1.A cross-sectional survey on the allocation of nursing human resources in burn centers in China
Shujun WANG ; Fangrong LI ; Hongyan LU ; Yuanyuan CHEN ; Xinzhu LIU ; Lihua CHEN ; Yanhua WANG ; Ziqing YAN ; Ping FENG ; Ying WU ; Yan ZHANG ; Chuan'an SHEN
Chinese Journal of Burns 2023;39(4):364-370
Objective:To investigate the allocation of nursing human resources in burn centers in China.Methods:A cross-sectional survey was conducted. Using a self-designed questionnaire, a survey was carried out from January to March 2022 to investigate the January to December 2021 status of 39 burn centers in China that met the inclusion criteria based on six strategic regions and other regions, including the hospital grade and the region, the number of nurses and opening beds in the burn centers and burn intensive care units (BICUs), the age, working seniority in burn specialty, educational background, professional title, personnel employment, and turnover of nurses and training of newly recruited nurses in the burn centers.Results:This survey covered 30 provinces, municipalities, and autonomous regions in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region, and Taiwan region of China). A total of 39 questionnaires were collected, all of which were valid. The 39 burn centers were located in 38 tertiary A hospitals and 1 tertiary B hospital, with 26 burn centers in strategic areas. The nurse/bed ratio of burn centers in the Greater Bay Area of Guangdong, Hong Kong, and Macao was the highest, while the nurse/bed ratio of burn centers in border ethnic minority area was the lowest. Except for the Chengdu-Chongqing Economic Circle, BICUs had been set up in burn centers in other regions. Among the 39 burn centers, the percentage of nurses aged 25 to 34 years was 51.21% (738/1 441), the percentage of nurses worked in burn specialty for less than 5 years was 31.16% (449/1 441), the percentage of nurses with bachelor's degree was 69.74% (1 005/1 441), and the percentage of nurses with nursing professional title was 44.14% (636/1 441), which were the highest. There were significant differences in the employment of nurses, the percentage of permanent nurses in burn centers in the collaborative development zone of Beijing-Tianjin-Hebei was 82.48% (113/137), while the percentage of permanent nurses in burn centers in important military strategic area was only 9.42% (34/361); the turnover rate of nurses was 9.03% (143/1 584), among which the turnover rate of nurses was 18.14% (80/441) in burn centers in important military strategic area. The training for newly recruited nurses in 39 burn centers was mainly based on the guidance of senior nurses and the pre-job education+specialist training.Conclusions:The burn nursing human resources in strategic areas in China are seriously insufficient and unevenly distributed, with unstable nurse team and lack of standardized specialist training. In particular, the nursing human resources in BICUs need to be equipped and supplemented urgently.
2. Relationship between glycosylated hemoglobin and hemorrhagic transformation after cerebral infarction
Guanghui ZHANG ; Zhenjie SUN ; Mingli HE ; Zhenwei GUO ; Yongjin ZHANG ; Na WANG ; Niu JI ; Fangrong WU
Chinese Journal of Postgraduates of Medicine 2020;43(2):101-106
Objective:
To assess the relationship between hemoglobin A1c (HbA1c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction.
Methods:
From January 2014 to June 2016, in the Lianyungang Hospital Affiliated to Xuzhou Medical University, 426 patients with acute anterior circulation infarction were included. The blood sugar status before stroke was expressed by HbA1c. HbA1c and fasting blood glucose (FBG) were measured on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission. The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge. CT or MRI/SWI examination was performed to determine whether there was HT. Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction.
