Objective:To explore the real experience of fertility concerns in cervical cancer patients with preserved fertility function, so as to provide a basis for developing targeted nursing measures.Methods:This study was a qualitative study of descriptive phenomenology. From June 2018 to June 2021, purposive sampling was used to select 17 young cervical cancer patients who underwent radical abdominal trachelectomy or minimally invasive laparoscopic radical trachelectomy at Zhejiang Cancer Hospital as the study subjects. Face to face semi-structured interview was conducted with patients. Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:Four themes were extracted, namely the multiple manifestations caused by fertility concerns, the sense of guilt caused by diseases and fertility issues, the need for health support, and strategies to actively address psychological issues caused by fertility concerns.Conclusions:Cervical cancer patients who preserve their fertility function generally have fertility concerns and an urgent need for health support, requiring support from medical and nursing staff, families, and society. Medical and nursing staff should pay attention to the fertility concerns of such patients, provide personalized psychological intervention as soon as possible to alleviate their fertility concerns.

ObjectiveTo explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines. MethodA total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups. On the basis of conventional western medicine treatment for hypertension， the control group （47 patients） was treated with Shugan Jieyu capsules for 8 weeks， while the treatment group （51 patients） with Gouteng prescription for 8 weeks. The two groups were compared in terms of the blood pressure level， 24-hour blood pressure variability， Hamilton anxiety scale （HAMA） score， Pittsburgh sleep quality index （PSQI） score， quality of life （SF-36 scale） score， traditional Chinese medicine （TCM） syndrome score and efficacy， incidence of adverse reactions， and the levels of interleukin （IL）-1β， IL-6， IL-10， and IL-4 in the serum of peripheral blood. ResultThe final trial was completed with 95 patients， including 46 in the control group and 49 in the observation group. The treatment in both groups lowered the blood pressure and blood pressure variability （P<0.05， P<0.01）. The observation group outperformed the control group in recovering the systolic blood pressure （SBP）， 24-hour mean systolic blood pressure （24 h SBP）， 24-hour systolic blood pressure variability （24 h SBPV）， and 24-hour diastolic blood pressure variability （24 h DBPV） （P<0.05）. After treatment， the HAMA and PSQI scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower HAMA and PSQI scores than the control group （P<0.05）. Compared with those before treatment， the SF-36 scores in both groups increased （P<0.05， P<0.01）. After treatment， the observation group had higher scores of physiological function （PF）， bodily pain （BP）， social function （SF）， role-emotional （RE）， and mental health （MH） indicators than the control group （P<0.05）. After treatment， the TCM syndrome scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower score than the control group （P<0.05）. The total response rate regarding TCM syndrome in the observation group was 85.71% （42/49）， which was higher than that （63.04%， 29/46） in the control group （χ²=6.621， P<0.05）. The treatment in both groups lowered the levels of pro-inflammatory cytokines （IL-1β， IL-6） and elevated the levels of anti-inflammatory cytokines （IL-10， IL-4） （P<0.05， P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.05）. There were no adverse events during the research process. ConclusionGouteng prescription can recover the blood pressure level， reduce blood pressure variability， suppress anxiety state， improve sleep and quality of life， decrease TCM syndrome score， increase total response rate， lower serum IL-1β and IL-6 levels， and elevate serum IL-10 and IL-4 levels in the patients with primary hypertension complicated with anxiety disorder due to yang hyperactivity and heat toxin. It may exert the effects by regulating the balance of pro-inflammatory and anti-inflammatory cytokines.

