Administrative Personnel ; psychology ; Burnout, Professional ; Female ; Humans ; Male ; Reproducibility of Results ; Research Personnel ; psychology ; Surveys and Questionnaires

Adult ; Burnout, Professional ; Female ; Humans ; Life Change Events ; Middle Aged ; Occupations ; Professional Competence ; Work ; psychology ; Young Adult

BACKGROUND: With mechanical ventilation widely used in intensive care unit, the ventilator associated pneumonia (VAP) has become a common and serious complication in critically ill patients. Compared with adults, the incidence of VAP and the mortality are higher in children in pediatric intensive care unit (PICU) because of immune deficiency, severe basic diseases, and increased use of artificial airway or mechanical ventilation. Hence it is of significance to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence and mortality of VAP in children. METHODS: From January 2008 to June 2010, 2758 children were treated in PICU of Wuhan Children's Hospital. Among them, 171 received mechanical ventilation over 48 hours in PICU, and 46 developed VAP. The distribution and drug-resistance pattern of the pathogenic bacteria isolated from lower respiratory tract aspirations were analyzed. RESULTS: A total of 119 pathogenic microbial strains were isolated. Gram-negative bacilli (G-) were the most (65.55％), followed by fungi (21.01％) and gram-positive cocci (G+, 13.45％). Among them, the most common pathogens were Acinetobacter baummannii, Escherichia coli, Klebsiella pneumoniae, candida albicans and coagulase-negative staphylococci. Antibiotic susceptibility tests indicated that the multiple drug-resistances of G- and G+ to antibiotics were serious. Most of G- was sensitive to ciprofloxacin, amikacin, imipenem, meropenem, cefoperazone-sulbactam and piperacillin-tazobactam. The susceptibility of G+ to vancomycin, teicoplanin and linezolid were 100％. Fungi were almost sensitive to all the antifungal agents. The primary pathogens of VAP were G-, and their multiple drug-resistances were serious. CONCLUSION: In clinical practice we should choose the most sensitive drug for VAP according to pathogenic test.

BACKGROUND: With beta-lactam drugs and immunosuppressants widely used, the infection caused byAcinetobacter baumannii (Ab) has become more and more serious with multidrug resistant Acinetobacter baumannii (MDRAb) emerging and worsening rapidly. Compared with other patients, the incidence and multidrug resistance of MDRAb are higher in children in pediatric intensive care unit (PICU) because of immune deficiency, severe basic diseases, prolonged hospitalization and invasive operations. Hence it is significant to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence of MDRAb in children. METHODS: A total 115 patients with MDRAb pneumonia and 45 patients with negative MDRAb (NMDRAb) pneumonia who had been treated from January 2009 to August 2011 were studied retrospectively at the PICU of Wuhan Children's Hospital. Clinical data were analyzed with univariate and multivariate Logistic regression. RESULTS: In 176 clinical strains ofAcinetobacter baumannii isolated, there were 128 strains of MDRAb, accounting for 72.73％. Drug susceptibility tests showed that the resistance rates of β-lactam antibiotics were more than 70％ except for cefoperazone sulbactam. The rates to carbapenems were higher than 90％. They were significantly higher than those of NMDRAb. Amikacin, levofloxacin, ciprofloxacin and minocycline had the lowest drug-resistance rates (<20％). Multivariate Logistic regression revealed that ICU stay, the time of mechanical ventilation, anemia, hypoproteinemia and the use of carbapenems were independent risk factors for MDRAb pneumonia. CONCLUSIONS: MDRAb is an important opportunistic pathogen to pneumonia in PICU, and its drug-resistance is severe. It increases significantly the mortality of patients. It is important to take the effective prevention measures for controlling it.

Objective To estimate the difference of PS、CBV/CBF in the evaluation pf angiogenesis and growth behavior of the C6 glioma.Methods Sixty adult Wistar rats were divided into 3 groups randomly.CT perfusion were performed at the time of 5,13,20 d after the rats were inoculated C6 glioma cells.Permeability surface(PS),cerebral blood volume(CBV),cerebral blood flow(CBF)of different part of the tumor(central part,peripheral part,adjacent part and contralateral normal parenchyma)were measured at different time.Results At the central parts of the lesions,there were obvious difference between different time of tumor growth among PS[(3.94?0.15),(8.47?0.34),(5.20?0.65)ml? 100g~(-1)?min~(-1)],CBF[(280.33?8.82),(388.33?14.00),(116.16?11.54)ml? 100g~(-1)?min~(-1)],CBV[(7.75?0.27),(12.73?0.98),(5.14?0.66)ml?100g~(-1)](F=4.421,P= 0.013;F=11.370,P=0.000;F=15.789,P=0.000).There were statistical difference of PS at the different time in both the peripheral and adjacent parts of the glioma.(F=13.567,P=0.000;F=12.470, P=0.000).No difference were detected in CBF or CBV at different time of the peripheral parts of the tumors(F=1.176,P=0.336;F=0.148,P=0.710).there were significant difference between different time of tumor growth among CBF[(175.33?12.95),(275.50?13.76),(246.33?12.81)ml? 100g~(-1)?min~(-1)],CBV[(4.15?0.47),(8.05?0.30),(7.54?0.89)ml?100g~(-1)]at the adjacent parts of the tumors(F=24.176,P=0.000;F=17.148,P=0.000;F=15.791,P=0.000). Coneluslon CBV,CBF can reflect the number and volume of the tumor vessels,while PS can directly reflect the function of the angiogenesis and the behavior of the glioma.

