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2023 Vol. 53, No. 2 Published: 2023-02-25   87 Correlation between cognitive changes and brain white matter network in children with obstructive sleep apnea CHEN Fangfang, FU Yuchuan, LU Yi, YU Chenyi, WANG Yu, CHEN Tao, YAN Zhihan, LYU Su DOI: 10.3969/j.issn.2095-9400.2023.02.001 Objective: To investigate the cognitive function and brain white matter network alterations in children with obstructive sleep apnea (OSA) and the correlation between them. Methods: From February 2018 to November 2020, a total of 29 age - and sex-matched OSA children and 21 healthy controls aged 7-13 years were collected at the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University for high-resolution 3D T1WI and DTI scanning. Global attributes (assortativity) and nodal attributes (clustering coefficient, degree centrality, local efficiency) of the white matter network and DN: CAS scale scores were calculated for each participant, compared between groups, and correlations between white matter network attributes and cognitive scores were analyzed using hierarchical linear regression. Results: Without FDR correction, the degree centrality of the right supplementary motor area, the right heschl gyrus and the clustering coefficients of the left postcentral gyrus and the right heschl gyrus, as well as the local efficiency of the left anterior cingulate and paracingulate gyri and the right heschl gyrus increased in the OSA group compared with healthy controls; the degree centrality of the left orbital part of middle frontal gyrus, the left lingual gyrus and the left middle temporal gyrus, the clustering coefficients of the right middle temporal gyrus and the local efficiency of the right middle temporal gyrus decreased in the OSA group compared with healthy controls. Degree centrality in the left middle temporal gyrus was positively correlated with word series in DN: CAS (β=0.421, P=0.015),clustering coefficient in the right middle temporal gyrus (β=0.507, P=0.023) and local efficiency (β=0.504,P=0.010) with simultaneous processing scale scores. Conclusion: The white matter network in children with OSA has a tendency to change, in which the nodal properties of the middle temporal gyrus are associated with cognition, suggesting that abnormalities in the brain white matter network, especially alterations in the structure of the middle temporal gyrus, may be the neural basis of cognitive impairment in children with OSA. 2023 Vol. 53 (2): 87-92 [Abstract] ( 324 ) HTML (1 KB)  PDF (1418 KB)  ( 587 ) 93 Diagnosis of significant liver fibrosis: An evaluation of the combined model of extracting liver-spleen radiomics features with MRI and clinical risk factors LI Jiajia, WANG Zhaohong, NI Zhonglin, CHEN Hui,ZHOU Bin, TONG Hongfei. DOI: 10.3969/j.issn.2095-9400.2023.02.002 Objective: To investigate the effect of combining liver-spleen radiomics features based on multimodality abdominal MRI with clinical risk factors in the diagnosis of significant liver fibrosis. Methods:A total of 110 patients who underwent liver biopsy or surgical pathological examination and received standard abdominal MRI within 6 months of pathological examination were collected from the Second Affiliated Hospital of Wenzhou Medical University from May 2017 to May 2022. All patients were randomly divided into training set and testing set by 7:3. According to the METAVIR scoring system, grade F2 and above was defined as significant liver fibrosis, and grade below F2 as no or non-significant liver fibrosis. The liver and spleen features were marked respectively, and the radiomics features were extracted respectively. After feature screening, SVM machine learning radiomics models of the liver and liver -spleen combined features were constructed to calculate the radiomics score of each patient (Rad-Score). Logistic regression was used to analyze the clinical influence factors for significant liver fibrosis. Finally, Logistic regression was used to construct a joint model based on clinical influence factors and Rad-score, and to draw a nomogram. The performance of the model was evaluated by using the receiver operating characteristic (ROC) curve