Background The increasing demand for emergency services coupled with the special working environment has exacerbated occupational stress and work-related rumination among emergency medical dispatchers, which is noteworthy for its impact on dispatchers' sleep quality. Objective To explore the relationship among occupational stress, work-related rumination, and sleep quality of emergency medical dispatchers, so as to provide reference for improving sleep quality and maintaining physical and mental health of this occupational group. Methods A total of 386 emergency medical dispatchers from 16 provinces and municipalities including Beijing, Shanghai, Tianjin, Inner Mongolia, Zhejiang, Shanxi, Jiangxi, Anhui, Hubei, Hebei, Henan, Sichuan, Guizhou, Yunnan, Fujian, and Hainan of China were investigated with the Chinese version of Effort-Reward Imbalance Questionnaire, Work-Related Rumination Questionnaire, and Insomnia Severity Index. Spearman correlation was used to analyze the association among occupational stress, work-related rumination, and sleep quality. A structural equation model was constructed, with occupational stress as independent variable, the two dimensions of work-related rumination as mediating variables, and sleep quality as dependent variable, respectively. Bootstrap testing was then used to verify potential mediating effect of work-related rumination on the relationship between occupational stress and sleep quality among the emergency medical dispatchers. Results Among the enrolled emergency medical dispatchers, the effort-reward imbalance (ERI) index was 1.03, the score of affective rumination was 15.35±5.26, the score of problem-solving rumination was 17.64±4.63, and the total score of sleep quality was 21.10±6.53. Their ERI index was positively correlated with affective rumination scores (r=0.636, P<0.01), but not with problem-solving rumination scores (P>0.05). Their ERI index, affective rumination scores, and problem-solving rumination scores were positively correlated with sleep quality scores (P<0.05). The direct effect size of occupational stress on sleep quality was 0.627, the indirect effect size of affective rumination was 0.124, and the mediating effect of affective rumination accounted for 16.4% of the total effect (0.755), while the problem-solving rumination had no mediating effect on the relationship between occupational stress and sleep quality. Conclusion Occupational stress and affective rumination in emergency medical dispatchers can predict their sleep quality. Occupational stress can directly affect sleep quality, and indirectly affect it through affective rumination. Managers should pay attention to and evaluate the affective rumination level of emergency medical dispatchers, so as to take corresponding intervention measures to reduce their occupational stress and improve their sleep quality.

Objective:To evaluate the role of autophagy in reduction of high glucose and hypoxia-reoxygenation (HG+ H/R) injury to isolated cardiomyocytes by dexmedetomidine in rats.Methods:The normally cultured rat H9c2 cardiomyocytes at the logarithmic growth phase were seeded in 6-well plates at a density of 1×10 6 cells/ml and divided into 4 groups ( n=15 each) using a random number table method: control group (group C), group HG+ H/R, dexmedetomidine group (group DEX) and dexmedetomidine+ autophagy inhibitor 3-methylpurine group (group 3-MA). The cells were incubated in culture medium with 1% fetal bovine serum + 1% double antibody for 24 h when the cell density reached 50%.To establish HG+ H/R injury model, the cardiomyocytes were cultured in high-glucose culture medium (glucose concentration of 33 mmol/L) for 24 h, and then incubated in a 37 ℃ incubator (95% N 2+ 5%CO 2) for 4 h followed by reoxygenation (90%O 2+ 10%CO 2) for 2 h. Dexmedetomidine was added until the final concentration reached 5 μmol/L at 1 h before hypoxia in DEX and 3-MA groups, and 3-MA was added until the final concentration reached 5 μmol/L at 1 h of incubation with dexmedetomidine.At 2 h after reoxygenation, the cell viability was recorded by the cell counting kit-8 assay, lactate dehydrogenase (LDH) activity was detected by LDH kit, the expression of autophagy-related protein LC3, P62 and Beclin-1 was detected by Western Blot, the ratio of LC3Ⅱ/LC3Ⅰwas calculated, and the expression of P62 and Beclin-1 mRNA was detected by real-time polymerase chain reaction. Results:Compared with group C, the cell viability was significantly decreased in HG+ H/R, DEX and 3-MA groups, LDH activity in the supernatant was increased and expression of P62 was decreased in HG+ H/R and 3-MA groups, ratio of LC3Ⅱ/LC3Ⅰwas decreased in group 3-MA, and the expression of Beclin-1 was down-regulated in group HG+ H/R ( P<0.05). Compared with HG+ H/R group, LDH activity in the supernatant was significantly decreased, expression of Beclin-1, P62 and its mRNA was up-regulated, and ratio of LC3Ⅱ/LC3Ⅰwas increased in DEX group, and LDH activity in the supernatant was increased in group 3-MA ( P<0.05). Compared with DEX group, cell viability were decreased, LDH activity in the supernatant was increased, Beclin-1, P62 and its mRNA was down-regulated, and ratio of LC3Ⅱ/ LC3Ⅰwas decreased in group 3-MA ( P<0.05). Conclusion:Autophagy is involved in the reduction of HG+ H/R injury to isolated cardiomyocytes by dexmedetomidine in rats.

