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OBJECTIVES@#Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset.@*METHODS@#This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score.@*RESULTS@#The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism.@*CONCLUSIONS@#PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.
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Humanos , Trastornos por Estrés Postraumático/diagnóstico , Bomberos/psicología , Estudios Transversales , Algoritmos , Aprendizaje AutomáticoRESUMEN
Objective:At present,the doctor-patient relationship is tense.The prevalence of negative emotions,such as depression and anxiety,among healthcare workers is increasing every year.Negative attitudes of medical workers toward mental problems may aggravate the doctor-patient conflict and psychological problems of medical workers.This study aims to explore the complex network relationships between outpatient medical workers'attitudes toward mental problems,doctor-patient relationships,and their depression/anxiety levels. Methods:A total of 578 outpatient medical staff from the Second Xiangya Hospital of Central South University(167 males,411 females)completed questionnaires on their attitudes toward mental problems,doctor-patient relationships,and depression/anxiety symptoms.Network analysis was conducted separately to construct the"attitude towards mental problems-doctor-patient relationship network"and"depression-anxiety related network". Results:The edge between"M15(insulting words)"and"D8(waste time)"showed the strongest strength in the"attitude towards mental problems-doctor-patient relationship network",and"M15(insulting words)"had the highest bridge strength in the network.For the analysis of emotional variables,"P1(anhedonia)"showed the most obvious association with"D10(communication difficulties)"in the doctor-patient relationship and"M2(poor quality of life)"in the psychiatric attitudes,and"P1(anhedonia)"was the key bridge symptom in the network. Conclusion:The"insulting words"may be an intervention target for medical workers'attitudes toward mental problems.The"anhedonia"in depression is the potential symptom that needs to be treated.Intervention targeting these variables may be beneficial to improve the mental health level of medical workers and the doctor-patient relationship.
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Objective To explore the application effect of modified installing method of high flexion rotating platform prosthesis trial model in double compartment knee arthroplasty.Methods A total of 20 patients(26 knees)with severe knee osteoarthritis admitted to Hebi People's Hospital from January 2021 to April 2022 and required double compartment knee arthroplasty were selected as the research subjects.Patients were divided into the control group(10 knees)and the observation group(16 knees)based on the installing method of high flexion rotating platform prosthesis trial model.The patients in the control group used the conventional installing method of high flexion rotating platform prosthesis test model(placing the tibial side test model,the femoral side test model and finally the pad test model),while patients in the observation group used the modified installing method of high flexion rotating platform prosthesis test model(matching the femoral test model,pad and tibial test model when the patient flexed 60° to 90°,and placing them together into the knee joint osteotomy groove).The intraoperative bleeding volume and surgical time of patients in the two groups were recorded.Before surgery,2 weeks after surgery and 18 months after surgery,the knee joint function of patients was evaluated by the American hospital for special surgery(HSS)scoring system,and the range of motion(ROM)of knee joint of patients was measured by protractor.Results The intraopera-tive bleeding volume of patients in the observation group was significantly less than that in the control group,and the surgical time was significantly shorter than that in the control group(P＜0.05).There was no statistically significant difference in preoperative HSS score and ROM of knee joint of patients between the two groups(P＞0.05).At 2 weeks and 18 months after surgery,the HSS score and ROM of knee joint of patients in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion Compared with the conventional installing method of high flexion rotating platform prosthesis trial method,the modified installing method of high flexion rotating platform prosthesis trial model in double compart-ment knee arthroplasty for patients with severe knee osteoarthritis can effectively improve surgical efficiency,reduce intraopera-tive bleeding,improve knee function and increase ROM of knee joint.
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BACKGROUND@#How to locate pulmonary ground-glass nodules in thoracoscopic surgery is an important clinical topic in minimally invasive thoracic surgery. There is no unified localization method at present. This study intends to investigate the accuracy and security of body surface theodolitic puncture localization method in video-assisted thoracoscopic surgery for pulmonary ground-glass nodules.@*METHODS@#The clinical data of 41 patients from August 2018 to December 2019 were analyzed retrospectively, including 28 males and 13 females. After anesthesia, the patient was located by body surface theodolitic puncture, and then partial lobectomy was performed under video-assisted thoracoscopy. The distance from the nodule to the marked suture and the distance from the nodule to the incisal margin were measured, and the accuracy of localization, the rate of complication and the success rate of surgical resection were calculated.@*RESULTS@#A total of 51 nodules in 41 patients were located by body surface theodolitic puncture localization method. The accuracy rate was 96.1%, and the average location time was 8.3 min. Puncture bleeding occurred in 5 cases (12.2%), all of which were successfully stopped by video-assisted thoracoscopy, and there were no other complications. All patients underwent thoracoscopic partial lobectomy, including 33 cases of anatomical segmentectomy and 8 cases of wedge lobectomy. All the patients in operation process smoothly. The distance between nodule and incisal margin was measured, and all specimens were more than 2 cm, reaching a safe distance. The success rate of surgical resection was 100.0%.@*CONCLUSIONS@#In video-assisted thoracoscopic surgery for ground glass nodules of lung, the body surface theodolitic puncture localization method can be accurate, safe and simple.
