Objective:To discuss the situation and differences of primary and secondary school teachers'job characteristics between mainland China and Hong Kong in order to provide the basis for improvement of job charac-teristics.Methods:A total of 504 teachers (242 in mainland China and 262 in Hong Kong)were chosen to com-plete the Job Characteristics Scale of Primary and Secondary School Teachers (including job demands sub-question-naire of six factors and job resources sub-questionnaire of six factors).Results:Teachers'job demands and job re-sources scores in both two areas were higher than the median 3.The scores of workload,emotional demands, student's misbehavior,role stress,and hard ware conditions,autonomy,work reward of Hong Kong teachers were higher than mainland China teachers(Ps <0.05),while the coworker support score was opposite.In addition,there were gender difference in workload and occupation moral requirements in Mainland China (Ps <0.05),as well as work age difference in workload,occupation moral requirements,organizational support,coworker support,hardware conditions and work reward,while school stage difference in organizational support,hardware conditions and work reward in Hong Kong (Ps <0.05).Conclusion:It suggests that teachers'job characteristics are both high demands-high resourcestype in the two areas,but the highdegree and the demographic characteristics are different.

Objective:To investigate the clinical effects of health and safety management in elderly patients receiving gastroenteroscopy under sedation.Methods:From February 2018 to November 2019, 126 elderly patients admitted to the cadre medicine and gerontology department of our hospital to undergo gastroenteroscopy under sedation were included as research subjects.According to the digital random number method, they were divided into the control group and the test group(n=63, each group). The control group was given routine management, while the test group was given routine management plus health and safety management.Clinical effects and safety were analyzed and compared between the two groups.Results:There was no significant difference in scores of the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)between the two groups before intervention.After intervention, the scores of HAMA and HAMD were lower in the test group than in the control group[(39.2±3.1)scores vs.(48.6±2.1)scores, (40.1±4.1)scores vs.(52.6±5.5)scores, t=19.926 and 14.463, both P=0.000]. The incidence of postoperative complications was lower in the test group than in the control group(7.94% or 5/63 vs.19.05% or 12/65, χ2=14.209, P=0.002). The differences between maximum and minimum values of heart rate(HR), diastolic blood pressure(DBP), respiratory rate(RR)and systolic blood pressure(SBP)were lower in the test group than in the control group(all P<0.05). The length of the procedure was shorter and the anesthetic dose was lower in the test group than in the control group(9.11±2.56 min vs.13.56±3.05 min, 15.35±2.66 ml vs.21.67±6.15 ml, t=8.870 and 7.486, both P=0.000). Patient satisfaction was higher in the test group than in the control group( χ2=16.383, P=0.014). Conclusions:Health and safety management can improve emotional health, stabilize vital signs and enhance satisfaction in elderly patients undergoing gastroenteroscopy under sedation.

Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.

Objective To study the effect of dexmedetomidine in the functional endoscopic sinus surgery (FESS) on the recovery period of general anesthesia. Methods Fifteen min before the end of surgery, 40 FESS patients were treated with intravenous infusion of dexmedetomidine at 0.6μg/kg. The occurrence of cough response, degree of pain and agitation in patients were observed. Result The response score of choking cough of the patients with intravenous infusion of dexmedetomiindine was (1.2 ± 0.5), the score of VSA was (1.9 ± 0.5), and the degree of agitation was (1.2 ± 0.4). Conclusion For those undergoing FESS, postoperative use of dexmedetomidine 15 min before the end of surgery, can not only have an effective effect for reducing the incidence of choking cough and agitation and but also decrease the pain degree so that the patients can live through the general anesthesia recovery period.

