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In recent years, in the face of the risks and challenges of public health emergencies, the demand and supply of public health talents are relatively tight, and the reform and exploration of the standardized training of public health professionals has become one of the most urgent and important topics. This study analyzed the problems of curriculum system setting, implementation of practical links and composition of tutors in the training process, and learned that Wenzhou Medical University has carried out practical exploration in strengthening theoretical study, highlighting the combination of research and study, deepening professional practice, etc., which has achieved the orderly promotion of public health training supported by supporting reform measures; Take the post competence as the guidance, and vigorously improve the practicing ability; Based on the process and result assessment, promote the reform of training mode and other preliminary results. However, there are also shortcomings and deficiencies in accuracy, supply and effectiveness. Looking at the current situation, it is suggested to promote mechanism construction, increase skill training, develop training standards, improve supporting measures, establish expert committees and other reform ideas, and explore and implement a new model of degree education connection.
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21-hydroxylase deficiency(21-OHD) is mainly characterized by cortisol deficiency with or without aldosterone deficiency and hyperandrogenemia.The disease requires lifelong exogenous glucocorticoid/salt supplementation.Excessive doses of exogenous glucocorticoids are often needed to control hyperandrogenemia, but the effect is not satisfactory.Corticotropin releasing factor (CRF) type 1 receptor antagonist can directly block the production of adrenocorticotropin, inhibit the generation of adrenogenic androgen, reduce the dose of glucocorticoid therapy, and thus lower the incidence of adverse reactions.In this article, the current research progress on 21-OHD therapy and CRF1 receptor antagonist was reviewed.
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BACKGROUND@#Diabetic wound healing remains a major challenge due to the impaired functionality of angiogenesis by persistent hyperglycemia. Mesenchymal stem cell exosomes are appropriate candidates for regulating the formation of angiogenesis in tissue repair and regeneration. Here, we explored the effects of exosomes derived from human amniotic mesenchymal stem cell (hAMSC-Exos) on the biological activities of human umbilical vein endothelial cells (HUVECs) treated with high glucose and on diabetic wound healing and investigate lncRNAs related to angiogenesis in hAMSC-Exos. @*METHODS@#hAMSCs and hAMSC-Exos were isolated and identified by flow cytometry or western blot. A series of functional assays such as cell counting kit-8, scratching, transwell and tube formation assays were performed to evaluate the potential effect of hAMSC-Exos on high glucose-treated HUVECs. The effect of hAMSC-Exos on diabetic wound healing were tested by measuring wound closure rates and immunohistochemical staining of CD31. Subsequently, the lncRNAs profiles in hAMSC-Exos and hAMSCs were examined to screen the lncRNAs related to angiogenesis. @*RESULTS@#The isolated hAMSC-Exos had a size range of 30–150 nm and were positive for CD9, CD63 and CD81. The hAMSC-Exos facilitate the functional properties of high glucose-treated HUVECs including the proliferation, migration and the angiogenic activities as well as wound closure and angiogenesis in diabetic wound. hAMSC-Exos were enriched lncRNAs that related to angiogenesis, including PANTR1, H19, OIP5-AS1 and NR2F1-AS1. @*CONCLUSION@#Our findings demonstrated hAMSC-Exos facilitate diabetic wound healing by angiogenesis and contain several exosomal lncRNAs related to angiogenesis, which may represent a promising strategy for diabetic wound healing.
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Objective To investigate the epidemiological chatacteristics and genotypes of parechovirus A (PeV-A) from children with acute diarrhea in Beijing in 2021. Methods Fecal samples were randomly collected from outpatient children under 60 months with acute diarrhea in a sentinel hospital in Beijing from January to December of 2021. RNA was extracted and detected for PeV-A by real-time RT-PCR. Nested RT-PCR was performed to amplify the VP3/VP1 conjunction region. PeV-A genotypes were determined based on sequencing and NCBI BLAST. Group A rotavirus, norovirus, enteric adenovirus, astrovirus and sapovirus were also detected for co-infection analysis. Phylogenetic and statistical analyses were performed using bioinformatics and statistical software. Results Of the 198 stool samples, 11 were positive for PeV-A, with a detection rate of 5.56% (11/198). Among them, 2 cases were co-infected with enteric adenovirus. 81.82% (9/11) of PeV-A infected cases were under 24 months. The highest detection rate was observed in fall, which was 12.50% (7/56). 90.91%（10/11）of PeV-A infection occurred in summer and fall. Among the 11 PeV-A isolates, 9 were sequenced successfully, of which 7 belonged to PeV-A1B genotype and 2 belonged to PeV-A3 genotype. Conclusion PeV-A1B and PeV-A3 are identified in children with acute gastroenteritis in Beijing in 2021. Infants and young children under 2 years old are the high-risk population for PeV-A infection. Most infections occur in summer and fall.
