Investigation on radiation doses and related influencing factors for CT adult examinations in Huai′an city / 中华放射医学与防护杂志

Objective:To investigate the level of radiation doses to adults caused by CT examination in Huai′an, and explore the local CT diagnostic reference levels (DRLs).Methods:Totally 45 CT scaners were selected to investigate the information on hospitals, equipment, scanning parameters, and radiation doses. Empirical formula were used to estimate the effective dose to adults. Nonparametric rank sum tests were used to analyze differences in radiation dose level between CT service age and hospital grade.Results:A total of 3 483 patients were collected, including 890 for head examinations, 890 for chest, 846 for abdomen, and 857 for lumbar spine. The 75% percentile values of CTDI vol to adult patients from CT scanning for head, chest, abdomen, lumbar spine examinations were 63.0, 12.4, 20.0 and 24.0 mGy, respectively. The 75% percentile values of DLP were 858.6, 416.0, 620.7 and 559.2 mGy·cm, respectively. The 75% percentile values of DLP for males was higher than those for females. There were significant statistical differences in radiation doses dependent on equipment service (head: U =10 326.00, P<0.05; chest: U=36 094.50, P<0.05; abdomen: U= 7 859.00, P<0.05; lumbar spine: U=42 408.00, P<0.05), and hospital grade (head: H=14.280, P<0.05; chest: H=17.85, P<0.05; abdomen: H=97.18, P<0.05; lumbar spine: H=138.94, P<0.05). Conclusions:The CT radiation dose levels in Huai′an city is basically consistent with standard-reommended values, which is in line with the current status of CT equipment dose levels in the country. It is necessary to strengthen the quality control and maintenance of CT equipment.

Effects and mechanism of anaphylactoid reaction induced by nonapeptide activating mast cells / 中国药房

OBJECTIVE To study the effects and potential mechanism of anaphylactoid reaction induced by nonapeptide IVQKIKHCF activating mast cells. METHODS Using human mast cell line LAD2 as subject， and substance P as positive control， the activation effects of 25， 50 and 100 μmol/L IVQKIKHCF on mast cells were investigated by determining the release rate of β-aminohexosidase， histamine release， and the contents of inflammatory factors； using MrgprX2-knockdown LAD2 cells and Mas- related G protein-coupled receptor X2 （MRGPRX2） high-expression human embryonic kidney cell line HEK293 （MRGPRX2/ HEK293 cells） as subject， the correlation between the activation effect of IVQKIKHCF and MRGPRX2 was investigated by determining the release rate of β-aminohexosidase， and intracellular calcium ion concentration. RESULTS IVQKIKHCF with 25， 50， 100 μmol/L could significantly increase the release rate of β-aminohexosidase and histamine release in LAD2 cells （P＜0.05）， and promote the release of tumor necrosis factor-α， interleukin-8， macrophage inflammatory protein-1β and monocyte chemotactic protein-1 to varying degrees （P＜0.05）. After knocking down MrgprX2， the effects of 25， 50， 100 μmol/L IVQKIKHCF promoting the release of β-aminohexosidase in LAD2 cells were reversed significantly （P＜0.05）， resulting in an increase of calcium ion concentration in MRGPRX2/HEK293 cells. CONCLUSIONS Nonapeptide IVQKIKHCF can promote mast cells to release granular matter and inflammatory mediators by activating MRGPRX2 thus inducing anaphylactoid reaction.

Establishment and evaluation of a predictive model for early neurological deterioration after intravenous thrombolysis in acute ischemic stroke based on machine learning / 中华危重病急救医学