Objective:To explore the optimal match degree between thoracolumbar kyphosis (TLK) and lower lumbar lordosis (LLL) in adult spinal deformity (ASD) after correction surgery.Methods:Data of 119 ASD patients (male: 28, female: 91), belonging to the Affiliated Hospital of Jining Medical University (19 cases), the Affiliated Hospital of Shandong University of Traditional Chinese Medicine (11 cases), and the First Medical Center of Chinese PLA General Hospital (89 cases) were reviewed and documented from March 2019 to March 2020. All patients (age, 64.48±8.88 years; range, 45-79 years) underwent the surgical procedure of thoracolumbar fusion with instrumentations were followed up over 24 months (51.68±15.60 months; range, 24-87 months) after surgery. Postoperative proximal interface failure, Oswestry disability index (ODI) score and Scoliosis Research Society-22 (SRS-22) score were recorded for all patients. The immediate match of TLK to LLL postoperatively was calculated as follows: TLM=TLK/LLL. The data of those individuals with excellent improvements in the ODI (>50%) at the final follow-up were recorded and analyzed. Then the mean value and the 95% CI of TLM in those individuals were calculated. All participants were subdivided into three groups according to the 95% CI value of TLM. After the receiver operating characteristic curve (ROC) analyzing, the area under the ROC curve (AUC) was the best cutoff value of TLM. The association of proximal junctional failure (PJF) developing with the abnormal TLM postoperatively was analyzed with logistic regression, and the odds ratio (OR) was calculated. Results:62 patients had significant improvements in ODI (>50%) at the final follow-up, and the mean TLM in those individuals was 0.41 [95% CI (0.2, 0.5)]. All patients were divided into three groups: TLM<0.2 (35 cases), 0.2≤TLM≤0.5 (48 cases) and TLM>0.5 (36 cases). The preoperative TLK (13.87°±16.61°) and T 1 pelvic angle (19.69°±10.55°) in the those patients with TLM<0.2 were the smallest, and those were the largest in those with TLM>0.5 (30.59°±16.68°, 28.30°±14.46°). The individuals with TLM<0.2 still had the smallest TLK (2.89°±1.78°), however, those with TLM>0.5 had the largest TLK (17.13°±12.13°) and the smallest LLL (-26.16°±11.02°) accordingly. Additionally, the ODI and SRS-22 for those with 0.2≤TLM≤0.5 at the final follow-up were the best ( P<0.05). ROC curve analysis results showed that the best cutoff value of TLM was 0.4 (sensitivity=78.9%, specificity=76.2%; AUC=0.802, 95% CI (0.708, 0.896) , P<0.001). During the follow-up after orthopedic surgery, there were 19 patients with postoperative proximal junction failure, including 16 patients in the mismatched group (6 patients in the TLM<0.2 group, 10 patients in the TLM>0.5 group) and 3 patients in the matched group (0.2≤TLM≤0.5 group), with the incidence of 23% (16/71) and 6% (3/48), respectively. The difference was statistically significant (χ 2=5.66, P=0.017). Thoracolumbar mismatch was significantly associated with proximal borderline failure after orthosis [ OR=4.35, 95% CI (1.196, 15.924)]. Conclusion:The abnormal correction in thoracolumbar kyphosis and lower lumbar lordosis may result in mismatch between thoracolumbar segments, which would undermine the quality of life, and increase the incidence of proximal junctional failure developing in those ASD patients underwent long-fusion surgeries. The match between TLK and LLL should be 0.2 to 0.5.

Objective:To investigate the value of ultrasound findings in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus and correlate it with clinical factors.Methods:A total of 535 patients with type 2 diabetes mellitus who received treatment in Taiyuan Second People's Hospital from January 2016 to June 2019 underwent color Doppler ultrasound examination (T2DM group). Vascular inner diameter, intima-media thickness, atherosclerotic plaque formation, lumen stenosis or occlusion, and hemodynamic characteristics were determined in patients with type2 diabetes mellitus compared with those in 107 patients with non-type 2 diabetes mellitus (non-T2DM group). These parameters were correlated with the course of the disease, blood glucose level, concomitant hypertension or not, and clinical Wagner grade.Results:The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were 69.9%, 89.0%, 77.0% and 11.6% respectively, in the T2DM group, which were significantly higher than 41.1%, 78.5%, 72.0%, and 1.9% respectively in the non-T2DM group ( χ2 = 32.52, P < 0.001; χ2 = 8.76, P = 0.003; χ2 = 27.77, P < 0.001). With the prolongation of the course of T2DM, the incidence of arterial lesions in the lower extremities increased ( P < 0.001). The incidences of intima-media thickening, atherosclerotic plaque, stenosis, and occlusion of lower extremity arteries were significantly greater in the poor blood glucose control group and non-hypertension group compared with the good blood glucose control group and hypertension group (all P < 0.05). The degree of lower extremity arterial stenosis in T2DM patients was related to Wagner's grade. As the degree of stenosis increased, Wagner's grade increased correspondingly and significantly ( P < 0.001). Conclusion:Color Doppler ultrasound examination has an important value in evaluating lower extremity arterial lesions in patients with T2DM. The degree of arterial lesions in the lower extremities of T2DM patients is correlated with the course of the disease, blood glucose levels, concomitant hypertension, and clinical Wagner grade. Color Doppler ultrasound examination has an important clinical significance in evaluating the degree of vascular lesions and guiding early interventions in the clinic.

