BackgroundNon-suicidal self-injury （NSSI） behaviors are common among adolescents with depressive disorders， and school bullying is recognized as a major risk factor. Previous research has shown that self-esteem and alexithymia are closely associated with both school bullying and NSSI. However， the mediating roles of self-esteem and alexithymia in the link between school bullying and NSSI are unclear. ObjectiveTo explore the mediating roles of alexithymia and self-esteem in the relationship between school bullying and NSSI behaviors in adolescents with depressive disorders， in order to inform intervention strategies targeting NSSI in this population. MethodsA total of 335 adolescents diagnosed with depressive disorders and treated at the First Psychiatric Hospital of Harbin from July 2023 to October 2024 were enrolled. Assessments included a self-developed demographic questionnaire， Adolescent Non-suicidal Self-injury Assessment Questionnaire-Behavior （ANSAQ-B）， Delaware Bullying Victimization Scale-Student （DBVS-S）， Rosenberg Self-Esteem Scale （RSES）， and 26-item Toronto Alexithymia Scale （TAS-26）. Pearson correlation analysis was used to examine the relationship among variables. Controlling for gender and age at onset of depressive symptoms， mediation analysis was performed using the “mediation” package in R 4.4.2. ResultsScores on DBVS-S and TAS-26 were positively correlated with ANSAQ-B score （r=0.408， 0.417， P<0.01）， while RSES scores were negatively correlated（r=-0.300， P<0.01）. Regression analysis showed that school bullying and alexithymia significantly positively predicted NSSI behaviors （B=0.212， 0.333， P<0.01）， while self-esteem negatively predicted NSSI behaviors （B=-0.368， P<0.01）. Alexithymia was found to mediate the relationship between school bullying and NSSI behaviors， with an indirect effect of 0.040 （95% CI： 0.018~0.069） ，account for 17.17% of the total effect. The indirect effect through self-esteem was not statistically significant （95% CI： -0.004~0.069）. ConclusionExposure to school bullying and high levels of alexithymia are important predictors of NSSI behavior in adolescents with depressive disorders， and school bullying may indirectly influence NSSI behavior through alexithymia. ［Funded by Scientific Research Project of Health Commition of Heilongjiang Province，（number， 20230303090154］

Early upper gastrointestinal cancer screening skills teaching is the vacancy and difficulty of endoscopic teaching and training. In this study, a standardized training program was set up for endoscopic physicians who had mastered the basic gastroscopy techniques. The training period was 12 weeks, including theoretical training, early cancer awareness training, standardized gastroscopy operation technology, endoscopic diagnosis of early esophageal and gastric cancer, and theoretical and skill examination. After passing the examination, trainees can participate in early cancer case competition. According to questionnaire survey, 100%(15/15) of trainees thought that standardized training was necessary for improving the detection rate of early upper gastrointestinal cancer, and it could significantly improve the trainees' diagnosis level. Therefore, the overall setting of the standardized training process for the diagnosis of early upper gastrointestinal cancer in our center is generally reasonable, which is worthy of further promotion.

Objective To evaluate the feasibility of obtaining good quality ultrasound pictures of sutures and anterior fontanelle with three-dimensional and two-dimensional ultrasound. Methods Eighty fetuses at 16-35 weeks of gestation were evaluated with two-dimensional and three-dimensional ultrasound. The sagittal, coronal, lambdoidal and metopic sutures, as well as anterior fontanelle, were inspected. Results The visualization of the sagittal suture of three-dimensional ultrasound was significantly superior to that of two-dimensional ultrasound, while no significant difference in visualization of the metopic, lambdoidal, coronal sutures and anterior fontanelle was found between the two modalities. The visualization of all sutures and anterior fontanelle was significantly superior with three-dimensional ultrasonography to that of two-dimensional ultrasonography before 30 weeks of gestation, whereas no significant difference was found between the two modalities after 30 weeks of gestation. Conclusion Three-dimensional ultrasound can provide more comprehensive information of fetal cranial sutures and anterior fontanelle than two-dimensional ultrasound does. Three-dimensional ultrasound can also supply high visualization of all sutures and anterior fontanelle before 30 weeks of gestation.

Objective To assess the application value of three-dimensional (3D) ultrasound in visualizing fetal cranial sutures and fontanels. Methods One hundred women at different pregnant ages (16-19~+ weeks, 20-24~+ weeks, 25-29~+ weeks, 30-34~+ weeks, respectively) underwent 3D ultrasound, in order to observe the cranial sutures and fontanels of fetuses. Results ①Most cranial sutures and fontanels (70.00%-98.00%) could be visualized with 3D ultrasound. However, the sagittal suture revealed a lower displaying rate (53.00%) than others. ②At different pregnant ages, there was no significant difference of displaying rate of the metopic, coronal, squamoal sutures and the sphenoid, mastoid fontanels between fetuses and there was significant difference of displaying rate of the anterior and post fontanels, sagittal and lambdoid sutures. Conclusion 3D ultrasound can be used as an effective method for visualizing fetal cranial sutures and fontanels.