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AIMS AND OBJECTIVES: The aim of this study was to explore the mental health of transplant recipients, especially psychological integration and the donor-recipient relationship. BACKGROUND: Psychological integration and the donor-recipient relationship are unique psychological perception of recipients with transplantation, which have important effects on their mental health and recovery. However, few studies have focused on the feelings and attitudes of cadaveric liver transplant recipients. DESIGN: A qualitative descriptive design was used. METHODS: Individual semi-structured interviews were conducted face-to-face with 30 recipients after liver transplantation. Qualitative content analysis was used and data saturation was achieved. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were used. RESULTS: Three themes and eight subthemes were identified. (1) Psychological integration-acknowledging the transplanted liver was a part of their own body and attaching great importance to the liver; (2) Attitudes towards the donor-gratitude to the donor, being inspired by the dedication of the donor and mourning the donor's misfortune; and (3) Living in the moment-health behaviours of self-care, emotional regulation and positive attitude about life. CONCLUSION: The psychological integration of recipients of cadaveric liver transplants is smooth, and the attitudes towards the donor are positive. From the perspective of positive psychology, we observed the important role of post-traumatic growth of the recipient and positive emotions in promoting the recipient's health behaviours for self-care, emotion regulation and attitudes towards life. RELEVANCE FOR CLINICAL PRACTICE: Medical staff should help recipients to deal with these issues about the organ and its donor constructively and guide them to focus on postoperative inner growth and positive emotion.

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OBJECTIVES@#The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden.@*METHODS@#A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested.@*RESULTS@#Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P<0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden (P<0.01). Caregiver's caring ability was positively correlated with caregiver's resilience (P<0.01), and both were negatively correlated with caregiver burden (both P<0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively.@*CONCLUSIONS@#Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.

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Objective:To investigate the feasibility of classifying imaging patterns of dermatomyositis/polymyositis-related interstitial lung disease (DM/PM-ILD) into subtypes based on chest CT radiomics features and a model was constructed by machine learning algorithms.Methods:From November 2011 to November 2020, 107 patients diagnosed with PM/DM-ILD at the First Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. A total of 315 cases with chest CT were collected. Doctors pre-classified image patterns, including 105 cases with non-specific interstitial pneumonia (NSIP), 90 cases with organizing pneumonia (OP), and 66 cases with non-specific interstitial pneumonia combined with organizing pneumonia (NSIP+OP), 35 cases with common interstitial pneumonia (UIP), and 19 cases with diffuse alveolar damage (DAD), ANOVA was used to test the difference of baseline clinical information among the imaging classification groups. All images were divided into the training set and the est set by stratified random sampling at a ratio of 4∶1. In each CT scan, 3D slicer was used to segment each lung lobe, and then reconstructed into 3 mm 3 of voxels, and Pyradiomics library was used to extract the radiomic features of the whole lung and each lobe. The multi-classification goal was achieved by constructing random forest base classifiers for each of the five groups and then voting as the final model. In the process of constructing the base classifier, firstly, the balance between sample groups was achieved by SMOTETomek comprehensive sampling, and the optimal feature set was selected by independent sample t test and L1 regularized least absolute shrinkage and selection operator (LASSO) regression. In this study, the Radiomics model was constructed based on chest CT radiomics features, and the Radiomics + model was constructed by introducing gender and age information. The base classifier and the integration model use the mean accuracy and the area under the receiver operator characteristics analysis curve (AUC) to evaluate the performance, respectively. Results:There was a statistically significant difference ( P<0.05) between the ages of the NSIP, OP, NSIP+OP, UIP, and DAD groups [(57±13),(53±8),(54±10),(44±11), and (46±8)years old, respectively], F=11.82, P<0.001. In the Radiomics model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.87, 0.91, 0.91, 0.96, and 0.99, respectively, and the AUC of the test set were 0.81, 0.82, 0.79, 0.93, 0.89. In the final Radiomics + model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.89, 0.91, 0.92, 0.97, and 0.99, respectively, and the AUCs of the test set were 0.84, 0.82, 0.78, 0.94, 0.90. Conclusion:Based on chest CT radiomics features and key clinical features (sex, age), the Radiomics + model constructed by machine learning has good classification performance for the imaging patterns of PM/DM-LD.

