Objective:To explore the relationship between friendship quality and loneliness and its influent factors like the measuring tool of friendship quality,the participants groups and cultural background. Methods:The studies on the association between the friendship quality and loneliness were collected through the databases of Chi-na National Knowledge Infrastructure,Wan Fang,Wiley Online library,Web of Science,Google Scholar and Duxiu from 1984 to 2014. Meta-analysis was conducted with the use of the CMA2. 0. Estimated value (r)and their 95%confidence interval (95%CI)was calculated to analyze the association between the friendship quality and loneliness from normal subjects except physiological disease (such as autism,etc. ). Results:Totally 46 literatures were met the requirements of meta-analysis with sample size of 19422,including 24 researches With 11846 participants who were from eastern countries,and 22 studies with 7676 western people. There was significant negative correlation of friendship quality and loneliness (r=-0. 28,95%CI:-0. 23--0. 32). The friendship quality measuring tool was able to adjust the relations of friendship quality and loneliness (Q=11. 95,P<0. 01). The participants groups had a regulatory role on the relationship between the friendship quality and loneliness (Q=19. 54,P<0. 001). Under dif-ferent cultural background of the subjects,the relationship between their friendship quality and loneliness was notsignificant difference (Q=0. 05 ,P>0. 05 ). Conclusion:It suggests that friendship quality has an influence on lone-liness. Measuring tools and subjects groups effect the relationship friendship quality and loneliness except cultural background.

Retinopathy of prematurity (ROP) is a proliferative vascular retinal disease. Cryotherapy, laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, scleral buckling surgery and vitrectomy are the main treatments. Treated with cryotherapy or laser photocoagulation or intravitreal injection of anti-vascular endothelial growth factor, patients with a history of ROP have thicker foveas, and the morphology of the fovea and the development of the retinal vessels in the macular area are affected, resulting in abnormal vision development. However, the specific mechanisms by which different treatments of ROP affecting the development of the macula are not yet clear. It still need further study with large samples to verify and explore, whether changes in the levels of intraocular vascular endothelial growth factor changing the process of normal macular development and how the abnormal development of the macula affects visual function.

Objective To evaluate the safety and feasibility of laparoscopic cholecystectomy(LC) in patients with cirrhosis,and compare the value of model for end-stage liver disease (MELD) score and Child-Pugh classification in predicting prognosis.Methods We reviewed the records of 55 laparoscopic cholecystectomies in cirrhotic patients in our department in the recent 11 years.Indications included symptomatic gallbladder disease,cholecystitis,cystic polyps and cystic adenoma.MELD score and Child-Pugh class were preoperatively calculated and associated with postoperative results.Data regarding patients and surgical outcome were retrospectively analyzed.Results No perioperative death occurred.Total cholecystectomy was employed in 53 patients and subtotal cholecystectomy in 2 patients.Median operative time was(77?5.1)min.Median intraoperative blood loss was(51.0?3.33)mL.Median hospital stay was(5.0?1.3)days.Postoperative complications occurred in 9.09% of the patients,including hemorrhage,intra-abdominal collections and wound complications,which were all controlled conservatively.The incidence of postoperative complications in Child A patients was 7.27%,in Child B was 10.0%;in MELD score below 14 was 2.44%,and in MELD score above 14 was 28.57%.The difference between rates of postoperative complications in patients with preoperative MELD score above 14 and below 14 was significant(P0.05).Conclusions Laparoscopic cholecystectomy is a safe procedure for selected cirrhotic patients,and with controllable complications.MELD score appears to predict morbidity more accurately than Child-Pugh classification system.

Objective To assess the prospect of integrated biphasic silk fibroin scaffold made by annulus fibrosus-nu?cleus pulposus tissue engineering in application as integrated intervertebral disc(IVD). Methods An integrated annulus fi brosus-nucleus pulposus(AF-NP)biphasic scaffold was made by silk fi broin using two different uncomplicated methods which were paraffin spheres-leaching method(outer AF phase)and phase separation method(inner NP phase). The scaf?fold was investigated by general observation, stereomicroscope and scanning electron microscopy(SEM). Its pore size, poros?ity, and compressive elastic modulus were determined. AF and NP cells were isolated from rabbit IVD and seeded into the corresponding phase of the scaffold respectively. The cell-scaffold complex was cultured for 48 hours. The biocompatibility of the scaffold was evaluated by SEM, live/dead staining while CCK-8 assay was used to assess cell proliferation. Results Stereomicroscope and SEM showed that AF phase and NP phase integrated perfectly without cross-linking. Both phases pos?sessed highly interconnected porous structure [pore size of AF and NP phase were(220.0±23.1)μm and(90.0±17.8)μm, re?spectively] and highly porosity(AF and NP phase were respectively 91%and 93%). In addition, this silk biphasic scaffold had impressive mechanical properties(150.7 ± 6.8)kPa. SEM revealed that disc cells attached to regions of pore walls, dis?tributed uniformly and secreted extracellular matrix. Live/Dead staining and cell count kit-8(CCK-8)analysis showed that the silk composite scaffold was non-cytotoxic to disc cells. Conclusion This silk biphasic AF-NP scaffold has satisfied pore size, porosity, biomechanical properties and biocompatibility, so it is ideal candidate for IVD tissue engineering.

