ObjectiveTo explore the influence of domestic violence on drinking and aggressive behaviors of adolescent， and to analyze the mediating role of psychological needs and moral disengagement. MethodsA cluster stratified random sampling method was adopted to select 1 280 students from 2 junior high schools and 2 high schools in Dazhou City， and all the enrolled students were assessed using Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Basic Psychological Needs Scale （BPNS）， Moral Disengagement Scale （MDS） and Adolescent Health related Risky Behavior Inventory （AHRBI）. Then the relationship of domestic violence with drinking and aggressive behaviors， along with the mediating roles of psychological needs and moral disengagement were discussed through the chain mediating effect analysis. ResultsCTQ-SF score was negatively correlated with BPNS score （r=-0.160， P=0.012）， and positively correlated with MDS and AHRBI scores （r=0.330， 0.250， P<0.01）. BPNS score was negatively correlated with MDS and AHRBI scores （r=-0.220， -0.270， P<0.01）. MDS score was positively correlated with AHRBI score （r=0.420， P<0.01）. The direct mediation value of domestic violence to drinking and aggressive behaviors was 0.041 （P>0.05）， the mediation effect values of domestic violence to psychological needs， domestic violence to moral disengagement， psychological needs to moral disengagement， psychological needs to drinking and aggressive behaviors， and moral disengagement to drinking and aggression behaviors were -0.468， 0.536， -0.241， -0.412 and 0.094， respectively （P<0.05）. The total mediation effect value of domestic violence to psychological needs to moral disengagement to drinking and aggressive behaviors was 0.295 （P<0.05）. ConclusionPsychological needs and moral disengagement mediate the influence of domestic violence on adolescent drinking and aggressive behaviors.

Objective To compare the efficacy of transumbilical-ultrafine gastroscope sympathectomy for severe palmar hyperhidrosis using two distinct levels of T3 and T4.Methods A total of 84 cases with severe primary hyperhidrosis were randomly allocated to undergo either T3 sympathectomy treatment (T3 group, n =42) or T4 sympathectomy treatment (T4 group, n =42) with no difference between the two groups.The operation time, postoperative hospital stay, patient's hands hyperhidrosis, axillary hyperhidrosis,complications were recorded at follow-up in 1,3,6,12 months.Results Operation on 84 patients were successful with mean operative time of T3 group being 55.02 ± 10.61 min and T4 group being 55.36 ± 10.51 min(P ＞ 0.05).The mean postoperative hospital stay were both 1.5 days.Patients were followed up for diaphragmatic hernia, umbilical hernia, Horner's syndrome and other serious complications for 12 months.No postoperative recurrence of palmar hyperhidrosis, severe compensatory sweating occurred in either group.The number of improved patients in T3 group's palmar hyperhidrosis,axillary hyperhidrosis, and foot hyperhidrosis were :42/42 cases, 10/16 cases, 21/29 cases, while those in T4 group were: 42/42 cases,16/17 cases 18/28 cases.Axillary hyperhidrosis improved to a larger extent in T4 group than in T3 group (P ＜0.05).There were 16(15 mild and 1 moderate)compensatory sweating in T3 group and 7(6 mild and 1 moderate) compensatory sweating in T4 group (P ＜ 0.05).Conclusion T3 and T4 thoracic sympathectomy using transumbilical-ultrafine gastroscope for primary palmar hyperhidrosis are safe, effective, and feasible.T4 sympathectomy is more effective in improving axillary hyperhidrosis than T3 and shows lower occurrence of postoperative compensatory hyperhidrosis.