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Objective:To investigate the current situation of nurses′ professionalism in secondary and tertiary general hospitals, analyze its influence factors, and establish norms of nurses′ professionalism in secondary and tertiary hospitals, so as to provide references for evaluation the level of professionalism in nurses.Methods:From May to December 2016, the nurses′ professionalism evaluation system was used to investigate 3 315 nurses in 35 secondary and tertiary general hospitals in 14 cities of 7 regions in China by using random cluster sampling, and the corresponding norm, classification norm and delimitation norm were defined.Results:The average norm scores of nurses′ professionalism in the secondary and tertiary general hospitals was (71.02 ± 16.70), and the average norm scores of each dimension were professional ethics (18.97 ± 4.52) , comprehensive capabilities (17.99 ± 4.46), professional skills (17.07 ± 4.80), professional emotions (16.98 ± 4.70) . According to the differences in characteristics, the classification norms for different gender, age, working years, educational background, professional title, position, department, marital status, with or without children were formed. The level of nurses′ professionalism was divided into five grades: the total score in the interval [90.92, 100.00] was excellent, in the interval [78.31, 90.92) was good, in the interval [64.27, 78.31) was general, in the interval [50.49, 64.27) was relatively poor, in the interval [0.00, 50.49) was poor.Conclusions:Nurses′ professionalism in secondary and tertiary hospitals was in the general level and affected by a variety of factors, medical managers and nursing managers should take corresponding measures to improve nurses′ professionalism.

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OBJECTIVES@#There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression.@*METHODS@#A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory.@*RESULTS@#The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables.@*CONCLUSIONS@#Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.

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Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.

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Objective:To develop a negative emotion screening scale for inpatients(NESSI) and test its validity and reliability.Methods:Based on our previous studies and the theory model of psychological stress, the original item pool was established through literature review, expert interviews and patient consultation.The first version of NESSI was constructed by Delphi method, then initially tested in 421 inpatients followed by the project analysis and reliability test. After those above, the formal scale was developed and tested in 318 inpatients followed by confirmatory factor analysis and reliability test.Finally, 7-item generalized anxiety disorder scale (GAD-7), 9-item patient health questionnaire (PHQ-9), anger state expression scale (SAS) and simplified Chinese version of fear of disease progression scale(FoP-Q-SF) were used to test the criterion validity.Results:After exploratory factor analysis, 17 items were retained in the final scale, which can be categorized into four dimensions: fear of illness, depression, somatization and anger, which could explain 63.49% of the total variation.Confirmatory factor analysis showed that the fitting degree of each factor model was good and met the requirements of reference value (χ 2/ df=2.949, RMR=0.044, CFI=0.929, NFI=0.897, IFI=0.930, TLI=0.915, PGFI=0.655, RMSEA=0.078). The Cronbach's α coefficient of the total scale was 0.925, and the Cronbach's α coefficient of the four factors ranged from 0.762 to 0.898.The criterion validity showed that there was a significant positive correlation between the scale and the four criterion scales ( r= 0.574-0.805, all P<0.01). Conclusion:The NESSI scale has good reliability and validity, and can be used as a psychological problem screening tool among non-psychiatric inpatients.

