OBJECTIVETo investigate the clinicopathological characteristics, diagnosis, treatment and prognosis of gastric hepatoid adenocarcinoma(HAS).

METHODSRetrospective analysis of clinicopathological data of 24 cases with gastric HAS diagnosed by surgery and pathology in Chinese PLA General Hospital from January 2013 to May 2016 were carried out. All the patients underwent preoperative serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), endoscopy and imaging examination (CT or B-mode ultrasonography), and those with elevated AFP were excluded from liver cancer, cirrhosis, endodermal sinus tumor and other diseases. The follow-up ended in June 2016 or the death of the patient. The survival was from the operation to the death of the patient or the end of follow-up.

RESULTSThere were a total of 24 cases with gastic HAS, accounting for 1.03%(24/2 326) of the total number of patients with gastric cancer diagnosed at the same time in our center. There were 19 males and 5 females, the ratio of male to female was 3.8:1.0, the mean age of the patients was 55.9 (31 to 72) years, and 2 of them had liver metastasis. The first symptom in 50% (12/24) patients was epigastric pain, in 25%(6/24) was abdominal distension with vomiting, and the rest included dysphagia (12.5%, 3/24), hematemesis (8.3%, 2/24) and melena (4.2%, 1/24). Preoperative serum levels of AFP and CEA were elevated in 10 (41.7%) and 5 patients (20.8%) respectively. All the patients underwent surgical treatment, including 23 cases with D2 radical resection of gastric cancer and R0 resection, and the other of palliative gastrojejunostomy. Lesions of HAS located in gastric antrum in 11 cases (45.8%), in cardia in 7 cases (29.2%), and in gastric body in 6 cases (25%). Tumor maximum diameter of 10 cases was larger than 5 cm, and the average diameter was 5.7(1.0 to 12.0) cm. Postoperative pathological TNM staging: stage I(b was in 1 cases, stage II( in 7 cases, stage III( in 14 cases, stage IIII( in 2 cases; lymph node metastasis in stage N1-3 in 20 cases (83.3%). Poorly-differentiated tumors were found in 21 cases (87.5%), and no well-differentiated tumors were found. There were 11 cases (45.8%) with formation of intravascular tumor thrombi. In immunohistochemistry, AFP positive expression was found in 11 cases(45.8%). Seventeen HAS cases (70.8%, 17/24) received postoperative SOX(oxaliplatin + S-1) or XELOX (oxaliplatin + capecitabine) as adjuvant chemotherapy, 5 cases postoperative immune therapy, and 2 cases postoperative traditional Chinese medicine. All the patients were followed up for 0.7 to 42.0 months (median 8 months). A total of 9 patients died, of whom, 1 case underwent gastrojejunostomy because of liver and peritoneal metastasis before operation, and died 20 days after surgery; 4 cases died of multiple liver metastases after 1.5 to 12.0 months with survival of 3 to 18 months; 3 cases presented local recurrence after 2 to 17 months with survival of 6 to 22 months; 1 cases had peritoneal metastasis after 12 month with survival of 26 months.

CONCLUSIONSHAS is a rare type of gastric cancer with poor prognosis. The diagnosis is mainly based on histopathology, and radical resection is the mainstay treatment.

OBJECTIVETo investigate the protective effect of hydrogen against hyperoxia-induced oxidative stress injury in premature rat type II alveolar epithelial cells (AECs).

METHODSThe type II AECs isolated from premature rats were randomly divided into air (21% oxygen) control group, hyperoxia (95% oxygen) control group, air + hydrogen group, and hyperoxia+ hydrogen group. The cells with hydrogen treatment were cultured in the presence of rich hydrogen. After the corresponding exposure for 24 h, the cell morphology was observed microscopically. MTT assay was used to evaluated the cell proliferation ability, and JC-1 fluorescence probe was used to detect the mitochondrial membrane potential (δφ) changes of the type II AECs. The concentration of maleic dialdehyde (MDA) and superoxide dismutase (SOD) activity in the cell supernatant were detected using colorimetric method.