Objective To evaluate the safety and feasibility of endoscopic transumbilical thoracic sympathectomy.Methods The technique was performed in 4 swine models.Under general anesthesia,a newly developed long abdominal trocar (60 cm in lengths) was placed through the umbilicus,which was also used to establish pneumoperitoneum.After insertion of gastroscope through this trocar,two small incisions of diagrams were created by needle-knife,through which the gastroscope was sent into the thoracic cavity to ablate the T3 ganglia by Hot biopsy forceps under One-lung ventilation.The animals were killed at the completion of the procedure.Results This procedure was completed in four pigs.The sympathetic chain was successfully ablated in all swine,as confirmed by gross surgical pathology and histology,the mean operative time was (81.7 ±15.4) minutes.There was no major bleeding.All bilateral T3 sympathetic chains were successfully ablated in the 4 swines as confirmed by gross surgical pathology and histology.There was no severe bleeding and damage to peripheral organs during the operation in any of the cases,and no prominent pneumothorax was revealed by postoperative chest X-ray radiography.Conclusion Endoscopic transumbilical thoracic sympathectomy is safe,feasible and effective with good cosmetic result.

Objective To investigate the clinical value of transumbilical endoscopic thoracic sympathectomy on women patients with palmar hyperhidrosis.Methods A total of 25 consecutive women patients with palmar hyperhidrosis underwent transumblical thoracic sympathectomy with ultra-thin endoscope.The operative data,including duration of operation,intra-operative and postoperative complications were recorded.Results The procedure was performed successfully in all 25 patients with a mean operative time of 64 min(58-113 min).No umbilical hernia,diaphragmatic hernia,Horner's syndrome or hemothorax were observed.Minor pneumothorax was found in postoperative chest X-ray in 3 patients,all of which were completely resolved with conservative treatment.All patients recovered to their normal life at 1 week after discharge.The scar was small and hidden in umbilical with no visible incisions.After a follow-up of 4 to 12 months,all patients' hands sweating symptoms completely disappeared,axillary sweat symptoms completely resolved in 6 patients,significantly improved in 4 and mildly improved in 1.Conclusion Transumbilical thoracic sympathectomy with ultrathin flexible endoscope is a safe and effective option for women patients with severe palmar hyperhidrosis,which provides excellent cosmetic outcomes.

Objective To investigate the diagnostic value of the modified esophageal capsule endoscopy (stringed esophageal capsule endoscopy,SCE) for esophageal diseases.Methods A total of 80 patients with esophageal related symptoms underwent SCE followed by esophagogastroduodenoscopy (EGD).The examination time,detection rate of esophageal lesions,complications and adverse effects were compared.Results All patients completed the study.The mean examination time of SCE and EGD was 226.18 ± 1 10.30 seconds and 21.28 ± 8.01 seconds respectively (t =-16.665,P =0.000).A total of 119 lesions were detected by SCE and EGD,and the diagnostic accordance rate of SCE and EGD was 82.4％ (98/119).Ten lesions of advanced squamous carcinoma,5 lesions of high grade intraepithelial neoplasia and 3 lesions of early squamous carcinoma were detected by both examinations,all of which were confirmed by histopathologic examination.The overall rate of complication in SCE (1.3％,1/80) was significantly lower than that of EGD (8.8％,7/80,x2 =4.238,P =0.040) and the rates of swallow difficulty (P =0.022),throat discomfort (P =0.007) and vomiting (P =0.000) of SCE were significantly lower than those of EGD.Conclusion SCE is a feasible,easy-to-operate,safe,well tolerated and accurate method for detection of esophageal diseases,and could be a non-invasive alternative for conventional EGD.

Objective To prepare serum cholesterol and triglycerides reference materials.Methods Blood units were collected from healthy donors and the sera separated and screened for cholesterol and triglycerides levels.Four serum pools were prepared by pooling sera grouped according to cholesterol and triglyceride levels.The materials were tested for homogeneity and stability and their values for total cholesterol,total glycerol and free glycerol and triglycerides were assigned by HPLC methods.Results The materials were tested to be homogeneous and stable for at least 4 years at-20℃.The certified values (reference value±expanded uncertainty)of the 4 materials for total cholesterol were(5.110±0.065) mmol/L,(4.761±0.062)mmol/L,(3.941±0.050)mmol/L and(3.158±0.041)mmol/L,respectively;for total glycerol(2.212±0.043)mmol/L,(1.679±0.033)mmol/L,(1.275±0.027)mmol/L and(1.067±0.023)mmol/L;for free glycerol(0.142±0.005)mmol/L,(0.149±0.004)mmol/L,(0.146±0.003)mmol/L and(0.122±0.003)mmol/L;and for triglycerides(2.069±0.043)mmol/L,(1.530±0.033)mmol/L,(1.129±0.027)mmol/L and(0.945±0.023)mmol/L.Conclusion Certified reference materials for serum total cholesterol,total glycerol,free glycerol and triglycerides have been prepared.

