Objective To investigate the post traumatic stress disorder scores of undergraduate and the correlation between emotional approach coping(EAC) in unaffected region after Wenchuan-earthquake.Methods PTSD Check list-Civilian Version (PCL-C) and emotional approach coping scale(EACS) were used to assessed 880 undergraduates in Nanjing. Results (1)The average score of PCL-C was 30.52±9.64, and the prevalence rates of PTSD was found 5.3%.(2)Gender difference were found in social function(male:1.66±0.80,female:1.52±0.63, t =2.664,P =0.005) and positive scores of PTSD(male:31.32±10.81,female:29.81±8.41,t =2.263,P =0.022).(3)No significant difference was found in different specialty between PTSD,but in emotional procession and emotional expression.(4)Emotional-approach coping and expose time in front of media came into the regression equation of PTSD symptoms.Conclusion The score of PCL-C of undergraduate in unaffected region are infected by how long he spend in front of media and how he use emotion-approach coping strategy to cope with this shock bringing by Wenchuan-Earthquake

Objective To examine the reliability and validity of Chinese revision of connor-davidson resilience scale(CD-RISC) in Chinese college students.Methods 1610 college students were tested with CD-RISC.783 of them took a more test by BFI and SCL-90 at the same time.After three weeks,83 students were retested by CD-RISC.Results (1) The results of confirmatory factor analysis (x2/df =6.632,RMSEA =0.059,GFI =0.934,AGFI =0.915,CFI =0.927,NFI =0.915) indicated that the three-factor model reasonably fitted Chinese college students.(2) The Cronabach α coefficients of the CD-RISC and three factors called adaptability,tenacity and autonomy were 0.914,0.865,0.784,0.767 respectively; the mean inter-item correlation coefficients of them were 0.364,0.417,0.425,0.398 respectively; the Guttman split-half coefficients were 0.888,0.843,0.707,0.650 respectively; the retest-reliability coefficients were 0.856,0.742,0.777,0.747.(3) The scores of the total scale of CDRISC and three factors were significantly correlated to BFI and SCL-90(P＜0.01).There were significant differences between the low-resilient group and the high-resilient group in every index of BFI and SCL-90.(4) There were significant differences between male and female students in CD-RISC and factor tenacity and autonomy(male:2.77±0.60,2.70-±0.74,2.65±0.68;female:Z70±0.53,2.62±0.67,2.54±0.62; P＜0.05).Conclusion The Chinese version of CD-RISC is a reliable and valid method for assessing resilience in Chinese college students.

Objective To analyze the prevalence of hospital acquired infection and the associated risk factors.Methods Nine hundred and three hospitalized preterm infants in our neonatal intensive care unit from August 2006 to October 2010 were retrospectively studied.Risk factors of hospital acquired infection were analyzed by single factor analysis and logistic regression analysis method.Site and pathogen of infection were also analyzed.Results One hundred and ten preterm infants developed 123 times of hospital acquired infection.The incidence of hospital acquired infection was 12.2％,and hospital acquired infection patient-day rates was 7.3‰.The mortality was 2.7％.Gestational age less than 32 weeks,birth weight less than 1500 gram,non-invasive ventilation,tracheal intubation,umbilical vein catheter(UVC),peripherally inserted central catheter(PICC),parenteral nutrition were the risk factors of hospital acquired infection.Logistic regression analysis showed mechanical ventilation,UVC and PICC were the main risk factors.The main sites of infection were sepsis(45.5％),low respiratory infection and conjunctivitis.Seventy positive culture samples were obtained.Bacteria were the main pathogen.Fifty percent was gram-staining positive,while 46％ was gram-staining negative.Conclusion It is very important to identify the high risk factors for hospital acquired infection.Standardized management of preterm infants,standardized usage of umbilical vein catheter and peripherally inserted central catheter,minimized usage of intubation would be conductive to reduce the incidence of hospital acquired infection.

A 65-year-old woman presented with intermittent right hand numbness and elevated serum creatinine for more than 2 months. The histological examination of kidney biopsy showed renal arterioles occlusion and interstitial fibrosis. Pathological abnormality was originally considered as a part of systemic atherosclerosis. Thus, rosuvastatin 20 mg/d, fosinopril 10 mg/d, metoprolol 47.5 mg/d and aspirin 0.1g/d were administrated. No improvement of renal function was seen. Further Congo red staining was applied. Diffuse amorphous eosinophilic substance was deposited in interlobular artery and small arteriolar artery. Combined with the abnormal free light chain (FLC) level and ratio (serum κ 340 mg/L, κ/λ 10.932), the diagnosis of systematic light-chain amyloidosis was confirmed. The patient received 3 courses of chemotherapy regimen as BCD (bortezomib 2 mg d1, 8, 15, 22, cyclophosphamide 0.3 g d1, 8, 15, 22 and dexamethasone 40 mg d1, 8, 15, 22). A hematologic partial response was achieved and serum creatinine decreased to 180 μmol/L.

