Gender differences on perceptions of health risks and adaptation of climate change among primary healthcare workers in Guangdong Province / 环境与职业医学

Background Climate change has resulted in long-term impacts on human health. Implementing efficient adaptation strategies among primary healthcare facilities is well determined by whether staff of different genders recognize the health risks related to climate change and are willing to take active measures. Objective To investigate gender differences on perceptions of health risks and attitude towards adaptation strategies among primary healthcare workers in China, and provide relevant suggestions. Methods By adopting a multi-stage cluster sampling method, we selected 21 urban and 10 rural healthcare facilities in Guangdong Province to collect information with a questionnaire. Then chi-square test, Wilcoxon rank sum test, and logistic regression analysis were used to explore the gender differences in climate change-related health risk cognition, knowledge acquisition channels, attitudes towards adaptation strategies, main obstacles, and resource requirements among the healthcare workers. Results Of 733 participants, 38.47% (282 participants) were male and 61.53% (451 participants) were female. The percentages of male healthcare workers who agreed that climate change is happening and recognized the causes of climate change (70.21%, 60.99%) were higher than the percentages of female counterparts (59.87%, 49.00%) (both Ps＜0.05), but no obvious gender differences existed in recognizing health risks of heatwaves and infectious diseases as well as sensitive population identification (all Ps＞0.05). Most of the participants (92.50%) received climate change and health-related information from mass media like TV, radio, and newspapers. Meanwhile less men chose new media channels than women (OR=0.62, 95%CI∶ 0.41-0.94). Only 30.56% of the participants (33.69% of men and 28.60% of women) reported involvement of relevant training and lectures. Most of them (90.96%) agreed to take active measures to deal with the health threats associated with climate change without gender differences for various measures (all Ps＞0.05). The leading obstacles were hard to integrate health adaptation to climate change into main work of institutions (most female agreed, 72.28%) and the lack of funds (most male agreed, 77.66%). Increasing funding for primary health care was regarded as the most needed resource by male (86.88%) and female (89.14%). After controlling the influence of other social factors, more men agreed with the lack of funds than women (OR=1.57, 95%CI∶ 1.10-2.24). Conclusion There are some gender differences in the perceptions of health risks and adaptation strategies of climate change among primary healthcare workers: Male staff are more likely to agree with climate change and regard the lack of funds as the main obstacle, while women prefer to choose new media channels to obtain information. It’s suggested that the government and relevant institutions focus on the learning and training of climate change and health-related knowledge and expand diversified information access, and promote capacity building to cope with health threats at grass-root level, in the light of recognized gender differences among primary healthcare workers.

The mediating effect of health belief on the relationship between health knowledge and health behavior among hypertensive patients with stroke / 中华行为医学与脑科学杂志

Objective To explore the mediating effect of health belief on the relationship between health knowledge and health behavior among hypertensive patients with stroke.Methods The questionnaire of Stroke Knowledge Questionnaire (SKQ),Short Form Health Belief Model Scale (SF-HBMS)and health behavior scale for stroke patients (HBS-SP) were used to investigate the health knowledge,health belief and health behavior among 151 hypertensive stroke patients.The structural equation model was established using SPSS 17.0 and Mplus7.0 software.Results The total score of SKQ,SF-HBMS and HBS-SP were (86.23±.14.67),(4.26±0.54) and (3.01 ± 0.46).The Pearson r value for SKQ and SF-HBMS,SF-HBMS and HBS-SP,SKQ and HBS-SP were 0.516,0.603 and 0.449,respectively,P＜0.01.Health knowledge had no direct effect on health behavior.but had an indirect effect through health belief=0.338 (P＜0.01).The health knowledge has direct and positive effect on the health belief including perceived susceptibility,health motivation,and perceived benefit to health behaviors;the health belief of perceived seriousness to stroke has direct and positive effect on the health behavior,while perceived barrier has direct and negative effect on the health behavior,all P＜0.05.Conclusion The health belief has mediator effect between health knowledge and health behavior among hypertensive stroke patients.Stroke education efforts should be targeted at not only health knowledge but also health belief in order to increase patients’health behavior so as to prevent secondary stroke.

