Objective:To observe the effects of adipose-derived stem cells(ADSC)combined with acellular scaffold(AS)on the ultrastructure of dorsal root ganglion and the protein and mRNA expression levels of ciliary neurotrophic factor(CNTF),Janus kinase 2(JAK2),phosphorylated JAK2(p-JAK2),signal transducer and activator of transcription 3(STAT3)and phosphorylated STAT3(p-STAT3)in the rats with sciatic nerve injury(SNI),and to clarify the protective effect of ADSC combined with AS on dorsal root ganglion in the SNI rats and its possible mechanism.Methods:The rat ADSCs were isolated and cultured and their multidirectional differentiation potential was detected.The AS of rats was prepared,and ADSCs were injected into the AS to construct tissue-engineered nerve.A total of 36 rats were randomly divided into control group,model group,AS group,and ADSC+AS group.The rats in control group were routinely fed,and the rats in other groups were used to establish the SNI models by resecting 10 mm of right sciatic nerve.The rats in model group received no further treatment,while the rats in AS group and ADSC+AS group were bridged with AS and the constructed tissue-engineered nerve at the two ends of the injured nerve,respectively.At 6 weeks after surgery,transmission electron microscope was used to observe the ultrastructure of dorsal root ganglion of the rats in various groups;immunofluorescence method was used to detect the protein expression levels of CNTF,p-JAK2,and p-STAT3 in dorsal root ganglion of the rats;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the mRNA expression levels of CNTF,JAK2,and STAT3 in dorsal root ganglion of the rats in various groups.Results:After 7 d of primary ADSC culture,a large number of large and long spindle-shaped cells were observed under the inverted microscope,arranged in clusters or whirlpools;red lipid droplets were observed with oil red O staining under microscope,and calcified nodules were observed with Alizarin red staining under microscope,indicating that the isolated and cultured cells had multidirectional differentiation ability.Compared with normal nerve tissue,the level of DNA in AS of rats was significantly decreased(P<0.05).Compared with control group,the nuclear membrane of dorsal root ganglion cells in model group was uneven and serrated,the number of organelles in the cytoplasm was decreased,mitochondria were swollen with broken or missing cristae and unclear structure;the CNTF protein and mRNA expression levels were significantly decreased(P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly increased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly increased(P<0.01).Compared with model group,the serrated change of nuclear membrane of the dorsal root ganglion cells in AS group was significantly alleviated,the number of organelles in the cytoplasm was increased,and mitochondrial swelling was reduced;in ADSC+AS group,the nuclear membrane of dorsal root ganglion cells tended to be intact,the number of organelles was increased,and mitochondrial swelling and vacuolization were significantly reduced;the CNTF protein and mRNA expression levels in the dorsal root ganglion in AS group and ADSC+AS group were significantly increased(P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly decreased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly decreased(P<0.01).Compared with AS group,the CNTF protein and mRNA expression levels in ADSC+AS group were significantly increased(P<0.05 or P<0.01),the p-JAK2 and p-STAT3 protein expression levels were significantly decreased(P<0.01),and the JAK2 and STAT3 mRNA expression levels were significantly decreased(P<0.01).Conclusion:The application of ADSC combined with AS can improve the ultrastructure of dorsal root ganglion in the SNI rats,and the mechanism may be related to the increased CNTF expression and decreased activation of the JAK2/STAT3 signaling pathway in the dorsal root ganglion by ADSC combined with AS application.

Transcription, Genetic

Through the definition of the concepts of disabled and demented elderly, caregivers, work ethic, and ethical principles of caring for elderly with disability and dementia, this paper analyzed the ethical risk factors from the work ethics level of caregivers, the overall service ability and management level of care industry, the caregivers’ occupational burnout, and the degree of social public support and recognition of caregivers’ profession. It is proposed that paying attention to the cultivation of the caregivers’ work ethic quality, establishing the work ethic supervision and evaluation system of caregivers of the elderly with disability and dementia, exploring the successful experience of integrating ethic norms into the care of the elderly with disability and dementia, and safeguarding the rights and interests of the caregivers of the elderly with disability and dementia, so as to gradually reduce the work ethic risk of caregivers of the elderly with disability and dementia, improve the work ethic quality of caregivers, and safeguard the rights and interests of the disabled and demented elderly to the greatest extent.

