Objective To explore the interleukin-4 (IL-4),interleukin-6 (IL-6),interferon-gamma (IFN-γ) levels in bronchoalveolar lavage fluid (BALF) of children with refractory mycoplasma pneumoniae pneumonia,and the features of bronchoscopy.Methods A total of 47 children with refractory mycoplasma pneumoniae pneumonia were selected as the observation group,28 children with bronchial foreign body in GAN zhengyan were chosen as controls during the same period.ELISA method was used to detect the IL-4,IL-6,IFN-γ levels in the BALF,and compared them in these two groups.The bronchoscope features of the observation group were observed.Results The IL-4,IL-6,IFN-γ levels in the BALF of children in the observation group were (8.3 ± 3.1) pg/mL,(62.3 ± 18.4) pg/mL,(76.5 ± 21.9) pg/mL,and they were significantly higher than those of the controls (3.1 ± 1.2) pg/m L,(30.0 ± 1.5) pg/m L,(31.3 ± 24.9) pg/mL (P ＜0.05,respectively).In the observation group,the bronchial mucosa congestion and edema were observed in all patients,there were variable amounts of mucus secretions.There were other changes include:microtubule reductus (68.1％),bronchial mucosal follicle-like hyperplasia (38.3％),mucosal erosions (8.5％),airway inflammatory stenosis,mucus plug blocking (59.6％),granulation proliferation (14.9％),bronchial obliteration (4.3％) Conclusions The IL-4,IL-6,IFN-γ levels in the BALF of children with RMPP significantly increased.This indicates a significant local inflammatory response in children with RMPP.Mycoplasma pneumoniae pneumonia (MPP) has certain features of bronchoscope,these features are helpful to the diagnosis and treatment of MPP.

Objective To find some risk factors correlated with test anxiety of middle school students,and to find out influencing pathway for test anxiety. Methods 647 middle school students were investigated with Sarason' Test Anxiety Scale (TAS), Achievement Motivation Scale (AMS), Coping Style Scale for School Students ( CSS), Eysenck Personality Questionnaire( EPQ), Egma Minnen av Bardndosnauppforrestran(EMBU) and Family Environment Scale-Chinese Version(FES-CV). Statistics were done with version of SPSS14.0,and data were analyzed by Pearson correlation, multiple linenear stepwise regression and path analysis. Results The rates of test anxiety respectively was mild 25.97% ,moderate 45.65% ,severe 28.38%; there were no significant different between the male and female students anxiety ( 16.71 ± 6.44,17.01 ± 7.02, t = 1. 469, P = 0.334). Test anxiety positively correlated with Achievement motivation, reach motivation of competition, endurance, escape, expos, deny the fantasy,family conflicts,parental punished severely,excessive interference,objective deny,overprotective of father.( r 1-16 :0. 214,0. 135,0. 254,0. 216,0. 308,0.472,0. 492,0. 168,0. 249,0. 537,0. 282,0. 102,0. 238,0. 185,0. 233,0.301,0.273; P 1-16 = 0. 000 ～ 0. 030) , and negatively correlated with Problem-solving, rationalizing interpretation, family cohesion, informative, entertaining, emotional expression, organization, parental warmth and understanding ( r1-9: -0. 121, -0. 134, -0. 178, -0. 215, -0. 221, -0. 101, -0. 298, -0. 136, -0. 168; P 1-9 =0.000 ～0.007). Enter test anxiety regression equation is the reached motivation of competition,emotional expose,organization, psychosis, Neuroticism, parent's warm and understanding , mother's refuse and deny ( t 1-7: 2.496,2.521, -2.687, -2. 150,3.503,2.237,2.259; P1-7 =0.001 ～0.038). Conclusion Test anxiety is commonly find in middle school students. Test anxiety is affected by some paths that are personality,achievement motivation,emotional coping style,family environment and parental education methods.

