Objective: To explore the relationship between snack consumption and depressive symptoms in first year junior high school students with different left behind experiences in Yunnan Province, so as to provide a basis for improving depressive symptoms among first year junior high school students with different left behind experiences. Methods: From October to December 2022,a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County) in Yunnan Province for a questionnaire survey. The Chinese version of Depression Anxiety Stress Scale-21 was applied to assess depressive symptoms in first year junior high school students, and snack consumption was collected by employing food frequency questionnaire. The generalized linear model was used to analyze the association between first year junior high school students snack consumption and depressive symptoms, and the analysis was stratified according to left behind experience. Results: The detection rates of depressive symptoms among firstyear junior high school students with and without left behind experience were 36.25% and 26.91%, respectively. After controlling for confounding variables, the generalized linear model analysis showed that sweet snacks ( β=0.16, 95%CI =0.07-0.25), fast food ( β=0.14, 95%CI =0.04-0.23) and carbonated drinks ( β=0.09, 95%CI =0.01-0.17) of first year junior high school students with left behind experience (all P <0.05). Compared with those without such behavior, the risk of depressive symptoms was higher in consumption of fast food ( β=0.13, 95%CI =0.07-0.18) and carbonated drinks ( β=0.10, 95%CI =0.06-0.15)among first year junior high school students without left behind experience (both P <0.05). Conclusion Snack consumption among first year junior high school students in Yunnan may increase the risk of developing depressive symptoms, while first year junior high school students with left behind experience may have a greater risk of developing depressive symptoms.

Objective To explore the relationships between social support,positive coping,caregiver burden and family resilience of primary caregivers of first-stroke patients.Methods A questionnaire survey was conducted among 307 primary caregivers of first-stroke patients in 2 tertiary hospitals in Shanghai by convenience sampling method.Social support rating scale,simplified coping style questionnaire,Zarit caregiver burden interview,and family resilience assessment scale were used for questionnaire survey.Pearson correlation analysis and structural equation models were used for data analysis.Results A total of 288 valid questionnaires were collected,and the effective recovery rate was 93.81％.Pearson correlation analysis showed that there was a positive correlation between family resilience and social support,family resilience and positive coping,and social support and positive coping(r=0.375,0.627,and 0.277;all P＜0.01),while caregiver burden and social support,caregiver burden and positive coping,and family resilience and caregiver burden were all negatively correlated(r=-0.203,-0.343,and-0.444;all P＜0.01).The mediating effect model was constructed with positive coping and caregiver burden as mediating variables,social support as independent variables,and family resilience as dependent variables.The results showed that social support could mediate family resilience through positive coping,with a mediating effect of 0.164,accounting for 26.1％of the total effect;social support could also affect the family resilience of the primary caregivers of first-stroke patients through the partial chain mediating effect of positive coping and caregiver burden,with a mediating effect value of 0.032,accounting for 5.1％of the total effect.Conclusion Social support can predict family resilience among primary caregivers of first-stroke patients,and positive coping and caregiver burden play chain mediating roles in the impact of social support on family resilience.

Objective:To investigate the relationship between amylase level in drainage fluid and the risk of salivary fistula(SF)after parotid benign tumor resection.Methods:106 patients underwent benign parotid tumor resection were included and divided into SF occurrence group(SF,n=31)and non-occurrence group(control,n=75).The amylase levels of drainage fluid were com-pared between the 2 groups at 24,48 and 72 h respectively after surgery,and the risk factors related to postoperative salivary fistu-la were evaluated by multivariate Logistic analysis and ROC curve.Results:The content in amylase in drainage fluid at 24,48 and 72 h after operation and partial retention of parotid masseter fascia during operation in the SF group were higher than those in the control group(P＜0.05),and the postoperative compression time was shorter than that in the control group(P＜0.05).Multiva-riate Logistic analysis showed that the amylase content of drainage fluid at 24,48 and 72 h and the complete preservation of parotid masseter fascia during operation were the influencing factors for the occurrence of postoperative SF(P＜0.05).The ROC curve showed that the AUC of amylase level of drainage fluid in predicting the risk of postoperative SF was 0.979(95％CI 0.930-0.997)at 72 h after surgery.Conclusion:The level of amylase in the drainage fluid is associated with the risk of SF after benign parotid tumor resection.The level of amylase in the drainage fluid 72h after benign parotid tumor resection can accurately predict SF after benign parotid tumor resection.

