Background::The potential impact of pre-existing coronary artery stenosis (CAS) on acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with PE.Methods::In this multicenter, prospective case-control study, 88 cases and 163 controls matched for age, sex, and study center were enrolled. Cases were patients with PE with elevated hs-cTnI. Controls were patients with PE with normal hs-cTnI. Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression was used to evaluate the association between CAS and hs-cTnI elevation.Results::The percentage of CAS was higher in the case group compared to the control group (44.3% [39/88] vs. 30.1% [49/163]; P = 0.024). In multivariable conditional logistic regression model 1, CAS (adjusted odds ratio [OR], 2.680; 95% confidence interval [CI], 1.243–5.779), heart rate >75 beats/min (OR, 2.306; 95% CI, 1.056–5.036) and N-terminal pro-B type natriuretic peptide (NT-proBNP) >420 pg/mL (OR, 12.169; 95% CI, 4.792–30.900) were independently associated with elevated hs-cTnI. In model 2, right CAS (OR, 3.615; 95% CI, 1.467–8.909) and NT-proBNP >420 pg/mL (OR, 13.890; 95% CI, 5.288–36.484) were independently associated with elevated hs-cTnI. Conclusions::CAS was independently associated with myocardial injury in patients with PE. Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.

Objective This study aims to explore the associations between threat and deprivation childhood traumas and dysfunctional attitudes among patients with major depressive episode,based on the dimensional model of adversity and psychopathology(DMAP).Methods Data from 970 patients with major depressive episode were collected and categorized based on the childhood trauma questionnaire-short form(CTQ-SF)scores into no trauma(426),threat-only(86),deprivation-only(210),and mixed groups(248).Cognitive distortions were assessed using the dysfunctional attitudes scale(DAS),with scores above the upper quartile indicating significant distortions.Multifactorial logistic regression analysis was employed to examine the association between threat and deprivation and dysfunctional attitudes.Results There were significant differences in the proportion of cognitive distortions among the no trauma,threat-only,deprivation-only,and mixed groups(19.25% vs.30.23% vs.20.00% vs.35.89%,P<0.001),with differences across all dimensions(P≤0.001).Multifactorial logistic regression revealed a positive correlation between threat and overall cognitive distortions(OR=2.031,P<0.001),and specific positive correlations with dimensions such as vulnerability(OR=1.709,P<0.001),appeal and repulsion(OR=2.088,P<0.001),perfectionism(OR=2.321,P<0.001),compulsivity(OR=1.765,P=0.001),approval seeking(OR=1.837,P<0.001),dependency(OR=1.554,P=0.006),and autonomous attitudes(OR=1.864,P<0.001).In contrast,deprivation was only positively correlated with the cognitive philosophy dimension(OR=1.495,P=0.015).Conclusion Childhood trauma is closely associated with dysfunctional attitudes in patients with major depressive episode.Threat correlates positively with cognitive distortions in all dimensions except cognitive philosophy,whereas deprivation correlates only with the cognitive philosophy dimension.

Objective:To comprehensively retrieve the evidence on bowel preparation before colonoscopy in children, evaluate and summarize the best evidence, so as to provide scientific reference for clinical improvement of bowel preparation quality in children, as well as for children and parents.Methods:According to the "6S" pyramid classification model of evidence-based retrieval resources, we systematically searched BMJ Best Practice, UpToDate, clinical guideline website, professional society website and database for clinical decisions, guidelines, expert consensus, evidence summary and systematicreview on children's bowel preparation before colonoscopy.The retrieval time limit was from the establishment of the database (station) to December 31, 2021.Two researchers independently evaluated the article quality, extracted theevidence and determined the level of evidence recommendation.Results:A total of 11 articles were included, involving 3 clinical guidelines, 4 systematic reviews and 4 expert consensus.After summarizing the relevant evidence, a total of 16 pieces of evidence were summarized from 8 aspects, including the method of education, diet preparation, the selection and use of intestinal cleanser.Conclusions:The endoscopic team, surgeon, nurseand other multi-disciplinary teams should consider different ages and special conditions of children before colonoscopy, and jointly discuss the best bowel preparation plan, so as to improve the quality of children's colonoscopy.

