Relationship between perceived organizational support and occupational pressure of general practitioners: the mediating role of professional identity / 中华医学教育探索杂志

Objective:To investigate the current situation of general practitioners' occupational pressure in Heilongjiang Province, and explore its relationship with professional identity and perceived organizational support. It aims to provide references for the construction of general practitioners and the development of general medical education.Methods:The general situation questionnaire, perceived organizational support scale, occupational pressure scale, and professional identity scale were applied through network and site surveys for collecting data. A total of 288 questionnaires were collected with 263 valid questionnaires (91.3%). Pearson correction analysis and bootstrap analysis were performed for data analysis.Results:The average score of occupational pressure among general practitioners was (115.95±22.40), and the results of Pearson correction analysis showed that perceived organizational support was negatively correlated with occupational pressure ( r=-0.413, P<0.01) and positive correlation with professional identity ( r=0.587, P<0.01). There were also significant negative correlations between professional identity and occupational pressure ( r=-0.442, P<0.01). Moreover, the mediating effect showed that professional identity had a certain mediating effect on the relationship between perceived organizational support and occupational pressure (LLCI=-0.2039, ULCI=-0.0760, P<0.05). Conclusion:General practitioners' occupational pressure was at a high level, which can be reduced through improving the perceived organizational support and professional identity.

Research progress of early clinical exposure in medical colleges and Universities in China:A review / 中华医学教育探索杂志

This paper systematically reviews the relevant literature on early clinical exposure (ECE) in China in recent years. It analyzes the main contents of literature, summarizes the various forms of ECE that the colleges and universities provide, and analyzes its positive effect on the students' learning interest and ability, their humanistic care for patients, as well as the teacher's self-improvement. Finally, according to the actual practical situation of ECE in medical universities in China and relevant experience from foreign studies, it is proposed that China should increase the emphasis on ECE in colleges and universities, strengthen the construction of teaching staff, and establish a scientific and systematic evaluation system.

Construction of the Medical Field Oriented Retrieval Thesaurus / 医学信息学杂志

The paper analyzes the problems of the specialized databases and search engines during document retrieval and the reasons for constructing retrieval thesaurus in the field of medical field,and establishes a retrieval thesaurus jointly reviewed by sci-tech novelty assessment and subject specialists by taking sci-tech novelty report of the sci-tech novelty station of the Ministry of Education since 2014 as the data sources.The thesaurus applies to sci-tech novelty assessment,document retrieval teaching and other fields,which can also be promoted in other fields.

Effects of extremity ischemic preconditioning on liver injury after cardiac valve replacement with cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effects of extremity ischemic preconditioning on liver injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA physical status Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ), weighing 44-72 kg, with ejection fraction≥40％, schedule for elective cardiac valve replacement with CPB, were randomly divided into 2 groups (n =30 each) using a random number table: control group (group C) and extremity ischemic preconditioning group (group E).Immediately after anesthesia induction, an auto-inflatable cuff was placed under the right lower extremity, and was inflated to 300 mmHg to induce ischemia (oxygen saturation at the finger tip undetected or foot pulse untouched on the operated side) which was preceded by 3 cycles of 5 min ischemia-5 min reperfusion in group E.Before anesthesia induction (T0) , and at 2, 12, 24, and 72 h, and 7 days after operation (T1-5) , blood samples were taken from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities.The expression of serum miR-122 was detected at T0-4 by real-time reverse transcriptase polymerase chain reaction.Results Compared with the value at T0, the serum ALT and AST activities were significantly increased at T2-4, and the expression of miR-122 was up-regulated at T1-3 in the two groups (P＜0.05).Compared with group C, the serum ALT and AST activities were significantly decreased at T2-4, and the expression of miR-122 was down-regulated at T1-3in group E (P＜0.05).Conclusion Extremity ischemic preconditioning can mitigate liver injury after cardiac valve replacement with CPB.

