Objective: To investigate the association between subthreshold depression, psychotic like experiences (PLEs), and their interactions with non suicidal self injury (NSSI) in adolescents from Shandong, so as to provide a reference for the prevention and early intervention of NSSI in adolescents. Methods: A random cluster sampling method was used to select a total of 6 090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province. Electronic surveys were administered using the SelfInjurious Behavior Questionnaire, Community Assessment of Psychic Experiencepositive 8 items(CAPE-P8), and the Center for Epidemiological Studies Depression Scale(CES-D). The relationship between subthreshold depression, PLEs, and their interaction with NSSI was analyzed using multivariate Logistic regression. Results: The detection rate of NSSI among adolescents was 21.3%. The highest NSSI reporting rate (27.9%) was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9% and 30.7%, respectively. Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI [OR(95%CI)=3.47(2.68-4.50)]. Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences [OR(95%CI)=5.32(4.10-6.89)]. When both subthreshold depression and PLEs coexist, the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition [OR(95%CI)=18.47(14.75-23.13)] (P<0.01). The relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were 11.44, 0.61, and 2.89, respectively, indicating that the combined interaction of subthreshold depression and PLEs accounted for 61% of adolescent NSSI. Conclusions Subthreshold depression and psychoticlike experiences are associated NSSI in adolescents and exhibit an additive interaction. Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.

Objective:To explore the relationship between parental psychological control,school climate and future orientation of high school students.Methods:Totally1 430 senior high school students were evaluated with parental control questionnaire,Adolescent perceived Campus atmosphere questionnaire and Adolescent Future orien-tation questionnaire.The moderating effect of school climate was analyzed using Modell of the PROCESS mac-ro.The bridge function in the network analysis methodology was usedto calculate the bridge expected influence in-dex to evaluate the bridge nodes between parental psychological control and future orientation network,school cli-mate and future orientation network.Results:The analysis of moderating effects shows a negative correlation be-tween parental psychological control and future orientation(β=-0.11,P＜0.001).Both positive and average school climates demonstrated a positive moderating effect(β=-0.11,-0.17,P＜0.001).The bridge expected impact index showed that the bridge connection nodes of parental psychological control and campus atmosphere on future orientation were guilt-thoughtfulness(bridge El=0.23,0.19)and teacher support-optimism(bridge EI=0.19,0.15).Conclusion:A positive school climate could mitigate the negative effects of parental psychological control on high school students'future orientation,with future emotional experience being a key aspect in how both influence the students'future direction.

Objective To observe the relationship between CYP2C19 gene polymorphisms and major adverse cardiovascular events in the patients of acute coronary syndrome (ACS) who accepted percutaneous coronary intervention (PCI) in Han population from Dalian. Methods A total 809 cases with ACS who had undergone PCI in the cardiology department of Dalian Municipal Central Hospital from Janurary 2012 to Janurary 2014 were selected,Among 809 cases of ACS,there were 178 cases of acute ST segment elevation myocardial infarction (STEMI),105 cases of acute non ST segment elevation myocardial infarction (NSTEMI) and 526 cases of unstable angina. The patients were divided into three groups according to their CYP2C19 genotype.CYP2C19 genotype (*1/*1) were classified as extensive metabolizers (EM group), CYP2C19 genotype (*1/*2、*1/*3) were classified as intermediate metabolizers (IM group) and CYP2C19 genotype (*2/*2、*3/*3、*2/*3) were classified as poor metabolizers (PM group). The occurrence of major adverse cardiovascular events at least 24 months was observed. Results Seven hundred and ninety patients finished the follow-up at least 24 months, 19 patients lost in follow-up, 350 cases (43.2%) were CYP2C19 (*1/*1),318 cases (39.3%) were CYP2C19(*1/*2), 42 cases(5.2%) were CYP2C19 (*1/*3),77 cases (9.5%) were CYP2C19 (*2/*2), 21 case(2.2%)were CYP2C19 (*2/*3), and 1 case (0.1%) was CYP2C19(*3/*3), 350 cases (43.2%) were classified as EM group, 360 cases (44.5%) were classified as IM group, and 99 cases(12.2%)were classified as PM group. No significant difference in age, gender, hypertention, diabetes mellitus, smoking was shown among three groups (P > 0.05). The rate of MACE were 3.3% , 8 cases had target lesion revascularization(EM group 3 cases, IM group 3 cases, PM group 2 cases), 2 cases had non-fatal myocardial infarction (IM group 1 case, PM group 1 case), 15 cases were died(EM group 6 cases, IM group 7 cases, PM group 2 cases), 1 case had subacute stent thrombosis in IM group. The rates of MACE were higher in PM group (5.1%) than those in EM group(2.65%) and IM group (3.41%) , but there was no significant difference in three groups (P>0.05). There was no significant difference in the rate of target lesion revascularization , thrombus in stent, non- fatal myocardial infarction and death among three groups(P > 0.05). Conclusions There is no significant correlation between CYP2C19 gene polymorphism and long-term prognosis in patients with ACS who accepte PCI treatment in Han population from Dalian.

