Association of professional identity, job satisfaction and burnout with turnover intention among general practitioners in China: evidence from a national survey

Background

The complex interrelationships between professional identity, job satisfaction, burnout, and turnover intention among general practitioners (GPs) are insufficiently understood in China. This study aimed to investigate the interrelationships between professional identity, job satisfaction, burnout, and turnover intention in China, and to examine whether job satisfaction and burnout played mediating roles between professional identity and turnover intention.

Methods

A cross-sectional survey was conducted between October, 2017 and February, 2018 in China. The participants were selected using a multistage stratified random sampling method. Data were collected with a self-administered questionnaire from 3236 GPs (response rate, 99.8%) working in community health institutions in China. Professional identity was measured by the 13 items scale, and job satisfaction scale with an 11-item designed by Shi et al. was employed. Burnout was measured using a 22-item Maslach Burnout Inventory-Human Services Survey, and turnover intention was measured with a 6 items scale. Descriptive statistics were calculated and groups’ differences were estimated Student’s t-test and analyses of variance. Pearson’s correlation analysis was used to assess the degree of correlation among different dimensions of professional identity, job satisfaction, burnout, and turnover intention. Structural equation modeling analysis was applied to examine the interrelationships among these study variables based on the hypothesized model.

Results

The proposed model achieved a good model fit. Job satisfaction had a direct negative effect on turnover intention (β = − 0.38, P < 0.001), burnout had a direct positive effect on turnover intention (β = 0.37, P < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and burnout.

Conclusions

Our study elucidated the pathways linking professional identity, job satisfaction, and burnout to turnover intention of GPs. This revealed that turnover intention was significantly affected by job satisfaction and burnout, and the effects of professional identity on turnover intention can be mediated by job satisfaction and burnout.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06322-6.

Isolation of lactic acid bacteria from pao cai, a Chinese traditional fermented vegetable, with inhibitory activity against Salmonella associated with fresh-cut apple, using a modelling study

AIMS

To isolate lactic acid bacteria (LAB) from pao cai, a Chinese traditional fermented vegetable, with outstanding inhibitory activity against Salmonella inoculated on fresh-cut apple, using a modelling method.

METHODS AND RESULTS

Four kinds of pao cai were selected. A total of 122 isolates exhibited typical LAB characteristics: Gram-positive and catalase negative, among which 104 (85·24%) colonies showed antibacterial activity against Salmonella by the well diffusion assay. Four colonies showing maximum antibacterial radius against Salmonella were selected to co-inoculate with Salmonella on fresh-cut apple and stored at 10°C, further identified as three strains of Lactobacillus plantarum and one strain of Lactobacillus brevis by 16s rRNA gene sequence analysis. The modified Gompertz model was employed to analyse the growth of the micro-organisms on apple wedges. Two of the four selected strains showed antagonistic activity against Salmonella on fresh-cut apple, one of which, RD1, exhibited best inhibitory activity (Salmonella were greatly inhibited when co-inoculated with RD1 at 10°C at 168 h). No deterioration in odour or appearance of the apple piece was observed by the triangle test when fresh-cut apple was inoculated with RD1.

CONCLUSIONS

The mathematical modelling method is essential to select LAB with outstanding inhibitory activity against Salmonella associated with fresh-cut apple. LAB RD1 holds promise for the preservation of fresh-cut apple.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provided a new method on fresh-cut product preservation. Besides, to make the LAB isolating procedure a more correct one, this study first added the mathematical modelling method to the isolating procedure.

Tissue levels of leukemia inhibitory factor vary by osteoarthritis grade

The objective of this study was to observe the expression of leukemia inhibitory factor (LIF) in animals and in different clinical grades of patient osteoarthritic tissues. Thirty-five rabbits were used in a Colombo model of experimental osteoarthritis (OA). Five rabbits each were sacrificed on postoperative days 3, 7, 14, 28, 42, 56, and 84. Immunohistochemistry analysis for LIF expression and distribution in the cartilage and synovium of animals was performed at these times. Sixty-seven samples of human articular tissue were obtained from patients with different grades of OA according to symptoms and radiographic inspection. The mRNA expression of LIF was determined by reverse transcription polymerase chain reaction, and LIF protein was determined by enzyme-linked immunosorbent assay (ELISA). The results showed a slight expression of LIF in normal cartilage tissue but less in synovium tissue; however, the expression of LIF was marked in synovial lining cells and superficial and middle-layer cartilage in animal OA (P<.05). Leukemia inhibitory factor mRNA was expressed at the highest level in moderate degrading subchondral bone, and LIF was expressed at the highest level in seriously degrading articular cartilage tissue. These results were similar to those found with ELISA. This study suggests that LIF in OA articular tissues varies by clinical symptoms and grade. It plays an important role in the pathogenesis of OA.

