Objective? To explore the polypharmacy and drug adverse reactions among elderly mentally illness patients so as to provide a basis for the training of individualized medication observation, nursing and safe medication. Methods? From March to April 2018, we selected 180 patients of geriatrics department at Beijing Huilongguan Hospital and Peking University Sixth Hospital by successive sampling. We collected data involving demographic data, disease data, drug types and names, drug adverse reactions by consulting medical records. Results? Among elderly mentally illness patients, schizophrenia (40.56%) and various types of dementia (40.56%) were the commonest; the number of accompanied diseases was (5.4±2.1) and the top 5 of the commonest was cerebral infarction, cardiovascular disease, hyperlipemia, osteoporosis and hypertension. The kinds of oral medicine were (6.5±2.4); the incidences of polypharmacy and drug adverse reactions were 90.56% and 73.33% respectively. The commonest drug adverse reactions included abnormal liver function (38.33%), constipation (31.67%) and extrapyramidal syndrome (11.67%). Conclusions? The incidence of polypharmacy among elderly mentally illness patients is relatively high accompanied by severe problems. It prompts that psychiatric medical staff should understand and pay more attention to polypharmacy, and provide individualized medication observation and nursing to reduce the adverse effects of polypharmacy on patients.

Objective To grope for an ideal immune strategy in grown-ups via comparison of immunological effects under 4 different vaccination schemes.Methods Study population was selected by stratified random cluster sampling.A total of 4 different vaccination proposals,including Strategy A (3 doses,10 μg,administrated repeatedly into the unilateral deltoid muscle at 0-1-6 months),Strategy B (2 doses,20 μg,administrated into the bilateral deltoid muscles simultaneously),Strategy C (3 doses,10 μ g,administrated repeatedly into the unilateral deltoid muscle at 0-1-2 months) and Strategy D (2 doses,10 μg,administrated to the bilateral deltoid muscles at the same time),were conducted in Liangzhou,Minqin Gulang,and the Tianzhu Tibetan Autonomic county respectively,in Wuwei city,Gansu province.Under 4 different strategies,post-vaccination immunological effectiveness was evaluated when blood samples of participants collected in the eighth months,post-first injection and in the third year,and tested by enzyme-linked immunoassays and electro-chemiluminescence immunoassay.Chi-squared test and Fisher exact test were used to evaluate the immumological differences between the 4 strategies.Wilcoxon's signed rank test and Kruskal-Waillis H test were conducted to compare the differences of the geometric mean titers (GMTs) of antibody against HBV surface antigen (anti-HBs) titers.Results A total of 1 621 eligible participants aged 16 to 60 years old,were recruited for the study.Numbers of administration and gender were testified as the presuming factors for influencing immune effectiveness.The vaccination completion rates were 53.97％ and 79.82％ in Strategy A and C,respectively,and the difference statistically significant (P＜0.05).In the first year,the protective antibody sero-conversion rates (standardization rate) were 89.21％,54.88％,92.11％,and 41.63％,in Strategy A,B,C and D,respectively,and the significant statistically differences emerged (P＜0.05) if Strategy B,C and D were compared with Strategy A (as the gold standard).Over a 3-year follow-up period,the levels of GMTs on protective antibody declined from 179.2 IU/L,51.6 IU/L,277.1 IU/L and 10.1 IU/L to 61.3 IU/L,21.2 IU/L,31.8 IU/L and 6.0 IU/L in Strategy A,B,C and D,respectively,and the differences of declination on GMTs showed statistically significant differences (P＜0.05) when compared within or between the 4 strategies.Conclusion The 0-1-2 months' prophylactic schedules (Strategy C) seemed superior to the others,in terms of effectively inducing the protective antibody,with shorter duration of vaccination,persisting longer immunity and having higher rate of completive vaccination,so is worth to be recommended as a feasible immune programme for adults,especially for migrants from the rural regions.

Objective To preliminarily verify the effectiveness and safety of bloodletting combined with drug bamboo cups in intervention of degenerative lumbar spinal stenosis,and to explore the prognostic factors that affect the efficacy of TCM regimens in the treatment of DLSS.Methods 64 consecutive patients with degenerative lumbar spinal stenosis were enrolled.Bloodletting combined with drug bamboo cup intervention was used.Acupoints were selected and treated with the same length of the governor channel of the lumbar spine,the first and second side lines of the bladder meridian and Ashi point,weekly 2 times,8 times per course,2 consecutive courses of treatment.Before treatment,after treatment,and 1 month follow-up,the changes of the patient's lumbar spinal stenosis specific scale(SSM),modified Oswestry dysfunction index(ODI),and 12 health survey summary scores(SF-12)were observed.Using SSM symptom or function score≥0.5,the criteria for grouping were first single-factor analysis,and then logistic regression was used to analyze the prognostic factors of the treatment.Results After 2 courses of treatment,the patient's SSM symptom score(2.25±0.56),SSM function score(2.06±0.67),ODI index(15.49±8.72),and SF-12 physiological score(36.31±7.35)were more significant than before treatment Improved,the difference was statistically significant(P<0.05),the SF-12 psychological score(49.70±9.47),the difference was not statistically significant compared with before treatment(P>0.05);the patient's SSM symptom score(2.22±0.54)was followed up for one month,SSM function score(2.09±0.66),ODI index(15.53±8.23),SF-12 physiological score(36.55±7.25),SF-12 psychological score(50.62±9.17),which are significantly better than before treatment,and the difference is statistically significant(P<0.05),the difference was not statistically significant(P>0.05)after 2 courses of treatment.The univariate logistic regression analysis of each influencing factor showed that:BMI,baseline symptom dimension,baseline functional dimension,foraminal stenosis,lateral recess stenosis,and two-stage stenosis had statistically significant differences between the effective and ineffective groups(P<0.05).Conclusion Bloodletting combined with drug bamboo cups has a certain clinical effect on degenerative lumbar spinal stenosis.

