Objective:To investigate the intention to stay on among primary health care workers (PHWs) during the COVID-19 epidemics and its influencing factors.Methods:An online questionnaire survey was conducted among PHWs from 62 primary health institutions in 31 provinces, autonomous regions and municipalities across China selected by multi-stage whole cluster random sampling method between May and October 2022. According to the job position, the PHWs were divided into 5 categories: general practitioners (GPs), nurses, public health doctors, managers and support staff. Intention to stay was measured using the Chinese version of the Intention to Stay Questionnaire. Multiple linear regression model was used to analyze the influencing factors of the intention to stay in PHWs of different occupational categories, including personal factors, work factors, factors related to the COVID-19 and psychological reactions.Results:A total of 3 769 PHWs from 44 community health service centers, 18 township hospitals of 27 provinces/autonomous regions and 4 municipalities participated in this survey. The mean age of participants was (37.4±9.2) years, including 2 971(78.8%) women. The mean score of intention to stay of participants was 21.7±4.1. Compared with GPs, managers had lower intention to stay ( P=0.004). Age, female, in marriage, monthly income, years of primary care service, self-evaluation of unit support function, MSQ-SF score, and PA score were positively correlated with the score of intention to stay (all P<0.05), while PHQ-9 score, EE score, and DP score were negatively correlated with the score of intention to stay (all P<0.05). The MSQ-SF scores of all occupational categories were positively correlated with the scores of intention to stay (all P<0.01). In addition, among GPs, monthly income, years of service in primary care, self-evaluation of unit support function, and PA scores were positively correlated with the score of intention to stay (all P<0.05), while PHQ-9 scores and EE scores were negatively correlated with the score of intention to stay (all P<0.05). Among nurses, age, female gender, monthly income, self-evaluation of unit support function, and PA score were positively correlated with the score of intention to stay (all P<0.05), while EE scores and retention will score were negatively associated with ( P<0.001). Among public health doctors, in marriage was positively correlated with the score of intention to stay ( P=0.018). Among managers, DP score was negatively correlated with the score of intention to stay ( P=0.001). Among support staff, female gender, monthly income, years of primary care service, self-evaluation of unit support function, and PA scores were positively correlated with the score of intention to stay (all P<0.05), while EE score and DP score were negatively correlated with intention to stay (all P<0.05). Conclusions:The intention to stay of PHWs in China during the COVID-19 was at an intermediate level, which was affected by many factors. Among them, job satisfaction was positively correlated with the intention to stay of all occupational categories, and the influencing factors of different occupational categories have some variations.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Coronavirus disease 2019(COVID-19),which is caused by SARS-CoV-2,varies with regard to symptoms and mortality rates among populations.Humoral immunity plays critical roles in SARS-CoV-2 infection and recovery from COVID-19.However,differences in immune responses and clinical features among COVID-19 patients remain largely unknown.Here,we report a database for COVID-19-specific IgG/IgM immune responses and clinical parameters(named COVID-ONE-hi).COVID-ONE-hi is based on the data that contain the IgG/IgM responses to 24 full-length/truncated proteins corresponding to 20 of 28 known SARS-CoV-2 proteins and 199 spike protein peptides against 2360 serum samples collected from 783 COVID-19 patients.In addition,96 clinical parameters for the 2360 serum samples and basic information for the 783 patients are integrated into the database.Furthermore,COVID-ONE-hi provides a dashboard for defining samples and a one-click analysis pipeline for a single group or paired groups.A set of samples of interest is easily defined by adjusting the scale bars of a variety of parameters.After the"START"button is clicked,one can readily obtain a comprehensive analysis report for further interpretation.COVID-ONE-hi is freely available at www.COVID-ONE.cn.

To analyze and identify the chemical components in Xingbei Zhike Keli by using ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry (UPLC-Q-TOF-MS/MS). The analysis was performed on Agilent Zorbax SB-C₁₈(4.6 mm×250 mm, 5 μm) column, with methanol-0.08% formic acid solution (including 0.1% ammonium formate) as the mobile phase for gradient elution. The flow rate was 1 mL·min⁻¹ and column temperature was 30 °C. The MS spectrum was acquired in both negative and positive ion modes by using electron spray ionization (ESI). These components were further analyzed based on accurate m/z, secondary fragmentation and other information combined with reference substance and literature data. As a result, 87 compounds were successfully identified and predicted, including alkaloids, flavonoids, coumarins and saponins, of which 23 compounds were verified by comparing with reference substances. These results provide reference for the quality control of Xingbei Zhike Keli, and lay the foundation for elucidating their effective components and mechanism of action.
Alkaloids ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Flavonoids ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

OBJECTIVETo explore the prognostic value of hyperuricemia for adverse events in patients >40 years old receiving valve replacement surgery for rheumatic aortic valve disease.

