1.Relationship between Doppler ultrasound parameters of uterine artery,umbilical artery,middle cerebral artery and placental vasculopathology and pregnancy outcome in preeclampsia rat model
Ruilin MA ; Yu LIU ; Guixiang XU ; Haoran SHI ; Jianjian CUI ; Zejun YANG ; Yan MAO ; Yin ZHAO
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(5):543-551
		                        		
		                        			
		                        			Objective·To measure the parameters of the uterine artery,umbilical artery and middle cerebral artery in a rat model of preeclampsia(PE)by Doppler ultrasound,and compare the pathological changes in placental blood vessels and pregnancy outcomes,in order to provide an effective method and reference for evaluating placental function in PE animal models.Methods·PE(n=8)and normal pregnancy(NP,n=8)groups in Sprague-Dawley(SD)rat models were established by intraperitoneal injections of N'-nitro-L-arginine methylesterhydrochloride(L-NAME)and 0.9%sodium chloride solution.Blood pressure and proteinuria indexes were detected to evaluate whether the model was successfully established.On gestational day 19(GD19),Doppler ultrasound was utilized to measure the parameters of the uterine artery,umbilical artery and the fetal middle cerebral artery in both the PE and NP groups.After termination of the pregnancies,placental function was evaluated through the pathology of placental blood vessels and the quality of the fetuses and placentas.Results·In the PE group,both blood pressure(GD15:P=0.001;GD19:P=0.001)and proteinuria(GD15:P=0.001;GD19:P=0.001)were significantly higher than those in the NP group.The pulsatility index(PI)of the umbilical artery and uterine artery was notably elevated in the PE group compared to the NP group(both P=0.000).Furthermore,the resistance index(RI)of the fetal middle cerebral artery was significantly lower than that in the PE group(P=0.000).While the number of fetal rats did not differ significantly,the quality of placental and fetal rats was notably lower in the PE group(P=0.006 and P=0.000,respectively).Immunohistochemical staining of placental tissue revealed that the number of placental micro vessel densities in the PE group was less than that in the NP group(P=0.001).Correlation analysis revealed that placental micro vessel density,fetal quality and placental quality were inversely related with the RI of the umbilical artery and the PI and RI of the uterine artery,and positively correlated with the S/D,PI and RI of the fetal middle cerebral artery(all P<0.05).Conculsion·Doppler ultrasound assessment of the uterine artery,umbilical artery and middle cerebral artery indices in L-NAME-induced PE rat models effectively reflects pregnancy outcomes and placental vascular pathology.This method is valuable for evaluating placental vascular perfusion in PE rat models,offering practicality and convenience for research involving animal models.
		                        		
		                        		
		                        		
		                        	
2.Effect of ultrasound-guided quadratus lumborum block on intraoperative hemodynamics and opioid dosage in emergency patients with ectopic pregnancy
Dongfeng MA ; Meilin AN ; Guixiang GUO ; Lei ZHANG ; Yu LI ; Fuyu TIAN ; Xinli HUANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(2):234-238
		                        		
