Analysis of influencing factors of multi-site musculoskeletal disorders among workers in the chemical pharmaceutical industry / 中国职业医学

{L-End}Objective To analyze the prevalence of multi-site work-related musculoskeletal disorders (WMSDs) and their influencing factors among workers in the chemical pharmaceutical industry. {L-End}Methods A total of 563 workers from three chemical pharmaceutical factories in Guangzhou City were selected as the research subjects using the judgment sampling method. The prevalence of multi-site WMSDs in the past 12 months was investigated using the electronic questionnaire of Chinese Version of Musculoskeletal Disorders Questionnaire. {L-End}Results The prevalence of multi-site WMSDs in the research subjects was 30.0% (169/563). The results of multivariable logistic regression analysis showed that workers who smoked regularly/frequently and those who had their hands above shoulder level for long periods of time had a lower risk of multi-site WMSDs than those who never/occasionally smoked (all P≤0.05). Workers with a high school, secondary specialty, college degree, or above had a lower risk of multi-site WMSDs than those with a middle school education or below (all P<0.05). The longer the daily working hours, the higher the risk of multiple WMSDs (all P<0.05). Workers with regular/frequently work shifts had a lower risk of multi-site WMSDs than those with none/occasional work shifts (P<0.05). {L-End}Conclusion The prevalence of multi-site WMSDs among workers in the chemical pharmaceutical industry is relatively high. The influencing factors are individual factors, unreasonable work organization and poor ergonomics factors.

Multicenter Studies: Relevance, Design and Implementation

Multicenter studies are essential in clinical and public health research with several advantages compared to single-center studies. Multicenter studies are attractive and advantageous, allowing quicker recruitment, diverse population coverage and increased generalizability. However, these studies often suffer from methodological, implementation and statistical challenges that can compromise the validity of the study. To meet the technical and interpretative integrity, a multicenter study must be conducted with sound study design, uniform implementation methodology, assured standardization, high-quality data and appropriate statistical considerations. A systematic site selection, rigorous study protocols, stringent quality assurance measures and appropriate analytical approach are indispensable to ensure high internal validity and minimize inter-site variability. For effective implementation of multicenter study, a well-organized coordination center and functional governance mechanism are critical. Transparent and effective network communication among the investigators with cultural sensitivities assists in building productive collaboration. This manuscript summarizes the design, organization, implementation and governance aspects of multicenter studies.

Multisite musculoskeletal pain in the general population: a cross-sectional survey

BACKGROUND: Epidemiological studies focusing on multisite musculoskeletal pain have revealed that the prevalence of multisite pain is high in general populations. OBJECTIVE: To ascertain the prevalence of multisite musculoskeletal pain in the last 12 months and in the last seven days, in a population-based sample and investigate its association with demographic, socioeconomic, behavioral, reported morbidity and ergonomic variables. DESIGN AND SETTING: Cross-sectional population-based survey in Bauru, São Paulo (Brazil). METHODS: 600 individuals were interviewed. The following data were collected: participants' characteristics, through a precoded questionnaire; physical activity level, through the International Physical Activity Questionnaire; and musculoskeletal symptoms, through the Nordic questionnaire. Descriptive, bivariate and Poisson regression analyses were performed. RESULTS: The prevalence of multisite musculoskeletal pain was 46.5% (confidence interval, CI 42.5 to 50.5) in the last 12 months and 26.1% (CI 22.8 to 29.8) in the last seven days. The variables associated with multisite pain in the last 12 months were female sex, presence of hypertension, diabetes mellitus or depression, watching TV more than three times a week and working in a seated position. Formerly smoking was a protection factor. The variables associated with multisite pain in the last seven days were female sex, age group 60 years and over, low income, presence of comorbidities of hypertension, diabetes mellitus or depression and working in a seated position. CONCLUSION: There was high prevalence of multisite musculoskeletal pain, which was associated with demographic, socioeconomic, work-related, electronic device-related and reported morbidity variables.

