Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Objective:To investigate the effects of the Epley and Semont procedures with varying lateral angles of the head on posterior semicircular canal benign paroxysmal positional vertigo （PC-BPPV）. Methods:A total of 115 patients with unilateral PC-BPPV were randomly divided into five groups: Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group, with 23 patients in each group. Corresponding reduction treatments were performed. Results:The total effective rates for the Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group were 95.7% （22/23）, 4.3% （1/23）, 30.4% （7/23）, 52.2% （12/23）, and 87.0% （20/23） respectively. The inefficiencies were 4.3% （1/23）, 95.7% （22/23）, 69.6% （16/23）, 47.8% （11/23）, and 13.0% （3/23）. Statistically significant differences were observed in the total effective rates among the five groups （χ²=54.11, P<0.01）. The total effective rates in the Semont group, Semont+10° group, and Semont+20° group were significantly different from that of the Epley group （P<0.01）, while no statistically significant difference was found between the Semont+30° group and the Epley group （P= 0.608>0.012 5）. Conclusion:Among the four Semont methods with different lateral lying angles, the total effective rate of reduction treatment increased with the elevation of the lateral lying angle on the affected side. The efficacy of the Semont+30° group in treating PC-BPPV was not significantly different from the Epley group's reduction effect, which was markedly superior to that of the other four Semont methods at different angles. Therefore, the Semont+30° reduction technique is recommended for the treatment of PC-BPPV.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Benign Paroxysmal Positional Vertigo/therapy* ; Head ; Posture ; Semicircular Canals/physiopathology* ; Treatment Outcome

Objective To establish a scientifically rigorous,standardized,and comprehensive evaluation index system for the emergency response competency of'Internet+'nurses,and to provide references for the access,training and assessment of'Internet+'nurses.Methods Between November 2022 and July 2023,a draft of the evaluation index system was developed based on theoretical analysis,literature reviews and semi-structured interviews.Delphi expert consultation and analytic hierarchy process were used to determine the evaluation index system for emergency response competence of'Internet+'nurses.Results The response rates of 2 rounds were 90.48％and 100％;the opinion rates were 63.16％and 10.53％;the authority coefficients of the experts were 0.855 and 0.850;the Kendall's coefficients of concordance were 0.175 and 0.182.Finally,the evaluation index system for emergency response competency of'Internet+'nurses was formed,which consists of 4 first-level indexes(including prevention capacity,preparedness capacity,response capacity and recovery capacity),13 second-level indexes and 40 third-level indexes.Conclusion The evaluation index system for the emergency response competency of'Internet+'nurses is highly scientific and practical,which has guiding significance for the access,training and assessment of'Internet+'nurses.

Objective:To establish an HPLC fingerprint of Shenling Baizhu Powder and Shenling Baizhu Pills; To evaluate the quality consistency of commercial Shenling Baizhu Powder and Shenling Baizhu Pills.Methods:HPLC method was adopted with Agilent TC-C18 column (250 mm×4.6 mm, 5 μm). The mobile phase was 0.05% phosphoric acid-acetonitrile with gradient elution; the flow rate was 1.0 ml/min; the detection wavelength was 203 nm; the column temperature was 25 ℃. The HPLC fingerprints of Shenling Baizhu Powder and Shenling Baizhu Pills from different manufacturing enterprises were established and analyzed by using the Similarity Evaluation System of Chromatographic Fingerprint of TCM (Version 2012) software for similarity evaluation, and the main chromatographic peaks were identified.Results:The control fingerprints of Shenling Baizhu Powder and Shenling Baizhu Pills were obtained. 73 common peaks and 79 common peaks were identified respectively. The similar degrees of all samples were over 0.92. The quality consistency of drugs different batches of different production enterprises was good. A total of 10 components were identified, including Liquiritin, Ginsenoside Rg1, Ginsenoside Rb1, Glycyrrhizin, Isoliquiritin, Ginsenoside Rd, Glycyrrhizic acid, AtractylenolideⅠ, AtractylenolideⅡ and AtractylenolideⅢ.Conclusions:The established HPLC fingerprints can quickly evaluate the formulation quality of Shenling Baizhu Powder and Shenling Baizhu Pills, providing basis the quality control.

