Background Schizophrenia patients often face high level of stigma and low level of self-esteem,significantly hindering their recovery.Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem.However,traditional mindfulness intervention typically involve high costs and require long-term professional involvement.Objective To explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia,so as to provide references for reducing stigma,enhancing self-esteem and promoting recovery.Methods Patients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023,who met the diagnostic criteria for schizophrenia in the International Classification of Diseases,tenth edition(ICD-10)and were in a stable phase,were recruited for the study(n=84).According to the random number table method,participants were randomly assigned to study group and control group,with 42 cases in each group.Both groups received treatment with the second-generation antipsychotic medications,while the study group additionally received blended mindfulness intervention for 8 weeks,with sessions lasting 45～60 minutes,three times a week.Both groups were evaluated with Five Facet Mindfulness Questionnaire(FFMQ),Internalized Stigma of Mental Illness Inventory(ISMI)and Rosenberg Self-Esteem Scale(RSES)at baseline and after 8-week intervention.Covariance analysis was used to compare the FFMQ,ISMI and SES scores between two groups after 8-week intervention.Results After 8-week intervention,there were statistically significant differences between two groups in total FFMQ scores,as well as in the observation,acting with awareness,non-judgment and non-reactivity subscale scores(F=50.680,12.952,13.567,22.799,14.043,P<0.01).Statistically significant differences were observed in total ISMI scores,and in the alienation,stereotype endorsement,discrimination experience,stigma resistance and social withdrawal subscale scores(F=513.125,148.990,125.055,75.996,154.850,54.125,P<0.01).The difference in RSES scores between two groups was also statistically significant(F=19.478,P<0.01).Conclusion Blended mindfulness intervention may help improve the mindfulness and self-esteem in stable schizophrenia patients while reducing stigma.

This study summarizes the construction background, rules and regulations and institutional settings of the MOOC and Micro-course Club in the Second Hospital of Jilin University, discusses the means of teacher training for clinical teachers, and shows the application effect of the club. At the same time, the related problems encountered in the process of club construction are summarized and reflected. The construction of MOOC and micro-course clubs is conducive to improving the information-based teaching level of clinical teachers, and also provides new inspiration and ideas for the construction of medical clubs.

Objective:To investigate the the dementia management capabilities of general practitioners (GPs) in urban district community health service centers (CHSCs) of Beijing.Methods:A survey on dementia management capabilities of GPs was conducted from July to November 2018, among 479 GPs from 6 urban districts in Beijing randomly selected by two-step sampling method. A self-designed questionnaire was used for survey, which contained demographic information and dementia management capacity of participants. Data were analyzed using multiple linear regression models with SPSS (20.0).Results:The overall score of GPs′ dementia management capacity was 53.9±10.3. The mean score of "detection, assessment and referral of dementia in pre-diagnosis" was 25.5±5.1; the highest score of the item "Can refer the suspected dementia patients to a specialist if necessary" was 4.1±0.8, while the lowest score of the item "Can use NPI-Q for behavioral and psychotic symptoms of dementia assessment" was 3.4±1.0. And the mean score of "treatment and management of dementia in post-diagnosis" was 28.4±6.2; the highest score of the item "Can provide guidance on safety for dementia patients " was 3.7±0.9, while the lowest score of the item "Can provide non-drug guidance on improving cognitive function for dementia patients " was 3.4±1.0. The factors affecting the GPs′ capability of dementia detection, assessment and referral were their attitudes ( t=0.69, P<0.01) toward dementia management in CHSCs and whether they had participated in dementia-related training in the last year ( t=2.18, P<0.05). And the factor affecting the GPs′ capability of dementia treatment and management was their attitudes toward dementia management in CHSCs ( t=9.17, P<0.01). Conclusions:The study shows that generally GPs feel inadequate in dementia management capability; while those with special training and positive attitudes have a higher dementia management capability. Therefore, adequate training and reasonable incentive mechanism may be the countermeasures to improve the capability of dementia management of GPs in CHSCs.

