Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

ObjectiveBidirectional and two-sample Mendelian randomization（MR） method was used to investigate the bidirectional causal relationship between constipation and pneumonia and to understand the potential relationship between the two diseases from a new perspective， providing new targets for future treatment strategies. MethodConstipation and pneumonia datasets were selected from the genome-wide association study（GWAS） website for the European population in 2021. The data related to constipation included 411 623 samples， and the single nucleotide polymorphism（SNP） data were 24 176 599. The pneumonia data contained 480 299 samples with a number of SNPs of 24 174 646. In this study， inverse variance weighting（IVW） was adopted as the main analysis method of MR， supplemented by weighted median method， simple model， weighted model and MR-Egger regression analysis results， and sensitivity analysis was performed to evaluate the robustness of the results. ResultSeventeen SNPs highly correlated with constipation and 12 SNPs highly correlated with pneumonia were finally included. IVW analysis results of forward MR analysis showed that constipation increased the risk of pneumonia｛odds ratio（OR）=1.143， 95% confidence interval（CI）［1.045， 1.249］， P=0.003｝， MR-Egger regression， simple model， weighted model and weighted median analysis all supported the result（P<0.05）. IVW analysis by reverse MR analysis showed that pneumonia did not increase the risk of constipation｛OR=1.138， 95%CI［0.974， 1.329］， P=0.103｝， MR-Egger regression， simple model， weighted model and weighted median analysis also supported this result. ConclusionThe bidirectional and dual-sample MR analysis method is used to confirm the causal relationship between constipation and pneumonia from the perspective of genetic variation， while there is no obvious causal relationship on the contrary. This study will be helpful for the clinical diagnosis and treatment of constipation and pneumonia， and provide a reference for the study of the pathogenesis between the two.

ObjectiveTo investigate the current status of first aid knowledge among middle-aged and elderly residents aged 50 and above in a community in Shanghai， in order to provide reference for improving the self-rescue and mutual aid capabilities of middle-aged and elderly residents. MethodsA multi-stage stratified random sampling method was used to conduct a survey on 335 residents aged 50 and above in a community in Shanghai using a self-made survey questionnaire. The current situation and related factors of emergency knowledge level of residents aged 50 and above in the community were comprehensively analyzed. ResultsFirst aid knowledge level of 335 residents aged 50 and above was low， and the rate of high cognitive level was only 24.18%. Univariate analysis showed that male residents had a higher awareness rate than female residents （P=0.044）， while residents aged 70 and above and 60‒ had lower awareness rates than residents aged 50‒ （P<0.05）. Residents with chronic diseases had a higher awareness rate than those who did not （P=0.031）. Residents with family members suffering from chronic diseases had a higher awareness rate than those without （P<0.001）. Experience of first aid training affected residents’ awareness of first aid （P=0.003）. ConclusionThe level of first aid knowledge among middle-aged and elderly residents aged 50 and above in the community is low. Age， the presence of chronic diseases in family members， and emergency training are independent and relevant factors that affect the awareness of first aid knowledge among middle-aged and elderly residents. The government and relevant institutions should explore the establishment of a standardized emergency response training system， implement classification and grading for middle-aged and elderly groups with different characteristics， and provide targeted emergency training to strengthen their self-rescue and mutual aid capabilities and improve the success rate of pre-hospital emergency care.

Objective:To explore the relation of depressive and anxiety symptoms to defense mechanism in transgender population.Methods:Totally 451 transgender patients in the sexual and psychological outpatient depart-ment of a hospital were selected.They were assessed with the self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)and Defense Mechanism Scale(DSQ).The SDS standard score of ≥53 was classified as having depressive symptoms,and the SAS standard score of ≥50 was classified as having anxiety symptoms.Re-sults:The detection rates of depression and anxiety were 46.8％and 28.8％respectively.Multiple linear regression analysis showed that SDS scores were positively correlated with DSQ scores of projection,conceit,complaint,with-drawal,somatization,control,isolation and identity(β=0.08-0.22),while SDS scores were negatively correlated with DSQ scores of sublimation,depression,omnipotence with incompetence and denial(0=-0.09--0.19).The SAS scores were positively correlated with the DSQ scores of projection,latent manifestation,somatization,control,isolation,identity,and consumption tendency(0=0.09-0.26),while the SAS scores were negatively cor-related with the DSQ scores of sublimation,depression,omnipotence accompanied by incompetence,and denial(β=-0.09--0.15).Conclusion:The proportion of depression and anxiety symptoms detected in the transgender group is higher,which may be related to the use of some defenses.

Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

This paper analyzed the foreign measurement and evaluation system of physician professionalism,from the perspectives of the evaluation of occupation behavior,the multi sources of evaluation,the evaluation of empathy,and the cross-cultural background.It also discussed the basic condition of the development of domestic evaluation and evaluation system,and analyzed it from the diversity and comprehensiveness of evaluation perspectives,the specific and objectivity of evaluation items,the clarity and quantitative feature of evaluation indexes,as well as the openness and feedback of evaluation system.In addition,this paper reviewed the domestic and foreign measurement and evaluation methods of physician professionalism in recent years and pointed out that the construction of good measurement and evaluation system is the only way to deepen the research of physician professionalism.

OBJECTIVE: To explore the application value of serum total IgE, tryptase and chymase in the identification of death caused by drug anaphylactic shock. METHODS: The general information from 235 cases of non-drug anaphylactic shock and 32 cases of drug anaphylactic shock were analyzed. The serum IgE level had been detected in the cases. Ten cases caused by coronary disease and 10 cases caused by sudden manhood death syndrome were selected from non-drug anaphylactic shock cases for the control group. Expressions of tryptase and chymase in the lung and heart were detected using immunohistochemistry method. The number and IOD of positive mast cells were counted. RESULTS: In the drug anaphylactic shock group, the IgE value of 18 samples (56.25%) was significantly higher than the normal upper limit of 120 IU/mL. In the non-drug anaphylactic shock group, the IgE value of 67 samples (28.51%) was higher than 120 IU/mL. The expressions of tryptase and chymase were significantly increased in lung and myocardial tissue in drug anaphylactic shock group (P < 0.05). CONCLUSION Tryptase and chymase are more superior than that of the serum total IgE in the diagnosis of death caused by drug anaphylactic shock, and are more suitable in forensic practice.
Adolescent ; Adult ; Aged ; Anaphylaxis/pathology* ; Autopsy ; Case-Control Studies ; Cause of Death ; Child ; Child, Preschool ; Chymases/metabolism* ; Death, Sudden, Cardiac/pathology* ; Drug Hypersensitivity ; Female ; Forensic Pathology ; Humans ; Immunoglobulin E/blood* ; Immunohistochemistry ; Infant ; Lung/pathology* ; Male ; Middle Aged ; Myocardium/pathology* ; Tryptases/metabolism* ; Young Adult

ObjectiveTo explore the death causes and its related factors among psychotic inpatients.MethodsThe medical records of dead psychotic inpatients over recent ten years were investigated with self-designed scheme.ResultsAmong all the investigated cases, the percentage of schizophrenia was more than 50%, the death diagnosis due to somatopathy was over 80%, and more than 50% inpatients suffered from 2～3 kinds of somatopathy. Marital status, diagnosis, smoking and drinking had influenced to the live time of psychotic inpatients.ConclusionThe death of psychotic inpatients might be influenced by multiple causes, including social factors and clinical features which should be paid much attention to extend their live time.

Objective To investigate the epidemiological characteristics of non-toxic goiter and non-toxic thyroid nodules in the regions with different iodine intakes and the factors influencing the occurrence, development and outcome of goiter and thyroid nodules. Methods 3 385 subjects, who had taken part in the previous survey in 1999 with the ultrasonic examination of thyroid, were composed of individuals in Panshan with chronic mild iodine deficiency,in Zhangwu with more than adequate iodine "after iodine supplementation and in Huanghua with excessive iodine. These 3 groups of subjects were followed up in 2004. Results (1) The cumulative incidences of diffuse goiter in Panshan ,Zhangwu and Huanghua were 7.1% ,4.4% and 6.9% ,respectively ,being the lowest in Zhangwu (P<0.01) and those of nodular goiter were 5.0% ,2. 4% and 0.8%, respectively, being the highest in Panshan (P<0.01). (2) The incidences of single nodule were 4.0% ,5.7% and 5.6%, respectively, and those of multiple nodules 0.4%, 1.2% and 1.0%, respectively. (3)The result of logistic analysis showed that iodine deficiency,iodine excess and positive thyroid autoantibodies (TAA) were the independent risk factors for the occurrence of goiter. (4)In Zhangwu ,the incidence of non-toxic goiter in the group with positive TAA was higher than that in the group with negative TAA(P<0.01) ,while there were no such differences in Panshan and Huanghua. (5)In these three regions, the rates of positive TAA in the individuals with diffuse non-toxic goiter were higher than those in the healthy subjects (P<0.05). And in Huanghua,the rate of positive TAA in subjects with non-toxic nodular goiter was also higher than that in the healthy individuals (P<0.05). Conclusion Iodine deficiency and iodine excess may both induce the raising incidence of goiter. Nodular goiter is prevalent in iodine deficient district and diffuse goiter is the predominant form in places with iodine excess. Thyroid autoimmunity is associated with occurrence and maintenance of goiter, and this phenomenon is more obvious in the community with previous iodine deficiency followed then by treatment with more than adequate iodine.