Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.

Objective:To understand the negative experiences of male master of nursing students during their studies.Methods:In this qualitative study, totally 11 male master of nursing students from China Medical University and Wuhan University were selected by purposive sampling in March 2023 for semi-structured interviews, and the data were analyzed using the KJ method.Results:Four themes were extracted: research pressure, pressure of time and finances, confusion about the future and development, and lack of identification with the nursing profession.Conclusions:Male master of nursing students experience negative emotions during their studies. Nursing educators and administrators should pay attention to the emotional management of male master of nursing students and gradually improve the training methods for nursing graduate students.

Objective:To investigate the predictive value of the combination of real-time three dimensional echocardiography of esophagus(RT-3D-TEE),computed tomography angiography(CTA)and congestive heart failure hypertension age diabetes mellitus prior stroke or transient ischemic attack vascular disease sex category(CHA2DS2-VASc)for left atrial appendage thrombosis in patients with non-valvular atrial fibrillation.Methods:A total of 88 patients with non-valvular atrial fibrillation admitted to the department of cardiovascular medicine of Cangzhou People's Hospital from January 2022 to June 2023 were selected as the study subjects.They were divided into thrombus group(n=36)and non-thrombus group(n=52)based on whether occurred left atrial appendage thrombosis.All patients underwent RT-3D-TEE and CTA examinations,and underwent CHA2DS2-VASc scoring.Logistic regression was used to analyze the related factors of forming left atrial appendage in patients with non-valvular atrial fibrillation.Receiver operating characteristic(ROC)curve was used to analyze the predictive values of RT-3D-TEE,CTA and CHA2DS2-VASc on left atrial appendage thrombosis in patients with non-valvular atrial fibrillation.And then,area under curve(AUC)value,sensitivity and specificity were calculated.Results:The maximum left atrial appendage emptying velocity(LAAeV)(51.48±5.87),the maximum left atrial appendage filling velocity(LAAfV)(48.36±5.49)and three-dimensional volume ejection fraction(3D-EF)(39.26±3.24)in the thrombus group were all significantly lower than those in the non-thrombus group,and the differences were statistically significant(t=5.933,6.767,4.605,P＜0.05),respectively.The opening diameter,short diameter and circumference,volume and area of left atrial appendage of the thrombus group were all larger than those of the non-thrombus group,while the ejection fraction was smaller than that of the non-thrombus group(t=6.581,3.410,9.220,3.178,4.453,4.162,P＜0.05),respectively.The ratios of cauliflower and cactus types of thrombus group were larger than those of non-thrombus group,and the ratios of wind vane type and chicken wing type were smaller than those of non-thrombus group,and the differences were significant(x2=3.771,7.132,1.003,5.455,P＜0.05),respectively.The CHA2DS2-VASc score of the thrombus group was significantly higher than that of the non-thrombus group,and the difference was statistically significant(t=12.269,P＜0.05).LAAeV,LAAfV,3D-EF,the long diameter of opening,the short diameter of opening,circumference of opening,volume,ejection fraction,spatial morphology and CHA2DS2 VASc score significantly correlated to the left atrial appendage thrombosis of patients with non-valvular atrial fibrillation(OR=4.323-19.562,P＜0.05).The sensitivity,specificity and AUC value of the combination of RT-3D-TEE,CTA and CHA2DS2-VASc were respectively 93.48%,90.83%and 0.895(0.654-0.963)in predicting left atrial appendage thrombosis of patients with non-valvular atrial fibrillation.Conclusion:The predictive values of RT-3D-TEE,CTA and CHA2DS2-VASc are higher for left atrial appendage thrombosis of patients with non-valvular atrial fibrillation.Among of them,the combinations of two or three indicators can effectively improve the predictive efficiency of individual test.The clinical practice should make choice on the basis of actual conditions.

A small proportion of mononuclear diploid cardiomyocytes (MNDCMs), with regeneration potential, could persist in adult mammalian heart. However, the heterogeneity of MNDCMs and changes during development remains to be illuminated. To this end, 12 645 cardiac cells were generated from embryonic day 17.5 and postnatal days 2 and 8 mice by single-cell RNA sequencing. Three cardiac developmental paths were identified: two switching to cardiomyocytes (CM) maturation with close CM-fibroblast (FB) communications and one maintaining MNDCM status with least CM-FB communications. Proliferative MNDCMs having interactions with macrophages and non-proliferative MNDCMs (non-pMNDCMs) with minimal cell-cell communications were identified in the third path. The non-pMNDCMs possessed distinct properties: the lowest mitochondrial metabolisms, the highest glycolysis, and high expression of Myl4 and Tnni1. Single-nucleus RNA sequencing and immunohistochemical staining further proved that the Myl4⁺Tnni1⁺ MNDCMs persisted in embryonic and adult hearts. These MNDCMs were mapped to the heart by integrating the spatial and single-cell transcriptomic data. In conclusion, a novel non-pMNDCM subpopulation with minimal cell-cell communications was unveiled, highlighting the importance of microenvironment contribution to CM fate during maturation. These findings could improve the understanding of MNDCM heterogeneity and cardiac development, thus providing new clues for approaches to effective cardiac regeneration.
Animals ; Mice ; Diploidy ; Heart ; Myocytes, Cardiac/metabolism* ; Cell Communication ; Gene Expression Profiling ; Mitochondria ; Regeneration ; Mammals/genetics*

