Objective:To verify the reliability and validity of the Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN-C) in patients with major depressive disorder(MDD).Methods:A total of 122 patients with MDD and 122 controls were recruited and measured with the BRIAN-C, 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16), 7-Item Generalized Anxiety Disorder Scale(GAD-7) and 6-Item Short Form Health Survey(SF-6). The index D and correlation analysis were conducted to evaluate the discrimination and homogeneity of the items, respectively. The Cronbach′s α coefficient, Spearman-Brown coefficient, intraclass correlation coefficient ( ICC) and retest correlation coefficient were conducted to evaluate the reliability.Confirmatory factor analysis, correlation analysis and the receiver operating characteristic (ROC) curve were conducted to evaluate the construct validity, criterion validity and prediction validity, respectively. Results:The item distinction and homogeneity analysis showed significant differences ( P<0.05). The Cronbach′s α coefficient and the Spearman-Brown coefficient were 0.911 and 0.807, while the ICC and the correlation coefficient r of test-retest reliability were 0.639 (95% confidence interval( CI):0.375-0.729) and 0.43 ( P=0.001), respectively. Confirmatory factor analysis showed that the fit indexes χ 2/dF=1.937, goodness-of-fit index(GFI)=0.822, comparative fit index (CFI)=0.877, Tucker-lewis index (TLI)=0.855, and root mean square error of approximation (RMSEA)=0.088. The score of BRIAN-C was significantly correlated with that of QIDS-SR16, GAD-7 or SF-6 ( r=0.74, 0.46, -0.69, all P<0.05).The ROC curve suggested that the area under curve (AUC) was 0.939 (95% CI: 0.909-0.970, P<0.05) for distinguishing MDD patients from controls. The optimal cut-off was 29, with 0.861 sensitivity and 0.926 specificity. Conclusions:The BRIAN-C scale has good reliability and validity, which is supposed to be used in Chinese cultural background to evaluate the biorhythms in patients with MDD.

Objective:To verify the reliability and validity of the Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN-C) in patients with major depressive disorder(MDD).Methods:A total of 122 patients with MDD and 122 controls were recruited and measured with the BRIAN-C, 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16), 7-Item Generalized Anxiety Disorder Scale(GAD-7) and 6-Item Short Form Health Survey(SF-6). The index D and correlation analysis were conducted to evaluate the discrimination and homogeneity of the items, respectively. The Cronbach′s α coefficient, Spearman-Brown coefficient, intraclass correlation coefficient ( ICC) and retest correlation coefficient were conducted to evaluate the reliability.Confirmatory factor analysis, correlation analysis and the receiver operating characteristic (ROC) curve were conducted to evaluate the construct validity, criterion validity and prediction validity, respectively. Results:The item distinction and homogeneity analysis showed significant differences ( P<0.05). The Cronbach′s α coefficient and the Spearman-Brown coefficient were 0.911 and 0.807, while the ICC and the correlation coefficient r of test-retest reliability were 0.639 (95% confidence interval( CI):0.375-0.729) and 0.43 ( P=0.001), respectively. Confirmatory factor analysis showed that the fit indexes χ 2/dF=1.937, goodness-of-fit index(GFI)=0.822, comparative fit index (CFI)=0.877, Tucker-lewis index (TLI)=0.855, and root mean square error of approximation (RMSEA)=0.088. The score of BRIAN-C was significantly correlated with that of QIDS-SR16, GAD-7 or SF-6 ( r=0.74, 0.46, -0.69, all P<0.05).The ROC curve suggested that the area under curve (AUC) was 0.939 (95% CI: 0.909-0.970, P<0.05) for distinguishing MDD patients from controls. The optimal cut-off was 29, with 0.861 sensitivity and 0.926 specificity. Conclusions:The BRIAN-C scale has good reliability and validity, which is supposed to be used in Chinese cultural background to evaluate the biorhythms in patients with MDD.

