1.Effectiveness and text analysis of Chinese adolescents mental health promotion policy
FANG Yajuan, WU Xiaoyan, CHEN Xiaowan, CHEN Ren, BAI Zhongliang, YAN Jing
Chinese Journal of School Health 2025;46(2):234-238
Objective:
To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy.
Methods:
Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on.
Results:
A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level.
Conclusions
China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.
2.Predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma patients undergoing radical radiotherapy
Yajuan WU ; Jie WANG ; Qi LI ; Yaqiong REN ; Fei CHEN ; Xiaomin LI
Cancer Research and Clinic 2025;37(1):19-26
Objective:To investigate the predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radical radiotherapy.Methods:A retrospective case series study was conducted. The clinical data of ESCC patients aged ≥ 70 years who received radical radiotherapy in Shanxi Province Cancer Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the radiotherapy planning system, the maximum transverse diameter of gross tumor volume of primary tumors (GTVt) and GTVt volume in the esophagus were calculated. The nutritional risk related indicators of ESCC patients before and after radiotherapy were calculated and recorded, including body mass index (BMI), geriatric nutritional risk index (GNRI), and neutrophil-to-lymphocyte ratio (NLR); Kaplan-Meier method was used for survival analysis, and log- rank test was performed; Cox proportional risk model was used to analyze the factors influencing the prognosis of patients. The overall survival (OS), progression-free survival (PFS), short-term efficacy, and adverse reactions of patients with different clinicopathological characteristics were compared.Results:The last follow-up time was 30 December, 2023. The 1-year, 3-year, and 5-year OS rates of 161 elderly patients with ESCC were 79.5%, 33.9%, and 16.1% respectively, with a median OS time of 25.8 months (95% CI: 20.11-31.49 months); the 1-year, 3-year, and 5-year PFS rates were 65.8%, 28.9%, and 14.8%, respectively, with a median PFS time of 20.0 months (95% CI: 16.31-23.69 months). There were statistically significant differences in the median OS time of patients with different age, lesion contrast length, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, NLR before radiotherapy, and NLR after radiotherapy (all P < 0.05); there were statistically significant differences in the median PFS time of ESCC patients with different age, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy (all P <0.05). The results of multivariate Cox regression analysis showed that the maximum transverse diameter of GTVt was an independent influencing factor of the patients' OS ( P < 0.05); GTVt volume, short-term efficacy, GNRI after radiotherapy, and NLR before radiotherapy were independent influencing factors for OS and PFS of the patients (all P < 0.05). Among 161 elderly patients with ESCC, 45 achieved complete remission (CR), 111 achieved partial remission (PR), and 5 achieved stable disease (SD). There were statistically significant differences in the proportions of patients with different maximum transverse diameter of GTVt, GTVt volume, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy reaching CR and PR+SD (all P < 0.05). Among the 161 patients, grade 0, 1, 2, and 3 radiation-induced esophagitis (RE) occurred in 59, 54, 42, and 6 cases, respectively during treatment and within 3 months after treatment; among them, ≥ grade 2 RE occurred in 48 cases (29.8%); grade 0, 1, 2, and 3 radiation pneumonitis (RP) occurred in 95, 38, 25, and 3 cases, respectively; among them, ≥ grade 2 RP occurred in 28 cases (17.4%). Conclusions:Nutritional risk related indexes GNRI and NLR may be predictive indicators for the prognosis of elderly ESCC patients undergoing radical radiotherapy.