Bismuth quadruple therapy is recommended as a first-line therapeutic regimen for Helicobacter pylori (Hp) infection in China.However, the renal toxicity induced by bismuth resulted in limitation of its clinical use.Aims: To assess the efficacy and safety of hybrid therapy for initial eradication of Hp infection.Methods: One hundred and fifty-two patients proved to be positive for Hp infection and treatment-na(i)ve at the Fuzhou General Hospital of Nanjing Military Command of Chinese PLA from Jan.2014 to Dec.2015 were enrolled and randomized to receive either hybrid therapy (esomeprazole and amoxicillin for 7 days, followed by esomeprazole, amoxicillin, clarithromycin and metronidazole for 7 days) or bismuth quadruple therapy (esomeprazole, amoxicillin, clarithromycin and colloidal bismuth pectin for 14 days).Hp eradication was assessed by 14C/13C-urea breath test at a minimum of 4 weeks after the end of treatment.Results: No significant differences were found in general status between the two groups at baseline (P>0.05).A total of 149 patients completed the therapy.In hybrid therapy group the eradication rate was 97.4% (75/77) by ITT analysis and 98.7% (75/76) by PP analysis;while in bismuth quadruple therapy group the eradication rates by ITT and PP analyses were 89.3% (67/75) and 91.8% (67/73), respectively.Hybrid therapy was superior to bismuth quadruple therapy (P all <0.05).Although the incidence of adverse events was higher in hybrid therapy group than in bismuth quadruple therapy group (29.9% vs.16.0%, P<0.05), none of the patients discontinued the therapy because of severe adverse events.Conclusions: Hybrid therapy showed better efficacy than bismuth quadruple therapy for treatment of Hp infection, and the adverse events were well tolerated.Hybrid therapy might be used as first-line treatment for Hp infection.

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OBJECTIVETo investigate the molecular basis of an individual featuring weak A phenotype of ABO blood group system.

METHODSSerologic investigations, serum transferases activity assay and absorption-elution test were carried out to identify the ABO blood group. The 7 exons and flanking introns of ABO glycosyltransferase gene were amplified with polymerase chain reaction (PCR). The products were sequenced bidirectinally following enzyme digestion. Haplotypes of exons 6 and 7 of the ABO gene were analyzed.

RESULTSA weak A antigen was identified on red blood cells of the proband. Eight heterozygous sites in exons 6 and 7 (261delG 297A/G, 421C/T, 467C/T, 646T/A, 681G/A, 771C/T, 829G/A) of the ABO gene were identified. Based on haplotype analysis, one allele was determined as O02, while a novel mutation 421T>C was identified in another allele, which resulted in the amino acid change Ser141Pro of the A glycosyltransferase.

CONCLUSIONAbove results suggested that amino acid substitutions resulted from a novel mutation 421T>C of the ABO gene may decrease the enzymatic activity and result in the weak A phenotype.

Objective To compare the clinical effect of the two operating methods: screws through fractured pedical arch operating method versus traditional operating method in the treatment of thoracolumbar burst fractures, to confirm the clinical advantages of screws through fractured pedical arch operating method in the treatment of thoracolumbar fractures. Methods A total of 62 cases suffered from thoracolumbar burst fractures were divided into two groups:screws through fractured pedical arch operating method group (n=27) and traditional operating method group (n=35). Each group was undergone the corresponding operation. The clinical results were evaluated between two groups. Results Patients in the screws through fractured pedical arch group by contrast to traditional group, margin height, Cobb's angle, internal fixation failure rates and area of vertebral canal were different, there was significant differences (P<0.01). Conclusion Screws through fractured pedical arch operating method had many advantages, which had a promising clinical applica-tion in the treatment of thoracolumbar burst fractures.