Policy background and stakeholder theory were elaborated.It could be concluded that the key stakeholders of the policy were residents,training hospitals,healthcare administrators,primary healthcare institutions and patients of such institutions.Through analysis of these stakeholders,effects on the interests of all parties were investigated and strategies to improve feasibility of the policy were put forward.Two key points were suggested for such policy goals.First,top-level policies should be designed and be effectively implemented.Second,conversion of the residents from permanent hospital employees to “contractors”or“ freelancers”.

Objective To analyze the feasibility of the policy that “Residents service or employment at primary care institutions after standardized training”.Methods Analyzing the feasibility of this policy by using questionnaire survey and in-depth interview.Results Constituent ratios of overall feasibility were 58.3％ (532/912)and 66.1％(603/912)for specialist and general practitioner respectively; percentage of feasibility of in-depth interview was 46.7％ (7/15).Conclusion The policy has feasibility,if government formulates and implements perfect complement policies effectively,and makes this policy to be impassable stage to resident.

To study the effects of the anthocyanin single component cyanidin-3-O-glucoside (Cy-3-glu) on the proliferation and migration of mouse melanoma cells and to elucidate the underlying mechanisms, B16-F10 cells were treated with different concentrations of Cy-3-glu. Cell viability was analyzed by a CCK-8 method. Cell migration was determined by the callus scratching technique. Cell cycle was measured by the flow cytometry. The expression levels of genes involved in cell cycle regulation were detected by real-time PCR. Protein expression levels of p-AKT, E-cadherin, N-cadherin and vimentin were analyzed by Western blot. The growth and migration of B16-F10 cells in C57BL/6J mice were monitored by the cryogenically cooled IVIS-imaging system. The results showed that Cy-3-glu significantly inhibited the growth (P < 0.001) and migration (P < 0.01) of B16-F10 cells, and arrested the cell cycle in the S phase. After Cy-3-glu treatment, the expression levels of p-AKT (P < 0.05), N-cadherin and vimentin (P < 0.001) were decreased significantly, and the expression level of E-cadherin was dramatically increased (P < 0.05). The size and weight of tumors and tumor metastasis in mice fed with a diet containing Cy-3-glu were significantly reduced (P < 0.05). In conclusion, Cy-3-glu inhibits proliferation and migration of B16-F10 cells by inhibiting the PI3K/AKT signaling pathway, cell adhesion and migration signals.
Animals ; Anthocyanins ; chemistry ; pharmacology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Glucosides ; pharmacology ; Melanoma, Experimental ; Mice ; Mice, Inbred C57BL ; Phosphatidylinositol 3-Kinases ; metabolism

OBJECTIVETo explore the risk factors and their differences of metabolic syndrome (MS) on male criminal police, thereby provide the scientific basis to make prevention and control strategies about the metabolic syndrome for the criminal police career.

METHODSBased on physical examination data of criminal police in 2010, 439 patients with MS (CDS) were randomly selected as cases. And as the 1:2 matched nested case-control study, 878 health controls were employed, which were matched with on the basis of sex and age (±1 year). An face-to-face epidemiological investigations on the past exposure status of several possible risk factors was conducted, such as the family history of hypertension and other social economic status, as well as body height and weight, waist circumference, blood pressure, serum lipid and plasma sugar. and the data were analyzed with logistic regression.

RESULTS1317 cases were surveyed, through single factor logistic regression analysis found that 12 factors are related to exposure. Multivariate logistic regression analysis suggested that six factors, such as stress events (OR = 1.989, 95%CI: 1.467∼2.696), snoring (OR = 1.672, 95%CI: 1.218∼2.294), sweets (OR = 0.562, 95%CI: 0.412∼0.766), meat and products (OR = 1.494, 95%CI: 1.065∼2.094), siting after dinner for more than 3 h (OR = 1.399, 95%CI: 1.023∼1.915).

CONCLUSIONSMS has become a important public health problems among criminal police. For their professional special, a series of bad habits , unhealthy life style and psychological problems became important risk factors of MS on criminal police. Targeted prevention and control measures should be taken to reduce the incidence of MS.

Adult ; Case-Control Studies ; Humans ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Occupations ; Police ; Risk Factors

[Objective]To explore the clinical application of Danggui Beimu Kushen Pill in tumor from the pathogenesis of phlegm-stasis-toxin.[Methods]Based on the relevant discussion of Lingshu,the important pathogenesis of tumor occurrence and development was discussed.Meanwhile,the mechanism of formulation of Danggui Beimu Kushen Pill was deconstructed on the basis of the pathogenesis of phlegm,stasis and poison,and related clinical cases were listed.[Results]The pathogenesis of ma-lignant tumor was"no phlegm stasis,no shape"and"no toxic evil,no malignancy".The formulation principle of Danggui Beimu Kushen Pill was the method of eliminating phlegm and removing stasis and detoxifying.Two cases were examplifed,the patient in case 1 was prostate cancer after adverse urination,because the patient had the body of phlegm stasis for a long time,after the operation,the collaterals were more damaged with phlegm stasis stagnation and adverse gasification,so Danggui Beimu Kushen Pill was used to remove phlegm and stasis,added with diuretic products for cure;In case 2,the patient had the whole urine blood due to the rupture of the advanced tumor lesion of kidney cancer,because the patient had phlegm and poison glued together,the pulse was warm,resulting in kidney collateral injury and forced blood overflow,so Danggui Beimu Kushen Pill and Xijiao Dihuang Soup were used to clear heat and free strangury,and cool the blood to stop bleeding.[Conclusion]De-constructing Danggui Beimu Kushen Pill from the pathogenesis of"phlegm-stasis-toxin"can better understand the decoction and apply it in tumor clinic.

