OBJECTIVE To explore the protective mechanism of amifostine on acute radiation injury mice. METHODS Thirty C57BL/6J mice were randomly divided into normal control group， model group and amifostine group （150 mg/kg）， with 10 mice in each group. Thirty minutes before irradiation， the mice in the amifostine group were intraperitoneally injected with amifostine； normal control group and model group were given constant volume of normal saline intraperitoneally； then acute radiation injury was induced by 4 Gy X-ray radiation in both model group and amifostine group. The white blood cell count （WBC）， platelet count and red blood cell （RBC） count in mice were detected 2 hours before irradiation and on days 1， 4， 7， 10 and 14 after irradiation； the changes in the proportion of WBC （neutrophils， lymphocytes and monocytes） on the 7th day after irradiation were analyzed. The 16S rRNA high-throughput sequencing was used to analyze the structure of gut microbiota in mice feces on the 7th day after irradiation， then its correlation with WBC was analyzed. RESULTS The counts of WBC on the 1st， 4th， 7th and 10th day after irradiation， platelet count on the 10th day after irradiation and RBC count on the 1st day after irradiation in the amifostine group were significantly higher than those in model group （P＜0.05）. Compared with normal control group，β diversity of gut microbiome showed significant change， relative abundance of Firmicutes increased and that of Bacteroidetes decreased in model group. Amifostine could reverse the change in β diversity of gut microbiome， and the relative abundance of Bacteroidetes and Firmicutes. The model group consisted of four distinct species， namely Allobaculum， Erysipelotrichia， Erysipelotrichales and Erysipelotrichaceae， which were significantly negatively correlated with the proportion of peripheral blood lymphocytes （P＜0.01）； amifostine group consisted of two distinct species， namely Lactobacillus murinus and L. crispatus， which were significantly negatively correlated with the proportion of neutrophils （P＜0.05）. CONCLUSIONS Amifostine significantly improves irradiation-induced injury by regulating dysbiosis of LY201816） gut microbiota.

Objective: To explore the association of milk tea consumption with comorbid of overweight/obesity and depressive symptoms among college students, so as to provide a reference for promoting the physical and mental health of college students. Methods: A questionnaire survey was conducted from August to October 2023 using convenience sampling among 13 920 students from nine universities in Shanghai, Jiangxi, and Hubei provinces (municipality directly under the central government). Information on college students demographic characteristics, milk tea consumption, overweight/obesity status, and depressive symptoms was collected. Chi square tests were used to compare the association between different demographic characteristics and milk tea consumption with comorbid overweight/obesity and depressive symptoms. Multivariate Logistic regression analysis was performed to infer the strength of the association. Results: The detection rate of comorbidity of overweight/obesity and depressive symptoms was 5.8% among college students. The univariate analysis revealed statistically significant differences in the detection rate of comorbidity of overweight/obesity and depressive symptoms among various groups, including gender, grade, parents education level, only child status, family economic status, meeting moderate to high levels of physical activity standards, sleep quality, and frequent fast food consumption ( χ 2= 82.10, 23.07, 8.91, 10.87 , 4.56, 47.60, 17.60, 386.74, 96.61, P <0.05). There were also statistically significant differences between groups based on milk tea consumption frequency and quantity ( χ 2=42.12, 38.76, P <0.01). Compared with the group of without consuming milk tea, Logistic regression analysis showed that college students who consumed milk tea 4-5 times and ≥6 times had higher risk of comorbid overweight/obesity and depressive symptoms ( OR =1.98, 2.46), and college students who consumed 1-1 500 mL and ≥3 000 mL of milk tea also had higher comorbidity risk ( OR =1.52, 1.22) ( P <0.05). Conclusions Frequent and excessive milk tea consumption among college students may increase the risk of comorbid of overweight/obesity and depressive symptoms. It is recommended to reduce the frequency and quantity of milk tea consumption to improve college students physical and mental health.

