Objective:To investigate the efficacy of different frequencies of modified electroconvulsive therapy in patients with depressive disorder and its effect on cognitive function and functional near infrared spectroscopy.Methods:The clinical data from 60 patients with depressive disorder, admitted to The Third People's Hospital of Huzhou between December 2022 and July 2023, were retrospectively analyzed. This study was designed as a case-control study. These patients were divided into three treatment groups according to different treatment methods: Group 1 ( n = 20), Group 2 ( n = 20), and Group 3 ( n = 20). All patients underwent conventional antidepressant therapy. Additionally, Group 1 received six sessions of modified electroconvulsive therapy, Group 2 received eight sessions, and Group 3 received ten sessions. The treatment duration for all groups was 4 weeks. Comparisons were made among the three groups for pre- and post-treatment scores on the 24-item Hamilton Depression Rating Scale, 14-item Hamilton Anxiety Rating Scale, Clinical Global Impression Scale, Mini-Mental State Examination, Wisconsin Card Sorting Test, Trail Making Test Part A (TMT-A), Trail Making Test Part B (TMT-B), and Digit Symbol Substitution Test. Furthermore, the incidence of adverse reactions during treatment was calculated, and the Treatment Emergent Symptom Scale was used to assess the occurrence of adverse drug reactions. Moreover, functional Near-Infrared Spectroscopy was used before and after treatment to evaluate the cognitive function of patients under the Verbal Fluency Task. Results:At 1, 2, and 4 weeks of treatment, the 24-item Hamilton Depression Rating Scale, 14-item Hamilton Anxiety Rating Scale, and Clinical Global Impression Scale scores of Group 2 and Group 3 were significantly lower than those of Group 1 ( Finter-group = 32.09, Ftime = 54.27, Finteraction = 7.53, all P < 0.05; Finter-group = 38.14, Ftime = 69.33, Finteraction = 8.59, all P < 0.05; Finter-group = 11.22, Ftime = 28.29, Finteraction = 9.14, all P < 0.05). The Mini-Mental State Examination, Wisconsin Card Sorting Test, and Digit Symbol Substitution Test scores of Group 1 and Group 2 were significantly higher than those of Group 3, while Trail Making Test Part A and Trail Making Test Part B scores of Group 1 and Group 2 were significantly lower than those of Group 3 ( Finter-group = 14.20, Ftime = 44.27, Finteraction = 6.24, all P < 0.05; Finter-group = 18.23, Ftime = 67.15, Finteraction = 8.54, all P < 0.05; Finter-group = 9.30, Ftime = 75.16, Finteraction = 9.41, all P < 0.05; Finter-group = 19.47, Ftime = 85.76, Finteraction = 9.33, all P < 0.05; Finter-group = 22.26, Ftime = 46.37, Finteraction = 6.52, all P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups ( Finter-group = 3.03, Ftime = 8.36, Finteraction = 1.25, all P > 0.05). After 4 weeks of treatment, the number of Verbal Fluency Task words and oxy-Hb level in Group 2 were significantly higher compared with those in Group 1 and Group 3 ( F = 29.71, 198.57, both P < 0.05). Conclusion:Modified electroconvulsive therapy is highly effective and safe in treating depressive disorders in patients. Eight sessions of modified electroconvulsive therapy administered within 4 weeks have been shown to exhibit better clinical efficacy and lead to greater improvements in cognitive function and functional near-infrared spectroscopy measurements compared with six or ten sessions of treatment.

Objective We aimed to explore the clinical efficacy of precise electro-acupuncture stimulation in the pterygopalatine fossa for the treatment of chronic sinusitis.Methods In total,40 patients with chronic sinusitis who visited the Xiyuan Hospital,China Academy of Chinese Medical Sciences between January 2022 and January 2023 were selected.The subjects were randomly divided into two groups:the treatment group(receiving precise electro-acupuncture in the pterygopalatine fossa)and the control group(receiving standard western medical treatment),with 20 cases in each groups.The treatments were administered twice a week for a period of 12 weeks.The effectiveness of the treatments was evaluated through computed tomography(CT)of the sinus changes and the Lund-Mackay scoring system.Results In cases of total opacity and partial opacity,there were significant differences between the two patient groups before and after treatment(P<0.05).Intra-group comparison revealed statistically significant improvements in both groups before and after treatment(P<0.05).The treatment group exhibited significant improvement in various sinus conditions(P<0.05),while in the control group,a significant improvement was only observed in the left maxillary sinus(P<0.05).Inter-group comparison also demonstrated that the treatment group's improvements were superior to those of the control group across multiple indicators(P<0.05).Conclusion The precise electro-acupuncture stimulation technique in the pterygopalatine fossa demonstrated significant therapeutic effects in the treatment of chronic sinusitis,with superior outcomes with respect to radiological changes compared to standard western medicine treatment.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human's health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumu-lates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