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Objective To prepare Herba Cistanche enteric release microspheres, optimize the preparation process and study the releasing characteristics of microspheres in vitro.Methods Ion gelatin-oven drying method was used to prepare Herba Cistanche enteric microspheres.The preparation process was optimized with the aid of a Box-Behnken design.Results The optimal preparation condition was 36.33 mg/ml of sodium alginate, 10.82 mg/ml of calcium chloride and 10.93 mg/ml of chitosan.Conclusion This technology is repeatable and feasible.The microspheres have high entrapment efficiency and good sustained release characteristics.
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OBJECTIVE:To establish drug use evaluation(DUE)criteria for tigecycline,and to provide reference for rational use of tigecycline. METHODS:Based on tigecycline instructions,referring to related specifications and literatures,DUE criteria for tigecycline was established. And on a basis of it,referring to DUE criteria,in retrospective study,the utilization of tigecycline in 179 inpatients of some one hospital during Nov. 2012-Oct. 2016 was evaluated and analyzed in respects of management indexes, medication indication,medication duration,medication results,etc. RESULTS:The results for DUE of tigecycline in this hospital was that the proportion of patients with consultation records was 83.2%(aiming at 100%);microbial inspection rate was 90.5%(aiming at 80%);the coincidence rate of medication indication was 98.9%(aiming at 90%);the rates of solvent selection,ad-ministration route,drug interaction,incompatibility,drug use in special populations meeting the criteria were all 100%(aiming at 100%);the rate of prescribing authority was 20.1%(aiming at 100%);the rate of drug dosage and medication interval meeting the criteria were 7.3%(aiming at 100%);response rate was 54.7%(aiming at 80%). CONCLUSIONS:Established DUE criteria of tigecycline can standardize the clinical utilization of tigecycline.
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Aim To investigate the relevance of 5-hydroxytryptamine transporter(SERT)gene polymorphism and chronic obstructive pulmonary disease(COPD).Methods A total of 51 COPD patients and 49 healthy controls were collected.SERT gene polymorphism and mRNA expression in COPD and control groups were assayed by PCR and real-time PCR,respectively.Lung function was evaluated by a forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC)and FEV1/FVC.Results Two allele gene 484 bp and 528 bp were detected.It consisted of three genotypes L/L(528/528),L/S(528/484)and S/S(484/484),and SS genotype was prevalent in control and COPD group;SERT mRNA expression in COPD group was higher than that in the control;L allele in COPD with PAH patients was higher than the control.The age at diagnosis of COPD in LS genotype patients was earlier compared with that in SS genotype patients.Conclusion SERT gene polymorphism is relevant to hereditary susceptibility of COPD,which may play an important role in the development of COPD,especially promoting PAH in advanced stage of COPD.
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Objective:To optimize the formula of Junduqing dispersible tablets .Methods:Using appearance , disintegration time and dispersing uniformity as the indices ,the types of filler, disintegrating agent and adhesive were optimized by single factor tests;the amount of filler and disintegrating agent was optimized by orthogonal experiments with the disintegration time as the index ; using ap-pearance and sticking as the indices , the single factor tests were also used to optimize the lubricant , and the adding method of disinte-grating agent was optimized using disintegration time as the index .Results: For 500 tablets, the amount of Junduqing extract was 61.25 g, microcrystalline cellulose (52.5 g) and dextrin (17.5 g) were used as the fillers, crospolyvinylpyrrolidone (8.75 g) and croscarmellose sodium (26.25 g) were applied as the disintegrating agents , 70% ethanol was the binder , magnesiumstearate (3 g) and talcum powder (2.25 g) were used as the lubricants , and stevioside (3.5 g) was the flavoring agent .Conclusion:The formula is reasonable and feasible ,which provides reference for the preparation of Junduqing dispersible tablets .