Prevalence and influencing factors of multi-site work-related musculoskeletal disorders among workers in coal mining enterprises / 环境与职业医学

Background Coal workers are inclined to report multi-site work-related musculoskeletal disorders (WMSDs) due to their specific working environment and extensive exposure to occupational hazards, which seriously affect the physical and mental health of coal workers. objective To investigate the prevalence of multi-site WMSDs among workers in coal mining enterprises in Xinjiang, and analyze the related factors influencing multi-site WMSDs. Methods Using stratified cluster random sampling method, Musculoskeletal Disorders Questionnaire, Job Burnout Questionnaire, and Brief Occupational Stress Questionnaire were distributed in six Xinjiang coal mining enterprises to collect data on general information, prevalence of WMSDs in the past year, work-related information, job burnout, and occupational stress among coal miners with a working experience ≥ 1 year. A multiple logistic regression model was used to analyze the influencing factors of multi-site WMSDs. Results A total of 1730 questionnaires were distributed in this survey, 1448 valid questionnaires were recovered, and the valid recovery rate was 83.7%. Among the 1448 coal miners, 93.2% were males and 6.8% were females; 39.2% were aged ≤ 35 years, 31.1% were aged 35-45 years, and 29.6% were aged > 45 years; 58.4% reported ≤ 10 years of working experience, 20.0% reported 10-20 years, and 21.6% reported > 20 years. The total prevalence rate of WMSDs in the coal miners was 75.6% (1095/1448), the prevalence rate of multi-site WMSDs was 58.4% (846/1448), and the prevalence rate of one-site WMSDs was 17.2% (249/1448). The results of multiple logistic regression analysis showed that working experience > 20 years (OR=2.245, 95%CI: 1.655-3.045), severe burnout (OR=2.644, 95%CI: 1.549-4.516), and multiple repetitive operations per minute very often (OR=2.038, 95%CI: 1.339-3.101), often bending at larger angles (OR=1.467, 95%CI: 1.111-1.938), long-time bending the neck forward (OR=1.671, 95%CI: 1.294-2.159), and slipping or falling down (OR=2.459, 95%CI: 1.908-3.168) were positively correlated with multi-site WMSDs; sufficient rest time (OR=0.718, 95%CI: 0.565-0.913) was negatively correlated with multi-site WMSDs. Conclusion Multi-site WMSDs is common among workers in coal mining enterprises, and the prevalence rate of multi-site WMSDs is higher than that of one-site WMSDs. Working experience, job burnout, frequent multiple repetitive operations per minute, often bending at larger angles, long-time bending the neck forward, slipping or falling down, and sufficient rest time are influencing factors of multi-site WMSDs in coal workers.

Influencing factors for work-related musculoskeletal disorders among assembly workers in four manufacturing enterprises / 环境与职业医学

Background The prevalence rate of work-related musculoskeletal disorders (WMSDs) among manufacturing workers is relatively high and has been widely concerned. However, research on the prevalence and risk factors of multi-site WMSDs is still insufficient. Objective To explore the prevalence and risk factors of multi-site WMSDs of assembly workers in four manufacturing enterprises. Methods The "Chinese Musculoskeletal Questionnaire" was used to conduct a cross-sectional survey among 1401 assembly workers selected by convenient sampling in four manufacturing enterprises, and their demographic characteristics, the prevalence of WMSDs in various body parts, and the information about biomechanical factors, work organizations, work environment, and psychosocial factor exposure were collected. The prevalence of WMSDs and multi-site WMSDs were estimated, Pearson χ2 test was used for univariate analysis of multi-site WMSDs risk factors, and logistic regression was used for multi-factor analysis. Results The total prevalence rate of WMSDs was 54.9% (769/1 401). The top three affected sites were neck (41.4%), shoulders (30.7%), and wrist/hand (25.1%). The prevalence rate of multi-site WMSDs was 41.9% (587/1 401). The prevalence rates of multi-site WMSDs in railway vehicle assembly and riveting workers were higher than those in electronic parts processing and glass manufacturing workers (P<0.001). The results of logistic regression analysis showed that individual factors such as female (OR=2.09, 95%CI: 1.48−2.97) and drinking (OR=1.52, 95%CI: 1.05−2.18), biomechanics factors such as keeping head down for a long time (OR=1.37, 95%CI: 1.22–1.53), keeping bending frequently (OR=1.18, 95%CI: 1.03–1.34), and keeping arms up for a long time (OR=1.25, 95%CI: 1.10–1.41), work organizational factors such as electronic parts processing, railway vehicle assembly, and riveting (OR values were 3.23, 5.70, and 13.83, respectively), environmental factors such as temperature a little cold (OR=4.84, 95%CI: 1.90–12.37), noise seriously affecting work (OR=2.25, 95%CI: 1.23–4.11), and psychosocial factors such as high job demands (OR=1.47, 95%CI: 1.04–2.08), fatigue after work (OR=1.92−2.61) were risk factors of multi-site WMSDs. Conclusion The prevalence rate of multi-site WMSDs in assembly workers is high, and the main influencing factors include individual factors, awkward work postures, environmental factors, and psychosocial factors.