METHDSConsecutive middle-aged and elderly patients receiving aortic valve replacement surgery for rheumatic aortic valve disease between March, 2009 and July, 2013 were recruited in this study. The patients were divided into hyperuricemic group and normouricemic group based on their serum levels of uric acid, and the clinical data and adverse events within 1 year after the surgery were compared between the 2 groups.

RESULTSA total of 632 consecutive patients were recruited, including 381 patients with hyperuricemia and 251 with normouricemia. The in-hospital mortality rate was significantly higher in hyperuricemic group than in normouricemic group (7.6% vs 2.0%, P=0.002). Serum uric acid levels were negatively correlated with eGFR (r=-0.421, P<0.001) and positively correlated with C-reactive protein level (r=0.093, P=0.025). Multivariate analysis showed that hyperuricemia was independently associated with the in-hospital mortality (OR=3.07, 95%CI: 1.13-8.37, P=0.028) and mortality at 1 year after the surgery (HR=3.14, 95%CI: 1.30-7.62, P=0.011) after adjusting for potential risk factors including age, NYHA III-IV and postoperative acute kidney injury (AKI). Kaplan-Meier analysis showed that the cumulative rate of 1-year mortality after surgery was significantly higher in patients with hyperuricemia (Log-rank=11.73, P=0.001).

CONCLUSIONHyperuricemia is a predictor of in-hospital and one-year mortality in middle-aged and elderly patients following aortic valve replacement surgery for rheumatic aortic valve disease.

Objective To observe the influence of the clinical pathway management intervention on medical service behaviors.Methods The clinical cases data in a grade A class 3 hospital of Zhangjiakou City,Hebei Province during 2011-2013 were retrospectively analyzed.The influence of implementing the clinical pathway management on the diagnosis results,medical records writing quality,clinical medication,operation,hospitalization time,medical costs,assisted examination items selection were observed and analyzed.Results The admission and discharge diagnosis coincidence rate and preoperative and postoperative diagnostic coincidence rate of 3 diseases entities in the two groups were 100%,the difference had no statistical significance (P>0.05);the medical record grade-A rate in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the medical record grade-B rate was significantly lower than that in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the antibacterial drugs cost and drugs proportion in the implementing clinical pathway group were significantly lower than those in the non-implementing clinical pathway group,the medication proportion within the directory in the implementing clinical pathway group was significantly higher than that in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the preoperative preparation time in the implementating clinical pathway group was less than that in the non-implementing clinical pathway group,the difference was statistically significant(P<0.05),the grade-A healing rate had no significant difference between the two groups (P>0.05);the average hospitalization time,total costs,drug costs,laboratory fee and examination fee in the implementing clinical pathway group were lower than those in the non-implementing clinical pathway group,the difference was statistically significant (P<0.05);the operation fee,healthy material fee and nursing fee had no statistically significant difference was statistically significant(P<0.05).Conclusion Implementing the clinical pathway can standardize the doctor′s diagnosis and treatment behaviors and makes the medical work to develop to be more favorable for patients.

BACKGROUNDThe prevalence of hepatitis B virus (HBV) infection is high among individuals infected with human immunodeficiency virus (HIV) in China. Both HIV and HBV can be treated with tenofovir disoproxil fumarate (TDF) and lamivudine (3TC), so we evaluated the safety and efficacy of combination antiretroviral therapy (ART) that included TDF, 3TC, and efavirenz (EFV) among ART-naive individuals who were co-infected with HIV and HBV.

METHODSOne hundred HIV/HBV co-infected ARV-naive individuals were started on the regimen of TDF, 3TC, and EFV, and the levels of plasma HBV DNA, HIV RNA, and biochemical evaluation related to the function of liver and kidney were analyzed.

RESULTSConcerning efficacy, this study found that by week 48, the vast majority co-infected participants receiving this ART regimen had undetectable HBV DNA levels (71%) and/or HIV RNA levels (90%). Concerning safety, this study found that the median estimated glomerular filtration rate of participants decreased from baseline (109 ml·min-1·1.73 m-2) to week 12 (104 ml·min-1·1.73 m-2) but was almost back to baseline at week 48 (111 ml·min-1·1.73 m-2).

CONCLUSIONThis combination ART regimen is safe and effective for patients with HIV/HBV co-infection.

TRIAL REGISTRATIONClinicalTrials.gov, NCT01751555; https://clinicaltrials.gov/ct2/show/NCT01751555.