Animals ; Cdc20 Proteins/metabolism* ; Cell Line ; Embryo, Mammalian/embryology* ; Embryonic Development ; Female ; Infertility, Female/metabolism* ; Mice ; Mutation ; Oocytes/metabolism*

Objective To evaluate the effect of tyrosol on myocardial ischemia-reperfusion (I/R) injury in diabetic rats and the role of silent mating-type information regulation 1 (SIRT1)/adenosine monophosphate-activated protein kinase (AMPK)/endothelial nitric oxide synthase (eNOS) signaling pathway.Methods SPF healthy adult male Sprague-Dawley rats,weighing 200-220 g,were intraperitoneally injected with streptozotocin 60 mg/kg to establish the model of diabetes mellitus.Fifty-six diabetic rats were divided into 4 groups (n =14 each) using a random number table method:sham operation group (S group),myocardial I/R group (I/R group),myocardial I/R plus tyrosol group (I/R+T group),and myocardial I/R plus tyrosol plus SIRT1 inhibitor EX527 group (I/R+T+E group).In I/R+T and I/R+T+E groups,tyrosol 20 mg · kg-1 · d-1 was given by gavage for 45 consecutive days,and the equal volume of normal saline was given in the other two groups.In I/R+T+E group,EX527 5 mg · kg-1 · d-1 was intraperitoneally injected for 3 consecutive days before ischemia,and EX527 5 mg/kg was intraperitoneally injected at 20 min before repeffusion.Myocardial I/R was induced by ligation of the left anterior descending branch of coronary artery for 30 min followed by 2-h reperfusion.The myocardial infarct volume was measured by TTC staining.The levels of creatine kinase-MB (CK-MB),lactic dehydrogenase (LDH) and 5-F2t-isoprostane in serum and superoxide dismutase (SOD) in myocardial tissues were detected by enzyme-linked immunosorbent assay.The expression of SIRT1,AMPK,phosphorylated AMPK (p-AMPK),eNOS and p-eNOS was detected by Western blot.Results Compared with S group,the levels of serum CK-MB,LDH and 15-F2t-Isoprostane and myocardial infarction volume were significantly increased,the SOD activity was decreased,and the SIRT1 expression was down-regulated in I/R group,and the levels of serum CKMB,LDH and 15-F2t-Isoprostane and myocardial infarction volume were significantly increased,the SOD activity was decreased,the SIRT1 expression was down-regulated,and the expression of p-AMPK and peNOS was up-regulated in I/R+T and I/R+T+E groups (P＜0.05).Compared with I/R group,the levels of serum CK-MB,LDH and 15-F2t-Isoprostane and myocardial infarction volume were significantly decreased,the SOD activity was increased,and the expression of SIRT1,p-AMPK and p-eNOS was up-regulated in I/R+T group (P＜0.05),and no significant change was found in the parameters mentioned above in I/R+ T+E group (P＞0.05).Compared with I/R+T group,the levels of CK-MB,LDH and 15-F2t-isoprostane in serum and myocardial infarct volume were significantly increased,the SOD activity was increased,and the expression of SIRT1,p-AMPK and p-eNOS was down-regulated in I/R+T+E group (P＜0.05).Conclusion Tyrosol can mitigate myocardial I/R injury,and the mechanism may be related to activating SIRT1/AMPK/eNOS signaling pathway and inhibiting oxidative stress response in diabetic rats.

