prominent receptors; the NRP (Neuropilin-1) and the Plexin A. Sema3A (Semaphorin3A) is primarily known for their role in modulating neuronal survival as well as neurite outgrowth and guidance via regulation of Sema3A-NRP-1-plexinA signal pathway. Also, sema3A is shown to be conductive to innervate the inner painful degenerated IVDs (Intervertebral discs). Furthermore, sema3A is thought to act as a barrier to endothelial cells survival and migration on vascular endothelial growth factor (VEGF) and inhibition of KLF5-induced (Krüppel-like factor 5) inflammatory mediators within degenerated IVDs. Therefore, Sema3A produce a new perspective of dual-action therapeutic agent for attenuating the regulator of innervation and angiogenesis into degenerated IVDs and inhibition of KLF5-induced inflammation.

Prevalence and associated factors of electronic products usage among primary school students of grade 4-6 in Beijing / 中国学校卫生

Objective@#To explore the prevalence and associated factors of non learning-based screen time of 4-6 grade school students in Beijing, and to provide a basic data for further research on hazard control measures such as myopia, overweight and obesity among children and adolescents in Beijing.@*Methods@#Multistage stratified random cluster sampling method was adopted. A total of 2 515 primary school students were randomly selected in from schools in Beijing, self-developed questionnaire was used to investigate on the time for each electronic products usage for non-learning purpose, the total of electronic products usage every day and other information.@*Results@#The rates of screen time >15 minutes each time and ≥1 h daily were 48.43%, 22.90%, respectively. Multiple Logistic regression analysis showed that ordinary school, 6 th grade, male, single-parent family and other types of family, and lack of moderate-to-vigorous physical activity at weekend were associated with the students’ non learning-based screen time (OR=1.66, 2.28, 1.27, 1.44, 1.87, 2.20, P<0.05).@*Conclusion@#The situation of excessive screen time of primary school students was improved in Beijing, but still be prevelent, male students of grade 4 should be given more attention, and more importance should be attached to the offect of family in children.

Current advances on surgical treatment for knee articular cartilage injuries / 中国骨伤

Chondral injuries are short of self-healing ability and need to surgical repair after articular cartilage injury. Conventional treatment includes debridement and drainage under arthroscope, micro-fracture, osteochondral autograft transplantation (OATS), mosaiplasty and osteochondral allografts (OCA), autologous chondrocyte implantation (ACI). Debridement and drainage could remove pain factor, and has advantages of simple operation, wide clinical application and early clinical effect. Micro-fracture and osteochondral autograft transplantation is suitable for small area of cartilage repair, while the further effect showed that fibrous cartilage permeated by drill could decrease postoperative clinical effect. Osteochondral autograft transplantation has better advantages for reconstruction complete of wear-bearing joint. Autologous chondrocyte implantation and allogeneic cartilage transplantation are suitable for large area of cartilage defect, postoperative survival of allogeneic cartilage transplantation is effected by local rejection reaction and decrease further clinical effect. Cartilage tissue engineering technology could improve repair quality of autologous chondrocyte implantation, and make repair tissue close to transparent cartilage, but has limit to combined subchondral bone plate, reactive bone edema, bone loss and bad axis of lower limb. New technology is applied to cartilage injury, and has advantages of less trauma, simple operation, rapid recover, good clinical effect and less cost;and could be main method for treat cartilage injury with surgical repair technology. How to improve repair quality with compression resistance and abrasive resistance are expected to be solved.

Clinical features and prognosis of renal mucinous tubular and spindle cell carcinoma / 医学研究生学报

Objective There are few clinical cases of mucinous tubluar and spindle cell carcin oma (MTSCC).The article aimed to explore its clinical features and prognosis in order to raise awareness of the disease . Methods A retrospective analysis was conducted on the clinical data of 12 patients with renal MTSCC from June 2009 to June 2017.All the patients were treated with unilater-al radical nephrectomy or enucleation .After discharge, the patients were regularly reviewed or followed up by telephone . Results Of the 12 patients with renal MTSCC, 8 were female, 4 were male, 10 were atypical and 1 was atypical (oligominal tubule), all of them were treated with surgery, one of them lost contact, and the remaining 11 patients had good prognosis. Conclusion Renal MTSCC is a rare form of renal cancer, which is more common in females.The imaging data show that there is no blood supply for renal tumors . Renal MTSCC has a good prognosis , with no recurrence or metastasis, and surgical resection is still the preferred treatment .All the 12 patients with renal MTSCC are in early pathological stage with good prognosis , indicating that renal MTSCC may be a low -grade malig-nancy with good prognosis .

