Objective: To explore the dual relationships and associated factors among Chinese counselors and psychotherapists.Methods: 1000 participants were investigated by a self-made questionnaire composed of ethical problems in psychotherapy and counseling.Results: The main dual relationships between counselors/psychotherapists and clients were the association of friends.Thirty-two percent of participants provided counseling or psychotherapy to their friends.To the item of "providing counseling or psychotherapy for their friends,students,supervisee,employees",the judges of ethical beliefs of participants were inconsistent,and forty-one percent of them thought that such behaviors were ethical.These items were the main associated factors,such as gender,the duration time of professional experience,the title of a technical post,the different experience of training,prescription,and medicine.Conclusion: The present state of nonsexual dual relationships between counselors/psychotherapists and clients are not rare,and the ethical beliefs of some participants in dual relationships were blurring.It is necessary to intensify the professional education,unify the ethical code,and accept the help of psychotherapy and supervision,in order to improve the current states of Chinese counselors and psychotherapists.

OBJECTIVETo investigate the quality of life and influencing factors for patients with silicosis and to provide a basis for treatment of silicosis.

METHODSTwo hundred and twenty stone workers with silicosis from June 1999 to June 2014 were enrolled into observation group, while healthy stone workers within the same period were used as controls. The quality of life was evaluated using the Chinese version of the World Health Organization Quality of Life Assessment (WHOQOL-100), and the influencing factors were determined using stepwise multivariate regression analysis.

RESULTSThe scores for psychological function, physiological, independence, spiritual realm, the overall quality of life, and physical condition in the observation group were significantly lower than those in the control group (t = 7.1168, P < 0.05; t = 3.8165, P < 0.05; t = 5.9230, P < 0.05; t = 2.7764, P < 0.05; t = 3.0761, P < 0.05). The scores for 11 items including pain, discomfort, energy, fatigue, sleep, and rest in the observation group were significantly lower than those in the control group (P < 0.05). Negative emotions, silicosis stage, recreation, age, reliance on health care, pain, discomfort, and spiritual beliefs were all influencing factors for the quality of life, which resulted in 68.3% of variation in the quality of life.

CONCLUSIONBesides clinical treatment, health and psychological education and recreation are important for patients with silicosis to improve their quality of life.

Case-Control Studies ; Fatigue ; Humans ; Multivariate Analysis ; Occupational Diseases ; psychology ; Quality of Life ; psychology ; Regression Analysis ; Silicosis ; psychology ; Surveys and Questionnaires ; World Health Organization

Objective To survey prevalence of behavior problems in children of off-farm workers and effects of family factors on children' s behavior problems.Methods The study was done in the whole 7 schools for off-farm workers' children in Shanghai Baoshan district,including all 3 ～ 6 grades students of primary school and 1 ～3 grades students of junior high school.Totally 4350 students finished survey (95.4％).Achenbach' s child behavior checklist ( CBCL,parent' s version) and general family questionnaire were used.Results ( 1 ) Prevalence of behavior problems in children was 11.2％ ; 12.8％ 12 ～ 16 years children had behavior problems( 14.7％boys and 10.4％ girls) ; 11.4％ of one-child children had behavior problems compared with that of 11.2％ child with siblings children ( x2 =0.038,P ＞ 0.05 ).(2) Total score ( 20.64 ± 17.67 ) and factor scores of thought problems,depressed,hyperactivity,delinquent rule-breaking behavior were higher than those of Chinese norm (P ＜0.05 or P ＜ 0.01 ) among 6 ～ 11 years boy group.Total score ( 17.23 ± 14.73 ) and scores of thought problems,depressed,social problems,hyperactivity,delinquent rule-breaking behavior were higher than those of Chinese norm (P ＜ 0.01 ) among 6 ～ 11 years girl group.Among 12 ～ 16 years boy group,total score (20.44 ± 19.32) and all factor scores of CBCL were higher than those of Chinese norm(P＜0.01 ).Total score ( 17.02 ± 16.72) and scores of immature,delinquent rule-breaking behavior,brutality were higher than those of Chinese norm(P ＜ 0.05 or P ＜0.01 ) among 6 ～ 11 years girl group.(3)Multi-regression analysis showed that poor parent-child relationship was the most important predict factor for higher score of CBCL among all family risk factors (P ＜ 0.05 ).Conclusion Children of the off-farm workers and their families need special mental health care program.