Entrepreneurial Leadership and Turnover Intention of Employees: The Role of Affective Commitment and Person-job Fit

The purpose of this study is to explore the causal system between entrepreneurial leadership and turnover intention of employees by examining the mediating effect of affective commitment and the moderating effect of person-job fit in start-ups. A quantitative approach was used to test the hypotheses and data were collected through the internet questionnaire tool. The authors selected employees from ventures newly established within the past five years and finally collected 427 questionnaires. The authors then used the hierarchical regression analysis method of Baron and Kenny for test mediating effect and the Hayes bootstrapping method for the test moderating effect by using Hayes' SPSS PROCESS macro. The results demonstrated that affective commitment functions as a mediator and person-job fit functions as a moderator. This paper provides implications for start-up leaders that entrepreneurial leadership is an effective style of leadership and plays a crucial role which accompanies the development of venture.

The global prevalence of sexual violence against pregnant women: a systematic review and meta-analysis

When committed against pregnant women, sexual violence may have adverse health consequences for both the mother and the unborn child. To date, no studies have systematically summarized the global prevalence of sexual violence against pregnant women. We conducted a comprehensive search of PubMed, Embase and Web of Science from inception dates to January 2021 for studies reporting the prevalence of sexual violence against pregnant women. Prevalence was estimated using a random-effects meta-analysis. Heterogeneity was evaluated using the I² statistic. Differences by study level characteristics were estimated through subgroup analysis and meta-regression. A total of 10 cross-sectional studies (a total of 8,439 participants) were included. The pooled proportion of sexual violence was 0.31 (95% CI: 0.22-0.40). Subgroup analyses showed higher prevalence of sexual violence against pregnant women in the 2010-2019 period (0.35, 95% CI0.15-7.53) and developing countries (0.32, 95% CI0.19-0.45). Almost one in three (31%) pregnant women around the world has been a victim of sexual violence in their lifetime. Sexual violence against pregnant women continues to be a major public health challenge. The global prevalence of sexual violence against pregnant women warrants the collective attention of the entire society.

The Effect of Entrepreneurial Leadership on Employees’ Tacit Knowledge Sharing in Start-Ups: A Moderated Mediation Model

Background

This study explores the causal relationship between entrepreneurial leadership and employees’ tacit knowledge sharing in start-ups. Construct a moderated mediation model to test the mediating role of affective commitment and the moderating role of career growth opportunities.

Methods

A questionnaire was used to collect data, and 485 samples of employees in Chinese start-ups were collected. Regression analysis and structural equation model were used to analyze data and verify hypotheses.

Results

The study shows that entrepreneurial leadership has a significant positive effect on employees’ affective commitment and tacit knowledge sharing. Affective commitment plays a mediating effect between entrepreneurial leadership and employees’ tacit knowledge sharing. Career growth opportunities play a positive moderating role in the impact of entrepreneurial leadership on affective commitment and tacit knowledge sharing, and positively moderate the indirect effect of entrepreneurial leadership on tacit knowledge sharing through affective commitment.

Conclusion

The research illustrates that the managers of start-ups can improve employees’ affective commitment by giving full play to entrepreneurial leadership and combining the career growth opportunities provided by the organization. Employees’ tacit knowledge sharing behavior is stimulated, providing guiding value for knowledge management and the human resource management of start-ups.

