多囊卵巢综合征经腔三维能量多普勒超声参数及血管化指标特征的分析

目的 探讨多囊卵巢综合征(PCOS)经腔三维能量多普勒超声特征.方法 运用二维超声、彩色多普勒血流显像及三维能量多普勒超声对75例PCOS患者、63例正常者进行观察,测量卵巢平均直径、最大切面卵泡数、搏动指数(PI)、阻力指数(RI)、卵巢容积(V总)、间质容积(V间质)、卵泡容积(V卵泡)、平均灰度值(MG)、血管化指数(VI)、血流指数(FI)和血管化-血流指数(VFI).结果 PCOS卵巢平均直径,卵泡数、V总、V间质、V卵泡、VI和VFI大于对照组,差异有统计学意义(P＜0.05或P＜0.01).PCOS卵巢PI、RI小于对照组,差异有统计学意义(P＜0.01).结论 PCOS患者具有多囊卵巢超声影像学特征性的改变,三维能量多普勒超声可以精确测量卵巢容积,定量评估卵巢间质血流,VI和VFI可作为辅助诊断PCOS的新指标.     

胰岛素抵抗对PCOS患者内分泌代谢及卵巢超声指标的影响

[目的]探讨胰岛素抵抗(IR)对多囊卵巢综合征(PCOS)患者内分泌代谢及卵巢超声指标的影响,并分析二者的相关性.[方法]120例PCOS患者以是否伴IR分为IR-PCOS组(n=65)和NIR-PCOS组(n=55).检测并比较两组血清雌二醇(E2)、黄体生成激素(LH)、卵泡刺激素(FSH)、胆固醇(TC)、空腹胰岛素(Fins)等内分泌代谢指标;阴道超声检查囊泡数量、卵巢体积(OV)、卵泡数目(NF)等.分析内分泌代谢及卵巢超声指标的相关性.[结果]IR-PCOS组空腹血糖(FPG)、甘油三酯(TG)、Fins、TC、LH水平明显高于NIR-PCOS组,FSH水平明显低于NIR-PCOS组(P＜0.05),两组其他内分泌代谢指标比较差异无统计学意义(P＞0.05).与NIR-P-COS组相比,IR-PCOS组囊泡数量、NF显著较多,血管化-血流指数(VFI)、OV显著增大(P＜0.05),两组卵巢间质面积(SA)及卵巢间质面积/总面积比值(SA/TA)比较差异无统计学意义(P＞0.05).相关性分析显示囊泡数量、NF、OV与PFG、Fins、TC、LH均呈正相关(P＜0.05),与FSH均呈负相关(P＜0.05);IR-PCOS组其他超声特征指标与其余内分泌指标无相关性.[结论]IR可增加PCOS患者内分泌代谢紊乱发生风险,改变卵巢超声指标,且伴IR-PCOS患者的内分泌代谢指标与卵巢超声指标具有一定的相关性.     

