Acute Disease ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nitrites ; poisoning

Objective To learn the burnout and turnover intention of physicians from township hospitals in Xi County,Henan province,for reference of health administrators and healthcare institution managers.Methods Cluster sampling method and qualitative interviews were used and all physicians from such hospitals were sampled for questionnaire survey in 2014,with 1 70 scales distributed.The questionnaire was the Markov Burnout Inventory generic version revised by Li Chaoping,and turnover intention questionnaire was that revised by Liang Kaiguang.Results 140 physicians from such hospitals were found with zero or low burnout (94.6%);Collaborative care in the county poses great positive effect on promoting professionalism and interpersonal relations, yet has limited positive impact on reducing workload and performance appraisal stress and increasing their income.Conclusion It is imperative to enhance training of managers of such hospitals for them to learn the appraisal method with organizational scale,and build a humanistic concern mechanism for physicians,for purposes of improving the organizational environment and minimize the burnout and turnover intention of the physicians.

Objective To compare the clinical features and severity of penetrating thoracoabdominal combined injuries (TACI) and thoracoabdominal multiple injuries (TAMI) so as to guide the diagnosis and management of trauma. Methods A total of 251 cases of penetrating chest trauma complicated by abdominal trauma were reviewed and divided into 2 groups. Group TACI (177 cases) was associated with diaphragmatic rupture but Group TAMI (74 cases) not. The injury features and the clinical characteristics of both groups were analyzed and the trauma severity of 2 groups evaluated by trauma score system. Results The pre-hospital time and the revised trauma score (RTS1) on admission were (1.86?2.27) hours and 6.45?1.64 respectively in the Group TACI, and (2.81?3.98) hours and 6.97?1.18 respectively in the Group TAMI ( P 0.05 ). TACI was easily complicated by injuries of vital organs such as the heart, the thoracic or the abdominal great vessel, the liver and the spleen. TACI was usually very serious and developed quickly. The overall mortality was 7.2% (18/251) of all the cases. The mortality was significantly higher in Group TACI (9.0%, 16/177) than that in Group TAMI (2.7%, 2/74) ( P

Overlapping PCR technology was employed to splice IFN?and HSA genes in vitro. The spliced gene was inserted into Pichia pastoris secretory vector pPIC9K. The IFN?-HSA gene was designed for secretory expression under the control of promoter AOX1 and Mat a signal peptide in pPIC9K. The recombinant plasmid pPIC9K/IFN?-HSA was linearized by restriction enzyme SalI and transformed into Pichia pastoris KM71 by electroporation. The recombinant strains identified by G418 selection and confirmed by PCR analysis were induced by methanol to express fusion protein IFNp-HSA. SDS-PAGE and Western blot analysis of the fusion protein showed that the expressed fusion protein IFNp-HSA with an apparent 90kDa molecular weight had the antigenicity of HSA. The specific activity of culture supernatant was about 640IU/ml assayed by the standard amiviral activity test on WISH cells challenged with VSV virus.

Acupuncture Therapy ; Adult ; Aged ; Failed Back Surgery Syndrome ; therapy ; Female ; Humans ; Male ; Middle Aged

Objective To observe the effects of mechanical ventilation with different tidal volumes (Vt) on the pulmonary surfactant in dogs during cardiopulmonary resuscitation (CPR) and discuss the strategy of mechanical ventilation for CPR.Methods A total of 24 healthy,adult and mongrel canines were randomly (random number) divided into three groups,namely control group (A),low Vt group (B) and high Vt group (C).Canines without ventricular fibrillation in group A were not supported with mechanical ventilation,while canines in group B and group C were induced to get ventricular fibrillation (VF) with pacing catheter inserted through right external carotid vein into the right ventricle.CPR was initiated with mechanical ventilation with different Vt for 6 hours after ventricular fibrillation.The Vt set in group B was 6 ml/kg body weight and Vt set in group C was 20 ml/kg body weight.The arterial blood gas analyses were tested in different intervals.The levels of phosphatidylchline in bronchia alveolus lavage fluid (BALF) was assayed with high performance liquid chromatography (HPLC).The ratio of wet and dry weight and the morphological change scores of lung tissue were calculated.Results After ventricular fibrillation,pH,PaO2 in both groups B and C decreased and PaCO2 increased in comparison with those before VF (P ＜ 0.05),while pH,PaO2 and PaCO2 were improved after mechanical ventilation.These was statistical difference in PaCO2 between group B and group C 2 h after mechanical ventilation (P ＜ 0.05).There was difference in HCO3-between group B and group C 6 h after ROSC.The rate of successful restoration of spontaneous circulation (ROSC) and the 72 h survival rate were 75％ and 50％ respectively in group B,and 62.5％ and 40％ respectively in group C.There were no statistically different between two groups (P ＞ 0.05).The levels of phosphatidylchline in BALF of group B and C greatly decreased compared with the group A (All P ＜0.01),while phosphatidylcholine detected in the group C decreased much more than that in the group B (P ＜0.01).The W/D ratio and morphological change scores in the group C were higher than those in the group B (P ＜ 0.01).Conclusion Low tidal volume ventilation can reduce the loss of pulmonary surfactant and mitigate pulmonary injury.Therefore it may be a protective ventilation strategy after resuscitation.

