Effect of knowledge of a friend's non-suicidal self-injury behavior on self injury and suicide behaviors of adolescents / 中华行为医学与脑科学杂志

Objective:To explore the relationship between knowledge of a friend's non-suicidal self-injury (NSSI) behavior and self injury and suicide behaviors of adolescents.Methods:From January 2020 to January 2021, totally 1 683 students from a middle school in Xiamen were randomly selected by cluster sampling.The suicide items of the self-injurious thoughts and behaviors interview(SITBT) were used to assess whether students were aware of their friends' self injurious history and their self injurious behaviors.The suicide items of the mini international neuropsychiatric interview for children and adolescents (MINI-KID) were used to assess students' suicide ideation and behavior.The data were statistically analyzed by SPSS 21.0 software.Logistic regression model was used to analyze the relationship between knowledge of a friend's NSSI and adolescents' own self-reported NSSI and suicidal behaviors.Results:A total of 1 683 junior and senior high school students completed the survey, including 412 (24.4%) who knew their friend's NSSI history and 1 271 (75.6%) who did not know their friend's NSSI history.There were statistically significant differences between the adolescents known and unknown friends' NSSI histories in terms of age, gender, whether they were left-behind children, mental disorders, their own NSSI, suicide attempts, and suicidal ideation (all P<0.05). Knowledge of a friend's NSSI behavior had positive predictive effect on adolescents' own NSSI behavior ( β=0.558, OR=2.01, 95% CI=1.58-3.88), suicidal ideation( β=0.238, OR=3.03, 95% CI=2.08-5.55), and suicide attempts ( β=0.233, OR=2.88, 95% CI=1.55-5.45) (all P<0.05). Conclusion:Knowledge of a friend's NSSI behavior may have an impact on adolescents' own self-injury and suicidal behavior.

Revision of the non-suicidal self-injury behavior scale for adolescents with mental disorder / 中南大学学报(医学版)

OBJECTIVES@#Adolescents are at high risk of non-suicidal self-injury (NSSI). Currently, there is no clinical assessment tool for adolescent NSSI behaviors measurement with global consistency. The Ottawa Self-injury Inventory (OSI) is considered as a relatively comprehensive assessment tool for NSSI, but the questionnaire is discussed with excessive content and timecostly, which may affect the reliability of the measurement results for adolescent.Thus, this study, based on OSI, aims to revise the assessment tool for adolescent with NSSI that is suitable for both clinically and scientifically, referring to the diagnostic criteria for NSSI in the 5th Diagnostic and Statistical Manual of Mental Disorder (DSM-5).@*METHODS@#This study was led by the Second Xiangya Hospital of Central South University and collaborated with 6 mental health service institutions in China from August to December 2020. Adolescent aged from 12 to 24 years old who had self-injury behavior and met the DSM-5 diagnostic criteria for NSSI were continuously recruited in the psychiatric outpatient department or ward. After clinical diagnosis by an experienced attending psychiatrist or above, the general information and OSI were collected by questionnaires. SPSS 24.0 and AMOS structural equation model statistical softwares were used to conduct item analysis and exploratory factor analysis on the obtained data to complete the revision of the scale. Cronbach's alpha coefficient, split-half reliability, test-retest reliability, and content validity and structure validity were performed to analyze the reliability and validity and confirmatory factor analysis was carried out to test the structure validity for the revised scale.@*RESULTS@#A total of 234 adolescent with NSSI were enrolled, including 33 (14.1%) males and 201 (85.9%) females with the mean age of (16.2±2.6) years old. The most common clinical diagnoses were depression disorder (57.4%), bipolar disorder (20.9%), adolescent mood disorder (17.1%), etc. Nine items (item 2, 7, 11, 13, 23, 24, 10, 17, 18) in the functional scale of OSI were deleted according to extreme grouping method, correlation analysis, and principal component analysis in exploratory factor analysis. The revised functional scale for NSSI consisted of 15 items. The reliability analysis showed that the Cronbach's alpha coefficients of NSSI thought and behavior frequency, addiction characteristics, and function scales were 0.799, 0.798, and 0.835, respectively, and the split-half coefficients were 0.714, 0.727, and 0.852, respectively. The test-retest coefficients of the latter 2 scales were 0.466 and 0.560, respectively. The correlation coefficient between sub-items and total scores in each part of the scale showed good content validity. The exploratory factor analysis showed that a component was extracted from the frequency of thoughts and behaviors of NSSI, one component was extracted from the addictive characteristics, and three components were extracted from the functional part. The three functional subscales were social influence, external emotion regulation, and internal emotion regulation. The factor load of each item was >0.400.@*CONCLUSIONS@#The revised Chinese version OSI targeted the adolescent patients with mental disorders has relatively ideal reliability and validity. The scale shows high stability, dependability, and a reasonable degree of fit. It is a suitable assessment tool for clinical and scientific research on adolescent with NSSI.

