The clinical internship is an important transitional period for humanistic spirit cultivation of the medical students.But in this period there are some problems exposed.For example,there is the lack of transitional link in management; the clinical instruction doctors lack educational consciousness or guidance ability,the medical students pay little attention to enhancing the individual humanistic spirit level and there is a gap between theory and practice of humanistic spirit for them.Strengthening training for students,attaching importance to training,selection and incentive of clinical instruction doctors and revising handbook of clinical internship will help to solve the problems.

Advertisement, which has strong association with the interest of media and the development of enterprise, can benefit both. The rampancy of illegal medical advertisement infringed on the interest of consumer, violated the social economic order, and even affected the image and the public trust of media. Hence, as the watchdog of medical advertisement, media should deal with the relation of the economic profit and social responsibility properly, and play a role as the transmitter of civilization.

Objective To observe the effect of 3R therapy on quality of life and subjective well-being in older patients with mild cognitive impairment (MCI). Methods 158 patients with MCI were collected from 8 communities in Ningbo city with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV as the diagnostic criteria, and assessed by Montreal Cognitive Assessment (MoCA). The experimental group (n=79) was intervened by 3R (Reminiscence, Reality Orientation, Remotivation) for 12 weeks, and the control group (n=79) received no intervention. Their quality of life was assessed with WHO Quality of Life-BREF (WHOQOL-BREF) and the subjective well-being was assessed with Philadelphia Geriatric Center Morale Scale (PGC). Results Their quality of life and subjective well-being improved after intervention in the experimental group (P<0.05), and were better in the experimental group than in the control group (P<0.05). Conclusion 3R therapy could effectively improve the quality of life and subjective well-being in patients with MCI.

Objective To investigate the best injection position and curative effect of ultrasound-guided thrombin injection (UGTI)on femoral pseudoaneurysm (FPA).Methods Review the data of FPA cases in the neurology department of southwest hospital from January 2010 to June 2015.Detailed clinical information of the patients,including the curative effect of local compression therapy,the position,meth-od,dosage and curative effect of ultrasound-guided thrombin injection were collected and analyzed.Results From January 2010 to June 2015,43 cases (1.20%)of FPA were diagnosed in 3573 patients undergoing cerebrovascular interventional operation.Local compression therapy was effective in 11 of 43 FPA patients.The remaining 32 patients who had no response to local compression therapy were treated by UGTI,and the average dosage of thrombin was (30 ±12)IU.All FPA were blocked successfully within 1 minute and without any distal em-bolism events after the first UGTI attempt.No relapse and complications occurred during the follow-up of 5 to 70 months,averagely (38.69 ± 20.79)months.Conclusion UGTI is effective for treatment of FPA who had no response to local compression therapy.Thrombin injection at position far away from the blood flow direction of pseudoaneurysm neck crevasse with ultrasound-guided could bring about highe success rate, less amount of thrombin,and less complications.

Objective: Through statistical analysis of drug resistance and homology of Acinetobacter baumannii in geriatric department of our hospital, we can provide evidence for clinical experience in antibiotics use and nosocomial infection control. Methods: The drug resistance of Acinetobacter baumannii isolated from the elderly rehabilitation department in Ningbo Kangning Hospital from January 2017 to December 2018 was analyzed by retrospective analysis.The homology of Acinetobacter baumannii isolated from clinical isolates was detected by PCR ERIC-PCR method and agarose gel electrophoresis method. Results: The resistance rates of Acinetobacter baumannii to ciprofloxacin and levofloxacin were 41.6% and 35.4%, respectively.The resistance rates to cefepime, ceftriaxone and ceftazidime were 40.3%, 38.9% and 36.7%, respectively.The resistance rate to imipenem was 38.9%, and the sensitivity rates to cefoperazone/sulbactam, gentamicin and tobramycin were all over 70%.A total of 226 strains of Acinetobacter baumannii were genotyped by ERIC-PCR.They were mainly classified into A, B, C, D and E 5 types.Among them, 116 strains were type A, 68 strains were type B, 26 strains were type C, 8 strains were type D and E. Conclusion The resistance rate of Acinetobacter baumannii to some antibiotics in geriatric rehabilitation department is still at a high level, so we should continue to strengthen the rational use of antibiotics; at the same time, the strains are highly homologous, and there is likely to be clonal transmission in the department, so we should take more effective measures to prevent and control its transmission in hospital.

