Objective  To investigate the needs of eight-year program clinical medical students for the organization and contents of clinical oncology courses.  Methods  From September to November 2020, a questionnaire survey was conducted among eight-year program clinical medicine students in Peking Union Medical College to find out their knowledge base in oncology, teaching mode preference and course contents of interest.  Results  A total of 122 students participated in the survey, in which 89.3%(109/122) of the students showed interest in basic and clinical research projects related to oncology, 84.4%(103/122) thought it was better to use Simulation-based medical education (SBME), and 91.0%(111/122) hoped to learn throughoff-line discussion. In terms of course contents, eight-year program medical students were more interested in knowledge directly related to clinical context, such as diagnosis, treatment, multidisciplinary comprehensive treatment and evidence-based medicine. In terms of sub-analysis, traditional eight-year students (86%, 92/107) showed a higher acceptance of palliative care than students in the 4+4 reform program(60%, 9/15) and were more willing to act as scriptwriters in SBME(26% vs. 7%, P=0.013). The students in clinical phase gained a better understanding of oncology knowledge through research training and were more inclined to take on the role of scriptwriters in SBME than those in basic phase (27% vs. 11%, P=0.048).  Conclusions  The eight-year program clinical medical students are interested in the clinical oncology course and prefer study in the form of Simulation-based medical education (SBME).

Objective:To investigate distinct trahectories of demoralization of maintenance hemodialysis patients in young and middle-aged adults, and analyze the factors that affect the trajectory category, so as to provides reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From April 2020 to April 2021, young and middle-aged maintenance hemodialysis patients fromShangyu People′s Hospital were collected by convenience sampling method and conducted 4-time follow-up investigation. The survey tools included general information questionnaire, Demoralization Scale Mandarin Version (DS-MV) and Experiences in Close Relationship Scale-Short Form (ECR-S). Latent class growth model was used to identify trajectory patterns of demoralization, Logistic regression was used to identify predictors of demoralization trajectories.Results:Totally, 105 patients were enrolled in the present study. Three distinct trajectories were identified and named as "table high level group" 24 cases, "slow reduction group" 39 cases and "continuous reduction group" 42 cases. Univariate analysis showed that age, occupational status, average income per person in family, number of comorbidities, attachment anxiety scores were related to the category of demoralization trajectories ( F = 15.92, χ2 values were 9.16-15.95, all P<0.05). Multivariate Logistic regression analysis showed that age, occupational status, average income per person in family, number of comorbidities, and attachment anxiety scores were important predictors of patterns of demoralization trajectories in young and middle-aged maintenance hemodialysis patients. Conclusions:This study identified three distinct demoralization trajectories in young and middle-aged maintenance hemodialysis patients, clinical nursing should formulate individualized intervention strategies according to the types of patients′ delirium trajectories.

Objective:To explore the effect of positive psychology theory on recovering patients with alcohol dependence.Methods:According to the order of admission, 60 patients with alcohol dependence in convalescence were divided into intervention group and control group, 30 cases each. The control group received only routine treatment for alcohol dependence. In addition to conventional treatment, the intervention group also underwent positive psychological treatment for 5 weeks to evaluate the changes in social support, negative automatic thinking, psychological craving, attention bias and other aspects at pre-baseline, week 1, week 3, and week 5 of treatment.Results:The positive psychology therapy had a good effect on the social support of alcohol-dependent patients. Except for the difference in the degree of support utilization in the intervention group ( P>0.05), the difference in other indicators was statistically significant ( F values were 1.653 - 6.571, P <0.01), while the difference in the subjective support score in the control group was statistically significant ( F value was 5.445, P<0.01). The time factors of repeated measurement anova showed that the total score of social support, objective support, subjective support, utilization of support, total score of automatic thinking and visual desire score were significantly different with the increase of treatment times ( F values were 3.324 - 17.153, P<0.01 or 0.05). The interaction between the total score of social support, subjective support, visual desire and intervention measures was significant ( F values were 9.331 - 17.578, P<0.01). The intergroup factors showed that the intervention measures had positive effects on the total score of social support, objective support, total score of automatic thinking and visual desire between the two groups, with statistically significant differences ( F values were 3.865-12.061, P<0.01 or 0.05). There was no statistically significant difference between the intervention group and the control group in response time of cue words, negative word response time and neutral word response time before intervention ( P> 0.05), and the response time of cue words in the intervention group was lower than that in the control group after intervention ( t value was -3.148, P<0.01). Before intervention in the intervention group and control group in the cue word correctly, negative word correctly, neutral accuracy differences of no statistical significance ( P > 0.05), after intervention intervention group negative word accuracy was higher than the control group, the difference was statistically significant ( t value was 2.298, P<0.05), and after the intervention intervention group neutral accuracy is higher than the control group, difference was statistically significant ( t value was 2.010, P<0.05). Conclusions:Positive psychological therapy can enhance the social support of alcohol-dependent patients, reduce the automatic thinking of patients, reduce the craving, and change the attention bias of alcohol-dependent patients, providing a basis for clinical research.

