Objective:To investigate the safety and utility of using polyester spacers in conventional pancreatico-enteric anastomosis in pancreaticoduodenectomy to achieve prevention of postoperative pancreatic fistula.Methods:The clinical data of 82 patients with pancreaticoduodenectomy completed by the same physician in Anyang People's Hospital from August 2018 to August 2023 were retrospectively analyzed, including 52 males and 30 females, aged (62.21±9.75) years. They were divided into two groups, test group ( n=40) and control group ( n=42) according to whether polyester spacers were used in pancreatico-intestinal anastomosis, the perioperative data of the two groups were compared, and Logistic analysis was used to analyze the risk factors affecting postoperative pancreatic fistula. Results:There was no statistically significant difference between the two groups in terms of biliary fistula, intestinal fistula, abdominal infection, abdominal bleeding, and postoperative mortality rate (all P>0.05). The incidence of postoperative pancreatic fistula in the test group was 20.0% (8/40) which was lower than that in the control group 45.2% (19/42), and the difference was statistically significant ( P=0.015). Soft pancreas texture ( OR=16.595, 95% CI: 1.891~145.657) was an independent risk factor for postoperative pancreatic fistula, while improved pancreatic enterostomy with polyester spacers ( OR=0.332, 95% CI: 0.114~0.969) could reduce the risk of postoperative pancreatic fistula. Conclusion:Use of polyester spacers to reinforce the pancreatico-enteric anastomosis during pancreaticoduodenectomy reduces the incidence of postoperative pancreatic fistulae with good safety and practicality.

Objective: To explore the mediating effect and gender difference of mobile phone use in the association between different types of childhood abuse experiences and sleep quality of medical students, so as to provide reference for promoting sleep quality of medical students. Methods: A longitudinal study design method was used to select freshmen and sophomores in two medical colleges in Anhui Province from November to December 2019, follow up data were collected from May to June 2020, and a total of 6 879 students were included in this study. Spearman correlation was used to analyze the association between baseline childhood abuse experiences, baseline mobile phone use and follow up sleep quality. Bootstrap program and Process software were applied to test the mediating effect of mobile phone use in the relationship between childhood abuse and sleep quality. Results: Childhood abuse experiences were positively correlated with mobile phone use and sleep quality score ( r = 0.27 , 0.24, P <0.01), and mobile phone use was positively correlated with sleep quality score ( r =0.31, P <0.01). In the total sample, after adjusting for confounding factors, mobile phone use played a partial mediating role in childhood abuse experiences (including emotional abuse, physical abuse, sexual abuse) and sleep quality, and the mediating effect was 18.08% (18.12%, 17.15%, 24.09%). The mediating effect of mobile phone use on the relationship between childhood emotional abuse, sexual abuse, childhood abuse and sleep quality in girls(18.32%, 28.05%, 18.24%) was higher than in boys(17.81%, 18.94%, 17.63%). Conclusion Mobile phone use has a mediating effect on the relationship between childhood abuse and sleep quality, controlling mobile phone overuse may contribute to improving the sleep quality for those who have experienced childhood abuse.

Objective:To investigate the value of plasma Epstein-Barr virus (EBV) DNA detection in the screening of nasopharyngeal carcinoma (NPC) and its clinical application in non-high-risk areas.Methods:Plasma EBV DNA results in 1 153 newly diagnosed nasopharyngeal carcinoma patients who were treated in Sichuan Cancer Hospital from 2015 to 2020 and 244 healthy control cases with matched sex and age were retrospectively analyzed. EBV DNA were detected by quantitative real-time PCR. Positive rate of EBV DNA was determined by the cutoff value of 400 (≥400 copies/ml as positive) and optimization threshold method (presence of S amplification curve as positive). Further analyses were conducted to compare EBV DNA load in different clinical stage, TNM stage and regions distribution characteristics. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of the cutoff value of 400 and optimization threshold method for NPC.Results:Compared with healthy controls, EBV DNA increased significantly in newly diagnosed NPC patients ( P<0.001). Both evaluation methods revealed that the EBV DNA positive percentage increased with TNM and clinical stage ( P<0.001). With 400 copies/ml as cutoff value, the diagnostic sensitivity and specificity were 40.85% and 100%, respectively. The area under the curve was 0.704 (95% CI 0.676-0.733, P<0.001). Evaluated by the optimization threshold method, the sensitivity and specificity could improve to 82.0% and 99.2%, respectively, and the area under the curve reached 0.910 (95% CI 0.894-0.924, P<0.001). Conclusions:In the low prevalence area of nasopharyngeal carcinoma, the sensitivity for diagnosis of nasopharyngeal carcinoma is only 40.9% by the 400 copies/ml cutoff value method. The optimization threshold method is a better choice to improve the diagnostic sensitivity without lowering the diagnostic specificity.

