Objective: To investigate the rate of post-stroke depression and psychosocial factors related to it, and to provide the direction and the basis for clinical nursing. Methods: 69 patients with stroke were assessed by Zung Self-rating Depression Scale and Type A Behavior Pattern Scale. Their sex, age, behavior type, marital condition, level of education, supportor of medical expenses were collected and analysed statistically. Results: The rate of post-stroke depression was 59.42%, and the rate in type A behavior group was higher than that in the other behavior groups(P

Medical team resource management is an effective way to control medical risk, ensure patient safety and enhance patient satisfaction. Based on defining the connotation, this paper illustrates the application and expe-rience of medical team resource management in Taiwan and finally proposes suggestions to apply medical team re-source management in domestic medical practice.

Objective To investigate the clinical effects of the treatment of cancer pain control by the partic-ipation of pharmacist,and the effect on cancer patients and families mental state and quality of life.Methods Clini-cal pharmacists took participate in the standardized treatment of pain,before and after different intervention,NRS scale was used to assess the patients'pain,self -rating anxiety scale(SAS)and self -rating depression scale(SDS)were used to assess the patients and families'psychological mental status.SF -36 scale was used to assess the quality of life.Results Compared with pre -intervention,two weeks later,the overall situation of patients with pain was signifi-cantly improved[NRS score (4.72 ±1.13)points vs.(3.57 ±0.97)points,t =7.722,P <0.01].Patients and their families,anxiety and depression significantly alleviated [patients:SAS (32.56 ±4.66 )points vs.(60.31 ± 4.27)points,t =38.180,P <0.01,SDS (45.89 ±5.46)points vs.(68.34 ±6.23)points,t =28.250,P <0.01;families:SAS(33.76 ±4.82)points vs.(50.31 ±6.47)points,t =15.593,P <0.01,SDS (32.89 ±3.54)points vs. (52.34 ±6.23)points,t =15.593,P <0.01 ].At the same time,the patients and families'quality of life were improved.Conclusion Clinical pharmaceutical care can relieve the body pain,meanwhile,those could effectively relieve the anxiety,depression and other negative psychology of cancer patients and families,improve the whole quality of life.

Objective To investigate the protection of agmatine on blood brain barrier (BBB) permeability and the effect on the expression of aquaporin 4 (AQP4) and matrix metalloproteinase 9 (MMP9) in ischemic reperfusion injury rats.Methods Sixty healthy male Sprague-Dawley rats were randomly divided into normal control group (NC),model group and agmatine group,and there were 20 rats in each group.Normal control group was treated with intraperitoneal injection of saline in 2 hours after incision and suture of skin.Model group was treated with intraperitoneal injection of saline in 2 hours after the establishment of middle cerebral artery occulation (MCAO) model.Agmatine group was treated with intraperitoneal injection of agmatine (AGM) in 2 hours after the establishment of MCAO model.The damage of blood brain barrier was detected by measuring the permeability of blood brain barrier.The infarct size of brain was observed with TTC staining.The morphological changes of neurons were observed with electron microscope.The expressions of AQP4 and MMP9 were detected using immunohistochemical method.Results The permeability of BBB of agmatine treatment group (0.31±0.10) decreased significantly compared with the model group (0.46±0.09) (P＜0.05),but was still significantly higher than the normal control group (0.24±0.12) (P＜0.05).There was no infarction area in normal control group and the infarction areas of agmatine group decreased obviously compared with the model group.Compared with model group,the number of neurons with morphological changes reduced significantly and the degree of pathological changes of neurons was obviously improved in agmatine group.Compared with normal control group,the expression of AQP4 and MMP9 in ischemic penumbra of left cerebral hemisphere parietal cortex in the rats of model group and agmatine group increased significantly(P＜0.05).And the expression of AQP4 and MMP9 in model group was significantly higher than that of agmatine group(P＜0.05).Conclusion Agmatine has a protective effect on BBB with ischemia-reperfusion injury due to its down-regulation the expression of AQP-4 and MMP-9.

Objective To evaluate the feasibility and safety of a delivery pathway for the performance of percutaneous left atrial appendage (LAA) occlusion in experimental canine models. Methods Transseptal puncture was performed via femoral vein approach under fluoroscopic and angiographic guidance in 12 experimental dogs. A pigtail catheter was advanced into the left atrium (LA), which was followed by LA angiography. The diameters of the neck of LAA were measured on LAA angiogram obtained in appropriate projection. After the delivery sheath was advanced along the wire into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably establish a pathway to advance the LAA occluder into LAA.

