Objective To investigate the impact of a peer support model on the mental health of caregivers and the perceived social support and psychiatric symptoms of the mental disorder patients under their care. Methods Patients with mental disorders undergoing long-term community-based rehabilitation and their primary caregivers were recruited for this study. A total of 44 pairs of eligible patients and caregivers were selected based on a 1∶1 matching ratio. Systematic peer support activities were conducted exclusively for the caregivers. The General Health Questionnaire (GHQ) and the Symptom Checklist-90 (SCL-90) were administered before and after the intervention to assess the mental health status of caregivers. The Perceived Social Support Scale (PSSS) and the Brief Psychiatric Rating Scale (BPRS) were employed to evaluate the patients' perceived social support and psychiatric conditions before and after the intervention. Results A total of 44 valid questionnaires from caregivers and 42 from patients were collected. The GHQ score and the total scores, the number of positive item, positive total scores, and positive mean scores of and SCL-90 of caregivers were significantly lower after the intervention compared to pre-intervention (P < 0.05 or P < 0.001). For patients, the family support score, extracurricular support score, and total score of the PSSS were significantly higher post-intervention compared to pre-intervention (P < 0.05 or P < 0.001). Compared to pre-intervention, patients'scores on anxiety and depression, lack of energy, thought disturbance, activation, hostility and suspicion, and the total score on the BPRS were significantly lower after the caregiver peer support intervention (P < 0.001). Conclusion The peer support model contributes to improving the mental health of caregivers for patients with mental disorders and enhancing the patients'psychiatric conditions.

Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.

Objective To investigate the clinical application value of contrast-enhanced chest CT in the detection of responsible vessels for hemoptysis before selective arterial embolization(SAE).Methods The clinical data of 74 patients with hemoptysis trea-ted with interventional therapy and preoperative contrast-enhanced chest CT and digital subtraction angiography(DSA)were ana-lyzed retrospectively.The responsible vessels were identified and then embolized via angiography.The detection of the responsible vessels via preoperative contrast-enhanced chest CT was analyzed.The patients were followed up to observe the efficacy and compli-cations,and the influencing factors of interventional efficacy and recurrence were analyzed.Results A total of 245 responsible ves-sels were detected by preoperative contrast-enhanced chest CT,including bronchial arteries(n=178),ectopic bronchial arteries(n=10)and non-bronchial systemic artery(NBSA)(n=57),which could accurately show the anatomical information of responsible vessels.A total of 4 posterior intercostal arteries were missed.The diagnostic accuracy was 98.4％(245/249).All patients were followed up for 12 to 25.6 months.The immediate hemostasis rate was 93.2％(69/74)and the effective rate was 79.7％(59/74),respectively.The factors affecting the efficacy were bronchial artery to pulmonary circulation fistula,pleural thickening at the bleeding site,and underly-ing lung disease.Among the 59 patients with effective treatment,underlying lung disease was the influencing factor for postoperative recurrence.Conclusion Contrast-enhanced chest CT can provide anatomical information about the responsible vessels for interven-tional therapy of hemoptysis,improving surgical efficiency and reducing the recurrence rate of hemoptysis.

