ObjectiveTo develop an emotion management course and evaluate its effectiveness in improving emotion regulation, coping strategies, and anxiety and depression among first-year university students, so as to provide a basis for colleges to optimize mental health education courses. MethodsUsing a multi-stage cluster random sampling method, five classes of first-year students (n=169) from a university were randomly selected as participants, with three classes assigned to the experimental group (n=102) and two classes to the control group (n=67). The experimental group attended both the standard mental health education course and the emotion management course developed in this study, while the control group only attended the standard mental health education course. Pre- and post-intervention assessments were conducted using the Emotion Regulation Questionnaire (ERQ), Simplified Coping Style Questionnaire (SCSQ), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). ResultsBefore the intervention, there were no significant differences between the experimental group and the control group in ERQ, SCSQ, SDS, and SAS scores (P>0.05). After the intervention, the experimental group demonstrated greater improvements than the control group in the ERQ expression inhibition subscale (14.42±5.05, 16.12±5.65), SCSQ positive coping tendency (1.97±0.51, 1.80±0.49) and negative coping tendency (1.26±0.55, 1.47±0.50), as well as in SDS (50.26±11.48, 53.86±8.21) and SAS (43.96±11.97, 47.59±9.50) scores (t value: 2.039, 2.144, 2.572; Z value: -2.214, -2.486; P<0.05). Compared with pre-intervention scores, the experimental group also showed improvements in the ERQ cognitive reappraisal subscale (32.19±5.76, 30.92±6.18), SCSQ positive coping tendency (1.97±0.51, 1.83±0.48), and SDS scores (50.26±11.48, 50.75±11.59) (t value: -2.654, -3.027; Z value: -2.100, P<0.05). ConclusionThe emotion management course effectively enhances students’ use of cognitive reappraisal strategies while reducing reliance on expressive suppression. It also contributes to improvements in coping strategies for life events and alleviates symptoms of depression and anxiety. Universities should consider integrating emotion management education into their curricula to enhance the mental well-being of first-year students.

Objective:To investigate the safety and effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pediatric pancreaticobiliary maljunction (PBM).Methods:Data of 40 pediatric patients under 14 with PBM diagnosed and treated by ERCP at Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from November 2012 to September 2022 were collected. PBM types, ERCP-related diagnosis and treatment, adverse events and prognosis were retrospectively analyzed.Results:Nineteen cases were P-B type (joining of common bile duct with pancreatic duct), 17 were B-P type (joining of pancreatic duct with common bile duct), and 4 were complex type. Forty children with PBM underwent 50 ERCP-related operations, among which 48 procedures succeeded. One case failed during cannulation of ERCP, replaced by rendezvous-assisted endoscopic retrograde pancreatography (RV-ERP) afterwards. There were no serious postoperative adverse events such as bleeding, perforation or death. Thirty-four patients (85%) were followed up successfully, among which 14 underwent further surgery and 20 continued conservative treatment.Conclusion:ERCP is the golden standard to diagnose pediatric PBM, and it is also safe and effective treatment for PBM.

OBJECTIVE To compare the changes of chemical components of Morus alba leaves， screen differential markers， and determine their contents， so as to provide reference for quality control of M. alba leaves before and after baked with honey. METHODS The fingerprints of M. alba leaves before and after baked with honey were established by high-performance liquid chromatography （HPLC）. The common peaks of the fingerprints were identified and the similarity was evaluated. The differential markers of M. alba leaves before and after baked with honey were screened by principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） using common peak are of raw material and product baked with honey of M. alba leaves as index. The quantitative analysis was carried out. RESULTS Twenty-three and twenty-four common peaks were identified from the HPLC fingerprint spectra of ten batches of raw material and ten batches of product baked with honey of M. alba leaves， respectively. The similarities of HPLC fingerprints for raw material and product baked with honey of M. alba leaves were all greater than 0.97. The results of PCA showed that raw material and product baked with honey of M. alba leaves could be divided into two categories. The results of OPLS-DA showed that the variable importance in projection of peak 2， peak H （5- hydroxymethylfurfural）， peak 1， peak 17 （isochlorogenic acid C） and peak 16 were all greater than 1. The average contents of differential marker of isochlorogenic acid C in raw material and product baked with honey of M. alba leaves were 0.093 6 and 0.127 8 mg/g， respectively； there was statistical significance （P＜0.05）. CONCLUSIONS Five differential markers such as isochlorogenic acid C are obtained. The content of isochlorogenic acid C in M. alba leaves is significantly increased after baked with honey.

