Objective To investigate the effects of recombinant human osteoprotegerin(rhOPG) on RANKL ,OPG protein expression in alveolar bone tissue of rats with periodontitis to provide the experimental evidence for the application of rhOPG in pe‐riodontitis treatment .Methods Totally 22 Wistar rats were enrolled .The random number table was adopted to select two healthy rats as the healthy group .The rest 20 rats were selected as the experimental group for establishing the rat models of periodontitis , and then subdivided into the experimental control group (n=10) and rhOPG group (n=10) .Rats in the rhOPG group were locally injected by rhOPG 10 mg/kg at periodontal pocket gap of maxillary second molar ,while those in the experimental control group were injected by sterile water for injection at the same site and some volume .The streptavidin‐perosidase(SP) method was em‐ployed to detect the expression of RANKL ,OPG protein in alveolar bone tissue .Results Compared with the healthy group ,the ex‐pression levels of OPG in alveolar bone tissue of rats in the experimental group were lower with statistically significant difference (P<0 .05) ,while the difference of RANKL expression levels between the two groups showed no statistical significance(P>0 .05) . Compared with the experimental control group ,the expression level of OPG protein in alveolar bone tissue of rats in the rhOPG group was significantly up‐regulated ,while that of RANKL protein was significantly down‐regulated(P<0 .05) .The OPG expres‐sion level after treatment in the rhOPG group was markedly enhanced ,while the RANKL expression level was reduced compared with before treatment ,the difference was statistically significant (P<0 .05) .Conclusion rhOPG may regulates the expression of RANKL and OPG in alveolar bone tissue of rats with periodontitis .

Objective: To explore the status of depressive symptoms among adolescents in different pubertal stages in a district of Chongqing. Methods: A self designed questionnaire and Children s Depression Inventory were administered among 1 001 students in a district of Chongqing. Score and associated factors of depressive symptoms of adolescents through descriptive statistical analysis, Chi square test, analysis of variance and Logistic regression analysis. Results: The detection rate of depressive symptoms among adolescents in a district of Chongqing was 17.3%, and the total score of depression scale was (12.02±6.72). There were statistically significant differences in the inefficiency subscale score of boys across stages of genital, pubic hair, armpit hair and beard, and whether the first spermatorrhea has occurred( t/F =7.08，5.46，5.18，4.21，5.84， P <0.05), while significant differences were found in the anhedonia and inefficiency subscales scores among girls across different stages of breast, pubic hair and armpit hair, and whether menarche has occurred( t/F =19.43，4.92，3.98，7.35， P <0.05). Multivariate Logistic regression analysis showed that the absence of first spermatorrhea and menarche were associated with lower prevalence of depressive symptoms in boys and girls ( OR=0.60, 95%CI=0.36-0.98; OR=0.46, 95%CI =0.22-1.00), while pubic hair development was associated with higher prevalence of depressive symptoms in girls ( OR=9.58, 95%CI =1.28- 71.71 ). Conclusion The detection rate of depressive symptoms among adolescents is relatively low. Boys who have had the first spermatorrhea, and girls with advanced pubic hair development or have had menarche are more likely to suffer from depressive symptoms.

Objective: This study explored the predictive effects of psychological stress in early and middle puberty on subsequent emotional and behavioral problems. Methods: A cohort of 911 boys and girls from primary and secondary schools in Chongqing was studied. Psychological stress was measured in early and middle adolescence, and the levels of emotional and behavioral problems were determined in one year follow up. Logistic regression analysis was used to analyze the effects of psychological stress in early and middle adolescence on subsequent emotional and behavioral problems. Results: The average psychological stress score in early and middle adolescence was (27.96±24.95), and the average scores of internalized and externalized behavioral problems and overall problems one year later were (8.21±8.46)(6.21±5.87) and (37.90±24.68) respectively. When grouped by gender, these scores, as well as the detection rate of anxiety and depression, withdrawal, physical discomfort, thinking problems, internalization problems and overall problems, were higher in girls than boys (t/Z=-6.38，-5.63，-6.06，-3.74，-6.80，-5.47， χ 2=15.88，12.01，3.92，6.64，24.67，15.88， P <0.05). Logistic regression showed that the psychological stress scale score was a risk factor for internalized and externalized behavioral problems and overall problems( P <0.05). Conclusion Psychological stress levels in early and middle puberty have a positive predictive effect on emotional and behavioral problems in the following year.

