Objective To study the reproductive health status in adolescents underwent repeated abortion and their psychosocial behavioral status and to understand their demanding on the knowledge of contraception, so as to provide suggestions on post abortion care. Methods From July ,2007 to May,2008,400 unmarried adolescents who visited doctors and met the following criteria were recruited in the study:①Younger than 24 years old;②Had artificial abortion at least once;③Have been pregnant for 5-10 weeks and asked for artificial abortion. Data were collected through symptom checklist 90 (SCL-90)and anonymous reproductive health questionnaire. The situation of reproductive tract infections (RTIs) were detected through gynecological examination and laboratory tests.The data was analyzed by SPSS 11.5 statistical software. Results The mean age of the subjects was 21. 18 ±2. 46 years. The mean time of previous artificial abortion was 1.96 ± 1.44,with 52% of ≥2 times. Aged less than 20 years old at the first abortion,having sex more than 3 times per week,more than 2 sex partners,and history of painless abortion were associated with repeated abortion in unmarried adolescents. The SCL-90 scores showed that the subjects had higher score of depression, terror, psychiatric symptoms, somatization, interpersonal sensitivity,anxiety and hostility factors than normal population (P < 0. 05). Of the subjects ,34. 5% had history of RTIs, and the current prevalence of RTI was 59. 5% ,and 58. 5% with one kind of RTI and 36. 0% with two kinds of RTI. Of these RTI patients,33. 5% did not present any clinical symptoms. Abortion for more than twice,first sex intercourse occurred at age younger than 18,history of RTI,sex intercourse of more than 3 time per week,multiple sex partners,especially18,history of RTI,sex intercourse of more than 3 time per week,multiple sex partners,especiallyhaving multi sex partner at the same, and poor sex sanitation were risk factors of RTI. Conclusions There are various reproductive health problems among repeated abortion adolescents in mental and physical aspects, lack of knowledge on reproductive health and contraception is the main reason. Improving post-abortion services will be helpful to prevent repeated abortion in adolescents and protect their physical and mental health.

Objective To summarize CT features , benign and malignant differential main points of the tumors of germ cell origin in the mediastinum.Methods 32 cases with pathologically confirmed the tumors of germ cell origin in the mediastinum were retrospectively analysed.Results Of 32 cases,26 were benign tumors,including cyst mass in 10,solid mass in 9 and cyst-solid mass in 7.6 cases were malignant tumors, including seminoma in 1 ,endodermal sinus tumor or yolk sac tumor in 1,embryo cell casinoma in 1 and malignant teratoma in 3 .Typical benign teratoid tumors appeared as water to soft tissue density masses,with defined margin,fat or calcification inside the tumors,around tissues were compresed by tumors,the malignant tumors appeared as lobular or irregular masses and around organ invaded.Conclusion CT is a reliable method for the diagnosis of the tumors of germ cell origin in the mediastinum accurately.Malignant tumors of germ cell origin in the mediastinum are difficult differentiation from other mediastinal malignant tumors.

Objective To investigate the clinical effect of treatment with local skin flap after primary surgical resection of non melanoma skin cancer.Methods A total of 176 patients with head and facial skin cancer who were admitted into our hospital from September 2008 to September 2015 were divided into three groups according to different repair plans.Namely,the suture group (41 cases),the local skin flap group (81 cases) and the skin graft group (54 cases).The repair effect of the three groups were compared after the operation.Results The good rate was 68.39%(28/41) in the suture group,98.77%(80/81) in the local skin flap group,and 83.33%(45/54) in the skin graft group,and it was significantly higher than any of the other two groups with statistically significant difference(P<0.05).The satisfaction rate of the local skin flap group was significantly better than that of the suture group,and the difference was statistically significant(P<0.05).But there was no significant difference in the satisfaction rate when compared with the skin graft group(P>0.05).The 3 groups were followed up for a period of 1 year,as a result,there was no recurrence and distant metastasis.Conclusion For patients with head and facial non melanoma skin cancer,repaired with local skin flap healing treatment after primary surgical resection can not only get high healing rate but also significant improvement of patient satisfaction rate.In addition,it can lower the rate of recurrence and distant metastasis after operation.

Objective To explore the imaging features of primary bone tumors and tumor-like lesions of the skull,so that to improve the diagnostic accuracy of the disease.Methods 47cases with bone tumors and tumor-like lesions of the skull confirmed by pathology or typical imaging manifestations were retrospectively analysed.Results Of 47 cases,there were benign tumors in 22 cases,malignant tumors in 6 cases and tumor-like lesions in 19 cases.Benign tumors included osteoma of 11cases,epidermoid tumor and cyst of 4 cases,osteochondroma and neurofibromatosis of 2 cases respectively,carvernous angioma ,osteoid osteoma,and benign fibrohistiocytoma of 1case respectively.Malignant tumors included multiple myeloma and angiosarcoma of 2 cases respectively,Ewing’s tumor and osteosarcoma each and all in 1 case .Tumor-like lesions included fibrodysplasis of bone in 8 cases, Langerhans’ cell histiocytosis in 7 cases ,brown tumor and deformed osteitis each and all in 2 cases.Conclusion Primary bone tumor and tumor-like lesions of the skull are of a great variety,each one has its own imaging characteristics,the diagnosis of them should be combined with clinic and pathologic data.

OBJECTIVETo study the factors affecting the long-term prognosis of patients with myasthenia gravis (MG) after thymectomy.

