Objective:To explore the clinical and histopathologic features of lupus nephritis (LN) patients with positive antineutrophil cytoplasmic antibody (ANCA), so as to provide more theoretical basis to recognize and treat this disease.Methods:Clinical data of biopsy-proven LN patients with ANCA test in the First Affiliated Hospital of Sun Yat-sen University from November 1, 2002 to September 11, 2020 were collected and analyzed retrospectively. The difference of clinical data, laboratory examination, and pathological examination of renal biopsy between ANCA-positive group and ANCA-negative group. The clinicopathological characteristics between different ANCA serotypes were compared.Results:A total of 1 304 patients with LN confirmed by renal biopsy and ANCA test results were enrolled. Eighty ANCA-positive patients from 1 304 LN patients were screened. There are 55(68.8%) ANCA-positive LN patients with positive anti-myeloperoxidase antibodies (MPO). There were 14(17.5%) ANCA-positive LN patients with positive anti-proteinase 3 antibodies (PR3), and 11(13.8%) ANCA-positive patients with double positive antibodies of MPO and PR3. ANCA-positive LN patients had significantly higher serum creatinine [135.5(68.0, 361.8) μmol/L vs 88.0(64.0, 165.0) μmol/L, P=0.004] and blood urea nitrogen [12.35(6.35, 21.18) mmol/L vs 8.60 (5.50, 15.70) mmol/L, P=0.026] as well as lower estimated glomerular filtration rate [45.70(13.83, 84.10) ml·min -1·(1.73 m 2) -1 vs 66.75(38.43, 96.22) ml·min -1·(1.73 m 2) -1, P=0.001] than ANCA-negative patients (stratified sampling of 160 patients). ANCA-positive LN patients had higher chronicity index than ANCA-negative LN patients [3(2, 7) vs 2(0, 5), P=0.006]. There were statistically significant difference in hemoglobin, serum creatinine and estimated glomerular filtration rate among ANCA-positive group, ANCA-negative group, and MPO-ANCA and PR3-ANCA double positive group. MPO-ANCA and PR3-ANCA double positive LN patients had the lowest hemoglobin and estimated glomerular filtration rate, and highest serum creatinine among the three groups (all P<0.05). Conclusions:ANCA-positive LN patients have worse renal function and higher renal histological chronicity index than ANCA-negative LN patients, especially for patients with double positive MPO-ANCA and PR3-ANCA. More stringent monitoring and therapy may be needed in this subgroup of LN patients.

OBJECTIVES: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression. METHODS: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory. RESULTS: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables. CONCLUSIONS Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.
Adaptation, Psychological ; Child ; China/epidemiology* ; Extraversion, Psychological ; Humans ; Only Child ; Surveys and Questionnaires

Objective To explore the effects of self-role recognition nursing on the agitation behavior and social interaction in schizophrenic patients with diabetes mellitus. Methods A total of 98 cases of schizophrenia patients with diabetes mellitus treated in Wuxi Mental Health Center of Jiangsu Province from October 2014 to October 2016 were selected as the research objects. The patients were randomly divided into control group and study group by random number table method. The control group was given routine nursing intervention, while the study group was given self-role recognition nursing intervention for 6 months. The level of fasting blood glucose and 2-hour postprandial blood glucose were compared between the two groups. Patients' agitation behavior was evaluated by Cohen-Mansfield agitation inventory (CMAI); social communication ability was evaluated by social skills checklist (SSC) and social adaptive functioning evaluation (SAFE); mental status was evaluated by positive and negative syndrome scale (PANSS). The data of this study were statistically analyzed with SPSS 19.0 statistical software, in which the measurement data were tested by t-test, and the enumeration data were tested by χ2test. Results Before intervention, there was no significant difference in fasting blood glucose and 2-hour postprandial blood glucose between the two groups (P> 0.05). After intervention, the fasting blood glucose and 2-hour postprandial blood glucose level in the study group were significantly lower than those in the control group, and the differences were statistically significant (P< 0.01). The scores of physically aggressive agitation, physically non-aggressive agitation, verbal agitation and the total score of CMAI in the control group were (16.4±3.7), (31.5±4.9), (25.2±4.5), (73.1±4.5) respectively after intervention, and the scores were (11.8±3.2), (24.1±5.3), (17.5±4.2), (53.4±4.7) in the study group. The differences between the two groups after intervention were statistically significant (t=7.268, 8.617, 8.561, 15.341;P<0.01). The results of SSC scale and SAFE scale in both groups decreased than before intervention, and the scores of the study group were all lower than those of the control group, with statistical significance (P<0.01). After intervention, the scores of positive symptoms, negative symptoms, negative symptoms and the total score of PANSS scale of the study group were significantly lower than those of the control group, and the differences were statistically significant (P<0.01). Conclusions Self-role recognition nursing intervention can be used to improve the patients' social interaction ability and mental status in the nursing process of schizophrenia patients with diabetes mellitus, and it is worthy of clinical promotion.

Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.

Purpose To study the clinicopathologic features and differential diagnosis of primary mucosal melanoma of the nasal cavity (PMMNC).Methods 17 cases of PMMNC diagnosed from January 2003 to September 2016 were studied by clinical pathological analysis and immunohistochemical staining,and relevant literatures were reviewed.Results 73％ of the PMMNC was characterized by unilateral nasal congestion and intermittent epistaxis and 61％ of the PMMNC occurred in the nasal septum and nasal side wall.Microscopically,the organizational structure and morphology were complex and diverse,which had several cell types including epithelioid cell type (6cases,35.3％),spindle cell type (3 cases,17.6％) and snall cell type (5 cases,29.4％),the other 3 cases (17.6％)were mixed cell type.Mitotic activity and tumor necrosis were more likely to be seen in PMMNC,among other clinicopathological features with a small amount of fibrous stroma and melanoma and rich blood vessels.The immunohistochemical study showed that the positive rate of S-100 and HMB-45 were both 93.8％(15 cases) and those of Melan-A and vimentin were both 87.5％ (14 cases),while CK and EMA were both negative (16 cases).Conclusion PMMNC is a rare disease and the phenotype of S-100,HMB-45,Melan-A and vimentin are useful for diagnosis of PMMNC.

Objective:To investigate the relationship between social support and depression of only-child-lost (OCL) people,and the mediation role of self-efficacy in this relationship.Methods:By stratified cluster sampling,214 OCL people were enrolled,with 80 males and 134 females,ages from 49 to 83 years old.They were assessed by General Self-Efficacy Scale,Social Support Rating Scale,and Self-rating Depression Scale.Results:Univariate analysis showed that there were significant differences in age groups (t=2.85,P＜0.05),with or without spouse (t=5.62,P＜0.05),family location (t=3.95,P＜0.05),per capita monthly income (F=3.48,P＜0.05) among the social support scores.There was significant difference between the per capita monthly income and self-efficacy scores in QCL people (F=5.46,P＜0.05).Correlation analysis showed self-efficacy and social support were positively correlated (r=0.26,P＜0.01).Self-efficacy (r=-0.59,P＜0.01) and social support (r=-0.59,P＜0.01) negatively correlated with depression in OCL people.Self-efficacy partially mediated the relationship between social support and depression.Conclusion:The person who is ＜60 years old,with spouse and the high per capita monthly income,and lives the rural area,would have high social support levels among QCL people.The person who has high per capita monthly income would have high self-efficacy.Self-efficacy is one of the direct prediction for depression,and plays an indirect role between social support and depression.Intervention of depression among OCL people could be applied to change their cognition,and to enhance their self-efficacy.

