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This study aimed to construct the molecular biomarkers of autophagy and endoplasmic reticulum stress (ERS), as well as their corresponding protein interaction network in Alzheimer’s disease (AD) patients with different levels of physical activity (PA) by bioinformatics methods. The expression profiles of the genes were downloaded from Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) between AD samples with low, moderate and high levels of PA were studied. The autophagy and ERS-related genes (AERSRGs) were extracted from GeneCards and MsigDB databases. The functional enrichment analysis was conducted to determine the function of DEGs. To explore the proteins, miRNAs and transcription factors (TF) interacting with DEGs, the protein–protein network, mRNA-miRNA network and mRNA-TF network were built using Cytoscape software. Then the receiver operating characteristic (ROC) analysis were conducted to verify the diagnostic performance of hub genes. A total of 533 AERSRGs were identified in Group H and 150 AERSRGs were screened in Group M. Functional enrichment analysis suggested genes of AD play vital roles in some biological process (e.g., cell cycle phase transition, mitochondrion organization, proteasomal protein catabolic process). KEGG enrichment analysis suggested that sarcopenia involves the pathways (e.g., GABA, P2Y receptors, serotonin release cycle). A total of 5 hub genes were screened in Group H and 9 were identified in Group M. ROC analysis suggested that several hub genes exhibited a relatively high sensitivity and specificity in both groups of AD. The hub genes screened in this study are closely correlated with autophagy and ERS in AD and can differentiate AD with different levels of PA. SRC, MAPK3 and MAP2K1 exhibit relatively high sensitivity and specificity in diagnosis in Group H; MCM2, CDC42, HNRNPM, ASF1A, NCBP2, SNRNP70 and MCM6 exhibit relatively high sensitivity and specificity in diagnosis in Group M.

Background and objectiveLifestyle modifications aimed at weight loss have been introduced as a cornerstone of nonalcoholic fatty liver disease (NAFLD) management. However, very few patients follow the doctor's prescription to change their lifestyle to achieve weight loss in the real world. The purpose of this study was to use the Health Action Process Approach (HAPA) model to examine the factors that affect adherence to lifestyle prescriptions among patients with NAFLD.MethodsSemi-structured interviews were conducted with patients with NAFLD. Reflexive thematic analysis and framework analysis were used to determine naturally identified themes and allocate them to theoretically driven domains.ResultsThirty adult patients with NAFLD were interviewed, and the identified themes were mapped directly onto the constructs of the HAPA model. This study revealed that key barriers to adhering to lifestyle prescriptions are related to the coping strategy and outcome expectation constructs of the HAPA model. For physical activity, conditional limits, lack of time, symptoms such as fatigue and poor physical fitness, and fear of sports injury are the primary barriers. Barriers to diet are mainly diet environment, mental stress, and food cravings. Key facilitators for adherence to lifestyle prescriptions include developing simple and specific action plans, coping strategies to flexibly deal with obstacles and difficulties, receiving regular feedback from doctors to improve self-efficacy, and using regular tests and behavior recording to enhance action control.ConclusionsFuture lifestyle intervention programs should pay particular attention to the planning, self-efficacy, and action control-related constructors of the HAPA model to promote the adherence of patients with NAFLD to lifestyle prescriptions.

The transmission of SARS-CoV-2 leads to devastating COVID-19 infections around the world, which has affected both human health and the development of industries dependent on social gatherings. Sports events are one of the subgroups facing great challenges. The uncertainty of COVID-19 transmission in large-scale sports events is a great barrier to decision-making with regard to reopening auditoriums. Policymakers and health experts are trying to figure out better policies to balance audience experiences and COVID-19 infection control. In this study, we employed the generalized SEIR model in conjunction with the Wells–Riley model to estimate the effects of vaccination, nucleic acid testing, and face mask wearing on audience infection control during the 2021 Chinese Football Association Super League from 20 April to 5 August. The generalized SEIR modeling showed that if the general population were vaccinated by inactive vaccines at an efficiency of 0.78, the total number of infectious people during this time period would decrease from 43,455 to 6,417. We assumed that the general population had the same odds ratio of entering the sports stadiums and becoming the audience. Their infection probabilities in the stadium were further estimated by the Wells–Riley model. The results showed that if all of the 30,000 seats in the stadium were filled by the audience, 371 audience members would have become infected during the 116 football games in the 2021 season. The independent use of vaccination and nucleic acid testing would have decreased this number to 79 and 118, respectively. The combined use of nucleic acid testing and vaccination or face mask wearing would have decreased this number to 14 and 34, respectively. The combined use of all three strategies could have further decreased this number to 0. According to the modeling results, policymakers can consider the combined use of vaccination, nucleic acid testing, and face mask wearing to protect audiences from infection when holding sports events, which could create a balance between audience experiences and COVID-19 infection control.

