Objective To explore the relation among depression,hopelessness and suicide risk,as well as the mediating effect of hopelessness between depression and suicide risk.Methods 1 381 students were recruited from five junior middle schools in Linyi by using cluster random sampling.They were investigated with General Situation Questionnaire,Scale for Suicide Ideation(SSI),Beck Hopelessness Scale (BHS) and Beck Depression Iventory (BDI).Results Suicide risk in junior middle school was significant positively correlated with depression and hopelessness (r=0.43 and 0.64 respectively,P＜0.01).Hopelessness partly mediated the relationship between depression and suicide risk (55.8％).Furthermore,hopelessness showed partial mediating effect on the relationship between depression and suicide risk in boys (42.7％) and in 7th Grade students (29.9％),and also complete mediating effect in girls (74.1％) and in 8th Grade students (95.3％).Conclusion The suicide risk in middle school students increase with the increasing of the severity of depression and hopelessness.The hopelessness plays different mediating effects on relation between depression and suicide risk in students with different gender and grade.

Objective To establish a method for the determination of complanatuside in Semen Astragali Complanati, and study the content change of complanatuside processed. Method HPLC was used with Apollo-C18 column (4.6 mm?250 mm, 5 ?m), acetonitrile-0.1%phosphoric acid (21∶79) as mobile phase, the flow rate at 1.0 mL/min, and detected wavelength was set at 266 nm. Result Complanatuside showed a good linearity relationship in the range of 0.041 6～0.665 6 ?g, r =0.999 9. The average recovery was 100.6%, RSD was 0.73%. Conclusion The method is simple, accurate, reproducibility and strong specificity. It can be used for the quality control of Semen Astragali Complanati. Processing with salt can lead to content decrease of complanatuside in Semen Astragali Complanati.

Objective To explore the chronergy of fibrinolysin and its influence on fibrinogen ( FIB ) and thrombus precursor protein (TpP) in treatment of acute cerebral infarction (ACI). Methods The clinical trial adopted the randomized single-blind placebo-controlled design.Totally, 150 patients with ACI (onset time≤12 h) were chosen and randomly divided into experimental group A ( group A receiving treatment of fibrinolysin after 12 h onset of ACI ) , experimental group B ( group B receiving treatment of fibrinolysin after 24 h onset of ACI) and control group ( group C without fibrinolysin treatment) , 50 cases in each group.The patients in experimental group A and B received basic treatment for ACI and fibrinolysin treatment.Patients in group C were given the basic treatment for ACI and placebo.The level of FIB and TpP before and after 7 days treatment, NIHSS scores before and after 14 days treatment, BI scores before and after 90 days treatment, incidence rate of progressive cerebral infarction ( PCI ) , stroke recurrence and mortality rate of the three groups were analyzed to evaluate the clinical effect of fibrinolysin.Hepatic and renal function before and after 7 days treatment, incidence rates of haemorrhage and hypersensitiveness were analyzed to evaluate the security of fibrinolysin. Results The NIHSS score of patients in group A, B and C (4.0±1.6, 6.5±2.2 and 8.0±4.7) was declined significantly after treatment (P<0.05).Group A and B declined more than group C (P<0.05).Group A declined even more than group B (P<0.05).The BI score of patients in group A, B and C after treatment was 68.5±30.6, 55.6±29.2 and 49.7±28.9.The BI score of all groups increased significantly after treatment (P<0.05).Compared with group B and C, group A increased more significantly (P<0.05).The incidence rate of progressive stroke in group A, B and C was 4%, 20% and 30%, respectively.The incidence rate of progressive stroke in group A was lower than that in group B and C (P<0.05).The recurrence rate of stroke after 90 days treatment in group A, B and C was 6.3%, 8.3% and 25.5%, respectively.The recurrence rate of stroke after 1 year treatment in group A, B and C was 10.4%, 12.5% and 31.9%, respectively.The recurrence rates of stroke in group A and B 90 days and 1 year after treatment were significantly lower than those in group C (P<0.05). There was no significant difference in the mortality between the three groups (P>0.05).The FIB in group A, B and C after treatment was (2.74±0.75) g?L-1,(2.82±0.83) and (3.67±1.35) g?L-1, respectively.The level of FIB in the three groups did not decrease significantly after treatment (P>0.05).However, the level of FIB in group A and B declined significantly as compared with that in group C.The TpP in group A, B and C after treatment was (3.56±1.26) mg?L-1, (3.43±1.22) and (13.21±6.54) mg?L-1, respectively.The level of TpP in group A and group B decreased significantly after treatment (P<0.05). The level of TpP in group A and B declined even more significantly than that in group C.Fibrinolysin did neither obviously injure liver and kidney nor increase the risk of bleeding, and had low hypersensitiveness incidence rate. Conclusion Treatment with fibrinolysin within 24 h after onset of cerebra infarction benefits the patients. However, dosing after 12 h onset of ACI benefits more than dosing after 24 h.Fibrinolysin plays a role of anti-thrombosis primarily by lowering the TpP level, and its influence on fibrinogen is limited.

To explain how to ensure and improve the quality of the clinical practice teaching for the clinical institutes,we expatiate on the practical experience in the hospital from enhancing the practice teaching management,improving the teaching consciousness,meliorating the teaching environment and reforming the method.