3.Predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma patients undergoing radical radiotherapy
Yajuan WU ; Jie WANG ; Qi LI ; Yaqiong REN ; Fei CHEN ; Xiaomin LI
Cancer Research and Clinic 2025;37(1):19-26
Objective:To investigate the predictive value of nutritional risk related indicators in the prognosis of elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radical radiotherapy.Methods:A retrospective case series study was conducted. The clinical data of ESCC patients aged ≥ 70 years who received radical radiotherapy in Shanxi Province Cancer Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the radiotherapy planning system, the maximum transverse diameter of gross tumor volume of primary tumors (GTVt) and GTVt volume in the esophagus were calculated. The nutritional risk related indicators of ESCC patients before and after radiotherapy were calculated and recorded, including body mass index (BMI), geriatric nutritional risk index (GNRI), and neutrophil-to-lymphocyte ratio (NLR); Kaplan-Meier method was used for survival analysis, and log- rank test was performed; Cox proportional risk model was used to analyze the factors influencing the prognosis of patients. The overall survival (OS), progression-free survival (PFS), short-term efficacy, and adverse reactions of patients with different clinicopathological characteristics were compared.Results:The last follow-up time was 30 December, 2023. The 1-year, 3-year, and 5-year OS rates of 161 elderly patients with ESCC were 79.5%, 33.9%, and 16.1% respectively, with a median OS time of 25.8 months (95% CI: 20.11-31.49 months); the 1-year, 3-year, and 5-year PFS rates were 65.8%, 28.9%, and 14.8%, respectively, with a median PFS time of 20.0 months (95% CI: 16.31-23.69 months). There were statistically significant differences in the median OS time of patients with different age, lesion contrast length, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, NLR before radiotherapy, and NLR after radiotherapy (all P < 0.05); there were statistically significant differences in the median PFS time of ESCC patients with different age, maximum transverse diameter of GTVt, GTVt volume, short-term efficacy, BMI before radiotherapy, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy (all P <0.05). The results of multivariate Cox regression analysis showed that the maximum transverse diameter of GTVt was an independent influencing factor of the patients' OS ( P < 0.05); GTVt volume, short-term efficacy, GNRI after radiotherapy, and NLR before radiotherapy were independent influencing factors for OS and PFS of the patients (all P < 0.05). Among 161 elderly patients with ESCC, 45 achieved complete remission (CR), 111 achieved partial remission (PR), and 5 achieved stable disease (SD). There were statistically significant differences in the proportions of patients with different maximum transverse diameter of GTVt, GTVt volume, BMI after radiotherapy, GNRI after radiotherapy, and NLR before radiotherapy reaching CR and PR+SD (all P < 0.05). Among the 161 patients, grade 0, 1, 2, and 3 radiation-induced esophagitis (RE) occurred in 59, 54, 42, and 6 cases, respectively during treatment and within 3 months after treatment; among them, ≥ grade 2 RE occurred in 48 cases (29.8%); grade 0, 1, 2, and 3 radiation pneumonitis (RP) occurred in 95, 38, 25, and 3 cases, respectively; among them, ≥ grade 2 RP occurred in 28 cases (17.4%). Conclusions:Nutritional risk related indexes GNRI and NLR may be predictive indicators for the prognosis of elderly ESCC patients undergoing radical radiotherapy.
4.Correlation of CD117 and DOG1 Expression with the Clinicopathological Features and Prognosis in Triple-negative Breast Cancer
Yajuan WANG ; Yuan WANG ; Xinyu REN
Medical Journal of Peking Union Medical College Hospital 2024;15(3):616-623
To investigate the expression of CD117 and DOG1 in triple-negative breast cancer (TNBC) and to explore their relationship with clinicopathologic features and prognosis. The patients with TNBC in Peking Union Medical College Hospital from 2000 to 2011 were retrospectively collected and tissue microarrays were made. The expression of CD117 and DOG1 in tumor cells was detected by immunohistochemistry to analyze their relationship with the clinicopathological characteristics of the patients, such as age, tumor diameter, American Joint Committee on Cancer (AJCC) cancer stage, histological grade, P53, and Ki-67 proliferation index, and explore the effect of both on the survival of patients. A total of 185 TNBC patients meeting the inclusion and exclusion criteria were selected, of which 24 (12.97%) were CD117 positive and 22 (11.89%) were DOG1 positive, with a co-expression rate of 1.62%. Compared with CD117-negative patients, CD117-positive patients had higher Ki-67 proliferation index (87.50% The expression of CD117 and DOG1 were significantly related to basal-like TNBC, CD117 positive with P53 diffuse strong positive may be correlated with a shorter overall survival and a higher mortality risk.
