Depressive disorder is a common psychiatric condition clinically characterized by impaired cognitive function， which profoundly affects patients' daily living and social functioning. Despite extensive research on the mechanism underlying the interaction between ghrelin and depressive disorder， comprehensive reviews， summary， and systematic organization of these findings remain lacking. To address this gap， this study aims to conduct a systematic evaluation of the effects and mechanisms of ghrelin on cognitive function in patients with depressive disorder， thereby providing references for targeted clinical interventions. On October 20， 2024， literature exploring the role and mechanisms of ghrelin in improving cognitive function in depressive disorder was sourced from the CNKI， PubMed and Web of Science databases， covering the period from the inception of the database till October 20， 2024. Two researchers independently conducted literature screening and data extraction. Ultimately， 9 articles were included in this review. The findings suggest that ghrelin improves cognitive function in patients with depressive disorder through multiple mechanisms， including mitigating inflammatory responses， modulating oxidative stress， and activating the cyclic adenosine monophosphate response element binding protein-brain-derived neurotrophic factor （CREB-BDNF） signaling pathway.

Objective:To analyze the clinical characteristics of poisoning inpatients in the first affiliated hospital of chongqing medical and pharmaceutied hospital, and to provide basis for improving the level of prevention, control, diagnosis and treatment of regional poisoning.Methods:In January 2024, using the HIS medical record system of The First Affiliated Hospital of Chongqing Medical and Pharmeceutical College, we collected the clinical data of poisoning inpatients admitted to our hospital from 2018 to 2023. The data of sex, age, time of poisoning, poison species, poisoning cause, poisoning route, season, treatment and prognosis were analyzed.Results:A total of 972 patients were enrolled, among whom 71.71% (697/972) were young and middle-aged adults, with a higher incidence in summer. Chemical poisoning accounted for 53.61% (521/972) , followed by pesticide poisoning and mixed poisoning in the second and third places. The overall detection rate of toxins was 58.23% (566/972) . The number of domestic poisonings increased year by year, while occupational poisonings decreased year by year, with statistically significant differences ( P<0.05) . The overall cure and improvement rate was 97.22% (945/972) , and the cure and improvement rate of pesticide poisoning was the lowest at 90.23% (120/133) . Factors such as age >60 years, intentional exposure to toxins, pesticide exposure, gastric lavage, blood purification, and length of hospital stay affected the prognosis of patients ( P<0.05) . Conclusion:Health education should be actively promoted, toxin control should be strengthened, scientific and reasonable prevention and control measures as well as treatment methods should be adopted to reduce the incidence and mortality of poisoning.