Objective: To understand the symptoms of depression and anxiety among rural returning adolescents and to analyze their association with physical activity related factors, so as to provide reference for interventions targeting depression and anxiety symtoms in the population. Methods: From April to June 2020, 3 495 middle school students were selected from 6 counties and districts of Shangrao City by random cluster stratified sampling sampling. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to evaluate the depressive and anxiety symptoms among middle school students. The International Physical Activity Questionnaire was used to assess their physical activity levels during the past week. Chi square test and Logistic regression analysis were used to determine the strength of the association between depression and anxiety symptoms and physical activity related factors in returning and non returning adolescents as well as the overall population. Results: Univariate analysis showed significant differences in the prevalence of depressive and anxiety symptoms between rural returning and non returning adolescents and the overall population in terms of "type of school" "family economic situation" "parental occupation" "number of sports classes per week" and "level of physical activity per week" ( χ 2=78.21, 16.56, 135.44, 107.75, 7.10, 8.62; 97.94, 24.26 , 124.07, 90.36, 9.60, 8.34, P <0.05). Multivariate regression analysis showed a correlation between the occurrence of depression and the number of sports classes per week for rural returning and non returning adolescents and the overall population (number of sports classes per week for non returning was 2 times, OR=1.22, 95%CI =1.01-1.49; returning adolescents for 1 time, OR=1.85, 95%CI =1.06-3.23; the overall population for 1 time, OR=1.34, 95%CI =1.01-1.77 and 2 times, OR=1.20, 95%CI =1.01-1.43, P <0.05). There was a correlation between anxiety symptoms and the number of sports classes per week for returning adolescents (number of sports classes per week for returning adolescents was 1 time, OR=2.10, 95%CI=1.21-3.63, P < 0.05 ). Conclusion A low frequency of weekly sports classes may be a risk factor for depressive or anxiety symptoms in rural and returning adolescents. Rural primary and secondary schools should appropriately increase the number of physical education courses or arrange sports extended classes to promote the development of adolescent mental health.

Objective:To introduce the early results of total aortic arch replacement (TAA) without cardiopulmonary bypass (CPB) and without interruption of cerebral blood supply, using the technique of arch branches preferential reconstruction and whole brain perfusion for brain protection.Methods:Between June 2020 and March 2021, a total of 9 Stanford type A aortic dissection patients we performed total arch replacement by using the technique of arch branches preferential reconstruction and whole brain perfusion without cardiopulmonary bypass and without interruption of blood supply to the brain. The method of this reconstruction technique is as follows: A 24F aortic cannula was inserted into the true lumen at the root of the transverse innominate artery (IA) to connect one end of the artery for cardiopulmonary bypass. The access was connected to 14F artery via Y-connector and inserted into IA cavity to maintain blood supply to brain. Without cardiopulmonary bypass, the 10 mm branch of the four branch artificial blood vessel was anastomosed with the innominate artery IA. The perfusion collateral was connected to the second end of the artery of CPB (single pump and double tubes) to continue to supply blood for IA. The left common carotid artery (LCA) and left subclavian artery (LSCA) were reconstructed by the same method. When IA and LCA were anastomosed, the distal blood supply was not interrupted. After the three branches of the aortic arch were anastomosed, we started to turn the machine, then cooled down and blocked the ascending aorta to further complete the operation of the aortic root and arch. During the period of lower body circulatory arrest, the whole brain was perfused with low flow.Results:No intraoperative death or perioperative complications occurred in all patients, and they were discharged smoothly. The cardiopulmonary bypass time was (192.4±58.1) min, the aortic clamping time was (128.3±52.4) min, the lower body circulatory arrest time was (29.1±1.3) min, and the postoperative awake time was (8.2±3.7) h.Conclusion:Off-pump arch branches preferential reconstruction can provide physiological whole brain perfusion, shorten the cardiopulmonary bypass time and aortic occlusion time, and the operation is safe and effective.

【Objective】 To study the technology of separating and purifying C1 esterase inhibitor (C1-INH) by using the waste washing liquid as raw materia during the preparation of human prothrombin complex (PCC) l. 【Methods】 C1-INH was isolated and purified by a two-step method of polyethylene glycol (PEG) 4000 precipitation and cation chromatography. The pH of raw materials and the concentration of PEG4000 were adjusted to investigate the optimal conditions of PEG4000 precipitation method. After PEG was precipitated and centrifuged, the supernatant is treated as the loading solution for cation exchange chromatography, using Fractogel EMD SE HiCap(M) gel and CM Sepharose FF gel for ion exchange chromatography. The most suitable gel and separation conditions were selected by comparing the C1-INH antigen yield, activity yield and specific activity. 【Results】 Under the condition of pH 6.1, when the mass fraction of PEG4000 was 14%, the recovery rate of C1 esterase inhibitor was close to 70%, and the removal rate of ceruloplasmin was more than 95% after stirring for 10 minutes. As fractogel EMD SE HiCap(M) gel was used for cation exchange chromatography, when the eluent salt concentration was 0.25 M sodium chloride, the activity yield of C1 esterase inhibitor was greater than 80%, and the specific activity was greater than 5 IU/mg. 【Conclusions】 Using the waste washing liquid as the raw material during the preparation of PCC, the C1 esterase inhibitor with high specific activity can be prepared through PEG precipitation and purification by Fractogel EMD SE HiCap(M) ion exchange chromatography.

