Willingness and Factors Influencing the Dissemination of Health Knowledge among Healthcare Profession-als in Shanghai under the Background of"Breaking the Five-Only" / 中国医院管理

Objective Under the background of"breaking the Five-Only"and the evaluation reform of healthcare professionals'titles,it analyzed the willingness of healthcare professionals in public hospitals to disseminate health knowledge and its incentives and constraints.Furthermore,it explored potential pathways to improve the willingness of healthcare professionals to popular science and disseminate health knowledge.Methods From November to Decem-ber 2022,a self-designed online questionnaire was used to survey healthcare professionals in four tertiary hospitals in Shanghai.The questionnaire included basic information of healthcare professionals,analysis of the current situa-tion and demands of healthcare professionals in health knowledge dissemination,willingness of healthcare profes-sionals to disseminate health knowledge and influencing factors.Results A total of 762 healthcare professionals partici-pated in this survey,79.9%(608/762)expressed willingness to promote the dissemination of health knowledge.A multiple-factor logistic regression analysis revealed that intermediate professional title,achieving personal value and so-cial responsibility,increasing patient resources,professional title promotion,science promotion-related awards,being included in performance appraisals,and difficulty in capturing science promotion skills were the influential factors affecting the dissemination of health knowledge among healthcare professionals(P＜0.05).Conclusion The willing-ness of healthcare professionals to disseminate health knowledge was strong,and hospitals should motivate health-care professionals to disseminate health knowledge through building a long-term incentive mechanism,strengthening training in science popularization ability,and improving humanistic qualities.

Association of Perceived Stress With Depression Among Vaccinated Healthcare Workers During the SARS-CoV-2 Variant Outbreak: The Mediating Role of Compassion Fatigue

Objective@#Depression was common during coronavirus disease-2019 (COVID-19) pandemic, while the association of perceived stress with depression among vaccinated healthcare workers has not been investigated. This study aimed to address this issue. @*Methods@#We included a total of 898 fully vaccinated healthcare workers during the outbreak of severe acute respiratory syndrome coronavirus 2 Delta variant in Nanjing, 2021. Depression was ascertained by Patient Health Questionnaire-9, with a cut-off score of ≥5 indicative of mild-to-severe depression. Perceived stress, resilience, and compassion fatigue were assessed by Perceived Stress Scale-10, Resilience Scale-25, and Professional Quality of Life Scale version-5, respectively. Logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI), along with subgroup and mediation analyses. @*Results@#The prevalence of mild-to-severe depression was 41.1% in vaccinated healthcare workers. The odd of mild-to-severe depression was increased with higher perceived stress. Compared with vaccinated healthcare workers with the lowest tertile of perceived stress, those with the highest tertile had increased odds of mild-to-severe depression by 120% (OR 2.20, 95% CI 1.46 to 3.31) after multivariable-adjustment. However, perceived stress was not associated with mild-to-severe depression in vaccinated healthcare workers with strong resilience, but was in those with weak resilience (pinteraction=0.004). Further analysis showed that compassion fatigue mediated the relationship between perceived stress and mild-to-severe depression, with a mediating effect of 49.7%. @*Conclusion@#Perceived stress was related to an increased odd of mild-to-severe depression in vaccinated healthcare workers during COVID-19 pandemic, and this relationship might be explained by compassion fatigue.

Qualitative study on remote pulmonary rehabilitation nursing needs of patients with chronic obstructive pulmonary disease / 中国实用护理杂志

