1.Diagnostic value of preoperative diffusion weighted imaging histogram parameters in the depth of invasion of early rectal cancer
Shengchao JI ; Xiaofeng JIN ; Daixi YE ; Zehua LU ; Lulu XUAN ; Chengjun GENG
Journal of International Oncology 2025;52(10):621-627
Objective:To explore the diagnostic value of preoperative diffusion weighted imaging (DWI) histogram parameters in the depth of invasion of early rectal cancer.Methods:A total of 180 patients with early rectal cancer admitted to 904th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from August 2020 to August 2024 were selected as the study objects. Patients were divided into intramucosal cancer group ( n=102) and submucosal cancer group ( n=78) according to the depth of tumor invasion. The general data of the two groups were compared. The intraclass correlation coefficient (ICC) was used to analyze the consistency of DWI histogram parameters extracted by the two radiologists, and the differences between the two groups were compared. Receiver operator characteristic (ROC) curve was used to analyze the predictive value of each parameter to the depth of tumor invasion. Multivariate logistic regression was used to analyze the independent influencing factors of invasion depth, and a predictive model was constructed. The ROC curve was drawn to analyze the predictive value of the model for tumor invasion depth, and the Hosmer-Lemeshow test was used to analyze the goodness of fit of the model. Results:There were statistically significant differences in age ( t=8.15, P<0.001), maximum tumor diameter ( χ2=29.29, P<0.001), endoscopic type ( χ2=20.96, P<0.001), histological type ( χ2=24.93, P<0.001) and differentiation degree ( χ2=73.35, P<0.001) between intramucosal cancer group and submucosal cancer group. The mean, variance, skewness, kurtosis, the 1 st, 10 th, 50 th, 90 th, and 99 th percentiles of the histogram parameters of DWI had good consistency (all ICC>0.75). There were statistically significant differences in the mean ( t=5.69, P<0.001), variance ( t=9.75, P<0.001), skewness ( t=10.88, P<0.001), kurtosis ( t=10.06, P<0.001), the 1 st percentile ( t=3.43, P<0.001), 10 th percentile ( t=3.59, P<0.001), 50 th percentile ( t=9.97, P<0.001), 90 th percentile ( t=4.63, P<0.001), and 99 th percentile ( t=2.44, P=0.016) of the DWI histogram parameters between the intramucosal cancer group and the submucosal cancer group. ROC curve analysis results showed that mean [area under the curve (AUC) =0.77], variance (AUC=0.88), skewness (AUC=0.88), kurtosis (AUC=0.78), 50 th percentile (AUC=0.86) and 90 th percentile (AUC=0.82) had certain diagnostic value for submucous cancer. Multivariate analysis showed that age ( OR=9.98, 95% CI: 1.10-90.70, P=0.041), maximum tumor diameter ( OR=7.36, 95% CI: 1.08-50.23, P=0.042), and differentiation degree ( OR=19.88, 95% CI: 1.21-327.92, P=0.037), variance ( OR=16.24, 95% CI: 2.26-116.68, P=0.006), skewness ( OR=21.13, 95% CI: 2.80-59.61, P=0.003), 1 st percentile ( OR=9.78, 95% CI: 1.17-81.76, P=0.035) were independent factors in predicting tumor invasion depth in patients with early rectal cancer. The predictive model based on the above indicators was logit ( P) =1.51+2.30×age+2.00×maximum tumor diameter+2.99×differentiation degree+2.79×variance+3.05×skewness+ 2.28×the 1 st percentile. ROC curve analysis showed that the predictive model had an AUC of 0.97 (95% CI: 0.95-0.99) for judging the occurrence of submucosal cancer in patients with early rectal cancer, the sensitivity was 0.95, and the specificity was 0.88. The Hosmer-Lemeshow test results showed that the goodness of fit of the model was ideal ( P=0.823) . Conclusions:Age, maximum tumor diameter, differentiation degree, variance, skewness, and the 1 st percentile are independent factors in predicting tumor invasion depth in patients with early rectal cancer. The predictive model constructed based on these factors can effectively predict the risk of submucosal cancer in patients with early rectal cancer.