不同分型多囊卵巢综合征患者的超声特征及其与内分泌指标的相关性

目的比较不同分型多囊卵巢综合征（PCOS）患者超声特征及内分泌指标差异并分析其相关性。方法2012年6-12月上海交通大学医学院附属瑞金医院收治的PCOS患者105例,以体重指数≥25 kg/m2为肥胖,分为肥胖型PCOS组（OB-PCOS组）32例和非肥胖型PCOS组（NOB-PCOS组）73例。经腔内超声检查测量并比较PCOS患者卵巢卵泡数、卵巢体积、卵巢间质动脉阻力指数（RI）、子宫动脉RI等超声参数;检测并比较OB-PCOS组与NOB-PCOS组患者空腹血糖（FPG）、空腹血浆胰岛素（FINS）、黄体生成素（LH）、卵泡刺激素（FSH）、黄体生成素与卵泡刺激素比值（LH/FSH）、孕酮（P）、雌二醇（E2）、游离睾酮（FT）、泌乳素（PRL）、性激素结合球蛋白（SHBG）、胰岛素抵抗指数（HOMA-IR）等内分泌指标浓度。分析各超声参数与各内分泌指标之间的相关性。结果 OB-PCOS组患者卵巢体积较NOB-PCOS组患者卵巢体积明显增大,且差异有统计学意义[（12.25±4.89）ml vs （10.73±2.30）ml,t=2.20,P＜0.05],2组患者卵巢卵泡数、子宫动脉RI、卵巢间质动脉RI差异均无统计学意义。OB-PCOS组患者FINS浓度、HOMA-IR均明显高于NOB-PCOS组患者,且差异均有统计学意义[（14.82±6.45）mU/L vs （8.04±4.57）mU/L,3.91±3.30 vs 1.64±1.20,t=4.87、3.47,P均＜0.01];NOB-PCOS组患者FSH浓度明显高于OB-PCOS组患者,且差异有统计学意义[（5.95±1.91）U/L vs （4.65±1.88）U/L, t=-2.77,P＜0.01];OB-PCOS组患者FT浓度高于NOB-PCOS组患者,但差异无统计学意义;2组PCOS患者LH、LH/FSH、P、E2、PRL、FPG、SHBG浓度的差异均无统计学差异。PCOS患者卵巢卵泡数与LH/FSH、FT浓度呈正相关（r=0.35、0.38,P均＜0.01）,卵巢体积与LH/FSH、BMI、HOMA-IR、FPG浓度呈正相关（r=0.27,P＜0.05;r=0.25,P＜0.05;r=0.40,P＜0.01;r=0.32,P＜0.01）,卵巢间质动脉RI与SHBG浓度呈正相关（r=0.28,P＜0.05）;PCOS患者其余超声参数与内分泌指标之间均无相关性。OB-PCOS组患者子宫动脉RI与PRL浓度呈负相关（r=-0.58,P＜0.05）,卵巢体积与HOMA-IR呈正相关（r=0.47,P＜0.05）。NOB-PCOS组患者卵巢卵泡数与LH/FSH、FT浓度呈正相关（r=0.33、0.56,P均＜0.05）;卵巢体积与FT浓度呈正相关（r=0.31,P＜0.05）。2组PCOS患者其余超声参数与内分泌指标之间均无相关性。结论 OB-PCOS组患者与NOB-PCOS组患者超声特征及内分泌指标具有一定的差异,且两者之间有一定的相关性。     

肥胖型与非肥胖型多囊卵巢综合征患者超声参数、内分泌指标及胰岛功能的差异性分析

目的分析肥胖型与非肥胖型多囊卵巢综合征(PCOS)患者超声参数、内分泌指标及胰岛功能的差异性。方法回顾性收集2016年3月至2019年3月南阳市卧龙区妇幼保健院诊治的82例PCOS患者的临床资料,根据是否肥胖分为A组(肥胖型)和B组(非肥胖型),其中A组31例,B组51例。比较分析两组的经阴道多普勒超声检查报告结果[卵巢间质面积(SA)、卵巢间质面积/卵巢总面积(SA/TA)、卵巢直径和体积、卵泡数目和体积]和内分泌水平[孕酮(P)、垂体泌乳素(PRL)、睾酮(T)、雌二醇(E2)、卵泡生成素(FSH)、血浆胰岛素(FINS)、空腹血糖(FPG)及胰岛素抵抗指数(HOMA-IR)]。结果 A组SA[(2. 61±0. 59) cm2]、SA/TA(0. 53±0. 07)、卵巢直径[(34. 14±2. 96) mm]和体积[(13. 96±2. 63) cm3]、卵泡数目[(14. 06±3. 35)个]和体积[(1. 53±0. 36) cm3]均高于B组[(2. 27±0. 65) cm2,(0. 41±0. 06),(27. 26±2. 31) mm,(11. 27±2. 05) cm3,(12. 29±2. 68)个,(1. 02±0. 24) cm3](P 0. 05); A组P、PRL、T、E2、FSH、FINS、FPG及HOMA-IR均高于B组(P 0. 05)。结论肥胖型与非肥胖型多囊卵巢综合征患者超声及内分泌指标均存在差异性,肥胖型患者超声表现为卵巢和卵泡增大,其内分泌指标水平和胰岛素抵抗程度均较非肥胖患者高。     