Analysis of serum and drug resistance levels between food source and human salmonella / 公共卫生与预防医学

Objective To analyze serotype distribution, drug resistance, quinolone resistance gene carrying status and genetic relationship of foodborne Salmonella and human Salmonella isolates in Changzhou from 2012 to 2018, to provide scientific basis for the prevention and control of Salmonella. Methods The serum type was identified by serum agglutination and liquid chip. The antibiotic sensitivity was determined by micro broth dilution method. The quinolone antibiotic resistance gene was determined by gene sequencing method. The multilocus sequence typing ( MLST ) typing was performed on quinolone-resistant Salmonella, and the genetic relationship was analyzed by BioNumerics 8.0. Results A total of 10 and 36 serotypes were detected in 46 foodborne Salmonella strains and 152 human Salmonella strains, respectively. The dominant serotypes were Indiana Salmonella and Salmonella typhimurium. Erythromycin resistance rate was the highest in both Salmonella strains, and the proportion of multidrug-resistant bacteria was 93.47 % ( 43 / 46 ) and 80.92 % ( 123 / 152 ), respectively. 38 strains of quinolone-resistant foodborne Salmonella GyrA subunit mainly occurred double mutations Asp87Asn, Ser83Phe, ParC subunit mainly occurred single mutation Ser80Arg, 119 strains of quinolone-resistant human Salmonella qnrS gene detection rate was higher, reached 68.1 % ( 81 / 119 ) ; The dominant ST types of quinolone-resistant Salmonella from two sources were ST17 and ST19, respectively. Conclusions The antibiotic sensitivity of the two Salmonella resistant strains from Changzhou was the same ; Synergistic drug resistance, but both quinolone resistance genemutations and carry inconsistent ; The ST type distribution of quinolone resistant strains isalso inconsistent, and the genetic relationship is far. It is suggested that the probability of Salmonella resistant bacteria infection caused by food transmission in our region is small, and the treatment of the two should be differentiated.

In vivo sensitivity of Phakopsora pachyrhizi to fungicides / Sensibilidade in vivo de Phakopsora pachyrhizi a fungicidas

ABSTRACT: Asian soybean rust is one of the most destructive diseases that can be found in this crop. It can be largely controlled by fungicide application. The objective was to assess the sensitivity of P. pachyrhizi isolates to fungicides. The tests were performed in a completely randomized design, with six replicates. The sensitivity of twelve isolates to site-specific and multisite fungicides at concentrations of 0.1; 1.0; 10.0, and 100.0 mg L-1, plus a control with absence of fungicide (0.0 mg L-1) was assessed. Soybean leaflets were immersed in the appropriate fungicide solutions, disposed in wet chambers in plastic boxes, and inoculated using each uredinia suspension of P. pachyhrizi (5.0 x 104 uredospores mL-1), separately. Boxes were incubated for 20 days at a temperature of 23°C and a 12-hour photoperiod. Next, the number of uredinia per cm2 on the abaxial face of each leaflet was evaluated. The active ingredients prothioconazole, trifloxystrobin, fluxapiroxade, trifloxystrobin + prothioconazole, trifloxystrobin + bixafen + prothioconazole, azoxystrobin + benzovindiflupyr, and azoxystrobin + benzovindiflupyr + diphenoconazole were highly fungitoxic for the majority of the isolates, with EC50 lower than 1.0 mg L-1. Diphenoconazole, azoxystrobin, and fenpropimorph were considered moderately fungitoxic for nine of the twelve isolates, with EC50 between 1 and 10 mg L-1. The multisites mancozeb and copper oxychloride presented EC50 responses classified as low toxic for the twelve isolates and eight for chlorothalonil (EC50 between 10 mg L-1 and 50 mg L-1). Site-specific fungicides showed high-to-moderate fungitoxicity to P. pachyrhizi isolates, even as the multisites presented moderate-to-less toxic activity.

