Objective To investigate the correlation between age and the prognosis of thrombolytic therapy in acute ischemic stroke (AIS).Methods One hundred and fourteen patients with AIS were divided into ≤60 years group,61-70 years group and ≥71 years group according to age.Thrombolysis and post-thrombolysis treatment was done in accordance with 2010 version of Chinese Acute Ischemic Stroke Treatment Guidelines standard.The United States National Institutes of Health Stroke Scale (NIHSS) score was done in patient immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis,and modified Rankin scale (mRS) score was assessed 3 months after thrombolysis The spontaneous intracranial hemorrhage (sICH) and the death of 2 weeks was recorded.Results ≤ 60 years group had 22 males and 10 females;61-70 years group had 26 males and 10 females; ≥71 years group had 20 males and 26 females.In ≥ 71 years group,women accounted for 56.52％ (26/46),which was higher than that in the other 2 groups,and there was significant difference (x2 =0.685,P =0.015).The NIHSS score immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis among 3 groups had no significant difference (P ＞ 0.05).The mRS score at the 3 months after thrombolysis among 3 groups was (1 ± 3),(2 ± 5) and (2 ± 3) scores,respectively,and there was significant difference(P =0.040).Mortality and incidence of sICH in 2 weeks also had significant difference (P =0.049,0.017).Conclusions Despite the differences in the mortality and incidence of sICE among different ages,thrombolytic therapy with recombinant tissue-type plasminogen activator can significantly improve the neurological deficit after 3 months in AIS patients of different ages.

ObjectiveTo investigate the expression of CD90 in human intrahepatic cholangiocellular carcinoma and its association with lymph node metastasis and poor prognosis. MethodsA total of 49 samples of intrahepatic cholangiocellular carcinoma tissue and 49 samples of adjacent tissue were collected after surgical resection in The Affiliated Hospital of Chengde Medical College from March 2013 to March 2016, and 40 normal liver tissue samples were selected as control. Immunohistochemistry was used to measure the expression of CD90 in each sample, and its association with clinical indices, survival, and prognosis of patients with intrahepatic cholangiocellular carcinoma was analyzed. The t-test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups, the Kruskal-Wallis H test was used for comparison between three groups and further comparison between two groups. The Kaplan-Meier curve was used to analyze postoperative recurrence and survival, and the log-rank test was used for comparison. Results The moderately positive expression rate of CD90 was 65.31% in intrahepatic cholangiocellular carcinoma tissue, 30.61% in adjacent normal tissue, and 0% in normal liver tissue, suggesting that the intrahepatic cholangiocellular carcinoma tissue had a significantly higher moderately positive expression rate of CD90 than adjacent normal tissue and normal liver tissue (P＜0.05). The expression of CD90 was associated with TNM stage and hilar lymph node metastasis in the patients with intrahepatic cholangiocellular carcinoma (χ2=12837 and 17.824, both P＜0.001). The patients with negative/weakly positive expression of CD90 had significantly higher relapse-free survival rate and overall survival rate after surgery than those with moderately/strongly positive expression (χ2=3.845 and 4.152, P=0025 and 0.021). ConclusionCD90 is highly expressed in human intrahepatic cholangiocellular carcinoma tissue, which is associated with hilar lymph node metastasis and poor prognosis and plays an important role in tumor development, progression, and metastasis.

Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

Objective: This study aims to investigate the impact of individual and family factors on anxiety and loneliness of middle school students during quarantine in the COVID-19 pandemic and to provide reference for discussing the possible effective intervention paths in the stress process of public health emergencies. Methods: A total of 11 596 students from junior and high schools in Shanghai were selected to complete the questionnaire with the stratified random cluster sampling method. Generalized Anxiety Disorder(GAD-7) and UCLA Loneliness Scale, University of California at Los Angeles(ULS-6) were used for the survey. Results: The prevalence of anxiety and loneliness were 34.78% and 52.44% respectively. The rate of anxiety and loneliness in girls (36.13%, 54.62%) was higher than that of boys (33.44%, 50.28%)(χ 2=17.03, 21.82, P<0.05). Logistic regression analysis showed that graduates (OR=1.34, 95%CI=1.18-1.52), students ranking in the middle (OR=1.25, 95%CI=1.08-1.45) or in the bottom 25% (OR=1.76, 95%CI=1.50-2.05), non only children in the family (OR=1.25, 95%CI=1.09-1.43) and low socioeconomic status (OR=1.42, 95%CI=1.23-1.65) were associated with increased risk of moderate and severe level of anxiety(P<0.05). Girls(OR=1.20, 95%CI=1.12-1.30), graduates(OR=1.13, 95%CI=1.04-1.24), non residents(OR=1.20, 95%CI=1.09-1.33), lower level of grades(OR=1.72, 95%CI=1.55-1.91) and not living with parents(OR=1.32, 95%CI=1.18-1.48) were associated with increased risk of loneliness(P<0.05). Conclusion During the quarantine period caused by the COVID-19 pandemic, negative emotions such as anxiety and loneliness among adolescents need attention, especially females, graduates, only children and students with low rankings or low socioeconomic status.

