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 observe the application effect of intra-aortic balloon pump (IABP) in the emergency coronary intervention.Methods 76 cases patients with acute myocardial infarction complicated with cardiogenic shock were selected in the Third Affiliated Hospital of Qiqihar Medical University.41 cases in the observation group used IABP,35 cases in the control group did not use the IABP.The left ventricular ejection fraction (LVEF),ejection fraction improvement rate (postoperative EF/pre-operative EF),and the incidence of postoperative complications of IABP were compared between two groups.Results LVEF changes,the rate of improvement in ejection fraction,systolic and diastolic blood pressure were statistically significant; after six months,LVEF changes and the number of cases of death in patients were also statistically different between two groups.Conclusions For the patients with AMI and hemodynamic disorders undergoing PCI,timely IABP can effectively improve the patients’ left ventricular ejection fraction,improve the patients’ blood pressure levels and reduce mortality rate of patients.

OBJECTIVE: To explore the effects of wind and dampness pathogens on cytokines in the lung tissue of rats with cold syndrome due to different gradient cold pathogens. METHODS: One hundred and four Wistar rats of SPF grade were randomly divided into 13 groups: normal temperature group, six cold pathogen groups and six cold plus wind-dampness pathogen (wind of grade 5 and 90%-100% relative humidity) groups. The cold pathogens were constant low temperature (including 10 degrees C, 0 degree C, -10 degrees C) and temperature change (including 20 to 10 degrees C, 20 to 0 degrees C, and 20 to -10 degrees C). The rats in different groups were kept in a temperature-controlled box under the corresponding condition for 2 hours on the first day of experiment. Then, the rats were all raised in normal temperature for 4 days and the rats' behaviors were observed. The contents of tumor necrosis factor alpha (TNF-alpha), interleukin-6(IL-6) and interleukin-4 (IL-4) in lung homogenate were measured by radioimmunoassay and the content of interferon-gamma (IFN-gamma) was detected by enzyme-linked immunosorbent assay. RESULTS: In comparison with cold pathogen groups, contents of TNF-alpha, IL-6 and IL-4 were obviously increased in lung homogenate of rats in cold plus wind-dampness pathogen groups (P<0.01), and the content of IFN-gamma and IFN-gamma/IL-4 ratio were obviously decreased (P<0.01). CONCLUSION: Wind-dampness pathogen can seriously aggravate the injury to lung tissue caused by cold pathogen, and the unbalance of Th(1)/Th(2) in lung homogenate of rats.

When auditory organ is stimulated by some tones,there will be a series of electric activities in our auditory systems,we call them auditory evoked potentials.we can divide them short,middle and long latency response by their latencies.Different potentials can reflect brain function activities in different pathes of auditory nerve.In forensic medicine expertise,they can be objective evaluation in audition function and handicap of pathes of auditory nerve brain function.In this article,we summarized the mechanism and characters of different auditory evoked potentials,sumed up their application value in forensic medicine.

Objective:To evaluate the sonographic characteristics of primary lymphoma of the thyroid gland and to analyze histo-pathologic findings and other imaging features to improve the diagnostic accuracy of this disease. Methods: We retrospectively re-viewed the records of 20 patients with histologically proven primary lymphoma of the thyroid gland. The clinical, pathologic, sono-graphic, CT, and MRI features were analyzed. Results:Histology revealed non-Hodgkin lymphoma in 20 patients. Ultrasound revealed lateral thyroid lobe disease in 12 cases and the presence of unilateral masses in 8 cases. The main features seen were diffusely enlarged thyroid gland. The lateral or unilateral thyroid lobe was with hypoechoic masses intermingled with echogenic structures. A total of 16 cases showed enlarged lymph nodes, 5 cases showed invasion of trachea, and 1 case involved the trachea and esophagus. Conclusion:Primary lymphoma of the thyroid gland usually presents with clinical and sonographic findings mimicking a carcinoma or benign tu-mor. If clinical features revealed rapidly enlarging neck masses and sonographic characteristics represented by malignant features of Hashimoto thyroiditis, then we should consider lymphoma. However, the final diagnosis depends on histopathology.

Objective To evaluate endoscopic ultrasound for preoperative staging of ampullar tumors.Methods A total of 31 patients with ampullar tumors who underwent surgery from 2010 to 2015 were retrospectively reviewed.B-US,CT,MRCP and EUS were performed in all patients.The diagnostic rates of EUS and other imaging technology,and the diagnostic accuracy of preoperative staging and postoperative pathological staging were compared.Results Diagoses of 31 patients of ampullar tumors patients undergoing preoperative endoscopic ultrasonography assessment T staging were as the following:uT1,4 cases; uT2,15 cases; uT3,10 cases; uT4,2 cases.Compared with the postoperative pathological diagnosis,the T staging accuracy was 90.3％ (28/31),anong which 1 case was overestimated,2 cases were underestimated.The accuracy of endoscopic ultrasound in preoperative diagnosis of ampullar lesions was superior to other detection technology.Conclusion EUS is a valuable diagnostic tool for patients with suspected ampullar tumors.

