Background:Guilt proneness and shame proneness are interconnected yet distinct personality traits that are gaining attention in addiction research. However, studies examining their differential associations with internet gaming disorder (IGD) and mediation mechanisms explaining these associations remain scarce. Theoretical and empirical evidence suggests that emotional dysregulation could be a potential mediator of the associations between guilt proneness and shame proneness and IGD. Objective:This study aimed to investigate the associations between guilt proneness in cognitive (guilt-negative behavior-evaluations) and behavioral (guilt-repair) domains and shame proneness in cognitive (shame-negative self-evaluations) and behavioral (shame-withdrawal) domains and IGD, as well as related mediation mechanisms via emotional dysregulation. Methods:A multicenter, cross-sectional, anonymous online survey was conducted among medical undergraduate students in seven Chinese cities (Wenzhou, Dali, Nanning, Harbin, Baotou, Qiqihar, and Shantou) from December 2023 to February 2024. In total, 12,912 invitations were sent out, of which 8522 eligible cases were included; the mean response rate was 71.0%. The 9-item DSM-5 IGD Checklist was used to screen for IGD cases; the 16-item Guilt and Shame Proneness Scale was used to assess guilt and shame proneness; the Cognitive Emotional Regulation Questionnaire was used to assess emotional dysregulation. Univariate logistic regression analysis was conducted to examine the associations between background factors and IGD. Structural equation modeling (SEM) was performed to test the mediation mechanism, with the adjustment of background factors. Results:Of all participants, the prevalence of IGD was 7.5%. Background factors of male sex (vs female, OR 2.78, 95% CI 2.36, 3.28) and self-reported poor household financial situation (vs good, odds ratio [OR] 1.96, 95% CI 1.51, 2.55) were significantly associated with a higher risk of IGD; the associations involving study city, year of study, study major, and origin (residency) of students were statistically nonsignificant. SEM showed that shame proneness in both cognitive (β=.29, 95% CI 0.26, 0.33) and behavioral (β=.20, 95% CI 0.18, 0.22) domains and emotional dysregulation of rumination, catastrophizing, and self-blame (β=.36, 95% CI 0.32, 0.40) were positively associated with IGD, while guilt proneness in both cognitive (β=-.08, 95% CI -0.12 to -0.03) and behavioral domains (β=-0.10, 95% CI -0.14 to -0.06) was negatively associated with IGD. Furthermore, emotional dysregulation partially mediated the association between guilt proneness and shame proneness in both domains and IGD (mediation effect size ranged from 22.0% to 45.8%). Conclusions:This study observed relatively high prevalence of IGD among medical undergraduate students in China. Furthermore, the associations between shame and guilt proneness and IGD were differential. Shame proneness and guilt proneness in cognitive and behavioral domains were both directly and indirectly (via emotional dysregulation) associated with IGD, suggesting that future intervention studies may reduce maladaptive shame proneness or shift from shame towards adaptive guilt to reduce the risk of IGD.

The stress-is-enhancing mindset has beneficial effects on physical, psychological, and emotional well-being. However, its association with internet gaming disorder (IGD) had not been investigated. By integrating stress mindset into the cognitive evaluation process of commonly used stress coping theories, this study examined the association between stress mindset and IGD and explored relevant mediation mechanisms via behavioral disengagement. The gender differences in the above associations and mediations were also explored. An online, anonymous, cross-sectional survey was conducted among medical undergraduate students from seven cities (Baotou, Qiqihar, Harbin, Wenzhou, Guangxi, Dali, and Shantou) in China from December 2023 to February 2024. The final sample size was 8,552 (a mean response rate of 71.0

