Objective:To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic.Methods:Thirty healthcare professionals from various places of China were recruited in the study from 6 thto 16 th February 2020 through WeChat platform advertising and by purposive sampling method. They were general practitioners (GPs), administrators, and other specialists, all of whom were involved in the prevention and control of COVID-19. Personal interview and focus group discussion were conducted online. The topic guide was as follows: (1) Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19. (2) Difficulties and challenges that healthcare professionals encountered. (3) Opinions on the prevention and control of COVID-19. (4) Advices on future outbreak of similar epidemics or disease. NVivo 12 software system was used to code and classify the interview content, and thematic framework analysis was used to sort out and analyze the data and extract the interview themes. Results:Six themes were extracted: (1) The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient; and the workload of GPs was heavy. (2) Primary care settings had carried out pre-screening and triage; while outpatient clinic continued to provide health care service for local residents, especially stressing online service and consultation to reduce the population mobility. (3) GPs should make full use of technical advantages and participate in joint prevention and control. (4) GPs offered various health education to residents to improve their awareness of self-protection. (5) GPs lacked professional skills and needed more related training, while the current training were still insufficient. (6) There were not enough supplies and GPs had increasing worries about the infection risks.Conclusions:GPs play an important role in effectively curbing the spread of the epidemic. It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted; and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future.

Background Traction of epiretinal membrane results in macular morphologic change and visual functional impairment in eye with idiopathic epiretinal membrane (IERM),therefore figuring out their relationship is helpful for evaluation of disease prognosis.Objective This study was to observe the morphological change of macula and microstructure,and analyze the relationship between retina thickness,integrity of cone outer segment tips (COST) line in fovea and visual acuity.Methods This was a retrospective case-observational study.Fifty-six consecutive cases diagnosed as IERM in Zhongshan Ophthalmic Center from March 2011 to December 2011 were enrolled in this study,and all the patients showed unilateral IERM with the normal fellow eyes.Sixteen patients were males and 40 were females,with a mean age of (61.05 ± 6.58) years old.Spectral-domain optical coherence tomography (SD-OCT) examination was performed on the eyes,and Macular Cube (512×128) and HD 5 Line program were selected.Mean retinal thickness of central area (＜1 mm diameter),inner ring area (1-3 mm diameter) and outer ring area (＞3-6 mm diameter) of macula and the status of COST line (intact or fractured) was recorded.Mean thickness of whole macular areas and the difference of foveal microstructure were compared,and the correlation between retinal thickness and visual acuity was analyzed using Pearson linear correlation analysis.Related parameters including age,visual acuity,retinal thickness were also compared between the continuous COST lines group and the fractured COST lines group by independent sample t test.Results The flatted or disappeared fovea was seen in IERM eyes on the SD-OCT image.Retinal thicknesses were (446±89)μm,(418±64)μm and (328±34)ttm in the central area,inner ring area and outer ring area of macula in the IERM eyes,exhibiting significant increasing in comparison with (250±22) μm,(319±17) μm and (279±17) μm in the normal fellow eyes (t=13.370,9.523,7.769,all P =0.000).Significantly negative correlations were found between the visual acuity and the central macular thickness,inner ring thickness or outer ring thickness (r=-0.686,-0.653,-0.417,P＜0.05).In the IERM eyes,COST band was intact in 20 eyes and lack in 36 eyes.Compared with COST band intact group,aging,worse vision and increased retinal thickness were seen in the COST band absent group (t =2.109,P =0.039 ; t =-4.093,P =0.000 ; t =6.669,P=0.000;t=5.376,P=0.000;t=4.247,P=0.000).COST band was clear in all the normal fellow eyes on the SD-OCT image.Conclusions Increase of macular thickness and disruption of COST band reflect the visual function damage in IERM eye.Deficiency of COST band on OCT image seems to be an early indication of photoreceptor damage.Incomplete fovea COST band is often seen in older patients.