The current study aimed to investigate the antiproliferative effect of Resv on the growth of VSMCs and to determine the association between Resv and STAT3 and the mitochondrial biogenesis signaling pathway under high-glucose conditions. Male Wistar rats weighing between 180 and 200 g were killed by cervical vertebra dislocation. Primary VSMCs were obtained by outgrowth methods. Cells from different treatment groups were then collected, and changes in cell proliferation and signaling pathway activity were analyzed by PCR and Western blotting. And the MTT assay was used to investigate the effect of Resv on VSMC proliferation. Resv inhibited proliferation of VSMCs under high-glucose conditions. Resv suppressed the transcriptional activity of STAT3, but the mitochondrial gene GRIM-19, which is responsible for STAT3 activation, was simultaneously upregulated. The mitochondrial biogenesis signaling pathway components NRF1, NRF2, TFB1m, and TFB2m were also upregulated. In addition, the mitochondrial genes NDUFA1, NDUFA2, and NDUFA3 were involved in the function of Resv. The results of the study suggest that Resv has an antiproliferative effect in high-glucose-cultured VSMCs partly through inhibiting STAT3 function and upregulating mitochondrial biogenesis.

Introduction: The prevalence of pediatric obesity remains high all over the world. Various exercise interventions have been applied to decrease the visceral fat in young individuals with obesity. But the evidence remains controversial on the effect of the exercise on visceral fat. Moreover, it is unclear which type of the exercise is the most effective for young individuals with overweight or obesity to reduce visceral fat.Objective: The objective of this review and meta-analysis is to evaluate and compare the effectiveness of different exercise interventions on visceral fat in young individuals with overweight or obesity.Methods: Four databases consisting of PubMed, Web of Science, EBSCO, and Cochrane Library were searched prior to May 2022. Fifteen studies with a total of 30 data points involving 1,134 participants were included in this meta-analysis. And the interventions were limited to 4 exercise types [i.e., aerobic exercise (AE), resistance exercise (RE), aerobic exercise combined with resistance exercise (CE), and high-intensity interval training (HIIT)].Data Synthesis: The results showed that AE (Standardized Mean Difference = −0.32; 95% CI = −0.50 to −0.13; p = 0.0007; I2 = 37%) and HIIT (SMD = −0.59; 95% CI = −0.87 to −0.31; p < 0.0001; I2 = 0%) had a significant reduction effect on visceral fat. And the effect of HIIT seemed better than AE. However, RE (SMD = −0.58; 95% CI = −1.34 to 0.17; p = 0.13; I2 = 76%) and CE (SMD = −0.21; 95% CI = −0.81 to 0.38; p = 0.48; I2 = 63%) had a non-significant effect on visceral fat decline. Additionally, compared with the control group, exercise interventions had a significant effect on reducing visceral fat in adolescents (SMD = −0.54; 95% CI = −0.82 to −0.26; p = 0.0001; I2 = 64%) and young adults (SMD = −0.42; 95% CI = −0.69 to −0.15; p = 0.003; I2 = 0%) rather than children (SMD = −0.15; 95% CI = −0.32 to 0.02; p = 0.08; I2 = 0%). And the gender-based subgroup analysis indicated that the effectiveness of the exercise on the reduction of visceral fat was more significant in males (SMD = −1.27; 95% CI = −1.67 to −0.87; p < 0.00001; I2 = 0%) than that in females (SMD = −0.31; 95% CI = −0.48 to −0.14; p = 0.0004; I2 = 0%).Conclusion: This review and meta-analysis demonstrates that exercise interventions are efficient to decrease visceral fat in adolescents (12–18 years old) and young adults (18–24 years old). Among different exercise types, AE and HIIT are helpful for young individuals with overweight or obesity to reduce visceral fat and HIIT appears to be the most effective exercise intervention. In addition, the effect of exercise interventions on the consumption of visceral fat is more significant in males than that in females.Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022310878].