ObjectiveTo find incidence rate of no-suicide self injury (NSSI) of junior school students in Dalian city,and to provide some evidences for interventions for them.MethodsRandomly drawn out 1463 junior school students were served as study objects.All objects were evaluated with Ottawa Self-Injury Inventory (OSI) and self-made investigate questionnaire,75 no-suicide self-injury were screening out.ResultsThe incidence ratio of NSSI of junior school students was 5.4％,there were no significant different between the male and female students.The highest incidence ratio was found at 13 years old.The average age for first-time self-harm was (12.24±1.344) years old.There were no significant different between the male and the female students( t=- 1.415,P =0.163 ) ; Cutting Skin was the most common way of NSSI ( 12.0％ ) ; Ideation of 80％ of the NSSI was from their Own Idea.2.7％ of the NSSI can Feel Relief through NSSI behavior.93％ of NSSI was to regulate their mood.100％ students of NSSI against NSSI behavior byReading Books or Listening Music,in which 60％ of NSSI believe the method was helpful to relax their mind.78.5％ of the NSSI resisted NSSI behavior by Watching TV or Playing Games,but they did not get enough effects.60％ NSSI considered themselves without the need to treat.41.3％ of NSSI had never been to treat.2.5％ of NSSI went to hospital for the wound.ConclusionNSSI is often be found in junior school students,and highest ratio is at 13 years old.The most common method of NSSI is Cutting Skin.More NSSI aim is to release their emotion,and self-injury behavior accordance with their inner thoughts.NSSI behavior often is secret,and reading and listening to music is cut off from the relative effective way to conduct.NSSI are seldom to initiative doctor,and education organ,parents and society in a three-dimensional one of the system is necessary.

Objective To discuss family environment and parent's education pattern of violent online games addictive disorder in junior middle school students. Methods From August to December at 2008,6000 students were randomly drown from 8 junior middle schools in Dalian. All subjects were investigated with the self-made internet game survey form and the Chen internet addiction scale (CLAS). 149(2.5% ) internet game addicts were screen out from 6000 students, and then were divided into the violence and entertainment game addicted group (66 students in per group, and the male 55, female 11). No-game group 66 students were matched according tothe sex and the age. All subjects were evaluated with Egma Minnen av Bardndosnauppforstran ( EMBU) and Moss's Family Environment Scale of Chinese version. Results Lower mother's understand and warm were observed in violence internet online game addictive student group than other two groups( (46. 37 ± 13. 93,49. 80 ± 7.13,53. 16 ± 14. 89) , F = 4.88, P<0.01) ,and the mother understand and warm were remarkably lower in the violence online game addictive group than the non-game addicted group(P<0.01) ,and mothers rejection and the denial are obviously higher in entertainment online game addictive group than the non-game group(P = 0. 038). In family environment survey results suggested there were significant different during the 3 groups (F1-3 = 13. 99, 12.24,10.56; P<0.05)in emotion expression(4. 74 ± 1. 32,6. 06 ± 1. 97,5. 80 ± 1. 11) ,and conflict (5. 57 ± 1.85,5.28 ± 1.41,3.63 ± 1.50) .independence (3.96 ± 1. 87,4.56 ± 1.84,4.63 ± 1. 85). In the violence online game addictive group, emotion expression was lower than other two groups (P<0. 01) ,the conflict score was higher than other two groups (P<0.01). The controlling was lower than other two groups ( all P<0. 01) ; family function and total score are lower in online game addictive groups than other groups (P<0. 01, P<0. 05). Conclusion -Lower emotion expression,higher conflict,lacks of mother's love and warm,and lower controlling are found in violence online game addictive junior middle school students.

