Objective: Based on the KAP and Prospect theory, to explore, construct and verify the theoretical model and formation mechanism of driving factors of primary care doctors′ willingness to carry out the primary diagnosis. Methods: Using the random cluster sampling method, from April to May 2019, a questionnaire survey was conducted among doctors at 20 primary medical and health service institutions in Hangzhou. The survey covered the primary care doctors′ cognition level of primary diagnosis, their self-evaluation of primary medical care capabilities, evaluation of policies and systems, expectation of primary medical care, and their job satisfaction. Descriptive statistic, multiple linear regression and structural equation model were used to analyze and explore the driving factors and formation mechanism of their willingness to carry out the primary diagnosis. Results: Primary care doctors′ willingness rate for primary diagnosis was 76.4%(308/403). Positive expectation(beta=0.309), cognition level(beta=0.216), evaluation of policies and systems(beta=0.184), and self-evaluation of primary diagnosis capability(beta=0.170), all of which directly affect the said willingness. The total effect of the five types of driving factors on the willingness of the primary diagnosis was as follows: cognitive level of the primary diagnosis(0.536), evaluation of the policy system(0.494), self-evaluation of the primary diagnosis capability(0.436), positive expectations of the primary diagnosis work(0.186), job satisfaction(0.146). Conclusions The cognition of the primary diagnosis, the capability of the primary diagnosis, the policy system and the positive expectation are the important premises, key driving forces, and a strong guarantee and motivation to drive primary care doctors to carry out the primary diagnosis. It is suggested that the government and medical institutions should further improve the cognition level of primary care doctors, focusing on systematically improving the service capability of primary care doctors′ primary consultation, coordinating to improve policy guidance measures such as financial input, medical insurance reimbursement and referral system, establishing and improving incentive measures such as career development, performance appraisal, salary and welfare of primary care doctors.

Objective To detect the damage incidence rate of liver and myocardium in infantile rotavirus (RV) enteritis.And to provide the basis for prevention and cure of liver and myocardium damage in infantile RV enteritis.Methods The liver function and myocardial enzyme detection results of 395 patients with infantile RV enteritis were collected .These results were compared with those of 40 healthy kids from health examinations . Results The levels of alanine aminotransferase ( ALT ) , aspartate amino transferase ( AST ) , serum creatine kinase (CK) and serum creatine kinase isozyme(CK-MB) from infantile patients were (34.49 ±29.13)U/L,(52.44 ± 24.10)U/L,(141.75 ±132.22)U/L and (48.69 ±32.53)U/L,respectively,which were higher than those of the healthy control [(16.00 ±3.24)U/L,(29.90 ±3.76)U/L,(101.82 ±64.56)U/L and (22.32 ±8.98)U/L,t=4.008,5.901,3.982,5.64,all P<0.05].The abnormal occurrence rates of ALT ,AST,CK and CK-MB in infantile patients were 19.49％,73.16％,12.15％,73.16％,respectively,which were higher than those in healthy controls (2.50％,20.00％,0.00％,0.00％),the differences were statistically significant (χ2 =7.128,47.397,5.464, 300.239,all P<0.05).The incidence rates of liver and myocardium damage were 19.49％and 73.16％,respectively. Conclusion There are higher incidence rates of liver and myocardium damage in infantile RV enteritis .So for the infantile RV enteritis patients ,it is necessary to detect the liver function and myocardial enzyme level .The treatment for infantile RV enteritis should be included liver and myocardial protection except antivirus and correcting dehydration .

Neurostimulation remarkably alleviates the symptoms in a variety of brain disorders by modulating the brain-wide network. However, how brain-wide effects on the direct and indirect pathways evoked by focal neurostimulation elicit therapeutic effects in an individual patient is unknown. Understanding this remains crucial for advancing neural circuit-based guidance to optimize candidate patient screening, pre-surgical target selection, and post-surgical parameter tuning. To address this issue, we propose a functional brain connectome-based modeling approach that simulates the spreading effects of stimulating different brain regions and quantifies the rectification of abnormal network topology in silico. We validated these analyses by pinpointing nuclei in the basal ganglia circuits as top-ranked targets for 43 local patients with Parkinson's disease and 90 patients from a public database. Individual connectome-based analysis demonstrated that the globus pallidus was the best choice for 21.1% and the subthalamic nucleus for 19.5% of patients. Down-regulation of functional connectivity (up to 12%) at these prioritized targets optimally maximized the therapeutic effects. Notably, the priority rank of the subthalamic nucleus significantly correlated with motor symptom severity (Unified Parkinson's Disease Rating Scale III) in the local cohort. These findings underscore the potential of neural network modeling for advancing personalized brain stimulation therapy, and warrant future experimental investigation to validate its clinical utility.
Adult ; Aged ; Brain Mapping ; Connectome ; Deep Brain Stimulation ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways ; diagnostic imaging ; physiology ; Oxygen ; blood ; Parkinson Disease ; diagnostic imaging ; pathology ; therapy ; ROC Curve ; United Kingdom

OBJECTIVETo investigate the effect of low-salt diet on gene expression of canine cardiac tissue.

