Challenges and Countermeasures of Mental Health Social Work in Shanghai in Post-Epidemic Era / 中国医学伦理学

This paper summarized three developing conditions and five service modes of mental health social work in Shanghai by reading literature and investigating and interviewing the social work service of mental health medical institutions in Shanghai. Three challenges to mental health social work after COVID -19 were identified: firstly, the reduction of direct services led to a decrease in the number of service beneficiaries, and the effectiveness of services could not be guaranteed; secondly, the application of social work methods was forced to adjust, which challenges the service ability of social workers; thirdly, the expansion or increase of the scope of service objects and the insufficient number of social workers led to difficulties in service response. In view of the above challenges and problems, countermeasures are proposed: ensure the continuity of professional relationship and service effectiveness through flexible and diversified service methods; knit for social work online working ability training, increasing network service experience; the scope of service objects expanding gradually and multi-sectoral cooperation to prevent psychological problems in key groups; set up a volunteer team to serve mental health.

Current situation and policy suggestions of medical social work supervision in shanghai / 中华医院管理杂志

Objective:To investigate the current situation of medical social worker supervision in Shanghai, for reference to promote the high-quality development of medical social work.Methods:From June to July 2022, a questionnaire survey was conducted on the in-service medical social workers in all medical institutions with medical social work departments or posts in Shanghai. The questionnaire mainly included demographic information, current status of supervision implementation, and effectiveness of supervision. The data were analyzed descriptively with t test for comparison between groups and the Pearson test was for correlation analysis. Results:A total of 99 medical social workers were included in this study, 65 had received supervision, and medical institutions where 58 people located had established the supervision system. The average scores of actual and expected supervisory support received by medical social workers were 3.71 and 4.20 respectively, and the mean burnout level score was 32.91. The effect of establishing a supervision institutions on burnout was statistically significant ( P<0.05) and actual access to supervision support was negatively associated with burnout ( P<0.05). Conclusions:The overall situation of medical social work supervision in Shanghai was positive, but the demand for supervision was not fully satisfied; Supervision had a positive impact on reducing the burnout level. It is suggested that medical social work should further strengthen the cultivation of supervisory talents, promote the construction of supervisory systems, and improve the quality of supervision.

Application value of ultrasound in evaluating the morphological and hemodynamic changes of aorta in mice model with aortic dissection induced by angiotensinogen Ⅱcombined with β-aminopropionitrile / 中华超声影像学杂志

Objective:To observe the morphological and hemodynamics changes of aortic segments in mice with angiotensinogen Ⅱ(Ang II) combined with β-aminopropionitrile(BAPN) induced-aortic dissection by color Doppler ultrasound(CDUS).Methods:Twenty male mice of 6-8 weeks old C57BL/6 were randomly divided into two groups: the model group( n=10) was induced by intraperitoneal injection of Ang Ⅱ combined with BAPN to establish mice model with aortic dissection; the control group( n=10) was intraperitoneally injected with normal saline.The body weight, systolic and diastolic blood pressure of the mice were routinely recorded. On the 42th day, CDUS was used to measure the indexes of ascending aorta(AoA), descending thoracic aorta(DAo) and suprarenal aorta(SAo) in both groups, including the inner diameter of the cross section, peak systolic velocity(PSV), the end diastolic velocity(EDV), the resistance index(RI), the pulsatility index(PI), time average mean velocity(TAMV), the heart rate(HR) and the maximal shear rate(SR). Then, the aortas were harvested from the root to the bifurcation of the renal artery. The pathological changes of the aortic wall were observed using hematoxylin-eosin(HE) staining. Results:①There were statistically significant differences in body weight, systolic blood pressure, diastolic blood pressure and heart rate between the model group and the control group(all P<0.05). Compared with the control group(0/10), the incidence of the AoA dissection(8/10) in the model group was obviously higher, the difference was statistically significant( P<0.05); while the incidence of the DAo dissection(4/10) and the SAo dissection(3/10) in the model group was slightly higher, the differences were not statistically significant (all P>0.05). ②Compared with the ascending aorta of the control group, the inner diameter, PSV, EDV, TAMV, PI and SR in the model group were significantly higher(all P<0.05), while RI showed no significant difference between the two groups ( P>0.05). For the descending thoracic aorta, PSV, EDV, TAMV, PI and SR in model group were higher than those of the control group(all P<0.05), however the inner diameter and RI were not significantly different between the two groups (all P>0.05). And for the superior renal aorta, PSV, TAMV, RI, PI and SR in the model group were obviously higher than the control group(all P<0.05), whereas the inner diameter and EDV were not significantly different between the two groups (all P>0.05). ③The HE of the tissue section in the model group showed, the aortas were obviously dilated, irregular, with inhomogeneously thickening wall; the endothelial cell nuclei were slightly stained, and some intima and middle layer ruptured and protruded outward to form dissecting aneurysms. The adventitias were markedly infiltrated with inflammatory cells. Conclusions:Ultrasonography could primarily evaluate the hemodynamic changes of aorta in hypertension with aortic dissection, and the PSV, TAMV, PI and SR of aorta may be important indicators for early predicting the occurrence of aortic dissection in hypertension.