Meglumine cyclic adenylate improves neurological function following acute spinal cord injury in rats

Elevation of intracellular cyclic adenosine monophosphate (cAMP) levels facilitates recovery following spinal injury by suppressing secondary pathology and promoting axonal regeneration. However, this treatment strategy is limited by lack of effective and tolerable clinical agents. The present study examined the effects of meglumine cyclic adenylate (MCA) on neurological recovery, cAMP concentration, adenylate cyclase 3 (AC3) activity and phosphodiesterase 4D (PDE4D) activity during early stage acute spinal cord injury (SCI) in rats. A total of 48 Sprague‑Dawley rats were randomly assigned to groups A, B or C, each consisting of 16 animals. SCI was induced by Allen's method using a 7 g x 3 cm extradural weight‑drop impact on spinal cord segment T11. A total of 30 min following SCI, group A received a single 30 mg/kg‑bw i.p. dose of methylprednisolone, group B received 2 mg/kg‑bw i.p. MCA daily for seven days and group C were administered an equal volume of normal saline. Seven days following SCI, the spinal cord samples from eight rats per group were obtained to measure the cAMP concentration, and the activities of AC3 and PDE4D. The remaining eight rats per group were used for behavioral assessments using the inclined plane stability test and Gale scale for up to six weeks post‑SCI. The drug‑treated groups A and B had higher cAMP concentrations and AC3 activities but lower PDE4D activities at the lesion sites, as well as superior behavioral scores post‑SCI compared with the vehicle‑treated group C (P<0.05). Furthermore, cAMP was higher in group B than in group A (P<0.05). It was concluded that MCA may serve as an effective SCI treatment by activating AC3 and suppressing PDE4D.

Related Biological Research in the Interface between Bone Cement and Bone after Percutaneous Vertebroplasty

Percutaneous vertebroplasty (PVP) is widely used in the treatment of painful osteoporotic vertebral compression fractures with the injection of PMMA cement, and the controversy for PMMA damage to the osteoporotic bone tissue and to affect the fractures repairing never stops. 72 old female rabbits, each age 3.0~3.5 y, rabbits were assigned randomly to two groups of thirty-six each; PMMA cement were injected into vertebral body in rabbits via mimic PVP, sacrificed at 1 h, 24 h, 3 d, 7 d, 4 w, and 12 w. The expression VEGF and collagen type I, the tissue response, and repair reaction in the interface between PMMA and bone tissue were observed dynamically with RT-PCR and western blot technique; the osteocalcin expression were studied by immunohistochemistry. Compared with the control group, the expression of collagen I increased at 1 hour and was higher from 24 h to 3 d. From 4 weeks to 12 weeks after injection of PMMA. The expression of VEGF decreased at 1 hour and 24 hours, significantly increased at 3 days, decreased once again at 7 days, then increased significantly at 4-12 weeks. The osteocalcin expression continued to increase during 4 to 12 week. PMMA would not cause local bone permanent necrosis, and interface injury repairing cycle could be prolonged in a vertebroplasty.

Mediating influences of entrepreneurial leadership on employee turnover intention in startups

We examined the relationship between entrepreneurial leadership and employee turnover intention in startups in China, through the mediating roles of work-to-family conflict and affective commitment. We collected survey data from ventures newly established within the past 5 years, through Wenjuanxing, a market research website. We collected 312 survey forms from 56 startups, with no more than 10 from each. We used structural equation modeling to test the hypotheses, and found that entrepreneurial leadership was negatively related to turnover intention through the fully mediating roles of work-to-family conflict and affective commitment in serial order. Theoretical and practical implications are discussed.

Social network and tourism consumption by households: Evidence from China

Tourism consumption is not only an important means by which to improve residents’ sense of happiness but is also the main way to promote national economic development. In a traditional relational society such as China, it remains unclear how social network affects tourism consumption by households. Here, we evaluated the impact of the social network on tourism consumption by Chinese households using the data of 3254 samples from the China Family Panel Studies. The empirical results from the ordinary least square method showed that the social network promotes tourism consumption, which can be projected to increase by about 28% for every 1% increase in social network strength. This was further confirmed using the instrumental variable method to address the issue of endogenous social network formation, as well as other robustness checks. The impact of the social network on tourism consumption was heterogeneous. Compared with other residents, there were higher positive effects for high-income families, households with a head aged 35–44 years, urban families, and households in eastern China. The quantile regression results revealed that the impact of the social network was weakened with increasing tourism consumption by households. These results are crucial for policymakers, in that they could form good habits of tourism consumption and strengthen tourism market management, especially for the management of tourism negative events in the context of new media.

