Objective:To develop the Abusive Behavior Scale for Superiors under the Chinese context (ABSSC) and test its validity and reliability.Methods:Based on literature analysis and the open questionnaire survey in 32 employees,this study defined the construct of ASBSS,and compiled the preliminary questionnaire.A sample of 200 employees coming from companies was selected for item analysis.A sample of 445 employees was investigated with this questionnaire,223 of them were assessed for exploratory factor analysis and 222 of them were assessed for confirmatory factor analysis and internal consistency test with 2 week interval.Results:The ABSSC consisted of 11 items in 3 factors,which were neglect and slander,obstructionism and hard on subordinates.The 3 factors explained 55.45％ of the total variance.Furthermore,the result of CFA indicated that the model fitted the data with well constmct validity (RMSEA =0.06,GFI =0.94,NFI =0.92,CFI =0.96,IFI =0.96).The Cronbach α coefficient of the whole scale and its three facts were 0.87,0.79,0.78,and 0.76,respectively.Conclusion:It suggests that the Abusive Behavior Scale for superiors under the Chinese context (ABSSC) is reliable and valid enough to be applicable to measure superiors' abusive behavior under the background of Chinese culture.

Virtual reality(VR)technology is known as immersive multimedia or computer-simulated reality.It is a three-dimensional environment, which highly replicated the real world or imaginary environment.In this virtual environment, users can experience everything inside and interact with them,including sensing surroundings,manipulating objects and communica-ting with characters.Nowadays,VR technology is winning favor in more and more fields.This review will conclude the applica-tion and development of VR technology in medicine, which may help readers understand this new technology better.

This article reported jaw osteomyelitis in ancient human bone specimens, helping us to understand the emergence of ancient human jaw osteomyelitis and other oral health conditions.

OBJECTIVETo investigate the expressions of gamma aminobutyric acid transporter 1 (GAT-1) and glutamate decarboxylase 65 (GAD65) mRNA in different brain regions at brain propofol uptake equilibrium in dogs.

METHODSEighteen 12- to 18-month-old healthy hybrid dogs were randomized equally into control group (group C), low dose group (group L), and high dose group (group H). In groups L and H, anesthesia was administered by intravenous injection of 5.5 and 7.0 mg/kg propofol followed by propofol infusion at a constant rate of 55 and 70 mg·kg(-1)·h(-1) for 50 min, respectively. Blood samples were taken from the internal carotid artery and jugular vein to measure plasma propofol concentrations, and the brain tissues of the hypothalamus, sub thalamus, dorsal thalamus, hippocampus, pons, parietal lobe and frontal lobe were examined for GAT-1 and GAD65 mRNA expressions using quantitative real-time PCR.

RESULTSIn groups L and H, propofol infusion at a constant rate for 50 min resulted in comparable plasma propofol concentrations between the internal carotid artery and jugular vein (P>0.05), but the concentrations differed significantly between the two groups (P<0.01). GAT-1 mRNA levels in the hypothalamus and hippocampus were significantly higher in groups L and H than in group C (P<0.05 and P<0.01), but comparable between the former two groups. The variations of GAT-1 mRNA levels between the hypothalamus and hippocampus were similar in both group L [(61.26∓7.17)% and (79.34∓39.95)%, P>0.05] and group H [(74.64∓19.63)% and (97.12∓32.31)%, P>0.05]. GAT-1 mRNA levels in other brain regions showed no significant difference among the 3 groups. GAD65 mRNA levels were similar between group L and group H, but both significantly higher than that in group C (P<0.01). GAD65 mRNA in other brain regions had no significant difference among the 3 groups.

CONCLUSIONGAT-1 mRNA in the hypothalamus and hippocampus and GAD65 mRNA in the dorsal thalamus are upregulated when propofol uptake reaches an equilibrium in the brain of dogs.

