ObjectiveTo determine the characteristics and influencing factors of hepatitis C virus （HCV） co-infection among HIV concordant couples in Dehong Prefecture. MethodsUsing the data of newly reported HIV concordant couples in Dehong Prefecture from 2016 to 2019， we collected the demographic characteristics， exposure history， and HCV infection to determine the characteristics of HCV co-infection among HIV concordant couples. ResultsAmong the 160 HIV concordant couples included in the study， 46 （28.8%） males and 14 （8.8%） females were co-infected with HCV. The prevalence of HIV-HCV co-infection was higher among the male spouses who were diagnosed less than 40， Jingpo ethnic， Burmese， illiteracy， farmers， and intravenous drug users. In contrast， the prevalence of HIV-HCV co-infection was higher among the female spouses who were diagnosed less than 40， Jingpo ethnic， and Burmese. Logistic regression analysis among male spouses showed that the Jingpo ethnic and intravenous drug users had higher risk of HCV co-infection. ConclusionHIV concordant couples in Dehong Prefecture have high prevalence of HIV-HCV co-infection. Effective intervention strategies should be developed based on ethnic-specific factors and exposure characteristics among male and female spouses of HIV concordant couples.

Objective:To explore the effect of SimMan 3G simulator based scenario simulation teaching method and case-based learning (CBL) in emergency medicine teaching.Methods:Sixty students from Batch 2013 eight-year program of clinical medicine were selected as subjects. They were randomly divided into an experimental group and a control group, with 30 students in each group. In the teaching of emergency medicine, the experimental group used the combination of scenario simulation with CBL teaching methods, and the control group used classic teaching methods. The test scores and the questionnaires satisfaction of the two groups were compared to evaluate the teaching effects. SPSS 17.0 was used for the statistical analysis, measurement data were compared between the groups by t test, and counting data were compared between groups by chi-square test.Results:The scores of the experimental group (94.24±1.13) were better than those of the control group (90.6±0.59), with significant differences ( t=12.85, P<0.05). The results of the questionnaires showed that the students of experimental group were more satisfied with the learning experience than those of the control group. Conclusion:The teaching method can improve the teaching effects, the students' emergency clinical thinking, skills, comprehensive analysis and judgment ability, team cooperation consciousness and leadership ability.

Objective:To investigate the preschool period neurodevelopmental status and analyze the perioperative data which associated with delayed neurodevelopment in patients underwent antergrade cerebral perfusion(ACP).Methods:To access the preschool period neurodevelopmental status in patients underwent ACP using Griffiths mental development scale-Chinese(GDS-C). Patients were classified as normal development group(ND) and low development group(LD) depending on the outcomes of assessment. Perioperative data including age, weight, CPB time, aortic cross-clamp time, mean arterial pressure, ACP time and flow were analyzed retrospectively.Results:62 children who met the inclusion criteria, of which 19 were accessed by GDS-C scale. Fourteen cases were lagged in general quotient(GQ) compared with normal children. The outcomes of assessment in six subscales of GDS-C scale indicated that 13 cases were delayed in language(C) and practical reasoning(F). Eight cases were delayed in locomotor(A) and personal-social(B). Eleven cases were delayed in eye-hand coordination(D). Ten cases were delayed in performance(E). The children in LD group had significant longer CPB time and aortic cross-clamp time than those in ND group. There were no differences between two groups in other perioperative data.Conclusion:The incidence of preschool period neurodevelopmental delay after ACP in infants is relatively high. In detailed analysis, their language and practical reasoning ability are lagged significantly. In addition, the longer time of CPB and aortic cross-clamp are associated with the neurodevelopmental delay.

