Objective This study was designed to determine the influence of acute ethanol intoxication (AEI) on brain edema and aquaporin-4(AQP-4) levels after traumatic brain injury(TBI) in rots. The underlying mechanism was also investigated. Method Severe traumatic brain injury models were made using the Feeny method; acute ethanol intoxication models were established by gavagy. One hundred and ninety-two male SD rats were randomly divided(random number) into four groups, namely the sham operation group(A ), the acute ethanol intoxication group( B ), the traumatic brain injury group(C) and the combination of acute ethanol intoxication with traumatic brain injury group(D). Each group was further divided into four sub-groups according to the time interval between injury and death of the rats. After brain tissue was fixed by affusing paraformaldehyde, the expression of AQP-4 was detected by immunohistochemistry. Water content was detected by dry-wet analysis, and AQP-4 mRNA and protein were detected by RT-PCR and western blotting respectively after the brain tissue was got by rapid decapitation. Data were analyzed by one-way ANOVA. Results The water content of brain tissue and expression level of AQP-4 were not significantly different between groups A and B( P > 0.05); however both were significantly increased in groups C and D relative to group A( P < 0.05). The water content of brain tissue in group D increased by mere than that in group C( P < 0.05), while the expression level of AQP-4 in group D was lower than that in group C(P<0.05). Conclusions Acute ethanol intoxication inhibited the expression of AQP-4,which induced a more severe cerebral edema after traumatic brain injury.

Objective: To evaluate the intervention effectiveness of broken window effect combined with narrative nursing on non-suicidal self-injury (NSSI) in adolescents, so as to provide the basis for NSSI prevention in adolescents. Methods: Totally 134 adolescents with NSSI admitted to Mental Health Center of the Affiliated Hospital of Anhui West Health Vocational College from January 2022 to December 2023 were enrolled and randomly assigned into the control and treatment group. All were given narrative nursing and routine care, and the adolescents in the treatment group were given additional intervention based on broken window effect. The effects were evaluated using Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Rating Idea of Suicide Scale (SIOSS), Ottawa Self-injury Inventory-Functions (OSI-F) and Nursing Satisfaction Scale, and the two groups were compared before and after intervention. Results: The treatment and control groups comprised 67 cases each, had a median age of 14.12 (interquartile range, 2.01) years and 14.10 (interquartile range, 1.52) years, included 71.64% and 68.66% girls, and 79.10% and 74.63% junior high school students, respectively. There were no statistically significant differences between the treatment and control groups in terms of gender, age or educational level (all P>0.05). The results of analysis of variance for repeated measures showed that there were interactions between time and group for SDS, HAMD and SIOSS scores (all P<0.05), and the decrease in scores before and after intervention was greater in the treatment group than in the control group. After intervention, the SDS, HAMD, SIOSS score and incidence of suicidal behaviors in the treatment group were all lower than the control group [SDS: (32.54±1.27) vs. (44.25±2.23); HAMD: (10.54±1.83) vs. (18.73±1.89); SIOSS: (10.37±2.20) vs. (15.76±1.62); incidence of suicidal behavior: 14.93% vs. 32.84%; all P<0.05]. The nursing satisfaction rate was significantly higher in the treatment group than in the control group (98.51% vs. 88.06%, P<0.05). Conclusion The broken window effect combined with narrative nursing would improve the depressive symptoms in adolescents with NSSI, and reduce the suicidal ideation and self injury.

