In this paper , the authors retrieved and screened the related literature of medical workplace vio-lence, and introduced the research situation of workplace violence among medical staff in order to provide a refer -ence for the further research .

ObjectiveTo discuss the application of medical elastic stockings in nursing of patients with deep venous thrombosis formation. Methods62 patients diagnosed as acute lower limbs deep ve-nous thrombosis from January, 2005 to January, 2008 were randomly divided into the experimental group and the control groups with 31 patients in each group, the control group took general nursing measures, the experimental group used the medical elastic stockings based on the general care measures, The inci-dence of post- thrombosis syndrome was observed in two groups and underwent χ2 test. ResultsAfter two years follow- up, 2 patients relapsed and 3 patients appeared post- thrombosis syndrome in the experimental group, 8 patients relapsed and 10 patients had post-thrombosis syndrome in the control group. The relapse rate and incidence rate of peat-thrombosis syndrome in the control group were higher than those of the experimental group. ConclusionsThe use of medical elastic stockings can prevent acute lower limbs deep venous throm-bosis, and can reduce the symptoms of post-thrombosis syndrome, which deserves to be spread widely.

Objective To investigate the association between the Adiponectin rs266729 and rs2241766 gene polymorphisms and nonalcoholic fatty liver disease in the Han Chinese population residing in Qingdao. Methods Adiponectin rs266729 and rs2241766 gene polymorphisms were genotyped in patients with NAFLD (n = 336) and healthy controls (n = 280) using polymerase chain reaction (PCR). Serum lipid profiles and adiponectin levels were determined using biochemical methods. Statistical analyses were performed using Pearson Chi square test, logistic regression analysis, t test, linear regression analysis. Results We found a significant association between the Adiponectin rs266729 genotype frequencies and allele frequencies between NAFLD pa-tients and controls (χ2= 9.929, P = 0.007; χ2= 9.809, P = 0.002). After adjustment of confounding factor, the rs266729 G allele was associated with an increased risk of NAFLD compared to the C allele (OR = 1.410, 95%CI: 1.082-1.831, P = 0.008) No significant differences were found in the rs2241766 genotype frequencies and allele frequencies between NAFLD population and the controls (OR = 1.410, 95%CI: 1.082-1.831, P = 0.008). Conclusion The Han Chinese in Qingdao carrying the rs266729 G allele are at increased risk of NAFLD.

Objective: To explore the diagnostic value of combined detection of blood osteopontin (OPN) and matrix metalloproteinase-9 (MMP-9) for in-stent restenosis (ISR) in patients after percutaneous coronary intervention (PCI). Methods: A total of 142 patients who received post-PCI coronary angiography (CAG) in our hospital were studied. The patients were divided into 2 groups based on if there were ISR condition: ISR group,n=21and Non-ISR group,n=121. The blood levels of OPN and MMP-9 were detected upon the follow-up CAG conduction and the basic clinical information with biochemical indexes were compared between 2 groups. Results: Blood levels of OPN and MMP-9 were signiifcantly higher in ISR group than those in Non-ISR group,P<0.001. Multivariate logistic regression analysis revealed that elevated levels of OPN and MMP-9 were the independent risk factors for post-PCI ISR occurrence (OR=2.861 and OR=3.343,P<0.01). The ROC area of OPN and MMP-9 for predicting post-PCI ISR occurrence were 0.821 and 0.887,P<0.001. Taking the optimal cut off value of OPN at 3.68 ng/ml and MMP-9 at 415.24 ng/ml, the combined detection could increase the sensitivity of detection (90.48%) and the negative predictive value (98.06%). Conclusion: Blood levels of OPN and MMP-9 are closely related to ISR occurrence in post-PCI patients, combined detection has certain predictive value for ISR occurrence, especially for negative predictive value.

