Objective To explore the causal relationship between family resilience and mental health in military personnel population.Methods A total of 204 military personnel were recruited from an army unit stationed in Western China with cluster convenience sampling.Family Resilience Scale(FRS)and Symptom Checklist 90(SCL-90)were used to survey them twice,in an interval of 4 months.Amos 26.0 was applied to construct a cross-lag model and analyze the data.Results After controlling mental symptoms from the first survey,family resilience in the first measure significantly predicted mental symptoms in the second measure(β=-0.14,P＜0.05).After controlling for family resilience from the first survey,mental symptoms in the first measure significantly predicted family resilience in the second measure(β=-0.13,P＜0.05).Conclusion The relationship between family resilience and mental health is mutually causal in military personnel,and one predicts the other one.Our findings highlight the key dimensions of the relationship between the two.

Objective:To evaluate the long-term efficacy of radiotherapy for elderly patients with esophageal squamous cell carcinoma.Methods:Clinical data of 118 elderly patients aged ≥65 years with esophageal squamous cell carcinoma treated with radiotherapy alone or concurrent chemoradiotherapy in Cancer Hospital affiliated to Xinjiang Medical University from January 2013 to January 2016 were retrospectively analyzed. All patients were randomly divided into the radiotherapy alone ( n=57) and concurrent chemoradiotherapy groups ( n=61). The effective rate, survival rate, adverse reactions and causes of death were compared between two groups. Rate and constituent ratio were used to describe the categorical variables, and Pearson Chi-square test was used for univariate analysis. Results:The effective rate (68.4% vs. 86.9%, P=0.016) and incidence of adverse reactions (21.1% vs. 50.9%, P<0.001) between radiotherapy alone and concurrent chemoradiotherapy groups were significantly differed. The 1-year overall survival rate significantly differed between two groups (75.4% vs. 91.8%, P=0.016), while no significant differences were observed in the 3-year overall survival rate (36.8% vs. 42.7%, P=0.088) and 5-year overall survival rate (10.7% vs. 18.0%, P=0.746). The main cause of death in two groups was recurrence combined with distant metastasis. Conclusion:Compared with the radiotherapy alone, concurrent chemoradiotherapy can significantly improve the effective rate and survival rate for elderly patients with esophageal squamous cell carcinoma, whereas it may increase the incidence of adverse reactions.

Background The mental health problems of employees in administrative organs and public institutions are highly valued.However,there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.Objective To analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region,so as to provide references for promoting their mental health and intervening in psychological problems.Methods From October 23 to 28,2022,a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique,and were assessed using Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).Results A total of 1797(58.04％)employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey.Depressive symptoms were noted in 579(32.22％).SDS scores yielded statistical difference among the selected employees of different ethnicities,types of job positions and educational levels(F=9.074,101.488,4.477,P<0.01),and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities,educational levels and types of job positions(H=49.196,17.028,160.848,P<0.01).Anxiety symptoms were detected in 711(39.57％)employees.SAS scores exhibited statistical difference among the employees with different genders,ages,ethnicities,educational levels,marital status and types of job positions(t=-4.571,F=6.648,3.950,5.243,12.008,22.253,P<0.01).Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages,genders,ethnicities,educational levels,marital status and types of job positions(H=24.361,-3.788,28.365,24.268,25.976,56.204,P<0.01).Conclusion About one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety.The depression symptoms are more severe among Tibetan people,those with low education levels and ordinary civil servants.The anxiety symptoms are more severe among employees aged 30 and below,those with low education levels,unmarried and those in technical positions.

Objective:To investigate the clinicopathological features of colorectal adenocarcinoma with enteroblastic differentiation (CAED).Methods:Eight cases of CAED diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China from January 2017 to August 2023 were collected. The histopathological, immunohistochemical, molecular and prognostic features of 8 CAED cases were analyzed. The relevant studies were also reviewed.Results:Among the eight patients, there were six males and two females, with an average age of 58 years (range: 29-77 years, median age: 61.5 years). Preoperative serum alpha-fetoprotein levels were elevated in five patients (14.0-286.6 μg/L). Four tumors were located in the colon, and four tumors in the rectum. Two patients were clinically staged as advanced stage (stage Ⅳ), and distant metastasis occurred at the initial diagnosis (one case had liver metastasis, and the other had lung, bone and multiple lymph nodes metastases). Six patients were clinically staged as locally-advanced stage (Stage Ⅱ-Ⅲ). Three of them developed distant metastases after surgery (one case had liver metastasis, one case had lung metastasis, and one case had peritoneal metastasis). Additionally, two patients died at 9 months and 24 months after surgery, respectively. The tumors were composed of various proportions of adenocarcinoma components with enteroblastic differentiation (30%-100%) and classical tubular adenocarcinoma components. The component with enteroblastic differentiation exhibited morphology similar to embryonic intestinal epithelium: cuboidal or columnar tumor cells arranged in tubular, papillary, cribriform, or solid nest patterns, with clear cytoplasm. Immunohistochemical studies showed that tumor cells expressed at least one oncofetal protein (SALL4, Glypican-3, and AFP). In addition, focal squamous differentiation was observed in 3 cases (3/8). Compared to the primary tumor, both CAED and squamous differentiation components were increased in the metastatic tumors. Based on the sequencing results of KRAS, NRAS and BRAF of the primary and/or metastatic tumors, 5 cases were wild-type, while KRAS exon 2 (G13D) mutations were identified in 2 cases.Conclusions:CAED is a rare colorectal malignancy with a dismal prognosis. Accurate pathological diagnosis is prognostically valuable. The histological features of enteroblastic differentiation, elevated serum AFP levels, and the expression of oncofetal proteins play an important role in the tumor diagnosis.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.

