Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective To explore the effect of Huangqi Danzhi Shenmai Decoction in treatment of coronary atherosclerosis patients with qi deficiency and blood stasis syndrome and its influence on the levels of serum malondialdehyde(MDA),superoxide dismutase(SOD),tumor necrosis factor-α(TNF-α),and interleukin-1 β(IL-1β).Methods A total of 120 patients with coronary atheroscle-rosis were selected and randomly divided into control group(conventional treatment+simvastatin)and observation group(conventional treatment+Huangqi Danzhi Shenmai Decoction)by random number table method,with 60 cases in each group.The clinical efficacy of the two groups was evalua-ted.The changes in traditional Chinese medicine(TCM)syndrome scores,blood lipids,inflammatory factors,and oxidative stress indicators before and after treatment were recorded for both groups.Re-sults The total effective rate in the observation group was higher than that in the control group(P＜0.05).After treatment,the TCM syndrome scores in the observation group were lower than those in the control group(P＜0.05).The improvement in blood lipid indicators was more pronounced in the observation group compared to the control group(P＜0.05).The serum levels of TNF-α,IL-1 β,and MDA in the observation group were lower than those in the control group,while the serum levels of SOD and glutathione peroxidase(GSH-PX)were higher than those in the control group,with statis-tically significant differences(P＜0.05).No severe adverse reactions occurred in either group dur-ing the treatment period.Conclusion Huangqi Danzhi Shenmai Decoction has a good clinical effi-cacy in treating coronary atherosclerosis with qi deficiency and blood stasis syndrome,and can im-prove the oxidative stress status,reduce inflammatory responses,and regulate blood lipid levels in patients,so it is worthy of clinical promotion and use.

Transcranial electrical stimulation(tES)is a process,in which a specific pattern of low-intensity electrical currents is applied to the cerebral cortex through a combination of electrode sheets placed on the surface of scalp,modulating neural activity and corresponding human behaviors.In recent years,its application in the field of psychiatry has been gradually increasing.This paper reviews the clinical applications and latest research progress of tES technology in schizophrenia,depressive disorders,bipolar disorder,obsessive-compulsive disorder and sleep disorders,aiming to provide references for its application and further research in the field of psychiatric practice.

Transcranial electrical stimulation(tES)is a process,in which a specific pattern of low-intensity electrical currents is applied to the cerebral cortex through a combination of electrode sheets placed on the surface of scalp,modulating neural activity and corresponding human behaviors.In recent years,its application in the field of psychiatry has been gradually increasing.This paper reviews the clinical applications and latest research progress of tES technology in schizophrenia,depressive disorders,bipolar disorder,obsessive-compulsive disorder and sleep disorders,aiming to provide references for its application and further research in the field of psychiatric practice.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective:To develop and analyze the predictive value of a combined predictive model based on the lower limb skin mottling score (SMS) for the outcome of sepsis patients admitted to ICU.Methods:Using a multicenter prospective, observational study, 458 patients admitted to six ICUs in 4 grade A tertiary hospitals in Fujian Province from March 1, 2019 to December 31, 2019 with first diagnosis of sepsis were selected as study subjects. Demographic data, clinical biochemical indexes, lower limb SMS, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) were collected. Binary Logistic regression was used to analyze the outcome of patients with sepsis after admission to ICU, a joint prediction model was constructed, ROC curves were drawn, and a comparison of the predictive efficacy of the lower limb SMS and the joint prediction model was performed.Results:Logistic multifactorial regression analysis showed that lower limb SMS, SOFA score, APACHEⅡscore, lactate, mean arterial pressure were the influencing factors of outcome of patients with sepsis after admission to ICU (all P<0.05). The area under the curve of lower limb SMS predicted ICU outcome risk was 0.718 (95% CI 0.675-0.959, P<0.001) with the sensitivity of 51.96% and specificity of 85.11%. The area under the curve of predictive ability of the combined model based on the lower limb SMS for ICU outcome of sepsis patients was 0.835 (95% CI 0.762-0.878, P<0.01) with the sensitivity of 81.40% and specificity of 73.00%, the difference was significant ( P<0.05). Conclusions:The combined prediction model based on lower limb SMS can more accurately predict the prognosis of sepsis patients after admission to ICU, which can be a new nursing assessment tool for nurses to evaluate the prognosis of sepsis patients and help nurses to make more accurate clinical care decisions and reduce the morbidity and mortality rate.

【Objective】 To study the serological and genetic characteristics of a case of B(A) blood group. 【Methods】 Serological and genetic ABO blood group typing were used to analyze the ABO subtype and family inheritance of the probands and her 8 family members. The B(A) blood type sample was used as the blood recipient, and the B-type and O-type donors were selected for cross-matching using microcolumn gel anti-human globulin method to evaluate the blood transfusion strategy. 【Results】 5 out of 9 family blood samples were B(A) phenotype, carrying B(A)04 allele. Among them, 1 was B(A)04/O1 type, and 4 were B(A)04/B type. The primary blood matching of B(A) blood type samples with type B and O recipients were all negative. 【Conclusion】 A total of 5 cases of B(A)04 blood type were found in this family investigation, and there were differences in serological manifestations. Washed RBCs with B and O type can be used for B(A) blood type transfusion, and type B suspended RBCs can be considered in case of emergency.

Objective To investigate the clinical imaging features and immune manifestations of clear cell carcinoma and papillary renal cell carcinoma at the same time in one side of the kidney,in order to increase the awareness of the disease and improve the clinical diagnosis and treatment.Methods This study retrospectively analyzed the clinical data of 7 patients with unilateral renal clear cell carcinoma combined with papillary cell carcinoma admitted to the Department of Urology,People's Hospital of Xinjiang Uygur Autonomous Region from January 2007 to June 2017.The general data,images performance,surgical methods,immunohistochemical results of the patients were observed.Results In 7 patients with multiple tumors of ipsilateral kidney,6 were males,accounting for 85.71％ (6/7);1 female,accounting for 14.29％ (1/7).Ages 45-78 years old,average 63 years old;4 cases were found by physical examination,accounting for 57.14％ (4/7);2 cases were admitted to hospital with obvious oncological symptoms,accounting for 28.57％ (2/7);1 case of renal nonfunction,accounting for 14.29％ (1/7).The tumor was located in 6 cases of left kidney,accounting for 85.71％ (6/7),and the tumor was located in 1 case of right kidney,accounting for 14.29％ (1/7).Preoperative imaging examination clearly indicated multiple tumors in 3 cases,and the remaining 4 cases only showed placeholders.Lesions,of which the maximum diameter of the tumor 7.5 cm,2 patients with a diameter of ＞ 4 cm;4 cases of radical renal resection and partial nephrectomy;3 cases of clear cell carcinoma Fuhrman Ⅰ grade,Fuhrman Ⅱ grade 5 cases postoperative pathology report There were 4 cases of papillary renal cell carcinoma in Fuhrman grade Ⅰ and 3 cases in Fuhrman grade Ⅱ,all of them were type Ⅰ cell carcinoma.Conclusions Ipsilateral kidney associated with papillary renal cell carcinoma and clear cell carcinoma is rare clinically,its formation is unknown.Readings should be repeated before surgery.If you can identify multiple tumors,you will be able to choose the surgical procedure.Partial nephrectomy or radical nephrectomy may be performed depending on the size of the tumor.Radical nephrectomy is recommended.