A questionnaire survey was conducted among 319 mental health workers from 319 grassroots health institutions of 21 districts (cities,counties) in Chengdu in March 2013.The items of survey included general information of participants,subjective perceptions and status of community mental health services.Total 252 effective questionnaires were received,the average age of participants was (33.12 ± 9.39) years (19-61);59.5％ had clinical medicine and 16.3％ had public health background;most of them had educational levels of three-year college or below (84.9％);the average duration of working experience was 18 months;86.5％ was part-time;most of participants (87.4％) thought that the mental health service was a hard job and only 25.3％ expressed satisfaction with the work.Only 16.3％ of community health service centers had rehabilitation facilities for mental illness patients.Public health education was carried out for average (2.21 ± 1.62) times/year,the education for mental patients and family members was (1.62 ± 1.83) times/year.Between areas with sufficient detection rate of mental illness and those with insufficient detection rate,there was significant difference in training frequency of mental workers (P =0.012),there were no significant differences in having formal employment of mental workers (P =0.064),professional guidance,co-working with police officers,co-working with Disabled Persons' Federation,and the duration of working experience (all P ＞ 0.05).The results suggest that the capacity of mental health service in community levels is relatively weak in Chengdu,and the personnel training,public education and rehabilitation work of mental health need to be strengthened.

Objective: To explore the protective effect of salvia miltiorrhiza for enteral nutrition in S-MODS model rats.Methods: 70 Wistar rats were randomly divided into four groups: control group (n=10), model group (n=20), nutrition fibre group (n=20) and salvia miltiorrhiza for enteral nutrition group (n=20) . The experiment period was 12 days. At the end of experiment, blood routine, biochemistry index (ALB, AST, ALT, BUN, Cr, CK and CK-MB), the concentrations of IL-6,TNF-α and IL-1β were measured. Results: The model was successful by clinical manifestation,blood routine and pathology. The clinical symptom was improved, blood routine and pathology damage were relieved in salvia miltiorrhiza group. The concentrations of IL-6, TNF-α and IL -1 in salvia miltiorrhiza group were lower than model group and nutrition fibre group(P<0.05).Conclusions: Salvia miltiorrhiza for enteral nutrition could prevent gut function damage,protect intestinal mucosa and decrease the concentrations of pro-inflammatory cytokines.

AIM:To investigate the combination therapeutic effect of ulinastatin and berberine on burn sepsis in the rats.METHODS:The rats with burn sepsis were administrated with ulinastatin or berberine or combination therapy .The survival rate and body weight of the rats were measured .The levels of IL-6, IL-10 and TNF-αwere examined by ELISA.The morphological changes of the lung were observed by hematoxylin and eosin staining .The content of bacteria in the liver , lung and spleen tissues was detected .RESULTS:Combination of ulinastatin and berberine significantly increased the survival rate and body weight in the rats with burn sepsis .Moreover , combination therapy inhibited the elevation of IL-6 and TNF-αlev-els, whereas increased the IL-10 level.Combination therapy protected the structure of hepatic lobule , and further reduced the bacterial content in the liver , lung and spleen .CONCLUSION: Combination of ulinastatin and berberine improves the symptoms of burn sepsis by regulating the levels of IL-6, IL-10 and TNF-αand inhibiting the content of bacteria .

Objective To investigate the job stressors and burnout of senior nurses, and explore the possible strategies for alleviating stress and reduction of demission rate of senior nurses. Methods Two hundred and thirty head nurses and senior nurses were included in this study. Nurse Job Stressors Inventory (NJSI) and Maslach Burnout Inventory (MBI) were applied to evaluate the burnout and work-related stress of nurses with the combination of convenience sampling and cluster sampling. Results The NJSI scores of senior nurses and head nurses were (2.62 ± 0.56) points, (2.45 ± 0.47) points, the two scores were significantly different (t=-2.465,P<0.05); the scores of three dimensions of MBI in senior nurses were (30.01±11.86) points, (8.01±5.74) points, (35.35±9.57) points, while the scores in head nurses were (21.65±10.39) points, (5.14±3.37) points, (38.81±8.45) points. Statistically significant difference was seen between the two groups (t=-5.261,-4.705, 2.691,P<0.05). There was a higher positive correlation between job stressors and burnout of senior nurses (r=0.521) than head nurses (r=0.432). Conclusions The level of job burnout is higher in senior nurses than head nurses, attributing to the higher controllability of head nurses. It is suggested to reduce the job burnout of senior nurses and to keep senior nurses in the profession fields, based on the theory of magnetic hospital.

