Objective:To investigate the chain mediation effect of psychological flexibility and dyadic coping between perceived social support and family function in parents of pediatric liver transplant recipients.Methods:Totally 320 parents of pediatric liver transplant recipients who were treated at the Department of Pediatric Organ Transplantation, Tianjin First Central Hospital from April to October 2023 were selected by convenience sampling. The participants were surveyed using a general information questionnaire, the Perceived Social Support Scale (PSSS), the Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ), the Dyadic Coping Inventory (DCI), and the Family APGAR Index (APGAR). Pearson correlation analysis was used to examine the relationships between perceived social support, psychological flexibility, dyadic coping, and family function in these parents. Structural equation modeling (SEM) was performed using Amos 26.0 to analyze the chain mediation effect of psychological flexibility and dyadic coping between perceived social support and family function, with the Bootstrap method used for model testing.Results:A total of 320 questionnaires were distributed, with 312 valid responses, yielding a response rate of 97.50% (312/320). The scores for the 312 parents were as follows: PSSS (59.29±15.64), AAQ-Ⅱ (20.35±9.07), DCI (124.64±32.65), and APGAR (6.98±2.74). Family function was positively correlated with perceived social support and dyadic coping ( P<0.01), and perceived social support was positively correlated with dyadic coping ( P<0.01). Psychological flexibility was negatively correlated with family function, perceived social support, and dyadic coping ( P<0.01). SEM results showed that psychological flexibility and dyadic coping had a significant chain mediation effect between perceived social support and family function, with a mediation effect value of 0.059. The chain mediation effect of psychological flexibility and dyadic coping accounted for 13.81% of the total effect (0.059/0.427) . Conclusions:Perceived social support directly affects family function in parents of pediatric liver transplant recipients and also indirectly influences family function through the chain mediation effect of psychological flexibility and dyadic coping.

Cognitive reserve referred to the cumulative flexibility of an individual's cognitive processes,whereas accurately assessing an individual's cognitive reserve and intervening was important for preventing the occurrence of cognitive dysfunction as well as promoting cognitive health.This article reviewed the main contents and applications of cognitive reserve assessment tools,and compared the characteristics and limitations of each assessment tool.The purpose was to provide ideas for the development of cognitive reserve assessment tools suitable for China's cultural background and population characteristics,and to provide a basis for accurately assessing the current status of China's cognitive reserve and formulating targeted cognitive reserve enhancement programs.

BACKGROUND: It is still unclear if and to what extent antenatal or infant or childhood vitamin D supplementation would affect the development of allergy diseases later in life. This study aimed to review the efficacy of vitamin D supplementation in pregnant women, infants, or children for the prevention of allergies. METHODS: MEDLINE (PubMed), EMBASE (OVID), and the Cochrane Central Register of Controlled Trials were searched up to March 1, 2020. We included only randomized controlled trials (RCTs). We performed a systematic review and meta-analysis for vitamin D supplementation in primary allergy prevention. These trials were assessed for risk of bias using the Cochrane Collaboration domains and the consensus was reached via discussion with the full study group. We descriptively summarized and quantitatively synthesized original data to evaluate vitamin D supplementation in primary allergy prevention by using Review Manager software for meta-analysis. RESULTS: The search yielded 1251 studies. Seven RCTs were included in this analysis. A meta-analysis revealed that vitamin D supplementation for pregnant women or infants may not decrease the risk of developing allergic diseases, such as asthma or wheezing (supplementation for pregnant women, risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.81-1.26, P = 0.90, I2 = 47%; supplementation for infants, RR: 1.00, 95% CI: 0.70-1.43, P = 0.99, I2 = 0%; supplementation for pregnant women and infants, RR: 0.35, 95% CI: 0.10-1.25, P = 0.11), eczema (supplementation for pregnant women, RR: 0.95, 95% CI: 0.80-1.13, P = 0.77, I2 = 0%; supplementation for infants, RR: 0.84, 95% CI: 0.64-1.11, P = 0.19, I2 = 42%), allergic rhinitis (supplementation for pregnant women, RR: 0.93, 95% CI: 0.78-1.11, P = 0.15, I2 = 47%), lower respiratory tract infection (LRTI) (supplementation for pregnant women, RR: 0.97, 95% CI: 0.85-1.11, P = 0.59, I2 = 0%), or food allergy. CONCLUSIONS: Supplementation of vitamin D in pregnant women or infants does not have an effect on the primary prevention of allergic diseases. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42020167747).
Child ; Dietary Supplements ; Female ; Humans ; Infant ; Pregnancy ; Pregnant Women ; Randomized Controlled Trials as Topic ; Rhinitis, Allergic ; Vitamin D/therapeutic use*