Objective? To explore the effect of cardiovascular family-care APP on self-management behavior of patients with coronary heart disease. Methods? The hospitalized patients with coronary heart disease who were admitted in the department of cardiovascular medicine of a Class Ⅲ Grade A hospital from May 2016 to May 2018 were recruited by non-probability sampling method. All the research subjects were randomly divided into intervention group and control group by random number table. The intervention group consisted of 143 cases and control group consisted of 147 cases. The intervention lasted 12 months. The intervention group received health management of cardiovascular family-care APP, while the control group received routine discharged-guidance and outpatient clinic follow-up. Self-management behavior and risk factors of coronary heart disease were evaluated at baseline and 6 months and 12 months after intervention. Results? At 6 months after intervention, the total score of self-management behavior, medical management and emotional management in the intervention group were significantly higher than those in the control group, with statistical significance (P＜0.05). At 12 months after intervention, the total score of self-management behavior and medical management in intervention group were significantly higher than those in control group, with statistical significance (P＜0.05). After 6 months of intervention, BMI, alcohol consumption, blood pressure control of the intervention group were better than those of the control group, with statistical significance (P＜0.05). After 12 months of intervention, the control of blood pressure in the intervention group was better than that in the control group (P＜ 0.05). Conclusions? Cardiovascular family-care APP can promote the establishment of good self-management behavior in patients with coronary heart disease. Self assessment on smoking, drinking, diet, exercise, stress, anxiety and depression can be increased in app,and relevant research can be carried out

As an important potential factor to enhance employees' performance and organizational management, job engagement is becoming a new research hotspot in organizational behavior and management. Since the job engagement of nursing staff directly affects the service quality and patients' safety, it is also an issue that badly needs further study by current nursing managers in hospitals. Based on a comprehensive review of the domestic research status of nurses' job engagement in the past five years and directed by Bakker and Demerouti's "Job Demand-Resource" (JD-R model, 2001,2008), this paper tries to summarize the resources and demands that influence nurses' job engagement and put forward the measures to enhance nurses' job engagement, with a view to providing a theoretical basis for formulating appropriate management strategies and improving the scientific and effective nursing management. It aims to help nursing managers improve their organizational management behavior, enhance the pertinence of the intervention mechanism for nurses' job engagement, and fundamentally improve the quality of nursing work.

Objective To investigate the significance of CD64 combined with C-reactive protein (CRP) and procalcitonin(PCT) in the diagnosis of neonatal sepsis.Methods A total of 70 neonates diag-nosed with neonatal sepsis(sepsis group),35 cases of non-infectious diseases(non-infected group),and 40 healthy newborns(healthy control group) were enrolled in the Department of Pediatrics,Fuzhou First Hospital Affiliated to Fujian Medical University from July 2015 to June 2016. Serum CD64 was detected by flow cytometry.Serum CRP and PCT were detected by automatic biochemical analyzer,and the results were com-pared and analyzed.Results The levels of serum CD64,CRP and PCT in sepsis group were significantly higher than those in non-infected group and healthy controls(P <0.05).The sensitivity and specificity of CD64 combined with CRP and PCT in the detection of neonatal sepsis were 97.14% and 96.00%,and the sensitivity and specificity in the combined detection were higher than those in three indicators alone.Conclusion CD64 combined with CRP and PCT in the detection of neonatal sepsis can improve the specificity,and provide the basis for early diagnosis.

Objective To investigate the value of neutrophil CD64 combined with monocyte chemotactic protein 1 (MCP-1),interleukin-8 (IL-8) and interferon-inducible protein-10 (IP-10) in the clinical diagnosis of neonatal sepsis.Method Cases of neonatal sepsis from March 2015 to June 2016 in the department were chosen as sepsis group.35 neonates with non-infection diseases were selected as noninfection group and 40 healthy newborn infants were assigned as control group.The level of CD64 in blood were detected by flow cytometry,while the level of MCP-1,IL-8 and IP-10 of the serum in the three groups were detected by automatic biochemical analyzer.The differences between groups were compared by single factor ANOVA.The ROC curves of sepsis diagnosed by whole blood CD64,serum MCP-1,IL-8 and IP-10 were drew.Result The level of CD64,IL-8 and IP-10 of the neonatal blood in the sepsis group were significantly higher than that in the non-infection group (P ＜ 0.05) and control group (P ＜ 0.05).There were no significant difference between the sepsis group and non-infection group in MCP-1 (P ＞ 0.05),but significantly higher than that in the control group (P ＜ 0.05).The levels of serum MCP-1 and IP-10 in the non-infection group were significantly higher than those in the control group (P ＜ 0.05),but there was no significant difference between the non-infection group and control group in CD64 and IL-8 (P ＞0.05).The optimal thresholds of blood CD64,MCP-1,IL-8 and IP-10 in the diagnosis of sepsis were 35.0 MFI,58.6 ng/L,60.3 ng/L,0.46 μg/L.The sensitivity and specificity of the diagnosis of sepsis were 92.8％ and 90.6％ in CD64,70.0％ and 42.6％ in MCP-1,78.5％ and 68.0％ in IL-8,72.8％ and 54.6％ in IP-10,97.1％ and 94.6％ when combined.Conclusion The combination test of CD64,MCP-1,IL-8 and IP-10 can improve the sensitivity and specificity of the diagnosis of sepsis.

