Objective To investigate the relationship between symptom burden and rehabilitation self-efficacy of patients after fragility fracture surgery,and to study the chain mediating role of social support and perceived stress in the influence of symptom burden on rehabilitation self-efficacy of such patients.Methods Approved by the Ethics Committee of the hospital,168 patients who met the admission criteria after fragility fracture surgery admitted to the Second Affiliated Hospital of Inner Mongolia Medical University from July 2020 to December 2023 were included in the study by convenient sampling method,and general data of the patients were collected.M.D.Anderson Symptom Inventor(MDASI),Self-Efficacy for Managing Chronic Disease 6-Item Scale(SECD6),Social Support Rating Scale(SSRS)and Perceived Stress Scale(CPSS)were used to investigate the above patients,and multiple sets of quantitative data were analyzed for attribution association profile and mediation effect.Results After removing invalid questionnaires,a total of 160 valid questionnaires were collected,with an effective response rate of 95.24％.Correlation analysis showed that symptom burden was negatively correlated with rehabilitation self-efficacy(r=-0.405,P＜0.05);social support was significantly positively correlated with rehabilitation self-efficacy(r=0.558,P＜0.05);perceived stress was negatively correlated with rehabilitation self-efficacy(r=-0.330,P＜0.05);symptom burden was negatively correlated with social support(r=-0.191,P＜0.05);social support was negatively correlated with perceived stress(r=-0.280,P＜0.05);symptom burden was positively correlated with perceived stress(r=0.376,P＜0.05).Mediating effect test showed that the symptom burden of patients after fragility fracture surgery had a direct impact on rehabilitation self-efficacy(β=-0.402,t=0.148,P＜0.05),and had an impact on rehabilitation self-efficacy through 3 mediating pathways:first,the mediating effect of social support alone(β=-0.098,95％CI:-0.112～-0.074);the second was the mediating effect of stress perception alone(β=-0.081,95％CI:-0.104～-0.061);the third is the chain mediating effect of social support and stress perception(β=-0.056,95％CI:-0.074～-0.030).Conclusion The burden of symptoms after fragility fracture surgery has a direct effect on rehabilitation self-efficacy.Symptom burden influences postoperative self-efficacy of patients with fragility fractures through the chain mediation of social support and perceived stress.Early and accurate assessment of symptom burden,stress perception and social support should be conducted.According to needs,the multidisciplinary medical team provides individualized and diversified health education support to actively help and guide the self-regulation of patients'stress perception,so as to reduce patients'symptom burden and promote the improvement of their self-efficacy in the process of rehabilitation.

The prevention and treatment of adolescent depression and suicide represent a current focal point. Therefore, it is crucial to understand the risk factors for suicide in adolescents with depression, scientifically monitor suicide risk, and conduct a multidisciplinary collaboration. There is still a lack of authoritative, evidence-based guidelines in China on how to assess suicide risk early time and how to take targeted prevention. This paper introduces the bio-psycho-social joint intervention model, aiming to help clinicians comprehensively assess the suicide risk in adolescents with depression. The author discussed comprehensive assessment methods and a collaborative system involving family, school, medical, and community entities working together as more effective interventions.

Objective To investigate the relationship between symptom burden and rehabilitation self-efficacy of patients after fragility fracture surgery,and to study the chain mediating role of social support and perceived stress in the influence of symptom burden on rehabilitation self-efficacy of such patients.Methods Approved by the Ethics Committee of the hospital,168 patients who met the admission criteria after fragility fracture surgery admitted to the Second Affiliated Hospital of Inner Mongolia Medical University from July 2020 to December 2023 were included in the study by convenient sampling method,and general data of the patients were collected.M.D.Anderson Symptom Inventor(MDASI),Self-Efficacy for Managing Chronic Disease 6-Item Scale(SECD6),Social Support Rating Scale(SSRS)and Perceived Stress Scale(CPSS)were used to investigate the above patients,and multiple sets of quantitative data were analyzed for attribution association profile and mediation effect.Results After removing invalid questionnaires,a total of 160 valid questionnaires were collected,with an effective response rate of 95.24％.Correlation analysis showed that symptom burden was negatively correlated with rehabilitation self-efficacy(r=-0.405,P＜0.05);social support was significantly positively correlated with rehabilitation self-efficacy(r=0.558,P＜0.05);perceived stress was negatively correlated with rehabilitation self-efficacy(r=-0.330,P＜0.05);symptom burden was negatively correlated with social support(r=-0.191,P＜0.05);social support was negatively correlated with perceived stress(r=-0.280,P＜0.05);symptom burden was positively correlated with perceived stress(r=0.376,P＜0.05).Mediating effect test showed that the symptom burden of patients after fragility fracture surgery had a direct impact on rehabilitation self-efficacy(β=-0.402,t=0.148,P＜0.05),and had an impact on rehabilitation self-efficacy through 3 mediating pathways:first,the mediating effect of social support alone(β=-0.098,95％CI:-0.112～-0.074);the second was the mediating effect of stress perception alone(β=-0.081,95％CI:-0.104～-0.061);the third is the chain mediating effect of social support and stress perception(β=-0.056,95％CI:-0.074～-0.030).Conclusion The burden of symptoms after fragility fracture surgery has a direct effect on rehabilitation self-efficacy.Symptom burden influences postoperative self-efficacy of patients with fragility fractures through the chain mediation of social support and perceived stress.Early and accurate assessment of symptom burden,stress perception and social support should be conducted.According to needs,the multidisciplinary medical team provides individualized and diversified health education support to actively help and guide the self-regulation of patients'stress perception,so as to reduce patients'symptom burden and promote the improvement of their self-efficacy in the process of rehabilitation.