Objective To investigate the willingness of hearing screening of non-hearing disease patients and analysis the hearing test result,in order to make people pay more attention to auditory healthy.Methods Patients clinical data including the willingness of hearing screening,gender,age,residence,hearing disease of someone important,long-term medicine usage,noise exposure were collected.Pure tone audiometry testing wereconducted for those who were willing to hearing screening;and a questionaire were conducted to those not.Results Among the 280 interviewers,only 72 patients were willing to hearing screening;frequent reason for refusing hearing screening were no self reported hearing loss and coming to doctor for non-hearing disease;60 years old or elders and have someone important were hearing diseases patients were more willing to hearing screening (P＜0.05);40.00％ longterm medicine usage patients weresuffering hearing loss(P＜0.05);self reported hearing loss was not the same as the test result (P＜0.05).Conclusion Hearing loss is common in patient who came to doctor for non-hearing diseases.More attention should be paid to those patients who are old,long-term medicine usage,people have no self reported hearing loss should pay attention to hearing loss.

Objective To discuss the short-term clinical curative effect of laparoscopic colorectal cancer radical resection for rectal cancer. Methods Clinical data of 50 patients with rectal cancer underwent radical resection from November 2015 to November 2016 were retrospectively analyzed. Among them, 27 cases underwent laparoscopic radical resection (Laparoscopy group), the other 23 cases underwent radical resection (Laparotomy group). Then observe and record the operation time, tumor diameter, specimen length, number of lymph node cleaning, time of ambulation, postoperative anal exhaust time, postoperative defecation time, postoperative complications and postoperative eating time of the two groups. Results The tumor diameter, length of specimens and number of lymph node dissection in laparoscopic group were (3.8 ± 1.4) cm, (18.5 ± 2.1) cm and (7.2 ± 3.1), while in Laparotomy group were (3.9 ± 1.4) cm, (18.6 ± 2.3) cm, and (7.7 ± 3.4), the difference has no statistical significance (P > 0.05). The intraoperative blood loss, operation time, ambulation time, postoperative anal exhaust time, postoperative defecation time, postoperative eating liquid diet time, postoperative hospitalization time in laparoscopic group were (105.3 ± 23.8) ml, (140.2 ± 22.3) min, (4.0 ± 1.2) d, (6.0 ± 1.5) d, (3.0 ± 1.0) d, (3.5 ± 0.5) d and (4.0 ± 1.0) d, while in Laparotomy group were (210.4 ± 21.3) ml, (118.9 ± 20.7) min, (4.5 ± 1.1) d, (7.8 ± 1.2) d, (7.0 ± 1.6) d, (8.1 ± 2.0) d and (10.0 ± 3.2) d, there was significant difference between the two groups (P < 0.05). Conclusion Laparoscopic surgery for rectal cancer is safe and effective. It can achieve radical tumor resection, and intraoperative less bleeding, faster postoperative recovery, shorter hospitalization time.