Response surface analysis (uniform precision of central composite design, SAS 9.1.3 software) was applied to optimize the four major factors (ratio of soybean meal to water, enzyme quantity, fermentation time and inoculation quantity) for soybean meal solid fermentation. According to the change of the hydrolyzation degree of soybean protein, the equation of polynomial regression was established between those factors and the response. The result showed that the optimum condition included as follows: ratio of soybean meal to water 1∶1.00,enzyme quantity 2.55%, fermentation time 65h and inoculation quantity 1.00%. Under the optimum level, the degree of hydrolyzation reached 13.3%, which increased 56% over pre-optimization.

Objective The patients with non-syndromic deafness in Shanxi Province were retrospectively an_alyzed for the common deafness gene mutations and frequency of mutations carrying rate ,to understand the molecu_lar pathogenesis of deafness in Shanxi area .Methods Genomic DNAs of 800 patients of non -syndromic deafness within Shanxi were obtained from peripheral blood .Genes GJB2 ,GJB3 ,SLC26A4 and mitochondrial 12SrRNA 1494 and 1555 loci were sequenced after polymerase chain reaction (PCR) amplification and compared with the NCBI website for the analysis of the formation of mutations .ResuIts Among 800 patients ,353 cases (44 .13% ) showed detected deafness related mutations and the genetic etiology was found for 294 patients (36 .75% ) .Among them , 153 cases (19 .13% ) carried double allele mutations in the GJB2 gene .The most frequent mutation of GJB2 gene was 235delC ,and the carrying rate was 13 .5% (216/1 600) .The double mutant allele of SLC26A4 gene was detec_ted in 123 cases (15 .38% ) ,and the most common mutation was IVS7-2A>G ,identified in 7 .44% (119/1 600) of patients .Homogenic mitochondrial 12S rRNA 1494C> T mutation in one patient and 1555A> G mutation in 15 patients were detected .GJB3 gene c .538C > T heterozygous mutation was found in two patients .Altogether , 36 .75% (294/800) of patients with deafness were caused by gene mutations .ConcIusionThe data containing GJB2 gene and SLC26A4 gene carrying rate are consistent with the published data of non-syndromic deafness in the Northwest region of China ,but the carrying rate of mitochondrial gene mutations is lower than the average level of China .Our data show that the gene mutations contribute to 36 .75% of etiology in patients with deafness .This study reflects the importance of deafness related genes screening in Shanxi area for early diagnosis and genetic con_sultation .

Objective:To analyze the mechanism on integration of health care services at the county and town-ship level from the perspective of stakeholder theory. Methods: The stakeholder interest demand was determined by word frequency analysis of interview data from stakeholders in the three regions of Qianjiang, Huangpi, and Zhen-jiang;the degree of attention and gains and losses of stakeholders towards various demands was investigated from the three regions through interest demand questionnaires;the impact of demand benefits on behavioral responses has been evaluated through comprehensive evaluation theory and game theory. Results:Regional integration policies reflect the interest demands of stakeholders in varying degrees; the higher were the scores of demand benefits in interest de-mands questionnaires, the stronger was the willingness of stakeholders to coordinate integration policies. Conclusion:The policies of integration of health care services in rural China should consider all stakeholder interest demands;the better the interest demands of the stakeholders are satisfied, the stronger their motivation for integration reform will be, which may affect the implementation effects of local integration reforms to some extent.

OBJECTIVE:To establish a HPLC method for the determination of ferulic acid in pedo spleen energy activating Misture.METHODS:The determination was performed on Hypersil ODS column,the mobile phase consisted of1%acetic acid-methanol(70∶30)with a flow rate of0.8ml/min,the column temperature was26℃,the detection wavelength was320nm and the sample size was20?l.RESULTS:Good linear relationship with peak area score was achieved when the detection con?centration range of ferulaic acid was within a range of0.02～1.2mg/ml(r=0.9997),the average recovery was97.88%(RSD=1.19%).CONCLUSION:The method can be served as a quality control for pedo spleen energy activating Misture.