Objective:To understand the demands of patients with COPD for tele-pulmonary rehabilitation nursing, and to provide theoretical basis for the construction of tele-pulmonary rehabilitation nursing model in China.Methods:The phenomenological approach of qualitative research was adopted in this study, purposive sampling method was used to select 14 COPD patients, who were admitted to the respiratory department of the Affiliated Zhongda Hospital, Southeast University from March to May 2022 for semi-structured interviews. Subject analysis was used to sort out and analyze the above interview data.Result:The demands of COPD patients for tele-pulmonary rehabilitation nursing could be summarized into three themes, namely, self-care demands, social support demands, information system demands.Conclusions:There were a large number of demands of COPD patients for tele-pulmonary rehabilitation remaining unmet. Therefore on the basis of patients′ disease characteristics and actual needs, a multi-disciplinary team of pulmonary rehabilitation should be established to provide personalized pulmonary rehabilitation guidance and continuous supervision and management. In addition, effective communication platform should be set up to provide multiple perspectives of social support, and a intelligent tele-pulmonary rehabilitation system which could be operated easily should be developed to meet the pulmonary rehabilitation needs of COPD patients and further improve the quality of their home rehabilitation.

A Study on Clinicians'Attitudes toward the Senior Health Technical Personnel Title Evaluation System / 中国医院管理

Objective Focusing on the evaluation system of senior health professional titles in Shanghai,it discusses the rationality of the existing policies from the perspective of clinicians who plan to participate in the promotion,and put forward suggestions for optimizing the content and form of the evaluation.Methods Online questionnaire surveys had been conducted for all clinicians who participated in the application for Shanghai's senior health professional titles in 2020 to collect the personal information and their attitudes towards the professional title review system.R 4.0.2 soft-ware was used to conduct statistical description,cluster analysis,chi-square test,non-parametric test,etc.Results A to-tal of 1,674 people from 32 clinical specialties were surveyed.According to the two factors of growth space and growth speed,the participating subjects are divided into four different categories of groups,which are named according to the sample characteristics:Stars,Mainstay and Veteran.There are no differences among the three groups in the familiarity,and difficulty evaluation of clinical indicators for the senior health professional title evaluation system.The proportion of Veteran considered unreasonable is relatively high.There are differences among the three groups in overall difficulty level,scientific research difficulty and qualification difficulty.Conclusion The incentive attribute of the health technical person-nel senior title evaluation system should be continuously strengthened,and the differentiated characteristics of the de-velopment of health talents should be paid attention to.Big data can be used to highlight the quantification and differen-tiation of clinical competency evaluation indicators,which can effectively improve the scientific level of professional title evaluation.

Clinical and CYP17A1 gene mutation analysis of 6 children with 17α-hydroxylase/17, 20-lyase deficiency / 中华实用儿科临床杂志

Objective:To analyze the clinical features and CYP17A1 gene mutation of 17α-hydroxylase/17, 20-lyase deficiency (17OHD). Methods:The clinical data, laboratory examination and genetic results of 6 children with 17OHD in the Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2019 were enrolled and analyzed retrospectively.Meanwhile, the clinical types of all congenital adrenocortical hyperplasia (CAH) patients were calculated and then the incidence of 17OHD was calculated.Results:The 6 cases were from 5 families, and the age at diagnosis was ranged from 1 year and 6 months to 15 years old, in which 2 cases were 46, XX and 4 cases were 46, XY.Their gender were all female.Three cases presented with hypertension (50.0%), 4 cases with hypokalemia (66.7%), and 1 case with labia mass (16.7%). The gonad developed into a testis in patients with 46, XY, and patients with 46, XX had ovarian hypoplasia.The laboratory tests revealed an decrease in the cortisol at 8 AM in all cases, ranging from 0.62 to 5.93 mg/L.Five cases displayed an increase in adrenocorticotropic hormone (ACTH) in the range of 84-271 ng/L, and 1 patient with normal ACTH (58 ng/L) had a peak cortisol of 1.75 mg/L after the ACTH challenge test.Elevated progesterone was detected in 6 patients with a normal 17 hydroxyprogesterone level.Further results proved low levels of testosterone and estradiol, and high levels of luteinizing hormone (LH), and follicle stimulating hormone (FSH). CT scan showed mild adrenal hyperplasia in all cases.Among 114 CAH patients during the same period, the incidence of 17OHD came second at 5.3%.The CYP17A1 gene mutation results indicated that 2 unrelated patients were homozygous mutation for p. Y329fs (c.985_987delTACinsAA), 2 siblings were compound heterozygous mutations for p. Y329fs and exon 1-7 deletion, 1 patient was compound heterozygous mutations of p. Y329fs and p. R416C (c.1246C>T), and 1 patient was homozygous mutations for p. L465P (c.1394T> C), which was first reported in China. Conclusions:17OHD is not rare in CAH.Female children with hypokalemia, hypertension, and hypogonadism can lead to diagnostic suspicion of 17OHD.The p. Y329fs mutation in Chinese 17OHD children is a hotspot.The p. L465P (c.1394T>C) mutation is a new mutation in China and it could enrich the mutant spectrum of CYP17A1 gene in China.

