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1.
Article in Chinese | WPRIM | ID: wpr-1025321

ABSTRACT

Objective:Utilizing a seven-year panel data set of a targeted admission medical student cohort,this study aims to examine their career development and provide insights for retaining healthcare talent in township health centers and village clinics in the central and western rural areas of China.Method:Starting from 2015,cohorts of targeted and general clinical graduates from four medical colleges in central and western China were selected and tracked for their career progression.Results:The targeted graduates'standardized residency training and medical licensing examination pass rates were similar to those of general clinical graduates.They advanced more quickly in professional titles and positions,with 82.5%becoming attending physicians and 16.2%obtaining positions in the seventh year after graduation.However,their monthly income was significantly lower than that of general clinical graduates,and this income discrepancy expanded annually.As of December 2022,among the 493 targeted graduates who completed their contracts,38.5%stayed in grassroots positions.Of those who left,60%moved to county-level or higher public hospitals,7.9%pursued further studies,and 27.7%were unemployed.Conclusion:Targeted graduates are well-trained and advance rapidly in their careers,but their lower income significantly impacts their willingness to remain at the grassroots level.After completing their service period,about one-third of the targeted graduates choose to stay in grassroots positions.

2.
Article in Chinese | WPRIM | ID: wpr-986026

ABSTRACT

Objective: To analyze the burden of disease attributable to high temperature exposure in China and globally from 1990 to 2019, and to study the current burden of disease in relevant populations. Methods: In October 2021, based on data from the global burden of disease 2019 (GBD 2019) study, population attributable fraction (PAF), number of deaths, mortality, disability-adjusted life year (DALY) and DALY rate of Chinese and global populations with different ages and genders in 1990 and 2019 were extracted and analyzed. The rate of change was calculated, the mortality rate was normalized by the age structure of the world standard population, and the causes of disease burden caused by high temperature exposure of Chinese residents were analyzed. Results: In 2019, compared with 1990, the PAF of Chinese and global population decreased by 43.98% and 12.41% respectively, the number of deaths increased by 29.55% and 49.40% respectively, the crude mortality rate increased by 7.81% and 3.30% respectively, the DALY decreased by 48.12% and 14.41% respectively, and the DALY rate decreased by 56.82% and 40.82% respectively. The mortality rate of the ≥70 age group was higher than that of other groups. The disease burden indicators such as PAF, standardized mortality and DALY attributable to high temperature exposure in men were higher than those in women. In 2019, the main cause of DALY affected by high temperature exposure in Chinese population was ischemic heart disease (84400 person-years), and the main cause of death was ischemic heart disease (4900 cases). Conclusion: The burden of diseases attributable to high temperature exposure is still serious in China and the world at large. Targeted interventions should be formulated for men, the elderly and people with occupational exposure, and a sound surveillance system should be established to reduce the burden of diseases caused by high temperature exposure.


Subject(s)
Humans , Male , Female , Aged , Quality-Adjusted Life Years , Temperature , Cost of Illness , China/epidemiology , Myocardial Ischemia
3.
Article in Chinese | WPRIM | ID: wpr-940357

ABSTRACT

ObjectiveTo explore the clinical efficacy and mechanism of Tongxie Yaofang in treating diarrhea-predominant irritable bowel syndrome(IBS-D) patients with liver depression and spleen deficiency. MethodA total of 168 IBS-D patients with liver depression and spleen deficiency who were treated from August 2017 to June 2021 were divided into observation group and control group by random number table,84 in each group. The observation group was administrated with Tongxie Yaofang decoction-free granules orally,and the control group received oral treatment of pinaverium bromide,both for 4 weeks. The main symptoms of IBS were compared before and after treatment,such as the degree of abdominal pain,stool changes,traditional Chinese medicine pattern curative effect scoring system(TCM-PES),IBS quality of life questionnaire (IBS-QOL),IBS symptom severity scale(IBS-SSS),self-rating anxiety scale (SAS),and self-rating depression scale(SDS). Nimodipine was used to evaluate the efficacy based on TCM syndrome score of liver depression and Qi stagnation. Enzyme-linked immunosorbent assay(ELISA) was conducted to detect the plasma interleukin-10(IL-10)and IL-12 before and after treatment. ResultAfter 4 weeks of treatment, the response rate of abdominal pain in observation group was 92.86% (78/84), higher than that in control group (82.14%, 69/84)(χ2=6.254,P<0.05). The response rates of diarrhea in observation group and control group were 91.67% (77/84)and 77.38% (65/84), respectively(χ2=8.214,P<0.01). TCM-PES and IBS-QOL scores of observation group after treatment were higher and IBS-SSS score was lower than those of control group (P<0.05). The efficacy rate of TCM syndromes in observation group was higher than that of control group (P<0.05). Additionally, after treatment, the observation group had lower SAS and SDS scores (P<0.05)and IL-12 level(P<0.05)and higher plasma IL-10 level than the control group (P<0.05). ConclusionTongxie Yaofang can relieve abdominal pain and diarrhea in IBS-D patients with liver depression and spleen deficiency,reduce negative emotion,and improve the quality of life of patients,which may be related to alleviating the visceral hypersensitivity.