INTRODUCTION: The purpose of this study was to assess the application of the early warning score system (EWS-S) and gauge physician awareness, perceptions of necessity and attitudes regarding these tools based on previously experienced unnoticed clinical deterioration (CDET). METHODS: A cross-sectional survey was carried out via an online questionnaire at a large 3,500-bed Class 3A general hospital in China. A total of 299 physicians of adult general wards were asked to answer a translated questionnaire that was localised from the original version. Demographic profiles of patients were included as well as three other sections assessing awareness of CDET/EWS-S and gauging attitudes towards and perceptions of the necessity of EWS-S at our hospital. RESULTS: A high level of physician awareness of the CDET problem was observed. Most physicians knew about the existence of a systematic assessment tool for clinical application. Physicians with previous experience in reanimation, unplanned transfer to intensive care unit (UTICU) and/or death tended to consider EWS-S necessary in attentive and well-trained staff (p < 0.05). Physicians who had previous experience with UTICU were more likely to recommend implementing EWS-S in their wards compared with those without such experience (p < 0.05). CONCLUSION Most physicians have positive attitudes towards EWS-S. However, their awareness should be further heightened. Physicians who had previous experience with CDET/UTICU were more likely to employ EWS-S in their clinical practices. To better facilitate the implementation of EWS-S in Chinese hospitals, existing facilities, policy supports, standardised managements and the development of information systems should be strengthened.
Adult ; Attitude ; Clinical Deterioration ; Cross-Sectional Studies ; Early Warning Score ; Humans ; Physicians

Humans ; Autistic Disorder ; China/epidemiology* ; Cohort Studies ; Autism Spectrum Disorder/genetics* ; Asian People

Objective:To explore the effect of individualized aerobic training combined with resistance training on heart rate recovery and exercise capacity among patients with obstructive sleep apnea syndrome (OSAS) and explore possible mechanisms.Methods:Forty middle-aged patients with moderate to severe OSAS were randomly assigned to an observation group (OG, n=20) or a control group (CG, n=20). Both groups were given routine health guidance and motor training, while the OG additionally underwent individualized aerobic exercise training at 60%~75% of their peak power and resistance training loaded at 60%~80% of their ten-times maximum repetition figure. The training was three times a week for 3 months. Both groups underwent cardiopulmonary exercise testing and polysomnography before and after the 12-week intervention. The changes in their sleep apnea hypopnea index (AHI), oxygen desaturation index (ODI) and lowest oxygen saturation (L-SAO 2) were collected. Exercise capacity indicators such as peak oxygen uptake (VO 2peak), peak power, anaerobic threshold and sitting heart rate recovery (HRR) 1, 2 and 3 minutes after the test were recorded (denoted as HRR-1, HRR-2 and HRR-3). Results:There were no significant differences between the two groups in any of the measurements before the intervention. Afterward the average AHI, ODI and L-SAO 2 values of the observation group had all improved significantly compared with those before the training and compared with the control group′s values after the training. After the training, the VO 2peak and peak power of the observation group had also improved significantly compared with before the training and compared with the control group. HRR-1, HRR-2 and HRR-3 were all significantly higher in the observation group than before the training and higher than the control group′s values after the training. Conclusion:Combining aerobic and resistance training can improve the exercise ability and heart rate of middle-aged patients with moderate to severe OSAS, and also reduce the severity of their OSAS to some extent.