Objective: To explore whether psychological stress in early and mid puberty is predictive of adolescent healthrisk behaviors. Methods: In April 2018, a total of 1 046 primary and secondary school students from grade 5 to 8 were recruited through purposive sampling. The basic information and psychological stress of the respondents were collected by questionnaire and physical examination. In addition, self reports of health risk behaviors were collected in October 2018. Logistic multiple regression analysis was used to analyze the relationship between psychological stress and health risk behaviors of adolescents. Results: The reported health risk behaviors of the surveyed adolescents ranking from high to low were unreasonable physical activity (62.05%), food preferences (24.76%), fighting (21.03%), suicidal ideation (17.02%), ideation of running away from home (9.85%), low mood (8.80%), smoking (4.21%), drinking (3.73%), gambling (3.63%) and internet addiction (3.06%). Logistic multiple regression analysis showed that the high level of psychological stress was a risk factor for fighting ( OR =1.02, 95% CI =1.01-1.03), suicidal ideation ( OR =1.02, 95% CI =1.01-1.03), low mood ( OR =1.02, 95% CI =1.01-1.03), ideation of running away from home ( OR =1.02, 95% CI =1.01-1.03), unreasonable physical activity ( OR =1.01, 95% CI =1.00-1.02), smoking ( OR =1.02, 95% CI = 1.00-1.03), internet addiction ( OR =1.02, 95% CI =1.00-1.03), food preferences ( OR =1.01, 95% CI = 1.00-1.02) and gambling ( OR =1.02, 95% CI =1.01-1.04)( P <0.05). Conclusion Unreasonable physical activity and food preferences are most common health risk behaviors among adolescents. Psychological stress during early to middle puberty is predictive of adolescent health risk behaviors.

Objective: To explore the relationship between the emotional and behavioral problems and family relations of firstborn children from an urban area of Chongqing during the role transition period, to provide a scientific basis for creating a good family relationship and to reduce the occurrence of children s emotional behavior problems. Methods: Totally 1 359 mothers of children in the role transition period were recruited from obstetric clinics at two Grade A hospitals in Chongqing, and mothers with informed consent using self designed questionnaire and parental version of the Child Behavior Checklist (CBCL). It was analyzed the association between family relationships and the emotional/behavioral problems of firstborn children of different ages. SPSS statistical software (version 20) was used for the descriptive statistical analysis, chi square test, and multiple linear regression analysis. Results: The parental relationship (56.6%), mother child relationship (80.4%) and father child relationship (64.9%) of most firstborn children was good, and 61.7% of families enjoyed a harmonious atmosphere. For the age groups 1.5-5 years and 6-13 years, the respective CBCL total scores were (18.22±13.63) and (24.20±17.52), and the detection rates were 10.7% and 10.5%, respectively. The results of the multiple linear regression analysis showed that, for both age groups, firstborn children who had good parental relationships, good mother child relationships, good father child relationships, and a harmonious family atmosphere exhibited fewer internalizing, externalizing and overall emotional behavior problems ( P <0.05). Conclusion The total detection rate of emotional and behavioral problems among firstborn children in the role transition period, which is low. Good parental relationships, good parent child relationships, and a harmonious family atmosphere are protective factors against emotional and behavioral disorders in firstborn children during the role transition period.

Objective: To compare the emotional and behavioral characteristics of preschool firstborn children across the transition to siblinghood with the only children in a district of Chongqing. Methods: Data were derived from a cohort study on firstborn children transition to siblinghood. Totally 882 firstborn children (3.58±1.25) years old and 329 only children (3.98±1.02) years old were recruited from two hospitals and 19 kindergartens in a district of Chongqing, respectively. Their mothers filled out the parental version of Child Behavior Checklist (CBCL) and self designed questionnaire. Results: The overall scores of emotional and behavioral problems of firstborn children and only children were (25.17±18.82) and (31.75±18.64). The results of rank sum test showed that the scores of the firstborn children in all dimensions, internalizing and externalizing behavior problems and overall emotional and behavioral problems were lower than those of the only children ( P <0.05). Chi square test results showed that the detection rates of internalizing, externalizing and overall emotional behavior problems in only children(12.77%, 13.07%, 14.59%) were higher than those in firstborn children(8.28%, 8.28%,8.16%) ( χ 2=5.62, 6.36, 11.09, P <0.05). Multiple linear regression showed that after adjusting for age, gender, family economic pressure, temperament type of children, family atmosphere and family type, the scores of internalizing problems, externalizing problems and overall problems of the only children were still higher than those of the firstborn children ( B =1.54, 2.32, 6.81, P <0.05). Conclusion The firstborn children across the transition to siblinghood show less emotional and behavioral problems than the only children, and the scores and detection rates of all types of emotional and behavioral problems of the firstborn children are lower than those of the only children.

