Nowadays,medical university students' mental quality is a question that shouldn't be ignored.This paper analyzed the causes of mental problems of medical university students,emphasized the importance of mental quality education in clinical practice and put forward methods of mental quality education in clinical practice.

The hematopoietic microenvironment provides an important place for hematopoietic stem cell (HSC) to self-renew, directional differentiation and maintain relative homeostasis, and it can regulate hematopoietic activity through various cellular components and factors. HSC is a primitive pluripotent stem cell in the blood system featured by the potential ability to self-renew for a long time and to differentiate into various mature blood cells, which exists in the bone marrow (BM). HSC plays an important role in regulating and maintaining the physiological balance of various cellular components of the blood system in the body, to ensure the continuous regeneration of the blood system. The hematopoietic microenvironment affects the development of HSC all the time, but the related cellular molecules and signals in the microenvironment still need to be studied in depth. This paper reviews the main components of the hematopoietic microenvironment, signaling pathways and the effects of abnormal changes on the diseases.

OBJECTIVE:To study the protective effects of Polygonum hydropiper extract on acute gastric mucosal lesion (AGML)in rats. METHODS:48 rats were randomly divided into normal group(normal saline),model group(normal saline), positive group(ranitidine hydrochloride,0.05 g/kg),P. hydropiper extract low-dose,medium-dose and high-dose groups(2.7, 8.1,24.3 g/kg by crude drug),i.g. for consecutive 7 d,once a day. Except for normal group,other groups were given absolute ethyl alcohol to induce AGMI model after 1 h of last administration. 1.5 h after modeling,gastric mucosal lesion index of rats was calculated;the pathological changes of gastric tissue in rats were observed;nuclear factor E2 related factor 2(Nrf2)content and SOD activity in gastric tissue of rats were determined by ELISA. RESULTS:Compared with normal group,the gastric mucosa of model group was damaged obviously,there was blood capillary rupture in submucosa,gastric mucosal lesion index was increased significantly(P<0.01);Nrf2 content and SOD activity were significantly decreased in gastric tissue of rats(P<0.05 or P<0.01). Compared with model group,gastric mucosal lesion of rats was relieved to different extent;in positive group,P. hydropiper extract medium-dose and high-dose groups,gastric mucosal lesion index was decreased significantly(P<0.05),and Nrf2 content and SOD activity were increased significantly(P<0.05 or P<0.01). CONCLUSIONS:P. hydropiper extract has good protective effect on absolute ethyl alcohol-induce AGMI,the mechanism of which may be associated with raising Nrf2 content and enhancing SOD activity in gastric mucosal tissue.

Objective:To investigate the current situation of paternal self-efficacy of support breastfeeding of late prematurity and analyze the factors affectingpaternal self-efficacy of support breastfeeding.Methods:This study was a cross-sectional survey. From July to October 2021, the fathers of 210 late prematurity in Neonatology and NICU wards of Shanxi Children′s Hospital, were selected by convenience sampling method for the research object. The survey was carried out using the General Information Questionnaire, Iowa Infant Feeding Attitude Scale and Father Support Breastfeeding Self-Efficacy Scale-Short Form, multiple linear regression was used to analyze the influencing factors of paternal self-efficacy of support breastfeeding of late prematurity.Results:The total score of Father Support Breastfeeding Self-Efficacy Scale-Short Form was 46.22 ± 10.03, and the total score of Iowa Infant Feeding Attitude Scale was 59.31 ± 5.65, which were positively correlated ( r = 0.224, P<0.01). In the multiple linear regression analysis, whether or not to receive breastfeeding education, feeding methods, family opinions, and fathers′ attitudes towards breastfeeding were the main factors affecting fathers′ self-efficacy in supporting breastfeeding ( t values were - 3.07 to 2.35, all P<0.05). Conclusions:The paternal support breastfeeding of late prematurity level was at a lower level. It is suggested that medical staff should not only pay attention to puerpera and baby, but also pay attentionto father and family, and construct personalized health education based on co-parenting theory.