Objective To observe the availability and safety of ventricular septal defect (VSD) occluder in infants and young children with large patent ductus arteriosus (PDA) associated with severe pulmonary hypertension.Methods Five patients (1 male and 4 fomale) of large PDA aged 5 months to 3 years,weighted from 5.1 to 15 kg,body surface area (BSA) 0.37-0.58 m2 underwent transcathter intervention with concentric VSD occluders from June 2008 to May 2009.Arterial ducta were tube-like and their diameters were 5.7 to 8.5 mm,with ulmonary vascular resistance from 4.8 to 5.7 Wood Unit,Qp/Qs 3.4-4.6.Three patients were given Bosentan after intervention.Results The large PDAs were successfully closed with VSD occluders,including 1 concentric perimembranous VSD occluder and 4 muscular VSD occluders.They all discharged 4 to 5 days with hidrosis and weight improved.Echocardiogram indicated VSD occluder was stable,no residue shunt and no stricture of left pulmonary artery and descending aorta were found.According to tricuspid and pulmonary regurgitation,pulmonary arterial pressure decreased differently and returned to normal after 6 months follow-up.Conclusion VSD occluder is available and effective to close large PDA associated with severe pulmonary hypertension in inrants and young children,but more cases and long-term follow-up are necessary.

Abstract: To report a case of Aspergillus salwaensis-induced spinal infection and its laboratory detection. The inflammatory granulation and necrotic tissue samples of a patient with spinal infection were collected from, the Affiliated Hospital of Chengde Medical College on June 17, 2020 for direct smear microscopy and culture, and the isolated strain was identified by microscopy by smear staining, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS), molecular identification and in vitro antifungal susceptibility test. The patient was 62 years old female and presented with recurrent chest and back pain with no obvious cause. The initial diagnosis was spinal infection, after 7 days of treatment with levofloxacin, the effect was not good. Surgery was then performed remove the lesion via posterior thoracic debridement, and fungal hypha was observed under microscope in tissue specimens. The isolated strains had no typical structure, MALDI-TOF-MS was used for identification for many times, but there was no identification result. After 7 days of fluconazole treatment, the patient's condition improved, and her chest and back pain were alleviated compared to before surgery. The patient was discharged and followed up in the outpatient department, the fungus was later identified as Aspergillus salwaensis by sequence analysis of the internal transcribed spacer (ITS) gene sequencing, and the patient's antifungal medication was changed to voriconazole after with the attending physician. The patient consciously recovered well with no pain in the operative area and normal spinal activity at 1 year follow-up. The possibility of spinal fungal infection should be considered in patients with back pain without a clear cause and poor response to routine antibiotic treatment. Direct smear report of microscopic results are very important for guiding clinical antibiotic selection for rare filament fungi with atypical colony and microscopic morphology and unsuccessful MALDI-TOF-MS identification, molecular biological methods such as ITS sequence analysis can be helpful for early identification of the fungal species, improving identification speed.

This paper summarizes the current situation of cognitive behavioral therapy (CBT) in China,and focuses on the issues existing in the current CBT application,including oversimplified and one-sided understanding of CBT,insufficient and inadequacy trainning,insufficient combination with Chinese Culture,reflection of the vocation being seen more important than back-feeding society,the lack of standardized practitioners management,and so on.Therefore,it is critical to strengthen the training of psychiatrists,establish a complete CBT training system,improve the training of practitioners,establish a CBT training system based on high education gradually,promote mutual understanding and cooperation of psychotherapists and psychiatrists,promote the research onto nativization of CBT,establish normalized certification system,promote the quality of CBT practitioners overall,strengthen service consciousness of awareness,and take advantage of CBT.

Abstract: Objective　To construct HepG2, Huh7 cell lines stably express hepatitis B virus X (HBx) mutant (C1653T, T1753C), and explore their effect on the biological behavior of hepatocellular carcinoma cells. Methods　The lentivirus plasmid of pLVX-HBxC1653T-IRES-tdTomato, pLVX-HBxT1753C-IRES-tdTomato were obtained by PCR site mutagenesis according to wild type ayr HBx. Double enzyme digestion and Sanger sequencing were performed for accuracy of plasmid. Blank HepG2 and Huh7 cells were used as the control group, HepG2, Huh7 cells were infected by pLVX-HBx-IRES-tdTomato, pLVX-HBxC1653T-IRES-tdTomato, and pLVX-HBxT1753C-IRES-tdTomato lentivirus solution, then monoclonal cell was selected by 0.6 μg/mL puromycin. Immunostaining and Western Blot were performed for the verification of stable strains. CCK8 assay was performed for the proliferation capacity of stable strains. Western Blot was performed for expression of EMT-related signal molecules in cells. The independent samples t-test was used for comparison between two groups. Results Double enzyme digestion and Sanger sequencing showed that that the size of the cut fragments of recombinant lentiviral plasmids was correct, and the point mutation location and base substitution were correct, suggesting that the plasmid of pLVX-HBx-IRES-tdTomato, pLVX-HBxC1653T-IRES-tdTomato, pLVX-HBxT1753C-IRES-tdTomato were constructed successfully. Immunostaining and Western blot showed that HBX were expressed in stable strains, while there was no HBX expression in the blank control group, indicating that the HepG2 and Huh7 cell lines stably expressing HBx, HBxC1653T, HBxT1753C were successfully constructed. CCK8 assay showed that the proliferation capacity of HBx and mutant were enhanced compared to the control group (P<0.01), HBx C1653T displayed further additive the effect compared to HBx (P<0.05). Moreover, HBxC1653T mutation also significantly upregulated N-cadherin expression and downregulated E-cadherin expression, thus promoting the occurrence of EMT. Conclusions　HepG2 and Huh7 cell lines stably expressing HBx, HBxC1653T, HBxT1753C were successfully constructed, HBxC1653T mutation significantly enhanced the proliferation of HCC cells and epithelial to mesenchymal transition occurrence.