Objective:To explore the effect and involved mechanism of naringenin on acute kidney injury (AKI) induced by ischemia-reperfusion (IR).Methods:The IR-AKI rat model was constructed using the classic bilateral renal pedicle clamping method, then renal function and pathological change were assessed, as well as inflammation-associated genes were detected by quantitative real-time PCR. The hub genes were selected through differential gene analysis and protein-protein interaction network analysis, and their transcription factors were predicted, which constructed a protein library together. The proteins binding to naringenin were selected by reverse molecular docking analysis and further their binding patterns were predicted to explore the mechanism of naringenin. Finally, the results of bioinformatics were verified by experimental methods.Results:Compared with the AKI group, the kidney pathology of the rats in the naringenin pretreatment group was significantly improved, and the renal tubular injury score was reduced ( P<0.01); meanwhile the serum creatinine level and the mRNA expression of the kidney injury molecule 1 (KIM-1) were significantly decreased (both P<0.05). Compared to sham group, IR-AKI increased the level of nuclear factor κB (NF-κB), tumor necrosis factor-α and interleukin-1β (all P<0.05), which reversed by naringenin indicated that naringenin inhibited inflammation in IR-AKI. Differential gene analysis was performed on the GSE98622 data set, and 359 differential genes were obtained. In reverse molecular docking, the proteins with smallest binding energy including NFKBIA, BCL3, NFKB2 and RELA were considered to be related to the preventive effect of naringenin, which were mainly enriched in NF-κB-related inflammation pathways. Domain functional analysis of NF-κB-related genes showed that naringenin could stably bind to its key domain. According to quantitative real-time PCR results, naringenin increased BCL3 level after AKI ( P<0.05), and further decreased the expression level of RELA and NFKB2 (both P<0.05). Conclusion:Naringenin protects IR-AKI by alleviating inflammation, and its mechanism is related to increasing BCL3 and thereby inhibiting the NF-κB pathway.

Objective:To explore the effects of video education based on multidisciplinary collaboration combined with popular science atlas in pregnant women with fetal congenital heart disease (CHD) .Methods:Taking the establishment time of multidisciplinary collaborative health education team in December 2019 as the boundary, the 60 cases of pregnant women with fetal CHD in the Outpatient Department of Obstetrics and Gynecology and Cardiac Surgery of Henan Provincial People's Hospital and Fuwai Central China Cardiovascular Hospital from February to November 2019 were included in the control group, and the 60 cases from December 2019 to October 2020 were included in the observation group, by convenience sampling method. The control group was given routine nursing, and the observation group was given video education based on multidisciplinary collaboration combined with popular science atlas. The scores of Exercise of Self-Care Agency Scale (ESCA) , State-Trait Anxiety Inventory-Form Y (STAI-Y) , Trait Anxiety Inventory (T-AI) , Beck Depression Inventory (BID) and Disease-Related Knowledge Mastery Questionnaire were compared between the two groups before and after intervention. Apgar score and mode of delivery were compared between the two groups.Results:After the intervention, the scores of self-care skills, self-care responsibility, health knowledge and self-concept of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The scores of STAI-Y, T-AI and BID of the observation group were all lower than those of the control group, and the differences were statistically significant ( P<0.01) . After the intervention, the scores of each dimension and total score of the disease-related knowledge mastery questionnaire of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . There was no statistically significant difference in the neonatal Apgar scores at 1 min and 5 min and delivery mode between the two groups ( P>0.05) . Conclusions:Video education based on multidisciplinary collaboration combined with popular science atlas can improve the psychological states of pregnant women with fetal CHD to some extent, and enhance the mastery of disease-related knowledge and self-care ability.