Objective: To explore the treatment plan for severe papillary defects in the aesthetic zone caused by severe periodontitis, providing a reference for clinical practice. Methods : A patient with severe periodontitis leading to severe papillary defects in the upper anterior teeth from 12 to 23 was treated using interdental tunnel technique combined with personalized connective tissue grafting for periodontal plastic surgery, and stable soft tissue augmentation was achieved. Resin restoration was conducted to modify the crown shape of the aesthetic zone teeth, reconstruct white aesthetics, guide the shaping of the gingival papillae, reduce “black triangles,” and enhance the patient’s confidence in smiling. Results : The patient’s periodontal condition and the regeneration of soft tissues in the aesthetic zone were good, and the smile aesthetics were restored. After a 3-year follow-up, the gingival morphology, color, and texture were good, and the effect was stable. The literature review indicates that for papillary defects in the aesthetic zone, analysis should be conducted based on the following aspects: whether a defect is present in periodontal hard and soft tissues, crown shape, and the distance from the most apical part of the crown contact area to the top of the alveolar crest. Based on the analysis of aesthetic defects and surgical indications, a personalized treatment plan should be designed. Conclusion For patients with obvious papillary defects in the aesthetic zone due to the reduction of periodontal support tissues caused by severe periodontitis, factors such as periodontal hard and soft tissue defects, crown shape, and the distance from the most apical part of the crown contact area to the top of the alveolar crest should be fully considered, and a personalized treatment plan should be formulated after multidisciplinary joint consultation.

Objective:To investigate the clinical efficacy of humidified high flow nasal cannula oxygen inhalation (HFNC) versus conventional nasal cannula oxygen inhalation on hypoxemia after complex ventral hernia surgery in elderly patients.Methods:The retrospective cohort study was conducted. The clinical data of 80 elderly patients with hypoxemia after complex ventral hernia surgery who were admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to June 2022 were collected. There were 44 males and 36 females, aged (74±7)years. Of the 80 patients, 40 cases undergoing HFNC were allocated into HFNC group, and 40 cases undergoing conventional nasal cannula oxygen inhalation were allocated into conventional group, respectively. Observation indicators: (1) postoperative blood gas analysis; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were represented as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Postoperative blood gas analysis. Before surgery and at 12 hours, 24 hours, 3 days after surgery, the partial pressure of blood oxygen was (13.5±2.3)kPa, (13.4±3.2)kPa, (13.8±2.3)kPa, (13.7±2.0)kPa for the HFNC group, and (12.7±2.1)kPa, (12.9±2.4)kPa, (12.3±2.5)kPa, (13.9±2.1) kPa for the conventional group. The partial pressure of carbon dioxide was (5.6±0.7)kPa, (5.0±0.6)kPa, (4.7±0.6)kPa, (4.9±0.6)kPa for the HFNC group, and (5.6±0.6)kPa, (4.4±0.8)kPa, (5.0±4.8)kPa, (5.1±1.1)kPa for the conventional group. The saturation of blood oxygen was 97.8%±2.2%, 98.1%±2.1%, 98.9%±1.8%, 99.2%±2.0% for the HFNC group, and 97.8%±3.1%, 97.8%±2.1%, 99.0%±1.5%, 98.8%±2.0% for the conventional group. The oxygenation index was 259±28, 300±45, 352±46, 353±57 for the HFNC group, and 262±29, 297±54, 304±63, 345±53 for the conventional group, respectively. There was a significant difference in the interven-tion effect of partial pressure of blood oxygen between the two groups ( Fgroup=4.09, P<0.05) and no significant difference in the time effect or interaction effect ( Ftime=2.37, Finteraction=1.71, P>0.05). There were significant differences in the time effect and interaction effect of partial pressure of carbon dioxide between the two groups ( Ftime=7.23, Finteraction=13.21, P<0.05) and no significant difference in the intervention effect ( Fgroup=1.02, P>0.05). There was a significant difference in the time effect of saturation of blood oxygen between the two groups ( Ftime=5.54, P<0.05) and no significant difference in the intervention effect or interaction effect ( Fgroup=1.78, Finteraction=0.46, P>0.05). There were signifi-cant differences in the intervention effect, time effect, interaction effect of oxygenation index between the two groups ( Fgroup=8.21, Ftime=42.07, Finteraction=3.49, P<0.05). (2) Postoperative complications. The time in intensive care unit and cases with pulmonary infection were 3(3,3)days and 3 for the HFNC group, versus 6(5,7)days and 10 for the conventional group, showing significant differences between the two groups ( Z=27.50, χ2=4.50, P<0.05). Cases with atelectasis and endotrachead intubation were 0 and 1 for the HFNC group, versus 4 and 7 for the conventional group, showing no significant difference between the two groups ( P>0.05). There was no death in either group. Conclusion:Humidified high flow oxygen inhalation has certain advantages over conventional nasal cannula oxygen inhalation in improving partial pressure of blood oxygen and oxygenation index after complex ventral hernia surgery in elderly patients.