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Objective To investigate the influencing factors for poor jaundice resolution after radical pancreaticoduodenectomy in patients with malignant obstructive jaundice.Methods The retrospective case-control study was conducted.The clinicopathological data of 121 patients with malignant obstructive jaundice who were admitted to the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University between March 2013 and June 2018 were collected.There were 70 males and 51 females,aged (69±9)years,with a range from 39 to 85 years.Of 121 patients,112 underwent open radical pancreaticoduodenectomy,and 9 underwent totally laparoscopic radical pancreaticoduodenectomy.Observation indicators:(1) situations of jaundice resolution after pancreaticoduodenectomy;(2) influencing factors for poor jaundice resolution after pancreaticoduodenectomy.Measurement data with normal distribution were represented as Mean ± SD.Measurement data with skewed distribution were represented as M (range).Count data were described as absolute numbers.Univariate analysis was performed using the chi-square test,t test,Fisher exact probability or Mann-Whitney U test.Multivariate analysis was performed by the Logistic regression model using P＜0.10 as an inclusion criteria in the univariate analysis.Results (1) Situations of jaundice resolution after pancreaticoduodenectomy:of 121 patients,97 had good jaundice resolution after pancreaticoduodenectomy,and 24 had poor jaundice resolution after pancreaticoduodenectomy.(2) Influencing factors for poor jaundice resolution after pancreaticoduodenectomy:results of univariate analysis showd that preoperative level of serum total bilirubin,comorbidity with diabetes mellitus were influencing factors for poor jaundice resolution after pancreaticoduodenectomy (t =-2.073,x2 =10.201,P＜0.05).Postoperative pancreatic fistula was also an influencing factor for poor jaundice resolution after pancreaticoduodenectomy (P ＜ 0.05).Results of multivariate analysis showed that comorbidity with diabetes mellitus and postoperative pancreatic fistula were independent risk factors for poor jaundice resolution after pancreaticoduodenectomy (odds ratio=0.258,0.129,95％ confidence interval:0.087-0.769,0.023-0.726,P＜0.05).Conclusions Preoperative level of serum total bilirubin,diabetes mellitus,and postoperative pancreatic fistula are influencing factors for poor jaundice resolution after pancreaticoduodenectomy.Comorbidity with diabetes mellitus and postoperative pancreatic fistula are independent risk factors for poor jaundice resolution after pancreaticoduodenectomy.

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Radiation-induced oral mucositis (RIOM) is a common toxicity in patients receiving radiotherapy for head and neck cancer. RIOM not only significantly affects the oral function of patients, but also affects the short-term and long-term quality of life. In severe cases, it can reduce the tumor control rate and thus impact the survival of patients. The influencing factors of RIOM has been intensively studied, whereas the conclusions of some studies are inconsistent. In this article, the research progresses on the influencing factors of RIOM in recent years were summarized, aiming to provide the basis for the prevention and management of RIOM.

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Objective@#To investigate the influencing factors for poor jaundice resolution after radical pancreaticoduodenectomy in patients with malignant obstructive jaundice.@*Methods@#The retrospective case-control study was conducted. The clinicopathological data of 121 patients with malignant obstructive jaundice who were admitted to the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University between March 2013 and June 2018 were collected. There were 70 males and 51 females, aged (69±9)years, with a range from 39 to 85 years. Of 121 patients, 112 underwent open radical pancreaticoduodenectomy, and 9 underwent totally laparoscopic radical pancreaticoduodenectomy. Observation indicators: (1) situations of jaundice resolution after pancreaticoduodenectomy; (2) influencing factors for poor jaundice resolution after pancreaticoduodenectomy. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Univariate analysis was performed using the chi-square test, t test, Fisher exact probability or Mann-Whitney U test. Multivariate analysis was performed by the Logistic regression model using P<0.10 as an inclusion criteria in the univariate analysis .@*Results@#(1) Situations of jaundice resolution after pancreaticoduodenectomy: of 121 patients, 97 had good jaundice resolution after pancreaticoduodenectomy, and 24 had poor jaundice resolution after pancreaticoduodenectomy. (2) Influencing factors for poor jaundice resolution after pancreaticoduodenectomy: results of univariate analysis showd that preoperative level of serum total bilirubin, comorbidity with diabetes mellitus were influencing factors for poor jaundice resolution after pancreaticoduodenectomy (t=-2.073, χ2=10.201, P<0.05). Postoperative pancreatic fistula was also an influencing factor for poor jaundice resolution after pancreaticoduodenectomy (P<0.05). Results of multivariate analysis showed that comorbidity with diabetes mellitus and postoperative pancreatic fistula were independent risk factors for poor jaundice resolution after pancreaticoduodenectomy (odds ratio=0.258, 0.129, 95% confidence interval: 0.087-0.769, 0.023-0.726, P<0.05).@*Conclusions@#Preoperative level of serum total bilirubin, diabetes mellitus, and postoperative pancreatic fistula are influencing factors for poor jaundice resolution after pancreaticoduodenectomy. Comorbidity with diabetes mellitus and postoperative pancreatic fistula are independent risk factors for poor jaundice resolution after pancreaticoduodenectomy.

