Objective
To investigate job satisfaction and influencing factors of medical staff in China.
Methods
From December 2017 to January 2018, based on the third round third-party evaluation of the Healthcare Improvement Initiative, data on job satisfaction of medical staff at 136 tertiary public hospitals in 31 provinces of China were collected.Chi-square test and binary multivariate logistic regression were used to analyze the influencing factors of job satisfaction.
Results
The job satisfaction of medical staff at 136 sample hospitals was relatively low.34.6% of the doctors were satisfied with their job, while the corresponding rate in the nurses was 48.7%.Multi-factor analysis showed that income level, workload, doctor-patient relationship, hospital′s compensation policy, and promotion policy were all significant factors influencing medical staff′s job satisfaction(workload OR 1, P<0.05).
Conclusions
Improvement of the medical staff′s job satisfaction depends on optimizing their income distribution policy, increasing their income, improving the promotion policy of professional titles, reducing their workload rationally and building a harmonious relationship between doctors and patients.
Key words:
Health manpower; Medical staff; Job satisfaction; Influencing factors; Third-party evaluation
Objective To determine contact allergens and their clinical significance in patients with dermatitis or eczema in Wuxi city.Methods Patch test was conducted in 1065 patients with a clinical diagnosis of dermatitis or eczema.A statistical analysis was carried out.Results Positive patch test reactions were observed in 83.19％ of the patients,with no statistical differences in the frequency of positive patch test reactions between female and male patients or between patients of different age groups.The most frequent 6 allergens were potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix in these patients.Female patients showed a higher frequency of positive patch test reaction to nickle sulfate and formaldehyde,but a lower frequency to potassium dichromate and carba mix compared with male patients (all P＜ 0.01 ); young,middle-aged,and old patients exhibited an increased frequency of positive reaction to cobaly chloride compared with child patients,while young and middle-aged patients showed a decreased frequency to nickel sulfate compared with child patients (all P ＜ 0.05).Conclusion Potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix are the main allergens causing dermatitis and eczema in Wuxi city.
Abstract Background Actinic keratosis (AK) is a precancerous disease, caused by ultraviolet radiation (UV). Objective To analyze the clinical and pathological characteristics of AK in four areas with different ultraviolet radiation intensities. Methods 1188 diagnosed AK patients, from January 2000 to July 2015, in dermatology department of four hospitals were collected. The UV intensity of hospital located cities from high to low is Kunming, Yinchuan, Shenyang and Nanjing. The information comes from medical records, and the pathological types and Keratinocyte Intraepithelial Neoplasia (KIN) grades were checked by two experienced pathologists. All information was conducted a retrospective multicenter research. Results The patients were mainly middle‐aged and elderly female, which was in direct contrast to the majority of men in European. The age of onset in Kunming group was lower than that in Yinchuan Group ( p = 0.013) and Nanjing Group ( p < 0.01). The course of disease in Kunming group was significantly shorter than that in Nanjing Group ( p < 0.001). The lesions were almost located in the exposed area. The proportion of unexposed areas in Shenyang group was significantly higher than that in other groups ( p < 0.001). There were statistical differences in pathological morphological classification among the four groups. These differences were not affected by age and gender. The number of KIN III grade patients in Shenyang group was significantly higher than that in other three groups ( p < 0.05). Conclusion The Asian patients were mainly female. The clinical characteristics of AK are closely related to UV intensity, and environmental pollution, lifestyle, religious beliefs and other factors are also related.
The aim of the present study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) on the expression of the autophagy-associated proteins, microtubule-associated protein light chain 3 (LC-3) and autophagy-related gene Beclin-1 (Beclin-1), in alveolar macrophages (AMs) in a rat model of silicosis. Furthermore, the study investigated the molecular mechanisms underlying the effects of BMSC treatment. A population of 60 adult female Sprague-Dawley (SD) rats were allocated at random into three groups, namely the control, model and BMSC treatment groups (n=20 per group). BMSCs were isolated from five male SD rats (age, 6-8 weeks) and cultured in vitro. The silicosis model was established using a single 1.0-ml infusion of silicon dioxide suspension administered via non-exposed tracheal intubation. Rats in the BMSC treatment group received a 1.0-ml transplantation of BMSCs (1×106/ml). The rats were sacrificed on days 1, 7, 14 and 28 after modeling, and AMs were extracted from the rats using bronchoalveolar lavage. Third-generation BMSCs were identified using flow cytometry with fluorescein isothiocyanate staining, and the morphological characteristics of the AMs were observed using hematoxylin and eosin staining. The expression levels of LC-3 and Beclin-1 were determined using immunocytochemistry sand western blot analysis. The expression levels of LC-3 and Beclin-1 were found to be increased at all the time points in the model group. LC-3 and Beclin-1 levels began to increase at day 1, peaked at day 14 and decreased after day 28; however, the levels remained elevated compared with the basal expression levels. The AMs of the BMSC treatment group exhibited significantly alleviated pathological symptoms compared with the model group AMs, as indicated by significantly decreased expression levels of LC-3 and Beclin-1 at each time point. Therefore, the results indicated that autophagy was promoted in the AMs of the silicosis model rats. Furthermore, treatment with BMSCs was demonstrated to reduce the expression levels of LC-3 and Beclin-1, subsequently inhibiting autophagic activity and mitigating the damage associated with silicosis.
