Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

AIM: To study the protective effect of edaravone on renal injury induced by chronic intermittent hypoxia and its effect on Caspase-1 mediated pyroptosis signaling pathway in rats. METHODS: Twenty four SPF male SD rats were randomly divided into normal control group, intermittent hypoxia group, intermittent hypoxia + normal saline group and intermittent hypoxia + edaravone group, with 6 rats in each group. The four groups of rats were placed in the closed feeding chamber for modeling. The oxygen concentration in the NC group was maintained at about 21%; the IH group, IH + NS group and IH + EDA group were given regular input of pure oxygen, pure nitrogen and compressed air to form anoxic-reoxygenation cycle (60 s hypoxic period + 60 s reoxygenation period). During the hypoxic period, the oxygen concentration in the chamber was reduced to 6%-7%, and the rats in the IH + EDA group were intraperitoneally injected with edaravone at a dose of 5 mg/kg per day before modeling, while the rats in the IH + NS group were intraperitoneally injected with normal saline at the same dose per day. After 8 weeks of modeling, blood and kidney tissue samples were collected to measure the levels of Crea and Urea in each group. The pathological changes and fibrosis degree of kidney were observed under light microscope after HE and Masson staining. The content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) were determined by chemical method. The expression levels of NLRP3, Caspase-1 and IL-1β in renal tissues were determined by immunohistochemical staining. The expression levels of caspase-1 and IL-1β in renal tissues were determined by Western blot. GSDMD and IL-18 mRNA were detected by RT-PCR. RESULTS: After intermittent hypoxia exposure, serum Crea and Urea were increased significantly (P < 0.01), renal tubules were damaged by pathology, collagen fiber deposition occurred in balloon space of renal units, MDA content was increased and SOD activity was decreased (P < 0.01). Caspase-1, NLRP3, IL-1β protein expression increased (P < 0.01 or P < 0.05), GSDMD mRNA and IL-18 mRNA amplification increased (P < 0.01); After Edaravone intervention, the above indexes showed a reverse trend compared with that after intermittent hypoxia exposure, and the pathological damage of kidney was reduced (P < 0.01 or P < 0.05). CONCLUSION: Chronic intermittent hypoxia may mediate kidney injury through oxidative stress activation of caspase-1 involved in the cell pyroptosis signaling pathway, while edaravone may inhibit the activation of pyroptosis signaling pathway by scavenging oxygen free radicals and down-regulating the level of oxidative stress in the body, thus playing a protective role in kidney.

【Objective】 To study the changes of platelet components(PC), apheresis platelets (AP) and pooled platelet concentrates (PPC) production of 19 provincial blood centers before and during the COVID-19 epidemic. 【Methods】 The data related to the collection of AP and the preparation of PPC from 2016 to 2021 of 19 provincial blood centers was collected. The production of PC, AP and PPC during the four years before the epidemic (i.e. 2016-2019) and during the COVID-19 epidemic (i.e. 2020 and 2021) were calculated respectively, and the change of production was analyzed. 【Results】 The total production of PC in 19 blood centers steadily increased from 2016 to 2019, with a decrease of 4.16% in 2020 and an increase of 15.60% in 2021, exceeding the output before the COVID-19 epidemic. In 2020, the production of PC of 42.11% (8/19) blood centers decreased compared with 2019, while 94.74% (18/19) in 2021 increased compared with 2020. The changes of AP output was basically consistent with the trend of PC. The total production of PPC in 2017 and 2018 both doubled compared to the previous year, while decreased by 67.98% in 2019, increased by 30.38% in 2020 and decreased by 27.08% in 2021. 【Conclusion】 The total production of PC kept increasing steadily between 2016 and 2019, but decreased in 2020 under the COVID-19 epidemic, with some blood centers being significantly affected. In 2021, with the strong support from government and various measures by blood centers, the total production of PC increased.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

Objective:To preliminarily estimate and study the effect of nucleic acid testing in blood screening on the residual risk (RR) of transfusion transmitted HBV infection (TTI HBV).Methods:Using the NAT yield/WP ratio model and adopting the relevant data of information management system of practice comparison working party in the Mainland of China, this paper analyzed the trend of the RR of TTI HBV among 18 blood centers from 2015 to 2019 in China, and compared the impact of two kinds of blood screening strategies which were ELISA+ ID-NAT/MP-NAT (individual-donation nucleic acid testing or mini-pool nucleic acid testing) and ELISA + MP-NAT on RR in 2019.Results:The overall trends of the 5-year RR of HBV among 18 blood centers showed by trend chi square test were NAT single positive rate trend χ2= 39.42( P<0.01) and residual risk trend χ2= 279.792( P<0.01); The influence on RR from the differences of ELISA+ ID-NAT/MP-NAT and ELISA+ MP-NAT was statistically significant, and chi square test showed that χ2= 7.4( P<0.01). Conclusions:Since the implementation of nucleic acid testing in the blood screening in China from 2015, the residual risk of transfusion transmitted HBV infection has decreased year by year. The observed two blood screening strategies which dominated in China may lead to discrepancy in the residual risk of TTI.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

Objective To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with B ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi. Methods From June 2004 to August 2009, 650 patients with renal stones≥20 mm underwent PCNL with B ultrasound-guided renal access in the lateral decubitus flank position. 512 men and 138 women,with a mean age of 38 years(range 11 - 78 years)and a mean stone size of 31 mm(range 20 - 58 mm). Results Successful access was achieved in 650 patients (100%). Minimally PCNL and PCNL were performed in 493 and 157 patients. Complete stone clearance rate was 86. 6% (563/ 650). The mean operative time was 72 min(range 35 - 145 min), and the mean hospital stay was 18d (range 9 - 32 d). There were no visceral injuries. Conclusions PCNL with B ultrasound-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.

Objective To analyze the association of hyperuricemia with incidence of carotid plaque in general population and furthermore to explore the predictive value of serum uric acid in the early prevention of atherusclerotic disease. Methods The participants were selected from a part of Chinese Multiprovincial Cohort Study (CMCS). Two investigations on cardiovascular risk factors and two on carotid ultrasound detection were carried out in 2002 and 2007, respectively. Results (1) The standard prevalence of hyperurieemia on baseline was 5.4%, being 7.7% in male and 3.9% in female. (2) The standard incidence of carotid plaque was 45.3%, being 51.7% in male and 42. 7% in female. It was shown that the incidence of plaque in the bulb of common carotid arteries was the highest. (3) After adjusting for age, smoking, high triglyceride, high cholesterol, hypertension, diabetes, overweight and obesity,hyperurieemia in female was an independent risk factor associated with 5-year incidence of formation plaque in the bulb of common carotid; the odds ratio (OR) was 3.56 (P = 0.02, 95% CI = 1.21-10. 41).Conclusion Hyperuricemia in female was an independent risk factor associated with 5-year incidence of plaque formation in the bulb of common carotid, and hyperuricemia in male was not an independent factor associated with 5-year incidence plaque formation.