Objective To establish an animal model of annulus fibrosus (AF) partial defect for the repairing of interver?tebral disc (IVD) defect. Methods Image J 1.46r software was used to measure the T12/L1-L6/S1 intervertebral height in ovine lumbar spine X-ray films. AF thickness was measured by axial split disc. A 11 blade was used to make a trapezoid de?fect of upper bottom 3 mm, lower bottom 5 mm, height 5 mm and thickness 3 mm, whose lower bottom toward the nucleus pulposus (NP) in the left front of ovine lumbar IVD in vitro. The minimally invasive lateral approach was used to make the same type of trapezoid defect in the left front of the ovine lumbar IVD in vivo. The trapezoidal defect length of the axial divid?ing disc was measured, AF and a small amount of NP from trapezoidal defect in IVD were weighed, and the production of trapezoidal defect in IVD was evaluated. Results The lumbar intervertebral space height of ovine was (4.45 ± 0.28) mm. There were significant differences in the thickness of AF (4.08±0.50) mm , thickness (3 mm) and height (5 mm) of trapezoidal defect (P<0.05), respectively. There were no significant differences in trapezoidal defects in ovine lumbar IVD in vitro on the upper bottom (3.03 ± 0.09)mm, the lower bottom (5.03 ± 0.09) mm, the height (4.97 ± 0.10) mm, the thickness(3.02 ± 0.06) mm and the trapezoidal defect predetermined value on the upper bottom 3 mm, the lower bottom 5 mm, the height 5 mm and the thickness 3 mm (P>0. 05). The weights of the AF and NP taken out from ovine lumbar IVD in vitro and in vivo were (0.162 ± 0.011) g and (0.166 ± 0.014) g, and there was no significant difference between them (P > 0.05). Conclusion Through the operation of minimally invasive lateral approach, the method of making a trapezoidal defect in the experiments can establish animal model of AF partial defect, which meets the requirements for the repairing of IVD defect, and is simple, safe and reliable.

Objective:The current systematic review aims to evaluate the effectiveness and quality of interventions on depressive symptoms of informal caregivers of people with dementia in China and to provide evidences regarding protocols for the most effective interventions.Methods:A systematic literature search of Chinese and English databases was performed, covering randomized controlled trails published up to March 2019. The papers for final review were selected based on the inclusion and exclusion criteria. Data were extracted and analyzed with RevMan 5.3, after a quality appraisal of the included studies.Results:A total of 17 papers were identified as eligible for descriptive analysis and 14 of the papers provided estimates for meta-analysis, with 991 participants. An overall mean reduction in depression was identified among the participants of intervention group, compared to those in the control group ( SMD value was -0.75, 95% CI -0.88 - -0.62, P<0.01). Psychotherapeutic ( SMD value was -0.59, 95% CI -0.78 - -0.40, P<0.01) and psychoeducational interventions ( SMD value was -0.84, 95% CI -1.02 - -0.67, P<0.01) showed significant reductions of depressive symptoms among the caregivers. In addition, Evidence exists for the effectiveness across from the short-term ( SMD value was -0.54, 95% CI -0.82 - -0.26, P<0.01), medium-term ( SMD value was -0.68, 95% CI -0.83 - -0.52, P<0.01) to the long-term interventions ( SMD value was -0.80, 95% CI -1.08 - -0.53, P<0.01). Conclusion:Interventions targeting to reduce depressive symptoms are effective among informal caregivers of persons with dementia in China. However, insufficient evidences are found regarding the most effective protocols and more high-quality studies are needed for the target population.

