Objective:To investigate the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine and to identify key populations.Methods:From October to November 2023, an anonymous online questionnaire survey was conducted to determine the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine. The scores of different dimensions of job burnout are expressed as mean±standard deviation, and the distribution of supervisors of different status is presented in frequency and percentage. All data analyses were performed in R 4.3.1. Distribution of the five profiles among supervisors of different status was compared using the chi-square test and compared pairwise using the Bonferroni method.Results:A total of 2 664 valid questionnaires were collected. The scores of emotional exhaustion, cynicism and personal accomplishment were（2.46±0.95),（1.74±0.89), and（4.23±0.90), respectively. The prevalence of job engagement, inefficacy, overexertion, disengagement, and burnout among the supervisors were 42.76%（1 139/2 664), 43.54%（1 160/2 664), 33.03%（880/2 664), 14.71%（392/2 664), and 13.66%（364/2 664), respectively. In terms of demographics, the distribution of the "burnout-engagement continuum" was significantly different by age, sex, marital status, and highest education level（ P<0.05). In terms of work-related characteristics, the distribution of the "burnout-engagement continuum" was significantly different by income, professional title, administrative position, and working hours on weekdays and holidays（ P<0.05). The distribution of engagement, inefficacy, and overexertion was significantly different between the eastern and western regions（ P<0.05). Conclusions:There is a high percentage of individuals with burnout among postgraduate supervisors of the Professional Master's Program in Clinical Medicine, and inefficacy is a common negative state. Supervisors who work in the western regions, are under 45 years of age, are male, are married, have a doctorate degree, hold associate senior professional title, have lower relative income, are not holding administrative duties, and work more than 10 hours on workdays and more than 4 hours on holidays are key populations that require increased attention. The psychological state of supervisors can be improved by providing them with more resources, work benefits, and incentives.

Objective:To analyze the scores and differences of various aspects of public health graduate education management in China, and to provide suggestions for universities to enhance graduate education management.Methods:Based on the data from the 2021 National Survey on Education Satisfaction and Job Evaluation of Medical Graduate Supervisors, we described the public health graduate education management in China from the five perspectives of student enrollment, curriculum, practice, research, and school management. The t-test and analysis of variance were used to analyze the differences in individual characteristics. Multiple linear regression was used to analyze factors influencing the scores of public health graduate education management. Results:Supervisors gave the highest score to curriculum and teaching (mean score, 4.00±0.77), followed by management system and input (mean score, 3.97±0.87), research conditions and achievements (mean score, 3.93±0.80), practical education conditions and effects (mean score, 3.80±0.91), and discipline attractiveness and enrollment quality (mean score, 3.70±0.84). Supervisors who supervised professional degrees, doctoral students, and located in the eastern region gave relatively high scores to public health graduate education, and those with associate professor titles gave relatively low scores.Conclusions:The quality of students recruited for public health graduate education needs to be improved, curriculum design and teaching method need to be adjusted, practice conditions need to be improved, research funding is insufficient, and the construction of academic communication platforms needs to be improved. The relevant universities/colleges need to strengthen the management and increase the investment to promote the high-quality development of public health graduate education.