PCOS患者血清VEGF、ES及LncRNA GAS5表达与胰岛素抵抗及卵巢间质血流的关系

目的探讨多囊卵巢综合征(PCOS)患者血清血管内皮细胞生长因子(VEGF)、内皮抑素(ES)及长链编码RNA生长停滞特异性基因5(LncRNA GAS5)表达的变化,及其与胰岛素抵抗、卵巢间质血流的关系。方法选取我院2016年1月至2018年7月收治的96例PCOS患者为PCOS组,96例月经周期正常的育龄期女性为对照组,检测两组血清VEGF、ES及LncRNA GAS5、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMAIR)、胰岛素敏感指数(ISI),采用彩色多普勒超声检测两组卵巢间质血流搏动指数(PI)、阻力指数(RI)。结果 PCOS组血清FPG、HbA1c与对照组比较差异无统计学意义(P0.05);PCOS组血清2hPG、FINS、HOMA-IR测定值高于对照组(P0.05),ISI测定值低于对照组(P0.05);PCOS组血清VEGF、ES水平高于对照组(P0.05),LncRNA GAS5表达水平低于对照组(P0.05);PCOS组卵巢间质血流RI、PI值低于对照组(P0.05);PCOS患者血清VEGF、ES与RI、PI、ISI、LncRNA GAS5呈显著负相关(P0.05),与患者HOMA-IR呈显著正相关(P0.05);LncRNA GAS5与ISI呈显著正相关(P0.05),LncRNA GAS5与HOMA-IR呈显著负相关(P0.05)。结论 PCOS患者血清VEGF、ES水平升高,LncRNA GAS5表达降低,并且与PCOS患者胰岛素抵抗及卵巢间质血流变化密切相关。     

经阴道三维超声对LUFS患者卵泡期卵巢血流灌注的评价

目的 利用经阴道三维超声定量分析LUFS患者卵泡期卵巢血流参数,探讨LUFS发生的卵泡期血流灌注特点.方法 选择在卵泡早期、卵泡中期、围排卵期行经阴道三维超声检查,应用VOCAL软件定量分析两组患者优势侧卵巢能量多普勒血流参数VI、FI、VFI.结果 对照组优势侧卵巢血流参数VI、FI、VFI在卵泡3个时期呈上升趋势(P＜0.01); LUFS组优势侧卵巢VI、VFI在各期逐渐升高(P＜0.05),FI则无明显周期性波动(P＞0.05);LUFS组与对照组比较,卵泡中期及围排卵期VI、FI、VFI明显降低(P＜0.05).对照组成熟卵泡血流分级以3～4级为主,LUFS组多呈1～2级.结论 成熟卵泡新生血管数量少,血流量低可能是LUFS发生的血流灌注特点.     

不同血糖状态的35～40岁PCOS患者超声特征分析

目的比较不同血糖水平的多囊卵巢综合征患者卵巢超声参数特征。方法根据空腹血糖水平和糖化血红蛋白水平不同,将PCOS患者分为非糖尿病组,共32例;空腹血糖异常组(IFG),共25例;糖耐量异常组(IGT),共19例。糖尿病HbA1c正常组,共24例;糖尿病HbA1c升高组,共21例。应用经腔内三维能量多普勒超声测量卵巢体积、间质容积和卵泡体积。卵巢血流量化指标:血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)。运用经腔内二维超声测量的卵泡数、平均卵巢直径、卵巢间质动脉搏动指数(PI)和阻力指数(RI)。结果 IFG组与非糖尿病组比较,VI%升高,差异有统计学意义(P0.05)。IGT组与非糖尿病组比较,卵巢直径增大、卵泡数增多、卵巢容积和卵泡容积增大,VI%和FI增高,差异有统计学意义(P0.05)。糖尿病HbA1c正常组与非糖尿病组比较,卵巢直径增大、卵泡数增多、卵巢容积增大、FI增高,差异有统计学意义(P0.05),卵泡容积增大,VI%增高,差异有统计学意义(P0.01)。糖尿病HbA1c升高组与糖尿病HbA1c正常组比较,间质容积减小,FI增高,差异有统计学意义(P0.05)。结论处于不同高血糖状态的PCOS患者,具有不同的超声参数特征:PCOS在糖耐量异常阶段和糖尿病阶段,卵巢体积和卵泡体积增大、卵巢直径增大、卵泡数量增多。PCOS患者在空腹血糖异常阶段出现VI%升高,糖耐量异常阶段和糖尿病阶段出现VI%和FI增高,糖尿病血糖控制差者FI增高。     

