Analysis on Components Absorbed into Blood and Cerebrospinal Fluid of Schisandrae Chinensis Fructus Based on Sequential Metabolism / 中国实验方剂学杂志

ObjectiveTo identify the prototypical components and metabolites absorbed into blood and cerebrospinal fluid of Schisandrae Chinensis Fructus（SCF） based on sequential metabolism combined with liquid chromatography-mass spectrometry. MethodBlood and cerebrospinal fluid samples of integrated metabolism， intestinal metabolism and hepatic metabolism were collected from male SD rats after gavage and in situ intestinal perfusion administration， and ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC Q-Exactive Orbitrap MS） was used to analyze and compare the differences in the spectra of SCF extract， blank plasma， administered plasma， blank cerebrospinal fluid and administered cerebrospinal fluid with ACQUITY UPLC BEH Shield RP18 column（2.1 mm×100 mm， 1.7 µm）， the mobile phase was acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-7 min， 95%B； 7-12 min， 95%-35%B； 12-17 min， 35%-15%B； 17-20 min， 15%-12%B； 20-22 min， 12%-5%B； 22-23 min， 5%B； 23-25 min， 5%-95%B； 25-28 min， 95%B）. And heated electrospray ionization（HESI） was used with positive and negative ion modes， the scanning range was m/z 100-1 500. The prototypical constituents and their metabolites absorbed into blood and cerebrospinal fluid of SCF were identified according to the retention time， characteristic fragments， molecular formulae and the information of reference substances. ResultA total of 42 chemical components were identified in the extract of SCF， including lignans， flavonoids， amino acids， tannins， and others， of which lignans were the main ones. A total of 27 prototypical components and 14 metabolites were identified in plasma samples from different sites. A total of 15 prototypical components and 9 metabolites were identified in cerebrospinal fluid. The main metabolic reactions involved in the formation of metabolites were mainly demethylation， methylation， demethoxylation and hydroxylation. ConclusionThrough the systematic identification of the prototypical components and metabolites of SCF in rats， it provides data support for further better exploring the material basis of SCF in the treatment of central nervous system diseases.

Analysis of Inhibitory Effect of Berberine Compounds on Acetylcholinesterase and Blood-brain Barrier Permeability / 中国实验方剂学杂志

ObjectiveTo examine the inhibitory effects of berberine compounds， including columbamine， on acetylcholinesterase from the perspectives of drug-target binding affinity and kinetics and explore the blood-brain barrier （BBB） permeability of these compounds in different multi-component backgrounds. MethodThe median inhibitory concentration （IC50） of acetylcholinesterase by berberine compounds including columbamine was measured using the Ellman-modified spectrophotometric method. The binding kinetic parameters （Koff） of these compounds with acetylcholinesterase were determined using the enzyme activity recovery method. A qualitative analysis of the ability of these components to penetrate the BBB and arrive at the brain tissue in diverse multi-component backgrounds （including medicinal herbs and compound formulas） was conducted using ultra performance liquid chromatography-high resolution mass spectrometry （UPLC-HRMS）. ResultBerberine compounds， including columbamine， exhibited strong inhibition of acetylcholinesterase， with IC50 values in the nanomolar range. Moreover， they displayed better drug-target binding kinetics characteristics （with smaller Koff values） than the positive control of donepezil hydrochloride （P<0.01）， indicating a longer inhibition duration of acetylcholinesterase. Berberine components such as columbamine could penetrate the BBB to arrive at brain tissue in the form of a monomer， as well as in the multi-component backgrounds of Coptis and Phellodendri Chinensis Cortex medicinal extracts and the compound formula Huanglian Jiedutang. ConclusionThese berberine compounds such as columbamine exhibit a strong inhibitory effect on acetylcholinesterase and can arrive at brain tissue in multi-component backgrounds. In the level of pharmacological substance， this supports the clinical efficacy of compound Huanglian Jiedutang in improving Alzheimer's disease， providing data support for elucidating the pharmacological basis of compound Huanglian Jiedutang.