Results:
Of the 426 patients enrolled, 93 (21.8%) appeared HT, 60 (14.1%) had hemorrhagic cerebral infarction (HI) and 33 (7.7%) had parenchymal hemorrhage (PH). Multivariate analysis showed that HbA1c and infarct volume were independent predictor of HT. When patients were grouped according to fasting blood glucose (FBG<7.8 mmol/L or ≥ 7.8 mmol/L), the predictive effect of HbA1c on HT was found in both groups. In multiple Logistic regression analysis, HbA1c was also a predictor of poor prognosis after stroke (
3.Regulatory relationship between lncRNA KCNQ1OT1 and miR-146a-3p in preeclampsia
Fangrong CHEN ; Linmei ZHENG ; Dongcai WU ; Humin GONG ; Hui CEN ; Wenchen CHEN
Chinese Journal of Obstetrics and Gynecology 2020;55(8):535-543
Objective:To observe the changes of the expression level of long non-coding RNA (lncRNA) KCNQ1OT1 and microRNA (miR)-146a-3p in placenta tissues of preeclampsia (PE) patients, as well as their effect and mechanism on the biological functions of trophoblast cells.Methods:A total of 45 cases of hospitalized PE patients in Hainan General Hospital from July 2017 to July 2018 were selected as the PE group, 55 normal pregnant women during the same period were chosed as the control group. The expression level of KCNQ1OT1 mRNA and miR-146a-3p in the placenta tissues between two groups were detected by using quantitative real time (qRT)-PCR. Pearson′s test was furtherly analyzed the correlation between them. Human trophoblast cell line (HTR8/SVneo) were randomly divided into control and lipopolysaccharide (LPS) groups, and then LPS group were divide into four sub-groups,included LPS group, short hairpin RNA (sh)-KCNQ1OT1 (after silencing the expression of KCNQ1OT1), miR-146a-3p inhibitor and sh-KCNQ1OT1+miR-146a-3p inhibitor. The targeting relationship between KCNQ1OT1 and miR-146a-3p were predicted by bioinformatics software and confirmed by luciferase assay. The cell proliferation and invasion capacities were respectively detected by cell counting kit-8 (CCK-8) and transwell assay. The expression level of KCNQ1OT1 mRNA and miR-146a-3p were detected by qRT-PCR and the protein expression level of CXC chemokine ligand 12 (CXCL12) and CXC chemokine receptor type 4 (CXCR4) were tested by western blot.Results:(1) The mRNA expression level of KCNQ1OT1 in the placenta of PE group was lower than that of control group (0.23±0.03 vs 0.51±0.04, P<0.05), and the miR-146a-3p expression level was higher than that of the control group (0.49±0.03 vs 0.31±0.03, P<0.05), there were statistical significant differences between the two groups. (2) Luciferase assay showed that there was a targeting relationship between KCNQ1OT1 and mir-146a-3p. Compared with the control group, the mRNA expression level of KCNQ1OT1 in the LPS group were significantly decreased (0.91±0.03 vs 0.35±0.03, P<0.05), and the expression level of miR-146a-3p were significantly increased (0.22±0.03 vs 0.63±0.04, P<0.05). The cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 significantly reduced in the LPS group compared with control group (all P<0.05). The mRNA expression level of KCNQ1OT1 (0.23±0.03) in the sh-KCNQ1OT1 group were further decreased, the expression of miR-146a-3p (0.85±0.03) were further increased, and the cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 were all further reduced compared with control group,there were significant difference between two groups (all P<0.05). Comparing the miR-146a-3p inhibitor group, and sh-KCNQ1OT1+miR-146a-3p inhibitor group with the sh-KCNQ1OT1 group, respectively, the expression level of KCNQ1OT1 mRNA (0.78±0.04 vs 0.50±0.03) increased, and the expression level of miR-146a-3p (0.42±0.03 vs 0.46±0.03) decreased, the cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 were all increased ,there were statistically significant differences (all P<0.05). Conclusion:KCNQ1OT1 could target the regulation of miR-146a-3p through CXCL12/CXCR4 pathway in the proliferation, invasion an migration of HTR8/SVneo cells, which may be involved in the pathogenesis of PE.