Objective To investigate the effect of capsule endoscopy on the small intestinal mucosa in the state of air insufflation. Methods Patients undergoing capsule endoscopy from November 2011 to April 2012 were divided into the air insufflation intervention group ( n＝14) and routine examination group (n＝13) by random number table method. The detection rate of small bowel disease, the transit time of capsule endoscope in small intestine, the degree of intestinal cleaning and the degree of intestinal lumen expansion were compared between two groups. Results There was no significant difference in total intestinal examination rate [ 85. 71%( 12/14) VS 61. 54%( 8/13),P＝0. 209] or disease detection rate [ 71. 43%(10/14) VS 84. 62%( 11/13), P＞0. 05] between air insufflation intervention group and conventional examination group. The mean procedure time of the air insufflation intervention group was 270. 86 ± 144. 85 min, which was shorter than that of the conventional examination group (325. 15±161. 76 min, P＝0. 369). The overall cleanliness of the air insufflation intervention group was higher than that of the conventional examination group (2. 05±0. 40 VS 1. 75±0. 40,P＝0. 060). The overall degrees of expansion of small intestine lumen were 1. 79 ± 0. 40 and 1. 38 ± 0. 29 scores, respectively ( P ＝ 0. 004 ). Conclusion Capsule endoscopy can significantly improve the degree of intestinal lumen expansion with trend of improving the overall cleanliness of the small intestine, and shortening the working time of the small intestine.

Objective To analysis the diagnostic values and characteristics of ultrasound and ultrasound guided fine needle aspiration cytology (FNAC) in patients with papillary thyroid carcinoma (PTC) before operation. Methods The data of ultrasound and ultrasound guided FNAC in 129 patients (including 148 PTC nodules) with PTC were collected from January 2014 to February 2017, and the diagnostic reports and feature descriptions of ultrasound and ultrasound guided FNAC were analyzed retrospectively. Results Among the 148 PTC nodules, the ultrasonographic imaging showed that 84.5% (125/148) with low echo-level solid nodules, 61.5% (91/148) with echo heterogenicity, 77.7% (115/148) with a ratio ≥ 1 in longitudinal/breadth, 69.6 % (103/148) with fuzzy boundary, 75.0% (111/148) with microcalcification in nodules, 97.3% (144/148) without or with incomplete aureole, 64.9% (96/148) with rich blood flow and 7.0% (9/129) with enlargement of cervical lymph nodes. The FNAC diagnosis showed that 78.4% (116/148) was diagnosed with suspected papillary carcinoma, 1.4% (2/148) was diagnosed with malignent tumor, 11.5% (17/148) was diagnosed with atypia of undetermined significance (AUS), 1.4% (2/148) was diagnosed with benign lesion, 0.7% (1/148) was diagnosed with follicular neoplasm and 6.7% (10/148) could not be diagnosed. If the suspected papillary carcinoma and malignent tumor were defined as cytodiagnosis, the diagnostic accordance rate with intraoperative pathology was 79.7%. Conclusion The preoperative accuracy rates of ultrasound diagnosis and ultrasound guided FNAC diagnosis for patients with PTC are high, and the characteristics of the both are also typical. The two examinations before operation are helpful for early diagnosis and treatment formulation for patients with PTC.