Objective To explore the value of prenatal MRI in the diagnosis of fetal simple expansion of lateral ventricle(ventriculomegaly), and follow up the nervous system development status after birth. Methods Simple expansion of the lateral ventricle fetus by prenatal MRI examination were collected in Huzhou Maternal and Child Care Hospital from May 2013 to June 2015, 126 cases of live births in expansion group, 50 normal cases were recruited in the same period as the control group. In expansion group, fetal subgroup analysis was done:(1) unilateral or bilateral lateral ventricle expasion:one group was 98 cases was lateral ventricle expansion (77.8%, 98/126), expansion of bilateral ventricle group was 28 cases (22.2%, 28/126). (2) Prenatal MRI in the diagnosis of the lateral ventricle of expansion: expansion of the lateral ventricle width was greater than 10.0 mm, if both sides were expanding, the expand width was the heavier one side, divided into 3 subgroups: ①Expansion in group A (lateral ventricle width 10.0-12.0 mm) were 88 cases (69.8%, 88/126).②Expansion in group B (lateral ventricle width 12.1-15.0 mm) were 29 cases (23.0%, 29/126). ③Expansion of group C (lateral ventricle width> 15.0 mm) were 9 cases (7.12%, 9/126). All 176 cases were followed up after birth at the 3rd, 6th, 12th, 18th month (corrected age was used for premature babies), and Gesell developmental schedules (GDS) were used to evaluate the neurobehavioral development. Results (1) The MRI results after birth:21 cases were followed up by MRI after birth. In group A, 11 cases had MRI and 9 were normal (the ventricular width<10.0 mm after birth) , the other 2 cases were stable (the ventricular width measured first time after birth was ≥10.0 mm, but the difference was within 2.0 mm from the MRI before birth). In group B, 4 cases had MRI, 1 was normal, 1 was stable, and 2 cases were getting better (the ventricular width measured first time after birth was ≥10.0 mm, but the width decreased more than 2.0 mm from the MRI before birth). In group C, 6 cases had MRI. 3 cases were getting better and 3 cases were stable. (2) Overall GDS results:expansion group after the birth of the 3rd, 6th, 12th, 18th month GDS evaluation results compared with control group, respectively, the differences were not statistically significant (all P>0.05). (3) The GDS results among the subgroups:in each evaluation after birth, there were no statistically significant differences between group A and the control group (all P>0.05). The GDS results of group B at the 3rd and 6th month were lower than those of the control group (P<0.05); while there were no statistically significant differences between the 2 goups at the 12th and 18th month (P>0.05). And for group C, statistically significant differences were found compared to the control group at each follow-up time (all P<0.05). (4) GDS results at different times after birth in the expansion group:there was no statistically significant difference between the results at the 3rd and 6th month (P>0.05). But when the result at the 3rd month was compared to the results of the 12th or 18th month, the differences were statistically significant (P<0.05). GDS result of 6th months after birth compared with 12th and 18th months, respectively, there were no statistically significant differences (P>0.05). There was no statistically significant difference between the results at the 12th and 18th month (P>0.05). (5) The GDS results in unilateral and bilateral ventricle expansion:at the 18th month, among the 98 unilateral cases, 86 (87.8%, 86/98) had normal GDS results(>85 scores);8 (8.2%, 8/98) had borderline results (75-85 scores);4 (4.1%, 4/98) had delayed results (<75 scores). Among the 28 bilateral cases, 23 (82.1%, 23/28) had normal GDS results;3 (10.7%, 3/28) had borderline results; 2 (7.1%, 2/28) had delayed results. There was no statistically significant difference (P>0.05). Conclusions Among the simple expansion of lateral ventricle, those whose ventricular width are≤12.0 mm may not need clinical treatment. If the width is between 12.1 to 15.0 mm, closely follow-up and targeted rehabilitation training after birth are recommended. When the width is more than 15.0 mm, the risk of the central nervous system function delay is significantly increased, and early intervention might improve the prognosis.

Objective To apply the ultrasound microbubble to mediate basic fibroblast growth factor(bFGF) for conducting the injuried facial nerve(rat model) repair and to investigate its feasibility and efficiency.Methods After establishing the models of facial nerve injury,40 SD rats were divided into 4 groups,10 cases in each group:group A,bFGF +ultrasound+microbubble(bFGF + MB/US),group B,bFGF and microbuble(bFGF+ MB),group C,bFGF and ultrasound(bFGF + US) and group D,simple operation(PBS).The general status of rats on 1,10,20,28 d after bFGF gene transfection was observed.The nerve conduction velocity (NCV),incubation period and amplitude of facial nerve action potential were measured.After taking the facial nerve tissue in injuried site,mRNA expression was detected by RT-PCR.Western blot was used to detect the bFGF protein expression.Results On 20 d after transfection,small swing of a small quantity of beard in the operation site of the group A could be observed;on 28 d after transfection,the general slatws of recavely in rats in the group A was better than that in the group B,C and D.The nerve electrophysiology manifestations after facial nerve repair in the group A were superior to the group B,C and D;the amount of bFGF mRNA and protein pxpression in the group A was significantly higher than that in the group B,C and D.Conclusion Ultrasound microbubble mediated bFGF is conducive to the repair of facial nerve injury.