Analysis on occupational stress status of employees and its influencing factors in pharmaceutical enterprises in Beijing City / 中国职业医学

{L-End}Objective To analyze the current status of occupational stress and its influencing factors among workers in pharmaceutical enterprises in Beijing City. {L-End}Methods A total of 860 employees from six pharmaceutical enterprises in Beijing City were selected as the research subjects using convenience sampling method. The Chinese version of the New Brief Job Stress Questionnaire was used to evaluate the occupational stress, and multiple linear regression analysis was used to analyze the influencing factors of occupational stress. {L-End}Results The detection rate of high occupational stress was 1.40% (12/860). The results of multiple linear regression analysis showed that the workers with higher education level and longer length of service had a higher risk of high occupational stress (all P<0.01). Workers who were satisfied with their jobs had a lower risk of high occupational stress than those who were unsatisfied with their jobs (P<0.01). Workers who were satisfied with life had a significantly lower risk of high occupational stress than those who were unsatisfied with life (P<0.01). {L-End}Conclusion The detection rate of high occupational stress in workers of pharmaceutical enterprises is relatively low. Occupational stress is mainly affected by individual factors such as education level and length of service, and work and life satisfaction. Improving job and life satisfaction is helpful to reduce occupational stress level.

Study on the methods of individual occupational stress examination and assessment for workers in electronic industry / 中国职业医学

{L-End}Objective To explore the suitable methods for individual occupational stress examination and evaluation for workers in China based on the electronics industry. {L-End}Methods A total of 1 164 workers from four electronics enterprises in Beijing City were selected as the research subjects using a convenient sampling method. The Occupational Stress Measurement Scale, which was developed based on the Japanese Brief Job Stress Questionnaire, was used to assess the occupational stress of the research subjects, and test the reliability and validity of the scale. Percentile norms and T-score norms were established, and the T-scores of the three dimensions of stress reaction (psychological reaction and physical symptoms), stress factors, and social support were divided into five stages using the normal distribution method with x¯±0.5 s and x¯±1.5 s, which was used to explore a proposed standard for assessing individual stress levels. {L-End}Results The revised scale consisted of 57 items, which could explain 64.0% of the total variation of occupational stress based on the result of item analysis and exploratory factor analysis. The results of confirmatory factor analysis showed that the model fitted well, with root mean square error of approximation of 0.052, standardized root mean square residual of 0.070, comparative fit index of 0.960, and Tucker-Lewis index of 0.958. The Cronbach's α coefficient of the scale was 0.951, and the Spearman-Brown coefficient was 0.837. Cronbach's α coefficients of the three dimensions ranged from 0.794 to 0.952, and the Spearman-Brown coefficients ranged from 0.737 to 0.850. The scores of the three dimensions of stress reaction, stress factors, and social support were (49.1±13.0), (44.9±7.7), and (18.1±3.6), respectively. Workers in the electronics industry met one of the following items were identified as the high level of occupational stress individuals: i) a score of stress reaction dimension ≥72.0 points; ii) a sum of stress factor and social support dimension scores ≥81.0 points, and a stress reaction dimension score ≥58.0 points. {L-End}Conclusion The Occupational Stress Measurement Scale and the criteria for determining high level of occupational stress can be used to assess the individual occupational stress levels of workers in the electronics industry in China. This method can provide a theoretical basis for the formulation of occupational stress examination and assessment for Chinese workers.