Objective: To explore the influence of parental company before and after having second child on the emotional and behavioral problems of preschool firstborn children, and to provide a reference for emotional problems prevention of firstborn children. Methods: Questionnaire survey was conducted among mothers of firstborn children who met the inclusion and exclusion criteria from two Grade A hospitals in Chongqing from March to December 2019. The average age of 845 firstborn children was (3.56±1.24) years old. The chi square test was used to compare the general characteristics and parent company of boys and girls. Rank sum test was used to compare the differences of emotional and behavioral problems of firstborn children with different parents company. Multiple linear regression models were used to compare the differences of internalizing, externalizing and total problems in firstborn children with different parents company. Results: After having the second child, parents spent less time with their firstborn children, among which the decrease of the accompanying time of the mother and the total accompanying time of the parents were statistically significant( Z =3.76, 2.86, P <0.05). The scores of internalizing problem were higher when the mother s company time decreased ( B=1.18, 95%CI = 0.01 -2.36) and the parents total company time decreased( B=1.41, 95%CI =0.33-2.48). The scores of the externalizing problem ( B=1.25, 95%CI =0.10-2.39) and the total problem ( B=4.31, 95%CI =1.05-7.57) with the decrease of parents total company time were higher. Conclusion Parent company has an important influence on the emotional and behavioral problems of firstborn children. Firstborn children whose parents accompanying time decreases after having second children scored higher on emotional and behavioral problems.

Objective To investigate effect of high dose irradiation on the performances of thermolumines-cence detectors (LiF:Mg, Cu, P). Methods The high-dose irradiated thermoluminescence detector was annealed by a thermoluminescence annealing furnace until the annealing was completed, and then the annealed thermoluminescent detector was irradiated 0.5Gy by 137Cs irradiator to verify the accuracy of the thermoluminescentdetector. Results The thermoluminescence detector after high-dose irradiation could not be completely annealed under the temperature condition of 240 ℃, and it could be completely annealed at a high temperature as 400℃. After 0.5 Gy irradiation by 137Cs irradiator, the measurement results of the annealed thermoluminescence detector were significantly smaller, and the dose response and dispersion of the detector were also changed significantly. Conclusions After a more than 5 Gy irradiation, the crystal structure of the thermoluminescence detector has changed, and a high temperature peak above 240 ℃ has appeared, which leads to the failure to completely anneal at normal temperature. Therefore, the thermoluminescence detector can no longer be used for dosimetry after high-dose irradiation.