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Objective To evaluate the effect of the intervention combined the high blood pressure health literacy(HBP-HL) with the stages of change on waist circumference( WC),body mass index( BMI) and physiological-biochemical indexes among the Kazakh-Chinese hypertensive patients. Methods The in-terventional plan was built based on the " Stages of Change of Transtheoretical Model" . This randomized con-trolled trial study was carried out from July 2014 to January 2016,and Kazakh hypertension patients from" qianjin" and " small canal" pastoral areas were sampled using stratified cluster sampling method,with 74 patients from each place. The general health management combined with " High Blood Pressure Health Edu-cation" handbook was applied in the control group. The intervention group was given the 12-month interven-tion combined the HBP-HL with the stages of change based on the control group. Meanwhile,WC,BMI and other data were collected at the first,twelfth and eighteenth months. Results Repeated variance analysis showed interaction effects between time and group (F=14. 396,15. 214,P<0. 05),indicating that the effect of intervention factors on WC and BMI would increase over time when intervention existed. The total choles-terol ((5. 69±0. 93)mol/L),low density lipoprotein ((3. 74±0. 86)mol/L) and serum creatinine ((65. 46 ±13. 45)mol/L) of hypertension patients in intervention group were lower than those before intervention (t=3. 998,4. 581,2. 574,P<0. 05). After intervention,the scores of total health literacy ( t=5. 157) ,under-standing ability (t=6. 504),the latest vital signs (t=11. 583) and avoiding food allergy ( t=3. 778) of the intervention group were higher than those of the control group,and the differences were statistically significant (P<0. 05). Conclusions The intervention strategy of " health literacy-behavioral change stage" is feasible and effective. It can significantly reduce WC,BMI,total cholesterol,low density lipoprotein and serum creati-nine in Kazakh hypertension patients in pastoral areas,and the short-term maintenance effect of the interven-tion is acceptable.

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Objective To explore the present situation and characteristics of depression in patients with non-small cell lung cancer (NSCLC),and to analyze the mediating role of resilience in the relationship between self-perceived burden and depressive symptom,so as to provide evidence for improving depression in patients. Methods A total of 306 subjects from 5 tertiary hospitals in Changsha,Hunan Province were se-lected by simple random sampling method. Before their discharge from hospital,those subjects were investiga-ted by self-made social demographic questionnaire,Self-rating Depression Scale(SDS),Self-perceived Bur-den Scale of Lung Cancer(SPBS-LC) and Connor&Davidson Resilience Scale(CD-RISC). Pearson analysis was used to analyze the correlation among the variables,and Amos 7. 0 was used to establish the structural e-quation model and test the mediating effect. Results ( 1) The total score of depression was ( 59. 10 ± 8. 37). The total scores of resilience and self-perception burden were (52. 77±10. 12) and (49. 64±8. 55) in newly-diagnosed advanced non-small cell lung cancer patients. (2) Pearson analysis showed that the total score of depression was negatively correlated with the total score of resilience,optimism,self-improvement and tenacity (P<0. 05). The total score of depression was positively correlated with the total score of self-percep-tion burden, physical burden, emotional burden, disease symptoms, social and economic dimensions (P<0. 05). (3) Structural equation model analysis showed that resilience played a partial role in mediating be-tween self-perceived burden and depression and mediating effect accounted for 29. 8% of the total effect. Conclusion The depressive symptom of the NSCLC patients is at the mild to moderate level. Reducing their self-perceived burden and promoting the resilience of lung cancer patients could alleviate their depressive symptom.

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In recent years, with the high incidence of lung cancer and mortality, the disease-relevant mental health problems such as depression began to attract attention. A growing number of studies have also begun to hypothesize and confirm the relationship between depression and survival or mortality in patients with lung cancer, and have made some progress in basic research, prospective cohort research and intervention research. In basic research, cancer can cause depression due to mediating the production of inflammatory factors, and the genotype of tumor epidermis growth factor receptor (EGFR) can explain the high mortality and risk of depression in patients with lung cancer from a certain point of view. Different studies in prospective cohort studies argue that depression is an important predictor of survival in patients with lung cancer and need to be further studied. In the aspect of intervention research, although some studies have confirmed the potential of antidepressants in anti-tumor oxidative therapy, there is no enough evidence in psychological intervention and drug intervention to prove their effectiveness in improving the survival outcome of lung cancer. In the future, it is necessary to further explore the possible mechanisms for antidepressants and psychological intervention to improve the survival time of the patients.

