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.

Objective To describe the clinical characteristics of acute lower respiratory tract infection (ALRTI)caused by human coronavirus (HCoV)in children.Methods Three thousand five hundred and three hospi-talized children diagnosed with ALRTI in Beijing Children′s Hospital from March 2007 to February 201 3 were re-viewed.Nasopharyngeal aspirate(NPA)specimen was collected from each patient.Reverse transcription (RT)-poly-merase chain reaction(PCR)methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV),rhinovirus (RV),parainfluenza virus (PIV)type 1 -4,influenza virus type A and B (IFA,IFB),adeno-virus (AdV),enterovirus (EV),HCoV,human metapneumovirus (hMPV)and human bocavirus (HBoV).Serum anti-bodies of mycoplasma and sputum bacterial culture were also detected.Only HCoV positive patients were analyzed in this study.Results Eleven of 3 503 patients were proved as HCoV -positive in NPA specimens.Of the 1 1 children,8 cases were male and 3 cases were female (2.71 .0).The median age was 3 months.The clinical symptoms of HCoV infection included cough (1 1 /1 1 cases,1 00.0%),wheezing (1 0 /1 1 cases,90.9%),fever (6 /1 1 cases,54.5%)and poor appetite (7 /1 1 cases,63.6%).Wheezing (8 /1 1 cases,72.7%)and moist rale in inspiratory phase (5 /1 1 ca-ses,45.4%)could be heard.Most patient′s chest X -ray showed bronchopneumonia.Full blood count displayed that leukocyte was in the normal range.Conclusions Respiratory tract infection with HCoV -positive will be easier to spread to ALRTI,especially in infants less than 1 year old.The symptoms include fever,cough and wheezing,but poor appetite and diarrhea can also be detected.

Objective To investigate the correlation between invasion ability and cytoskeleton remodeling of hepatocarcinoma cell by atomic force microscopy (AFM) and to explore mechanical properties during genesis,development and invasion of hepatocellular carcinoma (HCC).Methods Four HCC cell lines (MHCC-97H,MHCC-97L,SMMC-7721 ,Huh-7 )with different invasive ability were studied.Mechanical parameter (Young′s modulus)was measured by AFM.The pattern of cytoskeleton remodeling of HCC cell lines with different invasive ability was detected by immunofluorescent staining. The difference of cell invasive ability was tested by cell scratch experiment in other to verify mechanical data.Kruskal-Wallis H test was used to compare the differences between groups.Results The results of AFM indicated that Young′s modulus of cytoplasma area and nucleus area decreased gradually as cell invasion ability increased (χ2 =472.78,622.43,both P <0.01).According to invasive ability from low to high,Young′s modulus of cell cytoplasm area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 1 602.43 (845 .48,3 317.25)Pa,1 055 .28 (367.48,2 280.77)Pa,1 026.78 (369.20,2 019.96)Pa and 503.12 (366.11 ,700.31)Pa,respectively.Young′s modulus of cell nucleus area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 2 823.98 (1 262.78,4 440.07 )Pa,1 313.43 (590.71 , 2 678.62)Pa,1 285 .17 (583.29,1 961 .19)Pa and 655 .57 (441 .29,943.39)Pa,respectively.The results of immunofluorescent staining showed that the stronger the cell invasive ability,the worse cytoskeletal integrity and more irregular cell microfilament distribution. In cell scratch assay, the migration rate of MHCC-97H was 46.67% in 24 h and 86.47% in 48 h,that of MHCC-97L was 45 .70%in 24 h and 82.86% in 48 h,that of SMMC-7721 was 39.41 % in 24 h and 79.85 % in 48 h and that of Huh-7 was 34.60% in 24 h and 72.09% in 48 h,which showed that the cell migration orderly in creased as the cell invasion ability increased.Conclusions It seemed that HCC with higher invasive ability had lower Young′s modulus,softer cell,stronger deformability,worse cytoskeleton integrity and more irregular cell structure,and vice versa.

