Objective To learn the relationship between job burnout and social support,coping styles among nurses in 120 emergency center.provide basis for nursing management.Methods 64 nurses were surveied in 120 emergency center of Central Hospital of Hengyang,they were investigated by Chinese Maslach B urnoutInventory(CMBI),Social Support Rating Scale (SSRS),Coping Style Questionaire.Results they got lower score in emotion exhaustion and higher score in personal achievement comparee with norm.the discrepancies were statistically significant.Objective support contained in social support was negative correlated with all factors in Job burnout,also the same between availability of support and emotion exhaustion,personal achievement in job burnout,passive coping style was positive correlated with all factors of job burnout.Conclusions nurse in emergency center get higher level in job burnout,lower level in personal achievement,social support and coping style are Influential to job burnout,nursing management enhanced correspondingly.

Objective · To investigate the prevalence of smoking and awareness of smoking hazards in a community-based elderly population in Changning District, Shanghai. Methods · A total of 1809 subjects were randomly selected from 18 communities based on the chronic non-communicable diseases cohort in an elderly population aged 65 and over in Changning District, Shanghai. Information on smoking status, health condition and awareness of smoking hazards were obtained through face to face interviews. Chi-square tests and non-conditional Logistic regression analyses were used to evaluate the risk factors of the awareness of smoking hazards and current smoking status. Results · The overall prevalence of current smoking was 15.6% among the investigated elderly population. Smoking prevalence was significantly higher in men than that in women (30.0% vs 2.1%, P=0.000). Also, it was higher in the men aged 65-69 than that in those aged 70 and over (34.3% vs 20.4%, P=0.000). The participants with middle school education had the highest prevalence (19.1%) in the population. Overall, the proportion of participants who knew "smoking causes heart disease" "smoking causes stroke"and "smoking causes cancer" was 45.1%, 43.3% and 64.4%, respectively. Among the participants, 36.4% knew all the three smoking hazards. With the confounders such as age and gender being adjusted, current smoking behavior was associated with the participants' awareness of smoking hazards (OR=0.74,P=0.000). Conclusion · Currently, the awareness of smoking hazards is generally low in Shanghai elderly population, especially in those with lower education level and current smoking behavior. More targeted educational interventions are necessary in specific population.

Objective To determine the consumption of sugar-sweetened carbonated beverage and juice/fruit-flavored drink among residents aged 15 years and above in 2013 in Shanghai. Methods Data was extracted from the 2013 Shanghai Non-communicable Disease and Risk Factors Surveillance, in which multi-stage cluster sampling was performed.A total of 25 657 subjects aged ≥15 years across the city were selected for analysis. Results In the study, 34.42% (95%CI:32.33%-36.51%) and 37.85% (95%CI:35.37%-40.32%) of the subjects consumed sugar-sweetened carbonated beverage and juice/fruit-flavored drink in 2013 in Shanghai.The proportions declined with age (P for trend < 0.001), while increased with education level (P for trend < 0.001).They were 65.28% and 69.82% among students, which were much higher than other occupations.Men consumed more sugar-sweetened carbonated beverage than women (37.31% vs 31.37%), whereas less juice/fruit-flavored drink (36.14% vs 39.65%).Among the subjects consumed sugar-sweetened carbonated beverage (n=6 254) or juice/fruit-flavored drink (n=6 701), 52.20% (95%CI:49.41%-54.98%) and 54.04% (95%CI:51.09%-56.98%) consumed 1-3 times a week.The daily average amount of sugar-sweetened carbonated beverage and juice/fruit-flavored drink were 98.64 mL (95%CI:88.92-108.37) and 88.85 mL (95%CI:73.73-103.97), respectively, which were higher among the young (< 45 years old), male and students. Conclusion In 2013 in Shanghai, the consumption of sugar-sweetened carbonated beverage and juice/fruit-flavored drink is highly prevalent among residents aged 15 years and above, especially among the young, male, well-educated and students.Intervention should be tailored to reduce the consumption among at-risk population.

Objective To explore the heterosexual intercourse characteristics and its influencing factors among MSM population. Methods Voluntary counseling/testing and questionnaire survey were carried out at the bathhouses where MSM usually assemble. Results Among 342 MSM surveyed,52. 05% were married. 76 people( 22. 22%) were completely homosexual,while 266 people(77. 78%)were bisexual. 24(31. 57%)MSM who answered″ totally gay″ in self-assessment of sex orientation were married,significantly lower than those answered bisexual(57. 89%)(p<0. 05). 197 of participants had sex with women ,and 123 MSM had sex with women during the last six months,49 MSM of which used condoms at each heterosexual activity. MSM who were married or bisexual were easy to have heterosexual intercourse. Among the MSM surveyed,the HIV and syphilis infection rates were 11. 40% and 16. 67% respectively. There was no significant difference between the use of condoms and infection( both p>0. 05). In the recent six months,there was no significant difference in the use of condoms between infected( 43. 34%)and non-infected persons( 43. 34%)( p >0. 05). Conclusion Among MSM population,the prevalence of heterosexual intercourse is high,while condom use rate is relatively low. It is necessary to strengthen the behavioral intervention and promote condom use.

