Objective : To understand the current situation and characteristics of narcotic drugs and psychotropic drugs abuse or dependence among hospital patients and to provide reference for strengthening the management of narcotic drugs and psychotropic drugs. Methods : We collected clinical data from hospitals in Shandong and Guizhou provinces in 2016 and selected patients with history of narcotic drugs and psychotropic drugs. We investigated them through telephone or face-to-face interview,then described the characteristics of demographic information and abuse or dependence of narcotic drugs and psychotropic drugs in diagnosed drug abusers. Results : A total of 280 patients with drug abuse or dependence were recruited,of which 223 cases from nine hospitals in Shandong and 57 cases from five hospitals in Guizhou. There were 170 male patients,accounting for 60.71%; 193 patients aged 45 years and above,accounting for 68.93%; 223 married patients,accounting for 80.51%; 166 patients with a education level of junior high school and below,accounting for 61.25%; 125 patients engaged in agriculture,accounting for 48.64%. Benzodiazepine was the main drugs abused or dependenced by hospital patients,accounting for 73.57%（206 cases）. There were also 83 cases of polydrug abuse,accounting for 29.64%. Among the patients with drug abuse or dependence,45.71% had no special feelings,41.07% had symptoms or felt uncomfortable after withdrawal; 64.64% was for improving their sleep quality. Conclusion Most patients with abuse or dependence of narcotic drugs and psychotropic drugs are middle- or senior-aged and have polydrug abuse. Benzodiazepine are the main abused drugs. The common reason for narcotic and psychotropic drug abuse or dependence is to have a good sleep.

Objective:To investigate the expression of Slug,EMMPRIN and E-cadherin in salivary adenoid cystic carcinoma (SACC)and its correlation with clinicopathological characteristics,and the correlation among themselves.Methods:Slug,EMMPRIN and E-cadherin expression in 1 1 5 SACC cases of SACC was examined by immunohistochemical staining.The results and clinicopatho-logical data were statistically analyzed.Results:High positive expression frequencies of Slug(76.5%)and EMMPRIN(69.6%)and low positive expression frequency of E-cadherin(51 .3%)were found in 1 1 5 SACC cases.The expression of Slug and EMMPRIN was positively associated with the histopathological types,clinical stages,perineural invasion,recurrence and distance metastasis(P <0.05).The expression of E-cadherin was negatively associated with the histopathological types,clinical stages,perineural invasion and distance metastasis(P <0.05).There was a significant correlation between Slug and EMMPRIN expression(P <0.05),negative correlation between EMMPRIN and E-cadherin expression(P <0.05)and between Slug and E-cadherin expression(P <0.05).Con-clusion:The expression of Slug,EMMPRIN and E-cadherin is closely correlated to the clinicopathological characteristics of SACC.

BACKGROUND:Distraction osteogenesis is one of the most important tissue engineering technologies. However, the exact signaling pathway controling mesenchymal stem cel-osteoblast lineage (MSC-OB) migration during distraction osteogenesis has not yet been elucidated. More efforts should be paid to make a ful understanding of the mechanism on MSC-OB lineage migration, which can improve the clinical efficacy of distraction osteogenesis.
OBJECTIVE:To evaluate the effects of mechanical stretch on the ability of MSC-OB mobility and expression of mammalian target of rapamycin (mTOR) signaling pathway as wel as matrix metaloproteinases (MMPs) in MSC-OB, and to make clear the mechanism by which controls MSC-OB migration during distraction osteogenesis.
METHODS:Twelve Sprague-Dawley rats were randomized into two groups: experimental group (n=6), anin vivo rat mandibular distraction osteogenesis model was established on the right side of rats; non-stretch group (n=6), only the mandibular resection was done but with no distraction osteogenesis. Immunohistochemical staining was used to detect phosphorylated mTOR expression in new osteotylus at 15 days after operation. In addition, an in vitro cel stretch model was made in the mandibular mesenchymal stem cels from healthy Sprague-Dawley rats under resting tension force (6%, 4 hours); no distraction was done in control group. The ability of MSC-OB mobility, the expression of mTOR, Raptor, p70S6K and MMPs were evaluated using experiment methods including immunohistochemistry staining, real-time PCR and scratch assay.
RESULTS AND CONCLUSION: The expression of phosphorylated mTOR in MSC-OB was upregulated in the mandibular bone calus of the stretch group than the non-stretch group (P < 0.05). In thein vitro experiments, MSC-OB applied with mechanical stretch (6%, 4 hours) showed elevated gene expression levels of mTOR, Raptor, p70S6K, MMP-2, MMP-9 and MMP-13 compared with the control group (0%, 4 hours). Meanwhile, MSC-OB in the experiment group (6%, 4 hours) showed a greater ability of mobility, as demonstrated by a farther distance after 48 hours of observation (P < 0.05). The present study suggests that the enhancement of MSC-OB mobility correlates with increase of the gene expression of MMPs and mTOR signaling pathway. Mechanical stretch may promote MSC-OB migration through activation of mTOR/MMPs signaling pathway.

