Objective To explore the mediation effect of self-esteem on the relationship between perfectionism and depression in college students.Methods Totally 292 college students completed Frost Multidimensional Perfectionism Scale (FMPS),Hewitt Multidimensional Perfectionism Scale (HMPS),Slaney Almost Perfect Scale-Revised (APS-R),Rosenberg Self-esteem Scale (SES) and Beck Depression Inventory (BDI).Results Maladaptive perfectionism was positively correlated with depression (r =0.54,P ＜ 0.01),and negatively correlated with self-esteem (r =-0.55,P ＜ 0.01).Adaptive perfectionism was not correlated with depression (r =-0.09,P ＞ 0.05),and was positively correlated with self-esteem (r =0.36,P ＜0.01).Self-esteem partially mediated the association between maladaptive perfectionism and depression.The partial mediation effect was significant (P ＜0.05).The mediation model fitted the data well (GFI =0.986,CFI =0.988,NFI =0.981,TLI =0.970,RMSEA =0.075).Conclusion Self-esteem has partially mediating effect on perfectionism and depression.

Objective To explore the diagnostic value of CT-guided percutaneous lung biopsy for pulmonary solid lesions.Methods CT-guided percutaneous lung biopsy was performed in 97 cases of pulmonary solid lesions. The lesions were 2~10 cm (mean, 4.2 cm) in diameter, and the distance to the pleura was 0~8 cm (mean, 3.4 cm). Results Confirmative diagnoses were achieved in 73 cases of lung cancer and 21 cases of benign lesions (inflammation, tuberculosis, or sarcoidosis). The diagnostic rate was 96.9% (94/97). The biopsy could not indicate the accurate diagnosis in 3 cases, 2 of which were identified as having squamous cell carcinoma by operation, and 1 of which was followed for 2 years with no changes. Postoperative complications included 8 cases of pneumothorax, 2 cases of hemothorax, and 2 cases of emptysis. Conclusions CT-guided percutaneous lung biopsy is safe and offers a high diagnostic rate, especially suitable for lesions near the pleura.

We built a new platform based on teaching experiences and difficulties of applied psychology in Hunan University of Chinese Medicine.The new platform was built aiming at improving curriculum,establishing practice platform,reforming assessment methods and constructing supervising mode between teaching and studying.The new multi-leveled and multi-layered practice platform,starting from the mental health screening of freshmen,was consisted of levels of practice operations including mental health record-mental health assessment-psychological consult and therapy.

Aim Tostudytheprotectiveeffectsofin-hibition of neuronal nitric oxide synthase ( nNOS ) in methamphetamine ( METH ) induced neurotoxicity via oxidativestressinjuryinrats.Methods Ratmodelsof acute METH poisoning with/without 7 nitroindazole (7-NI) pretreatment were built to evaluate the protec-tive effects on the changes of ethology, nNOS, nitro-proteins, dopamine ( DA ) and apoptosis in rat stria-tum.Results ThenNOSexpression,nitroproteinex-pression and apoptosis increased significantly in the METH group( P<0. 05 ) and 7-NI pretreatment shows a dramatically protective effect against the changes ( P<0. 05 ) . DA concentration decreased significantly in the METH group(P<0. 05) and 7-NI pretreatment re-stored the depleted DA to normal level ( P >0. 05 ) . Stereotyped behavior increased significantly in the METH group and the 7-NI combined group compared with the 7-NI group and the control group(P<0. 01). Conclusions 7-NIshowssignificantprotectiveeffects against the alterations of DA level, nNOS expression, nitroprotein expression and apoptosis in rat striatum caused by acute METH poisoning. However, there is no obvious protective effect on METH-induced stereo-typed behavior.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

Organ transplantation is the most effective method to treat end-stage organ failure. As the increase of transmission risk of donor-derived diseases, the quality, safety and selection criteria of transplanted organs become more and more important. Chapter 7 of the European Union's Guide to the Quality and Safety of Organs for Transplantation (6th Edition) proposed basic requirements in terms of donor and organ quality assessment, selection criteria and procedures, which were worthy of study and practice in clinical practice.

Objective To investigate the clinical characteristics of DCD donor-derived CRKP infection and bleeding in kidney transplantation,and to summarize the experience of diagnosis,treatment and prevention.Methods A retrospective analysis was carried out from July 2016 to December 2017 in hospital,containing clinical data of 4 cases of CRKP-infected DCD donors and 7 cases of kidney transplantation recipients.Results In the CRKP culture of 4 cases of DCD donors,1 case was positive for blood culture,1 case was positive for urine culture,1 case was positive for sputum culture,and 1 case was negative for blood,urine and sputum culture.The corresponding 7 recipients were all positive for blood culture after renal transplantation,4 cases were positive for urine culture,3 cases were positive for sputum culture,and 5 cases were positive for perirenal drainage.Of the 7 patients,4 cases had renal artery hemorrhage,1 of them was died.The average bleeding time was 17.75 days after operation (14-19 days).In 7 patients with renal transplantation,CRP increasd.And in 3 cases of deaths,CRP was stably higher than normal.Meanwhile,CRP in 4 surviving patients gradually decreased to the normal range after effective anti-infection treatment.All 7 patients were treated with carbapenems;2 patients were dead without avibactam therapy;and 5 cases were treated with avibactam and carbapenems and survived,1 case died and 1 case had good renal function recovery.Conclusion Positive CRKP in blood,urine and sputum of DCD donors can lead to CRKP infection in kidney transplant recipients.Even if the body fluids of donors are all negative,the false negative results could not be excluded.Persistent or increased high-level CRP after operation is an early warning on CRKP infection.And CRP can be used as an indicator for evaluating the effectiveness of anti CRKP therapy.The combination of avibactam and carbapenem antibiotics is an effective regimen in the treatment of DCD donor-derived CRKP.