4.
Article in Chinese | WPRIM | ID: wpr-826686

ABSTRACT

OBJECTIVE@#To observe the clinical effect of acupuncture at lower- acupoints and front- acupoints combined with (TXYF) for diarrhea-type irritable bowel syndrome (IBS-D) of liver depression and spleen deficiency, and to explore its possible mechanism.@*METHODS@#A total of 123 IBS-D patients with syndrome of liver depression and spleen deficiency were randomly divided into an acupuncture+TXYF group, a TXYF group and a medication group, 41 cases in each group. The patients in TXYF group were treated with oral administration of TXYF, three times a day. The patients in acupuncture+TXYF group were treated with oral administration of TXYF and routine acupuncture at Shangjuxu (ST 37), Tianshu (ST 25), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36), once a day. The patients in medication group were treated with oral administration of pinaverium bromide, 50 mg, three times a day. All the treatment was given for four weeks. The total score of TCM syndrome scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS) scores as well as the expression of calcitonin gene-related peptide (CGRP), vasoactive peptide (VIP) and MAPK signal pathway indicators of ERK1 mRNA and ERK2 mRNA were compared before and after treatment; the clinical effect was also compared.@*RESULTS@#After treatment, the total score of TCM syndrome scale and SAS and SDS scores in each group were significantly reduced (<0.05), and the scores in the acupuncture+TXYF group were lower than those in TXYF group and medication group (<0.05). The total effective rate was 87.8% (36/41) in the acupuncture+TXYF group, which was higher than 78.0% (32/41) in the TXYF group and 68.3% (28/41) in the medication group (<0.05). After treatment, the levels of CGRP and VIP in each group were decreased (<0.05), and the levels in the acupuncture+TXYF group were lower than those in the TXYF group and the medication group (<0.05). After treatment, the levels of ERK1 mRNA and ERK2 mRNA in each group were decreased (<0.05), and the levels in acupuncture+TXYF group were lower than those in medication group (<0.05).@*CONCLUSION@#The acupuncture at lower- acupoints and front- acupoints combined with TXYF could effectively alleviate the clinical symptoms, improve anxiety and depression in IBS-D patients with syndrome of liver depression and spleen deficiency, and its mechanism may be related to regulating the expression of ERK1 mRNA and ERK2 mRNA in MAPK signaling pathway, and reducing the serum levels of CGRP and VIP.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Anxiety , Depression , Diarrhea , Drugs, Chinese Herbal , Therapeutic Uses , Irritable Bowel Syndrome , Psychology , Therapeutics , Liver , Medicine, Chinese Traditional , Spleen
5.
Acta Physiologica Sinica ; (6): 777-784, 2020.
Article in Chinese | WPRIM | ID: wpr-878225