Objective:To observe the effect of isorhmnetin on the ER/TGF-β1/Smad3 signaling pathways in human dermal fibroblasts (HSF) damaged by UVA.Methods:HSF were divided into control group, model group, estradiol group, isorhmnetin groups with 100, 10, 1, 0.1, 0.01, 0.001 μmol/L by random number table method, and cell photoaging models were established in all groups excepting the control group. After the intervention with corresponding drugs, cell proliferation rates were detected with MTT method, and the effective concentration of isorhmnetin was screened. Then the cells were divided into control group, model group, estradiol group, isorhmnetin group, TGF-β1 blocker group, Samd3 blocker group, and COL1A1 blocker group. Cell photoaging models were established in all groups excepting the control group. After intervened with corresponding drugs, the TGF-β1, Smad3, Ⅰ collagen α1 (collagen, type Ⅰ, alpha 1, COL1A1) mRNA and protein expression in all groups were detected by the real-time quantitative PCR and the Wester blot method.Results:The proliferation rate of isor administration group were increased than those in the control group ( P<0.01). Compared to the UVA irradiation group, the expression of TGF-β1 mRNA (0.956 ± 0.020 vs. 0.718 ± 0.036), Smad3 mRNA (0.981 ± 0.044 vs. 0.753 ± 0.047), COL1A1 mRNA (0.998 ± 0.032 vs. 0.786 ± 0.031), TGF-β1 protion (0.761 ± 0.026 vs. 0.542 ± 0.023), Smad3 protion (0.776 ± 0.016 vs. 0.551 ± 0.025), COL1A1 protion (0.792 ± 0.025 vs. 0.584 ± 0.012) in isor administration group significantly increased ( P<0.01). Compared to the isor administration group, the TGF-β1 mRNA (0.762 ± 0.051, 0.802 ± 0.012, 0.828 ± 0.030 vs. 0.967 ± 0.026), Smad3 mRNA (0.784 ± 0.027, 0.816 ± 0.015, 0.830 ± 0.032 vs. 0.998 ± 0.021), COL1A1 mRNA (1.082 ± 0.025, 1.101 ± 0.012, 1.138 ± 0.011 vs. 1.263 ± 0.022), TGF-β1 protion (0.675 ± 0.028, 0.682 ± 0.026, 0.722 ± 0.015 vs. 0.862 ± 0.014), Smad3 protion (0.712 ± 0.013, 0.764 ± 0.012, 0.778 ± 0.011 vs. 0.901 ± 0.015), COL1A1 protion (0.738 ± 0.016, 0.770 ± 0.038, 0.792 ± 0.026 vs. 0.964 ± 0.017) in the TGF-β1 blocker group, Smad3 blocker group and COL1A1 blocker group significantly decreased ( P<0.01). Conclusions:Isorhmnetin can promote the collagen synthesis of photo aging HSF cells, and its mechanism is related to the regulation of ERβ/TGF-β1 signaling pathway.

Objective:To analyze the risk factors of acute kidney injury (AKI) in hospitalized patients with infective endocarditis (IE), construct prediction model, and discuss its predictive value.Methods:The clinical data of 402 adult inpatients diagnosed with IE admitted to the Affiliated Hospital of Qingdao University from January 2010 to January 2020 were retrospectively analyzed. The patients were divided into the AKI group and the non-AKI group. The clinical data, such as gender, age, presence of diabetes, basic estimated glomerular filtration rate (eGFR), laboratory indexes at admission, involvement of valves, presence of sepsis, medication during hospitalization, surgery and outcome of the two groups were compared. Multivariate Logistic regression analysis was used to screen the risk factors of AKI in IE inpatients. A predictive model was constructed, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of the model.Results:A total of 290 patients with IE were enrolled, including 198 non-AKI patients and 92 AKI patients. The incidence of AKI was 31.7%. Among the 92 AKI patients, 46 patients were at AKI stage 1 (50.0%), while 46 patients were at AKI stage 2 and stage 3 (50.0%). Compared with the non-AKI group, patients in the AKI group were older [years old: 64 (55, 71) vs. 55 (46, 63)], and had lower basic eGFR (mL·min -1·1.73 m -2: 64.6±13.6 vs. 82.9±19.5), higher proportion of diabetic and incidence of sepsis (16.3% vs. 8.6%, 38.0% vs. 13.1%), more frequent use of angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor antagonists (ACEI/ARB), diuretics and non-steroidal anti-inflammatory drugs (NSAIDs; 25.0% vs. 15.2%, 82.6% vs. 63.1%, 58.7% vs. 24.2%), more abnormal urine test results (hematuria or proteinuria, 35.9% vs. 22.7%), higher pathogen culture negative rate (73.9% vs. 51.5%), lower Gram positive (G +) cocci infection rate and surgery rate (22.8% vs. 40.4%, 60.9% vs. 81.8 %), with significant differences (all P < 0.05). There were no significant differences in the gender, number and location of involved valves, and laboratory indexes at admission between the two groups. Compared with the non-AKI group, the inpatient mortality rate of the AKI group was higher (30.4% vs. 8.6%, P < 0.01), and the inpatient mortality rate of patients with AKI stage 2 and stage 3 was significantly higher than that of patients with AKI stage 1 (43.5% vs. 17.4%, P < 0.01). In multivariate Logistic regression analysis, the lower basic eGFR [hazard ratio ( HR) = 0.136, 95% confidence interval (95% CI) was 0.066-0.280], sepsis ( HR = 6.100, 95% CI was 2.394-15.543), demand for NSAIDs ( HR = 2.990, 95% CI was 1.184-7.546) and radiocontrast agent ( HR = 3.153, 95% CI was 1.207-8.238) were independent risk factors for AKI in hospitalized patients with IE (all P < 0.05). A prediction model was constructed based on the above risk factors, and ROC curve analysis showed that the area under the ROC curve (AUC) of prediction model for AKI was 0.888 (95% CI was 0.833-0.943, P < 0.01) with sensitivity of 86.4% and specificity of 80.9%. Conclusions:In the IE-susceptible population, low basic eGFR, sepsis, the need for NSAIDs and contrast agent are independent risk factors to AKI. The predictive model constructed by the above risk factors has certain predictive value for the occurrence of AKI in the IE inpatients.

