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 explore the intervention effect of virtual reality technology assisted early cardiac rehabilitation on exercise fear and self-efficacy after coronary artery bypass grafting (CABG), and provide theoretical basis for constructing intelligent and personalized cardiac rehabilitation models.Methods:A prospective non-contemporaneous controlled study was conducted. One hundred and two CABG patients admitted to the First Affiliated Hospital of the Chinese People's Liberation Army Naval Medical University were selected as the research subjects. They were divided into a control group (51 cases, from January to June 2024) and an experimental group (51 cases, from August to December 2024) according to their admission time, with July 2024 as the washout period. The control group received routine postoperative early cardiac rehabilitation intervention, while the experimental group received virtual reality technology intervention on the basis of the control group. The Tampa Scale of Kinesiophobia Heart (TSK-SV-Heart) and General Self-Efficacy Scale (GSES) were used to evaluate exercise fear and self-efficacy on the third day after surgery, one day before discharge, and one month after discharge, and the 6-minute walking distance was recorded at one day before discharge, and one month after discharge.Results:The control group consisted of 49 complete participants, aged (58.50 ± 5.88) years, with 26 males and 23 females, while the experimental group consisted of 48 complete participants, aged (60.31±6.58) years, with 30 males and 18 females. There was no statistically significant difference in the scores of exercise fear and self-efficacy between the two groups on the third day after surgery (both P>0.05). The exercise fear scores of the experimental group at one day before discharge and one month after discharge were (34.16 ± 5.76), (26.86 ± 4.52) points, respectively, which were lower than those of the control group (37.95 ± 6.14), (33.71 ± 5.49) points, and the differences were statistically significant ( t=3.13, 6.70, both P<0.05). The self-efficacy scores of the experimental group at one day before discharge and one month after discharge were (30.78 ± 3.49), (32.42 ± 3.37) points, respectively, which were higher than those of the control group (26.65 ± 4.21) , (26.54 ± 3.68) points, and the differences were statistically significant ( t=4.73, 8.25, both P<0.05). The 6-minute walking distance of the experimental group at one day before discharge and one month after discharge were (422.65 ± 74.32), (485.22 ± 76.84) m, respectively, which were longer than those of the control group (385.43 ± 68.17), (423.76 ± 62.75) m, and the differences were statistically significant ( t=2.57, 4.32, both P<0.05). Conclusions:Virtual reality technology can improve the fear of movement in patients after CABG surgery, enhance their self-efficacy, and simultaneously improve the 6-minute walking distance, providing a theoretical reference for the development of intelligent nursing measures after CABG surgery.

Objective To evaluate the effectiveness,safety and economy of generic venlafaxine sustained-release capsules and the original drug in clinical practice based on real world clinical data.Methods This is a multicenter,retrospective real-world study.The information of outpatients who used venlafaxine sustained-release capsules in 7 hospitals from October 2021 to October 2022 was collected,including prescription data and laboratory data.They were divided into generic drug group and original drug group.After the baseline level was corrected by propensity score match method,the prescription daily dose,plasma concentration,medication possession ratio,the continuous medication rate for 3,6 and 9 months,dressing change rate,the incidence of adverse reactions,the frequency of drug use,the average daily cost,the annual cost per capita and the proportion of the average annual cost of drugs were compared between the two groups.Results After the baseline level was corrected by propensity score matching method,the prescription daily dose and medication possession ratio(MPR≥0.8)in the generic drug group were higher than that of the original drug group(P＜0.05).There was no statistically difference in plasma concentration between the two groups(P=0.294).The continuous medication rate for 3,6 and 9 months in the generic drug group were statistically higher than those in the original drug group(P＜0.01).The single dressing change rate of the generic drug group was lower than that of the original drug group(P=0.032).There was no significant difference in the rate of secondary dressing change between the two groups(P=1.000).There were no significant differences in the incidence of abnormal ALT,AST,TC,Na,APTT,and PLC between two groups(P＞0.05).The average daily cost of the generic drug group was lower than that of the original drug group.The per capita annual cost of drugs and the proportion of average annual cost of drugs in the generic drug group were significantly lower than those in the original drug group(P＜0.01).Conclusion In the actual clinical diagnosis and treatment,no clinically significant differences in effectiveness and safety were found between the generic venlafaxine sustained-release capsule and the original-patented,while the economic advantages of the generic drug were better than that of the original-patented drug.