Ruifuping pectin protects against intestinal mucosal injury in the rat exertional heat stroke model / 中华危重病急救医学

Objective:To evaluate the intestinal function in rats with exertional heat stroke (EHS) and explore the protective role of Ruifuping pectin (RFP) against heat related intestinal mucosal injury.Methods:One hundred and twenty healthy special pathogen free (SPF) male Sprague-Dawley (SD) rats were randomly divided into normothermic control group, EHS model group, hyperthermic plus drinking water group (H 2O+EHS group) and hyperthermic plus pectin group (RFP+EHS group) with 30 rats in each group. The rats in the H 2O+EHS group and RFP+EHS group were given water 20 mL/kg or RFP 20 mL/kg orally for 5 days during adaptive training period. After 1 week, the temperature control range was adjusted to (37±1)℃ using the temperature control treadmill, and the rat model of EHS was reproduced by one-time high temperature exhaustive exercise. No rehydration intervention was given during the training adaptation period in the EHS model group. The rats in the normothermic control group were maintained to room temperature (25±2)℃ and humidity (55±5)% without other treatment. Behavior tests including withdraw response, righting, and muscle strength were performed immediately after onset of EHS. Blood of inferior vena cava was collected, and the serum inflammatory cytokines [tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-1β, IL-10)] and activity of diamine oxidase (DAO) were detected by enzyme linked immunosorbent assay (ELISA). The intestinal mucosa was collected, after hematoxylin-eosin (HE) staining, and Chiu score was performed to assess EHS induced pathological changes under light microscope. Results:The rats in the EHS model group had behavioral, inflammatory and pathological changes, such as delayed withdraw response and righting, decreased forelimb pulling, increased inflammatory index, and obvious intestinal mucosal injury, which indicated that the reproduction of the EHS model was successful. There was no significant difference in above parameters between the H 2O+EHS group and the EHS model group except that the inflammatory index in the RFP+EHS group was improved. Compared with the EHS model group, the withdraw reflex to pain and righting after RFP pretreatment in the RFP+EHS group were significantly improved (righting score: 1.4±0.2 vs. 0.3±0.2, withdraw reflex to pain score: 1.0±0.1 vs. 0.2±0.1, both P < 0.05), the muscle strength was significantly increased (N: 13.0±0.5 vs. 8.2±0.6, P < 0.01). The levels of pro-inflammatory factors in the RFP+EHS group were significantly lower than those in the EHS model group [TNF-α (ng/L): 67.5±9.2 vs. 194.3±13.7, IL-6 (ng/L): 360.0±54.1 vs. 981.2±84.4, IL-1β (ng/L): 33.7±9.0 vs. 88.7±6.1, all P < 0.01], while the level of anti-inflammatory factor IL-10 was higher than that in the EHS model group (ng/L: 208.7±10.5 vs. 103.7±7.0, P < 0.01). The degree of intestinal mucosal injury in the RFP+EHS group was less severe than that in the EHS model group, and the Chiu score and DAO were significantly lower than those in the EHS model group [Chiu score: 1.5±0.2 vs. 3.8±0.0, DAO (U/L): 83.7±6.7 vs. 128.7±10.5, both P < 0.05]. Conclusions:High temperature training can damage the intestinal barrier function, and induce endotoxemia and systemic inflammatory response syndrome (SIRS) in rats. Oral prophylactic RFP can protect the intestinal barrier function, alleviate SIRS, and promote the recovery of basic nerve reflex and muscle strength after the occurrence of EHS in rats.

