Objective To investigate the status of occupational burnout among general practitioners (GPs) and explore the relationship between coping style and burnout. Methods 243 GPs were assessed by Chinese Maslach burnout inventory(CMBI) and simple coping style questionnaire. Results 36.6% of GPs experienced mild burnout, 26.8% moderate burnout, and 3.3% severe burnout; 11.5% of GPs got high scores on emotional exhaustion(EE), 44.9% subjects got high scores on depersonalization(Dp) and 43.6% subjects got high scores on reduced personal accomplishment (RPA). Male GPs experienced greater personal accomplishment than female. Among technical post, subjects with senior technical post scored higher on Dp. The condition of occupational burnout among subjects in north Jiangsu was more serious. GPs with seniority of 5 to 9 years seemed to be more prone to occupational burnout. The coping style of GPs had obvious correlation with occupational burnout. Conclusion The status of occupational burnout among GPs is serious. To prevent and cure occupational burnout, more attention should be paid to female, senior technical post GPs and'persons with seniority of 5 to 9 years. And taking positive coping style can reduce GPs' occupational burnout.

A bacterium that contains a chitin deacetylase has been isolated from ocean soil. It has been identified Baciluus .The best suitable condition of producing this enzyme is that pH is 4.0,35℃,and the incubate time is 80 hours in the present of Ca 2+ as well as having no chitosan. The best temperature of this enzyme when it acts is 40℃～50℃ and the best pH range is 4.5～5.0.

Objective: To analyze the characteristics, treatment and prognosis in patients with essential thrombocythemia (ET) combining myocardial infarction (MI).
Methods: A total of 10 patients with ET combining MI treated in our hospital from 2003-01 to 2015-07 were retrospectively studied. The basic clinical information with major admission complaints, previous history and peripheral platelet counts were recorded;echocardiograph, coronary angiography (CAG), application of anti-platelet drugs and platelet reductive therapy with the prognosis were recorded in all patients.
Results: There were 6 male and 4 female with a mean age of (55.3 ± 9.7) years, 7 patients with AMI and 3 with old MI. The platelet counts at admission were (500-599) × 109/L in 3 patients, (600-699) × 109/L in 1 patient, (700-799) × 109/L in 3 patients, (800-899) × 109/L in 1 patients, (900-999) × 109/L in 1 patient and more than 1000 × 109/L in 1 patient. Echocardiograph indicated that 5 patient had LVEF≤50%and 5 had LVEF>50%. CAG revealed that there were 9 cases with left anterior descending involved, 2 with circumlfex involved and 5 with right coronary involved. All patients received dual anti-platelet drugs before operation, 4 had hydroxyurea for (20-30) days before operation and no post-operative cardiovascular events occurred;6 patients without hydroxyurea medication and 1 of them was re-hospitalized for angina pectoris and 2 had progressed coronary lesions.
Conclusion: Application of platelet reductive therapy at before and after interventional treatment may improve the prognosis in patients with ET combining MI.

To study the MEN1 gene mutations in a multiple endocrine neoplasia type 1 ( MEN 1 ) family,and determine the possible mechanism of disease induced by the mutations.Genomic DNA was isolated from peripheral blood leukocytes and the MEN1-related tumor tissues of the patient and the family members,then the coding exons and exon/intron boundaries of the MEN1 gene were amplified by polymerase chain reaction (PCR) and sequenced.Subclone sequencing was performed to identify the heterozygosity.Further immunohistochemistry was performed to observe menin protein expression in the tumor tissues.We identified a heterozygous deletion mutation of intron 9 ( IVS9+ 1_11 delGTGAGGGACAG) in the proband and two family menbers.We also demonstrated for the first time that the expression of menin protein is absent in the parathyroid adenoma tissue.The heterozygous mutation in the initial of intron 9,IVS9+ 1_11 delGTGAGGGACAG is a new type of MEN1 gene mutations in China.This mutation may produce an aberrant splicing of MEN1 mRNA,generating easily degradation and loss of expression of menin protein and resulting eventually in the disease.

80 mL/ min were 12 cases;minor lesion group(50

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods Ninety-one children with LN were diagnosed from 1993 to 2005,according to the clinical literature and renal pathology and the data were retrospectively summarized.Results Within the cohort of 91 children,there were 69 females and 22 males(female to male ratio 3.1).Most of the sick children were at the school age ranging from 6.0 to 15.5 years old.Nephrotic syndrome(44.0%) was the most common clinical manifestation.Fifty-nine renal biopsies were performed.Class Ⅳ LN(59.3%) was the most frequent pathological findings."A full-house pattern" on immunofluorescence was found in 72.0% of biopsies.The clinical and pathological manifestations of some children were atypical.There were 3 patients characterized by predominant deposits of immunoglobulin M(IgM),1 patient with predominant deposits of IgA,and 2 children with pauci-immune LN.Three children with class Ⅱ LN in our study presented with nephrotic syndrome.LN was initially controlled by aggressive treatment in 93.7% of thse patients.Relapses of nephritis covered 27.1% of them,mostly caused by the intermittent treatment.Conclusions The clinical and pathological manifestations of LN were variable.Some atypical LN was considered to be associated with the distinct pathogenesis.Most of LN could be controlled by aggressive treatment.Long and regular treatment is necessary to improve the prognosis of LN.

AIM To establish an HPLC method for the simultaneous content determination of huperzine A and huperzine B from seventeen species Huperzioideae subfamily (including 2 ineditus new species).METHODS The analysises of tartaricacid extracts of huperzine A and huperzine B were performed on a room temperature column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of methanol-spiritus mindereri flowing at 1.0 mL/min in a isocratic elution manner,and the detection wavelength was set at 310 nm.The contents were determined by external standards.RESULTS Huperzine A and huperzine B showed good linear relationships within 0.002 0-0.30 μg,0.001 8-0.27 μg (r=0.999 9),whose average recoveries were 103.86％,101.3％ with the RSDs of 1.85％,1.30％,respectively.Huperzine A and huperzine B were found in seventeen species,and there were significant differences in contents from species to species.The content of huperzine A in Phlegmariurus hamiltonii was the highest,which reached up to 0.22％,with higher levels of it in Phlegmariurus cryptomerianus,Phlegmariurus petiolatus,and Phlegmariurus phlegmaria;The content of huperzine B was the highest in P.phlegmaria.CONCLUSION This accurate,stable and reproducible method can be used for the quality control of huperzine A and B from Huperzioideae subfamily.

As one of the significant parts of medical science research in China, the research on Chinese medicine (CM) reflects the essence of healthcare tradition in the country both theoretically and clinically, and embodies the values of Chinese culture. Therefore, in the practice of ethics review on CM research protocols, besides abiding by the contemporary prevalent international principles and guidelines on bioethics, which emphasizes the scientific and bioethical value of the study, we should also stress the CM theoretical background and relevant clinical experience in the framework of Chinese culture and values. In this paper, we went over the traits of CM clinical research and the experience from the practice of ethics review by the institution review board for bioethics, and then attempted to summarize the key points for the bioethics review to CM researches in China, so as to serve as reference for the bioethics review to traditional and alternative medicine researches.
China ; Drug Monitoring ; Ethics Committees, Research ; ethics ; Ethics, Medical ; Humans ; Informed Consent ; Medicine, Chinese Traditional ; adverse effects

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.

Child ; Humans ; Pediatrics ; Practice Guidelines as Topic ; Tonsillectomy ; United States