[Objective] To explore whether the triglyceride level is associated with incidence of acute kidney injury in patients with acute pancreatitis. [Methods] From Jan 2015 to March 2017, 184 patients with acute pancreatitis were selected and divided in to 3 groups based on different triglyceride levels: ideal triglyceride group (n = 89) , mild high triglyceride group (n = 53) and severe high triglyceride group (n =42). The incidence of acute kidney injury and its severity were compared between the three groups.[Results]The incidence of acute kidney injury in severe high triglyceride group was 33.3％, significantly higher than that in ideal triglyceride group (12.3％). The surgical treatment (16.7％ vs 4.5％) , average hospitalization days (20 days vs 14 days) and systemic inflammatory response syndrome score (3.0 vs2.3) in severe high triglyceride group were higher than those in ideal triglyceride group, and all differences between the two groups were significant. After adjusting for factors such as age, sex, body mass index and other confounders, the risk of acute kidney injury occurring in severe high triglyceride group was 2.35 times that in ideal triglyceride group (95％CI: 1.32-4.29). [Conclusion] High triglyceride level proves to be associated with high risk of acute kidney injury in patients with acute pancreatitis.

BACKGROUNDPleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts is a rare soft tissue tumor, which is generally considered low-grade. To distinguish the tumor from other soft tissue lesions, we analyzed the clinicopathologic and ultrastructural features, immunophenotypes, and flow cytometric DNA ploidy of PHAT in 9 cases.

METHODSPHAT specimens were collected from 9 patients with PHAT from 1990 to 2004. Each specimen was cut into pieces and stained with hematoxylin-eosin, phosphotungstic acid-hematoxylin, Prussian blue, and Masson trichrome, respectively. Immunohistochemical stains for vimentin, S-100 protein, CD34, CD31, CD99, VEGF, desmin, CD117, alpha-SMA, and MIB-1 were performed with the Envision system. Flow cytometry was used in four specimens, two of which were observed by electron microscopy.

RESULTSIn the 9 cases, the PHAT occurred at the lower extremity in 2 patients, inguinal in 2, waist in 1, forearm in 1, buttock in 1, foot in 1, and the chest wall in 1. All the lesions presented in the superficial subcutaneous tissues. Follow-up data were available in 7 of the patients, among whom 2 (28.6%) had recurrence after primary therapy. Microscopically, typical PHAT was characterized by sheet-like proliferation of spindle or pleomorphic cells and clusters of thin-walled hyalinized cstatic vessels. In some areas of the tumor, hemosiderin-laden spindle cells, numerous small single vessels, and myxoid extracellular matrix could be identified, indicating an "atypical PHAT". Mitotic figures were rare in all the cases. In 5 of the 9 patients (55.6%), the tumor was typical PHAT; and in the other 4 (44.4%), typical and atypical PHAT coexisted. Immunohistochemically, the neoplastic cells were positive for vimentin, CD34, CD99, and VEGF, but negative for S-100 protein, desmin, SMA, and CD31. In all the cases, the MIB-1 proliferative activity of the neoplastic cells was lower than 2%. Ultrastructural analysis did not reveal any evidence of specific differentiation. Aneuploidy was not detected by flow cytometry.

CONCLUSIONSHistologically, typical PHAT is characterized by spindle and pleomorphic cells associated with an angiectatic vasculature. The neoplastic cells often express vimentin and CD34, and may be positive for CD99 and VEGF. Ultrastructurally, the tumor usually has no specific differentiation. The low MIB-1 index and the absence of aneuploidy in PHAT indicate a non-malignancy. However, we consider the tumor as a borderline neoplasm because of its aggressive behaviour, and suggest wide local resection with tumor-free margin for the treatment of the disease.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Diagnosis, Differential ; Female ; Flow Cytometry ; Humans ; Hyalin ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; Soft Tissue Neoplasms ; diagnosis ; pathology ; therapy ; ultrastructure

Objective To make assessment on construction effectiveness of the first batch of national chronic disease comprehensive control and prevention demonstration areas (NCD demonstration areas) in Shanghai, summarizing NCD experience and its characteristics, so as to provide reference for other regions. Methods Data were collected and analysed concerning construction of health support environment and regional characteristics of the six districts-Xuhui, Jing′an, Minhang, Jiading, Songjiang and Qingpu.Descriptive data from Shanghai Non-communicable Diseases and Risk Factors Surveillance in 2013 and 2017 was also analyzed for evaluation. Results It was noted that health support environment had been in continuous construction.The total number of health units increased by 1 502 as compared with pre-construction.The number of new type health units increased by 489 such as health theme parks, health trails and health huts.All six districts established self-help health test points covering all streets and towns.Residents′ living and behavior styles were improved, as there was a decrease in current smoking rate, oil intake and salt intake in the six NCD demonstration areas.In Xuhui, Minhang and Jiading three districts, the current smoking rate among residents over 18 years old remarkably declined.In five of the six districts, the average daily oil intake per family member was significantly reduced and so was the average daily salt intake per family member in the six districts.In addition, the six demonstration areas in Shanghai explored several models of NCD prevention and control in line with regional characteristics, which produced positive results. Conclusion The first batch of demonstration areas of Shanghai have achieved effective results in aspects of environmental support and health effects.The modes of NCD prevention and control in different districts present their regional characteristics, which provide significant reference for other regions of Shanghai in this regard.