The present study reports on the effects of a self-regulated (SRL) writing strategy-based intervention supported with e-learning tools on SRL strategy use in English writing with 468 Hong Kong prim...

Some studies show that athlete students are more likely to engage in health-risk behaviors with negative health consequences, while others suggest that they lead a healthier life than their non-athlete peers. Given these inconsistent results, this study aims to compare health behaviors, depression, and perceived health status between athlete and non-athlete students, and explore the associations between health behaviors and health outcomes. An online questionnaire survey including Heath Habits Scale for five health-risk behaviors and five health-promoting behaviors, Patient Health Questionnaire-9 (PHQ-9), and 5-point scale for perceived health status was conducted in Beijing Sports University in March 2021. Data from 372 athlete students and 252 non-athlete students aging from 18 to 22 were included in this study. Chi-squared tests and t-tests were used to determine differences between athlete and non-athlete samples, and logistic regression analyses were conducted to examine the associations of health behaviors with depression and perceived health status. The significance level was p

Hepatocellular carcinoma (HCC) is a leading malignancy of the digestive system, especially in China. Although radiotherapy, chemotherapy, and transarterial chemoembolization have achieved tremendous success, surgical resection remains the primary treatment for HCC patients. Recent studies have shown that intravenous anesthetic drugs may affect the malignant behaviors of tumor cells, ultimately leading to differences in the postoperative prognosis of patients. Etomidate is one of the most widely used intravenous anesthetic drugs for the induction and maintenance of anesthesia in tumor patients undergoing surgery. However, the effects and underlying mechanisms of etomidate on HCC cells have not yet been characterized. Our study indicated that etomidate significantly impedes the malignant progression of HCC cells. Mechanistically, etomidate inhibits phosphorylation and, ultimately, the activity of Janus kinase 2 (JAK2) by competing with ATP for binding to the ATP-binding pocket of JAK2. Thus, it suppresses the JAK2/STAT3 signaling pathway in HCC cells to exert its anti-tumor efficacy. Herein, we provide preclinical evidence that etomidate is the optimal choice for surgical treatment of HCC patients.

The effects of diethyl aminoethyl hexanoate (DA-6) with different concentrations on the growth and selenium (Se) uptake of grape seedlings were studied by a pot experiment. When the concentration of DA-6 was not higher than 20 mg/L, the biomass, photosynthetic pigment content, antioxidant enzyme activity, and Se content of grape seedlings had the increase trend. Then it decreased when the concentration of DA-6 was higher than 20 mg/L. At the concentration of 20 mg/L DA-6, the level of biomass, photosynthetic pigment content, antioxidant enzyme activity, and Se content of grape seedlings got the maximum. Compared to the control, the concentration of 20 mg/L DA-6 increased the root and shoot biomass by 37.46% and 27.55%, respectively, and increased the Se contents in roots and shoots by 51.45% and 111.41%, respectively. The net photosynthetic rate, transpiration rate, stomatal conductance, and CO2 concentration of intercellular of grape seedlings had the same changing trend as that of the biomass with the increase in DA-6 concentrations, while the vapor pressure deficit of leaf had the opposite trend. Therefore, at 20 mg/L DA-6 concentrations, it was found to promote the growth and improve the Se uptake of grape.

