Objective To analyze the validity of Caprini venous thrombosis risk assessment model (Caprini RAM) in the tunneled cuffed dialysis catheters (TCCs) dysfunction patients with central venous thrombosis (CVT).Methods A total of 187 maintenance hemodialysis patients with TCCs dysfunction admitted to West China Hospital of Sichuan University from January 2013 to September 2016 were analyzed retrospectively.According to the chest computed tomography venography results,patients were divided into CVT group and non CVT group.Their general clinical data (age,gender,primary diseases,history of dialysis access,etc.),blood biochemical data (hemoglobin,serum albumin,blood lipid,etc.) and 40 risk factors of Caprini RAM were collected.Caprini RAM scores were computed for risk stratification of thrombosis.Two groups were compared to analyze the value of Caprini RAM in these patients by statistics.Results One hundred and twenty CVT patients and sixty-seven non CVT patients were enrolled.In CVT group the duration of dialysis,hemoglobin and hematocrit were higher than those in non CVT group (all P ＜ 0.05).There was no significant difference between the two groups in gender,age,primary diseases,duration of catheter dependence,catheter tip position,usage of urokinase (all P ＞ 0.05).The average score of Caprini RAM in CVT group and non CVT group did not show statistical difference (6.23+ 1.81 vs 6.19+ 1.95,P=0.913).All patients were stratified into higher risk level and highest risk level according to Caprini RAM.Higher risk level patients accounted for 18.18％ and highest risk level patients accounted for 81.82％.As patients with inequable Caprini RAM scores,their incidence of CVT did not differ statistically (x2=0.105,P=0.746).CVT incidence rate of higher risk level patients was 61.76％,and of highest risk level patients was 64.70％.Conclusions Caprini RAM verifies that maintenance hemodialysis patients with TCCs dysfunction have high risk of venous thrombosis,but this model fails to distinguish patients between CVT group and non CVT group.Its clinical diagnosis is relatively limited and needs to be further explored.

Objective:To explore the association of peripheral blood neutrophil lymphocyte ratio(NLR) with primary osteoporosis (POP) in Chinese elderly women.Methods:From December 2015 to April 2019, a total of 788 elderly women in Chongqing Three Gorges Central Hospital were included in this study.They were divided into three groups according to bone mineral density: 242 cases of osteopenia, 206 cases of normal bone mineral density and 340 cases of osteoporosis.Their height, weight, statuses of bone of left femoral neck and results of blood tests were recorded, and the values of BMI, NLR and OSTA were calculated.The SPSS statistics software was used to analyze the differences of parameters among the three groups.Logistic regression analysis was used to get significant independent related factors for osteoporosis.The relationship of NLR and OSTA with T-score of left femoral neck was confirmed by Pearson correlation test.ROC curves were used to define the values of NLR and OSTA in diagnosis of osteoporosis.Results:There were statistically significant differences in age(median values: 66, 68 and 70, χ 2=71.596, P<0.001), BMI(median values: 23.46, 24.04 and 25.415, χ 2=64.936, P<0.001) and NLR(median values: 1.97, 2.435 and 2.84, χ 2=106.218, P<0.001) among the three groups(all P<0.01). Logistic regression analysis demonstrated that age, BMI and NLR were all independent significant related factors.There was correlation of NLR, OSTA with T-score of left femoral neck.In diagnosis of osteoporosis, the cut-off value, maximum Youden index, sensitivity and specificity were 2.395, 0.299, 70.3%, 59.6% for NLR, and -1.315, 0.174, 73.6%, 43.5% for OSTA. Conclusion:NLR has intermediate sensitivity and specificity in screening POP in Chinese elderly women, and deserves future researches.

Objective:To explore the characteristics and correlation of psychological defense mechanism and coping style of parents of children with autism spectrum disorder (ASD) .Methods:This study is a cross-sectional study. From March to August 2021, 223 parents of children with ASD in the Child Healthcare Department of Children's Hospital of Chongqing Medical University were selected by convenient sampling. The parents of the children were investigated with the General Information Questionnaire, the Defense Style Questionnaire (DSQ) and the Simplified Coping Style Questionnaire (SCSQ) . Pearson correlation was used to analyze the correlation between psychological defense mechanism and coping style. Multiple linear stepwise regression was used to analyze the impact of defense styles on coping styles. A total of 223 questionnaires were issued, 210 were recovered, and 206 were valid, with an effective recovery rate of 98.10% (206/210) .Results:Among 206 parents of children with ASD, the scores of mature, intermediate and immature defense types were (4.85±1.20) , (4.33±0.90) and (3.98±1.43) respectively. The scores of positive and negative coping in SCSQ were (1.76±0.53) and (1.18±0.58) respectively. Pearson correlation analysis showed that mature defense mechanism was positively correlated with positive coping ( r=0.26, P<0.01) and negatively correlated with negative coping ( r=-0.22, P<0.01) , and the immature and intermediate defense mechanisms were negatively correlated with positive coping ( r=-0.38, -0.22; P<0.01) and positively correlated with negative coping ( r=0.52, 0.43; P<0.01) . The multiple linear stepwise regression analysis showed that the four defense styles of complaint, expectation, sublimation and dissociation were the influencing factors of parents' positive coping in children with ASD ( P<0.05) , and projection, consumption tendency and passive aggression were the influencing factors of parents' negative coping in children with ASD ( P<0.05) . Conclusions:Although parents of children with ASD mainly use positive coping styles, they often use expectation, avoidance, fantasy and other defensive styles in psychological defense. There is a correlation between defense mechanism and coping styles. We should provide targeted social support for parents of children, improve their psychological defense and maintain positive coping styles.