Objective To explore the application value of the nomogram based on dual-energy CT in preoperative evaluation of human epidermal growth factor receptor 2(HER-2)status in patient with breast cancer.Methods A total of 269 patients with pathologically confirmed breast cancer were retrospectively collected and randomly divided into a training cohort(n=189)and a validation cohort(n=80)at a ratio of 7︰3.The dual-energy CT parameters and clinical features of all patients were measured and collected.Varia-bles with significant difference in univariate analysis were included in the multivariate logistic analysis to obtain independent risk fac-tors related to HER-2 status,with establishing a nomogram model.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive performance of the nomogram.Results There was a significant difference in axillary lymph node enlargement between the two groups(P<0.05).The venous phase iodine concentration(IC)and normalized iodine concentration(NIC)in the HER-2 positive group were significantly higher than those in the HER-2 negative group(P<0.05).Axillary lymph node enlargement,venous phase IC,and venous phase NIC were the independent risk factors for predicting HER-2 status in breast cancer.The nomogram con-structed from the above features exhibited good predictive performance,with area under the curve(AUC)of 0.856 and 0.834 in the training and validation cohorts,respectively.Conclusion The nomogram based on dual-energy CT has a high predictive value for HER-2 status in breast cancer patients.

BACKGROUND:There are increasing scientific and technological ways to promote the recovery of muscle fatigue after sports,such as vibrating foam shaft,fascia gun relaxation,and ultra-low temperature cold therapy.Fascia gun relaxation has been widely used in practice,but there is still relatively little research on fascial guns. OBJECTIVE:To compare the effects of three relaxation methods(fascia gun,stretching,fascia gun+stretching)on muscle status and muscle strength during the recovery of exercise-induced muscle fatigue,and to provide scientific basis for the application of the three methods in practice. METHODS:Forty college students were randomly divided into control group(n=10),stretching group(n=10),fascia gun group(n=10),and fascia gun+stretching group(n=10).All subjects completed leg flexion and extension training at 60%1 RM,15 times per set,for 10 sets in total,to make exercise fatigue models.After modeling,the subjects were intervened with supine rest,static stretching,fascia gun relaxation,fascia gun+stretching relaxation respectively.Muscle status and muscle strength indexes were tested before exercise,immediately after exercise,immediately after relaxation,24 and 48 hours after exercise. RESULTS AND CONCLUSION:The muscle tension and dynamic hardness of the control group and the stretching group immediately after relaxation were significantly higher than those before training(P<0.01).However,there was no significant difference in the fascia gun group and fascia gun+stretching group before and after training(P>0.05).At 24 hours after training,the peak torque of the control group and fascia gun group was significantly lower than that before training(P<0.01),and there was no significant difference in the stretching group and fascia gun+stretching group before and 24 hours after training(P>0.05).To conclude,the fascia gun can immediately and effectively improve the muscle state of sports fatigue and stretching can promote the effective recovery of muscle strength within 24 hours after sports fatigue.Relaxation using fascia gun plus stretching can achieve the superposition of the two effects.

Objective:To investigate the lower limb muscle strength characteristics in amateur runners with patellofemoral pain(PFP). Method:Thirty PFP amateur runners(20 males and 10 females)were recruited as the knee pain group,and 30 matched non-injured amateur runners were recruited as the non-knee pain group.The hip abductor strength,quadriceps strength,hamstring strength,hamstring/quadriceps ratio,and bilateral limb symmetry index were col-lected for all participants.Independent sample t-tests were used to compare the differences between the groups. Result:The hip abductor strength and bilateral limb symmetry index,quadriceps strength and bilateral limb symmetry index of male PFP amateur runners were significantly lower than those of the non-knee pain group,while the hamstring/quadriceps ratio was significantly higher than that of the non-knee pain group.The hip ab-ductor strength and bilateral limb symmetry index of female PFP amateur runners were significantly lower than those of the non-knee pain group. Conclusion:PFP amateur runners exhibit different lower limb muscle strength characteristics compared to non-knee pain runners,and the lower limb strength characteristics of male and female PFP amateur runners are not consistent.Therefore,functional and gender differences should be considered in the clinical treatment and rehabilitation training of PFP.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