RESUMO: A ferrugem-asiática da soja é uma das doenças mais destrutivas que ocorre na cultura. Seu controle é baseado, principalmente, na aplicação de fungicidas. O objetivo foi avaliar a sensibilidade de isolados de P. pachyrhizi a fungicidas. Os ensaios foram realizados em delineamento inteiramente casualizado, com seis repetições. Por meio de teste de folíolos destacados de soja, foram avaliadas as sensibilidades de doze isolados do fungo a fungicidas sítio-específicos e multissítios, nas concentrações de 0,1; 1,0; 10,0 e 100,0 mg L-1, mais uma testemunha sem fungicida (0,0 mg L-1). Os folíolos de soja foram imersos nas devidas soluções fungicida, dispostos em câmaras úmidas em caixas gerbox e inoculados com as devidas suspensões de esporos de P. pachyhrizi (5,0x104 uredosporos mL-1). As caixas foram incubadas durante 20 dias, em temperatura de 23 oC e fotoperíodo de 12 h. Em seguida, avaliou-se o número de urédias cm-2 da face abaxial de cada folíolo. Os ingredientes ativos protioconazol, trifloxistrobina, fluxapiroxade, trifloxistrobina + protioconazol, trifloxistrobina + bixafem + protioconazol, azoxistrobina + benzovindiflupir e azoxistrobina + benzovindiflupir + difenoconazol foram altamente fungitóxicos para a maioria dos isolados, com CE50 menor do que 1,0 mg L-1. Difenoconazol, azoxistrobina e fenpropimorfe foram considerados medianamente fungitóxicos para nove dos doze isolados, com CE50 entre 1 e 10 mg L-1. Os multissítios mancozebe e oxicloreto de cobre apresentaram respostas de CE50 classificadas como pouco tóxicas para os doze isolados do fungo e o clorotalonil para oito deles (CE50 entre 10 e 50 mg L-1). Os fungicidas sítio-específico apresentaram alta a moderada fungitoxicidade aos isolados de P. pachyrhizi oriundos dos distintos locais, enquanto os multissítios apresentaram atividade moderada a pouco tóxica.

Study on attitude differences between clinical nurses and nursing managers towards float nurse and multiple-sites practice / 中国实用护理杂志

Objective@#To investigate and compare the attitudes of clinical nurses and nursing managers towards float nurse, and to provide references for the implementation of nurse mobile practice mode in China.@*Methods@#By stratified sampling, the survey was conducted on clinical nurses and nursing managers of 15 tertiary hospitals in 9 prefecture-level cities in Fujian.@*Results@#A total of 9 389 valid questionnaires were recovered, including 525 for nursing managers and 8 864 for clinical nurses. By comparing the attitudes between two groups, it was found that nursing managers who knew more about mobile practice were more willing to practice floating practice, including 50.86% (267/525) heard and inquired, 49.14% (258/525) willing to float, than clinical nurses who paid less attention, including 32.41% (2 873/8 864) heard and inquired, 38.87% (3 445/8 864) willing to float. Multi-factor analysis showed that among nursing managers, those with a bachelor’s degree or above was more willing to float. While among clinical nurses, young, unmarried, side, bachelor degree or above were more willing to float. On the choice of flow mode, nursing managers were inclined to float between hospitals (46.54%, 215/525), but clinical nurses were prone to community float (42.45%, 3 142/8 864). Furthermore, nursing managers had higher requirements on the professional title and seniority of float nurse, and 39.43% (207/525) believe that the professional title should be supervisor, while 81.71% (429/525) thought that length of service as a nurse should be 5 years or more.@*Conclusion@#There are differences between clinical nurses and nursing managers in such aspects as the intention of floating practice, obstacles and guarantee factors, cognition and selection of demanders, and acceptance of practice threshold. The above differences should be fully considered in the trial of the "Internet + Nursing" floating practice mode for nurses.

D3Targets-2019-nCoV: a webserver for predicting drug targets and for multi-target and multi-site based virtual screening against COVID-19

A highly effective medicine is urgently required to cure coronavirus disease 2019 (COVID-19). For the purpose, we developed a molecular docking based webserver, namely D3Targets-2019-nCoV, with two functions, one is for predicting drug targets for drugs or active compounds observed from clinic or / studies, the other is for identifying lead compounds against potential drug targets docking. This server has its unique features, (1) the potential target proteins and their different conformations involving in the whole process from virus infection to replication and release were included as many as possible; (2) all the potential ligand-binding sites with volume larger than 200 Å on a protein structure were identified for docking; (3) correlation information among some conformations or binding sites was annotated; (4) it is easy to be updated, and is accessible freely to public (https://www.d3pharma.com/D3Targets-2019-nCoV/index.php). Currently, the webserver contains 42 proteins [20 severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) encoded proteins and 22 human proteins involved in virus infection, replication and release] with 69 different conformations/structures and 557 potential ligand-binding pockets in total. With 6 examples, we demonstrated that the webserver should be useful to medicinal chemists, pharmacologists and clinicians for efficiently discovering or developing effective drugs against the SARS-CoV-2 to cure COVID-19.