Objective To investigate the effect of continuous intraoperative insulin infusion on my-ocardial blood perfusion after cardiac surgery under cardiopulmonary bypass(CPB).Methods Forty-eight patients,21 males and 27 females,aged 55-80 years,BMI 18-28 kg/m2,ASA physical status Ⅱ-Ⅳ,who underwent elective cardiac surgery with CPB were selected and randomly divided into two groups:the insulin group(group I,n = 25)and the control group(group C,n = 23).The same anesthesia protocol was implemented in both groups.After induction of anesthesia,group Ⅰ received intravenously infusion of in-sulin 30 mU·kg-1·h-1,glucose 0.12 g·kg-1·h-1,and potassium chloride 0.06 mmol·kg-1·h-1,and group C received saline 10 ml/h,all of which were infused until the end of surgery.The targeted blood glucose range for both groups was set at 6.1-11.1 mmol/L.Transesophageal echocardiography(TEE)was performed 10 minutes after induction of general anesthesia(T2)and before the end of surgery(T6)to ex-amine the coronary sinus(CS)flow spectrum and diameter,pulmonary venous flow spectrum,and calculate CS net antegrade flow velocity time integral(VTI).Femoral mean arterial pressure(MAP),central venous pressure(CVP),stroke volume(SV),cardiac index(CI)and peripheral vascular resistance index(SVRI)were recorded at T2,2 minutes before CPB(T3),the end of CPB(T5),and T6.The concentra-tions of blood glucose and lactate 5 minutes before anesthesia induction(T1),T3,30 minutes after CPB(T4),T5,T6,6 hours after surgery(T7),12 hours after surgery(T8),and 24 hours after surgery(T9)were recorded.The levels of high-sensitivity C-reactive protein(hs-CRP),high-sensitivity troponin I(hs-TnI),and creatine kinase isoenzyme(CK-MB)were recorded 1 day preoperatively,1 and 2 days post-operatively.Results Compared with group C,in group I,CS net antegrade flow VTI and blood flow per minute were significantly increased(P<0.05),and pulmonary venous peak atrial reversal wave velocity(ARp)was significantly reduced at T6(P<0.05),SV and CI were significantly increased and SVRI was significantly decreased at T5 and T6(P<0.05),lactate concentration was significantly decreased at T7 and T8(P<0.05),hs-CRP and CKMB were significantly decreased 1 and 2 days postoperatively(P<0.05),hs-TnI was significantly reduced 2 days postoperatively(P<0.05).Conclusion Continuous insulin admin-istration during cardiac surgery with CPB while maintaining blood glucose at 6.1-11.1 mmol/L can enhance myocardial blood perfusion,mitigate postoperative inflammatory response,and reduce myocardial injury.

Objective:To explore the correlation between color Doppler ultrasound, Cyfra21-1, Fer and malignant ovarian lesions and the value of combined model identification.Methods:A total of 108 patients with suspected ovarian cancer admitted to our hospital from Jan. 2021 to Dec. 2023 were selected as subjects. All patients were tested by color Doppler ultrasound, Cyfra21-1 and Fer, and were divided into malignant group (61 cases) and benign group (47 cases) according to the pathological test results. The baseline data, ultrasound parameters, Cyfra21-1 and Fer levels of the two groups were compared, and multivariate regression analysis was performed to establish a multi-factor combined model, and ROC curve was used to evaluate the differential efficacy of the combined model.Results:There was no significant difference in baseline data such as age and course of disease between the two groups ( P>0.05). In the malignant group, the lesion diameter was (7.66±1.24) cm, with solid echo detection in 37 cases and inner wall with nipple detection in 38 cases. In the benign group, the lesion diameter was (5.14±1.03) cm, with solid echo detection in 18 cases and inner wall with nipple detection in 17 cases. In the malignant group, PS was (22.94±4.61) cm/s, EDV was (15.67±3.42) cm/s, VM was (12.43±3.15) cm/s. PS, EDV and VM in benign group were (15.63±4.24) cm/s, (8.95±3.04) cm/s and (17.08±4.21) cm/s respectively, and those in malignant group were higher than those in benign group ( P<0.05). RI in the malignant group was 0.35±0.06, RI in the benign group was 0.58±0.13, and RI in the malignant group was lower than that in the benign group ( P<0.05). Multivariate regression analysis showed that lesion diameter, solid echo, inner wall with papilla, PS, EDV, VM, Cyfra21-1, Fer and RI were all independent risk factors for ovarian malignant lesions, and lesion diameter, solid echo, inner wall with papilla, PS, EDV, VM, Cyfra21-1 and Fer were positively correlated with ovarian malignant lesions. RI was negatively correlated with ovarian malignant lesions ( P<0.05). ROC curve results showed that the diagnostic efficiency of the combined model was higher than that of the single use of Doppler ultrasound, Cyfra21-1 and Fer. Conclusion:The combined diagnosis model of color Doppler ultrasound, Cyfra21-1 and Fer is helpful to improve the diagnostic efficiency of ovarian malignant lesions.