Objective:To explore the impact of different family management patterns on the family resilience of children with brain tumors.Methods:A total of 210 parents of children with postoperative brain tumors in 2 tertiary Grade A pediatric hospitals were investigated by the general information questionnaire, family management measure (FaMM) and family resilience rating scale.SPSS 24.0 was used for cluster analysis.Results:(1) Among the scores of FaMM, child identity, condition management ability and parental mutuality were significantly positively correlated with family resilience ( r=0.312, r=0.470, r=0.391, all P<0.05), while view of condition impact, condition management difficulty and condition management effort were negatively correlated with family resilience ( r=-0.346, r=-0.177, r=-0.348, all P<0.05). (2) Family management patterns could be divided into four categories: burden managing (22.9%), effective managing (24.8%), poor managing (28.6%) and tacit managing (23.8%). (3) Family resilience scores of the four patterns were (197.21±20.08), (205.92±14.25), (181.47±18.13) and (198.06±17.08), and their differences were statistically significant ( F=19.498, P<0.01). Conclusion:The family resilience level of children with brain tumor is associated with different family management patterns.Therefore, effective strategies according to different family characteristics should be developed to improve family resilience level.

The characteristics of thyroid nodules in children are significantly different from those in adults,and the assessment and treatment of thyroid nodules in children are also different from those in adults.The key step to evaluate thyroid nodules is to differentiate benign from malignant nodules.Early identification of risk factors,definite diagnosis based on medical history,laboratory and related instruments,reasonable treatment and avoidance of overdiagnosis and treatment are helpful to improve the prognosis of children with thyroid nodules,especially children with malignant tumors,and reduce complications.

Objective To analyze the curative effect and prognosis of pancreatic ductal stone treated by pancreatectomy,pancreatic duct drainage or combined procedures.Methods The clinical data of 296 pancreatic ductal stone patients who received surgical treatment in First Affiliated Hospital of the Army Medical University between January 2008 and June 2017 were retrospectively analyzed.The cases were divided into pancreatectomy group (162 cases),pancreatic duct drainage group (104 cases) and combined procedures group (30 cases) according to their surgical procedures.The clinical characteristics and short-term and longterm outcomes of surgical treatment between the three groups were analyzed.Kaplan-Meier method was used to estimate the survival rate of no recurrence of pain after operation.Log-rank test and Cox-proportional hazard model were used to analyze the influencing factors on the recurrent pain free survival after surgery.Results The ratio of male patients was highest in pancreatectomy group,and the incidence of pancreatic exocrine insufficiency was highest in pancreatic duct drainage group.Of 296 patients,Ⅰ type pancreatic stone was most in pancreatectomy group and combined procedures group (80.2％,70.0％),and Ⅲ type pancreatic stone was most in pancreatic duct drainage group (46.2％).Medium size pancreatic stone was most in pancreatectomy group (52.5％),and medium and large size pancreatic stone was most in pancreatic duct drainage group (80.8％).Obvious pancreatic atrophy was most in pancreatic duct drainage group.Pancreatic head swelling,bile ductal dilation or compression,combined with pancreatic or surrounding organ complications were most in pancreatectomy,and all the differences were statistically significant (all P ＜ 0.05).In the short-term effect,the overall rate of pain relief was 99.3％,and there was no statistical difference among three groups.Pancreatic duct drainage group was superior to the other two groups in terms of operative time,bleeding volume,postoperative hospitalization days and postoperative complications (all P ＜0.05),but the total incidence of residual stones after operation in drainage group (64.8％) was higher than that in the other two groups,and the difference was statistically significant (all P ＜ 0.05).In the long-term effect,there were no significant differences in pain recurrence,stone recurrence reoperation,postoperative pancreatic function,body weight and quality of life recovery among the three groups.The 1-year,3-year and 5-year no recurrent pain after operation was 89.0％,79.2％ and 68.9％,respectively.Univariate and multivariate analysis showed that the course of CP ≥5 years(HR =2.113,95％ CI 1.160-3.848,P=0.014) and postoperative long-term alcohol consumption (HR =1.971,95％ CI 1.073-3.620,P =0.029) were independent risk factors affecting pain recurrence after surgery.Conclusions Surgery is still an important means for the treatment of pancreatic ductal stone.The short-term and long-term effect of pancreatectomy,pancreatic duct drainage and combined procedures for pancreatic ductal stones are definitely effective.However,none of the three methods can prevent the continued loss of pancreatic function in some patients.According to the preoperative clinical features,surgery strategy should be formulated individually,and the postoperative health guidance and follow-up should be emphasized,which can help to improve the prognosis of the patients with pancreatic ductal stones.

