Objective: To exploration the self-efficacy, self-esteem, and positive/negative affect and the re-lationships among them in Chinese adolescents. Methods: The Rosenberg's Self-Esteem Scale, Generalized Self-Ef-ficacy Scale, and Adolescents Positive/Negative Affect Scale were administrated to 2247 middle school students sampled from 16 schools from 6 districts. Results: Self-esteem tended to increase as grade [(2.91±0.38), (2.93±0.41), (3.01±0.41), (2.98±0.44), (3.04±0.41), (3.17±0.42)]. Boys had higher self-efficacy [(2.74±0.39)vs.(2.68±0.40), P <0.001]. Two senior grades had higher self-efficacy than other 4 grades (P<0.05). Girls had higher positive and negative affect [(2.77±0.67)vs.(2.68±0.67), (2.22±0.70) vs.(2.13±0.68), Ps <0.05]. Junior grade one had the highest positive effect (2.85±0.62), grade one and two in high school had more negative effect than other 4 grades (2.26±0.71, 2.25±0.73).Self-efficacy and self-esteem were positively correlated with positive affect (r=0.24, 0.36), negatively correlated with negative af-fect (r=-0.17, -0.32) ; self-esteem significantly mediated the relationship between self-efficacy and positive/negative affect (Z=13.00, -13.07) . Conclusion: Self-esteem tends to increase as grade, boys have higher self-efficacy than girls, and girls have higher positive and negative affect than boys. Self-esteem mediates the rela-tionship between generalized self-efficacy and positive/negative affect in Chinese adolescents after controlling the effects of gender and grade.

Objective　To better understand the clinical characters of juvenile onset spondyloarthropa-thies (JSpA).Methods　The clinical and laboratory data of 190 in-patients with JSpA were analyzed and the diagnosis,classification and differentiation of juvenile onset arthritis were discussed.Results　Among these 190 patients,163 were male,with a male to female ratio 6∶1.Of them 92.1% had the disease after the age of 8.Peak of age at onset was 12 to 15 years;157(82.6%) patients had peripheral arthritis and only 23(12.1%) patients felt low back pain at onset.During the disease course, peripheral arthritis was found in 187(98.4%) patients and the history of low back pain or buttock pain was recorded in 123(64.7%).The interval between peripheral arthritis and low back pain was from 0 to 20 years,with an average of (3.2±4.5)years.Extra-articular features including enthesitis in 67(35.3%)patients,dactylitis in 20(10.5%),iritis in 9(4.7%) were observed.HLA-B27 was positive in 87.9%(160/182) patients.Sacroiliitis on X-ray was observed in 76.0%(136/179) patients,and 106(55.8%) patients were diagnosed juvenile ankylosing spondylitis (JAS) according to 1984 New York modified criteria.The average disease course in JAS was (6.3±6.2) years,longer than that in JSpA (P＜0.01).Conclusion　The concept of JSpA is helpful to early diagnosis and treatment of juvenile onset arthritis.The JSpA are characterized by asymmetric lower limb predominant oligoarthritis,a wide spectrum of extra-articular features,presence of HLA-B27 and familial history of SpA or psoriasis.It will take an average of 6.3 years for JSpA patients to fulfill the diagnostic criteria of adult AS.

Objective To probe into protective action of taurine against exhaustive,exercise induced myocardial damage in rats.Methods Using the model of exhaustive exercise,the present study researches into the effects of taurine on the content of thyroid hormone(T3,T4)in serum and myocardium as well as T45'－ DI activity in myocardium of rats.Results The content of T3 in serum and myocardium,T45'－ DI activity in myocardium were significantly increased(P<0.01)while that of T4 in serum and myocardium had no significantly changed after exhaustive exercise,the supplement of taurine might significantly inhabits the changes.Conclusion Taurine could protect myocardium from exhaustive exercises induced damage by inhabiting hypermetabolism of thyroid hormone.

Objective:The efficacy and toxicity of anticancer drugs differ in different tumor patients. It could not meet the requirements of optimization of tumor treatment if only under the guidance of clinical and pathologic characteristics. More and more attention is focused on individualized therapy based on individual gene profiles. It has been identified that gene polymorphisms are responsible for different outcomes of individuals. Gene polymorphisms, including sequence polymorphism and single nucleotide polymorphism, will decrease the clinical efficacy of chemotherapeutic drugs or increase adverse reactions by influencing the expression or activity of the corresponding proteins. In recent years several gene polymorphisms related to drug metabolism, transportation, or inactivation may affect the outcomes of chemotherapy and the frequency of adverse reactions. Identification of the polymorphism genes is important for individual therapy for tumor patients.