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OBJECTIVE:To study in vitro antiviral effect of Junduqing granules. METHODS:Human laryngeal cancer Hep2 cells were inoculated with the Nancy strain of coxsackievirus B3 (CoxB3) and respiratory syncytial virus (RSV) to establish vi-rus-infected cell models. 2 mg/ml original liquid of Junduqing granules and 2 mg/ml original liquid of chlorogenic acid which were diluted according to the ratio of 1∶2-1∶256 were used to act on the virus-infected cells. Reed-Muench method was adopted to calcu-late 50% toxic concentration (TC50) and maximal atoxic concentration (TC0). Virus-infected cells were cultured with solution of Junduqing granules of 1.25,0.625,0.312 5 and 0.156 25 mg/ml and chlorogenic acid solution 0.5,0.25,0.125,0.062 5 mg/ml, and then the degree of cytopathic effect was evaluated with a microscope. Virus-infected cells were cultured with 1.25,0.625, 0.312 5 ,0.156 25,0.078 125 mg/ml solution of Junduqing granules and 0.5,0.25,0.125,0.062 5,0.031 25 mg/ml of chlorogenic acid solution,and Reed-Muench method was adopted to calculate 50% inhibitory concentration (IC50) and therapeutic index (TI) on RSV and CoxB3 cells. RESULTS:TC50 of Junduqing granules was 1.79 mg/ml and TC0 was 1.25 mg/ml,TC50 of chlorogenic ac-id was 0.71 mg/ml and TC0 was 0.5 mg/ml. Virus-infected cells grew normally when the mass concentration of solution of Jundu-qing granules was 1.25 mg/ml. IC50 of Junduqing granules was 0.22 mg/ml and TI was 8.14;IC50 of chlorogenic acid were 0.18 and 0.36 mg/ml,TI were 3.94 and 1.97. CONCLUSIONS:Junduqing granules have in vitro anti-CoxB3 and RSV effect.
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Health care is an important factor in the development of livelihood. As a central-level medical research institute, Chinese Academy of Medical Sciences has effectively implemented central-level special funds for repairing and purchasing, which has achieved certain success and experience on scientific research and talent building, meanwhile there are still urgent problems need to be solved in the future development.
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ObjectiveTo observe the effect of Gankang Ⅱ in reducing bilirubin level of patients with chronic hepatitis B,and discuss the mechanism.Methods124 cases hyperbilirubinemia patients with chronic hepatitis B were randomly divided into Gankang Ⅱ treatment group (the treatment group for short),and Yinzhihuang particles treatment group (the control group for short),with 62 eases in each group.The cure rate,recover rate of the treatment group and control group were observed,together with the changes of ALT,AST,GGT,and TBiL.Results①The cure rate was 80.6％,the recover rate was 19.4％ in the treatment group; the cure rate of was 62.9％ and the recover rate was 37.1％ in the control group; the cure rate of the treatment group was obviously higher than the control group.② There was no significant difference between the treatment group and the control group on TBiL,ALT,AST,and GGT before the treatment (P＞0.05).while after treated,TBiL (20.75±3.77) μmol/L,ALT (52.53± 12.23) U/L,AST (51.75 ±9.93) μmol/L,GGT (48.75 ±16.68) U/L of the treatment group were obviously lower than the TBiL(26.68 ±4.99)μmol/L,ALT(79.68± 1 1.92)U/L,AST (60.12 ± 8.12) μmol/L,GGT (58.97±15.47)U/L of control group.There was significant difference(P＜0.05～0.01).ConclusionThe effect of Gankang Ⅱ in reducing the bilirubin level of patients with chronic hepatitis B was sound.
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OBJECTIVE: To develop an HPLC method for content determination of protocatechualdehyde in Tong-jingkang oral liquid.METHODS:Zorbax Eclipse XDB-C18(250 mm?4.6 mm,5 ?m) was used as chromatographic column with mobile phase consisted of methanol-water-formic acid(20∶79.5∶0.5) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 280 nm and the temperature of column was kept at room temperature.RESULTS: The linear range of protocatechualdehyde was 0.025～0.5 ?g(r=0.999 9) with an average recovery of 101.1%(RSD=2.29%,n=6).CONCLUSION: The established method is simple,accurate and it is applicable for the quality control of Tongjingkang oral liquid.
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OBJECTIVE:To develop an RP-HPLC method for the content determination of berberine in Fujie lotion.METHODS:The separation was performed on Agilent 1200 technologies XDB-C18(250 mm?4.6 mm,5?m)column with acetonitrile-0.02%monobasic potassium phosphate(45:55)as mobile phase at flow rate of 1.0 mL?min-1.The UV detection wavelength was set at 265nm.RESULTS:The linear range of berberine were 0.029 6～0.236 8?g(r=0.999 1)with an average recovery of 99.21%(RSD=1.10%,n=9).CONCLUSION:Established method is sensitive,simple,rapid,accurate and reproducible for the quality control of Fujie lotion.