Objective: To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy. Methods: Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on. Results: A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level. Conclusions China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.

To investigate the expression of CD117 and DOG1 in triple-negative breast cancer (TNBC) and to explore their relationship with clinicopathologic features and prognosis.

Objective:To explore a new method of ultrasound-guided positioning of the tip of neonatal peri-pherally inserted central catheter (PICC).Methods:Clinical data of 174 newborn infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Beijing Chaoyang District Maternal and Child Healthcare Hospital from January 2019 to April 2021 receiving PICC catheter intubated under the guidance of ultrasound for positioning the tip were retrospectively analyzed to explore the accuracy, reliability and feasibility of the improved ultrasound-guided positioning technique.Before lower extremity catheterization, ultrasound was performed to monitor the vascular pattern and catheterization of PICC was conducted under the guidance of ultrasound.Results:(1) Among 174 infants intubated with ultrasound-guided positioning of the PICC tip, 172(98.9%) of them had the ideal position, and 2(1.1%) did not achieve the ideal position, but achieved the ideal position after ultrasound-guided correction.(2) Lower extremity venous catheterization was successfully performed at 100.0% after ultrasound-guided monitoring of blood vessels.The time-consuming of lower extremity venous catheterization was significantly shorter than that of the previous method [(31.50±2.58) min vs.(56.10 ±5.30 min)]( t=46.84, P<0.001). The total success rate of catheterization and catheterization of lower limb vein increased by 7.0% and 17.5%, respectively.(3) Only 1 (0.57%) case reported the complication of catheter tip thrombosis, the complication rate of which decreased from the previous 79.00% to 2.70%(2/112 cases). Conclusions:The improved ultrasound-guided positioning of the PICC tip is convenient, simple, faster and accurate, which enhances the success rate and is worthy to be applied in clinical practice.

Objective:To formulate a standardized management plan of Hemodialysis Room for patients with infectious diseases and explore the practical effect.Methods:The Beijing Ditan Hospital affiliated to Capital Medical University formulated a standardized management plan for hemodialysis room of patients with infectious diseases, which was implemented in 2017. Using convenience sampling method, 146 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January 2017 to October 2020 were selected as the experimental group, and 46 patients with end-stage renal disease on maintenance hemodialysis who were admitted from January to December 2016 were selected as the control group. We compared the nursing compliance rate before and after the implementation of the plan, the incidence of adverse events, and the satisfaction with nursing in the two groups.Results:After the implementation of the plan, the nursing compliance rate was 97.13% (406/418) , which was higher than 89.29% (50/56) before the implementation, and the difference was statistically significant (χ 2=8.316, P<0.01) . The incidence of adverse events in the experimental group was 6.85% (10/146) , which was lower than 17.39% (8/46) in the control group, and the difference was statistically significant (χ 2=4.567, P<0.05) . The Nursing Work Satisfaction Scale score of the experimental group was (94.67±3.08) , which was higher than (91.96±2.91) of the control group with a statistical difference ( t=8.882, P<0.05) . Patients' satisfaction with nursing in the experimental group was 98.63% (144/146) , which was higher than 91.30% (42/46) in the control group, and the difference was also statistically significant (χ 2=6.201, P<0.05) . Conclusions:The explored and implemented standardized management plan for hemodialysis patients with infectious diseases has achieved certain positive results, which provides a scientific, fine and standardized nursing management strategy for the construction of systematic solutions in the future.

Objective:To explore the prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot.Methods:From July 2017 to July 2018, 3 100 health examinees from Inner Mongolia National Examination Medical Center were selected as subjects for questionnaire survey, thyroid function test and thyroid ultrasound examination; a multinomial logistic regression model was used to analyze the relationship between relevant investigation factors and different types of thyroid diseases (simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules).Results:Among the 3 100 healthy examinees, there were 2 885 effective responders, including 743 males and 2 142 females, aged (46.23 ± 12.32) years; the simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules were 909, 648, and 619 cases, respectively, and the detection rates were 31.51%, 22.46%, and 21.46%, respectively. Logistic regression analysis results showed that age [35 - 54 years old: odds ratio ( OR) = 1.30, 95% confidence interval ( CI): 1.01 - 1.68; ≥55 years old: OR = 2.30, 95% CI: 1.68 - 3.14, P < 0.05], gender ( OR = 1.65, 95% CI: 1.32 - 2.07, P < 0.05), obesity ( OR = 1.35, 95% CI: 1.08 - 1.70, P < 0.05), and mental stress [significant: OR = 1.64, 95% CI: 1.09 - 2.48; some: OR = 1.54, 95% CI: 1.02 - 2.32, P < 0.05] were the risk factors affecting the occurrence of simple thyroid nodules. The age (35 ~ 54, ≥55 years old), gender, bad mood (a little), and mental stress (significant) were risk factors that affected the occurrence of simple thyroid dysfunction; eating high iodine food was its protective factor. The age (35 ~ 54, ≥55 years old), gender, obesity, and thyroid family genetic history were risk factors for thyroid dysfunction with nodules; the consumption of iodized salt was its protective factor. Conclusions:Older women are high-risk groups for thyroid diseases. Obesity, bad mood, mental stress will increase the risk of the disease. Daily consumption of iodized salt and moderate consumption of high iodine food can reduce the risk of the disease.

