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.

OBJECTIVETo observe the prevention and therapeutic effects of tanshitone (TAN) on retinoic acid induced osteoporosis in mice.

METHODThe mice osteoporosis was induced by given retinoic acid intragastrically for two weeks. The histomorphological features of bone were observed and biochemical indexes in serum (Ca, P, ALP, TRAP, E2, BGP) were determined after the mice were given TAN at the dose of 40, 80, 160 mg x kg(-1) respectly.

RESULTTanshinone can induce high conversion of osteoporosis. The levels of P, ALP, TRAP and BGP in the TAN groups were lower than the model group, while the E2 level was higher than the model group.

CONCLUSIONTanshitone can prevent the loss bone in the experimental mice. The mechanism may be that it improves the level of estrogenic hormone and inhibits the high bone turnover.

Alkaline Phosphatase ; blood ; Animals ; Bone Density ; drug effects ; Disease Models, Animal ; Diterpenes, Abietane ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Mice ; Osteoporosis ; blood ; chemically induced ; drug therapy ; prevention & control ; Phenanthrenes ; administration & dosage ; Tretinoin ; adverse effects

Objective:To investigate the current status of chronic respiratory disease (chronic obstructive pulmary disease, bronchial asthma and obstructive sleep apnea) management capacity in community health centers in Beijing Miyun district.Methods:From November 21 to 22,2018,nineteen community health centers and 65 general practitioners in Miyun district of Beijing were selected to participate in a questionnaire survey. The self-designed questionnaire was divided into two parts: the questionnaire for medical institutions(institution questionnaire)and questionnaire for general practitioners(doctor questionnaire). The institution questionnaires were distributed by the Miyun District Health Commission,and filled in by the person in charge of the institution; the knowledge questionnaires were sent to all general practitioners of 4 community health service centers. The two independent sample t test was used to compare the measurement data in accordance with normal distribution between the two groups, and analysis of variance was used for multi group comparison. Results:Nineteen institution questionnaires were sent to all centers in the district and all 19 valid questionnaires were recovered. Among them, 18 centers thought that chronic respiratory diseases should be included in the management of chronic non-communicable diseases, and health records should be established to achieve regular follow-up monitoring, but only one center had put asthma in the record. Nine centers purchased pulmonary function instrument; 8 centers were equipped with inhaled glucocorticoid, and 1 center was equipped with β 2-receptor agonists. The effective recovery rate of knowledge questionnaire was 100.0% (65/65). There was no significant difference in the knowledge scores of three kinds of chronic respiratory diseases (chronic obstructive pulmary disease, bronchial asthma, obstructive sleep apnea) among general practitioners [(63±19), (64±23), (62±21), F=0.087, P>0.05]. The scores of general practitioners with different ages and professional titles were (57±15), (66±13), (42±16) and (54±19), (67±12), (68±11) respectively. There were significant differences in the knowledge scores of general practitioners with different ages and professional titles ( F= 8.582 and 6.079, all P<0.05). The average scores of general practitioners with age>50 years or junior professional title were lower than others. Conclusions:The leaders of each center in Miyun district have a clear understanding of the necessity of diagnosis and treatment of chronic respiratory diseases, but there are still some problems, such as insufficient attention to chronic respiratory system, insufficient investment in disease management infrastructure, and lack of professional knowledge of chronic respiratory diseases among general practitioners. It is hoped that in the future, chronic respiratory diseases can be introduced into public health service projects, investment in related disease infrastructure will be strengthened, and comprehensive respiratory knowledge and ability training courses suitable for grass-roots general practitioners can be popularized as soon as possible.

Objective:To investigate the status quo of nursing capacity for chronic respiratory disease in community health service centers.Methods:A questionnaire survey on nursing capacity for chronic respiratory disease was conducted in November 2018 among nurses working in internal medicine, general practice and chronic disease management departments of 4 community health service centers in Beijing Miyun District. The questionnaire included the knowledge and work content of chronic respiratory diseases. At the same time semi-structured interviews was conducted on the role of nurses in the management of chronic respiratory diseases among nurses selected by purposive sampling method.Results:In the study 63 valid questionnaires were collected and 14 nurses were interviewed. The results showed that the total score of nurses′ knowledge about chronic respiratory diseases was (62.0±14.4), and the scores of knowledge of chronic obstructive pulmonary disease (COPD), bronchial asthma and obstructive sleep apnea were (55.5±19.3), (61.0±21.6), (69.5±25.1), respectively. The total knowledge score of nurses with middle-rank professional title or above was higher than that of those with primary title [(67.0±12.9) vs. (54.0±13.6), t=-3.07, P<0.01]. The work contents mainly involved were nursing procedures(22/63,34.9%), health education(18/63,28.6%) and nursing evaluation(8/63,12.7%).Three themes were extracted from the deep interviews: the main work contents for nurses should be nursing procedures, nurses should participate in the chronic respiratory disease management as a member of the integrated medical team; nurses expected practice-oriented trainings of chronic respiratory disease management. Conclusions:The knowledge of chronic respiratory diseases among nurses in community health center needs to be improved, and the nursing skills special for respiratory diseases are needed. It is suggested to develop training courses and nursing guidelines suitable for community health centers and for nurses to participate in chronic respiratory disease management as team members, so that nurses in primary care institutions can play a better role in the management of chronic respiratory diseases.

