Objective To investigate the role of cytochrome P450 2E1 (CYP2E1) in trichloroethylene (TCE)-induced skin sensitization and liver damage in guinea pigs, using diallyl sulfide (DAS), a CYP2E1 inhibitor, as an intervention. Methods Specific pathogen-free female guinea pigs were randomly divided into blank control group, solvent control group, positive control (2,4-dinitrochlorobenzene) group, TCE-exposure group, and DAS-intervention group. Skin sensitization experiments were conducted using the guinea pig TCE maximal dose-skin sensitization test. Urinary trichloroacetic acid levels were determined following TCE induction and challenge. At 48 hours after the final challenge, serum liver function markers and inflammatory cytokines levels were detected. Histopathological examination on skin and liver tissues was performed, and hepatic CYP2E1 protein expression and oxidative stress indicators were assessed. Results The sensitization rates of guinea pigs were 100.0%, 75.0%, and 33.3% in the positive control, TCE-exposure, and DAS-intervention groups, respectively, while the blank control and solvent control groups were both 0.0%. Compared with the guinea pigs in TCE-exposure group, those in the DAS-intervention group had lower urinary trichloroacetic acid levels at intradermal induction, local induction, first challenge, and 24 hours after the final challenge time point (all P<0.05). Histopathology of guinea pigs showed dermal inflammatory infiltration and basal keratinocyte necrosis in the TCE-exposure group, whereas only mild dermal inflammation was observed in the DAS-intervention group. The guinea pigs in TCE-exposure group exhibited diffuse hepatocellular necrosis, while hepatic damage in the DAS-intervention group was alleviated, characterized by only mild hepatocellular steatosis and hepatocyte swelling around the central vein. The skin sensitization rate of guinea pigs in the TCE-exposure group increased (all P<0.01), the serum alanine aminotransferase (ALT )activity, the levels of interleukin (IL)-2, IL-17, and tumor necrosis factor-α (TNF- α) increased (all P<0.05), the relative expression of CYP2E1 protein, the activity of superoxide dismutase (SOD), and the level of malondialdehyde in liver tissue increased (all P<0.05), while the activity of catalase decreased (P<0.05), compared with the blank control and solvent control groups. The serum ALT activity and the levels of IL-2, IL-17, and TNF-α of guinea pigs in DAS-intervention group reduced (all P<0.05), as well as CYP2E1 protein expression, SOD activity, and malondialdehyde level in liver tissue reduced (all P<0.05), compared with the TCE-exposure group. Conclusion TCE can induce hepatic CYP2E1 expression, thereby promoting oxidative stress and inflammatory responses, which contributes to skin sensitization and liver damage. DAS alleviates TCE-induced toxic effects on skin and liver by inhibiting CYP2E1 expression.

【Objective】 To explore the geographical environment factors that may affect serum uric acid (UA) of healthy people and explore the change trend of UA reference value at the national scale. 【Methods】 The UA reference values of 607905 healthy people from 565 loci in China were collected, and the correlation between 25 geographical environment factors and UA reference values was analyzed by correlation analysis. CatBoost model was constructed and SHAP value interpretation model was applied to predict the UA reference values of healthy people in counties and cities in China, and the geographical distribution map of UA reference values of healthy people in China was drawn by using ordinary Kriging. 【Results】 A total of 20 indicators, namely, latitude, altitude, annual average temperature, annual average relative humidity, annual precipitation, air temperature annual range, annual average wind speed, percentage of surface soil silt, surface soil bulk density, surface soil gravel content, surface soil organic matter content, surface soil PH, surface soil (clay) cation exchange capacity, surface soil (silt) cation exchange capacity, surface soil base saturation, total surface soil exchange capacity, T-CaCO3, T-CaSO4, surface soil alkalinity, and surface soil salt showed their correlation with UA reference value of healthy people nationwide. The spatial distribution of UA reference values of healthy people across the country differed, manifested as the changing trend of higher in high altitude regions, higher in coastal regions than in inland regions, lower in the mid-eastern region, and higher in Southwest China at similar altitudes. 【Conclusion】 This study lays a foundation for further studies on the mechanism of different influencing factors on UA reference value. CatBoost model was established to provide the basis for establishing reference standards using UA reference values as prognostic factors for hyperuricemia and related chronic diseases in different regions.

