Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

Objective:To explore the situation of insomnia, fatigue, depression, anxiety and cognitive impairment in adolescents with different characteristics, and the chain mediating effect of fatigue, depression and anxiety on insomnia and cognitive impairment.Methods:The general demographic data of 6 014 adolescents were collected.Insomnia severity index (ISI), the multidimensional fatigue inventory (MFI-20), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived deficits questionnaire-depression(PDQ-D) were used to compare the insomnia, fatigue, depression, anxiety and cognitive impairment of adolescents with different characteristics.Spearman correlation analysis was conducted by SPSS 20.0 software.The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The detection rates of insomnia, fatigue, depression, anxiety and cognitive impairment were different in adolescents with different genders, grades and academic achievements.Cognitive impairment was significantly positively correlated with insomnia ( r=0.654, P<0.01), fatigue ( r=0.476, P<0.01), depression ( r=0.677, P<0.01), anxiety ( r=0.655, P<0.01), which was suitable for mediating effect test.Fatigue, depression and anxiety in adolescents had a chain mediating effect between insomnia and cognitive impairment.Insomnia indirectly affects cognition by affecting fatigue and depressive symptoms.The intermediary effect value was 1.253, the effect amount was 55.60%, and the total effect was 2.254.Insomnia indirectly affects cognition by affecting fatigue and anxiety symptoms.The intermediary effect value was 1.161, the effect amount was 51.50%, and the total effect was 2.254. Conclusion:Insomnia can not only directly affect their cognitive impairment, but also indirectly affect their cognitive impairment through the chain mediation of fatigue, depression and anxiety of adolescents.

ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index （ISI） and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index （PSQI） were defined as insomnia. Among the selected patients， 22 subjects were classified into insomnia group， and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography （PSG）， and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status （RBANS）. A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia （t=-2.102， P<0.05）. The sleep efficiency （Z=-2.113， P<0.05）， the proportion of N3 sleep stage （Z=-3.175， P<0.01） and the duration of N3 sleep stage （Z=-3.196， P<0.01） in insomnia group were all lower than those in non-insomnia group， and the nocturnal awakening （Z=-2.058， P<0.01）， the proportion of N1 sleep stage （Z=-2.399， P<0.05） and the duration of N1 sleep stage （Z=-2.463， P<0.05） were higher than those of the insomnia group. Within insomnia group， the increased proportion of REM sleep was correlated with the improvement of attention function （β=0.953， 95% CI： 0.123~2.038， P<0.05）， and the increase of nocturnal awakening was correlated with the decline of delayed memory （β=-0.173， 95% CI： -0.325~-0.024， P<0.05）. ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia， the proportion of REM sleep has a positive impact on attention function， and frequent nocturnal awakening at night has a negative impact on delayed memory.

Objective: To explore the relationship among cognitive flexibility, depression and eating attitude of adolescents and the influencing factors of eating attitude. Methods: A total of 1 231 subjects were assessed using general information questionnaire, Kutcher Adolescent Depression Scale 11 item(KADS-11), Cognitive Flexibility Inventory(CFI), Eating Attitude Test 26(EAT-26). Data were analyzed by independent sample t-test, univariate linear regression, spearman correlation analysis and Logistic regression. Results: There were significant differences in EAT 26 among adolescents between genders and between those with or without depression(P<0.01). Statistically significant differences were observed in CFI, flexible control and KADS 11 among adolescents with or without eating disorders(P<0.01). The scores of EAT 26 was negatively correlated with CFI (r=-0.19, P<0.01) and flexible control(r=-0.23, P<0.01). And there was a significant positive correlation between EAT 26 and KADS 11(r=0.23, P<0.01). Female(OR=2.40, 95%CI=1.87-3.23), depression (OR=1.76, 95%CI=1.35-2.29) and poor flexible control (OR=1.94, 95%CI=1.48-2.54) were risk factors for eating disorders. Conclusion Female, individuals with depressive symptoms or with poor flexible control ability are more likely to have eating disorders which need more attention.

