Objective:To explore the relationship between depressive symptoms and filial piety in adult-child caregivers of disabled elderly,and the mediating effect of mutuality on the relationship.Methods:Totally 383 adult-child caregivers were assessed with the Center for Epidemiological Studies Depression Scale(CES-D),Dual Filial Piety Scale(DFPS)and Mutuality Scale(MS).The SPSS macro program Process was used to test the mediation model.Results:The CES-D scores were negatively correlated with the reciprocal filial piety scores and the MS scores(r=-0.49,-0.48,Ps＜0.01)and positively correlated with the authoritarian filial piety scores(r=0.37,P＜0.01).The MS scores were positively correlated with the reciprocal filial piety scores(r=0.76,P＜0.01),and negatively correlated with the authoritarian filial piety scores(r=-0.84,P＜0.01).Reciprocal filial piety scores were negatively associated with CES-D scores(β=-0.67).In addition,MS scores partly mediated the relationship between reciprocal filial piety scores and CES-D scores,the value of mediating effect was 22.89％.Conclusion:The depressive symptoms are correlated with filial piety and mutuality among adult-child caregivers of disabled eld-erly.

Objective:To explore the relation of behavioral inhibition system/behavioral activation system and affects in college students,and to analyze the parallel mediating role of facets of mindfulness in their relationship.Methods:Totally 268 college students were selected and assessed with the Five Facets Mindfulness Questionnaire,Behavioral Inhibition System and Behavioral Activation System Scale,Positive and Negative Affect Scale.The mediating effect of different mindfulness factors on the relationship between behavioral inhibition sys-tem/behavioral activation system and affects was examined using linear regression analysis and biased-corrected bootstrap confidence interval.Results:The factors of describe and non-reactivity mediated the relationship between the behavioral activation system and positive affects(effect=0.04,0.02),while the factors of act with awareness,non-judging and non-reactivity mediated the relationship between the behavioral inhibition system and negative af-fects(effect=0.09,0.06,0.04).Conclusion:The behavioral inhibition system/behavioral activation system may be related to negative affect and positive affect respectively.As a particular emotion regulation strategy,mindfulness factors play a unique mediating role in the relationship between behavioral inhibition system/behavioral activation system and affects.

Objective:To explore the efficacy and adverse reactions of image-guided hypofractionated intensity-modulated radiotherapy (Ig-HypoRT) conbined with contralateral esophageal protection in treatment of patients with unresectable stage Ⅲ non-small cell lung cancer (NSCLC).Methods:The clinical data of 45 patients with unresectable stage Ⅲ NSCLC who were admitted to Xuzhou Cancer Hospital from January 2016 to January 2019 were retrospectively analyzed. Patients received induction chemotherapy with a platinum-based dual-drug combination regimen, followed by Ig-HypoRT with a total dose of tumor of 60-63 Gy/12- 18 times at 3.5-5.0 Gy/time. Contralateral esophagus was delineated as an organ at risk during radiotherapy, limiting V 45 Gy≤1.8 cc and V 55 Gy ≤0.4 cc. Patients' efficacy, survival and the occurrence of adverse reactions were observed. Results:Among 45 patients, there were 9 cases of complete remission, 31 cases of partial remission, 4 cases of stable disease and 1 case of disease progression, and the effective rate was 88.8% (40/45). The median follow-up time was 34 months, 45 patients had a median overall survival (OS) time of 25.0 months (95% CI 21.7-28.8 months), with 1-, 2-, and 3-year OS rates of 78.9%, 56.8% and 47.7%, respectively; the median progression-free survival (PFS) time was 18.5 months (95% CI 15.0-22.0 months), with 1-, 2- and 3-year PFS rates of 59.8%, 32.6% and 18.6%, respectively. The 3-year local recurrence rate was 9% (4/45). The incidence of grade 1-2 radioactive esophagitis was 80% (36/45); the incidence of grade 1-2 chest pain was 20% (9/45). The incidence of grade 3-4 adverse reactions were 13% (6/45), including 7% (3/45) of grade 3 pulmonary atelectasis, 4% (2/45) of grade 3 radioactive pneumonia, and 2% (1/45) of grade 4 hemoptysis. Conclusions:Ig-HypoRT combined with contralateral esophageal protection for unresectable stage Ⅲ NSCLC can improve survival rate and reduce esophageal adverse reactions of patients.

