BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality.Methods Thirty-one ASA Ⅰ or Ⅱ Uighurs of both sexes,aged 21-59 yr,with body mass index 18-28 kg/m2,undergoing elective surgery,were enrolled in this study.Anesthesia was induced and maintained with propofol and sufentanil target-controlled infusion and iv injection of cisatracurium 0.2 mg/kg.The target effect-site concentration (Ce) of propofol was set at 3.0 μg/ml.Tracheal intubation was performed after the target Ce and plasma concentrations were balanced.The target Ce was set at 0.8 ng/ml in the first patient.Each time Ce increased/decreased by 10％ in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred.The positive cardiovascular response was defined as increase in systolic blood pressure by 15％ and/or HR＞ 90 bpm lasting for ＞ 15 s.The EC50(95％ confidence interval) of sufentanil blunting cardiovascular responses to trancheal intubation was calculated by Probit analysis.Results EC50 (95 ％ confidence interval) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofol was 0.46 (0.43-0.49) ng/ml.Conclusion EC50 of sufentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.

Objective To investigate the effects of total hip replacement (THR) and dynamic hip screw (DHS) to intertrochanteric fracture in the geriatric with serious osteoporosis. Methods The clinical data of 51 senile cases (age over 60 years) with serious osteoporosis (Singh index less than grade Ⅲ ) cured from January 2003 to March 2008 were retrospectively reviewed. Two different groups were randomly selected from all cases treated with THR and DHS. Nineteen cases of THR were selected in THR group, modified Gibson approach was taken to complete hip joint replacement Thirty-two cases of DHS were selected in DHS group,lateral hip approach was employed to complete DHS fixation. Mobilization by CPM from the 2nd day and weight burdening from 3rd to 7th day according to general physical condition after surgery were carried out in THR group, mobilization and weight bearing start according to different conditions from the 2nd to 10th week in DHS group. Results Among 51 cases, 47 cases had got follow-up for 5.0 -40.5 (28.1 ± 11.9) months. Nineteen cases in THR group had got follow-up, Harris hip score of 18 cases (94.7% ) were good or excellent, and the other 1 case was bad. Twenty-eight cases in DHS group had got follow-up. Harris hip score of 23 cases (82.1% ) were good or excellent, and the other 5 cases were bad. There was statistical significance between the two groups (P < 0.05 ) . The average periods to start partly weight bearing of THR group and DHS group were( 8.3 ±4.2) days and (43.6 ± 15.3) days respectively, there was statistical significance between the two groups (P< 0.05). Conclusion To the geriatric intertrochanteric fracture with serious osteoporosis, THR is a better choice than DHS, because THR has shorter recovery period before full weight bearing, higher hip functional outcome evaluated by Harris hip score, earlier recovery of mobilization and less complications related with long term bed-bound .

In view of the fact that the large quantities of data contained in the medical image do not have a favorable setting for effective storage and transmission in the existing network, we have developed a JPEG2000 DICOM image compression kit using VC++, and we have realized the medical image storage service according to the C-STORE rule of DICOM standard. The results showed that the medical image processed by JPEG2000 compression algorithm not only greatly saved the storage space, but also reduced the band width needed by transmission. In this paper is discussed the DICOM image compressed by JPEG2000 compression algorithm in DICOM strorage service application. The significance of JPEG2000 compression algorithm in the development of picutre archiving and communication systems (PACS) and telemedicine is also explained.
Algorithms ; Computer Communication Networks ; instrumentation ; Data Compression ; Diagnostic Imaging ; instrumentation ; Humans ; Image Processing, Computer-Assisted ; Medical Records Systems, Computerized