To investigate the job satisfaction among psychiatric nurses in China and to explore its associated factors.A cross-sectional survey among a nationwide sample from 32 tertiary psychiatric hospitals in 29 provincial capitals in China.Nurses (N = 9.907) were targeted for this survey in December 2017. In all, 8,493 responded (response rate = 85.7%) and 7,881 (79.5%) were included in the analysis. An online questionnaire was used to collect demographics and factors related to the work environment. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Multilevel regression was used to examine the association between job satisfaction and these factors.The mean job satisfaction score was 73.7. The multiple regression analysis indicated that self-rated health, monthly income, medical liability insurance coverage, perceived respect from patients, social recognition, nurse-physician collaboration, and trust were significantly associated with higher job satisfaction scores, while age, work hours, and directly experiencing patient-initiated violence were negatively associated with job satisfaction (p .05).Overall, Chinese psychiatric nurses are closer to satisfied than neutral and some demographics and factors related to stressful work environments were associated with nurses' job satisfaction scores.This study examined factors associated with the job satisfaction of Chinese psychiatric nurses in a nationwide sample and indicated that to improve nurses' job satisfaction, the government and hospital administrators could consider ways to promote nurses' personal health and to modify the stressful work environments, such as improving income, reducing work hours, promoting the psychiatric nursing specialty in ways that increase the public's respect for it, increasing awareness of medical liability insurance coverage, and protecting nurses from patients' violence.目的: 调查我国精神科护士的工作满意度,并探究其相关因素。 设计: 对全国19个省会城市32所三级精神病院进行横断面调查。 方法: 本次调查在2017年12月进行,护士(N = 9.907)为本次调查对象。在所有调查对象中,有8493名护士回复(回复率= 85.7%),其中7881 人(79.5%)被纳入了分析。我们使用了在线问卷手机人口统计数据以及与工作环境相关的因素。我们采用了明尼苏达州满意度调查问卷的简要版本以评估工作满意度,并使用了多水平回归以检验工作满意度与这些因素之间的关联。 结果: 平均工作满意度为73.7分。多元回归分析法表明自我评估的健康水平、每月收入、医疗责任保险范围、感知到的患者的尊重、社会认可、医护合作和信任度与更高的工作满意度分数显著相关,而年龄、工作时长以及直接经历患者暴力则与工作满意度呈负相关(p.05)。 结论: 总的来说,中国精神科护士的工作满意度中等偏上,与紧张的工作环境相关的因素以及人口统计数据与护士的工作满意度相关。 影响: 本研究在全国范围内调查了与中国精神科护士工作满意度相关的因素,本研究表明,为了提高护士的工作满意度,政府和医院管理者可以考虑采取措施改善护士个人健康并改变紧张的工作环境,例如提高收入,减少工作时间,提升公众对精神科护理专业的尊重,提高医疗责任保险覆盖意识,并保护护士免受患者伤害。.

Background The retention of psychiatric nurses is an important concern for healthcare administrators in China. However, Chinese psychiatric nurses’ intention to leave their jobs and the factors associated with it have been scarcely studied. Objective To investigate Chinese psychiatric nurses’ intention to leave their jobs, and to explore the associations between the intention to leave and individual characteristics, job-related factors and job satisfaction. Design A cross-sectional, anonymous survey of a nationwide sample was conducted. Settings Thirty-two tertiary psychiatric hospitals in 29 provincial capital cities in China. Participants All 9907 nurses in 32 hospitals were targeted for this survey conducted in December 2017; 8493 responded (response rate = 85.7%), and 7933 (without logic errors in the data) were included in the analysis. Methods A questionnaire was used to investigate the respondent’s intention to leave their job and to collect data on related factors, including individual characteristics (gender, age, marital status, educational background and self-rated health), job-related factors (professional title, working years, income, work hours, history of patient-initiated violence, perceived respect from patients, social recognition as well as physician-nurse coordination and trust) and job satisfaction. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Chi-square tests and multilevel logistic regression analysis were used to examine associations between an intention to leave and other factors. Results Among 7933 respondents, 20.2% reported an intention to leave their current jobs. The multiple regression analysis showed that better self-rated health (i.e. OR = 0.373, 95%CI = 0.308-0.452 for good health, reference: poor health), working more than 20 years (OR = 0.479, 95%CI = 0.389-0.590, reference: 20 years or less), higher monthly income (i.e. OR = 0.521, 95%CI = 0.399-0.680 for 6001–8000 RMBs, reference: 4500 RMB or less), perceived patient respect (OR = 0.727, 95%CI = 0.623-0.849), physician-nurse coordination (OR = 0.549, 95%CI = 0.480-0.629) and being satisfied with one’s job (OR = 0.373, 95%CI = 0.308-0.452) were negatively associated with an intention to leave; while those who were male (OR = 1.879, 95%CI = 1.605–2.199), working more than 40 hours per week (OR = 1.584, 95%CI = 1.374–1.825) and experienced patient-initiated violence in the past 12 months (OR = 1.566, 95%CI = 1.376–1.781) had a higher odds of reporting an intention to leave. Conclusions Self-rated health, monthly income, work hours, patient-initiated violence, perceived patient respect, physician-nurse coordination and job satisfaction are significant factors associated with a nurse’s intention to quit their job. In order to retain nurses in Chinese tertiary psychiatric hospitals, the government and hospital administrators should consider ways to address these factors.

