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Objective:To explore the potential application of combining 18F-FDG PET imaging and radiomics in the diagnosis of Parkinson′s disease (PD) and atypical parkinsonian syndromes (APS). Methods:A total of 154 subjects of two cohorts (training set and validation set) were enrolled from Huashan Hospital, Fudan University from March 2015 to August 2020 in this cross-sectional study, including 40 normal controls (NC; 23 males and 17 females, age: (60.2±10.5) years), 40 PD patients (20 males and 20 females, age: (64.7±6.3) years), 40 progressive supranuclear palsy (PSP) patients (20 males and 20 females, age: (64.1±5.9) years), and 34 multiple system atrophy (MSA) patients (19 males and 15 females, age: (65.0±9.2) years). 18F-FDG PET images and clinical scale were selected, and one-way analysis of variance was used to compare differences of clinical scale among groups. Radiomic features extraction and feature selection were carried out. Two and three classification models were constructed based on logistic regression, and the ROC curves of clinical model, radiomics model and combined model were calculated. Independent classification tests were conducted 100 times with 5-fold cross validation in two cohorts. Results:There were significant differences in the scores of unified PD Rating Scale (UPDRS) and Hoehn-Yahr rating scale (H&Y) among different groups in cohort 1 and cohort 2 respectively ( F values: 4.83-17.95, all P<0.05). A total of 2 444 imaging features were extracted from each subject, and after features selection, 15 features for classification were obtained. In the two classification experiment, the AUCs of the three models in binary classification of PD/MSA/PSP/NC group were 0.56-0.68, 0.74-0.93 and 0.72-0.93, respectively. The classification effects of the radiomics model were significantly better than those of the clinical model ( z values: 1.71-2.85, all P<0.05). In the three classification experiment, the sensitivity of the radiomics model reached 80%, 80% and 77% for PD, MSA and PSP, respectively. Conclusion:18F-FDG imaging combined with radiomics has potential in the diagnosis of PD and APS.
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Objective:To investigate the attitude of health providers towards hospice care in Shanghai,and analyze the related influencing factors.Methods:From November to December 2019,a questionnaire survey on the attitude towards hospice care was conducted among 7 074 health providers from 223 medical institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The total score of attitude to hospice care was (91.9±11.6),the average score of items was (3.7±0.5). The highest score rate was "perception of the benefits for the quality of life promotion" (87.08%),and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (60.88%).Health providers who were doctors ( B=-1.207), nurses ( B=-0.912), those without witness of dying or end-of-life patients ( B=-1.417), those without involving in hospice care services ( B=-1.203), and not willing to participating in hospice care ( B=-7.849) had lower attitude scores (all P<0.05). Conclusions:The survey indicates that health providers in Shanghai have a positive attitude towards hospice care,but the initiative to engage in hospice care service is not high. It is necessary to conduct targeted training of relevant professional knowledge to enhance the attitude and enthusiasm to hospice care among health providers.
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During the COVID-19 outbreak,the fever sentinel clinics were set up in Shanghai community health service institutions, based on the experience of Public Health Preparedness Clinic (PHPC) in Singapore. It is a successful case of rapidly transforming existing medical resources into the emergent use for epidemic prevention and control. This article summarizes the necessity and feasibility of setting up a fever sentinel clinic; the functional orientation, hardware and software configuration and operation mechanism of the fever sentinel clinic in different periods according to the operation results. Meantime, the article also proposes suggestions for future improvement of establishing fever sentinel clinic in different regions in China.
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The provision of hospice care can improve the quality of life for terminal patients. Currently the measurement tools for knowledge, attitudes and practices(KAP)of hospice care providers have been developed and widely used internationally. This article reviews the measurement scales and relevant factors for KAP of hospice care to provide reference for further studies. The databases of CNKI, Wanfang data, PubMed, Web of Science databases, Google and Baidu search engines were systematically searched. According to the retrieval strategy, 42 literatures were finally included for analysis. The development of measurement scales and influencing factors about KAP of medical staff were reviewed from the included studies. It appeared some mature scales have been applied in different extent, or available for interpretation into different language versions. Most of researches adopted quantitative tools to measure medical staff's KAP on hospice care. The current researches conducted in China mainland showed a change on target population from nurses to specialized doctors and from a single group to multidisciplinary medical team. In the future, it would be more focusing on multidisciplinary team mainly comprised of general practitioners, nurses and social workers. Till recently, there is little literature evidence for study of the characteristics of localization.
