Objective: To analyze the current status and influencing factors of psychological crisis among college students, so as to provide a scientific basis for the formulation of psychological crisis intervention plans in colleges and universities. Methods: From September to December 2024, 645 college students from a medical undergraduate university in Heilongjiang Province were selected with a convenience sampling method. A convergent mixed analysis design was used. Quantitative analysis was conducted using College Students Psychological Crisis Screening Scale, Emotion Regulation Questionnaire, Short-Egna Minnen av Barndoms Uppfostran and Perceived School Climate Scale. Binary Logistic regression analysis was used to explore the related factors of psychological crisis among college students. Qualitative research was conducted on 15 college students with psychological crisis identified in the quantitative analysis by a purposive sampling method. The interview data were organized and analyzed using the thematic framework analysis method. Results: Among the surveyed college students, 92 (14.3%) had psychological crisis. Binary Logistic regression analysis results showed that positive parenting style ( OR=0.97,95%CI =0.95-0.99), negative parenting style ( OR=1.01,95%CI =1.00-1.02), cognitive reappraisal ( OR=0.88, 95%CI =0.83-0.92), expressive suppression ( OR=1.08, 95%CI =1.02-1.15), and perceived campus atmosphere ( OR=0.97, 95%CI =0.95-0.98) were all related factors of psychological crisis among college students ( P <0.05). The qualitative analysis results showed that there were three themes for the influencing factors of college students psychological crisis, including differential impact of emotion regulation strategies on psychological state, shaping of psychological state of college students by family and bidirectional effect of perceived campus atmosphere on psychological state. Mixed analysis results showed that the influencing factors of college students psychological crisis were consistent in terms of emotion regulation strategies, and were expansive in terms of parenting style and perceived campus atmosphere. Conclusion Schools and mental health service departments can reduce the risk of psychological crisis by optimizing cognitive reappraisal and reducing expressive suppression, improve the level of psychological crisis by strengthening positive family interaction and blocking negative parenting style, and maintain the mental health level of college students by building a supportive campus environment and alleviating high pressure.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

【Objective】 To investigate the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (M-TESE) in patients with non-obstructive azoospermia (NOA) caused by different causes. 【Methods】 A retrospective analysis was performed on 225 NOA patients during Jan.2020 and Dec.2022. The relation between SRR and patients’ age,body mass index (BMI),testicular volume,endocrine hormones and different etiological classifications were analyzed. 【Results】 According to whether sperm was obtained by surgery,the patients were divided into two groups,including 107 cases in the sperm group and 118 cases in the non-sperm group. There were no significant differences in patients’ age,testicular volume and levels of endocrine hormones between the two groups (P>0.05). According to the different causes,NOA patients with mumps history,cryptorchidism history,AZFc deletion or Klinefelter syndrome (KS) had higher SRR,while idiopathic NOA patients had the lowest SRR (P<0.05). 【Conclusion】 M-TESE is an effective treatment of NOA. There is no correlation between SRR and patients’ age,MBI,testicular volume and levels of endocrine hormones. NOA caused by different etiological classifications may have different SRR.

Objective To summarize and analyze the clinical outcomes of gestational trophoblastic neoplasia (GTN) patients receiving primary treatment at Peking Union Medical College Hospital from 1985 to 2015,and investigate the changes in treatment efficacy between the first and the second 15 years.Methods Clinical data of GTN patient receiving primary chemotherapy at Peking Union Medical College Hospital from January 1985 to December 2015 were retrospectively analyzed.It further compared the therapeutic results and chemotherapy cycles given to GTN patients,according to International Federation of Gynecology and Obstetrics (FIGO,2000) prognostic score system,who were classified to different stages and low-or high-risk groups.Results In total,1 711 GTN patients were included in this study.Comparing the 1985-2000 group and the 2001-2015 group,the results showed that:(1) while the overall complete remission (CR) rate was 93.7％ (1 603/1 711),the CR rate of 2001-2015 group was significantly higher than that of 1985-2000 group [98.4％ (1 155/1 174) vs 83.4％ (448/537),x2=139.353,P＜0.01].This difference was significant between stage Ⅲ and Ⅳ patients,but nonexistent between stage Ⅰ and Ⅱ patients,including low-and high-risk groups.(2) The relapse rate of patients who had been in CR was 2.7％ (43/1 603),with no significant differences between the groups of 1985-2001 and 2001-2015 [3.6％ (16/448) vs 2.3％ (27/1 155),x2=6.867,P=0.142].(3) The overall mortality rate was 2.6％ (44/1 711),which significantly decreased in 2001-2015 group compared to 1985-2000 group [1.6％ (19/1 174) vs 4.7％ (25/537),x2=13.830,P＜0.01].This difference appeared only in high-risk patients with stage Ⅲ disease (x2=9.505,P＜0.01).(4) Fluorouracil was gradually replaced by floxridine in chemotherapy regimens.The total cycles of chemotherapy regimens given to low-risk patients with stage Ⅲ disease significantly decreased in 2001-2015 group,but no statistical difference was shown with patients at other stages.Moreover,the cycles of consolidation treatment were significantly reduced in patients with stage Ⅲ patients.Conclusions GTN patients could obtain satisfactory curative results after appropriate and standard treatment.Peking Union Medical College Hospital has achieved better curative effect in the latest 15 years than before.

