Objective:To describe and analyze suicide risk of patients with schizophrenia,major depressive disorder,and bipolar disorder.Methods:A total of 2 016 patients with schizophrenia,903 patients with major de-pressive disorder,and 381 patients with bipolar disorder from inpatients,clinics,or communities who met the diag-nostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition were recruited.All patients were interviewed by psychiatrists using the Mini International Neuropsychiatric Interview to diagnose mental disor-ders and assess suicide risk,as well as Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)to as-sess symptoms.Differences and risk factors of suicide risk among three types of mental disorders were explored u-sing multivariate logistic regression analysis.Results:In the past one month,37 patients with schizophrenia(1.8％),516 patients with major depressive disorder(57.1％),and 102 patients with bipolar disorder(26.8％)had suicide risk.Compared with patients with schizophrenia,suicide risk in patients with major depressive disorder(OR=36.50)and bipolar disorder(OR=20.10)increased.Female(OR=1.87),smoking(OR=1.76),family history of suicide(OR=5.09),higher score of CRDPSS hallucination(OR=1.80),and higher score of CRDPSS depression(OR=1.54)were risk factors of suicide risk of patients.Conclusions:Suicide risk of patients with ma-jor depressive disorder and bipolar disorder is higher than that of patients with schizophrenia.In clinical practice,it is important to regularly assess suicide risk of patients.Patients who experience symptoms of hallucination and de-pression should be paid more attention to.

Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Objective To establish the characteristic chromatogram for modified Huoxiang Zhengqi pills and determine the content of three components based on HPLC.Methods The analysis of methanol extract of this preparation was performed on a Agilent TC-C18 column(250 mm×4.6 mm,5 μm)at 30℃,with mobile phase comprising of acetonitrile-0.1%phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 254 nm and 284 nm.Results Three components(hesperidin,magnolol and honokiol)showed good linearity within the range of 2.715-434.400 μg/mL,2.760-176.600 μg/mL and 2.623-167.900 μg/mL(r=1.000 0),whose average recoveries were 99.2%,96.3%and 95.9%,with the RSD of 1.5%,1.3%and 1.8%(n=9),respectively.The established characteristic chromatogram controlled the 7 main Chinese medicinal herbs in the formulation,which provided a basis for evaluating the quality of raw materials,feedings,processes and preparations of different enterprises as a whole.Conclusion This method is accurate,reliable and has good repeatability,and can be used for the quality control of modified Huoxiang Zhengqi pills.

This paper aims to discuss the ideas and experience about the radiology residency training system of Canada with a presentation of its base accreditation standards for five aspects, competency goals for seven roles, four stages of training arrangement, and two types of final assessment questions. Although the Canada's radiology residency program differs from China's standardized resident and specialist training programs for radiology, there are still several points that are worth referencing, including emphasizing the training priority of competency goals, providing a specific basis for the stratification of training, offering clear guidance for the implementation of training content, and improving assessment methods to focus on competency goals. These points are of great value for improving the standardized radiology resident and specialist training programs in China, so as to provide a reference for the training of excellent radiologists in China.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To explore the effect of grid management combined with guided and driven teaching mode in operation teaching of nursing interns.Methods:From February 2020 to January 2022, 300 nursing interns from the 2020 and 2021 sessions of the Wuxi Second People's Hospital were selected as the research subject by convenience sampling. According to the method of random number table, the nursing interns from February 2020 to January 2021 were set as the control group, and the nursing interns from February 2021 to January 2022 were set as the experimental group, with 150 in each group. The control group adopted the traditional teaching, while the experimental group carried out the grid management combined with guided and driven teaching mode on the basis of the control group. The results, self-study ability, learning enthusiasm, teaching satisfaction, practice satisfaction, and the incidence of sharp tool puncture during the practice were compared between the two groups before and after the practice.Results:After the experiment, the scores of theoretical and operational skills, learning enthusiasm and self-study ability, practice satisfaction of nursing interns in the experimental group were higher than those in the control group, and the incidence of sharp tool puncture was lower than that in the control group, with statistical differences ( P<0.05) . Conclusions:Grid management combined with guided and driven teaching mode can improve the interns' theoretical mastery and clinical operation proficiency, enhance their self-study ability, fully stimulate their learning enthusiasm, and reduce the incidence of clinical accidental injuries, which is worthy of promotion and application.

