The current complex medical environment has a negative influence on doctors and also hinders the further development of healthcare industry in China.By analyzing the problems of medical social workers in doctors' social support system,this paper proposes the roles medical social workers should play in constructing a new social support system of doctors.

Objective: To understand the cognition of death among medical students and put forward some countermeasures .Methods:Stratified sampling was used to select 730 medical students in Fujian .A self -de-signed cognition of death questionnaire and Fear of Death Scale ( FODS) were adopted to conduct the survey .Re-sults:The general cognition of death among medical students was normal (84.8%).Fear of death, either towards themselves or their families , was significantly different in participants ' gender (χ2 =29 .552 , P<0 .001 ) , major (χ2 =6.343,P=0.042), and grade (χ2 =13.979, P=0.030).Thinking of death towards themselves was signif-icantly different in participants' living places (χ2 =10.110, P=0.006), bereavement experience (χ2 =7.353, P=0 .025 ) , religion (χ2 =16 .307 , P=0 .003 ) .Meanwhile , statistical significances were found in the thinking of death towards their families among different bereavement experience (χ2 =14.962, P=0.001) and religion (χ2 =12.359, P=0.015).Grade and religion greatly affected the attitudes towards death of families , while bereavement experience and grade had the great impact on the attitudes towards death of respondent themselves .In the fear of death for participant themselves and their families , gender made the biggest difference .Conclusion: Medical students have a high level of death anxiety .Medical universities and colleges should strengthen death education in medical students and improve its course system in the future .

La·Mettrie is an early outstanding representative of the French materialism philosophy in 18 Centu-ry.And with his unique " man a machine" ideology,he demonstrated the unity of the relationship between body and mind,criticized the religious theology,scholasticism and the philosophy of previous physical and mental sepa-ration,which played an active role in enlightening people's thinking and laid an ideological foundation for the de-velopment of the capitalist society and economy at that time.He returned all of the life activities to mechanical movements or physical and chemical reactions,which objectively provided the theoretical foundation of philosophy for the generation of modern biomedical mode and also foreshadowed various problems emerging in the process of modern medical diagnosis and treatment activities.

Objective To search for lymph node metastasis-associated proteins in human lung squamous carcinoma (hLSC).Methods Laser capture microdissection (LCM) was used to purify the target cells from lung primary tumor and matched lymph node metastatic tumor in hLSC. Two-dimensional gel electrophoresis (2-DE) was performed to separate the total proteins of microdissected tumor cells from lung primary tumor and matched lymph node metastatic tumor. PDQuest software was applied to analyze 2-DE images. Differential protein spots between the two types of tissues were identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). The expression of Rho-GDIα, one of the differential proteins, in the microdissected lung primary tumor cells (LPTC) and matched lymph node metastatic tumor cells (LNMTC) was detected by Western blot. Results In the present study, 2-DE patterns of microdissected LPTC and LNMTC were established, and 22 differential proteins in the above two tissues were identified, of which 14 were down-regulated in LNMTC and 8 were up-regulated in LNMTC.Conclusion The 22 differential proteins may play some roles in the process of lymph node metastasis in hLSC, and the data provide new clues for metastasis-associated biomarker screen and mechanism of hLSC.

Objective:To find out the occurrence of anxiety and depressive symptoms, and the major risk factors, and the participation rate, as well as the experience of medical personnel who are involved in the intervention.Methods:Since January 2018, a pilot intervention had been carried out on pregnant women registered in the antenatal clinic. The Generalized Anxiety Disorder Scale and the Patient Health Questionnaires were used as screening tools for anxiety and depression symptoms, and risk factors were screened too. Interventions were carried out on the psychological moderate and high risk women by obstetric medical staff and mental health personnel. A qualitative interview was conducted on the intervention providers.Results:A total of 9 488 pregnant women were included, and the positive rate of moderate anxiety symptoms was 3.0%, the positive rate of severe anxiety symptoms was 1.4%; the positive rate of moderate depression symptoms was 18.1%, and the positive rate of severe depressive symptoms was 5.2%; the comorbidity rate of anxiety and depression symptoms was 3.4%. The first three risk factors for pregnant women with anxiety symptoms were: once had premenstrual stress symptom, excessive fear of fetal growth, previous abnormal maternal history; the first three risk factors for pregnant women with depressive symptoms: once had premenstrual stress symptom, previous abnormal maternal history, this pregnancy was cherished; the first three risk factors for pregnant women with moderate and above anxiety combined with depression were: once had premenstrual stress symptom, excessive fear of fetal growth, and fear the delivery process is not successful. Among the psychological moderate risk pregnant women, 19.1% participated in the midwife joint counselor clinic, and 1.7% participated in the obstetrician joint psychological specialist nurse clinic, 2.2% of the pregnant women with high risk participated in the psychological multidisciplinary consultation, and 1.7% referred to the psychiatric department. From the interviews, providers believed that it was necessary to further strengthen the ability of psychological intervention capacity, and the psychological screening tools needed to be improved, and the problems sought by pregnant women involved in physical, psychological and social aspects, and the influence of pregnant women's treatment compliance included multiple factors.Conclusions:The psychological health care service during pregnancy was feasible, but the screening scales needed further examination. The mental health care ability of obstetric medical staff needed to be strengthened, and the compliance of pregnant women with mental health services needed to be improved.

