Objective:To test the effects and differences of gratitude,indebtedness and happiness on people's helping behaviors. Methods:Totally 190 college students from 3 classes in Henan Province were selected. Three sit-uational experiments of gratitude,indebtedness and happiness were used to inspire participants'mood according-ly. Each class randomized to receive a situational experiment,the altruism subscales of Philosophies of Human Na-ture(PHN),the assessment tool of helping others and helping others voluntarily were used to measure the college students'altruistic idea,helping others and helping behavior voluntarily,and the methods of descriptive statistics,co-variance analysis and regression analysis was adopted. Results:In helping others and helping others voluntarily,ac-cording to the results of covariance analysis,the effect of covariate altruistic ideas was significant [F(1,186)=9. 24,10. 52;Ps<0. 01],and the main effect of emotional state was also significant[F(2,186)=3. 50,3. 45;Ps<0. 05 ]. The scores of helping others and helping others voluntarily were higher in the gratitude group than in the happiness group[(4. 21 ±0. 10)vs. (3. 86 ±0. 09),(4. 22 ±0. 09)vs. (3. 90 ±0. 08)]. Regression analysis showed that gratitude could positively predict helping others and helping others voluntarily(β=0. 33,0. 20),and happiness could positively predict helping others voluntarily(β=0. 16). Conclusion:Excluding the effect of altruism idea to helping others and helping others voluntarily,the effects of emotional state to helping others and helping others vol-untarily are all significant. It suggests that participants under the state of gratitude could show more helping others and helping others voluntarily than participants under happiness,that is to say,comparing with happiness,gratitude may be more conducive to the cultivation of helping behavior.

Taking global minimum essential requirements(GMER)as standard,school of basic medical science in Wuhan University paid more attention to the cultivation of students' professional skills, innovation ability and communication ability. ‘Response to injury’integrated course was carried out. Based on the immunology,this course involves pathology and pathophysiology and explores the mecha-nism of the diseases' diagnosis and treatment. It took small classes,bilingual education,literature read-ing ,experiments and discussions in various forms . This reform aimed to improve the immunology , pathology and pathophysiology teaching and make our medical education meet the process of globalization.

Objective:To investigate the effect of paper towel combined with 360° horizontal turning over method on the field of vision, operation time and detection of small lesions before gastroscopy, so as to improve the detection rate of early gastrointestinal cancer.Methods:The outpatients and inpatients who voluntarily accepted gastroscopy in the First Affiliated Hospital of Shandong First Medical University from May to October 2020 were enrolled. A prospective randomized controlled study was used. They were divided into the experimental group (paper towel group combined with 360° horizontal turning over) and the control group (routine) according to the random number table. Finally, a total of 948 patients were included, including 487 cases in the experimental group and 461 cases in the control group. The visual field clarity, operation time, rinse times, detection of micro lesions and detection of early cancer of the two groups were compared.Results:The scores of gastric mucosa clarity (fundus, body, antrum and whole stomach) in experimental group were (1.61 ± 0.79), (1.18 ± 0.56), (1.01 ± 0.36), (3.20 ± 0.51) points, which were significantly lower than (2.56 ± 0.82), (2.01 ± 0.65), (1.98 ± 1.10), (5.05 ± 0.89) points in control group. The difference was statistically significant ( t values were 0.02-0.07, all P<0.05). The operation time of the experimental group was (5.91 ± 0.41) min, which was significantly shorter than (6.80 ± 0.72) min of the control group, and the difference was statistically significant ( t=-7.46, P<0.05). The number of flushing in the experimental group was 67 times, accounting for 13.8%, which was significantly lower than 144 times in the control group, accounting for 31.2%, and the difference was statistically significant ( χ2=54.78, P<0.05). The number of microlesions in the experimental group was 398 cases, which was higher than 245 cases in the control group. The difference was statistically significant ( χ2=8.43, P<0.05). For biopsy pathology, the detection of precancerous lesions or early carcinomas in the experimental group (56 cases) was significantly higher than that in the control group (24 cases), and the difference was statistically significant ( χ2=6.45, P<0.05). Conclusions:The application of paper towel combined with 360° horizontal turning over method before gastroscopy can significantly improve the clarity of gastroscope field of vision, shorten the operation time, increase the detection rate of small lesions, and effectively improve the detection rate of early gastrointestinal cancer, which is a simple and practical preoperative preparation method.