OBJECTIVETo explore the effects of hyperbaric oxygen preconditioning (HBOP) on human stress responses during acute exposure to high altitude and the possible mechanism.

METHODSEight male subjects were treated with HBOP for 3, 5, and 7 days, followed by acute exposure to hypoxia simulating an altitude of 4,000 m. Subjects at rest were divided into sea-level control group, simulated high-altitude group, and 5-day HBOP intervention group, while subjects after physical load were divided into sea-level control group, simulated high-altitude group, 3-day HBOP intervention group, and 7-day HBOP intervention group. The physical load test was performed for each subject before and after HBOP, and the plasma levels of dopamine (DA), epinephrine (E), norepinephrine (NE), and adrenocorticotropic hormone (ACTH) were determined before and after exercise. The physical load test was performed by stepping up on to a 30 cm-high stepping stool at a rate of 25/min for 5 minutes, which was a type of moderate physical exercise. The stepping rate and timing were controlled by a metronome.

RESULTSThe levels of DA, E, NE, and ACTH at rest and after physical load were significantly higher in subjects acutely exposed to high altitude than in the sea-level control groups (all P<0.05). Moreover, the levels of DA, E, NE, and ACTH at rest were significantly higher after acute exposure to high altitude in the 5-day HBOP intervention group than in the simulated high-altitude group (all P<0.01). Except for the ACTH level in the 3-day HBOP intervention group, the levels of DA, E, NE, and ACTH after physical load were significantly higher after acute exposure to high altitude in the 3-day and 7-day HBOP intervention groups than in the simulated high-altitude group (all P<0.01).

CONCLUSIONHBOP can elevate the plasma expression of DA, E, NE, and ACTH, and then speed up the establishment of a new balance of homeostasis to adapt to the acute hypoxia at high altitude.

Adrenocorticotropic Hormone ; blood ; Altitude ; Dopamine ; blood ; Epinephrine ; blood ; Exercise ; Homeostasis ; Humans ; Hyperbaric Oxygenation ; Hypoxia ; blood ; Male ; Norepinephrine ; blood ; Rest ; Stress, Physiological

Objective To explore the computed tomography angiography(CTA)and clinical features of Takayasu's arteritis(TA)with peripheral artery involvement.Methods In this retrospective study,CTA scan was performed in a total of 184 TA patients.TA patients were divided into two groups:60 patients within peripheral artery involvement(peripheral artery involvement group)and 124 patients without peripheral artery involvement(peripheral artery non-involvement group).The difference in comparison of clini-cal data and CTA findings were analyzed.Results A total of 194 peripheral arteries were involved in 60 patients.The most suscep-tible peripheral artery were axillary artery(52,26.8％),middle cerebral artery(26,13.4％)and femoral artery(22,11.3％).In the peripheral artery involvement group,the most common CTA manifestation was luminal stenosis(141,72.7％).The lumen dilata-tion,lumen stenosis with dilatation and wall calcification were not easy to be observed.The age and duration of disease in peripheral artery involvement group were significantly greater than those in peripheral artery non-involvement group(P＜0.05).The proportion of the peripheral artery involvement group in the active phase was significantly lower than that of the peripheral artery non-involvement group(P＜0.05).The incidence of pain in the limbs in peripheral artery involvement group was significantly higher than that in peripheral artery non-involvement group(P＜0.05).The utilization rate of tocilizumab in the peripheral artery involvement group was significantly higher than that in the peripheral artery non-involvement group(P＜0.05).Conclusion TA involving peripheral arteries is more common in patients with a long course of disease and in the inactive phase.Patients are prone to pain in their limbs.The CT A manifestations of these patients are also special,that is,the involved peripheral arteries are not prone to lumen dilatation and wall calcification.

We proposed a new stitching method based on sift features to obtain an enlarged view of transmission electron microscopic (TEM) images with a high resolution. The sift features were extracted from the images, which were then combined with fitted polynomial correction field to correct the images, followed by image alignment based on the sift features. The image seams at the junction were finally removed by Poisson image editing to achieve seamless stitching, which was validated on 60 local glomerular TEM images with an image alignment error of 62.5 to 187.5 nm. Compared with 3 other stitching methods, the proposed method could effectively reduce image deformation and avoid artifacts to facilitate renal biopsy pathological diagnosis.
Algorithms ; Artifacts ; Humans ; Image Processing, Computer-Assisted ; methods ; Kidney Glomerulus ; ultrastructure ; Microscopy, Electron, Transmission ; methods