The mutual grafting affecting the physiological characteristics and selenium (Se) absorption capacity in offspring of Solanum photeinocarpum from the farmland and mining ecosystems were studied by the pot experiments. The mutual grafting significantly increased the dry biomass, antioxidant enzyme activity, and soluble protein content in offspring of S. photeinocarpum from the farmland ecosystem, while the activities of superoxide dismutase and catalase in offspring of S. photeinocarpum from the mining ecosystem were inhibited than the ungrafted S. photeinocarpum. It was observed that the photosynthetic pigment level of S. photeinocarpum offspring from the farmland ecosystem was lower than the ungrafted S. photeinocarpum to varying degrees. Besides, mutual grafting not only increased the Se concentration of S. photeinocarpum offspring, but also significantly promoted the amount of extracted Se by S. photeinocarpum offspring. The shoots Se extraction and dry biomass of S. photeinocarpum offspring with combination of S. photeinocarpum from the mining ecosystem / S. photeinocarpum from the farmland ecosystem reached the maximum level, thereby promoting the growth and Se accumulation capacity of S. photeinocarpum offspring than another grafting combination.

Additional file 1.

Additional File 1. Results of supplementary analyses and the list of comorbidities included in the Elixhauser Comorbidity Index (ECI). Supplementary Table 1 listed the comorbidities of ECI. Supplementary Table 2–4 showed the results of the supplementary descriptive and univariate analyses. Supplementary Table 5–7 presented the results of the sensitivity analyses. Supplementary Table 8–9 showed the results for post-regression diagnostics and calibration plots of the primary and sensitivity analyses models.

Background Comorbidities are common among patients with schizophrenia yet the prevalence of comorbidity combinations and their associations with inpatient service utilization and readmission have been scarcely explored. Methods Data were extracted from discharge summaries of patients whose primary diagnosis was schizophrenia spectrum disorders (ICD-10: F20-F29). We identified 30 most frequent comorbidities in patients’ secondary diagnoses and then used the association rule mining (ARM) method to derive comorbidity combinations associated with length of stay (LOS), daily expense and one-year readmission. Results The study included data from 8252 patients. The top five most common comorbidities were extrapyramidal syndrome (EPS, 44.58%), constipation (31.63%), common cold (21.80%), hyperlipidemia (20.99%) and tachycardia (19.13%). Most comorbidity combinations identified by ARM were significantly associated with longer LOS (≥70 days), few were associated with higher daily expenses, and fewer with readmission. The 3-way combination of common cold, hyperlipidemia and fatty liver had the strongest association with longer LOS (adjusted OR (aOR): 3.38, 95% CI: 2.12-5.38). The combination of EPS and mild cognitive disorder was associated with higher daily expense (≥700 RMB) (aOR: 1.67, 95% CI: 1.20-2.31). The combination of constipation, tachycardia and fatty liver were associated with higher 1-year readmission (aOR: 2.05, 95% CI: 1.03-4.09). Conclusion EPS, constipation, and tachycardia were among the most commonly reported comorbidities in schizophrenia patients in Beijing, China. Specific groups of comorbidities may contribute to higher inpatient psychiatric service utilization and readmission. The mechanism behind the associations and potential interventions to optimize service use warrant further investigation.