Objective:To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas.Methods:Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Hematoxylin and eosin, and immunohistochemical stains were performed, and the relevant literatures were reviewed.Results:The two patients were both male, aged 60 and 74 years, respectively. Their symptoms were both abdominal pain. The tumor arose in the esophagogastric junction in case 1, and the cardia to the fundus and the posterior wall of the upper part of gastric body in case 2. Both tumors were present as an ulcerative mass. The patients died of tumor 11 months and 8 months after surgery, respectively. Histologically, the tumor cells arranged in sheets, nests, cords or trabecular patterns, and pseudoavleolar structure. The tumor cells were epithelioid with uniform morphology, while the tumors showed scant stroma and massive necrosis. Variable rhabdoid cells and multinucleated giant cells were seen in both cases. SMARCA4 encoding protein BRG1 was undetectable in both tumors, while SMARCB1 encoding protein INI1 was detected. The tumor cells were diffusely positive for vimentin and negative for epithelial marker (CKpan), gastrointestinal stromal tumor markers (CD117 and DOG1), myogenic markers (desmin and myogenin), melanoma markers (S-100 protein, SOX10 and HMB45), and lymphohematopoietic markers (LCA and CD20).Conclusions:Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma is a rare and highly aggressive tumor with poor prognosis. The detection of subunits protein expression of SWI/SNF complex is important for diagnosis of the tumor.

Objective: To investigate the clinicopathological features and outcome of gastroenteropancreatic high-grade neuroendocrine tumors. Methods: A total of 60 gastroenteropancreatic high-grade neuroendocrine tumors were collected from January 1st, 2013 to December 31th, 2018 at Fudan University Shanghai Cancer Center, with available pathology databases and clinic follow-up information. At the same time, 157 cases of gastrointestinal pancreatic neuroendocrine neoplasm (NEN) diagnosed at the hospital in 2018 were collected and the incidence of NEN at all grades was compared. Results: There were 32 males and 28 females, aged 13-80 years (mean 54 years). Pancreas primary was the most common (48%, 29/60). Nodal metastatic rate was 9/16 and distant metastatic rate was 41%(18/44). Liver was the most common site of metastasis. Among all the gastroenteropancreatic neuroendocrine neoplasms diagnosed in the hospital in 2018, the incidence of high-grade neuroendocrine tumors was the lowest (7%, 11/157). High-grade neuroendocrine tumors had typical pathologic features of well-differentiated/moderate neuroendocrine tumors, but with significant differences in mitotic rates. By immunohistochemical staining, most of the tumors expressed neuroendocrine markers and somatostatin receptor 2 was positive in 60% (12/20) of the cases. The average Ki-67 index was 30%-40%, and there was significant difference between cases (18%-80%). The overall survival of high-grade neuroendocrine tumors was 43 months, and the disease-free survival was 12 months. Conclusions High-grade neuroendocrine tumor is a rare group of neuroendocrine tumors, with unique clinicopathological features and good prognosis. Pathological classification and grading of gastroenteropancreatic neuroendocrine neoplasms can help clinicians to select appropriate treatment and accurately evaluate prognosis.

The Chinese space station will be built around 2020. As a national space laboratory, it will offer unique opportunities for studying the physiological effects of weightlessness and the efficacy of the countermeasures against such effects. In this paper, we described the development of countermeasure systems in the Chinese space program. To emphasize the need of the Chinese space program to implement its own program for developing countermeasures, we reviewed the literature on the negative physiological effects of weightlessness, the challenges of completing missions, the development of countermeasure devices, the establishment of countermeasure programs, and the efficacy of the countermeasure techniques in American and Russian manned spaceflights. In addition, a brief overview was provided on the Chinese research and development on countermeasures to discuss the current status and goals of the development of countermeasures against physiological problems associated with weightlessness.
China ; Humans ; Program Evaluation ; Space Flight ; Weightlessness ; Weightlessness Simulation

Mediation analysis is mainly used to explore the causal mechanism between independent variable X and dependent variable Y. It determines whether mediator M plays a role and evaluate the role’s degree in the causal path by decomposing the causal path between the independent variable X and the dependent variable Y. However, the classical mediation analysis is generally used for single mediator. This paper introduces a new mediation analysis method for multiple mediators.