Objective:To explore the effect of the non-suicidal self-injury (NSSI) management plan for hospitalized adolescents with mood disorders based on hazard analysis and critical control point (HACCP) theory.Methods:From February to July 2023, convenience sampling was used to select 76 adolescents with mood disorders and NSSI from two closed full care wards of the Affiliated Brain Hospital of Nanjing Medical University as the research subject. Adolescents were randomly divided into a control group and an experimental group. The control group received the routine diagnosis, treatment, nursing, and risk management plan, while the experimental group implemented the management plan based on the HACCP theory. This study compared the incidence of NSSI, Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSSIQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Accompanying Family Member Satisfaction Questionnaire scores before and after intervention between two groups of adolescents.Results:The control group included 35 patients, while the experimental group included 32 patients. After intervention, the anxiety and depression scores of the experimental group patients were lower than those of the control group, and the difference was statistically significant ( P<0.05). The incidence of NSSI in the experimental group was lower than that in the control group with a statistical difference ( P<0.05). The satisfaction of accompanying family members in the experimental group was better than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The management plan based on the HACCP theory is beneficial for reducing the occurrence of NSSI in hospitalized adolescents with mood disorders, improving their negative emotions, enhancing the satisfaction of accompanying family members, and ensuring the safety of the ward.

Objective:To explore the protective effect and safety of RotaTeq vaccine on children with rotavirus gastroenteritis (RVGE) in high mortality areas in the world and guide the correct use of RotaTeq vaccine.Methods:The literature on RotaTeq vaccine in high mortality areas in the world published from February 2006 to December 2021 was searched, screened and sorted out according to the exclusion and inclusion criteria, and the data were analyzed by RevMan 5.3, Stata 14.0 and SPSS 26.0 softwares.Results:A total of 5 reports were enrolled, including 63 974 subjects, including 32 092 subjects in the vaccine group and 31 882 subjects in the placebo group. In high mortality areas, the protection rates of RotaTeq vaccine against RVGE, severe rotavirus gastroenteritis (SRVGE) and very severe rotavirus gastroenteritis (VSRVGE) were VE RVGE=35% (95% CI: 28%-41%), VE SRVGE=51% (95% CI: 33%-65%) and VE VSRVGE=64% (95% CI: 41%-78%). The protection rates of SRVGE in Asia and Africa are VE SRVGE=43% (95% CI: 28%-55%) and VE SRVGE=57% (95% CI: 17%-77%), respectively. There was no significant difference in the incidences of serious adverse events (SAEs) between RotaTeq vaccine group and placebo group ( χ2=2.05, P=0.152). Conclusions:RotaTeq vaccine has a certain protective effect on severe and above RVGE with good safety in high mortality areas in the world.

Objective:To understand the epidemiological characteristics of group A rotavirus (RVA) infection in hospitalized children under 5 years of age with diarrhea in 2019, and to provide reference for the surveillance of RVA.Methods:Stool samples and clinical information of hospitalized children under 5 years of age with diarrhea were collected from sentinel hospitals in 20 provinces in 2019. RVA nucleic acid detection and genotyping were performed according to the rotavirus detection method in the National Viral Diarrhea Surveillance Program.Results:A total of 5 395 viral diarrhea samples were collected, 5 038 were tested, and 1 247 diarrhea samples showed RVA positive results (1 247/5 038, 24.75%). The positive rate of RVA in Fujian province was the lowest (30/319, 9.40%), and the positive rate of RVA was the highest in Henan province (182/338, 53.85%). The positive rate of RVA in male and female children was 25.24%(762/3 019)and 24.02%(485/ 2 019), respectively. There was no significant gender distribution of RVA infection ( χ2 = 0.96, P=0.326). Children aged 12 to 17 months were mainly susceptible to RVA (342/1 033, 33.11%), and the positive rate of RVA in children aged 48 to 59 months was lower (35/227, 15.42%). RVA infection showed significant age distribution characteristics ( χ2 = 86.78, P<0.001). RVA infection had significant difference between urban and rural areas ( χ2 = 20.92, P<0.001) and seasonal characteristics ( χ2 =411.42, P<0.001). RVA genotyping showed that G9P[8] type (994/1 122, 88.59%) was the dominant epidemic strain. Conclusions:In 2019, the main genotype of RVA infection in hospitalized children under 5 years of age with diarrhea was G9P[8], and RVA infection had significant age, region and season characteristics.

Objective:To analyze the evolutionary characteristics of the approximate whole genome of rotavirus G2P[4] type 2020BJ strain.Methods:The rotavirus genome was amplified by reverse transcription-polymerase chain reaction (RT-PCR), the amplified products were sequenced, and the sequences were subjected to phylogenetic analysis and homology analysis.Results:The approximate full-length 11 segments of human rotavirus G2P[4] type 2020BJ strain were obtained. Sequence analysis showed that the strain was G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2 genotype (DS-1-Like); evolutionary analysis shows that it is closely related to strains in Japan, India, Bangladesh, Italy and other countries; there are differences in the amino acids of antigenic epitopes between the closely related strains.Conclusions:There are differences in the amino acids of the epitopes of VP7 and VP4 of the five G2P[4] rotavirus strains that are closely related to 2020BJ, which may lead to different epidemic characteristics, and rotavirus surveillance should be strengthened.