Background and Purpose Exaggerated hypotension following administration of propofol is strongly predicted in patients with hypertension. Increased PKCs play a crucial role in regulating vascular tone. We studied whether propofol induces vasodilation by inhibiting increased PKC activity in spontaneously hypertensive rats (SHRs) and, if so, whether contractile Ca2+ sensitization pathways and filamentous–globular (F/G) actin dynamics were involved. Experimental Approach Rings of thoracic aorta, denuded of endothelium, from normotensive Wistar-Kyoto (WKY) rats and SHR were prepared for functional studies. Expression and activity of PKCs in vascular smooth muscle (VSM) cells were determined by Western blot analysis and elisa respectively. Phosphorylation of the key proteins in PKC Ca2+ sensitization pathways was also examined. Actin polymerization was evaluated by differential centrifugation to probe G- and F-actin content. Key Results Basal expression and activity of PKCβ2 and PKCθ were increased in aortic VSMs of SHR, compared with those from WKY rats. Vasorelaxation of SHR aortas by propofol was markedly attenuated by LY333531 (a specific PKCβ inhibitor) or the PKCθ pseudo-substrate inhibitor. Furthermore, noradrenaline-enhanced phosphorylation, and the translocation of PKCβ2 and PKCθ, was inhibited by propofol, with decreased actin polymerization and PKCβ2-mediated Ca2+ sensitization pathway in SHR aortas. Conclusion and Implications Propofol suppressed increased PKCβ2 and PKCθ activity, which was partly responsible for exaggerated vasodilation in SHR. This suppression results in inhibition of actin polymerization, as well as that of the PKCβ2- but not PKCθ-mediated, Ca2+ sensitization pathway. These data provide a novel explanation for the unwanted side effects of propofol.

Aims To identify and group hospitalization trajectory of alcohol use disorder (AUD) patients and its associations with service utilization, healthcare quality and hospital-level variations. Methods Inpatients with AUD as the primary diagnosis from 2012 to 2014 in Beijing, China, were identified. Their discharge medical records were extracted and analyzed using the sequence analysis and the cluster analysis. Results Eight-hundred thirty-one patients were included, and their hospitalization patterns were grouped into four clusters: short stay (n = 565 (67.99%)), mean psychiatric length of stay in 3 years: (32.25 ± 18.69), repeated short stay (n = 211 (25.39%), 137.76 ± 88.8 days), repeated long stay (n = 41 (4.93%), 405.44 ± 146.54 days), permanent stay (n = 14 (1.68%), 818.14 ± 225.22 days). The latter two clusters (6.61% patients) used 37.26% of the total psychiatric hospital days and 33.65% of the total psychiatric hospitalization expenses. All the patients in the permanent stay cluster and 41.77% of the patients in the short stay cluster were readmitted at least once within 3 years. Two-hundred thirty-four patients (28.16%) were admitted at least once for non-psychiatric reasons, primarily for diseases of circulatory and digestive systems. Cluster composition varied significantly among different hospitals. Conclusion Hospitalization pattern of patients with AUD varies greatly, and while most (>2/3) hospitalizations were short stay, those with repeated long stay and permanent stay used more than one third of the hospital days and expenses. Our findings suggest interventions targeting at certain patients may be more effective in reducing resource utilization.

Background Psychiatric readmissions negatively impact patients and their families while increasing healthcare costs. This study aimed at investigating factors associated with psychiatric readmissions within 30 days and 1 year of the index admissions and exploring the possibilities of monitoring and improving psychiatric care quality in China. Methods Data on index admission, subsequent admission(s), clinical and hospital-related factors were extracted in the inpatient medical record database covering 10 secondary and tertiary psychiatric hospitals in Beijing, China. Logistic regressions were used to examine the associations between 30-day and 1-year readmissions plus frequent readmissions (≥3 times/year), and clinical variables as well as hospital characteristics. Results The 30-day and 1-year psychiatric readmission rates were 16.69% (1289/7724) and 33.79% (2492/7374) respectively. 746/2492 patients (29.34%) were readmitted 3 times or more within a year (frequent readmissions). Factors significantly associated with the risk of both 30-day and 1-year readmission were residing in an urban area, having medical comorbidities, previous psychiatric admission(s), length of stay > 60 days in the index admission and being treated in tertiary hospitals (p Conclusion More than 30% of the psychiatric inpatients were readmitted within 1 year. Urban residents, those with medical comorbidities and previous psychiatric admission(s) or a longer length of stay were more likely to be readmitted, and men are more likely to be frequently readmitted. ECT treatment may reduce the likelihood of 30-day readmission and frequent admissions. Targeted interventions should be designed and piloted to effectively monitor and reduce psychiatric readmissions.

