Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome

Objective To investigate the risk factors for early neurological deterioration(END)in patients with acute minor stroke and vertebrobasilar occlusion who received best medical treatment.Methods A total of 114 patients with acute vertebrobasilar artery occlusion and NIHSS score of＜6 were enrolled from a single-center prospective database within 24 h of symptom onset.END was defined as an increase of≥4 points or a ≥ 2 points increase in any single NIHSS item within 72 h stroke onset and exclusion of intracranial haemorrhage.Multivariate Logistic regression analysis was used to identify risk factors associated with END.Results END occurred in 31 patients(27.2％).The age,baseline systolic blood pressure,proportion of proximal vertebrobasilar artery occlusion and time to peak(Tmax)＞6 s volume of patients in the END group were significantly higher than those in the non-END group(all P＜0.05).Multivariate Logistic regression analysis showed that baseline systolic blood pressure,proximal vertebrobasilar artery occlusion and Tmax＞6 s volume were independent risk factors for END in patients with acute vertebrobasilar artery occlusive minor stroke after receiving optimal medical treatment(all P＜0.05).Conclusion In patients with acute minor stroke and vertebrobasilar occlusion who received best medical treatment,baseline systolic blood pressure,proximal vertebrobasilar occlusion,and Tmax＞6 s volume are independent risk factors of END.

Objective To investigate the risk factors for early neurological deterioration(END)in patients with acute minor stroke and vertebrobasilar occlusion who received best medical treatment.Methods A total of 114 patients with acute vertebrobasilar artery occlusion and NIHSS score of＜6 were enrolled from a single-center prospective database within 24 h of symptom onset.END was defined as an increase of≥4 points or a ≥ 2 points increase in any single NIHSS item within 72 h stroke onset and exclusion of intracranial haemorrhage.Multivariate Logistic regression analysis was used to identify risk factors associated with END.Results END occurred in 31 patients(27.2％).The age,baseline systolic blood pressure,proportion of proximal vertebrobasilar artery occlusion and time to peak(Tmax)＞6 s volume of patients in the END group were significantly higher than those in the non-END group(all P＜0.05).Multivariate Logistic regression analysis showed that baseline systolic blood pressure,proximal vertebrobasilar artery occlusion and Tmax＞6 s volume were independent risk factors for END in patients with acute vertebrobasilar artery occlusive minor stroke after receiving optimal medical treatment(all P＜0.05).Conclusion In patients with acute minor stroke and vertebrobasilar occlusion who received best medical treatment,baseline systolic blood pressure,proximal vertebrobasilar occlusion,and Tmax＞6 s volume are independent risk factors of END.

Objective:To understand the situation of arboviruses carried by mosquito specimens in Daozhen county, Guizhou province.Methods:In July 2023, mosquito specimens were collected in Daozhen county, Guizhou province, using photocatalytic mosquito trap method. Reverse transcription polymerase chain reaction (RT-PCR) technology was used to detect the types of viruses carried by mosquitoes, and phylogenetic trees were constructed using the neighbor-joining method to analyze the phylogenetic position of the detected viruses.Results:A total of 5 313 mosquito specimens belonging to 2 genera and 2 species were collected in Daozhen county, Guizhou province, including 3 953 Culex tritaeniorhynchus, 1 355 Armigeres subalbatus, and 5 other mosquito species. The specimens were divided into 54 batches according to their species for grinding, nucleic acid extraction, and testing. Among them, 6 batches of Cx. tritaeniorhynchus specimens tested positive for flavivirus genus using universal primers, and further identification revealed that 5 batches were positive for Japanese encephalitis virus (JEV) nucleic acid, and 1 batch was positive for Tembusu virus (TMUV) nucleic acid. Phylogenetic analysis showed that the detected JEV strains were all genotype I and fell within the same evolutionary branch; the detected TMUV was located on the third branch of the evolutionary tree, with the main host source of the strains on this branch being mosquitoes. Conclusions:In the mosquito specimens collected in Daozhen county, Guizhou province in 2023, genotype I JEV and TMUV were detected, with TMUV being detected for the first time in mosquitoes in Guizhou province. It is essential to enhance the surveillance of JEV and TMUV to mitigate the potential public health risks they pose.

