Objective To assess the therapeutic effects of flupentixol and melitracen tablets combined with Saccharomyces boulardii on patients with diarrhea-predominant irritable bowel syndrome (IBS) accompanied with anxiety and depression.Methods This multi-center,randomized,prospective study enrolled 84 patients with diarrhea-predominant IBS who were divided into combined treatment group (42 patients) and control group (42 patients).Saccharomyces boulardii was administrated in both of the groups,and flupentixol and melitracen was added in combined treatment group.The treatment course was four weeks.The gastrointestinal symptoms and mood disorders were evaluated before treatment,one week and four weeks after treatment.Adverse reactions were also observed.Chi-square test was performed for statistical analysis.Results At the end of one week after treatment,the efficacy rates of gastrointestinal symptoms improvement of combined treatment group and control group were 31.0％ (13/42) and 23.8％ (10/42),and there was no statistically significant difference (P＞0.05).At the end of four weeks after treatment,the efficacy rate of gastrointestinal symptoms improvement of combined treatment group was 92.5％ (37/40),which was higher than that of control group (73.2％,30/41),and the difference was statistically significant (x2 =5.291,P =0.037).At the end of one week after treatment,the efficacy rates of Hamilton Depression Scale score improvement of combined treatment group and control group were 31.6％ (12/38) and 12.1％ (4/33),and there was no statistically significant difference (P＞0.05).At the end of four weeks after treatment,the efficacy rates of Hamilton Depression Scale score improvement of combined treatment group was 63.9％ (23/36),which was higher than that of control group (34.4％,11/42),and the difference was statistically significant (x2 =6.433,P=0.043).At the end of one week and four weeks after treatment,the efficacy rates of Hamilton Depression Scale score improvement of combined treatment group were 35.7％ (15/42) and 80.0％ (32/40),which were higher than those of control group (15.4％,6/39 and 34.2％,13/38),and the differences were statistically significant (x2 =9.759,P=0.007; x2 =17.105,P＜0.01).One week after treatment,the adverse events rates of combined treatment group and control group were 4.8％ (2/42) and 4.8％ (2/42) ; four weeks after treatment,the adverse events rates of combined treatment group and control group were 2.5％ (1/40) and 2.4％ (1/41).There was no statistically significant difference in adverse events rates between two groups (both P＞0.05).Conclusions Flupentixol and melitracen combined with Saccharomyces boulardii treatment could not only improve the anxiety and depression symptoms of patients with diarrhea-predominant IBS,but also effectively improve gastrointestinal symptoms.The efficacy of combined treatment is better than monotherapy Saccharomyces boulardii alone treatment.

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .

Pancreas of 53 aborted fetuses ranging from 5 to 41 weeks were fixed in Bouin's fluid and embedded in paraffin, and the sections were stained with Alcian bluephloxine and Grimelius silver technique. The A, B and D cell of islet of Langerhans were demonstrated with immunohistochemical PAP method also. 14 pancreas among them were fixed in 2% glutaraldehyde and embedded in Epon 812, and observed with TEM. Typical A, B and D islet cells were observed with LM at 12 weeks of fetal age. Undifferentiated, differentiated and degenerated cells were distinguished in the pancreatic islets at 14 to 41 weeks of fetal age. The secretory granules of the exoerine cells were observed after 14 weeks of fetal age. The functional differentiation of endocrine cells precede that of exocrine cells. The morphometrical measurement testified that the endocrine portion of fetal pancreas was obviously larger than that of adult. This study provides some morphological data for the pancreas transplantation in clinical medicine.

OBJECTIVEThis study aims to analyze the angulation of the maxillary anterior teeth relative to the alveolus to provide reference data for clinicians on the best conditions for implant placement in the esthetic zone.

METHODSNumerous cone beam computed tomography (CBCT) images were reviewed and screened. A total of 150 maxillary images were selected by strict adherence to the defined inclusive criteria, with 75 images each from male and female patients (between the ages of 19 and 48 years at the time of CBCT scan). The maxillary anterior teeth were gathered into the following three groups for males and females: upper canines, upper lateral incisors, and upper central incisors. Then, the long axis of each qualified tooth and its corresponding alveolar process were drawn, and the angles formed by these structures were measured. The resultant data were analyzed by SPSS 19.0.