[Emission Characteristics of Nitrogen and Phosphorus in a Typical Agricultural Small Watershed in Tuojiang River Basin]

The emission of nitrogen and phosphorus via non-point source pollution from a small watershed has become the main pollution source of river waters, while climatic conditions and human activities directly affect the changes in rainfall-runoff and types of land use that are closely related to nitrogen and phosphorus pollution. In this study, we explore the runoff loss, nitrogen and phosphors concentration, and nitrogen and phosphorus emission in Huajiaogou small watershed on the upper reaches of Yangtze River. The rainfall, runoff, and temporal changes of nitrogen and phosphorus were analyzed using the continuous position monitoring data. The results showed that:① the runoff volumes were 10.05×10⁵ m³ and 3.34×10⁵ m³ from July 1^st to September 30^th, accounting for 76.58% and 56.51% in 2012 and 2013, respectively, and they were positively correlated to rainfall. The peak concentrations of ammonia nitrogen (NH₄⁺-N) from April 1^st to June 30^th were 11.51 mg ·L^-1 and 4.44 mg ·L^-1in 2012 and 2013, respectively. ② The NH₄⁺-N emission risk period was from July 1^st to September 30^th, accounting for 78.45% and 62.24% in 2012 and 2013, respectively. The peak concentration and emission risk period of total nitrogen (TN) and nitrate nitrogen (NO₃^--N) were from July 1^st to September 30^th, and NO₃^--N was the main form of the total nitrogen emission. The peak concentration of NO₃^--N was 6.06 mg ·L^-1 and 11.43 mg ·L^-1in 2012 and 2013, respectively, and the loss in NO₃^--N from July 1^st to September 30^th accounted for 88.74% and 65.55% in 2012 and 2013, respectively. ③The emission risk period of total phosphorus (TP), dissolved total phosphorus (DTP), and particulate phosphorus (PP) was also from July 1^st to September 30^th, and the particulate phosphorus was the main form of the total phosphorus emission. The particulate phosphorus emission from July 1^st to September 30^th accounted for 36% and 68% in 2012 and 2013, respectively, and the ration of particle phosphorus to total phosphorus was easily affected by rainfall.

Penetration and Cratering of Steel Target by Jets from Titanium Alloy Shaped Charge Liners

In order to enlarge the crater diameter of shaped charge jet penetration into steel targets, this paper investigates the penetration and cratering characteristics of steel targets by shaped charge jets from titanium alloy liners. Titanium alloy shaped charge liners are prepared separately with mechanical processing and selective laser melting (SLM), and pulsed X-ray radiography is used to identify jet formation characteristics. Jet formation is numerically simulated by AUTODYN-3D, and steel target penetration tests are carried out at a short jet stand-off distance. The results show that AUTODYN-3D can realistically simulate jet formation from titanium alloy liners and that the SLM-processed liner exhibits better penetration performance than the mechanically processed liner. The existing cratering formula of jet penetration is modified to make it consistent with the aperture variations of jet penetration from titanium alloy-lined shaped charges at a short stand-off distance. The findings of this study are expected to provide technical and theoretical support for research on the penetration characteristics of the jets from titanium alloy-lined shaped charges.

Direct and spillover portfolio effects of COVID-19

This paper investigates the direct and spillover portfolio effects from the global outbreak of COVID-19. We find that an increase of the newly added cases of one specific country causes investors to significantly decrease their portfolio allocations in the outbreak countries (direct effect). Simultaneously, investors also decrease their allocations to other countries (spillover effect). In addition, we provide evidence and documentation that the transmission mechanism underlying foreign exposures matter to the above-mentioned portfolio effect. Moreover, we provide evidence for phase heterogeneity. The first wave of the COVID-19 pandemic has significant direct and spillover portfolio effects, but the impacts are weakened in second wave of the pandemic. The capital reallocation effect occurs only when the disease becomes global. Finally, our heterogeneities analysis shows that both local and spillover effects are mitigated when the economies are more developed and democratic and when the country has better health care facilities.