Objective To explore the therapeutic effect and toxicity of Croton tiglium L.(croton)oil on rats with cold accumulation constipation,and to clarify the toxic-effect relationship of croton oil in the treatment of cold accumulation constipation.Methods The rats were orally treated with 10%2℃activated carbon solution for 3 consecutive days to replicate the model of cold constipation.The rats were fed with croton oil on the fourth day,and then the time of first defecation and the number of defecations within 3 h were observed and recorded.HE staining was used to evaluate the general pathological conditions of the colon tissues of rats.The serum levels of interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-α,cyclooxygenase(COX)-2,macrophage inflammatory protein(MIP)-1,alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total protein(TP)were detected.Immunohistochemistry was used to detect the expression of myeloid differentiation factor 88(MyD88)and nuclear transcription factor(NF)-κB P65 in colon tissues of rats.Results Croton oil could shorten the time of first defecation and increase the number of defecations within 3h in rats with cold accumulation constipation to varying degrees,and the 3.78,2.83,and 1.89 g·kg-1 croton oil group had significant statistical significance(P<0.05).HE staining results showed that compared with the model group,croton oil group could cause different degrees of inflammation and focal necrosis,goblet cell loss and lamina propria edema in the colon tissue of rats,and the 3.78 g·kg-1 croton oil group was the most serious in the colon tissue injury.In addition,compared with model group,croton oil group could increase the levels of COX-2,TNF-α and IL-6 in serum to varying degrees(P<0.05),and 3.78 g·kg-1 croton oil group had the most obvious effect.The level of MIP-1 in serum was increased in croton oil group,and the effect was significant in 3.78 g·kg-1 croton oil group(P<0.01).But croton oil group had no significant effect on serum IL-10 level of rats.The immunohistochemical results showed that the protein levels of MyD88 were increased in croton oil dose groups except 0.05 dose group,and there were significant differences in 3.78,2.83,and 1.89 g·kg-1 dose groups(P<0.05).The expression level of NF-κB p65 was enhanced in the colon of rats after croton oil treatment,and there was significant difference in 3.78 g·kg-1 croton oil group(P<0.05).In addition,compared with model group,croton dose groups had no changes in organ indexes of heart,spleen,lung,kidney and thymus(P>0.05),while liver organ indexes in1.89 and 0.94 g·kg-1 croton oil groups were significantly increased(P<0.05).The results of liver biochemical indexes showed that croton oil group did not increase the contents of ALT,AST,and TP in serum of rats,and the differences were not statistically significant(P>0.05).Conclusion Croton oil can exert a dose-dependent purgative effect at 3.78,2.83,and 1.89 g·kg-1,but it also induced colonic mucosal injury in rats by regulating the inflammatory response mediated by the MyD88/NF-κB pathway.At 0.94 and 0.47 g·kg-1,croton oil almost did not cause colon tissue injury in rats,but it had a weak purgative effect at this dose,suggesting that the best concentration range of croton oil in the treatment of cold accumulation constipation may be between 0.94 and 1.89 g·kg-1.

Elderly inpatients with coronavirus disease 2019 (COVID-19) are often at nutritional risk and at higher risk of critical disease. The standardized nutrition treatment could effectively improve the nutritional status, quality of life, and clinical outcomes of COVID-19 patients, and is an important component of the comprehensive management of COVID-19. The individualized nutrition diagnosis, treatment and monitoring should be conducted in compliance to standard procedures of medical nutrition therapy, with consideration of the clinical characteristics of elderly COVID-19 inpatients. The Department of Clinical Nutrition at Peking Union Medical College Hospital has integrated the latest clinical nutrition guidelines and clinical practice of nutrition support of COVID-19, with the aim to provide evidence-based, concise and practical recommendations on nutritional management for elderly inpatients with COVID-19. The recommendations here are to inform effective and standardized nutrition support practice.

AIM:To investigate the effects of Prunus cerasifera Ehrh.polyphenol extract(PCE)on glucose metabolism in insulin-resistant HepG2(IR-HepG2)cells.METHODS:An IR-HepG2 cells model was established using high sugar and high insulin induction;a control group,an insulin resistance(IR)model group,a PCE treatment group with different concentrations,and a metformin treatment group were set up.Cells were treated with 50,100,200,and 400 mg/L of polyphenol extract for 24 hours,respectively,to detect their effects on cellular glucose consumption.At the same time,use thiazole blue(MTT)colorimetry to evaluate cell viability.Real-time PCR and Western blot were used to detect expression of glucose metabolism-related mRNA and proteins.RESULTS:Prunus cerasifera Ehrh.polyphenol ex-tract can significantly increase glucose consumption in IR-HepG2 cells,and cell activity tends to increase and then decline as its concentration increases;At mRNA and protein levels,in addition to significantly increasing the expression of phos-phorylated adenosine monophosphate activated protein kinase(p-AMPK)protein in IR-HepG2 cells,it also decrease gly-cogen synthase kinase 3β(GSK3β)in glycogen synthesis and gluconeogenesis pathways,forked protein O1(FoxO1),peroxisome proliferator activates gamma co-receptor activation 1-alpha(PGC-1α),glucose-6-phosphatase(G6Pase)and phosphoenol pyruvate carboxykinase(PEPCK)expression.CONCLUSION:Prunus cerasifera Ehrh.polyphenol extract can activate the AMPK signaling pathway in IR-HepG2 cells,to further inhibit gluconeogenesis and glycogen synthesis pathways,thereby improving the insulin resistance state of HepG2 cells.

