Objective To compare the differences of prescription pattern, adverse events, economic burden and drug-use adherence between preferred mood stabilizers and preferred antipsychotics in patients with bipolar disorder. Methods We investigated 240 cases of patients with bipolar disorder from 39 mental health institutions in 11 cities in Hebei province. The self-made questionnaire was used to investigate the demographic information, disease characteris-tics, prescription pattern and medical expense. The clinical global impression scale-severity of illness (CGI-SI) was used to assess the disease severity. The treatment emergent symptom scale (TESS) was used to assess the adverse drug reac-tions. The medication adherence rating scale (MARS) was used to assess drug therapy compliance in patients. Results One hundred fifty-two patients (63.3%) used antipsychotics as the first choice (antipsychotics group), 88 patients (36.7%) used mood stabilizers as the first choice (mood stabilizers group). The number of patients in-patient (90.1%vs. 76.1%), patients with psychotic symptom (27.0%vs. 11.4%), incidences of adverse events (46.1%vs. 31.8%), drug daily cost (me-dians 12.00 yuan vs. 8.37 yuan) and drug total cost (medians 344.61 yuan vs. 144.64 yuan) were larger in antipsychotics group than in mood stabilizers group (P<0.05). There was no significant difference between two groups in pattern of pre-scription, severity of adverse events and total scores of MARS (P>0.05). Conclusion The bipolar disorder patients more frequently use antipsychotics as the first choice in Hebei province. The use of antipsychotics does not alter the combina-tion medication pattern. In addition, antipsychotics cause a higher incidence of adverse events and heavier economic bur-den compared with mood stabilizers, suggesting that mood stabilizers should be the first choice to bipolar disorder.

In patient with primary biliary cirrhosis,the metabolism of calcium and vitamin D could be affected and osteomalacia and secondary hyperparathyroidism might occurr.Besides,hypoalbuminemia may mask the real level of serum calcium and thus lead to misdiagnosis of coexisting parathyroid adenoma.Therefore,a rare case of parathyroid adenoma associated with primary biliary cirrhosis was herewith presented to call attention to the effect of hypoalbuminemia on serum calcium.

Objective To investigate the clinical efficacy and side effects of malignant serosal effusion through injecting donor lymphocytes into serosal cavity once for all.Methods First,the serosal effusion was drained thoroughly,then donor lymphocytes were injected into pleural cavity once for all.Results Nine cases of malignant serosal effusion were treated;significant effectiveness included five cases,partial effectiveness four cases.The effect rate was 100 %.The main side effects were fever and chest pain.Conclusion Treatment of malignant serosal effusion through injecting donor lymphocytes into serosal cavity once for all has definite effectiveness,with acceptable side effects.

Objective:To test the validity and reliability of the Chinese version of the Br?set Violence Check-list (BVC-C).Methods:With the authorizing permission by the author,the BVC was translated into Chinese and a-dapted,and five psychiatry experts who had worked more than 20 years were invited (3 clinical doctors and 2 nur-ses)to evaluate the content validity of the scale as the content validity index.Totally 556 inpatients who met the di-agnosis criteria for mental disorders according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were totally selected to proceed the formal testing.The BVC scale was used to evaluate inpatients every 8 hours,the Modified Overt Aggression Scale (MOAS)was used to test concurrent validity;the results of the real attacking incidents were used to test the criterion validity;the internal consistency re-liability of the scale was tested by Cronbach αcoefficient.Results:The content validity index of the scale was0.93.In addition to the own attack subscale,the MOAS total scores and the other 3 subscales scores were positively correlated with the BVC total scores and each item score (r =0.11 -0.69,P <0.01).The best criterion validity was 8 hours through analyzed,the AUC was 0.98.When the cut-off was 2,the sensitivity and specificity were 78.9% and 95.1% respectively.The Cronbach αcoefficient was 0.76 and the item total correlations were 0.47 -0.80 (P <0.01).Conclusion:It suggests that the BVC-C has good validity and reliability,which could be used as an effective prediction tool for psychiatric violence risk assessment.

Background Currently,the diagnosis of depressive disorder relies on symptomatology,which is greatly influenced by subjective factors such as clinicians' experience.Finding more accurate and reliable quantitative diagnostic methods is currently an urgent problem.Objective To explore the value of Fisher discriminant function based on inflammatory cytokines in the diagnosis of depressive disorder,so as to provide references for clinical diagnosis.Methods A total of 136 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)criteria,who underwent inpatient treatment at Hebei Mental Health Center from April 2020 to November 2020,were enrolled as study group.67 healthy participants matched for age and gender,was recruited during the same period.Serum levels of inflammatory cytokine were measured using enzyme-linked immunosorbent assay(ELISA).Fisher discriminant model was employed to establish a discriminant function for inflammatory cytokines exhibiting significant statistical differences between study group and control group,which was then validated.Results The levels of pro-inflammatory cytokines interleukin-1β(IL-1β),interleukin-6(IL-6),interferon-γ(INF-γ)and tumor necrosis factor-α(TNF-α)were higher in the study group compared with control group,with statistically significant differences(U=9.115,5.239,4.431,5.428,P<0.01).Conversely,the levels of anti-inflammatory cytokines interleukin-4(IL-4),interleukin-10(IL-10)and interleukin-13(IL-13)were lower in the study group compared with control group,with statistically significant differences(U=7.398,7.331,7.614,P<0.01).The retrospective test in Fisher discriminant function achieved a correct discrimination rate of 89.66%,and the cross validation achieved a correct discrimination rate of 88.67%.Conclusion The Fisher discriminant function developed in this study may serve as a valuable auxiliary method in the diagnosis of depressive disorder.

