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Background Lead and manganese are heavy metal pollutants widely existing in the environment, which can accumulate in the human body through the food chain, exert neurotoxicity, and cause neurodegenerative disorders. Especially in early childhood, the developing blood-brain barrier and nervous system are highly susceptible to environmental chemical pollutants. Most of the previous studies focused on the toxic effects of single heavy metal such as lead or manganese, while the studies on combined toxic effect are still scarce, and involved mechanisms are still unclear. c-Jun N-terminal kinase (JNK) is involved in neuronal development and regeneration, and some studies have found that JNK is involved in lead or manganese induced neurotoxicity. Its role in the toxicity of combined lead and manganese is unknown. Objective To understand the neurodevelopmental toxicity mechanism and to observe changes of JNK expression in zebrafish induced by combined lead and manganese exposure at environmentlly low concentrations. Methods Zebrafish embryos within 2 h post fertilization (hpf) were divided into four groups: control group, lead exposure group (0.1 mg·L−1 lead acetate), manganese exposure group (0.3 mg·L−1 manganous chloride), and lead-manganese combined exposure group (0.1 mg·L−1 lead acetate +0.3 mg·L−1 manganous chloride) and exposed to lead or/and manganese at designed levels for 7 d. Spontaneous movements and motor locomotion were observed, and mortality rate were calculated. The changes of JNK mRNA expression in zebrafish were evaluated. Results The experimental results showed that no significant effect of lead or/and manganese on spontaneous movements and mortality rate was found in zebrafish compared with the control group (P＞0.05). The results of locomotion analysis showed that compared with the control group, the activity counts and activity distance of zebrafish in the manganese exposure group were slightly increased (P＜0.01); the activity counts and activity distance of zebrafish in the lead exposure group were reduced by 50% and those in the lead-manganese exposure group were reduced by 80% (P＜0.01). Compared with the lead exposure group, the activity counts and activity distance of zebrafish in the lead-manganese combined exposure group decreased significantly by 60% (P＜0.05). The real-time quantitative PCR results showed that the JNK mRNA expression level was significantly increased in the lead-manganese combined exposure group compared with the control group(P＜0.01). Conclusion Lead exposure combined with manganese exposure at environmentlly low concentration can induce neurodevelopmental toxicity to zebrafish. JNK may be involved in neurodevelopmental toxicity induced by the combined exposure to lead and manganese.
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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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Background Chronic low-level exposure to lead can damage the central nervous system and cause anxiety-like behavior. However, whether changes of blood metabolites occur in this process and its relationship with lead-induced neurobehavioral disorder remain unclear. Objective To explore the effects of chronic lead acetate (PbAc) exposure at different concentrations on anxiety-like behavior and serum metabolites and their relationships in mice, as well as the mechanism of lead exposure on neurobehavioral injury in mice from the perspective of metabolomics. Methods A total of 64 healthy 4-week-old C57BL/6J mice, half male and half female, were randomly divided into four groups: control group (normal drinking water), 20 mg·L−1 PbAc group, 100 mg·L−1 PbAc group, and 500 mg·L−1 PbAc group. After 10 weeks of free drinking of water containing designed concentrations of PbAc, the mice were tested for anxiety-like behavioral changes by open field experiment. After the mice were anesthetized, blood was collected from the eyes, the serum was separated, and the effects of designed doses of lead exposure on metabolites in the serum of mice were compared by liquid chromatography with tandem mass spectrometry combined with principal component analysis and partial least squares discrimination analysis. Results The results of the open field experiment showed that the reductions in movement time spent in central area in the 100 mg·L−1 and 500 mg·L−1 PbAc groups compared with the control group were of statistical significance (P<0.05); the reduction in crossing times of central region in the 500 mg·L−1 PbAc group was statistically significant compared with the control group (P<0.05); the increases in defecation frequency in the 100 mg·L−1 and 500 mg·L−1 PbAc groups were statistically significant compared to the control group (P<0.05). In both positive and negative ion modes, compared with the control group, 157 differential metabolites were screened out in the 20 mg·L−1 PbAc group, of which 80 were up-regulated and 77 were down-regulated; 172 differential metabolites were screened out in the 100 mg·L−1 PbAc group, of which 57 were up-regulated and 115 were down-regulated; 119 differential metabolites were screened out in the 500 mg·L−1 PbAc group, of which 42 were up-regulated and 77 were down-regulated. The results of the KEGG enrichment analysis on the differential metabolites revealed alterations in metabolic pathways mainly involving primary bile acid biosynthesis, bile secretion, and cholesterol metabolism. Among the differential metabolites, norethisterone was positively correlated with the number of central region crossings (r=0.406, P<0.05); dihydrothymine was negatively correlated with the number of central region crossings (r=−0.346, P<0.05); lysophosphatidylcholine 22∶1 and lysophospholipid 14∶0 were negatively correlated with time spent in central region (r=−0.429, P<0.05; r=−0.374, P<0.05). Conclusion Chronic lead exposure induces anxiety-like behavior in mice, and this altered behavior is associated with altered metabolites in serum, with differential metabolites enriched primarily in the metabolic pathways of primary bile acid biosynthesis, bile acid secretion, and cholesterol metabolism.
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Objective:Providing reference basis for effective shorten the average length of stay,this article analyses degree of the medical treatment index and the average length of stay.Methods:This article establishes a model of the weighted grey incidence of optimized grey entropy,and analyzes the influence of the medical treatment index for the average length of stay.Results:According to analyze correlation degree,the influence of the medical treatment index for the average length of stay in order of importance is open berths to count,bunk down times,treatment effectiveness,beds rate of utilization of hospital beds,annual outpatient service quantity,hospital surgery people number and discharge.Conclusions:Weighted grey incidence analysis method based on optimized grey entropy can effectively analyze influence degree of the medical treatment index for the average length of stay,and improving the quality of medical services.
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Objective To explore the application and effects of the specialized management of telephone follow-up in patients with tumor intermission of chemotherapy. Methods A total of 400 patients with tumor intermission of chemotherapy were randomly divided into the observation group and the control group with 200 cases in each group. Combined with the current general telephone follow-up and through the status of the investigation, content and process of specialized management of telephone follow-up in patients with tumor intermission of chemotherapy were designed and applied to the observation group. The control group did not implement the intervention except for the ordinary telephone follow-up. The two groups of patients were evaluated by self-designed questionnaire, the effect of follow-up and the satisfaction degree of the patients were evaluated. Results In the observation group (5 cases were lost to follow-up), the mental state steady, reasonable diet, moderate activity, understand medical medicine, law and adopt measures to prevent infection accounted for 73.85% (144/195), 74.36% (145/195), 67.69% (132/195), 80.51% (157/195) and 72.31% (141/195), 77.95% (152/195);while in the control group (8 cases were lost to follow-up), the proportion was 53.13% (102/192), 51.04% (98/192), 43.75%(84/192), 55.73%(107/192), 52.08%(100/192), 53.13%(102/192),χ2 values ranged from 16.84 to 27.41, P < 0.01. The satisfaction degree with follow-up time, health guidance and problem solutions during follow-up process of the observation group accounted for 67.69% (132/195), 69.23% (135/195), 86.15% (168/195), the proportion of the control group was 45.83% (88/192), 46.88% (90/192), 47.92%(92/192),χ2 values were 20.49, 49.01, 77.65 (P<0.01). Conclusions The specialized management of telephone follow-up will help to promote the treatment of patients with tumor intermission of chemotherapy of home care norms, improve the effect of follow-up and satisfaction.