Objective To investigate the correlation between the expression of serum 25hydroxyvitamin D[25(OH)D]and growth differentiation factor 15(GDF-15)levels and the risk of malignancy in patients with metabolic syndrome(MS)and the development of combined thyroid nodules(TN).Methods From August 2019 to August 2023,185 MS patients who visited the First Affiliated Hospital of Xinjiang Medical University were regarded as the study subjects,according to the results of thyroid ultrasound examination,they were separated into MS group(n=73)and MS+TN group(n=112).According to the malignant grading of thyroid nodules,MS+TN patients were separated into benign group(n=89)and malignant group(n=23).Another 68 healthy individuals who underwent physical examinations were regarded as control group.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of serum 25(OH)D and GDF-15 in each group.Pearson was applied to analyze the correlation between serum 25(OH)D and GDF-15 levels and clinical indicators in MS in TN patients.Multivariate Logistic regression was applied to analyze the influencing factors of malignant TN in patients with MS combined with TN.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum 25(OH)D and GDF-15 levels in MS with malignant TN.Results Comparison of serum 25(OH)D(30.41±6.73 ng/ml,27.23±6.15 ng/ml,24.67±4.38 ng/ml)and GDF-15(167.99±22.56 ng/L,239.75±25.92 ng/L,286.63±26.04 ng/L)levels in control,MS and MS+TN groups,the differences were statistically significant(F=22.219,472.113,all P<0.05).Compared with the benign group,the serum 25(OH)D(26.28±4.53 ng/ml vs 18.44±3.79 ng/ml)level in the malignant group was obviously reduced,while the GDF-15(276.93±24.53 ng/L vs 324.17±31.89 ng/L)level was obviously increased,the differences were statistically significant(t=7.631,7.718,all P＜0.05).The BMI,age,FPG,TG,TSH and TGAb levels of patients in the malignant group were obviously higher than those in the benign group,the difference were statistically significant(t=2.868,3.523,3.542,3.603,4.581,5.516,all P＜0.05).Pearson correlation analysis,and the serum 25(OH)D level in MS patients with TN was negatively correlated with FPG,TSH,TG and TGAb levels(r=-0.302,-0.482,-0.524,-0.546,all P<0.001),while GDF-15 level was positively correlated with TG,TSH,TGAb and FPG levels(r=0.467,0.541,0.578,0.623,all P<0.05).Multivariate logistic regression analysis,GDF-15(OR=1.673,95%CI:1.146～2.442)was a risk factor for the occurrence of malignant TN in MS patients(P<0.05),and 25(OH)D(OR=0.744,95%CI:0.604～0.916)was a protective factor for the occurrence of malignant TN,the AUC values of serum 25(OH)D and GDF-15 levels in the diagnosis of MS combined with malignant TN were 0.813,0.799 and 0.930,respectively,and the combination was superior to the single diagnosis(Z=2.088,2.021,P=0.037,0.043).Conclusion The levels of serum 25(OH)D and GDF-15 in patients with MS combined with TN are obviously correlated with nodular nature.The decrease in serum 25(OH)D level and the increase in GDF-15 level are risk factors for malignant TN in MS patients.

Objective:To explore the effectiveness and safety of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD).Methods:A retrospective analysis was conducted on data of 16 patients who underwent EUS-PD because of endoscopic retrograde pancreatography (ERP) failure, poor effectiveness or anatomical changes and couldn't undergo the routine ERP in Nanjing Drum Tower Hospital from June 2018 to July 2022. The technical success of EUS-PD, clinical efficacy and post-procedure adverse events were analyzed.Results:In the 16 patients, there were 14 males and 2 females, with age of 50.69±12.95 years. A total of 19 times of EUS-PD operations were included, 3 of them were rendezvous-assisted endoscopic retrograde pancreatography (RV-ERP), 15 transgastric or transenteric EUS-guided stent placement and 1 was EUS-guided nasopancreatic duct placement. Technical success was achieved in 84.21% (16/19) patients, and among whom 93.75% (15/16) achieved clinical success. The overall incidence of postoperative adverse events was 52.63% (10/19) including 47.37% (9/19) abdominal pain, 15.79% (3/19) fever and 15.79% (3/19) postoperative pancreatitis. All adverse effects were relieved after general conservative treatment and no primary disease or surgery-related death occurred. The mean follow-up was 17.6 (8.2,22.3) months and 93.75% (15/16) of the patients were followed up. By the time of follow-up, 76.92% (10/13) of the patients who had successfully received EUS-PD had no recurrence of abdominal pain or distension.Conclusion:EUS-PD is a safe and effective alternative therapy for those with pancreatic diseases with ERP failure, poor efficacy or anatomical changes.

To solve the problems of insufficient airway opening, insufficient or excessive ventilation, ventilation interruption, and the rescuer's physical strength during the process of cardiopulmonary resuscitation (CPR) outside the hospital and in the hospital, and to ensure the accuracy of ventilation frequency rate and tidal volume. Zhongnan Hospital and School of Nursing, Wuhan University, jointly designed and developed a smart emergency respirator with open airway function, that has been granted National Utility Model Patent of China (ZL 2021 2 1557989.8). The device is structured of pillow, pneumatic booster pump and mask. It can be used simply by plugging the pillow under the patient's head and shoulder, turning on the power supply and wearing the mask. The smart emergency respirator can quickly and effectively open the patient's airway and give accurate ventilation with adjustable ventilation parameters. The default settings are 10 times/min in respiratory rate and 500 mL in tidal volume. The whole operation does not require the operator have professional operation ability, which can be independently applied used in any cases without oxygen source or power supply, therefore, the application scenario has no limit. The device has the advantages of small size, simple operation and low production cost, which can reduce human source, save physical strength and significantly improve the quality of CPR. The device is suitable for respiratory support in multiple scenes outside and inside the hospital, and can significantly improve the success rate of treatment.