and the decision curve analysis (DCA). Results: After screening, 22 and 36 radiomics features were involved in the construction of liver and liver-spleen radiomics model respectively. In the multifactorial regression analysis, results showed that gender (female) (OR=0.126,95%CI=0.040-0.354, P<0.001), age (OR=0.985, 95%CI=0.066-0.999, P=0.011), hepatitis B infection (OR=5.139,95%CI=1.898-15.137, P=0.002), and APRI index≥1 (OR=3.793, 95 %CI=1.231-14.5, P=0.033) were independent clinical influence factors, which were included in the construction of the clinical predictive models. In the Logistic regression model, the area under the ROC curve (AUC) of the liver features and liver-spleen combined feature radiomics model were 0.828 and 0.917, respectively, indicating that the diagnostic efficiency of the liver-spleen combined feature radiomics model was better. The radiomics model was combined with the clinical predictive model to establish a combined predictive model, of which AUC in the training sets and in the testing sets was 0.948 and 0.963 respectively. DCA showed that the clinical applicability of the combined predictive model was optimal.Conclusion: The combined feature radiomics model based on multimodality abdominal MRI has better diagnostic efficacy than the single liver features. And the combined predictive model has better diagnostic efficacy than the clinical predictive model. 2023 Vol. 53 (2): 93-101 [Abstract] ( 329 ) HTML (1 KB)  PDF (1814 KB)  ( 502 ) 102 The mechanism of Cu-ATSM in protecting human umbilical vein endothelial cells from oxygen-glucose deprivation and reperfusion injury MENG Weiyang, WU Fangfang, JIN Can, CHEN Daqing. DOI: 10.3969/j.issn.2095-9400.2023.02.003 Objective: To investigate the effect of copper-diacetyl-2 (N4-methylthiosemicarourea) (Cu-ATSM) on human umbilical vein endothelial cells (HUVECs) apoptosis and its underlying mechanisms after oxygen-glucose deprivation/reperfusion (OGD/R). Methods: HUVECs were divided as the control, OGD/R and OGD/R+Cu-ATSM groups. Flow cytometry was used to detect the effect of Cu-ATSM on OGD/R induced cell apoptosis. Mito-tracker staining was used to detect the effect of Cu-ATSM on mitochondrial morphology. JC-1 staining was used to detect the change of mitochondrial membrane potential. Western blot was used to detect the expression of autophagy related proteins such as ATG5, Beclin1 and LC3I/II. Immunofluorescenc was used to detect the expression of LC3II. Results: Flow cytometry results showed that the number of HUVECs apoptosis was significantly increased in OGD/R group, compared with the control group. However, after Cu-ATSM treatment the apoptosis cells were significantly decreased (P<0.05), indicating that Cu-ATSM treatment inhibited the HUVECs cell apoptosis after OGD/R. Mito-tracker and JC-1 staining results suggested that mitochondrial morphology and function were significantly damaged and membrane potential decreased in the OGD/R group,compared with the control group. However, the Cu-ATSM treatment ameliorated mitochondrial function and maintained mitochondrial morphology and mitochondrial membrane potential. Western blot results suggested that compared with the control group, the expression of autophagy related protein such as ATG5, Beclin1 and LC3II increased in OGD/R group, while the expression of autophagy related proteins decreased after Cu-ATSM treatment (P<0.05). Immunofluorescence results showed that compared with the control group, the number of LC3II was significantly increased after OGD/R injury, while the number of LC3II was significantly decreased after Cu-ATSM treatment. Conclusion: Cu-ATSM improves mitochondrial function and inhibits apotosis on HUVECs after OGD/R, which may be achieved by inhibiting autophagy. 