BackgroundNon-suicidal self-injury （NSSI） behavior has become a major public health concern and can have significant implications for the physical and mental health of adolescents. Peer victimization is a risk factor for adolesents to have NSSI behavior， so exploring the relationship and underlying mechanism between peer victimization and NSSI functions will provide a promising strategy for the prevention and intervention of NSSI behavior. ObjectiveTo investigate the relationship between peer victimization and NSSI functions in adolescents with unipolar and bipolar depression， so as to provide references for the intervention of NSSI behavior in adolescent patients with unipolar and bipolar depression. MethodsUsing multi-stage stratified sampling， 940 adolescents with unipolar and bipolar depression who met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） criteria for bipolar depressive episodes or depressive disorders were selected from 14 psychiatric hospitals in China. All participations were assessed using Chinese version of the Functional Assessment of Self-Mutilation （C-FASM）， Multidimensional Peer-Victimization Scale （MPVS）， UCLA Loneliness Scale （UCLA-LS） and Patient Health Questionnaire-9 item （PHQ-9）. Pearson correlation coefficient was to assess the correlation among above scales， and the model fit and path coefficients for mediation were analyzed with model 4 in Process 4.0 for SPSS. ResultsA total of 698 （74.26%） adolescents with unipolar and bipolar depression completed the questionnaire survey. NSSI behavior was detected in 374 patients （53.58%）. Among adolescents with unipolar and bipolar depression and NSSI behavior， MPVS total score was positively correlated with the scores of NSSI emotion regulation function， attention-seeking function and social avoidance function in C-FASM （r=0.104， 0.130， 0.266， P<0.05 or 0.01）， UCLA-LS score also yielded a positive correlation with the scores of NSSI emotion regulation function， attention-seeking function and social avoidance function in C-FASM （r=0.321， 0.112， 0.246， P<0.05 or 0.01）， and UCLA-LS score was positively correlated with MPVS total score （r=0.241， P<0.01）. Loneliness demonstrated a complete mediating role in the relationship between peer victimization and emotion regulation function， with an indirect effect value of 0.033 （95% CI： 0.019~0.050） and an effect size of 73.33%. A partial mediating effect of loneliness was also observed for the relationship between peer victimization and social avoidance function， with an indirect effect value of 0.016 （95% CI： 0.007~0.025） and an effect size of 17.98%. ConclusionLoneliness may act as a mediator in the relationship between the peer victimization and the NISS emotion regulation and social avoidance functions in adolescents with unipolar and bipolar depression and NSSI behaviors. ［Funded by Guangzhou High-level Clinical Key Specialty （number， SZGSP013）］

Drug discrimination is a behavioral pharmacological technique to study the discriminative stimulus effects of drug. Currently drug discrimination has been widely used in preclinical drug development of CNS drugs, the most extensive of which is psychodependent research in the field of drug abuse. This review describes in general the basic principles of drug discrimination, preliminarily elaborates on the relevant characteristics and applications of the subjective effects, time-course effect, stereo specificity, individual differences, and receptor mechanisms, and its development prospects for hallucinogens and cannabis drugs are also presented.