Analysis of risk factors of multi-site work-related musculoskeletal disorders among workers in the industry of electronic equipment manufacturing / 中国职业医学

OBJECTIVE: To investigate the prevalence and risk factors of multi-site work-related musculoskeletal disorders(WMSDs) among workers in the industry of electronic equipment manufacturing. METHODS: A total of 815 workers in three factories of electronic equipment manufacturing in Guangdong Province were selected as study subjects by convenience sampling. The prevalence of multi-site WMSDs in the past year was investigated using Musculoskeletal Disorders Investigating Questionnaire and the influencing factors were analyzed. RESULTS: The total prevalence of WMSDs was 69.4%(566/815). The prevalence of multi-site WMSDs was 54.5%(444/815), and the prevalence of one-site WMSDs was 15.0%(122/815). Multiple logistic regression showed that female workers had higher prevalence of multi-site WMSDs than males [odds radio(OR) and 95% confidence interval(CI): 1.59(1.12-2.26), P<0.05]. The prevalence of multi-site WMSDs in left-handed workers was lower than that of right-handed workers [OR(95% CI): 0.42(0.19-0.91), P<0.05]. The longer service of current position and the more neck forward movement, the higher prevalence of multi-site WMSDs [OR(95% CI) were 1.33(1.09-1.63) and 1.62(1.23-2.15), P<0.01]. The workers who had long-time sitting at work, adopted uncomfortable working posture, could decide when to work on their own, kept head down for a long time, or often bending wrists up/down had higher prevalence of multi-site WMSDs [OR(95% CI) were 1.41(1.16-1.73), 1.82(1.40-2.38), 1.79(1.16-2.75), 1.92(1.38-2.69) and 1.60(1.14-2.24), respectively, P<0.01]. The workers who could take turns with colleagues to finish work or had enough rest time had lower prevalence of multi-site WMSDs [OR(95% CI): 0.57(0.41-0.78) and 0.67(0.48-0.92), P<0.05]. The workers who worked >10 h per day had lower prevalence of multi-site WMSDs than those who worked ≤8 h per day [OR(95% CI): 0.57(0.37-0.87), P<0.05]. CONCLUSION: Multi-site WMSDs were more common than one-site WMSDs among workers in the industry of electronic equipment manufacturing, and the prevalence of multi-site WMSDs was high. The risk factors include personal factors, work organization and adverse ergonomic factors.

A pregnant woman with condyloma acuminatum on the vaginal orifice, areola, groin, and umbilicus

Condyloma acuminatum (CA) is a benign tumor primarily caused by infection with human papillomavirus (HPV) type-6 or type-11, lesions of which are most frequently found on the genital, perianal squamous mucosa, and skin. CA outside the anogenital region is not common. Here, we report a case showing simultaneous presence of CA on the vaginal orifice, areola, groin, and umbilicus in a 32-year-old pregnant woman. Histopathological examination and HPV detection are essential in making a definitive diagnosis of CA on multiple sites. The patient was treated with microwave and liquid nitrogen cryotherapy, but repeated relapse of the lesions were observed. Patients with CA during pregnancy represent a special risk group. These cases are usually characterized by fast-growing warts, multi-site or special site warts, a reduced tolerance, and poor response to treatment. Hence, we should pay more attention to CA in pregnant women in the process of diagnosis and treatment, especially cases outside the anogenital region.