The mediating effect of health belief on the relationship between health knowledge and health behavior among hypertensive patients with stroke / 中华行为医学与脑科学杂志

Objective To explore the mediating effect of health belief on the relationship between health knowledge and health behavior among hypertensive patients with stroke.Methods The questionnaire of Stroke Knowledge Questionnaire (SKQ),Short Form Health Belief Model Scale (SF-HBMS)and health behavior scale for stroke patients (HBS-SP) were used to investigate the health knowledge,health belief and health behavior among 151 hypertensive stroke patients.The structural equation model was established using SPSS 17.0 and Mplus7.0 software.Results The total score of SKQ,SF-HBMS and HBS-SP were (86.23±.14.67),(4.26±0.54) and (3.01 ± 0.46).The Pearson r value for SKQ and SF-HBMS,SF-HBMS and HBS-SP,SKQ and HBS-SP were 0.516,0.603 and 0.449,respectively,P＜0.01.Health knowledge had no direct effect on health behavior.but had an indirect effect through health belief=0.338 (P＜0.01).The health knowledge has direct and positive effect on the health belief including perceived susceptibility,health motivation,and perceived benefit to health behaviors;the health belief of perceived seriousness to stroke has direct and positive effect on the health behavior,while perceived barrier has direct and negative effect on the health behavior,all P＜0.05.Conclusion The health belief has mediator effect between health knowledge and health behavior among hypertensive stroke patients.Stroke education efforts should be targeted at not only health knowledge but also health belief in order to increase patients’health behavior so as to prevent secondary stroke.

Role of tumor necrosis factor-αin the regulation of T-type calcium channel current in HL-1 cells / 中国病理生理杂志

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .

Relationship between CD56 antigen expression in leukemia cells and prognosis of patients with acute myeloid leukemia / 吉林大学学报(医学版)

Objective:To investigate the expression of CD56 antigen in leukemia cells of the patients with acute myeloid leukemia (AML)and its relationship with the prognosis of AML, and to clarify the role of CD5 6 antigen expression in predicting the prognosis of the AML patients.Methods:171 AML (non-M3)patients aged from 14 to 60 years old,who received a IA Regimen as the first time inducing chemotherapy were chosen.Flow cytometric analysis was used to evaluate the CD56 expression in leukemia cells.COX proportional regression analysis was used to select the prognostic factors,and bivariable analysis was used to study the relationship between the positive rate of CD56 and overall survival (OS).The CD56+ group (n=52),including CD56≥50% expression group (n=39) and CD560.05),while the 2-year survival rate in CD56≥50% group was lower than that in CD560.05).The relapse rate and first year relapse rate of patients in CD56+ group (64.3% and 37.5%)were significantly higher than those in CD56- group (34.3% and 17.9% )(P0.05).The DFS in CD56+ group was shorter than that in CD56- group (P<0.05).The same DFS result was also found between CD56≥50%group and CD56<50% group (P<0.05).Conclusion:The expression of CD56 antigen in leukemia cells predicts a bad prognosis in the AML patients,and the higher expression of CD56 indicates the worse prognosis.

Cx43 is involved in electrical remodeling of atrial myocytes through regu-lating L-type calcium current / 中国病理生理杂志

AIM:To investigate whether the association of connexin 43 ( Cx43 ) and L-type calcium channel involved in the pathogenesis of atrial fibrillation ( AF) .METHODS:The biochemical assays and whole-cell patch-clamp technique were used to study the expression of Cx43 in human atrial tissue.The co-localization of Cx43 and L-type calcium channel, and the regulation of L-type calcium current in atrial myocytes were investigated.RESULTS:The expression of Cx43 at mRNA and protein levels was decreased in human atrial tissues of AF patients.In cultured atrium-derived myocytes ( HL-1 cells) , knockdown of Cx43 significantly inhibited the mRNA expression of L-type calcium channelα1c subunit, as well as L-type calcium current.Co-localization of Cx43 with L-type calcium channel α1c subunit in mouse atrial myocytes was observed.CONCLUSION:The decrease in Cx43 is involved in the pathogenesis of AF, probably through reducing the L-type calcium current in atrial myoctyes by co-localization with L-type calcium channel, thus representing the potential pathogenesis in atrial fibrillation.