Evaluating the risk assessment method of occupational stress in workplaces / 中国职业医学

{L-End}Objective To study and develop a suitable scale to identify and assess risks of occupational stress in workplaces of enterprises, and to explore the establishment of a workplace occupational stress risk assessment method aimed at guiding enterprises to improve working conditions based on the electronics industry in Beijing City. {L-End}Methods The initial version of the Workplace Occupational Stress Risk Assessment Scale (WOSRAS) was constructed based on literature review and expert evaluation. A total of 1 284 employees from four electronics enterprises in Beijing City were selected as the research subjects using a convenient sampling method. Item analysis and exploratory factor analysis were used to determine the final items of the scale and test its reliability and validity. The method of percentile norms was used to establish risk assessment method for the electronics industry workplace and its stress sources, and the cut-off values of low, medium, high risk was graded by the 50th and 80th percentiles of the total score and the score of each dimension of the risk assessment scale. {L-End}Results i) Based on item analysis and exploratory factor analysis, a WOSRAS consisting of six dimensions and 23 items was constructed, which could explain 63.2% of the total variation of occupational stress. The results of confirmatory factor analysis showed that the root mean square error of approximation and standardized root mean square residual were both <0.080, and the comparative fit index and Tucker-Lewis index were both >0.900. The total criterion validity of the scale was 0.816. The total Cronbach's α coefficient of the scale was 0.835, and the Spearman-Brown coefficient was 0.802. ii) The cut-off values of WOSRAS scores for high, medium and low risk in electronics industry were <53.0, 53.0-60.0 and >60.0,respectively. According to the result, the workplace stress risk levels of the production, research and development, and logistics departments of the electronics industry in Beijing were medium risk, while the management department was low risk. {L-End}Conclusion The WOSRAS constructed in this study has good reliability and validity. The proposed risk assessment method can reflect the actual risk status of enterprises in the electronic industry and is convenient for widespread application.

An injectable signal-amplifying device elicits a specific immune response against malignant glioblastoma

Despite exciting achievements with some malignancies, immunotherapy for hypoimmunogenic cancers, especially glioblastoma (GBM), remains a formidable clinical challenge. Poor immunogenicity and deficient immune infiltrates are two major limitations to an effective cancer-specific immune response. Herein, we propose that an injectable signal-amplifying nanocomposite/hydrogel system consisting of granulocyte-macrophage colony-stimulating factor and imiquimod-loaded antigen-capturing nanoparticles can simultaneously amplify the chemotactic signal of antigen-presenting cells and the "danger" signal of GBM. We demonstrated the feasibility of this strategy in two scenarios of GBM. In the first scenario, we showed that this simultaneous amplification system, in conjunction with local chemotherapy, enhanced both the immunogenicity and immune infiltrates in a recurrent GBM model; thus, ultimately making a cold GBM hot and suppressing postoperative relapse. Encouraged by excellent efficacy, we further exploited this signal-amplifying system to improve the efficiency of vaccine lysate in the treatment of refractory multiple GBM, a disease with limited clinical treatment options. In general, this biomaterial-based immune signal amplification system represents a unique approach to restore GBM-specific immunity and may provide a beneficial preliminary treatment for other clinically refractory malignancies.

Antitumor synergism between PAK4 silencing and immunogenic phototherapy of engineered extracellular vesicles

Immunotherapy has revolutionized the landscape of cancer treatment. However, single immunotherapy only works well in a small subset of patients. Combined immunotherapy with antitumor synergism holds considerable potential to boost the therapeutic outcome. Nevertheless, the synergistic, additive or antagonistic antitumor effects of combined immunotherapies have been rarely explored. Herein, we established a novel combined cancer treatment modality by synergizing p21-activated kinase 4 (PAK4) silencing with immunogenic phototherapy in engineered extracellular vesicles (EVs) that were fabricated by coating M1 macrophage-derived EVs on the surface of the nano-complex cores assembled with siRNA against PAK4 and a photoactivatable polyethyleneimine. The engineered EVs induced potent PAK4 silencing and robust immunogenic phototherapy, thus contributing to effective antitumor effects in vitro and in vivo. Moreover, the antitumor synergism of the combined treatment was quantitatively determined by the CompuSyn method. The combination index (CI) and isobologram results confirmed that there was an antitumor synergism for the combined treatment. Furthermore, the dose reduction index (DRI) showed favorable dose reduction, revealing lower toxicity and higher biocompatibility of the engineered EVs. Collectively, the study presents a synergistically potentiated cancer treatment modality by combining PAK4 silencing with immunogenic phototherapy in engineered EVs, which is promising for boosting the therapeutic outcome of cancer immunotherapy.