Objective:To analyze the clinical characteristics that affect the early outcomes of the elderly patients with transient ischemic attack(TIA) and provide the guidance for the prediction of disease recurrence.Methods:From January 2016 to December 2019, 315 TIA patients over 60 years old based on the time-clinical definition who were admitted to the department of neurology in Beijing Shijitan Hospital were divided into recurrence cerebrovascular events group(RCVEs group) and non-recurrence cerebrovascular events group(non-RCVEs group) according to the recurrence at 1 month after onset. The clinical characteristics of the two groups were compared by Logsitic regression analysis.Results:There were 29 cases in the RCVEs group and 286 cases in the non-RCVEs group. Compared to the non-RCVEs group, patients in RCVEs group were more likely have higher prevalence of hypertension history(14/15, 83/203), moderate or severe intracranial artery stenosis(21/8, 132/154), carotid stenosis(22/7, 107/179), DWI positive, motor symptoms, carotid artery stenting and higher times of TIA episodes(2(2, 3), 2(1, 2)), fasting blood glucose and glycosylated hemoglobin levels(8.86(8.17, 9.56)mmol/L, 5.82(5.27, 6.33)mmol/L). Logistic regression analysis showed that patients in RCVEs group had a DWI positive( B=1.634, OR=5.124, 95% CI: 2.898-9.059, P=0.000) and higher prevalence of moderate to severe stenosis of carotid artery( B=0.572, OR=1.773, 95% CI: 1.050-2.993, P=0.032). Conclusion:DWI positive and moderate to severe carotid stenosis may influence the early poor prognosis in patients with TIA.

Objective:To explore the clients' assessment for the ethical behavior of the counselors and psychotherapists.Methods:The main method used in this evaluation was questionnaire,and the self-made questionnaire of the ethical problems in psychotherapy and counseling(for the clients)were used as evaluation tools.Totally 1100 clients,from 12 cities in China,were investigated with 807 questionnaires returned.Results:84.5% of the clients were confident in the treatments,and 89.2% of them gave positive assessment for the ability of their counselors and psychotherapists.15.9% of clients said the counselors and psychotherapists showed impatience or talked to them about their stress sometimes.Besides,59.1% knew about the characters,names and charge of the psychotherapies and counseling,and 53.4% knew the background of the counselors and psychotherapists.91.3% of clients thought the privacy and treatment could be kept secret.7% of clients had intimate relationship with their counselors or psychotherapists,1.5% had sexual relations,and 18.3% made friends in lives.79% of clients could receive timely psychotherapies and counseling.Conclusion:From the assessment of the clients,the vast majorities of the counselors and psychotherapists do well in work ability,confidentiality and time-setting,but not so well in informed-consent and dual relations,which need to be paid attention to and improved.

Objective To quantitatively assess renal hemodynamic changes in hypertensive acute kidney injury in rabbits induced by L-NAME using 64-slice spiral CT functional imaging techniques,and to explore the application of these techniques in evaluation of early kidney functional changes.Methods Fourteen female New Zealand white rabbits were randomly divided into normal control group (n=6)and L-NAME group (n=8).The control group was injected NaCl solution and the L-NAME group was injected the same amount of L-NAME solution to make hypertensive acute kidney injury model.64-slice spiral CT and SPECT were scanned af-ter injection.Blood samples were collected before and after injecting NaCl and L-NAME solution to detect serum creatinine (Cr).Cr level and CT perfusion parameters of the two groups were analyzed and compared with the pathology results.GFRCT detected by con-trast-enhanced CT and GFRSPECT detected by SPECT were analyzed by the rank correlation test.Results Renal blood volume,blood flow,permeability surface,time to peak,and peak value had statistically significant differences between the control and L-NAME group (P <0.05).GFRCT and GFRSPECT had obvious correlation.GFRCT of L-NAME group was obviously lower than that of the con-trol group.The kidneys of L-NAME group showed obviously injured under both light microscope and microscope.Conclusion 64-slice spiral CT functional imaging techniques can dynamically observe and quantitatively assess early hypertensive kidney dysfunc-tion,especially unilateral renal blood flow abnormalities.It is an effective examination in quantitatively assessing kidney function.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) on quantitative analysis of re?nal cortex perfusion in hypertensive rabbits model. Methods Hypertensive rabbit modal (n=10) were established by inject?ing N-nitro-L-arginin methylester (L-NAME). CEUS and Cystatin C (CysC) serum level analysis were performed at differ?ent time points:before and the 2nd, 4th, 6th and 8th week after injecting L-NAME. Time-intensity curve and area under curve (AUC) were analyzed quantatively while correlation of AUC and CysC were also analyzed. Results Serum level of Cys C in?creased significantly at the 6th week after L-NAME administration which is earlier than the increase of serum levels of Scr and BUN. AUC decreased at first then increased after L-NAME administration. Upon addition of L-NAME, rise time (RT) and peak intensity (PI) decreased while mean transit time (MTT), time from peak to one half (HPT) and time to peak (TTP) in?creased. Our study confirmed a positive correlation between AUC and Cys C (r=0.950, P<0.001). Conclusion Setting up rabbits model by L-NAME is convenient and reproducible, which is an useful tool in experimental study of preclinical and clinical phase of hypertensive renal injury. CEUS combining with CysC serum level analysis is considered as an effective technology for evaluating renal function in hypertensive patients.