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Objective To study the characteristics of colorectal cancer patients in Yunnan Tumor Hospital, and to provide the basis for the prevention and treatment of colorectal cancer. Methods Retrospective analysis was used to review colorectal cancer patients who were diagnosed first and received the main treatment in Yunnan Cancer Hospital from March 2005 to December 2014.According to the sampling principle ,there were 100 cases each year , with a total of 1000 cases. The clinical and pathological data were analyzed, including age, gender, pathogenesis, pathological type, and TNM stage. Results The average age of the 1000 patients enrolled in the survey was (63.4±12.8) years old, the male and female age group (60-69) accounted for the highest proportion.both men and women aged between 60 and 69 had a high occurance rate, and male patients were more than the female with a fraction of 1.42:1. Rectum is the most common primary site, accounting for 57%, followed by ascending colon, sigmoid colon, straight B junction, transverse colon, descending colon, and cecum. Adenocarcinoma was the main pathological type, accounting for 89.4%.Stage Ⅲ was the most common in TNM staging, accounting for 35.9%, followed by stage Ⅱ, Ⅰ, and stage Ⅳ. Most rectal cancers were found at stage Ⅲ, and colon cancer at stage Ⅱ . Conclusion The proportion of colorectal cancer in the age group (60-69 years) was the highest; the proportion of middle-aged and male was significant.The high incidence of colorectal cancer was 60～69 years old, especially males.The main part of colorectal cancer was located in the rectum.Adenocarcinoma was the most common pathological type. Most patients were later stage when diagnosed.

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BACKGROUND: Due to lack of companionship of parents, compared with non left behind children, left behind children (LBC) suffer from more psychological problems compared with children live with their parents. The aim of this study was to explore the mental health status and the relationship among psychological problems and the related factors of LBC. METHOD: Adopting delaminating-random-group sampling and using region, county, village (town) as sampling framework, we utilized Demographic Data Recording Form, Adolescent Self-Rating Life Events Check List, Scale of APGAR, Perceived Social Support Scale, Simplified Coping Style Questionnaire, Eysenck Personality Questionnaire, Self-Esteem Scale and Scale of Mental Health for Chinese Middle-school Student to assess 1309 left behind child in junior middle school students' mental health in Hunan. Statistic description, Structural equation model was adopted to analyze the data. RESULT: There was a significant difference in score of psychological problems between LBC and non-LBC(F = 18.224, P<0.000). Life event was the major factor(r = .487) that affected psychological problems (path coefficient, PC = 0.08) directly and affect psychological problems indirectly through affecting passive coping (PC = 0.01)and family functioning(PC = 0.02); family functioning impacted psychological problems indirectly through affecting social support (PC = 4.89) and self-esteem (PC = 0.10); social support (PC = -0.02), passive coping (PC =0.07) and active coping PC = -0.04) affected psychological problems directly. Psychoticism (P) (PC = 0.11), Neuroticism (N) influenced psychological problems of LBC both directly (PC = 0.04) and indirectly through affecting self-esteem (PC: P:-1.87; N: -0.83), while Extraversion/Introversion (E) (PC = 0.21) only impact psychological problems indirectly through self-esteem. Altogether, these variables accounted for 50.2% of total variance of psychological problems (F = 130.470, P = 0.000) for LBC. CONCLUSION: In this research we proved that LBC have more sever psychological problems than non-LBC. We also identified the direct and indirect influential factors of psychological problems of LBC. The findings had important implications for prevention policies and interventions to promote mental health of LBC.