Objective: The purpose of the current study was to determinate the prevalence of dating violence perpetration and victimization and to examine its relationship with childhood abuse among medical college students. Methods: Cluster sampling survey was carried out among 3 727 freshmen and sophomores in two medical colleges from Anhui Province. Information with general demographic variables, childhood abuse and dating violence was obtained. Logistic regression was used to identify the relationship of different types of childhood abuse and dating violence after controlled for confounding factors. Results: The rate of dating violence perpetration and victimization was 37.8% and 27.8%, respectively. Female students had higher childhood emotional abuse experience (61.9%) than male students (51.6%), while male students had higher childhood physical and sexual abuse (28.2% and 19.4%) than females (24.3% and 10.5%) (χ2=33.84，6.33，52.97，P<0.01). Results showed that increased dating violence perpetration [OR(95%CI)=1.71(1.48-1.98),1.55(1.33-1.82),1.75(1.43-2.15)]and victimization [OR(95%CI)=1.84(1.43-2.16),1.59(1.34-1.87),1.62(1.32-2.00)](P<0.01) among individuals with physical, emotional and sexual abuse after controlling for confounding variables. No gender difference was found within other groups in the relationship between childhood abuse and dating violence(P>0.05). Conclusion Childhood abuse experiences are associated with higher risk of dating violence perpetration and victimization among college students. Reducing childhood abuse is beneficial to the prevention and control of dating violence among medical college students.

Objective: The aim of this paper is to understand the associations between childhood abuse experience,parent-child relationship and non-suicidal self-injury (NSSI) in middle school students. Methods: Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen,Zhengzhou,Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on childhood abuse exposure,parent-child relationship and NSSI. Results: The prevalence of NSSI was 14.81%,while it was higher among male students (15.95%) than female students (13.64%) (χ2=15.29,P<0.01). A multivariate Logistic regression models showed that the moderate and high level of childhood abuse (OR=2.23,3.27) and the low level of parents-child relationship (OR=1.80,1.36) were associated with high NSSI detection rate among middle school students (P<0.01). In each group of childhood abuse,low level of father-child relationship was associated with high NSSI detection rate among middle school students (OR=1.36,1.34,1.56,P<0.05). In the group with high level of childhood abuse experience,low level of mother-child relationship was associated with high NSSI detection rate (OR=1.20,P<0.05). Among male students,those with high level of childhood abuse experience,low level of parentchild relationship were associated with high NSSI detection rate (OR=1.46,1.35,P<0.01); regardless of the level of childhood abuse experience,low level of father-daughter relationship was associated with NSSI detection rate (OR=1.64,1.54,1.68,P<0.01) among females. Conclusion Childhood abuse experience and poor parent-child relationship are associated with NSSI in middle school students, with distinct gender difference. Prevention of childhood abuse and the improvement of parent-child relationship are beneficial to the prevention and control of NSSI.