Ultrasonographic and pathologic features in fetal arthrogryposis multiplex congenita / 中华超声影像学杂志

Objective:To summarize the prenatal sonographic characteristics of affected joints of fetal arthrogryposis multiplex congenita (AMC) by comparing the ultrasonographic features and the postnatal pathological manifestations.Methods:The cases of AMC detected by antenatal ultrasound and confirmed by postnatal pathology were collected in the First Affiliated Hospital of Sun Yat-Sen University and Kaiping Central Hospital from January 2015 to June 2020. The differences between prenatal ultrasonic manifestations, types of affected joints and postnatal pathological features were analyzed. And the different involvements of joints in AMC cases with or without other system abnormalities were also explored separately.Results:A total of 31 cases of AMC were included, in which 11 cases were with other system abnormalities and 20 cases without. No significant difference was observed in number of affected joints between these two groups ( P>0.05). The prenatal sonogram features were completely consistent with the postnatal pathological manifestations in 21 (21/31, 67.7%) cases. Among 31 cases, the involvement rates of joints were: interphalangeal joints of fingers (23/31, 74.2%), knee joints (20/31, 64.5%) and ankle joints (19/31, 61.3%), temporomandibular joint (11/31, 35.5%), wrists (11/31, 35.5%), elbow joints (10/31, 32.3%), interphalangeal joints of toes (6/31, 19.4%), spinal joints (2/31, 6.5%), shoulder joint (1/31, 3.2%) and hip joint (1/31, 3.2%), respectively. The coincidence rates of prenatal ultrasound in involved joints were: interphalangeal joints of fingers (100%), ankles (100%), spines (100%), hips (100%), wrists (90.9%), knees (75.0%), elbows (70.0%), jaws (54.5%), interphalangeal joints of toes (50.0%), and shoulders (0), respectively. Conclusions:When postural abnormalities of fetal upper and lower extremities are detected by prenatal ultrasound screening, especially overlapping fingers, extended knee and club foot, AMC should be kept on alert. Simultaneously, other joints should be carefully scanned to improve the prenatal detection rate of AMC.

Analysis of clinical features and genetic variants among 12 children with Gitelman syndrome / 中华医学遗传学杂志

OBJECTIVE@#To summarize clinical manifestations and results of genetic testing in 12 children with Gitelman syndrome (GS).@*METHODS@#Clinical data of the children was collected. Whole exome sequencing(WES) was carried out to screen potential variants of genomic DNA. Candidate variants were verified by Sanger sequencing.@*RESULTS@#The patients have included 10 boys and 2 girls, whom were diagnosed at between 2.8 to 15.0 year old. Six patients were due to infections, 5 were due to short stature, and 1 was due to lower limb weakness. All patients were found to carry variants of SLC12A3 gene, which included 11 with compound heterozygous variants and 1 with homozygous variant. All of the 19 alleles of the SLC12A3 gene carried by the patients were delineated, which included 15 missense variants, 2 frameshift variants and 2 splice region variants. These variants were unreported previously, which included c.578_582dupCCACC (p.Asn195Profs*109), c.251C>T (p.Pro84Leu) and c.2843G>A (p.Trp948X).@*CONCLUSION@#The clinical symptoms of GS in children are atypical and often seen in older children. For children with occasional hypokalemia associated with growth failure, GS should be suspected. The majority of GS children carry two pathogenic variants of the SLC12A3 gene, mainly compound heterozygotes, among which p.Thr60Met is the most common one. The discovery of new variants has enriched the spectrum of SLC12A3 gene variants.

