BackgroundFamily factors are known to play a critical role in the development， progression and prognosis of adolescent patients with depressive disorder. Psychodrama group therapy has the potential for bringing about positive change in individual growth and relationship repair， but there is currently insufficient research evidence for the effectiveness of psychodrama group therapy in promoting the recovery in depressive disorder in adolescents through improving the family parenting skills of their parents. ObjectiveTo explore the influence of psychodrama group therapy based on family parenting intervention on parents of adolescent patients with depressive disorder， so as to provide references for promoting the recovery for adolescent patients with depressive disorder. MethodsPurposive sampling was used to recruit adolescent patients who met the diagnostic criteria for depressive disorder of the International Classification of Diseases， tenth edition （ICD-10） and hospitalized in the psychiatric outpatient department of the First Affiliated Hospital of Chongqing Medical University from October 2023 to March 2024， and their parents （either mother or father） were taken as the study subjects. Psychodrama group therapy based on family parenting intervention was performed once a week for 6 consecutive weeks. After intervention， semi-structured interviews were conducted with parents who participated in the group， and the interviews were recorded. Content analysis method was employed to perform qualitative analysis on the interview recordings and verbatim transcripts. ResultsAfter receiving psychodrama group intervention based on family parenting， parents of adolescent patients with depressive disorder demonstrated improvement in emotional state， enhanced reflective ability and altered coping style， which were specifically manifested as reducing negative emotions， increasing positive emotions， reflecting on themselves， empathizing with others， adjusting cognition， changing the way of stress regulation， improving communication styles and actively seeking resources. ConclusionApplication of psychodrama group therapy based on family parenting intervention may improve emotional state， reflective ability and coping style of the parents of adolescent patients with depressive disorder. ［Funded by Chongqing Education Commission Humanities and Social Science Research Project （number， 19SKGH018）； Chongqing Social Science Planning Project （number， 2021WT29）］

Objective To investigate the clinical characteristics of women with abnormal uterine bleeding(AUB)in sub-plateau regions and analyze the factors affecting their treatment methods.Methods AUB patients who were hospitalized from Jan 1,2018 to Dec 31,2022,in a sub-plateau region(Yongping County People's Hospital of Yunnan Province)with an average altitude of 1 620 meters were selected.The general clinical characteristics of the patients were summarized,and patients were classified into two categories(with or without uterine structural lesion)and nine subtypes(PALM-COEIN)according to the FIGO recommended etiological classification guidelines.Then the patients were divided into groups based on the presence or absence of uterine structural lesions,ethnic group(Han and minority),conservative drug treatment and surgical treatment groups,blood transfusion and non-blood transfusion groups.Binary Logistic regression analysis was used to identify factors affecting treatment methods.Results A total of 481 AUB patients enrolled,and the delayed consultation rate was as high as 80.46%,and the proportion of overweight and obese patients was 49.90%,which was higher than the average level among Chinese women.The main cause was AUB-O(AUB-ovulatory dysfunction),accounting for 78.59%of cases,the proportion of patients with delayed medical treatment was higher than those without delayed medical treatment(82.17%vs.74.47%).Patients who received blood transfusion were significantly younger,had lower hemoglobin(HGB)levels,fewer pregnancies,and lower BMI compared to those in the non-blood transfusion group(P<0.05).Univariate analysis showed that the surgical treatment group had older age,longer onset time,higher HGB levels,more pregnancies and deliveries,higher BMI,a higher proportion of Han ethnicity patients,lower rates of non-blood transfusion,higher rates of hypertension,and more uterine structural lesions compared to the conservative drug treatment group.Multivariate regression analysis revealed that blood transfusion treatment reduced the probability of surgical treatment.Age and uterine structural lesions were risk factors for requiring surgical treatment,for each additional year of age,the risk of undergoing surgical treatment increased by 10%.The risk of requiring surgical treatment for patients with uterine structural lesions was 2.987 times higher than for those without.Conclusion AUB patients in this sub-plateau regions have a high rate of delayed consultation and a high proportion of overweight and obesity,with AUB-O being the primary cause.Older age and the presence of uterine structural lesions were risk factors for requiring surgical treatment.