Objective:To evaluate the effect of anti-vascular endothelial growth factor (VEGF) in patients with wet age-related macular degeneration (wAMD) and investigate the recurrence factors.Methods:In this case-control study, 40 eyes of 38 patients with wAMD treated by anti-VEGF therapy in Xijing Hospital from October 2015 to April 2017 were included.Ranibizumab or conbercept was consecutively intravitreally injected monthly under 3+ pro re nata (PRN) regimen.All included patients were followed-up at least 12 months.The best corrected visual acuity (BCVA) was expressed in logarithm of the minimum angle of resolution (LogMAR) units.Optical coherence tomography (OCT) was used to observe the morphologic characteristics of macula and measure the central retina thickness (CRT). Patients were divided into recurrence and recurrence-free group based on whether recurrence occurred during follow-up.Potential associated factors with recurrence after treatment were analyzed by multivariate logistic regression analysis.Meanwhile, the morphological and functional response were identified at 1 month after loading phase as well as at last follow-up visit.This study protocol was approved by the Ethics Committee of Shanghai General Hospital (No.2016KY243) and written informed consent was obtained from each patient prior to receiving injection.Results:All the operative eyes showed retinal effusion absorption at least once, and 21 (52.5%) eyes had relapse during follow-up.The patients with lower BCVA (LogMAR) value at the first absorption time had higher risk of recurrence ( OR=16.7, 95% CI=1.22-100, P<0.05). The eyes in the recurrence group received more times of treatment than eyes in the recurrence-free group (5.8±2.3 vs 3.5±1.4, t=3.64, P<0.05). However, there was no significance between the two groups in BCVA change before and after treatment ( t=-1.52, P>0.05). In the recurrence group, the BCVA (LogMAR) and CRT at last visit were 0.73±0.34 and (187.2±81.7)μm respectively, while were significantly improved in comparison with 0.81±0.37 and (234.2±74.5)μm at the relapse time ( t=2.14, 2.62; both at P<0.05). There were 87.5% (35/40) eyes showed good morphological responses at 1 month after the loading phase while 12.5% (5/40) eyes presented poor morphological responses, the retinal effusion was absorbed after additional (3.2±2.2) times of injections.The BCVA of eyes with a good morphological response at 1 month following loading phase was better than that at the first retinal effusion absorption time ( t=-2.23, P<0.05). Average CRT at last visit was significantly decreased in comparison with the baseline CRT ( Z=-4.62, P<0.01). Conclusions:For wet AMD patients, the anti-VEGF treatment is safe and effective in the short term, while there is still a high rate of recurrence.More attention should be paid to eyes with better vision at the first time of retinal effusion absorption which may have more chance to experience recurrence.Patients need long-term follow-up after treatment to prevent recurrence.In addition, the complete loading treatment is needed for patients who have a good morphological response after the first retinal effusion absorbed.

Objective: To explore the relationship between childhood maltreatment and suicide ideation of college students,so as to provide basis for physical and mental health of college students. Methods: Students from 6 universities in Shanxi Province(3 854 college students provided eligible questionniare for childhood abuse and 3 882 for suicidal ideation) were selected by multi-stage random cluster sampling from May to July 2018, the Chinese Version of the Childhood Trauma Questionnaire and the Self-rating Idea of Suicide Scale were used in the survey. Results: Of all subjects,42.4% had at least one kind of abuse experience in childhood and 3.9% had suicidal ideation in the past week. By chi square test,the detection rate of suicidal ideation of college students who suffered physical abuse,emotional abuse,sexual abuse,physical neglect,emotional neglect in childhood was higher than that of college students without maltreatment (χ2=13.78，12.97，17.10，56.56，66.58，P<0.01)；Spearman correlation analysis showed that there was a positive correlation between each type of maltreatment in childhood and college students’ suicidal ideation(r=0.06，0.06，0.07，0.12，0.13，P<0.01)；Multivariate Logistic regression model found that after controlling other influencing factors,physical neglect and emotional neglect in childhood were independent risk factors for suicide ideation of college students (OR=2.18,2.07,P<0.05). Conclusion Physical neglect and emotional neglect in childhood can increase the risk of college students’ suicidal ideation. Paying enough attention and care to them in early childhood may help to prevent their suicidal ideation in adulthood.

Objective: To to describe the prevalence of cyberbullying and its relation with suicide among college students in Taiyuan,and to provide scientific basis for promoting the physical and mental health of teenagers. Methods: Using the method of multi-stage stratified random cluster sampling, a total of 4 012 people were randomly selected from 2 colleges (departments) in sophomore and junior years of 6 universities in Shanxi Province during May to Jul.2018, and the survey contents included basic demographic characteristics, internet usage, cyber bullying, and suicide behavior. Results: The total report rate of cyberbullying among college students was 19.42%, among which the report rates of cyberbullying vicitimization cyberbullying and both cyberbulling penetration and victimization were 1.60%,11.49％ and 6.16％(247/4 012), respectively.The overall reported rate of suicidal behavior was 10.87%(436/4 012).Logistic analysis indicated that cyberbullying victimization,as well as cyberbulling penetration and victimization were risk factors for suicidal behavior（OR=1.82，2.97，P<0.05). Conclusion Cyberbullying behaviors of college students, especially those who suffer from cyberbullying or the simultaneous implementation and suffering of cyberbullying, may increase the risk of suicide. Therefore, while reducing the occurrence of cyberbullying, we should pay more attention to the mental health of students suffering from cyberbullying and reduce the occurrence of health-risk behaviors such as suicide.