Effect of neuroelectrophysiological changes on the clinical manifestations and surgical outcomes of lumbar degenerative diseases / 中国骨伤

OBJECTIVE@#To evaluate the effects of electromyography on the clinical manifestations and prognosis after posterior lumbar interbody fusion(PLIF) of degenerative lumbar diseases.@*METHODS@#A retrospective analysis was performed on 68 patients with degenerative lumbar diseases, including 29 males and 39 females, aged 21 to 84 years old, who underwent electromyogram (EMG) from January 2018 to October 2019. The patients were divided into negative and positive groups according to whether theresults of EMG was normal or abnormal, PLIF surgery was performed in both groups. The preoperative duration of illness, postoperative recovery time, operative time, intraoperative blood loss, postoperative ambulation time and length of postoperative hospital stay were recorded. The clinical efficacy was evaluated by visual analogue scale(VAS) of low back and lower limb, the Japanese Orthopedic Association(JOA) score before and after operation.@*RESULTS@#All patients were follow-up from 26 to 39 months. The subjective symptoms, clinical signs, daily activities and JOA total scores after operation in two groups were significantly higher than those before preoperation(P<0.05);the clinical signs score and total JOA score in the negative group at 3 months after operation were higher than those in the positive group(P<0.05). The VAS score of leg pain in the negative group after 1 and 3 months was less than that in the positive group(P<0.05). Patients 's illness time, postoperative recovery time, hospitalization time and implantation time in the negative group were shorter than those in the positive group(P<0.05). At other time points, there was no significant difference in low pain VAS, leg pain VAS, JOA scores in the two groups(P>0.05). There was no significant difference in the operation time and intraoperative bleeding volume between the two groups(P>0.05).@*CONCLUSION@#Patients with normal electromyography had shorter disease duration than ones with abnormal electromyography in lumbar degenerative disease;after PLIF, patients with normal electromyography recovered faster than ones with abnormal electromyography, but the results of electromyography had no effect on the final prognosis of PLIF surgery.

Determination and effect of five alkaloids from extracts of Piper longum on rats with experimental myocardial ischemia induced by injection of pituitrin / 药学实践杂志

Objective To determine the content of five alkaloids from extracts of Piper longum and test the pharmacodynamic effect of them on rats with experimental myocardial ischemia induced by injection of pituitrin. Methods The content of five alkaloids was determined simultaneously by HPLC. The experimental myocardial ischemia in rats was induced by injection of pituitrin, and the absolute value of T wave change and change of heart rate before and after model establishment were chosen to be the observation index. The effects of large, medium and small dose groups were evaluated. Results Three batches of samples were analyzed, with the contents of piperine for 56.1%, 49.7%, 51.6%; N-isobutyl-(2E,4E)-octadecatrienamide for 4.5%, 4.2%, 4.3%; guineensine for 0.46%, 0.38%, 0.40%; piplartine for 1.73%, 1.67%, 1.70% and piperamide for 0.55%, 0.46%, 0.49%, respectively. All dose groups from extracts of piper longum had significantly reduced the absolute value of T wave and almost have no effect on the change of heart rate, except the high dose group showed the effect of reducing heart rate at some time . Conclusion The HPLC method was suitable for the simultaneous determination of five alkaloids from extracts of Piper longum. It was shown that extracts of Piper longum had good bioactivity in anti-myocardial ischemia.

