Psychiatrists’occupational stigma conceptualization,measurement,and intervention:A literature review

Psychiatrists require frequent contact with and treatment of patients with mental illnesses.Due to the influence of associative stigma,psychiatrists may also be targets of stigma.Occupational stigma warrants special consideration because it significantly affects psychiatrists'career advancement,well-being,and their patients’health.Given that there is no complete summary of this issue,this study reviewed the existing literature on psychiatrists'occupational stigma to clearly synthesize its concepts,measurement tools,and intervention strategies.Herein,we emphasize that psychiatrists’occupational stigma is a multifaceted concept that simultaneously encompasses physically,socially,and morally tainted aspects.Currently,standardized methods to specifically measure psychiatrists’occupational stigma are lacking.Interventions for psychiatrists’occupational stigma may consider the use of protest,contact,education,comprehensive and systematic methods,as well as the use of psychotherapeutic approaches.This review provides a theoretical basis for the development of relevant measurement tools and intervention practices.Overall,this review seeks to raise public awareness of psychiatrists'occupational stigma,thereby promoting psychiatric professionalism and reducing its stigma.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Epidemiological trends of urinary tract infections,urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019

Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.

Chlorogenic acid alleviates hypoxic-ischemic brain injury in neonatal mice

Recent studies have shown that chlorogenic acid(CGA),which is present in coffee,has protective effects on the nervous system.However,its role in neonatal hypoxic-ischemic brain injury remains unclear.In this study,we established a newborn mouse model of hypoxic-ischemic brain injury using a modified Rice-Vannucci method and performed intraperitoneal injection of CGA.We found that CGA intervention effectively reduced the volume of cerebral infarct,alleviated cerebral edema,restored brain tissue structure after injury,and promoted axon growth in injured brain tissue.Moreover,CGA pretreatment alleviated oxygen-glucose deprivation damage of primary neurons and promoted neuron survival.In addition,changes in ferroptosis-related proteins caused by hypoxic-ischemic brain injury were partially reversed by CGA.Furthermore,CGA intervention upregulated the expression of the key ferroptosis factor glutathione peroxidase 4 and its upstream glutamate/cystine antiporter related factors SLC7A11 and SLC3A2.In summary,our findings reveal that CGA alleviates hypoxic-ischemic brain injury in neonatal mice by reducing ferroptosis,providing new ideas for the treatment of neonatal hypoxic-ischemic brain injury.

Alterations of gut microbiota diversity, composition and metabonomics in testosterone-induced benign prostatic hyperplasia rats

Background: Studies had shown many diseases affect the stability of human microbiota, but how this relates to benign prostatic hyperplasia(BPH) has not been well understood. Hence, this study aimed to investigate the regulation of BPH on gut microbiota composition and metabonomics.Methods: We analyzed gut samples from rats with BPH and healthy control rats, the gut microbiota composition and metabonomics were detected by 16S rDNA sequencing and liquid chromatography tandem mass spectrometry(LC–MS/MS).Results: High-throughput sequencing results showed that gut microbiota beta-diversity increased(P<0.01) in the BPH group vs. control group. Muribaculaceae(P<0.01), Turicibacteraceae(P<0.05), Turicibacter(P<0.01) and Coprococcus(P<0.01) were significantly decreased in the BPH group, whereas that of Mollicutes(P<0.05) and Prevotella(P<0.05)were significantly increased compared with the control group. Despite profound interindividual variability, the levels of several predominant genera were different. In addition, there were no statistically significant differences in several bacteria. BPH group vs. control group: Firmicutes(52.30% vs. 57.29%, P>0.05), Bacteroidetes(46.54% vs. 41.64%,P>0.05), Clostridia(50.89% vs. 54.66%, P>0.05), Ruminococcaceae(25.67% vs. 20.56%, P>0.05). LC–MS/MS of intestinal contents revealed that differential metabolites were mainly involved in cellular processes, environmental information processing, metabolism and organismal systems. The most important pathways were global and overview maps, lipid metabolism, amino acid metabolism, digestive system and endocrine system. Through enrichment analysis, we found that the differential metabolites were significantly enriched in metabolic pathways, steroid hormone biosynthesis,ovarian steroidogenesis, biosynthesis of unsaturated fatty acids and bile secretion. Pearson correlation analysis(R=0.94) showed that there was a strong correlation between Prevotellaceae, Corynebacteriaceae, Turicibacteraceae,Bifidobacteriaceae and differential metabolites.Conclusions: Our findings suggested an association between the gut microbiota and BPH, but the causal relationship between the two groups is unclear. Thus, further studies are warranted to elucidate the potential mechanisms and causal relationships between BPH and gut microbiota.