Objective:To explore the predictive value of secretogranin II (SCG2) for the prognosis of pancreatic neuroendocrine tumors (pNET) and to construct a nomogram prediction model based on SCG2.Methods:One hundred and thirty-three patients with pNET who underwent radical surgery at the Fourth Hospital of Hebei Medical University from August 2013 to December 2021 were retrospectively collected. The cohort, including 60 males and 73 females with a mean age of (53.70±12.08) years, was divided into a training set ( n=93) and a validation set ( n=40). Clinical data such as gender, age, tumor size, lymph node metastasis, TNM stage, liver metastasis, surrounding tissue invasion, tumor histological grade, and carcinoembryonic antigen (CA) 19-9 levels were gathered. Immunohistochemical staining was performed to detect SCG2 expression. Patient survival information was obtained through outpatient records or telephone follow-up. The Cox proportional hazard model was used to analyze prognostic factors. A nomogram was created based on the multivariate Cox regression analysis results. The calibration curve and the area under the receiver operating characteristic (ROC) curve were used to evaluate the nomogram's accuracy and discrimination. Results:The SCG2 expression in pNET patients with AJCC stage Ⅲ-Ⅳ was higher than in those with stage Ⅰ-Ⅱ. Similarly, patients with histological grade G3 had higher SCG2 levels compared to those with grades G1-G2. SCG2 expression was also elevated in patients older than 60 years compared to those 60 years or younger, and in patients with CA19-9>30 U/L compared to those with CA19-9≤30 U/L. These differences were all statistically significant (all P<0.05). Multivariate Cox regression analysis revealed that lymph node metastasis ( HR=3.132, 95% CI: 1.212-8.096, P=0.017), liver metastasis ( HR=2.685, 95% CI: 1.002-7.192, P=0.049), histological grade G3 ( HR=3.692, 95% CI: 1.229-11.088, P=0.011), and high SCG2 expression ( HR=52.181, 95% CI: 38.476-108.118, P=0.002) were associated with significantly higher risks of shorter disease free survival. Additionally, patients with longer tumor diameters ( HR=1.297, 95% CI: 1.088-1.545, P=0.004), histological grade G3 ( HR=19.625, 95% CI: 5.276-88.634, P<0.001), and high SCG2 expression ( HR=39.454, 95% CI: 17.317-97.263, P<0.001) had a higher risk of shorter overall survival. A nomogram prediction model was constructed using these above factors. The calibration curve demonstrated good alignment between predicted and actual outcomes in both the training and validation sets. The areas under the ROC curves for the disease-free survival and overall survival nomogram models for predicting 1-, 3-, and 5-year survival of pNET patients in both sets were above 0.8. Conclusion:High SCG2 expression is an independent risk factor for poor prognosis in pNET patients. The nomogram model based on SCG2 has high predictive efficacy for pNET patient prognosis.

Objective:To explore the predictive value of secretogranin II (SCG2) for the prognosis of pancreatic neuroendocrine tumors (pNET) and to construct a nomogram prediction model based on SCG2.Methods:One hundred and thirty-three patients with pNET who underwent radical surgery at the Fourth Hospital of Hebei Medical University from August 2013 to December 2021 were retrospectively collected. The cohort, including 60 males and 73 females with a mean age of (53.70±12.08) years, was divided into a training set ( n=93) and a validation set ( n=40). Clinical data such as gender, age, tumor size, lymph node metastasis, TNM stage, liver metastasis, surrounding tissue invasion, tumor histological grade, and carcinoembryonic antigen (CA) 19-9 levels were gathered. Immunohistochemical staining was performed to detect SCG2 expression. Patient survival information was obtained through outpatient records or telephone follow-up. The Cox proportional hazard model was used to analyze prognostic factors. A nomogram was created based on the multivariate Cox regression analysis results. The calibration curve and the area under the receiver operating characteristic (ROC) curve were used to evaluate the nomogram's accuracy and discrimination. Results:The SCG2 expression in pNET patients with AJCC stage Ⅲ-Ⅳ was higher than in those with stage Ⅰ-Ⅱ. Similarly, patients with histological grade G3 had higher SCG2 levels compared to those with grades G1-G2. SCG2 expression was also elevated in patients older than 60 years compared to those 60 years or younger, and in patients with CA19-9>30 U/L compared to those with CA19-9≤30 U/L. These differences were all statistically significant (all P<0.05). Multivariate Cox regression analysis revealed that lymph node metastasis ( HR=3.132, 95% CI: 1.212-8.096, P=0.017), liver metastasis ( HR=2.685, 95% CI: 1.002-7.192, P=0.049), histological grade G3 ( HR=3.692, 95% CI: 1.229-11.088, P=0.011), and high SCG2 expression ( HR=52.181, 95% CI: 38.476-108.118, P=0.002) were associated with significantly higher risks of shorter disease free survival. Additionally, patients with longer tumor diameters ( HR=1.297, 95% CI: 1.088-1.545, P=0.004), histological grade G3 ( HR=19.625, 95% CI: 5.276-88.634, P<0.001), and high SCG2 expression ( HR=39.454, 95% CI: 17.317-97.263, P<0.001) had a higher risk of shorter overall survival. A nomogram prediction model was constructed using these above factors. The calibration curve demonstrated good alignment between predicted and actual outcomes in both the training and validation sets. The areas under the ROC curves for the disease-free survival and overall survival nomogram models for predicting 1-, 3-, and 5-year survival of pNET patients in both sets were above 0.8. Conclusion:High SCG2 expression is an independent risk factor for poor prognosis in pNET patients. The nomogram model based on SCG2 has high predictive efficacy for pNET patient prognosis.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective:To investigate the changes of liver volume and liver function in patients with extensive hepatic vein occluded Budd-Chiari syndrome (BCS) treated with transjugular intrahepatic portosystem shunt (TIPS).Methods:The clinical data of 29 BCS patients from Affiliated Hospital of Xuzhou Medical University during March 2016 to June 2019 were retrospectively collected and analyzed. The BCS was caused by extensive hepatic vein occlusion and patients were treated with TIPS. Pre- and postoperative abdominal CT/MRI images were collected and analyzed, and hepatic volume was measured with 3D-reconstruction. The liver volume and liver function during before and post the surgery were also collected and analyzed with preoperative value.Results:Patients including 8 males and 21 females, aged (33.3±6.3) years, were enrolled in this study. TIPS was successfully performed in all patients, with a technical success rate 100%. No serious complications related to TIPS occurred. Patients were followed up for 12-33 months (median, 16 months). Compared with preoperative [(2 124.6±420.9) cm 3] , the hepatic volume of time points after operation [1 week: (1 926.3±372.3) cm 3; 3 months: (1 480.6±183.1) cm 3; 6 months: (1 461.9±153.0) cm 3; 12 months: (1 469.3±148.5) cm 3] were all significantly reduced, and the differences were statistically significant ( P<0.05). Compared with preoperative values, the hepatic function indexes at each time point after operation were significantly improved ( P<0.05). The complete remission rate of ascites was 96.4% (27/28), 100.0% (28/28) and 100.0% (28/28) at 3, 6 and 12 months, respectively. Conclusion:The extensive hepatic vein occlusive BCS patients were benefit from TIPS therapy. Six months after operation, the hepatic volume and the hepatic function returned to normal level.