Objective To explore the clinical application of adaptive support ventilation (ASV) in elderly patients with acute respiratory failure.Methods A total of 46 mechanically ventilated patients aged over 65 years with acute respiratory failure admitted from January 2013 to June 2015 were enrolled.Comparison between the ASV mode and synchronized intermittent mandatory ventilation (SIMV) mode was carried out in respects of the impacts of both modes on respiratory mechanics, hemodynamics, oxygen availability and comfort rate.Results Difference between ASV and SIMV in respiratory rate was [(20.84 ±4.04) vs.(24.50 ±4.60) cycles/min, t =4.04, P ＜0.05], in inspiratory resistance was [(13.24 ±4.76) vs.(16.54±5.25) cmH2O/ (L·s), t=3.16, P＜0.05], in mean airway pressure was [(13.58±2.58) vs.(16.63 ±1.57) mmHg, t =6.84, P＜0.05], in peak airway pressure was [(25.96 ± 3.69) vs.(27.87 ± 2.45) mmHg, t =2.92, P ＜ 0.05], and tidal volume was [(378.41 ± 85.61) vs.(341.52 ± 86.84) mL, t =2.05, P ＜ 0.05], and comfort rate of patients was increased in ASV mode.There were no statistically significant differences in arterial oxygen partial pressure, carbon dioxide partial pressure, lactate, heart rate, mean arterial pressure and central venous pressure between the two modes (PP ＞ 0.05).Conclusions Compared with the synchronized intermittent mandatory ventilation mode, the adaptive support ventilation mode can improve the respiratory mechanics and can increase the comfort rate in the elderly patients with mechanical ventilation.

Objective To investigate the role of ECRG2,a novel tumor suppressor gene,in spindle assembly checkpoint. Methods Using siRNA approach to deplete the expression of ECRG2, using immunofluorescence to test the distribution of ECRG2,using Western blotting to examine the expression cell cycle proteins.Results ECRG2 localized to centrosomes during interphase and kinetochores during mitosis.Further analysis revealed that ECRG2 participates in the spindle assembly checkpoint.Depletion of ECRG2 abolished the spindle assembly checkpoint.Conclusion Our results indicated that ECRG2 is important for ensuring spindle assembly checkpoint,accurate chromosome segregation,and its depletion may contribute to chmmosome instability and aneuploidy in human cancers.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective To upgrade No.1 Military Medical Project from single operation to Oracle RAC to eliminate single failure of the operation system, protect medical data and lay a foundation for the following upgrade and deployment.Methods RAC software and hardware environment was constructed for database upgrade and deployment of Data Guard.Results The database was gifted with high availability and high performances, and database maintenance and upgrade could be carried out with the operation system less ceased than before.Conclusion The database is upgraded from a single-mode rigid architecture to a multi-mode elastic one, with the performances, safety and extendibility enhanced greatly.

Objective To evaluate the effect of problem-based learning (PBL)versus tradi-tional methods in medical statistics. Methods Computer retrieval was conducted to search for con-trolled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Results A total of 21 articles were retrieved,but only 7 were included. The results of Meta analysis showed that there was no significant difference between PBL and traditional methods in both the passing rate of student's score (RR=1.09,95%CI=0.98-1.23,P=0.12>0.05)and the exact score (WMD=0.30, 95%CI=-0.06 -0.67,P=0.10>0.05). Conclusion PBL showed no better learning results in medical statistics compared with traditional methods.

PurposeTo investigate a multi-parametric protocol for breast MRI examination and lesions assessment correlated to the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) categorization, and to improve the management of the breast lesions.Materials and Methods 301 pathologically confirmed lesions on 278 patients were retrospectively included. The scan protocol used a dynamic contrast enhancement sequence (DCE) of 1 mm×1 mm×1 mm spatial resolution, 120 temporal resolution and a diffusion weighted imaging (DWI) of b=1000 s/mm2. The malignant morphological features on the early-enhanced images, type II or III time intensity curve and the apparent diffusion coefficient (ADC) value less than benign/malignant threshold was equally weighted. Each was given 1 point when present malignant features and treated different on mass and non-mass-like enhancement lesions. When the sum of score was ≥2 points, the lesion was categorized as BI-RADS 5. When the sum of score was 1 point, the lesion was categorized as BI-RADS 4. When the sum of score was <1 point, the lesion was categorized as BI-RADS 3. The other specific benign findings were categorized as BI-RADS 2. No abnormality on DWI, DCE, T2WI and T1WI was categorized as BI-RADS 1. The final categories were correlated to the pathological grades as benign (B), high risk (HR) and malignant (M).Results When grouped HR as malignant (M+HR), the area under curve (AUC) of the ROC was 0.860. When grouped HR as benign (B+HR), the AUC of the ROC was 0.876, and the optimized sensitivity, specificity and accuracy was 85.3%, 86.8% and 85.1%, respectively, which were better than the other grouping. If the management of HR lesions could be lumptoectomy or short-term follow-up, the positive predictive value (PPV) of BI-RADS 5 for excisable lesions (M+HR) was 93.2%, the PPV of BI-RADS 4 for excisable lesions (M+HR) was 46.9% and the biopsy was essential. The PPV of BI-RADS 3 and below for follow-up lesions (B+HR) was 90.4%.Conclusion A simple diagnosis algorithm was established, which equally weighted the DCE morphological feature, DCE-TIC and DWI-ADC. The diagnosis protocol was well consistent with BI-RADS categorization and could predict the benign, high risk and malignant lesions in pathology as well as the proper management.