Objective To examine the expression levels of procalcitonin (PCT),neutrophils apolipoprotein (human neutrophil lipocalin,HNL) and neutrophil CD64 (CD64) in the blood of patients with bacterial infection and investigate their utility in early diagnosis and treatment of bacterial infection.Methods A total of 210 patients with confirmed infection who were treated in hospital from February 2013 to May 2017 were enrolled.The patients were classified into bacterial infection group (105 cases) and viral infection group (105 cases).Additionally,a cohort of 80 healthy subjects were randomly selected from health checkup during the same period as the control group.PCT and HNL were determined on the UPT up-converting phosphor microbial immunity analyzer provided by Beijing Hotgen Biotech Company.BD FACS calibur flow cytometer was used to measure and calculate CD64 percentage.Results The levels of PCT,HNL,CD64 and WBC were compared between bacterial infection group,viral infection group and control group.The between-group difference was statistically significant (P＜0.05).The CD64 and WBC levels were significantly different between viral infection group and control group (P＜0.05),but the PCT and HNL levels were not different significantly between viral infection group and control group (P＞0.05).The area under the ROC curve of PCT,namely AUC PCT,was 0.855,and AUC (HNL) was 0.930,AUC (CD64) 0.928,and AUC (WBC) 0.729.The cutoff value of PCT,HNL and CD64 for diagnosis of bacterial infections was ＞0.79 ng/mL,＞87.43 ng/mL,and ＞9.01％,respectively.Conclusions Bacterial infection is associated with elevated levels of PCT,HNL and CD64,which can be used in early diagnosis of bacterial infections.HNL may provide the highest diagnostic value.

Objective:To explore the application effect of pathway nursing combined with multimodal exercise intervention in patients with tumor-associated sarcopenia under multi-disciplinary team.Methods:Using the convenient sampling method, a total of 120 patients with tumor-associated sarcopenia who visited Cancer Center of Henan Provincial People 's Hospital from January 2020 to December 2021 were selected as the research objects. They were divided into the observation group ( n=60) and the control group ( n=60) according to the random number table method. The control group received routine nursing care, while the observation group received multi-disciplinary team pathway nursing combined with multimodal exercise. Skeletal Muscle Mass Index (SMI) , Hand Grip Strength (HGS) , daily walking speed, Cancer Fatigue Scale (CFS) and Irritability, Depression and Anxiety Scale (IDA) scores were compared and analyzed between the two groups. Results:After 4 weeks of intervention, HGS and daily walking speed in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . After 4 weeks of intervention, the total score of CFS in the observation group was lower than that in the control group, and the scores of physical fatigue, emotional fatigue and cognitive fatigue in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . After 4 weeks of intervention, the total IDA score of the observation group was lower than that of the control group, and the scores of anxiety, depression, extroversion and introversion stimulation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Multi-disciplinary team pathway care combined with multimodal exercise can improve the physical fitness of patients with tumor-associated sarcopenia, increase the level of physical activity, relieve fatigue and reduce negative emotions such as anxiety, depression and irritation.

The caring burden of the relative caregivers of breast cancer covers many aspects which include physiology,psychology,social interaction and economy,and is a multidimensional and complex self-cognitive feeling,involving caregivers themselves,patient and family.In the process of care,there are a large number of physical and mental problems and nursing needs,and the burden of care is affected by a variety of mixed factors.However,effective nursing intervention can reduce the burden of care and negative emotions,improve their quality of life and physical and mental health.

