Objective To explore the relationships among attachment,parental attachment and parental rearing style of adolescent depression.Methods 36 outpatients and hospital patients in Anhui Mental Health Center with depression and their parents were involved as the case group,33 age-,gender-,and education-matched high school students and their parents as the normal controls.The case group and control group were assessed with Experiences in Close Relationships Inventory (ECR) and Parental Rearing Pattern Questionnaire (EMBU).Results ① The score of attachment avoidance and anxiety dimension in the depression group were obviously higher than that of the control group(73.19 ± 16.63 vs 66.25 ± 12.91,62.76 ± 13.90 vs 51.97 ± 13.69,P ＜ 0.01) ;the score of mother's attachment anxiety in the depression group were significantly higher than that of the control group (72.06 ± 14.23 vs 57.42 ± 12.81),and there were significant differences between two groups (P ＜ 0.01).②The attachment avoidance was positively correlated with parental attachment avoidance in the depression group (r =0.534,r=0.488 ; P＜ 0.01).The attachment anxiety dimension was positively correlated with mother's attachment anxiety in depression group (r =0.532,P ＜ 0.01).Attachment avoidance was negatively correlated with parental warmness(r =-0.406,r =-0.462,P ＜ 0.01),however attachment avoidance had positive correlation with father's punishment and mother's rejection in depression group (r=0.395,r=0.468; P＜0.05).Father's attachment avoidance was negatively correlated with father's warmness(r =-0.527,P＜ 0.01),and mother's attachment avoidance was negatively correlated with mother's warmness (r =-0.491,P ＜ 0.01),which was positively correlated with mother's rejection (r =0.392,P ＜ 0.05).③ Regression analysis showed that mother's warmness rearing style had full mediating effect on the relationship between mother's attachment avoidance and attachment avoidance in depression group,and then mother's refused rearing style partly mediated the relationship between them.But father's warmness didn(t) have mediating effect on the relationship between father's attachment avoidance and attachment avoidance in depression group.Conclusion The attachment pattern is insecure in the depression group.Parenting attachment and rearing style significantly influence on adolescent depression attachment patterns,and mother's rearing style has mediating effect on the relationship between mother's attachment and depression attachment.

Objective To observe the value of dual-source CT energy spectral imaging in qualitative evaluation of metastatic lymph nodes in patients with gastric cancer.Methods Data of patients with pathologically diagnosed gastric cancer were collected,who underwent both dual-source CT abdomen plain scanning and energy spectrum double-phase enhanced scanning.The long diameter,short diameter,short length-diameter ratio,arterial phase and venous phase standardized iodine concentration of lymph nodes were measured and recorded.Energy spectrum attenuation curves were drawn,and the slopes were calculated.Parameters with statistical significant differences between metastatic and non-metastatic lymph nodes were used to plot ROC curves,and the thresholds for diagnosing metastatic lymph nodes of gastric cancer,and their diagnostic sensitivity and specificity were calculated.Results There were significant differences in short axis,short aspect ratio,normalized iodine concentration in arterial phase and venous phase between metastatic and non-metastatic lymph nodes in patients with gastric cancer (all P＜0.05),the area under the curve of ROC curve was 0.601 (P=0.006),0.881 (P＜0.001),0.865 (P＜0.001) and 0.834 (P＜0.001),respectively.When the short length to diameter ratio was 0.730,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 75.72％ and 93.64％.When standardized iodine concentration was 0.223 in arterial phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 69.81％ and 91.20％.When the standardized iodine concentration was 0.392 in the venous phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 78.33％ and 85.63％.Dual-phase energy spectrum curve of both gastric metastatic lymph nodes and non-lymph node decreased.Taken the arterial curve slope k=6.860 as the threshold,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 83.24％ and 84.72％.When the threshold venous phase slope k was set at 6.660,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 64.62％ and 97.70％,respectively.Combining arterial phase length-to-diameter ratio,arterial phase standardized iodine concentration and spectral curve slope,the sensitivity and specificity in diagnosing metastatic lymph nodes was 97.34 ％ and 87.83 ％,which was 80.13 ％ and 90.31％ when combining venous phase short length-diameter ratio,venous phase standardized iodine concentration and spectral curve slope.Conclusion The short-length-to-diameter ratio,arterial-venous phase standardized iodine concentration and arterial-venous phase slope of lymph nodes are the main parameters for evaluating metastatic lymph nodes in patients with gastric cancer.Combination of the above three parameters can obviously improve the sensitivity and specificity in diagnosis of metastatic lymph nodes in patients with gastric cancer.