Objective:To investigate the application effects of SBAR communication mode (situation, background, assessment and recommendation) combined with 3D printing model technology in bed-side teaching of trauma orthopaedics.Methods:A total of 80 clinical medicine students were randomly divided into two groups according to the order of the school number, with 40 students in each group. One was experimental group which received SBAR communication mode combined with 3D printing model technology teaching, and the other one was the control group, which received regular reaching mode. At the end of teaching, the teaching effects were evaluated, including the scores of theoretical examinations and operational examinations, total scores and the anonymous questionnaires. SPSS 22.0 was used for recording and statistical analysis.Results:The average scores of theoretical examinations (48.30±1.41), operational examinations (42.20±1.48) and total scores (90.70±1.38) of experimental group were significantly higher than those of control group [(43.40±1.52); (34.80±1.53); (78.10±1.51)], with significant differences ( P <0.05). The anonymous questionnaires showed that the students in the experimental group had a significant advantage in autonomous learning ability, learning enthusiasm, the ability of literature retrieval and analysis and clinical thinking ability, and enhancing students' humanistic care consciousness in clinical work ( P <0.05). While the two groups had the same recognition in improving problem solving ability, teamwork ability and communication ability with patients, with no significant difference ( P > 0.05). Conclusion:The new teaching mode, SBAR mode combined with 3D printing model technology, applied to trauma orthopaedics bed-side teaching is helpful for students to improve their learning interest and autonomous learning ability, cultivate their lifelong learning habits and their comprehensive quality, so this mode will significantly improve the teaching effects, with good application value.

Objective: To observe the difference in clinical efficacy between acupuncture with point selection based on syndrome differentiation along the meridians and acupuncture at non-meridian and non-acupoint points for functional dyspepsia (FD). Methods: A total of 74 FD patients were randomized into an observation group and a control group, with 37 cases in each group. Both groups received acupuncture treatment. Zusanli (ST 36) and Neiguan (PC 6) were selected in the observation group, with Taichong (LR 3) and Neiting (ST 44) added for excess syndrome, and Gongsun (SP 4) and Yinlingquan (SP 9) added for deficiency syndrome. Four non-meridian and non-acupoint points were selected in the control group. The treatments in both groups were performed once a day with a 2-day break after 5 consecutive treatments, which constituted one treatment course. A total of 4 courses were performed. The scores of Nepean dyspepsia index (NDI) and Leeds dyspepsia questionnaire (LDQ) were recorded before and after treatment, and during follow-up (8, 12, 16, 20 and 24 weeks after recruitment) to assess the clinical efficacy. Results: The NDI scores in the two groups after treatment and at each time point during follow-up were higher than those before treatment (all P<0.05), and the LDQ scores were lower than those before treatment (all P<0.05). The NDI scores after treatment and at each time point during follow-up in the observation group were higher than those in the control group (all P<0.01); the total LDQ score and scores of upper abdominal pain, postprandial satiety and upper abdominal burning sensation after treatment and at each time point during follow-up in the observation group were significantly lower than those in the control group (P<0.01 or P<0.05).. Conclusion: Acupuncture with point selection based on syndrome differentiation along the meridians has a better curative effect than acupuncture at non meridian and non-acupoint points in the treatment of FD.

In order to make sure whether Panax notoginseng is sensitive to chloridion and guide fertilization in planting of P. notoginseng, the effects of the different proportion of potassium chloride (KCl) and potassium sulfate (K2SO4) on the yield, quality of P. notoginseng were studied. The results showed that K fertilizer significantly improved the growth of P. notoginseng and increased the biomass per plant or per pot and the content of N, P, K and the content of saponin. In cases of conditions such as potassium, and the effects of K2SO4 on increasing the petiole length, leaf size, rhizome length, root length, and content and accumulation of Ginsenoside Rg1 were better than those of KCl. While compared with K2SO4, KCl was more conducive to augmenting height, root width, the biomass of shoot, rhizome, root and the content of Ginsenoside Rb1 and Rd. There was not remarkable difference in agronomic characters, biomass and the content of N, P, K among KCl, K2SO4 and the combination of KCl and K2SO4. However, the content of saponin of the treatment with combination of KCl and K2SO4 was significant higher than that of single KCl or K2SO4 treatments. K fertilizer significantly increased yield and the content of saponins. And P. notoginseng was not sensitive to chloridion. KCl increased the yield and the content of saponins of P. notoginseng as well as K2SO4, and the combination treatment was superior to single treatment. It is recommended that the KCl should be adopted in production, to reduce the cost of potash fertilizer.
Agriculture ; Fertilizers ; analysis ; Panax notoginseng ; chemistry ; growth & development ; Potassium Chloride ; analysis ; metabolism ; Quality Control ; Soil ; chemistry ; Sulfates ; analysis ; metabolism

OBJECTIVEIn this study, five heavy metals contamination of soil and different parts of Panax notoginseng in the plantation area was investigated. Analysis of heavy metals correlation between the planting soil and P. notoginseng; and the absorption and accumulation characteristics and translocation of soil heavy metals by P. notoginseng plants was revealed.

METHODThrough field investigation and laboratory analytical methods, analysis of China's 30 different soil P. notoginseng origin and content of heavy metals in five different parts of the P. notoginseng plant content of heavy metals.