Objective:To have a better understanding of congenital leukemia by summarizing its clinical features and prognosis.Methods:This study retrospectively recruited 10 neonates with congenital leukemia treated in Beijing Children's Hospital, Capital Medical University from January 2006 to December 2018. Clinical data including clinical manifestations, laboratory examinations, treatment and follow-up were described.Results:The 10 patients consisted of six boys and four girls. In all cases, symptoms presented within 11 d after birth. The admission complaints were jaundice ( n=4), polypnea ( n=3), fever ( n=2) and rash ( n=2). Physical examinations of the 10 patients showed eight with splenomegaly, seven with hepatomegaly and seven with petechia/skin rash. All patients had significantly increased white blood cell count (from 45.8×10 9/L to 553.0×10 9/L), complicated by different degrees of anemia and thrombocytopenia. By bone marrow biopsy, two cases were diagnosed as acute lymphoblastic leukemia and the other eight cases as acute myeloid leukemia. All cases refused chemotherapy on the preliminary diagnosis. Three cases lost follow-up and six died within two months after discharge requested by their parents. One baby had spontaneous remission, but relapsed two years later. Complete remission was achieved after strict management and no relapse was reported until ten years old. Conclusions:Congenital leukemia is a severe condition with high mortality. Some cases may achieve spontaneous remission, but long-term follow-up is needed.

OBJECTIVETo describe the distribution of zinc (Zn) and copper (Cu) in urine samples of generalpopulation in eight provinces of China, to analyze their characteristics of distribution between different region, gender and age-cohorts, and to provide the baseline of themetabolites in the general population.

METHODSFrom 2009 to 2010, 18 120 subjects from the general population aged from 6 to 60 years old were recruited from 24 areas among 8 provinces of China mainland by random sampling. The environmental and physical condition characteristics were collected from questionnaires, and urine samples were collected at the mean time. The levels of Zn and Cu in urine were measured using ICP-MS. Data were analyzed by statistical methods to compare the distribution characteristics of Zn and Cu among populations with different ages and genders.

RESULTSTotally, the median of Cu and Zn in urine were 9.28 and 115.47 µg/L respectively; and the inter-quartile range of Cu and Zn were 2.66-16.09 and 35.32-265.15 µg/L respectively. The median of Cu in male and female were 9.90 and 8.60 µg/L (Z=-5.63, P<0.001), and Zn in male and female were 140.44 and 95.27 µg/L (Z=-14.79, P<0.001). The median of Cu among the groups aged 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were 9.30, 10.14, 9.67, 9.33, 8.38 and 8.74 µg/L (χ2=70.94, P<0.001), respectively, and the median of Zn 130.83, 132.07, 139.34, 109.3, 78.74 and 109.51 µg/L ((χ2=146.00, P<0.001), respectively.There was statistically significant differences in urinary Cu and Zn levels between male and female, and among the different age groups.

CONCLUSIONThe Cu and Zn levels and distribution in urine among general population between 2009 and 2010 in China were reported in this article. These basic data in China will provide scientific and reliable reference for further scientific research.

Adolescent ; Adult ; Age Factors ; Child ; China ; Copper ; urine ; Environment ; Female ; Humans ; Male ; Middle Aged ; Sex Factors ; Surveys and Questionnaires ; Zinc ; urine

Humans ; Infant, Newborn ; Male ; Sepsis ; diagnosis ; microbiology ; Urethral Stricture ; complications ; microbiology ; Urinary Tract Infections ; complications ; microbiology

OBJECTIVETo evaluated the manganese (Mn), cobalt (Co) and molybdenum (Mo) levels in blood and urine among general population in China, and thereby to analyze their prevalent features.

