Objective To investigate the status of occupational burnout among general practitioners (GPs) and explore the relationship between coping style and burnout. Methods 243 GPs were assessed by Chinese Maslach burnout inventory(CMBI) and simple coping style questionnaire. Results 36.6% of GPs experienced mild burnout, 26.8% moderate burnout, and 3.3% severe burnout; 11.5% of GPs got high scores on emotional exhaustion(EE), 44.9% subjects got high scores on depersonalization(Dp) and 43.6% subjects got high scores on reduced personal accomplishment (RPA). Male GPs experienced greater personal accomplishment than female. Among technical post, subjects with senior technical post scored higher on Dp. The condition of occupational burnout among subjects in north Jiangsu was more serious. GPs with seniority of 5 to 9 years seemed to be more prone to occupational burnout. The coping style of GPs had obvious correlation with occupational burnout. Conclusion The status of occupational burnout among GPs is serious. To prevent and cure occupational burnout, more attention should be paid to female, senior technical post GPs and'persons with seniority of 5 to 9 years. And taking positive coping style can reduce GPs' occupational burnout.

Objective To evaluate the effectiveness of "dispersing lung-qi and relieving asthma, warming Yang to induce diuresis" method on CPHD patients during acute period with peripheral edema and observe the effect on ADH. Methods The CPHD patients during acute period with peripheral edema were randomly divided into treatment group and control group. The treatment group received Chinese medicine adding to regular western medicine, the principle is dispersing lung-qi and relieving asthma, resolving phlegm to stop coughing, warming Yang to induce diuresis. The control group received placebo adding to regular western medicine. Both of the groups were treated for 14 days. The effect observed indexes were as follows:general curative effect, integral of main symptoms of TCM, integral of western medical signs, serum electrolyte, etc. Mechanism index was about ADH. Results The treatment group had better effects than the control group on the general curative effect, reducing integral of symptoms and signs, rectifying electrolyte and acid-alkaline-balance disturbances, etc. The safety analysis of two groups had no significant abnormality. Meanwhile, the treatment group had more superiority than the control group on reducing serum ADH. Conclusion The comprehensive treatment of traditional Chinese and western medicine probably has more advantage in increasing the general effect, improving symptoms and signs, rectifying electrolyte and acid-alkaline-balance disturbances, etc. This therapeutic method can restrain secretion of ADH. It indicates that restraining secretion of ADH maybe part of the mechanism of using "dispersing lung-qi and relieving asthma, warming Yang to induce diuresis" method to treat CPHD patient during acute period with peripheral edema.

Objective Measurement of ankle brachial index (ABI) is a simple method of assessing lower limb arterial blood supply,while measurement of toe brachial index (TBI)has only been advocated as an alternative.The aim of this study was to obtain information about whether TBI should be taken in type 2 diabetes,even when ABI is normal,and to evaluate the relationship between TBI and atherosclerosis.Methods In a crosssection study,ABI,TBI,and carotid intimal-medial thickness (IMT) were measured on 979 outpatients with type 2 diabetes in Ruijin Hospital.Those with normal ABI (0.9 ≤ABI ＜ 1.3,n = 945) were divided into two groupsnormal TBI group(TBI≥0.6,n=893) and low TBI group(TBI＜0.6,n=52),and then the clinical and laboratory data were compared between these two groups.Furthermore,the relationship between TBI and atherosclerosis was investigated.Atherosclerosis was defined as the maximum IMT ≥ 1.1 mm.Results Low ABI and low TBI were detected in 1.3% and 6.6% of the patients,respectively.Comparison of the clinical and laboratory data between the two groups showed that age and HbA1C values were significantly higher in the low TBI group.Furthermore,TBI was inversely associated with IMT(β=-0.217,P＜0.01),an indicator for atherosclerosis of the carotid artery.Multiple logistic regression analysis revealed that decline of TBI was an independent risk factor of atherosclerosis (OR=1.30,95% CI 1.01-1.69,P＜0.05).Conclusion In type 2 diabetes,the decline of TBI is associated with atherosclerosis,indicating the necessity for diabetic patients to detect TBI,even when ABI is within normal range,in order to detect peripheral artery disease in early stage,and reduce the risk for atherosclerosis.

patients. Maintenance of systolic BP<120 mm Hg(1 mm Hg=0.133 kPa) and diastolic BP<80 mm Hg may reduce the risk of atherosclerosis in type 2 diabetes.

OBJECTIVEThe purpose of this study was to evaluate the maximum binding (Bmax) and affinity Kd value changes of acetylcholine receptor (n-AchR) on rat's superficial masseter muscles after functional mandibular advancement.

METHODSForty 5-week-old male SD rats were randomly divided into experimental and control groups. The mimic functional appliances were only used in experimental groups, and the rats of two groups were killed after 1, 3, 7, 14 days. Radio-ligand binding assay (RBA) was applied to determine the Bmax and Kd value of n-AchR on the superficial masseter muscles.

RESULTSThe Bmax of n-AchR in experimental groups was higher than that in the control groups at all time points, and the differences had statistical significance. The Kd value of n-AchR was higher in experimental group than that in control groups in 1, 3, 7 days, while Kd value in experimental group of n-AchR was lower than that in control groups in 14 days. The differences had statistical significance in 7 and 14 days, but the differences had no statistical significance in 1 and 3 days.

CONCLUSIONThe functional orthopedics can increase the Bmax and affinity of n-AchR on rapid growing rat's superficial masseter muscles.

