OBJECTIVE: To explore the factors influencing mental health and suicidal behaviors of medical students and provide a scientific basis for improving their mental health and reducing their suicidal behaviors. METHODS: We conducted a questionnaire-based survey among 11 270 medical students in the first and second years at 3 universities in the southern, northern and central regions of a province in China, and 10 340 valid responses were retrieved. Multiple logistic regression was used to analyze the factors affecting anxiety, depression and suicidal behaviors, particularly the impact of family environment on the mental health status of the medical students. RESULTS: Medical students of the female gender, in their second year in college, with dissatisfaction with their major, coming from poor families, families experiencing domestic violence or dysfunctional family were more likely to develop depression and anxiety; medical students who experienced violence by their parents or guardians and had childhood experience of separation from parents were more likely to develop anxiety ( CONCLUSIONS The mental health and suicidal behavior of medical students are affected by various factors involving family conditions, childhood experience, to which parents and relevant agencies should give due attention.
China/epidemiology* ; Cross-Sectional Studies ; Depression/epidemiology* ; Female ; Humans ; Mental Health ; Risk Factors ; Students, Medical ; Suicidal Ideation ; Surveys and Questionnaires ; Universities

Objective To investigate the clinical characteristics and the pathogens of recurrent urinary tract infection (RUTI) after renal transplantation.Methods The data of adult recipients with UTI from November 2011 to December 2016 were retrospectively analyzed.The recipients were divided into single UTI (SUTI) group and RUTI group.The clinical characteristics and pathogens were analyzed,and the independent risk factors of RUTI were analyzed using logistic regressionmodel.Results Fifty-three cases were selected,including 29 cases of SUTI and 24 cases of RUTI.The positive rate of blood culture (55％ vs.25％,P =0.042) and the concentration of FK506 in the peri-infection period (11.0 + 3.4 ng/mL vs.8.6 + 3.2 ng/mL,P =0.024) in the RUTI group were significantly higher than that those in the SUTI group at the first UTI.The increased concentration of FK506 in the peri-infection period at the first UTI was an independent risk factor for RUTI (β:0.282,95％ CI:1.026-1.713,P＜0.05).There were 86 infection events in 53 patients,and pathogenic microorganisms were cultured in blood culture and urine culture for 86 times.The positive frequency of culture in the RUTI group was higher than that in the SUTI group,but not significantly.The most common pathogenic microorganisms included Escherichia coli (17 times),pseudomonas aeruginosa (16 times),and Enterococcus (16 times).Conclusion Reduction of the FK506 concentration during the peri-infection period at the first UTI is the key to prevent RUTI after renal transplantation.The empirical antibiotics for RUTI should be sensitive for Escherichia coli (ESBL +)and pseudomonas aeruginosa.