Objective:To investigate the relationship between amylase level in drainage fluid and the risk of salivary fistula(SF)after parotid benign tumor resection.Methods:106 patients underwent benign parotid tumor resection were included and divided into SF occurrence group(SF,n=31)and non-occurrence group(control,n=75).The amylase levels of drainage fluid were com-pared between the 2 groups at 24,48 and 72 h respectively after surgery,and the risk factors related to postoperative salivary fistu-la were evaluated by multivariate Logistic analysis and ROC curve.Results:The content in amylase in drainage fluid at 24,48 and 72 h after operation and partial retention of parotid masseter fascia during operation in the SF group were higher than those in the control group(P＜0.05),and the postoperative compression time was shorter than that in the control group(P＜0.05).Multiva-riate Logistic analysis showed that the amylase content of drainage fluid at 24,48 and 72 h and the complete preservation of parotid masseter fascia during operation were the influencing factors for the occurrence of postoperative SF(P＜0.05).The ROC curve showed that the AUC of amylase level of drainage fluid in predicting the risk of postoperative SF was 0.979(95％CI 0.930-0.997)at 72 h after surgery.Conclusion:The level of amylase in the drainage fluid is associated with the risk of SF after benign parotid tumor resection.The level of amylase in the drainage fluid 72h after benign parotid tumor resection can accurately predict SF after benign parotid tumor resection.

Objective:To evaluate the safety and clinical efficacy of hypofractionated radiotherapy (HFRT) at 36.5 Gy in 10 fractions for the chest wall and reginal lymph nodes following modified radical mastectomy for breast cancer.Methods:This was a prospective, single-arm, phase Ⅱ clinical study. A total of 85 patients who received HFRT at 36.5 Gy in 10 fractions to the chest wall ± supraclavicular region following modified radical mastectomy for locally advanced breast cancer from March 2014 to December 2015 were included. The primary endpoint was radiotherapy toxicities. The secondary endpoints were locoregional failure-free survival (LRFFS), disease-free survival (DFS), and overall survival (OS).Results:The median follow-up period was 98 (94.0-109.0) months. Radiotherapy toxicities were mild. The incidence rates of grade 1 acute cutaneous and pulmonary toxicities were 52.9% and 40%, and those of grade 1 late cutaneous, pulmonary, and cardiac toxicities and upper extremity edema were 10.6%, 29.4%, 2.4%, and 21.2%, respectively. Only 1 (1.2%) patient suffered from grade 2 radiation-induced brachial plexus injury. Of the 85 patients, one patient had regional recurrence (supraclavicular lymph nodes), six patients had distant metastasis, and six patients died of breast cancer. The 9-year LRFFS, DFS, and OS were 97.7%, 91.8%, and 92.8%, respectively.Conclusions:HFRT at 36.5 Gy in 10 fractions following modified radical mastectomy for breast cancer is associated with mild toxicities. A phase Ⅲ study is necessary for validating HFRT's clinical efficacy.

