Objective To explore the mediating effect of self-efficacy on the relationship between coping styles and care burden among primary caregivers of elderly patients after hip replacement surgery.Methods A convenient sampling method was employed to enrol the primary caregivers of patients who received hip replacement surgery in a Grade ⅢA hospital between October 2022 and July 2023.A total of 260 caregivers were surveyed using the general self-efficacy scale,simple coping style questionnaire and Zarit care burden scale.A structural equation model was used to analyse the mediating effect of self-efficacy on the relationship between coping style and care burden.Results Toally 253 caregivers completed the study.The study had found that the mean self-efficacy among the primary caregivers scored(27.7±5.6),the positive coping score was(33.7±7.7),and the total care burden score was(34.4±10.2).Self-efficacy exhibited a positive correlation with the positive coping styles(r=0.550,P<0.05)and a negative correlation with the care burden(r=-0.427,P<0.05).The Bootstrap test revealed that self-efficacy mediated the relationship between coping styles and care burden,with a mediating effect of-0.232(95％CI:-0.359,-0.121),accounting for 47.02％of the total effect.Conclusion The self-efficacy of primary caregivers is moderate.It predominantly characterised by positive coping strategies.The coping strategies of primary caregivers work through their self-efficacy.

Objective To explore the mediating effect of self-efficacy on the relationship between coping styles and care burden among primary caregivers of elderly patients after hip replacement surgery.Methods A convenient sampling method was employed to enrol the primary caregivers of patients who received hip replacement surgery in a Grade ⅢA hospital between October 2022 and July 2023.A total of 260 caregivers were surveyed using the general self-efficacy scale,simple coping style questionnaire and Zarit care burden scale.A structural equation model was used to analyse the mediating effect of self-efficacy on the relationship between coping style and care burden.Results Toally 253 caregivers completed the study.The study had found that the mean self-efficacy among the primary caregivers scored(27.7±5.6),the positive coping score was(33.7±7.7),and the total care burden score was(34.4±10.2).Self-efficacy exhibited a positive correlation with the positive coping styles(r=0.550,P<0.05)and a negative correlation with the care burden(r=-0.427,P<0.05).The Bootstrap test revealed that self-efficacy mediated the relationship between coping styles and care burden,with a mediating effect of-0.232(95％CI:-0.359,-0.121),accounting for 47.02％of the total effect.Conclusion The self-efficacy of primary caregivers is moderate.It predominantly characterised by positive coping strategies.The coping strategies of primary caregivers work through their self-efficacy.

Stimulus-specific adaptation (SSA), defined as a decrease in responses to a common stimulus that only partially generalizes to other rare stimuli, is a widespread phenomenon in the brain that is believed to be related to novelty detection. Although cross-modal sensory processing is also a widespread phenomenon, the interaction between the two phenomena is not well understood. In this study, the thalamic reticular nucleus (TRN), which is regarded as a hub of the attentional system that contains multi-modal neurons, was investigated. The results showed that SSA existed in an interactive oddball stimulation, which mimics stimulation changes from one modality to another. In the bimodal integration, SSA to bimodal stimulation was stronger than to visual stimulation alone but similar to auditory stimulation alone, which indicated a limited integrative effect. Collectively, the present results provide evidence for independent cross-modal processing in bimodal TRN neurons.
Acoustic Stimulation ; Animals ; Auditory Perception/physiology* ; Geniculate Bodies ; Rats ; Rats, Wistar ; Thalamic Nuclei/physiology*

Ectopic pregnancy is a common gynecological acute abdomen disease. Once the pregnant tissue is ruptured, it will rapidly develop into hemorrhagic shock or even death. In recent years, blood transfusion from the body is widely used in the rescue of intra-abdominal hemorrhage of ectopic pregnancy, which can reduce the time of cross matching and blood collection, reduce the risk of allogeneic blood transfusion, and enable patients with hemorrhagic shock to receive timely and effective treatment. Hemolysis caused by autologous blood transfusion is rarely reported. Once hemolysis occurs, if it is not handled in time, severe cases can occur acute renal injury, hyperkalemia, or cardiac arrest or even sudden death. We retrospectively analyzed the diagnosis and treatment of a patient with hemolysis after autologous blood transfusion, suggesting that the adverse reactions of blood transfusion occur not only in allogeneic blood transfusion, but also in autologous blood transfusion. It should be handled reasonably in clinical work to reduce the occurrence of similar complications.

Bipolar disorder is a common, highly disabling psychiatric disorder characterized by early onset, frequent episodes, high suicide risk, and chronic outcomes, and is associated with severe social dysfunction. The pathogenesis of bipolar disorder is still unclear, and current studies mainly focus on circadian rhythm abnormalities, including rhythm gene mutation, polymorphism, abnormal kinase expression, and rhythm abnormalities in neurotransmitter secretion and transport. It has been found that at any stage of bipolar disorder, whether prodrome, episode, or remission, patients exhibit circadian rhythm disruptions, including disrupted sleep-wake cycles, hormonal phase abnormalities, and irregular social rhythms. Based on this mechanism, the time therapy, such as light therapy, dark therapy, sleep deprivation and behavioral intervention, can rapidly improve the circadian rhythm of patients with bipolar disorder, achieve the goal of rapid relief of symptoms, with fewer side effects, low risk of switching to manic. In this paper, circadian rhythm mechanism, clinical manifestations and chronotherapy of bipolar disorder are reviewed to provide a basis for clinical diagnosis and treatment.

Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.

Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; classification ; complications ; Receptors, Antigen, T-Cell, gamma-delta ; beta-Thalassemia ; complications

ObjectiveTo understand the marriage status marriage quality and marriage adaptation of inpatients with depression.Methods 100 inpatients with depression met the diagnostic criterion of major depression of CCMD-3 and 100 health people were recruited,and investigated by using the self-developed marriage status questionnaire,Olson's marriage quality questionnaire,Loche Wallace marriage adaptation scale and HAMD.Results ( 1 ) The marriage and remarriage rates of the depressive inpatients in female were significant higher than those in male(P＜ 0.05).(2) The score of ENRICH in the depressive inpatients group was significant lower than that in the health control group(P＜ 0.01 ).(3)The rate of the well adaptation of marriage in the depressive inpatients group was 32.0％,which was lower than that in the control group(P＜ 0.01 ).(4) The total score of the EN-RICH was negative correlation with the total score of HAMD( r=- 0.419,P＜ 0.01 ).ConclusionThe marriage status of the depressive inpatients is not fine and maladatative,which is influenced by the depressive symptoms.