Objective:To develop the Nutrition Knowledge, Attitude and Practice Questionnaire for Maintenance Hemodialysis (MHD) Patients and test its reliability and validity.Methods:This is a cross-sectional study. Based on the theory of knowledge, attitude and practice, and on the basis of literature analysis, semi-structured interviews and expert focus interviews, an initial questionnaire was formed through Delphi expert consultation and pre-survey. In July 2020, 200 patients with MHD were selected from the Blood Purification Center of Lu'an Hospital of Anhui Medical University by convenient sampling to carry out the first round of questionnaire survey and conduct item analysis of the questionnaire. In August 2020, 230 MHD patients were selected from 6 other Hemodialysis Centers in the same city by convenient sampling to carry out the second round of questionnaire survey and evaluate the reliability and validity of the questionnaire. In the first round of questionnaire survey, a total of 200 questionnaires were distributed, and 183 valid questionnaires were recovered, with an effective recovery rate of 91.50% (183/200) . In the second round of questionnaire survey, 230 questionnaires were distributed and 214 valid questionnaires were recovered, with an effective recovery rate of 93.04% (214/230) .Results:The formal questionnaire included 29 items in three dimensions of knowledge, attitude and practice. The total Cronbach's α coefficient of the questionnaire was 0.853, and the retest reliability coefficient was 0.880. The item-level content validity index of the questionnaire was 0.910 to 1.000. Exploratory factor analysis extracted 9 common factors, and the cumulative variance contribution rate was 62.89%. The confirmatory factor analysis showed that the fitting index of the model was ideal, the composite reliability in the convergent validity was more than 0.700, the correlation coefficient of the discriminant validity was positive and less than 0.500, less than the square root of average variance extracted, and the discriminant validity was good.Conclusions:Nutrition Knowledge, Attitude and Practice Questionnaire for MHD Patients has good reliability and validity, and can be used as a reliable tool to evaluate the nutrition knowledge, attitude and practice of MHD patients in China.

As the National Health Commission changes the management of novel corona virus infection, the situation and preventive policies for controlling the epidemic have also entered a new stage in China. Perioperative care strategies for orthopedic trauma such as designated isolation and nucleic acid test screening have also been adjusted in the new stage. Based on the perioperative work experiences in the new stage of epidemic from the frontline anti-epidemic staff of orthopedics in domestic hospitals and combined with the literature and relevant evidence-based medical data in perioperative care of orthopedic trauma patients under the current anti-epidemic policies at home and abroad, Chinese Orthopedic Association and Chinese Society of Traumatology organized relevant experts to formulate the Guideline for clinical perioperative care of orthopedic trauma patients in the new stage of novel corona virus infection ( version 2023). The guideline summarized 16 recommendations from the aspects of preoperative diagnosis and treatment, infection prevention, emergency operation and postoperative management to systematically standardize the perioperative clinical pathways, diagnosis and treatment processes of orthopedic trauma in the new stage of novel corona virus infection, so as to provide a guidance and reference for hospitals at all levels to carry out relevant work in current epidemic control policies.

【Objective】 To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment, in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. 【Methods】 Totally 376 adolescents diagnosed with depression in Lu′an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environment of adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. 【Results】 The scores of QSA and BSS in the case group were significantly higher than those in the control group (t=43.352, 96.527, P<0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group (t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311), and the differences were statistically significant (P<0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). 【Conclusions】 The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

BackgroundNon-suicidal self-injury （NSSI） behavior is highly prevalent in middle school students， which poses a significant risk to the physical and mental health of middle school students， so finding ways to improve the NSSI behavior among middle school students is of great significance for promoting their healthy growth. ObjectiveTo investigate the relationship between psychological quality and NSSI behavior among middle school students in western Anhui， and to examine the pathway of coping style in the above relationship. MethodsFrom November to December 2020， 22 872 middle school students in western Anhui were selected using stratified cluster random sampling method， and were subjected to complete the assessment of Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）， Adolescent's Psychological Suzhi Scale-Simplified Version （APSS-SV） and Coping Style Scale for Middle School Students （CSSMSS）. Spearman correlation analysis was adopted to examine the correlation among scores of scales and the frequency of NSSI behavior in middle school students. Amos 23.0 was utilized to test the pathway of coping style in the relationship between psychological quality and NSSI behavior. ResultsA total of 21 718 （94.95%） middle school students completed the effective questionnaire survey. NSSI behavior was detected in 7 798 middle school students （35.91%）. ANSAQ total score and CSSMSS positive coping style score of middle school students were negatively correlated with the frequency of NSSI behavior （r=-0.219， -0.179， P<0.01）. CSSMSS negative coping style score was positively correlated with the frequency of NSSI behavior （r=0.093， P<0.01）. The direct effect value of psychological quality on the frequency of NSSI behavior was -0.136， and the indirect effect value of coping style on the relationship between psychological quality and the frequency of NSSI behavior was -0.084. Among them， the effect value of positive coping style was -0.122， accounting for 55.45% of the total effect， while the effect value of negative coping style was 0.038， accounting for 17.27% of the total effect. ConclusionCoping style may mediate the relationship between psychological quality and NSSI behavior in middle school students， and the positive coping style and negative coping style play separate roles in the pathway of psychological quality on NSSI behavior.［Funded by 2020 Natural Science Research Project of Anhui Provincial Education Department （number， KJ2020B006）］