2.Transapical transcatheter aortic valve replacement in bicuspid aortic valve patients: In-hospital outcomes
Xuan HUANG ; Lulu LIU ; Tingxi ZHU ; Kehan LI ; Yingqiang GUO ; Xiaoyan YANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(08):1128-1136
Objective To compare the in-hospital outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) for bicuspid aortic valve (BAV) patients and tricuspid aortic valve (TAV) patients. Methods Patients (including BAV and TAV patients) who underwent TA-TAVR with the J-ValveTM in West China Hospital from July 2014 to July 2020 were included consecutively. The clinical outcomes of the patients were analyzed. Results A total of 354 patients were included in the study, 75 in the BAV group and 279 in the TAV group. There were 229 males and 125 females with a mean age of 72.2±6.0 years. No death occurred during the procedure, and the overall technical success rate was 97.7%. The all-cause in-hospital mortality rate was 1.4%. Twenty (26.7%) patients with BAV and 46 (16.5%) patients with TAV had mild or higher perivalvular leaks immediately after the procedure. No patients with BAV required permanent pacemaker implantation postoperatively, while 13 (4.7%) TAV patients required permanent pacemaker implantation, with an overall pacemaker implantation rate of 3.7%. One (1.3%) BAV patient and 7 (2.5%) TAV patients developed acute kidney injury postoperatively. One (1.3%) BAV patient and 1 (0.4%) TAV patient developed peri-operative myocardial infarction. The average postoperative hospital stay was 7.6±3.6 d for BAV patients and 8.6±6.1 d for TAV patients. There was no statistical difference in primary or secondary in-hospital outcomes between BAV and TAV patients (P>0.05). Conclusion Compared to TAV patients, BAV patients have similar in-hospital outcomes, with a low incidence of adverse clinical outcomes, which provides preliminary evidence for its implementation in Chinese patients with a high proportion of BAV.
3.Depressive symptoms and associated factors among adolescents in different pubertal stages in a district of Chongqing
XI Xuan, LIU Qin, LI Yueyue, FANG Bo, SHENG Lulu, WU Wenyi, ZHOU Yuanke, ZHANG Qin
Chinese Journal of School Health 2022;43(5):718-721
Objective:
To explore the status of depressive symptoms among adolescents in different pubertal stages in a district of Chongqing.
Methods:
A self designed questionnaire and Children s Depression Inventory were administered among 1 001 students in a district of Chongqing. Score and associated factors of depressive symptoms of adolescents through descriptive statistical analysis, Chi square test, analysis of variance and Logistic regression analysis.
Results:
The detection rate of depressive symptoms among adolescents in a district of Chongqing was 17.3%, and the total score of depression scale was (12.02±6.72). There were statistically significant differences in the inefficiency subscale score of boys across stages of genital, pubic hair, armpit hair and beard, and whether the first spermatorrhea has occurred( t/F =7.08,5.46,5.18,4.21,5.84, P <0.05), while significant differences were found in the anhedonia and inefficiency subscales scores among girls across different stages of breast, pubic hair and armpit hair, and whether menarche has occurred( t/F =19.43,4.92,3.98,7.35, P <0.05). Multivariate Logistic regression analysis showed that the absence of first spermatorrhea and menarche were associated with lower prevalence of depressive symptoms in boys and girls ( OR=0.60, 95%CI=0.36-0.98; OR=0.46, 95%CI =0.22-1.00), while pubic hair development was associated with higher prevalence of depressive symptoms in girls ( OR=9.58, 95%CI =1.28- 71.71 ).
Conclusion
The detection rate of depressive symptoms among adolescents is relatively low. Boys who have had the first spermatorrhea, and girls with advanced pubic hair development or have had menarche are more likely to suffer from depressive symptoms.
4.Construction of transgenic mice with Δ15 Des enzyme activity by using a PiggyBac transposon.
