Objective:To explore the mediating role of rumination thinking between demoralization and quality of life in malignant tumor patients, provide guidance and reference for helping tumor patients overcome rumination thinking and demoralization and improve quality of life.Methods:From February 2020 to June 2022, 189 patients with malignant tumors admitted to the Department of Oncology of the First Affiliated Hospital of Guangxi Medical University were selected by convenience sampling method as the research objects, and a cross-sectional survey was conducted using general information questionnaire, Demoralization Scale-Mandarin Version, Ruminative Responses Scale, Punctional Assessment of Cancer Therapy-General.Results:Among 189 malignant tumor patients, there were 102 males, 87 females, aged (43.54 ± 13.12) years old. The total score of loss of demoralization was (34.37 ± 10.34) points, the total score of rumination thinking was (41.01 ± 17.10) points, the total score of quality of life was (48.51 ± 15.41) points. The Pearson analysis results showed that the total score of demoralization in malignant tumor patients was negatively correlated with the total score of quality of life ( r = -0.502, P<0.01); the total score of rumination thinking was negatively correlated with the total score of quality of life ( r = -0.465, P<0.01), and the total score of demoralization was positively correlated with the total score of rumination thinking ( r = 0.628, P<0.01). Bootstrap mediation test results showed that ruminant thinking played a partial mediating effect between demoralization and quality of life of patients with malignant tumors, accounted for 30.9% of the total effect. Conclusions:Rumination plays a partially mediating role in the demoralization and quality of life of patients with malignant tumors, suggesting that clinical staff can improve the quality of life of patients with tumors by developing a systematic and comprehensive cognitive-behavioral intervention strategy to improve the demoralization and rumination.

Objective:To investigate the relationship between heart rate variability(HRV), deceleration capacity(DC) and cardiovascular metabolic disease(CMD) in children and adolescents with normal weight obesity(NWO).Methods:A total of 200 children and adolescents aged 6-17 who underwent normal physical examination in Chengdu Women′s and Children′s Central Hospital from December 2022 to June 2023 were included in this retrospective case-control study.They were divided into the NWO group, normal weight lean(NWL) group, and overweight-obesity(OW-OB) group according to their body mass index(BMI) and body fat percentage(BF%).Fifty children were enrolled into the NWO group; fifty-one children were enrolled into the NWL group; and 99 children were enrolled into the OW-OB group.All the subjects received 24-hour heart monitoring, and their HRV indexes, such as the standard deviation of N-N interval in normal sinus(SDNN), the standard deviation of the mean value N-N intervals every 5-minute(SDANN), the mean of the standard deviations of all N-N intervals for each 5-minute segment of 24 hours(SDNNindex), the root mean square of successive N-N interval difference(rMSSD), the proportion of N-N 50(the successive N-N interval differences>50 ms) in the total number of N-N intervals(pNN50), and DC were automatically calculated.Blood pressure, fasting blood glucose and blood lipids were measured, and the cardiometabolic risk score(CRS) was obtained through the accumulation of relevant factors.The general data, SDNN, SDANN, SDNNindex, rMSSD, pNN50, DC and CRS of the three groups were compared by variance analysis.Spearman correlation and multivariate Logistic regression were used to analyze the risk factors affecting CRS.Results:There was no significant difference in age, gender and other general information among the three groups(all P>0.05).SDNN in the NWO, NWL, and OW-OB groups were(120.88±16.36) ms, (129.07±16.36) ms, and(109.29±16.38) ms, respectively( F=26.231, P<0.001); SDANN were(64.44±11.61) ms, (66.25±8.34) ms, and(61.70±6.85) ms, respectively( F=5.048, P=0.007); rMSSD were(27.02±3.87) ms, (27.51±5.92) ms, and(25.12±6.78) ms, respectively( F=3.328, P=0.038); pNN50 were(12.62±4.04)%, (13.39±2.26)%, and(11.22±2.93)%, respectively( F=9.099, P<0.001); DC were(4.83±0.20) ms, (4.94±0.33) ms, and(4.63±0.28) ms, respectively( F=23.496, P<0.001)and CRS was 0.94±0.87, 0.69±0.19 and 1.57±1.07, respectively( P<0.01).The differences between the three groups were statistically significant.Spearman correlation analysis showed that BMI( r=0.211, P=0.003) and BF%( r=0.558, P<0.001) were significantly positively correlated with CRS, while SDNN( r=-0.258, P<0.001) and DC( r=-0.499, P<0.001) were significantly negatively correlated with CRS.Multivariate Logistic regression analysis showed that BF%(95% CI: 0.098-0.265, P<0.001) and DC(95% CI: -3.962--1.391, P<0.001) were independent risk factors for predicting CMD. Conclusions:Increased BF% and decreased DC are independent risk factors for CMD.Analysis of body composition and HRV in children and adolescents can help to identify potentially high-risk groups more accurately, intervene early, and reduce the risk of CMD.

