Objective: To describe bullying victimization of middle school students in Dalian and associated factors, so as to provide scientific basis for campus bullying prevention. Methods: The stratified cluster sampling method was used to select 2 540 middle school students from urban and rural areas in Dalian, who were investigated with campus bullying victimization and related factors. Results: The reported rate of campus bullying victimization among middle school students in Dalian was 25.11%. The rates of physical violence (5.99%, 3.66%) and verbal violence(24.93%, 15.87%) of male students were higher than that of female students( χ 2=6.56, 27.94, P <0.05). The rates of verbal violence (22.84%, 16.25%) and emotional neglect(16.84%, 13.18%) of junior high school students were higher than those of high school students( χ 2=14.21, 5.44, P < 0.05 ). The rates of physical violence(6.07%, 3.55%), verbal violence(24.58%, 16.05%) and emotional neglect(18.88%, 12.06 %) of rural students were higher than those of urban students( χ 2=7.72, 24.81, 19.64, P <0.05). Male students, junior high school students and rural students suffered more severe campus bullying than female students, high school students and urban students( Z =3.46, 3.75, 5.89, P <0.01). The structural equation model showed that academic performance (path coefficient -0.003) and father s education (path coefficient -0.004 ) have a direct negative effect on campus bullying behavior, while mother s education (indirect action coefficient -0.000 8), height(indirect action coefficient -0.000 3), father s education (indirect action coefficient -0.000 3) and weight (indirect action coefficient 0.000 2) indirect effects on campus bullying through academic performance. Conclusion The prevalence of campus bullying victimization among middle school students in Dalian is relatively high, which worths further attention to. Rural students, junior high school students and boys are more likely to suffer campus bullying. Improving academic performance might be beneficial for campus bullying prevention.

Objective:To investigate the value of whole-lesion histogram parameters of apparent diffusion coefficient (ADC) in evaluating and predicting the pathological complete response(PCR) to neoadjuvant chemotherapy (NAC) in different subtypes of breast cancer.Methods:This retrospective study included 117 patients with breast cancer who underwent MRI examination before NAC prior to surgery from January 2016 to December 2017 in the First Affiliated Hospital of Nanjing University. All cases were divided into Luminal B, HER2 positive ( n=21) and triple negative ( n=26) groups. The surgical pathology after chemotherapy was evaluated by Miller-Payne (M-P) system and the patients were divided into PCR group and non-PCR (nPCR) group. Firevoxel software was used to generate the whole-lesion ADC histogram. The parameters included mean (ADC mean), skewness, kurtosis, the minimum (ADC min), the maximum (ADC max), 10th percentile(ADC 10%), 50th percentile (ADC 50%) and 90th percentile (ADC 90%). The two independent samples t test or Mann-Whitney U test was used to compare the differences between PCR and nPCR groups in each subtype. The diagnostic performance of statistically different ADC parameters for predicting PCR was evaluated by receiver operating characteristic (ROC) curve. Results:Kurtosis was significantly higher in PCR group than that in nPCR group in HER2 positive subtype ( P=0.039). It achieved an area under the curve (AUC) of 0.813 with sensitivity of 100% and specificity of 68.7% at the optimal cutoff value (1.861) for differentiating PCR from nPCR cases. In triple negative subtype, ADC mean and ADC 50% were smaller in PCR group than those in nPCR group ( P=0.028,0.013). They achieved AUCs of 0.800, 0.842, respectively. When ADC mean of 1.030×10 -3 mm 2/s and ADC 50% of 0.976×10 -3 mm 2/s were used as cutoff value to differentiate PCR from nPCR, the sensitivities were 75.0%, 80.0% and the specificities were 83.3%, 83.3%, respectively. Conclusion:Kurtosis can predict post-NAC PCR in patients with HER2 positive breast cancer, while ADC 50% has a high value in predicting post NAC PCR of triple negative breast cancer patients.

Objective Through the visual analysis of the literature about the psychological distress in core journals of the Web of Science database for improving the quality of life of clinical patients and providing the reference for formulating targeted nursing measures. Methods CiteSpace V information visualization software was used to visualize and analyze 854 articles on psychological distress in the field of nursing from January 1,2008 to December 31,2017 in core journals of the Web of Science database, and draw knowledge graph about research hotspots and research frontier. Results In the recent decade, the number of psychological distress research in the field of nursing in SCI has generally risen; the research focuses on the key words of depression, stress, breast cancer, anxiety and so on;the United States issued the highest volume of documents, mainland China ranked fifth, China Taiwan ranked seventh in core journals of the Web of Science database. Conclusion Chinese research on psychological distress in the field of nursing is still lagging behind western developed countries, and nursing staff in China should work hard.