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Objective:To investigate the knowledge level of hospice care and the related influencing factors among health providers in Shanghai.Methods:From November to December 2019,a questionnaire survey on the hospice care knowledge was conducted among 7 074 health providers from 223 registered hospice care clinics or institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. Among the 7 027 responders, there were 1 460 males (20.8%) and 5 567 females (79.2%) with an mean age of (36.9±9.3) years; 2 682 nurses (38.2%) and 2 442 doctors (34.8%); 5 065 (72.1%) from community health service centers; 2 982 (42.4%) involving in hospice care services and 4 039 (57.5%) willing to work in hospice care. The average score of hospice care knowledge was (8.9±2.6), and the average accuracy for questions was 59.0%. Health providers had the highest awareness rate for the composition of hospice care professional team (93.9%, 6 597/7 027) and the lowest awareness rate for the emotional commitment in hospice care service (16.6%, 1 165/7 027). Health providers with junior colleges degree ( B=-0.429), vocational college degree and below ( B=-0.544), nurses ( B=-0.652), working in suburban areas ( B=-0.278), social office ( B=-0.891), without witness of dying process of end-of-life patients ( B=-0.329), not involving in hospice care services ( B=-0.283), and not willing to participating in hospice care ( B=-0.820) had low knowledge scores ( P<0.05). Conclusions:The overall level of hospice care knowledge of health providers in Shanghai is generally at a medium level, and the training of hospice care knowledge should be strengthened for the better development of hospice care.
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The data of registered general practitioners (GPs) in Shanghai Pudong New Area from 2014 to 2017 were collected through literature review and institutional investigation. The status of registered GPs was analyzed longitudinally by the methods of descriptive statistics and comparative analysis. The total number of registered GPs in Pudong New Area was increased from 1 227 in 2014 to 1 469 in 2017 and increased by 19.7%, with an average annual growth rate of 6.18%. But the human resources of GPs in Pudong New Area were not sufficient and the recruitment of GPs in grass-roots increased slowly. GPs in community health service centers in remote rural areas steadily increased year by year, however, the uneven distribution still existed. The proportion of GPs with senior professional titles had steadily increased, but it was still low.
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The data of registered general practitioners (GPs) in Shanghai Pudong New Area from 2014 to 2017 were collected through literature review and institutional investigation.The status of registered GPs was analyzed longitudinally by the methods of descriptive statistics and comparative analysis.The total number of registered GPs in Pudong New Area was increased from 1 227 in 2014 to 1 469 in 2017 and increased by 19.7％,with an average annual growth rate of 6.18％.But the human resources of GPs in Pudong New Area were not sufficient and the recruitment of GPs in grass-roots increased slowly.GPs in community health service centers in remote rural areas steadily increased year by year,however,the uneven distribution still existed.The proportion of GPs with senior professional titles had steadily increased,but it was still low.
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Based on the experience of Public-Private Partnership (PPPs) model in domestic and foreign medical field, this study innovatively explored and designed the Build-Transfer-Operate-Transfer (BTOT) operational structure taking the second phase project of ZP Hospital in Pudong New District as a case study.The exploration results showed that the model established the social capital of private non-profit medical institutions by setting up the project company, and used the asset rental and operating management fees in the form of return path.In view of this, the study put forward some relevant countermeasures and suggestions from the aspects of the institution nature and national treatment, property right ownership and risk mitigation, balancing of interests and the cooperation period and solving the core staff etc.All of these measures were taken in order to explore the replicable PPP model in the field of public hospital reform and development.
