Objective To study the Mediating effect of insecurity between childhood abuse and emotional distress of medical students,and to provide basis to intervene their mental disorder.Methods Through stratified sampling,262 medical students in Jiangsu were investigated by the Personal Report of Childhood Abuse( PRCA),Self-Rating Feeling of Insecurity Scale( SRFIS),Beck Depression Inventory( BDI ),Self-rating Anxiety Scale(SAS)and Suicide Ideation Scale(SIS).A path analysis was applied by Analysis of Moment Structures(AMOS) version 7.0.Results The path analysis showed that childhood abuse was directly related to insecurity of medical students ( β =0.538,P ＜0.01 ),and was directly related to emotional distress ( β =0.435,P ＜ 0.01 ).Insecurity were directly related to emotional distress of medical students ( β =0.342,P ＜ 0.05 ).Insecurity mediated partly the relationship between childhood abuse and emotional distress of medical students.The model fit indexes were X2/df =1.365 ＜ 3.000,P =O.082 ＞ 0.05,RMSEA =0.037 ＜ 0.050,GFI =0.971,AGFI =0.940,NFI =0.943,RFI =0.902,IFI =0.984,TLI =0.972,CFI =0.984.Conclusion Insecurity as mediated variable mediates the relationship between childhood abuse and emotional distress of medical students.

This study was aimed to observe the therapeutic effect of liver cirrhosis treated with Tibetan medicine . A total of 70 liver cirrhosis identified cases were orally administrated with Tibetan medicine for 45 days. The results showed that the cure rate, improvement rate, ineffective rate, and total effective rate were 24 . 29% ( 17/70 ) , 67 . 14% ( 47/70 ) , 8 . 57% ( 6/70 ) , and 91 . 43%. There were no significant differences on the routine tests of blood , urine , stool and renal function before and after the treatment . It was concluded that Ti-betan medicine has unique therapeutic effects in the treatment of liver cirrhosis without any obvious poisonous or side effect .

Objective:To study an identifying model of HPLC fingerprint for the overall quality control of traditional Chinese medicine. Methods: A HPLC method is used to establish the standard fingerprint as well as sample fingerprint first. Then through the principles of numerical taxonomy and statistics, the similarity of the sample to the standard is tested by coefficients of cosine and distant, which are calculated with computer. Results: The combination of the two coefficients of cosine and distant can test the similarity of the sample to the standard correctly and accurately. Conclusion: The coefficients along with HPLC fingerprint can be applied to the on-line control in workshop to ensure the products' quality of all batches.

Adult albino rats were exposed to simulated high altitude of 5000 m for 72 hours. Mild degree of interstitial pulmonary edema was observed under light microscope. Rats with the left lung excised were subjected to hypoxice of the same degree for 48 hours. On histologic examinations interstitial edema of the right lung was more obvious than that of the previous group. In isolated alveolus or in small groups of alveoli, edematous fluid could he seen.There were perivascular and peribronchial "Cuffs". The former were supposedto be accumulation of edema fluid leaking from the capillaries at the level of alveoli. The latter might be the result of extension of perivascular fluid to the peribrochial space.Excision of the left lung may result in a rise in pulmonary arterial pressure and over perfusion in certain areas remaining lung. Hypoxia may intensify the above changes. Pulmonary hypertension and overperfusion may in force promote the genesis of pulmonary edema.