5.Trop2 and β-catenin expression in triple negative breast cancer and relationship with clinicopathological characteristics and prognosis
Yajuan WANG ; Yuan WANG ; Xinyu REN
Chinese Journal of Clinical and Experimental Pathology 2024;40(11):1181-1187
Purpose To investigate the expression of Trop2 and β-catenin in triple negative breast cancer(TNBC)and to explore their relationship with clinicopathologic features and prognosis.Methods Clinicopathologic features and prognosis of TNBC patients were collected.TNBC was classified into HER2-low(1+,2+FISH negative)and 0 expression.The expression of Trop2 and β-catenin in tumors was evaluated by immunohistochemistry in paraffin embedded tissue.The correla-tion between Trop2,β-catenin expression and clinicopathologic features and prognosis was analyzed.Results Among 180 ca-ses of TNBC,there were 60.6%(109/180)high Trop2 expres-sion and 71.7%(129/180)abnormal β-catenin expression,and 48.9%(88/180)co-expression.Chi-square test showed compared with Trop2-low TNBC patients,Trop2-high TNBC pa-tients had high abnormal expression rate of β-catenin(80.7%vs 57.7%,P<0.001).TNBC patients with Trop2-high or β-catenin abnormal expression had higher AJCC stage(P=0.006,P=0.001),distant metastasis(P=0.005,P=0.006),and lower HER2-low(P=0.009,P=0.005).TNBC patients with Trop2-high had higher lymph node metastasis(P=0.031)and lower age<50 years(P=0.035).TNBC patients with β-catenin abnormal expression had higher histological grade(P=0.014).The median follow-up time was 69.5 months,3.3%(6/180)were lost to follow-up,36.1%(65/180)re-lapsed,and 19.4%(35/180)died.Survival analysis showed that Trop2-high(P=0.017,P=0.001),β-catenin positive(P=0.030,P=0.007)and Trop2(high)/HER2(0)/β-catenin(abnormal)(P<0.001)had shorter disease-free survival(DFS)and over-all survival(OS).Cox regression a-nalysis showed that the patients with high AJCC stage(HR=2.543,P<0.001)and basal-like TNBC(HR=3.948,P=0.024),Trop2(high)/HER2(0)/β-catenin(abnormal)(HR=4.452,P<0.001)had a higher mortality risk,but TILs≥ 30%(HR=0.341,P=0.044)had a lower mortality risk.Conclusion The expression of Trop2,β-catenin and HER2 were correlated in TNBC.Trop2(high)/HER2(0)/β-catenin(abnormal),can predict prognosis.
6.Trop2 and β-catenin expression in triple negative breast cancer and relationship with clinicopathological characteristics and prognosis
Yajuan WANG ; Yuan WANG ; Xinyu REN
Chinese Journal of Clinical and Experimental Pathology 2024;40(11):1181-1187
Purpose To investigate the expression of Trop2 and β-catenin in triple negative breast cancer(TNBC)and to explore their relationship with clinicopathologic features and prognosis.Methods Clinicopathologic features and prognosis of TNBC patients were collected.TNBC was classified into HER2-low(1+,2+FISH negative)and 0 expression.The expression of Trop2 and β-catenin in tumors was evaluated by immunohistochemistry in paraffin embedded tissue.The correla-tion between Trop2,β-catenin expression and clinicopathologic features and prognosis was analyzed.Results Among 180 ca-ses of TNBC,there were 60.6%(109/180)high Trop2 expres-sion and 71.7%(129/180)abnormal β-catenin expression,and 48.9%(88/180)co-expression.Chi-square test showed compared with Trop2-low TNBC patients,Trop2-high TNBC pa-tients had high abnormal expression rate of β-catenin(80.7%vs 57.7%,P<0.001).TNBC patients with Trop2-high or β-catenin abnormal expression had higher AJCC stage(P=0.006,P=0.001),distant metastasis(P=0.005,P=0.006),and lower HER2-low(P=0.009,P=0.005).TNBC patients with Trop2-high had higher lymph node metastasis(P=0.031)and lower age<50 years(P=0.035).TNBC patients with β-catenin abnormal expression had higher histological grade(P=0.014).The median follow-up time was 69.5 months,3.3%(6/180)were lost to follow-up,36.1%(65/180)re-lapsed,and 19.4%(35/180)died.Survival analysis showed that Trop2-high(P=0.017,P=0.001),β-catenin positive(P=0.030,P=0.007)and Trop2(high)/HER2(0)/β-catenin(abnormal)(P<0.001)had shorter disease-free survival(DFS)and over-all survival(OS).Cox regression a-nalysis showed that the patients with high AJCC stage(HR=2.543,P<0.001)and basal-like TNBC(HR=3.948,P=0.024),Trop2(high)/HER2(0)/β-catenin(abnormal)(HR=4.452,P<0.001)had a higher mortality risk,but TILs≥ 30%(HR=0.341,P=0.044)had a lower mortality risk.Conclusion The expression of Trop2,β-catenin and HER2 were correlated in TNBC.Trop2(high)/HER2(0)/β-catenin(abnormal),can predict prognosis.