Ying WANG ; Shisai YANG ; Xuan ZHAO ; Ya LI ; Lulu LÜ ; Guiming ZHU
Chinese Journal of Biotechnology 2022;38(1):196-206
Essential fatty acids are those that could not be synthesized by the body itself but crucial for health and life. Studies have shown that ω-3 fatty acids may facilitate human physiological functions. Mammals lack ω-3 desaturase gene, and the Δ15 fatty acid desaturase (Δ15 Des) from Caenorhabditis elegans can transform the ω-6 polyunsaturated fatty acids (PUFAs) into ω-3 PUFAs. Transgenic mice expressing Δ15 Des enzyme activity was constructed by using a PiggyBac transposon (PB). Homozygous transgenic mice with stable inheritance was bred in a short time, with a positive rate of 35.1% achieved. The mice were fed with 6% ω-6 PUFAs and the changes of fatty acids in mice were detected by gas chromatography (GC). The expression level of Δ15 Des in mice was detected by quantitative PCR (qPCR) and Western blotting (WB). qPCR and GC analysis revealed that the percentage of positive mice harboring the active gene was 61.53%. Compared with traditional methods, the transformation efficiency and activity of Δ15 Des were significantly improved, and homozygotes showed higher activity than that of heterozygotes. This further verified the efficient transduction efficiency of the PiggyBac transposon system.
Animals
;
Caenorhabditis elegans/genetics*
;
Fatty Acid Desaturases/genetics*
;
Fatty Acids
;
Fatty Acids, Omega-3
;
Mice
;
Mice, Transgenic
5.Associations between psychosocial stress in early and middle adolescence with emotional and behavioral problems one year later
WU Wenyi, LIU Qin, LI Yueyue, FANG Bo, SHENG Lulu, ZHOU Yuanke, XI Xuan, ZHANG Qin
Chinese Journal of School Health 2022;43(5):644-647
Objective:
This study explored the predictive effects of psychological stress in early and middle puberty on subsequent emotional and behavioral problems.
Methods:
A cohort of 911 boys and girls from primary and secondary schools in Chongqing was studied. Psychological stress was measured in early and middle adolescence, and the levels of emotional and behavioral problems were determined in one year follow up. Logistic regression analysis was used to analyze the effects of psychological stress in early and middle adolescence on subsequent emotional and behavioral problems.
Results:
The average psychological stress score in early and middle adolescence was (27.96±24.95), and the average scores of internalized and externalized behavioral problems and overall problems one year later were (8.21±8.46)(6.21±5.87) and (37.90±24.68) respectively. When grouped by gender, these scores, as well as the detection rate of anxiety and depression, withdrawal, physical discomfort, thinking problems, internalization problems and overall problems, were higher in girls than boys (t/Z=-6.38,-5.63,-6.06,-3.74,-6.80,-5.47, χ 2=15.88,12.01,3.92,6.64,24.67,15.88, P <0.05). Logistic regression showed that the psychological stress scale score was a risk factor for internalized and externalized behavioral problems and overall problems( P <0.05).
Conclusion
Psychological stress levels in early and middle puberty have a positive predictive effect on emotional and behavioral problems in the following year.
6.Predictive effects of psychological stress in early and middle puberty on adolescent health risk behaviors
ZHANG Qin, LIU Qin, LI Yueyue, FANG Bo, SHENG Lulu, WU Wenyi, ZHOU Yuanke, XI Xuan
Chinese Journal of School Health 2022;43(5):653-657
Objective:
To explore whether psychological stress in early and mid puberty is predictive of adolescent healthrisk behaviors.
Methods:
In April 2018, a total of 1 046 primary and secondary school students from grade 5 to 8 were recruited through purposive sampling. The basic information and psychological stress of the respondents were collected by questionnaire and physical examination. In addition, self reports of health risk behaviors were collected in October 2018. Logistic multiple regression analysis was used to analyze the relationship between psychological stress and health risk behaviors of adolescents.