Objective:To explore the mediating effect of self-efficacy of family caregivers of dementia patients between patient-related impairment and caregivers' health-related quality of life.Methods:This study was a aross-sectional study. Using the convenient sampling method, family caregivers of dementia patients who accompanied patients in two ClassⅢ Grade A hospitals in Shanghai from December 2015 to September 2019 were selected as the research objects. Self-Efficacy Questionnaire for Chinese Family Caregivers (SEQCFC) , the MOS 36-item Short Form Health Survey (SF-36) and the Chinese Version of the Relevant Outcome Scale for Alzheimer's disease (CROSA) were used to conduct the questionnaire survey. SPSS 22.0 and AMOS 22.0 software were used for statistical analysis, Pearson correlation was used to calculate the correlation between variables and structural equation model was established to test the relationship between variables.Results:A total of 291 caregivers who met the inclusion criteria completed the questionnaire assessment, and the completion rate of the questionnaire was 100%. The impairment score of dementia patients was (87.13±23.88) , the total score of self-efficacy of care givers was (57.49±16.42) , the overall physical health score of health-related quality of life was (41.33±9.71) and the total score of mental health was (48.85±7.69) . The results of Pearson correlation analysis showed that in addition to the self-efficacy of the support dimension, the total score of the patients' dementia-related impairment was positively correlated with the total score of the caregivers' self-efficacy and the self-efficacy of the care giving behavior dimensions ( P< 0.05) . The total score of dementia-related impairment of patients was positively correlated with the total score of physical health and the total score of mental health of caregivers ( P<0.01) . The total score of caregivers' self-efficacy and the self-efficacy of each dimension of caregiving behavior were positively correlated with the total score of physical health and mental health of caregiver ( P<0.01) . Caregivers' self-efficacy was a partial mediator between dementia-related impairment and physical and mental health related quality of life of caregivers, and the mediation effect accounted for 29.79% and 43.67% of the total effect, respectively. Conclusions:The dementia-related damage of patients can directly affect the caregivers' health-related quality of life and it can also indirectly affect the caregivers' health-related quality of life through the caregivers' sense of self-efficacy. Therefore, it can reduce effects of dementia-related impairment on health-related quality of life of caregivers by improving caregivers' sense of self-efficacy.

ObjectiveTo systematically review the intervention effect of cognitively engaging physical activity (CEPA) on executive function of children and adolescents. MethodsLiteratures in Chinese and English were retrieved from databases of Web of Science, PubMed, Medline, EBSCO and CNKI, from the establishment to November 30th, 2023. According to the inclusion and exclusion criteria, the literatures that met the requirements were screened, and their quality was evaluated and systematically reviewed. ResultsA total of 15 literatures were included, published between 2014 and 2023, from eight countries, involving 1 806 subjects aged four to 16 years. The average score of PEDro scale was 6.6. The intensity of the CEPA intervention ranged from 64% to 93% HR_max, the duration of a single session ranged from ten to 60 minutes, and the frequency of the intervention was two to five sessions a week, for four to 24 weeks. Specific forms of CEPA included football, basketball and floorball combined with cognitive tasks; running, jumping, squatting, sitting, spinning and balancing combined with cognitive tasks; and exergaming combined with cognitive tasks. Eleven researches showed positive effects of CEPA intervention on at least one component of executive function. However, six of the seven researches involving working memory failed to verify the positive effects. Twelve researches compared the intervention effects of CEPA and rutine exercise or regular physical education classes, and nine researches found that CEPA was more effective on executive function. ConclusionThe CEPA is effective on the executive function of children and adolescents, specifically on cognitive flexibility; it shows inconsistent effects on inhibitory control, and its effect on working memory has not been verified. The intervention types of CEPA are divided into ball games combined with cognitive tasks, basic motor skills training combined with cognitive tasks, and exergaming combined with cognitive tasks.

Objective:To explore the clinical efficacy of disease-modifying drug nusinersen on children with spinal muscular atrophy.Methods:The baseline and longitudinal clinical data of 15 children who were treated with nusinersen in the Children′s Hospital, Zhejiang University School of Medicine from October 2019 to October 2021 were retrospectively collected. The general data (gender, age, genotype, and clinical classification, etc.), motor function, nutritional status, scoliosis and respiratory function were analyzed. Wilcoxon rank-sum test was used for comparing multi-system conditions before and after treatment.Results:The age of 15 cases (7 males, 8 females) was 6.8 (2.8, 8.3) years, with 2 cases of type 1, 6 cases of type 2, and 7 cases of type 3 respectively, and the course of disease was 55.0 (21.0, 69.0) months. After 9.0 (9.0, 24.0) months of treatment, the motor function scale evaluations of the Hammersmith neurological examination section 2 (13.0 (7.0, 23.0) vs. 18.0 (10.0, 25.0) scores, Z=-2.67, P=0.018) of 15 children, the Hammersmith functional motor scale expanded (38.0 (18.5, 45.5) vs. 42.0 (23.0, 51.0) scores, Z=-2.38, P=0.018), and the revised upper limb module (27.0 (19.5, 32.0) vs. 33.0 (22.5, 35.5) scores, Z=-2.52, P=0.012) of children with type 2 and 3 had significantly improved. Thirteen patients achieved clinically significant motor function improvement, and 2 of them had kept stable scale scores. Subjective reports also indicated that the muscle strength and daily exercise ability of these children improved after treatment, and no serious adverse reactions were reported. Supplemented by the multi-disciplinary team management, the levels of some indicators such as Cobbs angle of scoliosis and forced vital capacity all had significantly improved (all P<0.05). Conclusions:Nusinersen can improve the motor function of patients with 5q spinal muscular atrophy, which is also proved safe to be used in children. The drug treatment supplemented by the multi-disciplinary team management is helpful to improve the multi-system function of the children with spinal muscular atrophy.