7.Improvement of ultrasound positioning technique for peripherally inserted central catheter tip position in neonates
Xiaoling REN ; Yajuan CHEN ; Jing LIU ; Jia SHEN ; Yali GUO ; Yuru WEI
Chinese Journal of Applied Clinical Pediatrics 2021;36(24):1896-1899
Objective:To explore a new method of ultrasound-guided positioning of the tip of neonatal peri-pherally inserted central catheter (PICC).Methods:Clinical data of 174 newborn infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Beijing Chaoyang District Maternal and Child Healthcare Hospital from January 2019 to April 2021 receiving PICC catheter intubated under the guidance of ultrasound for positioning the tip were retrospectively analyzed to explore the accuracy, reliability and feasibility of the improved ultrasound-guided positioning technique.Before lower extremity catheterization, ultrasound was performed to monitor the vascular pattern and catheterization of PICC was conducted under the guidance of ultrasound.Results:(1) Among 174 infants intubated with ultrasound-guided positioning of the PICC tip, 172(98.9%) of them had the ideal position, and 2(1.1%) did not achieve the ideal position, but achieved the ideal position after ultrasound-guided correction.(2) Lower extremity venous catheterization was successfully performed at 100.0% after ultrasound-guided monitoring of blood vessels.The time-consuming of lower extremity venous catheterization was significantly shorter than that of the previous method [(31.50±2.58) min vs.(56.10 ±5.30 min)]( t=46.84, P<0.001). The total success rate of catheterization and catheterization of lower limb vein increased by 7.0% and 17.5%, respectively.(3) Only 1 (0.57%) case reported the complication of catheter tip thrombosis, the complication rate of which decreased from the previous 79.00% to 2.70%(2/112 cases). Conclusions:The improved ultrasound-guided positioning of the PICC tip is convenient, simple, faster and accurate, which enhances the success rate and is worthy to be applied in clinical practice.
8.Formulation and practice of standardized management plan of Hemodialysis Room for patients with infectious diseases
Hong CHENG ; Wenwen REN ; Yajuan FANG
Chinese Journal of Modern Nursing 2021;27(19):2623-2628
Objective:To formulate a standardized management plan of Hemodialysis Room for patients with infectious diseases and explore the practical effect.Methods:The Beijing Ditan Hospital affiliated to Capital Medical University formulated a standardized management plan for hemodialysis room of patients with infectious diseases, which was implemented in 2017. Using convenience sampling method, 146 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January 2017 to October 2020 were selected as the experimental group, and 46 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January to December 2016 were selected as the control group. We compared the nursing compliance rate before and after the implementation of the plan, the incidence of adverse events, and the satisfaction with nursing in the two groups.Results:After the implementation of the plan, the nursing compliance rate was 97.13% (406/418) , which was higher than 89.29% (50/56) before the implementation, and the difference was statistically significant (χ 2=8.316, P<0.01) . The incidence of adverse events in the experimental group was 6.85% (10/146) , which was lower than 17.39% (8/46) in the control group, and the difference was statistically significant (χ 2=4.567, P<0.05) . The Nursing Work Satisfaction Scale score of the experimental group was (94.67±3.08) , which was higher than (91.96±2.91) of the control group with a statistical difference ( t=8.882, P<0.05) . Patients' satisfaction with nursing in the experimental group was 98.63% (144/146) , which was higher than 91.30% (42/46) in the control group, and the difference was also statistically significant (χ 2=6.201, P<0.05) . Conclusions:The explored and implemented standardized management plan for hemodialysis patients with infectious diseases has achieved certain positive results, which provides a scientific, fine and standardized nursing management strategy for the construction of systematic solutions in the future.