Results:
The reported health risk behaviors of the surveyed adolescents ranking from high to low were unreasonable physical activity (62.05%), food preferences (24.76%), fighting (21.03%), suicidal ideation (17.02%), ideation of running away from home (9.85%), low mood (8.80%), smoking (4.21%), drinking (3.73%), gambling (3.63%) and internet addiction (3.06%). Logistic multiple regression analysis showed that the high level of psychological stress was a risk factor for fighting ( OR =1.02, 95% CI =1.01-1.03), suicidal ideation ( OR =1.02, 95% CI =1.01-1.03), low mood ( OR =1.02, 95% CI =1.01-1.03), ideation of running away from home ( OR =1.02, 95% CI =1.01-1.03), unreasonable physical activity ( OR =1.01, 95% CI =1.00-1.02), smoking ( OR =1.02, 95% CI = 1.00-1.03), internet addiction ( OR =1.02, 95% CI =1.00-1.03), food preferences ( OR =1.01, 95% CI = 1.00-1.02) and gambling ( OR =1.02, 95% CI =1.01-1.04)( P <0.05).
Conclusion
Unreasonable physical activity and food preferences are most common health risk behaviors among adolescents. Psychological stress during early to middle puberty is predictive of adolescent health risk behaviors.
7.Factors influencing emotional and behavioral problems among firstborn children in transition to siblinghood:a systematic review
Chinese Journal of School Health 2021;42(10):1455-1459
Objective:
This study systematically reviewed the findings of studies on the factors influencing emotional and behavioral problems among firstborn children in transition to siblinghood, to provide a theoretical basis for the study of emotional behavior in firstborn children during role transition.
Methods:
CBM, VIP, CNKI, WanFang Data, PubMed, Web of Science, OVID and EBSCO were electronically searched to collect studies on the relevant factors influencing the emotional and behavioral characteristics of firstborn children in transition to siblinghood (TTS) from inception to March 3rd, 2021. Literature screening and data extraction were conducted by two independent authors to evaluate the risk of bias in the included studies. The results of the included studies were summarized by qualitative analysis.
Results:
A total of nine studies were included, comprising four prospective cohort studies and five cross sectional studies. Systematic evaluation results indicated three main types of factor associated with behavioral problems among firstborn children:factors of firstborn children (gender, age and temperament), family factors (parents upbringing, family relationships, family environment, social economy, maternal behavior and whether firstborn children knew that the second children would arrive), and social factors (relationships between teachers and students, peer relationships and life changes). The main factors affecting emotions were their own factors (age and self acceptance). Negative temperament in firstborn children, negative parenting styles, negative family relationships and family environments, prohibited behaviors among mothers, whether the firstborn children were informed of the arrival of the second children during pregnancy, poor relationships between teachers and students, peer relationships and life changes may increase the risk of emotional and behavioral problems among firstborn children. Whether other factors might have affected the results of the study is unclear.
Conclusion
Important factors influencing firstborn children s emotions and behaviors during TTS, must be confirmed through a high quality prospective cohort study. Intervention studies may be appropriate to verify the results and provide an empirical basis for behavioral interventions in firstborn children with different emotional problems.
8.A study on emotional behavioral problems and family relations of firstborn children from Chongqing during the role transition period
XI Xuan, LIU Qin, LI Yueyue, SHENG Lulu, FANG Bo, WU Wenyi, ZHOU Yuanke, ZHANG Qin
Chinese Journal of School Health 2021;42(10):1460-1464
Objective:
To explore the relationship between the emotional and behavioral problems and family relations of firstborn children from an urban area of Chongqing during the role transition period, to provide a scientific basis for creating a good family relationship and to reduce the occurrence of children s emotional behavior problems.
Methods:
Totally 1 359 mothers of children in the role transition period were recruited from obstetric clinics at two Grade A hospitals in Chongqing, and mothers with informed consent using self designed questionnaire and parental version of the Child Behavior Checklist (CBCL). It was analyzed the association between family relationships and the emotional/behavioral problems of firstborn children of different ages. SPSS statistical software (version 20) was used for the descriptive statistical analysis, chi square test, and multiple linear regression analysis.
Results:
The parental relationship (56.6%), mother child relationship (80.4%) and father child relationship (64.9%) of most firstborn children was good, and 61.7% of families enjoyed a harmonious atmosphere. For the age groups 1.5-5 years and 6-13 years, the respective CBCL total scores were (18.22±13.63) and (24.20±17.52), and the detection rates were 10.7% and 10.5%, respectively. The results of the multiple linear regression analysis showed that, for both age groups, firstborn children who had good parental relationships, good mother child relationships, good father child relationships, and a harmonious family atmosphere exhibited fewer internalizing, externalizing and overall emotional behavior problems ( P <0.05).