Objective To evaluate the effectiveness,safety and economy of generic venlafaxine sustained-release capsules and the original drug in clinical practice based on real world clinical data.Methods This is a multicenter,retrospective real-world study.The information of outpatients who used venlafaxine sustained-release capsules in 7 hospitals from October 2021 to October 2022 was collected,including prescription data and laboratory data.They were divided into generic drug group and original drug group.After the baseline level was corrected by propensity score match method,the prescription daily dose,plasma concentration,medication possession ratio,the continuous medication rate for 3,6 and 9 months,dressing change rate,the incidence of adverse reactions,the frequency of drug use,the average daily cost,the annual cost per capita and the proportion of the average annual cost of drugs were compared between the two groups.Results After the baseline level was corrected by propensity score matching method,the prescription daily dose and medication possession ratio(MPR≥0.8)in the generic drug group were higher than that of the original drug group(P＜0.05).There was no statistically difference in plasma concentration between the two groups(P=0.294).The continuous medication rate for 3,6 and 9 months in the generic drug group were statistically higher than those in the original drug group(P＜0.01).The single dressing change rate of the generic drug group was lower than that of the original drug group(P=0.032).There was no significant difference in the rate of secondary dressing change between the two groups(P=1.000).There were no significant differences in the incidence of abnormal ALT,AST,TC,Na,APTT,and PLC between two groups(P＞0.05).The average daily cost of the generic drug group was lower than that of the original drug group.The per capita annual cost of drugs and the proportion of average annual cost of drugs in the generic drug group were significantly lower than those in the original drug group(P＜0.01).Conclusion In the actual clinical diagnosis and treatment,no clinically significant differences in effectiveness and safety were found between the generic venlafaxine sustained-release capsule and the original-patented,while the economic advantages of the generic drug were better than that of the original-patented drug.

Objective:To explore the intervention effect of virtual reality technology assisted early cardiac rehabilitation on exercise fear and self-efficacy after coronary artery bypass grafting (CABG), and provide theoretical basis for constructing intelligent and personalized cardiac rehabilitation models.Methods:A prospective non-contemporaneous controlled study was conducted. One hundred and two CABG patients admitted to the First Affiliated Hospital of the Chinese People's Liberation Army Naval Medical University were selected as the research subjects. They were divided into a control group (51 cases, from January to June 2024) and an experimental group (51 cases, from August to December 2024) according to their admission time, with July 2024 as the washout period. The control group received routine postoperative early cardiac rehabilitation intervention, while the experimental group received virtual reality technology intervention on the basis of the control group. The Tampa Scale of Kinesiophobia Heart (TSK-SV-Heart) and General Self-Efficacy Scale (GSES) were used to evaluate exercise fear and self-efficacy on the third day after surgery, one day before discharge, and one month after discharge, and the 6-minute walking distance was recorded at one day before discharge, and one month after discharge.Results:The control group consisted of 49 complete participants, aged (58.50 ± 5.88) years, with 26 males and 23 females, while the experimental group consisted of 48 complete participants, aged (60.31±6.58) years, with 30 males and 18 females. There was no statistically significant difference in the scores of exercise fear and self-efficacy between the two groups on the third day after surgery (both P>0.05). The exercise fear scores of the experimental group at one day before discharge and one month after discharge were (34.16 ± 5.76), (26.86 ± 4.52) points, respectively, which were lower than those of the control group (37.95 ± 6.14), (33.71 ± 5.49) points, and the differences were statistically significant ( t=3.13, 6.70, both P<0.05). The self-efficacy scores of the experimental group at one day before discharge and one month after discharge were (30.78 ± 3.49), (32.42 ± 3.37) points, respectively, which were higher than those of the control group (26.65 ± 4.21) , (26.54 ± 3.68) points, and the differences were statistically significant ( t=4.73, 8.25, both P<0.05). The 6-minute walking distance of the experimental group at one day before discharge and one month after discharge were (422.65 ± 74.32), (485.22 ± 76.84) m, respectively, which were longer than those of the control group (385.43 ± 68.17), (423.76 ± 62.75) m, and the differences were statistically significant ( t=2.57, 4.32, both P<0.05). Conclusions:Virtual reality technology can improve the fear of movement in patients after CABG surgery, enhance their self-efficacy, and simultaneously improve the 6-minute walking distance, providing a theoretical reference for the development of intelligent nursing measures after CABG surgery.

Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.