【Objective】 To investigate the effect of sample processing at 56℃ for 30 min on routine examination in Department of Blood Transfusion. 【Methods】 A total of 40 cross matched blood samples submitted by clinical departments of our hospital, were collected, and each sample was equally divided into two. Before and after heating at 56℃ for 30 min, the ABO blood group was detected by manual method and card method (gel card and glass beadle card), antibody titer was detected by coagulant method, and cross-matching was conducted by anti-globulin card method. Chi-square test and Wilcoxon signed rank test were used to compare the differences between the two groups (before and after heating treatment). 【Results】 The blood group detection rates of the experimental group were 100% (40/40), 37.5% (15/40) and 80% (32/40) by manual test tube method, gel card and glass beads card, respectively, P<0.01. The geometric mean of blood antibody titers in the control group and the experimental group were anti-A IgM (14.936, 10.556) and IgG(3.563, 4.489), anti-B IgM (9.849, 10.556) and anti-G (5.039, 4.489)(respectively, P>0.05). The matching rate of two groups of samples, cross-matched with corresponding donor samples, was both 100% (40/40) by coagulant method, and 100% (40/40) vs 25% (10/40) respectively by the antiglobulin card method (P<0.01). The other 30 samples in the experimental group presented weak agglutination in the secondary side. 【Conclusion】 The treatment of virus inactivation at 56℃ for 30 min has little effect on blood group identification by test tube method, antibody titer and cross-matching by coagulant method, and reduceds the occupational exposure of staff in Blood Transfusion Department.

Objective? To investigate and explore actual help-seeking behaviors for depressive symptoms among college students. Methods? By convenience sampling, a total of 871 undergraduate students from the whole Wuhan university from November 2016 to March 2017 were selected and investigated by using the self-designed General Information Questionnaire, Family APGAR Index(APGAR), Center for Epidemiologic Studies Depression Scale(CES-D),Comprehensive International Diagnostic Interview(CIDI 2.1) Actual Help Seeking Questionnaire(AHSQ). Results? Totally 348(43.3%)college students reported that they had depressive problems and the situation about actual help-seeking behaviors had been reported over the part 12 months. Among those 348 respondents, 94(27.0%)students reported that they had never sought for help; 254(73.0%) reported they had sought for help. There was statistical difference of "whether had been through major life events in the past one year" in seeking help from "close companion","friends", and "teachers and classmates" (P＜0.05), the college students with better family function tend to seek help from their parents, the difference was statistically significant (P=0.005), there was statistical difference of "whether discomfort existed caused by psychological problems" in seeking help from "professional personnel in mental health", "hotline/internet resource"(P＜ 0.05); the college students with higher CES-D scores tend to seek help from "hotline/internet resources",the difference was statistically significant (P＜0.05). Conclusions? There is a high prevalence of depressive symptoms in college students, and they seek help mainly from "other nonprofessional personnel" and"hotline/internet resources". Their ability of making use of the public psychological health services should be improved.

Objective To evaluate the effect of internet-based cognitive behavior therapy MoodGYM on adolescents and college students with depression symptoms through Meta-analysis. Methods Databases as Web of Science, PubMed, Cochrane Library, Embase, Chinese Biomedical Database, China National Knowledge Internet and Wanfang were searched from their establishment to January 2017 for collecting randomized controlled trails and clinical controlled trails about MoodGYM for adolescents and college students with depression symptoms. Two reviewers independently selected studies,extracted data and assessed risk of bias.RevMan 5.3 software was used to perform Meat-analysis. Results Seven studies involving 1 632 participants were included.The results of Meta-analysis showed that the score of depression, anxiety and negative automatic thoughts in MoodGYM arm was lower than control arm, the statistic results: standardized mean difference=-0.45, 95% CI-0.82--0.07, P=0.02;mean difference=-7.36,95% CI-11.88--2.85,P=0.001;mean difference=-18.06,95% CI-26.44--9.68, P<0.01, the difference between experiment arm and control arm was significant. Conclusions MoodGYM can contribute to improve depression, anxiety and negative automatic thought of adolescents and college students. This intervention should be further examined by high-quality, large-sample randomized controlled trails.

Objective To investigate the clinical, biochemical and genetic features of a Chinese boy with holocarboxylase synthetase deficiency (HCSD). Methods The clinical and genetic data of a rare case of HCSD were retrospectively analyzed. Results After birth, the boy showed development delay. At 3 months old, the boy was started with rehabilitation. Tandem mass spectrum and gas chromatography analysis was carried in the 5th month after birth because of the recurrent upper respiratory tract infection and elevated level of C5-OH in the blood and decreased level of C0,and elevated level of 3-OH-propionic, pyruvic acid, methylcrotonylglycine in the urine were in accordance with the HCSD. Genetic analysis found compound heterozygous mutations of c.1648G>A and c.1544G>A in gene, of which the latter one is novel. After the treatment of biotin (20 mg/d) and L-Carnitine, the condition of this boy was gradually improved. Conclutions HCSD is characterized with slow onset and inconspicuous manifestations. The confirmed diagnosis can be built with MS/MS, GC/MS analysis and gene mutation analysis. The effect of early biotin treatment is satisfactory. In this study,we carried out clinical and genetic diagnosis,which lays a solid foundation for prenatal diagnosis and early treatment.