Conclusion
The total detection rate of emotional and behavioral problems among firstborn children in the role transition period, which is low. Good parental relationships, good parent child relationships, and a harmonious family atmosphere are protective factors against emotional and behavioral disorders in firstborn children during the role transition period.
9.Comparison of emotional and behavioral problems between preschool firstborn children across the transition to siblinghood and the only children
WU Wenyi, LIU Qin, LI Yueyue, FANG Bo, SHENG Lulu, ZHOU Yuanke, XI Xuan, ZHANG Qin
Chinese Journal of School Health 2021;42(10):1465-1468
Objective:
To compare the emotional and behavioral characteristics of preschool firstborn children across the transition to siblinghood with the only children in a district of Chongqing.
Methods:
Data were derived from a cohort study on firstborn children transition to siblinghood. Totally 882 firstborn children (3.58±1.25) years old and 329 only children (3.98±1.02) years old were recruited from two hospitals and 19 kindergartens in a district of Chongqing, respectively. Their mothers filled out the parental version of Child Behavior Checklist (CBCL) and self designed questionnaire.
Results:
The overall scores of emotional and behavioral problems of firstborn children and only children were (25.17±18.82) and (31.75±18.64). The results of rank sum test showed that the scores of the firstborn children in all dimensions, internalizing and externalizing behavior problems and overall emotional and behavioral problems were lower than those of the only children ( P <0.05). Chi square test results showed that the detection rates of internalizing, externalizing and overall emotional behavior problems in only children(12.77%, 13.07%, 14.59%) were higher than those in firstborn children(8.28%, 8.28%,8.16%) ( χ 2=5.62, 6.36, 11.09, P <0.05). Multiple linear regression showed that after adjusting for age, gender, family economic pressure, temperament type of children, family atmosphere and family type, the scores of internalizing problems, externalizing problems and overall problems of the only children were still higher than those of the firstborn children ( B =1.54, 2.32, 6.81, P <0.05).
Conclusion
The firstborn children across the transition to siblinghood show less emotional and behavioral problems than the only children, and the scores and detection rates of all types of emotional and behavioral problems of the firstborn children are lower than those of the only children.
10.The influence of parental company time before and after having second child on the emotional and behavioral problems of preschool firstborn children
SHENG Lulu, LIU Qin, LI Yueyue, FANG Bo, WU Wenyi, XI Xuan, ZHOU Yuanke, ZHANG Qin
Chinese Journal of School Health 2021;42(10):1475-1479
Objective:
To explore the influence of parental company before and after having second child on the emotional and behavioral problems of preschool firstborn children, and to provide a reference for emotional problems prevention of firstborn children.
Methods:
Questionnaire survey was conducted among mothers of firstborn children who met the inclusion and exclusion criteria from two Grade A hospitals in Chongqing from March to December 2019. The average age of 845 firstborn children was (3.56±1.24) years old. The chi square test was used to compare the general characteristics and parent company of boys and girls. Rank sum test was used to compare the differences of emotional and behavioral problems of firstborn children with different parents company. Multiple linear regression models were used to compare the differences of internalizing, externalizing and total problems in firstborn children with different parents company.
Results:
After having the second child, parents spent less time with their firstborn children, among which the decrease of the accompanying time of the mother and the total accompanying time of the parents were statistically significant( Z =3.76, 2.86, P <0.05). The scores of internalizing problem were higher when the mother s company time decreased ( B=1.18, 95%CI = 0.01 -2.36) and the parents total company time decreased( B=1.41, 95%CI =0.33-2.48). The scores of the externalizing problem ( B=1.25, 95%CI =0.10-2.39) and the total problem ( B=4.31, 95%CI =1.05-7.57) with the decrease of parents total company time were higher.
Conclusion
Parent company has an important influence on the emotional and behavioral problems of firstborn children. Firstborn children whose parents accompanying time decreases after having second children scored higher on emotional and behavioral problems.


Result Analysis
Print
Save
E-mail