Objective: To study the effects of altitude exposure and altitude exposure on mental health of Tibetan cadres. Methods: 105 cadres in Tibet were selected as the research objects. Among them, 74 cadres in Shannan and Lhasa of Tibet (average altitude 3 680 m), 31 in Shigaze and Ali (above 3 800 m) and 14 in Ali (above 4 300 m) were selected. Using Symptom Checklist 90 (SCL-90), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Ascension Insomnia Scale (AIS), 105 Tibetan aid cadres were tested by SAS, SDS, AIS and SCL-90 one week after entering Tibet and one week before leaving the plateau. The scores were collected and the mental health and sleep status of Tibetan aid workers were measured. Results: The number of positive items of SCL-90 of 105 Tibetan cadres increased from (13.21±9.05) one week after entering Tibet to (38.35±18.84) one week before leaving Tibet. SAS, SDS and AIS also increased from (25.49±5.19), (26.41±5.15), (5.16±3.54) points one week after entering Tibet to (36.78±7.53), (41.42±9.15), (8.71±4.64) points one week before leaving Tibet. The difference was significant in the last week (Z = 8.420, 8.689, 6.277, P<0.01). The correlation analysis between SCL-90 and SAS, SDS and AIS showed that SCL-90 was positively correlated with SAS, SDS and AIS scores (r = 0.651, 0.616, 0.356, P<0.01). Different altitudes have an effect on the mental health of Tibetan aid cadres. The paranoid item scores of Tibetan aid cadres with altitude>4 300 m in SCL-90 were (1.68 ± 0.50) points, which were higher than those of Tibetan aid cadres with altitude<4 300 m (1.24±0.28) points and (1.40± 0.38) points. The difference was statistically significant (F=5.255, P=0.007); The SDS scores of Tibetan aid cadres with altitude>4 300 m were (46.64 ± 7.24) points, which were higher than those of Tibetan aid cadres with altitude<4 300 m (40.76 ± 8.99) points and (40.58 ± 8.28) points. The difference was statistically significant (F=3.223, P=0.044). Conclusion Exposure to high altitude affects the mental health of cadres assisting Tibet to varying degrees. The mental health of cadres assisting Tibet deserves attention.

