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Objective:To understand the current situation of professional identity and burnout among nurses in health management department in Henan province, and analyze their correlation.Methods:This is a cross-sectional study. A general data questionnaire, the Nurse Professional Identity Scale and Nursing Burnout Scale were used to conduct an online questionnaire survey on 204 nurses from the health management departments of 6 tertiary A hospitals in Henan Province (Henan Provincial People′s Hospital, the First Affiliated Hospital of Henan University of Chinese Medicine, Henan Hospital of Traditional Chinese Medicine, Fuwai Central China Cardiovascular Hospital, Henan Chest Hospital and Zhengzhou branch of Henan Orthopedic Hospital) from March 1, 2023 to May 1, 2023. A total of 204 questionnaires were issued and 204 were recovered, with an effective rate of 100%. The correlation between professional identity and burnout was analyzed, and the general data was included into the regression equation as the control variables and the multiple linear regression analysis was carried out.Results:Among the 204 nurses in the health management department, 114 (55.9%) had a medium level and 25 (12.3%) had a low level of professional identity, 137 (67.1%) had job burnout. There was a significant negative correlation between professional identity and burnout ( r=-0.244, P<0.01). The results of multiple step-up regression showed that cognitive evaluation, frustration coping, social support, marital status, age and position were the main influencing factors of job burnout (all P<0.05). Conclusions:The professional identity and burnout of nurses in health management department are at a medium level. The higher the level of professional identity identity, the lower the burnout, and marriage, age and position were related to job burnout.
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Objective:To investigate the role and molecular mechanism of death receptor 5 (DR5) in early brain injury (EBI) after subarachnoid hemorrhage (SAH), as well as the neuroprotective effect of soluble DR5 (sDR5) on SAH.Methods:Experiment 1: SD rats were randomly divided into sham-operated group ( n=6) and SAH group (SAH model was established by carotid artery puncture, n=30), and the SAH group was further subdivided into post-SAH (6 h) group, post-SAH (12 h) group, post-SAH (24 h) group, post-SAH (48 h) group and post-SAH (72 h) group ( n=6); Western blotting was used to detect the expressions of tumor necrosis factor (TNF)-α and DR5; immunofluorescent DR5 and neuronal nuclear antigen (NeuN) double staining was used to evaluate the DR5 expression in neurons. Experiment 2: SD rats were randomly divided into sham-operated group, SAH group, Trail group (injected Trail agonist dordaviprone), and Trail+sDR5 group (injected dordaviprone+sDR5, n=6); at the 24 th h of successfully constructed SAH model, the caspase family protein levels were detected by Western blotting, and Tunel staining and immunofluorescent DR5 and Caspase-3 double staining were performed. Experiment 3: SD rats were divided into sham-operated group, SAH group, Trail group and Trail+sDR5 group ( n=6); long-term motor functions, by modified Gracia score, forelimb placement experiment, rotarod test and misstep experiment, were evaluated 5, 7 and 12 d after successfully constructed SAH model; and long-term learning and memory functions were detected by water maze experiment 14, 16, 18, 20 and 21 d after successfully constructed SAH model. Results:(1) Result of Experiment 1: the expressions of TNF-α and DR5 in sham-operated group, post-SAH (6 h) group, post-SAH (12 h) group, post-SAH (24 h) group, post-SAH (48 h) group and post-SAH (72 h) group were statistically different ( F=837.992, P<0.001; F=503.942, P<0.001), and these expressions peaked 24 h after SAH; immunofluorescent DR5 and NeuN double staining showed that DR5 was located in neurons after SAH. (2) Result of Experiment 2: compared with the SAH group and Trail group, the Trail+sDR5 group had significantly decreased levels of activated caspase-8, tBid and activated caspase-3, significantly decreased numbers of Tunel positive cells and DR5 and activated caspase-3 co-marked positive cells ( P<0.05). (3) Result of Experiment 3: compared with the SAH group and Trail group, the Trail+sDR5 group had significantly increased Garcia scores, decreased failure rate in forelimb placement experiment, prolonged duration of stick rotation, and decreased foot fault rate ( P<0.05), suggesting that sDR5 could improve the long-term motor function deficit after SAH; water maze experiment showed that 21 d after SAH, compared with the SAH group and Trail group, Trail+sDR5 group had significantly increased proportion of escape time in the original platform quadrat in total escape time and increased proportion of movement path in the original platform quadrat in total movement path after platform removal ( P<0.05), suggesting that sDR5 could improve long-term learning and memory impairment after SAH. Conclusion:The sDR5 can inhibit DR5-Trail-mediated neuronal apoptosis and improve long-term neurological functional deficits after SAH.