Objective To evaluate the effectiveness of group teaching of Third Hospital of Peking University (Beijing Medical Third Hospital) for a hospital located in remote area. Methods From 2016 to 2017, 19 medical staff from Peking University Third Hospital gave their support to Huanxian People's Hospital and provided respectively the theoretical support, guidance of clinical skills, medical consultation, free paid clinic, outpatient service, and teaching rounds, etc. A questionnaire survey was carried out to realize the subjective evaluation of the 155 clinical front-line staff who had participated in the class regarding the effect of group teaching and the most welcome teaching mode and contents; the objective data on the monthly outpatient visits, number of patients admitted into the hospital, the number of surgical patients, etc were calculated and compared between the pre-support (2014 to 2015) and post-support (2016 to 2017) period to evaluate the effect of counterpart support. Results One hundred and fourteen of the 155 medical staff in their respective departments were trained by the experts, and the percentage of medical staff believed that the counterpart support helped clinical work very much accounting for [58.8% (67/114)] being significantly higher than those who considered of no help [9.6% (11/114)], a little help [16.7% (19/114)] and some help [14.9% (17/114), χ2= 94.082, P = 0.000]; after support, the number of monthly outpatient visits compared to that of pre-support period (case times:43 816.5±3 406.9 vs. 37 319.5±4 302.1) and the number of monthly patients hospitalized compared to that of pre-support period (case times: 2 978.3±235.1 vs. 2 250.9±218.1) were significantly higher than those before the support (all P < 0.05), no statistical significant difference in monthly surgery volume (case times: 449.8±107.3 vs. 459.0±85.4, P > 0.05) between the above 2 periods was seen. The survey showed that the mostly demanding teaching method was theoretical teaching [65.8% (102/155)], followed by teaching rounds [50.3% (78/155)] and outpatient teaching the least [18.1% (28/155)]. That the ratios of various teaching contents with their sequence from high to low the medical personnel required were as follows: to learn new technologies [76.8% (119/155)], medical frontier knowledge [68.4% (106/155)], and standard diagnosis and treatment manipulations [67.7% (105/155)], cultivation of clinical thinking [66.5% (103/155)] and passing on surgical skills [56.1% (87/155)]. There were statistical significant differences between each teaching method and teaching content (all P < 0.05). Conclusions Teaching to cultivate qualified health personnel is the key to the development of hospitals located in remote areas, according to their needs, combining local conditions and the establishment of long-term cooperation mechanisms, we can comprehensively improve the professional quality of medical personnel and the overall strength of hospitals located in remote areas.

Objective Based on the theory of Service Quality to develop a scale for measuring personal digital assistant satisfaction by nurses and to detect the reliability and validity of this scale. Methods Through the literature research, cross-sectional study and present satisfaction evaluation tool for using personal digital assistant by nurse to build the item pool. The items were selected by 15 experts consultation and the pilot survey of 666 nurses. Results The satisfaction evaluation tool for using personal digital assistant by nurse scale consisted of 41 items;the exploratory factor analysis identified 8 principal factors and explained for 65.22%. Pearson correlation coefficient between each dimension was 0.213-0.684(P<0.01). Pearson correlation coefficient between each dimension and total scale was 0.574-0.798(P<0.01). The Cronbach α coefficient of the scale was 0.928 and test-retest reliability was 0.934. Conclusions The satisfaction evaluation tool for using personal digital assistant by nurse scale has good validity and reliability. It can be used as a tool to measure the satisfaction for using personal digital assistant by nurse.