Objective:To explore the radiology and short-term clinical outcomes of MAKO robotic-assisted total hip arthroplasty (THA).Methods:The present study retrospectively reviewed the medical records of 23 patients (32 hips) who diagnosed as osteonecrosis of the femoral head and underwent MAKO THA from August 1st to December 31st, 2018 as MAKO THA group. A total of 23 patients (32 hips) with the same diagnosis underwent manual THA at the same time as conventional THA group. There was no statistical difference between the two groups in terms of gender, affected side, age, height, weight, Body Mass Index (BMI), stage of the Association Research Circulation Osseous (ARCO), preoperative Harris hip score, WOMAC Osteoarthritis Index and limb length discrepancy. The patients in both groups were operated by the same doctors. The MAKO THA group underwent the acetabular preparation and the acetabular shell impaction with the assistance of the robotic arm. The leg length and offset were adjusted under the feedback of the MAKO system. Other intraoperative procedures and postoperative interventions of MAKO THA group were similar as conventional THA group. The operation duration, incidence of complications, the radiograph parameters (version, leg length discrepancy and offset), consistency of acetabular prosthesis position in MAKO operation plan, position in postoperative X-ray, the consistency of acetabular prosthesis inclination, version in MAKO operation plan, angles in postoperative CT and functional scores (Harris hip score, WOMAC Osteoarthritis Index and forgotten joint score) at 6 months and 12 months after operation were compared between the two groups.Results:The operation duration of the MAKO THA group was longer than that of the conventional THA group (101.2±19.9 min, 65.5±5.6 min, t=7.659, P<0.001). In terms of radiograph parameters, the different of version (22.63°±5.58°, 15.98°±7.13°, t=4.156, P<0.001) and limb length discrepancy (0.35±0.30 cm, 0.87±0.43 cm, t=4.775, P<0.001) and offset (0.27±0.19 cm, 0.49±0.16 cm, t=4.155, P<0.001) between the two groups were statistically significant. The MAKO operative plan and postoperative radiographs were measured. The difference of inclination/version were 1.18°±2.52°/2.06°±2.79° ( r=0.846, P<0.001; r=0.810, P<0.001), respectively. The horizontal/vertical directions of the joint rotation center were 2.25±1.08 mm and 2.20±1.28 mm ( r=0.975, P<0.001; r=0.974, P<0.001), respectively. In terms of functional results at 6 months and 12 months after operation, Harris hip score in MAKO THA group and in conventional THA group was 90.2±5.40/89.9±5.23 ( t=0.188, P=0.851) and 93.9±2.31/94.0±2.61 ( t=0.254, P=0.801), respectively. The WOMAC index was 27.3±10.36/29.1±12.03 ( t=0.623, P=0.535) and 16.4±8.39/15.2±8.35 ( t=0.597, P=0.552). The forgotten joint score was 76.3±6.11/73.7±6.84 ( t=1.560, P=0.124) and 81.7±4.52/80.7±5.11 ( t=0.816, P=0.418), respectively. Transient bleeding in the anterior superior iliac spine pin holes were reported in 4 hips after discharge in MAKO THA group, which were healed after dressing change. No other intraoperative or postoperative complication was reported. Conclusion:Robotic-assisted THA were more accurate and stable than conventional THA. The version of robot-assisted THA was closer to the target of 20° with similar discrepancy in leg length and hip offset. The short-term functional outcomes were similar in the two groups. However, the operation duration of robot-assisted THA was prolonged.

Zhishi Xiebai Guizhi Tang， derived from Synopsis of the Golden Chamber （《金匮要略》， Han dynasty， ZHANG Zhongjing）， is a famous classical prescription commonly used for chest impediment. By means of bibliometrics， the authors collected 63 ancient Chinese medical books related to Zhishi Xiebai Guizhi Tang and screened 36 effective books for statistical analysis of the historical origin， composition， main indications， dosage， processing， decocting method and other aspects of the prescription. The findings revealed that Zhishi Xiebai Guizhi Tang was composed of five medicinal herbs， namely， Aurantii Fructus Immaturus， Allii Macrostemonis Bulbus， Cinnamomi Ramulus， Magnoliae Officinalis Cortex， and Trichosanthis Fructus， with the function of activating Yang， dissipating mass， dispelling phlegm and lowering Qi. The prescription was mainly used to treat chest impediment， chest fullness， chest pain， wheezing， coughing and shortness of breath caused by suppressed Yang Qi， stagnant heart Qi， stagnant phlegm and stasis， and phlegm evil blocking heart， chest or lungs. Additionally， it was found that there were 70 modern literature recording the clinical applications of Zhishi Xiebai Guizhi Tang， and the main system diseases treated were circulatory system （51， 72.85%）， endocrine system （4， 5.7%）， respiratory system （9， 12.85%） and digestive system （6， 8.57%）， of which circulatory system is dominated by coronary heart disease （chest impediment in traditional Chinese medicine）. The involved medical syndrome types mainly included internal obstruction of phlegm heat and turbidity， obstruction of phlegm turbidity and stasis， congealing cold， phlegm， stasis and Qi stagnation， chest Yang depression and combined phlegm and stasis. Ancient medical records and modern clinical application are the keys to ensure the safety and effectiveness of famous classical prescriptions and compound preparations. Therefore， this paper sorted and mined ancient medical books of Zhishi Xiebai Guizhi Tang and statistically analyzed its modern clinical application， aiming to provide a literature reference for the research and development of new drugs and clinical application of the prescription.