Objective To discuss the personality characteristic and personal social attributes of junior middle school students of online violent games addictive disorder (VOGAD).Methods From August to December at 2008,6000 students were randomly drown from 8 junior middle schools in Dalian ,then they were investigated with the self-made internet game survey form and the Chen internet addiction scale (CLAS).149( 2.5% ) internet game addicts were screen out from 6000 students, and were divided into the violence and entertainment game addicted group ( 66 students in per group,and the male is 55, female is 11 ).Average age was ( 14.36 ± 0.81 ) years old.No-play game group 66 students were mach according to the sex and the age.All objects were evaluated with Eysenck personality questionnaire (EPQ) and Minnesota Multiphasic Personality Inventory Abbreviation Form (MMPI-AF).Results There were significant different during the 3 groups in psychoticism (50.60 ± 5.10;50.40 ± 6.30; 46.81 ± 4.62 ), neuroticism ( 51.74 ± 5.70; 49.03 ± 6.85; 49.25 ± 6.09 ) , manifest anxiety (55.29 ±9.58;45.11 ±8.31; 43.24 ±8.32) ,dependence (58.90 ±9.09; 55.97 ±8.63; 54.05 ± 11.39) ,and social responsibility ( 37.47 ± 12.41; 43.25 ± 11.24 ;46.34 ± 14.37 ) (F1-5 = 10.32,3.83,36.17,4.11,8.23; P 1-5 ＜ 0.05 ).Except of the social responsibility (P＞ 0.05 ) ,above results all suggested higher scores in the VOGAD group than other two groups (P1 ＜ 0.05 ).Conclusion The results suggest higher scores in the psychoticism, neuroticism, dependency, manifest anxiety in VOGAD group, and lower Re in online violence game addict students.

Objective To find out parental locus of control and mental health affecting students test anxiety. Methods The samples were from 5 middle schools including 1000 students,and their parents. They were investigated with the general life scales, Sarason's test anxiety scale, Symptom checklist 90 (SCL-90)and Parenting Locus of Control Scale(PLOC). Results The ratio of test anxiety: the mild was 28.8%, moderate was 45.0%, severe was 26.2% ,and felt anxiety was 55.8%. Ratio of test anxiety was higher in the boy students (X2=9.284, P =0.010) ,and heavier(F:16.42±6.70; M:15.18 ±6.51, t=2.716, P=0.007). Student test anxiety was significantly positively correlated with their parental mental health (r fatherl～11=0.166～0.272, Pfather l～11= 0.000;r mother 1～11=0.182～0.242, P mother 1～11= 0.000); Student test anxiety positively correlated with the effectiveness cof parents education, father's belief on the fate, eontrol of fathers for their children, locus of control from fathers (r1～5=0.075～0.143; P1-5=0.000～0.030);felt anxiety positively correlated with self-expect ,pressure from their mothers,over take care attitude from their parents,self-pressure from their parents( r1～6=0.068～0.230; P1-6=0.000～0.050) ,and negatively correlated with respect attitude of parents for their child, Marital relations,Communication time between the students and their parents,attitude of mother for learning( r1-7=-0.074～-0.140;P1～7=0.000～0.034). Felting test anxiety was served as a dependent factor, some factors enter the regression equation,and they were somatization of father, psychotic mother, the pressure from parents, mother over expectations, self-expectations ,the child control from student's father by Logistic regression analysis ( OR1～16=0.675～3.029;P1-6=0.000～0.007). Conclusion Students test anxiety is a common problem in male and female students. Mental health and locus of control from students' parents show test anxiety has somatization of father, psychotic mother, the pressure from parents, mother' expectations,self-expectations, the control of father for the child 6 risk factors.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Objective: To analyze the CD4+T cell count level of newly diagnosed HIV infected patients in Jiangsu province, and to understand their immune status and disease progression so as to provide scientific basis for HIV prevention and control strategy in the whole province. Methods: Flow cytometry was used to detect the absolute count of CD4+T lymphocytes in newly diagnosed patients who had not initiated ART in 2020. Multivariate Logistic regression was used to analyze the associated factors of CD4+T cell count. Results: In 2020, there were 2 175 new diagnosed cases with HIV infection in Jiangsu Province. Patients under 30 years old, infected by homosexual transmission, unmarried, with college degree or above, students, diagnosed in counseling and testing and floating population had a higher absolute count level of CD4+T cell count(P<0.05). Multivariate Logistic regression analysis showed that people aged ≥30 and diagnosed in medical institutions were more likely to be presented lately(P<0.05). Conclusion In recent years, the intervention strategy for men who had sex with men(MSM) in Jiangsu province had achieved remarkable results.In the future, much more attention should be paid for the population over or equal to 30 years old, married or divorced, infected by heterosexual transmission, with high school education or below, farmers or migrant workers, retirees and diagnosed in medical institutions so that the PITC service should be promoted, and the publicity and intervention should be strengthened to present cases as soon as possible.