Objective To study anxiety and depression among the abused children and their association with psychological resilience.Methods Self-rated questionnaires including the screen questionnaire of child abuse(SQCA),the screen for child anxiety related emotional disorder(SCARED),self-rating depression scale for children(DSRSC),Resilience Scale and General information questionnaire were applied to 447 children.Results (1) The score and rating of SCARED and DSRSC in the group of abused children(respectively(20.39 ± 12.79),(11.65 ± 5.44) and 40.26％,27.27％) was higher than that in control group(respectively(14.74 ± 10.91),(10.18 ± 4.75) and 22.43％,12.97％),the difference was statistically significant (P ＜ 0.01).(2) The score of psychological resilience of abused children in group of anxiety and depression (respectively (80.13 ± 12.82),(74.67 ± 10.71)) was lower than that in control group (respectively (93.91 ± 16.08),(93.50 ± 15.00)),the difference was statistically significant(P＜ 0.01).(3) Emotion control was a significantly negative predictor of anxiety among the abused children.Social assistance,family support and emotion control was a significantly negative predictor of depression among the abused children.Conclusion The abused children have more anxiety and depression problems.psychological resilience is an important predictive variable for anxiety and depression among the abused children.

Aim To observe the protective effects of ginkgolide B(GB)on cerebral ischemia-reperfusion injury in rats and explore its mechanism.Methods Cerebral ischemia-reperfusion injury in rats was induced by middle cerebral artery occlusion.The neurological out-come and infarct size were evaluated.SOD and LDH activity,LD and MDA levels of ischemia cerebral tissue were measured.The pathomorphology examination was done.Results GB did not improve neurologic defects in 3 h ischemia rats,but it improved neurologic defects in 21 h reperfusion rats.GB(10,5 mg?kg-1)markedly decreased infarct size in rats.SOD activity in GB(10,5 mg?kg-1)groups was higher,and LDH activity and MDA level in GB(10,5,2.5 mg?kg-1)groups were significantly lower than those in vehicle group.LD level did not chang.The cellular and intercellular edema was reduced markedly in the pathomorphology examination.Conclusions GB has protective effects on cerebral ischemia-reperfusion injury in rats.Its role is probably related to its effect on the activity of SOD and LDH,and the level of MDA.

Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.

Objective The application of nano-carbon tracer technique in radical antegrade modular pancreatosplenectomy (RAMPS) to treat malignant tumors of pancreatic body and tail.To investigate whether radical anterograde modulization of pancreatic body and tail combined with nano-carbon tracer technique is more beneficial to the prognosis of patients.Methods From January 2014 to September 2018,a retrospective analysis was performed in 48 patients in Linyi Central Hospital,all patients underwent RAMPS,all of whom were pathologically proved to be pancreatic carcinoma of the body and tail.Based on whether the nano-carbon lymph node tracer was performed during the operation,the patients were divided into two groups:nano-carbon group (nano-carbon lymph node tracing) and conventional operation group (no nano-carbon lymph node tracer).The differences between the two groups were analyzed,including operative time,intraoperative blood loss,postoperative complications (pancreatic fistula),postoperative hospitalization time,postoperative pathological lymph node status (number of dissection,number of positive lymph nodes,the positive rate of lymph node black staining in nano-carbon group) and survival time after operation.The measurement data were expressed as mean ± standard deviation (Mean ± SD),t-test were used for comparison among groups;Chi-square test was used for comparison of counting data,and Kaplan-Meier test was used for comparison of survival rate.Results There was no significant difference in the time of operation [(4.45 ± 0.59) h vs (4.41 ±0.65) h],the amount of blood lost during operation [(447.39 ± 109.51) ml vs (434.8 ± 76.38) ml] and the time of hospitalization after operation [(16.52 ± 4.12) d vs (16.56 ±2.92) d] between the two groups (P＞0.05).There were 1 case of pancreatic fistula in the nano-carbon group and 2 cases of pancreatic fistula in the convertional operation group,but the difference was not statistically significant (P =0.55).The number of lymph nodes dissected and positive lymph nodes in nano-carbon group were significantly higher than those in conventional operation group [(18.26 ± 2.49) vs (12.16 ± 2.19);(5.52 ± 1.50) vs (3.32 ± 0.85).The difference was statistically significant (P ＜ 0.05).The positive rate of lymph nodes in black stained lymph nodes (38.10％,96/252) was significantly higher than that in non-stained lymph nodes (18.45％,31/168),and the difference was statistically significant (P ＜ 0.05).The average survival time in the nano-carbon group [(25.48 ± 11.74) months] was significantly longer than that in the conventional operation group [(15.80 ± 11.64) months],and the difference was statistically significant (P ＜ 0.05).Conclusions It is safe,effective and feasible to treat malignant tumors of pancreatic body and tail by RAMPS combined with nano-carbon tracer technique.The positive rate of lymph node dissection and the detection rate of total lymph nodes are increased,and the prognosis of patients is improved,to improve the survival time of patients after operation is improved.