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Objective To investigate a convenient and quantitative solution to activation levels and functional characterization of CAR-T cells by inserting T cell activity-responsive promoter (TARP) nanoluciferase reporter gene system into a lentiviral plasmid containing the gene encoding the chimeric antigen receptor (CAR). Methods The recombinant plasmid was constructed by using whole gene synthesis and molecular cloning techniques. The lentivirus was packaged and was infected with human primary T lymphocytes. Flow cytometry was used to detected the positive rate of lentivirus-infected T cells. The functional characterization of CAR-T cells was identified by luciferase reporter gene system, Western blot, flow cytometry, and small animal live imaging techniques. Results The results of enzyme digestion identification and the plasmid sequencing showed that the recombinant plasmids were constructed, and flow cytometry displayed the normal preparation of CAR-T cells. This system could dynamically respond to the activation of CAR-T cells by luciferase reporter gene system. The functional assay in vitro confirmed that the system could reflect the exhaustion of CAR-T cells, and the small animal live imaging results demonstrated that the system can be used as a tracer of CAR-T cells in mice. Conclusion TARP nanoluciferase reporter gene system provides a more convenient, sensitive and quantitative method for evaluating CAR-T cells activation level, exhaustion phenotype and tracing.
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Humans , Animals , Mice , T-Lymphocytes , Cell Line, Tumor , Receptors, Chimeric Antigen/genetics , Promoter Regions, Genetic , Immunotherapy, Adoptive/methodsABSTRACT
Chronic liver diseases, including chronic hepatitis, autoimmune liver disease, alcoholic liver disease, cirrhosis, fatty liver disease, drug-induced liver injury and so on, are common and important disorders in China. A hospital-community-patient-family integration management model for chronic liver diseases has been implemented since 2018 in Shuangshuinian Community Health Service Center collaborated with Sichuan Provincial People′s Hospital. Patients were taken care by general practitioners in the community health center under the guidance of hospital specialists, and with the active participation of patients and their family. This article introduces this integrated management model and the preliminary accomplishment to provide a reference for the management of patients with chronic liver diseases in the community.
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Objective:To explore the application of flipped classroom teaching mode under the perspective of production oriented approach (POA) theory in orthopedic nursing teaching management.Methods:This study randomly enrolled 60 orthopedic clinical nursing interns from August 2018 to August 2019. They were randomly divided into control group (traditional teaching) and observation group (flipped classroom teaching under the perspective of POA theory), with 30 cases in each group. The out-department assessment results, error statistics of practice assessment, qualification rate of out-department assessment and the evaluation on teachers were compared between the two groups. SPSS 19.0 was used for chi-square test and t test. Results:When the interns leaving the department, the total scores of theoretical knowledge, nursing practice and assessment were higher than those before department admission, which were higher in observation group than in control group ( P<0.05). The scores of learning new knowledge, summarizing ability and clinical thinking ability in observation group were higher than those in control group ( P<0.05). The error rates such as unskilled physical examination and poor concept of aseptic debridement in observation group were lower than those in control group ( P<0.05). The satisfaction of interns with teachers' theoretical teaching ability, practical skill level and teaching attitude in observation group was higher than that in control group ( P<0.05). Conclusion:Flipped classroom teaching under the perspective of POA theory is beneficial to improve out-department assessment results and learning ability of orthopedics students, reduce physical examination and debridement errors in practice assessment, and improve higher satisfaction with teachers.
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Objective:To explore the effect of the location and size of region of interest (ROI) on the measurement of liver fat by means of quantitative computed tomography (QCT).Methods:A total of 98 subjects who were examined with QCT for bone mineral density examination from December 25, 2019 to January 17, 2020 were recruited continuously from the Department of Health Management of Henan Provincial People′s Hospital. The liver fat content was measured by QCT workstation. The ROI was located respectively in the left lobe, the right anterior lobe and the right posterior lobe of the liver, and it was measured independently by the A measurer and B measurer. The central position of the ROI was fixed and the diameter was increased, and it was measured by the A measurer. In this study, Friedman test was used to compare the differences of measurement results in different positions or sizes of ROI, and intra-class correlation coefficients (ICC) was used to evaluate the repeatability of inter-measurers.Results:There was a significant difference for liver fat content under different positions of ROI (χ2=62.306, P<0.001), but no difference under different seizes of ROI (χ2=1.088, P=0.581). The ICC values of the inter-measurers repeatability analysis of the A measurer and B measurer in the left lobe, right anterior lobe and right posterior lobe of the liver were 0.847, 0.917 and 0.874, all more than 0.75, and the reproducibility was good. Conclusions:When QCT technique is applied to the measurement of liver fat content, the location conditions of ROI may affect results, so it is necessary to select multiple ROI in the whole liver for measurement. The inter-measurers repeatability of QCT in different parts of the liver is good.
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Objective@#Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT).@*Methods@#We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software.@*Results@#A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01).@*Conclusions@#SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.