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A microbial fuel cell (MFC)-based microbial electrochemical sensor was developed for real-time on-line monitoring of heavy metals in water environment. The microbial electrochemical sensor was constructed with staggered flow distribution method to optimize the parameters such as external resistance value and external circulation rate. The inhibition of concentration of simulated heavy metal wastewater on voltage under optimal parameters was analyzed. The results showed that the best performance of MFC electrochemical sensor was achieved when the external resistance value was 130 Ω and the external circulation rate was 1.0 mL/min. In this case, the microbial electrochemical sensors were responsive to 1-10 mg/L Cu2+, 0.25-1.25 mg/L Cd2+, 0.25-1.25 mg/L Cr6+ and 0.25-1.00 mg/L Hg2+ within 60 minutes. The maximum rejection rates of the output voltage were 92.95%, 73.11%, 82.76% and 75.80%, respectively, and the linear correlation coefficients were all greater than 0.95. In addition, the microbial electrochemical sensor showed a good biological reproducibility. The good performance for detecting heavy metals by the newly developed microbial electrochemical sensor may facilitate the real-time on-line monitoring of heavy metals in water environment.
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Bioelectric Energy Sources , Electrodes , Metals, Heavy/analysis , Reproducibility of Results , Wastewater , WaterABSTRACT
Programmed death-1 (PD-1) is an immunosuppressive molecule on the surface of several cells, and functions as a negative regulatory factor in cellular and humoral immune responses via interaction with its ligand PD-L1 or PD-L2. The expression of PD-1 on the peripheral blood lymphocytes of human immunodeficiency virus (HIV) infected people is commonly up-regulated, which not only affects the susceptibility of the virus to target cells and the host′s antiviral immune response, but also affects the effect of antiretroviral therapy. In vitro blocking PD-1/PD-L pathway showed improved HIV-specific immune response of host cells, and PD-1 blockade and/or PD-L1 blockade have been used as an auxiliary means to enhance the efficacy of antiviral therapy and HIV vaccines. This article reviews the progress of the studies on PD-1 in HIV infection, prevention and treatment.
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Objective:To evaluate the detection accuracy of hepatitis B virus (HBV) serological markers among grassroots medical institutions in the demonstration areas of infectious diseases.Methods:A fixed sampling method was used among the followed-up hepatitis B cohort in general population of six infectious disease demonstration areas nationwide. Blood samples of chosen objects were collected, in which HBsAg and anti-HBs were tested by grassroots medical institutions and were also parallely tested by the third-party platform. The test results were compared between the two groups. Statistical analyses were conducted by SAS 9.4 software.Results:A total of 5 756 and 5 263 samples of HBsAg and anti-HBs were successfully tested, respectively. Comparing the results of HBsAg and anti-HBs from grassroots medical institutions with the results from the third platform, the agreement of HBsAg and anti-HBs was 97.13% and 77.33%, respectively. The Kappa value was 0.56 (95% CI 0.50-0.62) for HBsAg and 0.54 (95% CI 0.52-0.56) for anti-HBs, respectively; and the McNemar tests indicated the difference between the results (all P<0.01). There were also significant differences in agreement of testing results with the third platformin among different regions ( P<0.05 or <0.01). The Kappa values indicated that Jiangsu province and Guangdong province had high accordance rates of HBsAg (0.87 and 0.81, respectively), and Gansu province and Guangdong province had high accordance rates of anti-HBs (Both were 0.74). Regarding the results from the third platform as the standard, the sensitivity of HBsAg testing in grassroots medical institutions was moderate (40.51%) and the specificity was well (99.96%). The sensitivity of anti-HBs testing was substantial (73.18%) and the specificity was well (84.31%). Guangdong province (Youden index: 0.69) and Jiangsu province (Youden index: 0.80) had high identification ability for HBsAg, and for indicator of anti-HBs, Gansu province (Youden index: 0.78) and Guangdong province (Youden index: 0.76) had high identification ability. Conclusion:There are certain differences in results of HBV serological markers tests between the grassroots medical institutions in the demonstration areas of infectious diseases and the third platform. Current testing strategies in grassroots medical institutions are suitable for identifying people without hepatitis B infection, while it is necessary to pay attention to the situation of potential false negative error.