Objective: To assess the status of current e cigarette perception and its influencing factors among adolescents in Shanghai, so as to provide reference for the refinement of the prevention and control measures of teenagers e cigarette use. Methods: From May to June 2021, a stratified random cluster sampling was used to investigate 7 456 junior high and high school students in Shanghai. Harm and benefit perception of e cigarette as well as its social environment benefits were collected. Results: The rate of adolescents ever and current e cigarette use was 3.19% and 1.09%, respectively. The top four risk factors for low harm perception of e cigarette were adolescent e cigarette use( OR=2.74, 95%CI =2.10-3.59), high school students ( OR=1.47, 95%CI = 1.32 - 1.64 ), family members ( OR=1.45, 95%CI =1.24-1.70) and friends ( OR=1.36, 95%CI =1.20-1.54) using e cigarette. Adolescent ecigarette use ( OR=2.77, 95%CI =1.97-3.89), high school students( OR=2.11, 95%CI =1.89-2.36), friends ( OR= 1.63, 95%CI =1.42-1.87) and family members using e cigarette( OR=1.39, 95%CI =1.18-1.65) were the top four associated factors for high benefit perception of e cigarette. And, adolescent e cigarette use ( OR=1.95, 95%CI =1.47-2.59), high school students ( OR= 1.73, 95%CI =1.55-1.93), friends ( OR=1.60, 95%CI =1.40-1.82) and pocket money≥200 yuan using e cigarette( OR= 1.29 , 95%CI =1.17-1.43) were the top four risk factors for high social environmental benefit perception of e cigarette. Moreover, perception of e cigarette harm, benefit and social environmental benefit were associated with the risk of future use of e cigarette( OR = 0.78,1.44,1.21, P <0.01). Conclusion Being high school students and using e cigarette by oneself, friends, and family members are the important influencing factors for adolescents e cigarette perception. Both low harm and high benefit perception of e cigarette elevate the risk of future e cigarette use among adolescents, so effective measures should be taken to promote control education about e cigarette and smoke free environment construction.

Objective: To investigate the prevalence of adolescents dietary behavior in Shanghai, and to explore emotional influence on dietary behavior. Methods: A total of 7 456 students from 10 junior and 6 senior high schools in Shanghai were selected to participate in the questionnaire survey with the stratified random cluster sampling method. The survey included general information, eating behavior, PHQ-2 and GAD-7. Results: During the past week, the proportion of adolescents in Shanghai reported consumption of sugar sweetened beverages, sweet desserts, frequent fried food and fast food (≥4 times/week) were 13.26%, 16.90%, 6.99 % and 13.01%, respectively. The proportion of students reported consumption of fruits, vegetables, milk and breakfast every day were 56.96%, 73.00%, 65.03% and 76.11%, respectively. There were significant differences by sex and educational stages(both P <0.05). Adolescents with depression or anxiety have a higher incidence of unhealthy eating behaviors than those without depression or anxiety( P <0.01). After adjusting for gender, school, accommodation, grades, pocket money and social class, depression and anxiety increase the risk of various unhealthy eating behaviors in adolescents( P <0.05). Compared with those without anxiety, the risks of sugar sweetened beverages consumption (≥1 time/d) among adolescents with mild and moderate to severe anxiety were 1.42 times (95% CI =1.20-1.67) and 2.51 times (95% CI =2.09-3.01), the risks of insufficient fruits consumption (<1 time/d) were 1.30 times (95% CI =1.16-1.45) and 1.28 times (95% CI =1.11-1.47), the risks of insufficient vegetable consumption (<1 time/d) were 1.35 times (95% CI =1.20-1.52) and 1.41 times(95% CI =1.21-1.65), the risks of insufficient milk consumption (<1 time/d) were 1.29 times (95% CI =1.15-1.44) and 1.20 times(95% CI =1.04-1.39), and the risks of breakfast skipping were 1.75 times (95% CI =1.54-1.99) and 2.97 times (95% CI =2.55-3.46) among adolescents with mild and moderate to severe anxiety. Conclusion The proportion of unhealthy eating behaviors among adolescents in Shanghai is still high. Early education and intervention for students eating behaviors should be carried out, and attention should be paid to the occurrence of adolescents negative emotions, so as to reduce the risk of unhealthy eating behaviors among adolescents through the promotion of mental health.

Abstract Social network of adolescents is one of the important factors affecting the initiation and development of their unhealthy eating behaviors, and different types of social networks shows varied influences on adolescents eating behaviors through divergent mechanisms. In the context of the new media era, social networks of adolescents establish via social media appear more complex and extensive. Based on relevant previous literature, the paper explores the impact and possible mechanisms of social network on eating behavior of adolescents, as well as its development and application in the new media era to provide references for better intervention strategies and healthier eating behaviors among adolescents from the perspective of social network.