Mycobacterium abscessus complex (MABC), a rapidly growing nontuberculous mycobacterium, has received increasing attention worldwide due to its rising isolation rate. The similarity of symptoms between MABC pulmonary disease and tuberculosis, different treatment methods required by different subtypes, as well as high levels of innate, adaptive and acquired antibiotic resistance, make MABC treatment more difficult and lead to unfavorable clinical outcomes of patients. This article reviews the basic characteristics, common antibiotic resistance mechanisms, as well as diagnosis and treatment of MABC, to provide reference for future research and clinical treatment of MABC lung disease.

Objective:To study the application effect of objective structured clinical examination (OSCE)-based situational simulation case teaching on Nursing Fundamentals practical training. Methods:Using convenient sampling method, two undergraduate nursing classes of Batch 2018 in Hubei University of Chinese Medicine were chosen as the study objects. They were divided into observation group with 45 students and control group with 43 students through ball touching method. The control group used traditional teaching method, on this basis, the observation group used OSCE-based situational simulation case teaching. At the end of the semester, the results of theoretical assessment, operational skills assessment, humanistic care, health education achievements of the two groups of nursing students and students’ evaluation of the new teaching method in the observation group. SPSS 22.0 was used for t test. Results:The sores of theoretical assessment, operational skills and humanistic care assessment in the observation group were (81.01±8.53), (92.69±3.87) and (11.73±1.59), and the corresponding sores in control group were (76.94±9.74), (91.21±2.70) and (10.79±1.36). The nursing students in the observation group had significantly higher scores than the control group in above mentioned aspects ( P<0.05). In the observation group, 45 students (100.0%) believed that this teaching method could stimulate learning interest and comprehensively deal with clinical problems, 43 students (95.6%) thought that this teaching method could improve team cooperation ability, only one person (2.2%) did not agree that this teaching method could help to form critical thinking, and 42 students (93.3%) said that the teaching hours of this teaching method could be appropriately increased. Conclusion:The OSCE-based situational simulation case teaching may effectively improve the teaching quality of the nursing students and mobilize their learning activities.

BACKGROUND: Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants. METHODS: Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants. RESULTS: Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants. CONCLUSION This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.
Adolescent ; Adult ; China ; Female ; Health Records, Personal ; Humans ; Male ; Transients and Migrants/statistics & numerical data* ; Young Adult

BACKGROUND: Limited published research has examined the relationships of negative life events and coping styles with sleep quality in Chinese junior high school students. We aimed to investigate the prevalence of poor sleep quality and to clarify the role of coping styles between negative life events and sleep quality. METHODS: A cross-sectional study of 3081 students was conducted in Ganzhou City, Jiangxi Province, Southeastern China. Adolescent Self-Rating Life Events Checklist, Simplified Coping Style Questionnaire, and Pittsburg Sleep Quality Index were applied to assess negative life events, coping styles, and sleep quality, respectively. Descriptive analyses, independent-samples t tests, one-way analyses of variance, Pearson correlation analyses, and structural equation modeling (SEM) were applied to analyze the data. RESULTS: The prevalence of poor sleep quality was 26.7%. Negative life events (B = 0.038, P < 0.001) and negative coping style (B = 0.049, P < 0.001) demonstrated a positive association with poor sleep quality, while positive coping style indicated a negative association with poor sleep quality (B = -0.029, P < 0.001). Interactions of negative life events and coping styles with sleep quality were not found (all P > 0.05). The association between negative life events and sleep quality was mediated by negative coping styles. CONCLUSIONS Our results indicated that poor sleep quality was common in these Chinese adolescents. Negative life events and negative coping style were associated with an increased prevalence of poor sleep quality, while the positive coping style was related to a decreased prevalence of poor sleep quality. A negative coping style mediated the association between negative life events and sleep quality.
Adaptation, Psychological ; Adolescent ; Child ; China ; Cross-Sectional Studies ; Humans ; Life Change Events ; Psychology, Adolescent ; Psychology, Child ; Sleep

Objective: This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress.Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioningand psychological distress. Methods: Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item GeneralHealth Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzedusing multiple linear regression analysis and path analysis. Results: The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factorsof psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by generalwell-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated byexercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). Conclusion The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercisewere associated with psychological distress. Family functioning could affect psychological distress partially by affecting general wellbeing.Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.Psychiatry Investig 2020;17(4):356-365