Animals ; Brain ; drug effects ; metabolism ; Dogs ; GABA Plasma Membrane Transport Proteins ; genetics ; metabolism ; Glutamate Decarboxylase ; genetics ; metabolism ; Hippocampus ; drug effects ; metabolism ; Hypothalamus ; drug effects ; metabolism ; Propofol ; pharmacology ; RNA, Messenger ; genetics ; Thalamus ; drug effects ; metabolism

Objective To investigate the factors affecting the door-to-needle (DTN) time for intravenous thrombolytic therapy in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled prospectively. The demography, vascular risk factors, and other clinical data were collected. According to DTN time 60 min as a standard, the patients were divided into either a non-delay group or a delay group. The factors affecting DTN delay were analyzed. Results A total of 78 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled, 46 (59.0%) were males with an average age of 64.24 ± 10.06 years. The average National Institutes of Health Stroke Scale(NIHSS)score was 12.13 ± 3.17.The average DTN time was 79.77 ± 20.51 min, and the DTN time in 55 patients (70.51%) was >60 min. The age (66.3 ± 9.7 years vs. 59.3 ± 9.4 years; t=2.939, P=0.004), door-to-CT initiation time (32.7 ± 11.3 min vs. 24.6 ± 7.1 min; t= 3.183, P= 0.002), door-to-CT interpretation time (50.8 ± 16.8 min vs. 35.5 ± 8.8 min; t= 4.383, P< 0.001), and door-to-biochemistry result time (62.6 ± 11.0 min vs. 44.8 ± 5.6 min;t=7.377, P<0.001) in the delay group were all significantly higher or longer than those in the non-delay group.The proportions of patients with hypertension(58.2% vs. 26.1%;χ2=6.687,P=0.010) and using antihypertensive drugs before onset (41.8% vs. 13.0%; χ2=6.043, P=0.014) in the delay group were also higher than those in the non-delay group. Multivariate logistic regression analysis showed that the door-to-biochemistry result time (odds ratio 1.725, 95% confidence interval 1.058-2.814; P=0.029)was an independent influencing factor for DTN delay.Conclusions The delay of door-to-biochemistry result time is an independent factor for DTN time delay in patients with acute ischemic stroke treated with intravenous thrombolytic therapy.

Objective To understand the current situation of occupational exposure and protection among health care workers (HCWs ), and provide evidence for formulating preventive measures of occupational exposure. Methods From April 6,2016 to May 6,2016,questionnaire surveys were conducted in 158 different levels of hos-pitals in 13 provinces in China,occupational exposure,protection management,and monitoring of occupational expo-sure in the first year,2010,and 2015 was surveyed by cluster random sampling method.Results Occupational ex-posure in 81.65% (129/158)of hospitals was responsible by healthcare-associated infection management depart-ments;98.73%(156/158)of hospitals set up the relevant rules and regulations;77.22%(122/158)of hospitals had missing report of occupational exposure.A total of 11 116 times of occupational exposure occurred (1 542 cases in the first year,2 474 in 2010,and 7 100 in 2015).Of various types of occupational exposure,sharp injury accounted for 96.76%;among HCWs sustained occupational exposure,nursing staff accounted for 53.90%;the major de-partment that HCWs who sustained occupational exposure were general wards,operating rooms,and intensive care units;the main medical appliances related to occupational exposure were syringes,scalp needles,and surgical suture needles;high-risk behavior causing occupational exposure were intravenous injection,putting needles into the sharp con-tainers,and surgical suturing;among occupational exposure sources,HBV accounted for 58.69%.Conclusion HCWs in China face a high risk of occupational exposure,occurrence of occupational exposure should be reduced through gov-ernment legislation,application of safety appliances,standardizing behavior of HCWs,proper using of personal pro-tective equipment,strengthening education and training of HCWs,and establishing a sound occupational exposure report,evaluation and follow-up system.

This paper elaborates the specific implementation process of the "research-based learning" teaching reform of genetic experiment in medical undergraduate education, including the change of teaching philosophy among teachers, the integration and expansion of experimental contents, the innovation of classroom-teaching model, the compilation of proper textbook, the update of assessment methods and the establishment of evaluation mechanism for teaching and so on. Preliminary research shows that RBL teaching reform can stimulate medical students' interest and potential in learning, and improve their practical and scientific research innovation ability.