Analyzing the potential category of occurrence pattern of musculoskeletal disorders among workers in an electronic parts processing factory / 中国职业医学

OBJECTIVE: To explore the occurrence pattern of work-related musculoskeletal disorders( WMSDs) in electronic parts processing workers. METHODS: A total of 498 workers from an electronic parts processing factory were selected as study subjects by judgement sampling method. The prevalence of WMSDs in the past 1 year was investigated by using the China Musculoskeletal Questionnaire. The potential category model was used to classify the categories of WMSDs. RESULTS: The incidence of WMSDs in the past 1 year was 46. 8%( 233/498). Among them,the incidence of WMSDs involving only one site was 13. 1%( 65/498),and those involving at least 2 sites were 33. 7%( 168/498). The multi-site WMSDs were about 6-58 times of the single-site WMSDs. According to potential category analysis,the occurrence patterns of WMSDs were divided into three categories: i) cervical and shoulder occurrence group( 135 persons,27. 1%); ii) all parts group( 31 persons,6. 2%); iii) few or no site group( 332 persons,66. 7%). CONCLUSION: The occurrence of multi-site WMSDs in electronic parts processing workers were more common than the single-site. Analysis of potential category can be used to explore the occurrence pattern of WMSDs.

Analyzing the influencing factors of multisite work-related musculoskeletal disorders among workers in a railway vehicle manufacturing enterprise / 中国职业医学

OBJECTIVE: To analyze the prevalence and influencing factors of multisite work-related musculoskeletal disorders(WMSDs) of workers in a railway vehicle manufacturing enterprise. METHODS: A total of 366 male workers in the assembly and riveting workshop of a railway vehicle manufacturing enterprise were selected as the research subjects using the cluster sampling method. The Chinese Musculoskeletal Questionnaire was used to investigate the prevalence of multiple sites of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors. RESULTS: The total prevalence of WMSDs was 56.3%(206/366). The prevalence of WMSDs in all parts from high to low was as follows: lower back(35.5%), hand and wrist(27.6%), neck(23.2%), shoulder(21.0%), knee(19.9%), upper back(18.6%), hip and leg(18.0%), ankle/foot(15.8%) and elbow(12.3%)(P<0.01). The total prevalence of multisite WMSDs was 38.0%(139/366). The prevalence of WMSDs in different numbers of parts from high to low was as follows: 6 or more parts(12.0%), 2 parts(10.7%), 3 parts(6.6%), 5 parts(5.5%) and 4 parts(3.3%)(P<0.01). Multiple logistic regression analysis results showed that the overweight and obese workers had higher risk of multi site WMSDs than those with normal body mass index(P<0.05).Those with long-term low heads, frequent bending, long bending of the elbows, and higher frequency of work requirements, and less frequently communicated with the leader had higher risk of multi site WMSDs(P<0.05). CONCLUSION: The prevalence of multisite WMSDs in railway vehicle manufacturing enterprise is relatively high. The influencing factors include individual factors, adverse ergonomic factors and psychosocial factors.

Respuesta a la estimulación multisitio del ventrículo izquierdo en un paciente con terapia de resincronización y fibrilación auricular permanente / Multi-site stimulation of the left ventricle in a patient with dilated cardiomyopathy and permanent atrial fibrillation on resynchronization therapy

Resumen: Se presenta el caso de un hombre de 79 años con miocardiopatía dilatada severa, disfunción ventricular izquierda, fibrilación auricular permanente y portador de un resincronizador ventricular. Al efectuar un recambio del resincronizador se implantó un electrodo adicional para estimulación multisitio del ventrículo izquierdo. Ello condujo a significativa mejoría clínica y de la fracción de eyección del ventrículo izquierdo.

Abstract: A 79-year-old man with dilated cardiomyopathy and atrial fibrillation undergoing resynchronization therapy had and additional electrode implanted in the left ventricle. Multi-site stimulation led to an improved functional class and left ventricular ejection fraction.

Analysis of nurses' multi-site practice in Guangzhou based on interviews / 中华护理杂志

Objective To explore the current situation of nurses' multi-site practice,and the attitude and willingness of nurses towards multi-site practice in Guangzhou,and to analyze the pros and cons and the obstacles during implementing multi-site practice in Guangzhou.Methods Semi-structured interviews were conducted among nurses recruited from four general hospitals,one specialist hospital and two community health centers using convenience sampling in October 2016.Interviews were recorded and analyzed by quantitative method after transcription.Results Totally 55 registered nurses were interviewed,including 24 nurse managers and 31 clinical nurses.Fifty-four (98.18％) nurses were supportive to nurses' multi-site practice and 20(36.36％) had the will to carry out multi-site practice themselves.For benefits of multi-site practice,participants considered it could be good to nursing staffs personal growth and career development,contribute to the rational allocation of nursing staff resources and increase the income of nurses.The mentioned disadvantages of nurses' multi-site practice were difficulties of nurses' management and nursing quality management,and the risk of involving primary practicing work place in medical disputes.The obstacles of implementing nurses' multi-site practice included unclear laws and regulations,nursing quality being difficult to control,and inadequate training and management of multi-site practicing nurses.Conclusion The majority of the nurses in Guangzhou supported the nurses' multi-site practice,however,due to unclear regulations and inadequate guarantee system for medical risks,nurses' willingness to carry out multi-site practice were relatively low.Problems faced by nurses' multi-site practice need to be noted and laws and policies should be developed to carry forward the development of nurses' multi-site practice in the future.