BackgroundThe aging population presents a significant public health challenge, particularly concerning mental health and injury prevention. Anxiety and depression are common among the older adult, affecting their quality of life and increasing the risk of unintentional injuries (UI). This study aims to explore the association between anxiety and depression and UI risk among the older adult in Guangxi, China, using data from the 2023 National Health Service Survey.MethodsA cross-sectional design was employed, analyzing data from 2,894 participants aged 60 and above in Guangxi. The primary variables were anxiety and depression, assessed via validated scales, with UI as the dependent variable. Logistic regression was used to estimate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI), adjusting for potential confounders such as age, gender, socioeconomic status, and lifestyle factors.ResultsSignificant findings indicate that individuals with anxiety and depression had nearly double the risk of UI compared to those without these conditions (adj. OR = 1.92, 95% CI: 1.42–2.6, p < 0.001). Alcohol consumption was also associated with higher UI risk (adj. OR = 1.46, 95% CI: 1.05–2.03, p = 0.023). Females had a significantly higher adjusted odds of UI compared to males (adj. OR = 1.38, 95% CI: 1.03–1.84, p = 0.029), and rural residents were more likely to experience UI than urban dwellers (adj. OR = 1.38, 95% CI: 1.05–1.82, p = 0.02). Exercise frequency was inversely related to UI risk, with those exercising 1–2 times per week having reduced odds (adj. OR = 0.46, 95% CI: 0.22–0.98, p = 0.044). Other factors such as age, marital status, hypertension, diabetes, and main caregiver showed no significant associations with UI.ConclusionAddressing mental health issues and promoting moderate exercise may help reduce UI risk in the older adult. Policies should focus on enhancing mental health services and injury prevention programs, particularly in rural settings, to improve the overall health and safety of the aging population in Guangxi.

BACKGROUND:Functional disability significantly burdens healthcare services, negatively affecting older adults' social interaction and quality of life. This study aims to identify the association between functional disability and mental health, and examine the moderating effects of social participation and physical exercise on the association. METHODS:The data were drawn from 2018 wave of Chinese Longitudinal Healthy Longevity Survey, and ordinary least squares regression model was exploited to explore the association between functional disability and mental health. RESULTS:Activity of daily living (ADL) disability negatively predicted mini-mental state examination (MMSE) score. Furthermore, social participation and physical exercise moderated the association between ADL disability and MMSE score. CONCLUSION:The results highlight the importance of social participation and physical exercise for the older adults with ADL disability.

目的 分析非对称回波最小二乘估算法水脂迭代分离量化序列(IDEAL-IQ)对多发性骨髓瘤骨病(MMBD)的诊断价值.方法 30例MMBD患者(病例组)及30名健康志愿者(对照组)均接受腰椎MR检查,包括矢状位T1WI、T2WI及IDEAL-IQ序列.对比2组间T1WI信号(ST1WI)、T2WI信号(ST2WI)、脂肪分数(FF)、脂肪信号(SFat)及水信号(Swater)差异,采用受试者工作特征曲线分析各MRI参数对MMBD的诊断效能.结果 病例组ST1WI、FF及SFat均低于、ST2WI、Swater 均高于对照组(P 均＜0.01).ST1WI、ST2WI、FF、SFat 及 SWater 诊断 MMBD 曲线下面积分别为0.93、0.84、0.98、0.95及0.83;FF诊断效能优于ST2WI及Swater(P=0.02、0.01).结论 IDEAL-IQ可有效诊断MMBD,尤以定量参数FF的诊断效能更优.

调查卫生事业管理专业的课程体系,以期提供优化策略,更好地满足社会和学生需求.采用专家访谈和问卷调查的方法,收集了广西医科大学 20 位专家和 30 位卫生事业管理在职干部的意见,评估了不同课程模块的重要性,并计算了各课程模块的课时数分布.结果表明,课程设置覆盖自然科学、生物医学、专业基础和专业课程等模块,但课时分布不均,专业课程占比最大(50.4%).卫生事业管理人员对专业课程模块的课程重视程度较高,其中医院管理学得分最高.教育专家倾向于在课程设置中既要重视管理类课程,也要兼顾医学课程学习.生物医学和自然科学的部分课程虽在课时分布上占比少,但在重要性评分上得到了较高的评价.从而得出结论:卫生事业管理专业课程体系设计应考虑实践需求,优化课程设置,强化对被认为重要但课时分布较少的课程的课时分配,以更好地满足学生和行业的需求.

目的:探索PBL、CBL联合可视化技术在留学生医学影像学实习教学中应用的可行性.方法:将2019年在我科实习的64名本科留学生作为研究对象,并平均随机分为对照组和试验组,对照组32人采用LBL教学模式,试验组32人采用PBL、CBL联合可视化技术的综合教学模式.分析两组留学生考试成绩及对教学方法评价的差异性.结果:试验组理论及阅片考核成绩分别为(88.12±5.98)分、(86.31±5.72)分,均高于对照组(P＜0.01).试验组教学方法在激发学习兴趣、增强学习自主性、提高学习效率、加深知识理解、提升阅片能力、培养临床思维以及学生满意度方面明显优于对照组.结论:基于PBL、CBL联合可视化技术的教学模式,可有效提高留学生医学影像学实习教学质量,值得在临床教学中应用.

