Objective: To investigate the trend in burden of mental disorders among the elderly in China from 1990 to 2021, so as to provide the basis for formulating prevention, control and intervention measures for mental disorders in this population. Methods: Based on the data of the Global Burden of Disease 2021 (GBD 2021), the number of cases, prevalence, disability-adjusted life years (DALY) and DALY rate of mental disorders among the elderly in China were collected, and standardized prevalence and DALY rate were calculated using the world standard population. The burden of mental disorders was analyzed, and the trend in burden was analyzed using average annual percent change (AAPC). Results: The standardized prevalence and standardized DALY rate of mental disorders among the elderly in China showed upward trends from 1990 to 2021 (AAPC=0.160% and 0.286%, both P<0.05). In 2021, there were 38.944 9 million cases of mental disorders among the elderly in China, the DALY was 5.389 8 million person-years, the standardized prevalence was 14 462.91/105, and the standardized DALY rate was 1 993.69/105, with the increases of 184.12%, 192.90%, 5.71% and 9.60% compared to 1990, respectively. The burden of mental disorders increased significantly among the elderly aged 60 to <65, 65 to <70, 70 to <75, and 75 to <80 years, with the increases of 5.81%, 5.92%, 6.08% and 6.03% in prevalence, and the increases of 10.16%, 10.12%, 10.31% and 9.88% in DALY rates, respectively. Depression and anxiety ranked the top two in standardized prevalence and standardized DALY rates. The standardized prevalence and standardized DALY rate of autism showed the largest increases, at 18.82% and 18.10%, respectively, while congenital intellectual disabilities exhibited the largest decreases, at 36.15% and 29.71%, respectively. The standardized prevalence and standardized DALY rate of mental disorders were higher in women than in men (both P<0.05). Compared to men, women had higher standardized prevalence and standardized DALY rates of depression, anxiety and congenital intellectual disabilities, but lower standardized prevalence and standardized DALY rates of schizophrenia, autism, attention deficit hyperactivity disorder, and other mental disorders (all P<0.05). Conclusion The burden of mental disorders among the elderly population in China showed an upward trend from 1990 to 2021, with heavier burdens observed among women, individuals aged 60 to <80 years, and those with depression and anxiety.

Objective To evaluated the value of myocardial perfusion before delayed percutaneous coronary intervention (PCI) for predicting the recovery of systolic function of patients with acute myocardial infarction (AMI).Methods A total of 64 patients with AMI receiving delayed PCI treatment in the First People's Hospital of Foshan from January 2014 to June 2015 were selected.One day prior to delayed PCI,all of the patients underwent two dimensional strain to measure the longitudinal peak systolic strain (LPSS) of each left ventricular segment and the global longitudinal strain (GLS) of the left ventricle.The myocardial perfusion score (MPS) and the perfusion score index (PSI) were measured by myocardial contrast echocardiography (MCE).Left ventricular myocardial perfusions were classified as good,reduced,or absent.The two dimensional strain measurements were again conducted at 6 months after the delayed PCI to assess LPSS and GLS.The change of GLS and LPSS between one day prior to delayed PCI and six months after delayed PCI was assessed by paired t-test.The differences of LPSS among good,reduced,or absent myocardial perfusion groups were analyzed by one-way ANOVA.LSD-t test was used to compare in pairs of groups that had different values.The correlations between PSI and GLS,MPS and LPSS were assessed by Spearman's rank-correlation test.Results The GLS of all patients were higher at six months after delayed PCI than at one day prior to delayed PCI [(-15.39±7.80)％ vs (-12.44±8.38)％,t=14.398,P ＜ 0.001].The LPSS of myocardial perfusion in good,reduced and absent groups at one day prior to delayed PCI were (-2.64±5.60)％,(-6.19±6.87)％ and (-12.07±5.86)％,respectively.The LPSS of myocardial perfusion in good,reduced and absent groups at six months after delayed PCI were (-2.97 ± 4.93)％,(-11.38± 7.26)％ and (-15.82 ± 5.97)％,respectively.The myocardial LPSS of left ventricular segment with good or reduced perfusion was significantly higher at six months after delayed PCI (t=13.013,10.821,both P ＜ 0.001),but the LPSS of left ventricular segment with absent perfusion was similar to that of pre-PCI.Whether at one day prior to delayed PCI or six months after delayed PCI,there were significant differences in LPSS parameters among the three groups (at one day prior to delayed PCI,myocardial perfusion absent vs reduced or good,t=4.201 and 11.771,both P ＜ 0.001;myocardial perfusion reduced vs good,t=12.561,P ＜ 0.001;at six months after delayed PCI,myocardial perfusion absent vs reduced or good,t=9.714 and 15.646,both P ＜ 0.001;myocardial perfusion reduced vs good,t=9.254,P ＜ 0.001).The LPSS both at one day prior to delayed PCI and six months after delayed PCI in myocardial perfusion good group ＞ those of myocardial perfusion reduced group ＞ those of myocardial perfusion absent group.PSI was positively correlated with GLS at both one day prior to delayed PCI and six months after delayed PCI (r=0.69,0.72,both P ＜ 0.001).MPS was positively correlated with LPSS at both one day prior to delayed PCI and six months after delayed PCI (r=0.49 and 0.45,both P ＜ 0.001).Conclusion Myocardial perfusion before delayed PCI,monitored by MCE,is correlated well with myocardial systolic function,and may be used to predict the recovery of myocardial systolic function after delayed PCI.