【Objective】 To investigate the preoperative epidemiological factors affecting the surgical outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and to evaluate the clinical predictive value. 【Methods】 Patients undergoing TURP at our hospital during Dec.2018 and Sep.2021 whose pathological examination suggestive of BPH were involved. Before operation, the clinical data, International Prostate Symptom Score (IPSS), quality of life (QoL) score, overactive bladder (OAB) score, prostate-specific antigen (PSA), and urological ultrasound results were collected. After operation, all patients were followed up with telephone call or face-to-face interview, and the IPSS, QoL score and OAB score were examined. Patients were divided into effective and ineffective groups according to the efficacy rubrics. The epidemiological factors affecting the efficacy of TURP were identified with univariate analysis, the independent influencing factors were screened with binary logistic regression, and the diagnostic value of each independent influencing factor was evaluated using receiver operating characteristic (ROC) curve. 【Results】 OAB score (OR=0.749, 95%CI: 0.627-0.895, P=0.001), IPSS-V/S (OR=4.919, 95%CI: 1.617-14.963, P=0.005), history of urinary retention (OR=7.513, 95%CI: 2.289-24.656, P=0.001), and history of urinary incontinence (OR=2.656, 95%CI: 1.015-6.950, P=0.047) were independent influencing factors for poor postoperative outcomes. ROC curve revealed that the area under the ROC curve (AUC) showed that AUC of OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were 0.784 (95%CI: 0.718-0.841), 0.686 (95%CI: 0.614-0.751), 0.713 (95%CI: 0.643-0.777), and 0.723 (95%CI: 0.654-0.786), respectively. ROC curve of the regression model showed that the AUC was 0.888 (95%CI: 0.834-0.930), and the sensitivity and specificity were 93.53% and 67.35%, respectively. 【Conclusion】 Preoperative OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were independent epidemiological factors of poor outcomes after TURP in BPH patients. The diagnostic efficacy ranked from the highest to the lowest as regression model >OAB score>history of urinary incontinence >history of urinary retention>IPSS-V/S.

There is still a lack of sufficient evidence-based basis for the treatment of simple gaming disorder. The purpose of this paper is to review the research progress of gaming disorder intervention， in order to provide references for the treatment of patients with gaming disorder. With the development and popularization of the Internet， the adverse events caused by the pathological use of online games have attracted wide attention. At present， gaming disorder has been listed in the International Classification of Diseases， eleventh edition （ICD-11） by WHO. This paper reviewed the latest interventions measures about gaming disorder at home and abroad in the past decade， including psychological， pharmacological and physical intervention methods， and analyzed and summarized these intervention measures， so as to provide references for patients with gaming disorder to formulate a reasonable intervention plan.

Objective:To explore the relationship between knowledge of a friend's non-suicidal self-injury (NSSI) behavior and self injury and suicide behaviors of adolescents.Methods:From January 2020 to January 2021, totally 1 683 students from a middle school in Xiamen were randomly selected by cluster sampling.The suicide items of the self-injurious thoughts and behaviors interview(SITBT) were used to assess whether students were aware of their friends' self injurious history and their self injurious behaviors.The suicide items of the mini international neuropsychiatric interview for children and adolescents (MINI-KID) were used to assess students' suicide ideation and behavior.The data were statistically analyzed by SPSS 21.0 software.Logistic regression model was used to analyze the relationship between knowledge of a friend's NSSI and adolescents' own self-reported NSSI and suicidal behaviors.Results:A total of 1 683 junior and senior high school students completed the survey, including 412 (24.4%) who knew their friend's NSSI history and 1 271 (75.6%) who did not know their friend's NSSI history.There were statistically significant differences between the adolescents known and unknown friends' NSSI histories in terms of age, gender, whether they were left-behind children, mental disorders, their own NSSI, suicide attempts, and suicidal ideation (all P<0.05). Knowledge of a friend's NSSI behavior had positive predictive effect on adolescents' own NSSI behavior ( β=0.558, OR=2.01, 95% CI=1.58-3.88), suicidal ideation( β=0.238, OR=3.03, 95% CI=2.08-5.55), and suicide attempts ( β=0.233, OR=2.88, 95% CI=1.55-5.45) (all P<0.05). Conclusion:Knowledge of a friend's NSSI behavior may have an impact on adolescents' own self-injury and suicidal behavior.

