OBJECTIVE: To study the effect of Jianpi Huoxue Jiedu (JPHXJD) prescription on prevention of the postoperative metastasis of gastric cancer and to observe the changes of immunity and whole blood viscosity after treatment. METHODS: JPHXJD prescription and chemotherapy were administered to the treated group for 12 successive months, while only chemotherapy was given to the control group. RESULTS: The effective rate of anti-metastasis in the treated group was obviously better than that in the control group. In the aspects of enhancing Karnofsky scores, reducing whole blood viscosity and improving immunity after treatment, the treated group was better than the control group (P<0.05). CONCLUSION: JPHXJD prescription combined with chemotherapy shows apparent effect on anti-metastasis. It can improve the quality of life of the patients, lower the whole blood viscosity and improve the immunity function.

Objective To investigate the influencing factors on serum homocysteine level in healthy retired-elderly people in Tianjin,in order to provide theoretical basis and guidance for clinical intervention therapy.Methods A total of 184 participants meeting the standard of Chinese healthy elderly people (2013) were selected from 1247 retired-elderly people who took healthy physical examination in three grade Ⅲ-A hospitals in Tianjin from June to August in 2014.They were divided into two groups based on plasma Hcy level:hyper-homocystinemia group (≥15 μmol/L) and normal plasma Hcy level group (＜15μmol/L).The influencing factors on plasma Hcy level were analyzed by multiple stepwise regression and logistic regression analysis.Results The proportion of healthy retired-elderly people accounted for 14.76 ％,with men at 82.61％ and women at 17.39 ％,mean age (78.37±6.88) years.The Hcy level was higher in healthy males than in healthy females [(16.90± 6.86) μmol/L vs.(12.89 ± 5.97) μmol/L,P＜0.005].The proportion of people with hyper-homocystinemia accounted for 45.65％,and the mean Hcy concentration was (21.39±6.98) μmol/L.The age of people with hyper-homocystinemia was higher than that with normal Hcy [(80.58±6.09) years vs.(76.56±7.04) years,P＜0.005].There were no statistically significant differences in blood pressure,lipid and blood glucose levels and the proportion of patients with coronary heart disease,hypertension,type 2 diabetes mellitus,gout,periodontitis and other diseases between the two groups (all P＞0.05).Spearman correlation analysis showed that the level of serum Hcy was positively correlated with serum uric acid levels (P=0.000).Multiple stepwise regression and logistic regression analysis showed that age,gender and serum uric acid level were risk factors for plasma Hcy level in healthy elderly people.Conclusions Age,gender and serum uric acid level are risk factors for serum Hey level in healthy elderly people.

Objective To observe healing effect of different dressing measures on skin bruise.Methods 51 patients with skin bruises were randomly divided into control group and treatment group.The control group applied traditional dressing nursing method while the treat-ment group used nursing method of wet dressing of traditional Chinese medicine.Clinical curative effect of two groups was observed.Results Healing time of bruises,pain feeling after dressing, scar and hyperpigmentation in the treatment group was better than that in control group,so the difference was statistically significant (P <0.05).Conclusion Curative effect of nursing method of wet dressing of traditional Chinese medicine is significant.It can effectively relieve the pain of patients,so it is worthy of clinical application and promotion.

Objective To observe healing effect of different dressing measures on skin bruise.Methods 51 patients with skin bruises were randomly divided into control group and treatment group.The control group applied traditional dressing nursing method while the treat-ment group used nursing method of wet dressing of traditional Chinese medicine.Clinical curative effect of two groups was observed.Results Healing time of bruises,pain feeling after dressing, scar and hyperpigmentation in the treatment group was better than that in control group,so the difference was statistically significant (P <0.05).Conclusion Curative effect of nursing method of wet dressing of traditional Chinese medicine is significant.It can effectively relieve the pain of patients,so it is worthy of clinical application and promotion.