Transjugular intrahepatic portosystemic shunt (TIPS), after nearly 30 years of continuous exploration and development, has been widely used in the treatment of complications of portal hypertension. TIPS has significant advantages in acute esophagogastric variceal bleeding, prevention of rebleeding, refractory peritoneal effusion, and Budd-Chiari syndrome; however, if postoperative anticoagulant measures are inappropriate, it can cause several complications, such as stent dysfunction and acute thrombosis, and lead to the recurrence of the symptoms of portal hypertension before TIPS, which greatly affects middle- and long-term clinical outcomes and survival rate. Maintenance of stent patency is the key to good postoperative treatment outcome, and therefore, anticoagulants play an important role in the prevention and treatment of post-TIPS thrombosis. At present, no consensus has been reached on post-TIPS anticoagulant therapy in China and foreign countries. This article reviews the research advances in the application of anticoagulants after TIPS.

OBJECTIVETo systematically collect the thrombelastography (TEG)-or thromboelastometry (ROTEM)-related data, and predict to evaluate their values for the prediction of thromboembolic events.

METHODSDatabases including PubMed, Central and Embase were searched for the related clinical trials, and the references were retrieved manually; these included references were assessed qualitatively by the QUADAS-2 tool; finally the enrolled researches were qualitatively analyzed.

RESULTSA total of 15 studies consisting of 293 VTE patients met the inclusion criteria. The overall quality and the accuracy of TEG or ROTEM in predicting VTE varied a lot. Two thirds of the studies displayed that the changes of TEG parameters or ROTEM were related to the occurrence of VTE.

CONCLUSIONThe present studies showed that the TEG or ROTEM for predicting the VTE display higher difference in accuracy, therefore, the combination of TEG or ROTEM with other laboratory tests may improve the accuracy of VTE diagnosis.

Antineoplastic Agents, Immunological ; immunology ; pharmacology ; Cell Line, Tumor ; GPI-Linked Proteins ; antagonists & inhibitors ; immunology ; Humans ; Neoplasm Proteins ; analysis ; immunology ; Pancreatic Neoplasms ; drug therapy ; immunology ; pathology

Objective To explore the clinical outcome of individuals with Clinical High Risk (CHR) for psychosis and its relationship with Theory of Mind (ToM) function.Methods The Structured Interview for Prodromal Symptoms/Scale of Prodromal Syndromes (SIPS/SOPS) was applied to assess prodromal psychosis.The Reading the mind in the Eyes and faux pas Task were conducted to assess the function of Theory of Mind among the individuals of clinical high risk of psychosis.All participants had completed the 2-year follow-up.Conversion was determined using the criteria of presence of psychotic symptoms (POPS).According to the outcome,CHR individuals were divided into conversion group (n=20) and no-conversion group (n=50).The baseline clinical symptom characteristics and Theory of Mind were compared between groups.Results There was no significant difference in clinical symptom characteristics among individuals with CHR (P＞0.05).In the faux pas text,there were significant differences in Faux Pas Detection (P=0.01),Faux Pas Understanding (P=0.01) and Faux Pas Total (P=0.02) but not in control stories and the Reading the Mind in the Eyes Test between convertors and non-convertors (P＞0.05).Conclusion The ToM disability in clinical high risk population increases risk for conversion to psychosis.

[ ABSTRACT] AIM:To investigate the mechanism of L-type calcium channel ( L-Ca2+)/calpain signal transduc-tion pathway in verapamil inversing resistance of papillary thyroid carcinoma to doxorubicin .METHODS:Human papillary thyroid carcinoma TPC-1 cells were cultured for 2 d.For determining the appropriate concentrations and treatment time of verapamil and doxorubicin , a compatibility test was conducted to detect the cell viability by CCK-8 assay.The cells were divided into control group , doxorubicin group , verapamil group and doxorubicin +verapamil group .The techniques of whole-cell patch-clamp was used to record L-Ca2+currents.The protein expression levels of calpain 1 and LC3 were detec-ted by Western blot .RESULTS: Compared with control group , the density of L-Ca2+current decreased in doxorubicin group and verapamil group (P<0.05).Compared with verapamil group , the density of L-Ca2+current decreased in doxo-rubicin+verapamil group (P<0.01).Compared with control group, the expression of calpain 1 decreased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of calpain 1 decreased in doxo-rubicin+verapamil group (P<0.05).Compared with control group , the expression of LC3 increased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of LC3 increased in doxorubicin +ver-apamil group ( P<0.01) .CONCLUSION:The drug resistance of TPC-1 cells to doxorubicin may be related to the in-crease in autophagic activity .Verapamil further increases autophagic activity of TPC-1 cells, resulting in autophagic death and inversing the resistance of TPC-1 cells to doxorubicin .The mechanism may be involved in L-Ca2+/calpain 1 signal transduction pathway of autophagy .