OBJECTIVES: Health workers are at risk of workplace violence, which can seriously affects their mental health and work status. This study aims to explore the mediating role of depression between workplace violence and job burnout among healthcare workers. METHODS: From January 10 to February 5, 2019, a questionnaire was distributed to frontline healthcare workers through the wenjuanxing platform using convenient sampling (snowball sampling). The questionnaire included the Chinese version of the Workplace Violence Scale, Maslach Burnout Inventory, and Patient Health Questionnaires (PHQ-2). Descriptive statistics, correlation analysis, and mediation model tests were conducted on the cross-sectional data collection. RESULTS: The study included 3 684 participants, with (31.63±7.69) years old. Among them 2 079(56.43%) were experienced workplace violence, 687(18.65%) were screened positive for depression, and 2 247(60.99%) were experienced high levels of occupational burnout. Correlation analysis showed positive association between workplace violence and depression, workplace violence and occupational burnout, depression and occupational burnout (r=0.135, r=0.107, r=0.335, respectively, all P<0.001). After controlling for covariates, workplace violence had an indirect effect on occupational burnout through depression, with a standardized coefficient of 0.25 (SE=0.02, 95% CI 0.21 to 0.28), accounting for 13.87% of the total effect. CONCLUSIONS The study highlights the close relationship between workplace violence, depression, and occupational burnout among healthcare workers, with depression acting as a mediator between workplace violence and occupational burnout. This study suggests that it is necessary to improve the communication skills of healthcare workers, increase the installation of security systems and emergency plans, use new media platforms to convey positive energy between doctors and patients, and open channels for medical consultation and complaints. It is also necessary to provide guidance for healthcare workers' depressive emotions. Addressing depression among health care workers will help reduce the harm caused by workplace violence, protect the physical and mental health of healthcare workers, and reduce work burnout.
Humans ; Young Adult ; Adult ; Burnout, Professional ; Cross-Sectional Studies ; Depression/epidemiology* ; Workplace Violence ; Burnout, Psychological ; Health Personnel

Objectives:To investigate the clinical impacts of chronic total occlusion (CTO) in acute non-ST segment elevation myocardial infarction (NSTEMI) patients underwent primary percutaneous coronary intervention (PCI).Methods:A total of 2 271 acute NSTEMI patients underwent primary PCI from China Acute Myocardial Infarction Registry were enrolled in this study and divided into the CTO group and the non-CTO group according to the angiography. The primary endpoint was in-hospital mortality and mortality during a 2-year follow-up. The secondary endpoint was major adverse cardiovascular events (MACE) including revascularization, death, re-myocardial infarction, heart failure readmission, stroke and major bleeding.Results:Thirteen-point four percent of the total acute NSTEMI patients had concurrent CTO. In-hospital mortality (3.6% vs. 1.4%, P<0.01) and 2-year mortality (9.0% vs. 5.1%, P<0.01) were significantly higher in the CTO group than those in the non-CTO group, respectively. Multiple regression analyses showed that chronic obstructive pulmonary disease ( HR 7.28, 95% CI 1.50-35.35, P=0.01) was an independent risk factor of in-hospital mortality, and advanced age ( HR 1.04, 95% CI 1.01-1.07, P<0.01), and low levels of ejection fraction ( HR 0.95, 95% CI 0.93-0.98, P<0.01) were independent risk factors of 2-year mortality. CTO ( HR1.67, 95% CI 1.10-2.54, P=0.02) was an independent risk factor of revascularization, but not a risk factor of mortality. Conclusions:Although acute NSTEMI patients concurrent with CTO had higher mortality, CTO was only an independent risk factor of revascularization, but not of mortality. Advanced age and low levels of ejection fraction were independent risk factors of long-term death among acute NSTEMI patients.

The internal organs and meridians were associated with Yin and Yang, five elements, six qi, and time and space, based on the holistic view of heaven, earth and human, according to Huangdi Neijing. The syndrome differentiation system of six meridians and Zang Fu meridians were established by Shanghan Zabing Lun, on the basis of the three Yin, three Yang, six meridians, and five Zang system in Huangdi Neijing. We put forward the concept of the six meridians syndrome differentiation system of circular motion, considering that the six meridians syndrome differentiation system actually implies the theory of circular motion. The syndrome differentiation system was constructed with the circular model of one qi circulating around the road, rising left and falling right, corresponding up and down, and maintaining conservation in the middle as the core, integrating Yin and Yang, five elements, six qi, Zang Fu and meridians, qi, blood and body fluid, and the integration of heaven, earth and human, focusing on "disease location and disease nature", taking classical prescriptions as the main treatments, and cooperating with external treatments such as acupuncture and moxibustion. We organically combined the circular motion with the syndrome differentiation of the six meridians, systematically interpreted the physiological bases, pathological changes, progressive patterns, and the treatments, based on syndrome differentiation, by inheriting the classical thinking mode of Hetu, Luoshu,Zhouyi, Huangdi Neijing, ShennongHerbal Classic, and Shanghan Zabing Lun.