Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

Objective To observe the clinical efficacy of Feisu Granules,and its effects on quality of life,coagulation and immune function in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with syndrome of phlegm-heat and blood stasis of lung.Methods Totally 120 AECOPD patients were divided into observation group and control group according to random number table method,with 60 cases in each group.The control group was given conventional Western medicine treatment,and the observation group received Feisu Granules treatment on the basis of the control group,one bag each time,three times a day,orally.The treatment for both groups lasted for 7 d.The clinical efficacy of both groups were observed.TCM symptom scores,St.George's respiratory questionnaire(SGRQ)score,coagulation function indexes(fibrinogen,D-dimer),and immune function indexes(CD4+,CD8+,CD4+/CD8+)of both groups were compared.The side effects were observed.Results The total effective rate in the observation group(93.10%)was significantly higher than that of the control group(79.66%),with statistical significance(P<0.05).Compared with before treatment,TCM symptom scores,scores of cough,wheezing,venous congestion,and SGRQ score decreased in both groups after treatment(P<0.05);after treatment,the observation group had lower above scores than the control group(P<0.05).Compared with before treatment,both groups showed a decrease in plasma fibrinogen and D-dimer levels after treatment(P<0.05);after treatment,the observation group showed lower levels of plasma fibrinogen and D-dimer compared with the control group(P<0.05).Compared with before treatment,the peripheral blood CD4+ and CD4+/CD8+ levels in both groups significantly increased after treatment,while CD8+ levels significantly decreased(P<0.05);after treatment,the peripheral blood CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group,while CD8+ was lower than those in the control group(P<0.05).Neither group had any drug-related side effects.Conclusion On the basis of conventional Western medicine,the combination of Feisu Granules in the treatment of AECOPD with syndrome of phlegm-heat and blood stasis of lung can significantly improve clinical efficacy,improve patient quality of life,facilitate coagulation function recovery,and enhance cellular immune function.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

OBJECTIVE：To identify Panax notoginseng and its processed products . METHODS ：The fingerprint was established by HPLC. Using ginsenoside Rb 1 as reference ，HPLC fingerprints of 15 batches of P. notoginseng and its processed products were drawn and the similarity evaluation was conducted by using the Similarity Evaluation System for TCM Chromatographic Fingerprints（2012 edition）. The common peaks were confirmed by comparing with substance control. SPSS 21.0 and SIMCA 14.1 software were used to perform cluster analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis；taking the variable importance projection （VIP）value greater than 1 as the standard ，the differential marker components causing the quality difference between P. notoginseng and its processed products were screened. IR fingerprints of P. notoginseng and its processed products were established by OMNIC 8.2.0 software，and the spectral similarity was evaluated ；double index sequence analysis was used to analyze absorption peaks of IR fingerprints of 15 batches of P. notoginseng and its processed products. RESULTS ：There were 16 common peaks in the fingerprints of 15 batches of P. notoginseng ， and the similarities were 0.911-1.000；there were 25 common peaks in the fingerprints of processed products ，and the similaritieswere 0.862-1.000. They had 12 identical common peaks ，and wang668@sina.com three of them were ident ified as sanchinoside R 1，ginsenoside Rg1 and ginsenoside Rb 1. Results of cluster analysi s showed that when the distance was 10，15 batches of P. notoginseng could be clustered into two categories ，SW1-SW5 into one category ，SH1-SH5 and SQ 1-SQ5 into one category ，ZW1-ZW5，ZH1-ZH5 and ZQ1-ZQ5 of 15 batches of processed products could be clustered into one category. When the distance was 5，15 batches of P. notoginseng could be clustered into three categories ，SW1-SW5 into one category ，SH2-SH5 and SQ 2 into one category ，SQ1， SQ3-SQ5 and SH 1 into one category. Fifteen batches of processed products could be clustered into two categories ，ZW1-ZW5 into one category ，ZH1-ZH5 and ZQ 1-ZQ5 into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first two principal components was 80.104％ . The results of orthogonal partial least squares-discriminant analysis showed that the VIP values of the five peaks were greater than 1，which were peak H ，peak G ，peak J，peak F （ginsenoside Rg 1）and peak I. The similarity of IR fingerprints of 15 batches of P. notoginseng and its processed products were 0.889 7-1.000 0 and 0.972 8-1.000 0；the common peak rates were 80％-100％，and the variation peak rates were 0-17.65％ and 0-18.75％，respectively. By comparing the wave numbers of absorption peaks ，it was found that there were differences between P. notoginseng at 3 440 and 1 450 cm－1 and processed products at 1 530 and 575 cm－1. CONCLUSIONS ：Established HPLC fingerprint and IR fingerprint have good similarity ，and could effectively distinguish P. notoginseng and its processed products. P. notoginseng and its processed products from different habitats have high common peak rate and low variation rate ，and their chemical components are different ；peak H ，peak G ，peak J ，ginsenoside Rg 1 and peak I are differential marker components causing the quality difference between P. notoginseng and processed products.