Objective To study the in vitro killing effect of novel small molecule inhibitors, ribosomal S6 kinase1 (RSK1) inhibitor (BI-D1870) and polo-like kinase 1 (PLK1) inhibitor (BI2536), combined with recombinant attenuated vesicular stomatitis virus VSVΔM51 on various glioma cells. Methods (1) In vitro cultured GL261, CT2A and HS68 cells were divided into control group, rapamycin group, BI-D1870 group, BI-2536 group, VSVΔM51 group, rapamycin +VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group; pretreatments with 100 nmol/L rapamycin, 10 μmol/L BI-D1870, and 100 nmol/L BI-2536 for 2 h were given to the cells from the above groups, respectively, and then, they were infected with VSVΔM51 virus at 0.1 mutiplicity of infection (MOI); at 72 h after treatments, the cell survival rate was determined by Alarma Blue method; VSV△M51 virus was infected at 10 MOI one h after pretreatment with the above drugs, apoptosis of GL261 cells was detected by cleaved caspase-3 staining 24 h after that; the expression of apoptotic protein polyadp-ribosomal polymerase (PARP) was detected by Western blotting; Annexin V-FITC/propidium iodide double staining was used to detect the cell apoptosis. (2) GL261 and CT2A cells were divided into VSVΔM51 group, rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+ VSVΔM51 group; VSV△M51 virus was infected at 0.1 MOI one h after pretreatment with the above drugs,; 48 h after treatments, fluorescence microscope was used to detect the expression of green fluorescent protein (GFP); IVIS200 in vivo imaging system was used to detect the changes of cell virus luciferase in the 4 groups. (3) Fifteen CT2A intracranial implanted glioma model mice were divided into VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group according to random number table method (n=5); mice in the latter two groups were intraperitoneally injected with BI-1870 (100 mg/kg) or intravenously injected with BI-2536 (20 mg/kg); 24 h after that, mice in the three groups were intravenously injected with virus VSVΔM51; virus luciferase was detected by IVIS200 in vivo imaging system 24 and 72 h after treatments; the grouping and treatments of GL261 intracranial glioma model mice were the same as above, the expression of virus GFP was observed under fluorescence microscope 48 h after treatments, and virus titers of these mice were detected by virus plaque assay. Results (1) As compared with the control group, rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group, the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group had significantly lower cell survival rate (P<0. 05); cleaved Caspase-3 staining showed no cell apoptosis in the control group, a small amount of apoptotic corpuscles in the rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group, but obvious increased amount of apoptotic corpuscles in the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+ VSVΔM51 group; Western blotting indicated that GL261 and CT2A cells from the control group, rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group had lower cleaved PARP expression level than those from the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group. The results of Annexin V-FITC/propidium iodide double staining were consistent with those of cleaved Caspase-3 staining. (2) As compared with VSVΔM51 group and rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group and BI2536+VSVΔM51 group had significantly increased GFP expression and statistically higher intensity of virus luciferase (P<0.05). (3) CT2A cells in the VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group had increased intensity of virus luciferase successively, with significant differences (P<0.05); GL261 cells in the VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group had increased virus titers successively, with significant differences (P<0.05). Conclusion Both small molecule inhibitors promote the replication of VSVΔM51 virus and enhance the killing effect on glioma cells, and its synergistic effect is obviously better than rapamycin.

Spinal cord injury is a kind of central nervous system injury disease caused by trauma. It was found that the up-regulation of autophagy after spinal cord injury could promote the repair of spinal cord injury. Under the condition of stress, autophagy can reduce the number of misfolded proteins and damaged organelles in cells to maintain the stability of intracellular environment. Chinese medicine with Huoxue Quyu Tongluo (against stasis obstructing meridian) efficacy has attracted much attention in the treatment of spinal cord injury, which may associate with the role of regulation of autophagy.

This study was aimed to explore the death rule of viral hepatitis patient according to the 24-calendar cycle and time.Information of 40 681 inpatients diagnosed as viral hepatitis from 20 triple-A hospitals in China were collected from December 2003 to August 2011.The death rule of viral hepatitis patient according to the 24-calendar cycle and time was analyzed.It is the first time to put traditional Chinese medicine (TCM) concept of time into survival ending.Its mechanism was explained from the aspects of both TCM and modern medicine.It provided a reference method to combine TCM theory and clinical practice.The results showed that among 40 681 patients,36 547 patients had treatment ending.Among them,386 patients were dead,with the total death rate of 1.06％;308 patients were diagnosed as viral hepatitis B,which was about 79.79％ of the whole dead patients.The proportion of the death time is focused on the Great Heat and the Cold Dew,which is about 6.67％ and 6.4％,respectively.And the percentage of death in the winter is lowest,which is about 3％.The highest percentage of death in one day is Shen-Shi (from 3 pm to 5 pm,23.82％) and You-Shi (from 5 pm to 7 pm,21.78％).It was concluded that the death rule of viral hepatitis patient was at the highest percentage in summer and autumn;that of the spring was the second;and that of the winter was the lowest.In one day,the highest percentage of death lies in Jin-Shi (from 3 pm to 7 pm).