Haplotype and Genetic Analysis of 41 Y-STR Loci in the Wuwei Han Population from Gansu Province,China

Objective Y-Chromosomal short tandem repeat polymorphism(Y-STR)analysis plays an indispensable role in the identification of male individuals,population genetics,and biogeographic research.While profiles of many populations based on Y-STR markers in human genomes are ample,haplotype data for the Wuwei Han are still scarce.Methods In this study,2180 unrelated Wuwei Han male individuals residing in Gansu Province,China were collected and genotyped using the novel Microreader™40Y Plus ID system.Phylogenetic relationship reconstructions,multidimensional scaling(MDS),and heatmap analysis were performed based on the genetic distance(Rst)values between our studied population and other populations of the Ymax module in the Y-STR Haplotype Reference Database(YHRD).Results A total of 2129 unique haplotypes were obtained,and the haplotype diversity(HD)and discrimination capacity(DC)for the Wuwei Han were 0.9999 and 0.9931,respectively.Conclusion Our results demonstrate that the Wuwei Han population had intimate genetic relationships with East Asians,especially the geographically close Han populations.Overall,this Y-Chromosomal assay gives valuable information about paternal lineages in male individual tracking and genealogical database construction.

医学领域一次研究和二次研究的方法学质量(偏倚风险)评价工具

方法学质量(偏倚风险)评估是医学研究开始前的重要步骤。因此,准确判断研究类型是前提,选择合适的评价工具也很重要。本综述介绍了用于随机对照试验(包括个体和整群)、动物实验、非随机干预性研究(包括随访研究、有对照组的前后对照研究、前后对照研究、非对照纵向研究、间断时间序列研究)、队列研究、病例-对照研究、横断面研究(包括分析和描述性研究)、观察性病例系列和病例报告、比较效果研究、诊断性研究、卫生经济学评价、预测研究(包括预测变量研究、预测模型影响研究、预后预测模型研究)、质性研究、结果测量工具(包括患者-报告的结果测量发展、内容真实性、结构真实性、内部一致性、跨文化真实性/测量不变性、信度、测量误差、校标真实性、结构真实性假设检验、反应度)、系统评价与Meta分析,以及临床实践指南的方法学质量评价工具。通过本综述,读者可以区分医学研究的类型并选择适当的工具。全面掌握相关知识并多加练习是正确评估方法学质量的基本要求。

