BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Objective:To investigate genetic variation profiles of δ-globin (HBD gene) and hematological phenotypes in Guangdong population.Methods:Retrospective case analysis was performed in this study. Blood samples of 11 616 couples who participated in free thalassemia screening in Guangzhou from July 2020 to December 2022 were collected which underwent blood routine tests and hemoglobin (Hb) capillary electrophoresis. According to the results, 154 samples were enrolled in this study: (1)group of 35 cases with HbA 2 <2.0% but no HbF band; (2)group of 64 cases with HbA 2 < 2.0% and HbF band; (3)group of 25 cases with HbA 2 <2.0% and suspected HbA 2 variants; (4) group of 25 cases with HbA 2 ≥2.0% and <3.5% and HbF band, as well as abnormal blood routine report [mean corpuscular volume (MCV) <82 fl and/or mean corpuscular hemoglobin (MCH) <27 pg]; (5)group of 5 cases with HbA 2 ≥2.0% and <3.0% accompanied with β thalassemia gene carriers Sanger sequencing was used to detect single nucleotide variants of δ-globin. Results:(1) A total of 22 genetic variations were detected, including 6 de novo variations, and the top 3 genetic variations were respectively c.-127T>C (57.02%, 65/114), c.-80T>C (9.65%, 11/114), c.349C>T (7.89%, 9/114). (2) In group of patients with HbA 2 <2.0% but no HbF band, 22 cases (62.85%, 22/35) had HBD gene variation, including 7 cases with MCV and MCH lower than reference values, 4 cases with α thalassemia; 13 cases had no HBD gene variation, including 12 cases with lower MCV and MCH. Among 19 cases with abnormal blood routine test results, levels of HbA 2 in patients (7 cases) with HBD gene variation were lower compared with those without HBD gene variation (12 cases) ( P<0.01%). (3)In group of patients with HbA 2<2.0% with HbF band, 59 cases (92.18%, 59/64) had HBD gene variations whose mutations all occurred in promoter region, and the HbF were all lower than 5.0%; 5 cases with HbF >5.0% had no HBD gene variation. (4) In group of patients with HbA 2 <2.0% and suspected HbA 2 variants, the detection rate was 100% (25/25) and δ-globin variants <1.0%. (5) In group of patients with HbA 2 ≥2.0% and <3.5% and HbF band accompanied with abnormal blood routine results, no HBD gene variation was found. (6) In group of 5 patients with HbA 2 ≥2.0% and <3.0% with β thalassemia gene carriers, HBD gene variation were found in all cases, and the level of HbA 2 was (2.62±0.17)% and HbF was (3.62±2.22)%. Conclusions:There are various genotypes of HBD gene variation, among which HBD: c.-127T>C is the most common in Guangdong population in China. Mutations in the promoter region may cause decrease in HbA 2 and increase in HbF which is mostly less than 5% but exceeds 5.0% when combined with β thalassemia. Our study enriched the gene mutation profiles of HBD gene in Guangdong population.

Pregnancy ; Female ; Humans ; Diabetes, Gestational/diagnosis* ; Retrospective Studies ; Prognosis ; Pregnancy Outcome ; Maternal Age

Compared with other drug loading methods,PLGA drug-loaded microspheres have the advantages of sustained and con-trolled release ability,biodegradability,drug release stability,and targeted delivery function,which have become a research hotspot in pharmaceutics.With the improvement of the preparation technology and the quality of microspheres,they have been gradually promoted in clinical practice,and have achieved remarkable results in the treatment of tumors,osteoarthritis,diabetes,eye diseases and so on.However,there is still a lack of systematic review on the application of PLGA microspheres in stomatology.This article aims to intro-duce the clinical application characteristics of PLGA microspheres,and review their application prospect in oral and maxillofacial tumors,temporomandibular joint diseases,periodontitis,caries and alveolar bone defects,so as to provide reference for their applica-tion in stomatology.

High glucose level, bacterial infection, and persistent inflammation within the microenvironment are key factors contributing to the delay of diabetic ulcers healing, while traditional therapeutic methods generally fail to address these issues simultaneously. Here, we present a spatiotemporally responsive cascade bilayer microneedle (MN) patch for accelerating diabetic wound healing via local glucose depletion and sustained nitric oxide (NO) release for long-term antibacterial and anti-inflammatory effects. The MN patch (G/AZ-MNs) possesses a degradable tip layer loading glucose oxidase (GOx), as well as a dissolvable base layer encapsulating l-arginine (Arg)-loaded nanoparticles (NPs). After wound administration, the base part rapidly dissolved, resulting in prompt separation of the MN tip within the wound tissue, which subsequently responded to the overexpressed matrix metalloproteinase-9 (MMP-9) in diabetic lesions, leading to the responsive release of GOx. The released enzyme catalyzed glucose into gluconic acid and hydrogen peroxide (H₂O₂), which not only reduced glucose level within the diabetic wound, but also initiated the cascade reaction between H₂O₂ with the Arg that was released from NPs, thereby achieving continuous production of NO for 7 days. Our findings demonstrate that a single administration of the MN patch could effectively heal non-infected or biofilm-infected diabetic wounds with the multifunctional properties.