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In the present study, we use the state of art density functional theory (DFT) techniques to calculate the structural, optoelectronic and nonlinear optical (NLO) properties for two novel chalcone derivatives. The geometrical structures of chalcone derivatives compound 1 and 2 are optimized using periodic boundary conditions (PBC) in solid-state phase as well as isolated single molecular geometry in the gas phase. The reasonable agreement is found among experimental, solid-state and gas phase single molecular geometries, which provide us, further confidence to explore the potential of above-entitled derivatives as good functional materials for electro-optical applications. For instance, the frequency dependent real parts of dielectric functions are calculated for compound 1 and 2. The maximum value of real part of the dielectric function for compound 1 and 2 at 0eV are computed as 4.35 and 6.68 for the polarization vectors of (001) directions, respectively, which reveals the fact that the compound 1 and 2 might be good charge transport materials. The reflectivities of the compound 1 and 2 are 0.64 and 0.45 revealing that the compound 2 might be more efficient material for organic photovoltaic (OPV) applications. The results of the refractive index improved by doping the strong electron withdrawing groups (EWGs) shows that the compound 2 might be good refractor of the photon as compared to compound 1. The calculated values for static second-order polarizability are 3498 and 10464 a. u. and for frequency dependent second harmonic generations are 2557 and 6429 a. u. for compound 1 and 2, respectively, which indicates their significant potential for possible nonlinear optical applications.

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Objective To evaluate the reliability and validity of three-district and four-level triage standards in adult emergency department.Methods A randomized sampling cross-sectional study was conducted. A total of 1106 emergency adult patients admitted to the Second Xiangya Hospital of Central South University in Hunan Province from December 2015 to April 2016 were enrolled. The triage was independently performed by 12 nurses according to the emergency triage criteria. Based on the shift style, 2 nurses were assigned to each shift as the triage guider and assistant respectively, who did the triage for every patient independently. The clinical data were recorded as follows: the demographic data, emergency information (triage time, emergency way, complaints, vital signs, and conscious state), triage information (triage level, admitted department), waiting time, treatment time, destination and outcomes. The reliability of three-district and four-level triage standards was analyzed by Spearman correlation, and the receiver operating characteristic curve (ROC) was plotted to evaluate its validity.Results ① A total of 254 patients were enrolled for reliability evaluation in the first 2 weeks of the study. The overall internal consistency rate ofthe triage instructors and the triage assistants was 72%, the total Kappa value was 0.686 [95% confidence interval (95%CI) = 0.608-0.757,P < 0.001]. ② Validity analysis showed that in the 1125 emergency patients collected during the study, a total of 1106 patients were finally enrolled in the analysis excluding the patients who refused to accept the treatment, whose data was incomplete and who was diagnosed as prehospital death. With the increase of three-district and four-level triage level, a significant increase was showed in the waiting time of patients, the treatment time, and the retention rate; on the contrary, the salvage rate, the hospitalization rate, hospitalization time, emergency mortality, in-hospital mortality and total mortality rate were decreased [the waiting time of patients from triage level 1 to 4 (minutes) was 1.00 (1.00, 1.75), 1.00 (1.00, 5.00), 8.00 (2.00, 23.00), 10.00 (4.50, 28.00), the treatment received time (minutes) was 1.00 (1.00, 10.00), 6.00 (1.00, 23.00), 48.00 (25.00, 105.00), 87.00 (41.00, 140.00), the retention rate was 4.76%, 10.94%, 55.91%, 42.86%, the salvage rate was 95.24%, 87.94%, 20.81%, 0%, the hospitalization rate was 57.14%, 70.98%, 53.62%, 20.41%, the hospitalization time (days) was 19.50 (9.75, 28.00), 11.00 (8.00, 17.00), 12.00 (8.25, 17.00), 10.50 (8.75, 15.25), the emergency mortality was 19.05%, 6.92%, 1.41%, 0%, the in-hospital mortality was 16.67%, 15.09%, 6.25%, 0%, and the total mortality rate was 28.57%, 17.63%, 4.76%, 0%, allP < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of three-district and four-level triage standards for identifying patients needed an immediate intervention (triage level 1 to 2) was 0.854 (95%CI = 0.831-0.878), and the sensitivity and specificity were 78.62% and 89.89%, respectively, the misdiagnosis rate was 10.11%, and the missed diagnosis rate was 21.38%.Conclusion The three-district and four-level triage standards were proved to be a reliable and valid instrument, which can distinguish the severity of the disease and help nurses to triage patients correctly.