Objective: To evaluate the efficacy and safety of intravascular ultrasound guidance drug-coated balloon (DCB) in percutaneous coronary intervention (PCI) of situ coronary artery lesions in patients with acute coronary syndrome (ACS), and its effect on thrombus precursor protein (TpP). Methods: Seventy-eight patients with ACS in Central Hospital of Changchun City from January 2015 to January 2019 were selected, including 46 cases with unstable angina pectoris and 32 cases with acute non-ST-segment elevation myocardial infarction. The patients were divided into DCB group (38 cases) and drug-eluting stent (DES) group (40 cases) by random digits table method. Intravascular ultrasound was used to guide PCI in both groups, and DCB and DES were used respectively. Coronary angiography was performed immediately and 6 months after PCI in both groups. Minimum lumen diameter (MLD) was measured by QCA system, and the lumen loss (LLL) was calculated at 6 months after PCI. Plasma TpP before PCI, 1 and 6 months after PCI was measured by enzyme-linked immunosorbent assay (ELISA). Major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction and target lesion revascularization (TLR) were followed up 1, 3, 6 and 12 months after PCI. Results: Immediately after PCI, there was no statistical difference in MLD between DCB group and DES group: (1.87 ± 0.23) mm vs. (2.16 ± 0.15) mm, P>0.05; 6 months after PCI, the LLL in DCB group was significantly smaller than that in DES group: (0.31 ± 0.28) mm vs. (0.48 ± 0.19) mm, and there was statistical difference (P<0.05). There were no significant differences in the incidences of myocardial infarction, TLR and cardiac death in DCB group (P>0.05). Before PCI and 6 months after PCI, there was no statistical difference in TpP between 2 groups (P>0.05); 1 month after PCI, the TpP in DCB group was significantly lower than that in DES group: (15.31 ± 6.13) mg/L vs. (19.46 ± 8.24) mg/L, and there was statistical difference (P<0.05). Conclusions DCB is an accurate and effective treatment for ACS patients with situ coronary artery disease under the intravascular ultrasound guidance, and it can reduce the risk of thrombosis.

Objective: To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI. Methods: Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P-selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups. Results: In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance. Conclusions There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.

[ ABSTRACT] AIM: To investigate the differential expression of human leukocyte antigen-G ( HLA-G) isoforms and its receptors in human monocyte line THP-1 after human cytomegalovirus ( HCMV) infection for exploring the role of HLA-G in HCMV escaping the immune response of the organism .METHODS: THP-1 cells were infected with HCMV Towne strain.The expression of HLA-G isoforms at mRNA and protein levels was determined by RT-PCR and Western blot, respectively.The surface expression of HLA-G and its receptors ILT2/ILT4 and the cell viability were analyzed by flow cytometry.The levels of soluble HLA-G (sHLA-G) and IL-10 were measured by ELISA.RESULTS:After infection of the THP-1 cells with HCMV , no obvious apoptosis in the cells was observed , and the viability of the cells was high .A significant up-regulation of HLA-G1,-G3,-G4 and-G5 at mRNA expression level 1 d after infection was found , while the protein expression of HLA-G1 and HLA-G5 isoforms was mainly detected .The expression of HLA-G/ILT2/ILT4 was evi-dently up-regulated 1 d after infection .The level of sHLA-G was significantly increased 1 d after infection as compared with control group (P<0.01).The expression of IL-10 was obviously up-regulated 1 d post-infection as compared with control group.CONCLUSION:The differential expression of HLA-G isoforms and secretion of the receptors ILT 2/ILT4 and IL-10 in the THP-1 cells are induced after HCMV infection .This study provides experimental evidence for evaluating the immune mechanism of HCMV infection .

Objective To describe the status of anxiety and depression in patients with uveitis, and to explore the related factors of quality of life. Methods A total of 126 uveitis patients from September 2015 to March 2016 were investigated with the General Social Population Questionnaire, Life Quality for Diseases with Visual Impairment Scale, Self-rating Anxiety Scale and Beck Depression Inventory. Results There were 126 valid questionnaires, and the effective recovery rate was 96.9％(126/130). The score of Self-rating Anxiety Scale in uveitis patients was (43.49±7.20) points which lower than the standard mark standardized score, and 14.3％ (18/126)of patients were diagnosed with anxiety. The score of Beck Depression Inventory in uveitis patients was (7.50 ± 6.60) points which lower than the standard mark standardized score, 28.6％ (36/126)of patients were diagnosed with depression. The Self-rating Anxiety Scale scores and psychological dimensions of quality of life was negatively correlated (r=-0.310, P<0.01), and the Beck Depression Inventory scores and the average score of the quality of life, the 4 dimensions and total score of quality of life was negatively correlated(r=-0.534--0.240, all P<0.01). The multiple linear regression analysis showed that the related factors of quality of life were score of depression, vision loss, education and gender(P<0.05). Conclusions The incidence of depression and anxiety are both lower in patients with uveitis than general population. The status of quality of life is related to the score of depression, vision loss, education and gender.