Treatment adherence and correlated factors of patients with hypertension: a longitudinal study / 中国实用护理杂志

Objective This article aimed to investigate the treatment adherence of patients with hypertension and examine determinants of adherence.Methods A longitudinal design was adopted to test the treatment adherence and correlated factors of patients with hypertension twice from 2009 to 2012.The influencing factors of treatment adherence in patients with hypertension were analyzed.Results A total of 520 patients finished the first investigation,and 331 patients completed the second investigation.The comparison of demographic characteristics between patients who participated the second investigation or not showed no significant difference except for the education degree (x2=9.38).The incidences of symptoms and complications,systolic blood pressure and diastolic blood pressure of hypertensive patients and the laboratory indexes such as serum creatinine (SCr),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL),fasting blood-glucose and postprandial blood sugar in the second investigation were lower than those of the first investigation,but the difference showed no statistical significance.The scores of treatment adherence,self-efficacy,social support,quality of life were higher in the second investigation than those of the first investigation.The multiple regression analysis found that treatment adherence,social support,education degree and duration of disease course were significant predictors in the first investigation entered the equation,accounting for 26％ of the total variance,among which treatment adherence explained 15％ of the variance,social support 7％,education degree 3％ and duration of disease course 1％.Conclusions The treatment adherence of hypertensive patients improved over one year follow-up.Healthcare providers should pay attention to adherence behavior at initial phase of disease development,and effective strategies targeted patients at risk are suggested to be necessary and should be designed according to the factors affecting adherence.

Factors affecting treatment adherence for patients with hypertension by structural equation model / 中国实用护理杂志

Objective To explore the factors of treatment adherence for patients with hypertension.Methods Data were collected among 520 patients with essential hypertension from 2009 to 2010.It investigated the factors of treatment adherence for patients with hypertension by self-report scales.Results Structural equation model analysis showed age,self-rated health,self-eificacy,quality of life,family function and health concept were all directly associated with treatment adherence,and these variables explained 52.0％ of the total variance.Self-efficacy and quality of life were regarded as mediators in predicting treatment adherence of hypertensive patients,other variables indirectly affected adherence behavior by two mediators.Age and self-efficacy showed a strong independent predictive role to adherence.Conclusions Healthcare providers should take effective measures to improve treatment adherence for patients with hypertension based on patients characteristic once they make reasons for adherence clear,which can enhance quality of life,control blood pressure and prevent complications.

Analysis on the community elder care in Bao'an district of Shenzhen / 中华全科医师杂志

The status of health care for elderly in 110 community health service (CHS) centers of Bao'an District was surveyed.Data were collected from directors,health care managers and health workers in CHS centers by questionnaire.The results showed that the establishment of health file was satisfactory.but the management of health file needed to be strengthened,particularly for those required special care.The nutritional and psychological counseling should be specially focused.

The applicatlon of principal components:analysis in priority analysis of community health care project for elderlies / 中华全科医师杂志

A survey was conducted among 121 health care managers and health workers in community health care institutions with questionnaire and interview.Data on health care conditions in the community and health needs of elderly people were collected and analyzed using principle component analysis method.The priority order of 17 community health care projects for elderly people was ranked with this analysis method and the development strategy of community health service was suggested.

Dynamic changes and significance of antithrombin and fibrinolytic function in advanced lung cancer patients during chemotherapy / 中国肺癌杂志

<p><b>BACKGROUND</b>The prethrombotic state can be observed in advanced lung cancer patients. The aim of this study is to determine the dynamic changes and significance of antithrombin and fibrinolytic function in advanced lung cancer patients during chemotherapy.</p><p><b>METHODS</b>Antithrombin activity (AT:A), fibrinogen (FIB), D-dimer (D-D), plasminogen activity (PLG), tissue plasminogen activator antigen (t-PA:Ag) and plasminogen activator inhibitor-1 antigen (PAI-1:Ag) were measured in 33 advanced lung can-cer patients before and after chemotherapy, and 30 healthy people as controls.</p><p><b>RESULTS</b>Before chemotherapy, lung cancer patients had significantly lower AT:A (P < 0.01) and higher D-D, PLG:A, PAI-1:Ag and FIB (P < 0.01) than those of controls. There was no significant difference in t-PA:Ag between lung cancer patients and controls (P > 0.05). During the chemotherapy, AT:A, D-D and t-PA:Ag of lung can-cer patients remarkably decreased (P < 0.01), and PLG:A, PAI-1:Ag and FIB remarkably increased (P < 0.01) compared to those before chemotherapy.</p><p><b>CONCLUSIONS</b>Chemotherapy may enhance the prethrombotic state in advanced lung cancer patients. Dynamic observation of antithrombin and fibrinolytic function during chemotherapy might be useful for preventing pulmonary hemorrhage and pulmonary infarct and estimating prognosis of those patients.</p>