Objective To explore the clinical efficacy of nibble debridement combined with silver ions dressing in treatment of diabetic foot ulcer.Methods The data of 238 patients with diabetic foot ulcer in people's hospital of Meishan from January 2012 to December 2016 were retrospectively analyzed.Of which 125 patients were treated by nibble debridement combined with silver ions dressing(nibble debridement group),113 patients were treated with surgical debridement combined with silver ions dressing(surgical debridement group).The clinical efficacy,wound healing time and complication between two groups were compared.Results The wound healing time of nibble debridement group was (37.5 ± 10.8) days,which was shorter than (45.3 ± 11.7) days of surgical debridement group,the difference was significant (P ＜0.05).The total effective rate of nibble debridement group was 92.80％,which was higher than 73.45％ of surgical debridement group,the difference was significant(P ＜ 0.05).No complication occurred in two groups.Conclusion The method of nibble debridement combined with silver ions dressing treatment has a better satisfactory clinical result,shorter wound healing time and lower medical costs for patients with diabetic foot ulcer.

Objective To explore the distribution characteristics of ankle-brachial index ( ABI) examination for peripheral arterial dis-ease in diabetic patients, and to provide basis for clinical diagnosis. Methods Randomly selected 110 cases of patients who were admitted into our hospital from February 2014 to January 2015, and divided them into the observation group (34 cases with diabetic lower extremity peripheral vascular lesions) and the control group (76 cases without diabetic lower extremity peripheral vascular lesions). Measured the ABI of the two groups, and analyzed the value of ABI data range for the diagnosis of diabetic lower extremity peripheral vascular lesions. Mean-while, analyzed the risk factors of peripheral arterial disease in diabetic patients according to ABI. Results The sensitivity of ABI for diag-nosis of diabetic lower extremity peripheral vascular lesions was 91. 18%, and the coincidence rate was 95. 36%, the specificity was 98. 68%, the misdiagnosis rate was 8. 82%, and the omission diagnostic rate was 8. 82%. ABI of the observation group was obviously lower than that of the control group, and the difference was statistically significant (P<0. 05). Conclusion ABI examination could be basis of clinical diagnosis and important standard of disease assessment for peripheral arterial disease in diabetic patients. It is suggested to strengthen the control of blood glucose, blood pressure and weight of patients with diabetes in order to reduce the risk of morbidity.

Objective To identify the specific genotype and analyze clinical features of spinocerebellar ataxias (SCAs) pedigree in the region of Yunnan Province.Methods Fourteen SCAs pedigrees and 183 blood samples of the family members were collected between January 2011 and July 2014 from Department of Neurology,First Affiliated Hospital of Kunming Medical College.Polymerase chain reaction (PCR) amplification,agarose gel electrophoresis and DNA sequencing technologies were utilized to identify the specific genotype of SCAs pedigree.Presymptomatic tests were carried out and the clinical features and genetic test results of patients were carefully analyzed.Results SCA3 was the most common subtype of SCAs in the Han nationality of Yunnan region.Nine of the 14 families were SCA3,only one family was SCA2.Additionally,there were four SCAs families that remained indeterminate.The patients with di-allele mutations (46/77) of SCA3 gene had early onset,rapid progression and serious clinical symptoms.Hereditary SCA3 and autonomic dominant polycystic kidney disease can happen simultaneously in a family.The proband SCA3 gene' s CAG repeat number is 28/76,and repetitions of the mutation allele are in all range.The PKD1 gene exon 23 is found to be in abnormal sequence.Conclusions SCA3 is the most common subtype of SCAs in the Han population of Yunnan region.There are 15/46 incomplete penetrance nutation and 46/77 di-allele mutations.It is possible that di-allele mutations make the disease worse and accelerate clinical course progression.SCA3 and polycystic kidney disease can uncommonly happen simultaneously in a family,which perhaps suggests there are interactions between the two disease-virulence genes.

