Objective To detect the relationship between the pathological degrees of chronic cholecystitis and coincident diseases. Method The pathological degree was divided into mild,moderate and severe degree according to the pathological changes in 442 cases of chronic cholecystitis,and the proliferation of mucosa cell was detected by SP immunohistochemical staining in 105 cases. Results The coincident calculus, polyp, adenoma in the mild chronic cholecystitis were 65.0%,17.1% and 0.5%, respectively. The coincident calculus, polyp, adenoma and malignant neoplasms in the moderate chronic cholecystitis were 70.1%, 19.4%, 3.7% and 2.2%. The coincident calculus, polyp, adenoma and malignant neoplasms in the severe chronic cholecystitis were 88.0%, 26.4%, 24.2% and 9.9%. The positive expression rates of PCNA in mild, moderate and severe chronic cholecystitis were 12.3%, 17.5% and 38.7%, respectively. The results showed that the pathological degree of chronic cholecystitis was obviously related to the coincidence of calculus, polyp, adenoma, malignant neoplasms. Conclusions Severe chronic cholecystitis is a high-risk lesion of gallbladder carcinoma,it should be removed surgically.

Background: The public now imposes higher demands on the government than in the past, which has created the role overload faced by low-ranking government employees in China. This research investigates the relationship between role overload and health among low-ranking government employees and explores the mediating effects of burnout. Methods: It draws on a survey of 2064 low-ranking government employees by probability proportionate to size sampling in China's Shandong Province. Structural equation modeling (SEM) methods are used to analyze the data. Results: Both role overload and burnout were found to have negative effects on low-ranking government employees' health; however, the associations varied among the three age groups (less than 36, between 36 and 45, and over 45). Those over 45 reported the highest level of both physical and psychological health, while the youngest age group (less than 36) reported the lowest level of health. Role overload has a direct influence on health among government employees over 45 but not among those below 45. Burnout's mediating effects between role overload and health are significant among all age groups, but most significant among the youngest civil servants below 36. Conclusions The findings evidenced that both role overload and burnout affect low-ranking government employees' self-reported physical and psychological health. In addition, the effect of age differences in coping with role stressors and burnout should be considered.

Objective To investigate the risk factors of postoperative fecal contamination in children pa-tients with Hirschsprung's disease(HSCR),and to construct and evaluate the risk predictive model.Methods The clinical data in 377 children patients with HSCR in 3 class 3A hospitals in Guangxi from Janu-ary 2016 to June 2021were retrospectively analyzed by adopting the convenience sampling method.The pa-tients were divided into the modeling group(n=264)and testing model group(n=113)with a ratio of 7∶3.The risk factors of postoperative fecal soiling were analyzed by the single factor and multiple factors,and the risk predictive model was constructed.The receiver operating characteristic(ROC)curve was used to detect the discriminative ability of the model and the H-L test was used to determine the goodness of fit of the mod-el.The model was prospectively validated in 21 children patients with HSCR from August to December 2021.Results Among 377 children patients with HSCR,the fecal soiling occurred in 131 cases with a incidence rate of 34.75％.The constructed predictive model of fecal contamination risk after HSCR operation:logit(P)=-2.385+1.697 × special type of megacolon+0.929 × Soave+0.105 × length of bowel resection+2.065 × il-literate caregivers+0.808 × caregivers'implementation of postoperative diet+0.867 × postoperative defecation training by caregivers.The area under the curve(AUC)in the modeling group was 0.849,the Yoden index was 0.53,the optimal critical value of the model was 0.32,the sensitivity was 76.00％,and the specificity was 77.00％.The H-L test,X2=6.649,P=0.575.AUC of the testing model group was 0.736,the sensitivity was 81.25％,and the specificity was 78.46％.The prospective validation results showed that the sensitivity and specificity of the model were 66.67％and 100％respectively.Conclusion The constructed model has good i-dentification and predictive ability.