RESULTSNo significant differences were found in cell growth or measurements between air control and air + hydrogen groups. Compared with air control group, the cells exposed to hyperoxia showed significantly suppressed proliferation, reduced mitochondrial membrane potential, increased MDA content, and decreased SOD activity. Intervention with hydrogen resulted in significantly increased cell proliferation and SOD activity and lowered MDA content, and restored the mitochondrial membrane potential in the cells with hyperoxia exposure (P<0.05).

CONCLUSIONHydrogen can significantly reduce hyperoxia-induced oxidative stress injury in premature rat type II AECs, improve the cellular antioxidant capacity, stabilize the mitochondrial membrane potential, and reduce the inhibitory effect of hyperoxia on cell proliferation.

Animals ; Animals, Newborn ; Antioxidants ; metabolism ; Cell Proliferation ; Cells, Cultured ; Epithelial Cells ; drug effects ; Female ; Hydrogen ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Membrane Potential, Mitochondrial ; Oxidative Stress ; drug effects ; Oxygen ; adverse effects ; Pulmonary Alveoli ; cytology ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

Objective:To investigate the effect of online acceptance and commitment therapy(ACT) group intervention on psychological flexibility of undergraduate students with facial negative physical self.Methods:From March to June 2022, thirty-two undergraduates with facial negative physical self-image were recruited, assessed and selected from a university in Zhejiang Province.The subjects were randomly divided into the training group( n=16) and the control group( n=16). The training group received 20 days of online ACT group intervention, while the control group kept waiting.The cognitive fusion questionnaire(CFQ), acceptance and action questionnaire version Ⅱ(AAQ-Ⅱ) and negative physical self scale-face(NPSS-F) were used to measure the two groups before and after intervention and 1 month after intervention.Repeated measurement analysis of variance(ANOVA) conducted was used to compare scale results with SPSS 26.0. Results:(1)The interaction effect between group and time of CFQ scores was statistically significant( F(1.625, 48.755)=4.316, P=0.025, ηp2=0.126). After intervention, the CFQ score of the training group was significantly lower than those of the control group(34.38±8.66, 40.94±8.82, P<0.05). The CFQ scores of the training group after intervention and 1 month after intervention(36.00±9.49) were both significantly lower than those before intervention(41.87±8.72, all P<0.05). (2)The interaction effect between group and time of AAQ-Ⅱ scores was marginally statistically significant( F(2, 29)=3.009, P=0.065, ηp2=0.172). After intervention, the AAQ-Ⅱ score of the training group was significantly lower than those of the control group(24.12±4.97, 28.69±6.78, P<0.05). The AAQ-Ⅱ score of the training group after intervention was significantly lower than those before intervention(28.75±6.11, P<0.05). (3)The interaction effect between group and time of NPSS-F scores was not statistically significant( F(2, 29)=1.509, P=0.238, ηp2=0.094), while the main effect of time was marginally statistically significant between the two groups( F(2, 29)=3.315, P=0.051, ηp2=0.186). The NPSS-F score of the training group after intervention was significantly lower than those before intervention(16.06±6.67, 18.81±7.85, P<0.05). Conclusion:Online ACT group intervention can effectively reduce the cognitive fusion and experiential avoidance of undergraduate students with facial negative physical self, then can improve their psychological flexibility.

