Occupational burnout analysis of border guards in the background of COVID-19 / 中国职业医学

@#Objective To analyze the occupational burnout status and its influencing factors of border guards in the prevention （ - ）Methods and control of coronavirus disease COVID 19 . A total of 1 313 border guards who participate in the prevention and control of epidemic diseases were selected as research subjects using the random cluster sampling method. Military Occupational Burnout Scale and Military Occupational Stress Scale were used to investigate the occupational burnout status and Results occupational stress in the research subjects. The median and 25th and 75th percentiles of military occupational （ ， ） （ ， ）， burnout and occupational stress total scores were 9.0 3.0 15.0 and 76.0 70.0 86.0 respectively. About 73.1% of the subjects were suffered from high occupational stress. The results of multiple linear regression analysis indicated that the higher the scores of interpersonal relationship, military special life, work pressure, unclear role and leadership ability factor in P occupational stress, and the lower the score of personal development, the more serious the occupational burnout (all <0.05 ) ， after excluding the influence of confounding factors; subjects with panic psychology inconvenience caused by closed ， management fear on accountability for poor prevention and no personal hobbies had more serious occupational burnout than （ P ） Conclusion - ， subjects without those factors all <0.05 . In the period of COVID 19 prevention the level of occupational burnout and occupational stress of border guards were generally low. The occupational burnout was mainly affected by occupational stress and fear of the epidemic.

Polymorphism on chromosome 9p21.3 contributes to early-onset and severity of coronary artery disease in non-diabetic and type 2 diabetic patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Susceptibility to coronary artery disease (CAD) and diabetes is encoded by distinct, tightly-linked single nucleotide polymorphisms on chromosome 9p21. This study aimed to examine the association of variant rs1333049 on chromosome 9p21.3 with early-onset and severity of CAD in Chinese patients with and without type 2 diabetes, and to determine the possible impact of rs1333049 on glucose metabolism and inflammation pathways.</p><p><b>METHODS</b>Genotyping of variant rs1333049 on chromosome 9p21.3 was performed in 2387 patients with and without diabetes who were undergoing coronary angiography to evaluate suspected or established CAD. Serum levels of glucose, glycosylated hemoglobin A(1c) (HbA(1c)), insulin, high-sensitivity C-reactive protein, tumor necrosis factor-α, and interleukin-6 were also measured, and compared with each patient's genotype.</p><p><b>RESULTS</b>The homozygous CC genotype of rs1333049 was significantly associated with CAD in diabetic (OR: 1.270, P = 0.044) and non-diabetic (OR: 1.369, P = 0.011) patients after adjusting for traditional risk factors. There was an association between CC genotype and number of diseased vessels in diabetics (P = 0.019), but not in non-diabetics (P = 0.126). Among diabetic patients, CC genotype carriers had an increased risk of early-onset CAD (OR: 2.367, P = 0.008) and greater cumulative atherosclerotic burden compared with non-CC genotype carriers (Gensini score: 31.80 ± 17.20 vs. 23.09 ± 21.63, P = 0.039). No significant differences were observed between genotypes of rs1333049 in serum levels of glucose, insulin, HbA(1c), or inflammatory cytokines for diabetic or non-diabetic patients with CAD.</p><p><b>CONCLUSIONS</b>This study demonstrated a significant association of rs1333049 polymorphism on chromosome 9p21.3 with CAD in Chinese diabetic and non-diabetic patients. The homozygous CC genotype of rs1333049 confers a magnified risk of early-onset and more severe CAD in diabetic patients through a novel biological pathway unrelated to glucose metabolism or inflammation.</p>

Comparative study of 4Fr catheters using the ACIST variable rate injector system versus 6Fr catheters using hand manifold in diagnostic coronary angiography via transradial approach / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The transradial approach is regarded as a useful vascular site for coronary procedures. The aim of this study was to test whether 4Fr catheters assisted by ACIST variable rate injector system can produce comparable angiographic quality and reduce the risk of radial artery injury compared to hand manifold 6 Fr catheters.</p><p><b>METHODS</b>A total of 1816 patients were studied consecutively, among whom 856 patients received coronary angiography by 4 Fr catheters (4Fr group) and 960 patients by 6 Fr catheters (6Fr group). Angiographic and procedural characteristics were observed and recorded. The luminal inner radial arterial diameter before and after the procedure were collected.</p><p><b>RESULTS</b>The baseline clinical characteristics were similar in both groups. There were no significant differences in procedure time, radiation dose and quality scores in both groups (P > 0.05), but more contrast media was delivered in the 6Fr group (P < 0.001). The mean radial arterial diameter six months after the procedure in the 6Fr group reduced significantly compared to that measured one day prior to the procedure (P < 0.001).</p><p><b>CONCLUSIONS</b>Coronary angiography using the 4Fr catheters with Acist power injection system can achieve an acceptable diagnostic quality while at the same time minimizing radial artery injury and contrast media consumption.</p>

Effects of intravenous metoprolol by two injection methods on atrial fibrillation and rapid ventricular rates complicated with heart failure / 中华全科医师杂志

Objective To explore the effectiveness and safety of intravenous metoprolol by two injection methods in treatment for patients of atrial fibrillation anti rapid ventricular rates complicated with heart failure.Methods Patients of atrial fibrillation and rapid ventricular rates complicated with heart failure were administrated regular drug therapy for their heart failure,and then they were observed for half an hour.If their ventricular rates were above 100 beats/min and blood pressure equal to or above 100/60 mm Hg (1 mm Hg=0.133 kPa),they were randomly divided into three groups,the first one administrated with metoprolol 10 mg by minipump in an hour,the second one administrated with metoprolol 5 mg in 10 minutes by direct injection,and repeated by 5 mg 10 minutes later if their heart beats were still above 100 beats/min and blood pressure equal to or above 100/60 mm Hg,and the third one administrated with normal saline as control group.As either ventricular rates were equal to or lower than 60 beats/min or blood pressure lower than 90/60 mm Hg,drug administration would be terminated.Symptoms,physical signs, heart rate,blood pressure,rale on auscultation of the chest,parameters of haemodynamics,serum levels of brain natrium peptide (BNP) and atrial natrium peptide (ANP) were observed at 0 h and 1 h after drug injection.Results Clinical symptoms and physical signs of heart failure were improved significantly,heart rates and serum levels of BNP (F=15.929,14.534,all P