RESULTThe results revealed that the soil heavy metals should not be neglected in the plantation area Referring to the national soil quality standards (GB15608-1995), the excessive degree of soil heavy metals pollution showed Hg > As > Cd > Cr in the plantation area, and Pb content of soil was in the scope of the standard. Refer to 'Green Industry Standards for Import and Export of Medical Plants and Preparations', the excessive degree of heavy metals content of P. notoginseng plants showed As > Pb > Cr > Cd, and Hg content of plants was in the scope of the standard. Concentrations of five heavy metals of underground parts of P. notoginseng plants are higher than aboveground, and heavy metals elements are more concentrated in the root, followed by the rhizome of P. notoginseng plants. Heavy metal accumulation characteristics of the different parts of the P. notoginseng of the overall performance is the root > the rhizome > the root tuber > leaves > stems. From the point of view BCF value analysis of various parts of the P. notoginseng plants to absorb heavy metals in soil, BCF values of all samples were less than 1, description P. notoginseng not belong Hyperaccumulator. From the view of transportation and related analysis of the soil-P. notoginseng systems, the rhizome of P. notoginseng and the content of As and Cr in soil was significantly correlated, the root of P. notoginseng and the content of Cd in soil was significantly correlated, and no significant correlation between the other indicators. Through the analysis of transportation transfer coefficient showed: Pb, As and Cr are not easy to transport aboveground part from the underground, but Cd and Hg are relatively easy to transport stems from rhizome, the migration of five heavy metals in the aerial part is relatively strong, and heavy metal of stems is easily transported to the leaves.

CONCLUSIONP. notoginseng does not belong to the enrichment of heavy metals in crops, especially for Hg in soil with strong patience. In survey area, the content of heavy metals of P. notoginseng's planting soil is relatively high, and the heavy metals As, Pb, Cr, Cd of P. notoginseng also exist heavy metals exceeded problems. Due to the presence of heavy metals in crops internal absorption and translocation of special laws, accumulation of heavy metals varied significantly in different parts of P. notoginseng. The overall, the performance for the heavy metal content of the underground parts is more than aboveground, it explain heavy metals of P. notoginseng plants is still the main source of the soiL Therefore, the key to control of planting area soil environmental quality and reduce exogenous harmful substances secondary pollution of soil in the cultivation process are to study and solve the heavy metals pollution problem of P. notoginseng.

Adsorption ; China ; Laboratories ; Metals, Heavy ; analysis ; Panax notoginseng ; chemistry ; Soil ; chemistry ; Soil Pollutants ; analysis

Objective: To compare the efficacy difference between moxibustion at sensitized-acupoints and non-sensitized- acupoints using the same group of acupoints. Methods: A total of 139 patients with chronic superficial gastritis were divided into a sensitized acupoint group (102 cases) and a non-sensitized acupoint group (37 cases) based on whether acupoint sensitization occurred. The SPSS version 19.0 statistical software propensity score matching function was used to balance the baseline data between the groups. Finally, 29 pairs of matched patients were included, namely 29 cases in the sensitized acupoint group and 29 cases in the non-sensitized acupoint group. Both groups were treated with moxibustion therapy. The treatment lasted for 30 min per time, and was performed every other day for 8 weeks. Changes in the traditional Chinese medicine (TCM) symptom score and the short-form 36-item health survey (SF-36) score in both groups were observed before and after treatment, as well as the clinical efficacy. Results: The covariates of age, course of disease, TCM symptom score and SF-36 score in the two groups were balanced after matching (all P>0.05). After treatment, the total effective rate was 100.0％ in the sensitized acupoint group and 79.3％ in the non-sensitized acupoint group. The difference in the total effective rate between the two groups was statistically significant (P<0.01). After treatment and at the 4-week follow-up, the TCM symptom scores in the sensitized acupoint group were significantly lower than those in the non-sensitized acupoint group (all P<0.01); the SF-36 scores in the sensitized acupoint group were significantly higher than those in the non-sensitized acupoint group (all P<0.01). Conclusion: With the same group of acupoints, the sensitized acupoints have a better therapeutic effect and long-term efficacy than the non-sensitized acupoints in the treatment of chronic superficial gastritis.

OBJECTIVETo compare the effect of botulinum neurotoxin A (BTA) and denervation in inducing masseter muscle atrophy in rabbits to provide experimental evidence for the safe clinical application of BTA.

METHODSSeventy-five healthy adult New Zealand white rabbits were randomized equally into denervation group, BTA group and normal control group. In the former two groups, the rabbits were subjected to right masseter muscle denervation and botulinum (3 µg/kg) injection at the muscle, respectively, with the left side as the control. The thickness of the denervated masseter was determined using B type ultrasound and its weight measured after the treatment.