Objective To investigate the clinical characteristics of women with abnormal uterine bleeding(AUB)in sub-plateau regions and analyze the factors affecting their treatment methods.Methods AUB patients who were hospitalized from Jan 1,2018 to Dec 31,2022,in a sub-plateau region(Yongping County People's Hospital of Yunnan Province)with an average altitude of 1 620 meters were selected.The general clinical characteristics of the patients were summarized,and patients were classified into two categories(with or without uterine structural lesion)and nine subtypes(PALM-COEIN)according to the FIGO recommended etiological classification guidelines.Then the patients were divided into groups based on the presence or absence of uterine structural lesions,ethnic group(Han and minority),conservative drug treatment and surgical treatment groups,blood transfusion and non-blood transfusion groups.Binary Logistic regression analysis was used to identify factors affecting treatment methods.Results A total of 481 AUB patients enrolled,and the delayed consultation rate was as high as 80.46%,and the proportion of overweight and obese patients was 49.90%,which was higher than the average level among Chinese women.The main cause was AUB-O(AUB-ovulatory dysfunction),accounting for 78.59%of cases,the proportion of patients with delayed medical treatment was higher than those without delayed medical treatment(82.17%vs.74.47%).Patients who received blood transfusion were significantly younger,had lower hemoglobin(HGB)levels,fewer pregnancies,and lower BMI compared to those in the non-blood transfusion group(P<0.05).Univariate analysis showed that the surgical treatment group had older age,longer onset time,higher HGB levels,more pregnancies and deliveries,higher BMI,a higher proportion of Han ethnicity patients,lower rates of non-blood transfusion,higher rates of hypertension,and more uterine structural lesions compared to the conservative drug treatment group.Multivariate regression analysis revealed that blood transfusion treatment reduced the probability of surgical treatment.Age and uterine structural lesions were risk factors for requiring surgical treatment,for each additional year of age,the risk of undergoing surgical treatment increased by 10%.The risk of requiring surgical treatment for patients with uterine structural lesions was 2.987 times higher than for those without.Conclusion AUB patients in this sub-plateau regions have a high rate of delayed consultation and a high proportion of overweight and obesity,with AUB-O being the primary cause.Older age and the presence of uterine structural lesions were risk factors for requiring surgical treatment.

Objective:To evaluate the diagnostic performances of plasma placental extracellular vesicles (pcEV) and their clearance protein (Lactadherin) in predicting adverse pregnancy outcomes in patients with severe preeclampsia (sPE).Methods:This is a retrospective case-control study. 60 patients aged 32 (29, 36) years diagnosed with sPE at 27-37 weeks of pregnancy, who underwent prenatal examinations and delivered between January 31 th, 2018 and January 31 th, 2019, were recruited. According to the occurrence of endpoint events (fetal distress and/or fetal growth restriction), sPE patients were further divided into an event group of 34 cases and a non event group of 26 cases. 33 healthy pregnant women of the same gestational age were selected as the control group, aged 31 (29, 36) years old. 25 non pregnant healthy women were selected as the healthy control group, aged 26 (25, 38) years old. Flow cytometry was used to detect placental alkaline phosphatase antibody positivity as pcEV, while membrane surface expression of phosphatidylserine, i.e. membrane associated protein V (AV) positivity as AV +pcEV. ELISA kits were used to detect the level of Lactadherin. Logistic regression was used to perform multiple correlation analysis. The performances of pcEV and Lactadherin in predicting adverse pregnancy outcomes were evaluated by the receiver operating characteristic (ROC) curve. Survival analyses were performed by the Kaplan Meier curve. The hazard ratios (HR) was calculated by the Cox proportional risk regression model. Results:The plasma AV +pcEV levels in sPE patients were 8 260 (4 991, 16 751)/μl, which were higher than 1 088 (784, 1 871)/μl of healthy pregnant women and 206 (116,256)/μl of healthy controls ( H=94.490, P<0.05). The plasma AV +pcEV levels in sPE patients with endpoint events were 11 225 (7 496, 20 599)/μl, which were higher than 5 199 (2 914, 8 347)/μl of patients without endpoint events ( U=178, P<0.05). The plasma levels of Lactadherin in sPE patients were 2 635 (1876, 3 137) pg/ml, which were higher than 1 597 (1 287, 1 818) pg/ml in healthy pregnant woman and 1 123 (749, 1 405) pg/ml in healthy controls ( H=54.307, P<0.05). ROC showed that the critical value of AV +pcEV predicting fetal distress and/or fetal growth restriction events within 77 days in sPE patients was 6 524/μl and area under the curve(AUC) was 0.799 (95% CI 0.680-0.917). The critical value of Lactadherin was 2 336.5 pg/ml and AUC was 0.702 (95% CI 0.564-0.841). Logistic regression analysis showed that there was a significant correlation between AV +pcEV levels in sPE patients and 24-hour urine protein quantification ( OR=9.288, 95% CI 1.993-43.293), as well as the need for combined antihypertensive therapy ( OR=18.690, 95% CI 1.919-182.077) ( P<0.05). Survival analysis showed that the cumulative probability of fetal distress and/or fetal growth restriction events within 77 days were significantly increased in sPE patients with AV +pcEV levels above the critical value (Log-rank χ 2=21.430, P<0.05). The Cox proportional regression model showed that the levels of AV +pcEV can independently identify fetal distress and/or fetal growth restriction events ( HR=7.983, P<0.05). Conclusions:The changes of pcEV in plasma of pregnant women in late pregnancy were related to the development of PE. High concentrations of pcEV suggested an increased risk of fetal distress and fetal growth restriction, and pcEV could serve as an effective marker for early warning of adverse pregnancy outcomes.