Objective:To understand the situation of arboviruses carried by mosquito specimens in Daozhen county, Guizhou province.Methods:In July 2023, mosquito specimens were collected in Daozhen county, Guizhou province, using photocatalytic mosquito trap method. Reverse transcription polymerase chain reaction (RT-PCR) technology was used to detect the types of viruses carried by mosquitoes, and phylogenetic trees were constructed using the neighbor-joining method to analyze the phylogenetic position of the detected viruses.Results:A total of 5 313 mosquito specimens belonging to 2 genera and 2 species were collected in Daozhen county, Guizhou province, including 3 953 Culex tritaeniorhynchus, 1 355 Armigeres subalbatus, and 5 other mosquito species. The specimens were divided into 54 batches according to their species for grinding, nucleic acid extraction, and testing. Among them, 6 batches of Cx. tritaeniorhynchus specimens tested positive for flavivirus genus using universal primers, and further identification revealed that 5 batches were positive for Japanese encephalitis virus (JEV) nucleic acid, and 1 batch was positive for Tembusu virus (TMUV) nucleic acid. Phylogenetic analysis showed that the detected JEV strains were all genotype I and fell within the same evolutionary branch; the detected TMUV was located on the third branch of the evolutionary tree, with the main host source of the strains on this branch being mosquitoes. Conclusions:In the mosquito specimens collected in Daozhen county, Guizhou province in 2023, genotype I JEV and TMUV were detected, with TMUV being detected for the first time in mosquitoes in Guizhou province. It is essential to enhance the surveillance of JEV and TMUV to mitigate the potential public health risks they pose.

To explore the effect of doctor-patient relationship perception on work performance among medical staff in public hospitals and its mechanism. The convenient sampling method was used to select 380 medical staff working in four public tertiary hospitals in Sichuan Province, Zhejiang Province, and Fujian Province from August 2022 to October 2022 as the research objects, and the General Information Questionnaire, Doctor-Patient Relationship Scale, General Self-Efficacy Scale, Perceived Organizational Support Scale, Work Performance Questionnaire were used. This paper showed that the doctor-patient relationship perception of medical staff was negatively correlated with self-efficacy (r=-0.392, P<0.01) and work performance (r=-0.286, P<0.01), self-efficacy was positively correlated with perceived organizational support (r=0.538, P<0.01) and work performance (r=0.507, P<0.01), perceived organizational support was positively correlated with work performance (r=0.510, P<0.01). Self-efficacy played a partial mediating role between doctor-patient relationship perception and work performance, and its effect value was -0.241, accounting for 64.78% of the total effect. Perceived organizational support weakened the negative predictive effect of doctor-patient relationship perception on self-efficacy, which moderates the first half path of the mediating model that doctor-patient relationship perception affects work performance through self-efficacy. It indicated that the doctor-patient relationship perceived by medical staff in public hospitals is poor. Measures should be taken from the aspects of policy support, hospital and society levels to alleviate the doctor-patient relationship, play the mediating role of self-efficacy and the moderating role of organizational support, minimize the negative impact of doctor-patient relationship on the work performance among medical staff, and improve the work performance of medical staff, so as to improve the overall quality of medical services.