Objective:To investigate the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke with stress hyperglycemia under the guidance of glycosylated hemoglobin A1c (GHbA1c).Methods:The clinical data of 195 patients of acute cerebral infarction with admission blood glucose over 22.2 mmol/L and GHbA1c less than 15.59% were collected in Nankai University Affiliated Tianjin Fourth Central Hospital from January 2018 to June 2021 and analyzed retrospectively. Patients were divided into control group (60 cases), rt-PA low-dose group (0.6 mg/kg, 70 cases) and rt-PA standard-dose group (0.9 mg/kg, 65 cases) to evaluate the guiding effect of GHbA1c and the efficacy and safety of rt-PA.Results:The effective rate at 24 hours and good rate at 7 days were 61.4% (43/70) and 72.9% (51/70) in the rt-PA low-dose group, 64.6% (42/65) and 69.2% (45/65) in the rt-PA standard-dose group, respectively, both better than the control group [30.0% (18/60); χ2=18.25, P<0.001 and 46.7% (28/60); χ2=13.65, P=0.001]. The good outcome rate at 90 days was 82.8% (58/70) in the rt-PA low-dose group, which was better than 63.3% (38/60) in the control group (χ2=6.38, P=0.016), but without statistically significant difference compared with the rt-PA standard-dose group [72.3% (47/65); χ2=2.17, P=0.153]. The case fatality rate at 90 days of the rt-PA low-dose group was 7.1% (5/70), which was lower than 20.0% (13/65) in the rt-PA standard-dose group (χ2=4.82, P=0.041) and 18.3% (11/60) in the control group (χ2=5.04, P=0.030). The incidence of intracranial hemorrhage and symptomatic intracranial hemorrhage was 8.5% (6/70) and 2.9% (2/70) in the rt-PA low-dose group, lower than 20.0% (13/65; P=0.048) and 13.8% (9/65; P=0.020) in the rt-PA standard-dose group. The incidence of extracranial hemorrhage was 7.1% (5/70) in the rt-PA low-dose group, lower than 18.9% (12/65) in the rt-PA standard-dose group ( P=0.042). Conclusion:Acute cerebral infarction patients with admission blood glucose over 22.2 mmol/L can receive rt-PA treatment when GHbA1c is less than 15.59%, and 0.6 mg/kg dosage is recommended.

Objective:To investigate the efficacy and safety of thrombolytic therapy with intravenous alteplase(rt-PA)for elderly acute ischemic stroke patients on maintenance hemodialysis.Methods:In this retrospective study, data of 165 elderly patients with acute cerebral infarction on maintenance dialysis, aged 65-85, treated at the Stroke Center of the Fourth Central Hospital Affiliated to Nankai University between May 2018 and March 2021, were collected.Based on whether intravenous thrombolysis with alteplase(rt-PA)was used and differences in thrombolytic schemes, patients were divided into a conservative treatment group( n=58, receiving only standardized secondary stroke prevention), a low-dose rt-PA group( n=57, receiving rt-PA intravenous thrombolysis, 0.6 mg/kg)and a standard-dose rt-PA group( n=50, receiving rt-PA intravenous thrombolysis, 0.9 mg/kg). The safety and efficacy of rt-PA treatment were assessed. Results:The rate of effectiveness at 24 h and the rate of good prognosis at 7 d were 64.9%(37/57)and 70.2%(40/57)for the low-dose rt-PA group and 68.0%(34/50)and 74.0%(37/50)for the standard dose group, respectively.There was no significant difference between the two groups( χ2=0.417, P=0.518; χ2=0.636, P=0.425), but these rates were better than 29.3%(17/58)and 41.4%(24/58)for the conservative treatment group( χ2=10.583、16.714, P<0.001). The good prognosis rate at 90 days were 73.7%(42/57), 78.0%(39/50)and 69.0%(40/58)for the three groups, respectively, with no significant difference( χ2=1.126, P=0.569), but the fatality rate for the low-dose rt-PA group was 7.0%(4/57), lower than 18.0%(9/50)( χ2=5.420, P=0.020)for the standard dose rt-PA group and 20.0%(8/58)for the conservative treatment group( χ2=5.048, P=0.025). The incidence of intracranial hemorrhage was 8.8%(5/57)for the low-dose rt-PA group, lower than 24.0%(12/50)for the standard-dose rt-PA group( P=0.032). The incidence of extracranial complications was 15.8%(9/57)for the low-dose rt-PA group, lower than 36.0%(18/50)for the standard-dose group( P=0.017). Conclusions:For elderly patients with acute cerebral infarction on maintenance hemodialysis, intravenous thrombolytic therapy with low dose rt-PA should be considered with caution.