Objective To investigate the prevalence of chronic kidney disease (CKD) and its risk factors in Chinese elderly persons.Methods All of the people who underwent physical examination and treatment in the geriatric department of Beijing Hospital during January 2004 to January 2007 were included in the study.Age, body height, body mass index and blood pressure were recorded.Bloody urine was ascertained by phase-contrast microscope, and urine protein was measured by dipstick test.The hemoglobulin, serum eretinine, blood urea nitrogen, blood lipid and serum uric acid were measured by autobiochemical analyzer.HbsAg was checked by enzyme-linked immunosorbent assay (ELISA).Glomerular filtration rate (GFR) was estimated by Crockeroft-Gauh equation and abbreviated MDRD equation.Binary logistic regression analysis was used to test the risk factors for proteinuria and CKD.Results The prevalence of proteinuria was 4.9% in 1082 elderly persons.And 47.23% of the elderly suffered from decreased renal function.The morbidity of CKD was 48.43%.Binary logistic regression analysis showed that diabetes(OR= 2.257) and microscopic hematuria(OR=5.324) were the risk factors of proteinuria (both P<0.05).And the risk factors for CKD were hypertension(OR= 1.459), coronary arth'erosclerotic heart disease(OR=3.290), chronic obstructive lung diseases(OR=2.094), malignant tumor(OR=2.072), hyperuricemia(OR= 1.928),anemia(OR=8.122)and hematuria( OR= 1.604) (all P<0.05).Conclusions The morbidity of CKD in Chinese elderly persons was 48.43%.And the related risk factors were diabetes,hypertension, hyperuricemia, coronary artherosclerotic heart disease and chronic obstructive lung disease.

Objective: To understand the living status and needs of children with high loneliness in low-income families to provide the possibility and feasibility of social worker model in school, and to provide reference for specific intervention. Methods: Based on the survey data in 2016, 225 children aged 6-18 with high loneliness were screened for in-depth analysis to investigate their living status. Results: In the high loneliness children, 98.6% were in primary and secondary schools, school-based intervention showed more feasibility; 62.2% of children were facing various degrees of guardianship absence, 52.3% of children’s caregiver suffered from physical health problems, 63.3% of caregivers did not have any work; 62.1% of children were in the middle or lower academic achievement, 24.1% of children were lack interests in learning; 49.5% of children had no good friends in the community, about 40% suffered verbal and emotional violence, 17.6% suffered physical violence,12.6% to 16.7% suffered peer bullying, and the adverse experience was significantly higher than the average level. Conclusion Children with high loneliness in low-income families are facing certain difficulties in life and social integration. They need professional support and assistance. Social workers in schools can provide help to those children with psychological and resource-based aids, which would be an effective way to precise assistance for children in distress.

OBJECTIVETo observe the clinical characteristics and short-term survival of patients with splenomegaly and acute-on-chronic liver failure related to chronic HBV infection.

METHODSElectronic medical records of patients with acute-on-chronic liver failure were collected to analyze the clinical parameters and 4-week survival of patients with or without splenomegaly.

RESULTSOf the 149 patients enrolled, the overall 28-day mortality rate was 48.3%, which was lower in patients with enlarged spleen than those without (34.2% vs 54.1%, P=0.034). Compared with patients without splenomegaly, patients with splenomegaly had lower platelet counts (P=0.001), lower ALT levels (P=0.005) and lower PT-INR (P=0.010). Although the occurrence of hepatic encephalopathy was comparable between patients with or without splenomegaly, severe conditions were more frequent in those without splenomegaly. Hepatic encephalopathy grades, serum creatinine levels, neutrophil percentages over 70%, PT-INR and splenomegaly were independent factors associated with the 28-day survival, and this novel model was superior to model of end-stage of liver disease in predicting the 4-week survival (P=0.017).

CONCLUSIONPatients with splenomegaly that evolves into acute-on-chronic liver failure have unique clinical characteristics and further clinical observations are warranted.