Objective:To construct a risk prediction model for infection with Klebsiella pneumonia (KP) for patients with severe acute pancreatitis (SAP).Methods:Retrospective analysis was done on the clinical data of 109 SAP patients who were admitted to Shanghai General Hospital, between March 2016 and December 2021. Patients were classified into infection group ( n=25) and non-infection group ( n=84) based on the presence or absence of KP infection, and the clinical characteristics of the two groups were compared. The least absolute shrinkage and selection operator (LASSO) algorithm was used to reduce the dimension of the variables with statistical significance in univariate analysis. A nomogram prediction model was created by incorporating the optimized features from the LASSO regression model into the multivariate logistic regression analysis. Receiver operating characteristic curve (ROC) was drawn and the area under curve (AUC) was calculated; and consistency index (C-index) were used to assess the prediction model's diagnostic ability. Results:A total of 25 strains of KP were isolated from 109 patients with SAP, of which 21(84.0%) had multi-drug resistance. 20 risk factors (SOFA score, APACHEⅡ score, Ranson score, MCTSI score, mechanical ventilation time, fasting time, duration of indwelling of the peritoneal drainage tube, duration of deep vein indwelling, number of invasive procedures, without or with surgical intervention, without or with endoscopic retrograde cholangiopancreatography (ERCP), types of high-level antibiotics used, digestion disorders, abnormalities in blood coagulation, metabolic acidosis, pancreatic necrosis, intra-abdominal hemorrhage, intra-abdominal hypertension, length of ICU stay and total length of hospital stay) were found to be associated with KP infection in SAP patients by univariate analysis. The four variables (APACHEⅡ score, duration of indwelling of the peritoneal drainage tube, types of high-level antibiotics used, and total length of hospital stay) were extracted after reduced by LASSO regression. These four variables were found to be risk factors for KP infection in SAP patients by multiple logistic regression analysis (all P value <0.05). Nomogram prediction model for KP infection in SAP was established based on the four variables above. The verification results of the model showed that the C-index of the model was 0.939, and the AUC was 0.939 (95% CI 0.888-0.991), indicating that the nomogram model had relatively accurate prediction ability. Conclusions:This prediction model establishes integrated the basic clinical data of patients, which could facilitate the risk prediction for KP infection in patients with SAP and thus help to formulate better therapeutic plans for patients.

Objective: To evaluate the prognostic value of ultrasonographic measurement of optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio in stroke patients during hospitalization. Methods: Adult patients with stroke (ischemic stroke or hemorrhagic stroke) admitted to department of critical care medicine of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from November 2017 to November 2018 were enrolled. On the day of admission, ONSD and ETD (retina-retina at 3 mm behind the globe along) were detected by ultrasound, the ONSD/ETD ratio was calculated, and the baseline data and outcomes were recorded. Patients were divided into survival group and death group according to their survival status. Locally weighted scatterplot smoothing (LOWESS) and the receiver operating characteristic (ROC) curve were used to calculate the thresholds of ONSD and ONSD/ETD. The correlation between ONSD, ONSD/ETD and prognosis were assessed. Results: Thirty-eight of 83 patients (45.8%) survived and were discharged from the hospital, while 45 patients died (54.2%). There were significant differences in Glasgow coma score (GCS), shifting of the middle structure, ONSD and ONSD/ETD between the death group and the survival group [GCS: 4.7±2.8 vs. 11.0±3.2, shifting of the middle structure (mm): 5.8±5.9 vs. 1.3±2.6, ONSD (mm): 5.5±0.4 vs. 4.4±0.5, ONSD/ETD: 0.25±0.02 vs. 0.20±0.02, all P < 0.05]. LOWESS and ROC curve analysis suggested thresholds of ONSD and ONSD/ETD for predicting adverse prognosis of stroke patients were 5.0 mm and 0.25, respectively. By adjusting the influence of confounding factors on prognosis, a prediction model based on ONSD was established, and the ROC curve was drawn. The area under the curve (AUC) was 0.978, the optimal predictive point of the model was 0.870, the sensitivity was 89%, and the specificity was 100%. The ONSD/ETD prediction model was also obtained, and the AUC was 0.988, the optimal prediction threshold of the model was 0.768, and the sensitivity for predicting adverse clinical prognosis was 94%, and the specificity was 97%. The stability of ONSD/ETD was better than that of ONSD. ONSD coefficient of variation was 0.14, and ONSD/ETD coefficient of variation was 0.13. Conclusions ONSD and ONSD/ETD were significantly correlated with the prognosis of critical patients with stroke. The mortality increased significantly in patients with an ONSD greater than 5.0 mm and ONSD/ETD greater than 0.25. ONSD and ONSD/ETD may be promising tools for early assessment of clinical outcomes in these patients.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all <0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all <0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all <0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all <0.01). CONCLUSIONS The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.
Anxiety ; diagnosis ; Betacoronavirus ; Coronavirus Infections ; prevention & control ; psychology ; Depression ; diagnosis ; Fatigue ; diagnosis ; Health Personnel ; psychology ; Humans ; Mental Health ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; psychology