Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Objective To develop a health-promoting lifestyle scale for women with polycystic ovary syndrome(PCOS),and to test its reliability and validity,and preliminarily apply it.Methods Based on the Pender health promotion model,the item pool of the scale was constructed through literature research,semi-structured interviews and group discussions.After 2 rounds of Delphi expert consultation and pre-survey,the initial scale was formed.From April to July 2022,316 patients with PCOS in the health management center,reproductive medicine center and endocrinology department of a tertiary hospital in Nanjing were selected for item analysis,exploratory factor analysis and reliability test,respectively.From August to October 2022,358 PCOS patients were selected for confirmatory factor analysis.From November 2022 to February 2013,294 PCOS patients were selected,and the scale was used to investigate the status of health-promoting lifestyle in PCOS patients.Results The health-promoting lifestyle scale for PCOS patients included 5 dimensions and 33 items.The total content validity index of the scale was 0.942,and the content validity index of each item was 0.810-1.000.5 common factors were extracted by 2 exploratory factor analyses,and the cumulative variance contribution rate was 62.399％.Confirmatory factor analysis showed that the model fit was good.The Cronbach's a coefficient of the total scale was 0.930;the split-half reliability was 0.842;the test-retest reliability was 0.888.The preliminary application results showed that the total score of health-promoting lifestyle in PCOS patients was(96.925±14.273),and the average score of items was(2.937±0.433),which was at a medium level.Conclusion The health-promoting lifestyle scale for PCOS patients has good reliability and validity,which can be used as a tool for medical staff to assess the level of health-promoting lifestyle of PCOS patients,and can help nurses to quickly identify the level and dimensions of health-promoting lifestyle of patients,so as to formulate individualized precise health management plans.

Vertical root fracture is a type of longitudinal crack originating from the roots of teeth that can occur in vi-tal teeth and teeth after root canal treatment.It is a hard tissue disease of teeth with a complex etiology and poor progno-sis.The vertical root fracture that occurs in teeth after pulp treatment is called secondary vertical root fracture(SVRF).A comprehensive judgment should be made based on clinical signs such as pain,swelling,tooth looseness,sinus located near the gum edge,and deep and narrow isolated periodontal pockets,as well as apical films such as periodontal mem-brane widening,vertical and root bone loss,and"halo"or"J"shaped transmission shadows around the root.For teeth suspected of longitudinal root fractures,three-dimensional imaging such as cone beam computed tomography(CBCT)should be used to assist in the diagnosis.If CBCT shows a defect in the buccal or lingual bone plate,it can increase the possibility of diagnosing SVRF.The setting of CBCT parameters should be optimized by using small field CBCT,en-hancing dye-assisted applications,and metal artifact reduction(MAR)tools to reduce the impact of artifacts and improve the accuracy of CBCT diagnosis of SVRF.Magnetic resonance imaging(MRI),digital subtraction radiography(DSR),op-tical coherence tomography(OCT),and other imaging techniques can detect cracks of different widths,and artificial in-telligence(AI)diagnostic technology and predictive models provide further auxiliary means for SVRF diagnosis.SVRF cannot be determined through noninvasive methods,and the final diagnostic method is to detect the presence of SVRF through direct observation within the root canal and during flap surgery.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To visualize and analyze the studies on spleen-strengthening and dampness-expelling method for treating skin diseases in the past 20 years by using CiteSpace 6.3.R1 software,and to understand current status and hot spots of research on spleen-strengthening and dampness-expelling method for treating skin diseases,so as to provide reference for the treatment and research of skin diseases. Methods Literatures on the spleen-strengthening and dampness-expelling method for skin disease treatment,which were published from January 1,2004 to June 1,2024,were retrieved from China National Knowledge Network Infrustruction. Then,CiteSpace 6.3.R1 software was adopted to visualize the authors,distribution of research institutes,and keywords. Results A total of 1326 valid papers were included,and there was an overall increase in literature publication. The author with the largest number of publications was Liu Hongxia (31 papers) and Lu Chuanjian (11 papers),the institution with the largest number of publications was Beijing University of Traditional Chinese Medicine(66 papers),followed by Guangzhou University of Chinese Medicine (62 papers). In the keyword analysis,the current hot keywords in this field are Wuling San,external treatment method,treatment from the spleen,spleen deficiency and dampness accumulation,etc. The research hot spots in the literature mainly include the experience of famous doctors,the law of medication and the research on the mechanism of action,and the frontier trends mainly include the mechanism of action,inflammatory factors,and the same treatment of heterogeneous diseases. Conclusion The method of spleen-strengthening and dampness-expelling is an important rule of traditional Chinese medicine in treating dermatological diseases. The main research content in recent 20 years is clinical observation,experience of famous doctors and mechanism of action. The mechanism of action,inflammatory factors,and heterogeneity of the same treatment are the hot spots of the research. The multi-disciplinary integration may be future research direction. However,there are currently few core authors and institutions involved in the research,and the cooperation between regions needs to be strengthened.