Objective To observe the changes of bone formation in type 2 diabetes mellitus (T2DM) mice and the effect of different exercises on their cAMP/CREB/Atf4 pathway and bone formation.Methods Forty four-week-old C57BL/6 male mice were randomly divided into a normal control group (ZC) of 10 and a T2DM group of 30.T2DM was induced using the high-fat diet and injection of streptozotocin.Then,the T2DM mice were randomly divided into a T2DM control group (TC),a T2DM swimming group (TS) and a T2DM downhill running group (TD),each of 10.The TS and TD groups were trained for eight weeks as their group names indicated.Then the concentration of cAMP in serum was tested using the enzyme-linked immunosorbent assay (ELISA).The reverse transcription-polymerase chain reaction (RT-PCR) was used to test the mRNA expression of the cAMP-response element binding protein (CREB),activate transcription factor 4 (ATF4),osteocalcin (OC),bone gla-protein (OCN)and bone sialoprotein (BSP) in the left tibia,and Western blotting was employed to test the protein expression of CREB in the right femur.The bone marrow mesenchymal stem cells (BMSCs) were taken and induced to differentiate into osteoblasts (OBs) and dyed using the alkaline phosphatase (ALP) solution.The left side hindlimb bone was taken and scanned the bone mineral density (BMD) of the distal end using the Skyscan Micro-CT.Results Compared with group ZC,the concentration of cAMP declined in group TC.Moreover,the mRNA expression of CREB,ATF4,OC,OCN and BSP as well as the protein expression of CREB of group TC were significantly down-regulated(P＜0.01 or P＜0.05),together with the OB osteogenic capacity and BMD (P＜0.01) compared to group ZC.Compared with group TC,significant increase was observed in the mRNA expression of OC and OCN (P＜0.01 or P＜0.05),as well as the OB osteogenic capacity of group TS.The concentration of cAMP of group TD decreased,the mRNA expression of CREB,ATF4,OC and OCN,as well as the protein expression of CREB were all significantly up-regulated (P＜0.01 or P＜0.05) compared with group TD.The OB osteogenic capacity and BMD(P＜0.05) of group TD also increased significantly.Compared with group TS,the concentration of cAMP(P＜0.05) and the OB osteogenic capacity increased,and the mRNA expression of CREB,ATF4 and OC of group TD increased significantly(P＜0.01 or P＜0.05).Conclusion The bone formation metabolism of type 2 diabetic mice is inhibited.The downhill running is superior to swimming in promoting the osteoblast differentiation and bone formation,as well as the bone mineral density through activating the cAMP/CREB/Atf4 pathway in the bone of T2DM mice.

Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75％ (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23％,66.65％ and 33.18％ at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.

