[Abstrict] Objective To explore the effect of systemic family dynamics,egma minnen bardndom on the psychological traits,treatment efficacy of the first onset schizophrenia.Methods 53 schizophrenia patients with first onset were assessed by Self-rating Scale of Systemic Family Dynamics (SSFD),Egma Minnen Bardndom Uppforstran (EMBU),Neurotism Scale (Nf),Psychoticism (PSY),Paranoia Scale (Pa),Psychopathic Deviate Scale (Pd),Tolerance Scale(To) of MMPI-2,and lie Scale (L) was used to control assessment effectiveness.40 normal control cases were assessed by SSFD and EMBU.The scale scores between study group and control groupwere compared,and correlation and regression of study group were analyzed.Results Scores of family atmosphere,individuation,system logic of SSFD were higher in study group than those in control group (t=4.04,3.295,2.44,all P＜0.05),scores of emotional warmth and understand of EMBU in father and mother were lower in study group than those in control group (t=2.925,3.45,all P＜0.01),scores of refused and deny and punishment and stern of EMBU in father and mother were higher in study group than those in control group((t=4.715,4.971,4.331,4.067,all P＜0.01)).And correlation analysis showed that refused and deny of EMBU of father and mother,punishment and stern of EMBU of mother and PSY had significantly positive correlation(r=0.3378,0.4677,0.2895,all P＜0.05),refused and deny and punishment and stern of EMBU of father and mother and Pa had significantly negative correlation (r=-0.2913,-0.3254,-0.5003,-0.3242,all P＜0.05),punishment and stern and excessive interference of EMBU of father and Pd had significant positive correlation (r=0.3417,0.2958,all P＜0.05),PSY of MMPI-2 and treatment effect had significant negative correlation (r=-0.3194,P＜0.05).Regression analysis showed that psychoticism to forecast the poor treatment effect the rate was 10.2％,father and mother the refused and deny to forecast psychoticism high mark the rate respectively were 11.41％ and 21.87％,mother the severe punishment to forecast the psychoticism high mark the rate was 8.13％,Conclusion Father and mother the refused and deny,mother severe punishment have effects on psychological traits of the first onset schizophrenia,psychoticism of psychological traits has an affect on treatment efficacy,the psychoticism high mark presages the poor treatment efficacy.

Objective To improve patient postoperative comfort of vitrectomy with tamponnade in the prone position, design a new prone position headrest to reduce complications caused by improper body position and observe its clinical effect. Methods According to the postoperative position of the patients, 360 cases were collected. The patients were divided into the control group and the observation group with 180 cases of each group. Observation group was treated with the new prone position headrest nursing, control group were treated with routine prone position. The comfort of patients, postoperative adverse reactions, success rate of retina reattachment were observed. Results According to simplified comfortable situation scale, physiological, psychological, social culture and environment of each individual score respectively was (2.74±0.21), (3.54±0.29) , (3.25±0.23), (3.36±0.27) points in observation group and (2.30± 0.19), (2.92±0.31), (2.93±0.26), (2.79±0.30) points in control group, and there were significant differences (t=12.368-20.845, all P<0.05). The daily posture duration in postoperative first time and 5 days was respectively (220.00±25.08), (1008.00 ± 20.32) min in observation group and (85.00±28.07), (650.00± 30.12) min in control group, and there were significant differences(t=48.117, 133.194, all P<0.01). The incidence of corneal edema, conjunctival congestion, water turbidity in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (U=6.308,8.130, 6.875, P < 0.01). The incidence of high intraocular pressure, recurrent retinal detachment rate and reduction rate in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (χ2=9.000, 10.540, 11.770, P < 0.01). Conclusions The new prone headrest can effectively improve the resection of vitreous body with tamponade patients in comfort, ensure the operation effect.

Objective To explore the mediating effects of neuropeptide S receptor 1 and negative coping in chronic stress induced emotional responses. Methods A survey of 366 local residents who were chosen from County of Nandan in Guangxi Province by stratified random sampling method. Questionnaires of the life events scale (LES),the simplified symptom checklist and the Simplified Coping Style Questionnaire (SCSQ) were used. The level of NPSR1 was measured by Elisa. Data was analyzed by SPSS 21 and AMOS 21 statistical software for statistical analysis. Results The level of chronic psychological stress was (25. 24± 29. 26) and score of negative coping was(14. 84±4. 35). Somatic factor,anxiety factor,depressive factor and hostile factor were (1. 58±0. 58),(1. 43±0. 56),(1. 44±0. 55),(1. 23±0. 37). The total score of life e-vents was positively correlated with negative coping,somatic factor score,anxiety factor score,depression fac-tor score(r=0. 23-0. 46,P<0. 05),while negatively correlated with the expression level of detection of NPSR1 in plasma(r=-0. 26,P<0. 05). NPSR1 level was negatively correlated with body factor score,anxiety factor score,depression factor score and hostility factor score(r=-0. 18--0. 61,P<0. 05). Negative coping was positively correlated with body factor score,anxiety factor score,depression factor score and hostility fac-tor score(r=0. 12- 0. 27,P<0. 05). Both neuropeptide S receptor 1 and negative response had significant me- diating effects on emotional responses induced by chronic psychological stress (P<0. 05),and the effect val-ues were -0. 08 and 0. 05,respectively. According to the Bootstrapping method,the results of the mediation model showed that Bias-Corrected of 95% CI of the total standardization effect,the indirect standardization effect,the direct standardization effect were not including 0. Conclusion NPSR1 and negative coping plays a dual mediating effect on stress induced emotional responses.