Background With the events reporting on odors in drinking water, odorous substances in water have become a hot topic in water quality analysis. Due to the low concentration of the odor threshold and the complexity of the odor components in water, it is difficult to make accurate qualitative and quantitative analysis. So it is necessary to develop a highly sensitive and accurate qualitative and quantitative analysis method. Objective To establish a method for simultaneous determination of four odorous substances, including dimethyl disulfide, dimethyl trisulfide, 2-methylisoborneol, and geosmin in water by purge and trap-gas chromatography-tandem mass spectrometry. Methods A certain amount of water sample was stored in the sample vial of a purge and trapinstrument. Through nitrogen purging, the odorous substances in water were purged out and enriched in the trap. Subsequently, the odorous substances were rapidly released at high temperatures after heating the trap, and then carried by carrier gas into gas chromatograph. After temperature programming, the substances were separated by an Agilent DB-624 capillary chromatographic column (30 m×0.25 mm, 1.4 μm) and determined by tandem mass spectrometry in multiple reaction monitoring modes, with internal standard method for quantification. The current project optimized purge time, sodium chloride concentration in water sample, desorption temperature, desorption time, and split ratio during the experimental process. Under the optimized experimental conditions, the standard curve, detection limit, and quantification limit were validated. Recovery tests with spiking concentrations of 5.0, 10.0, 30.0, 80.0 ng·L⁻¹ and precision tests were conducted on water samples. Finally, the established method was applied to detect odorous substances in source water, finished water, and pipeline water in Deqing County of Huzhou City. Result After the optimization, the purge time was 20 min, the desorption temperature was 280 ℃, the desorption time was 2 min, the split ratio was 10∶1, and no sodium chloride was added during the purge process. Under the optimized experimental conditions, the calibration curves for the four odorous substances showed an excellent linearity in the range of 1 to 100 ng·L⁻¹ (R>0.999), with 0.3 ng·L⁻¹ limit of detection and 1.0 ng·L⁻¹ limit of quantitation. The average recoveries were from 85.5% to 102.4% and relative standard deviations (RSD) from 1.6% to 5.2%. After applying this method to detect local source water, finished water, and pipeline water, it was found that the positive rates of 2-methylisoborneo, and geosmin were relatively high, while the positive rates of dimethyl disulfide and dimethyl trisulfide were relatively low. Only one sample of source water tested positive for dimethyl disulfide, and all samples were negative for dimethyl trisulfide. Conclusion Combined with the superiority of purge and trap and tandem mass spectrometry, the method has the advantages of easy to perform, strong anti-interference ability, good accuracy and precision, which meet the limit requirements of the four odorous substances in the expanded indices and reference indices of Hygienic standards for drinking water (GB 5749-2022). It also provides technical support for water quality assessment and analysis of odorous substances.

Objective To investigate the factors associated with contralateral recurrence of primary spontaneous pneumothorax And prosvide referencee for how to prevent primary spontaneous Pneumothrorax with Contralateral recurrence.Methods From January 2006 to December 2011,the clinical follow-up data of 203 patients with primary spontaneous pneumothorax were reviewed.The median follow-up time was 43 months.Results Two hundred and three patients developed 241 recurrences,among which 27 patients had contralateral recurrences.The average time of contralateral recurrence was 20.19 months.Patients with contralateral recurrence of primary spontaneous pneumothorax had smaller age(P ＜ 0.05),lower body weight (P ＜ 0.05) and lower body mass index (P ＜0.01).All patients with contralateral recurrence of primary spontaneous pneumothorax received surgical treatment and were found bullae during surgery.Three patients had unilateral recurrences of pneumothorax during follow up,with single-stage bilateral video-assisted thoracoscopic surgery for bilateral primary spontaneous pneumothorax.Conclusions Contralateral recurrence of primary spontaneous pneumothorax is more common in patients with small age,low body weight and low body mass index.These patients could perform high-resolution computerized tomographic scan of the lung before surgery.Single-stage bilateral video-assisted thoracoscopic surgery may be considered for these patients with contralateral bullae on high-resolution computerized tomographic scan of the lung to prevent contralateral recurrence of primary spontaneous pneumuothorax.

