Objective:To investigate the role of clinical pharmacists in the anti-infective treatment of one patient with complexity urinary tract infection with septic shock induced by cellulitis. Methods:Clinical pharmacists participated in one case of complexity uri-nary tract infection with septic shock induced by cellulitis, and according to the clinical curative effect and the patient' s condition change, clinical pharmacists adjusted the medication nine times and provided individualized pharmaceutical care and service in the whole process. Results:Physician accepted the suggestions of clinical pharmacists, the infection was controlled after the 38-day treat-ment, and then the patient was discharged from the hospital. Conclusion:Clinical pharmacists should participate in the clinical treat-ment, provide whole process of pharmaceutical care for severe patients and assist physician in drug treatment decisions to promote safe, effective and economical drug use.

Objective: To describe the prevalence of depressive and/or anxiety symptom and disorder in patients with coronary heart disease(CHD) in the general hospitals.Methods: A hospital-based cross-sectional study was conducted in four main cities in China in 2004.359 eligible subjects with CHD were recruited from the outpatient or inpatient departments within six months.Face-to-face interviews were used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening.Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales by the licensed psychologists or psychiatrists.Results: The prevalence of depressive symptoms,anxiety symptoms,depressive and anxiety symptoms,and total depressive and/or anxiety symptoms were 19.8%,16.7%,13.6% and 22.8% respectively in patients with CHD.Less than 4% of the subjects had been diagnosed or treated for the depressive or anxiety disorders prior to the investigation.In inpatients,the diagnosis and treatment rate was low to less than 1% during the current admission.Conclusion: It was noticeable to health care providers and health policy makers that there was high prevalence of depressive and/or anxiety symptoms and depressive and/or anxiety disorders,and low percentages of previous diagnosis and treatment in patients with CHD in general hospitals.

Objective:To systematically evaluate the incidence of liver injury in multi-drug resistant tu-berculosis ( MDR-TB ) patients with the treatment of second-line anti-TB drugs.Methods: Medline (January 1, 1966 to March 1, 2014), Embase (January 1, 1974 to March 1, 2014) and the Cochrane library (January 1, 1993 to March 1, 2014) with four Chinese databases including VIP ( January 1, 1989 to March 1, 2014), CBMDisc (January 1, 1978 to March 1, 2014), CNKI (January 1, 1994 to March 1, 2014)and Wanfang (January 1, 1998 to March 1, 2014), were systematically searched with the keywords including “Tuberculosis”,“multidrug-resistant”,“MDR-TB”,“side effect”,“adverse”,“safety” and “tolerability” for the follow-up studies of MDR-TB patients with liver injury during the treatment of second-line anti-TB drugs.The relevant information was extracted and the data were analyzed using the random-effects model .Subgroup and sensitivity analyses were performed based on the diagnostic criteria, study population , study design , history of anti-TB treatment and treatment length .Results: A total of 26 articles with 3 875 MDR-TB patients were included , of which 373 patients developed liver in-jury, and the weighed combined incidence of liver injury was 7.7%(95%CI:5.5%-10.8%).There was some heterogeneity among the studies .Subgroup analyses showed that the incidence of liver injury was higher in groups with treatment length≥18 months and non-Asian populations , but there was no sig-nificant difference between the groups (P>0.05).Among the 26 articles, only nine of them reported the diagnostic criteria of liver injury , while the criteria were not uniform .Conclusion:The incidence of liver injury during the treatment of second-line anti-TB drug in MDR-TB patients was high , and the diag-nostic criteria were not uniform .We should pay attention to the prevention and treatment of liver injury , and develop standard diagnostic criteria for it .

Objective To evaluate the correlation between serum uric acid with cognitive disorder after acute cere?bral infarction by prospective study. Methods Four hundred consecutively enrolled patients of acute cerebral infarction were divided into no cognitive impairment group and cognitive impairment group according to the assess of Montreal Cog?nitive Assessment (MoCA). Univariate analysises were conducted in the potential risk factors of cognitive impairment in?cluding age, sex, smoking, alcohol, hypertension, diabetes, dyslipidemia, level of education, infarction in key parts, atrial fibrillation, serum uric acid, blood homocysteine between two groups. The statistically significant indicators in univariate analysises were used as independent variables and the scores of MoCA were used as the dependent variable to conduct multiple linear regression analysis. The assessment on the risk of cognitive impairment after cerebral infarction were con?ducted according to serum uric acid, sex, age and TOAST classification further. Results Serum uric acid was indepen?dent risk factors of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level and the relative risk was 1.35,95%CI(1.098,1.660). Especially for the young, male or patients with cerebral infarction in classification of small artery occlusion, the risk increased further, and the relative risk was 1.513, 95%CI(1.092, 2.096)1.412, 95%CI (1.125, 1.771)and 1.464, 95%CI(1.128, 1.900)respectively. Conclusion Exaltation of Serum uric acid was indepen?dent risk factor of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level, and especially for the young, male and patients with cerebral infarction in classification of small artery occlusion, the risk increased fur?ther.