Objective To assess the awareness and knowledge about chronic obstructive pulmonary disease ( COPD ) among community general practitioners and general practice residency trainees in Shanghai.Methods Questionnaire was designed and used to investigate the knowledge of COPD among 59 general practitioners from 10 community health centres and 75 general practice trainees in Shanghai from July to September 2012.Results Of the 134 respondents, 49 were male and 85 were female with average age of (30.4 ±8.0) years.In the self-evaluation of “the knowledge about COPD”, “the diagnosis of COPD”,“the differential diagnosis of COPD and asthma”, “the interpretation of lung function report”, “aerosol using method”, “method about absorption apparatus”, “the side effects of bronchodilator”, “COPD rehabilitation” and “long term oxygen therapy, the rates of knowledge mastery were 61.9% ( 83/134 ) , 81.3%(108/133), 83.6% (112/134), 59.0% (79/134), 83.6% (93/134), 35.8% (48/134), 61.2%( 82/134 ) , 56.7% ( 76/134 ) and 61.2% ( 72/134 ) .Except interpretation of “lung function report”, the sores of all items in self-evaluation of the community general practitioners were higher than those of residency trainees ( all P<0.01 ) .Among the COPD related questions, the hightest accuracy rate was 93.3%(125/134) ( smoking cessation can attenuate the declined lung function) and the lowest accrurcy rate was 16.4% ( 22/134 ) ( the differential diagnosis of COPD and asthma ) .Compared with the general practice residents, community general practitioners got lower scores in question “how differentiate COPD from asthma” (6.8%vs.24.0%,χ2 =7.136, P=0.008) and got higher scores in question“the treatment of moderate COPD” (55.9%vs.30.7%,χ2 =8.655, P=0.003).More than half [56.7%(76/134)] of respondents thought that“it is necessary to develop COPD screening in community”, and 20.1%(27/134) thought that“absolutely necessary”.Conclusion The awareness and knowledge about COPD among the community general practitioners and general practice residency trainees are not satisfectory. The future training should focus on the risk factors, the differential diagnosis and treatment of COPD.

Objective To investigate the value of CT pulmonary artery obstruction index (PAOI)in evaluating the severity in patients of pulmonary embolism (PE)by a correlation study between CT PAOI and right ventricular function parameters and arterial blood gas analysis index.Methods CT PAOI,right ventricular function parameters and arterial blood gas analysis index were collected from 70 patients with PE,who had received CT pulmonary angiography (CTPA)examination in our hospital.Spearman rank correlation coefficient was used to evaluate the correlation between the PAOI and right ventricular/left ventricular maximum short axis diameter ratio (RVd/LVd),main pulmonary artery diameter (MPAd),superior vena cava diameter (SVCd),arterial oxygen partial pressure (PaO2 ),arterial carbon dioxide into pressure (PaCO2 ),oxygen saturation (SaO2 ),Alveolar arterial oxygen partial pressure difference (P(A-a)O2 ).Results PAOI and PaO2 were negative correlation,the correlation coefficient was -0.442;PAOI and RVd/LVd, MPAd,SVCd,P(A-a)O2 were positively related,correlation coefficients ranged between 0.163-0.675;PAOI was not related to SaO2 .Conclusion CT PAOI can be used to evaluate the severity of PE,it is not consistent with the severity of the patient’s clinical condition.

Funding of research projects within the category of Endemiology (H2401) funded by National Natural Science Foundation of China (NSFC) from 2010-2019 was summarized in this paper. Granted projects were categorized and analyzed based on the funding type, support institute and disease classification. The characteristics and trends of granted projects supported by NSFC were analyzed and summarized in order to provide reference for researchers to apply for projects in the future.

Objective To investigate the supporting policies of assistant general practioner training program (3 + 2 mode) in Shanghai.Methods Total 53 subjects were involved in 15 in-depth interviews and 5 focus group discussions held from October 2012 to October 2013,including 8 graduates from the specialty of country doctor of Shanghai Institute of Health Sciences,12 country doctors,2 leaders of 3 + 2 mode training hospital,5 leaders of rural community health centers,3 leaders of Shanghai Institute of Health Sciences,9 leaders of Commission of Health and Family Planning in Shanghai suburbs,3 leaders of Shanghai Municipal Commission of Health and Family Planning,1 leader of National Health and Family Planning Commission.Results Three leaders of Shanghai Municipal Commission of Health and Family Planning admitted the training program involved multiple departments and there were no unified supporting policies,2 leaders of Commission of Health and Family Planning in Shanghai suburbs thought the enrollment amount should be appropriately controlled.The exploration of social person (non-formal employees)mode was encouraged by the leaders of Shanghai Municipal Commission of Health and Family Planning.Leaders of rural community health centers strongly recommended to increase the selection and withdrawal mechanism to ensure the quality of students and training.Three leaders of rural Commission of Health and Family suggested to enroll student from other provinces.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning agreed that qualifying as assistant general practioner was an important target of training which should be obtained before graduation.All 3 + 2 mood trainees had a strong expectation to get a bachelor degree at the same time of completing the training.Leaders of Shanghai Municipal Commission of Health and Family Planning and 3 + 2 mode training hospitals proposed to pay attention to the construction of training base and teacher training.About one third of the 3 + 2 mood trainees,graduates from the specialty of country doctor of Shanghai Institute of Health Sciences and country doctors hoped to get more space for development.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning considered that the qualification of assistant general practioner should be the minimal recruitment for recruitment of new medical personel.Leaders of Shanghai Institute of Health Sciences and 3 + 2 mode training hospital suggested the relevant departments to support the new country doctors in terms of income,promotion policies and so on.Conclusions The supporting policies of the pilot 3 + 2 training in Shanghai are imperfect.It can be improved from organization,management,training implementation and career development.Effective support policies can help to generalize the 3 + 2 training.