A case-control study on the risk of stroke in the elderly in Shanghai community / 上海预防医学

ObjectiveTo explore the risk factors of stroke， and to provide reference for the prevention and health management of stroke. MethodsFrom February 2022 to March 2022， four community residents over 60 years old with stroke in Shanghai were randomly selected as the case group （n=100）， and non-stroke residents were selected as the control group （n=100）. The survey was in the form of questionnaires to record and compare the age， body mass index （BMI）， blood lipids， blood pressure-related indicators， family history of other diseases， living habits， mood and sleep conditions of all subjects. The value of predicting the incidence of stroke among the elderly in Shanghai community was analyzed by receiver operating characteristic （ROC）， and the influencing factors of stroke were analyzed by logistic model. ResultsBMI， hypertension， heart disease， diabetes， transient ischemic attack （TIA）， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP， DBP， TG levels were significantly higher in the case group （P<0.05）. The level of HDL-C was significantly lower than that in the control group （P<0.05）. BMI， SBP， DBP， TG， HDL-C predicted the incidence of stroke by ROC analysis （P<0.05）. Logistic regression analysis showed that BMI≥23.820 kg·m-2， heart disease， diabetes， TIA， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP≥139.535 mmHg， DBP≥89.605 mmHg， TG≥1.565 mmol·L-1 and HDL-C≤1.105 mmol·L-1 were risk factors for stroke （P<0.05）. ConclusionPhysical health status including blood lipids and blood pressure， family history of certain diseases， and living habits could be important risk factors for stroke in the elderly in Shanghai community. Preventive intervention measures for the above factors have important clinical significance.

Cloning and expression analysis of wpHSP90 gene from Whitmania pigra at different temperatures / 中国中药杂志

HSP90 is a widely distributed molecular chaperone that participates in a variety of cellular processes and plays an important role in the meiosis of germ cells. However, its role in the gonadal development of hermaphroditic Whitmania pigra is not yet clear. To explore the effect of HSP90 on the germ cell development of Wh. Pigra, this study cloned the wpHSP90 gene, performed bioinformatics analysis, and measured its expression levels. The results showed that the cloned wpHSP90 was 2 592 bp in length, with an open reading frame(ORF) of 2 373 bp, encoding 790 amino acids. Prediction analysis revealed 85 phosphorylation modification sites on serine, threonine, and tyrosine residues of the wpHSP90 protein. Structural domain prediction and multiple sequence alignment results showed that wpHSP90 contained two conserved domains of HSP90 and exhibited the highest homology with Helobdella robusta, with a sequence similarity of 80.72%. RT-qPCR results showed that the relative expression level of wpHSP90 in the gonads of 5-month-old Wh. pigra was positively correlated with temperature within the range of 12 ℃ to 28 ℃. The expression level in the female gonads was significantly higher than in the male gonads and correlated with the trend of germ cell development in the ovaries and testes. In conclusion, wpHSP90 may be involved in regulating the development of germ cells, particularly oocytes, in Wh. pigra. This study provides a reference for further research on the gonadal development mechanism in Wh. pigra.

Analysis of the relationship between management capability of general practice team leaders and the team performance in community health service centers based on structural equation model / 中华全科医师杂志

Objective:To analyze the relationship between capacity of general practice team leaders and the team performance in community health service centers.Methods:This study was a cross-sectional study. A questionnaire survey was conducted between November and December 2022, among general practice team leaders and general practitioners (GPs) from 18 community health service centers in the urban and suburban areas of shanghai selected by stratified sampling method. The personal information questionnaire, leadership of general practice team leader questionnaire,and work performance scale of general team members were used for the survey. The relationship between leadership of general practice team leaders and team performance was analyzed based on structural equation model (SEM).Results:A total of 944 questionnaires were distributed and 856 valid ones were returned with a response rate of 91.0%, including 110 general practice team leaders and 749 were GPs. The SEM analysis showed that some dimensions of the management ability of the general practice team leader had significant effect on the employee organization loyalty (organizational management: β=0.37, teaching and research management: β=-0.29, strategy and cultural construction: β=0.23, personal quality: β=0.11) and work performance (special business management: β=0.95, organizational management: β=0.54) (all P<0.05); and employee organization loyalty played a partial mediator role in relationship between leadership of general practice team leaders and work performance with a mediating effect of 39.50%. Conclusion:The management ability of the general practice team leader directly affect or indirectly affect the work performance of team members through team members′ organizational loyalty.