Adolescent ; Adult ; Aged ; COVID-19 ; Child ; Child, Preschool ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Quarantine ; SARS-CoV-2 ; Surveys and Questionnaires ; United States ; Young Adult

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective:To study the use of contrast-enhanced ultrasonography (CE-US) and contrast-enhanced MRI(CE-MRI) in evaluation of therapeutic effect of transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC).Methods:A retrospective study was conducted on 60 patients with HCC (with 114 lesions), who were treated with TACE in Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2018. There were 53 males and 7 females, age ranged from 47 to 84 (mean age 61.9) years. CE-US, CE-MRI and digital subtraction angiography (DSA) were performed in all these patients within one week after TACE. Using DSA as the gold standard, the sensitivity, specificity and accuracy in the detection of residual lesions were compared between the two imaging methods. The consistency of results between CE-US and CE-MRI was analyzed.Results:CE-MRI and CE-US showed presence of active tumor foci (residual and/or recurrent lesion) in 78 lesions, and complete inactivation of HCC foci in 26 lesions. Ten lesions were diagnosed as active foci by CE-MRI, which were missed by CE-US. The diagnostic accuracy of CE-MRI was 100.0% (114/114), which was significantly better than the 91.2% (104/114) of CE-US ( P<0.05). The Kappa value between CE-US and CE-MRI was 0.781. The diagnostic coincidence between CE-MRI and CE-US was quite high. Among small lesions of less than 5 cm, the diagnostic accuracy of CE-MRI was 100.0% (78/78), which was significantly better than the 88.5% (69/78) of CE-US ( P<0.05). In large lesions of greater than 5 cm, the diagnostic accuracy of CE-MRI was comparable to that of CE-US. The difference was not significant ( P>0.05). The sensitivity of CE-MRI in detection of active lesions was higher than that of CE-US, and the specificity of the two imaging methods was consistent. The Kappa value between CE-US and CE-MRI was 0.747 for small lesions of less than 5cm, and 0.873 for large lesions of greater than 5 cm. The diagnostic coincidence between CE-MRI and CE-US was quite high. Conclusion:CE-MRI and CE-US can both be used as reliable imaging methods for evaluating the therapeutic effect of TACE for HCC.