Objective To explore the relationships among personality,coping style and clinicians' job burnout.Methods 1569 clinicians were investigated with Chinese Maslach Burnout Inventory,Eysenck Personality Questionnaire and Simple Coping Style Questionnaire.The data were performed with regression and path analysis.Results The proportion of burnout was 72.4％,the proportion of slight burnout was 36.5 ％,the proportion of moderate burnout was 31.2％ and the proportion of high burnout was 4.7％.When taking demographic variables into consideration,more introvert and neuroticism indicated increasing tendency of emotional exhaustion.More psychoticism,neuroticism and negative coping style indicated increasing tendency of depersonalization and more introvert and negative coping style indicated increasing of reduced personal accomplishment.Coping style could partly mediate the relationship between personality and job burnout.Conclusion Chinese clinicians suffer from burnout severely,coping styles mediate between the personality factors and the burnout level.

Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.

Adult ; Aged ; Bone Neoplasms ; diagnosis ; secondary ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; secondary ; Male ; Middle Aged ; Multimodal Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnosis ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Whole Body Imaging ; methods

Objective To investigate the clear effect of different blood purification techniques on the serum beta2-microglobulin ( β2-MG) of chronic renal failure maintenance hemodialysis patients.Methods Forty chronic renal failure maintenance hemedialysis patients were randomly divided into four groups: hemodialysis group (HD group), high flux dialysis group (HFD group), hemodiafiltration group (H D F group), hemodialysis and absorption group (HD+AP group). The serum β2-MG levels of the four groups were determined and compared before with after the therapy. Results The difference between the serum β2-MG in HD group detected at the first day before and after the therapy was insignificant difference [( 53.49±1.15 ) mg/L vs (49.10±2.31 ) mg/L ] (P > 0.05 ). The difference between the serum β2-MG in HD group detected at the first day before and after the therapy six months later [(55.63±1.30) mg/L] was significant difference (P <0.05). The serum levels at the first day and six months later after the therapy detected in HFD group, HDF group and HD+AP group were significantly decreased compared with those of the first day before the therapy (P < 0.05 ). Furthermore,the serum β2-MG level decreased in HD+AP group was more significant than HFD group and HDF group at six months later (P <0.05). Conclusions Hemodialysis can not clear the serum β2-MG. High flux dialysis, hemodiafiltration and resin absorptive devices associated hemedialysis can clear β2-MG effectively, while resin absorptive devices associated hemodialysis has the better effection after six months.

Objective To study the value of heart-type fatty acid-binding protein(H-FABP)for the early diagnosis of blunt cardiac injury(BCI).Method A prospective stuay was carried out in 42 patients,who suffered from blunt thoracic injury and were admitted from January 2007 to June 2008,and another42 heathy individuals in the health center of the Shanghai Fifth Hospital were recruited as control.Serum H-FABP,cTn Ⅰ and Myo levels of both healthy individuals and petients at 3,6 and 12 hours after trauma were measured by using ELLSA.Serum cTn Ⅰ levels was taken as a golden standard for the diagnosis of BCI.Accroding to serum cTn Ⅰ levels.42 patients with blunt thoracic injury were divided into group of patient with myocardial damage(13 patients)and group of patients without(29 patients).The receiver operating characteristic curves(ROC)of H-FABP and cTn Ⅰ in the diagnosis of BCI drawed at 3,6 and 12 hours after trauma,respectively,and the areas under curve(AUC)of ROC were compared.The values of H-FABP and cTn Ⅰ for diagnosing at 3,6 and 12 hours after trauma were analyzed Differences in serum H-FABP,cTn Ⅰ and Myo concentrations between groups were compared by Kruskal Wallis tegt.The delong.clarkepearson test was used to compare the areas under the ROC curves.Results AUCH-FABP and AUCcTn Ⅰfor diagnosing BCI at 3 hours after trauma were 0.9257 and0.6844,respectively,and AUCH-FABF was significantly more than AUCcTn Ⅰ(P=0.0125).AUCH-FABP,was significantly less than AUCcTnⅠ(0.9841 vs0.8276,P=0.0278)for diagnosing BCI at 12 hours after trauma.There was no significant difference in diagnosing BCI between AUCH-FABp and AUCcTn Ⅰat 12 hours after trauma(0.9655 vs.0.9125,P=0.2609).Conclusions H-FABP is valuabe in the early diagnosis of BCI,and its sensitivity is higherthanthat of cTnⅠ in diagnosing BCI at 3 hours after trauma.

Objective To detect the expression of metallothionein-3 (MT-3)mRNA in human esophageal squamous cell carcinoma. Methods Five cell lines of human esophageal cancer,TE-1,TE-13,TTN,ECA-109 (cell lines of esophageal squamous cell carcinoma) and OE33 (cell lines of esophageal adenocarcinoma),were used in this study. RT-PCR was employed to detect the expression of MT-3 mRNA. Peripheral blood monouclear cells from normal subjects were served as controls. Results Sequencing of RT-PCR product certified the gene of MT-3 mRNA. It was revealed by gel electrophoresis that there was expression of MT-3 mRNA in each cell line. The relative expression of MT-3 mRNA was 0.230?0.023,0.516?0.020,0.140?0.009,0.176?0.015 and 0.085?0.011 in cell lines of TE-1,TE-13,TTN,ECA-109 and OE33,respectively,significantly lower than that in controls (0.762?0.026) (P

OBJECTIVETo investigate the protective effect of hypothermia combined with dexamethasone on spermatogenesis and the expression of intercellular adhesion molecule 1 (ICAM1) after testicular torsion-detorsion.