RESULTSThe long axis of the maxillary anterior teeth all inclined to the palatal side of the alveolar process. The internal angle (α) formed by the long axis of the maxillary central incisors and the long axis of the alveolar bone presented a mean value of 16.22° (range: 2.50°-28.80°) for male subjects and 15.20° (range: 2.20°-27.20°) for female subjects. The internal angle (α) of the maxillary lateral incisors exhibited a mean value of 17.50° (range: 3.80°-29.50°) for male subjects and 15.99° (range: 4.10°-33.30°) for female subjects. Finally, the internal angle (α) of the maxillary canines presented a mean value of 16.27° (range: 1.00°-31.50°) for male subjects and 15.01° (range: 3.50°-27.40°) for female subjects.

CONCLUSIONSThe long axis of the maxillary anterior teeth all inclined to the palatal side of the alveolar process. For implant placement, careful preoperative analysis and evaluation with CBCT may be beneficial for avoiding the risk factors and achieving
a high probability of success in the esthetic region.

Adult ; Alveolar Process ; Cone-Beam Computed Tomography ; Cuspid ; Dental Implants ; Female ; Humans ; Incisor ; Male ; Maxilla ; Middle Aged ; Young Adult

Objective To investigate the situation of nurse job burnout and the occurrence of nursing adverse events in western area of Chongqing,and to analyse the correlation between them.Methods A total of 5 hospitals in different district of west area of Chongqing was randomly selected.Then the sample of nurses meeting the inclusion and exclusion criteria was selected by random number table method,200 nurses were selected in each hospital.Multivariate logistic regression analysis was used to analyze the factors influencing the adverse events of nursing,and the structural equation model was applied to analyze the relationship between nurses job burnout and nursing adverse events.Results A total of 1 000 nurses were surveyed,and 998 valid questionnaires were collected.The rate of nurse job burnout and the incidence of nursing adverse events in the survey year were 56.41％ and 54.21％,respectively.Among nurses with job burnout,85.08 ％ occurred nursing adverse events.The increased workload,night shift,no officially budgeted post and with occupational burnout were factors affecting the incidence of nursing adverse events (OR=1.250,1.445,1.615,1.991,P＜ 0.05).The emotional exhaustion dimension of job burnout had the greatest effect on nursing adverse events (the standard partial regression coefficient was 0.31,P＜0.05),followed by the disintegration of personality (the standard partial regression coefficient was 0.29,P＜0.05),while the reduction in the sense of accomplishment had no direct effect on nursing adverse events.Conclusion In hospitals of the western area of Chongqing,the prevalence of nurse job burnout is comparatively serious,and the incidence of nursing adverse events is relatively high.The nurse job burnout and nursing adverse events might be positively correlated.

Objective:To provide a promising and optimal laboratory susceptibility-testing method for the clinical usage of antibiotic (polymyxin), four susceptibility-testing methods were performed and the broth microdilution (BMD) was chosen as the gold standard.Methods:A total number of eighty-eight nonduplicate clinical Enterobacteriaceae specimes were collected from January to December of 2019 in the First Affiliated Hospital, Fujian Medical University. Among the clinical specimens, of which six strains were positive for mcr-1. The minimal inhibitory concentration (MIC) of polymyxin of the clinical specimens were examined by the following methods: (1) broth microdilution, (2) colistin broth disk elution, (3) Vitek-2?, (4)BD PhoenixTM,(5)commercial broth microdilution. With BMD as reference, essential agreement (EA), categorical agreement(CA), very major error(VME) and major error (ME) of polymyxins for different methods were analyzed. The Kappa-consistency testing, paired Chi-square testing and the Spearman-rank correlation testing were used to analyze the consistency between the four antimicrobial susceptibility testing methods and the gold standard.Results:Taking broth microdilution as reference, the EA of colistin broth disk elution, Vitek-2?, BD PhoenixTM, commercial broth microdilution were 94.32% (83/88), 92.05% (81/88), 90.90% (80/88), and 96.59%(85/88), respectively. The CA of all the four methods were 100% (88/88). No VME and ME were recorded for four methods. Moreover, the consistency between four susceptibility testing methods and the gold standard is acceptable (Kappa values=1, P<0.001, McNemar test P=1 and r>0.5, P<0.05). Conclusions:In the present work, four susceptibility testing methods all met the standards recommended jointly by the Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing, of which the performance of the commercial broth microdilution and CBDE fared relatively well. Thus, these four methods could be routinely used in clinical microbiology laboratory of our hospital for colistin and polymyxin B susceptibility testing.

Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.

Fibroblast growth factor receptors (FGFRs) have emerged as promising targets for anticancer therapy. In this study, we synthesized and evaluated the biological activity of 66 pyrazolo[3,4-