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Background:Functional dyspepsia (FD)with anxiety and gastric hypersensitivity is still one of the therapeutic difficulties in clinic. Gastrodin (Gas)may have dual effects of modulating gastric sensitivity and anxiety. Aims:To investigate the effect of Gas on gastric sensitivity and anxiety-like behavior in FD with anxiety-like gastric hypersensitivity in rats. Methods:Forty rats were randomly divided into control group,model group,buspirone group,low-dose Gas group and high-dose Gas group. Maternal separation,acute gastric irritation and restraint stress were sequentially performed to induce FD model with anxiety-like gastric hypersensitivity. At the 8th week,rats in control group and model group were intraperitoneally injected with 0. 9% NaCl solution 2. 0 mL/ kg,rats in buspirone group were given buspirone 3. 125 mg/kg,and rats in low- and high-dose Gas groups were given 62. 5,125. 0 mg/ kg Gas,respectively. The course was 7 days. Then elevated plus maze (EPM),open field test,abdominal withdrawal reflex (AWR)and electromyography (EMG) were performed. Results:Compared with control group,EPM test showed that proportions of open arms entries and duration were significantly decreased (P < 0. 01);open field test showed that virtual central grids duration (P < 0. 05),number of virtual grids climbed and times of lifting were significantly decreased (P < 0. 01);when gastric balloon dilatation pressure was equal or greater than 40 mm Hg,AWR score,area under ROC curve (AUC)of EMG was significantly increased in model group (P < 0. 05). Compared with model group,above-mentioned indices in low- and high-dose Gas groups were significantly ameliorated (P < 0. 05). Conclusions:Gas could influence the gastric sensitivity and anxiety-like behavior of the brain-stomach axis regulated anxiety-like gastric hypersensitivity in FD rat model.
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Objective To learn the acceptance of rural community health workers (CHWs ) following the reform of rural health workers′team building in Pudong New Area.Methods 3 295 CHWs were surveyed with questionnaire for their acceptance of the incentive policies,and chisquare test analysis was used to analyze the differences among CHWs in individual areas.Results Over 80.0% of the CHWs reported that they were motivated by the incentive policies to improve their professional competence, medical service and organizational commitment;40.9% of them reported that the policies improved their social status;and 47.3% of them believed the policies could promote the rural areas to attract and retain talents.When a comparison was made of CHWs′feedbacks on different aspects,significant differences indicated that the proportion of CHWs′positive attitudes was the highest at remote rural communities. Conclusions The rural health workers′team building reform could promote incentive on the CHWs,yet with obvious regional differences.
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Objective To survey the career identity and satisfaction of family doctors in Pndong New Area of Shanghai municipality.Methods Two hundred and thirty four family doctors were selected with random sampling method from 6 community health centers in Pudong New Area of Shanghai.The survey on career identity and satisfaction was conducted using a self-designed questionnaire.Results The results showed that 37.2％ of participants were very satisfied (8.1％,19/234) or satisfied (29.1％,68/234) with their current career situation.The three lowest satisfaction factors were salary (14.1％,33/234),benefit and social insurance (27.3 ％,64/234),professional reputation and social status (20.9％ 49/234).Meanwhile,the three highest factors were quality of their leadeship (79.5％,186/234),interpersonal relationship(74.4％,174/234) and the institutional management (63.3％,148/234).The survey also showed that 44.5％ and 30.6％ of participants expected their monthly pay as 8 001-10 000 and 5 000-8 000 RMB; 39.1％ thought the current performance evaluation mechanism as effective,while 25.7％ thought the opposite.Conclusion The social status and salary level of family doctors need to be improved; there is also an urgent need to improve the performance evaluation mechanism and other supporting measures.
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Objective To construct eukaryotic enhanced green fluorescent protein (EGFP) expressing recombinant plasmid, pEGFP-C1-hnRNP A1, which contains coding sequence of human hnRNP A1 (heterogeneous nuclear ribonucleo-protein A1), and to perform cellular localization analysis of EGFP tagged hnRNP A1 under stress. Methods Total RNA was isolated from HeLa cell used for synthesis of first-strand cDNAs using reverse primers that are specific for the 3′-un-translated region of hnRNP A1. hnRNP A1 gene fragments were then amplified by touch-down PCR from those cDNAs and inserted into pEGFP-C1 fluorescent bearing vector through EcoRⅠ/BamHⅡdouble enzyme digestion and T4 DNA Ligase connection. The recombinant pEGFP-C1-hnRNP A1 plasmid was transfected into HeLa cells and green fluorescent tagged fusion proteins was examined by Western blot and confocal fluorescence microscopy. Co-localization of EGFP-hnRNP A 1 with poly (A)+mRNA (the marker of the stress granules), or DCP1a (the marker of processome) were detected by RNA fluores-cence in situ hybridization and immunofluorescence. Results The pEGFP-C1-hnRNP A1 was sequenced and digested cor-rectly by restriction single/double enzyme. The green fluorescent fusion protein was also detected in transfected HeLa cell by Western blot and confocal fluorescence microscopy. EGFP-hnRNP A1 co-localizes with poly(A)+mRNA, but not DCP1a. Conclusion Recombinant eukaryotic plasmid of pEGFP-C1-hnRNP A1 was constructed successfully and expressed effec-tively. EGFP tagged hnRNP A1 takes part in forming stress granules.