METHODSMicroarray data (GSE17149) of heart tissue from dogs fed with low-salt diet was obtained from the Gene Expression Omnibus (GEO). The data were analyzed by Qlucore Omics Explorer 3.1, STRING 10.0, Genclip 2.0 and GCBI. The protein-protein interactions (PPI) of the differentially expressed genes in low-salt and control groups were conducted to screen the key node genes between the two groups.

RESULTSCompared with the control group, the gene expression profile of the dog heart tissue was changed in the low-salt diet group, and 1343 (3.12%) differentially expressed genes were found in 43 035 genes. The differentially expressed gene protein interaction analysis revealed a most obvious protein (NFKBIA) as the core, which might be related to inhibiting the differentiation of macrophage-derived foam cell and promoting cholesterol discharge and decomposition.

CONCLUSIONSGene expression of heart tissue in dogs fed with low-salt diet is significantly changed and low-salt diet may reduce the risk of cardiovascular disease by up-regulating the expression of NFKBIA.

Objective To investigate the physical constitution and living habits of 800 hypertensive patients by using the current investigation method, and to further explore the relationship.Methods The TCM constitution types and living habits of 800 hypertensive patients who met the diagnostic criteria of hypertension in outpatient and inpatient department of Shaanxi University of Traditional Chinese Medicine from 2014 to 2015 were studied.Results Hypertension patients showed the highest frequency of mediocre, and partial physical constitutionincluded yin deficiency, yang deficiency, phlegm and dampness, qi stagnation, dampness and heat, special temperament and blood stasis. It showed significant difference among the TCM constitution in the fields of age, gender (χ2 values were 40.273, 56.457, 31.719,P<0.01); the coronary heart disease, cerebrovascular disease and blood pressure control were consistent with the distribution of physical types of population, and the difference was significant (χ2 values were 48.975, 8.321, 6.514,P<0.01). In terms of lifestyle, the differences in physical constitution between different tastes were statistically significant (χ2= 480.403,P<0.05); exercise time and sleep (P<0.05), and the difference was significant (P<0.001) the relationship between yin deficiency and exercise time (P<0.001); phlegm-dampness and exercise time and sleep time (P=0.009,P<0.001,P=0.001); qi stagnation and dietary hobby and sleep time (P<0.001); special temperament and diet and sleep time (P values were 0.001, 0.008, respectively).Conclusions The constitution type of TCM in hypertensive patients is related to sex, age, educational level and previous diseases, and is affected by diet, exercise time and sleep habits

Aim To observe the effect of total flavonoid from Mori folium(TFMF) on renal interstitial fibrosis in type 1 diabetic mice and its possible mechanism.Methods Diabetic mice were induced by intraperitoneal injection of streptozotocin(STZ) dissolved in 0.01 mol·L-1 citrate buffer(pH 4.5) at 150 mg·kg-1 body weight after 12 h of food deprivation.Forty model mice were divided randomly into four groups: model group, and low-(0.25 g·kg-1), moderate-(0.5 g·kg-1), high-dose groups(1 g·kg-1) fed with TFMF once daily.In addition, eight normal mice were used as normal group.After 12 weeks, the fasting blood glucose(FBG), serum creatinine(Cr), blood urea nitrogen(BUN) and microalbuminuria(mAlb) were measured.Masson staining, Sirius red staining and collagen type Ⅳ immunohistochemical staining were used to detect the expression of collagen protein in the cortex, while laminin staining to assess the degree of glomerular and renal tubular basement membrane thickening.The protein expressions related to epithelial-mesenchymal transition and PI3K/Akt/mTOR in the renal cortex of mice were detected by Western blot.Results The moderate and high dose of TFMF could significantly decrease the levels of FBG, Cr, BUN and mAlb in diabetic mice, meanwhile decreasing the expression of α-SMA protein by inhibiting the activation of PI3K/Akt/mTOR signaling pathway, which led to the amelioration of the pathological alterations of renal tissue.Conclusions The moderate and high dose of TFMF can reduce the level of renal interstitial fibrosis in type 1 diabetic mice, and its mechanism may be related to the inhibition of activation of PI3K/Akt/mTOR signaling pathway.