Objective Mitochondrial DNA depletion syndrome is a rare autosomal recessive disorder characterized by complex genetic and clinical manifestations.This study aimed to investigate the clinical and laboratory features of a boy with mitochondrial encephalomyopathy caused by SUCLG1 mutation.Methods The clinical data and genetic test of a patient with mitochondrial DNA depletion syndrome were retrospectively analyzed.Result The proband presented with limb weakness at the 4th month after birth,and presented dystrophic appearance,muscular hypotonia,psychomotor retardation,failure to thrive,hearing impairment,scoliosis,thoracocyllosis and facial features at 9 months old.Laboratory tests showed blood lactic acid and pymvate increased,liver damage and abnormal myocardial enzymes.Plasma camitine ester profiling showed that amino acids decreased and C4-dicarboxylic-carnitine increased.Urinary organic acid analysis showed increased concentration of methylmalonic acid and its metabolites indicating methyl malonic aciduria.MRI showed bilateral T2 hyperintensities in bilateral caudate nuelei and lenticular and brain atrophy-like changes.Brainstem auditory evoked potential showed severe hearing loss.His development quotient was 35.Genetic sequencing of MUT,,MMAA,MMAB and other classic mitochondrial disease related genes of the proband revealed no mutation.Two heterozygous mutations,c.961C＞G and c.713T＞C,inherited from the phenotype of normal parents were detected in his SUCLG1 gene.The copy number of mitochondrial DNA was 244/cell in peripheral blood leukocytes,equivalent to 68.4％ of that in normal control.Conclusion In this study,an infant with muscular hypotonia,psychomotor retardation,deafness and slightly increased urine methyl malonic acid was diagnosed by genetic test.For patients with unexplained hypotonia,mental retardation,abnormal movements,hearing disorder together with increased blood pyruvic acid and lactic acid,mild methylmalonic acidemia and abnormal acylcarnitine,mitochondrial DNA depletion syndrome should be considered.Gene analysis is important for diagnosis and prenatal diagnosis of the next pregnancy.

Objective To discuss the correlation between procrastination and the mentalities of anxiety and depression among medical postgraduates,so as to carry out mental health work effectively.Methods 423 medical postgraduates in Central South University were assessed randomly, using General Procrastination Scale (GPS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale (SDS).Results Procrastination score and incidence in medical postgraduates was 54.92±8.40 and 60.99%respectively,the differences of procrastination scores(53.3l±8.21,55.90±8.30,55.75±8.49,P=0.013)and incidences(52.60%,66.09%,65.58%.P =0.028)among three grades were statistically significant.Both total coarse score of anxiety and that of depressionwere higher than that of the whole country(31.24±7.40,29.78±10.07,P=0.000;34.8±8.11,33.46±8.55,P=0.000),the differences were statistically significant.Procrastination had a positive correlation with anxiety and depression significantly(r=0.304,P=0.000;r=0.369,P=0.000),the higher the grade was,the weaker the intensity of correlation was.Hish-delay group,low-delay group and normal-behavior group had different deglees of anxiety(46.63±10.55,44.01±10.12,38.32±7.57,P=0.000)and depression(51.45±10.12,47.81±10.78,40.69±8.23,P=0.000),which was statistically significant.Conclusion Anxiety and depression among medical postgraduates were outstanding and had a close relationship with procrastination behavior,which should be taken seriously and handled by strengthening mental health education.

Objective To investigate the expression profile of human genes in response to acute sodium arsenite treatment by cDNA microarray. Methods The RNA was purified from the L-02 cells without and with arsenite sodium induction for 2 hours, 15 hours and 24 hours, respectively. Results The hybridization patterns were different between every interval of arsenite induction. Expression of hCYR61 increased after 2 hours' induction, but decreased after 15 hours and 24 hours. Expression of metallothionein Ⅳ and Ⅲ elevated at the whole induction phase. HSP86 was up-regulated after 15 hours and 24 hours' induction, but it did not alter at two hours' induction. Conclusion When exposed to arsenite, the cells are under a meet-an-emergency situation to synthesize the most necessary protein and inhibit synthesis of unessential proteins.