Objective To explore the effects of health education combined with WeChat′s public platform in the management of risk factors in patients with coronary heart disease. Methods A total of 100 coronary heart disease patients were randomly divided into intervention group and control group and there were 50 cases in each group by the random number table. The intervention group received health education about risk factors combined with WeChat′s public platform for 6 months. The control group received routine health education. Evaluate the control rate of blood pressure, blood glucose and blood lipid and the score of coronary heart disease self-management scale of the two groups before and after the intervention. Results At the 6th month after intervention, the control rate of blood pressure of the intervention group was 88.0％(44/50) and it of the case group was 70.0％(35/50).The difference between the 2 groups was statistically significant (χ2=4.882, P < 0.05). The score of coronary heart disease self-management scale of the intervention group was (102.44±8.22) points and it of the case group was (89.82±8.01) points . The difference between the 2 groups was statistically significant(t=7.776, P < 0.05). Conclusions The health education combined with WeChat′ s public platform contributed to help coronary heart disease patients to establish good self-management behavior and it can be widely used in the management of coronary heart disease risk factors.

Objective To investigate whether metabolic pathway-related gene polymorphisms are associated with arterial plaque stability and their gene-gene interactions increase the risk of cerebral infarctions.Methods Totally 294 patients with atherothrombosis stroke admitted to the Department of Neurology, the Third Affiliated Hospital of Wenzhou Medical University from September 2010 to December 2012 were divided into a carotid vulnerable plaque group ( n=69 ) and a stable plaque group ( n=225 ) according to the results of carotid B-mode ultrasonography.A total of 282 healthy volunteers excluded carotid plaque and stroke were enrolled as well.Genetic polymorphisms of ALOX5AP and CYP3A5, CYP2C9*2, CYP2C9*3 and EPHX2 were genotyped using polymerase chain reaction and mass spectrometry analysis.The SPSS16.0 software was used to compare genotype frequencies and the generalized multifactor dimensionality reduction ( GMDR ) method was applied for gene-gene interaction analyses.Results The results showed that EPHX2 GG genotype might protect against stroke ( OR =0.520, 95% CI 0.288 -0.940, P=0.030).The distribution of CYP3A5 genotypes showed statistically significant differences (χ2 =7.284, P=0.026) between the vulnerable plaque ( AA: 5 cases, AG: 36 cases, GG: 28 cases) and stable plaque ( AA: 26 cases, AG: 77 cases, GG: 122 cases ) groups.Multivariate Logistic regression analysis showed that the GG genotype of CYP3A5 was protective factor for unstable plaques ( OR=0.405, 95%CI 0.178 -0.920, P =0.031 ).Differences in other SNPs did not reach statistical significance between the two groups.The GMDR analysis showed a significant gene-gene interaction between SG13S114 and A6986G, with scores of 10 for cross-validation consistency and 9 for the sign test (P=0.011).The best model for ischemic stroke was found to be SG13S114 AA and A6986G AA.Adjusting for age, hypertension and diabetes, the certain gene-gene interaction predicted a significantly higher risk of cerebral infarction (OR=1.804, 95%CI 1.180-2.759, P=0.006).Conclusions The EPHX2 G860A gene might be linked with the incidence of cerebral infarctions.Only a CYP3A5 gene polymorphism might be associated with carotid plaque instability in patients with stroke.The gene-gene interaction predicts a significantly higher risk of cerebral infarction.There is a 1.804-fold increased risk for ischemic stroke in individuals with these combined genetic factors.

Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.