肥胖型多囊卵巢综合征患者超声特征及其与内分泌指标的相关性

目的 :探讨肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的超声特征及其与内分泌指标间的相关性。方法:共纳入126例PCOS患者,以体质量指数(BMI)≥25 kg/m2诊断为肥胖,分为PCOS肥胖组(45例)和PCOS非肥胖组(81例)。经腔内超声测量患者的卵巢和子宫灰阶及彩色多普勒二维超声参数,并检测性激素及血脂等相关内分泌指标,进行2组间比较,分析各超声参数与内分泌指标间的相关性。结果:PCOS肥胖组与非肥胖组比较,肥胖组患者的卵巢卵泡数、卵巢体积、卵巢间质面积与总面积之比(stromal area/ovarian total area,SA/TA)、子宫动脉阻力指数(resistance index,RI)及游离睾酮、三酰甘油、胰岛素抵抗指数(the extent of insulin resistance and hyperandrogenism,HOMA-IR)、餐后2 h血糖、空腹血浆胰岛素、餐后2 h胰岛素、空腹血糖水平均明显增高(P均<0.05),而卵巢间质动脉RI、性激素结合球蛋白、高密度脂蛋白胆固醇则均明显降低(P均<0.05)。结论:PCOS肥胖患者的超声参数具有一定特征性,且与内分泌指标间有一定相关性,而按BMI对患者进行分型,对评估其病情、发生代谢综合征风险及预防远期并发症有一定参考价值。     

肥胖型与非肥胖型多囊卵巢综合征超声指标与内分泌指标的关系分析

目的探讨肥胖型与非肥胖型多囊卵巢综合征(PCOS)患者超声指标与内分泌指标关系。方法选取我院56例PCOS患者,根据WHO标准,将25例体质量指数(BMI)≥25 kg/m~2者归为肥胖型PCOS组(OB-PCOS组),将31例BMI25 kg/m~2者归为非肥胖型PCOS组(NOB-PCOS组),比较两组最大切面卵泡数、卵巢体积、卵巢间质血管阻力指数(RI)及搏动指数(PI),以及促黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)内分泌指标水平;分析超声指标与内分泌指标的相关性。结果 OB-PCOS组最大切面卵泡数、卵巢体积、RI及PI均较NOB-PCOS组增大,LH和FSH均较NOB-PCOS组降低,差异均有统计学意义(均P0.01)。OB-PCOS组所有超声指标与内分泌指标均无相关性;NOB-PCOS组PI与FSH呈正相关(r=0.405,P0.05),其余超声指标与内分泌指标均无相关性。结论肥胖型PCOS与非肥胖型PCOS患者超声指标和内分泌指标均存在一定的差异,其中非肥胖型PCOS患者超声指标PI与内分泌指数FSH相关。     

伴或不伴胰岛素抵抗的多囊卵巢综合征的超声特征及其与内分泌指标的相关性

目的 比较伴或不伴胰岛素抵抗（IR）的多囊卵巢综合征（PCOS）患者的超声特征及其内分泌指标的相关性。方法 根据胰岛素抵抗指数（HOMA-IR）将126例PCOS患者分为PCOS伴胰岛素抵抗组（IR-PCOS组,67例）和PCOS不伴胰岛素抵抗组（NIR-PCOS组,59例）。经腔内超声测量并比较两组卵巢和子宫灰阶及彩色多普勒超声参数;检测并比较两组性激素及血脂等相关内分泌指标;分析超声参数与内分泌指标间的相关性。结果 IR-PCOS组卵巢卵泡数（FN）、卵巢间质面积与总面积之比明显增高（P<0.05）,卵巢体积、子宫动脉阻力指数（RI）显著增高（P<0.01）,卵巢间质动脉RI降低（P<0.01）,体质量指数（BMI）、游离睾酮增高（P<0.01）,性激素结合球蛋白降低（P<0.05）,甘油三酯、HOMA-IR、餐后2 h血糖（2hPG）、空腹血浆胰岛素（FINS）、餐后2 h血浆胰岛素显著增高（P<0.01）,FPG增高（P<0.05）,高密度脂蛋白降低（P<0.01）。IR-PCOS组FN与黄体生成素与卵泡刺激素比值呈正相关（P<0.01）;卵巢体积与BMI、糖化血红蛋白、HOMA-IR、FPG、2hPG呈正相关（P<0.01）;卵巢体积与FINS呈正相关（P<0.05）。结论 IR-PCOS与NIR-PCOS患者超声特征及内分泌指标有一定差异,且其间有一定相关性。     