Objective: To explore the effect of heme oxygenase-1 (HO-1) on level of reactive oxygen species (ROS) induced by zinc oxide nanoparticles (ZnO-NPs) in Human umbilical vein endothelial cells line EA.hy926. Methods: The EA.hy926 cells in logarithmic growth phase were incubated with 0.0, 2.5, 5.0, 10.0 and 15.0 mg/L ZnO-NPs respectively. The ROS level, reflected by mean fluorescence intensity (MFI), was examined by flow cytometer after 4 hours exposure, the protein expression of HO-1 which was determined by Western Blot after exposed to ZnO-NPs for 24 hours. Cells incubated with 15.0 mg/L were set as the ZnO-NPs group; a blank control group was set at the same time. Cells were pretreated with HO-1 inhibitor zinc protoporphyrin (ZnPPIx) and HO-1 activator cobalt protoporphyrin (CoPPIx), they were classified as ZnPPIx group and CoPPIx group. 15 mg/L ZnO-NPs was chosen to conduct the experiment of HO-1 activation and inhibition. Cells were classified as ZnPPIX+ ZnO-NPs group and CoPPIx+ ZnO-NPs group after pretreated with 10 μmol/L ZnPPIx or CoPPIx for 1 h, added 15 mg/L ZnO-NPs to cell culture medium. In all groups ROS levels were detected after exposed to ZnO-NPs for 4 hours, the protein expression of HO-1 was detected after exposed to ZnO-NPs for 24 hours. Results: With the increased dose of ZnO-NPs, levels of ROS and HO-1 in EA.hy926 cells were clearly elevated (the MFI of 0.0, 2.5, 5.0, 10.0 and 15.0 mg/L ZnO-NPs incubated groups was 22 627.22±718.27, 24 726.47±568.52, 31 141.75±1 312.24, 39 824.82±4 774.74, 50 569.03±1 497.63 respectively, and HO-1 relative expression were 0.16±0.01, 0.19±0.02, 0.16±0.01, 0.23±0.02, 0.92±0.06 respectively). HO-1 expression in ZnPPIx pretreatment group decreased compared with ZnO-NPs group (1.05±0.05 vs. 1.12±0.01, P<0.05), meanwhile ROS level enhanced (62 683.95±2 589.59 vs. 53 654.53±2 229.01, P<0.05). However, CoPPIx pretreatment had higher HO-1 level and lower level of ROS compared with ZnO-NPs group (HO-1: 1.74±0.11 vs. 0.22±0.03, P<0.05; ROS: 32 845.04±993.48 vs. 53 654.53±2 229.01, P<0.05). Conclusions Exposure to ZnO-NPs significantly induced ROS generation in EA.hy926 cells in a dose-dependent manner. HO-1 regulated ZnO-NPs-induced oxidative stress.

Objective:To explore the feasibility of adjusting the thyroid stimulating hormone (TSH) cut-off values for screening congenital hypothyroidism (CH) in newborns according to the seasons, and to establish a TSH screening cut-off value that is suitable for the actual situation in Quanzhou City.Methods:A total of 355 868 newborns who underwent CH screening at the Neonatal Disease Screening Center in Quanzhou in Fujian Province from January 1, 2018 to December 31, 2021 were included in the study. Heel blood samples were collected and made dried blood spots. TSH levels in the heel blood of newborns were measured using genetic screening processor (GSP). The TSH cut-off values for CH screening were established using the percentile method and the receiver operating characteristic (ROC) curve method, and were adjusted based on seasonal factors. The screening efficiency was then compared with the current TSH cut-off value (9.00 mU/L).Results:According to the percentile method, the 99th percentile TSH levels in newborn heel blood in spring, summer, autumn, and winter were 9.47, 9.01, 9.41, and 10.43 mU/L, respectively. Using these values as cut-off values, the initial screening positive rates in spring, summer, autumn, and winter were 1.00% (848/84 652), 1.04% (913/87 524), 1.00% (951/94 875), 1.00% (889/88 817) [1.27% (1 077/84 652), 1.05% (916/87 524), 1.23% (1 171/94 875), 2.01% (1 787/88 817) according to the current TSH cut-off value]. However, except for summer, there were 7, 6, and 17 cases of missed screening in spring, autumn, and winter, respectively. The cut-off values of TSH for the four seasons obtained by the ROC curve method were 9.01, 9.02, 9.01, and 9.01 mU/L, respectively. The initial screening positive rates in spring, autumn, and winter were consistent with the current cut-off values, at 1.27% (1 074/84 652), 1.23% (1 167/94 875), 2.01% (1 781/88 817), respectively, while in summer, it was 0.99% (866/87 524) [1.05% (916/87 524) according to the current TSH cut-off value], and the positive detection rates in all four seasons were 100.00%.Conclusions:It is not advisable to adjust the TSH cut-off value for CH screening according to seasons in Quanzhou City. Using the current TSH cut-off value of 9.00 mU/L for CH screening in Quanzhou City can effectively ensure the quality of screening.