Objective:To investigate the incidence of venous thromboembolic disease (VTE) in urological inpatients during perioperation.Methods:The clinical data of 7 988 inpatients admitted to the Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to December 2019 were analyzed retrospectively. The cohort included 5 657 males and 2 331 females. The average age of the enrolled patients was (56.3±15.8) years old, and the body mass index was (23.8±3.2) kg/m 2. There were 1 628 malignant tumors patients and 6 360 non-malignant tumors patients in the cohort. Of all the patients, 7 725 cases received surgical treatment. All patients were scored with the Caprini Risk Assessment Model (2005) after admission and 1 655 cases were classified as very low risk, 2 940 cases were low risk, 2 922 cases were medium risk, 345 cases were high risk and 126 cases were very high risk. Patients with Caprini score ≥ 2 and/or clinical symptoms were examined by venous color Doppler ultrasound. CT pulmonary angiography was performed for patients with chest pain, chest tightness, decreased blood oxygen saturation and other symptoms suspected of pulmonary embolism according to clinical judgment to screen the incidence of VTE. Results:Among the 7 988 cases, 180 cases (2.25%, 180/7 988) with VTE were found by preoperative examination, including 1 case (0.01%, 1/7 988) with pulmonary embolism. There were 199 new cases with VTE after operation, and the incidence of new VTE after operation was 2.58% (199/7 725). Among them, pulmonary embolism was found in 7 cases, with a incidence of 0.09% (7/7 725). Only 7.92% (30/379) of the VTE patients had VTE-related symptoms. The operations with higher incidence of VTE were radical cystectomy, nephroureterectomy, radical prostatectomy and radical nephrectomy, with the incidence of 11.61% (13/112), 10.87 (10/92), 8.25% (16/194) and 6.16% (22/357) respectively.Conclusions:The incidence of VTE in hospitalized patients with urinary surgery in this study is much higher than previously reported. Most of the patients with VTE are asymptomatic. The operations with high incidence of VTE after operation are radical cystectomy, nephroureterectomy, radical prostatectomy and radical nephrectomy. Therefore, it is necessary to carry out VTE screening for hospitalized patients in urology department, which is helpful to realize early intervention of VTE and reduce the risk of VTE progression and pulmonary embolism.

Objective:To investigate the mental health status and its influencing factors in people under COVID-19 quarantine.Methods:A total of 130 people under quarantine in a centralized isolation site in Beijing from October 21 2021 to November 12 2021 were included in the study. The demographic data were collected, and the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used for evaluation of mental health status.Results:One hundred and eleven people completed the survey; there were 10 people with anxiety (9.0%) and 34 people with depression (30.6%) among the study subjects. Multivariate logistic regression analysis showed that the number of physical diseases ≥2 was the independent risk factor for anxiety ( OR=119.76,95% CI: 5.31-2 702.08, P=0.003) and depression ( OR=41.41,95% CI:6.06- 282.75, P<0.001). Conclusions:The incidence of psychological problems among people under COVID-19 quarantine is relatively high, particularly for people with multiple physical diseases, it is necessary to carry out early intervention for vulnerable people in centralized isolation sites.

Objective:To evaluate the reliability and validity of Short-form health survey-36 (SF-36) during the first trimester of pregnancy.Methods:From January 2020 to January 2021, pregnant women aged 18―40 during the first trimester visit were admitted to the Obstetric Department of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Split-half reliability and Cronbach′s α coefficients were used to evaluate the reliability. The convergent and discriminative validity were evaluated by using AMOS 24.0 and the criterion-rated validity was evaluated with correlation analysis and non-parameter test. Exploratory factor analysis and confirmatory factor analysis based on structural equation modeling were used in the evaluation of contract validity.Results:SF-36 scale had good reliability (split-half reliability: R=0.901, Cronbach′s α coefficients=0.878), convergent validity, discriminate validity and the criterion-rated validity ( r=0.907). Second-order confirmatory factor analysis model was not well-fitted ( RMSEA=0.070, χ 2/dF=3.566, GFI=0.813, CFI=0.814, TLI=0.792, NFI=0.761), indicating that the construct validity was poor. Conclusions:The reliability, consolidation validity, discrimination validity and criterion-related validity of Sf-36 scale are good, while the construct validity is poor. Improvement is needed when the scale is used for pregnant women.