BackgroundThere are differences in executive function between major depressive episode patients with or without psychotic symptoms， and childhood trauma may affect the executive function of patients with major depressive episode. Previous research studies predominantly focused on adult patients with major depressive episode， with a lack of studies specifically focusing on adolescent patients with major depressive episode. ObjectiveTo investigate the differences in executive function among adolescent patients with major depressive episode， with or without psychotic symptoms and childhood trauma. MethodsA total of 112 hospitalized adolescent patients with major depressive episode who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） were included in the study. The participants were recruited from the Department of Child and Adolescent Psychiatry， Shenzhen Kangning Hospital during the period from August 2020 to November 2021. Additionally， 27 healthy controls were recruited through public advertisements. The Cambridge Neuropsychological Test Automated Battery （CANTAB） was used to assess executive function through the administration of the Motor Screening Task （MOT）， Spatial Working Memory（SWM） and Rapid Visual Information Processing （RVP） modules. Childhood Trauma Questionnaire-Short Form （CTQ-SF） was used to assess the trauma type. ResultsCompared with healthy controls， adolescent patients with major depressive episode had a longer mean delay （Z=-3.407， P=0.001） in the MOT task. In the SWM task， the patients had a higher total number of intergroup error responses （Z=-3.291， P=0.001）， a higher total number of intragroup error responses （Z=-3.461， P=0.001）， more total number of double error responses （Z=-3.218， P=0.001）， a higher total error responses （Z=-3.312， P=0.001）， higher strategy scores （Z=-2.437， P=0.015） and longer average delay time （Z=-2.055， P=0.040）. In the RVP task， the patients had fewer hits （Z=-3.196， P=0.001）， more misses （Z=-3.179， P=0.001）， fewer rejections （Z=-2.772， P=0.006）， lower hit probability （Z=-3.187， P=0.001） and lower A´ scores （Z=-3.070， P=0.002）.Compared with adolescent patients with major depressive episode without psychotic symptoms， those with psychotic symptoms had a lower total number of double error responses （Z=-2.566， P=0.010） in SWM task. Compared with adolescent patients with major depressive episode who did not experience emotional neglect， those who experienced emotional neglect had longer average delay time （Z=-3.183， P=0.001） in MOT task， fewer total hits （Z=-2.445， P=0.014）， more total missed reports （Z=-2.467， P=0.014）， lower hit probability （Z=-2.445， P=0.014） and lower A´scores （Z=-2.089， P=0.037） in RVP task. Adolescent patients with major depressive episode who had experienced emotional abuse had longer average delay time in MOT task than those who had not experienced emotional abuse （Z=-2.552， P=0.011）. ConclusionAdolescent patients with major depressive episode exhibit abnormalities in a majority of executive function domains. Specifically， those without psychotic symptoms and with childhood trauma demonstrate significantly impaired executive function. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGS013）， Basic and Applied Basic Research Fund of Guangdong Province （number， 2019A1515110047）， Shenzhen Science and Technology Planning Project （number， JCYJ20190809155019338）］

OBJECTIVES: To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders. METHODS: A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents. RESULTS: A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05). CONCLUSIONS Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.
Adolescent ; Cross-Sectional Studies ; Humans ; Mood Disorders ; Risk Factors ; Self Mutilation ; Self-Injurious Behavior/psychology* ; Suicide, Attempted/psychology*

Substance addiction is considered to be a chronic recurrent encephalopathy. The neural adap-tation changes induced by addictive substances are partly mediated by epigenetic mechanism. The perma￣nent changes of gene expression in tissues or brain can be affected by DNA methylation, histone modifica-tion and chromatin remodeling, these changes eventually lead to behavioral abnormalities of individual. Methyl-CpG binding protein 2 (MeCP2), an important transcription inhibitor, contains characteristic do-mains that regulated chromosome conformation, transcription and RNA splicing. It has also been identified that MeCP2 plays an important role in regulating neuronal plasticity and related target gene transcription during brain development, which add more attention about the importance of epigenetic mechanism in neuronal function. Studies have showed that DNA methylation, histone acetylation and phosphorylation regulate MeCP2 gene expression, affect gene and protein transcription, translation and cell regulation in learning, memory and substance addiction. Addictive substances induce psychological and mental dependence, which are related to the changes of neuronal plasticity and gene expression in addictive neural circuits. MeCP2 plays an important role in regulating synaptic transmission and neuronal plasticity in central nervous system. Therefore, it is of great scientific significance to explore the role of MeCP2 in regulating neuronal plasticity in the central nervous system. In this review we summarized the structure and function of MeCP2, the relationship between MeCP2 and epigenetics, and the role of MeCP2 epigenetic modifications induced by different addictive substances in substance addiction, which may provide further understanding of the molecular mechanism of substance addiction and provide new in￣sight for clinical intervention.