BACKGROUND: Islet transplantation is currently considered the most promising method for treating insulin-dependent diabetes. The two most-studied artificial islets are alginate-encapsulated b cells or b cell spheroids. As three-dimensional (3D) models, both artificial islets have better insulin secretory functions and transplantation efficiencies than cells in twodimensional (2D) monolayer culture. However, the effects of these two methods have not been compared yet. Therefore, in this study, cells from the mouse islet b cell line Min6 were constructed as scaffold-free spheroids or alginate-encapsulated dispersed cells. METHODS: MIN6 cell spheroids were prepared by using Agarose-base microwell arrays. The insulin secretion level was determined by mouse insulin ELISA kit, and the gene and protein expression status of the MIN6 were performed by Quantitative polymerase chain reaction and immunoblot, respectively. RESULTS: Both 3D cultures effectively promoted the proliferation and glucose-stimulated insulin release (GSIS) of MIN6 cells compared to 2D adherent cells. Furthermore, 1% alginate-encapsulated MIN6 cells demonstrated more significant effects than the spheroids. In general, three pancreatic genes were expressed at higher levels in response to the 3D culture than to the 2D culture, and pancreatic/duodenal homeobox-1 (PDX1) expression was higher in the cells encapsulated in 1% alginate than that in the spheroids. A western blot analysis showed that 1% alginate-encapsulated MIN6 cells activated the phosphoinositide 3-kinase (PI3K)/serine/threonine protein kinase (AKT)/forkhead transcription factor FKHR (FoxO1) pathway more than the spheroids, 0.5% alginate-, or 2% alginate-encapsulated cells did. The 3D MIN6 culture, therefore, showed improved effects compared to the 2D culture, and the 1% alginate-encapsulated MIN6 cells exhibited better effects than the spheroids. The upregulation of PDX1 expression through the activation of the PI3K/AKT/FoxO1 pathway may mediate the improved cell proliferation and GSIS in 1% alginate-encapsulated MIN6 cells. CONCLUSION This study may contribute to the construction of in vitro culture systems for pancreatic islets to meet clinical requirements.

Objective To retrospectively analyze the prognostic factors for locoregionally recurrent early?stage extranodal nasal?type natural killer/T?cell lymphoma ( NKTCL) . Methods A total of 56 patients with early?stage extranodal nasal?type NKTCL, who had locoregional recurrence after initial treatment and then received salvage treatment from 1995 to 2014, were enrolled as subjects. The effects of salvage treatment on the overall survival ( OS) rate were analyzed after initial treatment and recurrence. Univariate and multivariate prognostic analyses were performed on the OS rate after recurrence. Results The median follow?up time was 35. 9 months after initial treatment and 14. 8 months after recurrence. The 3?year OS rate was 73% after initial treatment and 58% after recurrence. Compared with chemotherapy alone, radiotherapy?containing salvage treatment significantly improved the OS rates after initial treatment and recurrence ( P=0. 040, 0. 009 ) , and re?irradiation also significantly improved the OS rates after initial treatment and recurrence (P=0. 018, 0. 019). Most (84%) of the acute and late adverse reactions after re?irradiation were grade 1?2 ones. The univariate and multivariate analyses showed that the Karnofsky Performance Status score, radiotherapy in initial treatment, and radiotherapy in salvage treatment were influencing factors for the OS rate after recurrence. Conclusions Radiotherapy achieves improved survival and tolerable toxicities, making it indispensable in the treatment of locoregionally recurrent extranodal nasal?type NKTCL.

Objective To evaluate the effects of nurses′standardized training and to provide basis for revision of the standardized training programme by investigating core abilities of nurses before and after standardized training and post competency of nurses after the training.Methods 198 nurses in this hospital who participated in standardized training in 2013 were selected as research objects and their core abilities before and after the training and their post competency after the training were evaluated by questionnaires with separate evaluation by themselves and others.Results After standardized training,total score of nurses′core abilities were (80.26 ±10.53),higher than the score before the training (73.73 ±9.65)(t =6.303,P <0.01).After the training,for the results of nurses′self-evaluation in post competency,dimensions of good personal characteristics (4.61 ±0.51 ),clinical nursing abilities (4.61 ±0.51 ),supporting and interpersonal communication abilities (4.33 ±0.64),critical thinking abilities (4.14 ±0.82),and professional construction and development abilities (4.27 ±0.66)were all higher than the results of evaluations by others (t =7.57, 6.11,5.52,3.22,3.22;P <0.01).Conclusions Standardized training has a positive effect on improving core abilities of nurses,which is in accordance with clinical needs;the evaluation results of nurses′post competency can provide basis for revision of the standardized training programme;person-post matching helps to motivate nurses to improve their skills.

Survivin is a member of inhibitor of apoptosis protein(IAP) family which is highly expressed in a large number of malignancies, has functions of inhibiting apoptosis, enhancing proliferation and promoting angiogenesis. Studies show survivin will be a marker for tumor diagnosis and a target for anti- cancer therapies.

Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.ResultsAs compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P＜0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P＜0.05].Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.