Objective To investigate the value of standardized iodine concentration and energy spectrum curve of dual-source CT in diagnosis of metastatic lymph nodes of gastric cancer.Methods The clinical data of 60 patients diagnosed as gastric cancer were collected in our hospital.All patients underwent dual-source CT routine abdominal scanning and dual-phase energy spectrum enhancement.According to the pathologic results,the lymph nodes were divided into metastatic and non-metastatic groups.Then the enhanced degree,dual-phase normalized iodine concentration (NIC)were measured and compared between metastatic lymph nodes and non-metastatic lymph nodes.The slope of the energy spectrum curve of metastatic lymph nodes and non-metastatic lymph nodes were calculated by dual-energy software.Results When the enhanced degree was higher than 80 HU,the sensitivity (82.4%)and specificity (78.6%)were higher. The artery-phase NIC values of metastatic lymph node and non-metastatic lymph node were(0.546±0.086)and(0.144±0.077),respectively. The difference was statistically significant (P<0.05).The venous-phase NIC values of metastatic lymph node and non-metastatic lymph nodes were (0.479±0.013)and (0.307±0.082),respectively.The difference was statistically significant (P<0.05).The dual-phase energy spectrum curves of metastatic and non-metastatic lymph nodes were all descending patterns.The difference was obvious at 40-80 keV and minimal at 80-140 keV.The sensitivity of diagnosing metastatic lymph nodes was 83.5%,and the specificity was 85.6%when the arterial curve slope was 6.87.The sensitivity of diagnosing metastatic lymph nodes was 63.6% and the specificity was 96.7%when the venous curve slope was 6.67.Conclusion The multiple parameters provided by dual-source CT dual-energy imaging are helpful to the qualitative and quantitative diagnosis of metastatic lymph nodes in gastric cancer.

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy

ObjectiveTo investigate the expression of serum Aldo-keto reductase family 1 member B10 （AKR1B10） in patients with hepatocellular carcinoma （HCC） in northern China， and to provide a new and valuable biomarker for the clinical diagnosis of HCC. MethodsThis study was conducted among 102 patients with HCC， 119 patients with benign liver disease， and 132 patients with other malignant tumors who attended The Affiliated Hospital of Chengde Medical University and 148 healthy individuals who underwent physical examination from May 2020 to May 2024. ELISA and chemiluminescence were used to measure the serum levels of AKR1B10 and alpha-fetoprotein （AFP）. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between three groups and further comparison between two groups； the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve （AUC） was used to assess diagnostic efficiency. ResultsThe expression level of AKR1B10 was 3 053.79 （1 475.67‍ ‍—‍ ‍4 605.86） pg/mL in the HCC group， 1 324.42 （659.68‍ ‍—‍ ‍2 023.88） pg/mL in the benign liver disease group， 660.68 （377.56‍ ‍—‍ ‍2 087.77） pg/mL in the other malignant tumor group， and 318.30 （82.73‍ ‍—‍ ‍478.82） pg/mL in the healthy group， with a significant difference between the four groups （H=240.86， P<0.001）， and further comparison between two groups showed that the HCC group had a significantly higher level than the other three groups （all P<0.001）. The ROC curve analysis of the HCC group and the other three groups showed that serum AKR1B10 had an optimal cut-off value of 1 584.97 pg/mL in the diagnosis of HCC， with an AUC of 0.86 （95% confidence interval ［CI］： 0.82‍ ‍—‍ ‍0.90）， a sensitivity of 74.3%， and a specificity of 85.2%. Compared with each indicator alone， a combination of AKR1B10 and AFP could improve the sensitivity （81.8%） and specificity （91.4%） of HCC diagnosis. AKR1B10 had an AUC of 0.84 （95%CI： 0.78‍ ‍—‍ ‍0.90） in the diagnosis of patients with early- or middle-stage HCC， with a sensitivity of 76.2% and a specificity of 81.2%. AKR1B10 had an AUC of 0.85 （95%CI： 0.77‍ ‍—‍ ‍0.92） in the diagnosis of patients with AFP-negative HCC， with a sensitivity of 81.6% and a specificity of 79.9%. ConclusionAKR1B10 is a promising serological marker for the diagnosis of HCC， and a combination of AKR1B10 and AFP can improve the detection rate of HCC patients in northern China， especially those with early- or middle-stage HCC and AFP-negative HCC.