The early diagnosis of congenital heart disease is very important. Ultrasound is widely used in the early diagnosis and evaluation of congenital heart disease because of its advantages of non-radiation, non-invasive property and portability.Speckle tracking imaging has the advantages of being free from angle, efficient and accurate, which makes up for some shortcomings of traditional echocardiography. It greatly improves the diagnosis accuracy of fetal congenital heart disease, especially congenital heart disease with outflow tract obstruction.Myocardial strain index and left ventricular torsion can more accurately evaluate myocardial function,help to judge prognosis, choose the time of operation and assist perioperative management. Blood speck tracking helps identify different blood flow patterns and may become an important diagnostic tool for the diagnosis and treatment of congenital heart disease.

There are some issues in the process of patient treatment in the medical field, such as knowledge inequality, difficulties in doctor-patient trust and interdisciplinary cooperation, disciplinary barriers, excessive diagnosis and treatment, and structural imbalance of medical resources. In response to these issues, combined with the advantages of conceptual integration, professional integration, and resource integration of medical social work, this paper proposed a practical path for integrating medical social work services in the medical field. The main paths include micro path that systematization, comprehensiveness, and personalization of patient’s diagnosis and treatment process, the integration of intermediary path that integration of disciplinary and professional perspectives, concepts, and practices, and macro path that collaboration and coordination among society, community, and healthcare systems.

Cohort study is one of the important research methods in analytical epidemiology because of its clear time sequence relationship, which is better than other observational studies in demonstrating causal association. However, screening diagnosis or other methods are often used to exclude the individuals with outcome events during the enrollment process of the subjects in cohort studies. The accuracy of screening diagnosis and the effectiveness of exclusion will affect the accuracy of the baseline status assessment of the subjects included in the study, which may lead to the causal time sequence reversal of exposure-outcome in the estimation of causal effect. Landmark analysis can be used to control reverse causality by excluding subjects with potentially unknown expose-outcome timing. In this paper, we describe the basic principles and analytical steps of landmark analysis, and use data from the Chinese Longitudinal Healthy Longevity Survey to explore the relationship between physical activity and frailty, and introduce the specific application of landmark analysis for the purpose of facilitating its application and inferring causal effects more accurately in cohort studies.

With completing a baseline survey of a large natural population cohort, conducting regular follow-up has become a key factor in further improving the quality of cohort construction and ensuring its sustainable development. Typical cohort follow-up methods include repeat surveys, routine monitoring, and community-oriented surveillance. However, in practical applications, there are often issues such as high costs, difficulty, and high error rates. Telephone follow-up is an important supplementary method to the methods mentioned above, as it has the characteristics of low cost, fast response, and high quality. However, the with difficult organization, quality control is challenging, response rates are low, and management levels vary widely, which limits its widespread use in large-scale population cohort studies. Given the above problems, this study draws on customer relationship management based on the actual needs of the China Northwest Cohort follow-up. It relies on the REDCap electronic data collection platform to build a telephone follow-up management and quality control system. Targeted solutions are provided for key issues in telephone follow-up implementation, including organizational structure, project management, data collection, and process quality control, to improve the quality control level of telephone follow-up comprehensively and thereby enhance the quality and efficiency of follow-up. We hope to provide standardized follow-up programs and efficient quality control tools for newly established and existing cohort studies.

Objective:To explore the mediating effect of caring ability of family caregivers on dementia patients′ self-care ability and family caregiver burden.Methods:A total of 113 dementia caregivers of dementia patients recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Mental Health Center from September 2020 to January 2021 were selected, and the Barthel Index, Family Caregiver Task Inventory and Zarit Burden Interview were used to capture their responses on dementia patients′ self-care ability, caring ability, and caregiver burden.Results:The score of self-care ability of dementia patients was (75.19 ± 28.56), and scores of caring ability and care burden of caregivers were 9.00(4.00, 15.00) and (33.78 ± 16.53), respectively. The self-care ability of dementia patients was negatively associated with caring ability and care burden of caregivers ( r=-0.424, -0.420, both P<0.01), and the caring ability and care burden were positively correlated ( r=0.605, P<0.01). The intermediary effect of dementia caregivers' caring ability between patients' self-care ability and caregivers' care burden is significant. The indirect effect was -0.107 and the total effect was -0.187. The indirect effect accounted for 57.22% of the total effect. Conclusions:Caring ability of family caregivers mediates the relationship between self-care ability of dementia patients and caregivers' care burden.The caring ability may be used as an intervening target for future studies.

