Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Persistent and maladaptive drug-related memories represent a key component in drug addiction. Converging evidence from both preclinical and clinical studies has demonstrated the potential efficacy of the memory reconsolidation updating procedure (MRUP), a non-pharmacological strategy intertwining two distinct memory processes: reconsolidation and extinction-alternatively termed "the memory retrieval-extinction procedure". This procedure presents a promising approach to attenuate, if not erase, entrenched drug memories and prevent relapse. The present review delineates the applications, molecular underpinnings, and operational boundaries of MRUP in the context of various forms of substance dependence. Furthermore, we critically examine the methodological limitations of MRUP, postulating potential refinement to optimize its therapeutic efficacy. In addition, we also look at the potential integration of MRUP and neurostimulation treatments in the domain of substance addiction. Overall, existing studies underscore the significant potential of MRUP, suggesting that interventions predicated on it could herald a promising avenue to enhance clinical outcomes in substance addiction therapy.
Humans ; Substance-Related Disorders/psychology* ; Memory Consolidation/physiology* ; Animals ; Extinction, Psychological/physiology*

Cardiac arrest (CA) is a serious cardiac event, which has a high incidence and low survival rate at home and abroad. In order to predict the risk of CA in advance, a large number of studies have been conducted by relevant researchers. This paper mainly summarizes the characteristics and research status of the existing analysis and prediction of CA from three aspects: the risk prediction factors of CA, the evaluation index of risk prediction of CA and the early warning scoring system of CA. We hope it can help medical staff to understand the current progress in this field, and provide new ways and methods for predicting the risk of CA.

Objective To explore the effect and safety of right unilateral modified electroconvulsive therapy(RUL-MECT)for major depressive disorder patients(MDD).Methods A randomized controlled trial was conducted on 70 patients with MDD who were randomly divided into a study group and a control group.The study group underwent age-based RUL-MECT,while the control group underwent bitemporal MECT.The participants were evaluated using the 17-item Hamilton depression scale(HAMD-17),MATRICS consensus cognitive battery(MCCB)and orientation recovery tests(ORT).Any adverse reactions that occurred during each intervention process were recorded.Results Before treatment,there were no significant differences in the HAMD-17(32.89±5.68 vs.33.54±4.78)between the two groups(P>0.05).The HAMD-17 score of the intervention group was 6.83±4.68,while the control group was 7.20±4.60 after 8 interventions,repeated measures analysis of variance showed the time effect(P<0.001)was significant.The intergroup effect and interaction effect was not significant(P>0.05).In terms of MCCB scores,there were significant main effect(P<0.001)in connectivity tests,symbol coding,language memory,spatial breadth,number sequence,maze test,visual memory,emotional management and the duration of continuous operation.The intergroup effects of language memory,number sequence,visual memory,speech fluency,and continuous operation were significant(P<0.05).The interaction effect of language memory and continuous operation were significant(P<0.05).After the intervention,the recovery of orientation time was significantly shorter in the study group than that in the control group[(508.57±104.48)s vs.(631.66±212.27)s](P<0.05).The incidence of adverse reactions between two groups(28.6% vs.40.0% )has no significance(P>0.05).Conclusions Compared with bitemporal MECT,RUL-MECT has comparable efficacy in treating depressant and better performance in improving cognitive function and recovery of orientation.

Objective To understand students' attitude changes before and after they started their internships in the department of psychiatry and evaluate their teachers' teaching methods. Methods Using a self-made questionnaire of Psychiatric Internship Attitude that has passed the reliability and validity test, from 2015 to 2016, a total of 208 undergraduate students in the clinical medicine mental health direction of Chongqing Medical University were selected through cluster random sampling to investigate their attitude changes towards psychiatry before and after they started their internships. At the end of their internships, another self-made Psychiatric Teach Evaluation Forming Questionnaire of the reliability and validity test was used to preliminarily evaluate the students' assessment of the teaching situation of their teachers during the internship. Results Before the internships, through the survey we found that 44.2% of the students felt nervous, 37.0% fearful, 57.2% compassionate, and the percentage of students who were willing to work in the department of psychiatry is only 41.4%. Through investigation, teachers carried out the teaching work with targeted goals, at the end of the internship the tension and fear decreased to 0.0%, the proportion of empathy rose to 78.4%, and the differences are statistically significant (P<0.05). Conclusion The students' attitude survey at the beginning of their internship can help teachers improve their teaching attitudes, con-cepts and methods, and make students' negative attitudes towards mental patients and psychiatry significantly reduce.