Status quo of management capabilities of general practice team leaders in community health service centers in Shanghai / 中华全科医师杂志

Objective:To survey on the status quo of the management capabilities of general practice team leaders in community health service centers in Shanghai.Methods:Using stratified sampling method, 18 community health service centers in the urban and suburban areas of Shanghai were selected, then the general practice team leaders and general practitioners (team members) in the centers were selected as the study participants. The questionnaire survey on the management capabilities of general practice team leaders was conducted among selected participants from November to December 2021. The self-assessment by general team leaders and the other-assessment by team members were carried out, and the total scores was calculated according to the weight of self-evaluation score (30%) and other-evaluation score(70%).Results:A total of 110 general practice team leaders and 749 team members participated in the survey. Among the team leaders, 63.64% (70/110) were females, 82.73% (91/110) were bachelor degree holders, 71.82% (79/110) had intermediate professional title, and 50.91% (56/110) worked for more than 9 h per day. The total score of general practice team leaders was (87.15±10.76) points, the other-assessment score was significantly higher than self-assessment score ((88.62±9.34) vs.(83.71±14.08), t=2.22, P<0.05). The average score of the 5 dimensions was 4.41 for special business management, 4.39 for organizational management, 4.38 for personal quality, 4.27 for teaching and research management and 4.22 for strategy and cultural construction, respectively. Conclusion:The overall management capabilities of Shanghai community general practice team leaders are at the upper-middle level, however, the capabilities in scientific research and team planning are relatively weak.

Analysis on Components Absorbed into Blood of Citri Reticulatae Pericarpium in Rats Based on Sequential Metabolism and UPLC-HRMS / 中国实验方剂学杂志

ObjectiveTo study the metabolism of chemical components from Citri Reticulatae Pericarpium（CRP）in different parts of rats by sequential metabolism and ultra performance liquid chromatography-high resolution mass spectrometry（UPLC-HRMS）. MethodSD male rats were employed as experimental subjects， and blood samples of intestinal metabolism and hepatic metabolism were prepared after administration of CRP ethanol extract by in situ intestinal perfusion， and comprehensive metabolic samples were collected after intragastric administration. UPLC-HRMS was used to analyze the samples with acetonitrile（A）-0.1% formic acid aqueous solution（B）as the mobile phase for gradient elution（0-10 min， 10%-30%A； 10-30 min， 30%-95%A； 30-31 min， 95%-10%A； 31-35 min， 10%A）at a flow rate of 0.35 mL·min-1， using a heated electrospray ionization with positive and negative ion mode scanning in the range of m/z 100-1 500. Under these conditions， the differences in the profiles of CRP ethanol extract， blank plasma and drug-containing plasma under different treatment groups were compared， and the chemical components of each sample were analyzed and identified based on the retention time， accurate relative molecular mass， primary and secondary ion fragments， and the information of reference substances. ResultA total of 44 chemical components were identified in the CRP ethanol extract， including flavone-O-glycosides， flavone-C-glycosides and polymethoxyflavonoids， etc. The results of sequential metabolism showed that 22 chemical components in CRP were detected in the intestinal metabolic sample， 18 chemical components were detected in the hepatic metabolic sample， and 9 identical chemical components（narirutin， hesperidin， meranzin， 5，7，8，3ʹ，4ʹ，5ʹ-hexamethoxy-flavone， isosinensetin， sinensetin， 3，5，6，7，8，3ʹ，4ʹ-heptamethoxyflavone， nobiletin and tangeretin）could be detected in all three metabolic samples， with a total of 22 compounds entering the blood in prototype form. ConclusionThe identified 21 components with well-defined structures entering the blood as prototypes may be potential active components of CRP， and differences in the components at different metabolic parts can provide an experimental basis for elucidating the in vivo biotransformation process of the metabolic components of CRP.

