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Objective@#To analyze epidemiological characteristics of campus bullying among primary and middle school students in central China to explore its relation with mental health problems, and to provide a reference for the campus bullying prevention.@*Methods@#Stratified cluster sampling method was used to select primary and middle school 10 581 students from Anyang, Nanyang and Xinxiang cities of Henan Province, Middle School Students Mental Health Scale and the Self designed Scale of Adolescent Bullying Behavior were used to analyze the relationship between mental health problems with campus bullying behavior.@*Results@#The total report rate of bullying penetrator was 12.5% among students in the three cities. Among primary and middle school students with mental health problems such as hostility, interpersonal stress, academic pressure and emotional imbalance, the detection rate of bullying behavior was 24.2%, 20.3%, 19.4% and 20.1%, respectively. The results of multivariate analysis showed that hostility symptoms ( OR =3.78, 95% CI =1.71-8.32), interpersonal stress ( OR =3.50, 95% CI = 1.62 -7.57), academic pressure ( OR = 1.62 , 95% CI =1.21-2.16) and emotional imbalance ( OR =2.80, 95% CI =1.41-5.56) showed a significant impact on campus bullying ( P <0.05).@*Conclusion@#Mental health problems of primary and middle school students are closely related to the occurrence of bullying behavior. It is necessary to pay attention to the mental health education of bullies and intervene bullying behaviors from the source.
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Objective:To explore the effects of intravenous combined epidural anesthesia on perioperative hemodynamic indexes, cardiac function and immune function during laparoscopic surgery in elderly gastric cancer patients complicated with coronary heart disease.Methods:A total of 94 elderly gastric cancer patients with coronary heart disease who were admitted to Shanxi Province Cancer Hospital from January 2017 to June 2021 were selected. They were divided into the total intravenous anesthesia group (control group) and intravenous combined epidural anesthesia group (observation group) by random envelope lottery, with 47 cases in each group. Hemodynamic indexes, cardiac function, immune function, pain and sedation scores were compared between the two groups.Results:When pneumoperitoneum was established (T 1) and the left gastric artery was immediately free during operation (T 2), systolic blood pressure in the observation group was (136.6±9.9) mmHg (1 mmHg = 0.133 kPa) and (133.9±9.4) mmHg, and diastolic blood pressure was (74.6±4.6) mmHg and (80.7±6.0) mmHg; heart rate was (79.8±4.0) times/min and (80.9±2.7) times/min, respectively. The systolic blood pressure of the control group was (159.3±7.6) mmHg and (162.5±8.5) mmHg, and the diastolic blood pressure was (91.2±5.2) mmHg and (88.3±4.7) mmHg, respectively. The heart rate was (106.2±3.3) times/min and (101.9±4.0) times/min, respectively; compared with the control group at the same time point, the observation group had lower blood pressure and slower heart rate ( t values were 4.25, 2.53, 6.40, 6.81, 1.85, and 1.35, all P < 0.05). The blood concentrations of cardiac troponin and creatine kinase isoenzyme in the control group were (0.143±0.052) ng/ml and (5.65±0.77) mg/L at 12 h (T 4) after surgery, which were higher than those in the observation group [(0.098±0.015) ng/ml and (3.08±1.06) mg/L] ( t values were 4.32 and 10.19, both P < 0.05). The intraoperative utilization rate of vasoactive drugs and the incidence of electrocardiogram abnormalities in the observation group were 19.1% (9/47) and 25.5% (12/47), which were lower than those in the control group [48.9% (23/47) and 55.3% (26/47)] ( χ2 values were 8.49 and 8.66, both P < 0.05). Compared with 1 day before operation (T 5), the proportion of CD4 + T cells increased and the proportion of CD8 + T cells decreased in control group at 3 days after operation (T 6) (both P < 0.05). The pain score and sedation score of the observation group at 12 h (T 4) and 1 day after surgery (T 7) were better than those of the control group (all P < 0.05). Conclusions:Laparoscopic radical gastrectomy with intravenous combined epidural anesthesia in elderly gastric cancer patients with coronary heart disease can achieve better anesthesia effect, and can provide better protection for the patient's cardiac function and immune function.