The prevention and treatment of adolescent depression and suicide represent a current focal point. Therefore, it is crucial to understand the risk factors for suicide in adolescents with depression, scientifically monitor suicide risk, and conduct a multidisciplinary collaboration. There is still a lack of authoritative, evidence-based guidelines in China on how to assess suicide risk early time and how to take targeted prevention. This paper introduces the bio-psycho-social joint intervention model, aiming to help clinicians comprehensively assess the suicide risk in adolescents with depression. The author discussed comprehensive assessment methods and a collaborative system involving family, school, medical, and community entities working together as more effective interventions.

Objective To investigate the prevalence of Spirometra mansoni infections in hosts in Jiangsu Province, so as to provide the scientific basis for the management of sparganosis mansoni. Methods From 2018 to 2019, nine counties (cities, districts) were randomly selected from Jiangsu Province as the survey sites, and 100 healthy individuals were randomly selected to perform the serological test of S. mansoni infections and the detection of S. mansoni eggs. The procercoids were detected in the intermediate host Cyclops, and the S. mansoni eggs were identified in the stool samples of the definitive hosts cats and dogs. Results The prevalence of S. mansoni human infections was 0 (0/900) in the 9 survey sites of Jiangsu Province, and the sero-prevalence of the specific IgG antibody against S. mansoni was 1.22% (11/900). The positive rate of procercoids was 0.33% (3/900) in Cyclops. In addition, the S. mansoni egg-positive rate was 1.48% (2/135) in cats and dogs. Conclusions Sparganosis mansoni is prevalent in Jiangsu Province. Health education pertaining to the damages of sparganosis mansoni and the route of S. mansoni infections should be improved.

correlation with cross-sectional area and negative correlation with bucking ratio. The effect of fat mass on hip geometric parameters at the three regions was inconsistent. (3) Fat mass and percentage of body fat ( Fat%) showed negative correlation with cross-sectional area and average cortical thickness and positive correlation with bucking ratio in young group. However, the negative contribution produced by fat mass and Fat% to hip geometric structure became weaker gradually in middle-aged and older groups. ( 4 ) Limb lean mass yielded the largest positive contribution to cross-sectional area and average cortical thickness at all three regions in young group. However, the contribution produced by trunk lean mass became the largest positive contribution to cross-sectional area and average cortical thickness in older group. Conclusions Among all the body composition parameters, hip BMD has showed the most marked correlation with hip geometric structure. Lean mass is ranked the second in the correlation. The impacts of fat mass and lean mass on hip geometry are changing with aging and their different tissue distributions.

Objective Investigate the operative techniques and early results of a normal thermic and non-cardiopulmonary bypass fashion to perform total thoracoabdominal aortic aneurysm repair (tTAAAR).Methods Between February 2009 and December 2010,41 patients with extensive Crawford Ⅱ thoracoabdominal aortic aneurysm (TAAA) underwent tTAAAR in our hospital.Among them,27 patients underwent tTAAAR in a normal thermic and non-cardiopulmonary bypass fashion.The mean age of this group of patients is (41.85 ± 10.11 ) years ( range 23-61 years),including 18 male and 9 female.The operation was performed via a combined left thoracoabdominal incision.The intercostal incision was through the left fifth (or sixth) intercostal space and an amputated costal arch.The abdominal incision was from the left linea pararectalis to the level of the pubic symphysis via a retroperitoneal approach.The diaphragm was incised circularly to expose the aorta.After the iliac arteries and proximal descending aorta were dissected and exposed sufficiently,two 10 mm side branches were anastomosed to iliac arteries in an end to side fashion.When this was accomplished,the proximal end of the main graft was anastomosed to the proximal descending aorta in an end to end fashion.Then the bypass from descending aorta to bilateral iliac arteries was established under normal thermia.The reestablishment of intercostal arteries and visceral arteries was followed with subsection circulatory arrest.Results The procedure was succeeded in all 27 patients but 1 patient died during operation because of pulmonary hemorrhage.The mean descending aortic circulatory arrest time was ( 13.78 ± 3.77 ) min,the spinal cord ischemia time was ( 19.19 ± 3.93 ) min,and the visceral organs ischemia time was ( 25.19 ± 5.88 ) min,respectively.Mean intubation time is (24.62 ±21.70) hours.Mean ICU stay time is ( 1.84 ± 1.29) days.Two of the 26 survivors suffered permanent spinal cord injury.The morbidity of pulmonary complication,temporal cerebral complications,renal failure,reoperation for hemorrhage,and delayed healing of incision was 11.54％,3.85％,3.85％,3.85％,7.69％,respectively.One Marfan patient suffered Stanford type A aortic dissection after 9 days of tTAAAR.She was rescued by emergency operation.Mean follow-up time was ( 16.04 ± 5.62 ) months,with a follow-up rate of 100％.No late death was found.Conclusion The normal thermic and noncardiopulmonary bypass tTAAAR is a reliable and effective therapeutic strategy for these patients.But the indication of this procedure is limited.If the thoracoabdominal aortic aneurysm grows too huge,the normal thermic tTAAAR cant be performed.So the TAAA patients in China should be treated in their early stage.