METHODS170 MG patients who had undergone thymectomies were studied retrospectively. Among them, 124 patients received long-term follow-up for more than 40 months postoperatively. The COX regression analysis model was used to analyze the factors that may influence the long-term prognosis. These factors included thymus pathology, patient gender, age, duration of disease at the time of surgery, preoperative Osserman classification and medication.

RESULTSThe research showed that thymus pathology was the single independent factor that affected the postoperative long-term prognosis. The long-term survival rates differed significantly with thymus pathological types: hyperplasia > benign thymoma > atrophy > malignant thymoma (P < 0.05).

CONCLUSIONThe different pathological types of the thymus were the important factor affecting long-term survival in MG patients after thymectomy.

Adolescent ; Adult ; Aged ; Atrophy ; etiology ; Child ; Child, Preschool ; Female ; Humans ; Hyperplasia ; etiology ; Male ; Middle Aged ; Myasthenia Gravis ; mortality ; surgery ; Postoperative Complications ; Prognosis ; Survival Analysis ; Survival Rate ; Thymectomy ; adverse effects ; Thymoma ; etiology ; Thymus Gland ; pathology ; surgery ; Time Factors

Objective:To explore the changes in serum advanced receptor for glycation end-products (sRAGE) and neuregulin-1 (NRG-1) in patients with different conditions of H-type hypertension combined with acute ischemic stroke (AIS) and their relationship with short-term prognosis.Methods:A total of 185 patients with H-type hypertension complicated with AIS admitted to the Linyi Central Hospital from January 2020 to December 2022 were selected and included in the AIS group. According to the National Institutes of Health Stroke Scale (NIHSS) score, there were 55 cases in the mild group (≤4 points), 86 cases in the moderate group (5-20 points), and 44 cases in the severe group (>20 points); According to the improved Rankin scale score, the patients were divided into a poor prognosis group (>2 points) and a good prognosis group (≤2 points). Another 100 healthy individuals who underwent physical examinations during the same period in our hospital were selected as the control group. Enzyme linked immunosorbent assay was used to detect serum sRAGE and NRG-1 levels in subjects. The correlation between serum sRAGE, NRG-1 levels and NIHSS score in patients with H-type hypertension complicated with AIS was analyzed through Spearman test. A multivariate logistic regression model was used to analyze the influencing factors of poor short-term prognosis in patients with H-type hypertension complicated with AIS. The receiver operating characteristic (ROC) curve analysis revealed the predictive value of serum sRAGE and NRG-1 levels for poor short-term prognosis in patients with H-type hypertension complicated with AIS.Results:The serum sRAGE level in the AIS group was higher than that in the control group, while the NRG-1 level was lower than that in the control group (all P<0.05). The serum sRAGE levels of patients in the mild, moderate, and severe groups increased sequentially, while the NRG-1 levels decreased sequentially (all P<0.05). Spearman correlation analysis showed that the NIHSS score was positively correlated with serum sRAGE levels ( rs=0.847, P<0.001) and negatively correlated with serum NRG1 levels ( rs=-0.810, P<0.001) in patients with H-type hypertension and AIS. After 90 days of follow-up, the incidence of poor prognosis in 185 patients with H-type hypertension and AIS was 37.84%(70/185). Multivariate logistic regression model analysis showed that increased age, diabetes, increased NIHSS score, increased homocysteine (Hcy) and increased sRAGE were independent risk factors for poor short-term prognosis of patients with type H hypertension combined with AIS, while increased NRG-1 was an independent protective factor (all P<0.05). ROC curve analysis showed that the combined detection of serum sRAGE and NRG-1 levels predicted a poor short-term prognosis in patients with H-type hypertension and AIS, with an area under the curve (AUC) of 0.876, which was higher than the predicted values of 0.795 and 0.791 for serum sRAGE and NRG-1 levels alone (all P<0.05). Conclusions:Elevated serum sRAGE levels and decreased NRG-1 levels are closely related to worsening of the condition and poor short-term prognosis in patients with H-type hypertension and AIS. The combined detection of serum sRAGE and NRG-1 levels has high predictive value for poor short-term prognosis in patients with H-type hypertension and AIS.

ObjectiveTo investigate the Character of Symptom Checklist 90 (SCL-90) in detoxification addicts in reeducation center.Methods100 detoxification addicts in reeducation center were evaluated.ResultsThe results showed that the mean scores of all factors in detoxification addicts were higher than those of normal population, and there was difference between different drug dependence addicts.ConclusionThe detoxification addicts shows serious psychological disorders.

ObjectiveTo explore the effect of synthesized rehabilitation on detoxification addicts.Methods100 detoxification addicts were randomly divided into the rehabilitation group and control group with 50 cases in each group. Cases of the rehabilitation group were treated with "ten-step" rehabilitation treatment, but that of the control group did not. The rehabilitating treatment included cognitive psychotherapy, behavioral therapy, family treatment, social skill training and etc. The effects of two groups were evaluate with Symptom Checklist-90 (SCL-90) scale.ResultsExcept hostility, other factorial scores of the rehabilitation group including positive items, somatization, obsession, interpersonal sensitivity, depression, phobia, paranoid and psychotic factors were significantly higher than that of the control group (P<0.05～0.01).ConclusionThe synthesized rehabilitation can obviously improve the psychology of detoxification addicts.