Objective To learn the current status of job burnout and influencing factors for nurses from infectious disease hospital.Methods The Chinese version MBI -HSS was used to survey 218 nurses from infectious disease hospital,and linear regression was used to analyze the influencing facters of job burnout.Results A total of 210 questionairs were cocleted.The incidence of severe occupational job burnout was 22.38%,and the score of emotional exhaustion (EE), depersonalization (DP),personal accomplishment (PA)was(22.82 ±9.98),(6.48 ±5.20),and (35.20 ±8.82), respectively.Regression analysis demonstrated that the main influencing factors were entering the isolation ward, opportunity for infectious diseases ,disinfection damage,fear of occupational exposure and concern on family infection(P <0.05).Conclusion The status of job burnout of nurses in infectious disease hospital is not optimistic.There is a positive relationship with the working environment,occupational exposure.Managers need to explore an effective way to ease the job burnout of nurses,and to stabilize the nursing team.

Objective To assess the effect of ursodeoxycholic acid on postoperative outcomes in biliary atresia (BA) patient undergoing Kasai procedure.Methods Correlative english articles published until Jun.2013 were searched by computer in Medline (PubMed),EMBASE,Cochrane library,Wanfang Database,China Knowledge Resource Integrated Database and China Biology Medicine Database,the output articles were screened according to inclusion and exclusion criteria.The selected articles were evaluated with the of Review Manager 5.2 software.Results Nine articles were obtained,but only 4 articles were included,including 284 patients with BA were conformed to the inclusion and exclusion criteria.The sensitivity analysis indicated that the total effective rate in ursodeoxycholic acid group was superior to that in the control group,and the difference between the 2 groups was notable significant (OR =7.24,95 ％ CI:2.42-21.68,Z =3.55,P =0.0004).There was no significant difference between ursodeoxycholic acid group and control group in the effect of ursodeoxycholic acid on outcome of patients who had BA(OR =5.50,95％ CI:0.96-31.64 ; Z =1.91,P =0.06).Conclusions Ursodeoxycholic acid has certain effect on alleviating jaundice after Kasai procedure,but it has no advantage on improving the long outcomes as comparison with control group.

Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.

OBJECTIVETo investigate the relationship of pre-pregnancy body weight, gestational weight gain and postpartum weight retention among women in Beijing.

METHODSUsing a cohort design, 600 pregnant women who went to district obstetrics and gynecology hospital in Beijing to establish preconception health care card from 5(th) February to 15(th) March 2009 were recruited. A total of 112 subjects (109 with valid data), 20% of that in baseline, were followed up at 6 months after delivery.70 subjects (66 with valid data) were followed up at one year after delivery. Weight, weight changes and postpartum weight retention were measured for low weight (BMI < 18.5 kg/m(2)), normal weight (18.5 kg/m(2) ≤ BMI ≤ 24.0 kg/m(2)) and overweight or obesity (BMI > 24.0 kg/m(2)) group.

RESULTSThe pre-pregnancy weight and antenatal weight were (54.8 ± 8.0) and (70.8 ± 9.3) kg respectively. Gestational weight gain was (16.0 ± 7.0) kg. The postpartum weight of 6 and 12 months were (60.5 ± 9.4) and (57.6 ± 8.6) kg respectively. Comparing to pre-pregnancy, postpartum weight retention in 6 months and 12 months were (5.7 ± 4.5) and (2.7 ± 4.5) kg, weight retention rates were (10.6 ± 8.6)% and (5.2 ± 9.3)%. Antenatal weight among low pre-pregnancy weight group, normal weight and overweight and obese women were (62.6 ± 5.7), (69.9 ± 6.6) and (84.2 ± 9.9) kg, and weight at postpartum 12 months among 3 groups were (49.3 ± 3.2), (56.5 ± 6.9) and (70.5 ± 6.0) kg respectively (F = 25.3, P < 0.01); At postpartum 12 months, low pre-pregnancy weight group ((5.6 ± 5.9) kg), overweight and obese women group ((4.7 ± 1.9) kg) postpartum weight retention was significantly higher than that of the normal weight group ((1.8 ± 4.3) kg) (F = 3.82, P < 0.05).

CONCLUSIONThe pre-pregnancy body weight is a key risk factor in weight gain during pregnancy and postpartum weight retention.

Adult ; Body Mass Index ; China ; Female ; Humans ; Overweight ; Postpartum Period ; Pregnancy ; Pregnancy Complications ; Risk Factors ; Weight Gain ; Young Adult

OBJECTIVETo evaluate the clinical effect of endotracheal lavage with porcine pulmonary surfactant (PS) in term neonates with severe meconium aspiration syndrome (MAS).