Objective To investigate the therapeutic effects of Flupentixol and Melitracen with conventional medicine on functional gastrointestinal disease of officers and soldiers.Methods Eighty-two officers and soldiers with functional gastrointestinal disease which defined by the Rome Ⅲ were randomly divided into two groups.The cases in therapy group were treated with Flupentixol and Melitracen combined with conventional medicine,and the cases in control group were simply treated with conventional medicine.The scales changes of clinical eddicacy,sympotoms,depression,anxiety amd the quality of life at the beginning and 8 weeks 'treatment were recorded.Results All offers and soldiers completed the therapy,and the overall response rate was 92.68％ in the therapy group and 70.13％ in the control group(x2 =6.61,P ＜0.05).The general severity score of symptoms,the score of depression and the score of anxiety in the therapy group after treatment were significantly lower than that of before treatment (t =27.76,16.24,16.28 ; P ＜ 0.05),while there were no significant difference in the control group(P ＞ 0.05).The score of the quality of life in the therapy group (SF-36) after treatment was improved significantly than that of before treatment (P ＜ 0.05),and the difference of two group was significant (P ＞ 0.05).Conclusion The therapy scheme of Flupentixol and Melitracen with conventional medicine on offiers and soldiers with functional gastrointestinal disease can improve the total effective rate,clinical symptoms,depression,anxiety and the quality of life.

Objective:To analyze the risk factors of neovascular glaucoma (NVG) after 25G pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR).Methods:A retrospective study. From January 2017 to December 2018, 340 PDR patients (340 eyes) with vitreous hemorrhage (VH) who were first treated with PPV in Tianjin Medical University Eye Hospital were included in the study. Among them, 185 were male and 155 were female, with an average age of 55.79±10.82 years. The duration of diabetes was 13.01±7.70 years, the fasting blood glucose was 7.55±2.15 mmol/L. Nineteen patients combined coronary heart disease, and 20 patients combined cerebral infarction. All patients underwent best-corrected visual acuity (BCVA), intraocular pressure (IOP), non-contact fundus examination, and fundus color photographs. BCVA was measured using an international standard Snellen visual acuity chart, and the values were converted to logarithm of the minimum angle of resolution (logMAR) scores for data analysis. The baseline logMAR BCVA was 2.04±0.73, The baseline IOP was 15.45±2.93 mmHg (1 mmHg=0.133 kPa). The duration of VH was 2.98±1.46 months, ranged from 3 weeks to 6 months. Three hundred and forty eyes included 93 eyes of PDR Ⅳ stage (27.35%), 107 eyes of Ⅴ stage (31.47%), and 116 eyes of Ⅵ stage (34.12%), combined tractional retinal detachment (TRD) 83 eyes. All patients underwent 25G standard three channel vitrectomy through the pars plana of the ciliary body. Preoperative anti-VEGF injection was performed in 57 eyes, internal limiting membrane (ILM) peeling in 234 eyes, combined phacoemulsification cataract surgery in 262 eyes and 141 eyes intravitreal anti-VEGF injection at the end of surgery. The patients were followed up for at least 12 months, with an average follow-up time of 10.80±5.79 months. NVG was defined as the presence of neovascularization in the anterior chamber angle or iris with an IOP higher than 21 mmHg after vitrectomy. Kaplan-Meier method and Cox univariate and multivariate regression were used to analyze the relationship between baseline factors, ocular factors, surgical factors and the occurrence of NVG after surgery.Results:Among 340 eyes, 66 eyes (19.41%) developed NVG after vitrectomy during 12 months of observation, NVG occurred from 6 to 335 days after surgery, and the mean period between vitrectomy and developing NVG was 98.00±5.79 days. The incidence of NVG was 11.50%, 15.29% and 20.75%, respectively in the 3rd, 6th and 12th month after PPV. The result of univariate analysis with the Cox regression analysis showed that the development of NVG at 12 months after surgery and age, combined coronary heart disease or cerebral infarction, combined with cataract phacoemulsification, ILM peeling, preoperative anti-VEGF injection had effect on postoperative NVG ( P<0.05). Ocular factors such as PDR staging, combined TRD, preoperative logMAR BCVA, preoperative intraocular pressure, etc. had no effect on the occurrence of NVG after surgery ( P>0.05). Combined cataract phacoemulsification surgery, internal limiting membrane peeling, surgical factors such as intracavity injection of anti-VEGF drugs 3 days before surgery, had an impact on the occurrence of NVG after surgery ( P<0.05). The meaningful variables of the Cox univariate analysis were incorporated into the multivariate Cox proportional hazard model for analysis, and the influencing factors of NVG after surgery were gradually regressed. The results showed that age, coronary heart disease or cerebral infarction, combined with phacoemulsification of cataract, and internal limiting membrane removal during surgery were independent risk predictors of NVG after surgery ( P<0.05). Conclusions:Younger, coronary heart disease or cerebral infarction, combined with cataract phacoemulsification are the risk factors of NVG in PDR patients after PPV. The removal of internal limiting membrane can reduce the incidence of NVG.