A survey on quality of life and its influencing factors among patients with non-melanoma skin cancers / 中华皮肤科杂志

Objective:To investigate quality of life and its influencing factors among patients with non-melanoma skin cancers (NMSC) .Methods:From June 2017 to January 2020, demographic, clinical and behavioral data were collected from 153 inpatients with NMSC, who received surgeries in Department of Plastic Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, by using a self-made questionnaire and the dermatology life quality index (DLQI) scale, and DLQI score was calculated to evaluate the quality of life of the patients. Chi-square test, Kruskal-Wallis H test, and multivariate logistic regression model were used to analyze factors influencing the quality of life of NMSC patients. Results:A total of 146 (95.4%) valid questionnaires were collected. The 146 patients were 31-92 years old, and 101 (69.2%) of them were over 60 years old, and 59 (40.4%) had a history of long-term ultraviolet exposure. There were 66 cases (45.2%) of basal cell carcinoma (BCC) , 57 (39.0%) of invasive squamous cell carcinoma (SCC) , 16 (11.0%) of extramammary Paget disease and 7 (4.8%) of Bowen disease. The median DLQI score ( M[ P25, P75]) was 3 (1, 7) . The quality of life were affected in 99 (67.8%) patients, including 52 (35.6%) mildly affected, and 47 (32.2%) moderately to extremely severely affected. Multivariate logistic regression analysis showed that the skin cancer type, long-term ultraviolet exposure history, and having 3 or more children affected the quality of life of the patients with NMSC. Conclusion:NMSC decrease the quality of life of the patients, and the type of skin cancers, history of long-term ultraviolet exposure and number of children are the factors influencing the quality of life of patients with NMSC.

A case of Van Wyk-Grumbach syndrome: clinical analysis / 中华全科医师杂志

The clinical data of a child with Van Wyk-Grumbach syndrome (VWGS) who visited Capital Institute of Pediatrics in 2019 were retrospectively analyzed. The patient was a seven year old girl, her main clinical manifestations included short stature (well below -2 standard deviations), obesity and breast development. The results of laboratory testing indicated that the level of thyrotropin (TSH)>100 mIU/L and the level of free thyroxine (FT 4) was 5.15 pmmol/L; serum estradiol and prolactin levels were significantly elevated; the gonadotropin-releasing hormone(GnRH) stimulation test showed that the gonad axis was not activated. She had giant ovarian cyst, pituitary hyperplasia, anemia and pericardial effusion. Bone age was delayed; and her blood lipids had increased. Therefore, she was diagnosed as Van Wyk-Grumbach syndrome. The patient received the treatment of levothyroxine, the drug does was gradually increased from 25 μg per day to 75 μg per day, vaginal bleeding was followed by medication for 3 days. Three months later, her thyroid function was back to normal, and giant ovarian cyst regressed, but the ovaries were bulky,pericardial effusion was absorbed. The levothyroxine dose was adjusted to 50 μg per day according to the test result of thyroid function. And 1 year late the thyroid function was normal, pituitary magnetic resonance imaging(MRI) showed the hyperplastic adenohypophysis was back to normal, no more vaginal bleeding occurred, and the giant ovarian cyst was shrunk.