Objective To systematically review the effect of enteral nutrition via a naso-gastric (intestinal) tube (NG) vs a percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) after liver transplantation,and provide support for the selection of proper nutrition.Methods Pub Med,web of science,Cochrane Library (Jan,2018),CNKI,VIP and Wanfang Date were search until Jan,2018.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer,about the research of retrospective study for the effects of enteral nutrition via NG vs PEG/PEJ after liver transplantation was performed and supplemented.Publication bias were evaluated,and Meta-analyses were conducted with RevMan5.3.Results 4 studies were collected,involving 430 patients.The Meta-analysis showed that starting time of enteral nutrition of PEG/PEJ was earlier than NG (MD =-1.77,95％ CI-1.83 to-1.70,P＜0.05).The average hospitalization time of PEG/PEJ was shorter than NG (MD=-2.88,95％CI-5.19 to-0.56,P＜0.05).The diarrhea incidence of PEG/PEJ was higher than NG (OR=1.66,95％CI 1.04 to 2.65,P＜0.05),and gastroesophageal reflux incidence of PEG/PEJ was lower than NG (OR=0.29,95％CI 0.12 to 0.66,P＜0.05).The gastric retention rate of PEG/PEJ was lower than NG (OR =0.26,95％ CI 0.14 to 0.41,P＜0.05).Dislocation incidence of PEG/PEJ was lower than NG (OR =0.06,95％CI 0.01 to 0.46,P＜0.05).The pneumonia incidence of PEG/PEJ tube was lower than NG (OR=0.59,95％CI 0.36 to 0.99,P＜0.05).There were no significant differences between PEG/PEJ and NG on indwelling time,occlusion,abdominal infection,acute renal insufficiency,and acute rejection reaction.Conclusion PEG/PEJ had earlier starting time of enteral nutrition,shorter hospitalization time,lower nutrition tube placement related complications such as gastric esophagus reflux,gastric retention,dislocation rate and lower incidence of pneumonia,but the incidence of diarrhea was higher.NG is the first choice after liver transplantation,and for patients with serious basic diseases,weak digestive function or digestive system disorders PEG/PEJ can be chosen.

Objective To explore the prevalence and influencing factors of psychological stress among pregnant women during second child or more child pregnancy. Methods Using self-designed questionnaire,according to the unified into the standard for pregnant women in a hospital obstetrics and gynecology clinic for pluripara and primipara 1:2 ratio to investigate from January 1,2016 to October 31, 2016.SPSS17.0 was used to sort and statistical analyze the data. Results The total pregnancy pressure was not,the score was 1.79±0.44,but the score of factor 2 was 2.19±0.69,the mean over 2,pluripara and primipara were different at stress caused by identifying the role of a parent. 2. Multivariate analysis revealed that age,income in month,schedule,whether spuc,gain weight were associated with pregnancy stress. Conclusions Pregnancy pressure of pluripara is no,the pressure of caused by identifying the role of a parent in pluripara was high than in primipara.Age,income in month,schedule,whether spuc,gain weight were main factor with pregnancy stress. It is suggested that education should be targeted for maternal health,and should be different from the healthy education.

Objective To examine the impact of liver cancer patients′ depression, anxiety, psychological distress on demoralization. Methods A cross-sectional survey was conducted among 116 liver cancer patients using Demoralization Scale-Mandarin Version, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Herth Hope Index, Distress Thermometer. Results The average score of demoralization was 33.22 ± 14.85. Analysis of variance showed that the demoralization syndrome′s difference caused by degree of working state, monthly incomewas significant(F=3.795-4.147, P<0.05), correlation analysis showed that patients′demoralization was positively correlated with depression,anxiety, psychological pain,the problems encountered,and negatively correlated with the level of hope(r=0.344-0.601, P<0.01). Multiple regression analysis indicated that working state,depression and hope level explained 50.0％ of the total variance of liver cancer patients′ demoralization. Conclusions Patients with liver cancer have higher levels of demoralization, psycho-physiological symptom can predict it, and the nurses should pay more attention to patients with demoralization.

