Objective:To analyze the status of social support and the influencing factors of support utilization among general practitioners.Methods:An investigation on the status of social support and the influencing factors of support utilization was conducted among general practitioners (GPs) from 6 communities in Shanghai Minhang District selected by simple sampling method in February 2023. The investigation included a questionnaire survey containing basic information and intervention measures (emotional support, information support, tool support); and assessments of the Social Support Rate Scale (SSRS), Perceived Social Support Scale, General Self-Efficacy Scale, Quality of Work Life Scale, Trait Coping Style Scale, and Psychological Resilience Scale. The association of social support status with various characteristics of GPs and their perceived social support and trait coping style was analyzed, and the influencing factors of social support utilization were determined.Results:A total of 184 questionnaires were distributed and 184 valid questionnaires were collected, with an effective recovery rate of 100.00%. Among the 184 participants, 55 (29.89%) had a general level of social support, and 129 (70.11%) were satisfied with their social support. The total score of SSRS was (37.49±8.41), with the objective support dimension scoring (9.67±3.42), subjective support scoring (20.04±4.52), and support utilization scoring (7.77±2.09). Univariate analysis showed significant differences in social support levels among respondents with different marital status, number of children, emotional support, informational support, instrumental support, positive coping, negative coping, psychological resilience, compassion fatigue, general self-efficacy, and perceived social support status ( P<0.05). Multiple linear regression analysis indicated that marital status, family support, professional skills, positive coping, and negative coping were independent influencing factors of social support. Among these factors, being married, having family care support, professional titles and skills and positive coping had a positive impact on social support levels, while negative coping had a negative impact ( P<0.05). Further stepwise multiple linear regression analysis showed that friend support, positive coping and family care were positive influencing factors for support utilization, while negative coping was a negative influencing factor ( P<0.05). Conclusion:The levels of social support among GPs in Minghang district of Shanghai are relatively high. Marital status, family support, professional title and skills and positive coping are positive factors for social support; and friend support, positive coping and family support are positive factors for support utilization.

Objective:To investigate the knowledge, attitudes, practices (KAP), and demands of medical staff in family physician teams regarding the application of artificial intelligence (AI) in contracted services, and to analyze the influencing factors.Methods:A cross-sectional study was conducted from June to July 2023. A total of 602 medical staff members from family physician teams in Shanghai Minhang District were selected as subjects. Data on demographics (age, gender, institution, position, education, work experience, household registration, professional title, marital status, fertility status) and KAP/demand regarding AI application in contracted services were collected using a self-designed questionnaire. Intergroup differences were analyzed. Multiple stepwise linear regression was employed to identify the main factors influencing AI application demand.Results:Among the 602 participants, 484 (80.4%) were aged 30-49 years, 466 (77.40%) were females, 559 (92.9%) held a bachelor′s degree or higher, and 505 (83.9%) had intermediate or senior professional titles. The awareness rate for knowledge, positive attitude rate, and practice implementation rate regarding AI application were 47.2% (284/602), 73.1% (440/602), and 32.1% (193/602), respectively. The mean scores for knowledge, attitude, and practice were 15.72±3.40, 18.34±3.41, and 14.60±3.89, respectively. Significant differences were found among the items within each KAP dimension (knowledge: F=7.688, P<0.001; attitude: F=5.106, P<0.001; practice: F=6.763, P<0.001). Within knowledge, item K3 (awareness of intelligent elderly monitoring devices) scored lowest (3.00±0.79), differing significantly from K1, K2, K4, and K5 (all P<0.05). Within attitude, item A5 (willingness to fully trust AI′s accuracy and convenience in contracted services) scored lowest (3.57±0.75), differing significantly from A3 and A4 (all P<0.05). Within practice, item P3 (increasing reliance on AI in daily contracted services) scored lowest (2.79±0.93), differing significantly from P1 and P2 (all P<0.05). KAP scores differed significantly across demographic subgroups. Knowledge scores differed significantly by age, gender, and marital status (all P<0.05). Attitude scores differed significantly by gender, household registration, and fertility status (all P<0.05). Practice scores differed significantly by gender, position, and marital status (all P<0.05). Regarding demand, the most frequently selected areas were follow-up services (28.74%, 173/602), data management (26.25%, 158/602), and data collection (25.42%, 153/602). Univariate analysis identified age, gender, education, professional title, fertility status, and KAP scores as significant factors influencing AI application demand (all P<0.05). Multiple stepwise linear regression revealed that older age ( t=3.905, P<0.001), female gender ( t=3.548, P<0.001), and higher practice scores ( t=-3.044, P=0.002) were significant predictors of greater AI application demand. Conclusions:Significant variations exist in the KAP levels regarding AI application among family physician team members. Gender, age, and practice behavior significantly influence demand. Tailored strategies for different subgroups, coupled with timely targeted training and practical exercises, are recommended to enhance the effective and widespread adoption of AI technology in family physician contracted services.