2023 Vol. 53 (2): 102-108 [Abstract] ( 353 ) HTML (1 KB)  PDF (2306 KB)  ( 688 ) 109 The inhibitory mechanism of a novel small molecular compound cyy-287 combined with CDK inhibitor roscovitine in SBC-2 cell growth ZHENG Shuwen, HUANG Huijing, CHEN Guo, MA Haoqun, QIAN Jianchang, ZHANG Qianwen. DOI: 10.3969/j.issn.2095-9400.2023.02.004 Objective: To explore the inhibitory effect of a new small molecule compound cyy-287,combined with cyclin dependent kinase (CDK) inhibitor roscovitine on the small cell lung cancer cell line SBC-2 and its mechanism. Methods: SBC-2 cells in logarithmic growth period were taken. The IC50 values of cyy-287 and the combination index (CI) of cyy-287 and roscovitine were detected by MTS. Experimental groups of cyy-287 in combination with roscovitine for antitumor activity studies were as follows: DMSO (control) group;roscovitine (20 μmol/L) group; cyy-287 (1.5 μmol/L) group and cyy-287+roscovitine group. The proliferation of tumor cells after drug treatment in each group was detected by clone formation experiment. The distribution of cell cycle and the proportion of apoptosis were measured by flow cytometry. The protein expression level of CLPARP and the phosphorylation level of AKT in each treatment group were detected by Western blot. Results:The IC50 of cyy-287 in SBC-2 was (1.77±0.10)μmol/L. The CI of cyy-287 and roscovitine was less than 1, which means that cyy-287 combined with rescovitine has synergistic effect on SBC-2 cells. Compared with cyy-287 alone treatment group, a combination of the two drugs could significantly inhibit the growth and clonogenesis of SBC-2 cells (P<0.001), and the proportion of apoptotic cells increased significantly (P<0.001). The protein expression level of apoptosis related CL-PARP increased significantly, and the expression level of P-AKT decreased (P<0.05). Conclusion: The combination of cyy-287 and roscovitine has a synergistic antitumor effect,which can effectively inhibit the growth of SBC-2 cells and induced their apoptosis. Its underlying mechanism is mainly suppressing the cell survival by inhibiting the phosphorylation of AKT. 2023 Vol. 53 (2): 109-114 [Abstract] ( 362 ) HTML (1 KB)  PDF (1799 KB)  ( 596 ) 115 Efficacy and safety of argatroban or low molecular weight heparin plus aspirin in early progressive ischemic stroke MIN Jingjing, CHEN Qi, PAN Mengxiong, LIU Tan, SUN Ru DOI: 10.3969/j.issn.2095-9400.2023.02.005 Objective: To observe and compare the efficacy and safety of aspirin combined with argatroban or low molecular weight heparin (LMWH) in the progressive ischemic stroke (PIS). Methods: 95 patients with PIS who met the criteria were randomly divided into two groups, 48 cases in the argatroban plus aspirin group (AA group) and 47 cases in the LMWH plus aspirin group (LA group). The National Institutes of Health Stroke Scale (NIHSS) score, the Activities of Daily Living (Barthel) index, and the modified Rankin Scale (mRS) score were compared between the two groups before and after treatment. At the same time, the hemoglobin (Hb) concentration, platelet (PLT) count, activated partial prothrombin time (APTT), high-sensitivity C-reactive protein (hs-CRP) concentration, and the occurrence of adverse drug reactions were monitored. Results: After 7 days of treatment, both groups had certain efficacy compared with those before treatment. The total effective rate of AA group was significantly higher than that of LA group (P<0.05). After treatment, the NIHSS score in the AA group was significantly lower than that in the LA group (P<0.05), and the Barthel index was significantly increased than the LA group (P<0.01). The mRS score in the AA group was significantly reduced than that in the LA group after 3 months of treatment (P<0.01). Moreover, compared with the mRS0-1 score at 3 months of treatment, argatroban was superior to the LMWH (P<0.05). Meanwhile, the APTT in the AA group was longer than that in the LA group after treatment (P<0.01) and the PLT in the LA group was reduced than AA group (P<0.01). There was no significant difference in Hb between the two groups after treatment (P>0.05). The adverse reactions of AA group and LA group were 4.17% and 8.51%, respectively, with no significant statistical difference (P>0.05).Conclusion: For patients with PIS, aspirin plus argatroban or LMWH both can improve the clinical symptoms and the risk of bleeding is low. In comparison, argatroban can better promote the recovery of neurological deficits and improve the ability of daily living, without increasing the adverse reactions of drugs. 