Objective To investigate the application of Montreal Cognitive Assessment (MoCA) and Mini- Mental State Examination (MMSE) in cognitive function evaluation for stroke patients during convalescence. Methods 127 stroke patients were selected and both Mo-CA and MMSE were conducted to assess their cognitive function. Results The detection rate was higher with MoCA (86.61%) than with MMSE (57.48%) (P<0.05). Conclusion Compared to MMSE, MoCA covers a broader scope of cognitive function, and is more sensitive.

Objective To investigate the effect of heroin abuse on attention switching. Methods Thirty-six Heroin abusers (33 males, 3 females) and 36 controls (32 males, 4 females) were enrolled in the study. Their cognitive function was tested by using the Switching Task, including Sustained Attention trials and Switching Attention trials. The reaction time and accuracy were recorded separately by the computer. Results The accuracy or reaction times were not signifi-cantly different between Switching Attention trial and Sustained Attention trial in heroin abusers, suggesting a lower Switch Costs value compared to the healthy controls [(19.7 ± 66.8) ms vs. (85.1 ± 92.4) ms]. The healthy controls showed faster reaction speed [Sustained Attention trial (695.3 ± 95.9) ms vs. Switching Attention trial (780.3 ± 93.3) ms, P<0.05] and higher accuracy [Sustained Attention trial (98.0%±2.2%) vs. Switching Attention trial (93.8%±5.0%), P<0.05] under the Sustained Attention trial. Compared with the healthy controls, the heroin abusers showed slower reaction speed [(791.6 ± 74.3) ms vs. (695.3±95.9) ms, P<0.05] and lower accuracy [(92.5%±8.4%) vs. (98.0%±2.2%), P<0.05] in Sus-tained Attention trial, but not in Switching Attention trial. Conclusions The present study has revealed absence of Switch Costs in heroin abusers, which may be related to the damage of heroin abusers in their Sustained Attention function.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.

Objective To compare effectiveness,performance,and complications between ultrasound-guided selective cervical nerve root block and interscalene brachial plexus block for patients undergoing arthroscopic surgery in perioperative period.Methods Seventy patients scheduled for arthroscopic surgery,25 males and 45 females,aged 18-75 years,were randomly divided into two groups.They were given either selective cervical nerve root block (group S,n =35) or interscalene brachial plexus block (group ISB,n=35).In group S,C5 and C6 nerve roots were given 0.5％ ropivacaine 5 ml respectively;In group ISB,patients were given 0.5％ ropivacaine 10 ml under ultrasound guidance.The primary outcome:VAS score and forearm modified Bromage scale (MBS) score were recorded at 4,12 and 24 hours after surgery;Secondary outcomes:cumulative tramadol consumption,the patients' satisfaction rate and adverse effects were recorded.Results The VAS scores in group S was significantly lower than that in group ISB at 12 hours after surgery (1.7±0.8 vs 3.6±0.7,P＜0.05).The forearm MBS scores in group S was significantly higher than that in group ISB 4 hours after surgery (P＜0.01).Compared with group ISB,the amount of tramadol consumption was lower at 24 hours after surgery [(37.5±35.9) mg vs (112.5±43.5) mg,P＜0.05)].The satisfaction rate of group S was higher than group ISB (88％ vs 56％,P＜0.05).There was no significant difference in side effects between the two groups.Conclusion In arthroscopic surgery,the selective cervical nerve root block is superior to the brachial plexus block.

Objective To study the validity of RAND-UCLA (Rand Corporation and University of California at Los Angeles) consensus panel method in developing guidelines of referral indications for low back pain (LBP).Methods Evidence-based clinical guidelines for LBP management at community level and its referral guidelines published since 2001 and other tools were retrieved with varied tools.All clinical guidelines met inclusion criteria were evaluated with clinical studies and evaluation tools (AGREE).An pool of indication items was established based on evidence for developing referral indications for LBP, which were added by RAND-UCLA consensus panel method, and alternative referral indications were selected and clinical guidelines for LBP referral were established.Results A total of 15 copies of clinical guidelines from nine countries or regions were included in it after critical appraisal.Four copies of referral guidelines from two countries were included.Referral indications for LBP were derived directly from the RAND-UCLA consensus panel process, consisting of 44 referral indications for three groups (immediate, urgent and routine referral).Conclusions The RAND-UCLA consensus panel method is a more useful and practical tool in developing clinical guidelines, referral guidelines, which is worthwhile being recommended and spread.

Objective:To investigate the prevalence of depressive disorders among school students aged 6-16 years in Beijing, the effect of age and gender on the prevalence, and the behavioral and emotional profiles of identified students with depressive disorders.Methods:The prevalence of depressive disorders in primary and secondary school students aged 6-16 years in Beijing from January 2012 to December 2014 was examined by a multistage stratified random sampling method.In the first stage, the Achenbach′s Child Behavior Checklist (CBCL) was used to identify high-risk children and adolescents.In the second stage, the high-risk group was further screened by Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and then two psychiatrists made the final diagnosis according to the diagnostic criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ). This study was a prospective epidemiological investigation.The effect of age and gender on the disease prevalence was analyzed by Chi- square test. Results:About 2.29% (234/10 215 cases) of the school students aged 6-16 years in Beijing had depressive disorders.The incidence of depressive disorders was 1.80% (106/5 866 cases) in boys and 2.94% (128/4 349 cases) in girls.There is an age effect on the prevalence of depression.As the age increases, the morbidity of depressive disorders increases.The age of 12 years was a critical turning point, and the peak incidence was reached at around the age of 15 years.The emotional and behavioral problems of patients with depressive disorders mainly include social problems, withdrawal depressed, anxiety and depressed, somatic complaints, and aggressive behavior.Conclusions:The prevalence of depressive disorders among school students aged 6-16 years in Beijing is 2.29%.Depressive disorders occur in primary and middle school students of all ages.More attention should be paid to the mood of students before and after the entrance exams for junior high school and senior middle school, especially the girls′ mood.In the process of screening, diagnosis and treatment of depressive disorders, the atypical symptoms of depression need to be paid more attention.