Adult ; Alanine Transaminase ; metabolism ; Anti-HIV Agents ; therapeutic use ; Aspartate Aminotransferases ; metabolism ; Benzoxazines ; therapeutic use ; CD4-Positive T-Lymphocytes ; metabolism ; Coinfection ; drug therapy ; Female ; HIV Infections ; drug therapy ; Hepatitis B virus ; drug effects ; pathogenicity ; Humans ; Lamivudine ; therapeutic use ; Male ; Tenofovir ; therapeutic use

To improve the solubility and antitumor activity of ampelopsin, ampelopsin-loaded nanomicelles from the mixture of pluronic F127 and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS1000) were prepared by film-thin hydration method, in order to optimize the process conditions and physicochemical properties. The antitumor activities against MCF-7 cells between ampelopsin and nanomicelles were compared by MTT method, respectively. The results showed that the optimal nanomicelles were round with the nanometric size of (22.6±0.5) nm, encapsulation efficiency rate of (80.42±1.13)%, and drug-loading rate of (4.41±0.26)%. The solubility of ampelopsin in mixed nanomicelles significantly increased by 16 times. In different release media, the mixed nanomicelles could release more than 90% of drug in 8 h, and showed stronger cytotoxicity and inhibition against MCF-7 cells (P<0.01). The mixed nanomicelles can be used as new drug delivery system of ampelopsin.

OBJECTIVETo translate the English version of The Premature Ejaculation Diagnostic Tool (PEDT) into Chinese, evaluate its reliability and validity, and analyze its feasibility in the diagnosis of premature ejaculation (PE).

METHODSFollowing the forward-backward translation procedure, we developed the Chinese version of PEDT, which was then revised by andrologists and bilingual linguists. We enrolled subjects with or without PE from 15 urological or andrological clinics in China and obtained the information about their demographic characteristics, PEDT scores, and intra-vaginal ejaculation latency time (IELT). We evaluated the internal consistency of PEDT using Cronbach alpha, was examined its reliability and stability by test-retest analysis, analyzed its correlation with IELT by Spearman correlation analysis, and tested its sensitivity and specificity by receiver operating characteristic ( ROC) analysis.

RESULTSTotally, 570 PE patients (aged [30.66 ± 7.11] years) and 226 non-PE men (aged [33.01 ± 5.41] years) were recruited, with the mean IELT of (1.34 ± 0.54) min in the former and (11.09 ± 7.5) min in the latter group. The Cronbach's alpha of the Chinese version of PEDT was 0.79, and the test-retest correlation coefficient was 0.75 (P < 0.01). The PEDT score was negatively correlated with IELT (Spearman's p = -0.52, P < 0.01). When the cutoff value of PE diagnosis was defined as 7.5, the sensitivity and specificity of PEDT were 0.80 and 0.78, and when as 8.5, they were 0.72 and 0.89, respectively.

CONCLUSIONThe Chinese version of PEDT was demonstrated to have good internal consistency, reliability, and validity, as well as a high predictability for PE. It can be used as a reliable and convenient tool to screen PE among Chinese men.

Adult ; Aged ; Asian Continental Ancestry Group ; China ; Ejaculation ; Feasibility Studies ; Humans ; Language ; Male ; Middle Aged ; Premature Ejaculation ; diagnosis ; ROC Curve ; Reaction Time ; Reproducibility of Results ; Sensitivity and Specificity ; Translations

Objective To evaluate the vitamin D status of residents in two cities of Zhejiang province.Methods 442 participants from Hangzhou and Ningbo were selected using multi-stage cluster random sampling method,then the blood samples were collected and the serum level of 25 -hydroxyl vitamin D [25 (OH)D]was detected by the method of radioimmunoassay to analyze the Vitamin D status.Results Median (25 th-75 th percentile)level of serum 25 (OH)D in subjects aged 6 -11,12 -17,18 -44,45 -59 and over 60 years were 53.19 (41.85 -64.89),48.76 (32.56 -60.52),59.91 (48.05 -72.79),68.67 (55.50 -78.07)and 70.97 (56.91 -84.65)nmol/L,respectively.The number of vitamin D deficiency [25(OH)D<25 nmol/L],insufficiency[25≤25(OH)D <50 nmol/L],normal [50≤25 (OH)D <75 nmol/L ],sufficiency [25 (OH )D ≥75 nmol/L ] were 2.95%,30.84%,44.22% and 22.00%, respectively.Conclusion The deficient and insufficient status of vitamin D is common among residents in two cities of Zhejiang province.Vitamin D nutrition situation should be improved.