OBJECTIVE To investigate the tinnitus' prevalence in Healthy check-up population in Dalian City. METHODS 1748 cases (male 806, female 942) were chosen from the Physical Examination Center of our hospital from February 1st, 2015 to April 1st, 2015, the tinnitus questionnaire was performed. For the cases with the tinnitus symptoms, the characteristics of tinnitus were further inquired, including the course of tinnitus, seizure frequency, the duration of tinnitus, pulsatile or persistent, unilateral or bilateral. RESULTS The total prevalence of tinnitus is 32.4%(566/1748), the prevalence of persistent tinnitus is 18.3%(320/1748), and the transient tinnitus is 14.1%(246/1748); The prevalence of tinnitus in female are 36.4%(343/942), 20.0%(188/942) and 16.5%(155/942) in turn, which are higher than that of the male 27.7%(223/806), P<0.01; 16.4%(132/806), P =0.054, and 11.3%(91/806), P<0.01. Both the total and persistent tinnitus prevalence increase with age(P<0.01), but the transient tinnitus doesn't increase with age. The prevalence of objective and subjective tinnitus are 1.3%(6.9% out of total prevalence of tinnitus), and 17.0%(93.1% out of total prevalence of tinnitus), respectively. The rate of bilateral tinnitus is 78.1% out of total tinnitus, and rate of unilateral tinnitus is 21.9%(right 11.6%, left 10.3%). In addition, the rates of acute tinnitus, subacute tinnitus, and chronic tinnitus are 4.4%, 3.8%, and 91.9% out of total, respectively. Otherwise, the rates of sleep disorders and hearing loss complaining accounted for 31.9% and 14.1% respectively. CONCLUSION The prevalence of tinnitus is high in healthy check-up population of Dalian, the total prevalence of tinnitus is 32.4%, mainly bilateral,chronic and subjective.

Objective To analyze the trend of transitional care in recent ten years and to find the advantages and shortages in this field between home and abroad, so as to provide reference for nursing researchers in China. Methods The literatures about transitional care pub-lished from January, 2005 to August, 2016 from Web of Science and CNKI were retrieved, and the visualizing map was drawn by operating CiteSpaceⅡ. Results The annual number publication of transitional care steadily increased in the world in recent ten years. China issued a small amount of documents before 2012, and then the research of transitional care obviously increased, while the number was comparable to the international in 2015. USA played a leading role in the field;China issued only 2%of the total, ranking the 9th. By comparing domestic and foreign research hot topics, international transitional care studies paid more attention to nursing program and the effect, while China fo-cused on the research of the disease. Research frontier showed that international transitional care service expanded to more and more sub-jects gradually, and inclined to the continuation of management, community and family support nursing research, which was relatively lack in China. Conclusion In recent years, the research of transitional care received increasing attention in China, while the depth and breadth of study was still lacking. China should learn from foreign research hot topics and frontiers to explore transitional care system, and provied pa-tients discharged nursing support and self care knowledge, to enrich high quality nursing connotation.

Objective To systematically review the predictive factors associated with reversibility of post-transplantation diabetes mellitus in adults using Meta-analysis,and to provide a theoretical basis for clinical prevention and treatment of diabetes after transplantation.Methods Pub Med,Web of Science,Cochrane Library (Issue 5,2017),CNKI,VIP and WanFang Data were searched from inception until May 2017.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer.Publication biases were evaluated,and the Meta-analyses were conducted with RevMan5.3.Results A total of 7 studies were analyzed which involved 979 adults.Metaanalysis showed the following significant predictive factors:male (OR =1.73,95％ CI 1.19 to 2.50,P ＜0.05),advanced age (MD =1.73,95％ CI 0.07 to 10.39,P =0.05),high FPG before transplantation (MD=5.66,95％CI 0.11 to 11.31,P=0.05),hepatitis C virus (HCV) infection (OR=1.52,95％CI 1.08 to 2.14,P ＜ 0.05),high frequency of combination therapy with MMF (OR =0.26,95％ CI 0.11 to 0.61,P ＜ 0.05),and short time before development of PTDM (MD =-19.08,95％ CI-37.08 to -1.07,P ＜ 0.05).There was no correlation with preoperative BMI,family history of diabetes and acute rejection.Conclusion The study showed that male,advanced age,high FPG before transplantation,hepatitis C virus infection,high frequency combination therapy with MMF,short time before development of posttransplantation diabetes mellitus were the predictive factors associated with reversibility of post-transplantation diabetes mellitus.

Objective To explore the effect of unsupported arm exercise (UAE) on dyspnea, exercise endurance of upper limbs and qual-ity of life in patients with chronic obstructive pulmonary disease (COPD). Methods From May to October, 2014, totally 70 patients with COPD were recruited and were randomly assigned to control group and intervention group. Both groups received routine care, and the inter-vention group performed UAE for six weeks additionally. The COPD Assessment Test (CAT), baseline dyspnoea index (BDI) and six-min-ute Pegbord and Ring Test (6PBRT) were recorded. Results The scores of CAT and BDI, and the number of turns in six minutes were better in the intervention group than in the control group (P<0.05). Conclusion UAE can increase the exercise endurance of upper limbs, relieve the dyspnea, and improve the quality of life in patients with COPD.