METHODSWe made unilateral testicular torsion models in 100 pubertal male Sprague-Dawley rats by 720 degree torsion of the left testis and then randomly divided them into four groups of equal number to be treated with normal temperature + physiological saline (group A), hypothermia + physiological saline (group B), normal temperature + dexamethasone (group C), and hypothermia + dexamethasone (group D). After 48 hours, we collected the testes, observed pathological changes of the testicular tissue by HE staining under the light microscope, detected the apoptosis of spermatogenic cells by TUNEL, and determined the expression of ICAM1 by Western blot.

RESULTSHE staining showed different degrees of testicular tissue injury in the four groups of rats, most obvious in group A, but mild in the other three. The ICAM1 protein expression was significantly higher in group A (0.68 +/-0. 03) than in B (0. 49 +/- 0. 06, P <0. 05) , C (0. 46 +/- 0. 09, P < 0.05) , and D (0.17 +/- 0.08, P <0.01). The nuclei were deep brown or brown. Lots of apoptotic spermatogenic cells were seen in the torsion testis of group A, with a significantly higher apoptosis index ( [33. 13 +/- 3.21 ]%) than in B ( [ 17. 12 +/-5.23 ]%, P < 0.05), C ([14.13 +/- 2.03]%, P <0.05), and D ([9.05 +/- 1.03]%, P <0.01).

CONCLUSIONHypothermia combined with dexamethasone can protect the testis from injury as well as the reproductive function of the testis after testicular torsion-detorsion and reduce the expression of ICAM1.

Animals ; Dexamethasone ; pharmacology ; Disease Models, Animal ; Hypothermia, Induced ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord Torsion ; metabolism ; physiopathology ; Spermatogenesis ; drug effects

Objective By observing the effect of Xiaoyuhuatan decoction on insulin resistance in rar with nonalchoholic fatty liver,the author made a reasearch into this herb'S machanism on cambating on nonalchoholic fatty liver.Methods The insulin resistance rat model was fed by high fat forage and Dongbaogantai control group was set up for the sake of comparion.We determined the contents of total cholesterol(TC),triglyceride(TG),free fatty acid(FFA),fasting plasma glucose(FBG),fasting serum insulin(INS)in serum and the contents of TC,TG of liver tissue homogenate of each group,and the degree of hepatocytic steatosis.Results Xiaoyuhuatan decoction could obviously decrease the index of insulin resistance and improve insulin insensitive index.Lipid in blood serum and hepatic tissues were significantly decreased,liver fat cell denaturation was improved.Conclusion The thrapentic eftect of Xiaoyuhuatan Decoction on fatty liver is probably contribute tO this herb's mechanism of improving insulin resistance and increasing insulin insensitive.

Objective To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. Methods Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. Results Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemia (NIns) in different glucose metabolism status [normal glucose tolerance, ( 1381.2 ±280. 8) cm/s vs ( 1280. 3 ±218. 7) cm/s; imparied glucose regulation, ( 1557. 5 ±319.3) cm/s vs (1474.7 ±305. 1) cm/s; diabetes, (1764.3 ±476.6) cm/s vs (1664.2 ±374.6)cm/s], especially in subjects with normal glucose tolerance ( P ＜ 0.01 ). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns ( P ＜ 0.01 ). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1. 169-3. 105, P ＜0.01 ) as compared to the subjects with NIns. Conclusion The subjects with HIns suffered from much more metabolic risk factors than NIns.Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.

ObjectiveTo explore the role of BTBD10 overexpression in the proliferation of insulinoma cell line INS-1and its mechanism. MethodsThe recombined expression plasmid of pcDNA4.0-BTBD10 was constructed by gene cloning technique and was transfected into INS-1 cell by lipofectamine 2000. The stable overexpression BTBD10 of INS-1cell was selected at 48th hour after transfection.INS-1 cell proliferation activity was measured by MTT method.The expression of BTBD10,protein kinase B(Akt),phospho-Akt(p-Akt),mammal target of rapamycin (mTOR) and phospho-mTOR (p-mTOR) were determined by Western blot.ResultsThe stable overexpression BTBD10 of INS-1 cell wassuccessfullyconstructed.OverproductionofBTBD10promotedbetacellproliferation.The phosphorylation of Akt and mTOR was increased and the ratio of p-Akt/Akt and p-mTOR/mTOR was enhanced in the INS-1 overexpressed by BTBD10.But the expression of total Akt and mTOR presented no obvious changes. Conclusion The overexpression BTBD10 of INS-1 cell could activate of Akt/mTOR signalling pathway via stimulating phospho-mTOR and Akt,and enhance overall cell protein translation,so as to promote proliferation of INS-1 cell.