OBJECTIVE@#To establish a machine learning model to predict the risk of early neurological deterioration (END) based on the clinical and laboratory data of patients with acute ischemic stroke (AIS) before intravenous thrombolysis.@*METHODS@#The clinical data of AIS patients who received intravenous thrombolytic with recombinant tissue plasminogen activator (rt-PA) at the Stroke Center of the First Hospital of Qinhuangdao City from January 2019 to July 2022 were retrospectively analyzed. Patients were divided into END group and non-END group according to whether END appeared after intravenous thrombolytic. Clinical data of patients at admission were collected, including demographic characteristics, clinical evaluation, comorbidification, drug use history, laboratory tests, etc. Univariate and multivariate Logistic regression analysis were performed to screen out the independent predictors of the END of AIS patients after intravenous thrombolytic. The study subjects were randomly divided into a training set and a test set in a 7 : 3 ratio. Four machine learning prediction models, including Logistic regression (LR), K-nearest neighbor (KNN), support vector machine (SVM) and random forest (RF), were established based on independent predictors. The receiver operator characteristic curve (ROC curve) was used to evaluate the predictive ability of each model in END.@*RESULTS@#A total of 704 patients were enrolled, of whom 99 were identified as END and 605 as non-END. Univariate and multivariate Logistic regression analysis was used to screen out the National Institutes of Health stroke scale [NIHSS, odds ratio (OR) = 1.049, 95% confidence interval (95%CI) was 1.015-1.082, P = 0.004], systolic blood pressure (OR = 1.013, 95%CI was 1.004-1.022, P = 0.004), lymphocyte percentage (LYM%, OR = 0.903, 95%CI was 0.853-0.953, P < 0.001), platelet to lymphocyte ratio (PLR, OR = 1.007, 95%CI was 1.002-1.014, P = 0.013) were the independent predictors of END in AIS patients after intravenous thrombolysis. The area under the curve (AUC) of LR, KNN, SVM, and RF machine learning models in the test dataset were 0.789 (95%CI was 0.675-0.902), 0.797 (95%CI was 0.685-0.910), 0.851 (95%CI was 0.751-0.952) and 0.809 (95%CI was 0.699-0.919), respectively. The RF model had the highest sensitivity (95.7%). The accuracy (0.736), specificity (72.0%) and AUC of SVM model were the highest, and its overall prediction ability was better than the other three models.@*CONCLUSIONS@#Machine learning models have a potential role in early predicting the risk of END after intravenous thrombolysis in AIS patients, and can provide help in clinical decision-making for intravenous thrombolysis.

Current status of the application of radiodiagnosis and radiotherapy resources in Huai′an City in 2020 / 中华放射医学与防护杂志

Objective:To investigate the current status of the radiodiagnosis and radiotherapy resources and medical exposure frequencies in Huai′an City.Methods:According to the monitoring data in the " Radiological Health Information Management Platform of Jiangsu Province" in 2020, a descriptive analysis was conducted on the personnel, equipment, and exposure frequencies in the institutes engaged in radiation-based diagnosis and treatment in Huai′an.Results:A total of 181 hospitals were investigated in 2020, including 7 tertiary hospitals(3.9%), 24 secondary hospitals(13.3%), 126 primary hospitals(69.6%), and 24 ungraded hospitals(13.3%). There were 1 397 radiation workers, including 948 males and 449 females, and 459 pieces of radiation equipment, including 420 for radio diagnosis, 13 for radiotherapy, 4 for nuclear medicine, and 22 for interventional radiology. The hospitals of different grades greatly differed in the number of radiation workers and equipment. There were 80.1, 20.9, 2.2, and 2.0 radiation workers and 15.7, 5.5, 1.4, and 1.6 pieces of radiation equipment in the tertiary hospitals, secondary hospitals, primary hospitals, and ungraded hospitals, respectively on average. There were 2 903 246, 27 648, 8 087, and 17 874 receiving radiodiagnosis, radiotherapy, nuclear medicine, and interventional radiology, respectively in 2020. The medical exposure frequencies in the whole city were calculated to be 599.50 per 1 000 population, including 334.59 treated with conventional X-rays, 239.82 receiving CT scan, 14.18 for breast and dentistry, 3.62 receiving interventional radiology, 5.61 treated with radiotherapy, and 1.69 receiving nuclear medicine.Conclusions:The radiodiagnosis and radiotherapy resources are unbalanced in the hospitals of different grades in Huai′an City. Therefore, it is necessary to pay more attention to the reasonable allocation of medical resources. Meanwhile, radiation workers in secondary hospitals may be more prone to job burnout. Facing the normalization of the prevention and control of COVID-19 epidemic, the supervision and management of radiological health should be strengthened to ensure the legitimacy of radiological diagnosis and radiotherapy and theoptimization of protection. The frequencies of medical exposure are consistent with the local economic level. To analyze the differences in medical exposure frequencies and predict the developmental trends in different regions, it is necessary to establish a more accurate prediction model.