Objective To explore the characteristic of fractional amplitude of low frequency fluctuation (fALFF) and the relationship with the severity of depression, suicidal ideation and suicide risk in depression patients with suicidal ideation with resting-state functional magnetic resonance imaging (rs-fMRI). Methods Resting state functional magnetic resonance imaging maps were conducted using fractional amplitude of low frequency fluctuation (fALFF) in 52 depression patients (30 with suicidal ideation and 22 without) and 21 healthy controls (HCs). The severity of depression was evaluat-ed by using Hamilton Depression scale(HAMD). The suicidal ideation, the suicide risk in depression patients with sui-cidal ideation were both assessed by the Beck Scale for Suicide Ideation. The correlation between the fALFF value and the score of HAMD and the Beck Scale for Suicide Ideation was analyzed. Results MRI revealed significant differences in fALFF in the left superior/middle occipital gyrus and the right middle/inferior occipital gyrus (P<0.05, AlphaSim cor-rected)between depression patients with suicidal ideation and the HCs. Compared to the HCs, depression patients with-out suicidal ideation showed a higher fALFF in the left middle occipital gyrus (P<0.05, AlphaSim corrected). MRI re-vealed significant differences in fALFF in the left middle occipital gyrus (P<0.01, AlphaSim corrected)and the right mid-dle occipital gyrus (P<0.01, AlphaSim corrected) between depression patients with suicidal ideation and without. The fALFF of left middle occipital gyrus (r=0.366, P=0.046) and right middle occipital gyrus (r=0.513, P=0.004) were posi-tively correlated with the scores of HAMD, respectively whereas were not correlated with suicidal ideation and suicide risk. Conclusions Depression patients with suicidal ideation have an abnormal spontaneous activity in their left and right middle occipital gyrus. The increased activity in these brain areas are probably associated with the severity of de-pression whereas are not associated with suicidal ideation or suicide risk.

We investigated the baseline brain activity level in patients with major depressive disorder (MDD) by am plitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). We examined 13 patients in the MDD group and 14 healthy volunteers in the control group by resting-state fMRI on GE Signa 3.0T. We calculated and compared the ALFF values of the two groups. In the MDD group, ALFF values in the right medial prefrontal were higher than those in control group, with statistically significant differences (P < 0.001). ALFF values in the left parietal in the MDD group were lower than those in control group with statistically significant differences (P < 0.001). This resting-state fMRI study suggested that the alteration brain activity in the right medial prefrontal and left parietal ALFF contributed to the understanding of the pathophysiological mechanism of MDD patients.
Brain ; physiopathology ; Brain Mapping ; Case-Control Studies ; Depressive Disorder, Major ; physiopathology ; Humans ; Magnetic Resonance Imaging

ObjectiveTo explore the status of social anxiety and study the relationship between social anxiety and self-consciousness,self-esteem among primary students.MethodsUsing stratified randomization sampling method,568 primary students in grade 4 ～ 6 were investigated with social anxiety scale for children( SASC ),self-consciousness scale for children(PHCSS) and self-esteem scale(SES).Results①The score of SASC in the group of primary students was obviously higher than that of Chinese norm (P＜0.01).②The SASC and negative evaluation scores in the female were higher than the male (P ＜ 0.05 ),the negative evaluation scores in the sixth grade (3.22 ± 2.82) was higher than the fifth grade (2.53 ± 2.76,P ＜ 0.01 ) and fourth grade ( 2.54 ± 2.68,P＜ 0.05 ).The primary students in migrant workers elementary school,the single parent family and the relatively low income family had higher social anxiety scores than others(P＜0.05 ).③The SASC and two major factors were significantly negative correlated with the self-consciousness and each subscale( r =-0.202 ～ -0.511,P ＜ 0.01 ),and positive correlated with the self-esteem( r =0.282,0.270,0.305,P ＜ 0.01 ).④)The anxiety and gregariousness had significant prediction function of 25.5％ on negative evaluation,and 28.2％ on SASC,anxiety,gregariousness,intelligence and school situation had significant prediction function of 20.4％ on social avoidance and distress.ConclusionsPrimary students in grade 4 ～ 6 existed social anxiety.There are significant differences for their level of anxiety in different gender,grade,elementary school,family structure,monthly income.And social anxiety is closely related to self-consciousness and self-esteem.

Objective To discuss the impact of relevant psycho-social factors on the driving adaptability. Methods A total of 870 vehicle drivers were screened out by stratified cluster sampling,and 620 drivers were finally selected for this study after eliminating those who had 1 -2 accidents. The 620 drivers were divided into accident group and non-accident group. Demographic questionnaire, life event scale, SCL-90 Scale and Eysenck Personality Questionnaire were applied to investigate their general condition, life event, mental health and personality. All data were analyzed by t test and stepwise Fisher discriminatory, and then the discriminatory equations of driving eligibility were established. Results The scores of factors including positive life events, negative life events, family events, work events and social events in accident group were 9.62 ± 11.36, 34.53 ± 30.01, 24.05 ± 23.09, 16.78 ± 17. 12 and 2.82 ± 5.07, respectively, which were higher than 4.67 ± 6.25, 6.38 ± 10. 15, 6.48 ± 9.43, 3.96 ±6.55 and 2.02 ± 5.43 respectively in the non-accident group ( P ＜ 0. 01 ). The total SCL-90 score and the scores of all factors in the accident group were higher than those in the non-accident group ( P ＜0. 01 ). The Eysenck Personality Questionnaire scores of the accident group were significantly higher than the non-accident group in N dimension ( 56. 32 ± 8.77 vs. 45.23 ± 8.06 ) and P dimension (52.22 ±10.43 vs. 48.31 ± 9.35 ) ( P ＜ 0. 01 ). Fisher discriminatory equations: Faccident group = 0. 258 × X6 + 0.119 ×X9 +0.637 ×X17 +0.043 × X5-7.476; Fnon-accident group =0. 137 × X6-1. 000 ×X9 + 1.423 ×X17 +0.003× X5-2.601. Total discrimination accuracy of verification was 88.3%, and the total accuracy of prospective discrimination was 88.0%. Conclusions There is clear correlation of driving adaptability with coercion, anxiety, emotion and negative factors. The discriminatory equations are useful for selecting drivers because of high accuracy, and may play an important role in reducing the occurrence of traffic accidents.