Objective To revise the Chinese version of the National Institutes of Health-Chronic Prostatitis Symptom Index (CHN-NIH-CPSD), and evaluate its feasibility, reliability, validity and responsiveness. Methods The NIH-CPSI was translated into Chinese according to a standard methodology including forward-backward-forward technique. The CHN-NIH-CPSI was pre-tested in consecutive samples of 162 native-speaking Chinese chronic prostatitis(CP)patients. Ninety-five of 162 filled the index again on the same day and after 4-week therapy. Ninety-seven healthy men were included as evaluated. Results The recovery of the questionnaires was 100% and all the patients filled the index completely. The mean time to complete the questionnaire for the patient group was 5.2±2.4 (range 2 - 12) min. The split-half reliability was 0.82. For the overall index and each subscale, the test-retest reliability was 0.98, 0. 98, 0. 98, 0. 97, respectively(P＜0.01);and the Cronbach's α coefficient was 0. 61,0. 71, 0. 59, 0. 75, respectively. The confirmatory factor analysis showed good construct validity with a goodness of fit index of 0. 85 and a x2 of 124.67(P＜0. 01). Of all 162 patients, the scores of the overall index and each subscale were 23. 33±5.91. 8. 80±4.26, 5.30±2.82, 9. 23±1.90, respectively;and those of healthy controls were 1. 95±1.97, 0. 37±1.03, 0. 15±0.58, 1.42± 1.20,respectively. Of the 95 patients, the original scores were 23. 53±5.60, 9.21 ±4.04, 5.10±2.75,9.21 ±2.05, comparing with 19.47±6.36, 7.79±3.95, 3. 58±1.88, 8.11±2.50, the 4 weeks later scores. The group t-test and paired t-test showed good responsiveness. Conclusions The CHN-NIH-CPSI has high feasibility, reliability, validity and responsiveness for testing the patients with CP. It is suitable for Chinese-speaking patients and helpful for cross-cultural comparisons of men with CP in clinical and research settings.

Objective To investigate the effects of bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression for patients with severe stroke.Methods 50 patients with severe stroke were selected and divided into two groups by using random number tables,which are the observation group and the control group,with 25 cases in each group.The patients in the observation group were treated with bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression,while the patients in the control group simply received bedside indwelling of nasogastric tube.The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day after admission and trace the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the two groups within 14 days and the situation of the days of mechanical ventilation,the days in ICU and the 30 -day mortality of patients were compared in the two groups.Results The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day in the observation group were superior to those of the control group[The goal -rate of target feeding volume on the 7th day:88% vs.64%,χ2 =3.947,P =0.047;the goal -rate of target feeding volume on the 14th day:80% vs.52%,χ2 =4.367,P =0.037].Meanwhile the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the observation group within 14 days were significantly lower than those in the patients of the control group within 14 days[The gastric retention rate:8% vs.56%(14 /25 ),χ2 =10.784,P =0.001;the reflux rate:0% vs.24%(6 /25),χ2 =4.735,P =0.03;the aspiration rate:8% vs.32%,χ2 =4.500,P =0.034;the incidence of aspiration pneumonia:24% vs.68%,χ2 =9.742,P =0.002].The days of mechanical ventilation and the days in ICU of the patients in the observation group are far less than those of the patients in the control group[The days of mechanical ventilation:(11.16 ±4.86)d vs.(13.72 ±3.67)d,t =-2.101,P =0.041;the days in ICU:(15.36 ±5.66)d vs.(18.72 ±2.99)d,t =-2.625,P =0.012].While there was no significant difference between the two groups on the 30 -day mortality(24% vs.32%,χ2 =0.397,P =0.529).Conclusion The bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression can significantly improve the enteral nutritional goal -rate of target feeding volume for patients with severe stroke and greatly reduce the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia,and limit the days of mechanical ventilation and the days in ICU.Accordingly,it has the value of popularization in the clinical application.

ObjectiveTo explore the relationship among the aggressive behavior,hostile attribution bias and childhood trauma in schizophrenic patients.Methods 135 schizophrenic patients were tested with Modified Overt Aggression Scale (MOAS),the Chinese-version of the Ambiguous Intentions Hostility Questionnaire (AIHQ-C) and Childhood Trauma Questionnaire (CTQ).According to the score of the MOAS,the patients were divided into the aggressive group ( n =58 ) and the non-aggressive group ( n =77 ).The hostile attribution bias and the childhood trauma were compared between the two groups,and correlation and hierarchical regression analysis were used to investigate the relationships of the variables.ResultsCompared with the non-aggressive patients,the aggressive patients had significantly higher AIHQ-C total hostility bias score (6.27 ± 1.20 vs 5.90 ± 0.97,P ＜0.05 ),total blame bias score (8.04 ± 1.97 vs 6.91 ± 2.10,P ＜ 0.01 ) and total aggression bias score ( 6.17 ±1.02 vs 5.59 ± 1.04,P ＜ 0.01 ).Correlation analysis showed that the MOAS score,AIHQ scores and the total score of CTQ were significantly positively correlated with each other ( r =0.171 ～ 0.350,P ＜ 0.05 ～0.01 ).Regression analysis indicated the hostile attribution bias directly predicted the aggressive behavior( β =0.342,P ＜0.05) and completely mediated the relationship between the childhood trauma and the aggressive behavior.ConclusionThe aggressive behavior in schizophrenic patients is associated with the experience of childhood trauma and the attribution style.The childhood trauma indirectly influences the aggressive behavior by the mediating of the hostile attribution bias.