BACKGROUNDThe glucose fluxes of individuals with prediabetes in Chinese population are not clear. This study was to determine whether the endogenous glucose production (EGP), oral glucose rate of appearance (Ra) and glucose rate of disappearance (Rd) were different in Chinese individuals with prediabetes under fasting conditions and following an oral glucose challenge.

METHODSFive subjects with type 2 diabetes, 5 subjects with prediabetes and 5 non-diabetic subjects matched for age, weight, fat free mass and body mass index underwent a 180 minute stable glucose isotope tracing ([6, 6-(2)H2] glucose, [1-(13)C] glucose, and [U-(13)C] glucose) study under fasting and after ingestion of a 75 g oral glucose load. Isotope glucose enrichment was measured by gas chromatography-mass spectrometry. Insulin sensitivity was estimated using the oral glucose tolerance test (OGTT)-derived insulin sensitivity index, β cell function was determined by the insulinogenic index (δI30/δG30).

RESULTSThe insulin sensitivity index (P = 0.043) and insulinogenic index (P = 0.021) were decreased in subjects with prediabetes compared with non-diabetes. Fasting EGP was slightly higher (P = 0.29) and postprandial EGP was comparable in subjects with prediabetes and non-diabetes during 120 minutes after glucose ingestion, but nadir EGP occurred later in prediabetic than non-diabetic subjects. Ra did not differ among the three groups. Rd was substantially lower in subjects with prediabetes than non-diabetes after glucose intake (P = 0.013).

CONCLUSIONThe mild hyperglycemia observed among individuals with prediabetes may result from decreased Rd during the postprandial state.

Blood Glucose ; metabolism ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; Fasting ; blood ; Female ; Glucose ; metabolism ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; blood ; Isotope Labeling ; Male ; Middle Aged ; Prediabetic State ; blood

BACKGROUNDCytochrome b5 reductase 2 (CYB5R2) is a potential tumor suppressor that inhibits cell proliferation and motility in nasopharyngeal carcinoma (NPC). Inactivation of CYB5R2 is associated with lymph node metastasis in NPC. This study aimed to explore the mechanisms contributing to the anti-neoplastic effects of CYB5R2.

METHODSPolymerase chain reaction (PCR) assays were used to analyze the transcription of 84 genes known to be involved in representative cancer pathways in the NPC cell line HONE1. NPC cell lines CNE2 and HONE1 were transiently transfected with CYB5R2, and data was validated by real-time PCR. A chick chorioallantoic membrane (CAM) embryo model was implanted with CYB5R2-expressing CNE2 and HONE1 cells to evaluate the effect of CYB5R2 on angiogenesis. An immunohistochemical assay of the CAM model was used to analyze the protein expression of vascular endothelial growth factor (VEGF).

RESULTSIn CYB5R2-transfected NPC cells, PCR assays revealed up-regulated mRNA levels of Fas cell surface death receptor (FAS), FBJ murine osteosarcoma viral oncogene homolog (FOS), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), integrin beta 3 (ITGB3), metastasis suppressor 1 (MTSS1), interferon beta 1 (IFNB1), and cyclin-dependent kinase inhibitor 2A (CDKN2A) and down-regulated levels of integrin beta 5 (ITGB5), insulin-like growth factor 1 (IGF1), TEK tyrosine kinase (TEK), transforming growth factor beta receptor 1 (TGFBR1), and VEGF. The angiogenesis in the CAM model implanted with CYB5R2-transfected NPC cells was inhibited. Down-regulation of VEGF by CYB5R2 in NPC cells was confirmed by immunohistochemical staining in the CAM model.

CONCLUSIONCYB5R2 up-regulates the expression of genes that negatively modulate angiogenesis in NPC cells and down-regulates the expression of VEGF to reduce angiogenesis, thereby suppressing tumor formation.

Animals ; Carcinoma ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Chickens ; Cytochrome-B(5) Reductase ; Down-Regulation ; Gene Regulatory Networks ; Genes, Tumor Suppressor ; Humans ; Nasopharyngeal Neoplasms ; Neovascularization, Pathologic ; Oxidoreductases ; Real-Time Polymerase Chain Reaction ; Transfection ; Up-Regulation ; Vascular Endothelial Growth Factor A