Objective To evaluate the effect of early aerosol inhalation on sore throat of the patients after double lumen endobronchial intubation. Methods 90 patients scheduled for thoracic surgery were randomly assigned to 3 groups,30 cases in each group: control group (Group C), early aerosol inhalation group (group one) and later aerosol inhalation group (group two). All patients were sent to PACU after extubation.The patients in group C were intraveously injected with 6 mL saline , those in group one were treated with aerosol inhalation of 1mg budesonide, while the patients in group two with budesonide at the same dosage 2 h later. Patients were examined with indirect laryngoscopy 6 h after surgery. The cases of vocal cord congestion and glottis edema were recorded. The degree of pharyngolaryneal pain was assessed with the Visual Analogue Scale (VAS) when they were sent to PACU , 6 , 24 and 48 hours after surgery . Results The rates of vocal cord congestion and glottis edema in group one were lower than those in group C and group 2, 6 h after surgery (P < 0.05). The pharyngolaryneal VAS in group one was significantly lower than that in group C and group 2 , 6 and 24 h after operation (P < 0.05), but there was no statistical difference between them 48 h after surgery between 3 groups. Conclusions Aerosol inhalation of budesonide after double lumen endobronchial intubation for the patients scheduled for thoracic surgery during early postoperative stage can reduce the incidences of vocal cord congestion and glottis edema, inhibit airway inflammation, significantly reduce the extent of the POST. The effect is better than that of the lateraerosol inhalation of budesonide.

Objective To explore the establishment of “four in one” integration training system in the nurses of orthopaedic group in Operating Room and assess its effects .Methods A total of 32 nurses in orthopedic group of Operating Room were trained according to the hierarchy management , target monitoring , training implementation , training effect evaluation of “four in one” integration system .Through collecting the doctors′satisfaction for nursing quality , the nurses′evaluation for teaching training effects , clinical nurse′s ability assessment , the indicators of nursing risk event rate , the training effects were compared before and after the established system .Results After training , the surgeon′s satisfaction for training , different aspects of nurses′assessment, nurses′evaluation for training effects were all improved compared before the training (P<0.05).After training, the incidence of nursing risk events decreased ( P <0.01 ).Conclusions The construction of“four in one” integrated training system can promote clinical comprehensive practice ability of the orthopaedic group nurses , improve the surgeon′s satisfaction, and reduce the nursing security risks , which is advantageous to nurses′growth in the orthopedic group , and is worth for universally popularization and application in clinical teaching in Operating Room .

Background and purpose:To perform whole mount technique in the diagnosis of the prostate cancer could provide orientation to the specimen. Whole mount technique has great value in pathologic diagnosis and morphological research. However, limited by the specimen-making technique, shortage of equipment and heavy workload, this technique has not been generally accepted in China. The aim of this study was to evaluate the signiifcance of whole mount technique in the diagnosis of the prostate cancer by comparing the clinical and pathological variables between whole mount patients and conventional ones after radical prostatectomy (RP).Methods:A total number of 229 patients’ whole mount RP specimens were recruited in the study from Dec. 2012 to Feb. 2014. The control group included 393 patients’ specimens which underwent conventional sampling from Jan. 2010 to Jun. 2012. We compared the clinical and pathological variables between the groups, including age, preoperative PSA level, methods of diagnosis, preliminary diagnostic Gleason score, clinical T stage, postoperative Gleason score, pathological T stage, positive surgical margin, extraprostatic extension, seminal vesicle invasion and pelvic lymph node metastasis.Results:Two groups shared similar preoperative parameters. Also there was no signiifcant difference between the whole mount and the conventional sampling groups in postoperative Gleason score, pathological T stage, extraprostatic extension and pelvic lymph node metastasis. However, positive surgical margin and seminal vesicle invasion rates were much higher in the whole mount group than the control one and both of the differences reached statistical signiifcance (26.2%vs 17.6%, 23.1%vs 17.0%;P=0.010, 0.025)Conclusion:After compared the clinical and pathological variables, we could conclude that whole mount technique has prevalence in the diagnosis of the positive surgical margin and seminal vesicle invasion compared with the conventional sampling technique. Thus, whole mount technique should be strongly recommended in the diagnosis of prostate cancer.