Migraine and genetic and acquired vasculopathies

It is remarkable that migraine is a prominent part of the phenotype of several genetic vasculopathies, including cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL), retinal vasculopathy with cerebral leukodystrophy (RVCL) and hereditary infantile hemiparessis, retinal arteriolar tortuosity and leukoencephalopahty (HIHRATL). The mechanisms by which these genetic vasculopathies give rise to migraine are still unclear. Common genetic susceptibility, increased susceptibility to cortical spreading depression (CSD) and vascular endothelial dysfunction are among the possible explanations. The relation between migraine and acquired vasculopathies such as ischaemic stroke and coronary heart disease has long been established, further supporting a role of the (cerebral) blood vessels in migraine. This review focuses on genetic and acquired vasculopathies associated with migraine. We speculate how genetic and acquired vascular mechanisms might be involved in migraine.     

Fibrinogen and fibrin structure and functions

Fibrinogen molecules are comprised of two sets of disulfide-bridged Aalpha-, Bbeta-, and gamma-chains. Each molecule contains two outer D domains connected to a central E domain by a coiled-coil segment. Fibrin is formed after thrombin cleavage of fibrinopeptide A (FPA) from fibrinogen Aalpha-chains, thus initiating fibrin polymerization. Double-stranded fibrils form through end-to-middle domain (D:E) associations, and concomitant lateral fibril associations and branching create a clot network. Fibrin assembly facilitates intermolecular antiparallel C-terminal alignment of gamma-chain pairs, which are then covalently 'cross-linked' by factor XIII ('plasma protransglutaminase') or XIIIa to form 'gamma-dimers'. In addition to its primary role of providing scaffolding for the intravascular thrombus and also accounting for important clot viscoelastic properties, fibrin(ogen) participates in other biologic functions involving unique binding sites, some of which become exposed as a consequence of fibrin formation. This review provides details about fibrinogen and fibrin structure, and correlates this information with biological functions that include: (i) suppression of plasma factor XIII-mediated cross-linking activity in blood by binding the factor XIII A2B2 complex. (ii) Non-substrate thrombin binding to fibrin, termed antithrombin I (AT-I), which down-regulates thrombin generation in clotting blood. (iii) Tissue-type plasminogen activator (tPA)-stimulated plasminogen activation by fibrin that results from formation of a ternary tPA-plasminogen-fibrin complex. Binding of inhibitors such as alpha2-antiplasmin, plasminogen activator inhibitor-2, lipoprotein(a), or histidine-rich glycoprotein, impairs plasminogen activation. (iv) Enhanced interactions with the extracellular matrix by binding of fibronectin to fibrin(ogen). (v) Molecular and cellular interactions of fibrin beta15-42. This sequence binds to heparin and mediates platelet and endothelial cell spreading, fibroblast proliferation, and capillary tube formation. Interactions between beta15-42 and vascular endothelial (VE)-cadherin, an endothelial cell receptor, also promote capillary tube formation and angiogenesis. These activities are enhanced by binding of growth factors like fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF), and cytokines like interleukin (IL)-1. (vi) Fibrinogen binding to the platelet alpha(IIb)beta3 receptor, which is important for incorporating platelets into a developing thrombus. (vii) Leukocyte binding to fibrin(ogen) via integrin alpha(M)beta2 (Mac-1), which is a high affinity receptor on stimulated monocytes and neutrophils.     

创伤高血糖与感染和MODS早期诊断和干预

本文详细介绍了创伤后血糖应激适度理论,以及高血糖与感染和多器官功能不全综合征的关系;提出涉及胰岛B细胞功能不全的MODS实验诊断新方案和极化液个体化干预新措施,可早期发现创伤MODS、降低感染率及MODS发生率和病死率。     