Entrepreneurial Leadership and Entrepreneurial Performance in Start-Ups: A Moderated Serial Mediation Model

The purpose of this study is to explore the impact of entrepreneurial leadership on entrepreneurial performance in start-ups. Specifically, a moderated serial mediation model was developed to investigate the mediating role of tacit knowledge sharing and job embeddedness and the moderating effect of career growth opportunities. Data was collected from 376 start-up employees via an online survey platform. Using hierarchical multiple regression and Hayes' PROCESS Macro by SPSS 21.0, and structural equation modeling by AMOS 23.0, support was found for both mediation and moderation effects. Results showed that entrepreneurial leadership significantly positively affects entrepreneurial performance by mediating with tacit knowledge sharing and job embeddedness. Moreover, career growth opportunities moderate the serial mediating effect of tacit knowledge sharing and job embeddedness between entrepreneurial leadership and entrepreneurial performance. This study provides theoretical guidance for entrepreneurial leadership to improve entrepreneurial performance.

The influence of internal motivation and external publicity on consumers' waste sorting behaviour

Waste sorting is an important aspect of environmental protection, which is now being enforced on a large scale in China. More broadly, it is beneficial to improve the implementation strategies for waste sorting policy and programmes. This study analyses the psychology of consumers that influences the mechanisms of consumer waste sorting and the governmental policies influencing consumers' attitudes and behaviours. About 295 validated participants were collected from four regions of China. Regression analysis was used to examine the relationship among consumers' internal motivation, government's external publicity and consumer behaviour, and the Hayes' PROCESS macro was used to test mediating effect and moderating effect. The results show that consumers' internal motivation and government's external publicity have a positive effect on consumer behaviour. Consumer attitude played a complete mediating role between consumers' internal motivation and consumer behaviour. Between the government's external publicity and consumer behaviour, consumer attitude played a complementary mediating role. Consumers with self-transcendence values, positive motivation of waste sorting and the government's external publicity had a greater positive impact on their attitudes than consumers with self-enhancement values. The greater the material benefits and psychic income consumers received from waste sorting, the more it promoted a positive attitude to consumer behaviour. The article puts forward some management suggestions to improve the government's implementation of its waste sorting policy.

The impact of burnout on turnover intention among Chinese general practitioners: The mediating effect of job satisfaction and the moderating effect of professional identity

BACKGROUND

Turnover among general practitioners (GPs) has become a significant public health concern worldwide.

AIMS

This study aimed to investigate the interrelationships between job satisfaction, professional identity, burnout, and turnover intention among GPs in China and to assess the mediating effect of job satisfaction on the association between burnout and turnover intention and the moderating effect of professional identity on the association between burnout and job satisfaction.

METHOD

A cross-sectional study was conducted to collect data from 3,236 GPs in eastern, central, and western China between October 2017 and February 2018 using a self-administered questionnaire. Pearson's correlation analysis and hierarchical regression were used to identify the relationships between job satisfaction, professional identity, burnout, and turnover intention among Chinese GPs.

RESULTS

Among these respondents, 65.02% reported a medium or high level of emotional exhaustion (EE), 35.38% reported a moderate or high level of depersonalization (DP), and 62.05% reported reduced personal achievement (PA). Overall, 71.08% of GPs expressed a relatively high intention to seek another position (turnover intention). We found all 3 dimensions of burnout contributed to job dissatisfaction while turnover intention arising from burnout was associated with EE and DP. Job satisfaction had a direct negative impact on turnover intention and partially mediated the impact of EE and DP on turnover intention. Professional identity played a partial moderated role between EE and job satisfaction.

CONCLUSIONS

The prevalence of burnout and turnover intention among GPs is high in China. The effect of EE and DP on turnover intention is mediated by job satisfaction, and the effect of EE on job satisfaction is moderated by professional identity.

Post-traumatic severe ankle valgus and forefoot supination deformities treated by staged surgery using ilizarov technique and limited osteotomy: A case report

RATIONALE

Post-traumatic ankle valgus deformities are relatively rare. Old post-traumatic ankle deformity compounded by abundant scar contracture tissue formation around the joint is a big challenge for orthopedics. Conventional one-stage corrective osteotomy with internal fixation always results in many knotty postoperative complications, such as soft tissue avascular necrosis, implant-related infections, and distinct lower limb discrepancy. Here, we describe a patient with old post-traumatic severe ankle valgus and forefoot supination deformities and obtained satisfactory clinical results following multi-stage surgery using the Ilizarov technique and limited osteotomy. Even more encouraging, any complications of conventional one-stage surgery were successfully avoided through our treatment regimen.

