Objective:To explore the characteristics and associations of symptoms among freshmen in high vo-cational education with varied levels of mental health state.Methods:A sample of 3 601 freshman students from a vocational college in Zhejiang province was chosen to evaluate their mental health state by the University Personali-ty Inventory(UPI).Based on network analysis method(NAM),the core symptoms associated with various levels of mental health state were analyzed by using the Ising model,cross-network comparisons were conducted by using the Network Comparison Test(NCT).Results:Among students who might have severe psychological problems,the strongest association was found between low self-esteem symptoms,with the core symptoms primarily concerning e-motions and interpersonal issues(egde=1.36).Among students who might have mental block,the strongest associ-ation was between social avoidance symptoms,with the core symptoms mainly linked to low self-esteem(egde=1.89).NCT revealed that there were no significant differences in general strength(P＞0.05)among vocational col-lege freshmen at different mental health state.However,there were significant differences in network structures(P＜0.001).Conclusion:In varying levels of mental health,symptoms among higher vocational college freshmen are primarily characterized by interpersonal emotional issues with low self-esteem,and interpersonal avoidance issues with low self-esteem.The students who may have severe psychological problems would have closer network con-nections.

Using the liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the plasma level of Lyso-GL3 in patients with Fabry disease and to analyze the clinical application of the method.

Objective:To explore the level of arterial stiffness and its influencing factors in prediabetic population.Methods:From June 2021 to June 2022, 207 prediabetes patients were prospectively and randomly recruited from the physical examination center and outpatient clinic of Tangdu Hospital of Air Force Military Medical University to be the prediabetic group and 130 healthy volunteers at the same time with the same gender and age as the healthy controls. The carotid-femoral pulse wave velocity (PWV), brachial-radial PWV, and femoral-ankle PWV were measured by an automatic ultrasonic arterial stiffness measurement technology. The common carotid artery wall intima-media thickness (IMT) and left heart function were routinely evaluated. A questionnaire was designed to investigate the subjects′ smoking, drinking, diet, staying up late, exercise and other living habits. Comparison between groups and multivariate linear regression analysis were used to analyze the relevant data.Results:The carotid-femoral PWV and common carotid artery wall IMT in prediabetic group were significantly higher than those in healthy controls [(7.10±2.00)m/s vs (6.26±1.14)m/s, (0.57±0.11)mm vs (0.51±0.08)mm; both P<0.001], but there were no significant differences in the brachial-radial PWV and femoral-ankle PWV between the two groups (both P>0.05). Multivariate linear regression analysis showed that prediabetes was an independent influencing factor in carotid-femoral PWV after adjusting for confounding factors ( P<0.001), in addition, age ( P<0.001), diastolic blood pressure ( P<0.001), staying up late ( P=0.011) and low density lipoprotein cholesterol ( P=0.022) were also the independent influencing factors of carotid-femoral PWV. Conclusions:Compared with healthy people, the stiffness of aorta is significantly increased in prediabetic people, but there is no significant change in the stiffness of peripheral arteries. Prediabetes, age, diastolic blood pressure, staying up late and low density lipoprotein cholesterol are independent influencing factors of carotid-femoral PWV.

Objective:To explore the diagnosis, surgical methods and therapeutic effect of primary duodenal malignant tumor.Methods:The clinical data of 116 patients with primary duodenal malignant tumor from January 2010 to December 2018 were retrospectively analyzed.Results:Among 116 patients, adenocarcinoma was in 74 cases, interstitial tumor was in 25 cases, carcinoid was in 9 cases, the others was in 8 cases. Before operation, duodenoscopy was performed in 107 cases, and CT examination was performed in 76 cases. There were 57 cases of pancreaticoduodenectomy, 15 cases of duodenal segmental resection, 13 cases of subtotal gastrectomy and duodenal bulbar resection, 13 cases of duodenal partial resection, and 18 cases of palliative short circuit operation. The total incidence of postoperative complication was 31.9% (37/116), including pancreatic fistula in 8 cases (grade B 5 cases, grade C 3 cases), biliary fistula in 6 cases, abdominal infection in 5 cases, pulmonary infection in 4 cases, intestinal fistula in 3 cases, delayed gastric emptying in 3 cases, and hemorrhage in 8 cases. Four cases (3.4%) died during the perioperative period. Single factor Cox regression analysis result showed that the postoperative survival time was related to the tumor differentiation degree, operation method, tumor infiltration degree and lymphatic metastasis ( P<0.05 or <0.01); multi-factor Cox regression analysis results showed that the operation method, tumor infiltration degree and lymphatic metastasis were the independent risk factors for the postoperative survival time of patients with primary duodenal malignant tumor ( P<0.05). The patients were followed up until June 2021, and 9 cases were lost to follow-up. Kaplan-Meier survival curve analysis result showed that the postoperative overall 1-,3- and 5-year survival rates were 82.11%, 57.56% and 33.11%, respectively. Conclusions:Adenocarcinoma is the main primary malignant tumor of duodenum. Duodenoscopy and CT are the main examination methods. Radical resection is the most effective treatment for primary duodenal malignant tumor, and pancreaticoduodenectomy is the first choice. Surgical method, tumor infiltration degree and lymphatic metastasis are the independent risk factors affecting the prognosis of patients.