This study was aimed to summarize the clinical medication rule of professor Shi Qi in the treatment of cervical spondylosis of vertebral artery type (CSA),in order to explore the academic ideas.A total of 265 CSA cases from professor Shi Qi's outpatient clinic were collected in Longhua Hospital from 2009 to 2015.Frequency analysis and cluster analysis were conducted on used herbal medicine from included cases by SPSS 21.00 software.The results showed that there were a total of 202 types of herbs used.The five most commonly used herbs were Rhizoma Ligustici Wallichii,Radix bupleuri,Radix Achyranthis Bidentatae,Codonopsis and Gastrodia elata.The cluster analysis revealed that professor Shi Qi frequently used Huo-Xue Hua-Yu herbs,Bu-Xu herbs,Ping-Gan Xi-Feng herbs,Qu-Feng-Shi herbs.Sheng-Yu decoction and Tian-Ma Gou-Teng decoction were the core prescriptions used by professor Shi Qi in the treatment of CSA.It was concluded that the cluster analysis showed that academic ideas of professor She in the treatment of CSA was to pay equal attention to both qi and blood,to focus on liver and kidney,as well as to remove phlegm and blood stagnation,to treat both the branch and the root.The cluster analysis revealed a certain medication rule of professor Shi Qi in the treatment of CSA.It can be used as guidance in the clinical practice.

Objective To explore the expression level of OTUB1 and its clinical significance in breast cancer.Methods Immunohistochemistry was used to detect the expression level of OTUB1 in 78 cases of breast cancer tissues and 30 cases of normal breast tissue adjacent to carcinoma,and the relationships between OTUB1 and the clinical pathological features of breast cancer were analyzed.Results The positive expression rate of OTUB1 in breast cancer tissues [66.7％ (52/78)] was significantly higher than that in adjacent normal breast tissues [30.0％ (9/30)],with a statistically significant difference (x2 =11.851,P =0.001).OTUB1 expression level was related to the lymph node metastasis (x2 =5.029,P =0.025),postoperative TNM staging (x2 =4.478,P =0.034),expression of human epidermal growth factor receptor-2 (HER-2) (x2 =8.775,P =0.003),expression of P53 (x2 =4.708,P =0.030),expression of estrogen receptor (ER) (x2 =10.364,P =0.001) and molecular subtypes (x2 =10.934,P =0.012).However,OTUB1 expression level in breast cancer was not related to the age (x2 =2.194,P =0.139),menopausal status (x2 =1.843,P =0.175),tumor size (x2 =0.643,P =0.423),histological grade (x2 =3.580,P =0.167),expression of progestin receptor (PR) (x2 =3.371,P =0.066) and expression of Ki-67 (x2 =1.345,P =0.246).Conclusion OTUB1 expression level increases in breast cancer,which is associated with the lymph node metastasis,TNM staging,expressions of HER-2,P53,ER and molecular subtypes of breast cancer.It suggests that the expression of OTUB1 is related to the progression and metastasis of breast cancer.

Objective:To explore the effect of multidisciplinary management combined with 60-second high-risk diabetic foot screening in diabetic foot.Methods:From January to December 2022, 138 patients with diabetic foot were selected from Xinxiang Central Hospital by convenience sampling. The patients were randomly divided into a control group and an observation group, with 69 cases in each group. Control group implemented routine follow-up management of diabetic foot, and observation group carried out multidisciplinary management combined with 60-second high-risk diabetic foot screening on the basis of control group, and the intervention lasted for six months. The progress of Wagner grading of diabetic foot and foot self-care were compared between the two groups.Results:After intervention, the number of Wagner grading progression patients in observation group and control group was four cases (5.80%) and 10 cases (14.49%), respectively. The number of progression patients in observation group was less than that in control group, and the difference was statistically significant (χ 2=4.161, P=0.041). The total score and dimension scores of diabetic foot self-management in the two groups after the intervention were higher than those before the intervention, but only the scores of observation group before and after the intervention were statistically significant ( P<0.05). After intervention, the total score and dimension scores of diabetic foot self-management in observation group were higher than those in control group, with a statistically significant difference ( P<0.05) . Conclusions:Multidisciplinary management combined with 60-second high-risk diabetic foot screening can effectively delay the progress of diabetic foot and improve patients' foot self-care.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.