目的 探讨弥散峰度成像(diffusion kurtosis imaging,DKI)评估前交叉韧带早期退变损伤的临床意义.方法 收集2021年1月～2022年3月期间50例单膝关节DKI成像数据,据关节镜结果分为退变组(n=25)和正常组(n=25),对比两组患者前交叉韧带平均弥散峰度(mean kurtosis,MK)、轴向弥散峰度(axial kurtosis,AK)、径向弥散峰度(radial kurtosis,RK)、平均弥散系数(mean diffusivity,MD)及弥散各向异性分数(fractional anisotropy,FA)的差异性.结果 退变组MK值、AK值、RK值以及FA值均低于正常组(t=8.132、5.313、6.885、9.035,均P＜0.01),而MD值高于正常组(t==-5.145,P＜0.01).ROC 曲线示DKI以上各参数对前交叉韧带早期退变性损伤均具有诊断意义,以MK值最高.当MK=0.884时,其诊断效能最大,敏感性92％,特异性96％,约登指数0.88,曲线下面积为0.979.结论 弥散峰度成像可定量评估前交叉韧带早期退变损伤,为临床评估前交叉韧带生理退变提供参考.

Purpose: The purpose of this study was to investigate the difference between the quantitative MRI values of Wiberg type III and stable patellar cartilage, and to improve the accuracy of MRI quantification in early patellar cartilage damage.Methods: The knee joints of 94 healthy volunteers were scanned by a GE Signa Pioneer 3.0-T synthetic MRI machine. According to the Wiberg classification, the patella was divided into types I-III. Types I-II made up the stable patella group, and type III made up the unstable patella group. Two radiologists independently measured patellar cartilage thickness and quantitative synthetic MRI values (T1, T2, PD) in both groups. Interobserver agreement for quantitative variables was assessed using the Bland-Altman method. A third radiologist assessed differences in measurements.Results: The medial T2 and T1 value of Wiberg III patella did not show a normal distribution (all P > 0.05). Compared with the stable group, the Wiberg type III group had thinner cartilage of the medial surface of the patella (P < 0.05), lower cartilage T2 and PD values (P < 0.05), but a similar cartilage T1 value (P > 0.05). There was no significant difference in the cartilage thickness, T1, T2, or PD value of the lateral patella between the Wiberg type III and the stable group (P > 0.05). Conclusion: There were certain differences in the cartilage thickness of the medial surface of the patella and the quantitative value of synthetic MRI in Wiberg type III patellas. Quantitative studies of patellar cartilage MRI measurements need to consider the influence of patellar morphology.

目的 探讨磁共振子宫输卵管造影评估女性不孕症输卵管通畅度及检查舒适度的临床价值.方法 招募34例女性不孕症患者,同一天随机顺序行磁共振子宫输卵管造影(MR-HSG)及X线子宫输卵管造影(X-HSG),分析两种检查评估输卵管通畅度及发现病变能力、检查舒适度的差异性.结果 31例患者顺利完成两种检查,62支输卵管纳入统计研究.X-HSG与MR-HSG评估输卵管通畅度差异无统计学意义(x2=1.125,P=0.289),发现病变能力差异有统计学意义(Z=-3.446,P=0.001),疼痛NRS评分差异有统计学意义(Z=-3.91,P＜0.001).结论 与X-HSG相比,MR-HSG评估输卵管通畅度一致性好,发现病变能力强,舒适度更高,评估女性不孕症患者器质性病变更有优势.

目的:探讨合成磁共振成像(SyMRI)评估前交叉韧带(ACL)早期退变的临床价值.方法:搜集80例患者的单侧膝关节合成磁共振成像数据.根据关节镜结果将所有患者分为3组:正常组(30例)、早期轻微退变组(28例)和早期明显退变组(22例).采用单因素方差分析比较各组患者A C L的T1值、T2值及质子密度(PD)值的总体差异性,并采用LSD-t检验对各参数进行组间两两比较.采用受试者工作特征(ROC)曲线评估各项参数值对ACL早期退变的诊断效能.结果:单因素方差分析结果显示,T1值、T2值和PD值在3组间总体分布的差异均具有统计学意义(F=11.248、11.991和118.162,P均<0.001).LSD-t检验结果显示,正常组的PD值低于轻微退变组,轻微退变组的PD值低于明显退变组,差异均具有统计学意义(P均<0.05).T1值及T2值在正常组与轻微退变组之间的差异无统计学意义(P均>0.05),而正常组和轻微退变组的T1值及T2值均低于明显退变组(P均<0.05).ROC曲线分析结果显示T1值对ACL早期退变的敏感度、特异度、约登指数及曲线下面积分别为58％、80％、0.38和0.706,T 2值的相应指标值分别为88％、40％、0.28和0.677,PD值的相应指标值为92％、90％、0.82和0.957.结论:合成磁共振成像质子密度值可定量评估前交叉韧带早期退变性损伤.