Objective? To understand the status quo of continuing rehabilitation nursing needs of orthopaedic patients after discharge, and to analyze the influencing factors of their rehabilitation needs. Methods? Using convenience sampling method, 210 orthopaedic inpatients from March to June 2017 in a ClassⅢ Grade A hospital in Wuhan were selected. The status quo and influencing factors of patients' rehabilitation needs after discharge were investigated by self-made Questionnaire of Orthopaedic Patients' Continuing Rehabilitation Nursing Needs. Results? The total score of continuing rehabilitation instruction needs of 210 patients was (46.35 ±13.20), 47.2% of them hoped to continue rehabilitation through network communication, 85.9% chose to do rehabilitation at home, 84.8% hoped that the former medical staff would provide continuing rehabilitation instruction, and 83.3% accepted rehabilitation exercises with the help of Wechat public account. Multivariate linear regression analysis showed that education level, disease diagnosis, knowledge of rehabilitation and willingness to guide rehabilitation were independent influencing factors (β=-3.138, 3.162,-3.985,-3.786; P＜ 0.01). Conclusions? Orthopaedic patients have a strong demand for rehabilitation knowledge and exercise. It is suggested that medical staff strengthen continuing rehabilitation nursing exercise and knowledge instruction for orthopaedic patients through the internet Wechat platform.

Objective To understand the gender selection and prognosis of children with 46,XY disorders of sex development (DSD) after surgery,and to provide reference for future clinical decision-making.Methods Data of 85 (80 males and 5 females) postoperative patients with 46,XY DSD with follow-up age of 6(4,11) years who were treated at the Department of Endocrinology,Genetics and Metabolism of Beijing Children's Hospital Affiliated to Capital Medical University during the period from September 2009 to April 2018 were retrospectively analyzed.The patients were grouped based on diagnosis.The basis of postoperative gender selection,patient satisfaction and related factors,gender characteristics,and adolescent development were analyzed.The Pre-school Activities Inventory or the Children's Sex Role Inventory were used in the analysis of gender tendency.Mann-Whitney U test was used to compare postoperative gender satisfaction of different factors.The Kruskal-Wallis method was used to compare the postoperative gender satisfaction of each group.Fisher's test was used to compare the follow-up status of male children over 11 years old in each group.Results Among the 85 patients,62 individuals were raised as girls after birth,9 were facultative and 14 as boys.According to the diagnosis,there were 31 individuals in group 1 (with 5α-reductase deficiency),11 individuals in group 2 (with androgen insensitivity syndrome),9 individuals in group 3 (with NR5A1 gene mutation),4 individuals in group 4 (with hypergonadotropic gonadal dysplasia),and 30 indiviudals in group 5 (with unclear diagnosis and normal human choionic gonadotophin test).Among the 71 children who were raised as girls or facultative children after birth,66 selected as boys,and 5 continued as girls (among them,3 individuals were female with passive selection,and 2 individuals of testicular dysplasia with uterus in group 4 and 5 were female with active selection).Among the 71 patients faced with gender selection,only one was unsatisfied,that was a postoperative female.There was no significant difference in postoperative gender satisfaction among different disease diagnoses,surgical age and penis length (x2(H)=6.007,P=0.199;Z=-0.860,P=0.390;Z=-0.438,P=0.661).Fifty-nine of the 85 cases completed the gender tendency scale test and 46 cases (78％) were consistent.In the male patients,45 cases were consistent.Thirteen inconsistent patients (22％) were female or facultative after birth who were 5 years old or older.There was no stigmatization noticed in the inconsistent patients' daily life and school social settings.There were 22 male patients aged 11 years and older.They were 13(12,16) years old.Fourteen (64％) individuals' penile length reached the normal minimum,15 (68％) individuals' testicular volume were equal or more than 4 ml,16 (73％) individuals' sex hormones entered puberty levels,12 (55％) individuals had been spermatorrhea,the age of first spermatorrhea was (13.3±2.4) years.They were satisfied and adaptable after surgery.There was no significant difference in the above indicators among the groups (x2 =2.999,P=0.694;x2 =7.278,P=0.086;x2 =5.597,P=0.358;x2 =6.904,P=0.127).Conclusions The appropriate gender of 46,XY DSD patients was selected according to gonadal status after diagnosis.Regardless the diagnosis,the age of operation and the length of the penis at the first diagnosis,male patients were satisfied with the gender after the operation.A few of patients were inconsistent with the results of gender tendency scale test who were raised as girls or facultative children after birth,and they required sustained special attention.Some of the children showed natural adolescent development in males,and the prognosis may be ideal.