Objective To explore the prognosis impact of lymph nodes metastasis in pancreatic cancer.Methods The clinical data of 61 patients with pancreatic cancer who underwent pancreaticoduodenectomy from January 2004 to September 2011 were analyzed retrospectively.Patients were categorized into different groups by lymph nodes metastasis status,count of positive lymph nodes,location of positive lymph nodes,lymph nodes ratio (LNR) and other factors.Kaplan-Meier,log-rank and COX proportional hazard models were used to evaluate the prognostic effect.Results Median survival for the overall 61 patients was 13 months (95％ CI 9.158-16.842),with 6 months,1 year,3 years,5 years survival rates of 84.6％,47.7％,14.3％ and 9.1％ respectively.Univariate analysis showed:the median survival of patients with and without lymph nodes metastasis had statistical significant outcome (P ＜ 0.01).Patients within the first station lymph nodes metastasis had a better outcome than those lymph nodes metastasis beyond the first station (P ＜0.05).Patients with LNR ≤0.2 had better prognosis than those LNR ＞ 0.2 (P ＜ 0.01).The number of lymph nodes examined had no effect on overall survival in either nodes-positive patients or nodes-negative patients (P ＞ 0.05).The count of positive lymph nodes did not affect the prognosis in the pN1 patients (P＞ 0.05).Multivariate analysis showed:location of positive lymph nodes and LNR were independent predictors of the prognosis in the pN1 patients.Conclusions Lymph nodes metastasis status has significant effect on the prognosis of the pancreatic cancer.Location of positive lymph nodes and LNR are independent predictors of the prognosis in the pN1 patients.The number of lymph nodes examined and the number of positive lymph nodes have no effect on the prognosis of the pancreatic cancer.

Neurovascular unit is a new paradigm to explore pathophysiology of central nerve system. Its components constitute complex networks for maintaining the steady-state microenvironment of neurons. This article reviews the steady-state changes, related diseases, and neurovascular unit protection among all the components of neurovascular unit, mainly focuses on the neurovascular coupling, ion signal of neurovascular unit, channel regulation, neurovascular regeneration and nutritional factors, as well as the pathological changes of neurovascular unit of ischemic stroke and related control methods.

In this paper, 17 autopsy cases of poisoning by toxic plants: mushroom 4, xanthium sibiricum 3, trichosanthes kirilowii 2, aconitum chinense 3, tripterygium wilfordii 1, gelsemium elegans 1, nerium indicum 1, pachyrhizus erosus 1, dioscorea simulans 1 were reported (accident 15, suicide 2). Emphasis was put on analyses of the selective injured locations, namely, target organs or tissues, which were poisoned by these poisonous plants. The machanisms of poisoning and causes of death were approached based on the pathological changes. The associated problems of forensic medicine were discussed summarily. On the basis of author's experiences, it is essential for medicolegal examination and expertise that the body should be systematically, completely, forensic-pathologically inspected and the species of questioned poisonous plants should be identified by the associated expert. Poisoning by toxic plants is one of often contacted and difficult problems in medicolegal expertise, so that we should pay attention to it.

We have used continuous epidural anaethesia for 308 cases of orthopoedis operation of poliomyelitic sequel since 1983 to 1987. The satisfactory rate of anesthesia effect is 92%. However, as the disease caused by a special change of pathology, we have also found some ineffective cases. The causes of defect are multiple. The questions met during Anesthesia in our case series were discussed.

The pharmacodynamic methodology of Chinese materia medica (PMCMM) at present was discussed comprehensively in this article and the problems were found While the primary study on the PMCMM was carried out This article offers that the development of the science of Chinese traditional medicine is the premise and basis of the study of PMCMM, especially that the breakthrough of modern study on the theory of viscera state and channel theory and channel tropism theory leads dominantly the study of PMCMM; the four dimensional system theory has been investigated in PMCMM, on the two dimensional basis of the physical foundation of medicinal efficacy and the mechanism of medicinal efficacy, the time dimension and human spirit dimension are added

To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.