Objective:To explore the effects of 75% ethanol pre-degreasing combined with 0.5% iodophor disinfection on the number of colonies in the surgical site of brain tumors and the postoperative healing of surgical incisions.Methods:Totally 142 patients who underwent surgery for brain tumors in the Department of Neurosurgery, Qinhuai Medical Area, General Hospital of Eastern Command Theater from January 2017 to December 2018 were selected by convenient sampling, and divided into the control group and the observation group according to the random number table. Patients in the control group received 0.5% iodophor disinfection conventionally, while the surgical site of patients in the observation group was pre-degreased with 75% ethanol prior to 0.5% iodophor disinfection. The number of skin colonies in the surgical site, the continuous exudation time of the incision and the infection of the incision were compared between the two groups.Results:The number of colonies in the observation group was (3.73±0.62) cfu/cm 2 preoperatively and (3.92±0.47) cfu/cm 2 at the end of the operation, both lower than those of the control group, and the differences were statistically significant ( t=2.684, 5.559; P<0.05) . The time of postoperative incision exudation of the observation group was (2.12±0.95) days, which was lower than that of the control group, and the difference was statistically significant ( t=5.415, P<0.05) ; 2 cases of incision infection occurred in the observation group and 9 cases in the control group, and the difference was statistically significant (χ 2=4.834, P<0.05) . Conclusions:In craniotomy for brain tumors, pre-degreasing with 75% ethanol and disinfecting with 0.5% iodophor can reduce the number of colonies in the surgical site, the duration of wound exudation, and the incidence of incision infection.

Objective To explore the effect of doctor-nurse integration mode health education on the compliance of patients with breast cancer treated with Fulvestrant injection. Methods A total of 89 patients with breast cancer who received Fulvestrant injection in Breast Center of the Affiliated Hospital of Qingdao University were selected from October 2015 to June 2016 by convenient sampling method and they were divided into observation group (n=46) and control group (n=43) using randomly number table method. Patients in the control group received routine outpatient clinic medication treatment, while patients in the observation group received extra doctor-nurse integration mode health education during the treatment circle. Endocrine therapy compliance questionnaire for breast cancer patients was applied to assess treatment compliance of patients in two groups. Results After the implementation of doctor-nurse integration mode health education, scores of treatment compliance and each dimension of observation group were significantly higher than those of the control group (P<0.05). Conclusions For patients with breast cancer treated with endocrine therapy for a long time, the implementation of doctor-nurse integration mode health education could improve the compliance of patients, ensure the completion of the treatment cycle and promote the rehabilitation of patients.

OBJECTIVE： To establish the fingerprint of Mahai zhitan capsule， to determine the contents of main components， and to provide scientific basis for the stability and quality control of the preparation technology. METHODS： The determination was performed on Inertsil ODS-3 column with acetonitrile-0.1％ phosphoric acid as mobile phase （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 250 nm （0-23 min and 31-120 min） and 230 nm （23-31 min）. The column temperature was set at 30 ℃. HPLC fingerprint for 10 batches of Mahai zhitan capsule was established by using “similarity evaluation software for chromatographic fingerprint of traditional chinese medicine” （2012 edition） and the similarity was evaluated. The chromatographic peaks were assigned and identified with reference substance， negative samples without ingredient and substance control respectively， and the identified main components were quantitatively analyzed. RESULTS： The similarity of 10 batches of sample was more than 0.99； 20 common peaks were found， and 10 common peaks were identified. Among them， No. 1，13，14，15，16，17，18，19，20 chromatographic peaks originated from Rheum palmatum； No. 3，4，6，7 chromatographic peaks originated from processed Strychnos nuxvomica； No. 8 chromatographic peaks originated from Angelica sinensis； the corresponding source of medicinal materials was not found in No. 2，5，9，10，11，12 chromatographic peaks. By comparing the reference substances， No. 1，4，6，7，8，16，17，18，19 and 20 chromatographic peaks were identified as gallic acid， loganin acid， strychnine， brucine， ferulic acid， aloe-emodin， rhein， emodin， chrysophanol and emodin methyl ether， respectively. In the determination of identified five main components （loganin， strychnine， brucine， emodin and chrysophanol）， the methodological investigation met the relevant standards. In 10 batches of samples， the contents of loganin， strychnine， brucine， emodin and chrysophanol were 2.477 1-2.785 9， 1.746 1-1.946 0， 1.374 6-1.505 8， 1.573 2-1.824 1 and 0.232 1-0.261 7 mg/g， respectively. CONCLUSIONS： The established method is reliable， accurate， stable and simple， which could provide reference for the preparation technology and quality control of Mahai zhitan capsule.