		                        			
		                        			Objective To study the effects of ultrasound-guided quadratus lumborum block(QLB)on intraoperative hemodynamics and opioid dosage in emergency patients with ectopic pregnancy.Methods A total of 70 patients with ectopic pregnancy undergoing laparoscopic surgery in Langfang People's Hospital from January 2021 to February 2024 were selected as subjects.According to the different anesthesia methods,the patients were divided into the control group and the study group,with 35 cases in each group.The control group was given general anesthesia,while the study group additionally added ultrasound-guided QLB.The intraoperative sedation effect,hemodynamics,postoperative pain,incidence of adverse reactions and opioid use at different times(admission,entry,intubation,skin incision,extubation,and discharge)were observed in the two groups.Results There were no statistically significant differences in the onset time of sedation,the rate of salvage sedation,the incidence of intraoperative body movements,the modified observer's assessment of alert/sedation(MOAA/S)at each time,and the hemodynamics at the time of admission,entry and intubation between the two groups.The mean arterial pressure(MAP),systolic blood pressure(SBP)and heart rate(HR)in the study group were significantly lower than those in the control group during skin incision,extubation and discharge[skin incision:MAP(mmHg,1 mmHg≈0.133 kPa)was 85.24±4.59 vs.96.95±4.68,SBP(mmHg)was 92.24±4.85 vs.99.49±5.13,HR(times/min)was 85.33±2.96 vs.94.51±2.92;extubation:MAP(mmHg)was 94.84±5.02 vs.102.05±5.13,SBP(mmHg)was 96.48±4.72 vs.105.03±5.07,HR(times/min)was 95.51±4.95 vs.102.49±5.87;discharge:MAP(mmHg)was 86.14±4.99 vs.93.71±5.25,SBP(mmHg)was 96.48±4.69 vs.104.37±5.02,HR(times/min)was 84.05±4.57 vs.90.51±4.86,all P<0.05]and pulse oxygen saturation(SpO2)was higher than those in the control group(skin incision:0.988 5±0.012 2 vs.0.965 4±0.012 3,extubation:0.974 7±0.012 4 vs.0.963 2±0.012 1,discharge:0.981 1±0.012 4 vs.0.970 3±0.012 3,all P<0.05).The resting numeric rating scale(NRS)scores and active NRS scores in the study group were lower than those in the control group at 3,6,12,and 24 hours after surgery,the random time was prolonged,the resting NRS and active NRS in the two groups gradually increased,reaching a peak at 24 hours after surgery,and the resting NRS and active NRS in the study group were significantly lower than those in the control group(resting NRS:3.86±0.82 vs.4.53±1.04,active NRS:4.26±1.05 vs.4.85±1.13,all P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group[11.43%(4/35)vs.34.29%(12/35),P<0.05].The dosage of Sufentanil in 24 hours and 48 hours,the number of analgesic pump in 48 hours and the number of relief analgesia cases in the study group were lower than those in the control group[the dosage of Sufentanil in 24 hours(μg):23.28±4.02 vs.36.14±4.57,the dosage of Sufentanil in 48 hours(μg):41.61±4.82 vs.59.33±6.25,the number of analgesic pump in 48 hours(times):2.94±1.22 vs.6.15±1.71,the proportion of relief analgesia:8.57%(3/35)vs.28.57%(10/35),all P<0.05].Conclusion Ultrasound-guided QLB can reduce hemodynamic fluctuations,relieve postoperative pain,reduce adverse reactions and opioid use in emergency patients with ectopic pregnancy,demonstrating a positive impact.
		                        		
		                        		
		                        		
		                        	
3.Effect of quadrate lumbomuscle block anesthesia on blood gas indexes and postoperative recovery in female uremic patients undergoing peritoneal dialysis catheterization
Meilin AN ; Dongfeng MA ; Guixiang GUO ; Lei ZHANG ; Yu LI ; Fuyu TIAN ; Xinli HUANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(4):451-454
		                        		
		                        			
		                        			Objective To observe the effect of quadratus lumborum block(QLB)anesthesia on intraoperative blood gas indexes and postoperative recovery in female uremic patients with peritoneal dialysis catheterization.Methods A total of 70 female uremic patients with peritoneal dialysis catheterization admitted to Langfang People's Hospital from January 2021 to December 2023 were selected as the research objects.According to the random number table method,they were divided into the control group and the study group,with 35 cases in each group.The control group was given conventional local infiltration anesthesia,whereas the study group was given QLB anesthesia.The changes of mean arterial pressure(MAP),heart rate(HR),blood gas indexes[pulse oxygen saturation(SpO2),arterial partial pressure of carbon dioxide(PaCO2)]and numeric rating scale(NRS)score,at different points pain factors[5-hydroxytryptamine(5-HT),substance P(SP),norepinephrine(NE)]before operation and 24 hours after operation,postoperative recovery(time to get out of bed for the first time,exhaust time,length of hospital stay)and adverse reactions were observed in the two groups.Results There was no significant difference in MAP,HR,blood gas index and NRS score between the two groups at the admission.The MAP,HR,PaCO2 in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture,and leaving the room,and SpO2 was significantly higher than that in the control group,and NRS score in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture(all P<0.05).There was no significant difference in the levels of 5-HT,SP and NE between the two groups before operation,but the levels of 5-HT,SP and NE at 24 hours after operation were significantly higher than those before operation,but the levels of 5-HT,SP and NE in the study group were lower than those in the control group.The first ambulation time,exhaust time and hospitalization time in the study group were significantly shorter than those in the control group(all P<0.05).The incidence of nausea and vomiting,constipation,pruritus,dizziness and other adverse reactions in the study group was significantly lower than that in the control group(all P<0.05).Conclusion QLB can reduce the fluctuation of intraoperative blood gas indexes in female uremic patients with peritoneal dialysis catheter,relieve postoperative pain,reduce the level of pain factors and reduce the occurrence of adverse reactions,and has a good effect on promoting postoperative recovery of patients.
		                        		
