Objective To explore the anxiety status and coping strategies of clinical postgraduates,and to provide practical approaches to promote their mental health.Methods Using the phenomenological research method of qualitative research,12 subjects were interviewed in a semi-structured way.Using the 7-step analysis method of Co-laizzi phenomenology,the original data were analyzed and summarized.Results Five themes were extracted,in-cluding stress sources and psychological condition,interpersonal relationship,adjustment to cope with stress,self-understanding,career understanding and future vision.Clinical work,scientific research and economic pressures were the main causes of anxiety to the interviewees,who made cognitive,psychological,attitudes and behaviors ad-justments,they hope to achieve a good work-life balance in the future.Conclusions Effective measures should be taken in view point of individual,school,family and social dimensions to alleviate anxiety and promote their physi-cal and mental health.

Objective:To detect the pathogen and clinically diagnose for a suspected case of Neisseria meningitidis with positive blood culture result, and assess the risk of disease transmission among the community. Methods:Blood sample was collected for Neisseria meningitidis isolation and culture. Pathogen identification and serogroup typing were conducted by colony morphology, Gram staining, biochemical tests, latex agglutination test, slide agglutination test, and nucleic acid testing. The susceptibility to 12 antibiotics was also tested. Epidemiological investigation was conducted on the case, and epidemic control measures were also implemented. Results:Through various detection, the suspected case was diagnosed as Neisseria meningitidis invasive infection. The isolated strain belonged to group Y serotype, type 767 (multilocus sequence typing), and the ST167 clonal complex. The strain was sensitive to nine antibiotics, including penicillin, ampicillin, and meropenem. It exhibited intermediate sensitivity to ciprofloxacin and levofloxacin, and resistance to methicillin/sulfamethoxazole. Close contacts of the case and environmental testing results were negative. Conclusions:The case is confirmed to be an invasive infection caused by group Y Neisseria meningitidis, the ST167 clonal complex. Epidemiological investigation shows a relatively low risk of epidemic transmission. Continuous monitoring and surveillance are necessary for further assessment.

Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.

Thyroid nodule is a common endocrine system disease in clinic. Its onset is mostly related to affect-mind internal damage. The core pathogenesis is dysfunction of the liver and liver-qi stagnation, and the main pathological changes are qi stagnation, phlegm turbidity and blood stasis. Constitution is inherited from the natural factors and nourished from the postnatal factors, which is closely related to the occurrence of diseases, the transformation of syndromes and the transmission of diseases. Chaihu constitution refers to the type of constitution suitable for long-term use of Bupleuri Radix and prescriptions about Bupleuri Radix. The characteristics of patients with Chaihu constitution are similar to those of patients with thyroid nodules in clinic, and the risk of developing thyroid nodules is higher. Chaihu constitution is the internal basis of thyroid nodules. When treating thyroid nodule patients with Chaihu constitution, the dominant position of Bupleuri Radix should be highlighted, and Bupleuri Radix and prescriptions about Bupleuri Radix should be used flexibly. The dosage of Bupleuri Radix is mostly between 6-15 g, and according to the change of pathogenesis, it is often combined with Chinese materia medica with the efficacy of soothing liver and promoting qi, resolving phlegm and removing turbidity, promoting blood circulation and removing blood stasis, in order to prevent the occurrence and development of thyroid nodules.

Abstract In recent years, the incidence of adolescent suicide has been increasing, and it has become a serious public health problem that threatens the physical and mental health and even the life of adolescents. Adolescents with depressive disorder are a high risk group for suicidal behavior. The paper reviews the personal psychological factors, as well as the family, school and social factors that play a role in the suicidal behavior of adolescents with depressive disorder, providing a scientific basis for the effective prevention of suicidal behavior in adolescents.

Objective:To analyze the clinical characteristics and differences of inpatients who have been diagnosed with both cardiovascular and cerebrovascular diseases.The findings from this study will help medical professionals make informed decisions regarding diagnosis and treatment strategies for patients with coexisting cardiovascular and cerebrovascular diseases.Methods:This study included a total of 275 patients who were hospitalized in both the Neurology and Cardiology Departments of our hospital between January 2012 and December 2019.The study compared the treatment, hospitalization, and prognosis of the two departments using retrospective stratified analysis.Results:The majority of patients hospitalized in the Cardiology Department were diagnosed with circulatory system diseases(I00-I99), accounting for 92.0%(253 cases). In the Neurology Department, the main diagnoses were circulatory system diseases(I00-I99), nervous system diseases(G00-G99), symptoms and signs involving circulatory and respiratory systems, cognition, perception, emotional state and behavior(R00-R09, R40-R46), accounting for 69.8%(192 cases), 16.7%(46 cases)and 13.1%(36 cases), respectively.There was a significant difference in the distribution of diagnoses between the Cardiology and Neurology Departments( χ2=67.8, P<0.001). The Cardiology Department had a higher proportion of patients with 5 or more other diagnoses[153(55.6%) vs.59(21.5%)], while Neurology Department had a higher proportion of patients with 2-4 other diagnoses(64.0% vs.36.4%). When comparing the distribution of other diagnoses during hospitalization in the Cardiology Department, the proportion of patients with only one other diagnosis was higher in the first visit group of Neurology Department compared to those with two or more diagnoses, which was statistically significant( χ2=9.3, P=0.03). There was no statistical difference in hospitalization days between the two departments( χ2=2.2, P=0.14). Although there was a significant difference in patient outcomes, with a lower proportion of patients not recovering or dying in the Neurology Department( χ2=4.6, P=0.03), there was no significant difference in the interval between hospitalizations for the two groups(180 d, χ2=0.1, P=0.72; 90 d, χ2=1.8, P=0.18). Conclusions:The need for early prevention, diagnosis, and treatment of patients with both cardiovascular and cerebrovascular diseases is still a pressing concern.Exploring a combined diagnosis and treatment model for multiple diseases may prove useful in overcoming the limitations of the current single disease diagnosis and treatment approach.