Objective To evaluate the value of polymerase chain reaction (PCR) combined with probe detection method in diagnosis of Mycoplasma pneumonia (MP) pneumonia (MPP) in children and to analyze the factors influencing the diagnostic accuracy,and to identify the rate of MP mutation for drug resistance and the involving factors.Methods Two hundred and twenty-five children with MPP hospitalized in the Department of Respiratory Medicine,Beijing Children's Hospital,Capital Medical University between June 2015 and March 2016 were enrolled in this study.Nasopharyngeal swab samples from the participants within 24 hours of admission were detected by using PCR combined with fluorescence probes for MP-DNA and macrolide-resistant mutations.The information of age,sex,clinical symptoms,course of disease,duration by admission,the history of macrolide treatment and the increase or decrease of quadruple or more serum MP antibody titer were extracted from medical records within 4 weeks of treatment,which received further correlation analysis with the detection rate of MP-DNA and the drug resistance mutation.Results The sensitivity of the MPP by using the method of PCR combined with fluorescence probes was 80.4％ (181/225 cases),while the specificity was 98.0％ (99/101 cases).The MP-DNA positive rate for patients with double MP antibody 4 times increased during treatment was 88.8％ (71/80 cases),which was significantly higher than that of patients with antibody titer ≥1 ∶ 160 [75.9％ (110/145 cases)],and the difference was sigmficant(x =5.443,P =0.020).The positive rate of MP-DNA of patients had no obvious association with gender,age,and disease duration and macrolide treatment history before admission.Macrolide-resistant mutation rate of MP-DNA was 85.1％ (154/181 cases),macrolide-resistant mutation rate of MP for patients finishing one course of macrolide treatment when admission(89.6％)was higher than that of the patients without using macrolide and the patients treated with macrolide but not finishing one course of treatment (71.9％ and 86.6％),and the significant difference among the three groups was observed(x2 =4.454,P =0.035).Conclusions PCR combined with fluorescence probe for MP-DNA detection has a high accuracy for the diagnosis of MPP,and the overall mutation rate is high,suggesting that the clinical treatment of MPP needs to be adjusted according to drug resistance in children.

OBJECTIVE:To provide reference for rational use of antipsychotic drugs in schizophrenia patients. METHODS:The general information and antipsychotic treatment information,which were extracted from the database of prior drug investigation in Mental Health Center of Hebei Province in 2002,2006 and investigation data in 2012 of 5014 schizophrenia patients,were ana-lyzed. RESULTS:Over time,the frequency of the first generation antipsychotic drugs decreased(P<0.05),while that of the sec-ond generation antipsychotic drugs increased (P<0.01). The frequency of long-acting antipsychotic drugs were generally low among outpatients and inpatients in 2002,2006,2012,with statistical significance(P<0.01). There were no significant difference in the proportion of outpatients receiving antipsychotic drugs combination treatment and monotherapy (P>0.05). Over time,the proportion of inpatients receiving monotherapy decreased,while that of inpatients receiving combination treatment increased (χ2=18.682,P<0.01). CONCLUSIONS:The second generation antipsychotic drugs have gradually replaced the first generation antipsy-chotic drugs,and have became the leading drugs in the treatment of schizophrenia in Hebei province. The proportion of inpatients receiving combination treatment has increased,which is different from the domestic and foreign prevention and treatment guide-lines.

Objective:To screen the factors that were conducive to prolonging the effective half-life of 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive 131I. Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired t test. The factors which were conducive to prolonging the effective half-life of 131I were analyzed by linear and multiple regression analyses. Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% vs (82.38±2.33)%; t=2.674, P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% vs (82.12±2.27)%; t=2.644, P=0.010), prolonged the effective half-life of 131I ((123.03±3.09) vs (130.38±2.49) h; t=2.656, P=0.010), and decreased serum FT 3 ((26.46±1.65) vs (21.31±1.42) pmol/L; t=3.421, P=0.001) and serum FT 4 ((56.59±2.12) vs (49.24±2.19) pmol/L; t=3.289, P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of 131I before lithium carbonate treatment were related to the effective half-life of 131I after lithium carbonate treatment ( b values: from -0.576 to 0.642, all P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of 131I after taking lithium carbonate ( b=0.642, 95% CI: 0.453-0.832, P<0.001). Multiple linear regression equation was y=-49.785+ 0.642 x. Lithium carbonate treatment could prolong the effective half-life of 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%. Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of 131I after taking lithium carbonate.

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.