Objective:To analyze the root canal diameter of the mandibular first premolar by using finite element analysis to simulate the stress distribution of dentin under three different preparation methods,and to provide the basis for clinical root canal preparation strategies of the mandibular first premolars.Methods:Twenty-one patients with complete cone beam computed tomography(CBCT)images were selected.The original DICOM format data from CBCT were imported into Mimics 21.0 software to measure the root canal diameter at 3,6,9,and 12 mm from the apex and the root canal taper was segmentally calculated.Based on this,three-dimensional finite element models of the dental and periodontal tissues were constructed.Control group,maximum diameter preparation group,uniform preparation group,and 0.06 taper instrument preparation group were designed.In ANSYS Workbench 17.0 finite element analysis software,a 200 N load was applied to the buccal,lingual,and occlusal surfaces in various groups,and the stresses on dentin in various groups were analyzed.Results:The analysis of root canal taper at 3-6 mm,6-9 mm,and 9-12 mm from the apex of mandibular first premolar teeth showed that the taper was similar in the mesial-distal direction at 3-6 mm from the apex.The average taper in the buccal-lingual direction at 6-9 mm from the apex was 0.29,which was greater than the taper in the apical 1/3 and coronal 1/3.Under the same load,the peak stress values in dentin of mandibular first premolar teech in various groups were increased sequentially:4.693 6,16.304 0,14.278 0,and 18.682 0 MPa.The stress in maximum diameter preparation group concentrated on the canal wall with the highest stress value.The stress in uniform preparation group concentrated on the root surface,and the stress values on each section were lower than those in maximum diameter preparation group.The stress in 0.06 taper instrument preparation group concentrated on the apical 1/3 of the root surface.Conclusion:The root canal of the mandibular first premolar has a unique elliptical taper shape,and there are significant differences in diameter and taper between the mesial-distal and buccal-lingual directions.Different preparation methods result in different stress distributions on the canal wall,and the uniform preparation is the best method for enlarging the canal.

Objective To introduce a practical high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS)method for the detection of seven growth hormone-releasing peptides (GHRPs)including GHRP-1,GHRP-2,GHRP-4,GHRP-5,GHRP-6,Hexarelin and Alexamorelin and two growth hormone secretagogues(GHS)including anamorelin and ipamorelin,and study the stability of these nine substances in the human urine.Method The urine samples were purified and extracted by a solid phase extraction procedure using Oasis(R) WCX column.The urine was first centrifuged and taken out 1 mL into a small column,cleaned by 5％ NH4OH and 20％ CH3CN respectively,eluated using the mixture of water and acetomitrile(1/3)with 2％ formic acid,blow-dried in the nitrogen at 35℃ and finally redissolved to be injected into the LC-MS/MS.Result The limits of detection were between 0.01～0.5 ng/mL accordingly.The spiked recoveries at the low concentration(1 ng/mL),medium concentration(2 ng/mL)and high concentration(10 ng/mL)ranged between 40％ and 76％.The intra-and interday precisions of the target substances at these three concentrations were all less than 15％.The indoor temperature,refrigeration condition and multigelation were observed to have significant impact on the anamorelin,GHRP-2,GHRP-4 and GHRP-5.Conclusion The method established in this study is simple,and its specificity and sensitivity meets the international standard and technical documents for laboratories set up by the Wworld Anti-Doping Agency.It has been applied in our routine work.Multigelation should be avoided in the transport,detection and long-term laboratory storage of urine samples.

Objective:To investigate the time and characteristics of screen exposure, to analyze the risk factors affecting screen exposure in children aged 3 years and younger, and to provide scientific basis for the intervention of screen exposure in children.Methods:The data were collected by convenience sampling from 317 children for routine examination aged 0-36 months who visited the Department of Child Healthcare, Children′s Hospital, Capital Institute of Pediatrics from December 2019 to December 2020. Self-designed questionnaires of the screen exposure were completed by the parents. The basic information, home nurture environment and screen exposure conditions were investigated. Children <18 months of age who used electronic devices and 18-36 months of age who spent more than 1 h/d on electronic devices were defined as with screen exposure. The differences between <18 and 18-36 months of age were compared by rank sum test. Chi-square test and multivariate Logistic regression were used to analyze the association between screen exposure and potential influential factors.Results:Among 317 children, 209 were boys and 108 girls, aged (28±10) months. There were 117 patients aged <18 months and 200 patients aged 18-36 months. Screen exposure time was 0.3 (0, 1.0) h/d and 1.2 (0.6, 2.0) h/d in children aged <18 months and aged 18-36 months, respectively ( Z=-6.770, P<0.01). The proportion of screen exposure was 25.6% (30/117) and 49.0% (98/200) in two age groups, respectively. Logistic regression analysis disclosed that not being the first child ( OR=3.81, 95% CI: 1.13-12.77, P=0.030), caregivers spending >1 h/d on electronic devices in front of their children ( OR=7.39, 95% CI: 2.24-24.46, P=0.001), caregivers believing that screen exposure can promote early childhood development ( OR=4.14, 95% CI: 1.26-13.52, P=0.019) were risk factors for children′s screen exposure in <18 months of age. Caregivers spending >1 h/d on electronic devices in front of their children ( OR=3.29, 95% CI: 1.78-6.08, P<0.01) was risk factor for children′s screen exposure in 18-36 months of age. Mothers with bachelor′s or higher degree ( OR=0.19, 95% CI: 0.05-0.66, P=0.009; OR=0.35, 95% CI: 0.19-0.66, P=0.001), no television in living room ( OR=0.11, 95% CI: 0.03-0.42, P=0.001; OR=0.45, 95% CI: 0.21-0.98, P=0.045) were protective factors for children′s screen exposure in children <18 months and 18-36 months of age. Conclusions:Excessive screen exposure is common among children aged 3 years and younger. The exposure time increases with age, and is affected by several factors.