9.Prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot
Yuanyuan ZUO ; Hongyu GUO ; Wenxiu GUO ; Buqi NA ; Wei REN ; Haicheng JIA ; Jianan QIAO ; Yajuan XIA
Chinese Journal of Endemiology 2020;39(7):477-482
Objective:To explore the prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot.Methods:From July 2017 to July 2018, 3 100 health examinees from Inner Mongolia National Examination Medical Center were selected as subjects for questionnaire survey, thyroid function test and thyroid ultrasound examination; a multinomial logistic regression model was used to analyze the relationship between relevant investigation factors and different types of thyroid diseases (simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules).Results:Among the 3 100 healthy examinees, there were 2 885 effective responders, including 743 males and 2 142 females, aged (46.23 ± 12.32) years; the simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules were 909, 648, and 619 cases, respectively, and the detection rates were 31.51%, 22.46%, and 21.46%, respectively. Logistic regression analysis results showed that age [35 - 54 years old: odds ratio ( OR) = 1.30, 95% confidence interval ( CI): 1.01 - 1.68; ≥55 years old: OR = 2.30, 95% CI: 1.68 - 3.14, P < 0.05], gender ( OR = 1.65, 95% CI: 1.32 - 2.07, P < 0.05), obesity ( OR = 1.35, 95% CI: 1.08 - 1.70, P < 0.05), and mental stress [significant: OR = 1.64, 95% CI: 1.09 - 2.48; some: OR = 1.54, 95% CI: 1.02 - 2.32, P < 0.05] were the risk factors affecting the occurrence of simple thyroid nodules. The age (35 ~ 54, ≥55 years old), gender, bad mood (a little), and mental stress (significant) were risk factors that affected the occurrence of simple thyroid dysfunction; eating high iodine food was its protective factor. The age (35 ~ 54, ≥55 years old), gender, obesity, and thyroid family genetic history were risk factors for thyroid dysfunction with nodules; the consumption of iodized salt was its protective factor. Conclusions:Older women are high-risk groups for thyroid diseases. Obesity, bad mood, mental stress will increase the risk of the disease. Daily consumption of iodized salt and moderate consumption of high iodine food can reduce the risk of the disease.
10.Preliminary analysis of risk prediction model for recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery
Yajuan WU ; Xiaomin LI ; Qi LI ; Yaqiong REN
Journal of Chinese Physician 2019;21(1):98-102
Objective The aim of this study is to build a risk prediction model for the recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery,and to analyze the factors affecting the disease free survival (DFS).Methods Conducted analysis of 1 191 patients with thoracic esophageal squamous cell carcinoma,who received radical resection from January 2007 to December 2011.The VaR boundary value of the risk prediction model was obtained by receiver operating characteristic (ROC) curve,and the boundary value was verified.The factors that affected DFS were analyzed by univariate analysis and Cox multiple factor prognosis analysis.Results There were 472 cases had recurrence and metastasis after treatment.There was a significant difference in VaR between patients with and without failure (t =-5.307,P ≤ 0.001).The VaR boundary value was 0.30 according to ROC curve analysis.The recurrence rate of the patients in the VaR ≤ 0.30 group was 27.5%,which was significantly lower than 48.2% in the ≥0.30 groups (x2 =51.659,P ≤ 0.001).The univariate analysis showed that the patient's sex,the length of the lesion,the degree of tissue differentiation and the VaR value were all factors that significantly affected the recurrence and metastasis of the patients (x2 =13.460,21.111,17.540,39.175,P ≤0.001).Multivariate analysis showed that tissue differentiation and VaR were independent factors affecting recurrence and metastasis of patients (P ≤ 0.001).Conclusions The model can be applied to predict the recurrence and metastasis risk of patients with thoracic esophageal squamous cell carcinoma after radical surgery.


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