Objective:To analyze the status of social support and the influencing factors of support utilization among general practitioners.Methods:An investigation on the status of social support and the influencing factors of support utilization was conducted among general practitioners (GPs) from 6 communities in Shanghai Minhang District selected by simple sampling method in February 2023. The investigation included a questionnaire survey containing basic information and intervention measures (emotional support, information support, tool support); and assessments of the Social Support Rate Scale (SSRS), Perceived Social Support Scale, General Self-Efficacy Scale, Quality of Work Life Scale, Trait Coping Style Scale, and Psychological Resilience Scale. The association of social support status with various characteristics of GPs and their perceived social support and trait coping style was analyzed, and the influencing factors of social support utilization were determined.Results:A total of 184 questionnaires were distributed and 184 valid questionnaires were collected, with an effective recovery rate of 100.00%. Among the 184 participants, 55 (29.89%) had a general level of social support, and 129 (70.11%) were satisfied with their social support. The total score of SSRS was (37.49±8.41), with the objective support dimension scoring (9.67±3.42), subjective support scoring (20.04±4.52), and support utilization scoring (7.77±2.09). Univariate analysis showed significant differences in social support levels among respondents with different marital status, number of children, emotional support, informational support, instrumental support, positive coping, negative coping, psychological resilience, compassion fatigue, general self-efficacy, and perceived social support status ( P<0.05). Multiple linear regression analysis indicated that marital status, family support, professional skills, positive coping, and negative coping were independent influencing factors of social support. Among these factors, being married, having family care support, professional titles and skills and positive coping had a positive impact on social support levels, while negative coping had a negative impact ( P<0.05). Further stepwise multiple linear regression analysis showed that friend support, positive coping and family care were positive influencing factors for support utilization, while negative coping was a negative influencing factor ( P<0.05). Conclusion:The levels of social support among GPs in Minghang district of Shanghai are relatively high. Marital status, family support, professional title and skills and positive coping are positive factors for social support; and friend support, positive coping and family support are positive factors for support utilization.

Objective:To investigate the knowledge, attitudes, practices (KAP), and demands of medical staff in family physician teams regarding the application of artificial intelligence (AI) in contracted services, and to analyze the influencing factors.Methods:A cross-sectional study was conducted from June to July 2023. A total of 602 medical staff members from family physician teams in Shanghai Minhang District were selected as subjects. Data on demographics (age, gender, institution, position, education, work experience, household registration, professional title, marital status, fertility status) and KAP/demand regarding AI application in contracted services were collected using a self-designed questionnaire. Intergroup differences were analyzed. Multiple stepwise linear regression was employed to identify the main factors influencing AI application demand.Results:Among the 602 participants, 484 (80.4%) were aged 30-49 years, 466 (77.40%) were females, 559 (92.9%) held a bachelor′s degree or higher, and 505 (83.9%) had intermediate or senior professional titles. The awareness rate for knowledge, positive attitude rate, and practice implementation rate regarding AI application were 47.2% (284/602), 73.1% (440/602), and 32.1% (193/602), respectively. The mean scores for knowledge, attitude, and practice were 15.72±3.40, 18.34±3.41, and 14.60±3.89, respectively. Significant differences were found among the items within each KAP dimension (knowledge: F=7.688, P<0.001; attitude: F=5.106, P<0.001; practice: F=6.763, P<0.001). Within knowledge, item K3 (awareness of intelligent elderly monitoring devices) scored lowest (3.00±0.79), differing significantly from K1, K2, K4, and K5 (all P<0.05). Within attitude, item A5 (willingness to fully trust AI′s accuracy and convenience in contracted services) scored lowest (3.57±0.75), differing significantly from A3 and A4 (all P<0.05). Within practice, item P3 (increasing reliance on AI in daily contracted services) scored lowest (2.79±0.93), differing significantly from P1 and P2 (all P<0.05). KAP scores differed significantly across demographic subgroups. Knowledge scores differed significantly by age, gender, and marital status (all P<0.05). Attitude scores differed significantly by gender, household registration, and fertility status (all P<0.05). Practice scores differed significantly by gender, position, and marital status (all P<0.05). Regarding demand, the most frequently selected areas were follow-up services (28.74%, 173/602), data management (26.25%, 158/602), and data collection (25.42%, 153/602). Univariate analysis identified age, gender, education, professional title, fertility status, and KAP scores as significant factors influencing AI application demand (all P<0.05). Multiple stepwise linear regression revealed that older age ( t=3.905, P<0.001), female gender ( t=3.548, P<0.001), and higher practice scores ( t=-3.044, P=0.002) were significant predictors of greater AI application demand. Conclusions:Significant variations exist in the KAP levels regarding AI application among family physician team members. Gender, age, and practice behavior significantly influence demand. Tailored strategies for different subgroups, coupled with timely targeted training and practical exercises, are recommended to enhance the effective and widespread adoption of AI technology in family physician contracted services.