Objeoctive To evaluate the association between blood methotrexate concentrations at 24 hours (C24 h) after the initiation of high-dose methotrexate (HDMTX) infusion and clinical outcomes in patients with hematologic neoplasm.Methods The literature on C24 h after the initiation of HDMTX treatment and clinical outcomes in MEDLINE (Ovid),EMBASE (Ovid),Clinical Trials.gov,CNKI,WanFang Data,and SinoMed databases up to March 2018 were retrieved (the outcome indicators mainly included safety indicators,such as adverse event incidence and effectiveness indicators,such as complete remission rate).The quality of the enrolled literature was evaluated by Newcastle-Ottawa Scale (NOS) and related outcome indicators were analyzed by meta-analysis or descriptive analysis.Results A total of 6 studies were enrolled,including 4 with high quality (NOS scores were 7-9) and 2 with medium quality (both of NOS scores were 6).All the subjects in the 6 studies were children with acute lymphoblastic leukemia (ALL),aged 0.4 to 17.0 years,and a total of 516 HDMTX treatments were given to them.Five studies reported the association between methotrexate C24 h and safety outcomes and 1 reported the association between methotrexate C24 h and effectiveness outcomes.For safety outcomes,compared with C24 h ＜ 10 μ mol/L,methotrexate C24 h ＞ 10 μmol/L might increase the risk of hematological toxicity (OR =4.17,95％ CI:1.17-14.90) rather than the risks of gastrointestinal toxicity (OR =2.22,95％ CI:0.97-5.04),renal toxicity (P =0.130),oral mucositis (P =0.166),or dermal toxicity (P =0.227).Compared with C24 h ＜40 μmol/L,methotrexate C24 h ＞40 μmol/L might increase the risks of hepatotoxicity (OR =16.64,95％ CI:6.35-43.64),oral mucositis (OR =31.73,95％ CI:12.37-81.41),severe oral mucositis (P =0.002),and gastrointestinal toxicity (P =0.003).For effectiveness outcomes,the single study suggested that methotrexate C24 h ＞ 16 μmol/L could increase the complete and partial remission rates (P ＜ 0.05 for both) and decrease the 1.5 year-recurrence rate (P =0.006).Conclusions There was a significant association between methotrexate C24 h and clinical outcomes in children with ALL.Methotrexate C24 h ＞16 μmol/L was significantly associated with a favorable clinical outcome while C24 h ＞ 40 μmol/L was significantly associated with increased risks of hepatotoxicity,oral mucositis,and gastrointestinal toxicity.