The effect of initial fluid resuscitation with different ratio of crystalloid-colloid on prognosis of patients with severe acute pancreatitis / 中国医师进修杂志

Objective To investigate the effect of initial fluid resuscitation with different liquid crystal glue ratio on prognosis of patients with severe acute pancreatitis(SAP).Methods Ninety-four cases of SAP patients were selected,with the first 24 h liquid crystal glue ratio of 1.5 and 3.0 for the sector,were divided into low crystal glue ratio group(crystal glue ratio ＜ 1.5,26 cases),microtek glue ratio group (crystal glue ratio 1.5-3.0,30 cases)and high crystal glue ratio group(crystal glue ratio ＞3.0,38cases).24 h mechanical ventilation rate,oxygenation index,intra-abdominal pressure(IAP),third interstitial fluid retention,the parameters of fluid resuscitation and 2 week survival rate were observed in three groups.Results 24 h crystal solution volume,crystal glue ratio,third interstitial fluid retention and 72 h infusion volume in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [(3612 ± 799)ml vs.(2309 ±417),(2125 ±478)ml,(3.66 ± 0.14)vs.(2.44 ±0.15),(1.42 ±0.09),(2835 ±632)ml vs.(1889 ±283),(1866 ±305)ml,(11942 ± 1162)ml vs.(9037 ± 983),(9401 ± 1052)ml],and there were significant differences(P ＜ 0.05).24 h crystal glue ratio in microtek glue ratio group was higher than that in low crystal glue ratio group,and there was significant difference(P＜ 0.05).24 h glue volume in low crystal glue ratio group was higher than that in high crystal glue ratio group and microtek glue ratio group [(1507 ± 335)ml vs.(994 ± 234),(949 ± 141)ml],and there were significant differences(P＜0.05).There was no significant difference in 24 h crystal volume,third interstitial fluid retention and 72 h infusion volume between microtek glue ratio group and low crystal glue ratio group(P＞ 0.05).24 h mechanical ventilation rate,IAP in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [65.8％(25/38)vs.23.3％(7/30),26.9％(7/26),(16.9 ± 3.7)cm H2O(1 cm H2O =0.098 kPa)vs.(13.5 ± 3.6),(13.2 ± 3.4)cm H2O],24 h oxygenation index was lower than that in microtek glue ratio group and low crystal glue ratio group [(180.8 ±26.4)mm Hg(1 mm Hg =0.133 kPa)vs.(280.7 ±24.9),(260.4 ±25.8)mm Hg],and there was significant difference(P ＜ 0.05).2 week survival rate in high crystal glue ratio group was lower than that in microtek glue ratio group and low crystal glue ratio group [34.2％(13/38)vs.86.7％ (26/30),57.7％(15/26)],there was significant difference between high crystal glue ratio group and microtek glue ratio group (P ＜ 0.05),but there was no significant difference between high crystal glue ratio group and low crystal glue ratio group(P ＞ 0.05).There was no significant difference in 2 week survival rate between low crystal glue ratio group and microtek glue ratio group(P ＞ 0.05).Conclusion In early SAP patients should follow the appropriate crystal glue ratio controlled fluid resuscitation,reduce fluid retention and improve the cure rate,and the use of microtek glue ratio controlled fluid resuscitation strategy is best.

Establishment of first national standard of Cystatin C / 中华检验医学杂志

Objective To establish the first national standard of Cystatin C.Methods The candidate standard was prepared from human recombinant Cystatin C,diluted and dispensed aseptically.Homogeneity and stability study were carried out on the automated biochemical analyzer.The target value was assigned by six laboratories using widely recognized immumoassay under strict conditions,and traceable to ERM-DA471.Commutabilities of the candidate standard and its saline dilutions were evaluated according to EP14-Evaluation of Matrix Effects.Excel 2007 was used to analyze the results.Results The preparation had good immunological activity and was proved to be homogeneous and stable (6 months sealed at 2-8 ℃,30 days sealed at room temperature and 37 ℃,30 days open-vial at 2-8 ℃).The assigned value of the preparation was (4.47 ± 0.25) mg/L (coverage factor k =2).The candidate standard and/or its saline dilutions have commutability on the 10 evaluated systems.Conclusion The preparation meets the requirements of national secondary standard and could be used in quality control and evaluation of Cystatin C assays in China.

Low dose of argatroban saline flushes anticoagulation in hemodialysis patients with high risk of bleeding.