Gegen Qinlian Decoction (GQD), a traditional Chinese medicine (TCM) formula, has long been used for the treatment of common metabolic diseases, including type 2 diabetes mellitus. However, the main limitation of its wider application is ingredient complexity of this formula. Thus, it is critically important to identify the major active ingredients of GQD and to illustrate mecha-nisms underlying its action. Here, we compared the effects of GQD and berberine, a hypothetical key active pharmaceutical ingredient of GQD, on a diabetic rat model by comprehensive analyses of gut microbiota, short-chain fatty acids, proinflammatory cytokines, and ileum transcriptomics. Our results show that berberine and GQD had similar effects on lowering blood glucose levels, modulating gut microbiota, inducing ileal gene expression, as well as relieving systemic and local inflammation. As expected, both berberine and GQD treatment significantly altered the overall gut microbiota structure and enriched many butyrate-producing bacteria, including Faecalibacterium and Roseburia, thereby attenuating intestinal inflammation and lowering glucose. Levels of short-chain fatty acids in rat feces were also significantly elevated after treatment with ber-berine or GQD. Moreover, concentration of serum proinflammatory cytokines and expression of immune-related genes, including Nfkb1, Stat1, and Ifnrg1, in pancreatic islets were significantly reduced after treatment. Our study demonstrates that the main effects of GQD can be attributed to berberine via modulating gut microbiota. The strategy employed would facilitate further stan-dardization and widespread application of TCM in many diseases.

Objective:To investigate the features and trends of functional speech sound disorder and related erroneous consonants in children, so as to provide evidence for clinical evaluation and rational intervention.Methods:Clinical data of 1 562 children diagnosed with functional speech sound disorder in the language-speech clinic of the Department of Child Health Care, Children′s Hospital, Capital Institute of Pediatrics from January 2007 to December 2018 were analyzed retrospectively. By using the mandarin phonetic test table, the picture-naming method was adopted to test the word-level pronunciation. The Chi-square test was conducted to analyze the incidence of consonant errors in different age groups, gender and different places of articulation. The trend in incidence of the consonant errors in different age groups and during the last 12 years were analyzed by chi-square trend test. Results:A total of 1 562 cases were diagnosed with functional speech sound disorder, including 1 171 males and 391 females, the age was 4-17 years. The incidence of consonant errors in different places of articulation was 43.0% (672/1 562) for labial, 47.0% (734/1 562) for lingua-palatal, 63.7% (995/1 562) for velar, 77.7% (1 213/1 562) for linguo-alveolar, 78.9% (1 233/1 562) for apico-dental and 81.6% (1 274/1 562) for palatal. The incidence of consonant errors in males on labial, lingua-palatal, linguo-alveolar and palatal was higher than that in females (44.7% (523/1 171) vs. 38.1% (149/391), 49.1% (575/1 171) vs.40.7% (159/391), 80.1% (938/1 171) vs.70.3% (275/391), 82.8% (970/1 171) vs.77.7% (304/391), χ2 =5.138, 8.379, 16.126 and 5.042,all P<0.05). The incidence of consonant errors on labial, lingua-palatal, velar, linguo-alveolar, apico-dental and palatal decreased with age (χ2 =27.023, 13.230, 20.579, 29.718, 26.390, and 17.887, all P<0.01). The incidence of consonant errors on labial, linguo-alveolar, apico-dental increased with years (χ2 =9.030, 51.894 and 18.507, all P<0.01). Conclusions:The incidence of palatal errors is the highest in children with functional speech sound disorder. As part of the palatal errors could not be completely self-healing with growing, the phonological therapy for palatal errors should be carried out as early as possible. The incidence of consonant errors on labial, linguo-alveolar, and apico-dental presents an upward tendency with years, more attention should be paid to the factors related to the acquisition of these consonants.