Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.

Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.

Objective To investigate the occurrence of posttraumatic stress disorder (PTSD) and the relationship between PTSD and emotional regulation strategies of mothers with neonates hospitalized in the neonatal intensive care unit (NICU). Methods One hundred and twenty-seven postpartum women with neonate hospitalized in the NICU were selected from a general hospital. All the cases were investigated by PTSD check list-Civilian version (PCL-C) and emotion regulation questionnaire (ERQ). Results The incidence of PTSD of postpartum women with neonate in NICU was 13.4%(17/127). The expressive suppression scores in positive PTSD group were (17.76±2.46) points,which were significantly higher than (14.16 ± 5.14) points in negative PTSD group (t=-4.659, P<0.01). Expressive suppression contributed significantly positive correlation to the total and the dimension scores of PCL-C (r=0.187-0.243, P<0.05 or 0.01). Expressive suppression was found to contribute significantly to the explained variance in mothers′ PTSD (P<0.05), whereas no association was found between PTSD and cognitive reappraisal (P>0.05). Conclusions The admission of neonates to the NICU is a stressful event for mothers, which could cause PTSD symptoms. PTSD has a closer relationship with expressive suppression, rather than cognitive reappraisal. Therefore, health workers should instruct mothers with neonates in NICU to regulate emotions by appropriate coping strategies, decreasing the possibility of psychological problems, promoting the mental health of women in the perinatal period.

Objective To exam the quality of life of the caregivers of patients with breast cancer, to explore their related factors, including medical characteristics of the patients, demographic characteristics of the caregivers, relationship with the patients, social support and psychological resilience, and to test the mediating and moderating roles of psychological resilience between social support and quality of life. Methods A total of 179 hospitalized patients diagnosed with breast cancer were recruited in Qilu Hospital of Shandong University. The self-designed demographic questionnaire, Medical Outcome Study 12-Item Short Form Health Survey,Version 2(SF-12V2), Perceived Social Support Scale(PSSS), and 10-item Connor-Davidson Resilience Scale(CD-RISC-10) were used to collect information about demographic characteristics and measure the quality of life, perceived social support and psychological resilience of the caregivers. The factors affecting the quality of life of the caregivers were analyzed by multiple linear regression analysis, and the mediating and regulating effects of mental resilience on social support and mental health were analyzed. Results The age of the caregivers was negatively correlated with the physical health (P=0.010). The score of the body health of the family members of the middle and late stage cancer patients was lower than that of the family members in the early stage (P=0.003). There was a positive correlation between friend support and resilience and mental health (P<0.01). Resilience played a moderating role and mediating role in the relationship between friend support and mental health. Conclusions Attention should be paid to the quality of life of caregivers in patients with breast cancer. The medical staff should provide more social support for the caregivers, and should pay more attention to improve the psychological resilience of the caregivers, guide them to better cope with the burden and pressure of care, and improve their mental health with half the effort.

Objective:To investigate the predictive effect of perioperative depression and anxiety symptoms in breast cancer patients on the fear of cancer recurrence.Methods:A total of 194 patients with breast cancer during perioperative period from May 2019 to May 2020 in Qilu Hospital of Shandong University were selected. The depression, anxiety and fear of cancer recurrence were investigated by the general information questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9) and the Fear of Progression Questionnaire-Short Form (FOR-Q-SF) at admission and two weeks after surgery, respectively.Results:Perioperative depression and anxiety symptoms of breast cancer patients were significant predictors of fear of cancer recurrence ( B value was 2.325, OR value was 10.22, P<0.05; B value was 2.570, OR value was 13.07, P<0.05), and patients with depression and anxiety symptoms after surgery were at higher risk of fear of cancer recurrence ( OR values were 7.653-25.403, P<0.01). Conclusions:For breast cancer patients with negative emotions and fear of disease progression, it is necessary to help them improve their psychological coping ability, encouraging patients to actively cooperate with follow-up treatment, improving the prognosis, and improving their overall quality of life.

The raw and processed roots of Plygonum multiflorum Thunb (PM) are used to treat different diseases in clinical practice. In order to clarify the influence of processing, a comparative study of chemical substance analysis was carried out. As the xenobiotics with a high enough exposure in target organs being considered as the potential effective or toxicity components, an in vivo study was also implemented to characterize the constitutes and metabolites, and meanwhile, the factor of compatibility with black bean were also considered. As a result, a total of 148 compounds were detected in PM extracts and more than 40 compounds were only detected in the processed products, which were probably new components produced during the steaming process. In in vivo study, 7 prototype components and 66 metabolites were detected or tentatively identified, 24 of which were reported for the first time. Our results indicated that processing greatly changed the chemical composition of PM and influenced the disposition of the compounds in vivo. To the best of our knowledge, this was the first global comparative study of raw and processed PM. These results expanded our knowledge about the influence of processing of PM and provided the essential data for further efficacy or toxicity studies.
Animals ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; metabolism ; Male ; Plant Preparations ; chemistry ; isolation & purification ; metabolism ; Plant Roots ; chemistry ; Polygonum ; chemistry ; Rats ; Rats, Sprague-Dawley ; Spectrum Analysis

A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.