2023 Vol. 53 (2): 115-120 [Abstract] ( 260 ) HTML (1 KB)  PDF (1343 KB)  ( 506 ) 121 Effect of postoperative hope level and social support on the outpatient follow-up compliance in patients with colorectal cancer LIN Xiaojing, ZHOU Xiaocong, HUANG Weihong, YE Hui, JIAN Jingwen DOI: 10.3969/j.issn.2095-9400.2023.02.006 Objective: To explore the effect of postoperative hope level and social support on the outpatient follow-up compliance in patients with colorectal cancer (CRC). Methods: A total of 187 eligible CRC patients from Wenzhou Central Hospital between January 2019 and April 2021 were selected as subjects. The postoperative hope level was assessed by the Chinese version of Herth hope index, while the social support level was assessed by the Chinese version of Social science research solutions. Routine follow-up time after operation was determined based on the Chinese guidelines for the diagnosis and treatment of colorectal cancer. Participants were contacted by phone or WeChat two weeks after the specified follow-up date to determine whether the patients were followed up on time, and the compliance rate of on-time follow-up was calculated. Results: The total score of Herth Hope Index for CRC patients was 29.6±5.1, and the total score of social support was 39.5±7.6. 42 (22.5%). The rate of on-time follow-up was 100%, with the median (interquartile range) compliance rate of 62.5% (33.3%, 72.7%) in all CRC patients. Multiple Logistic regression analysis showed independent risk factors for poor outpatient follow-up compliance (P<0.05) included lower education, lower monthly family income, traveling to the hospital without car, no ostomy, lower level of hope and lower level of social support. Conclusion:The postoperative outpatient follow-up compliance of CRC patients is poor and is affected by the level of hope and social support, which is of significance to develop targeted intervention strategies for patients with poor outpatient follow-up compliance. 2023 Vol. 53 (2): 121-126 [Abstract] ( 326 ) HTML (1 KB)  PDF (1298 KB)  ( 503 ) 127 The expression of long noncoding RNA lnc-CCDC33-1:1 in papillary thyroid carcinoma and its clinical significance LI Pengping, LAN Xiabin, HUANG Yuqing DOI: 10.3969/j.issn.2095-9400.2023.02.007 Objective: To evaluate the expression of lnc-CCDC33-1:1 in papillary thyroid carcinoma (PTC) and its clinical significance. Methods: A total of 120 patients with PTC admitted to the First People’s Hospital of Xiaoshan District, Hangzhou from November 2021 to March 2022 were selected. The expression levels of lnc-CCDC33-1:1 were detected in 120 PTC and 30 adjacent noncancerous thyroid tissues by quantitative realtime polymerase chain reaction. The relationships between the expression of lnc-CCDC33-1:1 in PTC and the clinicopathologic factors were analyzed both in our cohort and TCGA cohort. Receiver operating characteristic (ROC) curves were generated to assess the diagnostic value of lnc-CCDC33-1:1 as a biomarker for PTC. Results: The expression of lnc-CCDC33-1:1 was significantly upregulated in PTC tissues compared with adjacent noncancerous tissues (P<0.001). The ROC curves revealed that lnc-CCDC33-1:1 had a potential diagnostic value in predicting malignancy. The area under curves was 0.803 (95%CI=0.736-0.869, P<0.001). The local cohort showed that the expression of lnc-CCDC33-1:1 was correlated with PTC tumor size (P=0.048), extraglandular invasion (P=0.019), T stage (P=0.011), and lymph node metastasis (P=0.009). TCGA group data showed that the expression level of lnc-CCDC33-1:1 was correlated with PTC extraglandular invasion (P=0.036), and lymph node metastasis (P<0.001). Conclusion: The abnormally upregulated expression of lnc-CCDC33-1:1 in PTC is correlated with high-risk characteristics of PTC. Therefore, it may serve as a potential diagnostic biomarker or lnctreatment target for PTC. 2023 Vol. 53 (2): 127-131 [Abstract] ( 263 ) HTML (1 KB)  PDF (1345 KB)  ( 574 ) 132 Application of pleural effusion wax block in the diagnosis of lung adenocarcinoma and detection of EGFR/ALK/ROS1 gene mutation LIN Rixu, LI Yida, LIN Yi, WANG Fang, JIANG Lei, LI Jianmin DOI: 10.3969/j.issn.2095-9400.2023.02.008 Objective: To explore the application value of pleural effusion cell