Objective:To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months.Methods:MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies.Results:A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups ( P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (a OR=1.39, 95% CI: 1.06-1.83), married/cohabiting (a OR=1.74, 95% CI: 1.39-2.16), high school education or less (a OR=1.39, 95% CI: 1.15-1.67), had not used new-type drugs in the last six months (a OR=2.27, 95% CI: 1.89-2.71), had not received peer education in the last year (a OR=1.59, 95% CI: 1.28-1.98), had never been tested for syphilis (a OR=11.30, 95% CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (a OR=5.65, 95% CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (a OR=1.80, 95% CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (a OR=1.50, 95% CI: 1.26-1.80). Conclusions:The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Objective To examine the effects of ankle brace on biomechanics of the lower extremity during landing, so as to provide a theoretic support to choose ankle brace for people with different sports levels. Methods The key words (ankle brace OR ankle braces OR ankle bracing OR ankle support) AND (landing OR land OR jump OR hopped OR hopping) AND (biomechanics OR kinematics OR kinetics OR electromyography OR neuromuscular) in Chinese and English were searched from different electronic databases (CNKI, Web of Science, EBSCO, PubMed and other databases), for a period of Jan. 2000 to Dec. 2020. Cochrane was used to evaluate the quality of eligible studies. For meta analysis, subgroup analysis was used to assess the impact of ankle braces on ankle biomechanics.Results Thirteen studies with a total of 222 participants were included for mata analysis in this study. The semi-rigid ankle brace reduced the peak of ankle inversion by 25.8% compared with the elastic ankle brace (SMD=-0.562, P<0.001). Moreover, the elastic ankle brace reduced ankle plant flexion during landing among athletes (SMD=-3.42, P=-0.021). As for collagiate students, both elastic ankle and semi-rigid ankle decreased the ankle inversion (elastic ankle brace: 35.4%, SMD=-1.000, P=-0.013; semi-rigid ankle brace: 31.11%, SMD=-0.881, P<0.001) and ankle plant flexion (elastic ankle brace:23.30%, SMD=-1.381, P<0.001;semi-rigid ankle brace: 36.33%, SMD=-1.605, P<0.001).Conclusions Both ankle braces can prevent ankle sprain for athletes (basketball, volleyball, running) who experience training more than 5 years. The elastic ankle brace can limit the inversion and plantar flexion, while the semi-rigid ankle brace can merely decrease the ankle inversion. Therefore, athletes are more suitable for the elastic ankle brace. As for collegiate students without training history, both ankle brace can decrease the ankle inversion and plantar flexion. The elastic ankle brace has greater restriction on inversion, while the semi-rigid ankle brace has more restriction on plantar flexion. Therefore, the elastic ankle brace should be utilized if collegiate students have calcaneofibular ligament injury, while the semi-rigid ankle brace is more suitable for collegiate students who have a history of anterior talofibular ligament injury.

Under the background that the family doctor teams undertake the evaluation function of long-term care insurance for the elderlies living at home, it is imperative to further improve the efficiency of its integrated aging-medical care by strengthening the management. The Huacao community health service center and Hongqiao community health service center in Minhang District of Shanghai explored the construction of a family doctor′s home-based aging care management path, a practice launched since February 2021. This path was mainly designed with the entry criteria, management requirements for various services and evaluation indicators, with a service path form formulated on such basis. The form covered three stages: that before the on-site service, that on the day of the on-site service and that after the on-site service. Each stage was subdivided into three dimensions: the work content of the main aging-medical care, the key works of family doctors and the key works of assistant nurses. The implementation of this management path can enable such teams to provide further refined, standardized and procedural aging-medical care services, avoid service delays, improve service quality and management efficiency, and improve the utilization efficiency of health resources.

Objective To study the effect of gender and maneuvers on anterior cruciate ligament (ACL) injury risk factors for volleyball players. Methods Sports biomechanics data of volleyball players during stop-jump, drop landing and sidestep cutting were collected. The ACL injury rate and biomechanical parameters of simulated injured jumps were obtained with Monte Carlo simulation. The influence of gender and maneuvers on ACL injury risk factors was validated by 2×3 mixed designed two-way ANOVA. Results Sidestep cutting was the highest risk maneuver of ACL injury for both genders (P＜0.001). Compared with male players, female players had a greater risk of ACL injury during sidestep cutting and stop-jump (P＜0.001), while male players were more prone to have ACL injury than female players during drop landing (P＜0.001). The risk factors of ACL injury obtained by simulation were significantly influenced by gender and maneuvers (P＜0.001). Conclusions Male players were more likely to increase ACL load due to smaller knee flexion, forward leg tilt and heel landing than female players during sidestep cutting, while female players owned larger ground reaction force (GRF) and knee extension moment. Smaller knee flexion angle during stop jump was the major risk factor for both genders, however more characteristics contributed to the males. Female players with large GRF, knee valgus and extension moment, and heel-landing were likely to have ACL injury, while the small knee flexion angle was the key risk factor for male players. The results can provide evidences for evaluation of volleyball players’ ACL injury risk, individualized injury prevention protocols, and clinical treatment and rehabilitation directions.