Acupuncture and Tuina are the main non-drug therapies for low back pain, which are recommended by the guidelines. Acupuncture and Tuina can alleviate pain, which is regarded as conditional specific outcome, and improve mental, emotional problems, as non-conditional specific outcomes. There are some problems of the outcome assessment of acupuncture and Tuina treatment for pain such as insufficient evaluation of specific effect and unclear evaluation of characteristic outcome. Therefore, the key to above problems is to construct a Specific ouTcomE Assessment Modal of acupuncture and Tuina treatment for pain (STEAM-A&T) based on the qualitive and quantitative methods. By describing the experience, narrative expression, feelings and needs of patients who receiving acupuncture and Tuina treatment, the item banks of acupuncture and Tuina treatment effect are constructed, and the characteristic outcome of acupuncture and Tuina for pain will be screened, and then the relationship model among outcomes is constructed and optimized, which reflected the characteristics of acupuncture and Tuina for pain from multiple dimensions, multiple levels and multiple views. We reveal the relationship between the outcome of acupuncture and Tuina for pain. It will provide a new theory and methods for the construction of specific outcome assessment modal of Traditional Chinese Medicine.

Objective To investigate the expression significance and prognostic value of long non-coding RNA tumor susceptibility candidate gene 9(lncRNA CASC9)and YKT6 in oral squamous cell carcinoma(OSCC).Methods A total of 110 patients with OSCC treated in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2016 to January 2018 were selected as the study objects.The mRNA expression of lncRNA CASC9 and YKT6 in OSCC cancer tissue and adjacent tissues was detected by real-time fluorescence quantitative PCR.Immunohistochemistry was used to detect YKT6 protein expression in OSCC cancer tissue and adjacent tissues.Kaplan-Meier curves were used to analyze the influence of different lncRNA CASC9 and YKT6 mRNA expression on the prognosis of OSCC patients.Cox regression model was used to analyze the prognostic factors of OSCC.Results The lncRNA CASC9 and YKT6 mRNA expression in OSCC cancer tissues were 3.12±0.57 and 2.69±0.42,respectively,which were significantly higher than those in adjacent tissues(1.02±0.25,1.13±0.21),and the differences were statistically significant(t=35.386,34.843,P＜0.05).The positive rate of YKT6 protein in OSCC cancer tissues was 81.82％(90/110),which was higher than that in adjacent tissues[9.09％(10/110)],and the difference was statistically signifi-cant(x2=117.333,P＜0.05).There was a positive correlation between lncRNA CASC9 mRNA expression and YKT6 mRNA expression in OSCC cancer tissues(r=0.788,P＜0.001).The lncRNA CASC9 and YKT6 mRNA expressions in cancer tissues of OSCC with TNM stages m to Ⅳ,low differentiation and lymph node metastasis were higher than those in cancer tissues of OSCC with TNM stages Ⅰ to Ⅱ,high school differenti-ation and no lymph node metastasis,the difference was statistically significant(all P＜0.05).The 5-year cu-mulative survival rate of lncRNA CASC9 high expression group and YKT6 mRNA high expression group was lower than that of lncRNA CASC9 low expression group and YKT6 mRNA low expression group,and the difference was statistically significant(Log-rank X2=7.080,8.741,P=0.008,0.003).High expression of ln-cRNA CASC9,high expression of YKT6 mRNA,TNM stage m to Ⅳ,low differentiation and lymph node me-tastasis were prognostic risk factors in OSCC patients.Conclusion The expression of lncRNA CASC9 and YKT6 in OSCC cancer tissue is elevated,which can be used as tumor markers to evaluate the prognosis of OS-CC patients.

Objective:To study the effects of metformin on marginal bone resorption of implants in patients with type 2 diabetes melli-tus(T2DM)and exercise habit.Methods:63 cases with 73 implants were included.Among them,there were 41 cases(47 implants)without T2DM in group N,10 cases(13 implants)with T2DM and without exercise habit in group M,12 cases(12 implants)with T2DM and exercise habit in the MR group.The patients were followed up at 6 months,1 and 2 years after implantation.The marginal bone loss(MBL).Implantation success rate and peri-implantitis incidence rate were compared among the groups.Results:The bone resorption of the proximal and median margins of the long-term bone level of the implants in the N and MR groups were significantly lower than that in the M group(P=0.001 and P=0.000 5,respectively).The implant success rates of group N,MR and M were 95.74％,100％and 76.92％,respectively.The incidence of peri-implantitis of the three groups was 2.13％,0 and 15.38％,respec-tively.Conclusion:Metformin is more effective in the improvement of the long-term marginal bone resorption of implants,increase the success rate of implants,and reduce the incidence of peri-implantitis in patients with T2DM and exercise habit in the mandibular first molar area.