METHODSA total of 136 full-term infants with severe MAS who were admitted to the neonatal intensive care unit between January 2010 and June 2013 were randomly and equally divided into PS lavage and PS injection groups. In the PS lavage group, patients were treated with endotracheal lavage using 3-5 mL of diluted PS (12 mg/mL) each time, and the PS injection group was given PS by intratracheal injection at the first dose of 200 mg/kg. Blood gas, oxygenation index (OI), and PaO2/FiO2 (P/F) of the two groups were evaluated before and 2, 12, 24, and 48 hours after the treatment, and the duration of mechanical ventilation, complication rate, and cure rate were compared between the two groups.

RESULTSCompared with the PS injection group, the PS lavage group had significantly higher PaO2 and P/F ration and significantly lower PaCO2 and OI at 12, 24, and 48 hours post-treatment (P<0.01), a significantly shorter duration of mechanical ventilation (P<0.01), a significantly smaller amount of PS (P<0.01), a significantly lower complication rate (P<0.05), and a significantly higher cure rate (97% vs 88%; P<0.05).

CONCLUSIONSCompared with the intratracheal injection of PS, endotracheal lavage with diluted PS in term neonates with severe MAS can increase ventilation and oxygenation efficiency, shorten the duration of mechanical ventilation, reduce the complication rate, and increase the cure rate, indicating that this method is a safe and effective therapeutic strategy.

Animals ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; drug therapy ; Pulmonary Surfactants ; administration & dosage ; Swine ; Therapeutic Irrigation ; Trachea

Objective To observe the effect of human β-defensin-3 (HBD-3) on proliferation and the secretion of prostaglandin E2(PGE2) and matrix metalloproteinase-1 (MMP-1) in human gingival fibroblasts(HGF).Methods The HGF were cultured with tissue-explant method and the fourth-generation HGF were plated in 96-well plate.All groups except the control group were treated with different concentrations of HBD-3 for 7 days.Then the HGF proliferation was evaluated with methyl thiazolyl tetrazolium(MTT) colorimetry and the secretions of PGE2 and MMP-1 at the 12th hours of each group were detected by enzyme-linked immunosorbent assay(ELISA).Results The result of MTT dynamic monitoring showed that the amount of HGF increased with time in all groups in concentration dependent manner.ELISA showed that the secretions of PGE2 and MMP-1 in 1.0 mg/L HBD-3 group were (350.56 ± 63.96) ng/L and (13.22 ±0.59) μg/L,significantly higher than those in the control group and 10.0 mg/L HBD-3 group (P ＜ 0.05).Conclusions HBD-3 promoted the proliferation of HGF.The low concentration of HBD-3 may play a role in immunoregulation through increasing the secretions of PGE2 and MMP-1.

BACKGROUND AND OBJECTIVECT-guided microwave coagulation is a minimally invasive surgery for patients with liver cancer. Total intravenous anesthesia with propofol and fentanyl is commonly used. The depth of anesthesia during microwave coagulation for liver cancer is still monitored by clinical signs. There are few subjective and effective indicators. This study explored the application of Narcotrend-assisted "depth of anesthesia" monitoring on microwave coagulation for patients with liver cancer during total intravenous anesthesia with propofol and fentanyl.

METHODSForty liver cancer patients underwent CT-guided microwave coagulation were randomly assigned to receive Narcotrend index monitoring or standard clinical monitoring for depth of anesthesia with 20 patients in each group. All patients received total intravenous anesthesia with propofol and fentanyl. The depth of anesthesia for patients in the Narcotrend group was measured according to a Narcotrend index, which was maintained between D2 and E0. The depth of anesthesia for those in the standard clinical practice group was measured according to heart rate, mean arterial pressure, and patient movement. Changes of hemodynamics, the duration of the emergence from anesthesia, and the recovery of orientation were recorded. The doses of propofol and fentanyl, postoperative visual analogue scores (VAS), and the incidence of postoperative nausea and vomiting were also recorded.

RESULTSThere was no significant alteration in heart rate or mean arterial pressure between the two groups. Compared with other anesthetic stages, both heart rate and mean arterial pressure decreased during the induction of the anesthesia in the two groups(P<0.05). The doses of propofol were higher in the standard clinical practice group than in the Narcotrend group [(460+/-30) mg vs. (380+/-35) mg, P<0.01]. The duration of emergence and orientation were longer in the standard clinical practice group than in the Narcotrend group [(9.5+/-2.9) min vs. (4.9+/-2.2) min, P<0.01; (12.2+/-3.5) min vs. (6.6+/-3.2) min, P<0.01, respectively]. There was no difference in the dosage of fentanyl, VAS, or the incidence of postoperative nausea or vomiting between the two groups (P>0.05).

CONCLUSIONFor patients with liver cancer, monitoring the depth of anesthesia with Narcotrend on microwave coagulation can contribute to lower dosage of propofol and shorten duration of recovery during total intravenous anesthesia with propofol and fentanyl.