Acute respiratory distress syndrome (ARDS) is a leading cause of high mortality in critically ill patients in intensive care units (ICU). Prone ventilation is one of the important treatment methods for ARDS, but due to the severity of the patients' conditions, their physical weakness, and poor cooperation, it is difficult for them to adjust to the prone position on their own. This requires a large number of medical staff to adjust the patient to a prone position and implement prone ventilation for than 12 hours daily to achieve therapeutic effects. Clinical implementation often faces challenges such as a shortage of staff, patient discomfort, difficulty in changing positions prolonged time leading to bedsores, and lack of auxiliary equipment. It is particularly challenging for ARDS patients, especially those in critical condition, to adjust their on their own. Therefore, healthcare workers from the department of emergency of Yingtan 184 Hospital designed a prone and side lying double-purpose inflatable mattress for ARDS, and obtained the National Utility Model Patent of China (patent number: ZL 2023 2 1249425.7). The prone and side lying dual-purpose inflatable mattress mainly consists of a main mattress, a forehead pad, a prone position pad, and bilateral side lying position pads. The prone position pad and the lateral position pad on both sides are relatively independent, and can be inflated separately through their inflation nozzles to meet the ventilation needs of ARDS patients in prone or lateral positions, making it easy to adjust the patient's position. This mattress is reasonably designed, simple in structure, easy to operate, comfortable, and practical. It has transformation, promotion, and application value.