The Reviews of Evaluation on Teaching Hospitals in China / 中华医学教育探索杂志

The author reviewed papers on Evaluation on Teaching Hospitals in China from 1997 to now.Teaching hospitals were evaluated by educational and health administrator of local government since 1997.The methods the roles of evaluation,advantage and disadvantage of evaluation on teaching hospitals were described in this paper.

A comparison of the Sino-foreign medical humanity quality for higher education / 中华医学教育探索杂志

With the development of modern medical model,higher requirements are raised on medical humanity quality education.Based on the analysis and comparison of the current situation in terms of the set up of the course,course arrangement,teaching method and teaching strength,the author raises the solution of strengthening the medical students’humanity quality.

Pathogens and Characteristics of Antimicrobial Resistance among Nosocomial Infection Inpatients:A Clinical Investigation and Analysis 2002-2006 / 中华医院感染学杂志

OBJECTIVE To understand epidemiologic situation of pathogens causing nosocomial infection,their resistance and changing pattern.METHODS A retrospective analysis was made upon the pathogens data from 2002 to 2006.The identification of bacteria was evaluated by VITEK32 and susceptibility test by K-B method.RESULTS The prevalence rate was 6.4%,and main infection sites were lower respiratory tract and urinary tract.Gram-negative bacteria(38.11%) stood first,followed by Gram-positive bacteria(25.25%) and fungi(22.54%).The mean resistance of Gram-negative bacteria was very high,from them Stenotrophomonas maltophilia(72.71%) and Chryseobacterium meningosepticum(68.13%) stood the highest.Besides Enterococcus faecalis,the mean resistance of Gram-positive bacteria exceeded 55.00%.Candida albicans stood first on the list of fungi.CONCLUSIONS The composition of pathogens is changing and showing serious resistances.It is important to strengthen nosocomial infection management and utilize drug rationally.

Effect of Puerarin on the Apelin and its receptor of lung tissue in chronic hypoxia-hypercapnia rats / 中国药理学通报

Aim To explore the effects of Puerarin on the Apelin and its receptor APJ of lung tissue in rats with hypoxia pulmonary hypertension.Methods Thirty SD rats were randomly divided into normal control group(N),and hypoxia hypercapnia group(F),and hypoxia hypercapnia+Puerarin group(P).The levels of Apelin-36 in serum and in lung tissue were measured by radioimmunity,the expressions of Apelin and APJ in pulmonary tissuse were observed by RT-PCR.Results ①Mean pulmonary arterial pressure(mPAP),weight ratio of RV to LV+S,the levels of Apelin in serum and in lung tissue of group F were significantly higher than those of group N(P

Effect of puerarin on reperfusion injury after thrombolytic therapy in acute pulmonary thromboembolism / 中国药理学通报

Aim To study the effect of puerarin on reperfusion injury after thrombolytic therapy in acute pulmonary thromboembolism and its mechanism. Methods Thirty-two Japanese rabbits were randomly divided into sham operation group (group S),Thrombolysis-only group(group T), and Puerarin group(group Pur). Acute pulmonary thromboembolism models of rabbits were established with injection of autologous blood clots through the right heart catheters,haemodynamic monitoring was performed by introducing heart catheter through right jugular vein.The activity of plasma superoxide dismutase (SOD) and content of plasma malondialdehyde (MDA) were detected before embolization,2 h after embolization,2 h and 4 h after thrombolysis. At the end,the rabbits were sacrificed and their lung,removed for histopathologic and electron microscopic investigations. Results ①Pulmonary arterial mean pressure (PAMP) were decreased at 1 hour after thrombolysis both in group T and group Pur(P