腹膜后纤维化与肾积水发生关系的临床研究

目的：探讨腹膜后纤维化（RPF）导致肾积水的原因及诊治经验。方法：回顾分析2004年1月—2010年12月24例腹膜后纤维化致肾积水患者的诊治资料。结果：（1）RPF患者常见首发症状为腰背痛或腹痛（69.2%）;（2）红细胞沉降率（ESR）增快和血清IgG4升高最常见。超声检查仅提示上尿路积水。RPF的静脉肾盂造影（IVP）和CT尿路成像（CTU）表现具有特征性。IVP肾盂输尿管显影不良时,CTU能较清晰的显示上尿路影像。CT扫描发现腹膜后软组织肿块9例（37.5%）,优于超声检查;（3）输尿管松解和腹腔化手术治疗22例;行肾切除术1例;行输尿管置双J管术1例。最终确诊为继发性RPF8例,其中4例为术前诊断,3例为术中腹膜后软组织肿块冷冻活检证实,1例为术后病理证实;（4）特发性RPF手术后肾积水均获长期缓解,而继发性RPF的预后取决于原发疾病及其治疗方案。结论：影像学检查是诊断RPF的重要手段,CTU优于超声检查和IVP。输尿管松解和腹腔化手术可以使特发性RPF输尿管梗阻得到长期的缓解,术中对肿块进行冷冻活检有助于鉴别特发性和继发性RPF,及时调整治疗方案。     

Telemedicine and teleradiology technologies and applications

Summary. Telemedicine and teleradiology hold the key for improving future health care delivery. In this paper we first review current communication and computer technologies used in telemedicine and teleradiology. Five examples in teleradiology applications are given including hospital-integrated picture archiving and communication systems, tele-neuro-imaging, telemammography, university consortium teleradiology service, and teleradiology for second opinion. Parameters important to teleradiology applications like costs, image quality, system reliability, and turn around time are considered. Data security is discussed, including patient confidentiality and image authenticity-which will be a major issue in future teleradiology applications.     

探讨儿童慢性顽固性咳嗽与支原体感染的关系及临床治疗观察

目的探讨儿童慢性顽固性咳嗽与肺炎支原体（MP）感染的关系及临床疗效观察。方法采用回顾性研究方法对于现将2005年3月至2008年3月在我院的55例确诊慢性顽固性咳嗽患儿,主要表现为肺炎支原体感染为临床特点进行分析,并进一步临床治疗研究。结果①临床特点：在55例确诊慢性咳嗽的患儿中,以慢性顽固性咳嗽为主要症状。58％（32／55）的病例无肺部体征;②外周血：85％（47／55）的病例外周血变化不大,WBC（4—10）×10 9／L之间,嗜酸性粒细胞增多;③特别检查：47．27％（26／55）肺炎支原体IgM（MP—IgM）抗体阳性,83．64％（46／55）PeR技术检测肺炎支原体特异性DNA;④X光报告为多种形式。结论肺炎支原体（MP）感染是引起儿童慢性顽固性咳嗽的病因之一,对儿童慢性咳嗽,特别是顽固性咳嗽的诊治中应更加重视。     

Acetaminophen and acetylcysteine dose and duration: Past,present and future

Abstract

Acetylcysteine has been utilized successfully in the treatment of acetaminophen overdose since the 1970s. Although prospective trials as to efficacy and safety of acetylcysteine were conducted, there were no randomized controlled trials. This commentary addresses the reasons for this, and the background to choice of dose of acetylcysteine utilized in the oral and IV dosing regimens. Nomograms to predict possible hepatotoxicity based upon time of ingestion of acetaminophen were developed from a relatively arbitrary definition of toxicity as an aspartate aminotransferase/alanine aminotransferase (ALT/AST) greater than 1000 IU/L. While these have proved generally useful, patients still continue to develop hepatic damage after acetaminophen overdose, particularly if they present late after ingestion. The optimum management of these patients remains unclear, and one area of uncertainty is the dose and duration of acetylcysteine in various circumstances. This article discusses the issues that need to be elucidated to better target changes in acetylcysteine dose. The potential for measurements of other markers to improve treatment selection is the subject of further research.     

Physician and Nurse Practitioner Teamwork and Job Satisfaction: Gender and Profession

Designing interprofessional primary care teams composed of physicians and nurse practitioners (NPs) is a national priority. We assessed how profession and gender affect teamwork and job satisfaction among primary care physicians and NPs by using survey data from 186 physicians and 398 NPs practicing in New York State. Our regression models show profession (NP vs physician) moderates the associations of gender with teamwork and job satisfaction. Among NPs, men had higher job satisfaction than women. Among physicians, women had higher job satisfaction than men. Our results can benefit interprofessional primary care teams to optimize their professional and gender mix.