PATIENT CONCERNS

A 24-year-old healthy man had post-traumatic 90-degree hindfoot valgus and forefoot supination deformities of the right foot for more than 10 years. The complicated issue was the vast, poorly vascularized scar contracture tissues tightly adhered to the bones of the lateral malleolus and dorsum pedis.

DIAGNOSES

Old post-traumatic severe ankle valgus and forefoot supination deformities and scar contracture of soft tissues of the foot and ankle joint.

INTERVENTIONS

In the first stage, Ilizarov external fixation was used to stretch the scar contracture tissue of the lateral malleolus. In the second stage, limited osteotomy of the tibiotalar joint and progressive closure of the osteotomy site were performed. In the third stage, Chopart joint osteotomy and slow forefoot pronation by external frame were performed.

OUTCOMES

Our treatment regimen not only guaranteed soft tissue safety, but also avoided infection and obvious lower limb discrepancy. At the 1-year follow-up, the patient acquired aesthetic and functional right foot.

LESSONS

Although relatively rare, old post-traumatic severe ankle valgus and forefoot supination deformities can be corrected using Ilizarov external fixation technology combined with limited osteotomy. With a well-designed staged operation scheme, soft tissue avascular necrosis, infection of the wound, obvious lower limb discrepancy, and flap grafting can be avoided.

[Experimental research on repair of rabbit articular cartilage deffects with composite of autologous cell-carriers]

OBJECTIVE

To study the effect of the repair of rabbit articular cartilage defects by the composite of chondrogenic induction of autologous MSCs and autologous "two-phase" bone matrix gelatin (BMG).

METHODS

Twenty-four healthy adult New Zealand rabbits weighing 2 to 3 kg were divided into group A, B and C with 8 in each. Autologous MSCs derived from group A were cultured in vitro and observed under inverted phase contrast microscope when enough cells through trypsinization transferring in vitro were obtained. Then the growth curves of 1, 3 and 5 passage culture of MSCs were drawn. The 3rd passage MSCs were induced into chondrogenic differentiation by adding TGF-beta1 (10 ng/mL), IGF-1 (10 ng/mL) and vitamin C (50 ng/mL) in vitro. At 8 days after induction, the features of chondrocytes were observed under inverted phase contrast microscope,and immunohistochemical staining and Mallory staining were made. Getting out part of the ilium of group A and B, according to the method of Urist, the "two-phase" BMG was acquired. Chondrogenic induction of autologous MSCs was inoculated into the corresponding BMG to set up a composite of cell-carrier, and then it was observed through scanning electric microscope after 3 days of culture. The model of articular cartilage defects of rabbits was made: in group A,autologous cell-carriers were implanted; in group B, there only existed autologous BMG; in group C,there was nothing. At 8, 12 weeks after operation, the gross, HE staining and immunohistochemical staining were made,and grading scales were evaluated according to Wakitani histological grading method.

RESULTS

Features of MSCs were as follows: the shape of primary cells was shot-spindled and of passage cells was long. As to the growth curves of 1, 3 and 5 passage culture of MSCs,passage cells grew slowly for 3 days after being passaged and went into log-growth during the 3rd and the 7th days and into plateau later, but the 3rd passage cells grew best. Observation of MSCs after chondrogenic induction was performed: the shape of cells was elliptical and the effect of induction was verified by the positive results of collagen type II, S-100 and Mallory staining. Under scanning electric microscope,the structure of BMG was good and cells were observed growing in it well. As far as repair of articular cartilage defects are concerned at 8, 12 weeks after transplantation, the defects in group A were repaired by the hyline-like tissue and the structures of the cartilage surface and normal cartilage were in integrity,and immunohistochemical staining of collagen type II was positive, while those in group B and C were repaired by the fibrous-like tissues and the surfaces were irregular. In Wakitanni histological score, at 8 weeks after operation, group A was (3.50 +/- 1.51) points, group B was (10.00 +/- 1.41) points and group C was (12.00 +/- 0.93) points; at 12 weeks, group A was (1.13 +/- 0.99) points, group B was (8.38+/-1.30) points, and group C was (10.13 +/- 1.64) points. At different time points,group A was significantly better than group B and C, showing significant differences (P < 0.05).