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Objective To evaluate the performance of community health institutions of Pudong new district.Methods According to the criteria of the Ministry of Health of China,the performance evaluation system appropriate for local area was developed.A cross-sectional survey was conducted at 44 community health centers,and data was analyzed using descriptive statistics,correlation coefficients and multi-factor linear regression.Results The average score of total performance of these 44 community health centers was 78.53.The average scoring rate for institution management,public health service,basic medical care service,CTM service,and comprehensive satisfaction was 68.49％,89.09％,63.51％,87.80％,76.32％,respectively.Degree of informationization (0.477),regional location (0.331) and participating in medical consortia(-0.309)had significant impact on the total performance.Degree of informationization(0.302)and pilots for family doctors(0.301)had significant impact on the basic medical service performance.Conclusion There is a tremendous room for performance improvement for community health institutions in Pudong.Regional location and degree of informationization were the most crucial factors affecting the performance,irrelevant to institutional sizes.Proposals were raised for strengthening the construction of informationization,expanding pilots for family doctors,perfecting the mechanism of medical consortia.
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@#With the development of social concept and community service, the development of model of community rehabilitation serviceshas been changed profoundly to promote the mainstream development of the disabled. By means of eliminating poverty, supportingthe disabled and their families to benefit from health, education, livelihood development and social integration, etc., meeting the basic needsand raise quality of life, helping the disabled to integrate and participate in the community development process become mainstream thoughtin the community rehabilitation development. Referring to the community rehabilitation concept advocated by international organizationsuch as WHO, this article elaborates the accomplishments and experiences of community rehabilitation achieved by China Disabled PersonsFederation in the 8 poverty-stricken counties in midwestern China .
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<p><b>OBJECTIVE</b>To compare the quality of cultivated and wild Anemarrhena Rhizome from Yi County (Xiling Zhimu) based on contents analysis of active constituents.</p><p><b>METHOD</b>Samples of cultivated Anemarrhena Rhizome from most townships of Yi County were analyzed and compared with wild ones. Six indexes belonged to three kinds active constituents of saponin, flavornoid and polysaccharide were adopted. HPLC-ELSD method with cholesterol as internal standard was adopted to determine the content of sarsasapongenin. HPLC-ELSD method was used to simultaneously determine the contents of anemasaponin C and Anemasaponin A III. Contents of neomangiferin and mangiferin were determined by HPLC-UV method. Total polysaccharide was determined by phenol sulfate method.</p><p><b>RESULT</b>The mean content of sarsasapongenin in cultivated Anemarrhena Rhizome samples is slightly lower than the wild. The mean contents of anemasaponin C and Anemasaponin A III in cultivated Anemarrhena Rhizome samples are higher than the wild. There is no notable difference of these three index between the cultivated and the wild. The cultivated Anemarrhena Rhizome samples have a lower content of neomangiferin and a higher content of mangiferin than the wild. While the total content of these two flavonoids have no notable difference. The cultivated Anemarrhena Rhizome samples have a higher content of total polysaccharide than the wild samples.</p><p><b>CONCLUSION</b>Contents of active constituents in cultivated Anemarrhena Rhizome from Yi County (Xiling Zhimu) are not notably different with the wild Anemarrhena Rhizome. They have similar good quality as the wild ones.</p>
Subject(s)
