Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To investigate the self-care contribution and binary coping level of spouse caregivers for middle-aged and young stroke patients and explore the relationship between the two, in order to improve the quality of self-care contribution of spouse caregivers to middle-aged and young stroke patients.Methods:A cross-sectional survey was conducted among 200 middle-aged and young stroke patients ′ spouse caregivers in the People ′s Hospital of Xinjiang Uygur Autonomous Region from January to June 2023 by the general data questionnaire, the Caregiver Contribution to Self-care of Stroke Patient Scale, the Dyadic Coping Inventory. The correlation between self-care contributions and binary coping strategies of spousal caregivers was analyzed, and the factors that affect their self-care contributions were screened. Results:Finally, 192 middle-aged and young stroke patients ′ spouse caregivers were included, including 70 males and 122 females, aged 18-59 years old. The total score of self-care contribution of spousal caregivers of middle-aged and young stroke patients was (75.43 ± 6.80) points, and the total score of binary coping was (117.12 ± 9.59) points, both of which were positively correlated ( r=0.691, P<0.05). Hierarchical regression analysis showed that after controlling for the influence of general data, binary coping could explain 28.4% variation in the self-care contribution of spouse caregivers of middle-aged and young stroke patients ( P<0.05). Conclusions:The duality coping level positively predicts the quality of spouse caregivers ′ self-care contribution to middle-aged and young stroke patients. Medical staff should assess the dual coping level of middle-aged and young stroke patients and their spouses, and carry out targeted dual intervention measures to improve the quality of caregivers' contribution to stroke patients ′ self-care.

Objective To investigate the safety and efficacy of domestic Kangduo endoscopic robotic surgical system(SR1500)in laparoscopic partial nephrectomy via abdominal approach.Methods Perioperative data of 5 patients with renal tumors undergoing transabdominal partial nephrectomy with SR1500 at Miyun Hospital during Jul.and Aug.2023 were prospectively collected.The surgical procedure,operation time,pathological margins,intraoperative bleeding,hospital stay,and catheter removal time were recorded.Results The average tumor diameter was 1.92 cm,staged as T1a in TNM classification,with an average R.E.N.A.L score of 5.80.The mean docking time of equipment was 3.00 min,robotic arm operating time 97.20 min,and renal warm ischemia time 19.80 min.Postoperative pathology revealed negative surgical margins in all patients.No high-grade perioperative complications or device-related adverse events occurred.Conclusion Laparoscopic partial nephrectomy using the Kangduo endoscopic robotic surgical system(SR1500)via abdominal approach is safe and effective in the treatment of T1a renal tumors.

Objective To investigate the correlation between the level of oxidative stress indicators in placental tissues and placental perfusion level in twin-to-twin transfusion syndrome (TTTS). Methods A total of 105 cases of dichorionic monoamniotic monozygotic twin pregnant women were included in the study. They were divided into control group of 90 cases and observation group of 15 cases based on whether TTTS occurred during pregnancy. The levels of oxidative stress indicators[malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX)]in placental tissues below the attachment points of the two umbilical cords in the two groups were detected. The maximum diameters of arterio-arterial (AA) anastomosis, veno-venous (VV) anastomosis, and arterio-venous (AV) anastomosis, as well as the difference ratio of placental tissue areas (PTD), were compared between the two groups. The correlation between the levels of oxidative stress indicators in placental tissues and placental perfusion level was analyzed. Results Compared with placental A and placental B in the control group, the MDA level in the placental tissues of the blood supply end and the blood recipient end in the observation group was increased, while the SOD and GSH-PX levels were decreased, and the maximum diameter of AA anastomosis was reduced, there were statistically significant differences (P < 0.05). In the observation group, the MDA level in the placental tissues of the blood supply end was higher than that of the blood recipient end, the SOD and GSH-PX levels were lower than those of the blood recipient end, and the maximum diameter of AA anastomosis was smaller than that of the blood recipient end, with statistically significant differences (P < 0.05). The maximum diameters of AV anastomosis and PTD in the observation group were larger than those in the control group (P < 0.05). There was no significant difference in the maximum diameter of VV anastomosis between the two groups (P>0.05). Pearson correlation analysis showed that there were no significant correlations of MDA, SOD and GSH-PX levels with the maximum diameter of AA anastomosis and PTD in the placental tissues of the control group (P>0.05).In the placental tissues of the blood supply end and the blood recipient end in the observation group, MDA levels showed a strong negative correlation with the maximum diameter of AA anastomosis and a strong positive correlation with the maximum diameter of AV anastomosis and PTD (P < 0.05). SOD and GSH-PX levels showed strong positive correlations with the maximum diameter of AA anastomosis and strong negative correlations with the maximum diamete of AV anastomosis and PTD (P < 0.05). Conclusion There is a significant imbalance of oxidative stress in placental tissues of TTTS pregnant women, and the decrease in antioxidant activity of placental tissues may be an important cause of placental perfusion injury.

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.