Influencing factors of weaning outcome of intensive care unit patients with planned extubation / 中华危重病急救医学

Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.

Construction of a medical service experience system based on staff role play / 中华医院管理杂志

Objective:To build a medical service experience system based on role play of hospital staff, and explore its contribution to upgrading medical service, elevating medical service quality, and improving patients′ satisfaction.Methods:An indicator system for medical service experience was developed via literature review. 20 newly recruited hospital employees in 2019 were sampled randomly to form a service experience team, who were arranged to experience the full medical service process of outpatients and inpatients based on role play. The questionnaire for service quality based on patient perception and expectation was used to survey the expectation and perception values of those role players on their medical service experiences, and summarize the defects found on such six dimensions as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness. After due corrections of these defects, further experiences and patient satisfaction survey were made to assess the effects of such actions taken. Paired t test was used respectively in statistical analysis of service experience value and actual perception value, as well as the perception values before and after the actions taken, and χ2 test was used for a statistical analysis of patient satisfaction. Results:Role players experienced respectively at the emergency, outpatient and inpatient departments of the hospital for a week in August 2019. Statistics of their experiences indicated≥0.50 points difference between the mean expectation and perception values on doctor-patient communication, patient help responsiveness, outpatient process, examination report delivery duration, service attitude, patient trust on medical workers, medical environment and patient privacy protection.Following a 3-month reform, role players found improvements in such aspects as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness; patient satisfaction improved sizably in December 2019 over January of the same year( P<0.05). Conclusions:The construction and application of the medical service experience system based on role play of hospital staff prove highly useful in upgrading medical service actions, improving medical service quality, and improving patient satisfaction.

Diagnostic value of microRNA-29b for left ventricular hypertrophy in elderly patients with coronary heart disease / 中华老年医学杂志

Objective:To investigate the diagnostic value of microRNA-29b(miR-29b)for left ventricular hypertrophy(LVH)in elderly patients with coronary heart disease(CHD).Methods:From January 2015 to December 2018, 140 elderly patients with CHD admitted in our hospital were enrolled, including 70 CHD patients without LVH(the NLVH group)and 70 CHD patients with LVH(the LVH group). Seventy healthy elderly adults without CHD who underwent heart examination at our hospital during the same period were included as the control group.The interventricular septum thickness(IVSD), left ventricular posterior wall thickness(LVPWD) and the relative expression level of microRNA-29b were detected and compared among the three groups.The correlation of microRNA-29b with IVSD and LVPWD was analyzed, and the diagnostic value of microRNA-29b for LVH in elderly CHD patients was analyzed.Results:There were significant differences in IVSD, LVPWD and the relative expression level of microRNA-29b among the three groups( F=22.838, 22.147 and 114.096, all P=0.000). The IVSD, LVPWD and the relative expression level of microRNA-29b were higher in the LVH group than in the NLVH group( t=3.479, 3.206 and 9.852, all P=0.000)and than in the control group( t=3.904, 3.553 and 10.792, all P=0.000). The relative expression level of microRNA-29b was higher in the NLVH group than in the control group( t=2.306, P=0.420). The receiver-operating characteristics(ROC)curve analysis of microRNA-29b for the diagnosis of LVH in elderly CHD patients showed that the maximum entry point of Youden index was 0.80, the optimal critical value was 3.52, the sensitivity and specificity for the diagnosis of LVH was 91.73% and 88.27%.Pearson correlation analysis showed that the expression level of microRNA-29b was positively correlated with IVSD and LVPWD( r=0.63 and 0.61, P=0.000). Conclusions:The expression level of microRNA-29b is significantly increased in elderly CHD patients with LVH, and positively correlated with IVSD and LVPWD.The expression level of microRNA-29b has high sensitivity and specificity in the diagnosis of LVH in elderly CHD patients.