Acute-On-Chronic Liver Failure ; mortality ; physiopathology ; Chronic Disease ; Hepatic Encephalopathy ; physiopathology ; Humans ; Splenomegaly ; mortality ; physiopathology

Objective: To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index (BMI) and gut microbiota in the infants. Methods: A total of 1 752 healthy pregnant women and their infants (breast feeding) in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis (If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy). Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results: Compared to the group with no calcium supplementation during the pregnancy ((12.76±1.23), (17.68±0.76)kg/m²), the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy ((13.51±0.47), (17.91±0.23)kg/m²) were significantly higher(P<0.05). In the group with maternal calcium supplementation, the BMI at 6 months ((18.63±0.52)kg/m²), BMI increment ((5.71±0.54)kg/m²) and the content of lactobacillus (21.04%±3.68%) in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup ((17.69±0.89) kg/m², (4.17±1.01) kg/m² and 12.28%±3.86%) (P<0.05). In the group without maternal calcium supplementation, the content of lactobacillus (20.15%±4.87%) in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup (14.64%±3.71%) (P<0.05). Conclusion Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.

Objective:To investigate the value of ultrasound and Ki-67 for early predicting pathological complete response (pCR) of triple negative breast cancer(TNBC) after neoadjuvant chemotherapy (NAC).Methods:Retrospective analysis was performed in 190 patients with TNBC who underwent surgery after NAC treatment at the Cancer Hospital of Fudan University from January 2019 to December 2022. All patients underwent ultrasound examination before and after 2 and 4 cycles of NAC treatment. According to the operation pathological results after NAC, the patients were divided into pCR group and non-pCR group. The differences in ultrasound and Ki-67 parameters were compared between the pCR and non-pCR groups, and binary Logistic regression analysis was performed to determine the independent predictors for pCR. The ROC curve was plotted to evaluate the diagnostic efficacy.Results:Tumor maximum diameter, relative change rates of tumor maximum diameter after 2-cycle and 4-cycle NAC (ΔD2, ΔD4), relative change rate of lymph node short diameter after 2-cycle NAC (ΔS2), T-stage, N-stage and Ki-67 showed statistically significant differences between the pCR group and the non-pCR group (all P<0.05). Logistic regression analysis showed that ΔD4, T-stage, N-stage and Ki-67 were independent predictors for pCR ( OR=1.029, P=0.011; OR=0.300, P=0.009; OR=0.653, P=0.048; OR=1.028, P=0.001). The area under the curve (AUC) of pCR was 0.804 (95% CI=0.742-0.866), the sensitivity and specificity were 67.5% and 83.2% respectively. Conclusions:The combination parameters of ΔD4, T-stage, N-stage and Ki-67 have certain clinical value for predicting pCR of TNBC.

Objective:To understand the genome sequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and spike protein variations during different epidemic periods in Wuxi City.Methods:Nucleic acid was extracted from the nasopharyngeal swab samples of six local cases of coronavirus disease 2019 (COVID-19) (from January to February, 2020) and 13 imported cases of COVID-19 (from March to September, 2021) in Wuxi City, and the whole genome was amplified to construct the sequencing library. The second-generation sequencer was used for sequencing. The CLC Genomics Workbench (21 version) software was used to analyze the offline data with NC_045512.2 as the reference strain, and MEGA 7.0 software was used to construct the phylogenetic tree.Identification of type was conducted by Nextstrain typing method and phylogenetic assignment of named global outbreak lineages (Pangolin) typing method.Results:There were five subtypes in Nextstrain and seven subtypes in Pangolin of the nineteen patients with COVID-19. Compared with NC_045512.2, the median nucleotide mutation sites were 29 (range 0 to 42) and amino acid mutation sites were 20 (range 0 to 34). The six local and 13 imported cases had no common nucleotide mutation sites and were in different evolutionary branches. The sequences of the six local cases were highly homologous with the reference strain sequences (NC_045512.2) at the early stage of the pandemic, and the evolutionary distance was close to that of the reference strain. The 13 imported cases were obviously divided into three evolutionary branches (Alpha, Beta, Delta variant).The four Beta variants shared eight amino acid mutation sites in spike protein, and the two Alpha variants shared eight amino acid mutation sites in spike protein, and the seven Delta variants shared five amino acid mutation sites in spike protein.Conclusions:New mutations of SARS-CoV-2 are constantly emerging during the epidemic. The increase of the nucleotide sites number may result in the change of spike protein amino acid. Therefore, the whole-genome sequencing analysis plays an important role in the accurate tracing of epidemic origin and adjustment of prevention and control measures.