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Objective:To investigate the correlation between acoustic radiation force impulse imaging(ARFI) and reserve function of liver and the feasibility of liver reserve function assessment by ARFI.Methods:According to the inclusion criteria, 74 patients were screened and 71 patients were finally enrolled from Henan Province People′s Hospital during June 2017 and June 2019. The portal vein diameter (D PV), spleen length (L SP) were measured by two-dimensional ultrasound. The liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were measured by ARFI. Serological markers were checked, and the indocyanine green (ICG)15-minute retention rate (ICG R15) was measured by excretion test. The patients were divided into ICG R15<10% group and ICG R15≥10% group, the difference of the measurements between two groups were calculated, the correlations of the measurements and ICG R15 were analyzed. LSWV diagnostic performance for liver reserve function was evaluated by the ROC curve. Results:There were significant differences in LSWV, D PV, SSWV, L SP, aspartate transaminase(AST), alkaline phosphatase(ALP), y-glutamyl transpeptidase(γ-GGT) and albumin (ALB) between ICG R15<10% group and ICG≥10% group( P<0.05), but no significant differences in other measurements( P>0.05). The correlations between ICG R15 and LSWV( r=0.673, P<0.001), D PV( r=0.355, P<0.05), SSWV( r=0.384, P<0.05), L SP( r=0.403, P<0.001), ALP( r s=0.245, P<0.05) and ALB( r s=-0.390, P<0.05) were statistically significant. The ROC curve showed high diagnostic performance for liver reserve function assessment by LSWV. The area under the ROC curve was 0.903 (95% CI=0.810-0.961, P<0.01), and the cut-off value was 2.15 m/s (sensitivity 84.6%, specificity 86.7%). Conclusions:The LSWV can evaluate the reserve function and it is a useful supplement to the ICG excretion experiment.
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Objective:To provide support for the clinical application of quantitative computed tomography (QCT) in the measurement of liver fat content, this study evaluated the intra-observer and inter-observer reproducibility of liver fat content measured by QCT in a population receiving physical examinations.Methods:From April to July 2019, 291 people were consecutively selected who underwent QCT examination in the health management department of Henan Provincial People′s Hospital. There were 214 males (73.5%) and 77 females (26.5%), aged 48.7±11.0. We measured liver fat content by QCT workstation. Three observers (A, B, C) measured their liver fat content independently, then observer A performed re-testing two weeks later. The mean value of the two measurements from observer A was taken as the final result. Measurement data were described by mean±SD. Intra-observer and inter-observer reproducibility were assessed using intra-class correlation coefficients ( ICC). Results:The first measurement result for observer A was 10.46±5.55 and the second measurement for observer A was 10.66±5.59, resulting in a final value of 10.56±5.51. The measurement results of observers B and C were 10.70±5.45 and 10.86±5.77, respectively. The ICC value of liver fat content values measured by the three observers was 0.960 (95% CI: 0.951-0.967, P<0.001) and the ICC value of liver fat content values for the two measurements of observer A was 0.953 (95% CI: 0.941-0.962, P<0.001). The ICC values were>0.75, so reproducibility of results was good. Conclusions:If the measurement method is consistent, the results for liver fat content measured by a conventional CT scanner and QCT workstation will have good reproducibility between and within observers, and will also have certain clinical application prospects.
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Objective@#To estimate the influenza infection rate among severe acute respiratory infection(SARI) cases and the hospitalization rates of SARI attributable to influenza, based on two sentinel hospital surveillance databases in Beijing, 2015.@*Methods@#Surveillance was conducted at two sentinel hospitals in Beijing in 2015. A total of 1 842 patients who admitted to the sentinel hospitals and met the definition of SARI were enrolled in the study. The respiratory tract specimens of SARI cases were collected, and sent to laboratories within 48 hours for influenza RNA detection. The catchment area of sentinel hospitals was defined by reviewing the home address of inpatients; A total of 1 491 patients were sampled and tested for influenza. The population size of catchment areas was obtained from demographic year book. We investigated the number of pneumonia patients admitted to the sentinel hospitals and other hospitals in catchment areas in 2015, and calculated the proportions of pneumonia patients that were admitted to sentinel hospitals in catchment areas. The catchment population size was calculated using the number of total population of catchment areas multiply by the proportions of pneumonia patients that were admitted at sentinel hospitals.@*Results@#Among 1 491 patients, 13.7% (205 cases) was test positive for influenza viruses, 2 (0.9%) cases positive for influenza A (H1N1), 91 (44.6%) cases influenza A (H3N2), 1 (0.5%) case influenza B/Victoria, 111 (54.0%) cases influenza B/Yamagata. Influenza was associated with an estimated 30 (95%CI:9-51) SARI hospitalizations per 100 000 during 2015. The hospitalization rate was 243 (95%CI: 232-255), 86 (95%CI: 59-112),1(95%CI: 0-5), 8 (95%CI: 0-23) and 92 (95%CI: 16-168) SARI hospitalizations per 100 000 population for<5 years children, 5-14 years children, 15-24 years adult, 25-59 years adult and ≥60 years population, respectively. The hospitalization rate of SARI attributed to influenza A and B was 14 (95%CI:4-17) and 16 (95%CI:0-23) per 100 000 population, respectively.@*Conclusion@#The influenza positive rate among SARI cases was relatively high. The hospitalization burden of SARI attributed to influenza was the greatest in children under 5 year-old.