经尿道前列腺等离子双极电切术与剜除术治疗良性前列腺增生的有效性和安全性的系统评价和Meta分析

目的评估经尿道前列腺等离子双极电切术(TUPKP)与剜除术(TUPEP)治疗良性前列腺增生(BPH)的有效性与安全性。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、维普、中国生物医学文献数据库及万方数据库中相关的随机对照试验,检索至2020年9月15日,同时手动检索参考文献。由两名研究者独立进行文献筛选、资料提取与质量评价。采用Stata 13.0软件进行Meta分析。结果共纳入30项研究,包括3218例BPH患者,其中1626例接受TUPKP,1592例接受TUPEP。Meta分析结果显示:有效性方面治疗普通体积(<80 mL)前列腺时,TUPKP组比TUPEP组切除组织量更少,但术后6、12个月的残余尿量(PVR)更多,术后3、6个月的国际勃起功能指数-5(IIEF-5)更低,差异有统计学意义(P<0.05);术后1、3、6、12个月的国际前列腺症状评分(IPSS)、最大尿流率(Q_(max))、生活质量(QoL)及术后1、3个月的PVR在两组间无统计学差异(P>0.05)。治疗大体积(≥80 mL)前列腺时,相较于TUPEP组,TUPKP组切除组织量更少,但术后6个月的IPSS更高,3个月的Q_(max)更小且PVR更多,差异有统计学意义(P<0.05);术后1、3个月的IPSS,术后1、6个月的Q_(max),术后1、3、6个月的QoL,术后6个月的PVR和IIEF-5在两组间无统计学差异(P>0.05)。安全性方面治疗普通体积前列腺时,相较于TUPEP组,TUPKP组手术时间、住院时间、术后导尿管留置时间、膀胱冲洗时间更长,术中出血量更多,发生包膜穿孔、膀胱痉挛的风险更高,差异有统计学意义(P<0.05);尿道狭窄、暂时性尿失禁、逆行射精、尿潴留、尿路感染的风险在两组间无统计学差异(P>0.05)。治疗大体积前列腺时,与TUPEP组相比,TUPKP组手术时间、住院时间、术后导尿管留置时间、膀胱冲洗时间更长,差异有统计学意义(P<0.05);术中出血量,以及发生包膜穿孔、尿道狭窄、暂时性尿失禁、逆行射精、膀胱痉挛、尿潴留、尿路感染的风险在两组间无统计学差异(P>0.05)。结论对于普通体积和大体积BPH患者,TUPKP和TUPEP的有效性整体相当,但TUPEP在安全性方面优于TUPKP。

1990年与2017年中国8种消化道疾病的疾病负担分析

目的对比分析1990年与2017年中国8种消化道疾病的疾病负担。方法采用2017年全球疾病负担数据,分析我国消化道疾病的发病率、死亡率、伤残调整寿命年、早死损失寿命年、伤残损失寿命年等指标及其变化趋势,分析不同性别和年龄人群的消化道疾病负担特点。结果1990年至2017年,8种消化道疾病的发病例数均增加。2017年标化伤残调整寿命年率排名前3的疾病均为消化道恶性肿瘤,分别为胃癌(391.66/10万)、食管癌(222.58/10万)和结直肠癌(216.19/10万)。在标化死亡率方面,仅有结直肠癌标化死亡率升高8.20%,增长至10.10/10万,其余均降低。随着年龄的增长,疾病负担逐渐增加。与女性相比,男性消化道疾病发病率低,但死亡率和伤残调整寿命年率均较高。结论消化道恶性肿瘤导致的疾病负担占据我国消化道疾病负担的主要地位,男性高于女性,结直肠癌等恶性肿瘤的防治是消化道疾病防控的重点。

Global,regional,and national burden of kidney,bladder,and prostate cancers and their attributable risk factors,1990–2019

Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.

Improving DNA Data Capacity:Forensic Parameters and Genetic Structure Analysis of Jinjiang Han Population with the Microreader^(TM) Y Prime Plus ID System

Objective Population genetic analysis based on genetic markers harbors valuable forensic applications.In this regard,it is informative and imperative to explore Han groups as they are the largest population of China.In particular,there is a largely underrepresented amount of information from recent decades regarding the southeast costal Han Chinese.Therefore,the aim of this study is to investigate the available genetic characteristics of the Han population living in the Jinjiang,Fujian Province,Southeastern China.Methods We sampled 858 saliva samples and used the commercially available Microreader^(TM) Y Prime Plus ID System to identify population data of Y-short tandem repeat(STR)loci of this region.Results A total of 822 different haplotypes were observed.The overall haplotype diversity,discriminatory power and haplotype match probability were 0.9999,0.9999 and 0.0012,respectively.Conclusion Our results showed that the Jinjiang Han population was closely genetically related to Han groups of China.Overall,we identified a set of 37 Y-STRs that are highly polymorphic,and that can provide meaningful information in forensic practice and human genetic research.