Animals ; Male ; Mandibular Advancement ; Masseter Muscle ; Rats ; Rats, Sprague-Dawley ; Receptors, Cholinergic

Purpose To investigate the positive rate and concordance rate of BRAF mutation in papillary thyroid carcinoma detected by real-time PCR method and Sanger sequencing. Methods 312 papillary thyroid carcinomas patients were enrolled in this study. Real-time PCR method and Sanger sequencing were performed to detect BRAF gene mutations. The frequency of BRAF mutation and the concordance of two methods were analyzed. Results BRAF mutation was detected in 65. 4% (204/312) and 63. 8% (199/312) of 312 papillary thyroid carcinoma samples by using real-time PCR method and Sanger sequencing, respectively. There was no significant correlation between BRAF gene mutations and patients’ gender. There was significant correlation between BRAF gene mutations and patients’ age. The overall concordance between real-time PCR method and Sanger sequencing for BRAF mutation detection was 98. 4%. Conclusion Real-time PCR method provides an effective method in BRAF gene mutation detection.

Objective To identify the expression of sphingosine-1-phosphate receptor (S1PR) subtypes, C-myc and His tag proteins of human umbilical vein endothelial fusion cell line, EA.hy926 and human umbilical vein endothelial cells (HUVEC), CRL-1730 for studying the function of apolipoprotein M (ApoM)-S1P axis. Methods Two kinds of cells (EA. hy926 and CRL-1730) were cultured to reach the density of 60%-70% in vitro. Immunofluorescence technique was em?ployed to investigate the expressions of coagulation factorⅧ(FⅧ), ApoM, S1PR1-S1PR5, C-myc and His tag proteins. Re?sults (1) Two kinds of cells both expressed FⅧand ApoM. FⅧpresented scattered particle distribution in CRL-1730, while uniform distribution in EA.hy926. However, ApoM was strongly expressed and widely distributed in cytoplasm of two kinds of cells. (2) S1PR1-3 can be detected on their membrane other than S1PR4 and S1PR5. S1PR1 was highly expressed but S1PR2 and S1PR3 were in a low level expression. (3) Two kinds of cells both expressed C-myc and His tag proteins in cytoplasm. Conclusion Two kinds of cells have the properties of endothelial cells and can express FⅧ, ApoM, C-myc and His tag proteins. It is not suitable for choosing C-myc and/or His tag–conjugated recombinant ApoM to study the fuction of ApoM-S1P axis with these two kinds of cells.

Objective To investigate the activity change pattern and corresponding significance of gly- colytic enzymes including alsolase A(ALDA)and lactate dehydrogenase M(LDH-M)regulated by hy- poxia-inducible factor 1?(HIF-1?)in spinal cord injury(SCI)of rats.Methods SD rats were ran- domly divided into control group and groups at 12 hours,1,2 and 3 days,1 and 2 weeks after compres- sive SCI,in which the activity changes of ALDA and LDH-M in the injured spinal cord were observed at different time points by means of enzyme histochemistry.Results Opitical density(A)value of AL- DA continued significant increase from two days to one week after SCI(P＜0.05)and decreased gradual- ly at 2 weeks after SCI.A value of LDH-M began significant increase at day 1 after SCI and recovered to normal level at 2 weeks after SCI(P＜0.05).Conclusion Activities of ALDA and LDH-M regulated by HIF-1?in spinal cord injury is significantly increased.

Objective To investigate the prevalence and associated risk factors of hypertension in Songnan community so as to provide evidence for the early prevention of hypertension.Methods Cluster sampling was employed,and questionnaire survey was performed in 10 185 residents aged above 40 years in Songnan community of Baoshan District.The questionnaires involved with hypertension and associated risk factors.Results The prevalence of hypertension was 49.9% in Songnan community of Baoshan District,and that of men was significantly higher than that of women(53.7% vs 47.3%)(P

BACKGROUND AND OBJECTIVESapylin is one of the biological response modifiers. It has been used in the comprehensive treatment for advanced cancer, and its clinical efficacy has been proved. This study was to evaluate the effect of preoperative intraperitoneal injection of Sapylin in treatment of advanced gastric cancer.

METHODSSeventy-nine patients eligible for radical gastrectomy were randomly divided into the treatment group (Sapylin + mitomycin C, 40 patients) and the control group (mitomycin C alone, 39 patients). In the treatment group, 5 KE Sapylin was injected intraperitoneally 48 h before operation and 4 mg of mitomycin C was injected into peritoneal cavity before the closure of the peritoneum. In the control group, only 4 mg mitomycin C was injected into peritoneal cavity before the closure of the peritonium.

RESULTSThere was no operative mortality or duodenal stump leakage in the two groups. Postoperative complications were anastomotic leakage (2.5%, 1/40) and incision rupture (2.5%, 1/40) in the treatment group, and incision rupture (2.6%, 1/39) in the control group, with no significant difference between the two groups (P > 0.05). The 3-year survival rate was significantly higher in the treatment group than in the control group (76.5% vs. 49.4%, P < 0.05).

CONCLUSIONSPreoperative intraperitoneal injection of Sapylin can raise the 3-year survival rate after radical gastrectomy , without increasing the incidence rate of operative complications. Preoperative intraperitoneal injection of Sapylin is therefore a valuable therapy for advanced gastric cancer in clinic.

Adenocarcinoma ; drug therapy ; pathology ; surgery ; Aged ; Anastomotic Leak ; etiology ; Antibiotics, Antineoplastic ; administration & dosage ; therapeutic use ; Antineoplastic Agents ; administration & dosage ; therapeutic use ; Biological Products ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Follow-Up Studies ; Gastrectomy ; adverse effects ; methods ; Humans ; Injections, Intraperitoneal ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; therapeutic use ; Neoplasm Staging ; Preoperative Period ; Stomach Neoplasms ; drug therapy ; pathology ; surgery ; Stomach Rupture ; etiology ; Streptococcus pyogenes ; chemistry ; Survival Rate