Objective:To analyze the clinical characteristics of poisoning inpatients in the first affiliated hospital of chongqing medical and pharmaceutied hospital, and to provide basis for improving the level of prevention, control, diagnosis and treatment of regional poisoning.Methods:In January 2024, using the HIS medical record system of The First Affiliated Hospital of Chongqing Medical and Pharmeceutical College, we collected the clinical data of poisoning inpatients admitted to our hospital from 2018 to 2023. The data of sex, age, time of poisoning, poison species, poisoning cause, poisoning route, season, treatment and prognosis were analyzed.Results:A total of 972 patients were enrolled, among whom 71.71% (697/972) were young and middle-aged adults, with a higher incidence in summer. Chemical poisoning accounted for 53.61% (521/972) , followed by pesticide poisoning and mixed poisoning in the second and third places. The overall detection rate of toxins was 58.23% (566/972) . The number of domestic poisonings increased year by year, while occupational poisonings decreased year by year, with statistically significant differences ( P<0.05) . The overall cure and improvement rate was 97.22% (945/972) , and the cure and improvement rate of pesticide poisoning was the lowest at 90.23% (120/133) . Factors such as age >60 years, intentional exposure to toxins, pesticide exposure, gastric lavage, blood purification, and length of hospital stay affected the prognosis of patients ( P<0.05) . Conclusion:Health education should be actively promoted, toxin control should be strengthened, scientific and reasonable prevention and control measures as well as treatment methods should be adopted to reduce the incidence and mortality of poisoning.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To investigate the high risk factors of endometrial polyps (EPs)in infertile patients and its impact on the pregnancy outcome after embryo transfer.Methods A case-control trail was conducted on the infertility patients who undergoing embryo transfer in our hospital for the first time after hysteroscopy from January 2016 to December 2022.Their clinical data were collected and retrospectively analyzed.Univariate and stepwise logistic regression analyses were used to identify the risk factors for EPs,and the impact of polyps on the pregnancy outcomes of assisted reproductive pregnancy was analyzed with propensity score matching (PSM)at a 1:2 ratio.Results A total of 388 patients diagnosed with Eps and undergoing hysteroscopic endometrial polypectomy were assigned into the Eps group,and 2163 non-polyp patients were into the non-Eps group.Univariate analysis showed statistical differences were observed in age[31 (29,34)vs 31 (28,33),P=0.002],history of pelvic inflammatory disease (42.78％vs 64.17％,P=0.000),age at menarche[14 (12,14)vs 13 (12,14)years old,P=0.000],number of pregnancies[0 (0,1 )vs 1 (0,2),P=0.000],primary infertility (60.30％vs 50.20％,P=0.000),duration of infertility[4 (2.1,6.0)vs 4 (2.0,6.0)years,P=0.002],concomitant endometriosis (9.53％ vs 6.52％,P=0.032),concomitant uterine fibroids (11 .85％vs 6.93％,P=0.001 ),and basal estrogen level[38.12 (27.00,59.00)vs 36.00 (25.00,53.00)μg/L,P=0.016]between the 2 groups.Logistic stepwise regression analysis indicated that age (OR=1 .082,95％CI:1 .053～1 .113,P<0.05 ),primary infertility (OR=2.951,95％CI:1 .990～4.376,P<0.05),and elevated basal estrogen (OR=1 .003,95％CI:1 .001～1 .005,P<0.05)were risk factors for Eps.The postoperative biochemical pregnancy rate (59.28％vs 52.70％),clinical pregnancy rate (53.09％vs 45.48％),and live birth rate (43.81％vs 35.82％)were significantly higher in the matched Eps group than the non-Eps group (P<0.05 ).No statistical difference was observed in pregnancy outcome in the patients with different polyp locations and sizes.The patients with multiple polyps had an obvious higher rate of early miscarriage than those with single polyp (17.27％ vs 7.29％,P<0.05 ),while those with recurrent polyps also had a higher rate of early miscarriage than those with primary polyps (27.78％vs 11.23％,P<0.05).Conclusion Age,primary infertility,and elevated basal estrogen are risk factors for Eps in infertility patients,while hysteroscopic endometrial polypectomy prior to embryo transfer results in improved pregnancy outcomes in those with Eps.The location and size of endometrial polyps have weak impact on pregnancy outcomes following embryo transfer,but,the presence of multiple or recurrent polyps may elevate the risk of early miscarriage.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.

Objective: To study the difference in the flora structure and gene function of dental plaque in caries-free and caries-active preschool children by 16S rRNA sequencing. Methods: After oral examination of 96 preschool children aged 3-6 years, they were divided into 3 groups according to their decayed, missing and filled surface (dmfs) index: group CF with no caries (n=31), group ECC with moderate early childhood caries (n=29) and group SECC with severe early childhood caries (n=36). Dental plaques were collected, and DNA was extracted and then underwent metagenomic sequencing by Illumina HiSeq 2 500. The bacterial community structure was analyzed by Qiime. Results : A total of 12 phyla, 31 classes, 31 orders, 50 families, 92 genera and 1 104 species were found in the dental plaque samples of the three groups, most of which belonged to 9 dominant genera, including Streptococcus, Veillonella, etc. The microbial diversity of the dental plaques in the three groups was similar (P > 0.05). Veillonella, Lactobacillus, Megasphaera, and Scardovia in the SECC group were significantly higher than those in the other two groups. There was a significant correlation between the decayed, missing and filled surface (dmfs) index and the genus. Bifidobacterium, Veillonella, Lactobacillus had a positive correlation with the dmfs index, while Eikenella had a negative correlation with the dmfs index. Indicator species analysis showed that Atopobium, Veillonella, Megasphaera, Scardovia, Lactobacillus and Bifidobacterium had high indicative values in the SECC group. Conclusion There are significant differences in plaque microbiota among preschool children with different caries sensitivities. Veillonella, Megasphaera, Scardovia, Lactobacillus, Bifidobacterium and Atopobium may be the indicator genera of severe early children caries.