Rotavirus is the most important pathogen of severe diarrhea in infants and young children in the world. According to the World Health Organization, about 185 000 children die from rotavirus each year. The related deaths mainly occur in low-income countries in Asia and Africa. Rotavirus infections are common even in areas with better sanitary conditions, indicating that rotavirus has a high transmission capacity. At present, there is no specific treatment for rotavirus diarrhea, only symptomatic treatment is available. Therefore, safe and effective vaccines are of great significance in reducing the incidence and mortality of rotavirus diarrhea. The World Health Organization also recommends that oral rotavirus vaccines should be included in the immunization program of all countries. At present, China’s oral rotavirus vaccine LLR has been on the market in China since 2001. The vaccines available on the market in most countries are Rotarix (RV1) and Rotateq (RV5). The vaccine is useful for preventing diarrhea caused by rotavirus infection. The vaccination to prevent rotavirus disease is very cost-effective. This article reviews the current situation of rotavirus vaccines in order to provide a scientific evidences for the prevention and control of rotavirus.

Objective To investigate the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy (Kimura method and Warshaw method) for benign lesions of pancreatic body and tail.Methods The retrospective cohort study was conducted.The clinicopathological data of 39 patients with benign lesions of pancreatic body and tail who underwent laparoscopic spleen-preserving distal pancreatectomy in the Second Affiliated Hospital of Nanchang University between March 2008 and January 2018 were collected.Of 39 patients,28 undergoing Kimura method (splenic artery and vein-preserving distal pancreatectomy) were allocated into the Kimura group,and 11 undergoing Warshaw method (cutting splenic vessels and preserving short gastric vessels)due to serious adhesion between pancreatic body and tail and splenic hilum were allocated into the Warshaw group.Observation indicators:(1) operation situations;(2) postoperative situations;(3) follow-up situations.Followup using outpatient examination and telephone interview was performed to detect blood glucose level and tumor recurrence of patients up to March 2018.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was done using nonparametric rank-sum test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Results (1) Operation situations:39 patients received laparoscopic spleen-preserving distal pancreatectomy,operation time and volume of intraoperative blood loss of 39 patients were respectively (194 ±58)minutes and 100 mL (range,30-800 mL).The operation time and volume of intraoperative blood loss were respectively (197±56)minutes,100 mL (range,30-800 mL) in the Kimura group and (186±63)minutes,150 mL (range,30-450 mL) in the Warshaw group,with no statistically significant difference between groups (t =0.494,Z =-0.597,P＞ 0.05).(2) Postoperative situations:time to anal exsufflation and duration of hospital stay were respectively (2.6±0.8)days,(9.2±7.3)days in 39 patients and (2.4±0.6)days,(7.5±4.2)days in the Kimura group and (2.8±1.3)days,(13.5±11.1)days in the Warshaw group,with no statistically significant difference between groups (t=-0.720,-1.736,P＞0.05).Seven patients had postoperative complications.The incidence of complication was 2/28 in the Kimura group,1 patient with pancreatic leakage at 5 days postoperatively was cured by 15-day B ultrasound guided catheter drainage,and 1 who was diagnosed as pulmonary infection by chest CT examination at 5 days postoperatively was discharged from hospital after 8-day anti-infection and sputum-inductive treatments.The incidence of complication was 5/11 in the Warshaw group,3 patients with sustained fever at 5 and 7 days postoperatively who were diagnosed as grade 1 splenic infarction by epigastric enhanced CT examination were improved and discharged from hospital by antibiotic and low molecular weight heparin treatments,and then epigastric enhanced CT re-examination at 3 months postoperatively showed recovery of splenic perfusion;1 with pancreatic leakage at 7 days postoperatively was cured by 18-day conservative treatment;1 who was diagnosed as delayed gastric emptying by upper gastrointestinal contrast at 16 days postoperatively was improved and then discharged from hospital by 15-day placement of intestinal feeding tube and nutrition support therapy.There were statistically significant differences in the incidences of overall complication and splenic infarction between groups (x2 =5.485,4.878,P＜0.05) and no statistically significant difference in the incidence of other complications between groups (P＞0.05).(3) Follow-up situations:39 patients were followed up for 12 months (range,2-64 months).During the follow-up,six patients had normal blood glucose level,and all patients had good quality of life,without recurrence.Conclusions Laparoscopic spleen-preserving distal pancreatectomy for the benign lesions of pancreatic body and tail is satisfactory in short-and long-term curative effects.The incidences of complication and splenic infarction of Kimura method are lower than that of Warshaw method.