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA) on malignant lesions in gastrointestinal adjacent tissue, and further to analyze the risk factors influencing positive rate of EUS-FNA. Methods The clinical data of 171 patients undergoing EUS-FNA from January 2009 to May 2016 were collected. The lesion location, size and characteristics, the number of needle passes, puncture suction negative pressure, size of puncture needle, and years of operator experience in EUS were retrospectively analyzed. Results The overall sensitivity, specificity, and accuracy of EUS-FNA in the diagnosis of malignant lesions were 78. 3％ ( 83/106) , 100. 0％ ( 65/65) , and 86. 5％( 148/171) , respectively. The univariable logistic regression analysis demonstrated that the risk factors of EUS-FNA were lesion location, lesion characteristics, and lesion size. In multivariate analysis, larger lesion size ( OR=1. 029, 95％CI: 1. 011-1. 047, P=0. 001) and lesion characteristics of solid ( OR=5. 098, 95％CI:1. 324-19. 633, P=0. 018) were independent factors affecting the positive rate of EUS-FNA. Among 171 cases performed by EUS-FNA, the incidence of postoperative complications was 1. 75％ ( 3/171 ) included 2 cases of fever and 1 case of acute pancreatitis, which were improved after conservative treatment. Conclusion EUS-FNA is a safe and effective method of cytological and histological diagnosis with high accuracy and sensitivity, importantly in distinguish malignancy from benign lesion in gastrointestinal adjacenttissue. Positive rate of diagnosis on malignant lesions by EUS-FNA is positively correlated with lesion size, and EUS-FNA positive rate of solid malignant lesions is significantly higher than that of cystic lesions.

Hematologic Neoplasms

OBJECTIVETo investigate the clinical characteristics, therapeutic effects, long-term survival and prognostic factors of the newly diagnosed patients with Hodgkin lymphoma (HL).

METHODSOne hundred and thirty five newly diagnosed HL patients in West China hospital from January 1, 2000 to December 31, 2010 were analyzed retrospectively. Software SPSS18.0 was applied to determine the risk factors for therapeutic results and long term survivals.

RESULTSOf 135 patients, 78 cases were male and 57 female, the median age was 32(7-77) years old, and the median follow-up of 42(12-141) months. The peak age of HL was 20 to 30 years old and lymph node enlargement was the first presenting symptom in 69.63% of the patients. Among the all pathological types of HL, mixed-cellularity subtype (MC) and nodular sclerosing (NS) were the most common types, accounting for 59.7% and 34.0%, respectively. In MC subtypes, 66.2% of patients were male, while in NS subtypes, 61.4% were female. Among the 114 patients with complete follow-up data, 73 patients (64.0%) obtained complete remission and the total response rate was 77.2%. The 2-, 3- and 5-year overall survival (OS) rates were 91.2%, 88.0% and 80.9%, respectively. The progression free survival rates were 76%, 80.3% and 81.6%%, respectively. Among the patients with early unfavorable prognosis, 96.3% of them accepted full course chemotherapy and 13(48.1%) were combined with local radiotherapy. The 3- and 5- year survival rates of early unfavorable patients were higher than that of early favorable and advanced patients, but the difference was not statistically significant. Age≥45 years old and B symptom were adverse factors affecting curative effect for MC and NS subtypes, respectively. Furthermore, Age≥45 years, B symptoms and hepatomegaly were independent risk factors affecting the survival.

CONCLUSIONHL is more common in young patients (age<45 years old) and usually diagnosed at the early stage, with predominance of MC subtypes. B symptoms were adverse prognostic factors of therapeutic effects. The standard- dose chemotherapy and suitable courses of treatment combined with radiotherapy may provide the best benefits for the HL patients.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Disease-Free Survival ; Female ; Hodgkin Disease ; drug therapy ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Young Adult

OBJECTIVETo identify the predictive factors for differentiating pancreatic ductal adenocarcinoma (PDAC) from other neoplastic solid pancreatic lesions and assess the accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of PDAC.

METHODSWe retrospectively analyzed the clinical data of patients referred for EUS-FNA evaluation of pancreatic lesions in the Digestive Endoscopic Center of Nanfang Hospital between January, 2009 and May, 2016. The cases with unknown diagnosis, missing data, repeated punctures, cystic lesions and benign lesions were excluded from the analysis. The positivity rates of EUS-FNA were compared between patients with PDAC and those with non-PDAC lesions, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA were assessed in the diagnosis of PDAC. Univariate and multivariate logistic regression analyses were used to identify the factors for differentiating PDAC from non-PDAC lesions based on the demographic characteristics, clinical presentations, laboratory data, and endoscopic ultrasonography imaging features of the patients.

RESULTSAmong the 75 patients with solid neoplastic pancreatic lesions, 54 (72.0%) were found to have PDAC and 21 (28.0%) had non-PDAC lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNA for the diagnosis of PDAC were 77.8%, 100.0%, 100.0%, 63.6% and 84.0%, respectively. No significant difference was found in the positivity rate of EUS-FNA between patients with PDAC and those with non-PDAC lesions (77.8% 76.2%, > 0.05). Multivariate regression analysis identified abdominal pain (=5.163, 95%: 1.093-24.389, =0.038), lesion size (=0.926, 95%: 0.877-0.978, =0.006), characteristics of the solid lesions (=7.105, 95%: 1.440-35.043, =0.016), and evidence of metastases (=6.165, 95%: 1.332-28.533, =0.020) as the independent factors for predicting PDAC.

CONCLUSIONSThe pretest characteristics including abdominal pain, evidence of metastases, and lesion size and lesion characteristics defined by endoscopic ultrasonography findings can reliably predict a diagnosis of PDAC. EUS-FNA has a high sensitivity and a high specificity for the diagnosis of PDAC.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.