Objective:To observe the effects of cervical region Ⅱ and oral target area optimization on therapeutic efficacy, salivary gland function and oral mucosal response during intensity modulated radiation therapy (IMRT) for oropharyngeal cancer.Methods:A total of 50 patients with oropharyngeal squamous cell carcinoma in Xuzhou Cancer Hospital from January 2012 to May 2017 were collected. According to the random number table, they were divided into normal radiotherapy group (the control group), oral and cervical target area optimization group (the observation group), 25 cases in each group. Both groups were treated with IMRT and platinum-chemotherapy. The control group received bilateral cervical region Ⅱ-Ⅳ lymphatic drainage area irradiation (the positive side of the cervical lymph node included Ⅰ B region), and bilateral cervical region Ⅱ was given a tumor dose of 60 Gy (positive lymph nodes were given intensified irradiation); the observation group was optimized for the target area, and the contralateral cervical region Ⅱ B (the side with no positive lymph node) was given a tumor dose of 50 Gy; the observation group's oral structure was delineated as an organ at risk and the average radiation dose (D mean) was limited to <32 Gy. The differences in radiation dose of parotid gland, acute oral mucosal reaction and long-term xerostomia (6 months after the end of radiotherapy), objective remission rate (ORR), local recurrence rate (LRR), 3-year overall survival (OS) were compared between the two groups. Results:In the control group, the contralateral parotid gland D mean was (29±4) Gy, the proportion of irradiation volume exposed to 34 Gy (V 34) was (48±5)%; in the observation group, contralateral parotid gland D mean was (23±3) Gy, V 34 was (41±5)%, and there are statistically significant differences between the two groups ( t values were 6.14, 4.98, all P < 0.05). In the control group, oral D mean was (35±6) Gy, the proportion of volume exposed to 30 Gy (V 30) was (36±5)%; in the observation group oral D mean was (29±4) Gy, V 30 was (28±4)%, and there were statistically significant differences between the two groups ( t values were 4.11, 5.98, all P < 0.05). The incidence of ≥ grade Ⅱ acute oral mucosal adverse reaction and the duration time of oral mucosal ≥ 2 weeks was 64% (16/25) and 76% (19/25), respectively in the control group, 36% (9/25) and 40% (10/25), respectively in the observation group; and the differences were statistically significant ( χ2 values were 3.92, 6.65; P values were 0.048, 0.009). The incidence of ≥ grade Ⅱ long-term xerostomia reaction was 72% (18/25) and 44% (11/25), respectively in the control group and the observation group, and the difference between the two groups was statistically significant ( χ2 = 4.02, P = 0.044). The ORR, LRR, and 3-year OS rates were 80%, 28%, 48% in the control group, and 76%, 24%, 44% in the observation group. There was no statistically significant difference in the OS between the two groups ( χ2 = 0.04, P = 0.849). Conclusions:Optimization of the target area of the oral and cervical region Ⅱ during IMRT for oropharyngeal carcinoma can improve the function of salivary glands, thereby reducing dry mouth and oral mucosal reactions, improving the quality of life of patients; and it does not affect the efficacy of tumor treatment.

Abstract With the growing popularity of electronic devices, cyberbullying has gradually become a common form of bullying. Compared with traditional bullying, cyberbullying is more likely to cause serious psychological problems of its victims, leading to school absences, depression, even selfinflicted injury and suicide. Unfortunately, psychological intervention and prevention for cyberbullying and cyber victimization is rather sparse in China. This paper summarizes some foreign cyberbullying intervention projects, aiming at providing reference localized and specific interventions.

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.

Objective To observe the clinical efficacy of large fraction intensity modulated radiation therapy combined with apatinib in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome. Methods A retrospective analysis was made on 46 elderly patients with non-small cell lung cancer and superior vena cava syndrome who were admitted to Xuzhou Cancer Hospital Affiliated to Jiangsu University from February 2015 to December 2017. The patients were divided into observation group and control group with 23 cases in each group. The control group received radiation therapy only. Apatinib was enrolled in the observation group on the first day synchronously. The remission time of symptoms, short-term efficacy, occurrence of adverse reactions and 1-year overall survival rate were observed and compared between the two groups. Results The complete remission rate was 78.3％ (18/23) in the observation group and 43.3％ (10/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.60, P < 0.05). The effective response rate was 86.9％ (21/23) in the observation group and 65.2％ (15/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.294, P < 0.05). The main adverse reactions in the two groups were radioactive esophagitis, radiation pneumonitis and leukopenia, and most of them were grade Ⅰ-Ⅱ, there was no significant difference between the two groups (all P > 0.05). The 1-year overall survival rate was 56％ in the observation group and 40％ in the control group, and the difference between the two groups was statistically significant (P = 0.009). Conclusion Large fraction intensity modulated radiation therapy combined with apatinib is effective in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome, and theadverse reactions are well tolerated.

