This article studies the status quo of professional psychological pressures among 211 doctors in Peking University and influencing factors.It can be inferred that the most important source for professional psychological pressures comes from overloaded job.Certain countermeasures are also raised from a humanistic perspective on national,social,organizational,and individual levels,aiming to relieve clinicians' professional psychological pressures and fully develop their working potentials.

Objective To study the effect of cardiac troponin T(cTnT)on the prognosis of chronic heart failure in the elderly patients.Methods Serum level of cTnT,and serum activities of creatine kinase (CK)and creatine kinase-MB(CK-MB)were measured in 60 elderly patients of chronic heart failure with varied classes of cardiac function.Cardiac events,including malignant cardiac arrhythemia,repeated or aggravated heart failure or cardiac death,in patients with increased cTnT during hospitalization were compared to those without it.Results Serum level averaged(89.1?13.6)mmol/L for CK and(7.9? 1.4)mmol/L for CK-MB in 20 patients with Class Ⅱ cardiac function by New York Heart Association (NYHA)classification and without increased cTnT,(88.2?13.4)mmol/L for CK and(7.5?1.8) mmol/L for CK-MB in 19 patients with Class Ⅲ cardiac function and four of them with increased cTnT,and (93.3?14.2)mmol/L for CK and(8.1?1.6)mmol/L for CK-MB in 21 patients with Class Ⅳ cardiac function and 14 of them with increased cTnT.Malignant cardiac arrhythemia occurred in six,repeated heart failure in eight,and death in three of 18 patients with increased cTnT,and one,two and one in 22 patients without increased cTnT,respectively.Incidence of cardiac events was higher in patients with increased cTnT than those without it(P

The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation.
Biomechanical Phenomena ; Humans ; Models, Biological ; Robotics ; Stroke Rehabilitation ; Upper Extremity

Aged ; Female ; Humans ; Lymphohistiocytosis, Hemophagocytic ; virology ; Orthobunyavirus ; classification

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

Adolescent ; Adult ; Carbon Monoxide Poisoning ; epidemiology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To explore the application of gastric(enteric)-pharyngeal anastomosis for cervical esophageal carcinoma. Methods The clinical data of 12 cases with surgical management of cervical esophageal carcinoma were retrospectively analyzed. Results The resectability of cervical esophageal carcinoma was 100%,no case complicated with pharyngeal fistula.Swallowing function of all cases was in a good state.The overall follow-up was 1 to 7 years,among them 9 surviving,3 dead.The surviving 5 cases are over 3 years,the ongest beyond 7 years. Conclusions Gastric(enteric)-pharyngeal anastomosis is a good primarily rehabilitating method of the cervical esophageal defect after surgical treatment of cervical esophageal carcinoma.

Objective To detect the sperm apoptosis rate and level of reactive oxygen species (ROS) in seminal plasma and explore their correlation among infertile males. Methods Ninety-two inferitile males were divided into varicocele (VC) group (n=32), leukocytospermia group(n=30) and the other cause group (n=30), and another 24 in vitro fertilization sperm samples were sereved as controls. The routine sperm parameters including seminal pH, sperm viability and sperm density were examined by computer assisted sperm analysis, the sperm apoptosis rate was asseseed using Annexin V/PI staining, and the ROS level in seminal plasma was detected by TBA method. The differences in seminal parameters between three infertile groups and control group were compared, and the correlation of sperm apoptosis rate with level of ROS in seminal plasma was explored in each group. Results The sperm viability of three infertile groups was significantly lower than that of control group (P<0.01). The sperm apoptosis rates and levels of ROS in seminal plasma in VC group and leukocytospermia group were significantly higher than those in control group (P < 0.05 or P < 0.01). The sperm apoptosis rate was positively correlated with the level of ROS in seminal plasma in leukocytospermia group(r=0. 573, P < 0.05). Conclusion The increased sperm apoptosis rate and level of seminal plasma ROS may be related to the infertility of patients with VC and leukocytospermia. The increased level of seminal plasma ROS may be one of the causes of increased sperm apoptosis rate in patients with leukocytospermia.

Objective To identify a unique protein as a novel genetic marker for rapid molecular typing of Mycobacteriutn tuberculosis Beijing genotype strains by comparing the proteome of Beijing genotype strains with non-Beijing strains.Methods Fifty-six clinical isolates of Mycobacterium tuber- culosis were analyzed by spoligotyping to determine genotypes.The two-dimensional electrophoresis (2 DE)was used to compare the global protein patterns between Beijing genotype strains and non Bei jing strains.Differential expressed proteins were measured by matrix assisted laser desorption ioniza tion lime of flight mass spectrometry(MALDI-TOF-MS).The data obtained from peptide mass fingerprinting were compared in protein database.The genes encoding differential expressed proteins and their upstream were sequenced.Results Forty nine of the 56 isolates were Beijing genotype strains and 7 isolates were non-Beijing strains.A unique protein Rv0927c was identified,which is absent in Beijing genotype strains compared with 7 non Beijing strains and H37Rv.There were two characteristic mutations in Beijing genotype strains,a deletion of AGC at nucleotide position 421 of Rv0927c and a 127 G→A muta- tion in the upstream of Rv0927c.but not in non Beijing strains and H37Rv.Conclusion Characteris tic mutations of Rv0927c in Beijing genotype strains can be used as a novel genetic marker for rapid molecular typing of Mycobacteriuln tuberculosis Beijing genotype strains and non Beijing strains.

The deubiquitinating enzyme ubiquitin specific peptidase 15 (USP15) is regarded as a regulator of TGFβ signaling pathway. This process depends on Smad7, the inhibitory factor of the TGFβ signal, and type I TGFβ receptor (TβR-I), one of the receptors of TGFβ. The expression level of USP15 seems to play vital roles in the pathogenesis of many neoplasms, but so far there has been no report about USP15 in psoriasis. In this study, immunohistochemical staining of USP15, TβR-I and Smad7 was performed in 30 paraffin-embedded psoriasis specimens and 10 normal specimens to investigate the expression of USP15, TβR-I and Smad7 in psoriasis and to explore the relevance among them. And USP15 small interfering RNA (USP15 siRNA) was used to transfect Hacat cells to detect the mRNA expression of TβR-I and Smad7. Of 30 cases of psoriasis in active stage, 28, 24 and 26 cases were positive for USP15, TβR-I and Smad7 staining, respectively. The positive rates of USP15 and Smad7 were significantly higher in psoriasis specimens than in normal skin specimens (44.1%±26.0% vs. 6.1%±6.6%, 47.2%±27.1% vs. 6.6%±7.1%), and positive rate of TβR-I (20.3%±22.2%) in psoriasis was lower than that in normal skin specimens (46.7%±18.2%). There was a significant positive correlation between USP15 and Smad7 expression, and significant negative correlations between USP15 and TβR-expression, an I d between TβR- and Smad7 expression I in psoriasis. After transfection of USP15 siRNA in Hacat cells, the expression of TβR-mRNA was up I -regulated and that of Smad7 was down-regulated. It is concluded that USP15 may play a role in the pathogenesis of psoriasis through regulating the TβR-I/Smad7 pathway and there may be other cell signaling pathways interacting with USP15 to take part in the development of psoriasis.