Objective: To investigate the mediating effects of resilience and emotion regulation on family cumulative risk and positive coping style among primary and middle school students, so as to provide insights into promoting psychological health among them. Methods: The primary and middle school students from three counties (districts) of Baise City, Guangxi Zhuang Autonomous Region were selected through the stratified cluster random sampling method. Resilience, emotion regulation, family cumulative risk and positive coping style were investigated using the Resilience Scale for Chinese adolescent, Emotion Regulation Questionnaire, Chinese family Assessment Instrument, and Simple Coping Strategies Questionnaire, respectively. Mediating effects of resilience and emotion regulation on family cumulative risk and positive coping style were examined using Process macro program. Results: Totally 1 076 questionnaires were allocated, and 1 006 valid questionnaires were recovered, with an effective rate of 93.49%. There were 515 boys, accounting for 51.19%. The median age was 13 (interquartile range, 1) years. The mean scores of resilience, emotion regulation and positive coping style were (3.36±0.63), (2.26±0.56) and (1.85±0.39) points, respectively. The median family cumulative risk index was 0 (interquartile range, 0). The results of mediating effects showed that family cumulative risk had a direct negative effect on positive coping style (β=-0.037, 95%CI: -0.059 to -0.014, P=0.011), and also had an indirect negative effect on positive coping style through psychological resilience (β=-0.029, 95%CI: -0.041 to -0.017, P=0.006) as a mediator or through psychological resilience and emotion regulation (β=-0.002, 95%CI: -0.004 to -0.001, P=0.001) as a chain mediator. The mediating effect of resilience contributed 44% to the total effect, while the chain mediating effect of resilience and emotion regulation contributed 3%. Conclusion Resilience and emotional regulation serve as negative mediators between family cumulative risk and positive coping style among middle and primary school students.

Objective:To compare the value of Liaoning scoring system, model for end-stage liver disease (MELD), model for end-stage liver disease-Na (MELD-Na) and Blatchford score in predicting high-risk esophageal varices (EVs), hemorrhage or re-hemorrhage within 1 year and blood transfusion treatment in cirrhotic patients.Methods:Clinical data of 170 patients with esophageal varices confirmed by endoscopy from January 2018 to September 2019 were recorded. Liaoning score, MELD, MELD-Na score and Blatchford score were calculated when the first endoscopy was performed. These patients were followed up, and hemorrhage or re-hemorrhage within 1 year was recorded. Receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) was used to evaluate the accuracy of 4 scoring systems in predicting high-risk EVs, hemorrhage or re-hemorrhage within 1 year after the first endoscopy and blood transfusion. Cut-off values were obtained, and groups divided by cut-off values were compared for the proportion of high-risk EVs and hemorrhage or re-hemorrhage.Results:The cut-off value of high-risk EVs in patients with cirrhosis predicted by Liaoning score was 0.45, and the AUC was 0.702 (95% CI:0.612-0.781, P<0.01), superior to MELD, MELD-Na and Blatchford score (AUC were 0.593, 0.648, 0.610, respectively). The proportion of high-risk EVs in Liaoning score ≥0.45 and <0.45 were 71.8% (89/124) and 34.8% (16/46) with significant differences ( χ2=19.442, P<0.01). The AUC of Liaoning score for predicting hemorrhage or re-hemorrhage within 1 year was 0.680 (95% CI: 0.595-0.765, P<0.01), superior to MELD, MELD-Na and Blatchford score (AUC were 0.605,0.615,0.598, respectively). AUC of Blatchford score for predicting blood transfusion was 0.775 (95% CI:0.687-0.863, P<0.01), superior to MELD, MELD-Na and Liaoning score (AUC were 0.653, 0.719, 0.631, respectively). Conclusion:Liaoning score can predict high-risk EVs, hemorrhage or re-hemorrhage within 1 year after the first endoscopy in patients with cirrhosis and is superior to MELD, MELD-Na and Blatchford score. Blatchford score can effectively predict whether cirrhosis patients with EVs need blood transfusion.

Objective To optimize the treatment process of patients in Ophthalmology Outpatient, so as to enhance patient′s satisfaction and quality of care service. Methods The nurse manager of Department of Ophthalmology experienced treatment process in other hospital with team and summarized the feeling of other hospital′s treatment process, and improve the treatment process according to the existed problems including reconstruction of Outpatient work process, the implementation of registration system in Outpatient, building up Office of Returning Visit, doing extended nursing, developing “I am patient” activity, training communication ability and skills for constructing doctor-patient relationship, strengthening health education and other nursing services. Results 2014 and 2015 in Ophthalmology Outpatient of our hospital, the patients′ waiting time for treatment became short after carrying out the experience of nurses′transposition experience ( P<0.05) , and the patients′satisfaction were significantly improved after exchanging ( P<0. 05 ) , as well as the reduction of effective complaint rate (P<0.05).Conclusions To optimize the treatment process of patients in Department of Ophthalmology can shorten the time of treatment waiting time, improve the satisfaction of outpatients, so as to improve the quality of nursing service.

Malignant digestive system tumors are a leading cause of cancer-related deaths in China,drawing significant attention in clinical and basic research owing to their complex molecular mechanisms.B7-H4,a member of the B7 protein family within the immunoglobulin su-perfamily,exerts various biological functions,primarily inhibiting T-cell activation and proliferation and blocking cytokine synthesis,thereby suppressing the immune response.Overexpression of B7-H4 in various tumor tissues is closely associated with tumor cell proliferation,dif-ferentiation,apoptosis,invasion,metastasis,and correlates with patient prognosis.Despite its crucial role in tumor onset and progression,the specific mechanism of B7-H4 action remains unclear.This article reviews the research progress on B7-H4 in gastrointestinal tumors,aim-ing to provide new perspectives for future studies.