4.Evaluation of the inactivation performance under physical and chemical conditions against human infected H9N2 avian influenza viruses
Fangrong GAN ; Ye ZHANG ; Minju TAN ; Yanhui CHENG ; Hong BO ; Qiongqiong FANG ; Weimin ZHOU ; Dayan WANG ; Jie DONG ; Guizhen WU
Chinese Journal of Experimental and Clinical Virology 2020;34(1):87-91
Objective Assess and determine inactivation effect of heat,.ultraviolet (UV) light and three disinfectants against human infected H9N2 avian influenza virus in laboratory.Methods Suspension containing with 1010.67 TCID50/ml viral was exposed to 50 ℃,56 ℃,60 ℃,65 ℃ for 10 to 60 minutes and UV every 10 interval minutes from 10 to 80 minutes.The residual viruses after physical treatment were determined through half of tissue culture infective dose (TCID50) with MDCK cells and calculated by Reed-Muench method.Suspension with 1010.37EID50/ml quantitative virus was applied to equal volume of 10% 84 sanitizer,75% ethanol,1% Virkon solution and incubated for 1 minute to 15 minutes respectively.The residual viral activity would be evaluated by inoculating in SPF chicken embryo.When the virus titer dropped by 4 lgTCID50/ml or virus in chicken embryo culture was observed to be negative,the physical and chemical treatment was considered effective.Results Human infected H9N2 avian influenza virus titer decreased by 4.02 lgTCID50 at 56 ℃ for 15 minutes,and after 30 minutes at 56 ℃ or 10 minutes at 60 ℃/65 ℃,the post-viral titer would decline below the detection level.20 minutes of UV irradiation would lead to a 5.67 log reduction,and after 70 minutes lighted,the virus titer fell below the detection level.Virus proliferation was not detected after 3 minutes of disinfection with 10% 84 sanitizer,75% ethanol and 1% Virkon.Conclusions We should note that it is necessary to meet the specific condition to effectively inactivate the human infected H9N2 avian influenza virus.Our study provides an experimental basis for the biosafety operation of human infected H9N2 avian influenza virus.
5.Impact of diabetes prevalence and mortality on health life expectancy among residents in Zhejiang province
Ruying HU ; Fangrong FEI ; Jin PAN ; Xuying WANG ; Hao WANG ; Haibin WU ; Meng WANG ; Weiwei GONG
Chinese Journal of Epidemiology 2017;38(6):779-783
Objective To evaluate the impact of diabetes prevalence and mortality on health life expectancy (HLE).Methods A cause-excluded health adjusted life expectancy method was used to quantitatively analyze the impact of diabetes on HLE and the composition of health life losses (HLL),using the integrated data on population mortality,self-assessed health status and diabetes prevalence.Results The HLE for people aged 15 was 55.80 in Zhejiang,in 2013.After removing the diabetes morbidity and mortality,the HLE for men aged 15 increased by 0.86 and 1.13,respectively,with an increase of 1.04 and 0.66 for urban and rural residents.Substantial increase of HLE was observed in women and urban residents than those for men and rural residents.HLL caused by diabetes mortality and morbidity appeared as 0.10 and 0.79,with a ratio of 7.92.Conclusion HLL caused by diabetes mortality was much greater than those caused by diabetes mortality,suggesting the most effective measure in reducing the diabetes-related HLL is to promote the healthy lifestyle in urban areas and especially for women.
6.Disability adjusted life years of type 2 diabetes in population in Zhejiang province, 2013.
Huiqin WANG ; Ruying HU ; Fangrong FEI ; Weiwei GONG ; Jin PAN ; Hao WANG ; Haibin WU ; Meng WANG ; Min YU
Chinese Journal of Epidemiology 2016;37(1):98-101
OBJECTIVETo estimate the disease burden of type 2 diabetes in population in Zhejiang in 2013.
METHODSAccording to the method in global burden of disease study (GBD) 2010, the related disability adjusted life years (DALYs), years of life lost (YLL) and years lived with disability (YLD) were calculated by using the incidence, prevalence and mortality data of type 2 diabetes in population in Zhejiang and DISMODⅡ.
RESULTSThe overall DALYs of type 2 diabetes was 5.36 per 1000 population, which was higher in women (5.49 per 1000) than in men (5.24 per 1000), The population in urban area had higher DALYs (5.47 per 1000) than those in rural area (5.42 per 1000). The DALYs in old population was high, which peaked in age group 80-84 years (32.63 per 1000) with YLL/YLD of 0.62. The disease burden of type 2 diabetes was mainly caused by disability.
CONCLUSIONThe YLL of type 2 diabetes in Zhejiang was higher than the national average level.
China ; epidemiology ; Diabetes Mellitus, Type 2 ; epidemiology ; Disabled Persons ; Female ; Humans ; Incidence ; Male ; Prevalence ; Quality-Adjusted Life Years ; Rural Population ; Urban Population
7.Effect of QCC activities on improving the compliance of hand hygiene of nurses in Burn Department
Hongyan LU ; Shujun WANG ; Fangrong LI ; Ya SI ; Na′na WU ; Yuanyuan LI ; Xu LI
Chinese Journal of Modern Nursing 2016;22(14):1929-1932
Objective To explore the effect of QCC activities on the compliance of hand hygiene of nurses in Burn Department.Methods From March 201 3 to July 201 3,we set up the QCC group,designed the prevalence survey questionnaire of compliance of hand hygiene,analyzed the root causes by using QCC method;as a result,three measures were developed and implemented.Results After the activity,unqualified rate of hand hygiene of nurses in Burn Department reduced from 35.6% to 7.8%(P <0.05).Conclusions QCC activities can effectively improve the compliance of hand hygiene of nurses in Burn Department.