Objective:Under the premise of the policy of everybody has medical insurance,it discussed the integration plan of the basic medical insurance system for urban and rural residents in Tibet about the problems and the countermeasures.Methods:Descriptive and contrastive methods were used to analyze the status of urban and rural medical system operation in Tibet.Results:The problem of unbalanced development of urban and rural medical and health services in Tibet and the management of post-merger were put forward.Conclusion:It was necessary to put forward policy recommendations from the aspects of horizontal co-ordination,multi-sectoral collaborative management,unified medical insurance information management system,hierarchical diagnosis and treatment mechanism,perfect Tibetan medicine reimbursement catalog,one system and multiple files and vertical co-ordination,and gradually realize the urban and rural medical insurance in Tibet System integration.

Objective To explore the changes in inflammatory reactions in tail-suspension mice infected by Klebsiella pneumoniae from spaceflight.Methods Tail suspension was used to simulate the physiological effects of microgravity.C57BL/6 mice were randomly divided into control (Con),control+K.pneumoniae T16-169 (Con+T16-169),tail suspension (TS) and tail suspension+K.pneumoniae T16-169 (TS+T16-169) groups.The level of inflammatory cytokines TNF-α,IL-6 and IL-1β mRNA in lung tissue and the plasma cytokine concentration were detected by RT-qPCR and xMAP technology,and HE staining was used to represent the morphological changes in lung tissue.Results Compared with the control group,the expression of inflammatory cytokines in lung tissue and plasma concentrations of all experimental groups were increased,and the difference in TS+T16-169 group was the most significant (P<0.01 or P<0.001).HE staining showed that the lung tissues in Con+T16-169 and TS+T16-169 groups were damaged in different degrees,and the damage of TS+T16-169 group was the most serious.Conclusion The K.pneumoniae from spaceflight significantly increases the expression of inflammatory cytokines in lung tissue and plasma concentrations after infecting tail-suspension mice,and induces more serious damages to the lung tissue,which suggests that inflammatory reactions can be increased in tail suspension mice infected by K.pneumoniae from spaceflight.

Objective To explore the predictive value of diffusion weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in chemotherapy for patients with metastatic tumor of liver.Methods Eighty patients (with 148 lesions) with gastrointestinal hepatic metastases were enrolled.The maximum diameters of the metastases tumor were compared before and after the treatment,and patients were divided into sensitive group and ineffective group according to the tumor diameter.Correlation between the ADC value and the diameter was analyzed,and the ROC curve was drawn to predict the sensitivity and specificity of the therapy.Results The maximum diameter of the tumor was similar in the two groups,and the ADC value of the sensitive group was significantly less than the ineffective group before treatment (P =0.000).In the aspect of ADC,the ADC value increased significantly in the sensitive group after 2 weeks or 12 weeks of treatment.The ADC value before treatment had negative correlation with the change of the diameter of the tumor(r =-0.662,P =0.000),and the change of ADC value after two weeks of treatment had negative correlation with the change of the diameter of the tumor as well(r =-0.846,P =0.000).The AUC value for ADC before treatment was 0.914.The AUC value for the changing rate of ADC after two weeks of treatment was 0.893.In combination of the ADC value before and after two weeks of treatment,the AUC increased significantly.Conclusion The ADC value before treatment,the change of ADC value after two weeks of treatment and collaborative assessment has favorable effective functions for the forecast of the chemotherapy effect on patients with colorectal and gastric cancer.

Objective To explore the predictive value of diffusion weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in chemotherapy for patients with metastatic tumor of liver.Methods Eighty patients (with 148 lesions) with gastrointestinal hepatic metastases were enrolled.The maximum diameters of the metastases tumor were compared before and after the treatment,and patients were divided into sensitive group and ineffective group according to the tumor diameter.Correlation between the ADC value and the diameter was analyzed,and the ROC curve was drawn to predict the sensitivity and specificity of the therapy.Results The maximum diameter of the tumor was similar in the two groups,and the ADC value of the sensitive group was significantly less than the ineffective group before treatment (P =0.000).In the aspect of ADC,the ADC value increased significantly in the sensitive group after 2 weeks or 12 weeks of treatment.The ADC value before treatment had negative correlation with the change of the diameter of the tumor(r =-0.662,P =0.000),and the change of ADC value after two weeks of treatment had negative correlation with the change of the diameter of the tumor as well(r =-0.846,P =0.000).The AUC value for ADC before treatment was 0.914.The AUC value for the changing rate of ADC after two weeks of treatment was 0.893.In combination of the ADC value before and after two weeks of treatment,the AUC increased significantly.Conclusion The ADC value before treatment,the change of ADC value after two weeks of treatment and collaborative assessment has favorable effective functions for the forecast of the chemotherapy effect on patients with colorectal and gastric cancer.