Study on Pre-processing Methods of Clinical Data from TCM Individual Treatment of Insomnia Based on Syndrome Differentiation / 中国中医药信息杂志

Objective To explore suitable pre-processing methods for the TCM clinical data based on prospective study on insomnia treated by syndrome differentiation. Methods Based on the TCM shared clinical and research information platform and by using man-machine combination method, data cleaning rules, physician review, rule revision, procedural import and batch processing were used to conduct pre-processing for data in prospective study on insomniac treated by syndrome differentiation of 8 TCM doctors. Results Totally 27534 rules for symptoms data of individual treatment of insomnia were made and 1036 rules for diagnostic data, 842 rules for therapeutic ways, 540 rules for formula data, 3785 rules for data of Chinese materia medica. Conclusion Different kinds of terminology concepts were normalized at different levels, at the same time, characteristics of individualized treatment based on syndrome differentiation were reserved. Appropriate pre-processing methods can be used in the reaserch of individualization and standardization of TCM syndrome differentiation clinical data and can provide support for data mining.

Minimally invasive treatment of femoral intertrochanteric fracture in osteoporotic elderly patients:A retrospective study / 解放军医学杂志

Objective To evaluate the clinical outcomes of minimally invasive internal fixation for femoral intertrochanteric fracture in osteoporotic elderly patients. Methods A retrospective study was conducted in 112 patients using interan nail (IN) or trochanteric antegrade nail (TAN) for the management of intertrochanteric femoral fracture from January 2009 to September 2015 in our hospital. According to AO classification, there were 34 cases of type 31-A.1, and 61 cases of type 31-A.2, 17 cases of type 31-A.3. Clinical and radiological follow-up were available. Surgical and fluoroscopic time, length of hospital stay, blood loss, complications and hip functions were compared between two groups. Results A total of 78 patients meeting the criteria were evaluated at a mean follow-up of 15 months (range, 3-27 months). The IN was used in 41 patients and the TAN in 37 patients. Operative time, fluoroscopy time and blood loss showed significant difference between the IN group and TAN group (respectively, 58.9±6.9 vs. 75.6±5.9min; 2.70±0.47 vs. 4.40±0.47min; 107.6±6.7 vs. 127.8±6.8ml, P0.05). Conclusions For minimally invasive treatment of unstable femoral intertrochanteric fractures, use of either the IN or TAN is clinically effective. However, IN presents more advantages (e.g., easy operation, reliable fixation, less bleeding, better clinical outcomes, and less complications). The use of IN is a suitable option for the treatment of unstable intertrochanteric fractures in osteoporotic elderly patients.

Effect of TGF-β3 on rabbit nucleus pulposus(NP) cells cultured in three-dimensional polylactic-co-glycolic acid scaffold in vitro / 中国生化药物杂志

Objective To evaluate the effect of TGF-β3 on rabbit nucleus pulposus( NP) cells cultured in three-dimensional polylactic-co-glycolic acid (PLGA)scaffold in vitro.Methods PLGA scaffolds were fabricated by particulate leaching method and soaked in rabbit NP cells suspension(1 × 106/scaffold).PLGA-seeded NP cells were devided into 4 groups: 100 ng/mL TGF-β3/PLGA,500 ng/mL TGF-β3/PLGA,1 μg/mL TGF-β3/PLGA, PLGA control group.Cell proliferation activity was measured using MTT assay.The glycosaminoglycan ( GAG ) analysis were performed by 1, 9-dimethylmethylene blue(DMMB) assay.mRNA expression was measured by quantitive PCR at each time point.Histological observation was performed to elucidate the morphological changes of NP cells in PLGA effected by TGF-β3.Results Higher cellular proliferation activity, GAG production,Collagen type II, Aggrean expression were observed in TGF-β3 /PLGA-seeded NP cells compared with PLGA control group on day-7,day-14,day-21(P<0.05). Higher dose of TGF-β3 exhibited intense cellular proliferation activity and peri-cellular matrix by increasing trend(P<0.05).Histological observation showed TGF-β3/PLGA developed more significant disc cells cluster than PLGA groups on day-21.Conclusion The 3D porous PLGA scaffold-seeded cells using TGF-β3 can promotes cell proliferation, and prompt extracellular matrix(ECM) production.It is a potential biotherapy for the treatment of disc degeneration.