Objective: To analyze the trends in incidence and mortality of prostate cancer in Ningbo City, Zhejiang Province, so as to provide insights into the prevention and control of prostate cancer. Methods: Data of the incidence and mortality of prostate cancer in Ningbo City from 2011 to 2023 were collected through Ningbo Chronic Disease Collaborative Management System. The incidence and mortality of prostate cancer were calculated and standardized by the data from the sixth national population census in 2010 and the Segi's world standard population in 1960. The trends in incidence and mortality of prostate cancer were evaluated using average annual percent change (AAPC). Results: A total of 15 411 cases of prostate cancer were reported in Ningbo City from 2011 to 2023, and the crude incidence, Chinese-standardized incidence and world-standardized incidence were 39.62/105, 22.18/105 and 16.49/105, respectively, showing upward trends (AAPC=14.782%, 10.390% and 10.608%, all P<0.05). The Chinese-standardized incidence of prostate cancer was higher in urban areas than in rural areas, and both showed upward trends (25.14/105 vs. 19.44/105; AAPC=9.057% and 14.272%, both P<0.05). The crude incidence of prostate cancer in the groups aged 50-<60 years, 60-<70 years, 70-<80 years and ≥80 years showed upward trends (AAPC=11.657%, 14.031%, 10.734% and 5.300%, all P<0.05). A total of 3 739 deaths were reported, and the crude mortality, Chinese-standardized mortality and world-standardized mortality were 9.66/105, 5.23/105 and 3.71/105, respectively, showing upward trends (AAPC=8.458%, 3.620% and 3.602%, all P<0.05). The Chinese-standardized mortality of prostate cancer was higher in urban areas than in rural areas, and both showed upward trends (5.35/105 vs. 5.13/105; AAPC=3.183% and 3.962%, both P<0.05). The crude mortality of prostate cancer the groups ageds ≥80 years showed an upward trend (AAPC=7.482%, P<0.05). Conclusions From 2011 to 2023, the incidence and mortality of prostate cancer in Ningbo City showed upward trends. Special attention should be paid to urban residents, and prostate cancer screening should be strengthened among males aged 50 years and older.

Objective:To compare and analyze the efficacy of supraumbilical longitudinal auxiliary incision and left lower abdominal oblique auxiliary incision during laparoscopic radical resection of rectal cancer.Methods:The data of 196 patients with rectal cancer treated in the Second Affiliated Hospital of Xiamen medical college from January 2015 to December 2020 were analyzed retrospectively. Different abdominal auxiliary incisions were used for grouping. The control group (101 cases) used the oblique auxiliary incision of the left lower abdomen, and the observation group (95 cases) used the longitudinal auxiliary incision of the upper umbilical cord. The intraoperative indicators (operative time, intraoperative blood loss, auxiliary incision length, distance between anastomotic teeth and dentate line), postoperative indicators (first postoperative exhaust time, postoperative pain score, fluid intake time, first out of bed time and hospital stay) and operative complications between the two groups were compared.Results:The first postoperative exhaust time ((56.8±4.3) h vs. (70.3±5.8) h, t=4.796) and the first postoperative out of bed time ((38.81±2.04) h vs. (47.93±2.63) h, t=5.113) in the observation group were significantly shorter than those in the control group, and the pain scores at 24 hours ((2.01±0.22) vs.(2.43±0.40), t=5.882) and 48 hours pain score ((2.23±0.44) vs. (3.14±0.72), t=6.58) after operation were significantly lower than those in the control group (all P<0.05). The incidence of incision hernia in the observation group was significantly lower than that in the control group (5.3% (5/95) vs.9.9% (10/101), χ 2=4.29)( P<0.05). Conclusion:Compared with the left lower abdominal oblique auxiliary incision,the supraumbilical longitudinal auxiliary incision in laparoscopic radical resection of rectal cancer can not only significantly reduce the postoperative pain scores and recover the postoperative intestinal function as soon as possible, but also significantly reduce the incidence of postoperative incision hernia.