An empirical judicial case study on the authenticity disputes of electronic medical records / 中华医院管理杂志

Based on a research on judicial cases concerning the authenticity of electronic medical records in the past three years, the authors encountered judicial dilemmas in judicial practice. The challenges arise due to the special manifestations of electronic medical records, unclear and disputable criteria for the authenticity of electronic medical records, low application level of electronic medical records identification, and inconsistent responsibility attribution. In order to effectively apply the electronic medical record system, it is recommend to promote pre-litigation prevention by unifying the construction standards of the computerized patient record system, strengthening hospital electronic medical record management and entrusting third-party storage to ensure the evidential weight. In addition, it is necessary to establish standards for authenticity of medical records, improve the electronic medical record forensic identification system and clarify the attribution of the responsibility for untrue medical records, so as to improve the handling of such medical damage cases during litigation.

Protection of medical data rights from the perspective of private law / 中华医院管理杂志

With the rapid development of " Internet+ healthcare" , medical data has gained an ever important role. How to determine the reasonable use boundary of medical data and leverage its supporting role, has grown an urgent problem to be solved. The authors analyzed the characteristics of medical data, and held that medical data is not equivalent to information, as it does not have the characteristics of legal objects in nature. In addition, it lacks originality. Therefore it is difficult to protect through the existing rights system. However, due to its property interest and personality, the authors tried to establish a new right for protection. In the construction of such medical data right, the authors claimed that patients should be the subject of the right, and medical institutions can appropriately restrict the freedom of patients′ through reasonable use rules and legal licensing system. In this way, we can not only promote medical data sharing and the development of social health, but also fully protect the legitimate rights and interests of patients.

Liabilities for damages incurred by delayed medical treatment in patients with low cure rate / 中华医院管理杂志

It is difficult for the patients with low cure rate to achieve the requirements of the"but for rule"or "preponderance of evidence standard" in the traditional causal argument. In dealing with such cases ,judicial practice has tried to broaden the concept of damage ,and adopt the theories of"loss of chance" ,"expectation infringement theory"or"comparative possibility theory" ,with the purpose to make up for the applicable dilemma of traditional causality. However ,the expansion of the concept of the damage will objectively cause some problems like abuse of rights ,concrete right becoming nothing and even subjective imputation.In the current legal system ,we can analogical apply the rule of joint dangerous act ,and correct the causal relationship to resolve such incidents. It will be more fair and just .

Vitamin C enhanced myocardial differentiation of dedifferentiated fat cells / 中国病理生理杂志

[ ABSTRACT] AIM:In order to observe the myocardial differentiation capacity of the dedifferentiated fat ( DFAT) cells treated with vitamin C in vitro.METHODS: DFAT cells were dedifferentiated from the mature rat adipocytes with ceiling adherent culture.The DFAT cells of passage 3 were used in the study.Vitamin C and/or neonatal rat heart tissue lysate were added into the culture medium to induce myocardial differentiation for 3 weeks.The cell morphology was ob-served under microscope.The myocardial-specific markers, such as cTnT, GATA-4 and NKx2.5, were examined by the methods of immunofluorescence, PCR and Western blot.RESULTS:Mature rat adipocytes dedifferentiated into fibroblast-like DFAT cells after ceiling adherent culture.The DFAT cells spontaneously differentiated into cardiomyocyte-like cells under normal culture condition with a low incidence.After treated with neonatal rat heart cell lysate, the DFAT cells be-came cardiomyocyte-like cells that had bigger size, longer shape and myotubule-structure.The expression of cTnT, GATA-4 and NKx2.5 was remarkably increased at both mRNA and protein levels as compared with the normal cultured DFAT cells.The expression of cTnT, GATA-4 and NKx2.5 was further increased in DFAT cells after treating with vitamin C.No spontaneous beating cell was observed.CONCLUSION:Vitamin C enhances the differentiation of DFAT cells into cardio-myocyte-like cells.