Objective:To investigate the safety and efficacy of intravenous thrombolysis with recombinant human tissue-type plasminogen activator (rt-PA) in acute cerebral infarction combined with hyperglycemia under the guidance of glycosylated hemoglobin A 1c (HbA1c) level in the elderly. Methods:A retrospective study was performed. Two hundred and sixty-two elderly patients with acute cerebral infarction, admitted to our hospital from January 2018 to June 2021, were chosen in this study. Patients with admission blood glucose of 2.8-22.2 mmol/L and accepted intravenous thrombolysis with standard dose of rt-PA were enrolled into control group; patients with admission blood glucose over 22.2 mmol/L and HbA1c less than 15.59% were enrolled into experimental group. The patients in the experimental group were subdivided into conservative treatment group ( n=63), rt-PA low-dose group (0.6 mg/kg, maximum dose 60 mg, n=67) and rt-PA standard dose group (0.9 mg/kg, maximum dose 90 mg, n=60) according to whether these patients received rt-PA intravenous thrombolysis or not and dosage of rt-PA. The response rate 24 h after treatment and short-term prognosis 7 d after treatment were evaluated by referring to the treatment effectiveness evaluation criteria developed by NINDS clinical trials. The long-term prognosis was evaluated by modified Rankin Scale (mRS) 90 d after treatment. The safety evaluation indexes mainly included incidences of intracranial hemorrhage and complications within 90 d of treatment. Results:(1) The response rate 24 h after treatment showed significant differences among the 4 groups ( P<0.05): that in the control group, rt-PA low-dose group, and rt-PA standard dose group was significantly higher than that in the conservative treatment group ( P<0.05); the good prognosis rate 7 d after treatment showed significant differences among the 4 groups: that in the control group, rt-PA low-dose group, and rt-PA standard dose group was significantly higher than that in the conservative treatment group ( P<0.05). (2) Ninety d after treatment, 59 patients (81.9%), 46 (73.0%), 53 (79.1%), and 46 (76.7%) in the control group, conservative treatment group, rt-PA low-dose group, and rt-PA standard dose group had good prognosis, without significant differences among each group ( P>0.05). (3) There was significant difference in the incidence of cerebral hemorrhage within 90 d of treatment among the 4 groups ( P<0.05): that in the rt-PA standard dose group and rt-PA low-dose group was significantly higher than that in the control group and conservative treatment group, and that in the rt-PA standard dose group was significantly higher than that in the rt-PA low-dose group ( P<0.05). Seven patients (9.7%), 8(12.7%), 5(7.5%), and 13(21.7%) in the control group, conservative treatment group, rt-PA low-dose group, and rt-PA standard dose group had extracranial complications: the incidence of extracranial complications in the rt-PA low-dose group was significantly lower than that in the rt-PA standard-dose group ( P<0.05). There were 7 kinds of residual neurological dysfunction in 4 groups within 90 d of treatment, among which, numbness, weakness and speech impairment were the most common. Conclusion:Elderly acute cerebral infarction patients with admission blood glucose over 22.2 mmol/L can receive rt-PA treatment when HbA1c is less than 15.59%, and 0.6 mg/kg dosage is recommended.