CONCLUSION

Induced autologous MSCs and the composite withautologous "two-phase" BMG have the function to repair articular cartilage defects, and they are better than autologous BMG transplanted only or nothing transplanted.

Effect of dynamic platelet-to-lymphocyte ratio on the prognosis of patients with esophageal squamous cell carcinoma receiving chemoradiotherapy

Systemic inflammatory load affects the long-term developmental outcomes in patients with malignancy. The purpose of this study was to investigate the effect of the dynamic levels of platelet-to-lymphocyte ratio (PLR) at different treatment stages on the prognosis of patients with esophageal squamous cell carcinoma (ESCC) undergoing chemoradiotherapy. This study included 168 patients who received chemoradiotherapy between 2012 and 2018. PLR levels at different treatment stages were calculated based on blood test results. The association between PLR and overall survival (OS) was determined using the Kaplan-Meier method and Cox proportional regression models. The cutoff values of PLR before and after treatment of 168 patients with ESCC were 195.7 and 403.6, respectively. The 5-year OS rates of patients in the low and high pre-PLR groups were 42.1% and 21.7%, respectively. The overall 5-year OS rate of all patients was 27.1%. Multivariate analysis results showed that patient age (hazard ratio [HR] = 1.736; 95% confidence interval (CI) = 1.129-2.669; P = .012), alcohol consumption (HR = 1.622; 95%CI = 1.050-2.508; P = .029), T stage (HR = 12.483; 95%CI = 3.719-41.896; P < .001), pre-PLR (HR = 1.716; 95%CI = 1.069-2.756; P = .025), post-PLR (HR = 1.664; 95%CI = 1.106-2.503; P = .015) were independent factors of the prognosis of patients with ESCC. PLR at different treatment stages can be used to effectively evaluate the prognosis of patients with ESCC undergoing chemoradiotherapy.

[CEMENTLESS TOTAL HIP ARTHROPLASTY AND IMPACTED BONE GRAFTING FOR PROTRUSIO ACETABULI IN PATIENTS WITH RHEUMATOID ARTHRITIS]

OBJECTIVE

To evaluate the effectiveness of total hip arthroplasty (THA) with impacted autologous bone grafting and a cementless cup in the treatment of rheumatoid arthritis (RA) with protrusio acetabuli.

METHODS

Between January 2001 and April 2009, 18 cases (20 hips) of RA with protrusio acetabuli were treated, including 6 males and 12 females with an average age of 46 years (range, 36-62 years). The disease duration was 3-10 years (mean, 6 years). Preoperative Harris score was 40.25 ± 6.68. The protrusio acetabuli was (5.70 ± 4.26) mm. According to Sotelo-Garza and Charnley classification criterion, there were 12 hips of type 1 (protrusio acetabuli 1-5 mm), 5 hips of type 2 (6-15 mm), and 3 hips of type 3 (>15 mm). All patients received THA with impacting bone graft and cementless prosthesis for recovery of acetabular center of rotation.

RESULTS

The average operation time was 74 minutes (range, 48-126 minutes); the average blood loss was 350 mL (range, 150-650 mL). Deep venous thrombosis of lower extremity and poor healing of incision occurred in 3 and 2 cases respectively. Other patients achieved primary healing of incisions. The mean time of follow-up was 108 months (range, 60-156 months). According to X-ray films, bone grafting fusion was observed within 6 months after operation. At last follow-up, the Harris score was 87.20 ± 4.21, showing significant difference when compared with preoperative score (t = -27.68, P = 0.00); the protrusio acetabuli was (-1.11 ± 0.45) mm, showing significant difference when compared with preoperative value (t = 5.66, P = 0.00). No loosening of acetabular components was found.

CONCLUSION

For RA patients with protrusio acetabuli, THA with impacted autologous bone grafting and a cementless cup has satisfactory medium-term effectiveness.