BACKGROUND: The incidence of the adjacent vertebral fracture after kyphoplasty is about 2.4%-23.0%, and 2/3 of new fractures occurred in adjacent vertebrae in 6 months. There is controversy addressing the reason which is the development of osteoporosis or the result of bone cement augment at present.OBJECTIVE: To determine the correlations between percutaneous kyphoplasty on adjacent vertebral endoplates stresses pressure under physiologianl load and a new fracture of adjacent vertebral body in physiological load.METHODS: Computed tomography (CT) data of an old female osteoporotic patient was selected, and a three-dimensional finite element model of the osteoporetic thoracolumbar spine T_(12)-L_1-L_2 was created by using kinds of computer aided design software.The height of vertebral L_1 was compressed by 60% to simulated the compressed fracture, and the height of L_1 became the 90% of normal to simulate the replacement, two columns-like PAMA mass (4 mL) was placed in vertebral L_1 to simulate pemutaneous kyphoplasty. The stress on inferior endplate of L_(12) and superior endplate of L_2 was compared with three models. RESULTS AND CONCLUSION: Compared to the normal vertebral body, the maximum stress in the adiacent vertebral bodies endplates increased by 76% for L_1 compress fracture model and increased by 27% for kyphoplasty model, respectively. The stress on the posterior part of vertebral body after percutaneous kyphoplasty have an average increase of 13.2%, of which 4.5% increase in the pedicle, isthmus, and 6.15% increased in the key points 25.6%, but with the wedge-shaped fracture of L_1 vertebral body compared to the model, percutaneous kyphoplasty after pedicle, isthmus and the articular process had reduced stress. The results indicate that the stress on inferior endplate of L-(12) and superior endplate of L_1 increased after percutaneous kyphoplasty under all loading conditions. Increased stress may lead endplate fracture, and increase the risk of adjacent vertebral body fracture. Further researches are needed to support the conclusion.

OBJECTIVE:To systematically review the efficacy and safety of gemcitabine combined with docetaxel in the treat-ment of non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Elsevier,CJFD,Wangfang Database and VIP,randomized controlled trials(RCT)about the ef-ficacy and safety of gemcitabine combined with docetaxel(test group)versus the 3rd generation chemotherapeutic agents combined with cisplatin(control group)in the treatment of NSCLC were collected. Meta-analysis was performed by using Rev Man 5.3 soft-ware after quality evaluation by modified Jadad scale. RESULTS:Totally 9 RCTs were included,involving 1 986 patients. Results of Meta-analysis showed,there were no significant differences in the total effective rate [RR=0.93,95%CI(0.83,1.05),P=0.27], 1-year survival rate [RR=0.97,95%CI(0.87,1.09),P=0.64],the incidences of liver dysfunction [RR=0.35,95%CI(0.06,2.18), P=0.26] and leukopenia [RR=0.80,95%CI(0.57,1.10),P=0.17] and decreased rate of hemoglobin [RR=0.65,95%CI(0.25, 1.69),P=0.38] in 2 groups;the incidences of liver dysfunction [RR=0.09,95%CI(0.02,0.38),P=0.001] and neurotoxicity in test group were significantly lower than control group,while the incidence of lung injury [RR=8.71,95%CI(2.04,37.12),P=0.003] was significantly higher than control group,the differences were statistically significant. CONCLUSIONS:Gemcitabine com-bined with docetaxel shows similar efficacy to the 3rd generation chemotherapeutic agents combined with cisplatin in the treatment of NSCLC,less effect on renal function and nerve while high on pulmonary toxicity.

Objective To evaluate the value of dynamic susceptibility-contrast (DSC) MR perfusion imaging in differentiating benign and malignant meningiomas on the basis of differences in their vascularity in both tumor parenchyma and peritumoral region. Methods 33 patients with pre-operation meningiomas(25 benign and 8 malignant) underwent conventional and DSC MR perfusion imaging. Maximum relative cerebral blood volume (rCBV) and corresponding relative mean transit time (rMTT) values of the same part in both tumor parenchyma and peritumoral region were calculated (compared with contralateral normal white matter). The peritumoral region was defined as the area immediately adjacent (0.05) in parenchyma part and both were statistically significant (t test, ?

Objective To investigate the effects of improved end-to-end invagination pancreaticojejunostomy on the occurrence of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 396 patients who received pancreaticoduodenectomy at the Cancer Hospital of Shandong Province from January 2001 to January 2011 were retrospectively analyzed.All patients were divided into the improved group(235 patients)and traditional group(161 patients)according to different anastomotic methods.All the operations were done by the same surgical group,and the digestive tract was reconstructed by the Child method.Patients in the improved group received improved end-to-end invagination pancreaticojejunostomy,and patients in the traditional group received traditional end-to-end anastomosis.The volume of operative bleeding,operation time,incidence of pancreatic fistula and duration of hospital stay of the 2 groups were compared.All data were analyzed using the t test,chisquare test or Fisher exact probability.Results The operative blood loss,operation time and duration of hospital stay were(383 ±56)ml,(7.2 ± 1.0)hours,(21 ±3)days in the improved group,and(381 ±39)ml,(7.0 ± 0.5)hours,(22 ± 5)days in the traditional group,with no significant difference between the 2 groups(t =0.388,1.680,-1.835,P ＞ 0.05).No operative death was detected in the 2 groups,and the overall incidence of pancreatic fistula was 7.6％(30/396).The incidence of pancreatic fistula of the improved group was 0(0/235),which was significantly lower than 18.6％(30/161)of the traditional group(P ＜ 0.05).Patients complicated with pancreatic fistula in the traditional group were cured by drainage,somatostatin administration and parenteral nutrition.Conclusion Improved end-to-end invagination pancreaticojejunostomy can significantly reduce the incidence of pancreatic fistula after pancreaticoduodenectomy.