Objective To explore the relatianship of social anxiety and parental rearing style and self-es-teem among medical students, and to provide theoretical guidance for students' mental health. Methods 346 medical students were assessed with interaction anxiousness scale(IAS), Egala minnen on bardndosnauppforstran (EMBU) and self-esteem scale (SES). Results Medical students' social anxiety was negatively correlated with emotional warmth and understanding of parents (FF1, MFI) (r=-0.162,-0.150, P<0.01) and self-esteem (r -0.355, P <0.01), and positively correlated with mother's over-interference, over-protection, refusal, rejection and favoring subject(MF2, MF3, MF5) (r=0.137,0.127,0.116, P<0.05). Stepwise regression analysis re-vealed that father's warmth and understanding and father's over-protection and self-esteem enter regression equa-tion and adjusted R square was 0.047 and 0.123. Conclusion The medical students' social anxiety was influ-enced by EMBU and SES, but the level was lower.

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objectives To explore the effect of traditional Chinese medicine wine combired with electromagnetic therapy for the neck,shoulder,back and leg pain. Methods Eighty cases of patients with neck,shoulder,back and leg pain were randomly divided into 2 groups,with 40 cases in each group,treatment group was given the traditional Chinese medicine wine and electromagnetic therapy,the control group was prescribed(only with electromagnetic therapy),use the numerical rating scale to observe the effects of two groups before therapy,3 days and 7 days after therapy . Result After treatment,the pain of the treatment group was relieved significantly better than that of the control group(P<0.05). Conclusion Traditional Chinese medicine wine combired with electromagnetic therapy for the neck,shoulder,back and leg pain has satisfactory effect,and is worthy to promotion.

Objective: To investigate the changes of serum carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), β₂-microglobulin (β₂-MG) levels in non-Hodgkin's lymphoma (NHL) patients and their clinical significance. Methods: From February 2015 to February 2018, 54 patients with NHL who were hospitalized in Shiyan People's Hospital were selected as the observation group. All patients underwent two cycles of chemotherapy combined with radiation therapy. Another 54 healthy subjects were selected as the control group. To observe the changes of serum LDH, β₂-MG, CEA levels in the control group, and compare the changes of serum LDH, β₂-MG, CEA levels before and after treatment with different clinical stages, different conditions, and different effects in NHL. Results: The levels of serum LDH, β₂-MG, and CEA in the observation group were higher than those in the control group (P<0.05); the levels of serum LDH, β₂-MG, and CEA in patients with NHL in stage Ⅲ to Ⅳ were higher than those in stage Ⅰ to Ⅱ (P<0.05); the levels of serum LDH, β₂-MG, and CEA in patients with NHL in the middle-high-risk and high-risk groups were higher than those in the middle-risk and low-risk groups (P<0.05); after treatment, the levels of serum LDH, β₂-MG, and CEA in stable disease (SD) and progression disease (PD) patients were not significantly different from those before treatment (P>0.05). While after treatment, the levels of serum LDH, β₂-MG and CEA in complete relief (CR) and partial remission (PR) patients were lower than those before treatment (P<0.05), and were lower than those in SD and PD patients. Conclusions The level of serum LDH, β₂-MG and CEA in patients with NHL increased, and the combined detection of the level changes is of great clinical value in the determination of clinical stage, malignant degree, clinical efficacy and prognosis of NHL patients.

Objective To evaluate the outcomes of children with Phenylketonuria(PKU)detected by newborn screening program.Methods One hundred and two children with PKU were detected and diagnosed in Shanxi Newborn Screening Center from June 2004 to September 2014.All children with PKU were followed up until December 2015.During the follow-up,the Phenylalanine(Phe)levels,physical and intellectual development, nutrition status of those children were monitored.Results Among 102 PKU children,there were 96(94.12%)with normal physical development,and 93(91.18%)with normal DQ/IQ.The average DQ or IQ score in children who started the therapy before 1 month was higher than that in those who started after 1 month old(93.07 ±9.50 vs.87.39 ±10.99,t=3.09, P=0.00).Among these children 82.47%(80/97)had zinc deficiency and 31.46%(28/89)had dyslipidemia; and the normal Phe concentration rate was(59.73 ±19.03)%.The intellectual development level was negatively correlated with the age of starting therapy(r=-0.25, P=0.01), positively correlated with the education levels of his/her father(r=0.21,P=0.03)and mother(r=0.23, P=0.02).And the intellectual development was better in urban areas than that in rural areas.Conclusions With the standardized treatment, the physical and intellectual development of children with PKU can basically reach normal levels,and the earlier treatment can make better therapeutic effect.

【Objective】 To explore a transfusion therapeutic plan for hemolytic disease of the newborn(HDN) caused by anti-c antibodies in mother of Asian-type DEL. 【Methods】 The ABO blood type and Rh phenotype of the mother and child were determined using the saline tube method. The mother′s RhD negativity was confirmed through classical anti-human globulin testing and RhD adsorption-elution test. The mother′s unexpected antibodies were screened and their titers were measured using classical anti-human globulin testing, antibody card test and polyamine method. Cross-matching was conducted. The three hemolysis tests were performed by antibody card test. The mother′s RHD gene typing was conducted using a commercially available RHD negative identification gene detection kit (PCR-SSP method). 【Results】 The mother exhibited a CCee Rh serological phenotype, and the DEL gene test confirmed the presence of RHD*1227A, indicating the production of anti-c antibodies. The infant displayed a DCcEe Rh serological phenotype, positive for direct antiglobulin test and red cell elution. Based on the mother′s obstetric history, clinical manifestations of the infant and blood examination results, the diagnosis was HDN caused by anti-c antibodies. 【Conclusion】 For infants with HDN caused by anti-c antibodies in mother of Asian-type DEL, DCCee Rh phenotype red blood cell transfusion is recommended, while CCee Rh phenotype deglycerolized red blood cell transfusion is recommended for the mother.

Objective To compare the clinical efficacy and short-term prognosis of laparoscopic radical resection of right colon cancer guided by superior mesenteric artery and superior mesenteric vein.Methods 80 patients with right colon cancer of cT2-4 and/or N0-2M0 admitted from January 2020 to October 2022 were selected as the research objects,and they were randomly divided into observation group and control group,with 40 patients in each group.The observation group was treated with SMA-oriented laparoscopic radical resection of right colon cancer,while the control group was treated with SMV-oriented laparoscopic radical resection of right colon cancer.The curative effect and prognosis of the two groups were compared.Results There was no significant difference between the two groups in general condition,operation time,gastric tube placement time,recovery time of farting,postoperative fasting time,postoperative drainage time,postoperative nutritional index,total incidence of complications and postoperative hospitalization time(P>0.05).The lymph nodes in the observation group were significantly more than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,the lymph nodes in the anterior and left side of superior mesenteric artery were examined(No.D3),and 273 lymph nodes were detected,and Seven patients(17.5% )were diagnosed with D3 metastasis,and 13 lymph nodes were positive(5.2% ).Conclusion Laparoscopic radical resection of right colon cancer guided by superior mesenteric artery,without increasing the incidence of complications and high safety,can more thoroughly clean lymph nodes and reduce tumor recurrence,which is expected to significantly improve the prognosis of patients.