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Objective To investigate the risk factors of bloodstream infections caused by multiple drug resistant Acinetobacter baumannii (MDRAB) and those associated with 30-day clinical outcomes of MDRAB patients. Methods A case-control study was designed to retrospectively analyze 49 cases of MDRAB-related bloodstream infections treated in our hospital during the period from January 2013 to December 2014. Additional 29 cases of non-MDRAB bloodstream infections were included as control group. Univariate and multivariate logistic analysis were used to identify the risk factors of MDRAB bloodstream infections. The prognostic factors were analyzed similarly for all the 78 cases of bloodstream infections by comparing the relevant factors between survival group (38 cases) and non-survival group (40 cases) based on the survival status 30 days after collecting blood samples. Results Univariate analysis revealed that the risk factors for MDRAB bloodstream infection included use of carbapenems, quinolones, or at least 2 antibiotics, mechanical ventilation, nasogastric tube, indwelled central venous catheter, and ICU stay prior to infection. Subsequent multivariate logistic analysis showed that ICU stay (OR=7.118) and prior use of at least 2 antibiotics (OR=8.073) were independent risk factors for MDRAB bloodstream infection. Univariate analysis revealed that ICU stay, mechanical ventilation,and MDRAB in blood sample were the prognostic factors of 30-day survival. Multiple logistic regression analysis showed that MDRAB infection (OR=5.837) and mechanical ventilation (OR=4.926) were the independent risk factors predicting of 30-day patient death. Conclusions ICU stay and prior use of at least 2 antibiotics were independent risk factors for MDRAB bloodstream infection. MDRAB infection and mechanical ventilation were the independent risk factors predicting 30-day patient death in MDRAB bloodstream infections.

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Objective:To investigate the relationship between social support and depression of only-child-lost (OCL) people,and the mediation role of self-efficacy in this relationship.Methods:By stratified cluster sampling,214 OCL people were enrolled,with 80 males and 134 females,ages from 49 to 83 years old.They were assessed by General Self-Efficacy Scale,Social Support Rating Scale,and Self-rating Depression Scale.Results:Univariate analysis showed that there were significant differences in age groups (t=2.85,P＜0.05),with or without spouse (t=5.62,P＜0.05),family location (t=3.95,P＜0.05),per capita monthly income (F=3.48,P＜0.05) among the social support scores.There was significant difference between the per capita monthly income and self-efficacy scores in QCL people (F=5.46,P＜0.05).Correlation analysis showed self-efficacy and social support were positively correlated (r=0.26,P＜0.01).Self-efficacy (r=-0.59,P＜0.01) and social support (r=-0.59,P＜0.01) negatively correlated with depression in OCL people.Self-efficacy partially mediated the relationship between social support and depression.Conclusion:The person who is ＜60 years old,with spouse and the high per capita monthly income,and lives the rural area,would have high social support levels among QCL people.The person who has high per capita monthly income would have high self-efficacy.Self-efficacy is one of the direct prediction for depression,and plays an indirect role between social support and depression.Intervention of depression among OCL people could be applied to change their cognition,and to enhance their self-efficacy.

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Objective To understand the adverse reaction profile of linezolid during clinical treatment,especially lactic acidosis and pancytopenia.Methods One case of linezolid-induced lactic acidosis and pancytopenia was described in a patient receiving long-term treatment in our hospital.Similar cases were searched and identified from literatures reports both in China and abroad from 2000 to 2015 for further review.The data were analyzed in terms of patient age,sex,underlying conditions,as well as onset time,clinical characteristics,and outcomes of the adverse reaction.Results A total of 50 similar cases (male/female ratio:1.78∶1) were analyzed,42.0％ of which were old patients (at least 65 years old).Liver and/or renal insufficiency was found in 20 cases (40.0％).The onset of lactic acidosis was at 5.5 weeks after initiation of linezolid on average,and the onset of pancytopenia was at 3.5 weeks after initiation of linezolid.Conclusions Linezolid-induced lactic acidosis or pancytopenia is more frequently found in the elderly patients with hepatic dysfunction and long-term treatment.