【Objective】 To analyze the implementation and problems in the process of the first policy of serious illness benefits for voluntary blood donors in China, therefore provide reference for other provinces and cities to formulate care policies for voluntary blood donors. 【Methods】 The number of blood donors who received serious illness benefits and the proportion to the total number of blood donors in that year were obtained by Excel, and their basic demographic information, illness and reasons for failing to receive benefits were analyzed. 【Results】 From 2015 to 2019, a total of 198 blood donors applied for serious illness benefits, and 159 received benefits (638 000 yuan), accounting for 0.017% of the total number of voluntary blood donors in Nanjing. The average age of the recipients was 52.66, with the proportion of males (63.5%) higher than that of females (36.5%). 52.8% (the highest proportion) got benefits of 5 000 yuan. 39 applicants failed to obtain serious illness benefits, among which 27 applicants failed during 2017 to 2018 due to unidentifiable funding source. But after Nanjing Blood Donation Regulations clarified the funding sources, the implementation of serious illness benefits policy was continued in 2018. 【Conclusion】 The implementation of serious illness benefits for voluntary blood donors presented the Nanjing municipal government's care for voluntary blood donors. The legalization of this policy is conducive to the continuity and stability of policy implementation. Relevant departments and blood centers should continue to strengthen the policy publicity and make sure the policy is implemented effectively.

Purpose: Plasma osmolality, a marker of dehydration, is associated with cardiovascular mortality. We aimed to investigate whether elevated plasma osmolality is associated with case fatality within 1 year after severe acute ischemic stroke. Materials and Methods: We included severe ischemic stroke patients (defined as National Institutes of Health Stroke Scale ≥15 score) within 24 hours from symptom onset admitted to the Department of Neurology, West China Hospital between January 2017 and June 2019. Admission plasma osmolality was calculated using the equation 1.86 * (sodium+potassium)+1.15 * glucose+urea+14. Elevated plasma osmolality was defined as plasma osmolality >296 mOsm/kg, indicating a state of dehydration. Study outcomes included 3-month and 1-year case fatalities. Multivariable logistic regression was performed to determine independent associations between plasma osmolality and case fatalities at different time points. Results: A total of 265 patients with severe acute ischemic stroke were included. The mean age was 71.2±13.1 years, with 51.3% being males. Among the included patients, case fatalities were recorded for 31.7% (84/265) at 3 months and 39.6% (105/265) at 1 year. Elevated plasma osmolality (dehydration) was associated with 3-month case fatality [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.07–3.66, p=0.029], but not 1-year case fatality (OR 1.51, 95% CI 0.84–2.72, p=0.165), after full adjustment for confounding factors. Conclusion Elevated plasma osmolality was independently associated with 3-month case fatality, but not 1-year case fatality, for severe acute ischemic stroke.

Purpose: Plasma osmolality, a marker of dehydration, is associated with cardiovascular mortality. We aimed to investigate whether elevated plasma osmolality is associated with case fatality within 1 year after severe acute ischemic stroke. Materials and Methods: We included severe ischemic stroke patients (defined as National Institutes of Health Stroke Scale ≥15 score) within 24 hours from symptom onset admitted to the Department of Neurology, West China Hospital between January 2017 and June 2019. Admission plasma osmolality was calculated using the equation 1.86 * (sodium+potassium)+1.15 * glucose+urea+14. Elevated plasma osmolality was defined as plasma osmolality >296 mOsm/kg, indicating a state of dehydration. Study outcomes included 3-month and 1-year case fatalities. Multivariable logistic regression was performed to determine independent associations between plasma osmolality and case fatalities at different time points. Results: A total of 265 patients with severe acute ischemic stroke were included. The mean age was 71.2±13.1 years, with 51.3% being males. Among the included patients, case fatalities were recorded for 31.7% (84/265) at 3 months and 39.6% (105/265) at 1 year. Elevated plasma osmolality (dehydration) was associated with 3-month case fatality [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.07–3.66, p=0.029], but not 1-year case fatality (OR 1.51, 95% CI 0.84–2.72, p=0.165), after full adjustment for confounding factors. Conclusion Elevated plasma osmolality was independently associated with 3-month case fatality, but not 1-year case fatality, for severe acute ischemic stroke.