The incorporation of site-specific recombination systems can help to overcome bottlenecks in livestock transgenic technology. For evaluating the efficiency of Cre/lox mediated DNA recombination in embryos and somatic cells, a working model was established using rat mammary carcinoma cell line SHZ-88, aimed at creation of and use repeatedly of selected "friendly loci" in transgenic livestock. An integration vector pTE-lox2272-DsRed-loxP-GFP-loxP, which red fluorescence gene DsRed served as the first target gene and green fluorescence gene GFP as marker gene, was constructed for introduction of acceptor loci in genome. At the same time a replacement vector pT-lox2272-neo-loxP in which Neo coding sequence served as the second target gene was also constructed for replacing DsRed gene. Transgenic cell clones were produced by electroporating SHZ-88 cell with the integration vector. Cells from three transgenic clones selected randomly were further amplified and were then co-electroporated with the replacement vector as well as cre gene. Analysis of the expression patterns of DsRed and GFP indicated that among the 1 070 cell colonies the efficiency on marker GFP deletion was 91.1% and the efficiency on gene replacement was 29.3%. Molecular analysis by PCR and Southern blotting confirmed that the color patterns as expressed by cell colonies could represent the actual molecular events. This working model mediated by Cre/lox system should be useful for the improvement of the present animal transgenic technology.

ObjectiveTo determine the feasibility of using left ventricular volume-time curve in the evaluation of left ventricular diastolic function,and to analyze characteristics of left ventricular volume-time curve changcs in hypertrophic cardiomyopathy (HCM).MethodsSeventeen cases of HCM and 12 healthy volunteers received cardiac MRI (CMRI) examination,and left ventricular (LV) 2-chamber long and short axis cine imaging were performed,LV volume-time curves were reconstructed and platform time,different diastolic volume recovery (DVR) time and their corresponding filling velocity were calculated from LV volume-time curve off-line.The DVR time and their corresponding filling velocity were analyzed by using multiple linear regression analysis. Results Compared with the group of healthy volunteers,ventricular septal HCM group had delayed left ventricular 50％,70％ DVR time[ (8.9 ± 1.3) versus (7.7 ± 0.8 ) phase,F=6.787,P=0.016;(11.3 ±1.6) versus(9.7±1.8) phase,F=4.927,P=0.036] and shortened plateau time [ ( 1.8 ± 1.7) versus ( 4.1 ± 1.4 ) phase,t =6.787,P ＜ 0.01 ].Ventricular septal HCM group had reduced 30％,50％ DVR filling rates [ (0.22 ± 0.11 ) versus (0.40 ± 0.15 ) ml/ms,F =12.916,P ＜ 0.01 ; (0.20 ± 0.09 ) versus (0.30 ± 0.10) ml/ms,F =7.121,P =0.014 ] compared with those in the group of healthy volunteers.But 70％,80％,90％ DVR filling rates showed no statistically significant different in the two groups.In HCM patients,myocardial fibrosis caused 50％,70％,80％ DVR time delay [ (9.6 ± 1.0) versus ( 7.9 ± 1.5 ) phase,F =5.000,P =0.045 ; ( 12.3 ± 1.4 ) versus ( 9.6 ± 1.8)phase,F=8.039,P=0.015;(13.1 ±1.4 ) versus(10.9±1.9)phase,F=5.060,P=0.044],but no significant difference of DVR filling rate was found between the two groups. Conclusions Left ventricular volume curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function.The left ventricular diastolic dysfunction of hypertrophic cardiomyopathy occurs mainly in early diastolic period,and accompanied by the shortening of the plateau time. Myocardial fibrosis can aggravate early left ventricular diastolic dysfunction of hypertrophic cardiomyopathy.

Objective To explore the expression of CD44v8 protein in human bladder and urothelial carcinoma ,as well as the value in diagnosis of human bladder and urothelial carcinoma .Methods RT‐PCR was used to analysis the expression of CD44v8 protein in 75 patients with bladder and urothelial carcinoma in the pathological stage and clinical stage and 20 subjects of normal bladder mucosa were collected as control .Results CD44v8 protein was negative in all normal bladder and urothelial mucosa ,the copy number was less than 1 × 102 copy/mL ;26 cases of bladder and urothelial carcinoma was positive ,and the positive rate of CD44v8 was 34 .7% ,and Ct values were less than 35 and copy number was greater than 1 × 104 copy/mL .Positive rate was correla‐ted with high pathological grades and TNM stages ,but no significant difference was observed in recurrence of tumor .Conclusion CD44v8 could be useful indicator for the assessment of pathological grades and TNM stages of bladder and urothelial carcinoma .

Objective To investigate the gene mutation in a pedigree with pachyonychia congenita typeⅡ(PC-Ⅱ)and to explore the relationship between the mutation and clinical manifestations.Methods The exon1of K17gene of genomic DNA from peripheral blood was amplified by PCR,and the PCR products were sequenced by automated sequencing system.Results In all the3patients of the pedigree with PC-Ⅱ(2patients presented as delayed-onset PC at4and15-16years of age respectively),the codon92(AAT)of K17gene was mutated as AGT,which caused missense mutation(N92S)in the1A domain of keratin17,but the2unaffected members of the pedigree and50unrelated controls had no such mutation.Conclusions Mutation of N92S in the1A domain of keratin17exists in this pedigree with PC-Ⅱ.Our results indicate that mutation in the1A domain of keratin17can present as delayed-onset pachyonychia congenita.Therefore,the site and type of keratin mutation are not the sole determinant of the age of onset for PC-Ⅱ,there may be other genetic and/or environmental factors that determine the age of onset of PC-Ⅱ.