After the implementation of national essential drugs in China, the management of the pharmaceutical supply chain faces a dilemma. The effects of national essential drug system on pharmaceutical manufacturers, distributors, hospitals and consumers were stated in this paper. In addition, the obstacles of the supply chain of national essential medicine were analyzed. Finally, the proposals for the supply chain of Chinese essential medicine were given. The essential medicines supply system should be diversified. State-owned large pharmaceutical companies and private enterprises are responsible to reduce prices in the medicine supplying market. The medium and small pharmaceutical companies should give up some common brands, but concentrate on the production of specialty products. The distribution industry should also be public-private partnerships, to comply with competition rules. The reform in public hospital should accelerate the pace from personnel system, medical service prices, the establishment of compensation mechanism of zero circulating interest. National sectors related with the pharmaceutical circulation should balance the interests of pharmaceutical supply chain, only by which could from the source to ensure the smooth advance of essential medicines policy.
Objective: To investigate the current status of the occupational hazards of welding fume, manganese, and manganese compounds in the welding environment of a large container manufacturing enterprise, as well as the status of occupational health examination of workers, and to provide a basis for improving the welding environment of this enterprise. Methods: In August 2016, July 2017, and August 2018, convenience sampling was used to perform an on-site occupational hygiene survey of the welding workshop for three consecutive years, and welding fume, manganese and, manganese compounds (counted as manganese dioxide) were measured for their workplace exposure concentrations and exposure levels in workers. A comprehensive analysis was performed for the results of occupational health examination. Results: Welding fume, manganese, and manganese compounds in the welding environment gradually increased from 2016 to 2018 (χ(2)(trend)=5.14 and 5.54, P<0.05). The maximum over-standard rate of concentration-short term exposure limit was 43.3% (13/30) for welding fume and 40.0% (12/30) for manganese and its compounds, and the maximum over-standard rate of time-weighted average concentration was 26.7% (8/30) for welding fume and 23.3% (7/30) for manganese and its compounds. Abnormalities were observed in the occupational health examination of welding workers in 2016-2018, among which respiratory system abnormalities (cough, expectoration, and wheezing), nervous system abnormalities (dizziness, fatigue, sleep disorders, amnesia, hyperhidrosis, and palpitations), and electrocardiogram abnormalities (bundle conduction block) had an incidence rate of above 10.0%, and the incidence rate of abnormalities on posterior-anterior X-ray high-kV chest radiograph was close to 8.9% (30/336) . Conclusion: There is severe exposure to welding fume, manganese, and manganese compounds among workers in this enterprise, which cause great hazards to the health of workers. It is necessary to strengthen occupational health management, take measures to improve the welding environment, and enhance occupational disease prevention.目的： 了解某大型集装箱制造企业焊接作业环境中电焊烟尘、锰及其化合物职业危害现状和作业工人职业健康检查情况，为改善企业焊接作业环境提供依据。 方法： 采用方便抽样方法，分别于2016年8月、2017年7月和2018年8月对某大型集装箱制造企业焊装车间进行现场职业卫生学调查，对电焊烟尘、锰及其化合物（以二氧化锰计）进行连续3年工作场所接触浓度及作业人员接触水平检测，并对焊接作业人员连续3年职业健康检查结果进行综合分析。 结果： 该企业2016至2018年焊接作业环境中电焊烟尘、锰及其化合物浓度呈逐年上升趋势（χ(2)(趋势)=5.14、3.54，P<0.05），电焊烟尘、锰及其化合物短时间接触浓度（C(STEL)）最大超标率分别为43.3%（13/30）和40.0%（12/30）；电焊烟尘、锰及其化合物个体接触时间加权平均浓度（C(TWA)）最大超标率分别为26.7%（8/30）和23.3%（7/30）。该企业2016至2018年焊接作业人员职业健康检查结果中呼吸系统（咳嗽、咳痰、喘息）、神经系统（头晕、易疲乏、睡眠障碍、健忘、多汗、心悸）、心电图（束枝传导阻滞）异常发生率均高于10.0%，后前位X射线高千伏胸片异常发生率为8.9%（30/336）。 结论： 该企业电焊烟尘和锰及其化合物超标情况较为严重，对作业人员健康危害较明显，应加强职业卫生管理，采取措施改善焊接作业环境，切实做好职业病的预防工作。.
With the Chinese government "WTO" promise coming to true, the retail industry in China have become the highest market-oriented industry.In order to survive, marketing strategy for continuous innovation will be continued, and the development of self-brand is innovation strategies.
In the past two years, it is difficult for farmers to increase income, and the proportion of operating income of farmers has decreased year by year.The "Internet +" action plan is becoming an engine of economic development, also bringing farmers' operating income growth.Before production, farmers can gain more and accurate demand information from markets for production decisions.In the production, farmers more focus on outsourcing, the quality of agro-products.Ultimately it meets consumer's demand, enhances farmers' market position, and increases farmer's household operating income.The growth of operating income comes from the connection dividend in agricultural production and consumption; scale effects by the specialization; return increasing from knowledge combination; the expansion of the value space of agroproducts and the decline of cost.Promoting "Internet+" in China has practical significance to increase farmer's household operating income.
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