Effect of occupational stress on depression and sleep of gene sequencing enterprise employees / 环境与职业医学

Background Gene sequencing industry is an emerging innovation-driven industry. Employees have high requirements for independent learning and innovation ability and face great professional pressure. Objective To understand the occupational stress, depression, and sleep of gene sequencing enterprise employees and to analyze the effect of occupational stress on depression and sleep. Methods From November to December 2021, occupational stress, depression, and sleep conditions of 469 workers from 34 enterprises in gene sequencing industry were surveyed by Core Occupational Stress Scale (COSS), Patient Health Questionnaire 9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). A total of 427 valid questionnaires were recovered with a questionnaire valid response rate of 91.04%. The relationship of occupational stress with depression or sleep was analyzed by logistic regression. Results The rates of occupational stress, depression, and sleep disorder were 27.40%, 33.50%, and 28.10%, respectively. Significant difference were found in the rates of depression and sleep disorder in different occupational stress groups (P<0.05). The results of logistic regression analysis showed that, for every 1 increase in social support score, the risk of depression increased by 1.206 (95%CI: 1.117−1.304), and the risk of sleep disorder increased by 1.143 (95%CI: 1.059−1.233). For every 1 increase in organization and reward score, the risk of developing depression increased by 1.082 (95%CI: 1.017−1.151). Mild, moderate, and severe occupational stress were all associated with a higher risk of depression in reference to no occupational stress (OR=2.535, 95%CI: 1.465−4.386; OR=3.774, 95%CI: 1.809−7.870; OR=3.823, 95%CI: 1.486−9.837). Severe occupational stress was associated with a higher risk of sleep disorder in reference to no occupational stress (OR=3.141, 95%CI: 1.233−8.006). Conclusion Occupational stress among employees in the gene sequencing industry can increase the risks of depression and sleep disorder. Enterprises need to take intervention measures and pay attention to prevention and treatment.

Research progress on pharmacokinetics and toxicity of vinorelbine / 中国药房

Vinorelbine（NVB）is a semisynthetic vinca alkaloid and can play an anti-tumor role by inhibiting the synthesis of tubulin. Its oral preparation has been used in the treatment of a variety of tumors as its convenience and good clinical response. The blood concentration of NVB is closely related to its curative effect and toxicity. Small variations in blood concentration may reduce the curative effect and even produce serious toxicity. There are some risks in the clinical drug use due to limited clinical data and effective pharmacodynamic monitoring methods. By reviewing the relevant literature at home and abroad ，this paper summarizes the research progress of in vivo pharmacokinetics and toxicity of NVB ，fully understands the pharmacokinetic characteristics and influencing factors of NVB ，the influencing factors of toxicity ，and the application status of pharmacokinetics in the adjustment of administration scheme ，so as to provide reference for its clinical rational use.

Anterior mediastinal inflammatory myofibroblastic tumor with thymoma: A case report / 中国胸心血管外科临床杂志

@#Anterior mediastinal inflammatory myofibroblastoma is a rare tumor with insidious onset and easy misdiagnosis. In this report, we presented a case of anterior mediastinal inflammatory myofibroblastoma with thymoma. The mediastinal tumor was found by physical examination, and the prognosis was good after surgical treatment. For this disease, operation is an effective method for definite diagnosis and treatment, and complete excision can achieve good outcomes.