block in the pathological diagnosis of lung adenocarcinoma and the detection of EGFR/ALK/ROS1 gene mutation. Methods: We selected pleural effusion cell blocks from 41 patients diagnosed with lung adenocarcinoma in the First Affiliated Hospital of Wenzhou Medical University from January 2017 to December 2021. The conventional cell smears and cell blocks were used for pathological HE staining, and NGS and ARMS methods were used for EGFR/ALK/ROS1 gene mutation detection, respectively. Results: The sensitivity of conventional smear was 90.2% and the false negative rate was 9.8%. The diagnostic sensitivity of pleural fluid cell blocks was 100%, and the false negative rate was 0. In the cell smears of malignant pleural effusion (MPE), the overall mutation rate of EGFR/ALK/ROS1 was 70.7% (29/41) and the EGFR mutation rate was 61.0% (25/41); ALK fusion gene detection rate was 7.3% (3/41); ROS1 fusion gene detection rate was 14.6% (6/41). In the cell blocks of MPE, the overall mutation rate of EGFR/ALK/ROS1 was 73.2% (30/41); the EGFR mutation rate was 68.3% (28/41); the ALK fusion gene detection rate was 2.4% (1/41); the ROS1 fusion gene detection rate was 4.9% (2/41). In addition, EGFR/ALK/ROS1 mutation-positive patients tested by both methods had increased overall survival rate, progression-free survival rate and disease control rate, compared with those without mutations. Conclusion: Compared with pleural effusion cell smear, pleural effusion cell block method has a higher positive detection rate, which can be used to guide pathological diagnosis and molecular/genetic testing for targeted therapy. 2023 Vol. 53 (2): 132-136,141 [Abstract] ( 493 ) HTML (1 KB)  PDF (1575 KB)  ( 746 ) 137 The role of machine learning in dose verification of intensity modulated radiotherapy planning YAN Huawei, ZHANG Ji, LIN Zhixi, JIN Xiance, HAN Ce. DOI: 10.3969/j.issn.2095-9400.2023.02.009 Objective: To explore the role of machine learning in dose verification of intensity modulated radiotherapy planning. Methods: A total of 141 patients who received double-arc volumetric modulated arc therapy (VMAT) treatment in the First Affiliated Hospital of Wenzhou Medical University from March 2019 to August 2020 were enrolled, extracting 13 complexity parameters of intensity modulation plan, and gamma pass rate (GPR) under different conditions were collected. The data was randomly divided into the training set and the test set at a ratio of 7:3. The Pearson correlation analysis and LASSO were used to screen parameters. The models based on the machine learning method of SVM were used to predict values and classification of GPR, respectively. The root mean square error (RMSE) and mean square error (MAE) were used to evaluate the accuracy of model numerical prediction and the AUC to evaluate the accuracy of model classification. Result: In the numerical prediction of GPR, under the respective condition of 3% mm, 3% mm and 2% mm, the RMSE in the test set was 2.22, 3.51, 4.59, and MAE 1.56, 2.68, 3.67 accordingly. In the GPR classification prediction, under the respective condition of 3%/3 mm, 3%/2 mm, and 2%/2 mm, the AUC result of the test set was 0.79, 0.78, 0.77 accordingly. Conclusion: The dose verification of IMRT/VMAT plan based on machine learning is of clinical application value, which provides a new perspective for quality assurance. 2023 Vol. 53 (2): 137-141 [Abstract] ( 385 ) HTML (1 KB)  PDF (1359 KB)  ( 780 ) 142 A clinical evaluation of swallowing dynamic characteristics in the pharyngeal phase of patients with dysphagia after stroke based on digital B/M ultrasound FAN Liubo, HAN Wensheng, SHEN Jiawen,ZHANG Luding, LUO Mimi DOI: 10.3969/j.issn.2095-9400.2023.02.010 Objective: To observe the geniohyoid muscle activity parameters and hyoid activity parameters in patients with dysphagia after stroke by real-time B/M ultrasound, and to explore its clinical value and application in the evaluation of dysphagia after stroke. Methods: Totally 30 patients with dysphagia after stroke in Taizhou Hospital of Zhejiang Province from January 2021 to December 2021 were selected as the observation group, and another 30 healthy subjects as the control group. Pharyngeal dysphagia