OBJECTIVETo compare the clinical efficacy of the lymph node dissection patterns of the reverse and the traditional cabbage in hand-assisted laparoscopic D2 radical gastrectomy (HALG).

METHODSFrom December 2010 to October 2013, 194 patients with HALG in Chengdu Military General Hospital were enrolled in this study. According to the pattern of lymph node dissection, 108 patients were performed with the reverse procedure which took spleen as starting point, from left to right, and 86 patients were performed with the traditional cabbage procedure which took the abdominal cavity as the center, from both sides to middle. A retrospective comparative analysis was made on the intra- and post-operative data between the two groups.

RESULTSAll the patients were successfully performed with HALG, and no peri-operative death occurred. There were no significant differences in the incision length [(7.0 ± 0.2) cm vs. (6.9 ± 0.3) cm], the operative time [(170.9 ± 33.8) minute vs. (174.6 ± 22.4) minute], dissected lymph node number (17.6 ± 7.5 vs. 17.1 ± 5.8) and post-operative complications [(6.5%(7/108) vs. 8.1%(7/86)] between the reverse group and cabbage group (all P>0.05). However, less blood loss [(204.6 ± 98.2) ml vs. (259.1 ± 122.6) ml, P<0.01] and shorter postoperative hospital stay [(9.0 ± 1.7) day vs. (10.5 ± 4.0) day, P<0.01] were observed in reverse group as compared to cabbage group. During 1 to 6 months follow-up, no death case was found in reverse group, while 1 case died due to upper gastrointestinal bleeding 48 days after operation in cabbage group.

CONCLUSIONEfficacy is similar between the two HALG procedures in lymph node dissection, while reverse procedure has certain advantages, such as less blood loss and faster recovery.

Gastrectomy ; methods ; Hand-Assisted Laparoscopy ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery

Objective To explore the neuroprotective effect of cyclosporine A against cerebral ischemia in a rat model of cerebral ischemia reperfusion. Methods Fifty-two adult male SD rats, weighted 250-280 gram, were randomly divided into three groups: the sham group (group A, n=6), PBS control group (group B, n=23) and cyclosporine A group (group C, n=23). Group C received hypodermic injection of cyclosporine A 10mg/kg daily after surgery and group B re?ceived equal volume of PBS instead. Modified Neurological Severity(mNss)scores were used to assess the neurological deficits at 3, 7, 14, 21 and 30 days following cerebral ischemia. The infarct volume were measured 3 days after reperfu?sion. The neurons, reactive microglia and astrocytes around the infract area were detected by immunofluorescence at 3 and 30 days after surgery. Results Modified Neurological Severity scores were significantly lower in group C than group B at the third(P=0.003),seventh (P=0.011),Fourteenth (P=0.000),twenty-first (P=0.003) and thirtieth (P=0.004) days after surgery. cyclosporine A reduced infarct volume, reactive microglia and astrocytes while increased survived neurons (P<0.001) in ischemic penumbra 3 and 30 days after reperfusion (all P<0.001). Conclusion Continuous injection of cyclosporine A not only protects neurons against ischemia damage but also improves neurological functional recovery af?ter acute stage of damage, possibly through reduction of reactive microglia cells and proliferation of astrocytes.

Objective To investigate the relationship between RAD51 135G ＞ C polymorphism and prognosis in triple-negative breast cancer patients by retrospective analysis.Methods The clinical data of 62 triplenegative breast cancer patients were collected.The 62 cases underwent standard chemotherapy and radiotherapy after tumor resection from Jan.2004 to Dec.2010 in Affiliated Cancer Hospital of Zhengzhou University.RAD51 135G ＞ C polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) technology.The survival curve about progress free and overall survival time were then made.Results The median progress free and overall survival time in triple-negative breast cancer patients with or with-out RAD51 135G ＞ C polymorphism were(77.00 ±5.55)and(89.00 ± 10.40) months vs(99.00 ±4.26)and (103.00 ±4.30) months.The difference had statistical significance(P =0.039 and 0.015 respectively).Conclusion RAD51 135G ＞ C polymorphism is related with prognosis of triple-negative breast cancer patients,which might be a prognostic factor for breast cancer.