Objective:To explore the characteristics of nail fold microcirculation in hemodialysis patients and its correlation with cardiovascular events.Methods:The clinical data of 185 patients undergoing regular hemodialysis in Dongguan Donghua Hospital from January 2017 to December 2021 were retrospectively analyzed. Among them, there were 76 cases of cardiovascular events (cardiovascular events group) and 109 cases of no cardiovascular events (non-cardiovascular events group). The nail fold microcirculation detector was used to detect the nail fold microcirculation of the first row of capillaries in the nail fold dermal papilla of the left ring finger. The nail fold microcirculation indexes and morphology integral, flow integral, loop integral, total integral were recorded. The general information and laboratory indexes (peripheral venous blood) were recorded. The value of total integral of nail fold microcirculation in predicting the cardiovascular events in hemodialysis patients was evaluated using the receiver operating characteristics (ROC) curve.Results:The age, proportion of hypertension, proportion of diabetes, C-reactive protein (CRP), alkaline phosphatase and N-terminal pro-brain natriuretic peptide (NT-ProBNP) in cardiovascular events group were significantly higher than those in non-cardiovascular events group: 58 (44, 69) years vs. 49 (40, 63) years, 97.4% (74/76) vs. 83.5% (91/109), 43.4% (33/76) vs. 24.8% (27/109), 9.02 (2.73, 11.70) mg/L vs. 3.76 (1.28, 11.70) mg/L, 82 (75, 97) U/L vs. 72 (59, 82) U/L and 2 652 (1 020, 5 359) ng/L vs. 1 894 (780, 4 601) ng/L, the creatinine and triglyceride (TG) were significantly lower than those in non-cardiovascular events group: (961.95 ± 277.11) μmol/L vs. (1 058.93 ± 284.66) μmol/L and (1.73 ± 1.02) mmol/L vs. (2.27 ± 2.02) mmol/L, and there were statistical differences ( P<0.01 or <0.05). There were no statistical differences in gender composition, dialysis age, dialysis time, dialysis pathway, blood routine, serum iron, serum ferritin, total iron binding capacity, serum potassium, serum calcium, serum phosphorus, parathyroid hormone, urea nitrogen, albumin, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol between two groups ( P>0.05). There was statistical difference in erythrocyte aggregation between two groups ( P<0.05); there were no statistical differences in the number of vascular loops, diameter of input branch, diameter of output branch, length of loop, diameter of loop top, blood flow rate, clarity, condition of cross loop, condition of malformed loop, shape of nipple and subpapillary venous plexus between two groups ( P>0.05). The morphology integral and total integral in cardiovascular events group were significantly higher than those in non-cardiovascular events group: 1.8 (1.1, 3.1) scores vs. 1.4 (0.8, 2.5) scores and 4.2 (2.4, 6.1) scores vs. 3.1 (1.8, 5.2) scores, and there were statistical differences ( P<0.05); there were no statistical differences in flow integral and loop integral between two groups ( P>0.05). ROC curve analysis result showed that the area under the curve of the total integral of nail fold microcirculation for predicting cardiovascular events in hemodialysis patients was 0.590 (95% CI 0.506 to 0.673), the best cut-off value was 2.85 scores, the sensitivity was 69.7% and the specificity was 45.9%. Conclusions:The nail fold microcirculation disorder is more serious in hemodialysis patients with cardiovascular events. The nail fold microcirculation detection may help to predict cardiovascular disease.

Fathers play an important role in supporting maternal breastfeeding. Father's self-efficacy in supporting breastfeeding can predict the outcome of breastfeeding. This article reviews the concept, evaluation tools, roles, status, influencing factors, and intervention measures of self-efficacy in father's support for breastfeeding, so as to provide suggestions for further promoting the formation of breastfeeding intervention plans, thereby improving marital relationships, and promoting infant health.