Online survey of family physician′s contract service and its influencing factors in Luohu District, Shenzhen / 中华健康管理学杂志

Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Expression of ERAP1, TNFR-Ⅰ, TNFR-Ⅱ in psoriasis vulgaris / 中国医师杂志

Objective:To explore the possible role of endoplasmic reticulum aminopeptidase 1 (ERAP1), tumor necrosis factor-α receptor Ⅰ (TNFR-Ⅰ), tumor necrosis factor-α receptor Ⅱ (TNFR-Ⅱ) in the pathogenesis of psoriasis vulgaris.Methods:15 cases of normal skin and 20 cases of psoriasis vulgaris in Xinjiang Uygur Autonomous Region People's hospital were enrolled. Immunohistochemical staining techniques were used to detect the expression of ERAP1, TNFR-Ⅰ, TNFR-Ⅱ protein in the two groups. Statistical analysis was then performed to compare the difference in expression between the two groups.Results:⑴ In normal skin , ERAP1 is mainly expressed in the basal layer of the epidermis. In the psoriatic vulgaris lesions, ERAP1 was diffusely positive. The expression of ERAP1 in the psoriatic lesions was stronger than that of normal tissues, with stastically significant difference ( Z=-4.170, P<0.05). ⑵ TNFR-Ⅰ is diffusedly expressed in the normal skin tissues. However, in the epidermis of psoriatic lesions, the expression of TNFR-Ⅰ in the spinous layer was stronger than that of the basal layer (χ 2=17.740, P<0.05). ⑶ In the normal skin, TNFR-Ⅱ was not expressed; in the psoriatic lesions, TNFR-Ⅱ was diffusely expressed in the basal cell layer and acanthosis of the epidermis in varying degrees, and the difference between normal and psoriatic skin was statistically significant (χ 2=17.500, P<0.001). ⑷ The expression of ERAP1 in the epidermis of psoriasis vulgaris was negatively correlated with TNFR-Ⅰ ( rs=-0.662, P=0.001). There was no significant correlation between ERAP1 and TNFR-Ⅱ ( rs=0.343, P=0.139). Conclusions:ERAP1, TNFR-Ⅰ, and TNFR-Ⅱ may play important roles in the pathogenesis of psoriasis vulgaris. They may interact with each other to regulate the proliferation and apoptosis of keratinocyte in order to maintain the abnormal proliferation and benign proliferation of psoriasis vulgaris epidermis.

Advances in genetic research of FOXL2 in patients with blepharophimosis-ptosis-epicanthus inversus syndrome / 中华实验眼科杂志

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare autosomal dominant disease, which has been divided into two types according to whether it involves premature ovarian failure.BPES is characterized by typical eyelid malformations, including a narrowed horizontal palpehral aperture, ptosis, epicanthus inversus and telecanthus.Mutations in FOXL2 have been identified in the majority of patients with BPES.With the deepening of research, the relationship between FOXL2 genotype and phenotype has received more and more attention, and some researchers have found that the same mutation of the FOXL2 gene may have different phenotypes in different families or even the same family.This review summarizes the relationship between FOXL2 gene mutation and BPES.