Objective:To study the neuroprotective effect of Chuanjin Jieyu decoction on a chronic unpredictable stress (CUMS) induced depression rat model.Methods:A total of 48 adult male healthy Sprague-Dawley (SD) rats were randomly selected, with 12 rats as the control group, and the remaining rats were used to establish a CUMS depression model. After successful modeling, the rats were randomly divided into three groups: CUMS group, fluoxetine group, and Chuanjin Jieyu decoction group; 0.9% sodium chloride solution fluoxetine and Chuanjin Jieyu decoction were respectively administered for intervention for 4 weeks. After modeling and intervention, depression levels in rats were measured through open field experiments and sugar water preference experiments; After intervention, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression levels of brain-derived neurotrophic factor (BDNF), tyrosine protein kinase receptor B (TrkB), and cyclic adenosine monophosphate responsive element binding protein (CREB) mRNA in the dentate gyrus of the hippocampus. Immunofluorescence was used to detect the expression levels of BDNF and NeuN. Western blot was used to detect the level of glial fibrillary acidic protein (GFAP).Results:After modeling, the sugar consumption, sugar preference, vertical and horizontal movement results of the CUMS group, fluoxetine group, and Chuanjin Jieyu decoction group were significantly lower than those of the control group (all P<0.01); After intervention, the above indicators in the CUMS group were lower than those in the control group (all P<0.01). The above indicators in the fluoxetine group and the Chuanjin Jieyu decoction group were higher than those in the CUMS group ( P<0.01 or P<0.05), but lower than those in the control group ( P<0.01 or P<0.05). The qRT-PCR results showed that the mRNA expression levels of BDNF, TrkB, and CREB in the CUMS group, the fluoxetine group, and the Chuanjin Jieyu decoction group were significantly lower than those in the control group (all P<0.01); The above indicators in the fluoxetine group and the Chuanjin Jieyu decoction group were significantly higher than those in the CUMS group (all P<0.01). The immunofluorescence results showed that the expression levels of BDNF and NeuN in the CUMS group were significantly lower than those in the control group (all P<0.01); The above indicators in the fluoxetine group and the Chuanjin Jieyu decoction group were higher than those in the CUMS group ( P<0.01 or P<0.05), and all indicators in the Chuanjin Jieyu decoction group and the NeuN expression level in the fluoxetine group were lower than those in the control group ( P<0.01 or P<0.05). Western blot results showed that the expression of GFAP protein in the CUMS group was lower than that in the control group ( P<0.01); The expression of GFAP protein in the fluoxetine group was higher than that in the CUMS group ( P<0.05). Conclusions:Chuanjin Jieyu decoction can improve the behavioral indicators of depression in rats, increase the expression of BDNF, TrkB, CREB, and NeuN in the hippocampal dentate gyrus, suggesting that Chuanjin Jieyu decoction may exert neuroprotective effects through the BDNF/TrkB/CREB pathway.

Tooth transposition is a challenge for orthodontists, especially in correcting the order of teeth. At present, the literature on transposition canines mainly focuses on epidemiological studies and case reports, and no systematic treatment guidance has been formed. In this article, the definition and classification, epidemiology and etiology, imaging diagnosis, treatment and risk control of transposed canines are systematically described in order to provide reference for clinical practice.

Objective: To investigate the epidemiological characteristics of cluster vomiting diarrhea outbreaks caused by Sapovirus infection in Baoshan District, Shanghai, and to provide reference for the standardized management of cluster vomiting diarrhea events in schools. Methods: The cluster of vomiting and diarrhea outbreaks in Baoshan District from 2017 to 2019 were collected, and the basic information and scene of each cluster were summarized. Sample results were collected and descriptive epidemiological methods were used to analyze the epidemiological characteristics of the outbreak. Results: From 2017 to 2019, a total of 100 cluster vomiting and diarrhea events were reported in Baoshan District, including 9 cases caused by Sapovirus, 120 cases of cluster vomiting diarrhea caused by Sapovirus, with an average incidence rate of 2.37%, including 39 laboratory confirmed cases, the epidemic epidemic time was mainly concentrated in September to November, the places were distributed in 4 primary schools and 5 kindergartens, the main clinical manifestations were vomiting (112/120, 93.33%), abdominal pain (27/120, 22.50%), diarrhea (26/120, 21.67%), compared with Norovirus events, the positive rate, vomiting and fever ratios of Zarovirus were lower than those of Norovirus( χ 2=8.32, 4.52, 14.20, P <0.05). Conclusion In school cluster vomiting and diarrhea events, the positive detection rate of Sapovirus is second enteric vinus behind Norovirus, and it s recommended to formulate a prevention and control plan for Sapovirus infection diarrhea to provide a basis for the on site treatment of school cluster vomiting diarrhea events.

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ²=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ²=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ²=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4⁺， and CD4⁺/CD8⁺ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19^-， HLA/DR⁺， and CD25⁺ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4⁺， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Objective:To understand the current situation of the demand for humanistic care of schizophrenics in convalescence and analyze the influencing factors, so as to provide the basis for clinical nurses to carry out targeted humanistic care for patients.Methods:A self-produced scale with a total score of 49-245 was used to investigate 516 convalescent period schizophrenic patients in 18 tertiary mental health institutions in 13 provinces of China, single factor analysis and multiple regression analysis were performed on their influencing factors.Results:The Likert 5-point scoring method was used. The overall score of the nursing care needs of hospitalized schizophrenic patients was (202.85±35.06) points, and the average score of total items were (4.14±0.16) points. Multiple linear regression results showed female ( B=0.100, P=0.024), stable marriage ( B=-0.098, P=0.026),high school (including secondary school) Education ( B=-0.107, P=0.018), family per capita monthly income of 2 000 yuan or above ( B=0.093, P=0.043),central region ( B=-0.110, P=0.014) were the main factors that affect the demand for humanistic care of inpatients with schizophrenia in convalescence. Conclusion:The hospitalized schizophrenic patients have higher and diversified needs for humanistic care. Patients with different genders, marital status, education level, monthly family income and living area have different needs for humanistic care. Individualized and standardized nursing should be given according to the actual situation of patients' needs to provide a more supportive environment for their rehabilitation.