Objective:To evaluate the relationship between regional coronary flow reserve (CFR) obtained from cadmium-zinc-telluride SPECT(CZT SPECT) myocardial functional perfusion imaging (MFPI) and invasive fractional flow reserve (FFR) measured during coronary angiography (CAG) and its clinical value in guiding coronary interventions.Methods:Forty-two patients (30 males, 12 females, age (63.3±9.8) years) who completed CZT SPECT MFPI in the First Affiliated Hospital of Nanjing Medical University from June 2022 to September 2022 and underwent CAG within 3 months were included retrospectively. The concordance of CFR and FFR for diagnosing myocardial ischemia (CFR<2.0 and FFR<0.8) was calculated at the vascular level. The diagnostic efficacy of coronary stenosis≥70% for decreased myocardial blood flow (CFR<2.0) was calculated. Kappa test was used to analyze the data. Results:A total of 126 major coronary arteries were identified in 42 patients, of which 30(23.8%) had a CFR<2.0 by CZT SPECT and 33(26.2%) had stenosis≥70% in CAG. A total of 32 coronary vessels were performed with MFPI CFR and FFR measurements, of which 6 were both decreased and 21 were both normal, so the concordance rate was 84.4%(27/32)( Kappa=0.612, P<0.001). Among 33 coronary vessels with stenosis≥70%, 13 were with CFR≥2.0. Among 30 coronary vessels with CFR<2.0, 10 were with stenosis<70%. When using stenosis≥70% to diagnose CFR decreasing, the sensitivity was 66.7%(20/30), specificity was 86.5%(83/96), positive predictive value was 60.6%(20/33), negative predictive value was 89.2%(83/93), and accuracy was 81.7%(103/126). Conclusions:The concordance between CFR and FFR for the diagnosis of myocardial ischemia is good. Nearly 1/3 of the coronary arteries with decreased CFR have stenosis<70%, whereas nearly 40% of the coronary arteries with stenosis≥70% are not result in myocardial ischemia. Regional CFR determined by CZT SPECT may have potentially significant clinical value in the diagnosis of coronary artery disease and decision-making of coronary intervention.

Objective:To investigate the characteristics of anorectal dynamics in elderly patients with functional defecation disorders(FDD), and to provide a basis for their diagnosis, treatment and prevention.Methods:In this retrospective study, 226 patients with FDD receiving 3D high-resolution anorectal manometry were divided into an elderly group(93 cases)and a non-elderly group(133 cases). Results from anorectal manometry parameters were compared and analysis of patterns of anorectal pressure changes in elderly participants based on sex, the Bristol stool classification and clinical symptoms was conducted.Results:The resting anal pressure, rectal pressure and anal relaxation rate were lower( t=-3.407, -2.051, Z=2.548, P=0.001, 0.040, 0.011)and the volume of first sensation was higher( t=1.998, P=0.047)in the elderly group than in the non-elderly group.The maximum anal squeezing pressure, residual anal pressure and maximum tolerated volume were higher( t=4.589, 4.730, 2.025, all P<0.05), whereas the anal relaxation rate and anorectal pressure gradient were lower in elderly men than in elderly women( Z=4.059, t=-3.714, P<0.001 for both). Regarding the types of FDD, both the elderly group and the non-elderly group were dominated with type Ⅱ defecation disorder, with more men than women having type Ⅱ defecation disorder in the elderly group( χ2=10.343, P=0.001). In cases of paradoxical sphincter contraction during simulated defecation, the incidence in the elderly group was 80.65%(75/93), which was higher than 68.42%(91/133)in the non-elderly group( χ2=4.194, P=0.041). The volume of first sensation, volume of first defecation sensation, and maximum tolerated volume of patients in the elderly group without the urge to defecate were(59.86±23.84)ml, (96.76±34.61)ml, and(144.32±30.57)ml, respectively, higher than those of patients with the urge to defecate(46.79±17.20)ml, (75.26±28.75)ml, and(120.00±40.28)ml( t=-2.241, -2.493, -2.891, P=0.027, 0.014, 0.005). The rectal pressure(26.52±16.08)mmHg of patients with defecation dyssynergia was lower than that of patients without defecation dyssynergia(39.91±8.82)mmHg(1 mmHg=0.133 kPa)( t=-3.128, P=0.002), while the resting anal pressure of patients with defecation dyssynergia(90.60±28.44)mmHg was higher than that of patients without defecation dyssynergia(73.65±27.10)mmHg( t=-2.201, P=0.030). The resting anal pressure and maximum anal squeezing pressure in patients with anal blockage sensation[(87.11±24.64)mmHg, (149.28±48.29)mmHg]were higher than those in patients without anal blockage sensation[(72.43±20.02)mmHg, (121.76±26.35)mmHg]( t=2.954、3.066, P=0.004、0.003). There was no significant difference in values from parameters of anorectal dynamics between patients with different Bristol stool types, with and without incomplete defecation or with different degrees of abdominal distension(all P>0.05). Conclusions:Anorectal dynamics in patients with FDD are characterized by paradoxical anal sphincter movements, but older patients with FDD are mainly characterized by inadequate rectal propulsion, pelvic floor muscle dysfunction and reduced rectal sensitivity.