Monitoring and evaluation on effect of mosquito control at external environment in residential areas with property management in Wuhan, 2016-2018 / 公共卫生与预防医学

Objective To investigate the effect of mosquito control at public environment in residential areas with property management in Wuhan from 2016 to 2018, and to provide background information for making scientific mosquito control strategies in residential areas. Methods The control rate of mosquito route index was taken as the evaluation index. A retrospective analysis of the ocular monitoring results of mosquito breeding sites in the public external environment of property communities in Wuhan from 2016 to 2018 was conducted. Chi-square test was used to compare the route index control rate between different years. Results The residential areas with property management that were effectively incorporated into surveillance were 179 in 2016, 437 in 2017 and 548 in 2018, while the control rate of route index was 51.40%, 59.27% and 41.06%, respectively. The outcome of statistical analysis indicated that the control rate of mosquito route index monitored in 2018 at external environment of residential areas with property management was significantly lower than that in 2017 (χ2=26.342，P<0.001). However, there was no significant difference between the control rate of route index monitored in 2016 and that in later two years. Conclusion Mosquito control effect at public environment on property management areas in Wuhan declined during the consolidation phase of the establishment of national health city. Relevant departments should make effort to explore more reasonable and scientific management strategies and measures for mosquito control to provide more healthy and safe living environment for city residents in Wuhan.

Investigation and estimation of medical X-ray diagnostic examination frequency in Huai′an city in 2017 / 中华放射医学与防护杂志

Objective:To estimate the frequencies of medical X-ray diagnositic examinations and analyze their distribution in Huai′an City.Methods:Stratified random sampling was used to select 2 tertiary hospitals including 1 general hospital and 1 MCH hospital, 4 secondary hospitals, 20 primary and unclassified hospitals to investigate medical X-ray examination frequencies in the 26 hospitals in 2017.Results:The average number of X-ray diagnostic equipment were 13.5 pieces in tertiary hospitals, 7.3 in second-level hospitals and 1.6 in primary and ungraded hospitals. The fraction of imported equipment accounted for 85.2%, 69.0% and 9.4%, respectively. The higher the hospital level, the greater the proportion of equipment with five years of service history. The number of examinations in 2017 in the 26 hospitals were X-ray photography 350 221, fluoroscopy 71 597, CT 327 404, dental 23 820 and breast 12 849, respectively. The number of examinations per 1 000 population were estimated to be 444.22 by conventional X-ray and 236.40 by CT.Conclusions:The frequency of conventional X-ray examinations in the city is slightly lower than the average level in Jiangsu province in 2016 and the CT examination frequency is roughly same as in Jiangsu province.

Clinical effect of addition and subtraction of Xiaojiyinzi prescription in the treatment of bleeding after bipolar vaporization of prostate for benign prostatic hyperplasia / 中国基层医药

Objective To explore the effect of addition and subtraction of Xiaojiyinzi prescription in the treatment of bleeding after bipolar vaporization of prostate for benign prostatic hyperplasia.Methods From June 2013 to June 2017,90 patients with benign prostatic hyperplasia who underwent bipolar electrovaporization in the Traditional Chinese Medicine Hospital of Wenling were selected in this study.The patients were divided into observation group and control group according to a random number table,with 45 cases in each group.The observation group was givenaddition and subtraction of Xiaojiyinzi prescription,while the control group was treated with finasteride orally.The clinical effects of the two groups were compared and analyzed.Results The amount of bleeding in the control group at 3 days,5 days and 7 days after operation were (13.69 ± 1.27) mL,(8.37 ± 1.23) mL,(6.13 ± 0.58) mL,respectively,which in the observation group were (9.22 ± 1.18) mL,(6.12 ± 0.98) mL,(3.98 ± 0.33) mL,respectively,there were statistically significant differences between the two groups (t =17.297,P =0.000,t =9.597,P =0.000,t =21.613,P =0.000).The amount of bleeding in both two groups decreased with the prolongation of time,and the differences were statistically significant between each two moments (all P ＜ 0.05).After treatment,the I-PSS and NIH-CPSI scores in the control group were (13.22 ± 2.95) points and (13.64 ± 4.22) points,respectively,which in the observation group were (8.11 ± 1.35) points and (7.88 ± 3.06) points,respectively,which were lower than those before treatment,and the differences were statistically significant(t =12.286,P =0.000,t =14.359,P =0.000,t =21.041,P =0.000,t =25.989,P =0.000).The scores in the observation group after treatment were lower than those in the control group,and the differences were statistically significant between the two groups (t =8.217,P =0.000,t =7.413,P =0.000).Conclusion Hemorrhage is the most common complication of transurethral resection of prostate in elderly men,which seriously interferes with postoperative recovery.The addition and subtraction of Xiaojiyinzi prescription can reduce bleeding and improve postoperative recovery.