Objective To investigate the effects of circ_UBE2C on the proliferation and glycolysis of lung cancer cells and its mechanism of action.Methods The expression of circ_UBE2C,miR-107,and hexokinase 2(HK2)in lung cancer tissues and normal lung tissues were analyzed based on the The Cancer Genome Atlas(TCGA)database.Kaplan-Meier survival curve was plotted to analyze the correlation between circ_UBE2C/miR-107/HK2 expression and survival of the lung cancer patients.qRT-PCR was used to detect the expression of circ_UBE2C and miR-107,and Western blotting was employed to measure the expression of HK2 and PCNA in human normal lung epithelial cells(BEAS-2B)and human lung cancer cell lines(A549,NCI-H460,and NCI-H1299).Then A549 and NCI-H1299 cells were divided into the blank group(NC),circ_UBE2C knockdown group(si-circ),HK2 knockdown group(si-HK2),simultaneous knockdown of miR-107+HK2 group(miR-inhibitor+si-HK2),and simultaneous knockdown of circ_UBE2C+miR-107 group(si-circ+miR-inhibitor).CCK-8 assay and colony formation assay were employed to measure the proliferation of above cell groups.The glucose uptake,lactate generation,and ATP production in the cells were measured by glucose uptake colorimetric assay kit,lactic acid detection kit,and ATP content determination kit,respectively.Seahorse XF glycolytic stress test and Seahorse XF cellular mitochondrial stress test were respectively performed to detect the extracellular acidification ratio(ECAR)and cellular oxygen consumption ratio(OCR).The targeting relationship between the circ_UBE2C and miR-107,and miR-107 and HK2 was validated by dual-luciferase reporter gene assay.Results Compared with normal lung tissues,the expression of circ_UBE2C and HK2 was up-regulated,while that of miR-107 was down-regulated in lung cancer tissues(P＜0.05).The expression of circ_UBE2C and HK2 was elevated,and that of miR-107 was reduced in A549 and NCI-H1299 cells when compared with BEAS-2B cells(P＜0.05).Survival analysis showed that the patients with high expression of circ_UBE2C and HK2 or low expression of miR-107 had shorter survival(P＜0.05).Compared with the NC group,both si-circ and si-HK2 resulted in significantly reduced proliferation,glucose uptake,lactate generation,ATP production,and ECAR and OCR values in A549 and NCI-H1299 cells(P＜0.05).Dual luciferase reporter gene assay confirmed that circ_UBE2C could directly bind to and negatively regulate miR-107 expression.HK2 was then identified as a downstream target of miR-107.Compared with the si-HK2 group,the proliferative ability and glycolysis level of A549 and NCI-H1299 cells were significantly increased in the miR-inhibitor+si-HK2 group and the si-circ+miR-inhibitor group.Conclusion Knockdown of circ_UBE2C significantly suppresses the proliferation and glycolysis of lung cancer cells via targeting up-regulation of miR-107 and then exerting inhibitory effect on HK2 expression.

Objective:To describe the current status of the resilience of the primary caregivers ′ families of patients with first-ever stroke and to explore the factors that influence it, in order to assist medical professionals in timely identification of related factors, formulate targeted nursing rehabilitation programs, and provide better support and care to patients and their families. Methods:Using convenience sampling, the primary caregivers ′ families of patients with first-ever stroke admitted to The First Affiliated Hospital of Naval Medical University of the People ′s Liberation Army of China and Shanghai Tenth People ′s Hospital from May 2021 to January 2022 were selected as subjects for a cross-sectional survey of family resilience. The Family Resilience Assessment Scale was used to evaluate the primary caregivers of first-ever stroke patients, and multiple linear regression was employed to clarify the influencing factors of the family resilience of primary caregivers. Results:A total of 307 questionnaires were distributed, and 288 valid questionnaires were collected. There were 84 males and 204 females, aged ≤30 years old with 23 cases, aged 31-40 years old with 63 cases, aged 41-50 years old with 63 cases, aged 51-60 years old with 32 cases, aged ≥ 61 years old with 107 cases. The total score of family resilience of the primary caregivers was (210.80±17.32) points. Univariate analysis showed that there were statistical differences in the caregiver ′s occupational status, relationship with the patient, age, family residence, marital status, type of family, daily caregiving time, and the patient ′s gender and age with the caregiver ′s family resilience score ( t=2.06, -3.38, F values were 4.96-21.32, all P<0.05). The level of family resilience of primary caregivers was positively correlated with social support, positive coping methods, and family support ( r=0.375, 0.627, 0.642, all P<0.05), and negatively correlated with caregiving burden and negative coping methods ( r=-0.444, -0.563, both P<0.05). The multiple linear regression equation showed that social support, family support, positive coping, and negative coping were the main influencing factors of the family resilience of primary caregivers of patients with first-ever stroke ( t values were -6.68-6.27, all P<0.05), explaining 57.5% of the variance in family resilience. Conclusions:The family resilience of primary caregivers of patients with first-ever stroke is at a high level. Primary caregivers who receive more family support and social support, and who adopt positive coping methods and reduce negative coping methods, have higher levels of family resilience.