目的 探讨全模型迭代重建(IMR)联合低剂量评估门静脉侧支循环的可行性.方法 收集60例多发门静脉侧支循环患者的全腹部CT静脉成像(CTV)数据,随机分为常规组(n=30)和实验组(n=30).常规组管电压为100 kV,采用iDose4重建;实验组管电压为80 kV,采用IMR重建.对比2组图像噪声(SD)、信噪比(SNR)、对比噪声比(CNR)、临床评分、容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)以及有效剂量(ED)的差异性.结果 与常规组相比,实验组图像SD减低,而SNR、CNR及临床评分均增加(P＜0.01),且实验组CTDIvol、DLP及ED分别较常规组减低35.29％、37.15％及37.13％(P＜0.01).结论 IMR联合低剂量成像可提高门静脉侧支血管图像质量并减低患者ED,适宜临床应用.

目的:探讨弥散峰度成像(DKI)评估前交叉韧带轻度损伤的价值.方法:搜集我院经关节镜检查证实的22例前交叉韧带损伤(Ⅰ、Ⅱ级)者纳入前交叉韧带轻度损伤组,21例前交叉韧带正常的患者为对照组.对比各向异性分数(FA)、平均弥散系数(MD)及平均峰度(MK)各参数值在2组之间的差异,并分析各参数诊断前交叉韧带轻度损伤的效能.结果:前交叉韧带轻度损伤组的FA、MK值显著低于对照组,MD值显著高于对照组,差异均具有统计学意义(P＜0.05);受试者工作特征(ROC)曲线示DKI各参数对前交叉韧带轻度损伤均具有诊断价值,且以FA值最高.当FA=0.535时,其诊断效能最大,灵敏度、特异度、约登指数及ROC曲线下面积分别为85.7％、95.5％、0.81及0.898.结论:DKI能够定量评估前交叉韧带轻度损伤,间接反映其微观结构变化,为临床提供有价值的参考信息.

目的 探讨原发性肾上腺淋巴瘤(PAL)的CT表现特征,提高诊断准确率.方法 回顾性分析经病理证实的10例PAL患者的影像资料,并结合相关文献复习.结果 10例(3例单发,7例双发)共17个病灶,最大径均为上下径(3.6～14.7cm),其中3个病灶上下径≤4.5cm,均表现为肾上腺肿大且保持原有轮廓,密度均匀,增强扫描呈轻度均匀强化,均不伴有淋巴结肿大,1例误诊为肾上腺增生.14个病灶上下径>4.5cm,呈类圆形或不规则状肿块,8个密度均匀,10个边界清晰,8个病灶冠面呈"三角形",10个与脊柱缘平直且不引起骨质破坏,10个包绕血管,但未引起血管狭窄;10个不伴有附近淋巴结肿大,4个伴有同侧附近淋巴结肿大;增强扫描:轻度强化11个,中度强化3个,6个病灶内可见条索状强化;1例误诊为肾上腺皮质癌,1例误诊为转移瘤.结论 PAL影像学具有一定特征,当其表现不典型(体积较小、密度/强化不均、边界不清等)时,容易引起误诊,应引起临床重视.

目的 探讨全模型迭代重建(IMR)联合低管电压在门静脉CT成像(CTPV)中的应用价值.方法 前瞻性搜集60例行CTPV检查的患者,依据管电压及重建方法,随机分为A组(100 kV、iDose4)和B组(80 kV、IMR),每组30例.采用独立样本t检验或近似t检验对比两组肝实质噪声、信噪比,门静脉主观评分、噪声、信噪比、对比信噪比以及两组患者CT容积剂量指数(CTDIvoL)和剂量长度乘积(DLP)的差异性.结果 A、B组肝实质噪声及信噪比分别为12.21 ±1.61、9.81±2.02和7.84±1.28、16.46±2.67,差异均具有统计学意义(P值均＜0.01);A、B组门静脉主观评分、噪声、信噪比及对比信噪比分别为(4.30±0.47)分、13.71±2.44、14.61±3.55、9.63±4.62和(4.80±0.41)分、11.25±2.13、23.46±5.06、20.41±6.58,差异均具有统计学意义(P值均＜0.01),A、B组CT-DIvoL和DLP分别为(7.79±1.34)mGy、(164.30±33.34) mGy·cm和(5.71±0.95) mGy、(119.31±25.41)mGy·cm,差异均具有统计学意义(P值均＜0.01).结论 IMR重建技术联合低管电压可提高CTPV图像质量,适宜临床应用.