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder (OAB).Methods A total of 20 outpatients with OAB of.1 - 20 ( mean, 8 )years, 12 males and 8 females, aged 21 - 83 ( mean, 43) years were included in this study.Five mg solifenacin was given orally once daily for 12 weeks.Before and after treatment, overactive bladder symptom score (OABSS), patient perception of bladder condition symptoms rating scale (PPBC), and filling cystometry was performed.Results Before and after solifenacin administration, significant decrease were detected in term of unstable detrusor waves ( 2.3 ± 2.4) vs (0.6 ± 1.3 ) ( P ＜ 0.05 ), and detrusor overactivity ( DO ) disappeared in 6 patients.Bladder capacities at first desire to void and maximum bladder capacity were significantly increased (P ＜0.01 ).Bladder compliance and detrusor pressure at maximum urine flow had no significant difference (P ＞ 0.05 ).All patients had significant improvement in OAB symptoms evaluating by OABSS and PPBC ( P ＜ 0.05 ).Six patients had mild side effect of dry mouth and could be relieved by drinking more water.Conclusion Urodynamically, solifenacin decreases the detrusor overactivity, increases the bladder capacity and improves the quality of life of OAB patients.

Objective To investigate the association of radial arterial calcification damage with bone mineral density (BMD) and bone metabolism biomarkers in uremia patients.Methods Sixty-seven incident hemodialysis patients were recruited into uremic group.Serum creatinine,calcium,phosphorus,lumbar spine and femoral neck BMD were measured.Parathyroid hormone (iPTH),25OHD,1,25(OH)2D,fibroblast growth factor (FGF) 23,bone specific alkaline phosphates (BAP) and osteocalcin (BGP),type Ⅰ collagen pyridine crosslinked C-telopcptidc (ICTP) were detected.Radial artery calcification was analyzed by von Kossa staining and transmission electron microscopy.Arterial type Ⅰ collagen (Col Ⅰ) expression was examined.Twenty-three healthy cases received serum and BMD examination only as control.Results Uremic patients presented higher serum phosphate,iPTH,FGF23,lower serum calcium,25OHD,1,25 (OH)2D (all P ＜ 0.05),and lower lumbar spine and femoral neck BMD (all P ＜ 0.01) compared to controls.Significant calcium deposit was observed in radial arteries in 24 uremic cases (35.8％),including 10 cases of diabetes.Immunohistochemistric assay confirmed that Col Ⅰ expression increased around calcification site and electron microscope revealed that more calcium and phosphorus plaque attached among collagen fibers.No correlation was showed between iPTH and radial artery calcification (r =-0.08,P =0.306),but after stratified by iPTH levels,correlation of iPTH and calcification was found in low iPTH (＜ 150 ng/L) group and high iPTH group (＞ 300 ng/L) (r =-0.41,0.31,P=0.044,0.023).Diabetes,lumbar spine and femoral neck BMD,ICTP,FGF23 were correlated with arterial calcification (r =0.62,-0.25,-0.43,0.34,0.86,P =0.000,0.001,0.012,0.018,0.000).Multiple regression analysis showed femoral neck BMD,ICTP,FGF23 levels were independently associated with radial arterial calcification (β =-0.221,0.181,0.260,P =0.021,0.024,0.036).Conclusion In uremic patients,reduced BMD,abnormal bone turnover rate,especially accelerated bone reabsorption,and increased serum FGF23 level are independently associated with radial artery calcification.

Objective To explore the structure of violent attitude and the predictive character of the passionate criminal and recidivist. Methods This study used FMMU-Abnormal Personality Risk Factors Inventory (FMMU-APRI) for measuring explicit violent attitude of the passionate criminal and recidivist in prison; while used the picture Attitude Activation paradigm (AAP) for assessing implicit violent attitude. Results The AAP results showed that parts of passionate criminal and recidivist had reversed priming effect, according to whether reversed, there were divided into four types: no-reversal passionate criminals, reversal passionate criminals, no-reversal recidivists and reversal recidivists, VIO scores of no-reversal passionate criminals and recidivists recidivist were significantly higher than the norm, as reversal passionate criminals and recidivists had no significance; in noreversal passionate criminals, compatible response rate was 1.104, incompatible response rate was 1.053; in reversal passionate criminals, compatible response rate was 1.042, incompatible response rate was 0.997; in no-reversal recidivists, compatible response rate was 1.059, incompatible response rate was 1.097; in reversal recidivists , compatible response rate was 1.039, incompatible response rate was 0.998, as each group had strong priming effect, and each group had a dissociation of implicit and explicit violent attitude. Conclusion The results suggest that offenders who have committed a crime in the same category also had a different violent attitude; and integrating indirect methods with direct methods would predict a crime more accurately.