		                        		
		                        		
		                        	
4.Effect of single nucleotide variation of OPG gene on osteoporosis in patients with gestational diabetes mellitus
Lina MA ; Cong WANG ; Guixiang MEN ; Yongheng ZHAO ; Shuai SHAO
Chinese Journal of Endocrine Surgery 2023;17(2):209-213
		                        		
		                        			
		                        			Objective:To investigate the effect of single nucleotide variation of osteoprotegerin (OPG) gene on the occurrence of osteoporosis (OP) in patients with gestational diabetes mellitus (GDM) .Methods:From Apr. 2018 to Apr. 2022, 276 pregnant women with GDM who underwent prenatal examination and gave birth in Linyi People’s Hospital were collected for analysis, general data were collected and bone mineral density was tested. According to the bone mineral density test results, they were divided into normal group and OP group. The OPG genotype was tested, and the general information, OPG genotype and allele frequency of the two groups were compared. The differences in bone mineral density among different genotypes of OPG were compared, and the genotypes affecting the risk of OP in GDM patients were analyzed.Results:There was no significant difference in the general data of the two groups of patients (all P>0.05). The allelic distribution of the rs3134069 and rs2073618 loci of the OPG gene in the two groups of patients conformed to the Hardy-Weinberg equilibrium law (all P>0.05). There was a statistically significant difference in the frequency of the AC genotype at rs3134069 between the two groups ( χ2=7.75, P=0.005). Taking patients with the AA genotype as a reference, patients with the AC genotype had a lower risk of developing OP ( OR=0.15, 95% CI: 0.03-0.59). There was a statistically significant difference in the frequency of CC genotype at rs2073618 between the two groups ( χ2=11.30, P=0.001). Taking patients with GG genotype as a reference, patients with CC genotype had a higher risk of developing OP ( OR=7.42, 95% CI: 2.19-27.18). Comparing rs3134069 and rs2073618 loci, there was no significant difference in bone mineral density at each part of the three genotypes (all P>0.05). The multivariate Logistic regression model showed that the AC genotype of rs3134069 ( OR=0.18, 95% CI: 0.03-0.70, P=0.029) was a protective factor for the induction of OP, while GC genotype of rs2073618 ( OR=6.86, 95% CI: 1.57-27.15, P=0.007) were the risk factors for OP in GDM patients. Conclusion:The CC genotype of rs2073618 is significantly positively correlated with the susceptibility to OP in GDM patients.
		                        		
		                        		
		                        		
		                        	
5.Effects of ursolic acid on iron death in endometrial stromal cells via JAK2/STAT3 signaling pathway
Cong WANG ; Guixiang MEN ; Shuai SHAO ; Lina MA
Chinese Journal of Endocrine Surgery 2023;17(3):317-322
		                        		