Objective To explore the value of three antibodies in the differential diagnosis of papillary thyroid carcinoma ,by de‐tecting the expression of HBME‐1 ,CK19 and CD117 in papillary thyroid cacinoma ,thyroid follicular adenoma and Hashimoto′s thy‐roiditis tissues .Methods Totally 85 cases were collected from January 2013 to December 2015 ,including papillary thyroid cacino‐ma ,thyroid follicular adenoma and Hashimoto′s thyroiditis .They were immunohistochemical stained by HBME‐1 ,CK19 and CD117 .SPSS16 .0 software was used to analyze the relationship between the staining results with different pathological changes . Results The positive rates of HBME‐1 ,CK19 and CD117 were 87 .3% ,98 .2% ,and 7 .3% ,respectively .The positive expression of them in benign and malignant groups had significant difference (P< 0 .05) and their consistency checking Kappa were 0 .582 , 0 .551 ,and 0 .874 ,respectively .Conclusion In the differential diagnosis of papillary thyroid carcinoma and benign lesions ,CD117 is better than HBM E‐1 and CK19 .It′s possible to use a combination of them in practice .

Ranpirnase (onconase, ONC) is a new drug, with weak RNase activity and strong cytotoxicity to various tumor cells in vitro and in vivo. This study is to obtain recombination onconase (rONC) with high bioactivity. Based on the codon preference of Pichia pastoris, we designed and synthesized the gene according to cDNA sequences of ONC and the α mating factor's prepeptide. We screened positive clones after transforming the recombination plasmids into P. pastoris X-33, GSS115 and SMD1168. We screened the best combination of seven different vectors and host strains. Moreover, we optimized culture condition in shake flasks and 10 L bioreactor, and purified rONC from the supernatant after inducing it with 0.25% methanol by aqueous two-phase extraction coupling G50 molecular exclusion method. The highest rONC production was 13 mg/L in pPICZα-A/X-33/ONC combination under the condition of pH 5.5 and 23 degrees C in shake flasks for 7 d; and that the highest rONC production was 180 mg/L when the induction is performed in the lower basic salt medium with pH 5.5 in the 10 L bioreactor for 7 d. The yield of rONC is more than 90% at a purity of above 95%. rONC can kill various tumor cells in vitro. The expression and purification of rONC would be useful for further investigation of this new drug.
Antineoplastic Agents ; metabolism ; Bioreactors ; Cell Line, Tumor ; Codon ; DNA, Complementary ; Genetic Vectors ; Humans ; Pichia ; metabolism ; Recombinant Proteins ; biosynthesis ; Ribonucleases ; biosynthesis

Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.

Objective:To evaluate the efficacy of specific immunotherapy (SIT) with standardized dermatophagoides pteronyssinus extract for allergic rhinitis (AR)accompanied with asthma.Method:One hundred and fifty-five patients(40 AR with asthma, AR & asthma) in accordance with the inclusion criteria of SIT, were allocated to receive standardized Dermatophagoides pteronyssinus extract (SIT group, n=89) or medical treatment(control group, n=66). AR with or without asthma was observed separately. Symptom and medicine scores, quality of life were recorded and analyzed before and after 1 year treatment. Side effects were registered. Subjective evaluation of symptoms was made by the patients.Result:Rhinitis and asthma symptom scores, medicine scores and quality of life were greatly improved in SIT group of AR & asthma after 1 year, which were not significant changed in control group except for medicine scores. The subjective evaluation of symptoms was also significantly improved in SIT group. In patients of AR without asthma, the symptom scores, medicine scores and quality of life were both improved. The SIT group improved greater than that of control group.Conclusion:The clinical efficacy of patients with AR & asthma was not good with simple medical treatment, while great clinical efficacy could be acquired with SIT.