Objective: To examine the patterning cropped and shaped mesh repair for perineal hernia after abdominoperineal excision (APE) in rectal cancer. Methods: The clinical data of 8 patients with perineal hernia after APE who accepted surgical treatment in the Department of Hepatopancreatobiliary and Hernia Surgery, the First Affiliated Hospital of Fujian Medical University from March 2017 to December 2022 were retrospectively reviewed. There were 3 males and 5 females, aged (67.6±7.2) years (range: 56 to 76 years). Eight patients developed a perineal mass at (11.3±2.9) months (range: 5 to 13 months) after APE. After surgical separation of adhesion and exposing the pelvic floor defect, a 15 cm×20 cm anti-adhesion mesh was fashioned as a three-dimensional pocket shape to fit the pelvic defect, then fixed to the promontory or sacrum and sutured to the pelvic sidewalls and the anterior peritoneum, while two side slender slings were tailored in front of the mesh and fixed on the pectineal ligament. Results: The repair of their perineal hernias went well, with an operating time of (240.6±48.8) minutes (range: 155 to 300 minutes). Five patients underwent laparotomy, 3 patients tried laparoscopic surgery first and then transferred to laparotomy combined with the perineal approach. Intraoperative bowel injury was observed in 3 patients. All patients did not have an intestinal fistula, bleeding occurred. No reoperation was performed and their preoperative symptoms improved significantly. The postoperative hospital stay was (13.5±2.9) days (range: 7 to 17 days) and two patients had postoperative ileus, which improved after conservative treatment. Two patients had a postoperative perineal hernia sac effusion, one of them underwent placement of a tube to puncture the hernia sac effusion due to infection, and continued irrigation and drainage. The postoperative follow-up was (34.8±14.0) months (range: 13 to 48 months), and 1 patient developed recurrence in the seventh postoperative month, no further surgery was performed. Conclusions: Surgical repair of the perineal hernia after APE can be preferred transabdominal approach, routine application of laparoscopy is not recommended, combined abdominoperineal approach can be considered if necessary. The perineal hernia after APE can be repaired safely and effectively using the described technique of patterning cropped and shaped mesh repair.
Male ; Female ; Humans ; Animals ; Herniorrhaphy/methods* ; Surgical Mesh ; Retrospective Studies ; Hernia, Abdominal/surgery* ; Hernia ; Rectal Neoplasms/surgery* ; Proctectomy ; Laparoscopy ; Perineum/surgery* ; Postoperative Complications ; Incisional Hernia/surgery* ; Hominidae

Compensatory hyperhidrosis (CH) is a severe side effect that occurs after endoscopic thoracic sympathotomy (ETS) for the treatment of palmar hyperhidrosis. CH significantly interferes with daily activities such as work, study, and social interactions, leading to a substantial decrease in the quality of life for patients. Preventing and treating CH are currently important and challenging issues in minimally invasive surgery for palmar hyperhidrosis. In this report, we presented a 29-year-old male patient who experienced severe CH for 8 years following ETS. The patient underwent staged unilateral endoscopic expanded sympathotomy (ES) at our hospital on December 11, 2023 and January 3, 2024, targeting the R4-R10 levels. After a 3-month follow-up, the patient experienced significant improvement in clinical symptoms and quality of life, with no recurrence of palmar hyperhidrosis or other complications. The treatment outcome was satisfactory.

Endoscopic thoracic sympathicotomy/sympathotomy (ETS) is the first-line treatment for palmar hyperhidrosis with best minimally invasive effect. In recent years, with the widespread development of ETS in the treatment of palmar hyperhidrosis, many medical centers list ETS surgery as the day surgery. Nevertheless, there is no expert consensus on medical quality control of day surgery for ETS yet. Therefore, the Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee, Sympathetic Neurosurgery Expert Committee of WU Jieping Medical Foundation, and Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee organized domestic experts to conduct repeated consultations and sufficient discussions based on domestic and foreign literatures, to formulate the "Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis". It aims to provide a reference for the clinical diagnosis and treatment of palmar hyperhidrosis for thoracic surgery colleagues in our country, to enhance their management level and work efficiency, and ultimately to achieve standardized quality control.