Ultrasonic vibration-assisted multi-scale plastic forming of high-entropy alloys in milliseconds

Due to their excellent properties of specific strength,fracture resistance,corrosion and oxidation resistance,the high-entropy alloys have attracted widespread attention as engineering materials.For the sake of industrial applications,one of the essential stages would be the forming of them,especially the construction of multi-sc ale structures from macroscale to nanoscale.

新型冠状病毒肺炎药物预防、诊断、治疗与出院管理临床指南计划书

本计划书为《新型冠状病毒(2019-nCoV)感染的肺炎诊疗快速建议指南(标准版)》更新版的研究方案。计划书涵盖指南制定方法学、指南的目标用户、指南的目标人群、利益冲突调查与声明、临床问题和结局指标的遴选与确定、证据的检索、合成与评价、证据与推荐意见分级标准、推荐意见的形成、指南的更新,并附录指南临床问题清单、文献检索策略及利益冲突调查表。

河南省新型冠状病毒肺炎疫情特点分析

目的分析河南省新型冠状病毒肺炎(NCP)的流行病学特点,为河南省NCP的防控决策提供证据支持。方法收集河南省及省内各地市卫生健康委员会官方疫情信息、省内官方媒体及新媒体报道,整理、汇总省内各地区新型冠状病毒肺炎病例信息,采用描述性统计方法,分析我省新型冠状病毒肺炎疫情发生发展的流行病学特点和病例特点。结果截止至2020年2月7日,河南省累计确诊病例981例,累计密切接触者20928例,累计医学观察者10187例。患者年龄主要集中于19~60岁,约占81.75%;男性患者比例略高于女性(54.09%vs.44.58%);发热为新型冠状病毒肺炎的主要症状,近一半的患者在3天之内得到确诊;56.31%的患者有武汉旅居史,24.23%和8.63%的患者有接触确诊病例史和接触疑似病例史,仅14.93%的患者在发病前接受隔离观察;39.38%的患者在确诊前进行过0~1次的就诊,57.74%的患者居住地位于城区。结论河南省新型冠状病毒肺炎病例大多数为输入性病例,春运期间人员流动是影响疫情发展的主要因素。实施严格的隔离政策可有效控制疫情发展。

A Cohort Analysis of Patients with Stage I Twin-to-Twin Transfusion Syndrome from a Major Referral Hospital in Northern China

Objective:To describe the outcomes of StageⅠtwin-to-twin transfusion syndrome among patients treated with expectant management(EM),amnioreduction(AR),or fetoscopic laser occlusion of chorioangiopagous vessels(FLOC).Methods:A cohort of 89 cases was studied.Based on the initial management strategy,patients were classified into three groups:the EM,AR,and FLOC.We assessed perinatal survival to 28 days of age and categorized pregnancy outcomes as good(twin live birth at≥30.0 weeks),mixed(single fetal demise or delivery between 26.0 and 29.9 weeks),or poor(double fetal demise or delivery at<26.0 weeks).Results:26(29.2%)patients underwent EM,35(39.3%)underwent AR,and 28(31.5%)underwent FLOC therapy.Of those managed expectantly,19.2%experienced spontaneous abortion,50%progressed in stage,and 30.8%remained stable or regressed.After adjusting for potential confounders including maternal age,'null'iparity,placenta location,and recipient maximum vertical pocket,and so on,FLOC therapy and AR were associated with significantly[odds ratio(OR)=0.09]and borderline significantly(OR=0.20)reduced risks of poor pregnancy outcomes and of no survivors to 28 days of age after birth(OR=0.04 and OR=0.20,respectively)compared with EM.Conclusion:About 70%of those treated with EM progressed in stage or experienced fetal loss.Compared to EM,intervention may decrease the risk of poor pregnancy outcomes and improve the perinatal survival rate.