Objective To observe the therapeutic effect of the combination of cinobufacini with DC chemo-therapy in the treatment of advanced stomach cancer .Methods 65 patients who were diagnosed advanced gastric cancer on the basis of histocytology and pathology results , were randomly divided into DC chemotherapy group (31 cases) and combined treatment group (34 cases).The clinical curative effect ,adverse reaction,quality of life ( KPS questionnaire ) and the easement rate of pain were analyzed .Results The two groups had no statistically significant differences in adverse reaction (t=-0.0047,P>0.05) and clinical curative effect (χ2 =0.077,P>0.05),and the clinical response rate of the combined treatment group (35％) was similar to the DC chemotherapy group (32％).Besides,the easement rate of pain in the combined treatment group increased to 71％,which in the DC chemotherapy group increased to 45％(χ2 =19.969,P<0.05).And the improvement rate of quality of life (QOL) in the combined treatment group was 82％,which of the DC chemotherapy group was 55％,the difference was statistically significant(χ2 =13.923,P<0.05).Conclusion Cinobufaconi combined with DC chemotherapy in the treatment of advanced stomach cancer has no significant effect on increase of short -term efficacy ,but it can improve quality of life and alleviate pain obviously .

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

Tumor recurrence is the main factor affecting the postoperative prognosis of hepatocellular carcinoma.The forecast of tumor recurrence by monitoring biomarker can effectively improve the prognosis of such disease.To improve the detection rate of early cancer recurrence can be achieved by detecting the level of the alpha-fetoprotein (AFP),Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3),des-γ-carboxyprothrombin (DCP),or combined detection.In recent years,the researches on the miRNA and Long Noncoding RNAs (LncRNA),which are key regulators in the upstream of signal pathways,could provide a new way for HCC recurrence monitoring.The combined detection of biomarkers in different control levels,maybe is the effective measure to improve the tumor recurrence detection rate,and is also the focus of the further research.

Objective To investigate the present situation of anticoagulant therapy on the elderly non valvular atrial fibrilla‐tion (NVAF) hospitalized patients with thromboembolic complications [ischemic stroke ,transient ischemic(TIA)] .Methods A to‐tal of 255 hospital patients in the First Affiliated Hospital of Chongqing Medical University from 2012 to 2014 were recorded by retrospective case analysis .The basic characteristics ,the risk factors of AF ,the medical treatment plan and INR monitoring were analyzed respectively with SPSS20 .0 statistical software .Results A total of 255 patients were enrolled ,66 cases (25 .88% ) were treated with anticoagulation ,and 157 cases (61 .57% ) were treated by antiplatelet drugs .In patients who were taken anticoagulant drugs ,the rate of INR was 15 .15% .Conclusion In the elderly nonvalvular atrial fibrillation patients with thromboembolic compli‐cations ,the rate of anticoagulant therapy is lower than expected .More than half patients were treated by antiplatelet drugs .The pa‐tient who were treated anticoagulation therpy had a low rate of INR standard rate .

Objective To investigate the present situations of anticoagulant treatment of non-valvular atri-al fibrillation in order to get better guidance of the clinical anticoagulant therapy and reduce the incidence of stroke caused by atrial fibrillation. Methods The clinical data of NVAF patients hospitalized in the first affili-ated hospital of Chongqing Medical University from January 1 , 2012 to December 31 , 2014 were retrospectively reviewed and analyzed in terms of basic characteristics , medical treatment plan and INR monitoring. Results A total of 1,390 patients were enrolled, 85.97% of whom needed anticoagulant therapy and 25.18% of whom were treated with anticoagulants. For 15.71% of the NVAF patients treated with warfarin , INR met the standard during hospitalization. In the study, such factors as age, coronary heart disease, history of stroke and history of bleed-ing might affect prescription of anticoagulant drugs. Conclusion Most NVAF patients need anticoagulant thera-py, but the rate of anticoagulant therapy is lower than we expected. Among those patients treated with warfarin during hospitalization , the rate of INR meeting the standard is at a lower level. The novel oral anticoagulants are not in wide use in the clinical practice.