Effect of Trifolium pratense extract on methionine-choline-deficient diet-induced steatohepatitis in C57BL/6 mice / 中国天然药物

AIM@#The potential of Trifolium pratense (red clover) extract in the prevention of lipid disorder has attracted increasing attention in recent years. In this study, the aim was to determine whether and how red clover extract affected the development of murine diet-induced non-alcoholic steatohepatitis.@*METHODS@#Non-alcoholic steatohepatitis was induced in C57BL/6 mice by feeding mice with a methionine-choline-deficient (MCD) diet. Hematoxylin and eosin staining was used for histological analyses. Real-time PCR was used to analyze the mRNA expression levels.@*RESULTS@#Hepatic steatosis and necroinflammation was observed in MCD diet-fed mice, and this diet-induced steatosis was significantly attenuated, whereas liver inflammation was not significantly attenuated, by red clover extract treatment. Consistent with the results of H&E staining, the MCD diet-induced increase of liver triglycerides and cholesterol levels were significantly reduced by red clover extract treatment. However, with the improvement in hepatic steatosis, mRNA levels of acetyl CoA oxidase, carnitine palmitoyl transferase-1, and liver fatty acid-binding protein, three genes regulated by peroxisome proliferator-activated receptor (PPAR) α, were unaffected.@*CONCLUSION@#Red clover extract alleviated MCD diet-induced hepatic steatosis, but did not ameliorate liver inflammation in C57BL/6 mice, and the improvement in hepatic steatosis was not through activating PPARα.

Inhibiting valosin-containing protein suppresses osteosarcoma cell metastasis via AKT/nuclear factor of kappa B signaling pathway in vitro.

Background and Aim: The strategies of targeting valosin-containing protein (VCP) may have therapeutic potential for treating cancer metastasis. In this study, we aim to investigate the correlation of VCP protein expression in osteosarcoma (OS) tissues with pulmonary metastasis and its possible molecular mechanism. Materials and Methods: Expression of VCP in 60 OS specimens was detected by immunohistochemistry (IHC) and the relationship with metastasis was analyzed. An artifi cial micro ribonucleic acid, targeting VCP, was performed to silence the expression of VCP in U2-OS cells. Cell mobility was detected by wound healing and Transwell assays. Western blot and real-time polymerase chain reaction were performed to investigate the expression of VCP in U2-OS cells. Furthermore, the protein of pAKT (phosphorylated serine/threonine protein kinase) and nuclear factor of kappa B protein65 were measured by western blot to evaluate the effect of silencing VCP on AKT/nuclear factor of kappa B (NF-B) signaling pathway. Results: The results showed that the expression level of VCP protein in cases with pulmonary metastases was signifi cantly higher than that in those without metastasis (P = 0.004). The invasion and migration of U2-OS cells were suppressed by silencing VCP. Furthermore, silencing VCP could down-regulate the phosphorylation of AKT and nuclear transfer of NF-B. Conclusions: Our fi ndings suggested that inhibition of VCP could suppress OS cells invasion and migration through down-regulating AKT/NF-B signaling pathway.

Application of the ultrasonic guidance-assisted neonatal internal jugular vein cannulation / 中华医学超声杂志（电子版）

Objective To investigate the application of the ultrasonic guidance-assisted neonatal internal jugular vein catheterization.Methods Sixty two newborns (including low birth weight infants) receving thoracic/abdominal operation or resection of malignant tumor on the body-surface were randomly assigned to ultrasound guidance (UG) group or surface mark landmark(S) group.Newborns in both groups were all punctured with 22G venous indwelling needles to place the external casing,followed by the steel wire guidance-assisted implantation of ARROW 4F dual chamber central venous catheter.Then we compared the rate of successful insertion attempt,rate of malpositioning,complications and average operation time between the two groups.Results The rate of successful insertion attempt was 96.8%(30/31) in the UG group,significantly higher than that in the S group (32.3%,10/31),there was significant difference between the two groups(χ2=28.182,P=0.000).Malpositioning happened in 2 cases in the UG group,but 25 cases in the S group.Rate of complications was higher in the S group compared to the UG group (64.5% vs 3.2%,χ2=25.99,P=0.000).Most importantly,the average operation time was (4.366±1.137)min in the UG group,significantly shorter than that of the S group [(13.70±5.34)min,t=5.463,P=0.028)].ConclusionUltrasound guidance-assisted catheterization for neonatal internal jugular vein is safe and feasible and can dramatically improve the success rate and prevent complications.

Effects of Long-term Administration of Low-dose FTY720 on Survival of Murine Cardiac Allograft / 华中科技大学学报（医学）（英德文版）

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism.Murine models of abdominal heterotopic heart transplantation were established.Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografis until the occurrence of rejection or the observation terminals.The animals without FTY720 treatment and those with syngencic cardiac grafts transplanted served as controls.The mean survival time (MST) of grafts,and T lymphocyte subsets in gratis,peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry,and compared among groups.The results showed that the MST of allografts in FTY720-treated mice was more than 40 days,significantly longer than that in the untreated group (MST=8 days,P＜0.01).After the long-term administration of FTY720,the proportion of CD4+ and CD8+ lymphocytes in peripheral blood was diminished significantly,but the proportion ofCD4+ lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen.lmmunofluorescence staining revealcd that the infiltration of CD4+ and CD8+ lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720.It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts,resulting in the inhibition of rejection and the long-term survival of allografts.