Objective: To explore the main influencing factors of health tenacity of unmarried female breast cancer patients after operation, and to provide theoretical basis for clinical nursing intervention. Methods: A total of 222 unmarried female breast cancer patients were selected from 3 Grade 3A hospitals in Tianjin (Tianjin Cancer Hospital, Tianjin Central obstetrics and Gynecology Hospital, Tianjin People′s Hospital). The Simplified Coping Style Questionnaire (SCSQ), Social Support Rating Scale (SSRS), was used in the study. The Revised Health Hardiness Inventor (RHHl-24) and the self-designed general data questionnaire were used to analyze the main influence of the patient′s health tenacity. Results: The total score of health tenacity among 222 unmarried female breast cancer patients after operation was 75.58 ± 8.87, which was located at the middle level; the score of positive coping was 2.16 ± 0.53 and negative coping was 1.56 ± 0.44; the total score of social support was 39.93 ± 8.45, which was higher than score of domestic norm. The regression analysis showed that the main factors of health tenacity were social support, the stages of breast cancer, the source of medical expenses, positive coping and place of residence in unmarried female breast cancer patients after operation (t=-5.403-5.908, P<0.05 or 0.01). Conclusions We should strengthen nursing intervention for unmarried female breast cancer patients with low social support, late course of disease, poor economic status, negative coping and non-urban residence, and encourage patients to adopt positive coping style. Provide all-round social support to patients in order to improve the patient's health and tenacity.

Objective To investigate the correlation between postoperative self-image and coping style of patients after breast cancer resection .Methods Totals of 410 patients undergoing breast cancer resection were assessed by using simplified coping style questionnaire ( SCSQ ) and body image after breast cancer questionnaire ( BIBCQ ) .The correlation was then analyzed through Pearson method .Results Totals of 410 questionnaires were distributed , and 391 questionnaires returned , with an effective rate of 95.4%.The total score of postoperative self-image was (81.51 ±21.96).Within the aspects of disease susceptibility , body shame, functional limitation , physical attention dimensions and etc , the highest was disease susceptibility with a score of (29.33 ±7.99), while the lowest was limb attention with a score of (0.98 ±3.90).For the SCSQ, the score of positive coping style was (2.05 ±0.53), and the score of negative coping style was (1.46 ± 0.51).There was an obvious negative correlation between self-image level and positive coping style ( P <0.05).The scores of disease susceptibility , body shame, functional limitation, physical attention dimensions also had significantly negative correlations with positive coping style (P<0.05).Conclusions The level of self-image is low in patients with breast cancer .A more positive coping style can help the patients achieve a better self-image, thus, it can raise the quality of life of patients .

Objective To explore the mediating effect of facial emotion recognition on prosocial behavior of medical students in mask-obscured scenes.Methods Fifty-three medical students from a medical university in Chongqing were enrolled from July to September 2023 to complete the facial emotion recognition task,the dictator gaming task and the state empathy test.Spearman correlation analysis was used to examine the correlation between mask wearing and state empathy,trait empathy and prosocial behaviours,and the PROCESS procedure was used to test the mediation of state empathy and the moderating effect of mask wearing or not.Results ①mask wearing,state empathy and prosocial behaviour were significantly correlated(P＜0.01);② State empathy exerted mediated effect between facial emotion recognition and prosocial behavior,with the largest effect size(47％)for the relative mediating effect of sadness;③The interaction terms of facial emotion recognition and mask wearing had a significant effect on state empathy(P＜0.05).Conclusion Facial emotion recognition can influence prosocial behavior directly and also exert indirect effect on prosocial behavior through state empathy.Compared to the condition without mask wearing,mask wearing can significantly facilitate the effect of happy,sad and neutral emotions on state empathy.

Objective:To investigate the independent influencing factors of wound drainage tube time delay in patients with breast cancer and establish a predictive model.Methods:Patients admitted to Tianjin Medical University Cancer Hospital from January to November 2021 were selected as the research objects. They were divided into sword modeling group (156 cases) and verification group (86 cases) according to the admission time. Delayed time to postoperative wound drainage and extubation in breast cancer patients was the end point, 95 cases of 156 patients in the modeling group whose extubation time was less than or equal to 7 days were set as the normal group, 61 cases whose extubation time were more than 7 days were set as delayed group, and the influencing factors of the two groups were compared to establish the prediction model, Hosmer-Lemeshow test was conduct to verify the fitting effect, used the ROC curve to verify the prediction model performance.Results:Univariate and multivariate Cox proportional hazards regression analysis showed that patients' high BMI, related basic disease history, operation mode, axillary lymph node dissection, breast tumor size (T3, T4) and drainage fluid volume 48 hours (≥50 ml) after operation were independent influencing factors for wound drainage tube time delay ( P<0.05). The prediction model was P=0.822, and the area under the ROC curve was 0.877, and the Youden index was 0.605, the sensitivity was 0.736, and the specificity was 0.869. The research data of 86 cases in the validation group were used as the test set for internal and external validation of the model, and the model verification was 96.51%. Conclusion:This prediction model has a good effect, providing a reference basis for clinical medical workers.