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Objective To summarize the characteristics and associated malformation of fetal isolate cleft palate in prenatal ultrasonography, and analyze the reason of ultrasound misdiagnosis and missed diagnosis in isolate fetal cleft palate prenatally. Methods Systemic screening was performed with two-and three-dimensional ultrasonography in 3 576 cases. The fetal lip and plane were observed especially in nasolabial coronary plane, axial plane through maxilla, median sagittal plane, oblique coronal plane through oral cleft. Meanwhile the accompanied deformity were also screened. And prenatal ultrasound results were compared with postpartum ifndings. Results Eleven in 3 598 cases (0.31%, 11/3 598) were diagnosed as fetal isolate cleft palate by prenatal ultrasonography. The ultrasonic characteristics of isolate cleft palate were:(1) One case ofⅠ° cleft palate, the ultrasonic manifestations:in median sagittal plane, the hyperecho line of median palatine suture was disappeared, and the mucous membranes above and below it were complete;in oblique coronal plane of soft palate through oral cleft, the soft palate was complete and continuous;uvula couldn′t be displayed. (2) Three cases ofⅡ° cleft palate, the ultrasonic manifestations:in median sagittal plane though jaw, the hyperecho line of median palatine suture was shorter;the latter half and the midline of soft palate was disappeared;in both paramedian sagittal plane, the arc-shaped hyperecho line of median palatine suture were displayed;and longer than the hyperecho of midline of palate;in oblique coronal plane of hard palate through oral cleft, the ifrst half hyperecho line of hard palate was continuous, the middle of the latter half hyperecho line was interrupted;in oblique coronal plane of soft palate through oral cleft, the midline of soft palate was interrupted. 3D volume data analysis showed that the ifrst half hard palate was complete, the midline of the latter half hard palate and soft palate was interrupted. (3) Seven cases ofⅢ° cleft palate, the ultrasonic manifestations:in median sagittal plane, the hyperecho line of median palatine suture was disappeared;in oblique coronal plane of hard palate through oral cleft, the middle part echoes of the hard palate was interrupted;in oblique coronal plane of soft palate through oral cleft, the midline of soft palate was interrupted;oral and nasal cavity were communicated;the hyperecho of the vomer at the lower edge of the nasal septum could be displayed though oral cavity. 3D volume data analysis showed that hard palate and soft palate were interrupted. The hyperecho of the vomer at the lower edge of the nasal septum could be displayed clearly though oral cavity. Prenatal ultrasonic diagnosis was conifrmed by postpartum ifndings. And 2 cases were misdiagnosed (0.06%, 2/3 598), 1 case was missed diagnosed (8.33%, 1/12). The incidence of isolate fetal cleft palate was 0.33%(12/3 598). In 12 cases of isolate fetal cleft palate, 11 cases were accompanied with other fetal deformities, including central nervous system malformations (6/12), small jaw (6/12), urinary tract malformation (5/12), hydramnios (2/12), and absence of amniotic lfuid (1/12). Conclusions Fetal secondary palate should be routinely included in the prenatal screening. When secondary palate planes weresuccessfully demonstrated, the isolate cleft palate could be detected. Prenatal diagnosis of the isolate cleft palate is contributive to prenatal counseling and risk assessment.
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Objective To evaluate the value of angled insonation technique in obtaining the volumes of the fetal palate and in three-dimensional post-processing.Methods Five hundred and sixty-six cases of 20~28 weeks fetuses with normal face were confirmed by systemic ultrasound examinations and post-natal examination.The volumes in the standard midsagittal plane and angled midsagittal plane were obtained,then post-processed these data by 4D-View software.The same technology was used for volume data acquisition and processing to 1 case of cleft lip and palate fetal.Results In 566 fetuses,two groups of volume data were successfully acquired in 458 cases (standard midsagittal plane group) and 411 cases (angled midsagittal plane group).Fetal primary palate in the standard group and the angled group can be both well visualized(100%).Axial plane of hard palate can not be reconstructed in the standard group.Only 36% of the fetal hard palate's coronal plane and transoral oblique coronal plane can be reconstructed.The visualization rate of soft palate was 87% in the standard group,which was slightly higher than the angled group (82%).The visualization rate of hard palate's axial plane,coronal plane and transoral oblique coronal plane was 100% respectively in the angled group.Cleft alveolar process involving the secondary palate can be clearly visualized in 1 case of cleft lip and palate fetus.Conclusions By using the angled insonation technique,which is based on clearly visualizing secondary palate to obtain volumes,using three-dimensional post-processing technique can obtain the conventional three orthogonal planes and any other section of the whole palate.By using it we can assess the integrity of fetal palate,diagnose cleft lip with or without cleft palate and classify the cleft palate,even make prenatal diagnosis of the isolated cleft palate possible.