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 the diagnostic value of plasma cardiac troponin Ⅰ (cTnI) and brain natriuretic peptide (BNP) for heart failure complicated with pneumonia in children.Methods 30 children of heart failure complicated with pneumonia (heart failure group),30 children with pneumonia in acute phase (pneumonia group) and 30 healthy children (control group) were selected.The levels of plasma cTnI and BNP in the heart failure group were detected in acute phase(6-24h) and recovery phase(5-7d),and the results were compared with pneumonia group and control group.Results The levels of plasma cTnI and BNP in the heart failure group were significantly higher than those in the pneumonia group and control group(F =5.303,4.632,all P ＜ 0.05).The levels of plasma cTnI and BNP were not significantly different between the pneumonia group and control group(P ＞ 0.05).The levels of plasma cTnI and BNP in recovery phase of the heart failure group were significantly lower than those in acute phase of the heart failure group (t =4.291,5.393,all P ＜ 0.05),but there were no siganificant differences compared with the pneumonia group and control group(P ＞ 0.05).Conclusion The plasma cTnI and BNP maybe a reliable index in the diagnosis of heart failure complicated with pneumonia in children.

Objective To explore the effect of high bilirubin on myocardial injury.Methods The levels of serum total bilirubin (TBIL),creatine kinase (CK),creatine kinase-isoenzyme MB(CK-MB),cardiac troponin Ⅰ (cTnI) were measured and compared in newborns without obvious physiological jaundice (control group) and newborns with hyperbilirubinemia (study group) before and after treatment.Results Compared with those in control group,the levels of serum TBIL,CK,CK-MB and cTnI in study group before treatment were obvious higher[(270.24 ± 36.89) μ mol/L vs.(68.95 ± 10.87) μ mol/L,(414.27 ± 135.45)U/L vs.(178.35 ± 59.62) U/L,(63.31 ± 23.25) U/L vs.(16.78 ± 8.89) U/L,(0.39 ± 0.11) μ g/L vs.(0.18 ± 0.07) μ g/L],and the differences between two groups were statistically significant (P ＜ 0.05).The levels of serum TBIL,CK,CK-MB and cTnI after treatment in study group [(69.13 ±9.98) μmol/L,(183.35 ± 61.01) U/L,(17.45 ± 9.0.8) U/L,(0.19 ± 0.01) μ g/L] were decreased obviously compared with those before treatment,and the differences between two groups were statistically significant (P ＜ 0.05).There was no significant difference between control group and study group after treatment (P ＞ 0.05).Conclusions High bilirubin can lead to a reversible myocardial injury.Cardiac enzymes and troponin testing should be routinely done for neonatal hyperbilirubinemia.It suggests doctors to attend to the treatment of myocardial protection.

Objective To explore the optimal experiment conditions of CCK-8 and MTS for cell proliferation assays in human amniotic epithelial cells and to evaluate the cytotoxicity of these reagents. Methods Human amniotic epithelial cells (hAECs) in logarithm growth stages were prepared in different cell concentrations with DMEM/F12 and 10% FBS. The sensitivity and optimal wavelengths was determined based on the optical density (OD) measured at 450 nm and 492 nm. The optimal time was determined under the conditions of the same cell concentration and defined OD values. HAECs were treated with DMSO, CCK-8 and MTS for 1 h, 2 h, 3 h, and 4 h, respectively. 24 h later, cytotoxicity of the CCK-8 and MTS was evaluated by determination of cell proliferation and Trypan Blue staining. Results The optimal detection wavelength was 450 nm for CCK-8, and 492 nm for MTS. The sensitivity of CCK-8 was slightly lower then that of MTS. The optimal time for incubation hAECs with CCK-8 was 4 h within 1~4 h. The inhibitory on cell proliferation and cytotoxicity of CCK-8 were weaker then those of MTS. Conclusion CCK-8 is a convenient reagent with low cytotoxicity for detection of the proliferation of hAECs.

Objective To probe the regulation of TCM treatment for essential hypertension by analyzing the frequency of herbs usd in the literature of hypertension TCM treatment included in CNKI from 1979 to 2009 with a view to provide a reference for the clinical treatment and research.Methods The herbs meeting the inclusion criteria in the selected literature was recorded by using Excel table,and analyzed by using SPSS13.0 statistical software.Results Of the 301 herb medicine,the tonics,heat-clearing,calming liver wind,promoting blood circulation and removing blood stasis,removing dampness and promoting diuresis,diaphoretics totally accounted for 79.16%.The attributive channel of these herbs involved in 12 viscera,in which liver meridian,kidney meridian,spleen meridian,heart meridian accounted for 66.97%.All herbs involved in 7 kinds of herbal flavors,and total appearance frequency of the 7 flavors was 12584,in which sweetish,bitterness,pungent herbs accounted for 82.99%.Conclusion Efficacy,property flavors and attributive channel of herb medicine used for essential hypertension are closely related to the pathogen and pathogenesis.These herbal medication regularity provides a reference for the current syndrome differentiation and treatment of essential hypertension.