Objective To analysis the related influencing factors and explore the approach of improving the effect of platelet transfusion through compared the posttransfusion effect of matched-type with random platelet transfusion.Methods Analysis the results of platelet antibody screening test and matched-type test in our hospital′s inpatients during July 2013 to June 2014,who applied for platelet transfusion.The influence of sex,blood transfusion history,pregnant history on the antibody were analyzed.The factors of sex,times of blood transfusion,pregnant times,platelet component sorts,storage time,combined with other components,platelet antibody (positive or negative) and transfusion matched-type platelet on the effect of platelet transfusion were analyzed.Application in our clinical blood transfusion intelligent management and evaluation system to evaluate the effect of platelet transfusion.Results Totally 812 patients′ platelet antibody were screened.Then we randomly selected 87 antibody positive inpatients were selected and 1 247 U plateletswere transfused,which including matched-type platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening negative patients,there were statistical difference (P<0.05).With Logistics regresion analysis,the history of blood transfusion was an independent risk factor for platelet antibody production (P<0.05,OR=13.104,95%CI:7.784-22.061).Sex (P<0.05,OR=1.629,95%CI:1.236-2.148),transfusion times,different platelet component sorts (leukocyte-reduced platelets aphaeresis and irradiation leukocyte-reduced platelets aphaeresis),different storage time,transfusion combined with other components (RBC)(P<0.05,OR=2.464,95%CI:1.053-5.765),transfusion matched-type platelet(P<0.05,OR=0.576,95%CI:0.389-0.854) were the risk factors for platelet transfusion.Conclusion Matched-type test should be done to improve efficiency when the platelet antibody screening were positive.Sex,times of blood transfusion,platelet component sorts,storage time,combine with other components,transfusion matched-type platelet couldinfluence the effect of platelet transfusion.

Objective To evaluate the transfusion efficacy and safety of patients with non‐specificity irregular antibodies .Meth‐ods A total of 19 cases of patients with non‐specificity irregular antibodies were analyzed ,then the transfusion efficacy and the in‐cidences of adverse transfusion reactions were investigated .Blood donor samples with the same ABO blood type of patients were randomly collected ,then blood cross‐matching was carried out .And the transfusion efficacy and safety of patients with non‐specific‐ity irregular antibody were evaluated when compatible blood were found by using both micro‐column gel technique and saline meth‐od .Results The non‐specificity irregular antibodies of the 19 cases of patients all were IgG irregular antibodies .The erythrocyte transfusion was carried out in the 19 cases of patients ,the total efficiency rate ,partial efficiency rate and inefficiency rate was 73 .7% ,26 .3% and 0 .0% ,respectively .No delayed hemolytic transfusion reactions were observed in any patient .Conclusion For patients with non‐specificity irregular antibodies ,the blood transfusion could be efficacy and safety when compatible blood samples are confirmed by using both micro‐column gel technique and saline method .

Vascular tissue engineering is a novel approach by which an ideal vascualr graft constructed in vitro that will not be obstructed for a long time without immunological reaction after implantation. This article reviewed the definition of the tissue engineering blood vessel (TEBV), cellular resourses, the selection of biocompatible materials, the devising methods and the research achievements. Furthermore, it also discussed the current problems of TEBV and looked forward to future clinical application.
Biocompatible Materials ; Bioprosthesis ; Blood Vessel Prosthesis ; Cell Culture Techniques ; Tissue Engineering ; methods

OBJECTIVETo evaluate the value of three preoperative imaging methods in the anterolateral thigh flap (ALT) transplantation.

METHODSAccording to preoperative imaging, patients who underwent the ALT flap transplantation were divided into three groups: computed tomography angiography (CTA) group, digital subtract angiography ( DSA) group and magnetic resonance angiography (MRA) group. There were fifteen cases in each group. We compared the imaging quality of the ALT artery among these groups and recorded the parameters of lateral femoral circumflex artery, descending branches and perforators including type, course and size. The results from images were compared with intraoperative findings. The success rate and complications were also recorded.

RESULTSThe preoperative imaging accuracy of the types of the lateral femoral circumflex artery and descending branch was more than 92.3%, with no significant different between any two of three groups (P > 0.05). The difference in diameters of descending branches and perforators from preoperative measurement and from intraoperative measurement was also not significant between any two of the three groups; the success rate and complications were not also obviously different (P > 0.05 , P > 0.05, respectively).

CONCLUSIONSPreoperative mapping using CTA, DSA and MRA is a feasible and reliable method for the flap design in ALT transplantation. As a preoperative evaluation means, CTA and MRA may replace DSA in the ALT transplantation.

Angiography, Digital Subtraction ; methods ; Feasibility Studies ; Femoral Artery ; anatomy & histology ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Preoperative Care ; Surgical Flaps ; transplantation ; Thigh ; Tomography, X-Ray Computed