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

Objective To introduce a new method for preparation of bioactive β-tricalcium phosphate (β-TCP) by rapid stem cell screen-and-enrich-and-combine circulating system (SECCS) and evaluate its efficacy in the treatment of fresh fractures and bone defects.Methods Twenty-two patients with fresh fracture and bone defects were treated with SECCS from July 2013 to April 2016.They were 16 males and 6 females with an average age of 52.2 years (from 27 to 81 years).There were 15 tibial plateau fractures and 7 calcaneal fractures.The average size of bone defects was 12.5 mL.Bioactive β-TCP was prepared by SECCS intraoperatively and implanted back immediately into the bone defects.Radiographic examination,Lysholm knee scoring and Maryland foot scoring were used for assessment of curative efficacy.Results The 22 patients were followed up for an average of 25.7 months (from 12 to 46 months).By SECCS,the enrichment efficiency of bone marrow stromal cells (BMSCs) reached up to 82.4％ and the cell viability was not affected.The tibial plateau fractures were re-transplanted with 13,381.3 BMSCs on average and healed after an average of 8.9 weeks (from 6 to 15 weeks).The Lysholm knee scores at one year postoperatively averaged 93.6 points (from 84 to 100 points),yielding 10 excellent cases,4 good cases and one fair case.The calcaneal fractures were implanted back with 16,677.7 BMSCs on average and healed after an average of 9.4 weeks (from 8 to 13 weeks).The average Maryland foot score at one year after operation was 93.6 points (from 85 to 98 points),yielding 6 excellent cases and one good case.Conclusion Bioactive materials prepared by SECCS are good bone grafts for fresh fractures and bone defects.

Objective:To investigate the application value of intrathoracic double-flap tech-nique (Kamikawa anastomosis) in combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients with esophagogastric junction cancer who were admitted to the First Affiliated Hospital of Xiamen University between July 2022 and April 2023 were collec-ted. There were 7 males and 3 females, aged 62(range, 53-71)years. All the 10 patients underwent combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer. Reconstruction was performed with an intrathoracic Kamikawa anastomosis. Observation indicators: (1) intraoperative and postoperative situations; (2) postoperative pathological examination; (3) follow-up and survival. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative and postoperative situations. All the 10 patients underwent surgery successfully. The operation time and volume of intraoperative blood loss were (347±41)minutes and (91±41)mL. The time to postoperative fluid diet intake, time to removal of postoperative abdominal drainage tube, time to removal of postoperative chest drainage tube, duration of postoperative hospital stay were (4.3±1.1)days, (5.0±1.6)days, (10.5±3.9)days, (13.3±3.8)days. Six patients had postoperative complications, including 1 case of Clavien-Dindo grade ⅢB, 3 cases of Clavien Dindo grade Ⅱ, 2 cases of Clavien Dindo grade Ⅰ. An upper gastrointestinal contrast at postoperative day 7 showed no anastomotic leak or anastomotic stricture in the 10 patients. (2) Postoperative pathological examination. Results of postoperative pathological examination in the 10 patients showed negative surgical margin. The number of lymph node dissected was 22±6. There were 3 patients with 5 positive lymph nodes. The tumor diameter and distance from center of tumor to squamocolumnar mucosal junction were (3.3±0.5)cm and (1.9±1.4)cm. One patient had tumor differentiation degree as high and moderate differentiation, 5 cases as moderate differentiation, 3 cases as moderate and low differentiation, 1 case as low differentiation. There were 5 patients with squamous cell carcinoma of the esophagogastric junction and 5 patients with adenocarcinoma of the esophagogastric junction. (3) Follow-up and survival. All the 10 patients were followed up for 7(range, 3?12)months, achieving disease-free survival. The visick quality of life grade Ⅰ, Ⅱ, Ⅲ, Ⅳ were observed in 7, 3, 0, 0 patients. Postoperative gastroscopy was completed in 7 patients, in which mild anastomotic strictures were noted in 2 patients, but no treatment was required. There was no reflux esophagitis.Conclusion:Intrathoracic Kamikawa anastomosis in combined thoracoscopic and laparoscopic radical resection for esophagogastric junction cancer is safe and feasible, with satisfactory short-term efficacy.

肌肉硬度； 竖脊肌； 信度； 康复训练

Objective To investigate the early clinical characteristics and radiographic changes in confirmed Novel coronavirus pneumonia (NCP) and excluded NCP patients. Methods Twenty-four patients with suspected NCP admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital between January and February, 2020 were chosen as our research subjects. Early clinical features and radiographic changes were analyzed in 10 patients of confirmed NCP and 14 patients of excluded NCP. Results In the early stage, all 24 suspected patients were mild, and had normal blood gas analysis. Of 10 diagnosed patients, 50% were male. All the 10 patients had fever and fatigue, with body temperature between 37.5℃ and 38.5℃. Only 1 patient had dry cough. 2 patients had no clear epidemiological exposure history, the other 8 had a clear epidemiological exposure, with a possible incubation period of 1-10 days. From CT imaging, lesions were characterized as ground glass shadow ( n =9), which could be unilateral ( n =1) or bilateral ( n =9), and were mainly close to the pleura ( n =9), with nodule shadow ( n =1) and without focal necrosis, and could combined with pleural effusion ( n =1. Among patients excluded NCP, all 14 patients had a clear history of epidemic exposure, with an onset time of 1 to 13 days. 12 patients had fever , including 4 with temperature > 38.5°C, 8 with temperature 37.3-38.5°C, and 2 without fever. All patients had fatigue , 7 patients had dry cough and 2 patients had chest pain. From CT imaging, ground glass shadow appeared in 4 patients , lesions were unilateral in 10 patients and bilateral in 4 patients , and the lesions were relatively sporadic, without necrosis or pleural effusion. Conclusion 1．Not all patients with NCP have a direct history of epidemiology exposure, some patients may be infected unknowingly. 2. According to CT imaging, NCP seems to have no special manifestations different from other viral pneumonia. 3. NCP is more common among middle-aged people.