The quality of Paeoniae Radix Alba and Paeoniae Radix Rubra is evaluated by root thickness, and paeoniflorin serves as a common quality indicator of them. However, the correlation between the content of bioactive compounds and the root size is still unclear. Therefore, this study characterized the distribution patterns and content of seven bioactive compounds including paeoniflorin in different tissues of Paeonia lactiflora roots, analyzed the correlation between the root size and the content of bioactive compounds based on the xylem-to-bark ratio, and further determined the index components for quality assessment. Nine samples of fresh P. lactiflora roots were collected from the genuine cultivation area. The distribution of bioactive compounds in different tissues on the cross-section of the root was firstly analyzed by desorption electrospray ionization-mass spectrometry imaging(DESI-MSI). Subsequently, the content of bioactive compounds was determined in the xylems and barks of the roots by UPLC. The compounds with the largest difference between the xylem and the bark were selected by orthogonal partial least squares discriminant analysis(OPLS-DA). The results indicated that paeoniflorin, benzoylpaeoniflorin, oxypaeoniflorin, gallic acid, and 1,2,3,4,6-pentagalloylglucose were significantly accumulated in the xylems, while albiflorin and catechin were mainly distributed in the barks. Paeoniflorin and albiflorin, with the largest differences in the xylem and the bark, had the highest content in the two tissues. The root diameter was positively correlated with paeoniflorin content and negatively correlated with albiflorin content. As isomers with different efficacies, paeoniflorin or albiflorin can be chosen as the quality marker corresponding to specific clinical application to launch quality classification evaluation of multi-functional Chinese medicines.
Bridged-Ring Compounds ; Catechin/analysis* ; Chromatography, High Pressure Liquid/methods* ; Gallic Acid/analysis* ; Monoterpenes/analysis* ; Paeonia/chemistry* ; Plant Roots/chemistry* ; Spectrometry, Mass, Electrospray Ionization

ObjectiveTo investigate the quality of life and demands of family members of patients with mental disorders in hospice care， in order to create a better medical care environment for patients to meet their demands. MethodsA total of 205 family members of patients with mental disorders in hospice care were consecutively sampled from two special psychiatric hospitals in Deyang city with convenient sampling method. The Chinese version of WHO Quality of Life-BREF （WHOQOL-BREF） and Critical Care Family Needs Inventory （CCFNI） were used to assess the quality of life and demands of family members. ResultsAmong the patients' family members， WHOQOL-BREF scored （68.08±9.98） in the physiological field， （63.82±9.39） in the psychological field， （70.73±12.61） in the social relations field， and （64.24±11.87） in the environmental field. Compared with the domestic general population， there were significant differences in other fields except the physiological field （t=3.066， 9.845， 16.109， P<0.01）. In CCFNI， the score of condition assurance factor was （3.20±0.41）， information support was （2.86±0.50）， proximity to patients was （2.79±0.46）， self comfort was （2.35±0.47）， and medical staff support was （2.60±0.44）. ConclusionThe quality of life of the family members of patients with mental disorders in hospice care may be higher than that of the general population， and their demands mainly focus on the condition assurance and information support.

ObjectiveTo analyze the prevalence rate of non-suicidal self-injury （NSSI） behavior in Chinese adolescents with depression， so as to provide references for the intervention of NSSI behavior in adolescents with depression. MethodsThe literature databases such as CNKI， VIP， Wanfang， China Biology Medicine Disc， PubMed， Web of Science， Cochrane Library and Embase were searched via computer for the cross-sectional studies related to the prevalence of NSSI behavior in adolescents with depression published from inception to February， 2020. Then the eligibility assessment， data extraction and assessment of methodological quality were performed independently by two reviewers， and the Meta-analysis was performed by using RevMan 5.4. ResultsA total of 2 238 adolescents in 10 studies were included. Meta-analysis yielded that the prevalence rate of NSSI behavior in Chinese adolescents with depression was 51% （95% CI： 43%~59%）. Subgroup analysis of NSSI behavior in adolescents with depression implied that the prevalence rate was 36% （95% CI： 22%~50%） in female adolescents， which was higher than 18% （95% CI： 12%~24%） in male adolescents. The prevalence rate of NSSI behavior was 57% （95% CI： 38%~77%） in depression adolescents with suicidal ideation， which was higher than 4% （95% CI： 0~8%） in those without suicidal ideation. The prevalence rate of NSSI behavior was 54% （95% CI： 41%~67%） in depression adolescents diagnosed with Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， which was higher than 46% （95% CI： 40%~51%） in those diagnosed with the International Classification of Diseases， tenth edition （ICD-10）. The prevalence rate of NSSI behavior was 52% （95% CI： 41%~63%） in depression adolescents in the literatures with quality score of 7， which was close to 50% （95% CI： 44%~55%） in depression adolescents in the literatures with quality score of 6. The comparison of above subgroups all had statistical differences （P<0.05 or 0.01）. ConclusionChinese adolescents with depression suffer a high prevalence rate of NSSI behavior， with higher prevalence in females than in males， and in those with suicidal ideation than in those without suicidal ideation.