Objective To observe the clinical effect of intensity modulated radiation therapy (IMRT) combined with apapatinib mesylate in the treatment of elderly patients with locally advanced cardia adenocarcinoma and its effect on vascular endothelial growth factor receptor (VEGFR). Methods Forty-six elderly patients with locally advanced cardia cancer who were unwilling to accept surgery or couldn't get complete removal of cancers in Xuzhou Hospital Affiliated to Jiangsu University between January 2015 and April 2016 were collected. All the patients were randomly divided into the control group (23 cases) and the observation group (23 cases) according to the random number table method. The control group received radiotherapy alone. In the observation group, oral apatinib (500 mg/d) was taken in the first day of radiotherapy after breakfast until the disease progress or death occurred. Results The total effective rate was 92 % (19/23) in the observation group and 60 % (10/23) in the control group. There was a significant difference between the two groups(χ2=5.86,P <0.05). After treatment, the average level of VEGFR in both groups was decreased[(76.3±4.9)vs.(55.0±2.3)pg/ml],and there was a significant difference between the two groups (t = 3.93, P < 0.05). The common adverse reactions were blood adverse reactions and gastrointestinal reactions. The incidence rate of gastrointestinal reaction was both 83 %, and the blood adverse reaction was 100 %, and there was no significant difference between the two groups (both P > 0.05). Hypertension, proteinuria and rash response in the observation group were increased compared with the control group,but noⅣ grade of adverse reactions occurred. The median progression-free survival time was 10 months in the observation group and 8 months in the control group respectively (P = 0.01). Conclusion IMRT combined with apatinib in the treatment of elderly patients with locally advanced gastric cardia has a favorable efficacy and tolerance.

Objective To explore the relationship between perceived stress and work well-being of medical stuffs,and test the mediating effect of self-efficacy between above two variables.Methods A total of 1 296 doctors from 29 hospitals in Beijing were assessed by work well-being scale,general serf-efficacy scale (GSES) and Chinese Perceived Stress Scale (CPSS).Structural equation modeling (SEM) was conducted to test the mediating effect of self-efficacy on the relationship between perceived stress and work well-being.Results (1) Perceived stress(37.62±7.20) was negatively correlated with general self-efficacy(2.47±0.55),cognitive work well-being (4.16 ± 0.78) and affective work well-being (21.57 ± 5.63) (r =-0.456,P＜0.01;r=-0.406,P＜0.01;r=-0.542,P＜0.01).General serf-efficacy was positively correlated with cognitive work well-being and affective work well-being(r=0.382,P＜0.01;r=0.510,P＜0.01) (2) In the relationship between perceived stress and affective work well-being,general self-efficacy played a partial mediator role (P＜0.01),the mediating effect was 14.5％.In the relationship between perceived stress and cognitive work well-being,general self-efficacy played a partial mediator role (P＜0.01),and the mediating effect was 46.3％.Conclusion Perceived stress of medical stuffs influenced their work well-being through self-efficacy.It is advised to improve the medical stuffs' self-efficacy in order to raise their level of work well-being.

Objective To evaluate the effect of losecplatin combined with compound matrine in the intraperitoneal perfusion treatment of ovarian cancer with malignant ascites and its influence on the levle of serum tumor necrosis factor alpha(TNF-) of ovarian cancer marker.Methods 60 ovarian cancer patients with malignant ascites were divided into three groups:losecplatin combined with compound matrine perfusion group(combination group),single losecplatin perfusion group(losecplatin group) and single compound matrine perfusion group(compound matrine group),20 cases in each group.Before treatment,all the three groups were drained intraperitoneal fluid,then given the above-mentioned group of intraperitoneal perfusion therapy.The effects,side effects and serum TNF- levels of the three groups were compared.Results The patients of the three groups were successfully completed treatment,the effective rate of the combination group was 95%,which of the losecplatin group was 60%,which of the compound matrine group was 55%.The effective rate of the combination group was significantly higher than that of the single drug group(χ2=7.025,P<0.05),and the adverse reaction of the combination group was not significantly increased(χ2=1.026,P>0.05).The serum TNF- levels of the three groups after the perfusion treatment were significantly decreased(t=15.40,13.82,8.90,all P<0.05),TNF- level of the combination group was significantly lower,the difference was statistically significant(F=9.719,P<0.05).Conclusion Losecplatin combined with compound matrine in the intraperitoneal perfusion is a more effective method for the treatment of ovarian cancer with malignant ascites,which is worthy of promotion.