OBJECTIVE: To investigate the asthma control status of occupational sensitizer-induced asthma(OSIA) and explore the influencing factors. METHODS: A total of 50 OSIA patients were selected as study subjects by judgment sampling method. Asthma Control Test(ACT) and Asthma Quality of Life Questionnaire were used to investigate the asthma control status and the quality of life of patients. The fractional exhaled nitric oxide(FeNO) level, pulmonary function, peripheral blood eosinophil ratio(EOS%)and serum total immunoglobulin E(IgE) level of the patients were measured. RESULTS: Among the 50 cases of OSIA patients, 27(54.0%) cases were well controlled, and 23(46.0%) cases were non-fully controlled. The patients with allergic rhinitis, with no inhaled corticosteroids treatment and with poor compliance were risk factors of the non-fully controlled OSIA(all P<0.05). The scores of ACT and the quality of life, and the percentage of the first second forced expiratory volume(FEV_1%) decreased(all P<0.05), while the level of FeNO increased(P<0.05) in the non-fully controlled group compare with the well-controlled group. There was no statistical significance in EOS% and serum total IgE level between the two groups(both P>0.05).CONCLUSION: Allergic rhinitis, lack of inhaled corticosteroids treatment and poor compliance are the influencing factors that affect the control of OSIA. The combinational scores of ACT and quality of life, FeNO, FEV_1% and other indicators can reflect the status of OSIA and assess the level of asthma control, and help guiding OSIA diagnosis and treatment plans.

Objective: To explore the relationship between childhood abuse and cyberbullying among college students and to provide theoretical support for early intervention of cyberbullying among college students. Methods: A total of 3 850 sophomores and juniors from 6 universities in Shanxi Province, randomly selected by stratified cluster sampling method, were investigated by using the Questionnaire on Cyberbullying and the Chinese Version of the Child Abuse Questionnaire. Results: Male students reported higher rates of sexual abuse, emotional neglect and physical neglect than female students(χ2=5.22, 4.39, 7.53 P<0.05). The child abuse report rate of college students whose parents divorced was higher than that of those whose parents were not divorced(χ2=86.80, 134.06, 130.18, 175.64, 118.46，P<0.05). In addition to physical neglect, childhood abuse rate of only children was higher than that of non-only children, with statistically significant differences(χ2=9.44, 12.44, 21.18, 21.26, all P<0.05). The scores of all factors and total scores of cyberbullying implemented by male students were higher than those by female students(t=9.35, 5.59, 5.83, 7.57，P<0.05); the scores of all factors and total scores of cyberbullying implemented by only-child students were higher than those by non-only-child students(t=2.79, 3.74, 4.78, 4.40，P<0.05); the scores of all factors and total scores of cyberbullying implemented by students whose parents were divorced were higher than those by students whose parents were not divorced, with statistically significant differences(t=6.99,6.78, 8.04，11.33, P<0.05). Multiple linear regression model showed that there was a positive correlation between the childhood abuse of college students and the implementation of cyberbullying, and regression coefficient differences of all factors were statistically significant(β=0.10, 0.11, 0.05, 10.08,0.06, P<0.05). Conclusion Childhood abuse experiences increase the risk of college students practicing cyberbullying.

OBJECTIVE: To investigate the levels of cortisol and inflammatory factors and their influencing factors in patients with occupational noise-induced hearing loss(ONID). METHODS: A total of 106 ONID patients were selected as the ONID group, and 50 healthy participants without noise exposure were selected as the control group by judge sampling method. The levels of salivary cortisol in the two groups were detected by enzyme-linked immunosorbent assay.The serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) in the peripheral blood were detected by electrochemiluminescence assay. Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus in ONID patients. RESULTS: The level of salivary cortisol in the morning and in the nighttime, and cortisol, TNF-α, IL-6 in the serum were higher in the ONID group compared with that in the control group(P<0.05). There was no significant difference in the serum level of CRP between these two groups(P>0.05). Spearman correlation analysis results showed that the level of cortisol in the saliva and in the serum was not correlated with TNF-α and IL-6(P>0.05). Analysis of multiple linear regression showed that the levels of serum cortisol and salivary cortisol in the morning in the ONID patients were positively correlated with noise exposure level(P<0.05). The level of TNF-α in the serum was positively correlated with tinnitus score(P<0.05). CONCLUSION: Hyperactivity of hypothalamus-pituitary-adrenal axis and inflammation activation may exist in patients with ONID. The cortisol can be used as a biomarker for the effect of noise-stress.