Analysis on job burnout status and its influencing factors of grassroots public health service personnel in Huaian city / 中华劳动卫生职业病杂志

Objective@#To analyze the status of job burnout among the community and township public health workers, and to provide scientific basis for formulating comprehensive prevention and control measures.@*Methods@#A census sampling method was used to investigate the job burnout by using the self-made general demographic data questionnaire and the MBI-GS in HuaiAn.@*Results@#A total of 1074 valid questionnaires were collected, and the total physical examination rate of job burnout was 58.7%, 51.3% were mild burnout, 7.4% were highly burnout. Multivariate ordered logistic regression analysis showed that sex (OR=1.32), chronic disease (OR=1.92)、and daily working hours greater than 7 h (OR=1.40)、township health center (OR=1.31) were independent risk factors for occupational burnout. The age "≥51" (OR=0.45)、"41~" (OR=0.58) are the independent protective factors for the occurrence of job burnout.@*Conclusion@#Job burnout detection rate was high in the staff of essential public health service, sex, daily working hours, health status, age and work unit are the main factors influencing job burnout.

Study on the characteristics of auditory in children with autism spectrum disorders / 中国学校卫生

Objective@#To explore the characteristics of Auditory Brainstem Response (ABR) in children with ASD, and analyze their relation with the core symptoms of ASD.@*Methods@#Ninty children aged 2-6 with ASD were recruited from Harbin in this study. The data of ABR was collected by using BAEP, and the association among children’s absolute latency and interpeak latency of ABR, core symptoms of ASD children’s behavior and clinical manifestation was analyzed.@*Results@#Compared with the normal average value, children with ASD had longer the absolute latency of wave Ⅰ,Ⅲ,Ⅴ in bilateral ears, which were (1.51±0.20)(3.83±0.34)(5.63±0.23)ms, (1.54±0.16) (3.78±0.23) (5.63±0.22)ms, respectively(P<0.05). Some children’s interpeak latency of Ⅰ-Ⅲ, Ⅲ-Ⅴ, Ⅰ-Ⅴ were longer than normal values. Children younger than 3 years old showed prolonged peak intervals of Ⅰ-Ⅲ and Ⅰ-Ⅴ than children in 3-7 years old. The study has also showed that there was positive correlation between the absolute latency of waveⅠin left ear and the social function defect(r=0.45, P<0.05); there was positive correlation between the latency of wave Ⅴin right ear or the latency of waveⅠin left ear or the Ⅰ-Ⅲ peakinterval and nonverbal communication ability dysfunction(r=0.35, 0.39, 0.34, P<0.05); there was positive correlation between the Ⅰ-Ⅲ peak interval and the repeated stereotyped symptoms(r=0.39, 0.35, P<0.05).@*Conclusion@#Children with ASD have abnormal auditory behavior. The absolute latency and interpeak latency of ABR is correlated to some parts of core symptoms of ASD.

Characteristics of branch pulmonary artery flow patterns in fetuses with left heart hypoplasia syndrome in the second trimester / 中华医学超声杂志（电子版）