Objective To evaluate the detection performance of common strains and the antimicrobial binding capacity of four blood culture systems made by BMX-FA/N Plus,Zhengzhou Anto,Zhuhai DIER and Chongqing Zhongyuan.Methods According to the common pathogens of clinical bloodstream infections in Wuhan No.1 Hospital,ATCC standard isolates of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis,Escherichia coli,Pseudomonas aeruginosa,Haemophilus influenzae,Stenotrophomonas Maltophil,Bacteroides tenuis and Candida glabla were chosen to explore.Prefabricated bacterial suspension and sterile horse blood were injected into different brands of blood culture systems to simulate the blood samples of patients with non-antibiotic treatment and antibiotic treatment.Six commonly used clinical antibiotics,Imipenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam,Levofloxacin,Vancomycin and Micafungine,were added to the blood samples after simulated antibiotic treatment.The performance was evaluated by recording the positive bottles and the detection time of each brand culture systems within five days with and without antibiotic.Results In the absence of antibiotic,four blood culture systems showed 100％recovery on all of the pathogens.Staphylococcus aureus,Pseudomonas aeruginosa and Haemophilus influenzae were recovered earlier in DIER aerobic bottles than BMX-FA Plus aerobic bottles,and the differences were statistically significant(t=2.608,5.547,12.247,all P＜0.05).The time to detection of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis and Haemophilus influenzae in Zhongyuan anaerobic bottles was significantly faster than that of BMX-FA Plus anaerobic bottles,with an average shortening of 1.92～10.80 h,and the differences were statistically significant(t=30.187,5.367,33.068,24.855,all P＜0.05).When antibiotics added,BMX-FA Plus culture bottle showed 100％recovery to all the detecting pathogens with the peak concentration antibiotics except Cefoperazone/Sulbactam,while the recovery in Zhongyuan blood culture bottle also was 100％with peak concentration antibiotics of Piperacillin/Tazobactam,Levofloxacin and Micafunzin.The peak concentration of imipenem antibiotics in domestic bottles was only detected in Anto anaerobic bottles,with lower positive detection rate(66.7％)lower than that of BMX-FA Plus(100％)and a later detection,and the difference was statistically significant(t=-21.000,P=0.030).Conclusion In the absence of antibiotic interference,the positive detection rate of the above pathogens are the same for four blood culture systems,and the time to detection of DIER and Zhongyuan systems is shorter than that of BMX-FA/N Plus.In the presence of antibiotic interference,the detection ability to pathogens in BMX-FA/N Plus system is the best,followed by domestic Zhongyuan system.

