nges in standard square field.

Objective:To observe the clinical efficacy of tuina plus ultrasonic therapy in treating infantile muscular torticollis. ＜br> Methods:Seventy kids with muscular torticollis were intervened by tuina plus ultrasonic therapy, and the efficacy was evaluated after 8-month treatment. ＜br> Results: After 8-month treatment, 41 subjects were cured, accounting for 58.6%, 27 were improved, occupying 38.6%, 2 failed, occupying 2.8%, and the total effective rate was 97.2%. ＜br> Conclusion: Tuina plus ultrasonic therapy can produce a significant efficacy in treating infantile muscular torticollis, without adverse effects.

Objective To evaluate the clinical efficacy of acupuncture plus acupoint application in treating irritable bowel syndrome with diarrhea (IBS-D).Method Sixty patients were randomized into two groups, 30 cases in each group. The acupuncture group was intervened by acupuncture at Neiguan (PC6), Zhongwan (CV12), and Zusanli (ST36), etc, plus application withBai Jie Zi(Semen Brassicae) powder at Qihai (CV6), Guanyuan (CV4), and Tianshu (ST25), etc; the medication group was prescribed with oral administration of Trimebutine maleate capsules (0.2 g each dose, 3 times a day). Four-week treatment was taken as a course. The symptoms score and quality of life (QOL) scale were evaluated prior to and after the treatment.Result The clinical symptoms were significantly improved in the acupuncture group, and the total effective rate was89.3%, significantly higher than 63.0% in the medication group (P<0.05). After 4-week treatment, the clinical symptoms scores of the two groups were analyzed by rank-sum test (Z=-19.627,P=0.000<0.05), revealing a significant difference between the two groups and indicating that the improvements of clinical symptoms in the acupuncture group were more significant than those in the medication group. After 4-week treatment, the general QOL scores of the two groups were examined by rank-sum test (Z=-10.039, P=0.000<0.05), revealing a significant difference between the two groups and indicating that the improvement of QOL in the acupuncture group was superior to that in the medication group.Conclusion Acupuncture plus acupoint application can obviously mitigateabdominal pain and discomfort.

Objective:To observe the clinical efficacy of warm needling plus acupoint sticking therapy for primary dysmenorrhea.
Methods:A total of 60 eligible cases were randomly allocated into a treatment group (n=30) and a control group (n=30) according to their sequence of consultation. Patients in the treatment group were treated with warm needling combined with acupoint sticking therapy, whereas patients in the control group were treated with oral Ibuprofen (Fenbid) capsules. After two menstrual cycles, the visual analogue scale (VAS) score, COX menstrual symptom scale (CMSS) and clinical efficacy were compared between the two groups.
Results:After treatment, the VAS and CMSS scores were significantly reduced in both groups, indicating that both treatment protocols can remarkably alleviate pain. There was a between-group statistical difference in comparing the CMSS score (P<0.05), but no between-group statistical difference in the VAS score (P>0.05). However, the follow-up visit showed between-group statistical differences in comparing VOA and CMSS scores (bothP<0.01). The clinical effect, relapse rate and long-term efficacy in the treatment group were better than those in the control group.
Conclusion:Warm needling plus acupoint sticking therapy is a simple but effective therapy for primary dysmenorrhea. In addition, it causes fewer cases with relapse.

