Objective To investigate the occurrence of posttraumatic stress disorder (PTSD) and the relationship between PTSD and emotional regulation strategies of mothers with neonates hospitalized in the neonatal intensive care unit (NICU). Methods One hundred and twenty-seven postpartum women with neonate hospitalized in the NICU were selected from a general hospital. All the cases were investigated by PTSD check list-Civilian version (PCL-C) and emotion regulation questionnaire (ERQ). Results The incidence of PTSD of postpartum women with neonate in NICU was 13.4%(17/127). The expressive suppression scores in positive PTSD group were (17.76±2.46) points,which were significantly higher than (14.16 ± 5.14) points in negative PTSD group (t=-4.659, P<0.01). Expressive suppression contributed significantly positive correlation to the total and the dimension scores of PCL-C (r=0.187-0.243, P<0.05 or 0.01). Expressive suppression was found to contribute significantly to the explained variance in mothers′ PTSD (P<0.05), whereas no association was found between PTSD and cognitive reappraisal (P>0.05). Conclusions The admission of neonates to the NICU is a stressful event for mothers, which could cause PTSD symptoms. PTSD has a closer relationship with expressive suppression, rather than cognitive reappraisal. Therefore, health workers should instruct mothers with neonates in NICU to regulate emotions by appropriate coping strategies, decreasing the possibility of psychological problems, promoting the mental health of women in the perinatal period.

Objective To probe into the relationship of the cumulative effect of childhood trauma types and symptoms of depression and anxiety among pregnancy women. Methods A total of 276 cases of pregnancy women were investigated by using Childhood Trauma Questionnaire (CTQ- SF), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). Results The cumulative number of childhood trauma types were positively correlated with the scores of EPDS, state anxiety and trait anxiety (r=0.245, 0.262 and 0.292, P<0.01);the scores of CTQ-SF, EPDS, state anxiety and trait anxiety of multi-CTQ group were higher than that of non-CTQ group, as well as the positive rate of depression symptom and anxiety symptom (P<0.05 or 0.01);Logistic regression analysis showed that the cumulative number and accumulation group of CTQ may be predictors or risk factors of depression and anxiety of women during pregnancy, and existed cumulative effect. When the cumulative number of childhood trauma types more than two types, it increased 2.37 and 3.12 times likelihood of depression and state anxiety comparing to non-CTQ group. Conclusions It suggested that childhood trauma experience may be a risk factors of depression and anxiety during pregnancy, and exist cumulative effect.

Objective To compare effect and security between duloxetine combined with small-dose of mirtazapine and duloxetine alone in treatment of refractory depression in elder patients.Methods A total of 100 cases elder refractory depression patients were randamly divided into study group (duloxetine+mirtazapine, 50 cases) and control group(duloxetine, 50 cases).Compared HAMD,HAMA and CGI-SI between two groups, as well as the side reactions and TESS.Regression analysed mirtazapine blood concentration and HAMD subtraction rate.Results The effective rate of study group was 92.00%, while in control group was 76.00%, the difference was statistically significant(P<0.05).After treatment, the HAMD, HAMA and CGI-SI of each group significantly increased, and the difference of HAMD, HAMA and CGI-SI at 2w, 4w and 8w between two groups were statistically significant(P<0.05).The TESS and side reaction of two groups had no statistical difference.Conclusion Effect of duloxetine combined with small-dose of mirtazapine in treatment of refractory depression is better than duloxetine alone use, without significant side reaction.

Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.

Objective To explore whether emotion regulation mediates the relationship between occupational stress and job burnout in a large sample of nurses, in order to provide a targeted intervention. Methods Chinese Nurses Stressor Scale, Maslach Burnout Inventory-Human Services Survey, Emotion Regulation Questionnaire and Ruminative Responses Scale were used to investigate 602 nurses working in three tertiary hospitals in Jinan. SPSS 16.0 and AMOS 17.0 software were used to analyze the data. Results Job burnout were positively correlated with stressors, expression suppression and rumination (r=0.112–0.576, P<0.01), and negatively correlated with cognitive reappraisal (r=-0.277, P<0.01). Stressors were positively correlated with expression suppression and rumination (r = 0.140–0.403, P <0.01), and negatively correlated with cognitive reappraisal (r =-0.110, P < 0.01). Occupational stress could make a positive role on job burnout directly. Moreover, in the indirect approach, occupational stress could make a positive role on job burnout through the mediating role of cognitive reappraisal and ruminative, but not expression suppression. Conclusions Cognitive reappraisal and ruminative partially mediated the relationship between occupational stress and job burnout.

BACKGROUND:Bone cement containing antibiotics for repair of bone defects can achieve sustained release of a higher concentration of sensitive drugs, which wil help kil bacteria and provide the necessary bone grafting bed and space to reduce massive bleeding due to removal of the granulation at bone defects during the second phase. OBJECTIVE:To analyze the clinical efficacy of antibiotic bone cement combined with autologous bone transplantation and Ilizarov external fixator on tibial bone defects after traumatic osteomyelitis. METHODS:A total of 31 patients with tibial bone defects after chronic osteomyelitis, including 19 males and 12 females, aged 17-40 years old. After positive debridement of necrotic tissues at bone stump, Ilizarov external fixator was used for fracture fixation, and autogenous iliac bone grafting combined with bone cement containing antibiotics was performed to repair bone defects. Fracture healing time, knee and ankle scoring were fol owed up. RESULTS AND CONCLUSION:The 31 patients were fol owed up for 6 months to 3.5 years. Tibial fractures were healed without infection recurrence in al patients. The bony union time was 3-6 months, the fixation time was 3-6 months, and the limb extended length was (7.50±1.01) cm. No adverse reactions related to bone cement and bone graft occurred. At 3 months after bone grafting, the scores on the knee and ankle joints were improve significantly. These findings indicate that the antibiotic bone cement combined with autologous bone transplantation and Ilizarov external fixator for repair of post-osteomyelitis posterior tibial bone defects can control infection, promote fracture healing, and restore joint functions.