Objective:To investigate the clinical efficacy of second-line therapy with dasatinib in the treatment of chronic myeloid leukemia.Methods:Sixty patients with chronic phase chronic myeloid leukemia who received treatment in Hongqi Hospital of Mudanjiang Medical University between January 2015 and January 2021 were included in this study. They were randomly divided into control and observation groups, with 30 patients in each group. The control group was treated with conventional chemotherapy, and the observation group was treated with conventional chemotherapy combined with oral dasatinib. All patients were treated for 6 months. Clinical efficacy, immune function indexes, quality of life score, and incidence of adverse reactions (abnormal liver function, rash, fatigue, peripheral edema, nausea and vomiting, alopecia) were compared between the two groups.Results:Objective response rate (ORR) in the observation group was significantly higher than that in the control group [83.33% (25/30) vs. 53.33% (16/30), χ2 = 6.23, P < 0.05). Before treatment, there were no significant difference in immune function indicators between the two groups ( t = 0.03, 0.20, 0.44, all P > 0.05). After treatment, CD 4/CD 8, CD 3+ and natural killer cells in the observation group were (1.03 ± 0.32), (43.77 ± 6.62)%, (31.12 ± 3.38)%, respectively, which were significantly higher than (0.74 ± 0.28), (35.79 ± 6.27)%, (28.22 ± 2.84)% in the control group ( t = 3.69, 4.78, 3.60, all P < 0.05). The scores of social functioning, material well-being life, mental health, somatic health in the observation group were (85.48 ± 6.25) points, (80.12 ± 6.34) points, (79.94 ± 6.48) points, and (77.92 ± 5.81) points, respectively, which were significantly higher than (72.79 ± 5.89) points, (63.47 ± 5.82) points, (68.87 ± 6.08) points, (63.14 ± 6.12) points in the control group ( t = 7.91, 10.59, 6.82, 9.59, all P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group [16.67% (5/30) vs. 40.00% (12/30), χ2 = 4.02, P < 0.05). Conclusion:Second-line therapy with dasatinib for chronic phase chronic myeloid leukemia is effective and safe. It can effectively improve the efficacy and safety of chemotherapy and can also improve immunological function and quality of life.

Alzheimer's disease(AD)represents the main form of dementia;however,valid diagnosis and treatment measures are lacking.The discovery of valuable biomarkers through omics technologies can help solve this problem.For this reason,metabolomic analysis using ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS)was carried out on plasma,hippocampus,and cortex samples of an AD rat model.Based on the metabolomic data,we report a multi-factor combined biomarker screening strategy to rapidly and accurately identify potential bio-markers.Compared with the usual procedure,our strategy can identify fewer biomarkers with higher diagnostic specificity and sensitivity.In addition to diagnosis,the potential biomarkers identified using our strategy were also beneficial for drug evaluation.Multi-factor combined biomarker screening strategy was used to identify differential metabolites from a rat model of amyloid beta peptide 1-40(Aβ1-40)plus ibotenic acid-induced AD(compared with the controls)for the first time;lysophosphati-dylcholine(LysoPC)and intermediates of sphingolipid metabolism were screened as potential bio-markers.Subsequently,the effects of donepezil and pine nut were successfully reflected by regulating the levels of the abovementioned biomarkers and metabolic profile distribution in partial least squares-discriminant analysis(PLS-DA).This novel biomarker screening strategy can be used to analyze other metabolomic data to simultaneously enable disease diagnosis and drug evaluation.

The cross regional loose medical alliance is an important carrier in the current integrated development process of medical services in the Yangtze River Delta region. Smith policy implementation process model was used to analyze the development difficulties of cross regional loose medical alliances from idealized policies, policy implementation institutions, policy target groups, and policy implementation environment. Such medical alliances were formed under the background of integrated development in the Yangtze River Delta, with Shanghai′s tertiary public hospitals as leading units and medical institutions in Jiangsu, Zhejiang, and Anhui provinces as member units. Analysis showed that the policies for such medical alliances development had not yet clearly defined the organizational management mode, operational mechanism, and implementation path, and the corporate governance structure of medical alliance was immature; The policy implementation agencies were relatively lagging behind in the support of special funds and the formulation of related supporting policies; Participation of policy target groups was insufficient and their incentive mechanisms was imperfect; There were problems in the policy implementation environment, namely inconsistent medical and health service regulations and systems in different regions, different health financing capabilities of local governments, insufficient coordination of medical institution management concepts, and a lack of unified standards in information systems. Based on the above difficulties, this study proposed to strengthen the development planning and layout of cross regional loose medical alliances, and improve the corporate governance structure; To strengthen the government′s main responsibility and improving policy implementation capabilities; To improve the internal cooperation and operation mechanism of cross regional loose medical alliances, and enhance the sense of identity of the target group; To optimize the policy implementation environment and implement various support measures, so as to provide references for further promoting the coordinated development of high-quality medical resources in the Yangtze River Delta region.