Tobacco point-of-purchase marketing in primary and middle school neighbourhoods in Tianjin / 中国学校卫生

Objective@#To understand the distribution of tobacco point-of-purchase(pop) activies 100 meters around the primary and middle school and the situation of selling cigarettes to students of Tianjin. To provide evidence for creating a smoke-free and healthy school environment.@*Methods@#With the method of simple random sampling, 195 schools were selected to investigate the tobacco retailers within 100 meters around the school, and the nearest tobacco retailers was observed.@*Results@#Totally 36.9 percent of the schools found tobacco retailers within 100 meters. There were 127 tobacco retailers, and no tobacco advertisements were found. The percentage of tobacco retailers within 100 meters of vocational schools, primary schools and middle schools was 33.3%, 34.1% and 40.4%, respectively. Among the 72 tobacco retailers observed, the proportion of tobacco retailers within 20, 21-50, and 51-100 meters from the school were 9.7%, 36.1% and 54.2%, respectively. The majority of tobacco retailers were grocery stores/convenience stores (55.6%), followed by alcohol and tobacco stores (34.7%). The proportion of tobacco selling points failing to set up the signs of "smoking harmful to health" and "not selling cigarettes to minors" were 81.9% and 86.1% respectively.@*Conclusion@#It’s concerning that the layout of tobacco retailers and the posting of signs, and the tobacco products for to minors in Tianjin. It is necessary to strengthen the surrounding environment renovation and publicity and law enforcement.

Internet-based assessment technology for age-related cognitive impairment / 中华全科医师杂志

With the population aging,the number of elderly with Alzheimer's disease or other types of dementia is increasing,which seriously threatens the health and quality of life in elderly.The early screening and detection of dementia among high-risk population and appropriate interventional measures would delay the disease course,and maintain patients' self-care abilities and dignity.Computerized neuropsychological assessment devices are economic and efficient,and suitable for screening in large population.This article reviews the theory,characteristics and application of internet-based neuropsychological assessment for age-related cognitive impairment,as well as the prospect in the future studies.

Coactosin-like protein 1 inhibits neuronal migration during mouse corticogenesis

Coactosin-like protein 1 (Cotl1), a member of the actin-depolymerizing factor (ADF)/cofilin family, was first purified from a soluble fraction of Dictyostelium discoideum cells. Neuronal migration requires cytoskeletal remodeling and actin regulation. Although Cotl1 strongly binds to F-actin, the role of Cotl1 in neuronal migration remains undescribed. In this study, we revealed that Cotl1 overexpression impaired migration of both early- and late-born neurons during mouse corticogenesis. Moreover, Cotl1 overexpression delayed, rather than blocked, neuronal migration in late-born neurons. Cotl1 expression disturbed the morphology of migrating neurons, lengthening the leading processes. This study is the first to investigate the function of Cotl1, and the results indicate that Cotl1 is involved in the regulation of neuronal migration and morphogenesis.

Implementation effect of nursesˊ hierarchical training plan based on training outline and nurses′needs / 中国实用护理杂志

Objective To explore the implementation effect of nurses′ hierarchical training plan based on training outline and nurses′ needs. Methods Nurses′ hierarchical training outline was established in accordance with three theoretical training modules(humanistic accomplishment, professional competence, career planning/development) as well as three skill training modules(basic nursing skills, specialist nursing skills and first aid nursing skills); the training needs of nurses were investigated by adopting a self-made Training Needs Questionnaire, then the hierarchical training plan was developed based on the training outline and nurses′ training needs. Results There were some differences in the training needs of different levels of nurses in the fields of clinical knowledge and skills,nursing management, nursing education, scientific research and new nursing guidelines and progress(F=2.80-22.47,P<0.05 or 0.01). Before the implementation of nurses′ hierarchical training plan based on training outline and nurses′ needs, nurses′ satisfaction about training, theoretical examination result, clinical working ability and patients′satisfaction towards nursing were 89.06%(228/256),94.80%(1 185/1 250), 96.63%(1 060/1 097) and 95.35%(5 470/5 737), respectively. Then, after the implementation, the corresponding values got improved into 96.76%(239/247), 97.44%(1 297/1 331), 98.75%(1 106/1 120) and 99.22%(6 070/6 118),which were statistically significant(χ2=11.11-176.27,P<0.01). Conclusion Integrating nurses′hierarchical training outline with the training needs helps to provide targeted hierarchical training so as to improve the professional quality of nurses and the patients′satisfaction towards nursing.