RESULTSThe thickness of the masseter muscle on the experimental side was significantly decreased to 50.80% and 54.07%, and its weight to 66.80% and 56.16% of the normal level after denervation and BTA injection, respectively.

CONCLUSIONBTA-induced denervation produces less potent atrophy-inducing effect on skeletal muscle than surgical denervation. BTA causes atrophy mainly at the injection site of the target muscle without significant diffusion or toxicity to the muscular cells.

Animals ; Botulinum Toxins, Type A ; toxicity ; Female ; Male ; Masseter Muscle ; drug effects ; pathology ; Muscle Denervation ; Muscular Atrophy ; pathology ; Rabbits

OBJECTIVE: To compare intranasal midazolam and intramuscular phenobarbital sodium for their sedative effect in neonates undergoing magnetic resonance imaging (MRI). METHODS: A total of 70 neonates who underwent cranial MRI from September 2017 to March 2019 were randomized into an observation group and a control group, with 35 cases in each group. The observation group received intranasal drops of midazolam (0.3 mg/kg), and the control group received intramuscular injection of phenobarbital sodium (10 mg/kg). The sedation status of the neonates was evaluated using the Ramsay Sedation Scale. Meanwhile, the two groups were compared for the success rate of MRI procedure and incidence of adverse reactions. RESULTS: In the observation group, the sedation score was the highest at 20 minutes post administration, then was gradually decreasing, and decreased to the lowest level at 70 minutes post administration. In the control group, the sedation score was the lowest at 10 minutes post administration, then was gradually increasing, and increased to the highest level at 40 minutes and 50 minutes post administration, followed by a gradual decrease. Comparison of the sedation score at each time period suggested that the sedation score was significantly higher in the observation group than in the control group within 40 minutes post administration (P<0.05), while there were no significant differences between the two groups in the sedation score after 40 minutes post administration (P>0.05). The success rate of MRI procedure was significantly higher in the observation group than in the control group (89% vs 69%, P<0.05). There was no significant difference between the two groups in the incidence of adverse reactions (P>0.05). CONCLUSIONS Intranasal midazolam is superior to intramuscular phenobarbital sodium in the sedative effect in neonates undergoing MRI, with the benefits of being fast, convenient, safe, and effective.
Humans ; Hypnotics and Sedatives ; pharmacology ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Midazolam ; Prospective Studies ; Single-Blind Method

OBJECTIVETo detect possible relationship between genetic defect within the gene encoding member A3 of the ATP Binding Cassette family (ABCA3) and neonatal respiratory distress syndrome (NRDS), thus to understand the genetic mechanisms of NRDS in Han ethnic group.

METHODThe clinical data of 11 cases with NRDS hospitalized in neonatal intensive care unit was investigated. Blood samples were collected from 11 cases with NRDS and 97 unassociated normal individuals. Polymerase chain reaction (PCR) and DNA direct sequencing were performed to screen all exons and their flanking introns of ABCA3 gene for mutation analysis in 11 cases with NRDS. If a new missense variation was identified, single strand conformation polymorphism analysis was performed in 97 healthy controls. Lung tissue sample from a case who died 12 hours after birth was examined with light microscopy and electron microscopy.

RESULTThree missense genetic variants in exons, which include c. 2169 G > A (p.M723I), c. 1010 T > G (p.V337G), c. 4972 A > G (p.S1658G), one splice junction site variation (Exon 30 + 2 T/G), several unreported polymorphism sites [213 C > T(p.F71F), exon 21 + 34C/T] and reported polymorphism site (p.F353F) were identified on ABCA3 gene coding region in 11 case. The homozygous variation (c.2169G > A), which was in exon 17 and causes an M723I amino acid change, was found in the case who died 13 hours after birth, but not detected in 97 controls, indicating that this variation is indeed a mutation and not a polymorphism. In the case carrying c.2169G > A, ultrastructural examination of the alveolar type II cells with electron microscopy demonstrated abnormally small and dense lamellar body with eccentrically distributed electron dense substance.

CONCLUSIONGenetic variants within ABCA3 may be the genetic cause of or a contributor to some unexplained refractory NRDS. Identification of ABCA3 genetic variant in NRDS infants is important to establish appropriate management and evaluation of treatment options, as well as to offer genetic counseling and prenatal diagnosis.

ATP-Binding Cassette Transporters ; genetics ; DNA Mutational Analysis ; Exons ; Humans ; Infant, Newborn ; Polymorphism, Genetic ; Respiratory Distress Syndrome, Newborn ; etiology ; genetics