【Objective】 To evaluate the diet quality of pregnant women in Shaanxi Province by Diet Balance Index for Pregnancy (DBI_P) and investigate the influencing factors. 【Methods】 By using a multi-stage stratified random sampling method, 7375 pregnant women in 30 districts (counties) of Shaanxi Province were recruited. A structured questionnaire was adopted to collect general information in pregnancy, and a semi-quantitative food frequency questionnaire was used to obtain dietary information in pregnancy. DBI_ P was used to evaluate the diet quality during pregnancy, and the factors influencing diet quality were assessed by multiple linear regression. 【Results】 More than 50% pregnant women had inadequate intakes of dairy products, fish and shrimp, meat and poultry, vegetables, eggs, fruits and diet variety. More than 69% pregnant women had excessive intakes of cooking oil, cereals and salt. The average values of high bound score, low bound score, and diet quality distance were 12.9, 19.5, and 32.5, respectively. The proportions of medium inadequate, excessive, and imbalance of dietary intakes were 20.3%, 22.55%, and 40.8%, respectively. DBI_LBS during pregnancy was negatively correlated with childbearing age, education level, family per capita annual income, antenatal examination frequency and folic acid supplementation, but positively correlated with living in southern and northern Shaanxi, residing in rural areas, being farmers, and drinking alcohol. DBI_HBS during pregnancy was negatively correlated with living in southern and northern Shaanxi, but positively correlated with active/passive smoking and drinking strong tea. DBI_DQD during pregnancy was negatively correlated with education level, family per capita annual income, antenatal examination frequency and folic acid supplementation, but positively correlated with living in southern Shaanxi, residing in rural areas, being farmers, parity, active/passive smoking, and drinking strong tea and coffee. 【Conclusion】 The dietary intake of pregnant women in Shaanxi Province was insufficient and unbalanced, and the dietary quality was affected by sociodemographic and life behavior factors during pregnancy. Nutritional intervention measures should be targeted.

Objective:To study the relationship between the Chinese dietary guidelines compliance index for pregnant women (CDGCI_PW) and congenital heart disease (CHD) in offspring.Methods:In a hospital-based case-control study conducted in Xi'an, Shaanxi province, semi-quantitative food frequency questionnaires were used to investigate the diets of pregnant women throughout pregnancy. The modified CDGCI_PW score was used to evaluate dietary quality during pregnancy, logistic regression was applied to analyze the relationship between CDGCI_PW score and offspring CHD, and the ROC curve was adopted to construct the prediction model of CDGCI_PW for offspring CHD.Results:A total of 1 422 subjects were enrolled, including 474 in the case group and 948 in the control group. The CDGCI_PW score in the case group M ( Q1, Q3) was 46.0 (26.0, 65.0) lower than that in the control group, which was 60.0 (40.0, 77.0). The difference between the two groups was significant ( P<0.001). Compared with those in the Q1 of CDGCI_PW, the offspring in the Q2, Q3, and Q4 of CDGCI_PW had a lower risk of total CHD ( OR=0.60, 95% CI: 0.43-0.83; OR=0.64, 95% CI: 0.45-0.89; OR=0.29, 95% CI: 0.19-0.44), with the trend test P<0.001. The risk of total CHD was reduced by 17% ( OR=0.83, 95% CI: 0.79-0.88) when 10 points increased the CDGCI_PW score. The area under curve predicted by constructing the ROC curve was 0.793 (95% CI: 0.768-0.818), and at the maximum of the Youden index, the sensitivity was 0.740, and the specificity was 0.725. Conclusion:This study suggests that improving dietary quality during pregnancy may reduce the risk of CHD in offspring.

Objective:To evaluate the feasibility of transcatheter atrial septal defect(ASD) closure with deficient rim.Methods:From January 2017 to November 2019, patients at the Department of Pediatric Cardiology, Chengdu Women′s and Children′s Central Hospital were diagnosed as the secondary ASD and divided into 2 groups based on whether it has deficient rim[the deficient rim group (experimental group) and non deficient rims group (control group)]. The complications should be followed for 1-2 years.Results:A total of 66 patients, including 17 males (25.8%) and 49 females (74.2%), had the median age of 4 years and 2 months (2 years and 1 month-16 years), and the median body mass was 15.0 kg, ranging from 9.0 kg to 60.0 kg, with 23 cases (34.8%) in the experimental group and 43 cases (65.1%) in the control group.There were no statistically significant differences in gender, age, body weight, size of ASD, fluoroscopic dose, electrocardiogram, and pulmonary artery pressure between the two groups (all P>0.05). The immediate success rate was 95.4%(63/66 cases). There were no statistically significant differences between the surgical success rate [91.3%(21/23 cases) vs.97.6%(42/43 cases)] and the incidence of residual shunt [30.4%(7/23 cases) vs.16.2%(7/43 cases)](all P>0.05). And there were no statistically significant differences of the incidence of residual shunt between groups at each follow-up point ( P>0.05). No arrhythmia occurred in the experimental group during follow-up, and 1 case of atrioventricular block in the control group persisted until the time of publication.A total of 4 cases of frequent atrial premature beats or non-paroxysmal atrial tachycardia returned to normal at the follow-up node 6 months after intervention. Conclusions:Under the selection of appropriate cases and skilled catheter technology, the transcatheter treatment of ASD in children with deficient rims is feasible.