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Objective The purpose of this study is to provide a reference for the selection of clinical radiotherapy plan by comparing the difference of dosimetry between coplanar dynamic intensity modulation dIMRT and coplanar VMAT plan in hippocampal protective whole brain radiotherapy (WBRT). Methods 10 patients were selected whose hippocampal were protected by WBRT, dIMRT and VMAT plans were designed for each patient, the differences of target dose, organ-endangering dose and machine hop count were compared between the two groups. Results The two technical plans PTV V30 Gy, D98% and D2% all meet the standard of RTOG 0933, which is better than the dIMRT group for the PTV HI VMAT group (P = 0.004). The hippocampal dose of dIMRT group was better than that of VMAT group, but it did not meet the standard of RGOT 0933. The average Dmax of hippocampus in dIMRT group and VMAT group was 18.44 Gy and 19.30 Gy, respectively (P = 0.004). The average value of hippocampal Dmin was 10.03 Gy and 10.77 Gy, respectively (P = 0.013), and the mean value of hippocampal Dmean was 14.20 Gy and 15.12 Gy, respectively (P = 0.002). The doses of lens, eyeball and optic nerve all met the standard of RTOG0933, and the dose of dIMRT group was significantly better than that of VMAT group (P = 0.000). The treatment time in VMAT group was significantly lower than that in dIMRT group. The treatment time in VMAT group was significantly lower than that in dIMRT group. Conclusion Varian dIMRT has more advantages in controlling hippocampal dose and protecting lens than VMAT, but PTV HI and treatment efficiency are higher in VMAT group.
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OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.
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Objective@#To investigate the gender difference of left-behind adolescents mental health in rural junior middle schools, and to explore possible moderating role of parent-child interaction.@*Methods@#Based on the data of China Education Panel Survey (CEPS) from 2014 to 2015, the self-reported parent-child interaction frequency and mental health of 3 470 eighth grade students lived in rural area were analyzed.@*Results@#Mental health scores were higher in left-behind boys (68.90±22.45) whose parents migration compared to left-behind girls (63.59±20.83)(t=3.02, P<0.01). The two-level mixed effect linear regression model showed that the negative impact of parental migration on the parentchild interaction and mental health of left behind girls was greater than that of left behind boys (B=-0.90, -4.02, P<0.05). The frequency of parent-child interaction moderated the gender difference of mental health of left behind adolescents (P<0.01). The above-mentioned gender differences decreased after adding the frequency of parent-child interaction (B=-3.65, P<0.1).@*Conclusion@#The negative impact of parental migration on mental health of left-behind girls in junior high school is stronger than boys. It is needed to take more care of the mental health and promote parent-child communication for left-behind girls.
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Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a kind of autoimmune disease aiming at NR1 subunit of NMDA receptor. In the early stage, functional damage is the main cause. Electroencephalogram (EEG) can reflect the abnormal brain function by recording the changes of EEG signals. The common EEG patterns of anti NMDA receptor encephalitis are slow wave abnormality, epileptic discharge, a large number of β activity, extreme delta brush, etc. Here we review the waveform characteristics, origin, pathogenesis and clinical value of EEG in patients with NMDA receptor encephalitis.
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Humans , Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Electroencephalography , ResearchABSTRACT
Objective:To evaluate the effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor (CGRP-mAbs) on migraine.Methods:Database of PubMed, Embase, Cochrane, CNKI, Wangfang digital journals were searched for randomized controlled trials (RCTs) of CGRP-mAbs in treatment of migraine. Quality of enrolled literature was assessed by the software of Review Manager 5.3 and software of StataMP14 was employed to conduct meta analysis.Results:A total of 13 RCTs were included, including 6 218 adult migraine patients (experimental group: 2 679 patients, placebo group: 3 539 patients). Meta analysis suggested that CGRP-mAbs for preventive treatment of migraine significantly reduced the monthly migraine days from baseline (standardized mean difference (SMD)=-0.35, 95% CI-0.4--0.3) and monthly acute migraine-specific medication consumption from baseline (SMD=-0.38, 95% CI-0.43--0.32), as compared with placebo group. CGRP-mAbs for preventive treatment of migraine significantly increased the ≥50% reduction from baseline in migraine days per month ( RR=1.65, 95% CI 1.54-1.76). The adverse events were similar between the CGRP-mAbs group and placebo group ( RR=1.06, 95% CI 1.01-1.10). Conclusion:CGRP-mAbs are effective and safe for preventive treatment of migraine.