was detected by pharyngography (VFSS) in all patients in the observation group. Pharynx ultrasonography was performed by the same ultrasound doctor in both groups. When all subjects swallowed 5 mL dilute fluid, the maximum distance, minimum distance and required time between hyoid and mandible were measured or calculated, hyoid mobility, distance shortening rate, geniohyoid muscle activity, activity time and activity speed were calculated, and the differences between the two groups were compared. Results: The observation group had lower activity range and speed of geniohyoid muscle, and longer activity time than the control group, with statistical difference (P<0.05). The range of motion,velocity and shortening rate of distance from mandible to hyoid in patients with dysphagia after stroke were lower than those in the control group, and the activity time was longer than that in the control group (P<0.05).Conclusion: B/M mode ultrasound can quantitatively detect the dynamic parameters of hyoid and geniohyoid muscles, which is helpful to accurately analyze the degree of dysphagia in patients with dysphagia after stroke and provide quantitative indexes for clinical rehabilitation evaluation and treatment. 2023 Vol. 53 (2): 142-145,151 [Abstract] ( 260 ) HTML (1 KB)  PDF (1381 KB)  ( 564 ) 146 A 6-year follow-up of the family with resistance to thyroid hormone syndrome carrying the THR β gene c.728G>A mutation GUO Manli, QIU Yali, LI Jing, MA Shaogang DOI: 10.3969/j.issn.2095-9400.2023.02.011 Objective: To detect clinical features and gene mutation in the family with resistance to thyroid hormone syndrome (RTH) and to conduct a six-year follow-up. Methods: The proband and her five family members were enrolled in this study for thyroid function, thyroid ultrasound and ECT examination. The THR β gene was considered for mutation screening. Genomic DNA was extracted from peripheral blood leukocytes.Direct sequencing was performed to screen for the mutation in the exon fragments in the proband and her family members. The proband and mutation carrier were followed up regularly. Results: Of the five family members,only her father showed elevated levels of thyroid hormone and TSH, which was consistent with RTH. Both the proband and her father had no signs of hypothyroidism, hyperthyroidism or goiter. However, the father showed a hypoechoic nodule in the left lobe without other malignant signs. Molecular analysis revealed a missense mutation c.728G>A (p.Arg243Gln, p.R243Q) in the exon 7 of THR β gene in two patients with RTH. During the six-year follow up, the proband and her father had no signs of hyperthyroidism or hypothyroidism and therefore were not treated with any drugs. The father showed no significant increase in thyroid nodule volume or any other malignant signs. Conclusion: The heterozyous mutation c.728G>A in the THR β gene was identified in the family with RTH, which requires long-term follow-up. 2023 Vol. 53 (2): 146-151 [Abstract] ( 281 ) HTML (1 KB)  PDF (1480 KB)  ( 506 ) 161 A comparative study of occupation satisfaction and career development between pediatric practitioners and non-pediatric practitioners: a survey of pediatric graduates LIN Wenshi, SHI Hongying, RUAN Jichen DOI: 10.3969/j.issn.2095-9400.2023.02.015 Objective: To understand the pediatric graduates’ occupation identity, satisfaction and career development in pediatrics, so as to provide reference for the training and development of pediatricians. Methods: A total of 210 pediatric major (orientation) graduates from Year 2011, Wenzhou Medical University, aged 35 and below were selected as subjects. A self-designed questionnaire was carried out to compare the difference between pediatric practitioners and non- pediatric (other clinical departments) practitioners in terms of occupation satisfaction and career development. Results: The pediatric employment rate of male pediatric graduates (49.52%) was lower than that of female (53.80%). From 2007 to 2014, the later the graduation year was, the lower the proportion of choosing pediatric occupation. Pediatric practitioners had lower occupation satisfaction rate (66.36%) than nonpediatric practitioners (85.84%), and