Objective To investigate the influence of serum cystatin C(Cys-C)and hypersensi-tivity C-reactive protein(hs-CRP)levels on the 3-year survival of patients undergoing maintenance he-modialysis(MHD).Methods A total of 358 patients with chronic renal failure who underwent MHD at the Second Affiliated Hospital of Nantong University from April 2011 to October 2020 were selected as study subjects.General clinical data,pre-dialysis laboratory test indicators,and echocardiographic indicators 3 months after dialysis were recorded.The survival status of patients after 3 years of dialysis was followed up,and the general clinical data,pre-dialysis laboratory test indicators,and echocardio-graphic indicators 3 months after dialysis were compared between surviving and deceased patients.Un-ivariate and multivariate Cox regression analyses were performed to screen influencing factors of 3-year survival in MHD patients.Results At the 3-year follow-up,of the 302 MHD patients'203 survived,and 99 died.Statistically significant differences were observed in age,primary disease,diabetes sta-tus,congestive heart failure,statin use,antiplatelet drug use,diuretic use,dialysis mode,esti-mated glomerular filtration rate(eGFR)and gamma-glutamyl transferase(GGT),alkaline phospha-tase(AKP),total bilirubin(TBIL),β2-microglobulin(β2-MG),creatinine(Cr),low-density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),and serum phos-phorus(P)levels between surviving patients and deaths(P＜0.05 or P＜0.01).Univariate Cox regression results showed that age of MHD patients,primary disease(diabetic nephropathy,hyper-tensive nephropathy,polycystic kidney disease,others),comorbidities(diabetes,congestive heart failure,other cardiovascular diseases),drug use(statins,antiplatelet drugs),dialysis method(he-modialysis,hemodialysis+perfusion),laboratory test indicators[GGT,AKP,TBIL,total bile acid(TBA),albumin(ALB),Cr,Cys-C,eGFR,apolipoprotein A(APO-A),hs-CRP]were all influential factors of 3-year survival rate of MHD patients.Multivariate Cox regression analysis re-vealed that age,primary disease,other cardiovascular diseases,dialysis mode,AKP,ALB,TBIL,Cys-C,and hs-CRP were significant influencing factors for the survival of patients with chronic renal failure(P＜0.05).Conclusion Serum Cys-C and hs-CRP levels before MHD in patients with chronic renal failure may be associated with their 3-year survival after dialysis treatment.High serum Cys-C may reduce the risk of poor clinical prognosis,while high serum hs-CRP may increase the risk of poor clinical prognosis.

Objective To investigate the influence of serum cystatin C(Cys-C)and hypersensi-tivity C-reactive protein(hs-CRP)levels on the 3-year survival of patients undergoing maintenance he-modialysis(MHD).Methods A total of 358 patients with chronic renal failure who underwent MHD at the Second Affiliated Hospital of Nantong University from April 2011 to October 2020 were selected as study subjects.General clinical data,pre-dialysis laboratory test indicators,and echocardiographic indicators 3 months after dialysis were recorded.The survival status of patients after 3 years of dialysis was followed up,and the general clinical data,pre-dialysis laboratory test indicators,and echocardio-graphic indicators 3 months after dialysis were compared between surviving and deceased patients.Un-ivariate and multivariate Cox regression analyses were performed to screen influencing factors of 3-year survival in MHD patients.Results At the 3-year follow-up,of the 302 MHD patients'203 survived,and 99 died.Statistically significant differences were observed in age,primary disease,diabetes sta-tus,congestive heart failure,statin use,antiplatelet drug use,diuretic use,dialysis mode,esti-mated glomerular filtration rate(eGFR)and gamma-glutamyl transferase(GGT),alkaline phospha-tase(AKP),total bilirubin(TBIL),β2-microglobulin(β2-MG),creatinine(Cr),low-density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),and serum phos-phorus(P)levels between surviving patients and deaths(P＜0.05 or P＜0.01).Univariate Cox regression results showed that age of MHD patients,primary disease(diabetic nephropathy,hyper-tensive nephropathy,polycystic kidney disease,others),comorbidities(diabetes,congestive heart failure,other cardiovascular diseases),drug use(statins,antiplatelet drugs),dialysis method(he-modialysis,hemodialysis+perfusion),laboratory test indicators[GGT,AKP,TBIL,total bile acid(TBA),albumin(ALB),Cr,Cys-C,eGFR,apolipoprotein A(APO-A),hs-CRP]were all influential factors of 3-year survival rate of MHD patients.Multivariate Cox regression analysis re-vealed that age,primary disease,other cardiovascular diseases,dialysis mode,AKP,ALB,TBIL,Cys-C,and hs-CRP were significant influencing factors for the survival of patients with chronic renal failure(P＜0.05).Conclusion Serum Cys-C and hs-CRP levels before MHD in patients with chronic renal failure may be associated with their 3-year survival after dialysis treatment.High serum Cys-C may reduce the risk of poor clinical prognosis,while high serum hs-CRP may increase the risk of poor clinical prognosis.