Objective: To understand current situation of the awareness of tobacco hazards among middle school personnel in Shanghai and to explore its influencing factors,and to provide reference for making targeted measures to control tobacco hazards in schools. Methods: A total of 30 middle schools in Shanghai were selected by stratified cluster sampling method. The questionnaires were used to investigate the smoking prevalence and tobacco hazard awareness of 3 007 faculty members. Results: The total smoking rate of school personnel in Shanghai was 8.25%; the complete correct rate on the harm of smoking and second-hand smoke was only 19.72% and 23.74%, respectively. The correct awareness rate of harm caused by tobacco, such as stroke, osteoporosis and heart disease, was less than 50%. Gender, education level, smoking behavior and tobacco control training were related with tobacco hazards perception level. Conclusion The smoking rate among middle school personnel in Shanghai has been generally improved, but the faculty and staff have an unbalanced understanding of tobacco hazards. The school's tobacco control education should be targeted. Smoking, men and personnel with relatively low education levels are the key groups in school tobacco control education.

Objective: This study conducted a tobacco control intervention practice on vocational school students based on social cognitive theory, for exploring the practical and feasible tobacco control strategies among students, so as to reduce adolescents’ smoking behaviors. Methods: Cluster random sampling method was used to select students in four vocational schools in Shanghai, which were randomly divided into the intervention group (2 schools 1 003 students) and the control group (2 schools 1 096 students). The intervention was conducted on the intervention group based on the social cognitive theory and lasted for 6 months. The control group was blank. Descriptive and analytical statistical methods were used to evaluate the effect of intervention. Results: After the intervention, in the intervention group, the current smoking rate (2.77%) and the smoking intention in the next 1 year (8.50%) both decreased, the scores of the cognition of the harm of smoking as well as second hand smoking and the attitudes towards tobacco all increased(39.04%, 32.93%), the self-efficacy of refusing smoking increased (88.93%), the social pressure decreased(12.40%), the exposure rate of secondhand smoke in family decreased(35.45%), and the exposure to tobacco control message on media increased (36.68%). The difference was statistical significant compared to the control group (χ2=8.67，19.32，17.87，8.32，13.51，14.71，17.36，20.09，P<0.01). Conclusion The tobacco control model based on social cognitive theory could effectively improve adolescents’ self-efficacy, increase their tobacco-related knowledge, and significantly reduce their future smoking intention and behavior.

Objective To analyze the efficacy and safety of CyberKnife combined with temozolomide (TMZ) in treatment of brain metastasis of non-small cell lung cancer (NSCLC). Methods From March 2013 to March 2016, 62 NSCLC patients with brain metastases in department of oncology of the 187th Hospital of PLA were divided into two groups according to the random number table method, the CyberKnife combined with TMZ group (CyberKnife + TMZ group, 31 cases) and simple CyberKnife group (CyberKnife group, 31 cases). Hypofractionated radiation of CyberKnife was given 18-36 Gy in 1-5 fractions of 5-25 Gy. CyberKnife+ TMZ group was given temozolomide 150 mg·m-2·d-1 for 5 days in first cycle, then every 28 days they received temozolomide therapy from the second to the sixth cycles: 200 mg·m-2·d-1 for 5 days. The clinical symptom remission rate after the treatment of CyberKnife in one week, the effective rate after CyberKnife in 3 months, the median intracranial progression-free survival time, overall survival, and the incidences of adverse reaction were comparatively analyzed. Results The clinical symptom remission rates of CyberKnife+TMZ group and CyberKnife group after the treatment of CyberKnife in one week were 93.6 ％ (29/31) and 96.8 ％ (30/31). There was no significant difference in the clinical symptom remission rates (χ2= 1.207, P=0.547). The effective rates of the two groups after CyberKnife in 3 months were 93.6 ％ (29/31) and 90.3 ％(28/31). There was no significant difference in the effective rates (χ2 = 0.695, P= 0.706). The median intracranial progression-free survival time in CyberKnife + TMZ group (14.0 months) was significantly higher than that in the CyberKnife group (9 months) (χ2=8.977, P=0.003), and the median overall survival time in CyberKnife + TMZ group (15.0 months) was also significantly higher than that in the CyberKnife group (12.0 months) (χ2 = 5.190, P= 0.023). There was no significant difference in the adverse reaction of the central nervous system between the two groups (χ2=0.746, P=0.689), but the adverse reactions of the digestive system (χ2 = 6.062, P= 0.014) and the hematologic system (χ2 = 6.613, P= 0.010) in CyberKnife + TMZ group were significantly higher than those in the CyberKnife group. Systemic adverse reactions of the two groups were tolerated by most patients. Conclusions CyberKnife combined with TMZ is a feasible therapeutic option for NSCLC patients with brain metastases. This therapy can improve the median survival time to cerebral progression of the disease and the median overall survival time.