OBJECTIVE:To evaluate the availability and equipment of antidiabetic drugs in public hospitals from Shaanxi prov-ince. METHODS:Using a standardized methodology developed by WHO and Health Action International,the availability and equipping rate of the most common oral antidiabitic drugs were investigated and evaluated in public hospitals of Shaanxi province. RESULTS:The availability and equipping rate of tertiary hospitals and secondary hospitals were all higher than those of community health service centers. Among generic drugs,the availability of metformin was the highest (94.4%),and those of glibenclamide and repaglinide were the lowest(5.6%). Among original drugs,the availability of acarbose was the highest(68.1%). The equip-ping rate of original drugs was higher than that of generic drugs. The equipping rate of generic drugs(25.0%)was higher than that of original drugs(12.5%)in community health service center,but the equipping rates of generic drugs and original drugs were in low level. CONCLUSIONS:General hospitals (especially tertiary hospitals) have high equipping rate of original antidiabetic drugs,the community health services have low availability and equipping rate. Comprehensive measures should be taken to im-prove the availability of drugs in primary medical institutions and ensure drug use of chronic disease patients in primary hospitals.

Objective To investigate the distribution of TCM Constitution in hypertensive patients with diabetes mellitus by means of cross-sectional study.Methods A total of 150 hypertension patients from Shaanxi university of traditional Chinese medicine and Xianyang central hospital were selected from year 2014-2015,and were divided into two groups, including 62 patients complicated with diabetes, as the observation group; 88 patients without diabetes, as the control group. The distribution of TCM Constitution in the two groups was compared. Results The proportion of Yi n deficiency constitution, phlegm dampness constitution in the observation group was relatively high,but the proportion of Q i deficiency and Yi n deficiency in the control group was relatively high. Compared with the female patients,the proportion of Yi n deficiency constitution,phlegm dampness constitution and blood stasis constitution of the male patients was higher,while the Qi depression constitution and the proportion of the specific physical constitution were relatively low, and the difference was statistically significant (χ2value were 4.408, 3.723, 3.723, 3.964, 3.893, P value were 0.036, 0.044, 0.044, 0.046, 0.039). The factors like gender, age, BMI, alcohol intake, history of coronary heart disease, diet and taste preference were correlated with the physical types (B value were 1.967, 0.089, 0.017, -0.871, -0.959, -0.014,P<0.01 or P<0.05), and the taste preference and history of coronary heart disease posed a negative correlation with all types of constitution. Conclusions The types of TCM Constitution in hypertensive patients with diabetes are mainly Yi n deficiency and phlegm dampness, and the patients with hypertension are the deficiency of Q i and Yi n deficiency. The gender, age, BMI, alcohol consumption, coronary heart disease, and dietary preferences can influence the physical type of constitution.

Objective To investigate the epidemiologic and behavioral characteristics of HIV among community population in Liangshan prefecture.Methods We collected social demographic,behavioral and serological information by means of the monitoring questionnaire and serological tests.Data was analyzed by using the chi-square test and logistic regression.Results From April to June of 2010 to 2015,14 092 cases of community population were selected as the study objects,with 267 cases diagnosed as HIV positive patients.The HIV positive rates were 3.24％,3.07％,1.17％,1.38％,1.42％ and 1.25％,respectively.We observed that when community population having the following characteristics as:living in Butuo country (OR=3.83),being males (OR=1.77),being Yi nationality (OR=4.40) being widowed (OR=28.57),with history of drug abuse (OR=3.71) or injecting drug use (PWID) (OR=4.92),or history of needle sharing among PWID (OR=8.53),were under higher risks for HIV infection.With histories as:having had secondary or above levels of schooling (OR=0.59),having protected sex with regular parmers (OR =0.21) and with non-regular partners (OR =0.46),they seemed to be somehow protected for getting HIV infection.Conclusion The positive HIV rates of HIV among community population in Dechang,Ningnan and Butuo varied from 0.10％ to 8.77％while the HIV transmission among general population remained challenging.

Objective:To evaluate the knowledge, attitudes and practices ( KAP) on National Essential Medi-cine System among pharmacists from secondary public hospitals in Shaanxi province. Methods: The quantitative re-search of KAP questionnaire is used, and the content of questionnaire includes personal information, knowledge, atti-tudes and practices. Results: A total of 520 copies of questionnaires were distributed and 82. 3% were effective. Respondents’ overall knowledge and attitudes are at the middle level;the main way to obtain knowledge is via training and meeting;respondents’ education level and frequency of participating in training have a significant impact on their level of knowledge;the degree of attention paid by hospitals has yet to be strengthened; and respondents are mostly concerned about the supply and distribution of essential drugs. Conclusion: In order to improve the awareness and recognition levels of pharmacists on the implementation of National Essential Medicine System in secondary public hospitals, the government should take the relevant measures, including introducing the high educated persons into secondary public hospitals, organizing related training programs and standardizing the daily monitoring of essential drugs in secondary public hospitals, etc.