Does the Definition Of Multisite Musculoskeletal Pain Influence Its Occurrence And The Assessement Of Physical Work Exposures?

Most people with musculoskeletal problem suffer pain at multiple body sites. The most frequent form of multisite pain studied is chronic widespread pain (CWP). Focusing solely on CWP may exclude the commoner form of multisite pain which is less wide spread. Therefore, studies on multisite pain which do not consider the spatial distribution of pain can be beneficial to tackle the overall problem of musculoskeletal pain. Nevertheless, multisite pain has been defined differently in the studies among workers. The absence of uniformed definition will jeopardize the understanding of this musculoskeletal problem. A review was thus carried out to identify how multisite pain were defined, how they influenced the reported occurrence of multisite pain and whether the definition determined the physical work exposures assessed in previous studies among worker. A systematic review was initiated by the search of electronic databases for multisite pain. Articles were included and excluded based on the selection criteria. A final of nine full text articles were reviewed. It was found that the difference in the definitions lies mainly in the body sites considered and the pain characteristics. The characteristics of pain influenced the multisite pain prevalence more than the sites.It wasdifficult to conclude whether the definition used determined the physical work exposures since only five studies were involved and three of them had similar research team which may explained the usage of similar exposures. The findings from this review, however, could not be inferred due to the small number of studies involved.

Insights for multi-site physician practice / 中华医院管理杂志

Western developed countries have already made multi-site physician practice a mainstream in their physicians'regulatory system,which remains however at the beginning stage in China during the ongoing health reform since 2009.This article justified the significance of this practice,then analyzed its main roadblocks encountered in China,and in the end proposed countermeasures in terms of better awareness,better policy support and practicality of the practice.

Insights on multi-site physician practice in the cooperative medical background / 中华医院管理杂志

The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.

Construction of a lentivector containing over-expressing β-catenin gene by multisite Gateway technology / 国际生物医学工程杂志

Objective To construct a lentiviral vector over-expressing β-catenin gene by multisite Gateway technology and confirm its effect.Methods By using multisite Gateway clone technique,the entry clone of pDown-Ctnnb1 was constructed using BP recombination reaction.Then,LR recombination reaction was performed among pUp-EF1A,pDown-Ctnnb1,pTail-IRES/DsRed-Express2 and pLV.Des3d.P/puro to generate an expression clone of pLV.EX3d.P/puro-EF1A＞Ctnnb1 ＞IRES/DsRed-Express2.In each step,PCR and sequencing analysis were used to verify the constructions.When it was verified that plasmids were transfected into 293T cells,PT-PCR was performed to determine the mRNA level of β-catenin gene.Results Both PCR and sequencing analysis revealed that β-catenin over-expression gene was inserted into the target site and the insertion sequence was perfectly corrected.The RT-PCR results showed that the expression of β-catenin gene was significantly upregulated.Conclusion The lenvivirus-mediate β-catenin over-expression gene was successfully constructed..

Research in application of two kinds of pressure ulcer assessment scale in children patients / 中国实用护理杂志

Objective To evaluate and compare the predictive validity of the Braden Q and Braden pressure ulcer risk assessment scales in the acute pediatric patients, and explore the cutoff score of the scales. Methods We adopted the prospective cohort study design.The settings included three PICU of three different children's hospitals. Two nurses were appointed as the data collectors, and they were in charge of both the scoring and the skin assessment separately. Results We collected 145 samples. There were 9 patients who developed the pressure ulcers, and the incidence rate was 6.2%. The cutoff score of Braden Q and Braden scale was 17 and 14. The AUC of the ROC curve of the two scales was 0.481 and 0.398. Conclusions The Braden Q scale is more suitable for the pediatric patients. Further study is neededed to improve the scale.