Objective:To investigate the efficacy of enhanced recovery after surgery(ERAS)combined with laparoscopy for the treatment of colorectal cancer in the elderly and its effects on proinflammatory factors and immune responses.Methods:A total of 158 elderly patients with colorectal cancer treated with surgery were retrospectively analyzed.According to different treatment methods, they were divided into the control group(76 cases)and the study group(82 cases). The control group received traditional open surgery and routine perioperative care.The study group received laparoscopic radical resection of colorectal cancer plus perioperative ERAS.Surgery parameters, complications, postoperative immune function and proinflammatory factor levels were compared between the two groups.Results:The operation duration of the study group was significantly longer than that of the control group[(128.5±33.7)min vs.(117.4±28.7)min, t=2.220, P=0.028], whereas the intraoperative blood loss[(100.8±20.5)ml vs.(250.7±62.3)ml, t=20.621, P<0.01]and the incision length[(4.5±1.2)cm vs.(17.5±3.0)cm, t=36.243, P<0.01]were significantly less than those in the control group.The time to first flatus[(2.0±0.9)d vs.(3.8±1.8)d, t=8.037, P<0.01], time to first defecation[(2.8±0.8)d vs.(4.5±1.1)d, t=11.167, P<0.01], time to first ambulation[(1.2±0.2)d vs.(3.8±1.3)d, t=17.888, P<0.01]and hospitalization length[(7.1±0.2)d vs.(11.4±2.2)d, t=17.625, P<0.01]were also significantly shorter than those in the control group.The incidences of surgical site infections(2.4% vs.10.5%, χ2=4.351, P=0.037), abdominal distension(7.3% vs.19.7%, χ2=5.279, P=0.023)and intestinal obstruction(9.8% vs.22.4%, χ2=4.711, P=0.030)in the study group were significantly lower than those in the control group.The levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α in the study group were significantly lower than those in the control group at 1 d, 3 d and 7 d after surgery( t= 9.612, 7.300, 5.446, 8.762, 12.138, 15.370, 10.186, 10.432, 13.512, respectively, all P<0.05). The levels of CD3 + , CD4 + and CD4 + /CD8 + in the study group were significantly higher than those in the control group at 1 d, 3 d and 7 d after surgery( t= 2.128, 2.957, 2.313, 2.914, 2.937, 2.809, 5.089, 5.623, 5.409, respectively, P<0.05 for all), and the levels of CD8 + were significantly lower than those of the control group( t= 2.008, 2.580, 4.902, all P<0.05). Conclusions:Laparoscopy combined with ERAS for the treatment of colorectal cancer in the elderly can reduce surgical injury and complications and mitigate inflammatory responses with little impact on immune responses.

BackgroundAnxiety exists as a prevalent psychological problem among college students nowadays， which brings negative influence on their normal life. Mobile phone addiction and loneliness both have an impact on college students' anxiety. However， the acting path of loneliness between mobile phone addiction and anxiety requires further exploration. ObjectiveTo analyze the relationships among mobile phone addiction， loneliness and anxiety in college students， and to explore the acting path of loneliness between mobile phone addiction and anxiety. MethodsOn December 21， 2023， 1 400 college students from a university in Henan Province were selected， in accordance with the simple random sampling method， for investigation of this study. Questionnaire survey was conducted by using several scales including Mobile Phone Addiction Tendency Scale （MPATS）， Self-rating Anxiety Scale （SAS） and University of California Los Angeles-Loneliness Scale （UCLA-LS）. Pearson correlation analysis was used to examine the correlation between the scores of each scale above， and SPSS macro program Process 3.3 was used to test the mediation effect. ResultsA total of 1 239 valid questionnaires were collected， with an effective recovery rate of 88.50%. The MPATS score of college students was positively correlated with both SAS and UCLA-LS scores （r=0.474， 0.387， P<0.01）， and UCLA-LS score was positively correlated with SAS score （r=0.541， P<0.01）. The indirect effect of loneliness between mobile phone addiction and anxiety was 0.160 （95% CI： 0.118~0.173）， accounting for 33.97% of the total effect. ConclusionMobile phone addiction can positively predict anxiety among college students， and loneliness may act as the mediation path between mobile phone addiction and anxiety among college students.

OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Emergency Medical Services ; organization & administration ; Health Services Needs and Demand ; Hospitals, General ; organization & administration ; Humans ; Outpatients ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control