Anemarrhena , Chemistry , China , Chromatography, High Pressure Liquid , Gardening , Methods , Plant Extracts , Rhizome , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of long-term and low-level occupational Mn exposure on the level of uric acid (UA) in human urine.</p><p><b>METHODS</b>In this study, 65 volunteers were recruited, who were working on welding and foundry work in an plant in Gansu province, China. Additionally, 29 control samples were collected from individuals who did not have any history of excessive Mn exposure. An improved high performance liquid chromatography system equipped with a diode-array detector (HPLC-DAD) method was developed to determine the UA level in human urine. A Spectra AA 220 Atomic Absorption Spectrophotometer (AAS) was used to measure the Mn level in the urine.</p><p><b>RESULTS</b>The analytical method was validated for concentrations ranging from 3.82-45.84 μg/mL with acceptable accuracy, precision, and recovery. Overall, the UA levels of Mn exposure samples were significantly lower than that of control samples (P<0.05).</p><p><b>CONCLUSION</b>The practical method developed here is suitable for both routine monitoring of UA level in human urine and metabolism research. Long-term and low-level occupational Mn exposure may lead to a lower UA level in urine, and UA might be an indicator of the early stage of manganism.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Chromatography, High Pressure Liquid , Manganese , Occupational Exposure , Sex Factors , Uric Acid , UrineABSTRACT
<p><b>OBJECTIVE</b>To establish an HPLC-ELSD method for determination of Anemarsaponin C and Anemarsaponin A III in Anemarrhenae Rhizoma.</p><p><b>METHOD</b>Kromasil C18 column(4.6 mm x 250 mm, 5 microm) was used as stationary phase. Mobile phase was methanol-water gradient with the flow rate of 1 mL x min(-1); the temperature of the drift tube and evaporation was 50 degrees C and 70 degrees C respectively. The gas pressure was 1.03 x 10(5) Pa.</p><p><b>RESULT</b>There are good linearity in the range 0.310-3.10 microg of anemarsaponin C (lgA = 1.254 2lgM + 5.734 7, r = 0.999 5) and in the range 0.323-3.23 microg (lgA = 1.328 41gM + 5. 937, r = 0.999 6) of anemarsaponin A III. The average recovery of anemarsaponin C and anemarsaponin A III was 98.1% with RSD 2.1% and 97.3% with RSD 1.5% (n = 6) respectively.</p><p><b>CONCLUSION</b>The method is rapid and accurate. It is suitable for quality control of Anemarrhenae Rhizoma. The result of determination reveals that the quality of Anemarrhenae Rhizoma from different places of north China are of notable difference.</p>
Subject(s)
Anemarrhena , Chemistry , Chromatography, High Pressure Liquid , Methods , Drugs, Chinese Herbal , Saponins , TriterpenesABSTRACT
Objective To investigate the significance of IL-18R? expression on CD4+ T cells in peripheral blood (PB) of children with Mycoplasma pneumoniae pneumonia (MPP).Methods T cell subtype CD3/CD4/CD8 and expression of IL-18R? on CD4+ T cells in PB from 35 children with MPP and 15 age- and sex-matched control subjects was determined by flow cytometry.Results Compared with that of healthy control, CD3+ and CD4+ positive cells in MPP children were decreased (P0.05).Conclusion There exists cell-mediated immune function disorders and Th1/Th2 imbalance in children with MPP. Th1 immune response is dominant in acute-stage MPP.
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Objective To observe the clinical significance of detection of platelet-associated immunoglobulin (PAIgG).Methods Flow cytometry was used to detect PAIgG in 42 idiopathic throbocytopenic purpura (ITP) patients, 39 aplastic anemia (AA) patients, 21 patients with other autoimmune diseases and 20 normal controls. Rate of inefficient platelet infusion was calculated.Results Percentage of PAIgG positive in ITP, AA and other autoimmune diseases was higher than that in normal controls (P
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Objective To study the expression of adhesion molecule glycoprotein(CD_(44)) in children with primary nephrotic syndrome(NS) and its clinical significance.Methods The expression of CD_(44) in peripheral blood was detected in 28 children with NS by flow cytometry,controlled by 20 cases of healthy children.Results The CD_(44) expression level of NS in active stage was significantly higher than that of the control(P