Progress of researches on schistosomiasis-associated pulmonary arterial hypertension / 中国血吸虫病防治杂志

Schistosomiasis-associated pulmonary arterial hypertension (Sch-PAH) is categorized as WHO Group I PAH because its clinical manifestations, laboratory and hemodynamic features share with PAH of other etiologies, such as idiopathic, heritable, HIV and autoimmune disorders. Sch-PAH is usually a life-threatening complication of hepatosplenic schistosomiasis characterized by changes in the vascular wall, remodeling and vasoconstriction with lesions primarily located in the precapillary segments of the pulmonary vasculature, which may result in a marked and sustained increase in pulmonary vascular resistance, right ventricular failure and ultimately death. Although egg deposition into lung and subsequent inflammatory cascades are key factors in the pathogenesis of Sch-PAH, the exact pathogenesis, course of disease and treatment of Sch-PAH remain largely uncertain. This review mainly discusses the pathophysiological and immunological mechanisms of Sch-PAH, so as to provide insights into the clinical diagnosis and treatment of Sch-PAH.

Influence of hospital ethical climate on the turnover intention and job embeddedness of nurses / 中国职业医学

OBJECTIVE: To explore the influence of hospital ethical climate on the turnover intention and the mediating role of job embeddedness of nurses. METHODS: Totally 468 clinical nurses from there public general hospitals in Zhengzhou City were selected as the research subjects using convenience sampling method. The Hospital Ethical Climate Survey, Job Embeddedness Scale and Turnover Intention Questionnaire were used to investigate the scores of hospital ethical climate, job embeddedness and resignation intention respectively. RESULTS: The mean scores of hospital ethical climate, job embeddedness and turnover intention were(3.5±0.4),(2.8±0.3) and(2.8±0.7) respectively. The turnover intention of nurses was negatively associated with hospital ethical climate and job embeddedness [correlation coefficient(r)=-0.67,-0.60, all P<0.01]. The results of multiple linear regression analysis showed that the higher the scores of hospital ethical climate and job embeddedness, the lower the score of turnover intention of nurses(all P<0.01), after adjusting confounding factors such as length of service, educational level, professional title and personnel employment. The structural equation analysis results showed that job embeddedness played a part of the mediating role between the hospital ethical climate and the turnover intention of nurses and the mediating efficacy accounted for 23.3% of the total efficacy. CONCLUSION: The hospital ethical climate has a significant negative effect on the turnover intention, and job embeddedness has an intermediary effect between them.

[Discussion on multidisciplinary treatment mode of advanced schistosomiasis and its standardized implementation].

Advanced schistosomiasis is the most serious clinical type of schistosomiasis. Its diagnosis and treatment are related to many special departments, such as gastroenterology, general surgery, neurology, endocrinology, radiology, traditional Chinese medicine, blood purification, endoscopy, intervention, and ICU. It is necessary to apply a multidisciplinary treatment (MDT) mode. However, the mode has no universal standard and guide in practice. It is very important for the implementation of MDT mode of advanced schistosomiasis to form a treatment expert team, formulate the formal working procedures, and standardize the treatment schedules. The standardized implementation of MDT mode will be important to provide a more effective clinical decision on advanced schistosomiasis.

[Management strategy and technology of medical assistance to advanced schistosomiasis patients in Hunan Province].

The medical assistance to advanced schistosomiasis patients established by the Chinese government is a major public facility for patients with advanced schistosomiasis. Since the medical assistance to advance schistosomiasis patients in Hunan Province started ten years ago, a set of mature and operable programs with whole program management and related technologies has been developed. The author investigated the data on medical assistance to advanced schistosomiasis patients in Hunan Province during the last 10 years (from 2006 to 2015) retrospectively, and found that the program had high therapeutic effect and high satisfaction degree of both patients and the society. In order to improve the management of the medical assistance to advanced schistosomiasis patients and share our experiences of the whole program management and related technologies with the colleagues of other provinces, this paper mainly illustrates the experiences of the program, as well as the existing problems and related strategies.

[Value and evaluation on multidisciplinary treatment of advanced schistosomiasis].

Advanced schistosomiasis, encompassing a wide range of pathologic entities and multi-complications, poses a serious threat on the patients' health. Through comprehensive analysis and evaluation on related aspects regarding clinical classification, main methods of auxiliary examination and treatment (including types of surgical procedure) of advanced schistosomiasis, we think that the individual based multidisciplinary comprehensive treatment according to varying conditions of patients is the most optimal treatment mode of advanced schistosomiasis. It is further proposed that multidisciplinary collaborative diagnosis and treatment system should be undoubtedly established, multidisciplinary case discussions be regularly organized, and treatment expert teams be stably formed, in order to significantly improve the level of diagnosis and treatment of advanced schistosomiasis, so as to reduce the misdiagnosis and improve the therapeutic effect in advanced schistosomiasis control.

[Diagnosis and treatment of imported African schistosomiasis].

This paper summarizes the clinical diagnosis and treatment of imported African schistosomiasis, in order to make the therapeutic standards. Imported African schistosomiasis includes mainly schistosomiasis haematobia and schistosomiasis mansoni in China. In order to set up the operational standards, enhance diagnostic and cure rates, and reduce the complications, we review the related literature combined with our experience over years, and summarize, in this paper, the pathogenic mechanism, and key points of clinical diagnosis and treatment of schistosomiasis haematobia and schistosomiasis mansoni, so as to provide the reference for clinical doctors.