Establishment of evaluation index system for management capability of general practitioner team leaders in Shanghai community health centers / 中华全科医师杂志

Objective:To develop an evaluation index system for the management ability of general practice team leaders in community health service centers.Methods:Based on literature review, key insider interviews and other methods, the framework and indicator pool for management capability of general practice team leaders were formed. Two rounds of Delphi consultations with 15 experts were conducted from July to October 2021, and the evaluation index system of general practice team leaders' management ability established.Results:All 15 experts had at least 5 years of work experience, including 10 engaging in clinical general practice, 3 in public health and 2 in community management. The response rates for the two rounds of expert consultation was 15/15, and the expert authority coefficient was 0.84, with Kendall's W coefficient of 0.35 ( P<0.001) and 0.46 ( P<0.001), respectively. Finally, the evaluation index system of the management ability of general practice team leaders was established, which consisted of 5 primary indicators (personal quality, special business management, organizational management, teaching and research management, strategy and culture building), 11 secondary indicators and 37 tertiary indicators. Conclusions:The management capability evaluation index system general practitioner team leaders of the community health centers has been established in this stu, which may be used for the training and selection of general practice team leaders in the community health centers.

Clinical analysis of 37 patients with bilateral frontal lobe contusion / 中国基层医药

Objective:To investigate the treatment methods and their efficacy for bilateral frontal lobe contusion.Methods:The clinical data of 37 patients with bilateral frontal lobe contusion who received treatment in Fujian Provincial Hospital between May 2017 and May 2018 were analyzed. The 37 patients were divided into surgical group ( n = 19) and non-surgical group ( n = 18) according to different treatment methods. Clinical efficacy was compared between the two groups. All patients underwent intracranial pressure monitoring. Intracerebral pressure was divided into three stages: < 20 mmHg, 20-40 mmHg, > 40 mmHg. Clinical efficacy was compared among patients with different levels of intracranial pressure. Results:In the surgical group, one patient died, one patient was in a vegetative state, two patients had severe disability, eight patients had mild disability, and seven patients well recovered. In the non-surgical group, four patients died, three patients were in a vegetative state, six patients had severe disability, three patients had mild disability, and two patients well recovered. There was significant difference in good recovery rate between the two groups ( χ2 = 9.83, P < 0.05). The good recovery rate was statistically significant among patients with different levels of intracranial pressure ( χ2 = 7.97, P < 0.05). The vegetative state rate in patients with > 40 mmHg intracranial pressure was significantly higher than that in patients with < 20 mmHg intracranial pressure (50.0% vs. 0.0%, χ2 = 7.65, P < 0.05). The good recovery rate in patients with > 40 mmHg intracranial pressure was significantly lower than that in patients with < 20 mmHg intracranial pressure (0.0% vs. 61.5%, χ2 = 7.57, P < 0.05). Conclusion:The choice of treatment for bilateral frontal lobe contusion mainly depends on clinical symptoms, dynamic brain CT findings, and the changes in dynamic intracranial pressure monitoring. Active surgery can reduce the incidence of death and severe disability. Intracranial pressure monitoring has a positive role in guiding clinical treatment.

Effects of Wp-PKC on gonadal development of Whitmania pigra / 中国中药杂志

Protein kinase C(PKC) is a kind of kinase which is widely involved in cell proliferation and development. PKC(Wp-PKC) in Whitmania pigra body belongs to classic PKC. In order to investigate the effect of Wp-PKC on the development of Wh. pigra germ cells, 17β-estradiol(17β-E2)(100 ng·mL~(-1)) and methyltestosterone(MT)(150 μg·L~(-1)), 150 μg·L~(-1)(MT)+0.5 mg·L~(-1) PKC, 0.5 mg·L~(-1) PKC inhibitor were added to Wh. pigra culture water, and no addition group(control group) was added, and the effects on the development of Wh. pigra germ cells and the expression of Wp-PKC were observed. The results showed that: Wp-PKC in male gonads was always higher than that in female gonads; MT promoted the development of male gonads in Wh. pigra, while the expression of Wp-PKC was significantly higher than that in the control; 17β-E2 promoted the development of female gonads in Wh. pigra and Wp-PKC expression significantly lower than that of the control; while the development of the female and male gonads in the PKC inhibitor group was inhibited, the expression of Wp-PKC was significantly lower than that of the control. In summary, Wp-PKC may promote the development of Wh. pigra, especially the development of male gonads.