Objective To explore the establishment of a two-way referral system for the treatment of cervical diseases within a medical alliance. The two-way referral system was introduced to reduce the morbidity and mortality of cervical cancer through better management of patients'who have tested positive for cervical disease, screening effectively for early diagnosis and treatment of cervical precancerous lesions, and providing early interventions for cervical cancer patients. Methods The control group consisted of 2, 515 patients who had screened positive for cervical disease between January 2018 and December 2018 at one of four community health service centers that were not within the medical alliance. The experimental group consisted of 2, 384 patients who had screened positive for cervical disease at one of four community health service centers in the medical alliance. The control group was treated using the original management mode;the experimental group's treatment was managed within the two-way referral system, which included standardized screening, referral, follow-up, health education, and professional training. The hospital visit rates, time intervals from diagnosis to the start of interventions, detection rates, and treatment rates were observed for both groups of women. Results The hospital visit rates, detection rates, and treatment rates were higher for those in the experimental group than the control group. The time interval from receiving a diagnosis to the first hospital visit was (16.9±11.5) days for patients in the experimental group and (25.7±20.9)days for those in the control group. The difference was a statistically significant (-0.05). Conclusion The management of cases in a two-way referral system within a medical alliance facilitates patients receiving earlier diagnosis and treatment for cervical pre-cancerous lesions and malignant tumors. Such efficiency improvements may reduce morbidity and mortality as well as help control medical costs, all of which have long-term economic and social significance.

Objective To explore the effect of the modular teaching for nursing students based on WeChat in the comprehensive training before the practice.Methods The undergraduate students of nursing were randomly divided into 5 classes,among which class 1,2,3 as the control group,and class 4,5 as the experimental group.The control group used the traditional ‘Case Teaching Method',taking the group as a unit to practice the clinical nursing skills individually;while the experimental group took the method which integrated individual nursing skills and practical materials with humanistic qualities in clinical cases.They conducted practical training by dividing the learning module with the ‘representative patients',using WeChat as the learning and exchange platform andbuilding modular training model.After the training,the results were evaluated by the score sheet for integrated skills,a critical-thinking scale and the learning model questionnaire.The data was analyzed by T-Test and Chi-Square inspection.Results All of the nursing students were willing to use WeChat for autonomous learning.The scores of the nursing students in the experimental group were higher than those in control group in the abilities of judgement,communication,operation and introspection.The difference was statistically significant (P＜0.05).In addition to the cognitive maturity,the scores of experimental group were higher than those in control group in the searching for truth,opening mind,abilities of analysis and integration and self-confidence in critical thinking and desire for knowledge,The difference was statistically significant (P＜0.05);Also the proportion of experimental group was higher than the control group in students' attitude to study,knowledge acquisition and practical training mode.The difference was statistically significant (P＜0.05).Conclusion The implementation of nodular teaching mode based on WeChat is beneficial to improve the clinical comprehensive ability of nursing students,and help to train the high quality nursing talents who meet the needs of clinical practice.

Objective To develop an ideal hypertension combined hyperlipidemia(HP/HL)rat model by feeding spontaneously hypertensive rats(SHRs)with high fat diet, and to evaluate the pathological changes in target organs including heart and kidney. Methods Twenty 3-week old male SHRs were randomly divided into two groups: normal fat control group(SHR-NC)and high fat group(SHR-HF). Moreover,ten 3-week old male Wistar-Kyoto rats(WKY)were taken as the model control group(WKY-NC). The rats in SHR-HF group were fed with high-fat diet to induce HP/HL, while rats of WKY-NC and SHR-NC groups were fed with normal diet. The systolic blood pressure(SBP)and body weight were measured every week. At the end of the experiment, the rats were sacrificed to take serum samples for blood lipid analysis including high density lipoprotein(HDL-C), low density lipoprotein(LDL-C), total cholesterol(TC)and triglyceride(TG). Heart and kidney tissue samples were collected to examine the pathological changes using HE and Masson staining. Results Compared with the SHR-NC group, the SHRs fed with high-fat diet for 23 weeks presented significant increase of blood pressure and TC, TG, LDL-C, and decrease of HDL-C. The HP/HL rat model showed pathological changes in the HP/HL target organs, heart and kidney. Renal tissues were severely damaged and showed a large area of fibrosis. Besides, left ventricular hypertrophy and myocardial fibrosis were also observed. Conclusions A HP/HL rat model is successfully constructed by feeding SHRs with high-fat diet for 23 weeks. Most importantly,this model exhibits progressive renal and cardiac alterations, similar to those of patients with HP/HL. This HP/HL rat model may become widely used for evaluation of HP/HL therapeutic drugs.