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.

Objective:To construct the admission criteria and job responsibility scheme for polycystic ovary syndrome (PCOS) case managers.Methods:The first draft of the scheme was constructed through literature research, pre-consultation and group discussion. From February to April 2022, the convenient sampling method was used to select 18 experts for two rounds of Delphi expert letter consultation. Analytic hierarchy process was used to determine the weight of each indicator.Results:The effective response rates of the questionnaire for two rounds of expert inquiries were 94.74% (18/19) and 100.00% (18/18), respectively. The expert authority coefficients were 0.892 and 0.897, respectively. After two rounds of expert consultation, the Kendall's W of the first, second, and third level indexes for the admission criteria and job responsibilities of PCOS case managers were 0.361, 0.306, 0.283 and 0.250, 0.134, 0.142 ( P<0.05), respectively. The final admission criteria for PCOS case managers included 3 first level indicators, 8 second level indicators and 30 third level indicators. Their job responsibilities included 5 first level indicators, 13 second level indicators and 46 third level indicators. Conclusions:The admission standards and job responsibility scheme for PCOS case managers systematically and comprehensively reflect the characteristics of disease management for PCOS patients in China, which are reliable and scientific, and provide reference value for the screening and work practice of PCOS case managers.

Objective:To explore the current status and influencing factors of exercise intention in patients with polycystic ovary syndrome (PCOS) .Methods:From March to July 2022, 174 PCOS patients admitted to the Health Management Center of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the study subject by convenience sampling. A survey was conducted using the General Information Questionnaire, Exercise Intention Scale, Exercise Self-efficacy Scale and the Exercise Social Support Scale.Results:The Exercise Intention Scale score of 174 PCOS patients was 15.00 (13.00, 18.00). The results of multiple linear regression analysis showed that education level, PCOS related disease visits, exercise self-efficacy, exercise social support, and exercise self-identification were the influencing factors of exercise intention in PCOS patients, and the difference was statistically significant ( P<0.05), which could explain 42.4% of the total variation. Conclusions:The subjective intention of patients with polycystic ovary syndrome to participate in exercise needs further improvement. Medical and nursing staff should focus on patients with polycystic ovary syndrome who have low levels of education and fewer visits, and focus on enhancing their self-efficacy and self-identification in exercise. At the same time, medical and nursing staff should actively mobilize social support systems to promote their subjective intention to exercise at a high level.

Bioelectrical impedance measurement technology is a non-invasive detection technology for extracting human physiological and pathological information. The analysis method of the relationship between bioimpedance and human physiological parameters is an important part of this technology. In order to calculate the internal and external liquid volume of human cells more accurately, based on the Moissl equation for calculating the internal and external fluid volume of human cells, a segmented human bioimpedance spectrum measurement model and an improved calculation method of intracellular and external fluid capacity were proposed. The measurement and calculation experiments of the intracellular and extracellular fluid volume before and after the human body's water intake were designed and compared with the Moissl calculation method. The results show that the improved calculation method can calculate the intracellular and extracellular fluid volumes more effectively, and the relative error is less than 5%, which may provide new ideas or more accurate methods for the analysis of human body components, facilitating the diagnosis and treatment of diseases.
Body Water ; Electric Impedance ; Extracellular Fluid ; Humans ; Intracellular Fluid

The injury of the knee joint is usually accompanied with the generation of hydrops. The volume of hydrops can be used as a reference to evaluate the extent of knee joint injuries. Based on the principle of bioimpedance detection, in this paper, a new method is proposed to detect knee joint hydrops. Firstly, a three-dimensional model of the knee joint was established according to the physiological and anatomical structure of the knee joint. Secondly, a knee impedance detection system was constructed based on the four-electrode theory, and the relationship between the knee impedance change and the volume of hydrops was calculated by linear regression. Finally, the model of rat knee joint hydrops was established, and the knee joint impedance was measured under different hydrops content to deduce the relationship between the fluid content and the knee joint impedance. The fluid volume in the joint was calculated by measuring the knee joint impedance, and the error rate was less than 10%. The experimental results show that the method proposed in this paper can establish the relationship between the impedance of the knee and the volume of fluid and realize the detection of the fluid volume.
Animals ; Edema ; Electric Impedance ; Humans ; Knee ; Knee Injuries ; Knee Joint ; Rats