Objective:To control the pandemic of coronavirus disease 2019 (COVID-19) effectively, strict isolation measures have been taken in China. Suspected patients must be isolated, and the confirmed patients specifically are isolated in negative-pressure isolation rooms. During the isolation, patients face difficulty in adapting to their surrounding environment, worry about the prognosis of the disease, lack confidence in treatment, separate from their families, and have a sense of distance from medical staff. Isolated patients may possess the feelings of negativity, including loneliness, anxiety, depression, insomnia, and despair. Hence, to reduce the risk of adverse psychological outcomes,"family member-like"care strategies were developed and implemented to solve problems associated with the COVID-19 pandemic. This study aims to examine whether using"family member-like"care strategies can improve psychological resilience and reduce depression, anxiety, and stress symptoms among patients with COVID-19 in an isolation ward.Methods: A quasi-experimental design was used to evaluate the"family member-like"care strategies for adult patients with COVID-19 in an isolation ward. COVID-19 patients in the Xiangya ward of the West District of the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology in Wuhan, Hubei province, were included in this study from February 9 to March 20, 2020. Healthcare providers who volunteered as family members were assigned to patients. They practiced one-to-one care and provided continuous and whole care for the patients who were from admission to discharge. Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Depression Anxiety Stress Scale-21 (DASS-21) were used to evaluate the resilience and psychological status of COVID-19 inpatients upon hospital admission, 2 weeks after admission, and at their discharge from the hospital. Results: The questionnaire response rate of the"family member-like"strategies was 100％. Of the 60 patients, 39 (65.0％) were male, and 21 (35％) were female. The hospital stay was (27.5±3.5) days. All the 60 patients were cured and discharged without any death and serious complications. The total scores for CD-RISC were 8.83±6.86 at admission, 29.13±5.42 at 2 weeks after admission, and 33.87±6.14 at discharge, which were significantly improved at the 2 follow-ups (F=404.564, P<0.001). Multivariate analysis and repeated measurements also indicated that patients experienced significant improvements in tenacity (F=360.839, P<0.001), strength (F=368.217, P<0.001), and optimism (F=328.456, P<0.001) at the 2 follow-ups. The total scores of DASS-21 were 49.27±11.30 at admission, 30.77±16.71 at 2 weeks after admission, and 4.17±11.03 at discharge, and the scores were significantly decreased at the 2 follow-ups (F=270.536, P<0.001). Multivariate analysis and repeated measurements also indicated that patients experienced significant decreases in depression (F=211.938, P<0.001), anxiety (F=285.592, P<0.001), and stress (F=287.478, P<0.001) at the 2 follow-ups.Conclusion:"Family member-like"strategies had positive effects on improving psychological resilience and reducing the symptoms of anxiety and depression of COVID-19 patients. It might be an effective care method for COVID-19 patients. It should be incorporated into emergency care management to improve care quality during public health emergencies of infectious diseases.

The general data, blood routine, liver and kidney function, glucose metabolism and lipid metabolism of 11 922 participants who underwent physical examination at the Health Management Center of the Second Xiangya Hospital of Central South University from January 2019 to December 2019 were collected. Clinical characteristics and independent factors of patients with discordance between HbA1c and FPG were evaluated and analyzed. The prevalence of HbA1c-defined diabetes and prediabetes (respectively 8.13%, 34.79%) were significantly higher than that in FPG-defined diabetes and prediabetes (respectively 4.70%, 8.97%) (χ2=2 635.940; P<0.001). The prevalence of inconsistence between HbA1c and FPG was 35.65% and increased with increasing age. This inconsistence mainly occurred in population with HbA1c:5.7%-6.0% and FPG<5.6 mmol/L, followed by population with HbA1c:6.1%-6.4% and FPG<5.6 mmol/L. The risk factors of inconsistency included advanced age, overweight or obesity, hypoalbuminemia, dyslipidemia and hyperuricemia. Among these special participants, compared with participants under 45 years old, participants with over 45 years of age ( OR=3.525, 95% CI: 3.216-3.863, P<0.001) were more likely to have inconsistence between HbA1c and FPG; and overweight participants ( OR=1.474, 95% CI: 1.341-1.620, P<0.001) or obese participants ( OR=1.856, 95% CI: 1.633-2.110, P<0.001) are prone to have the inconsistence than those with normal weight.

The general data, blood routine, liver and kidney function, glucose metabolism and lipid metabolism of 11 922 participants who underwent physical examination at the Health Management Center of the Second Xiangya Hospital of Central South University from January 2019 to December 2019 were collected. Clinical characteristics and independent factors of patients with discordance between HbA1c and FPG were evaluated and analyzed. The prevalence of HbA1c-defined diabetes and prediabetes (respectively 8.13%, 34.79%) were significantly higher than that in FPG-defined diabetes and prediabetes (respectively 4.70%, 8.97%) (χ2=2 635.940; P<0.001). The prevalence of inconsistence between HbA1c and FPG was 35.65% and increased with increasing age. This inconsistence mainly occurred in population with HbA1c:5.7%-6.0% and FPG<5.6 mmol/L, followed by population with HbA1c:6.1%-6.4% and FPG<5.6 mmol/L. The risk factors of inconsistency included advanced age, overweight or obesity, hypoalbuminemia, dyslipidemia and hyperuricemia. Among these special participants, compared with participants under 45 years old, participants with over 45 years of age ( OR=3.525, 95% CI: 3.216-3.863, P<0.001) were more likely to have inconsistence between HbA1c and FPG; and overweight participants ( OR=1.474, 95% CI: 1.341-1.620, P<0.001) or obese participants ( OR=1.856, 95% CI: 1.633-2.110, P<0.001) are prone to have the inconsistence than those with normal weight.

Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.