Objective: To investigate the value of ultrasound in the localization of peripherally inserted central catheter (PICC) in neonates. Methods: A retrospective analysis of the PICC catheterization was conducted at Department of Neonatology, Beijing Chaoyang District Maternal and Child Healthcare Hospital from June 2017 to December 2018.The ultrasound monitoring was performed immediately after PICC catheterization.The probe was placed into the midline position of the lower xiphoid or the subclavian parasternal line for scanning, and it would be the PICC if a high-echo " equal sign" was observed by ultrasound.It was believed that the PICC was successfully placed when ultrasound detected that the PICC tip was located in the junction of inferior vena cava or superior vena cava in the right atrium. Results: (1)Among 112 infants with PICC catheterization, 103 cases (92.0%) were accurately placed, 9 cases (8.0%) were not placed in the ideal site, among them, 2 cases were too deep, 4 cases were too shallow and 3 cases were catheter heterotopia.The tip position was accurate after the readjustment under ultrasound monitoring in those patients whose the first ultrasound showed the tip position was not ideal.(2)The PICC indwelling time was as short as 2 days (removed due to severe arrhythmia) and as long as 56 days with an average of (15.1±10.7) days.(3)The catheter-related complications occurred in 3 cases with an incidence of 2.7%. Conclusions Using ultrasound to determine the PICC tips position is accurate and reliable, which is worthy of extensive application in the neonatal wards.

Objective The aim of this study is to build a risk prediction model for the recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery,and to analyze the factors affecting the disease free survival (DFS).Methods Conducted analysis of 1 191 patients with thoracic esophageal squamous cell carcinoma,who received radical resection from January 2007 to December 2011.The VaR boundary value of the risk prediction model was obtained by receiver operating characteristic (ROC) curve,and the boundary value was verified.The factors that affected DFS were analyzed by univariate analysis and Cox multiple factor prognosis analysis.Results There were 472 cases had recurrence and metastasis after treatment.There was a significant difference in VaR between patients with and without failure (t =-5.307,P ≤ 0.001).The VaR boundary value was 0.30 according to ROC curve analysis.The recurrence rate of the patients in the VaR ≤ 0.30 group was 27.5％,which was significantly lower than 48.2％ in the ≥0.30 groups (x2 =51.659,P ≤ 0.001).The univariate analysis showed that the patient's sex,the length of the lesion,the degree of tissue differentiation and the VaR value were all factors that significantly affected the recurrence and metastasis of the patients (x2 =13.460,21.111,17.540,39.175,P ≤0.001).Multivariate analysis showed that tissue differentiation and VaR were independent factors affecting recurrence and metastasis of patients (P ≤ 0.001).Conclusions The model can be applied to predict the recurrence and metastasis risk of patients with thoracic esophageal squamous cell carcinoma after radical surgery.

Objective To clarify the significance of chest radiotherapy in the treatment of oligometastatic stage Ⅳ non-small cell lung cancer ( NSCLC ) and to explore the optimal time of interventional therapy during chest radiotherapy. Methods A total of 192 patients with oligometastatic stage Ⅳ NSCLC admitted to Shanxi Provincial Cancer Hospital from 2008 to 2014 were randomly and evenly divided into the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups. Survival analysis was performed with Kanplan-Meier method. Results The median survival of 192 patients with oligometastatic stage Ⅳ NSCLC was 14. 50 months, and the 1-,2-and 3-year survival rates were 57. 4％,24. 0％ and 10. 7％, respectively. The median survivalin the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+late intervention groups was 10,21,18 and 13 months, respectively. The 1-year survival rates were 34％, 73％,71％ and 51％,10％,40％,32％ and 13％ for the 2-year survival rates, and 0％,24％,16％ and 3％for the 3-year survival rates ( P=0. 000) . The median survival of patients with radiotherapy dose ≥ 60 Gy and< 60 Gy was 21 and 13 months, 76％ and 53％ for the 1-year survival rates, 34％ and 21％ for the 2-year survival rates, and 17％ and 10％ for the 3-year survival rates ( P=0. 002 ) . Conclusion Early interventional therapy and high-dose radiotherapy can improve the local control rate and prolong the survival time of patients with oligometastatic stage Ⅳ NSCLC.