METHODSFrom 2009 to 2010, a total of 18 120 subjects of general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland, by cluster random sampling method. The information about their living environment and health status were collected by questionnaire, and their blood and urine samples were also collected.Inductive coupled plasma mass spectrometry (ICP-MS) was applied to test the Mn, Co and Mo levels of blood and urine samples, and the Mn, Co, Mo distribution in blood and urine among groups of population in different ages and genders were then analyzed.

RESULTSAmong general population in China, the geometric mean (GM) of Mn concentration in blood was 8.98 µg/L. The Mn concentration in blood among males and females were separately 8.14 µg/L and 9.88 µg/L (Z = -18.84, P < 0.01). The GM of Mn concentration in urine was 0.63 µg/L. The Mn concentration in urine among males and females were separately 0.62 µg/L and 0.63 µg/L (Z = -0.67, P > 0.05). The geometric mean (GM) of Co concentration in blood was 0.194 µg/L. The Co concentration in blood among males and females were separately 0.166 µg/L and 0.225 µg/L (Z = -23.04, P < 0.01). The GM of Co concentration in urine was 0.282 µg/L. The Co concentration in urine among males and females were separately 0.260 µg/L and 0.307 µg/L (Z = -7.35, P < 0.01). The GM of Mo concentration in blood was 0.25 µg/L. The Mo concentration in blood among male and female group were separately 0.27 µg/L and 0.23 µg/L (Z = -5.03, P < 0.01). The GM of Mo concentration in urine was 27.7 µg/L. The Mo concentration in urine among males and females were 29.8 µg/L and 25.6 µg/L (Z = -6.31, P < 0.01), respectively.

CONCLUSIONThe Mn, Co and Mo levels in blood and urine varied by gender and area among general population in China, the study provided basic data evidence for the following Mn, Co and Mo biological monitoring studies in near future.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cobalt ; Environmental Exposure ; Environmental Monitoring ; Female ; Humans ; Male ; Manganese ; Middle Aged ; Molybdenum

OBJECTIVETo investigate the level of zinc (Zn) and copper (Cu) in whole blood among general population from 8 provinces in China, and to analyze the characteristics of distribution among different regions.

METHODSThis cross-sectional study was performed in 8 provinces from eastern, middle and western China between 2009 and 2010, including 13 110 subjects from 24 regions, and the blood and urine samples were collected. The ICP-MS was applied to test the content of ICP-MS in blood samples, and the results were used to analyze the characteristics of contents and distributions of Zn and Cu among population from different ages, genders and regions groups.

RESULTSTotally, the mean (95%CI) contents of Cu and Zn in blood were 795 (791-799)µg/L and 3 996(3 976-4 015) µg/L, respectively. The characteristics of distribution of Cu content were as followed, the content of males were lower than it of females (male:767 µg/L; female: 822 µg/L, t = -13.302, P < 0.01). The contents of blood Cu in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 860(853-868), 758(748-769), 734(728-734), 782(774-790), 811(795-827) and 820(815-826) µg/L. The differences showed statistical significance (F = 78.77, P < 0.01). The blood Cu content of people in eastern China (800µg/L) were also significantly higher than it in middle (774 µg/L)and western China (782 µg/L) (F = 10.94, P < 0.01). Distribution of blood Zn content showed characteristics as follows: the Zn content was higher in males than in females (male 4 085 µg/L and female 3 908 µg/L, t = 8.78, P < 0.01). The contents of blood Zn in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 3 306 (3 261-3 350), 3 888 (3 839-3 937), 3 948 (3 902-3 994), 4 272(4 228-4 315), 4 231(4 180-4 281) and 4 250 (4 205-4 294)µg/L, which showed significant statistical differences (F = 233.68, P < 0.01). The blood Zn content of people in eastern China (3 938 µg/L) were significantly lower than it in middle (4 237 µg/L)and western China (4 105 µg/L) (F = 53.16, P < 0.01). In addition, the study also compared the relation between content of Cu and Zn and the frequency of eating seafood. The results found that the frequency of eating seafood could influence the content of Cu and Zn (Cu: F = 13.54, P < 0.01; Zn: F = 200.20, P < 0.01).

CONCLUSIONThe contents and distributions of Cu and Zn in blood differs among people from different groups in ages, genders and regions. The baseline data of this study provided reliable scientific evidence for further research.

Adolescent ; Adult ; Child ; China ; epidemiology ; Copper ; blood ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc ; blood

OBJECTIVETo evaluated the levels of arsenic (As) in blood and urine among general population in China and analyze its influencing factors.