Objective To evaluate the effectiveness of mini clinical evaluation exercise (miniCEX) in community rotation of general practice residency training.Methods Forty nine general practice residency trainees,who participated in community rotation during July 2012 to July 2014 in 3 community teaching bases,were randomly divided into two groups:25 trainees in intervention group received conventional teaching and additional 2 rounds of mini-CEX in one month,and 24 trainees received conventional teaching only.The changes of self-evaluation scores of clinical competence after the community rotation were evaluated.Focus group discussions of 8 trainees and 8 teachers from intervention group were also adopted in January to February 2013 to assess the effectiveness of mini-CEX.Results Three trainees withdrew in the study and the interventional group completed 232 mini-CEXs.The self-evaluation scores of clinical competence were elevated in all items in interventional group after community rotation (from 7.03 ± 0.68 to 7.30 ±0.77 in medical history,from 7.00 ± 0.83 to 7.18 ± 0.88 in physical examination,from 7.42 ± 1.20 to 7.52 ± 0.76 in humanistic qualities,from 6.79 ± 0.82 to 7.12 ± 0.70 in clinical judgment,from 6.85 ± 1.06 to 7.18 ± 0.81 in counseling skills,from 6.85 ± 1.15 to 7.12 ± 0.96 in organization,from 7.09 ±0.81 to 7.33 ±0.69 in overall competence),while in control group,scores of humanistic qualities (from 7.74 ± 0.89 to 7.60 ± 0.97),clinical judgment (from 6.94 ± 0.77 to 6.77 ± 1.10) and organization/efficiency (from 6.94 ± 0.96 to 6.80 ± 0.76) were declined.Mter adjusting self-evaluation score before rotation,the increased scores in clinical judgment(7.12 ±0.70 vs.6.77 ± 1.10,F =4.339,P =0.042) and organization (7.12 ± 0.96 vs.6.80 ± 0.76,F =4.336,P =0.042) of intervention group were significantly higher than those of control group.In focus group discussions both trainees and teachers recognized that mini-CEX would enhance clinical competence,be more comprehensive in assessing and adaptable in training program than former rotation tests.The major concerns of using mini-CEX were subjective rating process,non-unified rating standards and insufficient teaching ability.Conclusions Application of mini-CEX in community rotation of general practice residency training can enhance clinical competency of trainees.

An ultrasensitive immunoassay was developed based on As3+ and Hg2+ labeled SiO2 @ Au nanoparticles signal tags and hydride generation-atomic fluorescence spectrometry (HG-AFS) for the detection of carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9 (CA 19-9) respectively. Firstly, amino SiO2@ Au NPs were synthesized for selective absorption of As3+ and Hg2+ ions respectively. Subsequently,the secondary antibody (Ab2) of CEA and CA 19-9 was respectively labeled on As3+ or Hg2+-SiO2 @ Au NPs to prepare the corresponding signal tags for CEA and CA 19-9. Based on the sandwich immunoassay scheme, the tags, two antigen and corresponding first antibodies were bio-conjugated on the bottom of 96-well plate at room temperature to form the immunocomplex. After it was dissolved in alkali solution, As3+ and Hg2+ ions were released in solution and detected by HG-AFS, which concentration was proportional with logarithms of CEA and CA 19-9. The reaction conditions were optimized and the tags were characterized. This assay was based on determination of the concentration of As3+ and Hg2+ for quantization of the corresponding CEA and CA 19-9 antigen. The assay showed a wide linear range from 0. 001 to 100. 0 μg / L for CEA and 0. 01-80 U/ mL for CA 19-9, and a lower detection limit of 0. 5 ng / L and 0. 005 U/ mL respectively. This proposed method was used in real serums samples, the results were consistence with that by ELISA. The immunoassay showed three orders of magnitude of sensitivity lower than that of ELISA, which provides a promising simultaneous immunoassay for the early diagnosis of cancer .