In this paper, based on the special influence of supramolecular chemistry on the basic theory of Chinese medicines ( CM) , the authors further analyzed the history of meridian tropism and natural origins of CM organisms and explained CM ingredients and the universal regularity of the automatic action of the supramolecular "imprinting templates" hole channel structure. After entering human bodies, CMs, as the aggregation of supramolecular "imprinting templates" , automatically seek supramolecular subjects that are matched with their "imprinting templates" in human meridians and organs for the purpose of self-recognition, self-organization, self-assembly and self-replication, so as to generate specific efficacy in meridians and organs, which is reflected as the meridian tropism phenomena at macro level. This regularity can be studied by in vitro and in vivo experimental studies. In vitro methods are mostly supra molecular structure analysis and kinetic and thermodynamic parameter calculation; Whereas in vivo methods are dominated by the analysis on object component distribution, chromatopharmacodynamic parameters and network chromatopharmacodynamic parameters; Particularly, the acupoint-medicine method can simplify to study the supramolecular subject-object relations. Consequently, CM's'meridian tropism reveals the universal regularity for interactions of macromolecular and micromolecular "imprinting templates" of subjects and objects in natural organisms. As the first barrier for the material base of the CM theory and breakthrough in the modernization of the basic CM theory, meridian tropism plays an important role in studies on basic theories of the basic CM theory.
Acupuncture Points ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; Meridians

OBJECTIVETo analyze the reliability and validity of Instrument zur stre beta bezogenen Tätigkeitsanalyse 6.0 (ISTA 6.0).

METHODS991 participants were sampled with stratified cluster randomly methods from various kinds of occupations, including teachers in primary and middle schools, doctors, bankers and environmental protection officers in order to study the reliability and validity of ISTA 6.0 with inter-item consistency and construct validity.

RESULTSThe Cronbach's alpha coefficient of ISTA 6.0 was over 0.7 with exception of Cooperation closeness (KOP) and Cooperation requirements (KER). Single factor analysis of construct validity of ISTA showed that the first and fifth subitem of Complexity (AK), the fifth subitem of Task control (HS) and Work organization problems (AOP) had lower factor loading (P < 0.05). The multilevel confirmatory factor analysis showed that the fit index and factor loading were significantly greater except KER of Regulation possibilities (RR) and Cooperation possibilities (KSP) of Regulation possibilities (RP). The non-normed fit index (NNFI) and Comparative fit index (CFI) were lower than 0.9, possibly because of irrationality of some subitems and lower factor loading of KER and KSP factor. It implied that Chinese edition of ISTA6.0 needed further improvement according to the modification index (MI) and the special knowledge for higher construct validity.

CONCLUSIONISTA 6.0 can measure truthfully occupational stressors. Owing to the difference of culture, economy and custom, some subitems of ISTA 6.0 does not fit in with Chinese situation. Therefore it will be revised further for use in China.

Burnout, Professional ; epidemiology ; China ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Sampling Studies

OBJECTIVETo compare of strain of mental workers by characteristics.

METHOD851 participants were sampled with stratified cluster random methods from various kinds of occupations, including teachers in primary and middle schools, doctors, bankers and environmental protection officers. The psychological strain was measured with SCL-90 and General Well-being Schedule (GWB). The physiological strain were assessed by Plasma sugar, TG, HDL, VLDL, LDL, CHOL, cortisol and ACTH level, neurobehavioral reaction function.