Objective To explore the effect of Chaihu Shugan Powder (CSP) on the content of 5-hydroxytryptamine (5-HT) in the hippocampus and the expression of tryptophan hydroxylase 2(TPH2) in median raphe nuclei in depression rats.Methods SD rats were randomly divided into normal group(n=12),model group (n=12),fluoxetine group (n=12),low-dose and high-dose CSP group (n =12,respectively).Depression model was made by reserpine intraperitoneal injection.During the experiment,the weight and the open-field scores were calculated;the content of 5-HT was detected by ELISA.The expression of TPH2 in median raphe nuclei was detected by Western blot.Results Compared with the weight ((225.02±5.23) g),the open-field scores ((12.6± 5.1)score) and content of 5-HT ((1.09±0.27) ng/ml) in the model group,high-dose CSP showed significantly improve the depressive rats in weight,open field score and content of 5-HT ((238.78±5.16) g,(15.6±7.8) score and (1.80±0.58) ng/ml,respectively;P＜0.05 or P＜0.01).The expression of TPH2 (0.66±0.21) in median raphe nuclei in the high-dose CSP group was apparently increased compared with that in the model group(0.16±0.04) (P ＜0.01).Conclusion CSP have the effects of anti-depression,which could be related with the increase of the 5-HT content in the hippocampus and the expression of TPH2 in median raphe nuclei.

Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.

Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years (P<0.05). There was a significant difference in WAI between different occupational stress groups (P<0.05). WAI was negatively correlated with ORQ score and PSQ score (r_s=-0.387, P<0.05; r_s=-0.467, P<0.05) and positively correlated with PRQ score (r_s=0.343, P<0.05). The multiple linear regression analysis showed that high ORQ score and PSQ score were the inhibitory factors for high WAI (B=-0.058; B=-0.082) and high PRQ score was a contributing factor for high WAI (B=0.029) . Conclusion Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.

Objective:To observe the correlation between the frontal P-wave axis and the severity of chronic obstructive pulmonary disease (COPD) and the prognosis evaluation system.Methods:Patients with COPD>45 years old who were followed up in the outpatient department of Hunan Chest Hospital from January to July 2022 were continuously selected as subjects. At the same time, the healthy people who examined in the health management center of our hospital were in the control group. Both groups of subjects completed electrocardiogram and pulmonary function tests. The level of frontal P-wave axis and the results of pulmonary function examination were recorded, and the differences of frontal P-wave axis between the COPD group and the control group were compared, so as to clarify the value of frontal P-wave axis in the diagnosis, disease severity and prognosis evaluation of COPD.Results:The level of forced expiratory volume in the first second/forced vital capacity(FEV1/FVC )in the COPD group was significantly lower than that in the control group, while the level of P-wave axis was significantly higher than that in the control group (all P<0.05). The receiver operating characteristic (ROC) curve of P-wave axis showed that the AUC of P-wave axis in predicting COPD was 0.96 ( P<0.001), the best cut-off value was 63.80, the sensitivity was 0.89, and the specificity was 0.93. There were significant difference in P-wave axis level, the forced expiratory volume in one second to forced vital capacity ratio (FEV 1%pred), body mass index (BMI) and BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index between groups according to the degree of airflow limitation (all P<0.05). Correlation analysis showed that P-wave axis level was positively correlated with BODE index ( r=0.77, P<0.001), and negatively correlated with pulmonary function FEV 1%pred ( r=-0.76, P<0.001). Conclusions:There is a good correlation between the level of frontal P-wave axis and the severity of COPD and the prognosis evaluation system, which has clinical application value.

Objective Through project performance management,to mobilize the enthusiasm of hospital information de-partment engineers and ensure the quality of hospital information project construction.Methods Change the traditional perform-ance allocation scheme,with the project as the main KPI value,and evaluate the comprehensive score through three dimensions:project stage coefficient,difficulty coefficient,and plan completion degree,to obtain the activity coefficient for performance allo-cation.Results Following the principle of"more work,more pay"and"better work,more pay",employees who have the cour-age to undertake information technology projects have received higher performance-based salaries.Conclusion By changing the performance allocation plan,the success rate of information technology projects has been improved,and the overall technical level and professional literacy of the information department have been improved.