Objective:To survey on the status quo of the management capabilities of general practice team leaders in community health service centers in Shanghai.Methods:Using stratified sampling method, 18 community health service centers in the urban and suburban areas of Shanghai were selected, then the general practice team leaders and general practitioners (team members) in the centers were selected as the study participants. The questionnaire survey on the management capabilities of general practice team leaders was conducted among selected participants from November to December 2021. The self-assessment by general team leaders and the other-assessment by team members were carried out, and the total scores was calculated according to the weight of self-evaluation score (30%) and other-evaluation score(70%).Results:A total of 110 general practice team leaders and 749 team members participated in the survey. Among the team leaders, 63.64% (70/110) were females, 82.73% (91/110) were bachelor degree holders, 71.82% (79/110) had intermediate professional title, and 50.91% (56/110) worked for more than 9 h per day. The total score of general practice team leaders was (87.15±10.76) points, the other-assessment score was significantly higher than self-assessment score ((88.62±9.34) vs.(83.71±14.08), t=2.22, P<0.05). The average score of the 5 dimensions was 4.41 for special business management, 4.39 for organizational management, 4.38 for personal quality, 4.27 for teaching and research management and 4.22 for strategy and cultural construction, respectively. Conclusion:The overall management capabilities of Shanghai community general practice team leaders are at the upper-middle level, however, the capabilities in scientific research and team planning are relatively weak.

Objective:To analyze the relationship between capacity of general practice team leaders and the team performance in community health service centers.Methods:This study was a cross-sectional study. A questionnaire survey was conducted between November and December 2022, among general practice team leaders and general practitioners (GPs) from 18 community health service centers in the urban and suburban areas of shanghai selected by stratified sampling method. The personal information questionnaire, leadership of general practice team leader questionnaire,and work performance scale of general team members were used for the survey. The relationship between leadership of general practice team leaders and team performance was analyzed based on structural equation model (SEM).Results:A total of 944 questionnaires were distributed and 856 valid ones were returned with a response rate of 91.0%, including 110 general practice team leaders and 749 were GPs. The SEM analysis showed that some dimensions of the management ability of the general practice team leader had significant effect on the employee organization loyalty (organizational management: β=0.37, teaching and research management: β=-0.29, strategy and cultural construction: β=0.23, personal quality: β=0.11) and work performance (special business management: β=0.95, organizational management: β=0.54) (all P<0.05); and employee organization loyalty played a partial mediator role in relationship between leadership of general practice team leaders and work performance with a mediating effect of 39.50%. Conclusion:The management ability of the general practice team leader directly affect or indirectly affect the work performance of team members through team members′ organizational loyalty.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group. Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors. Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson χ² and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence. Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；P<0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P<0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P<0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485，P<0.05). Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.

ObjectiveBased on sequential metabolism and ultra-high performance liquid chromatography-high resolution mass spectrometry （UPLC-HRMS）， to identify the prototype components and metabolites of Tongfengding capsules in rat plasma. MethodAn ACQUITY UPLC BEH Shield RP18 column （2.1 mm×100 mm， 1.7 µm） was used for gradient elution with 0.1% formic acid aqueous solution （A）-acetonitrile （B） as the mobile phase （0-1 min， 5%B； 1-2.4 min， 5%-10%B； 2.4-13.5 min， 10%-32%B； 13.5-18.5 min， 32%-90%B； 18.5-19 min， 90%-5%B； 19-21 min， 5%B） at a flow rate of 0.3 mL·min^-1， injection volume of 2 μL and column temperature at 35 ℃. The heated electrospray ionization （HESI） was applied under positive and negative ion modes， and the scanning range was m/z 100-1 500. By comparing the differences between the administered plasma and the blank plasma， the prototype components and metabolites in intestinal metabolism sample and liver metabolism sample prepared by intestinal perfusion with parallel blood collection， and comprehensive metabolism sample prepared by intragastric administration method were identified. ResultA total of 76， 53， 74 chemical components were detected in the intestinal metabolism sample， the liver metabolism sample and the comprehensive metabolism sample. A total of 100 components were identified from these different plasma samples， including 64 prototype components （34 alkaloids， 12 terpenoids， 9 organic acids， 6 flavonoids and 3 other components） and 36 metabolites. The main metabolic reactions involved in the formation of metabolites were glucuronidation， deglucosylation， dehydrogenation and hydroxylation. ConclusionThe chemical components of Tongfengding capsules can undergo a series of metabolic reactions in the intestine and liver， and a large number of metabolites are generated， among which alkaloids may be the leading component group for efficacy， which can lay the foundation for systematic elucidating the material basis of Tongfengding capsules in vivo.