Objective:To explore the mediating role of family cohesion between family expressiveness and preschool children's behavior.Methods:Using the method of stratified cluster random sampling, the parents of 1 213 children in Shenzhen kindergartens were assessed by the Achenbach child behavior checklist (parent questionnaire) (CBCL, 4-16 years) and family environment scale-Chinese version (FES-CV). After the survey, SPSS 24.0 was used to conduct the data analysis and the Bootstrap method was used to test the mediation effect.Results:(1)The total score of children's behavior 147.0(135.0, 163.0) was found to be significantly negatively correlated with family expressiveness score 6.0 (5.0, 7.0) and family cohesion score 8.0 (6.0, 9.0), and the correlation coefficients were -0.145 and -0.187(both P<0.01). (2) Family expressiveness score was positively related to family cohesion score ( r=0.443, P<0.01). (3)The direct effect of family expressiveness on children's behavior was -0.072, and the 95% confidence interval was (-0.133, -0.010). Family cohesion had a mediating effect between family expressiveness and children's behavior, 95% confidence interval was (-0.129, -0.058), and the mediating effect accounted for 56.4% of the total effect. Conclusion:Family cohesion plays a partial mediating role between family expressiveness and children's behavior.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy. METHODS: We performed a multicenter, retrospective study of all patients at Beijing Friendship Hospital affiliated to Capital Medical University, Xijing Hospital affiliated to Air Force Military Medical University, Beijing Youan Hospital affiliated to Capital Medical University, and the Fifth Medical Center of the People's Liberation Army General Hospital from June 2003 to August 2019. The adverse events of inpatient ERCP for patients with ( n  = 182) and without liver cirrhosis (controls; n  = 385) were compared. RESULTS: A total of 567 patients underwent ERCP between January 2003 and December 2019 were enrolled in this study. Compared to patients without cirrhosis, patients with cirrhosis were at higher risk for postoperative complications (odds ratio [OR], 4.172; 95% confidence interval [CI], 1.232-7.031; P  < 0.001) such as postoperative pancreatitis (OR, 2.026; 95% CI, 1.002-4.378; P  = 0.001) and cholangitis (OR, 3.903; 95% CI, 1.001-10.038; P  = 0.036). The main indications for ERCP for patients with cirrhosis in this study included choledocholithiasis (101 cases; 55.5%), benign bile duct strictures (46 cases; 25.3%), and malignant bile duct strictures (28 cases; 15.4%). Among them, 23 patients (12.6%) underwent balloon dilation and 79 patients (43.4%) underwent sphincterotomy. Of the patients with cirrhosis, delayed bleeding occurred in ten patients (5.5%), postoperative pancreatitis occurred in 80 patients (44.0%), and postoperative cholangitis occurred in 25 patients (13.7%). An additional multivariate analysis showed that the total bilirubin (TBIL) level (OR, 4.58; 95% CI, 2.37-6.70) and Child-Pugh score of C (OR, 3.11; 95% CI, 1.04-5.37) were risk factors for postoperative complications in patients with cirrhosis. CONCLUSIONS Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects* ; Retrospective Studies ; Constriction, Pathologic ; Risk Factors ; Liver Cirrhosis/complications* ; Pancreatitis/etiology* ; Postoperative Complications/epidemiology* ; Cholangitis