OBJECTIVE To screen the potential active components of Polygonum orientale flower against myocardial ischemia- reperfusion injury （MIRI） in rats based on physiological and pathological states. METHODS SD rats were divided into normal control group， normal administration group， MIRI control group and MIRI administration group， with 5 rats in each group. After drug intervention or modeling and drug intervention， chromatographic separation plasma samples were collected， and chromatographic separation and mass spectrometry data collection were performed by using UPLC-Q-TOF/MS. The prototype components and metabolites were analyzed by comparing the reference substance maps， the maps of each plasma sample， and the relevant literature. At the same time， the common peaks in plasma samples of rats in normal administration group and MIRI administration group were identified. Combined with principal component analysis and orthogonal partial least square-discriminant analysis， the differential transitional components were screened out according to the value of variable importance in the projection （VIP）＞1， to speculate the potential active components of P. orientale flower in rats under physiological and pathological states. The SD rats were divided into control group， MIRI group， positive control group （Compound danshen tablets 0.2 g/kg， 3 times a day）， and potentially active compound groups （10 mg/kg， twice a day）， with 5 rats in each group. The rats in administration groups were given relevant medicine intragastrically， for 3 consecutive days. The activity of superoxide dismutase （SOD）， the leakages of lactate dehydrogenase （LDH）， creatine kinase isoenzyme-MB （CK-MB） and cardiac troponin Ⅰ （cTnⅠ） in plasma were detected after the last administration. RESULTS Twenty-six main chromatographic peaks were obtained from the total ion chromatogram of the extract of P. orientale flower， and 14 of them were determined， including gallic acid， catechin， protocatechuic acid and so on. There were fifteen （including 6 absorbed prototype components and 9 metabolites） and nineteen transitional components （including 6 absorbed prototype components and 13 metabolites） in the plasma sample of normal rats and MIRI rats. Eight transitional components were detected in both normal rats and MIRI rats， and the VIP values of kaempferol glucuronidation metabolites， quercetin carbonylation metabolites and N-p-paprazine to the corresponding peak were higher than 1. Compared with MIRI group， the activities of SOD were increased significantly in the plasma of MIRI rats in each potential active compound group （P＜0.01）， and the leakages of LDH， CK-MB， and cTnⅠ in the plasma of MIRI rats were reduced significantly （P＜0.01）. CONCLUSIONS The potential anti-MIRI active components in extract of P. orientale flower are N-p-paprazine， quercetin， kaempferol and kaempferol-3-O-β-D-glucoside.

Animals ; Apoptosis ; Brain/metabolism* ; Male ; Phosphatidylinositol 3-Kinases/metabolism* ; Rats ; Rats, Sprague-Dawley ; Subarachnoid Hemorrhage/drug therapy* ; Thyroxine/pharmacology*

Objective? Based on the clinical nursing ability and the needs of nurses, a network information platform for standardized training of nurses is constructed, which is practical, comprehensive, scientific and reasonable. Methods? Using semi-structured interview method to construct the questionnaire of the functional requirements of the standardized training network information platform module for nurses, using the questionnaire to investigate the standardized training nurses, clinical teachers and nursing managers to obtain the functional requirements of the standardized training network information platform module for nurses. Two rounds of Delphi expert consultation were used to determine the modules and functions of the network information platform for standardized training of nurses, and a multidisciplinary information platform team was established to initially build the network information platform. In August 2015 and August 2016, 90 new openly recruited nurses from a ClassⅢ Grade A hospital were set as the control group, and 98 new openly recruited nurses in August 2017 were set as the observation group. The control group used the traditional training method, and the observation group used the network information platform for training. Questionnaire survey was used to compare the two groups' clinical nursing ability, academic achievement and professional skill achievement. Results? According to the demand, the standardized training network information platform for nurses was designed into four parts:basic module, specialized module, humanistic module and assessment module. The scores of self-evaluation, leadership of peer review, critical patients′ monitoring, teaching and cooperation, planning and evaluation, communication and professional development in the observation group were significantly higher than those in the control group (P＜ 0.05). The professional theoretical results and professional skills results of the observation group were higher than the control group and the difference was statistically significan(t P＜0.05). Conclusions? Based on the clinical nursing ability, the network information platform for standardized training of nurses is constructed, and the platform is used for standardized training of nurses, which can improve the clinical nursing ability,the academic examination results and the professional skill examination results of the trained nurses.