BACKGROUND: Anticoagulation in hemodialysis (HD) patients with high risk of bleeding is still an intractable problem. METHOD: A total of 80 HD sessions with high risk of bleeding were completed with either heparin-free (HF) or low dose of argatroban saline flushes (LASF) anticoagulation. Clinical clot formation in the pipeline and dialyzer was inspected to evaluate the local anticoagulation efficiency; prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer were tested to investigate the influence on the whole body coagulation system; urea reduction ratio (URR) and Kt/V were used to evaluate the efficiency of dialysis. RESULTS: Comparing with HF, LASF showed a satisfactory efficiency in reducing the clot formation and the URR and Kt/V of it were also higher. CONCLUSIONS: Low dose of argatroban saline flushes is a feasible and safe alternative anticoagulation protocol in HD patients with high risk of bleeding.

Clusters of VIP-36-positive vesicles between endoplasmic reticulum and Golgi apparatus in GH3 cells.

The vesicular integral membrane protein VIP36 belongs to the family of animal lectins and may act as a cargo receptor trafficking certain glycoproteins in the secretory pathway. Immunoelectron microscopy of GH3 cells provided evidence that endogenous VIP36 is localized mainly in 70-100-nm-diameter uncoated transport vesicles between the exit site on the ER and the neighboring cis-Golgi cisterna. The thyrotrophin-releasing hormone (TRH) stimulation and treatment with actin filament-perturbing agents, cytochalasin D or B or latrunculin-B, caused marked aggregation of the VIP36-positive vesicles and the appearance of a VIP36-positive clustering structure located near the cis-Golgi cisterna. The size of this structure, which comprised conspicuous clusters of VIP36, depended on the TRH concentration. Confocal laser scanning microscopy confirmed the electron microscopically demonstrated distribution and redistribution of VIP36 in these cells. Furthermore, VIP36 colocalized with filamentous actin in the paranuclear Golgi area and its vicinity. This is the first study to show the ultrastructural distribution of VIP36 in the early secretory pathway in GH3 cells. It suggests that actin filaments are involved in glycoprotein transport between the ER and cis-Golgi cisterna by using the lectin VIP36.

Localization of VIP36 in the post-Golgi secretory pathway also of rat parotid acinar cells.

VIP36 (36-kD vesicular integral membrane protein), originally purified from Madin-Darby canine kidney (MDCK) epithelial cells, belongs to a family of animal lectins and may act as a cargo receptor. To understand its role in secretory processes, we performed morphological analysis of the rat parotid gland. Immunoelectron microscopy provided evidence that endogenous VIP36 is localized in the trans-Golgi network, on immature granules, and on mature secretory granules in acinar cells. Double-staining immunofluorescence experiments confirmed that VIP36 and amylase co-localized in the apical regions of the acinar cells. This is the first study to demonstrate that endogenous VIP36 is involved in the post-Golgi secretory pathway, suggesting that VIP36 plays a role in trafficking and sorting of secretory and/or membrane proteins during granule formation.

Determination of Total Alkaloids in Semen Strychni and Optimization of Its Extraction Conditions by Orthogonal Design / 中药新药与临床药理

Objective To establish the RP- HPLC method for the determination of total alkaloids in Semen Strychni and to optimize its extraction conditions by orthogonal design. Methods With strychnine and brucine content as the indexes, ethonal volume, ethonal concentration , pH and extracting time were screened and L9(34) orthogonal test were applied. Results The optimal extraction conditions were as follows: refluxing and extracting with 6- fold 50 % alcohol (pH=5) for 3 times, one hour for each time. Conclusion The optimized condition is the best for the extraction of alkaloids and this increase the availability of Semen Strychni.

Tissue distribution of strychnos nux-vomica alkaloids in rats / 中国药理学通报

AIM To study the tissue distribution of strychnos nux vomica alkaloids in rats. METHODS Rats were given strychnos nux vomica alkaloids intravenously and strychnine(S), brucine(B), strychnine N oxide(SNO), brucine N oxide(BNO) in every tissue was determined by HPLC timely. RESULTS The concentration of S, B, SNO and BNO were high in brain and spinal marrow. CONCLUSION S, B, SNO and BNO all have the ability to permeate blood brain barrier.