Objective To develop a Jingcen DY?1 type spraying tanker for Oncomelania hupensis snail control and evaluate its effect of field application as well as the cost. Methods The currently available tractor was used as a vector,and the mechan?ical and electrical equipments and containers were integrated with shafts,pipelines and electric lines to produce a spraying tank?er for snail control,with the functions of carrying people and molluscicides,generating electric power and getting water,mixing stocking solutions,adjusting molluscicide solutions evenly,and spraying drugs. The volume of the molluscicide solution,flow rate of water injection,and the flow rate,range and advance speed of the spray gun were tested,and the solution concentrations of molluscicide in the tanker and at the muzzle of the spray gun at different time were detected. Meanwhile,the molluscicidal ef?fect and cost of the spraying tanker were analyzed by the field test. Results The volume of the liquid storage pot of the Jingcen DY?1 type spraying tanker was 1 800 L,the flow rate of water injection was 400 L/min,the flow rate and the spray range of the standard spray gun were 110-200 L/min and 19.70-23.50 m,respectively,the efficiency of drug spraying of the spraying tanker was 6 000 m2/h,and the ratio of spray width(m)to march speed(m/min)was 1∶200. When 5 min post mother liquid recirculat?ing ,the average concentration of the molluscicide at the upper? ,middle? and lower?layers of the liquid storage pot was (1 030.39 ± 43.00)mg/L,with a variation coefficient of 4.17%. The average concentration of the molluscicide in the spraying process(spraying for 2,4,6,8,9 min)was(953.00 ± 68.87)mg/L,with a variation coefficient of 7.22%. The concentration of the residual drug in the liquid storage pot post spraying was 1 000.43 mg/L,which reached the effect concentration for snail con?trol. After spraying for 7 days in the field,the average density of living snails reduced by 88.20% as compared to that before spraying,and the adjusted mortality of snails was 87.65%. The unit cost of Jingcen DY?1 spraying tanker was 0.086 7 Yuan/m2, which reduced by 58.20% as compared to that of the conventional spraying tanker. Conclusions Jingcen DY?1 type spraying tanker for snail control which integrates various equipments together can effectively control the concentration and dose of the mol?luscicide,and the machine is labor?saving,efficient,economic and well adapted,and is worthy to be widely applied.

Objective To observe the Oncomelania hupensis snail control effects of molluscicides with different formula?tions in the ditch with unstable water level in field of marshland and lake areas,so as to provide the evidence for formulating the prevention strategies. Methods A drainage channel with O. hupensis snails in Jiangling County,Jingzhou City were selected as the study field,then it was divided into 6 segments,except 1 segment was treated as the blank control group for observing the natural mortality rate of the snails,the other 5 segments were treated as observation groups,where 4% niclosamide ethanol?amine salt powder,5%niclosamide ethanolamine salt granule,25%suspension concentrate of niclosamide ethanolamine salt, 26% suspension concentrate of metaldehyde and niclosamide ethanolamine salt,50% niclosamide ethanolamine salt wettable powder were applied respectively. Before and after the mollusciciding,the snail surveys were carried out through the systematic sampling method,and the short?and long?term effects of snail control were observed,and the mortality rates of the snails on the slope above the water level and those below the water level were compared. Results When 7 d and 15 d after mullusciciding, the mortality rates of snails on the slope above the water level in each observation group were 79.52%-97.87% and 90.43%-96.30%,respectively,when compared with those before mollusciciding,all the differences were statistically significant(all P<0.01). When 7 d after mullusciciding,the mortality rates of snails below the water level in each observation group were 17.11%-50.00%,which were all lower than those of the snails on the slope above the water level in the corresponding groups(all P<0.05);when 15 d after mullusciciding,the rates were 9.43%-95.24%,and those in 25%suspension concentrate of niclosamide ethanolamine salt,26%suspension concentrate of metaldehyde and niclosamide ethanolamine salt,50%niclosamide ethanol?amine salt wettable powder groups were all lower than those of the snails on the slope above the water level in the corresponding groups(all P<0.01). Compared with the densities of living snails before mollusciciding,those 6 months after mollusciciding in each observation group decreased by 70.21%-78.98%. Conclusions The molluscicides in the formulation of powders and granule are suitable for both the snail environment with or without water,while those in the formulation of suspension agents and wettable powders are suitable only for environments with water.