8.CT and MRI Manifestations of Lumbar Spinal Epidural Angiolipoma
Jianbing MA ; Fangrong YU ; Fan WU ; Jia WANG ; Linna YUAN
Chinese Journal of Medical Imaging 2015;(6):428-431
Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.
9.Epidemiological characteristics of incidence of diabetes mellitus in Zhejiang Province during 2007-2012
Jin PAN ; Ruying HU ; Weiwei GONG ; Fangrong FEI ; Haibin WU ; Min YU
Chinese Journal of Endocrinology and Metabolism 2015;31(10):846-850
Objective To study the epidemiological characteristics of diabetes,and to provide effective prevention and intervention strategies for diabetes in Zhejiang Province.Methods Descriptive epidemiological method was used to analyze the surveillance data of diabetes from 2007 to 2012.Results 272 534 cases of new on-set diabetes were reported through the noncommunicable disease surveillance system in Zhejiang Province from 2007 to 2012,and the annual incidence was 277.08/100 000.According to different types of diabetes,the proportions of type 1,type 2,gestational,and other types diabetes were 0.69%,96.04%,2.23%,and 1.03%,respectively.The incidence was higher in urban and female population.The diabetes incidence was increased with 20.18% per year and the growing speed of incidence in rural area and males were faster than those in urban area and females,respectively.The incidence in 70-year group was the highest and the growth speed in 20-year group was the fastest one.11.89% of diabetes patients were diagnosed with complications simultaneously and the proportion of diabetic neuropathy,vasculopathy,and nephropathy was accounted for 82.81%.The incidence of diabetic complications was increased at first and then decreased from 2007 to 2012.Conclusion With the aging trends in Zhejiang province,the incidence will be increased rapidly,and the rural,male,and adolescence populations should be the focus objectives for the diabetes prevention and control in the future.Although the trend of diabetic complications incidence was tended to decline,the result should be confirmed by further researches.
10.Association between hemoglobin A1c and outcomes of patients with spontaneous intracerebral hemorrhage
Guanghui ZHANG ; Mingli HE ; Yan XU ; Xiaobing HE ; Pin MEN ; Na LIU ; Fangrong WU
Chinese Journal of Neuromedicine 2015;14(10):1018-1022
Objective Admission hyperglycemia is thought to be related to poor neurological function and high mortality in patients with spontaneous intracerebral hemorrhage (sICH).However, it is not known whether preictal glycemic status affects functional outcome of sICH.The study is aimed to disclose the association between preictal glycemic status and neurological outcomes in patients with acute sICH.Methods Three hundred and thirty-two patients with sICH, admitted to our hospital from January 2011 to September 2013 (within 24 h of onset), were chosen in our study.Pre-stroke glycemic status, represented by hemoglobin A1c (HbA1c), was determined the next day after admission.Patients were categorized into four groups according to HbA1c values (<6%, 6.1%-7%, 7.1%-8% and ≥8%).The correlations of HbA1c in the four groups with different variables (NIHSS scores, hematoma volume, modified Rankin scale [mRS] scores) were analyzed using Spearman correlation test.Patients were also categorized into two groups according to hematoma volume (≤25 mL or >25 mL) or mRS scores (≤2 or >2).Logistic regression analyses were used to determine the relative independent risk factors for both hematoma volume and mRS scores.Results The hematoma volume, NIHSS scores, mRS scores, and number of patients with diabetes mellitus were significantly different among the four groups (P<0.05).Blood glucose at admission and HbA1c level were significantly correlated with hematoma volume (r=0.085, P=0.027;r=0.164, P=0.014).Age and HbA1c level were significantly correlated with mRS scores (r=0.027, P=0.019;r=0.199, P=0.003).Conclusion HbA1C alone could serve as a better predictor of poor outcome after sICH than glucose at admission;HbA 1 C is the independent risk factor of poor prognosis for sICH.

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