Objective To explore the characteristics of branch pulmonary artery flow patterns in fetuses with left heart hypoplasia syndrome (HLHS).Methods HLHS fetuses were divided into an unobstructed group and an obstructed group according to the blood flow pattern across the interatrial septum.Main pulmonary artery diameter,right pulmonary artery diameter,and Doppler parameters of first-order right pulmonary artery of both groups were measured by fetal echocardiography and compared with those of normal controls.Results There was a significant difference in the diameter of pulmonary trunk among different the three groups (F=198.56,P ＜ 0.05),and the main pulmonary artery diameter in the two groups of HLHS fetuses were larger than that in normal controls (t=-18.501,-13.97,P ＜ 0.05),but there was no significant difference between the two groups of HLHS fetuses (P=0.85).There was no significant difference in right pulmonary artery diameter among the three groups (P=0.59).The end-diastolic velocity,time-averaged maximum velocity,and velocity-time integral in the two HLHS groups were lower than those in normal controls,and these parameters in the obstructed group were less than those in the unobstructed group.The pulmonary artery pulsatility index in the two HLHS groups was higher than those in normal controls,and it was higher in the obstructed group than in the unobstructed group.There was no statistically significant difference in peak systolic velocity among the three groups (P=0.34).Conclusion The antegrade resistance of the pulmonary arteries of HLHS fetuses increase and these pathologcial conditions are more obvious in those with obstructed flow across the atrial septum compared to those with unobstructed flow.

The application of 18F-FDG PET/CT in the evaluation of the prognosis of non-small cell lung cancer / 临床外科杂志

Lung cancer is one of the important causes of human death among the malignant tumors, in which non-small cell lung cancer accounts for about 85％. The treatment of lung cancer is complex. How to predict the prognosis of lung cancer is very important to choose better therapy methods. The traditional prognostic evaluation methods have some disadvantages. With the development of new technology, 18F-FDG PET/CT is applied to stage and re-stage, evaluate therapy effect and predict the prognosis of lung cancer. In this review, the prognosis effect of non-small cell lung cancer via 18F-FDG PET/CT will be discussed.

Building and application of a smart nursing interactive system / 中华医院管理杂志

This nursing interactive system, based on hospital information system, minimizes manual repetitions of nurses and their cross-space communication problems. It provides an accurate and intuitive information display and communication channel for clinical nursing care, which can also provide a preliminary evaluation of its application effects. On such basis, the authors propose that building such a system is a necessity in nursing informationization, as it elevates nursing efficiency, scientific management and patient safety.

Design and clinical application of rehabilitation VR system for breast cancer patients / 中华护理杂志

With the application and integration of high-quality computer software and hardware as well as the advanced sensors,a rehabilitation VR system has been explored and developed for breast cancer patients.According to the changes of lymphedema and motor function,the rehabilitation process was divided into four phases.After a three-month control experiment among 76 cases of breast cancer patients,the results showed that the VR system with auxiliary game treatment to control patients' training process was able to substantially improve limb function recovery,compliance and subjective initiative in rehabilitation training,and reduce the edema of affected limbs,and the differences were statistically significant(P＜0.01,P＜0.05).Therefore,the VR system helps patients' limb function recovery and reduce negative emotions after surgery.

TDP-43 regulates cancer-associated microRNAs

Aberrant regulation of miRNA genes contributes to pathogenesis of a wide range of human diseases, including cancer. The TAR DNA binding protein 43 (TDP-43), a RNA/DNA binding protein associated with neurodegeneration, is involved in miRNA biogenesis. Here, we systematically examined miRNAs regulated by TDP-43 using RNA-Seq coupled with an siRNA-mediated knockdown approach. TDP-43 knockdown affected the expression of a number of miRNAs. In addition, TDP-43 down-regulation led to alterations in the patterns of different isoforms of miRNAs (isomiRs) and miRNA arm selection, suggesting a previously unknown role of TDP-43 in miRNA processing. A number of TDP-43 associated miRNAs, and their candidate target genes, are associated with human cancers. Our data reveal highly complex roles of TDP-43 in regulating different miRNAs and their target genes. Our results suggest that TDP-43 may promote migration of lung cancer cells by regulating miR-423-3p. In contrast, TDP-43 increases miR-500a-3p expression and binds to the mature miR-500a-3p sequence. Reduced expression of miR-500a-3p is associated with poor survival of lung cancer patients, suggesting that TDP-43 may have a suppressive role in cancer by regulating miR-500a-3p. Cancer-associated genes LIF and PAPPA are possible targets of miR-500a-3p. Our work suggests that TDP-43-regulated miRNAs may play multifaceted roles in the pathogenesis of cancer.