Abstract: Objective To explore the dynamic characteristics of stigmatization in HIV/AIDS patients and provide scientific evidence for psychological care. Methods HIV/AIDS patients receiving antiretroviral therapy (ART) treatment in Nanning Fourth People's Hospital were randomly selected for baseline and 1 year follow-up questionnaire survey including internalized HIV stigma, anticipated HIV stigma, exposure to HIV stigma. The differences between the two groups at different time points were dynamically compared to analyze the changing characteristics of stigma in HIV/AIDS patients. Results After one year of ART treatment, among the eight items of internalizing stigma, five items including the proportion of feeling ashamed of being infected with HIV/AIDS, feeling unclean because of being infected with HIV/AIDS, feeling inferior to others because of having HIV/AIDS, feeling guilty because of having HIV/AIDS, and having a poorer self-perception due to how others view HIV/AIDS decreased significantly from 34.0% to 43.5% at the baseline to 19.5% to 29.5%, showing significant improvement with statistical significance (χ2=18.586, 14.277, 10.473, 12.219, 9.934, P<0.05); among the nine items of anticipated stigma, four items including the proportion of community/community workers not taking my needs seriously, discriminating against me, refusing to provide services for me, and healthcare workers avoiding contact with me decreased significantly from 16.0% to 27.5% at the baseline to 7.0% to 15.5%, respectively, showing significant improvement with statistical significance (χ2=13.690, 15.787, 12.034, 12.593, P<0.05); among the 16 items of exposure to HIV stigma, six items including the proportion of experiencing physical attacks, psychological pressure from spouses/partners, being refused sexual relationships, losing jobs or other economic sources, being rejected or losing a job opportunity due to HIV/AIDS, changing job nature due to HIV/AIDS, or being refused medical services decreased significantly from 2.5% to 15.0% at the baseline to 1.0% to 8.0%, respectively, showing significant improvement with statistical significance (χ2=8.619, 15.558, 6.061, 9.049, 5.432, 8.156, P<0.05). Physical assaults on people with HIV/AIDS increased by 5.5 percent(χ2=5.368, P<0.05). Conclusions Through 1-year dynamic monitoring, 48.48% of the three dimensions of stigma of HIV/AIDS patients were alleviated. Treatment intervention, self-acceptance and the creation of a good non-discriminatory social environment have an important impact on the stigma of HIV/AIDS patients and deserve the attention of society as a whole.

In order to investigate developmental coordination disorder (DCD) of kindergarten children in Zhejiang province, 200 ordinary kindergartens were randomly selected by stratified random sampling in 11 prefecture-level cities of Zhejiang Province, and 38 900 children from 1 000 classes in each grade were then randomly selected into the study from June 2019 to December 2019. The Little DCD Questionnaire and a self-designed questionnaire were used to screen the DCD of those children. There were 36 807 valid questionnaires, and 6.50% (2 391/36 807) of them were positive results. The results showed that boy, age ≤5 years, overweight or obesity, left handedness, comorbidity with motor or developmental disorders and premature infants were risk factors of DCD in children. As for parents and families, maternal gestational age<20 years, maternal overweight or obesity before pregnancy, low-middle level education of parents, direct family and low income of family were also associated with DCD in children. Therefore, it is necessary to conduct early prevention and intervention strategies targeting on identified risk factors among relevant population.

In order to investigate developmental coordination disorder (DCD) of kindergarten children in Zhejiang province, 200 ordinary kindergartens were randomly selected by stratified random sampling in 11 prefecture-level cities of Zhejiang Province, and 38 900 children from 1 000 classes in each grade were then randomly selected into the study from June 2019 to December 2019. The Little DCD Questionnaire and a self-designed questionnaire were used to screen the DCD of those children. There were 36 807 valid questionnaires, and 6.50% (2 391/36 807) of them were positive results. The results showed that boy, age ≤5 years, overweight or obesity, left handedness, comorbidity with motor or developmental disorders and premature infants were risk factors of DCD in children. As for parents and families, maternal gestational age<20 years, maternal overweight or obesity before pregnancy, low-middle level education of parents, direct family and low income of family were also associated with DCD in children. Therefore, it is necessary to conduct early prevention and intervention strategies targeting on identified risk factors among relevant population.

OBJECTIVE：To overview the systematic review on the effectiveness of indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP），and to provide reliable evidence-based reference for the prevention of PEP. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，CBM，CNKI，Wanfang database and VIP，systematic review on indomethacin in the prevention of PEP were collected during the inception to Nov. 2020. The methodological quality ，report quality and evidence quality of the included studies were evaluated by AMSTAR 2 scale，PRISMA statement and GRADE method. The effectiveness of PEP prevention was described. RESULTS ：Finally，23 systematic reviews were obtained ，including 12 in Chinese and 11 in English. Tweenty-two systematic reviews showed that compared with placebo ， indomethacin could effectively reduce the incidence of PEP. Eight systematic reviews showed that indomethacin significantly reduced the incidence of moderate and severe PEP compared with placebo. Five systematic reviews showed that indomethacin could reduce the incidence of postoperative hyperamylasemia compared with placebo. Three systematic reviews showed that indomethacin also had a good preventive effect on people with high risk of PEP. PRISMA score of included systematic reviews ranged from 15 to 25. The quality evaluation of AMSTAR 2 methodology included in systematic reviews was low ，and the key items of complete report were 4，9，11 and 13. The GRADE evidence quality evaluation of the included systematic reviews showed that the quality of the evidence was concentrated in the low level. CONCLUSIONS ：Indomethacin has a certain effect in the prevention of PEP ，but the overall evidence quality of the included literatures is generally not high. It needs to be further validated by high-quality clinical research.