Objective To explore the possibility of MR Ti-mapping imaging technology to provide additional indicators for clinical quantitative evaluation of renal function in children with renal insufficiency.Methods A total of 13 children with renal insufficiency diagnosed and underwent renal function MRI examination were selected(renal insufficiency group),and 23 children with normal renal function were included as the control group.The difference of renal cortex T1 value between the control group and the renal insuffi-ciency group was compared,and the correlation between renal cortex T1 value and biochemical indexes such as serum creatinine(SCr)and cystatin C(CysC)in the renal insufficiency group was analyzed.Results There was significant difference in T1 value of renal cortex between the renal insufficiency group and the control group(P＜0.01).The correlation between T1 value of renal cortex and SCr and CysC in renal insufficiency group was higher(r=0.75,P＜0.01;r=0.68,P＜0.01).Conclusion MR T1-mapping technol-ogy can non-invasively monitor the renal function status of children with renal insufficiency,and has a suggestive value for clinical quantitative evaluation of renal function in children.

Objective Corruption is the most common cadaver phenomenon in forensic practice and an important basis for inferring time of death(PMI),but the definition of corruption degree and the construction of model inference models have always been difficult in the practice of forensic science.Methods In this study,the late postmortem phenomena were observed.Meanwhile,the microbial flora structure of gut and gravesoil and the nature of gravesoil were detected,for analyzing the changes before and after the key moment of abdominal rupture which naturally happened during the cadaver decay.Results The results found that from the macroscopic and microscopic levels,there were significant differences in cadaver decay,including microbial flora structure and gravesoil properties before and after the key moment of the natural abdominal rupture during cadaver decay.The phenomena are highly observable and can be accurately judged by forensic examinations,as well as related means in the field of biology and physiochemistry.In this study,this critical event was called Rupture Point.Conclusion The Rupture Point can be used as an important node for the assessment of cadaver decay degree in the practice of forensic medicine.It can be utilized for a cut-off point as well when constructing PMI inference models based on microbial flora structure changes.The accuracy of PMI inference models can be improved when the models were constructed in segments.

Objective:To evaluate the qualitative and quantitative diagnostic value of transvaginal contrast-enhanced ultrasonography for benign and malignant adnexal masses.Methods:Forty-nine patients with adnexal masses detected by routine ultrasound examination at Wenzhou People's Hospital from January 2021 to December 2022 were included in this study. Initially, transvaginal two-dimensional ultrasound, two-dimensional ultrasound integrated with color Doppler, and contrast-enhanced ultrasonography were used to accurately classify the masses as benign or malignant. Using postoperative pathology as the gold standard, the qualitative diagnostic accuracy of various detection methods was compared. Subsequently, the receiver operating characteristic curve analysis was performed to assess the quantitative diagnostic accuracy of transvaginal contrast-enhanced ultrasonography-related parameters in distinguishing between benign and malignant adnexal masses.Results:Among the 49 patients, 10 were diagnosed with malignant tumors. The diagnostic accuracy of contrast-enhanced ultrasonography was 93.88% (46/49), with a sensitivity of 90.00% (9/10), a specificity of 94.87% (37/39), a positive predictive value of 81.82% (9/11), and a negative predictive value of 97.37% (37/38). The results of the diagnostic difference assessment (McNemar test) revealed that there was no significant difference between two-dimensional ultrasound ( χ2 = 0.37, P = 0.546), two-dimensional ultrasound combined with color Doppler ( χ2 = 0.17, P = 0.683), and contrast-enhanced ultrasonography ( χ2 = 0.00, P = 1.000), and the gold standard test results. The consistency assessment (Kappa test) revealed that the diagnostic results of contrast-enhanced ultrasonography exhibited the highest concordance with the gold standard, with a Kappa value of 0.82 ( P < 0.001). Furthermore, the receiver operating characteristic curve analysis indicated that the initial increase time, peak intensity, and mean transit time in contrast-enhanced ultrasonography demonstrated high quantitative diagnostic accuracy. The areas under the curve were 0.83, 0.82, and 0.84, respectively, and the diagnostic cutoff values were 17.30 s, 21.65 dB, and 92.60 seconds, respectively. Conclusion:Contrast-enhanced ultrasonography exhibits diagnostic value in the differential diagnosis of benign and malignant adnexal masses, both qualitatively and quantitatively. This method can provide valuable insights for further treatment.