Abstract The increasing fragile and vulnerable adolescents mental health determines the increasing demand for psychological health services among teenagers, which indicates the inadequacy of traditional mental health service models. This article summarizes the necessity of digital mental health services for adolescents, and then lists the application examples of digital mental health services across the world, aiming to provide reference for digital mental health services among Chinese adolescents.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Objective To utilize the magnetic resonance neurography (MRN) as a feasible tool for measuring the anatomical parameters of lumbar spinal nerves, and further to evaluate the neuro-safety of interlaminar percutaneous endoscopic lumbar discectomy.Methods Thirty healthy adult volunteers without significant history of low back pain or lumbar deformity were selected in our hospital from September 2016 to December 2016. All subjects accepted MRN. The nerve roots of L2-S1 were measured at the starting point of dural sac, and the angles between nerve roots and dural sac were measured. The distances between L2-L5 nerve roots and the edge of ipsilateral dural sac were measured and analyzed statistically.Results All MRN showed a gradual increase in the origin of the nerve roots from L2 to S1. The origin of the root was found to be below the corresponding disc for the L2 to L4 roots. There were 70％ of the L5 roots originated below the L4/5 disc, 26.7％ at the L4/5 disc, and 3.3％ above the L4/5 disc; about 70％ of the S1 roots originated above the L5/S1 disc. There were no statistically significant differences in the angles between dural sac and both left and right nerve roots (P>0.05). The angels between the nerve root and the dural sac from L5 and S1 was smaller than those from L2, L3, and L4 (P<0.05); that from S1 was significantly smaller than that from L5 (P<0.05). The distance of the nerve root and the ipsilateral dural sac was significantly increased in each side from L2 to L5 (P<0.05). There was no statistically significant difference in the distances between the left and right nerve roots and the edge of the ipsilateral dural sac in the same segment (P>0.05).Conclusion MRN is a feasible tool to measure the anatomical parameters of the lumbar spinal nerve, and there is a safe neurological area of the percutaneous endoscopic lumbar discectomy through the interlaminar approach.

Objective To investigate the outpatient visitor′s B19 infection in Fuzhou area, study the correlation between B19 virus infection and clinical diseases.Methods The infection status of B19V IgM and IgG in 22 089 outpatient visitors in Fuzhou area from 2011 to 2016 has been retrospectively analyzed.The patients were divided into different groups according to sex,age,different pregnant outcomes, healthy people and hematopoietic system diseases.Results The positive rate in 22 089 patients of B19V IgM was 4.5%(998/22 089)and the IgG positive rate was 36.9%(8 155/22 089); The positive rate of B19V IgM in female patients(4.8%,546/11 374)was higher than male patients(4.2%,452/10 715)(χ2=4.333,P<0.05); The middle-aged and elderly patients IgG positive rate(53.6%,3 629/6 772;54.3%,1 542/2 838)were significantly higher than infants,children and young people(36.0%,989/2 747;25.4%,237/934;20.0%,1 758/8 797); The positive rate of IgM in adverse pregnancy outcomes (8.2%,20/245)was higher than normal pregnant women(3.3%,23/688)(χ2=9.548,P<0.05).In pancytopenia,thrombocytopenia and anemia patients, the positive rates of B19V IgG were 39.8%(165/415),38.1%(297/780)and 35.4%(81/226)respectively, all of which were higher than that in the healthy people(14.4%,78/543)(χ2=80.127,88.626,43.461; P<0.05).Conclusions The outpatient visitor′s infection rate of B19V in Fuzhou is high.B19V is a common virus who can lead to adverse pregnancy outcomes.What′s more, it also can lead to pancytopenia, thrombocytopenia, anemia or other related hematopoietic diseases.

Concerns have been raised about the reporting quality in nutritional epidemiology.Therefore,strengthening the reporting of observational studies in epidemiology-nutritional epidemiology (STROBE-nut) has been proposed by extending the STROBE statement to include additional recommendations on issues related to nutritional epidemiology and dietary assessment,aiming to provide more specific guidelines on how to report observational research in the field.This paper presents a brief introduction to STROBE-nut and also an explanation of the key points in the additional items,with an example illustrating the application of the checklist.

Objective To investigate both genetic and environmental influences on the exercise participation and sedentary behavior in Qingdao,Shandong province and 326 in Lishui, Zhejiang province. Methods 568 twin pairs,including 242 in Qingdao and 326 in Lishui,were studied. Exercise participation was measured by two questions on the frequency and intensity and then divided into two groups. Sedentary behavior was measured by one question as‘how long do you spend on sitting every day’. Variance component models based on twins was used to estimate the genetic and environmental factors on these traits. Results The average age in monozygotic twins was(41.14 ± 10.11)while in dizygotic twins it was(41.23 ± 9.89). Genetic factors accounted 78%(35%-96%)and 59%(0-94%)for exercise participation variance in Qingdao and Lishui in people aged between 20 and 40. However,there were no heritability noticed on physical activity in people older than 40 years of age. Rates of heritability on sedentary behavior in Qingdao and Lishui were 68%(59%-75%)and 32%(7%-62%),respectively. Conclusion Results from the study suggested that sedentary behavior in Chinese people was influenced by genetic factors,which could also explain much of the exercise participation variance in people aged between 20 and 40.