Different off-loading mattresses with different repositioning intervals for preventing pressure ulcers in criti-cal patients:A randomized controlled trial / 医学研究生学报

Objective The incidence rate of pressure ulcer is high in critical patients and off-loading mattresses and reposi-tioning are known as effective interventions for the prevention of pressure ulcers .However, evidence is lacking for selection of the right type of mattresses and suitable interval of repositioning .This study was to compare the effects of two types of off-loading mattresses with two different repositioning intervals in preventing pressure ulcers in critical patients . Methods According to the design of this ran-domized controlled trial , we made a training plan concerning the participants , methods of intervention and comparison , criteria and methods of observation , and methods of recording , and trained 26 nurses from 7 hospitals .Using non-inferiority design and the method of stratified blocked randomization , we divided 1194 patients with the risk of pressure ulcer into a trial group ( n=596) and a control group ( n=598) , a viscoelastic sponge mattress with every-four-hours repositioning used for the former and an automatic aeration mat-tress with every-two-hours repositioning for the latter , both for 7 successive days .We examined the patients every day , recorded the in-cidence and stages of pressure ulcer , and compared the data obtained between the two groups of patients . Results The total inci-dence rate of pressure ulcer was 1.09%(13/1194), significantly lower in the trial than in the control group (0.34%[2/596] vs 1.84%[11/598], P=0.012). Conclusion A viscoelastic sponge mattress with every-four-hours repositioning is superior to an automatic aeration mattress with every-two-hours repositioning and therefore is preferred to the latter in preventing the incidence of pressure ulcer in critical patients in the ICU .

Study on air pressure changes in negative-pressure isolation capsule during casualty transport / 医疗卫生装备

Objective To prevent the medical personnel from infection during aeromedical evacuation of fulminating respiratory infectious disease patients by exploring the changes of differential pressure between those in and out of the negative-pressure isolation capsule and analyzing the stability of the capsule during aeromedical evacuation.Methods A differential pressure monitor developed by Institute of Medical Equipment was used for real-time recording of the changes the differential pressure in and out of the capsule during five flight phases of the aircraft,and the safety of the capsule during aeromedical evacuation and corresponding considerations were investigated.Results The maximum and minimum values of the negative pressure in the capsule were-60 Pa and-120 Pa respectively during aeromedical evacuation,which were all less than the safety threshold-15 Pa.The negative pressure was is directly proportional to the flying altitude.Conclusion The capsule keeps negative pressure effectively during flight,and thus facilitates patient aeromedial evacuation greatly.

Study of insulin resistance and first-phase insulin secretion of β-cells in obese children with different levels of glucose tolerance / 中华实用儿科临床杂志

Objective To investigate insulin resistance and first-phase insulin secretion among the obese children with normal glucose tolerance,impaired glucose tolerance (IGT) and type 2 diabetes mellitus(T2DM) and to further explore their effects on children with T2DM.Methods Both physical examination and oral glucose tolerance test (OGTT) were performed to determine the glucose tolerance levels on a total of 87 subjects.They were divided into normal glucose tolerance group,IGT group and T2DM group according to their glucose tolerance levels.Insulin resistance and insulin secretion were represented by insulin sensitivity index (IAI) and △ I30/△ G30 =(I30min-I0min) /(G30 min-G0 min),respectively.SPSS software version 10.0 was used for statistical analysis.Differences from the groups were assessed by performing One-way ANOVA,and P ＜ 0.01 was considered significant.Results Among 87 subjects,52 cases turned out to have normal glucose tolerance (normal glucose tolerance group),16 cases were with IGT (IGT group) and 19 cases were with T2DM (T2DM group),respectively.The groups of normal glucose tolerance,IGT and T2DM were found to have the IAI values of-4.36 ±0.79,-4.80 ±0.56 and-4.73 ±0.53,respectively,which indicated that the IAI value of normal glucose tolerance group was significantly higher than those in both IGT and T2DMgroups(F =5.28,P ＜ 0.01),while there was no significant difference between the 2 groups of IGT and T2DM.The △I30/△G30 values of the obesity,IGT and T2DM groups were also indicated as 57.02-± 30.20,28.19 ± 23.47 and 11.65 ± 7.50,respectively,and therefore it could be revealed that the △ I30/△ G30 value of the IGT and T2DM groups were both significantly lower than that of the normal glucose tolerance group (F =47.90,P ＜ 0.01).Conclusions Both insulin sensitivity and first-phase insulin secretion respectively show statistically significant decrease in IGT andT2DM groups compared with those in obesity group,which indicates that they both may play important roles in diabetes onset in children.