OBJECTIVE：To investigate the effects of dihydroartemisinin （DHA）on the metabolism of amino acid metabolites in human hepatocellular carcinoma cells Huh 7 and BEL- 7402，and to provide theoretic basis for clarifying the mechanism of DHA regulating the metabolism of hepatocellular carcinoma cells. METHODS ：CCK-8 method was taken to detect the effect of different concentrations of DHA （12.5，25，50，100 µmol/L）treating for 24，48，72 h on the two kinds of cells. Two kinds of cells were divided into control group and administration group （DHA，25 µmol/L），and then cultured with drug-free or drug-containing medium for 24 h，operated in parallel for three times. After derivatization of cell samples in each group ，GC-MS method was used to detect the content of amino acid metabolites ，combined with SIMCA-P software analysis and compound library comparison ，the differential metabolites in two kinds of cells were screened out. The pathway enrichment analysis of differential metabolism was conducted with Metaboanalyst 4.0 software. RESULTS ：Compared with control group ，the contents of glutamine ，glutathione， phenylalanine，fumaric acid and taurine were trending down in Huh 7 or BEL- 7402 cells. There were 28 and 29 differential metabolites obtained from the above two kinds of cells ，and 10 of them were common differential metabolites ，including glutamine，glutathione，taurine，fumaric acid ，phenylalanine，etc. The differential metabolites were enriched in 8 and 6 pathways respectively. The common enrichment pathways were amino acid-tRNA biosynthesis ，aspartate-alanine-glutamate metabolism ， nitrogen metabolism ，phenylalanine metabolism and pentose phosphate pathway ，etc. CONCLUSIONS ：DHA can significantly reduce the activities of Huh 7 cells and BEL- 7402 cells，and the contents of glutamine ，glutamic acid ，glutathione and phenylalanine，etc. It may regulate the growth of the two kinds of cells by influencing the mechanism of aspartic acid- alanine-glutamate metabolic pathway ，etc.

BackgroundDepression as a major mental health condition is commonly found in junior high school students. Peer attachment， emotional resilience and childhood abuse have been found to be associated with depressive symptoms， and it has been hypothesized that peer attachment and emotional resilience may play a chained effecting path in the relationship between childhood abuse and depressive symptoms in junior high school students. ObjectiveTo explore the relationship between childhood abuse and depressive symptom in junior high school students， analyze the effecting path of peer attachment and emotional resilience， thus to provide references for improving the mental health of junior high school students. MethodsFrom May to July 2022， a cluster sampling technique was utilized to recruit 1 781 junior high school students from a junior high school in Anhui province. Childhood Trauma Questionnaire Short Form （CTQ-SF）， Revised version of Inventory of Parent and Peer Attachment （IPPA-R）， Adolescent' Emotional Resilience Questionnaire （AERQ） and Center for Epidemiological Studies Depression Scale （CES-D） were used as the measurement tools. Pearson correlation coefficient was calculated to assess the correlation among above scales. Process4.2 and Bootstrapping method were employed to verify the effecting path of peer attachment and emotional resilience in the relationship between childhood abuse and depressive symptoms. ResultsCTQ-SF score was negatively correlated with IPPA-R peer attachment subscale score and AERQ score （r=-0.527， -0.495， P<0.01） and positively correlated with CES-D score （r=0.669， P<0.01） in junior high school students. IPPA-R peer attachment subscale score was positively correlated with AERQ score （r=0.556， P<0.01） and negatively correlated with CES-D score （r=-0.599， P<0.01） in junior high school students. AERQ score was negatively correlated with CES-D score （r=-0.698， P<0.01） in junior high school students. Childhood abuse in junior high school students was shown to be a positive predictor of depressive symptoms （β=0.675， P<0.01） and a negative predictor of peer attachment （β=-0.824， P<0.01） and emotional resilience （β=-0.305， P<0.01）. Peer attachment and emotional resilience were independent effecting path between childhood abuse and depressive symptoms， with indirect effect size of 0.093 （95% CI： 0.066~0.122） and 0.108 （95% CI： 0.084~0.133）， respectively. Peer attachment and emotional resilience affected as a chain effecting path between childhood abuse and depressive symptoms， with indirect effect size of 0.087 （95% CI： 0.071~0.105）， accounting for 12.89% of the total effect. ConclusionChildhood abuse in junior high school students can affect the presence of depressive symptom both directly and indirectly through either separate or chained effecting path of peer attachment and emotional resilience. ［Funded by 2020 Provincial General Scientific Research Project of West Anhui Health Vocational College （number， KJ2020B006）； 2024 Provincial University Natural and Humanities Sciences Research Project of West Anhui Health Vocational College （number， 2024AH053467）］