Objective: To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China. Methods: IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors. Results: The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group (P=0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference-in-differences model, the increase of the qualified rate in the intervention group was 8.2% greater than that in the control group (P=0.021). The proportion of violent discipline by caregivers in the intervention group showed a decrease of 6.2% (mid-term 49.1% (478/973) vs. baseline 55.3% (554/1 001)), whereas the proportion in control group showed an increase of 4.5% (mid-term 58.4% (560/959) vs. baseline 53.9% (558/1 036)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 11.0% (P=0.001). The proportion of families with three or more children's books in the intervention group showed an increase of 12.7% (mid-term 42.7% (588/1 378) vs. baseline 30.0% (432/1 440)), whereas the proportion of the control group showed an increase of 4.2% (mid-term 25.7% (349/1 357) vs. baseline 21.5% (298/1 388)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 6.1% (P=0.007). Conclusions The IECD intervention strategy implemented in rural China effectively improved the mental health of caregivers, optimizes families' child feeding and early stimulation behaviors, while reducing violent discipline and other risk factors. IECD provides better nurturing care for the early development of children aged 0-35 months in rural China.

Objective To investigate the serum levels of uric acid (UA) in bipolar disorder patients and their clini?cal significance. Methods Serum levels of UA was measured in 126 bipolar disorder patients including 77 mania pa?tients and 49 depression patients, 69 first-episode schizophrenic patients and 126 healthy controls (control group). Bipo?lar disorder patients was assessed by using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAMD). Results The serum UA levels were significantly higher in bipolar group [(349.34 ± 107.21) μmol/L] than in schizophrenic group [(319.71±84.48)μmol/L] and in control group [(280.94±71.90)μmol/L] (P<0.01). There were signifi?cant differences in serum UA levels between manic episode and depressive episode [(366.45 ± 104.01) μmol/L vs. (322.45±107.69)μmol/L]. The serum UA levels were higher in both manic episode and depressive episode groups than in control group (P<0.01). The serum UA levels was not significantly different between patients with and without medication (P>0.05). Correlation analysis indicated that the correlation of serum UA levels with YMRS scores and HAMD scores was not significant in bipolar disorder patients (P>0.05). Conclusions Patients with bipolar disorder has elevated serum uric acid levels which may be a biomarkers of bipolar disorder.

Objective To observe the clinical curative effect of Ⅲb~Ⅳstage non-small cell lung cancer treated by radiofrequency ablation combined with chemotherapy. Methods Forty-eight Ⅲb~Ⅳstage non-small cell lung cancer patients were divided into the study group (RFA + chemotherapy) and 74 were in control group (chemotherapy alone) by the method of non randomized controlled. Curative effect was evaluated every two cycles during the treatment. A 6 to 36 months follow-up was conducted after the treatment. Results The objective response rate of experiment group and control group was 58.3%and 41.9%respectively (P>0.05) with no significant difference and disease control rates of experiment group and control group were 91.7% and 75.7% respectively (P<0.05). MST were 14.4 months and 8.2 months respectively (P<0.01), with statistically significant differences in experiment group and control group and clinical benefit efficient were 87 . 5% and 66 . 2% respectively ( P < 0.05). Conclusion The treatment of radiofrequency ablation combined with chemotherapy for advanced non-small cell lung cancer can significantly improve the patient′s survival and the clinical curative effect.

In this study, we explored the establishment of the database of Chinese medicine and minimally invasive surgery (MIS) for tumor based on the internet, thus to promote the application of Chinese medicine in the comprehensive treatment for tumor. The database was composed of general information database, Chinese medicine database, MIS database, which was characterized by the internet-based information system structure. Data exchange between net server and remote terminal can be achieved through the firewall. The results of testing performance showed that the established database can realize the real-time share of case report, and is convenient in basic retrieve and information analysis function, indicating the feasibility and stability of the database.