Study on the competency model of academic leaders in tertiary hospitals in shanghai area / 中国医师杂志

Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.

Research progress of immunoscore / 国际肿瘤学杂志

A methodology named immunoscorehas been proposed in recent years.It has been demonstrated to be a prognostic factor superior to the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC)TNMclassification.Over the past few years,it has gained a forefront posi-tion in colorectal cancer.It has the advantages of simple operation,low cost and high accuracy,and it is nee-ded for individual therapy.However,it still has its limitations.

Analysis on influence factors of medication compliance in elderly patients with hypertension / 中华老年医学杂志

Objective To know the medication compliance in elderly patients with hypertension,to analyze the influence factors of medication compliance,and to propose forward intervention countermeasures.Methods The treatment of hypertension in elderly patients was investigated by questionnaire survey.Medication compliance and influence factors were analyzed.Results 166 cases with poor medication compliance,and the rate was 45.0％; 203 cases with good medication compliance,and the rate was 55.0％.It's showed significantly difference on degree of education between the observation group and control group (x2 =12.071,P=0.002).The proportion of peasant and worker was higher in the observation group than control group (78.9％ vs.62.1％,x2 =12.817,P=0.002).The smoker (48.8％) and drinker (59.0％) in observation group more than smoker (27.1％) and drinker (31.0％) in control group(x2=18.481,P＜0.001; x2=29.115,P＜ 0.001).The ratio of payout of-pocket for healthcare was higher in the observation group (21.1％) than control group (9.9％) (x2=9.084,P=0.003).The duration of hypertension was longer in the observation group (8.8±4.6) than control group (6.0±4.1) (t=1.806,P=0.036).The income per month was less in the observation group (1850±150) than control group (2150±200) (t=5.799,P＜ 0.001).There were regression relationship between medication compliance and degree of education,medical security and duration of hypertension.Conclusions According to the influence factors of medication compliance in elderly hypertensive patients,it's useful to improve medication compliance by enhancing health education and designing a personal treatment.

Antibacterial and nematicidal activity of endophyte ThF-11 of Tripterygium hypoglaucum (Levl.)Hutch / 中国药理学通报

Aim To investigate the chemical compo-nents and antibacterial and nematicidal activity of en-doparasitic fungi ThF-1 1 of Tripterygium hypoglaucum (Levl.)Hutch.Methods The endophyte ThF-1 1 was isolated,purified and identified based on fungal ITS sequence.The chemical components were isolated and identified with column chromatography and NMR spec-trometer,respectively.The nematicidal and antibacte-rial activity was investigated by biological active meth-od and inhibition zone method.Results The endo-phyte ThF-1 1 was identified as Penicillium simplicissi-mum,the compounds were identified as Penicillic acid [1 ],2,4-dimethoxy-6-methylphenol [2]and 5 (6)-dihydropenicillic acid [3 ] based on spectral data. Compound [1 ]showed significant activity against Cae-norhabditis elegans in a dose-dependent manner,and had antibacterial activity to Escherichia coli,Bacillus cereus,Bacillus subtilis, Staphylococcus aureus and Pseudomonas aeruginosa.Conclusion These com-pounds are firstly isolated from endophyte ThF-1 1 of T. hypoglaucum (Levl.)Hutch.Compound [1 ]shows strong nematicidal activity and antibacterial activity, and is worth further studying and developing.