gender, hospital level and working city level had no effect on the difference of satisfaction rate between the two groups (all Pinteractions>0.05). Pediatric practitioners had lower rate of overseas study (1.92%) than non-pediatric practitioners (13.20%). Among pediatric graduates who had worked for 8 years or more, the rate of intermediate and above professional titles of pediatric practitioners (54.28%) was lower than that of non pediatric practitioners (84.38%), and the hospital level and educational background had no effect on the difference between the two groups (all Pinteractions>0.05). Conclusion: The pediatric occupation identity of young pediatric graduates under 35 years old is unstable. The pediatric practitioners’ occupation satisfaction is relatively low and their career development is relatively slow. 2023 Vol. 53 (2): 161-165,封三 [Abstract] ( 273 ) HTML (1 KB)  PDF (1307 KB)  ( 513 ) 166 Mental health status and related influencing factors of front-line medical staff in Wenzhou during regular epidemic prevention and control SONG Yuya, LAI Xinyi, LIN Jie DOI: 10.3969/j.issn.2095-9400.2023.02.016 Objective: To investigate medical staff’s mental health status and its influencing factors during regular epidemic prevention and control so as to provide sufficient evidence for timely and effective psychological prevention and intervention. Methods: From March to April 2022, 581 front-line medical staff in Wenzhou were included in this study by convenience sampling method. They completed the general information questionnaire,Occupational Stress Scale, Social Support Scale, Self -Assessment Work-Family Conflict Item, Depression Anxiety Stress Scale-21 Short Version and Insomnia Severity Index through online questionnaire survey platform. A total of 558 valid questionnaires were collected. The general information questionnaire, DASS-21 Scale and ISI Scale were used to evaluate the mental health status of front-line medical staff and demographic variables were compared among them. Besides, stepwise regression analysis was used to explore the potential influencing factors of mental health. Results: Of all the medical staff surveyed, 280 (50.18%) had anxiety, 272 (48.75%) had depression, and 356 (63.80%) had symptoms of insomnia. Women had higher scores of anxiety than men (P<0.05); the scores of anxiety (P<0.01), depression (P<0.05) and insomnia (P<0.01) of nurses, those with a bachelor's degree or below and those with poorer physical conditions were more severe than those with higher education and those with other occupations and better physical health; in addition, the scores of anxiety (P<0.001), depression (P<0.001) and insomnia (P<0.001) of those who worked less than 3 years were lower than those with longer service years.Stepwise regression analysis found that poor physical condition (β=2.72, P<0.01; β=2.50, P<0.05; β=2.54,P<0.01), higher level of occupational stress (β=1.29, P<0.001; β=1.29, P<0.001; β=0.61, P<0.001) and more intense work-family conflict (β=1.04, P<0.001; β=0.89, P<0.01; β=0.66, P<0.01) were risk factors of anxiety,depression and insomnia among front-line medical staff during the normalization of the epidemic, while higher level of social support (β=-0.30, P<0.01; β=-0.51, P<0.001; β=-0.24, P<0.01) was a protective factor of the three; working >3-5 years (β=2.77, P<0.01) and >5-10 years (β=2.16, P<0.05) were risk factors for depression and insomnia, respectively; and nurses were at high risk for anxiety and insomnia (β=-2.34, P<0.01; β=-1.39,P<0.05). Conclusion: It is necessary to pay closer attention to the front-line medical staff’s mental health status during regular epidemic prevention and control. And it is recommended that governments at all levels take the lead in negotiating various departments and giving full play to the positive role of social support by reducing occupational stress of the front-line medical staff, and providing psychological services such as personalized psychological assistance to improve the psychological prevention and intervention system. 2023 Vol. 53 (2): 166-172，封三 [Abstract] ( 350 ) HTML (1 KB)  PDF (1394 KB)  ( 683 )

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