Esophageal squamous cell carcinoma(ESCC)is a major histological subtype of esopha-geal cancer with a poor prognosis.Although several serum metabolomic investigations have been reported,ESCC tumor-associated metabolic alterations and predictive biomarkers in sera have not been defined.Here,we enrolled 34 treatment-naive patients with ESCC and collected their pre-and post-esophagectomy sera together with the sera from 34 healthy volunteers for a metabo-lomic survey.Our comprehensive analysis identified ESCC tumor-associated metabolic alterations as represented by a panel of 12 serum metabolites.Notably,postoperative abrosia and parenteral nutrition substantially perturbed the serum metabolome.Furthermore,we performed an examina-tion using sera from carcinogen-induced mice at the dysplasia and ESCC stages and identified three ESCC tumor-associated metabolites conserved between mice and humans.Notably,among these metabolites,the level of pipecolic acid was observed to be progressively increased in mouse sera from dysplasia to cancerization,and it could be used to accurately discriminate between mice at the dysplasia stage and healthy control mice.Furthermore,this metabolite is essential for ESCC cells to restrain oxidative stress-induced DNA damage and cell proliferation arrest.Together,this study revealed a panel of 12 ESCC tumor-associated serum metabolites with potential for monitor-ing therapeutic efficacy and disease relapse,presented evidence for refining parenteral nutrition composition,and highlighted serum pipecolic acid as an attractive biomarker for predicting ESCC tumorigenesis.

Objective This paper intends to compare the efficacy and safety of high-dose dual regimens containing Vonoprazan and proton pump inhibitor in patients infected with Helicobacter pylori(H.pylori).Methods A prospective randomized controlled study was conducted.According to inclusion and exclusion criteria.,243 patients with H.pylori infection admitted to the Department of Gastroenterology,the First Hospital of Lanzhou University from February 2023 to December 2023 were enrolled as the research objects.They were randomly divided into two groups.The high-dose dual therapy containing Vonoprazan group(VPZ-HDDT group)was given Vonoprazan fumarate tablet 20mg twice daily plus amoxicillin 750 mg four times daily for 14 days and the high-dose combination group containing PPI(PPI-HDDT group)was given esomeprazole 40 mg twice daily plus amoxicillin 750 mg four times daily for 14 days.Patients were followed up and recorded by telephone or WeChat on the 7th and 14th day of starting treatment for drug intake and occurrence of adverse reactions.Patients were instructed to recheck the 13C or 14C urea breath test at least 1 month after the end of medication.Treatment by protocol(PP)analysis,modified intention to treat(mITT)and intention-to-treat(ITT)analysis were used for H.pylori eradication rates in both groups,and compliance and incidence of adverse reactions were compared between the two groups.Results The eradication rates of the VPZ-HDDT group and the PPI-HDDT group in the initial treatment were 94.0％and 88.5％(P=0.209)by PP analysis,and 91.8％and 87.5％(P=0.358)86.7％by mITT analysis,and 81.9％(P=0.377)by ITT analysis,respectively.In the retreated patients,the PP analysis and mITT analysis eradication rates in these two groups were consistent,87.0％and 84.2％(P=0.800),respectively,and 83.3％and 76.2％(P=0.550)by ITT analysis.For the refractory H.pylori patients,the PP analysis and mITT analysis eradication rates in these two groups were also consistent,71.4％and 50.0％(P=0.429),and the eradication rates of ITT analysis were 62.5％and 50.0％(P=0.640),respectively.In different stratifications,the eradication rates of the VPZ-HDDT group were higher than those of the PPI-HDDT group,but the differences were not statistically significant.The incidence of adverse reactions and compliance of the VPZ-HDDT group and the PPI-HDDT group were similar,with no statistically significant differences.Conclusion Both two combination regimens can achieve clinically acceptable eradication rates(＞85％)in the first-time treatment patients.For the retreated and refractory patients,the choice of vonoprazan is more beneficial.

The current research status of different structures,driving modes and training modes of hand rehabilitation robots at home and abroad was introduced.The disadvantages of the existing hand rehabilitation robots were analyzed.It's pointed out hand rehabilitation robots in the future would involve in the combination of rigid and flexible wearing,new intelligent driving mode and multi-mode rehabilitation training.[Chinese Medical Equipment Journal,2024,45(11):88-96]