Objective To investigate bone health conditions in 1637 aged women. Methods From May 2004 to October 2008, Bone mineral density (BMD) of 1637 women at age of more than 60 years old were measured by Hologic DephiA dual energy X-ray absorptiometry (DXEA) in Huadong hospital affiliated to Fudan University. All data were compared and analyzed among each group which will be divided by every ten years. Those women were divided into groups on 10 years range. BMD of lumbar vertebral and hip bone,fracture incidence and bone turnover marker were compared and analyzed. Results (1) BMD: at age of 3=90, 80 - 89, 70 - 79, 60 - 69, BMD of the lumbar vertebral 2 - 4(L2-4) values were (0. 96 ± 0. 18),(0. 90 ± 0. 20) , (0. 81 ± 0. 16) , (0. 83 ± 0. 14) g/cm2 , respectively. There were significantly increased BMD of lumbar of women at the age of 80 - 89 and ≥90 year-old compared with those of 60 - 69 year-old (P<0. 05). At age of ≥90,80 -89,70-79,60 -69 BMD of femur neck, Total, Torch, Ward's trianger were(0. 60 ±0. 11) , (0. 65 ±0. 11) ,(0. 47 ±0. 09) ,(0. 37 ±0. 09) g/cm2; at age of 80 -89 BMD of FN,Total, Torch, Ward's trianger were(0. 57 ±0. 10) , (0. 68 ±0. 13) , (0. 48 ±0. 11) , (0. 35 ±0. 10) g/cm2;at age of 70-79 BMD of FN, Total, Torch, Ward's trianger were (0.57±0. 10) ,(0. 69 ±0. 12), (0.49± 0. 10) , (0. 36 ± 0. 11) g/cm2; at age of 60 - 69 BMD of FN, Total, Torch, Ward's trianger were (0. 63 ± 0. 10) , (0. 76 ±0. 12) , (0. 54 ±0. 10), (0. 45 ±0. 15) g/cm2; There were significantly decreased in BMD of hip at the age of 70 - 79, 80 - 89,≥90 year-old compared with those of 60 - 69 year-old (P < 0. 05).(2) Fracture incidence: one time fracture incidence at age of 60 - 69,70 - 79,80 - 89, ≥ 90 were 34. 8 % (242/695) ,45. 0% (296/658) ,51. 3% (137/267) ,5/17. There were increasing trend of fracture in aged women. (3) Bone turnover marker of bone Gla protein (BGP) N-mid(N-midBGP) in serum and C-terminal telopeptide of type Ⅰ collagen/Cr (CTX/Cr) in urine values were (17 ±5) μg/L, (106 ±56) μg/mmol at age of more than 90 years ,(17 ±7) (μg/L,(128 ±99)μg/mmol at age of 80-89 years,(21 ± 14) μg/L,(182 ± 173)μg/mmol at age of 70-79 years, (25±13)μg/L, (190 ± 168)μg/mmol at age of 60 - 69 years. There were significant decreased trends of N-midBGP at age of 70 -79,80 -89 compared with that of 60-year (P < 0. 05). There were significant decreased trends of CTX/Cr 80 - 89 compared with that of 60-year (P < 0. 05). Conclusions There were significant decreased bone metabolism in aged women. The risk of hip fracture is significantly increased in aged women. Diagnosis of osteoporosis based on BMD of hip in aged women is more reliable.

Objective To investigate the feasibility of amplitude of intraoperative nerve action potentials (NAP) for early quantitative diagnosis of peripheral nerve injury. Methods The sciatic nerve injury model were established in 16 rabbits. Intraoperative NAP were recorded after 4 weeks. According to amplitude of NAP, the injuried nerve were divided into 3 groups: NAP ＜ 100 μV in A group, 100 μV ≤NAP ＜ 500 μV in B group, NAP ≥ 500 μV in C group. Nerve specimen 1cm distal to injuried point were resected that received glycine silver stain and image analysis including number, diameter and cross section area of regenerative axons. Footprint parameter and ulcer area were measured and contrasted between each two groups. Results The number, diameter and cross section area of A group regenerative axons have significant difference with B and C group, no significant difference between B and C group; Footprint parameter and ulcer area have significant difference in each two groups. Conclusion Amplitude of intraoperative NAP can be a quantitative criteria to diagnose the degree of peripheral nerve injury that provides experiment evidence for guide intraoperative decision-making in clinical practice.