Objective To investigate acute CT radiation injury on rabbit liver after the whole body CT scans with high-dose abdominal CT scan model.Methods The forty-six New Zealand white rabbits were randomly assigned into 3 groups.High-dose CT scanning groups included one-off CT scanning group(group 1)and repeated CT scanning group (group 2)with high-dose abdominal CT scan modes,and 18 rabbits in each group.The other two groups were routine-dose CT scanning group(n=5)and control group(n=5).Rats in both group 1 and 2 were divided into 6 subgroups(n= 3).Four to twenty-four times of continuous or discontinuous CT scans with 240 mAs and 140 Kv were performed on every rabbit.The liver samples of every animal were eoUected at 48 h or 24 h after CT scans and pathological examination and immunohistochemistry assay of Cpp32 and Bax expression were performed.Results(1)Light microscope showed①in group 1,slight hepatic injury occurred at 6 times of continuous CT scanning;after 6～18 times of continuous CT scanning,hepatocytes were slight swelling at first,followed by hydropic or fatty degeneration,constriction or emphraxis of hepatic sinuses,puncture necrosis of hepatocytes,and local hepatic hemorrhage;②in group 2:slight hepatic injury occurred at 8 times of CT scanning,and after 8～24 times of CT scanning,hepatocytes were slight or mild swelling at first,followed by moderate or diffuse swelling,hydropic degeneration,and dispersed karyopyknosis of hepatocytes near central vein.(2)Immunohistochemistry assay showed:①in group 1,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were observed in part of liver samples,the expressions of Bax and Cpp32 were correlated with CT radiation dose;②in group 2,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were found in every subgroup,but the expression was not correlated with CT scan times.(3)The hepatic tissues of routine-dose CT scanning group were normal under the light microscope and immunohistochemistry assay.Conclusion Routine-dose CT scanning on liver is very safe,but high-dose CT scanning with non-routine scan times may cause acute pathological hepatic injury and hepatocyte apoptosis.

Objective:To explore the clinical characteristics, treatment and prognosis of primary cardiac tumors in infants and children.Methods:The clinical information for 21 patients with primary cardiac tumor in the Department of Pediatric Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University from May 2010 to August 2018 were analyzed retrospectively.Their median age was 7 months (gestational age 26 weeks-15 years old, and 6 cases were found in fetal phase) and 10 cases of them were male, 11 cases were girl.The clinical features, treatment methods and prognosis were summarized.Results:Among the 21 patients, 8 cases had an atypical heart murmur, 2 cases with chest tightness and chest pain, 2 cases with congestive heart failure, 1 case with dizziness and amaurosis, 1 case with cerebral artery embolism, 1 case with higher inflammatory index, and 9 cases were asymptomatic.Totally, 13 cases underwent surgical resection.All of them were confirmed as benign tumors, including 4 cases of rhabdomyoma, 3 cases of myxoma, 3 cases of fibroma and 2 cases of inflammatory myofibroblastic tumor (IMT) and 1 case of teratomas.There was no death during perioperative period.Follow-ups were performed from 3 months to 7 years, and 3 cases had recu-rrence (2 cases with myxomas and 1 cases with IMT). There were 8 cases without treatment, of which 7 cases were clinically diagnosed as transverse leiomyoma.During the follow-up, 3 cases disappeared, 1 case became small, 2 cases had no obvious change, and 1 case was lost to follow-up.One case was considered to be malignant tumor, and died within half a year.Conclusions:Primary cardiac tumors in children are mostly benign, especially transverse leiomyoma, and their clinical manifestations are diverse.Pathological examination is the golden standard for diagnosis.Surgical treatment is a radical method for most cardiac tumors, some benign tumors can be treated with drug adjuvant therapy, while the prognosis is poor for malignant cardiac tumor patients.

Objectives: To study the value of glutamine dipeptide supplemented lower caloric parenteral nutrition in elder abdominal surgical patients. Methods:Forty patients were randomly allocated into study group and control group, receiving isocaloric (83.6 kJ/kg?d -1 ) and isonitrogenous (0.16 g/kg?d -1 ) PN from post operation day1 to post operation day 6. The study group received 0.3 g of alanyl glutamine/(kg?d)? Plasma albumin, pre albumin, IgG, IgA and IgM level were measured and lymphocyte was counted before surgery and on days 1 and 7 after surgery. Nitrogen balances were calculated postoperatively on day 1, 4 and 7. Results:Compared with preoperation, plasma albumin and pre albumin levels were both decreased in two groups and was markedly decreased in the control group ( P