Application of Raman spectroscopy in the stomatology / 华西口腔医学杂志

Raman spectroscopy is an optical technology based on the theory of Raman scattering, which is generally used in the research of medical and biological science. Raman spectroscopy can be used to detect the molecular structures and components of proteins, lipids, DNA, and other biological molecules, and provide substantial information about molecules. Thus, Raman spectroscopy is generally considered a "molecular fingerprint", and it has exceptional advantages in medical research. Moreover, this technique can reflect the changes in molecular structures and detect the alterations of chemical constituents in the samples. Raman spectroscopy, given its high sensitivity and specificity in the detection of the biological samples, has been successfully used to detect and diagnose diseases in numerous sites, such as skin, oral mucosa, breast, head, and neck. In this paper, we introduce the application of Raman spectroscopy in stomatology by conducting a review of the literature.

Raman spectral characteristics of oral squamous cell carcinoma, epithelial dysplasia and normal mucosa / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the Raman spectral characteristics of oral squamous cell carcinoma, high-grade epithelial dysplasia and normal mucosa.</p><p><b>METHODS</b>Fifty- six fresh samples of oral carcinoma, 50 of high-grade epithelial dysplasia and 32 of normal mucosa were collected. The i-Raman spectrometer with an optical fiber tube was applied to acquire Raman spectrum. The diagnostic model established by principle component analysis (PCA) and discriminant function analysis (DFA) was used to analyze and classify the spectra of different samples.</p><p><b>RESULTS</b>There were significant differences among the Raman spectra of these samples. Compared with the spectra of normal mucosa, the spectra of oral carcinoma and dysplasia showed strong peaks which were contributed to nucleic acids, proteins and lipids. The diagnostic models established by PCA-DFA could successfully classify these Raman spectra of different samples with a high accuracy of 96.4% (133/138). The model was evaluated by 'Leave one out' cross-validation and reached a high accuracy of 92.8% (128/138).</p><p><b>CONCLUSIONS</b>The proliferation and metabolism of oral squamous cell carcinoma and epithelial high-grade dysplasia are more active than normal mucosa. The diagnostic models established by PCA-DFA can classify these Raman spectra of different samples with a high accuracy.</p>

Bone marrow mesenchymal stem cells are involved in tissue repair of A549 lung adenocarcinoma / 中国组织工程研究