Objective:To evaluate the correlation between ultrasound parameters of internal carotid artery blood flow and regional cerebral oxygen saturation (rScO 2) in elderly patients undergoing coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). Methods:Sixty-four elderly patients undergoing elective CABG under CPB, aged 60-80 yr, regardless of gender, with body mass index of 18.1-28.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with New York Heart Association class Ⅱ or Ⅲ, with left ventricular ejection fraction≥50%, were selected. The rScO 2 and ultrasonic parameters of internal carotid artery including peak systolic velocity (PSV-ICA), end-diastolic velocity (EDV-ICA), diameter (D-ICA) and blood flow volume (Q-ICA) were recorded before anesthesia induction (T 0), at surgical skin incision (T 1), at 30 and 60 min of CPB (mean value was calculated, T 2), and at 30 and 60 min after termination of CPB (mean value was calculated, T 3). The ratio of unilateral internal carotid artery blood flow to cardiac output (Q/CO) was calculated. The receiver operating characteristic curve was used to analyze the accuracy of ultrasound parameters of internal carotid artery blood flow in predicting rScO 2 < 60%. Results:PSV-ICA was positively correlated with rScO 2 at T 0, T 1 and T 3 ( P<0.05), but no correlation was found between PSV-ICA and rScO 2 at T 2 ( P>0.05). There was no correlation between EDV-ICA and rScO 2 at each time point ( P>0.05). Q-ICA was positively correlated with rScO 2 at each time point ( P<0.05). Q/CO was not correlated with rScO 2 at T 1 ( P>0.05), but Q/CO was positively correlated with rScO 2 at T 2 and T 3 ( P<0.05). During the non-CPB period (T 0, T 1, T 3), the cutoff values of PSV-ICA and Q-ICA in predicting rScO 2< 60% were 51.35 cm/s and 283.5 ml/min respectively, the sensitivity was 0.900 and 0.900 respectively, and the specificity was 0.610 and 0.857 respectively (AUC=0.761, P=0.006; AUC=0.903, P< 0.001). During the CPB period, the cutoff values of Q-ICA and Q/CO in predicting rScO 2<60% were 296.5 ml/min and 5.84% respectively, the sensitivity was 0.900 and 0.800, and the specificity was 0.545 and 0.659 (AUC=0.764, P=0.001; AUC=0.748, P=0.002), respectively. Conclusions:PSV-ICA and Q-ICA are positively correlated with rScO 2 during the non-CPB period, and Q-ICA and Q/CO are positively correlated with rScO 2 during the CPB period in elderly patients undergoing CABG. PSV-ICA, Q-ICA and Q/CO can accurately predict rScO 2<60%.

Objective To assess the impact of intravenous esketamine administered prior to car-diopulmonary bypass(CPB)initiation on ventricular function and internal carotid artery blood flow in pa-tients undergoing heart valve replacement surgery.Methods Sixty patients underwent elective CPB heart valve replacement,38 males and 22 females,aged 18-75 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅱ or Ⅲ,NYHA cardiac function classification Ⅰ-Ⅲ,and a left ventricular ejection fraction(LVEF)of≥45％,were selected.The patients were randomly divided into two groups:esketamine group(group E)and normal saline group(group C),30 patients in each group.Total intravenous anesthesia was used during the operation.Following the initiation of CPB,group E received an intravenous infusion of es-ketamine at a rate of 0.5 mg·kg-1·h-1 until the conclusion of the procedure,while group C received an equivalent volume of normal saline concurrently at the same rate.HR,MAP,CVP,and cardiac output index(CI)were recorded before anesthesia induction,during skin resection,and within 60 minutes after stopping CPB.LVEF,left ventricular global longitudinal strain(GLS),global longitudinal time-to-peak strain standard deviation(GLTSD),global circumferential strain(GCS),global circumferential time-to-peak strain standard deviation(GCTSD),right ventricular ejection fraction(RVEF),right ventricular GLS,and GLTSD were obtained during skin resection,within 40 minutes of CPB,and 60 minutes after stopping CPB.rScO2,BIS,concentrations of Hb and lactic acid(Lac),peak systolic flow velocity(SPV),quantity of flow-internal carotid artery(Q-ICA),and blood flow resistance index(RI)were recorded before anesthesia induction,during skin resection,within 40 minutes of CPB,and within 60 minutes after stopping CPB.Concentrations of cardiac troponin Ⅰ(cTnⅠ),alanine aminotransferase(ALT),creatinine(Cr),and neuron-specific enolase(NSE)were recorded before anesthesia induction and 6 hours after operation.Spon-taneous resuscitation after CPB,postoperative extubation time,duration of ICU stay,total hospital stay,in-cidence of adverse cardiac events,and 30-day postoperative mortality were recorded.Results Compared with group C,group E exhibited a significant increase in CI within 60 minutes after stopping CPB(P＜0.05).The LVEF,RVEF,and right ventricular GLS demonstrated significant increases within 60 minutes after stopping CPB in group E compared with group C(P＜0.05).The left ventricular GLS and left ven-tricular GCTSD displayed significant increases 30 minutes after stopping CPB in group E compared with group C.The RI exhibited a significant increase within 40 minutes of CPB in group E compared with group C(P＜0.05).There were no significant differences in cTnⅠ,ALT,Cr,NSE,spontaneous resuscitation affter CPB,postoperative extubation time,duration of ICU stay,total hospital stay,incidence of cardiac adverse events,and 30-day postoperative mortality between the two groups.Conclusion Administration of esket-amine following the onset of CPB in patients undergoing cardiac surgery demonstrates a significant elevation in CI post-CPB cessation.Furthermore,it may augment ventricular longitudinal strain,thereby enhancing myocardial contraction,leading to increased postoperative ventricular ejection fraction,and sustaining hemo-dynamic stability.