Objective To establish a method for detecting the 2019 novel coronavirus subgenomic RNA(sgRNA),and evaluate the performance of the established method.Methods Primers and probes were designed according to the subgenomic sequence of the 2019 novel coronavirus,and a reverse transcription PCR method for sgRNA detection was established.The established method was optimized,including the concentration and propor-tion of primers and probes,extension temperature,reaction volume and template amount.The performance of the method was evaluated,including the limit of detection,sensitivity,specificity and repeatability.sgRNA and genomic RNA(gRNA)were detected in clinical samples,and the results were analyzed.Results In this study,an RT-PCR method for the detection of sgRNA of the 2019 novel coronavirus was established.The limit of detection of this method was 100 copies/mL,and the detection results of common pathogens were negative.The CV of sgRNA in high,medium and low concentration samples were less than 5%.sgRNA was positive in 115 suspected 2019 novel coronavirus infected patients(115/330,34.85%).When the Ct value of gRNA-N was less than 30,the positive rate of sgRNA was 100.00%.When the Ct value of gRNA-N was in the range of 30-32,the positive rate of sgRNA was 68.75%.When the Ct value of gRNA-N was in the range of 32-35,the positive rate of sgRNA was 44.44%.When the Ct value of gRNA-N was greater than 35,the sgRNA was negative.Conclusion The RT-PCR method for the detection of sgRNA of the 2019 novel coronavirus was established,and the detection method was sensitive,specific and reproducible.

OBJECTIVE: To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea. METHODS: Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints. RESULTS: Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group (P>0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group (P<0.05, P<0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group (P<0.05). CONCLUSION In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.
Humans ; Female ; Microcirculation ; Dysmenorrhea/therapy* ; Menstrual Cycle ; Acupuncture Points ; Acupuncture Therapy

Objective:To analyze the molecular epidemiological characteristics of Campylobacter fetus subsp. testudinum ( Cft). Methods:Fifteen strains of Cft collected in our laboratory from 2010 to 2022 were subjected to whole-genome sequencing. Their epidemiological characteristics were analyzed based on the global genome data of Cft on GenBank database. MLST-GrapeTree software was used to obtain the genetic structure of Cft strains. A phylogenetic tree was constructed using core-genome single nucleotide polymorphism (cgSNP) analysis, and the sequence clusters were identified using rhierBAPS. Virulence genes and drug resistance genes of Cft strains were annotated using CARD, ResFinder and VFDB database. Their susceptibility to antibiotics was tested using E-test method and the results were analyzed using the CLSI-M45 sensitivity standard for Campylobacter jejuni/ Campylobacter coli. Results:Based on average nucleotide identity (ANI) analysis, the genome data of 41 Cft strains including 24 isolated from human, 13 from animals and four of unknown sources were collected from GenBank database. Among the 24 human-derived strains, 20 were linked to Asian descent and only one was linked to Caucasian descent (spouse of Asian descent), showing statistically significant differences in human ethnicity. All of the 13 animal-derived strains were originated from reptilian sources, including six from turtles, four from snakes and three from lizards. MLST revealed that ST46 was the predominant ST in China, while ST15 was the major sequence type in the United States. Grapetree analysis also demonstrated that the genetic diversity in China was greater than that in the United States. The phylogenetic tree constructed based on cgSNP and BAPS identified six distinct sequence clusters. The Chinese isolates were scattered in diverse sequence clusters and closely related to animal-derived strains, while the American isolates mainly belonged to ST15. The genes encoding virulence factors such as flagella, glycosylation systems and adhesins were carried by all of the 41 Cft strains (100.00%). The invasion-related virulence genes, such as the genes encoding the IV type secretion system ( virB4, virB9, virD4) and the resistance-related tetO efflux pump gene were specifically identified in the emerging ST74 clones. In vitro drug susceptibility testing of 15 Chinese isolates revealed 46.67% of the Cft strains were resistant to ciprofloxacin and 100.00% were sensitive to erythromycin. Conclusions:The global sequence clusters of Cft isolates showed a great genetic diversity. Most of the people with Cft infection had basic immune diseases and might have eaten or had contact with reptiles. Notably, the Chinese domestic infection of ST46 and the emerging ST74 should arouse our more attention.