BACKGROUND:Tumor has been considered as a specific nonhealing trauma. Bone marrow mesenchymal stem cel s participate in tumor mesenchymal reconstitution by tumor tissue homing and differentiation into mesenchyme, resulting in changing tumor microenvironment and affecting tumor growth and transfer. OBJECTIVE:To explore the mechanisms of participation of bone marrow mesenchymal stem cel s in tumor tissue repair in an A549 lung cancer-bearing mouse model. METHODS:Bone marrow mesenchymal stem cel s were isolated in vitro, cultured, and identified using flow cytometry, and then used to establish a mouse model of A549 lung cancer-bearing. In the experimental group, human bone marrow mesenchymal stem cel s were injected into tissue surrounding the tumor. In the control group, an equal volume of PBS was injected. Animal survival condition and tumor size were compared. At 4 weeks, the specimens were harvested. Hematoxylin-eosin staining was used to compare tumor tissue. Masson staining was utilized to compare col agen fiber content. Reverse transcription-PCR was employed to detect the expression ofα-smooth muscle actin. Immunohistochemistry was used to examine the expression of fibroblast specific protein and fibroblast activation protein to reflect the degree of interstitial fibers in tumor tissue in both groups. The expression levels of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C were compared between the two groups using immunohistochemistry. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s promoted tumor growth in tumor-bearing mice. The growth rate of tumor tissue in experimental group was faster than the control group (P<0.05). Compared with the control group,α-smooth muscle actin mRNA expression was significantly higher in the experimental group. Immunohistochemistry was used to detect the expression of tumor angiogenesis factors markers (fibroblast specific protein and fibroblast activation protein) in tumor tissue of experimental group. The expression levels of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C were significantly greater in the experimental group than in the control group (P<0.05). Results indicated that bone marrow mesenchymal stem cel s differentiated into fibroblasts in tumor microenvironment, participated in the formation and construction of tumor stroma as wel as promoted the growth and repair of tumor via the secretion of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C.

偏瘫患者适宜衣服的探讨 / 中国康复理论与实践

@#目的探讨偏瘫患者适合穿着何种衣服。方法根据患者穿着不同款式的衣服，观察偏瘫患者究竟穿何种衣服方便。结果和结论偏瘫患者适合穿着开衫、方扣、袖子散口的衣服，速度快，穿着成功率高。

Clinical application of an double-cavity balloon oppressor in primary retinal detachment surgery / 眼科研究

Objective The double-cavity balloon oppressor surgery for rhegmatogenous retinal detachment (RRD) has been utilized in past decades. But we have not yet a domestic device available. Present study was to investigate the effectiveness of double-cavity balloon oppressor using a domestic device in primary RRD surgery. Methods This clinical trial was a prospective study. Total 74 cases of patients with rhegmatogenous retinal detachment(RRD) (74 eyes) were enrolled. Double-cavity balloon oppressor surgery was performed in 40 eyes of 40 patients, and conventional segmental scleral buckling surgery was used in 34 eyes of 34 patients. The mean operative time, retinal attachment rate, vision and astigmatism change after operation between two different operative fashions were compared. The intra- and post-operative complication was discussed. The mean follow-up period was 4. 5 months. Written informed consent was obtained from all the patients before clinical trial. Results The retinal anatomic attachment rate was 92. 5% (37/40) in balloon oppressor surgery group and 91. 1% (31/34) in conventional surgery group, and there were no significant difference in retinal attachment rate among PVR grade A, B and C1 (P ＞0. 05) . The postoperative best corrected visual acuity (operative 3 months) was improved in 29 eyes(72. 5%) after balloon oppressor surgery and 25 eyes(73. 5%) after conventional surgery, showing insignificant difference between them (P ＞ 0. 05) . The mean surgical time was about (27. 00 ±8. 60) minutes in balloon oppressor surgery group and (47. 00 ± 14. 30) minutes in conventional surgery group(t =7. 41, P ＜0. 01) . Cylinder diopter change after surgery was insignificantly different between before and after operation in balloon oppressor surgery group (0. 52 ± 0. 30 D vs 0. 81 ± 0. 41 D, P ＞ 0. 05), however, there was a significant difference in cylinder diopter change between preoperation and postoperation (0. 65 ± 0. 32 D vs 1. 83 ± 0. 69 D, P ＜ 0. 05) . Conclusion Double-cavity balloon oppressor surgery for RRD is accurate and reliable. This operation procedure offer an economic, efficient and convenient choice for treatment of RRD.