【Objective】 To analyze the influencing factors of blood re-donation among street voluntary blood donors in Nanjing, and to provide basis for increasing the proportion of blood donation/donors. 【Methods】 29 650 street voluntary blood donors in Nanjing from May 21, 2017 to May 21, 2018 in the information management system of Nanjing Red Cross Blood Center were taken as the sampling population, and 2 965 (10%) were randomly selected to ask whether they donated again and reasons by telephone calls. They were divided into re-donation group and lapsed group.The demographic variables and donation frequency of street blood donors in the two groups were analyzed and compared by Chi-square test, and multivariate logistic regression was used to analyze the influencing factors of re-donation of blood donors. 【Results】 The response rate of this survey was 63.37% (1 879/2 965), and the re-donation rate of street blood donors in Nanjing from May 2017 to May 2018 was 40.34% (758/1 879), which was lower than the re-donation rate of global blood donors as 50%. The primary motivation for street blood donors in Nanjing to donate blood again was "help others", accounted for 62.27% (472/758), and the primary deterrent to redonate blood again was "too busy to donate blood", accounted for 49.15% (551/1 121). 【Conclusion】 There is a certain gap between the rate of blood re-donation in Nanjing and worldwide, therefore, further incentive measures are needed and flexible recruitment and blood donation methods should be adopted to facilitate blood donation for donors.

【Objective】 To explore the promote and deter factors of blood donation among street blood donors in Nanjing, in order to improve the accuracy of street blood donors recruitment. 【Methods】 A questionnaire with high confidence was designed based on the theory of planned behavior(TPB). The multi-stage hierarchical sampling method was adopted according to the geographical location and economic development level of 11 districts(regions) in Nanjing, and the street blood donors were divided into three groups according to the history of blood donation: one donation(n=361), donation numbers ≥ 2(n=417)and non-donation (n=241). The blood donation behavior was investigated from four aspects as external promote factors (such as seeking a free blood examination, self-interest factors, etc.), internal promote factors(such as altruistic, self-interest factors, blood donation can help others, etc.), external deter factors (too busy to donate blood, opposition from my family, etc.) and internal deter actors ( worry about dizziness after blood donation, fear of needles, ect.). The database was established using Epidata software, and chi-square test was applied for statistical analysis between groups. 【Results】 The groups mainly affected by the promote factors (altruistic and self-interest factors) of Nanjing street population in blood donation were unmarried, 18~24 years old, childless, below bachelor degree, and have barely no income. The main groups less affected by the deter factors were students, male, unmarried, 18~24 years old, childless and have barely no income.Promote factors increases with the number of blood donations, while deter factors decreases with the number of blood donation. 【Conclusion】 TBP can better analyze and explain the promote and deter factors affecting blood donation behavior among street blood donors in Nanjing, which is helpful for blood stations to formulate targeted measures to improve the availability of street blood donors.

OBJECTIVES: We assessed the role of social support in presenteeism by examining organizational commitment among Chinese healthcare workers. METHODS: One thousand four hundred thirty-four healthcare workers from 6 hospitals in 4 Chinese cities completed a questionnaire measuring presenteeism, social support, and organizational commitment. With organizational commitment as the mediator, regression analyses and structural equation modeling were used to test the model. RESULTS: Organizational commitment was directly inversely associated with presenteeism (β = - 0.42, p < 0.001). Coworker support was moderately but significantly inversely associated with presenteeism (β = - 0.15, p < 0.001), but the path from supervisor support to presenteeism was not significant (β = 0.05, p > 0.05). The correlation between supervisor support and coworker support was significant (β = 0.71, p <0.001). Supervisor support and coworker support were significantly positively associated with organizational commitment (β = 0.41, p < 0.001, and β = 0.14, p < 0.001, respectively). CONCLUSIONS Supervisor support was more important in promoting organizational commitment, while coworker support was more effective in reducing presenteeism. The mediating effect of organizational commitment was significant.

Hospital research mainly by high-level researcher to promote,and researcher of the research initiative will determine the contribution of their research.This initiative from the start of economic regulation researcher to explain the economics-based perspective that affect high-level researcher positive factors research and put forward relevant mathematical relationship between the influencing factors and mathematical models,and scientific researcher positive regulator of a number of ways.