METHODSA total of 18 120 subjects from general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland from 2009 to 2010, by cluster random sampling method. Blood samples and urine samples were collected, the information of the life-style was collected by questionnaire.Inductive coupled plasma mass spectrometry was applied to test the As level in the samples, and the distribution of As in blood and urine for different ages, genders, areas and life habits were then analyzed.

RESULTSThe geometric mean (GM) of blood As concentration among general population was 2.33 µg/L;the GM of blood As in male (2.35 µg/L) was higher than and female (2.30 µg/L) (Z = -1.42, P < 0.05); from eastern, central to western China, the blood As level were 2.94, 1.30 and 0.98 µg/L (χ(2) = 643.22, P < 0.05) , respectively; the GM in smokers (2.84 µg/L) was higher than non-smokers (2.27) (Z = -6.28, P < 0.05) ;the seafood consumer had a higher blood As level (2.59 µg/L) than people not consuming seafood (1.47 µg/L) (Z = -23.68, P < 0.05). The urine As level of the whole population was 13.72 µg/L;while its GM in male (14.10 µg/L) was higher than female (13.33 µg/L) (Z = -3.94, P < 0.05); the values from eastern, central to western China were 14.14, 16.02 and 9.57 µg/L (χ(2) = 353.89, P < 0.05), respectively;the level in smokers (16.06 µg/L) was higher than nonsmokers (13.70 µg/L) (Z = -2.63, P < 0.05); the level in seafood consumers (14.82 µg/L) was higher than people not consuming seafood (10.99 µg/L) (Z = -3.20, P < 0.05). The blood As level had a positive correlation with urine As level (correlation coefficient:0.285, P < 0.05).

CONCLUSIONThe As level in blood and urine varied by gender and area among general population in China, and related to life-styles. There was a positive correlation between As level in blood and that in urine.

Adolescent ; Adult ; Arsenic ; blood ; urine ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Male ; Middle Aged ; Sentinel Surveillance ; Young Adult

OBJECTIVETo evaluate the levels of lead (Pb) and cadmium (Cd) in blood and urine among general population in China, and thereby analyze their prevalent features.

METHODSA total of 18 120 subjects from general population aged 6-60 years were recruited from 24 districts in 8 provinces in eastern, central and western China mainland from 2009 to 2010, by cluster random sampling method. The blood samples and urine samples of these people were collected. The questionnaire survey was used to collect the information of the living environment and health conditions.Inductive coupled plasma mass spectrometry was applied to test the Pb and Cd levels in the samples, and the distribution of Pb and Cd in blood and urine for different ages, genders, areas and life habits were then analyzed.

RESULTSAmong the general population in China, the geometric mean (GM) of blood Pb concentration was 34.9 µg/L; the GM of blood Pb in male and female groups were 40.1 and 30.4 µg/L (Z = -28.05, P < 0.05), respectively; the GM from eastern, central and western China were 31.2, 38.8 and 58.9 µg/L (χ(2) = 1 483.33, P < 0.05) , respectively. The GM of urine Pb of the whole population was 1.05 µg/L;while the GM in male and female groups were 1.06 µg/L and 1.05 µg/L (Z = -0.73, P > 0.05) , respectively;the values from eastern, central and western China were 0.76, 2.85 and 3.22 µg/L (χ(2) = 1 982.11, P < 0.05), respectively. The GM of blood Cd concentration among general population was 0.49 µg/L; and the values in male and female group were 0.60 and 0.41 µg/L (Z = -11.79, P < 0.05) , respectively; the GM from eastern, central and western China were 0.45, 0.65 and 0.67 µg/L (χ(2) = 69.87, P < 0.05), respectively; the GM of urine Cd concentration of the whole population was 0.28 µg/L, while the GM in male and female groups were 0.29 and 0.28 µg/L (Z = -3.86, P < 0.05), respectively; the values from eastern, central and western China were 0.29,0.42 and 0.18 µg/L (χ(2) = 402.76, P < 0.05), respectively. the Spearman's rank correlation coefficient for Cd in blood and Cd in urine was 0.22, for Pb in blood and Pb in urine was 0.21. Both the correlations were statistic significant (P < 0.05).

CONCLUSIONThe Pb and Cd levels in blood and urine were relatively higher among general population in China varying by gender and area. There were positive correlations between Pb and Cd levels in blood and those in urine.

Adolescent ; Adult ; Cadmium ; blood ; urine ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Lead ; blood ; urine ; Male ; Middle Aged ; Sentinel Surveillance ; Young Adult