目的 观察采用全模型迭代重建(IMR)技术联合80 kV管电压进行CT-Ⅲ、Ⅳ级肝硬化患者CT门静脉成像(CTPV)的可行性.方法 将80例CT-Ⅲ、Ⅳ级肝硬化患者随机分为试验组(40例)和对照组(40例).试验组采用管电压80 kV,剂量指数(DRI)17,以IMR技术重建;对照组管电压100 kV,DRI 19,采用iDose4算法重建.对比2组图像的主观评分、客观评价指标及辐射剂量的差异.结果 试验组肝实质及门静脉噪声值均低于、信噪比(SNR)及对比信噪比(CNR)均高于对照组(P均＜0.01);试验组门静脉主观评分高于对照组(P＜0.01).2组肝实质主观评分结果差异无统计学意义(P＞0.05).试验组容积CT剂量指数(CTDIVOL)、剂量长度乘积(DLP)及有效剂量(ED)分别为(6.28±1.38)mGy、(134.48±34.79)mGy · cm和(2.29±0.59)mSv,相比对照组[分别为(8.66±1.58)mGy、(186.38±47.63)mGy · cm及(3.17±0.81)mSv,P均＜0.01)]减低各27.5％、27.8％及27.8％.结论 IMR技术联合低管电压可提高CT-Ⅲ、Ⅳ级肝硬化患者CTPV图像质量,并减少ED.

目的:探讨全模型迭代重建(IMR)对肝硬化患者门静脉图像质量的影响.方法:随机搜集25例肝硬化患者门静脉CT成像原始数据,分别采用iDose4、IMRleven、IMRlevel2、IMRlevel3重建,比较各重建组噪声(SD)、信噪比(SNR)、对比信噪比(CNR)及噪声降低率.并由2名具有10年以上腹部影像诊断经验的医师对门静脉图像质量进行主观评分.数据采用One-way ANOVA分析,主观评分的一致性采用Kappa检验.结果:各组SD、SNR及CNR均值差异均具有统计学意义(P＜0.05),SD:iDose4(14.88±3.64)＞IMRlevel1 (9.71±3.67)＞IMRlevel2 (6.77±3.14)＞IMRlevel3 (4.70±2.65),SNR:iDose4(14.74±4.18)＜IMRlevl1 (23.82±7.85) ＜IMRlevel2 (35.40±12.43) ＜IMRlevel3 (54.69±21.31),CNR:iDose4 (8.65±1.94)＜IMRlevel1 (16.30±3.26) ＜IMRlevel2 (25.22±5.79)＜IMRlevel3 (40.13±10.73).降噪率分别为IMRlevel1 35.50％、IMRlevel255.37％、IMRlevel369.23％;主观评分:iDose4(2.12±0.33)＜IMRlevel1 (3.12±0.33) ＜IMRlevel2 (4.08±0.28) ＜IMRlevel3(4.96±0.20),差异具有统计学意义(P=0.00).结论:IMR技术可显著降低肝硬化门静脉噪声,且降噪级别越高,图像质量越高,值得临床推广.

目的 探讨肾上腺海绵状血管瘤(ACH)的CT表现.方法 回顾性分析经病理证实的8例ACH患者的影像资料.结果 8例病灶均为单侧单发、边界清楚的类圆形肿块,最大径1.2～10.9 cm,实质区CT值21～43HU;其中4例可见点片状钙化.4例囊实性肿块,体积较大(最大径线3.8 ～6.2 cm),密度不均,增强扫描呈填充式强化;3例实性肿块,体积较小(最大径线1.2～2.5 cm),非钙化区持续轻度强化;1例囊性肿块,囊壁局部残存较厚且持续轻度强化.结论 ACH CT多表现为单发囊实性或实性肿块,病灶钙化常见,实质区密度较高(CT值≥21HU),增强扫描呈填充式强化或持续轻度强化;少数囊性肿块可见残存囊壁且持续轻度强化.认识这些征象有助于做出提示性诊断.