		                        			
		                        			Objective:To investigate the effects of ursolic acid (UA) on proliferation, migration and iron death of ectopic endometrial stromal cells (EESCs) and its mechanism.Methods:Mouse model of endometriosis was established and the primary EESCs were isolated. The cells were treated with UA at different concentrations (0, 2.5, 5, 10, 20, 40, 50, 80, 100, 200 μmol/L). The cells were divided into Control group (normal culture), 2.5 μmol/L UA group (2.5 μmol/L UA treatment), 5.0 μmol/L UA group (5.0 μmol/L UA treatment), 10.0 μmol/L UA group (10 μmol/L UA treatment), and UA+DUSP19 group (10 μmol/L UA+50 μmol/L JAK2/STAT3 signal pathway activator DUSP19 treatment). Cell survival rate was detected by CCK-8 method. Cell proliferation was detected by plate cloning method. Transwell chamber assay was used to detect cell migration. The levels of Fe 2+ and the contents of malondialdehyde (MDA), reactive oxygen species (ROS) and superoxide dismutase (SOD) were detected by kit. Protein expression levels of Ki67, PCNA, CyclinD1, p-JAK2, p-STAT3, JAK2 and STAT3 were detected by western blot. Results:The number of clones in Control, 2.5 μmol/L UA, 5.0 μmol/L UA and 10.0 μmol/L UA groups were as follows: 152.22±15.47, 121.22±11.54, 92.00±5.54, 66.44±6.88; Ki67 protein expression was 1.08±0.10, 0.73±0.07, 0.61±0.06, 0.45±0.02, respectively; The expression of PCNA protein was 0.85±0.07, 0.64±0.05, 0.41±0.03, 0.31±0.05, respectively; CyclinD1 protein expression levels were 0.98±0.11, 0.65±0.06, 0.51±0.05, 0.42±0.07, respectively. The migration numbers were 92.78±6.27, 62.22±2.20, 50.22±4.59 and 39.11±4.33, respectively; Fe 2+ levels were (1.06±0.07) μmol/g, (1.21±0.11) μmol/g, (1.33±0.08) μmol/g, (1.47±0.09) μmol/g, respectively; MDA content was (0.48±0.06) μmol/g, (0.65±0.07) μmol/g, (0.85±0.08) μmol/g, (1.03±0.11) μmol/g, respectively; ROS contents were (19.85±1.21) %, (24.83±2.79) %, (29.04±1.86) %, (33.87±2.45) %, respectively; SOD content were (36.41±3.56) U/mg, (31.03±2.81) U/mg, (25.63±2.84) U/mg, (19.62±1.67) U/mg, respectively; p-JAK2 protein expression was 0.85±0.10, 0.75±0.06, 0.53±0.05, 0.31±0.03, respectively; p-STAT3 protein expression was 1.08±0.11, 0.79±0.06, 0.63±0.07, 0.42±0.03, respectively. The p-JAK2 protein content in UA group and UA+DUSP19 group was 0.38±0.05 and 0.75±0.08, respectively; p-STAT3 protein expression was 0.46±0.04 and 0.80±0.03, respectively; The cell survival rates were (52.55±2.44) % and (82.18±4.72) %, respectively; Fe 2+ levels were (1.57±0.06) μmol/g and (1.21±0.13) μmol/g, respectively. The differences in the above indicators between the Control group and the 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group were statistically significant ( P<0.05). There were statistically significant differences among 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group ( P<0.05). There were statistically significant differences in p-JAK2, p-STAT3, cell survival rate and Fe 2+ levels between UA group and UA+DUSP19 group ( P<0.05) . Conclusion:Ursolic acid can inhibit the proliferation and migration of EESCs cells and induce iron death by regulating JAK2/STAT3 signaling pathway, thus playing a protective role in endometriosis.
		                        		
		                        		
		                        		
		                        	
6.Improvement of the quality standard of Gerbera piloselloides
Guixiang YANG ; Yingying WU ; Xue MA ; Chunhua LIU ; Lin ZHENG ; Yongjun LI ; Yonglin WANG
China Pharmacy 2022;33(4):408-418
		                        		