Objective:To explore the risk factors of postpartum sepsis and provide references for clinical prevention of postpartum sepsis.Methods:The clinical data of postpartum patients who were treated and delivered in the maternity ward of Shengjing Hospital Affiliated of China Medical University from January 2016 to December 2018 were analyzed retrospectively. Among them, 99 patients with postpartum sepsis were assigned to the case group and 212 patients without postpartum sepsis in the same period were selected with a simple random method and as the control group. The clinical data of the two groups were collected by consulting the hospital electronic medical record system. Single factor and multivariate Logistic regression were applied to analyze the risk factors of postpartum sepsis.Results:The infection sites of 99 postpartum sepsis patients were mainly genital tract and respiratory system, accounting for 28.28% (28/99) and 26.26% (26/99), respectively. In blood culture of 99 cases of postpartum sepsis patients, 58.59% (58/99) pathogens of Gram-positive bacteria were detected with the highest proportion, among which Streptococcus was mainly, accounting for 23.23%(23/99). The proportion of Gram-negative bacteria was 38.38%(38/99), and Escherichia coli was mainly, accounting for 31.31% (31/99). Multivariate Logistic analysis showed that gestational diabetes ( OR = 2.643, 95% CI 1.123 - 6.276), genital tract infection ( OR = 7.542, 95% CI 3.571-15.959), vaginal trial (switch to cesarean section) ( OR = 1.218, 95% CI 1.008-1.493), premature rupture of membranes ( OR = 1.152, 95% CI 1.019 - 1.449), postpartum hemorrhage ( OR = 1.562, 95% CI 1.263 -1.881) and cesarean delivery ( OR = 2.074, 95% CI 1.442 - 2.993) were the risk factors of postpartum sepsis. Conclusions:The main risk factors affecting postpartum sepsis includes gestational diabetes, genital tract infection, vaginal trial (switch to cesarean section), premature rupture of membranes, postpartum hemorrhage and cesarean delivery. It is necessary to take corresponding intervention measures to strengthen prevention of these risk factors, which is of great significance for prevention and treatment of postpartum sepsis.

The community teaching bases play an important role in training of general practice talents. To raise the training quality, the development of their own capacity is crucial, but community medical institutions also need close cooperation with the departments of general practice in medical schools and the higher-level general hospitals. This article discusses the integration model of management, teaching and research in general practice talent training based on the cooperation of community teaching bases with relevant governmental departments, professional societies/associations, general hospitals and medical schools.

BackgroundCompared with male adolescents， depression among female adolescents is of higher prevalence and greater severity. The level of generalized trust correlates with the severity of depression， and attachment correlates with the level of generalized trust. Therefore， based on the mediating role of generalized trust between attachment and depression， this study explores the pathogenesis of depression in female adolescents. ObjectiveTo explore the mediating role of generalized trust between paternal， maternal and peer attachment and depression in female adolescents， so as to provide references for improving the depression of female adolescents. MethodsThis study included 73 female adolescents who met the diagnostic criteria for depressive disorder in the International Classification of Diseases， tenth edition（ICD-10） as well as received outpatient and inpatient treatment in Hangzhou Seventh People's Hospital between March 2022 and October 2022. Investigation was conducted by use of Revised Inventory of Parent and Peer Attachment （IPPA-R）， the Inclusive General Trust Scale （IGTS） and Children's Depression Inventory （CDI）. Pearson correlation analysis was used to explore the correlation between each scale score. The Bootstrap method was used to test the mediating role of generalized trust between attachment and depression. Results① CDI score in female adolescents with depression was negatively correlated with scores of paternal， maternal and peer attachment in IPPA-R （r=-0.463， -0.459， -0.447， P<0.01）. Scores of paternal， maternal and peer attachment in IPPA-R were positively correlated with IGTS score （r=0.372， 0.318， 0.395， P<0.01）. IGTS score was negatively correlated with CDI score （r=-0.531， P<0.01 ）. ②The test of mediating role showed that the direct effect of paternal， maternal and peer attachment on depression level was significant in female adolescents with depression （effect size=-0.138， -0.136， -0.107， 95% CI： -0.236~-0.039， -0.242~-0.029， -0.203~-0.012）. ③The mediating role of generalized trust between paternal， maternal peer attachment and depression level was significant （effect size=-0.069， -0.066， -0.071， 95% CI： -0.127~-0.021， -0.137~-0.010， -0.145~-0.018）. ConclusionPaternal， maternal and peer attachment can influence the depression level of female adolescents both directly and indirectly through the generalized trust.