ABSTRACT

The objective of this study was to elucidate the effect of chronic stress (CS) on dopamine (DA) level and synaptic efficiency in the hippocampal dentate gyrus (DG) during spatial learning and memory. Sprague Dawley (SD) male rats were randomly divided into control group and CS group (n = 10). CS group was treated with chronic mild unpredictable stress, and control group did not receive any treatments. The levels of epinephrine and corticosterone (CORT) in serum were measured by using enzyme-linked immunosorbent assay (ELISA); the spatial learning and memory abilities of rats were measured by Morris water maze (MWM) test. Meanwhile, the amplitude of field excitatory postsynaptic potential (fEPSP) and concentration of DA in the DG region were determined by in vivo electrophysiology, microdialysis and HPLC techniques during MWM test in rats. After that, the DA D1 receptor (D1R) and its key downstream members in DG were examined by immunohistochemistry or Western blot assay. The results showed that the levels of epinephrine and CORT in the serum of the rats in CS group were significantly increased compared with those in the control group (P < 0.05). In CS group rats, the escape latency was significantly prolonged and the number of platform crossing was markedly decreased during MWM test, compared with those in control group (P < 0.05). Furthermore, the amplitude of fEPSP in the DG was not changed during MWM test in CS rats, while it was significantly increased on the 3rd day of MWM test in control group (P < 0.05). Compared with baseline or control group, CS group showed significantly increased DA level from the 1st to 3rd days of MWM test in the DG (P < 0.05). In addition, the protein expression of D1R was markedly up-regulated in the DG in CS group, while the protein expression levels of p-PKA, p-CREB and BDNF were significantly reduced, compared with those in control group. These results suggest that CS may impair spatial learning and memory abilities in rats through the enhancement of the DA levels in the hippocampal DG.


Subject(s)
Animals , Male , Rats , Dentate Gyrus , Dopamine , Hippocampus , Maze Learning , Rats, Sprague-Dawley , Spatial Learning , Spatial Memory
6.
Article in English | WPRIM | ID: wpr-296488

ABSTRACT

<p><b>OBJECTIVE</b>The effect of the silica nanoparticles (SNs) on lungs injury in rats was investigated to evaluate the toxicity and possible mechanisms for SNs.</p><p><b>METHODS</b>Male Wistar rats were instilled intratracheally with 1 mL of saline containing 6.25, 12.5, and 25.0 mg of SNs or 25.0 mg of microscale SiO2 particles suspensions for 30 d, were then sacrificed. Histopathological and ultrastructural change in lungs, and chemical components in the urine excretions were investigated by light microscope, TEM and EDS. MDA, NO and hydroxyproline (Hyp) in lung homogenates were quantified by spectrophotometry. Contents of TNF-α, TGF-β1, IL-1β, and MMP-2 in lung tissue were determined by immunohistochemistry staining.</p><p><b>RESULTS</b>There is massive excretion of Si substance in urine. The SNs lead pulmonary lesions of rise in lung/body coefficients, lung inflammation, damaged alveoli, granuloma nodules formation, and collagen metabolized perturbation, and lung tissue damage is milder than those of microscale SiO2 particles. The SNs also cause increase lipid peroxidation and high expression of cytokines.</p><p><b>CONCLUSION</b>The SNs result into pulmonary fibrosis by means of increase lipid peroxidation and high expression of cytokines. Milder effect of the SNs on pulmonary fibrosis comparing to microscale SiO2 particles is contributed to its elimination from urine due to their ultrafine particle size.</p>


Subject(s)
Animals , Male , Rats , Air Pollutants , Toxicity , Dose-Response Relationship, Drug , Lung , Pathology , Microscopy, Electron, Transmission , Nanoparticles , Toxicity , Pulmonary Fibrosis , Metabolism , Pathology , Random Allocation , Rats, Wistar , Silicon Dioxide , Toxicity , Specific Pathogen-Free Organisms , Spectrometry, X-Ray Emission , Urine , Chemistry
7.
Article in English | WPRIM | ID: wpr-301036

ABSTRACT

Exosomes are cell-derived vesicles that take part in intercellular signaling. Research has shown that acupuncture is closely related to affecting the functions of the mast cells in the local region of the acupoint, and stimulating the afferent nerve. Mast cells have a connection with the conduction within the meridians, and play an important role in immuno-regulation. The 'synapse-like' connection between the mast cells and nerve endings is the basis for the exchange of information between these two tissues. Exosome mediates mast exchange of information between mast cells and the nerves, starting the process of neuro-immuno regulation. Therefore, we propose that mast cell-derived exosomes mediate the neuro-immuno regulation at the local site of acupuncture, and this is one of the key factors resulting in the effectiveness of acupuncture.

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