Expression of vascular endothelial growth factor in chronic hypoxia and hypercapnia rats and effects of SHENYI Capsule / 中国临床药理学与治疗学

AIM: To explore the roles of vascular endothelial growth factor (VEGF) in hypoxia pulmonary hypertension and effects of SHENYI Capsule. METHODS: Thirty SD rats were randomly divided into normal control group (N), hypoxia hypercapnia group (F), and hypoxia hypercapnia+SHENYI Capsule group (S). The levels of VEGF in serum and lung tissue are measured by ELISA, the ultrastructure of pulmonary arterioles was observed by electron microscopy, and the expression of VEGFmRNA was observed by in situ hybirdization. RESULTS: Mean pulmonary arterial pressure (mPAP), weight ratio of RV to LV+S, the levels of VEGF in serum, and lung tissue of group F were significantly higher than those of group N and group S (P

The regulation of nitric-oxide synthase/nitric-oxide system by endogenous carbon monoxide in rats with pulmonary hypertension / 中国病理生理杂志

AIM: To study the role and the mechani sm of heme oxygenas/endogenous carbon monoxide on nitric oxide synthase/nitric oxide system in rats with pulmo nary hypertension induced by hypoxic hypercapnia. METHODS: Spr ague-Dawley rats w ere randomly divided into three groups: control group (A group),hypoxic hypercap n ic group (B group), hypoxic hypercapnia+hemin group (C group). Blood CO concentr at ion (COHb%),NO concentration,HO-1 activity, iNOS, cNOS in blood serum and lung h omogenate were measured, respectively. RESULTS: ① mPAP and RV /(LV+S) of B g roup were significantly higher than those of A and C group( P

Rat urotensin-II-induced main pulmonary artery contractions are mediated by MAPK * / 中国病理生理杂志

AIM:To investigate rat Urotensin-II(ra t U-II)-induced vasoconstriction of rat main pulmonary arteries and the role of mitogen-activated protein kinase(MAPK). METHODS: The main pulmon ary artery was dissected from the male Sprague -Dawley rats and artery ring width was 3-4 mm. Concentration-response curves wer e gene rated to rat U-II(0 03 nmol/L-30 nmol/L).Inhibitor of MAPK,PD 98059(0 1 ?mol/ L -10 ?mol/L) were added into the medium after rat U-II(30 nmol/L)induced vasoc onstriction had reached plateau to construct the relaxant concentration-respons e curves and their EC 50 and E max . RESULTS: Rat U-II was a potent vasoconstrictor of isolated rat main pulmonary arteries [EC 50 =7 95?0 4 0, E max =(14 28?6 34)% of the response to 60 mmol/L KCl]; PD 98059 caused c oncentration-dependent relaxations of rat U-II precontracted arteries [EC 50 =5 91?0 45, E max =(81 39?13 65)%]. CONCLUSION: Rat U- II was a potent vasoconstrictor of rat main pulmonary arteries and this response was med iated through MAPK.

Relationship between thromboxane synthase gene and prostacyclin synthase gene expression and pulmonary hypertension induced by hypoxic hypercapnia / 中国病理生理杂志

AIM: To study the effect of chronic hypoxic hypercapnia on gene expression of thromboxane synthase and prostacyclin synthase in pulmonary arterioles. METHODS: Sprague-Dawley rats were randomly divided into two groups: control group and hypoxic hypercapnic group. TXS mRNA and PGI 2-S mRNA were observed in pulmonary arterioles by in situ hybridization. RESULTS:mPAP, weight ratio of right ventricle (RV) to left ventricle plus septum(LV+S), contents of TXB 2 and 6-keto-PGF1 ? in plasma and lung and TXS mRNA in pulmonary arterioles were much higher in rats of hypoxic hypercapnic group than those of control group. Differences of PGI 2-S mRNA in pulmonary arterioles were not significant in two groups. Light microscopy showed hypertrophy of vessel smooth muscle cells and vessel cavity straitness were found in hypoxic hypercapnic group. CONCLUSION: Changes of gene expressions of thromboxane synthase and prostacyclin synthase and imbalance of TXA 2/PGI 2 may play an important role in hypoxic hypercapnic pulmonary hypertension.