Objective:To review the funding status of the National Natural Science Foundation of China in the field of preventive medicine, summarize the characteristics of approved funding for sub-disciplines and institutions, to further analyze the effects of funding distribution.Methods:Descriptively analyze the funding status of the National Natural Science Foundation of China in the field of preventive medicine from 2010 to 2019, and analyze its aggregation effect by constructing a single funding strength and intensity index.Results:The project number, funding amount and number of research institutions have shown an overall upward trend. In the past 10 years, a total of 1.683 billion has been approved for funding, and the proportion in the Department of Health Sciences has remained at about 4%. Non-communicable disease epidemiology, human nutrition, and health toxicology are among the top three in terms of project number, funding amount, and number of grantee institutions. Sub-discipline funding is uneven, showing a phenomenon of development differentiation. The amount of approved funding, the number of institutions, and the strength of individual funding for universities are significantly higher than those of scientific research institutions and CDCs. The total amount of Top 10 funding accounted for 41.49%, which obviously showed a " head" effect.Conclusions:The Natural Science Foundation of China should continue to increase investment in the field of preventive medicine. Key breakthroughs in dominant disciplines, weaker disciplines make up for shortcomings, guide universities, research institutes, and CDCs to carry out inter-institutional project cooperation based on their respective advantages, and encourage interdisciplinary research to enhance discipline innovation capabilities.

Objective:To analyze the situation of influenza vaccination among primary healthcare workers, find out the problems, and explore the strategies and measures to promote influenza vaccination among grass-roots medical staff.Methods:From April to May 2021, key insider interviews and literature research were carried out based on the perspectives of influenza vaccine suppliers (influenza vaccine manufacturers), consumers (primary medical institutions and primary healthcare workers), and managers (governments at all levels, health administrative departments and disease prevention and control departments). The SWOT (strengths, weaknesses, opportunities, and threats) analysis technique was used to comprehensively evaluate the current situation of influenza vaccination among grass-roots healthcare workers, and a SWOT analysis matrix was established.Results:Influenza vaccination of grass-roots healthcare workers have advantages and opportunities, including primary medical and health institutions' vital influenza vaccination accessibility, influenza vaccine safety is higher, COVID-19 outbreak improves the public awareness of respiratory infectious diseases and vaccine production enthusiasm, coronavirus vaccination has strengthened the capacity of the vaccine distribution system. There are also disadvantages and threats such as the high price of influenza vaccine, insufficient supply, low awareness of influenza vaccine vaccination among grass-roots healthcare workers, lack of demand assessment mechanism on influenza vaccine, poor vaccine deployment, structural imbalance in vaccine supply in different areas, and severe vaccine waste. SWOT analysis matrix of the influenza vaccination status of grass-roots healthcare workers was established, forming dominant opportunity (SO) strategy, dominant threat (ST) strategy, inferior opportunity (WO) strategy, and inferior threat (WT) strategy.Conclusion:Measures should be taken by the supplier, the demand—side, and the management side to improve the influenza vaccine coverage rate of primary healthcare workers, but the emphasis should be on the coordination and management of the management side.

Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is characterized by significant gastrointestinal dysmotility. Early and long-term nutritional therapy is highly recommended. We report a case of MNGIE in a patient who was undergoing long-term nutrition therapy. He was diagnosed with a serious symptom of fatty liver and hyperlipidemia complications, along with homozygous mutation of the thymidine phosphorylase (TYMP) gene (c.217G > A). To our knowledge, this is the first report of such a case. Herein, we describe preventive measures for the aforementioned complications and mitochondrial disease-specific nutritional therapy.
Fatty Liver ; Humans ; Hyperlipidemias ; Nutrition Therapy* ; Thymidine Phosphorylase

BACKGROUND:The narrowing of intervertebral space induced by the intervertebral disc degeneration is mainly characterized by the expression of proteoglycan in nucleus pulposus cells and the reduction of col agen type II. OBJECTIVE:To quantitatively observe col agen type II protein in adult normal and degenerative intervertebral disc nucleus pulposus cells by immunofluorescence staining and safranin O staining.
METHODS:The nucleus pulposus specimens were col ected from adult scoliosis patients and patients with intervertebral disc protrusion, who were al volunteers. After culture, 26 cells in each patient were measured. There were 78 cells in both normal group and degeneration group. The normal and degenerative intervertebral disc nucleus pulposus cells were subjected to safranin“O”staining, and gray values were determined;intracellular col agen type II was detected by immunofluorescence staining.
RESULTS AND CONCLUSION:Immunofluorescence staining revealed that, degenerative intervertebral disc nucleus pulposus cells were only mildly stained, with the fuzzy staining, the shape was round, spindle, fusiform and irregular. There were a very smal amount of fluorescent particles within cells. The expression of col agen type II was decreased significantly compared with normal cells (P<0.05). Safranin O staining showed that, degenerative nucleus pulposus cells began to swel , the nuclei swel ed and were stained slightly, cellprocesses were prolonged, cytoplasmic dyeing was uneven accompanying with vacuole, celldisruption, scattered and chaotic distribution were visible, patches of necrosis were observed. The image gray value showed no significant difference compared with normal nucleus pulposus cells (P>0.05). The degenerative intervertebral disc nucleus pulposus cells have a smal quantity and partial y become apoptotic, the content of col egen type II protein is decreased significantly compared with normal nucleus pulposus cells.

ObjectiveTo observe the expression of Caspase-3 mRNA in prefrontal cortex and hippocampus of chronic stress-induced depression rats,and to detect the machnisms of antidepression by electro-acupuncture.MethodsSprague-Dawley rats were randomly divided into four groups:control group,model group,model +electro-acupuncture group and model + paroxetine group,12 rats in each group.Open-field test was used to observe the changes of movements,and real-time fluorescence quantitative PCR (RT-PCR) method was used to detect Caspase-3 mRNA levels in prefrontal cortex and hippocampus.Results ①Open-field test:after stress,compared with control group rats,the model group rats' crossing numbers (29 ± 7),rearing times (6 ± 2) were apparently less than those of control group( (66 ± 13),( 10 ±2) ; P＜0.05,P＞0.05).In comparison with model group,the crossing times and rearing times being increasing in degree in electro-acupuncture group( (61 ±9),( 13 ±1 ) ) and paroxetine group( (39 ± 10),(8 ± 1 ),P＜0.01,P＞0.05).② Compared with the control group,Caspase-3 mRNA in prefrontal cortex and hippocampus significantly increased in model group(P ＜0.05 ) ;and compared with model group,Caspase-3 mRNA in prefrontal cortex in electro-acupuncture group and paroxetine group significantly decreased(P ＜ 0.05 ),and both expression of Caspase-3 mRNA in hippocampus in electro-acupuncture group and expression of Caspase-3 mRNA in hippocampus in paroxetine group decreased (P ＞ 0.05 ).ConclusionChronic stress can increase the expression of Caspase-3 mRNA in prefrontal cortex and hippocampus of chronic stress-induced depression rats,while electro-acupuncture can decrease the expression of caspase-3 mRNA,which may be an important way to anti-depression by electro-acupuncture.