Objective:To discuss the clinical characteristics of the Pneumocystis jirovecii pneumonia (PCP) in the non-HIV-infected blood disease patients, and to analyze its risk factors, treatment methods, prognosis and prevention measures.Methods:A female patient aged 18years old was confirmed as acute myeloid leukemia (AML) , and experienced dyspnea, chest congestion and hypoxaemia during the recovery period of hemogram after chemotherapy.The chest CT showed the bilateral lung diffuse ground glass density images.The patient had a dry cough and the oxygen saturation was gradually decreased to 75％5dafter antibacteriological treatment.A repeat chest CT showed enlarged diffuse ground glass density images on both lungs.Considering about the possibility of PCP, the patient received oral trimethoprim/sulfamethoxazole (TMP/SMX) 1g, once every 6h, in combination with caspofungin.Results:Two days later, the symptoms of the patients were not improved.The patient was transferred to ICU and was diagnosed PCP by bronchoalveolar lavage.The patient was switched to oral TMP/SMX2g, once every 8h, in combination with caspofungin.Meanwhile, the patient received bi-level positive airway pressure ventilation (Bipap) for the increased work of breathing.Five days later, the symptoms of the patients were improved and the Bipap was stopped.The patient got better and discharged 5dlater.The patient continuely received oral TMP/SMX 2g, once every 8hfor 36d.Conclusion:Prevention of PCP should be focused, in the non-HIV-infected blood disease patients receiving chemotherapy.Diagnosis of PCP should be considered in these patients without prevention who once have suspected clinical manifestation of PCP in non-granulocytic phase.Early empirical treatment of PCP and ICU management in the non-HIV-infected blood disease patients with acute respiratory failure are the keys to reduce death and improve the prognosis of PCP.

Objective To investigate the effect of NDRG2 on neuropathic pain model rats with spinal cord ligation(SNL)in the dorsal horn of the spinal cordby using intrathecal NDRG2 adenovirus (AD-Ndrg2-RNAi).Methods Forty-two male SD rats weighing 180-230 g were randomly divided into sham operation group (n=6)and SNL group (n=3 6).SNL group underwent lumbar spinal dor-sal ligation.The sham operation group only exposed the spinal nerve without ligation.The mechanical withdraw threshold (MWT)and thermal withdrawlantency (TWL)were measured at 1 d before op-eration and at 1,3,7,10,14 and 21 d after operation.After the behavioral testing,the rats in SNL group were sacrificed and the lumber segment of the spinal cord was removed to test theprotein and mRNA level of NDRG2.Another forty-eight male SD rats were randomly divided into 4 groups after intrathecal catheterization (n=12):group sham operation with saline (group CS);group sham oper-ation with adenovirus (group CA);group SNL with saline (group SS);group SNL with adenovirus(group SA).The rats in groups CS and SS were treated with intrathecal injection of normal saline 10 μl on the third day after operation,while groups CA and SA received the single injection titer of 2× 109PFU/ml of AD-Ndrg2-RNAi on the same day.The rat plantar MWT and TWL were measured at 1 d before SNL and at 1,3,7 and 10 d after SNL.The rats were sacrificed after the lastbehavioral test.Lumbar enlargement of the spinal cord was removed to test the level of NDRG2 and GFAP pro-tein.The expression of NDRG2 mRNA was detected by real-time fluorescence quantitative PCR. Results Compared with sham group,the MWT and TWL was significantly decreased and reduced in SNL group 1,3,7,10,14,21 d and 3,7,10,14,21 d after surgery respectively(P<0.01).Com-pared with 1 d before surgery,protein content and mRNA expression of NDRG2 in the spinal dorsal horn of the SNL group were significantly decreased 1 d after surgery,and they were significantly in-creased on the 7,10,14,and 21 d after operation(P<0.01).Compared with group CS,the MWT and TWL were significantly decreased and reduced in group SS and group SA 1,3,7 and 10 d after surgery(P<0.05).MWT and TWL on 7 and 10 d were increased significantly in group SA (P<0.05)compared with group SS.Compared with group CS,protein content and mRNA expression of NDRG2 in the spinal dorsal horn of group CA were significantly decreased,and increased significantly in group SS 10 d after surgery(P<0.05).Compared with group SS,protein content and mRNA ex-pression of NDRG2 in the spinal dorsal horn of group SA were significantly decreased.Compared with group CS,the protein content of GFAP in spinal dorsal horn of group CA,group SS and group SA were increased significantly 10 d after surgery (P<0.05).Conclusion Intrathecal injection of AD-Ndrg2-RNAi significantly inhibits neuropathic pain caused by spinal cord ligation in rats,suggesting that NDRG2 in astrocytes is involved in the development and progression of neuropathic pain.

Objective: To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods: The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation. Results: The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively]. Conclusion The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.