Objective:To investigate the prevalence,related factors,and career implications of occupational burnout among resident physicians during standardized training in Inner Mongolia.Methods:This cross-sectional study used convenience sampling to enroll 2 891 resident physicians,assessing them with a self-developed general information questionnaire,socio-psychological scales,and a universal burnout inventory.Latent profile analysis clas-sified participants based on burnout dimensions,while logistic regression models examined the factors influencing burnout and their relationship with career choices.Results:Resident physicians were divided into low(59.0％),moderate(28.9％),and high(12.1％)burnout subgroups.Logistic regression showed that,compared to the low burnout group,significant risk factors included professional master's students(OR=0.44),working＞70 hours weekly(OR=0.63),＞4 night shifts monthly(OR=0.66),anxiety(mild OR=0.49;moderate OR=0.26;se-vere OR=0.14),depression(mild OR=0.38;moderate OR=0.24;severe OR=0.11),insomnia(mild OR=0.51;moderate OR=0.44;severe OR=0.38),low social support(OR=0.23),and low happiness index(OR=0.42).Male residents(OR=1.25)were less likely to experience burnout.High burnout residents were 5.11 times more likely to quit the medical profession.Conclusion:Training intensity and socio-psychological factors signifi-cantly contribute resident physicians' burnout levels,with severe burnout increase career attrition.

Objective:To investigate the prevalence,related factors,and career implications of occupational burnout among resident physicians during standardized training in Inner Mongolia.Methods:This cross-sectional study used convenience sampling to enroll 2 891 resident physicians,assessing them with a self-developed general information questionnaire,socio-psychological scales,and a universal burnout inventory.Latent profile analysis clas-sified participants based on burnout dimensions,while logistic regression models examined the factors influencing burnout and their relationship with career choices.Results:Resident physicians were divided into low(59.0％),moderate(28.9％),and high(12.1％)burnout subgroups.Logistic regression showed that,compared to the low burnout group,significant risk factors included professional master's students(OR=0.44),working＞70 hours weekly(OR=0.63),＞4 night shifts monthly(OR=0.66),anxiety(mild OR=0.49;moderate OR=0.26;se-vere OR=0.14),depression(mild OR=0.38;moderate OR=0.24;severe OR=0.11),insomnia(mild OR=0.51;moderate OR=0.44;severe OR=0.38),low social support(OR=0.23),and low happiness index(OR=0.42).Male residents(OR=1.25)were less likely to experience burnout.High burnout residents were 5.11 times more likely to quit the medical profession.Conclusion:Training intensity and socio-psychological factors signifi-cantly contribute resident physicians' burnout levels,with severe burnout increase career attrition.

Objective:To investigate the effect of transcranial clipping in the treatment of intracranial aneurysms and its influence on hemodynamics, neuron specific enolase(NSE) and S100B expression.Methods:A retrospective analysis was made in 47 patients with intracranial aneurysms who admitted to Taizhou Hospital of Zhejiang Province from January 2017 to June 2019, all patients were treated by transcranial clipping.The hemodynamics, NSE and S100B levels were compared before operation and 1 week after operation.All patients were followed up for 6 months to evaluate the prognosis.Results:All patients completed the operation, the operation time was (2.79±0.43)h, the intraoperative bleeding volume was (243.51±28.73)mL, the incidence of postoperative complications was 6.38%(3/47), and the average hospitalization time was (16.74±1.86)d.One week after operation, the cerebral blood volume [(27.98±3.24)mL/100g] and cerebral blood flow [(2.08±0.34)mL·100g -1·min -1] were higher than those before operation [(23.41±2.36)mL/100g and (1.56±0.27)mL·100g -1·min -1] ( t=7.816, 8.211, all P<0.05). The serum NSE[(15.28±2.18)μg/L] and S100B[(0.83±0.16)μg/L] were lower than those before operation [(26.39±4.25)μg/L and (1.59±0.27)μg/L]( t=15.946, 16.601, all P<0.05). After follow-up for 6 months, 38 cases(80.85%) had a good prognosis. Conclusion:Transcranial clipping is effective in the treatment of intracranial aneurysms, and can improve hemodynamics, reduce the expression of NSE and S100B in serum, and reduce complications.

Objective: To study the clinical efficacy of microsurgical clipping treatment for intracranial aneurysm rupture and optimal timing. Methods: From January 2016 to December 2017, 80 patients with intracranial aneurysm rupture in Taizhou Enze Medical Center(Group) Hospital were randomly divided into the control group (24-72h after rupture) and the observation group (within 24h after rupture) according to the digital table, with 40 patients in each group.The pre- and intra-surgical re-rupture and surgical clipping, post-surgical complications, and clinical efficacy of 6-month follow-up in the two groups were observed and compared. Results: Compared with the control group, the incidence rate of pre-surgical re-rupture was significantly reduced in the observation group (0.0% vs.10.0%, χ²=4.21, P<0.05). Compared with the control group, the incidence rate of post-surgical complications was obviously reduced in the observation group (20.0% vs.42.5%, χ²=4.71, P<0.05). Compared with the control group, the excellent rate of treatment was significantly improved in the observation group (87.5% vs.65.0%, χ²=5.59, P<0.05). Conclusion The microsurgical clipping treatment can improve the clinical efficacy of intracranial aneurysm rupture and sooner surgery with better prognosis.