Objective:To analyze the status and its influencing factors of job burnout among female workers of labor-intensive enterprises.Methods:A total of 750 female workers from 5 labor-intensive enterprises in Guangdong Province were selected as the study subjects by random cluster sampling method in August, 2019. 665 valid questionnaires were collected, and the effective recovery rate was 88.67%. The Maslach Burnout Inventory-General Survey was used to assess job burnout and its influencing factors were analyzed.Results:Among 665 female workers, 429 (64.51%) found to have different levels of burnout, among which 380 (57.14%) were mild to moderate burnout and 49 (7.37%) were severe burnout. The comprehensive scores of job burnout in different age, marital status, current post working age, working time per week, personal monthly income, working system and occupational stress groups were statistically significant ( P<0.01) . There were significant differences in the score of emotional exhaustion in different age, marital status, current working age, working time per week, personal monthly income and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of depersonalization in different age, weekly work time, personal monthly income, working system and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of low individual achievement in different education levels, weekly work time, working system and occupational stress groups ( P<0.05) . Conclusion:The female workers of labor-intensive enterprises are generally have mild to moderate job burnout. The main influencing factors of job burnout are weekly work time and occupational stress.

Objective:To analyze the status and its influencing factors of job burnout among female workers of labor-intensive enterprises.Methods:A total of 750 female workers from 5 labor-intensive enterprises in Guangdong Province were selected as the study subjects by random cluster sampling method in August, 2019. 665 valid questionnaires were collected, and the effective recovery rate was 88.67%. The Maslach Burnout Inventory-General Survey was used to assess job burnout and its influencing factors were analyzed.Results:Among 665 female workers, 429 (64.51%) found to have different levels of burnout, among which 380 (57.14%) were mild to moderate burnout and 49 (7.37%) were severe burnout. The comprehensive scores of job burnout in different age, marital status, current post working age, working time per week, personal monthly income, working system and occupational stress groups were statistically significant ( P<0.01) . There were significant differences in the score of emotional exhaustion in different age, marital status, current working age, working time per week, personal monthly income and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of depersonalization in different age, weekly work time, personal monthly income, working system and occupational stress groups ( P<0.05) . There were significant differences in the dimensions of low individual achievement in different education levels, weekly work time, working system and occupational stress groups ( P<0.05) . Conclusion:The female workers of labor-intensive enterprises are generally have mild to moderate job burnout. The main influencing factors of job burnout are weekly work time and occupational stress.

Objective: To summarize the characteristics of abdominal-pelvic unplanned reoperation (URO) in a cancer hospital. Methods: Retrospectively descriptive cohort research was adopted. The classification of diseases was based on ICD-10, and surgical classification was based on ICD-9-CM-3. Medical record summary database from 2008 to 2018 in Beijing Cancer Hospital was collected, and all URO information of abdominal-pelvic surgery was retrieve. The time of URO, disease type, surgery type and cause were statistically analyzed. Distribution of main disease incidence and constituent ratio, and the application of major surgery and surgery type composition ratio were analyzed as well. Results: From 2008 to 2018, a total of 46854 cases underwent abdominal-pelvic surgery (including gastrointestinal, hepatic-biliary-pancreatic, gynecological, urological, or esophageal cancer surgery) and 713 patients received URO (1.52%), including 486 males and 227 females (2.14:1.00) with a mean age of (58.1±12.2) years. A total of 246 patients (34.50%) had comorbidity, and with comorbidity: without comorbidity was 1.13:1.00. The hospital stay was (44.5±43.0) days, and the total cost was (178000±112000) yuan. There were 22 deaths (3.09%). The median interval between URO and the first operation was 8 (0 to 131) days. The highest rate of URO was 2.45% (89/3629) in 2012, while the lowest was 0.95% (53/5596) in 2015. The top 3 major cancer types of URO included colorectal cancer (222 cases, 31.14%), gastric cancer (166 cases, 23.28%) and esophageal cancer (45 cases, 6.31%). The cancer types with the highest URO rate included pancreatic cancer (3.97%, 30/756), gastric cancer (1.81%, 166/9171) and colorectal cancer (1.80%, 222/12333). The top 3 surgical procedures resulting in URO were rectal resection (109 cases, 15.29%), total gastrectomy (79 cases, 11.08%), and total pancreatectomy (64 cases, 8.98%). Focusing on 497 URO cases from 2012 to 2018, 465 cases (93.56%) followed relatively difficult grade III and IV surgery, while only 32 cases (6.44%) followed grade I and II surgery. The top 5 main causes of URO were bleeding (225 cases, 31.56%), anastomotic leak (225 cases, 31.56%), infection (89 cases, 12.48%), intestinal obstruction (53 cases, 7.43%), and wound dehiscence (35 cases, 4.91%), adding up to a total of 87.94% of all URO. Conclusion This study summarizes the epidemiology of abdominal - pelvic URO in our cancer institution, providing the solid baseline for future investigation of URO and the subsequent formulation of corresponding prevention and intervention measures.