OBJECTIVE： To systematically evaluate the effects of MTHFR， RFC1 and MDR1 gene polymorphisms on high- dose methotrexate-induced ADR in osteosarcoma patients， and to provide evidence-based reference for individual medication of high-dose of methotrexate. METHODS： Retrieved from Medline， Embase， clinical trials.gov， CNKI， Wanfang database and CBM， cohort studies about the association of MTHFR C677T/A1298C， RFC1 G80A， MDR1 C3435T gene polymorphisms with high-dose methotrexate-induced ADR were collected. After data extraction of clinical studies met inclusion criteria， and quality evaluation with the Newcastle-Ottawa Scale， Meta-analysis and descriptive analysis were performed for outcome indexes as the incidence of high-dose methotrexate-induced ADR （hematotoxicity and myelosuppression， hepatotoxicity， nephrotoxicity， oral mucositis， digestive tract toxicity and overall adverse events） with Rev Man 5.3 and Microsoft Excel 2016 software. RESULTS： Totally 8 cohort studies involving 608 patients were included； 6， 5， 4 and 2 studies reported outcome indexes related to MTHFR C677T/A1298C， RFC1 G80A and MDR1 C3435T gene polymorphisms respectively. Meta-analysis and descriptive analysis showed that MTHFR C677T gene polymorphism was significantly associated with the risk of G3-4 renal toxicity [TT/CT vs. CC： OR＝12.35， 95％CI＝（3.28，46.42）， P＜0.001]， G3-4 oral mucositis [T vs. C： OR＝2.04， 95％CI＝（1.06，3.93）， P＝0.03]， oral mucositis [（TT vs. CT/CC： OR＝2.27， 95％CI＝（1.20，4.27）， P＝0.01] and renal toxicity （P＜0.05）； MTHFR A1298C gene polymorphism was associated with G3-4 hepatotoxicity， G3-4 nephrotoxicity and G3-4 oral mucositis， without statistical significance （P＞0.05）. There was no significant correlation between RFC1 G80A polymorphism and hemotoxicity， hepatotoxicity， nephrotoxicity and digestive tract toxicity （P＞0.05）. MDR1 C3435T polymorphism was significantly correlated with oral mucositis （P＜0.05）， but not with hematotoxicity and hepatotoxicity （P＞0.05）. CONCLUSIONS： MTHFR C677T mutation can increase the risk of high-dose methotrexate-induced ADR. There is no significant association between MTHFR A1298C polymorphism and high-dose methotrexate-induced ADR. There are few studies on RFC1 G80A or MDR1 C3435T polymorphism and high-dose methotrexate-induced ADR， and their association is unclear.

Objeoctive To evaluate the association between blood methotrexate concentrations at 24 hours (C24 h) after the initiation of high-dose methotrexate (HDMTX) infusion and clinical outcomes in patients with hematologic neoplasm.Methods The literature on C24 h after the initiation of HDMTX treatment and clinical outcomes in MEDLINE (Ovid),EMBASE (Ovid),Clinical Trials.gov,CNKI,WanFang Data,and SinoMed databases up to March 2018 were retrieved (the outcome indicators mainly included safety indicators,such as adverse event incidence and effectiveness indicators,such as complete remission rate).The quality of the enrolled literature was evaluated by Newcastle-Ottawa Scale (NOS) and related outcome indicators were analyzed by meta-analysis or descriptive analysis.Results A total of 6 studies were enrolled,including 4 with high quality (NOS scores were 7-9) and 2 with medium quality (both of NOS scores were 6).All the subjects in the 6 studies were children with acute lymphoblastic leukemia (ALL),aged 0.4 to 17.0 years,and a total of 516 HDMTX treatments were given to them.Five studies reported the association between methotrexate C24 h and safety outcomes and 1 reported the association between methotrexate C24 h and effectiveness outcomes.For safety outcomes,compared with C24 h ＜ 10 μ mol/L,methotrexate C24 h ＞ 10 μmol/L might increase the risk of hematological toxicity (OR =4.17,95％ CI:1.17-14.90) rather than the risks of gastrointestinal toxicity (OR =2.22,95％ CI:0.97-5.04),renal toxicity (P =0.130),oral mucositis (P =0.166),or dermal toxicity (P =0.227).Compared with C24 h ＜40 μmol/L,methotrexate C24 h ＞40 μmol/L might increase the risks of hepatotoxicity (OR =16.64,95％ CI:6.35-43.64),oral mucositis (OR =31.73,95％ CI:12.37-81.41),severe oral mucositis (P =0.002),and gastrointestinal toxicity (P =0.003).For effectiveness outcomes,the single study suggested that methotrexate C24 h ＞ 16 μmol/L could increase the complete and partial remission rates (P ＜ 0.05 for both) and decrease the 1.5 year-recurrence rate (P =0.006).Conclusions There was a significant association between methotrexate C24 h and clinical outcomes in children with ALL.Methotrexate C24 h ＞16 μmol/L was significantly associated with a favorable clinical outcome while C24 h ＞ 40 μmol/L was significantly associated with increased risks of hepatotoxicity,oral mucositis,and gastrointestinal toxicity.