Objective To evaluate the efficacy and safety ofGuipi Decoction vs. antidepressants for depression. Methods Articles about the randomized controlled trials (RCTs) ofGuipi Decoction for depression were searched in the databases of CNKI, VIP, Wanfang Data, CMB, Embase, PubMed, and Cochrane Library. Two researchers independently screened the articles, extracted the data, and evaluated the methodological quality. Meta-analyses were performed by using RevMan 5.2 software.Results A total of 9 RCTs articles involving 893 cases were included. Meta-analysis results suggested that as compared with antidepressants only,Guipi Decoction together with antidepressants was associated with a significantly greater reduction in HAMD scores (MD=-4.63, 95%CI [-5.95, -3.32];P<0.001). There was no significant difference in HAMD scores betweenGuipi Decoction used alone and antidepressants (MD=-0.30, 95%CI [-4.22, 3.62];P=0.88). As compared with antidepressants,Guipi Decoction together with antidepressants increased in the rates of total effective events (RR=1.26, 95%CI [1.14, 1.38];P<0.001). No serious adverse reactions were reported. Meta-analysis results suggested that the incidence of adverse reactions of Guipi Decoction(RR=0.48, 95%CI [0.40, 0.58];P<0.001) andGuipi Decoction together with antidepressants (RR=0.51, 95%CI [0.30, 0.85];P=0.010) were lower than that of antidepressants alone.Conclusion The present evidence suggests thatGuipi Decoction is effective and relatively safe for patients with depression. However, because the quality of included research was low, more large-scale RCTs with multicenter and high quality are needed for further verification.

Objective To investigate the relationship between social support and subjective well-be-ing in only-child-lost ( OCL ) people, and the mediating effect of self-efficacy in this relationship. Methods By stratified cluster sampling,206 only-child loss people were investigated with Social Support Rating Scale ( SSRS) ,General Self-Efficacy Scale ( GSES) and Index of Well-Being ( IWB) ,and data were analyzed with SPSS19.0 software and Amos17.0 software. Results ①Scores of SSRS,GSES and IWB in only-child-lost people were(31.78±8.18),(24.12±0.67) and (8.38±3.05). ②Correlation analysis showed that scores of GSES,SSRS and 3 dimensions of SSRS were positively correlated with scores of IWB ( r=0. 542,0.332,0.214,0.332,0.216;P<0.05) . ③Self-efficacy partially mediates the relationship between social support and subjective well-being through mediating effect test(χ2/ df=1.986,GFI=0.985,AGFI=0.942, RMSEA=0.069),mediating effect accounted for 16.08%.Conclusion Social support is an important factor which plays a direct or indirect role in subject well-being. Self-efficacy is the intermediate link between social support and subject well-being.

Adopting self-designed questionnaires, the paper investigates medical information demands of clinicians in third-level hospitals, secondary-level hospitals and basic medical and health institutions in Sichuan province.The results show a higher demand for medical information services in Sichuan province, various continuing education and training service should be taken to meet the informa-tion demands of clinicians in different levels.

Objective Gambogic acid ( GA) can suppress the growth of multiple tumor cells , including gastric carcinoma , hepatoma , hematologic neoplasms and breast carcinoma , but there have been few reports about its effect on urologic neoplasms .This study was to investigate the possible mechanisms of GA inducing bladder cancer cell apoptosis and cell cycle arrest . Methods We cultured human bladder cancer BIU8-7 cell lines in vitor and treated the cells in the logarithmic growth phase with isotonic saline solu-tion (negative control)or GA at the concentrations of 1.0, 2.0, and 3.0μmol/L, respectively.We determined the expression of the Caspase-3 protein in the tumor tissue using the immunohistochemical S-P method and detected GA-induced apoptosis of the bladder cancer cells and cell cycle changes by flow cytometry . Results The expressions of the Caspase-3 protein were 4.28 ±1.86, 5.03 ± 0.78, and 6.47 ±1.31 in the 1.0, 2.0, and 3.0μmol/L GA groups, respectively, significantly higher than 2.13 ±1.27 in the nega-tive control (P<0.05).Flow cytometry showed a gradual decrease of the cells in the G 0/G1 phase and a gradual increase in the G2/M phase , but no obvious change in the S phase . Conclusion Gambogic acid can promote the apoptosis , arrest the cell cycle , and in-hibit the proliferation of bladder cancer cells by increasing the expression of the Caspase -3 protein.