		                        			
		                        			OBJECTIVE To improve th e quality standard for Gerbera piloselloides. METHODS The properties of G. piloselloides were observed and microscopic identification was conducted for powder. The moisture ,total ash ,acid-insoluble ash and ethanol-soluble extract were detected according to the method stated in 2020 edition of Chinese Pharmacopoeia (part Ⅳ). The contents of nodakenin,luteolin-7-O-β-D-lutinoside,luteoloside,apigenin-7-O-β-D-lutinoside,apigenin-7-O-β-D-glucopyranoside and marmesin were determined by high performance liquid chromatography method. RESULTS G. piloselloides were shrunken ,densely covered with thick white cotton wool ,with many fibrous roots ;the surface was taupe or gray-brown ;its texture was brittle and easy to break ;the cross section was yellow-white ,and there was an obvious small wooden heart in the center. Its powder was tan , and non-glandular hairs ,stone cells ,calcium oxalate cubes ,ducts,fibers could be seen unde r microscope. The measured values of moisture,total ash ,acid-insoluble ash and alcohol-soluble extract , for 15 batches of samples were 8.63%-11.34%,10.39%-14.93%, 3.29%-6.37% and 9.03%-15.02%,respectively;average values were 10.01%,12.26%,4.61%,12.36%. The linear ranges of nodakenin,luteolin-7-O-β-D-rutinoside,luteoloside,apigenin- 7-O-β-D-lutinoside,apigenin-7-O-β-D-glucopyranoside and marmesin we re 3.87-154.88,1.64-65.41,1.60-64.00,1.92-76.96, 1.27-50.93,0.40-15.89 μg/mL,respectively(r≥0.999 1). RSDs of precision ,stability(24 h)and repeatability tests were all less than 3%. The average recoveries were 101.88%,100.89%,102.64%,95.75%,96.71% and 103.48%,respectively;RSDs were 0.55%,0.43%,0.34%,0.49%,0.47% and 0.37%,respectively(n=6);the contents of above 6 components were 0.152 7-0.852 2, 0.084 5-0.669 7,0.136 7-0.961 0,0.126 0-1.193 2,0.128 8-1.102 2,0.046 9-0.678 0 mg/g. CONCLUSIONS The established method can be used for the quality control of G. piloselloides . It is preliminarily proposed that the moisture in G. piloselloides is not more than 12.0%;the total ash is not more than 15.0%,the acid-insoluble ash is not more than 6.0%,the alcohol-soluble extract is not less than 9.0%;the contents of luteoloside and apigenin- 7-O-β-D-glucopyranoside are not less than 0.016%.
		                        		
		                        		
		                        		
		                        	
7. The prevalence of snoring and its related family factors of children from 3 to 14 years old in Beijing
Xin ZHANG ; Xiaodan LI ; Guoshuang FENG ; Zhifei XU ; Jiangnan DU ; Guixiang WANG ; Jun MA ; Peijin HU ; Xiaoyan YAN ; Jie ZHANG ; Yamei ZHANG ; Yuanhu LIU ; Jing ZHAO ; Li ZHENG ; Jun CHEN ; Jun TAI ; Xin NI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2019;54(12):902-906
		                        		
		                        			 Objective:
		                        			To investigate the snoring status and related family factors of children from 3 to 14 years old in Beijing.
		                        		
		                        			Methods:
		                        			From May to July, 2015, data of children from 3 to 14 years old were obtained from a status survey from 7 districts(Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing. A total of 11 420 children from 25 primary and middle schools were randomly selected. Pediatric Sleep Questionnaire (PSQ) and a self-administered questionnaire were carried out for the adopted children. Self-administered questionnaire included the snoring related family factors. Logistic regression was used to estimate the odd ratio(OR) with 95% confidence intervals for variables.
		                        		
		                        			Results:
		                        			A total of 9 198 children meet the inclusion criteria and are analyzed in the study, of whom 901 (9.80%) were found with snoring behavior. The incidence of boys is higher than girls. Obese children take higher risk of snoring. Compared with younger children (≤6 years old), older children (≥12 years old) have a significantly lower risk of snoring (
		                        		
		                        	
8. Analysis of sleep quality and related factors among children in Beijing
Hongbin LI ; Jun TAI ; Guoshuang FENG ; Xiaodan LI ; Jiangnan DU ; Guixiang WANG ; Zhifei XU ; Jun MA ; Peijin HU ; Xiaoyan YAN ; Jie ZHANG ; Yamei ZHANG ; Yuanhu LIU ; Jing ZHAO ; Li ZHENG ; Jun CHEN ; Wentong GE ; Xin NI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2019;54(6):416-420
		                        		
		                        			 Objective:
		                        			To investigate the sleep quality of children in Beijing and to analyze the related factors.
		                        		