A pot experiment was conducted to study the effects of intercropping with Youngia erythrocarpa, Conyza canadens and Mazus japonicus on physiological and biochemical characteristics of hyperaccumulator Galinsoga parviflora under cadmium (Cd) stress. The results showed that intercropping with Y. erythrocarpa (GIY), C. canadens (GIC) and M. japonicus (GIM) all increased the superoxide dismutase (SOD), peroxidase (POD), peroxidase (CAT) activity and the soluble protein content of G. parviflora compared with monoculture (MG), the photosynthetic pigment (chlorophyll a, chlorophyll b, total chlorophyll, carotenoid) content and chlorophyll a/b of G. parviflora increased after intercropping, too. Among all treatments, GIC had the highest antioxidant enzyme activity, soluble protein content and photosynthetic pigment content. As for photosynthetic characteristics, GIC had the highest net photosynthetic rate (Pn), followed by GIY, GIM and MG. Compared with MG, the stomatal conductance (Gs) and transpiration rate (Tr) of GIC and GIM all increased significantly while that of GIC had no significant change, moreover, GIC had significantly lower CO2 concentration of intercellular (Ci) than other treatments, there was no significant difference in value of pressure deficit leaf (Vpdl) among all treatments. Therefore, under Cd stress, intercropping with C. canadens can improve the antioxidant enzyme activity and photosynthetic capacity of G. parviflora to the greatest extent, which was conducive to its remediation of Cd contaminated soil.

As materials for the study, peach seedlings were sprayed with various concentrations (0, 1, 2, 4 and 6 g/L) of chitosan for the sake of the uptake of total iron, manganese and boron content and a more particular knowledge of the growth of the seedlings. The results in experiment showed that the total manganese content accumulated more in peach seedlings compared with other two elements. The total manganese and boron content in roots and leaves of chitosan-treated seedlings could increase in general. In the wake of the chitosan concentration increased, the total iron content in roots and leaves of seedlings gradually decreased but increased in stems. When it comes to the absorption of nutrients by peach seedlings, there were existing synergism and antagonism in this experiment among iron, manganese and boron, which were good for the growth of peach seedlings.

Objective: Involuntary admission is one of the most controversial issues in psychiatry in China. This study aimed to examine the implementation of the new risk criteria for involuntary admission, as defined by the new Mental Health Law (MHL), in major psychiatric hospitals; and to explore factors associated with the implementation. Method: We selected 32 psychiatric hospitals in 29 provincial capital cities in mainland China. We included all involuntarily admitted psychiatric inpatients who were discharged from December 25 to 27, 2017. Patients' demographic and clinical data and reasons for admission were retrieved. Hospitals' information was also collected. Multilevel logistic regression was applied to explore factors associated with the implementation. Results: We collected valid data from 814 inpatients. Rates of risk criteria implementation ranged from 7.9 to 88.5% in these hospitals. Only 369 inpatients (45.3%) met the MHL-defined risk criteria. Overall, between 62.2 and 78.5% of the variance in risk criteria implementation was at the patient level, and between 21.5 and 37.8% of the variance was at the hospital level. Patients with higher Global Assessment of Functioning (GAF) scores at admission were less likely to meet the risk criteria (OR 1.02, 95% CI 1.01–1.03). No statistically significant association was found between risk criteria implementation and other patient level or hospital level factors. Conclusion: Our findings show the implementation rate of the MHL's risk criteria overall was low, with only 45.3% of involuntary admissions meeting the MHL-defined criteria. This suggests that some patients' civil rights might have been violated.

Objectives To develop a medical record-based, comprehensive system of healthcare quality indicators for psychiatric hospitals in China. Design A modified Delphi process with analytic hierarchy process (AHP) was used. Participants Twenty nationally-recognized experts were invited to participate in two rounds of Delphi expert consultation and AHP. Methods Fifty potential indicators were included based on literature review, and 20 experts were asked to rate the importance of each indicator using two rounds of email surveys. The AHP was used to determine the relative importance of the finalized quality indicators. Results The average authoritative coefficient was 0.92 ± 0.07. After two rounds of Delphi consultation, 47 healthcare quality indicators were identified for Chinese psychiatric hospitals. The mean importance ratings ranged from 7.06 to 8.84 on a nine-point scale, with variation coefficients ranging from 0.04 to 0.22. The percentage of full score for potential indicators ranged from 16% to 74%. In two rounds, the Kendall's W coefficients ranged from 0.423 to 0.535. The weights of structure, process and outcome were 0.175, 0.211 and 0.614, respectively. Conclusion We developed the first set of healthcare quality indicators for psychiatric hospitals in mainland China, and it will provide a standardized and meaningful guide to evaluate the healthcare quality of psychiatric hospitals across the country.