Objective: To investigate the prevalence of affective disorder in Kunming City. Methods: A rep-resentative sample of the Kunming general population composed of 5033 individuals aged 15 years and older was se-lecteed randomly by the method of probability proportional to size (PPS), and then was interviewed with the World Health Organization Composite International Diagnostic Interview Version 2.1 (CIDI, version 2.1).The preva-lence of affective disorder was investigated. And the relative factors, onset age and comorbid were also analyzed. Results: The 30-duy prevalence of affective disorder was 0.98%, the 12-month prevalence was 1.22%,and the lifetime prevalence was 1.89%. The results of the single factor analysis showed that the urban residents, the persons who divorced, limited divorced or lost one's spouse, and the unemployed or the higher educated were more vulnerable to depression. The results of the multifactor analysis showed that the rural residents and the males were protective factors to affective disorder. Different subunits of affective disorder had different onset ages. The onset age of 90% bipolar disorder patients was before 25 years old. The patients before 50 years old was risky to dysthy-mia. The patients with major depression had a lifetime risk of onset. Anxiety disorder and pain disorder would in-crease the risk of affective disorder. Conclusion: The findings show that the prevalence of the affective disorder is lower than the same kind survey abroad while it is close to the domestic's. More attention and intervention should been given to the urban population, the females, the singles, the unemployed, and the higher educationed.

Objective:To evaluate the test-retest reliability and validity of Chinese version of World Health Organization Composite International Diagnostic Interview version 3.0(CIDI-3.0)by community-based study.Methods:Among 202 subjects from Dalian city,with the clinician-administered Structured Clinical Interview for DSM-IV(SCID),102 patents were diagnostic as mood disorder,anxiety disorder,schizophrenia or psychotic disorder and so on.All of the patients and the other 100 subjects without mental disorders as the control group were interviewed blindly by CIDI-3.0 to test the validity of CIDI-3.0.Ten patients among them were interviewed twice independently in a 7-day interval to evaluate the reliability of CIDI-3.0.Results:(1)For the screen section,the sensitivity values of different mental disorders ranged from 60.4% to 93.1%,while the specificity values from 33.6% to 92.7%.The positive predictive values were from 60.1% to 95.1%,and the negative predictive values were from 68.1% to 93.7%.(2)For different mental disorders,the specificity values ranged from 97.1% to 98.9%,while the sensitivity values were from 33.3% to 70.3%.Positive predict values were from 66.7% to 95.7%,and negative predictive values were from 87.7% to 95.4%.(3)The consistency was 0.78 in any mental disorder.(4)For test-retest reliability,kappa values ranged from 0.737 to 1.0.Conclusion:By clinical reappraisal,the Chinese version of CIDI-3.0 has satisfied validity and reliability.The screen section has high sensitivity,while the diagnostic sections have high specificities.That indicates that CIDI-3.0 is acceptable as a validated instrument for community survey on mental disorders.

Background Xenotransplantation is arousing more attention of researchers because of the lack of corneal donors.Biological corneal scaffolds constructed by porcine corneal acellular stroma appears to have an acceptable biocompatibility.However,its clinical effects and the histomorphological features in the corneal tissue of receipts' are still unclear.Objective This study was to evaluate the viability of bioengineered corneas as a new material of human lamellar keratoplasty and observe the in viva biological features after human keratoplasty under the laser confocal microscope.Methods A prospective serial cases observational study was carried out.Fifteen eyes of 15 patients with infectious keratitis were enrolled in Henan Eye Hospital from February to August 2014 under the approval of Ethic Committee of Henan Eye Hospital and informed consent of each patient, including 4 eyes of fungal keratitis,1 eye of bacterial keratitis, 9 eyes of mixed infectious keratitis and 1 eye of leucoma.Corneal lamellar transplantation was performed on the eyes with the bioengineered corneas as grafts and the follow-up time was one year.The survival of grafts was assessed and scored, and the indices including corneal transparency,neovascularization, graft lysis or inflammatory recurrence and visual acuity (logMAR) were evaluated.The morphology and density of corneal epithelial cells and endothelial cells, corneal stroma and subepithelial neural fibers were examined by laser confocal microscope 3,6,9 and 12 months after surgery.Results Postoperative inflammatory response was seen 3 days and disappeared 7 days after surgery.The grafts were clear 1 month after surgery, and no corneal dissolution was found during the follow-up duration.Glaucoma occurred in 1 eye at 6 months and graft rejection occurred in another eye 12 months after surgery.The logMAR, corneal transparency scores and corneal neovascularization scores improved after surgery in comparison with before surgery,with a significant difference among various time points (x2 =92.63,59.37,10.50 ,all at P＜0.05).Complete epithelization of grafts was seen.Compared with the contralateral eyes,the morphology of epithelial cells was similar and endothelial cells were enlarged in the operated eyes.In addition,no stromal cell structure was seen in the corneal stroma in the operative eyes.Subepithelial nerve fibers appeared in 8 eyes at 6 months, but the fiber density was lower in the operated eyes than that in the contralateral eyes.Significant difference was found in epithelial cell density among different time points (F=1.48, P =0.22).The endothelial cell densities were (2 542 ± 119), (1 895 ± 129), (1 869 ± 135), (1 854 ± 101) and (1 844 ± 103)/mm2 before surgery and 3, 6, 9 and 12 months after surgery, showing significant differences between preoperation and postoperative time points (all at P＜0.05).The subepithelial nerve fibers densities were (1.26± 0.13),(3.62±0.81) and (5.98±0.44) mm/mm2 at 6,9 and 12 months after surgery,with significant differences between adjacent two time points (t'=-8.16 ,-7.24;both at P=0.00).Conclusions Bioengineered corneal grafts survive well in human eye after lamellar transplantation,which can reconstruct ocular surface and improve the visual acuity.Biological cornea can replace human corneal materials.

