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Objective@#To investigate the clinical characteristics, diagnosis, treatment, and prognosis of descending necrotizing mediastinitis (DNM) to provide a reference for the early diagnosis and timely treatment of DNM.@*Methods@#Data on DNM in China was electronically retrieved from the core databases and comprehensively reviewed from June 2012 to June 2023. The infection, pathogenic microorganisms, main symptoms, comorbidities and treatment methods of DNM were analyzed.@*Results@#The data of a total of 781 DNM patients, with an average age of (52.97 ± 5.64) years, were retrieved, including 554 males and 227 females. Odontogenic source, tonsillitis, pharyngeal abscess, sialoadenitis, upper respiratory tract infection, foreign body injury, or iatrogenic traumatic procedures are common causes. Among these, odontogenic infection is the most common source. Streptococcus sp. (n = 217) and Staphylococcus sp. (n = 82) were most isolated, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (equally n = 59). A total of 69.4% (542/781) of DNM patients recruited in this study were discovered to have various comorbidities, and more than one-third of these patients (n = 185) had diabetes. Of the broad antibiotics, carbapenem was most frequently used as treatment, and vancomycin was the most frequently coadministered. The mediastinal drainage approach varies widely, and the optimal regimen is still unknown. Seventy-two patients were treated with video-assisted thoracoscopic/mediastinoscopic surgical drainage, 22 patients were treated with percutaneous catheter drainage, 30 underwent the transcervical approach, and 40 underwent thoracotomy. A total of 617 patients who were selected underwent the appropriate combined operation for surgical drainage according to the specific location of the infected focus. The overall mortality rate of all 781 DNM patients included was 11.2%.@*Conclusion@#The most effective diagnosis and treatment of DNM is a high degree of clinical vigilance followed by prompt and adequate drainage with intensive care, including hemodynamic monitoring, nutritional support, computer tomographic scanning repeated as necessary, and combined use of systemic antibiotics.
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Objective@#This study amis to evaluate the effect of resilience group counseling based on Achieving Success Everyday(ASE) group counseling model on mental health promotion of junior high school students.@*Methods@#An experimental design of 2 (experimental group/control group)×3(pre-test/post-test/follow-up test) was adopted to conduct resilience group counseling for junior high school students in a school in southern Xinjiang (8 weeks, once a week, each activity lasts for 60-90 min), followed by a detailed analysis of intervention effect.@*Results@#After intervention, scores of resilience, goal focus, emotional control, family support, interpersonal assistance, core self-evaluation, coping styles and positive coping in intervention group increased significantly(t=8.93, 3.78, 6.62, 3.17, 6.13, 5.18, 4.01, 2.91, P<0.01). The scores of mental health and negative coping significantly decreased (t=-4.24, -3.01, P<0.01) and was lower than control group(t=-2.58, -3.11, P<0.05). The scores of resilience, goal focus, interpersonal assistance, core self-evaluation, coping styles and positive coping were significantly higher than those of the control group(t=3.88, 2.84, 3.18, 4.19, 3.68, 2.49, P<0.01). The results of the follow-up test showed that the scores of resilience and goal concentration, emotional control, positive cognition, family support, interpersonal assistance, core self-evaluation and positive coping were still significantly higher than those of the pretest(t=5.69, 3.50, 2.26, 2.80, 2.64, 4.13, 3.39, 2.13, P<0.05), and the scores of mental health were still significantly lower than the pretest(t=-4.62, P<0.01).@*Conclusion@#Mental resilience group counseling based on ASE model can effectively improve students’ mental health level, and at the same time, it shows positive effect on improving core self-evaluation and coping styles.
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Objective @#To investigate the effect of different concentrations of MTA on the proliferation and differentiation of stem cells from the apical papilla (SCAP) and the potential of the SCAP to differentiate into odontoblasts.@*Methods@#SCAP were cultured in different concentrations of mineral trioxide aggregate（MTA）. MTA experimental group with concentration of 0.01 mg/mL, 0.02 mg/mL, 0.1 mg/mL, 0.2 mg/mL, 1 mg/mL, 2 mg/mL, 10 mg/mL and 20 mg/mL were prepared. The number of cells at 1 day, 3 days, 5 days and 7 days were measured via a CCK-8 assay to observe the effect of MTA on SCAP proliferation. Real-time PCR was used to detect the gene expression changes. Cells cultured in alpha MEM culture containing 15% FBS without MTA were set as the control group.@*Results @#When cultured for 1 d, statistically significant differences in the promotion of in vitro proliferation of SCAP were not observed between each MTA experimental group and the control group (P>0.05). When cultured for 3 d, 5 d and 7 d, the 0.01 mg/mL MTA group presented obvious promotion of SCAP proliferation compared with the control group (P<0.05), whereas the 0.02 mg/mL, 0.1 mg/mL, 0.2 mg/mL, 1 mg/mL groups did not presented differences with the control group (P>0.05). The in vitro proliferation of the 2 mg/mL, 10 mg/mL and 20 mg/mL groups was lower than that of the control group (P<0.05). Real-time PCR detection showed that the expression levels of DSPP (t=-11.12, P < 0.05) and Runx2 (t=-10.62, P < 0.05) in the experimental group treated with 0.01 mg/mL MTA for 7 days were higher than those in the control group. @*Conclusion @#The 0.01 mg/mL concentration of MTA significantly promotes the proliferation of SCAP and shows the best ability to induce osteogenic and odontoblast differentiation in the SCAP, whereas high concentrations of MTA inhibited the proliferation of SCAP.