RESULTSThe subjects at age of 40-years exhibited the highest scores of SCL-90 significantly among three groups. Likewise, 20-years service group were higher than 10- and under 10 years groups. However females' GWB scores were higher than males'. It tended to be higher in postgraduate and undergraduate teachers than others groups, indicating the greater psychological strain increased, the higher age and service were. Plasma sugar, LDL, TG and CHOL level were compared; Subjects 40- years group were higher than 30- and 20 age groups, as well as senior versus minor. Female teachers were lower than males. Meanwhile single subjects were lower than married. As HDL level, 30-age group were lower decreased than 40-years group; 10-service group were responsible for lower HDL level than 20-years group; Divorced and spouse-lost teachers were higher concentration than single and married. VLDL level in under 10 years service were lower than 10-years group; The senior was the highest level of VLDL among three groups and the minor was the lowest. The tendency was equal to increased professional title; Married and spouse-lost groups were higher than single groups. It had no individual difference in plasma cortisol and ACTH. But reaction sensitivity in 40- and 30-age groups were lower than 20-age group. Likewise, 20- years service teachers had lower reaction and action sensitivity than 10- and under 10 years groups; Senior group was lowest among three groups; However 40- years old group were lower than 20- years group, postgraduate and undergraduate teachers were higher than others groups in muscle endurance. It indicated that reaction and action sensitivity had descent tendency with increased age and service length.

CONCLUSIONPsychological strain is higher with increased age, length of service and education career. The trend is the same as plasma sugar, TG, CHOL, HDL, LDL and VLDL, but neurobehavioral reaction function is decreased. In addition general well-being feeling of females is lower than males.

Adult ; Analysis of Variance ; Burnout, Professional ; Female ; Humans ; Male ; Occupations ; Sampling Studies ; Stress, Physiological ; Young Adult

Objective To judge method performance of routine biochemistry parameters on Roche Modular PPI testing system by using westgard's method evaluation decision chart.Methods We assessed imprecision(CV)from internal quality control and inaccuracy(bias)from external quality control evaluation.Combined estimates of imprecision and inaccuracy by plotting imprecision as the x-coordinate and inaccuracy as the y-coordinate to locate an expected operating point of every item on the chart.By comparing this operating point with allowable total errors(TEa),we can decide whether the performance is acceptable or not.Results In the 27 different parameters tested,imprecision and bias of calcium were 0.08 mmol/L and 0.06 mmol/L respectively,its performance was marginal.The imprecision of creatinine,urea,glucose, sodium,chloride and phosphorus were 3.20%,2.13%,1.52%,0.89 mmol/L,1.10% and 1.55%,the bias were 4.79%,0.96%,4.63%,0.80 mmol/L,1.74% and 4.13% respectively,their performance was good.M1 other 20 items were of excellence performance.Conclusions Routine biochemistry parameters on Roche Modular PPI testing system possessed good precision and accuracy,and their performance were acceptable.To judge method performance of biochemistry testing system by using westgard' s method evaluation decision chart was easy to do and suited for clinical laboratory.

The paper aimed to elucidate the specific impact of supramolecular chemistry on the Chinese medicine theories (CMT) in their modernization, after had summarized up the research status of supramolecular chemistry and analyzed the possible supramolecular forms of Chinese medicine (CM), as well as considered the problems in modernization of CM theories. On comparison of the classical chemistry that delt with chemical bonds among atoms, the supramolecular chemistry was rather concerned with varietes of weak noncovalent bonds intermolecules, and reflected the macro-apparent chemical properties of each molecules, and was the most appropriate chemical theories to explain the CMT and microcosmic materials. The molecules in the human body and Chinese material medica (CMM) formed supramolecules by way of self-assembly, self-organization, self-recognition and self-replication, with themselves or with complexation, composition, chelation, inclusion, neutralization etc. Meridian and Zang-fu viscera in CMT might be a space channel structure continuously consisted of unique molecules cavity that was imprinted with the supramolecularly template inside and outside of cells, through which the molecules in CMM interacted with the meridian and Zang-fu viscera. When small molecules in human body imprinted with macromolecules in meridian and Zang-fu viscera, in other words, they migrated along within imprinting channels of meridian and Zang-fu viscera on behavior of "Qi chromatography" impulsed by the heart beat, finally showed up on macroscopic the anisotropy of tissue and organ, as described namely as visceral manifestation in Chinese medical science. When small molecules in CMM interacted with imprinting channel on meridian and Zang-fu viscera, the natural properties and efficacy regularities of CMM was reflected on macroscopic. Therefore, the special representation forms of basic CMT is based on the macroscopic expression of "Qi chromatography" abided by imprinting effect regularities, and on whether the imprinted template of small molecules matched with cavity template of macromolecules in meridian and Zang-fu viscera, only is the adequate representation of supramolecular chemistry for them. The CMM materials is the mixture including single molecules and supramolecules. The compatibility for CM prescriptions can significantly change the function rules. Therefore in the study of basic CMT, we should pay special attention to the laws of supramolecular chemistry. It is the most essential differences of the CMT from the modern medicine which established by the laws of single molecular theories.
Chemistry, Pharmaceutical ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Meridians ; Nanotechnology