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Objective:To evaluate the operating performance, effectiveness and safety of a new portable endoscopic system for upper gastrointestinal endoscopy in an animal model.Methods:A parallel control, non-inferiority study was designed. Ten healthy Bana pigs were selected as the study subjects, and underwent upper gastrointestinal endoscopy using portable endoscope followed by Olympus GIF-Q260 endoscope. The instrument quality, image quality and safety of the new system were evaluated by means of quantitative scores.Results:The time for deployment and installing of the new portable endoscopic system during single operation was 110.24±8.93 s and 91.33±11.59 s, respectively, and the time for the endoscope with disposable protective cover was 233.48±17.06 s. The time of attracting 400 mL normal saline of the portable endoscope and Olympus endoscope was 56.44±5.18 s and 33.71±3.56 s, respectively. The water vapor attraction performance of the portable endoscope was not as good as the Olympus endoscope, but still met the technical requirements of medical devices (attraction capacity >400 mL/min). While in terms of the seal property, biopsy channel, softness and curvature of gastroscopy body, knob operation, and field of view, the two endoscopic systems were equivalent. In terms of image quality evaluation, including clarity, distortion, color resolution, illumination and quality comprehensive evaluation, the performance of the new portable endoscopic system was similar to that of the Olympus endoscopic system. One pig developed nausea during operation with the Olympus endoscope. No adverse events occurred during operation with the new portable endoscope.Conclusion:The new portable endoscopic system is easy to assemble. In terms of device quality, image quality and safety, the new portable endoscopic system is similar to the clinically used Olympus endoscopic system. Therefore, the new portable endoscope system is safe and effective for upper gastrointestinal endoscopy.
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Objective To investigate the epidemiological characteristics of viral diarrhea in children under 5 years old during 2015-2018 in Xicheng District of Beijing, and to provide evidence for prevention and control of viral diarrhea. Methods Fecal specimens from patients under 5 years old were collected from the outpatient clinic of the Children's Diarrhea Surveillance Sentinel Hospital in Xicheng District, Beijing from 2015 to 2018. Real-time fluorescence PCR was used to detect group A rotavirus (RVA), norovirus (NV), and adenovirus (AdV), Astrovirus (AstV). Results A total of 972 fecal specimens were collected, 142 were tested positive for RVA (14.61%), 136 were tested positive for NV (13.99%), 67 were tested positive for AdV (6.89%), and 49 were tested positive for AstV (5.04%). Mix-infection was found in 46 cases, which accounted for 4.73%. The detection rates of the 4 viruses in children under 2 years old were 80.28%, 77.94%, 83.58%, and 87.75%, respectively. Conclusion Rotavirus and norovirus were the main pathogens of viral diarrhea in children in Beijing Xicheng District from 2015-2018, and iinfants under 2 years old were the high-risk group. The peak incidence was in winter.
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Although the flu vaccine is the most effective strategy for preventing influenza currently,the population incidence and mortality of influenza present an unstable trend.Due to the rapid variability of influenza virus,the conventional flu vaccine components and dominant lineage are not matching;more importantly,trivalent influenza vaccine (T IV) contains only A/H3N2,A/H1N1 and B/Victoria lineage,which does not match the B/Yamagata lineage that have prevailed in recent years.Quadrivalent influenza vaccine (QIV) adds the B/Yamagata lineage,and it has been used abroad for susceptible populations.Compared with TIV,QIV provides better protection for susceptible populations and is considered to have better public health benefits.This article reviews the history of development and current status,the safety,immunogenicity,efficacy of prevention and control and cost-effectiveness of QIV,to provide reference for the promotion and implementation of influenza vaccination.
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OBJECTIVE： To provide reference for perfecting the quality standard revision of TCM preparations in medical institutions， and improving the quality standard of TCM preparations in medical institutions. METHODS： By sorting out the quality standards of TCM preparations in Guangdong provincial medical institution preparation specification， this paper summarized the main problems and put forward suggestions for improvement. RESULTS & CONCLUSIONS： There are 897 kinds of TCM preparations included in the Guangdong provincial medical institution preparation specification. The recent quality standards （2017 edition） have been greatly improved compared with those of the first edition （1985 edition）； however， there are still some problems in the overall quality control of preparations， quantitative control of indicative components， project specificity， source control of medicinal materials， control of medicinal materials not included in the Chinese Pharmacopoeia and quality standards of the same series of varieties. It is suggested that on the premise of considering both advancement and applicability， the quality control of the whole， local and toxic preparations of TCM hospitals should be strengthened， the detection methods with good specificity and reproducibility should be properly updated， the control of key parameters of production process should be strengthened， the quality standard of TCM preparations in medical institutions should be fully improved， so as to provide the products with safe， effective and controllable in quality products in medical institutions.