Objective: To investigate the antimicrobial resistance in and multilocus sequence typing (MLST) of Campylobacter jejuni in meat and meat products in Liaoning Province, so as to provide insights into the management of C. jejuni infection. Methods: Nine C. jejuni isolates from meat and meat products in 2020 were subjected to whole genome sequencing, and the minimum inhibitory concentration was measured with the agar dilution method. MLST of C. jejuni isolates was performed with the microbial resistance mechanism traceability reference database and analysis system. Results: Six drug-resistant C. jejuni isolates were detected, and there were four multidrug-resistant isolates. There were six C. jejuni isolates resistant to tetracycline, five isolates resistant to nalidixic acid, four isolates resistant to ciprofloxacin, two isolates resistant to florfenicol, one isolate resistant to gentamicin and one isolate resistant to streptomycin. Nine C. jejuni isolates showed sensitive to azithromycin, chloramphenicol and clindamycin. MLST identified six ST types in nine C. jejuni isolates, with ST45 and ST2274 as the predominant type, and detected one isolate with unclassified ST type. Phylogenetic analysis showed that KW028 and KW029 of ST45 type were closely related and had high homology, and KW040 and KW042 of ST2274 type were closely related with high homology, while KW007 of ST6701 type was closely related to KW040 and KW042 of ST2274 type, with only one pgm housekeeper gene in difference. Conclusions High resistance to tetracycline, nalidixic acid and ciprofloxacin was detected in nine C. jejuni isolates from meat and meat products, and ST45 and ST2274 were predominant ST types of C. jejuni.

Objective:To explore the effectiveness of self-assisted couple communication program(SACCP)onprenatal depression and marital quality in pregnant women.Methods:Totally 90 pregnant women receiving ante-natal checkup in Air Force Medical Center with the Edinburgh Postnatal Depression Scale(EPDS)scores of ≥10 were voluntarily recruited and randomly allocated in routine caring and SACCP groups.Thirty-nine pregnant women in SACCP group and 37 pregnant women in routine caring group ultimately completed the study.In addition to rou-tine caring,the SACCP group completed a 10-week self-assisted family communication program once a week.The EPDS and Olson Marital Quality Questionnaires(ENRICH)were used as outcomes,and covariance and independ-ent t-teat were adopted to evaluate intervention effectiveness.Statistical analysis was conducted using the full analy-sis set and the per protocol set respectively.Results:Totally 76(84.4％)pregnant women received allocation and end-point revaluation.Covariance analysis revealed that EPDS adjusted means were higher in the SACCP group than in the routine caring group(P＜0.05)in both sets.T-test showed that marital satisfaction and couple communica-tion scores were higher in the SACCP group than in the routine caring group(Ps＜0.01)in the full analysis set.Conclusion:The self-assisted couple communication program(SACCP)could effectively alleviate clinical symptoms of prenatal depression of pregnant women and improve marital quality.

Primary prostate synovial sarcoma (PPSS) is rare in clinic. One patient was admitted to our hospital in May 2021. The patient was admitted to the hospital because of the physical examination. Preoperative pelvic enhanced MR, PETCT and preoperative puncture pathology suggested that pelvic soft tissue sarcoma was likely. Robot-assisted radical resection of pelvic tumor was performed, and the unilateral PPSS was diagnosed by postoperative pathology, immunohistochemistry and gene detection. Patients were treated with ifosfamide + adriamycin adjuvant chemotherapy one month after operation, and Proton therapy radiotherapy five months after operation. Follow-up for more than 2 years showed that the patients were generally in good condition, and no recurrence or metastasis was found in imaging.

Volume dynamics is a two-compartment dynamical model using hemoglobin (Hb) derived plasma diluted level as input data and urine output as input variable through consecutive repeated measurements of Hb concentration in the blood during infusion. It could be applied to evaluate and guide crystalloid fluid rehydration for patients with dehydration or hypovolemia and during anesthesia or surgery. Volume dynamics could be also used to quantificate of strains, hypovolume, and the change of fluid distribution and elimination caused by anesthesia or surgery. The factors which influence the volume resuscitation are complex, including gender, age, hemodynamic state [mean arterial pressure (MAP)], health and stress state, renal function, consciousness, surgical or anesthesia state and so on, which may affect the half-life, distribution, and volume of the fluid. This article summarizes and analyzes the pathophysiological changes of crystalloids fluid in vivo, in order to provide reference for volume management in critically ill patients.

Objective:To explore the common pathogenic gene mutation in non-syndromic craniosynostosis in Chinese population.Methods:Patients with non-syndromic craniosynostosis were recruited in Huashan Hospital Affiliated to Fudan University from March 2018 to December 2020. A clinical questionnaire was designed to collect the general information of the patients. The gene panel was designed by entering the keywords craniosynostosis and gene panel in PubMed, extracting all relevant literature from January 1995 to May 2017. The gene library was sequenced on the Illumina HiSeq X platform, and bioinformatic analysis and pathogenic analysis were performed.Results:A total of 237 literatures were reviewed in the PubMed and Ovid databases, and the total sample was 3375 patients, of which 1822 cases (54%) were detected with corresponding mutations, involving 21 pathogenic genes. Based on the mutation detection rate of not less than 0.4%, 12 genes were selected in the gene panel: FGFR2, TWIST1, FGFR3, EFNB1, FGFR1, SKI, POR, RAB23, TCF12, MSX2, SMAD3 and ERF. A total of 109 patients with non-syndromic craniosynostosis were recruited in this study, including 62 males and 47 females; the average age was 2.1 years old. All participants denied family history. The average age at childbearing of father was 28.3 years old and of mother was 26.7 years old. 14 different pathogenic/ probable pathogenic mutation loci were found in the gene sequences of 19 patients. The mutation rate was 17.4%. The 14 mutation varients were distributed in 5 genes (FGFR2, TWIST1 , TCF12, EFNB1 , and FGFR3) . The 14 mutations can be classified into 5 missense mutations, 3 nonsense mutations, 1 splice mutation, 1 frameshift mutation and 4 in-frame deletion mutations, 11 of which have not been reported. These 11 novel mutations were mainly concentrated in two genes, TWIST1 and TCF12. The mutation types included: 3 loss-of-function, 4 frameshift deletions, 3 missense mutations, and 1 frameshift insertion, of which 7 were de novo mutation.Conclusions:TWIST1 and TCF12 are common pathogenic genes in Chinese patients with non-syndromic craniosynostosis.