Objective To study the clinical significance of apolipoprotein B and apolipoprotein A1 ratio (ApoB/ApoA1) in patients with polycystic ovary syndrome (PCOS) combined metabolic syndrome (MS),by detecting the level of ApoB and ApoA1 in patients' serum.Methods 160 patients with PCOS were selected in our hospital from Jan.2014 to Dec.2015,and they were divided into MS group and non-MS group according to the diagnostic criteria of MS.The anthropometric measurements,endocrine markers,glucose and lipid metabolism indexes of patients in the two groups were measured and compared.Correlation of ApoB/ApoA 1 ratio and components of MS were analyzed,respectively.Relationship between ApoB/ApoA1 ratio and the number of abnormal components in MS were also investigated.Results Significant difference was found in the levels of ApoB ((1.01±0.34) g/L) and ApoA1((1.15±0.29) g/L) between MS group and non-MS group (P＜0.05),and ApoB/ApoA1 ratio in MS group was obviously higher than that in non-MS group (P＜0.05).ApoB/ApoAl ratio was positively correlated with BMI,waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),insulin resistance index (HOMA-IR),high triglycerides (TG) and low density lipoprotein (LDL-C),respectively,and it was negatively correlated with high density lipoprotein (HDL-C)(P＜0.05).However,there was no significant correlation between ApoB/ApoA1 ratio and the age,fasting insulin (FINS),as well as the total cholesterol (TC) (P＞0.05).Moreover,ApoB/ApoA1 ratio increased with increase in the number of abnormal components (P＜0.05).Conclusion ApoB/ApoA1 ratio is closely related to the components of MS,and it may have important clinical significance for diagnosis of PCOS combined MS and preventing long-term complications of PCOS.

Objective To explore the effect of amifostine combined with low-dose cyclosporine in treatment of refractory immune thrombocytopenia effect and related mechanisms.Methods 60 cases of refractory immune thrombocytopenia patients using parallel randomized controlled groups, divided into three groups, 20 cases in each group, amifostine group were treated with amifostine, cyclosporine group were treated with cyclosporine, amifostine+CSA group received amifostine+cyclosporine A treatment.The platelet count, platelet membrane glycoprotein antibody, lymphocyte subsets and bone marrow megakaryocyte count were observed and compared.Results After different treatment of three, six months, the level of platelet count of patients in three groups were compared with the group before treatment were significantly increased, and the treatment of platelet count level of amifostine group and cyclosporine group were significantly lower than that of amifostine +CSA group, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.The total efficacy of amifostine+CSA group was significantly higher than the other two groups, the difference was statistically significant ( P<0.05 ) , there was no significant difference between amifostine group and cyclosporine group.After the treatment, the platelet membrane glycoprotein GPIIb/IIIa antibody levels in three groups were significantly increased, and ring the detection level of amifostine+CSA group after treatment was significantly higher than the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the three groups of CD4 +, CD4 +/CD25 +and CD4 +/CD8 +levels were significantly increased, CD8 +decreased significantly, the difference was statistically significant (P<0.05).And the level of change after treatment with amifostine +cyclosporine group was significantly higher than that of the other two groups, the difference was statistically significant (P<0.05), there was no significant difference between amifostine group and cyclosporine group.After treatment, the number of bone marrow megakaryocytes in the three groups was significantly lower than that before treatment , the level of count after treatment with amifostine +cyclosporine was significantly lower than that of the other two groups, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and cyclosporine group.The adverse reactions of amifostine group and amifostine+CSA group were significantly lower than that in cyclosporine group, the difference was statistically significant (P<0.05).there was no significant difference between amifostine group and amifostine+CSA group.Conclusion Amifostine combined with low dose of cyclosporine in treatment of refractory immune thrombocytopenia can play a synergistic effect, improve the therapeutic effect, and effectively reduce the dosage and adverse reactions.

Objective To reproduce an SD rat model of prostatic calculus by using nanobacteria (NB), and explore the role of NB in contributing to prostatitis and prostatic calculus. Methods Twenty adult male SD rats were randomized to the control group and 20 to the model group. Rat prostate infection models were reproduced by infusing 0. 2 ml (Concentration, 1 Mai unit) NB suspension transurethrally. 0.2 ml physiological saline was infused transurethrally in the rat control group. The rats were sacrificed 4 and 8 weeks later and prostatic pathology were viewed by hematoxylin and eosin (HE) staining. Lithogenesis was observed by scanning electron microscope (SEM) or Transmission electron microscopy (TEM). Re-isolation, culture and identification of nanobacteria were also done in rat prostatic tissues. Results Chronic inflammatory changes of prostates were shown in the model group at both 4 weeks and 8 weeks after infusing NB suspension. Prostatic calculi were detected by SEM and TEM at 8 weeks in the prostates of the rat model group (7/10). Neither chronic inflammatory changes nor prostatic calculus was found in the control group. NB was positive in the model group, but negative in the control group. Conclusions NB infection could cause chronic prostatitis and prostatic calculus in rats.