OBJECTIVE:To investigate the effects of dexmedetomidine on myocardial injury and postoperative cognitive function in patients with cardiopulmonary bypass(CPB)valve replacement. METHODS:A total of 90 patients underwent elective CPB valve replacement in our hospital during Jan. 2015-Dec. 2017 were divided into group C and group D according to random number table,with 45 cases in each group. Group D was given Dexmedetomidine hydrochloride injection 0.6 μg/kg after anesthesia induction and intravenous injection at 0.6μg/(kg·h)to the end of the operation;group C was given 0.9％ Sodium chloride injection at equal volume and rate. SBP,DBP,HR and MAP were observed in 2 groups immediately before medication (T0),immediately after medication (T1), immediately after incision (T2), immediately after sternotomy (T3), immediately before CPB (T4), immediately after CPB stopping(T5)and immediately after operation(T6),respectively. The levels of CK-MB,H-FABP and cTnⅠwere observed at T0,T5,T6,at 6 h(T7)and 24 h(T8)after operation. The levels of S-100β protein and NSE were observed at T0, T8 and 72 h after operation (T9). MMSE and MoCA scores were observed 1 d before operation and 3,7 d after operation. The application of cardiovascular active drugs and the occurrence of ADR were observed during operation. RESULTS:SBP and DBP of group C at T2-T6,SBP at T4-T6 and DBP at T4 of group D were significantly lower than at T0;SBP and DBP of group D were significantly higher than group C at T4-T6. HR of 2 groups at T4 were significantly lower than at T0,while those of 2 groups at T5-T6 were significantly higher than at T0;the group D were significantly lower than group C at T2-T3. MAP of 2 groups at T2-T3 were significantly higher than at T0,and those of group D were significantly higher than group C at T4,with statistical significance(P<0.05). At T5-T8,the levels of CK-MB,H-FABP and cTnⅠ in 2 groups were significantly higher than at T0;the levels of CK-MB and cTnⅠ at T7-T8,the level of H-FABP at T5-T8 ingroup D were significantly lower than group C,with statistical significance(P<0.05). At T8-T9,the levels of S-100β protein and NSE in 2 groups were significantly higher than at T0,but the group D was significantly lower than group C,with statistical significance(P<0.05). MMSE scores and MoCA scores of 2 groups 3 d after operation,MMSE score and MoCA score of group C 7 d after operation were significantly lower than 1 d before surgery;those of group D 3,7 d after operation were significantly higher than group C,with statistical significance(P<0.05). The amount of dopamine and norepinephrine,the rate of adrenalin use in group D were significantly lower than group C,with statistical significance (P<0.05). There was no statistical significance in the amount of milrinone between 2 groups (P>0.05). The incidence of ADR in group D (6.7％) was significantly lower than group C(24.4％), with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine is helpful for hemodynamic stability,relieve myocardial damage,and improve postoperative cognitive dysfunction in patients with CPB valve replacement with good safety.

Objective To compare the different goal-directed fluid therapy(GDFT)strategies on the recovery of tissue perfusion and postoperative recovery in patients undergoing hepatectomy. Methods Ninety patients undergoing hepatectomy with ASA physical status Ⅱor Ⅲ were divided into three groups based on fluid treatment by random number table method:control group(conventional fluid therapy), observation group Ⅰ(GDFT filled with colloi) and observation group Ⅱ(GDFT filled with crystalloids),with 30 cases in each group.The ScvO2,Lac and Glu were tested at 5 min before anesthesia induction(T1),5 min before hepatectomy(T2),5 min after hepatectomy(T3)and the end of operation(T4). The duration of operation,fluid requirement,urinary output, bleeding volume and the use of vasoactive agent were recorded. The exhaust time, ambulation time and postoperative hospital stay were recorded. Preoperative and postoperative liver and kidney function tests and postoperative complications were followed up.Results Compared with that in control group,the amount of crystalloids[(1408.5 ± 348.4) ml vs. (1 819.4 ± 315.1) ml],the amount of colloids [(468.6 ± 193.4) ml vs. (1 009.7 ± 440.9) ml],the total volume[(1 867.3 ± 370.4)ml vs.(2 821.3 ± 264.6)ml]were all lower,first flatus time[(51.8 ± 8.5)h vs.(63.6 ± 9.2) h], ambulation time [(3.4 ± 0.7) d vs. (4.3 ± 0.7) d] and postoperative hospital stay [(7.8 ± 1.7)d vs.(10.5 ± 2.9)d]were all shorter,ScvO2at T3,T4was higher,Lac at T2-T4were lower,Glu at T3,T4was lower, and ALT and AST on the third day and the fifth day after surgery were lower in observation groupⅠ(P<0.05).Compared with those in observation groupⅠ,the amount of crystalloids [(2 014.7 ± 388.2)ml vs.(1 408.5 ± 348.4)ml]was increased,and the incidences of postoperative nausea and vomiting[33.3%(10/30)vs.10.0%(3/30)]were significantly higher than those in observation groupⅡ(P<0.05). Conclusions GDFT using colloids in hepatectomy probably improves the microcirculation and tissue oxygenation, protects liver function, promotes gastrointestinal function recovery and shortens postoperative hospital stay. It has a much lower incidence of postoperative nausea and vomiting, compared with crystalloids.