Objective To investigate the effects of glycogen synthase kinase-3β (GSK-3β) and β-catenin signaling on the human renal proximal tubular epithelial HK-2 cell injury induced by depleted uranium(DU),and provide a new enlightenment for the development of DU antidotes.Methods H K-2 cells were exposed to different concentrations of DU for 3-24 h,then the protein expressions of kidney injury molecule 1 (KIM-1),neutrophil gelatinase-associated lipocalin (NGAL) and nuclear β-catenin were detected by immunofluorescence staining.The protein expressions of p-GSK-3 β(S9),GSK-3β and cmyc were detected by Western blot assay.HK-2 cells were transiently transfected by GSK-3β (KD) plasmid or treated by TDZD-8 to inhibit the activity of GSK-3β specifically.Other HK-2 cells were transiently transfected by β-catenin plasmid to overexpress the β-catenin protein.Results The percentages of KIM-1 and NGAL-positive cells increased with DU exposure time and concentrations from 300 and 600 μmol/L,and they were significantly higher than those of the blank control at 6-24 h of DU exposure (KIM-1-positive cells:t =11.06,18.97,30.49,P ＜0.05;t =6.79,16.02,85.45,P ＜ 0.05;NGAL-positive cells:t =11.78,11.37,34.29,P ＜0.05;t =7.34,21.63,36.84,P ＜0.05).In contrast,the ratio of p-GSK-3β (S9) to GSK-3β and percentage of nuclear β-catenin-positive cells were significantly higher than that of the blank control at 3-24 h of DU exposure (p-GSK-3β(S9)/GSK-3β:t =3.95,4.69,5.40,3.34,P ＜ 0.05;nuclear β-catenin-positive cells:t =4.61,6.52,36.64,14.93,P ＜ 0.05) with a maximum response at 9 h of DU exposure accompanied with corresponding increase of protein level of c-myc,a downstream target gene of β-catenin.Transient transfection of HK-2 cells with GSK-3β (KD) plasmid significantly inhibited the activity of GSK-3β (t =8.07,P ＜ 0.05) and reduced the DU-increased percentage of KIM-1-positive cells (t =24.77,P ＜ 0.05).Treatment cells with TDZD-8 inhibited the activity of GSK-3β and enhanced the percentage of nuclear β-catenin-positive cells,and it also significantly reduced the percentage of KIM-1-positive cells in HK-2 cells exposed to DU (t =6.25,6.73,P ＜ 0.05).Moreover,overexpression of β-catenin significantly reduced DU-induced cell injury (t =7.48,P ＜ 0.05).Conclusions GSK-3β/β-catenin signaling plays a key role in regulating the DU-induced cytotoxicity of HK-2 cells.Inhibition of GSK-3β activity and overexpression of β-catenin can protect the HK-2 cells from DU-induced damage.

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

Objective To investigate the application of middle segment pancreatectomy (MSP) in treating benign pancreatic tumors and the effect on exocrine function.Methods From Jan.2010 to Feb.2013,19 cases with benign pancreatic tumor undergoing MSP were enrolled in our study.Pre-and postoperative pancreatic exocrine function were studied.Results No perioperative death happened.The tumor diameter was 4.2 to 7.0cm,operative time was 80 to 320 mins,and intraoperative blood loss was 200 to 1000 ml.The retained pancreas was＞l.5 cm at pancreatic head side,and＞5 cm at pancreatic caudal side.Three days after surgery,the peritoneal drainage and amylase was 2.5-12.5 ml and 568.4-1013 IU/L,respectively.Seven days after surgery,the peritoneal drainage and amylase was 1.0-19.8 ml and 45.4-76.3 IU/L,respectively.The postoperative hospitalization stay were 10 to 25 days.Three cases (all single anastomosis) had pancreatic fistula after surgery and healed after 3 months without undergoing surgery again.Patients were followed up for 2 months to 3 years.All patients have a good life quality,without new-onset diabetes and cancer recurrence.MSP had no side effects on pancreatic exocrine function.Conclusion MSP is safe and feasible in treatment of benign pancreatic tumors.

Objective To evaluate the potential feasibility of γ-H2AX foci as a biodosimetry after exposure to ionizing radiation by comparing DNA double-strand break repair kinetics in rat blood lymphocytes with that in human lymphocytes.Methods Peripheral blood lymphocytes separated from Sprague-Dawley(SD) male rats and healthy adults were exposed to γ-rays,and some rats were also subjected to total body irradiation.The inductions of DNA repair-related foci of γ-H2AX,pATM (S1981) and pDNA-PKcs (T2609) were detected with immunofluorescence staining technique at different time points post-irradiation,and the status of their co-localization was analyzed.Results The induction kinetics of γ-H2AX foci in rat lymphocytes was similar to that observed in human lymphocytes.The frequencies of γ-H2AX foci peaked at 30 min after γ-ray irradiation (trst =62.64,th =28.52,P ＜ 0.05),then decreased rapidly after 6 h post-irradiation (trat =45.96,th =14.80,P ＜0.05),and the residual foci number remained only about 3％-8％ of its maximal value at 24 h post-irradiation.At 30 min after γ-ray irradiation,the frequencies of pATM (S1981) and pDNA-PKcs (T2609) foci in rat and human lymphocytes significantly higher than those of nonirradiated control (trat =21.05,25.80,th =11.07,29.52,P ＜ 0.05),and the frequencies of co-localization of pATM (S1981) or pDNA-PKcs (T2609) foci with γ-H2AX foci also markedly increased by 26％-32％ in irradiated lymphocytes of rat and human (trat =5.34,9.14,thuman =18.32,51.28,P ＜0.05).Moreover,γ-H2AX foci incidence in rat lymphocytes in vitro was consistent with that induced by total body irradiation of rat.The number of γ-H2AX foci in irradiated rat lymphocytes increased with irradiation dose in a linear dose-dependent manner,its slope was similar to that of irradiated human lymphocytes reported by other laboratory.Conclusions Rat is a useful animal model to evaluate radiation biodosimetry with γ-H2AX foci in lymphocytes.The co-activation of ATM and DNA-PK plays an important role in DSB repair in the irradiated lymphocytes of rat and human.