		                        			Methods:
		                        			The data were collected from the survey of 3-14 years old children in 7 urban districts of Beijing in 2015. By using multi-stage stratified cluster random sampling method, 26 kindergartens and primary and secondary schools in 7 districts and counties, including Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou, were randomly selected, with a total of 11 420 children. Children′s sleep status was investigated with Children′s Sleep Questionnaire (PSQ), and the proportion of children with sleep quality problems when the PSQ score was greater than 7. Various sleep related factors were investigated with self-made questionnaire. A multilevel model was used to analyze the relationship between PSQ score and related factors.
		                        		
		                        			Results:
		                        			The average PSQ score of the children was 3.60±2.69. The proportion of children with sleep quality problems was 8.87%(816/9 198). Multilevel model analysis showed that the younger the children, the higher the PSQ score (<6 years old 
		                        		
		                        	
9. The prevalence of snoring and its association with academic performance among school-aged children in Beijing
Jun TAI ; Zhifei XU ; Xiaodan LI ; Jiangnan DU ; Guixiang WANG ; Jun MA ; Peijin HU ; Xiaoyan YAN ; Jie ZHANG ; Yamei ZHANG ; Yuanhu LIU ; Jing ZHAO ; Li ZHENG ; Jun CHEN ; Xin NI
Chinese Journal of Preventive Medicine 2018;52(7):697-702
		                        		
		                        			 Objective:
		                        			To investigate the snoring status of school-aged children in Beijing and explore the association of snoring and academic performance.
		                        		
		                        			Methods:
		                        			A total of 7 925 children aged from 6 to 14 were selected from 15 primary and middle schools at 7 districts (Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing in 2015, using multi-stage stratified cluster random sampling method. The recruited children were asked to complete the Pediatric Sleep Questionnaire (PSQ) and a questionnaire related to sleep behavior. The multiplelogistic regression was used to analyze the association of snoring and academic performance.
		                        		
		                        			Results:
		                        			A total of 794 (12.44%) children showed a decline in academic performance among 6 383 eligible respondentsfor data analysis. 580 (9.08%) children with snoring was identified, of which 333 and 247 were in frequency of 1-2 times per week and frequency of ≥3 times per week, respectively; 357, 170 and 53 were in snoring grade Ⅰ, grade Ⅱ and grade Ⅲ, respectively. Compared with the children without snoring, the 
		                        		
		                        	
10.Effect of emotional resilience group training on perceived stress, anxiety and depression in patients with gastrointestinal cancer
Yumei CHEN ; Yanfen LIU ; Shuying YAN ; Hua ZHANG ; Haiyan ZHAO ; Haixia LI ; Guixiang MA ; Xiaoyan ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(4):343-347
		                        		
		                        			
		                        			Objective To investigate the effect of emotional resilience group training on perceived stress,anxiety and depression in patients with gastrointestinal cancer.Methods 325 cases of patients with gastric cancer were divided into experimental group(n=163) and control group(n=162) by random digital table method.Two groups of patients were treated with chemotherapy and routine treatment and the experimental group was trained once a week for 8 weeks of emotional resilience group training.Chinese version perceived stress(CPSS),SDS and SAS were used to evaluate the effect of intervention before and after intervention.Results After 8 weeks of emotional elastic group training,the CPSS score((39.98±4.82) vs (33.96±5.02)),SAS score((48.83±4.58) vs (42.12±4.01)) and SDS score((49.23±4.12) vs (45.21±3.27))were lower than those before the intervention (all P< 0.05).The difference of CPSS ((-6.02 ± 3.74) vs (-0.19±2.78)),SAS((-6.71±3.86) vs (-0.39±5.62)) and SDS((-4.02±2.03) vs (-0.62±2.31)) before and after the intervention of the two groups were statistically significant(t=-9.325,-9.529,-6.132,P<0.01).Conclusion Emotional resilience group training can effectively reduce the level of perceptual stress in patients with gastrointestinal cancer,and improve depression and anxiety.
		                        		
		                        		
		                        		
		                        	
            
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