Case-control studies on therapeutic effects for the treatments of tibial plateau fractures between arthroscopic technique in minimally invasion surgery and minimally invasive internal fixation with plates and screws / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of minimally invasive arthroscopic internal fixation with plates and screws in treating tibial plateau fractures.</p><p><b>METHODS</b>A retrospective study from December 2006 to June 2010 was done on 69 patients with tibial plateau fractures. According to Schatzker classification, 5 patients were type I, 5 patients were type II, 25 patients were type III, 20 patients were type IV, 9 patients were type V and 5 patients were type VI. Thirty-six patients were treated with arthroscopy-assisted reduction and internal fixation, including 21 males and 15 females, ranging in age from 17 to 59 years (averaged, 34.2 years); another 33 patients were treated with small incision and fixed with plates and screws,including 19 males and 14 females, ranging in age from 18 to 62 years (averaged, 35.4 years). The operation time, blood loss during operation,drainage volume of blood, healing time, weight-bearing time and function of effected knee were compared between the two groups.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 6 to 12 months (averaged, 10.3 months). All the patients had no complications such as infection, articular collapse, re-fracture and joint stiffness. There were no significant differences in weight-bearing time, complications and Rasmussen scores between two groups (P>0.05); but there were significant differences in the operative time, blood loss, drainage volume of blood, hospital stay time, the healing time between two groups (P<0.05). The results showed that arthroscopy-assisted technique was better than minimally invasive internal fixation in operation duration, blood loss during operation and the healing time.</p><p><b>CONCLUSION</b>Different types of fracture of tibial plateau should be treated with different surgical treatments. Arthroscopic technique for reduction of fractures, which has less influence on bony union and minimally invasive, and can provide a good clinical outcome.</p>

Predictive value of serum uric acid on type 2 diabetes mellitus / 中华流行病学杂志

Objective To evaluate the predictive value of uric acid (UA) on type 2 diabetes mellitus (DM).Methods 711 subjects aged 45-60 years old with normal fasting blood glucose (FBG) were studied in 1992.The subjects were divided into 2 groups according to their 1992 UA data in the normal UA group and in the hyperuricemia (HUA) group.We analyzed the prevalence of DM-2 in 2007 according to data on UA in 1992.Relative risk (RR) of the cohort was calculated under x2 test and logistic regression analysis.Results FBG and the prevalence rate of DM in 2007 in the HUA group were statistically higher than those in the normal group.The relative risk (RR) of HUA to DM was 3.749 (P=0.000),with 95％ Confidence interval (CI) as 2.387-5.890.Data from the logistic regression analysis,after adjusting for other risk factors,the RR of UA to DM was 1.426 (P＝0.003),with 95％ CI as 1.173-1.705.Conclusion The abnormal UA was closely related to glucose metabolism disorder while hyperuricemia appeared to be associated with increased risk of type 2 DM.

In vivo study of innervation of degenerative intervertebral discs in rabbit anular-injury model / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To observe degenerative intervertebral disc and to examine innervation of degenerative discs in the rabbit anular-injury model.</p><p><b>METHODS</b>Two different magnitudes of anular injury at 5 mm depth were performed by 11 blade or 16 gauge needle at the L3-L4 or L5-L6 discs in New Zealand white rabbits (n=48, 2.5-3.0 kg). Disc degeneration was evaluated by radiographic, MRI and histological examination at different time points after surgery. To identify nerve ingrowth into disc, two general markers PGP 9.5 and GAP 43, for nerve fibers were examined by immunohistochemistry.</p><p><b>RESULT</b>Significant decreases in disc height and signal intensity in magnetic resonance imaging were observed in 11 blade group and 16 G puncture group (P<0.01). 16 G puncture group induced slower and more progressive disc degeneration companed with the stab group and control group. At the 12-week time point, nucleus pulposus tissues were extruded and scar tissues formed outside the disc. In stab discs, nerve ingrowth was scattered on the surface of injury site and in the deeper part of the scar tissues, more than 1 mm from the surface. However, in punctured discs, PGP 9.5 and GAP 43-immunoreative fibers were only observed in the outmost part of the scar tissues and superficial area. More nerve fibers were observed in stab group.</p><p><b>CONCLUSION</b>Innervation may act as a source of discogenic pain which is associated with intervertebral disc degeneration caused by disc anular injury.</p>