Background China's Mental Health Law was implemented in 2013 to provide a legal foundation to protect patients' rights and provide involuntary treatment for patients at high risk of suicide or self-injury, or of harming others, or both. However, the law has not been thoroughly examined since its implementation. This study aimed to examine compliance of major psychiatric hospitals in China with the criteria of involuntary admission defined in the Mental Health Law. Methods As part of a national survey, we collected data from discharged inpatients from 32 tertiary psychiatric hospitals across all 31 provinces of China. We manually retrieved patients' admission information from discharge medical records, and calculated the proportion of the patients who met the criteria of involuntary admission. Findings We included data from 1663 (93%) of 1780 discharged inpatients from all hospitals. 814 (49%) of 1663 patients were admitted to hospital involuntarily. 369 (45%) of these 814 patients were admitted because of risks of suicide or self-injury, or of harming others, or both, as defined in the Mental Health Law. Among the 369 patients, 85 (23%) had risk of suicide or self-injury, 310 (84%) had risk of harming others, and 26 (7%) had both. The rest of the patients who were admitted involuntarily, although needing treatment, did not meet the Mental Health Law-defined criteria for involuntary admission. Interpretation The number of involuntary admissions in major psychiatric hospitals in China is high. Fewer than half of the patients who were admitted involuntarily met the criteria for involuntary admission, as defined by the Mental Health Law. Psychiatric hospitals and clinicians need to be mindful of balancing the safety of patients or others and avoiding the unnecessary restriction of patients' freedom. Funding Beijing Medical and Health Foundation.

Medical staff in China&rsquo, s tertiary public hospitals are responsible for providing healthcare to a considerable number of patients, and their job satisfaction needs attention. The aim of this study is to investigate the job satisfaction of medical staff in tertiary public hospitals and to explore its associated factors. Based on a national survey conducted in 2016, this study included 43,645 physicians and nurses nested in 136 tertiary public hospitals in 31 provinces of China. Multi-level logistic regression was used to examine job satisfaction and its association with individual characteristics and job-related factors. Results showed that 48.22% respondents were satisfied with their job, and they were least satisfied with their compensation. Individual characteristics including occupation, gender, education background, alcohol drinking and self-reported health status, as well as job-related factors regarding professional title, work years, income, workload, doctor-patient relationship and practice setting were found to be significantly associated with job satisfaction. Given that some of these factors may be amenable to interventions, we suggest that government and hospital administrators could take some measures to promote continuing education, improve personal health, balance workload and compensation for medical staff, in order to improve the job satisfaction of medical staff in tertiary public hospitals.

Protein kinase C (PKC) isoforms improve endothelial nitric oxide synthase activity and contractile Ca sensitivity in blood vessels. These actions may have opposite effects on propofol-induced vasodilation. This study examines the hypothesis that propofol induces relaxation by enhancing the PKC-mediated nitric oxide synthesis in endothelium and/or inhibiting the PKC-regulated Ca sensitivity in vascular smooth muscle (VSM). Propofol (1-100 μM) induced greater relaxation in endothelium-intact rings compared with denuded rings, and this effect was antagonized by the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME). In contrast, treatment with the general PKC inhibitor GF-109203X augmented both the endothelium-dependent and endothelium-independent relaxation induced by propofol, and this enhancement was more profound in the intact rings at lower propofol concentrations. The enhancement was unaffected by L-NAME. Interestingly, calphostin C (an inhibitor of conventional and novel PKCs) and Gö-6976 (an inhibitor of conventional PKCs) had similar effects in augmenting propofol-induced relaxation in endothelium-denuded rings. Downregulation of novel isoforms not only reduced the norepinephrine-elicited contraction but also decreased the magnitude of propofol-induced relaxation. In vascular smooth muscle cells, propofol prevented norepinephrine-elicited phosphorylation of myosin light chain. Propofol can increase the PKC-mediated availability of nitric oxide but inhibit the novel PKC-regulated Ca-sensitization, which provides a novel explanation for the mechanism of propofol-induced vasodilation.

Background Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM. Design and Settings A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing. Methods 412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed. Results Patients with type D personality were significantly more likely to have poor medication adherence (p