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With the development of the next-generation sequencing technology, circular RNAs (circRNAs) are again receiving attention. Circular RNAs have a circular structure that without 5' and a 3' ending. This special structural characteristics and unique formation mechanism (backsplicing) has been known well, but few studies aim to its biological functions. Related researches are mainly focused on its functions as a regulator of the splicing of pre-mRNAs and the expression of parental gene in nucleus or as a competitive inhibitor of miRNAs absorbed by the circRNAs in cytoplasm. The related diseases include Parkinson disease, diabetes, cancers, cardiomyopathy and so on. According to the nature of the sequence contained in the ring, circRNAs can be divided into circular exonic RNA, circular intronic RNA, and ElciRNAs. The sequences contained within the circRNAs are mainly exons, whose ability of guiding the protein synthesis still remains controversial. In this paper, the current researches on the translation ability of circRNAs were reviewed, and the possible biological information tools and lab methods to identify such ability were recommended.
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Objective To explore the influencing factors for usage of the official App of a hospital, based on Unified Theory of Acceptance and Use of Technology (UTAUT).Methods 616 outpatients were randomly sampled from outpatient clinics of three tertiary hospitals in Hangzhou for questionnaire survey, to learn the usage and intention for hospital′s official App.Results It was found that women (0.134), high performance expectancy (0.321), facilitating conditions (0.256), high effort expectancy (0.224), and desirable social influence (0.100) all contributed positive influence (P<0.05) to usage of such App.Conclusions It is recommended to enhance service functions of such App and simplify its usage, in addition to better promotion and online security measures.
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Objectives To understand the current situation and evaluation about the employer's demand of knowledge level and comprehensive ability of professional undergraduate talents in the health management. Methods Using self-designed questionnaire, the investigation was carried out on the company executives and teachers from 12 health management-related enterprises where health management graduates of Hangzhou Normal University practice internships . A total of 31 valid questionnaires were recovered . SPSS 19.0 software was used to conduct descriptive analysis, hierarchical analysis and rank-sum test of one-way ordinal data. Results Employers believe that students need to strengthen the knowledge of health man-agement and medical knowledge, and the top three skills that students are most likely to improve are common disease management skills, health risk factors intervention skills and health monitoring skills. Amongst those areas of professional abilities that need improving, three of the most important skill sets include suffi-cient fundamental knowledge in medicine and pharmacology, analytical and problem-solving abilities and teamwork as well as communication skills. There is a significant difference among the level of students' pro-fessional knowledge, the level of their professional skills and the level of their comprehensive ability by the rank-sum test (P<0.05). Conclusion According to the results of the demand-side's survey, training of health management undergraduate talents should increase the proportion of teaching about medical theory knowledge, redesign practical teaching modules, carry out foreign language learning as well as promoting the training method of health talents by the means of information, in order to optimize the training of profes-sional health talents through multi-angle as well as multi-level.
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Objective:To investigate the possible reversal effects of 1 ,3-diphenyl-1 ,3-propanedione (DPPD)for cocaine-induced content changes of neurotransmitters of brain in mice.Methods:In this study,36 healthy ICR male mice were randomly divided into control group,cocaine group,three DPPD pretreatment groups (200,400,and 800 mg/kg)and DPPD alone group (800 mg/kg).The mice in control group were administered intragastrically with 1 % Tween 80 for 3 d,and the mice in cocaine group were administered intragastrically with 1 % Tween 80 for 2 d before cocaine was injected subcutaneously on the 3rd day.The mice in the three DPPD pretreatment groups were administered intragastrically (DPPD 200,400,and 800 mg/kg)for 3 d before cocaine was injected subcutaneously 30 min after the administration on the 3rd day.The mice in DPPD alone group were administered intragastrically with DPPD at dose of 800 mg/kg for 3 d.The mice were sacrificed 20 minutes after cocaine injection.The contents of dopamine (DA)and 5-hydroxytryptamin (5-HT)in the mice brain were determined by high performance liquid chromatography (HPLC)-fluorescence detector,the contents of glutamic acid (Glu) and γ-aminobutyric acid (GABA)in the mice brain were determined by HPLC-ultraviolet detector,and the neurotransmitter levels were compared between the groups.Results:The results showed that as com-pared with the control group,DA and GABA contents in cocaine group increased significantly (P <0.01 and P <0.05),while Glu content decreased (P <0.05).As compared with cocaine group,the DA levels in the three DPPD pretreatment groups (200,400,and 800 mg/kg)all decreased significantly (P <0.01 ).In DPPD 200 mg/kg pre-administration group,GABA content decreased (P <0.05),and the contents of the four kinds of neurotransmitters had no statistical differences with those of the control group.Conclusion:DPPD may have potential reversal effects of the content changes of neurotransmitters in mice brain induced by cocaine at a lower dose.