Adult ; Aged ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; administration & dosage ; Electrocoagulation ; methods ; Fentanyl ; administration & dosage ; Hemodynamics ; Humans ; Liver Neoplasms ; surgery ; Male ; Microwaves ; Middle Aged ; Monitoring, Intraoperative ; instrumentation ; methods ; Propofol ; administration & dosage ; Tomography, X-Ray Computed

Objective To master the Keshan disease situation, guide and evaluate Keshan disease control work scientifically, and consolidate the control achievements in Ganquan County of Shannxi Province. Methods According to the scheme of National Keshan Disease Surveillance, the residents were surveyed including the case history, blood-pressure, electrocardiogram and X-ray examinations for chronic and suspected cases. Levels of selenium in hair and grain were determined by the diaminonaphthalene method. Results Twenty latent and one chronic Keshan disease patients were detected, accounting for 2.67% (20/749) and 0.13% (1/749), respectively, of surveyed residents in Leoshan Village. Electrocardiography showed abnormalities in 82 of the 749 surveyed individuals(10.95%). The heart-chest ratio was increased in seven of 16 chronic or suspected Keshan disease patients. The content of selenium in hair, wheat and millet was (0.335±0.102), (0.045±0.019), (0.029±0.017)mg/kg, respectively. Conclusions Keshan disease prevalence showed a stable and decreasing tendency due to the general control measures, especially supplementation of selenium in food in Ganquan County. No acute or subacute Keshan disease occurred. Currently, latent and chronic Keshan diseases are the main types of Keshan disease.

Objective:To investigate the safety,efficacy,and prognosis of high-dose melphalan in combination with autologous hematopoietic stem cell transplantation (ASCT) for the treatment of multiple myeloma (MM). Methods:The clinical data of 17 patients with newly diagnosed MM who underwent ASCT as first-line consolidation therapy at the Yijishan Hospital of Wannan Medical College from March 2020 to October 2022 were retrospectively analyzed. The safety,efficacy,and prognosis of this treatment approach were evaluated. Results:Of the 17 patients,10 were male and 7 were female,with a median age of 56 (45-64) years. The stem cell engraftment rate was 100％,with a median neutrophil engraftment time of+10 (9-12) days and a median platelet engraftment time of+12 (10-21) days. The incidence of oral mucositis and intestinal infection after transplantation was 100％,with 2 cases of pulmonary infection,1 case of urinary tract infection,1 case of skin infection,and 11 cases of transient elevation of serum amylase. After transplantation,13 patients achieved a complete response (CR) or better,and the CR rate showed an increasing trend compared to before transplantation (13/17 vs 8/17;P=0.078). The median follow-up time was 18 (6-36) months,and 15 patients survived without progression,1 patient experienced disease progression,and 1 patient died due to clinical relapse and abandonment of treatment. The 2-year overall survival (OS) rate and progression-free survival (PFS) rate were approximately 90.0％ and 83.9％,respectively. Conclusion:High-dose melphalan in combination with ASCT as first-line consolidation therapy for MM can enhance the depth of patient response,further improve therapeutic efficacy,and the transplant-related complications are controllable,making it a viable option worth promoting in clinical practice.

OBJECTIVETo explore the epidemic characteristics of vaginal douching, human immunodeficiency virus (HIV) and other sexually transmitted diseases(STD) among female sex workers (FSWs) in Yunnan province.

METHODSFSWs were recruited to be investigated on their demographic data, drug abuse and sexual behavior, HIV/AIDS knowledge and procreation health status. Venous blood were collected to test for HIV, herpes simplex virus 2 (HSV-2) and syphilis while urine specimen was for morphine, cervical secretion for Gonorrhoea and Chlamydia trachomatis, and vaginal secretion for Trichomonas.

RESULTSA total number of 833 blood specimen were collected, in which 84 specimen were confirmed to be HIV positive with a prevalence rate of 10.1%. The prevalence rates of syphilis and HSV-2 were 8.2% and 68.4% respectively. 832 vaginal and cervical secretion specimen were collected with the prevalence rates of Gonorrhoea, Chlamydia trachomatis and Trichomonas were 11.5%, 28.2% and 11.9% respectively. In multivariate logistic analysis, the factors associated with vaginal douching were: being Han nationality, locations of sex work at middle/high level, ever heard of HIV/AIDS, emerged hypogastric pain last year, the number of sex work location > or =4.

CONCLUSIONVaginal douching was shown a risk factor for HIV and some STD.

Adolescent ; Adult ; China ; epidemiology ; Chlamydia Infections ; epidemiology ; Female ; Gonorrhea ; epidemiology ; HIV Infections ; epidemiology ; Herpes Genitalis ; epidemiology ; Humans ; Middle Aged ; Sex Work ; statistics & numerical data ; Sexually Transmitted Diseases ; epidemiology ; Syphilis ; epidemiology ; Vaginal Douching ; adverse effects ; Young Adult