Objective:To evaluate the anxiety and depression symptoms of burning mouth syndrome (BMS), and to explore risk factors to BMS.Method:In this case-control study,147 patients with BMS and 140 sex-and age-matched healthy volunteers were recruited.Three questionnaires were used to collect information of psychical and mental condition.The Self-Rating Anxiety Scale (SAS)and Self-Rating Depression Scale (SDS)were applied to evaluate symptoms of anxiety and depression.The scores of SAS and SDS were statistically analyzed by t-test.The risk factors of BMS were statistically analyzed by Chi-square test and logistic regression analysis.Result:The scores of SAS and SDS were higher in the patients with BMS than in the controls [SAS:(44.4 ±9.9)vs. (35.7 ±6.2);SDS:(48.1 ±11.6)vs.(37.5 ±8.9)].The risk factors of BMS included ischemic stroke (OR =4.46,95%CI:1.87 -10.95),low level of education (OR =1.91,95%CI:1.04 -3.49),anxiety symptom (OR =8.12,95%CI:2.60 -25.37)and depression symptom (OR =2.57,95%CI:1.26 -5.27).Conclusion:BMS is a multi-factorial disease.It indicates that ischemic stroke,lower level of education,anxiety symptom and depression symptom are the risk factors of BMS.A positive association could be established between psychological alterations and BMS.According to these findings it can be assumed that mental factors should be taking into account in the etiologyof BMS.It should be advocated to treat BMS patients by psychotherapy.

This paper aims to review treatment delay in first-episode schizophrenia,depression,and bipolar disorder,and to compare related factors of treatment delay in the three first-episode mental disorders.It is found that increased patient responsibility,stigma,lack of disease-related knowledge,lack of access to resources,and insuffi-cient medical support lead to delay treatment,and making patients to have longer course,heavier symptoms,and lower social functions.

Objective To formulate effective safety management method for falls and reduce inpatients' fall occurrence rate and fall injury rate. Methods Setting up a multi-sectoral fall management team and the failure mode and effect analysis (FMEA) was used to form a fall assessment, education, prevention and disposal management system. Taking the inpatients of Changshu Hospital Affiliated to Soochow University from January 2014 to December 2017 as the research object, the incidence and injury rate of falls of inpatients before and after FEMA implementation were compared. Results After implementation, fall occurrence rate reduced from 0.091‰ in 2014 and 2015 to 0.076‰ in 2016 and 2017, however there was no statistical significance (P＞0.05). The rate of injury above Grade 2 caused by falls decreased from 42.86% to 21.25%. The difference was statistically significant (P＜ 0.05). Conclusions Using FEMA quality improvement tools to form a fall management system can effectively reduce the fall injury rate of hospitalized patients.