Abstract Ion mobility spectrometry ( IMS) based explosives detectors is wieldy deployed at the check points of airport, etc, so the development of new ionization method to replace the radioactive 63 Ni ion source in IMS is highly demanded. In this study, a novel negative corona discharge was developed for ion mobility spectrometer for rapid detection of trace explosives, which was running in the unidirectional mode to efficiently remove nitrogen oxides and ozone produced from the discharge process. The diameter of target electrode was 3 mm, the distance between the needle and the target electrode was 2 mm, the discharge voltage was 2400 V and the flow rate of drift gas was 1200 mL/min. Under the optimized conditions, the dominant reactant ions was O-2(H2O)n and could be used to directly detect the common explosives, such as trinitrotoluene (TNT), ammonium nitrate (AN), nitroglycerin (NG), pentaerythritol tetranitrate (PETN) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX). The limit of detection of TNT was 200 pg/μL. These results indicated that negative corona discharge ionization source, with the advantanges of the high sensibility, simple structure and no radioactivity, could be used as a potential and promising ionization source for ion mobility spectrometry to detect explosives.

Objective:To investigate the characteristics of posttraumatic stress disorder (PTSD) symptom and posttraumatic growth (PTG) in the patients with burns during rehabilitation, and the relationships among PTSD symptom, PTG, neuroticism and resilience.Methods:A cross-sectional study was carried out among 110 patients with burns during rehabilitation.The PTSD Check-list-Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), Five Factors Inventory-Neuroticism Subscale (FFI-N) and the 10-item Connor-Davidson Resilience Scale (CD-RISC) were used.Result:A significant effect of different groups of marital status (F=5.66, P=0.019), annual household income (F=7.97, P=0.006), and neuroticism (F=34.24, P＜0.001, Partial η2=0.259) on PCL-C scores.A significant effect of different groups of gender (F=6.44, P=0.013) and resilience (F=14.87, P＜0.001, Partial η2=0.132) were significant for PTG scores.There existed a significant interaction between neuroticism and resilience on PTG (F=4.47, P=0.037, Partial η2=0.044).Conclusion:Being married, low annual household income, and high levels of neuroticism were associated with high PTSD symptom levels.Being female and high levels of resilience were associated with high PTG levels.Resilience moderated the effect of neuroticism on PTSD symptoms.

BACKGROUNDIn grass-roots hospitals, the rate of misdiagnosis for lung cancer is rather high. The aim of this study is to investigate the reasons of misdiagnosis for lung cancer.

METHODSA total of 31 patients with signs out of lung from 1987 to 2004 were analyzed retrospectively.

RESULTSThere were different degrees of misdiagnosis in these 31 patients. One half of misdiagnostic reasons were medical factors, and the other half were due to patients' carelessness (15 cases/16 cases, 48%/52%). The medical factors included lack of knowledge of medical workers about tumor and limited conditions in grass-roots hospitals. The patient factor was mainly that they did not receive medical treatment in time.

CONCLUSIONSThe key point of reducing the misdiagnostic rate of lung cancer is to improve the professional level of medical workers and popularize peoples' knowledge about lung cancer.

Objective:Through TTC staining, immunohistochemical analysis, RT-PCR and hind limb motor function evaluation and other experimental methods, to explore the regulatory mechanism of metformin on anti-apoptosis in rats with spinal cord injury (SCI).Methods:Establish a rat spinal cord injury model. Through Basso-Beattie -Bresnahan locomotor rating scale (BBB) and cant test to evaluate the recovery of hindlimb motor function in rats. The changes of necrotic area of spinal cord tissue were compared by TTC staining. Extraction of rat spinal cord tissue, by Dot blot analysis and immunohistochemical detection of the hydroxyl of DNA methylation level. By qPCR, Western Blot detection TET2mRNA and protein expression level, and the changes in the scope of spinal cord injury were detected by inhibiting the expression of TET2. The interaction between TET2 and Foxo3a was detected by immunoblotting and immunoprecipitation. Through RT-PCR assay Foxo3a downstream related changes in the level of gene expression.Results:Compared with the SCI+NS group, the necrotic area of the spinal cord tissue was reduced after metformin treatment, and the BBB score and the incline test score were higher ( P<0.05). At the same time, we found that the levels of TET2mRNA and protein increased significantly after SCI at 24 h, and the 5-hmC level of DNA increased. The levels of TET2mRNA and protein and 5-hmC increased further after the use of metformin. After using SC-1, compared with the SCI+MET group, the level of 5-hmC decreased and the area of infarction increased. After SCI, the mRNA levels of downstream genes Bim, P27kip, Bax increased significantly. After metformin treatment, the mRNA levels of Bim and Bax were lower than those in the SCI+NS group ( P<0.05). After SCI, the 5-hmC levels of downstream genes Bim, P27kip, Bax increased significantly. After metformin treatment, the 5-hmC levels of Bim and Bax were lower than those in the SCI+NS group ( P<0.05). Conclusion:Metformin can promote the interaction between TET2 and Foxo3a, increase the 5-hmC level of the overall DNA, and inhibit the activation of related apoptosis genes, thereby improving tissue damage and nerve function recovery after spinal cord injury.