Objective To investigate the effect of fecal microbiota transplantation (FMT) on a rat model of hypertriglyceridemic acute pancreatitis (HLAP). Methods A total of 72 male Sprague-Dawley rats were randomly divided into sham-operation group, model group, Rheum officinale group, and fecal microbiota group, with 18 rats in each group. After 8 weeks of feeding with high-fat diet, the rats in the sham-operation group were given sham operation, and those in the other three groups were given retrograde pancreaticobiliary injection of 5% sodium taurocholate to induce acute pancreatitis; after modeling, the rats in the Rheum officinale group were given enema with Rheum officinale , and those in the fecal microbiota group were given enema with fresh fecal microbiota solution. Blood, pancreatic, and terminal ileal tissue samples were collected at 6, 24, and 36 hours after surgery. HE staining was used to observe histopathological changes of the pancreas and the intestine; an automatic biochemical analyzer was used to measure the serum levels of amylase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HLD-C); ELISA was used to measure the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and endotoxin as an index for intestinal permeability. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test or the Tamhane T2 test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Bonferroni method was used for further comparison between two groups. Results Compared with the sham-operation group, the Rheum officinale group and the fecal microbiota group had no significant increase in the pathological score of the terminal ileum at 6 and 24 hours, and there was no significant difference between the fecal microbiota group and the sham-operation group at 36 hours (all P > 0.05). At 36 hours, the Rheum officinale group and the fecal microbiota group had a significantly lower serum level of amylase than the model group (all P < 0.05). Compared with the model group, the Rheum officinale group had a significantly lower serum level of ALT at 36 hours ( P < 0.05) and a significantly lower serum level of AST at 24 hours ( P < 0.05), while the fecal microbiota group had a significantly lower level of ALT at each time point ( P < 0.05) and a significantly lower serum level of AST at 24 and 36 hours (all P < 0.05). The Rheum officinale group and the fecal microbiota group had significant reductions in the serum levels of TC and TG (all P < 0.05); compared with the Rheum officinale group, the fecal microbiota group had a significantly higher serum level of HDL-C at 24 and 36 hours (all P < 0.05), and compared with the model group, the fecal microbiota group had a significantly lower serum level of HDL-C at each time period (all P < 0.05). There were no significant differences in the inflammatory indices IL-6 and TNF-α between the fecal microbiota group and the sham-operation group at each time point (all P > 0.05), and the Rheum officinale group had significantly higher levels than the sham-operation group (all P < 0.05); both the Rheum officinale group and the fecal microbiota group had a significantly lower serum level of endotoxin than the model group (all P < 0.05), and the fecal microbiota group had a significantly lower level of endotoxin than the Rheum officinale group within 6 hours of treatment ( P < 0.05). Conclusion Both Rheum officinale and fecal microbiota transplantation can improve tissue inflammation and intestinal permeability in HLAP rats and can improve lipid metabolism and alleviate the progression of pancreatitis to a certain extent, and fecal microbiota transplantation shows a better clinical effect than Rheum officinale alone, but more randomized controlled trials are needed for further investigation.

Anorexia nervosa (AN) is a type of eating disorder characterized by severe malnutrition and abnormally low body weights, resulting from patients′ intentionally strict restrictions on eating. Patients with AN often have body image disturbances and are comorbid with psychiatric symptoms, such as obsessive-compulsive symptoms, depression, anxiety, and so forth. These patients may suffer from severe malnutrition, amenorrhea, and even death since they refuse to eat. As a mental disorder with a high mortality rate, there is still no specific medicine to treat AN. This case is a female patient with AN treated with bilateral anterior capsulotomy (BACA) combined with deep brain stimulation (DBS). The treatment efficacy was evident. Before the operation, her body mass index (BMI) was only 12.22 kg/m 2. She had repeated binge-eating-emetic behaviors, severe obsessive-compulsive symptoms, anxiety and depression, suicide attempt, severe malnutrition, amenorrhea, recurrent infections, and so forth. At the 3-month follow-up after the operation, the patient was emotionally stable and had a BMI of 19.40 kg/m 2. The reducing rates of the total scores of the Hamilton Anxiety Scale (HAMA), the 24-item Hamilton Depression Scale (HAMD 24), and the Yale-Brown Obsessive-Compulsive Scale (Y-BROW) were 64%, 64%, and 52%, respectively. This study found that BACA combined with DBS surgery can rapidly and effectively improve the prognosis of patients with the binge-eating/purging subtype of AN.

Anorexia nervosa (AN) is a type of eating disorder characterized by severe malnutrition and abnormally low body weights, resulting from patients′ intentionally strict restrictions on eating. Patients with AN often have body image disturbances and are comorbid with psychiatric symptoms, such as obsessive-compulsive symptoms, depression, anxiety, and so forth. These patients may suffer from severe malnutrition, amenorrhea, and even death since they refuse to eat. As a mental disorder with a high mortality rate, there is still no specific medicine to treat AN. This case is a female patient with AN treated with bilateral anterior capsulotomy (BACA) combined with deep brain stimulation (DBS). The treatment efficacy was evident. Before the operation, her body mass index (BMI) was only 12.22 kg/m 2. She had repeated binge-eating-emetic behaviors, severe obsessive-compulsive symptoms, anxiety and depression, suicide attempt, severe malnutrition, amenorrhea, recurrent infections, and so forth. At the 3-month follow-up after the operation, the patient was emotionally stable and had a BMI of 19.40 kg/m 2. The reducing rates of the total scores of the Hamilton Anxiety Scale (HAMA), the 24-item Hamilton Depression Scale (HAMD 24), and the Yale-Brown Obsessive-Compulsive Scale (Y-BROW) were 64%, 64%, and 52%, respectively. This study found that BACA combined with DBS surgery can rapidly and effectively improve the prognosis of patients with the binge-eating/purging subtype of AN.

Objective:To construct nursing quality evaluation indicator system for comprehensive stroke center, so as to provide reference for standardized nursing quality evaluation of comprehensive stroke center.Methods:From September 2018 to December 2019, based on the theory of Donabedian′s structure-process-outcome quality model, literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to determine nursing quality evaluation index system and index weight for comprehensive stroke center.Results:A total of 16 experts from comprehensive stroke center were consulted for two rounds. The clinical working time was 24.63±10.08 years, and the effective recovery rates of two rounds were 100%. The authority coefficient of experts was 0.888, and the coordination coefficients W of two rounds were 0.229 and 0.283 respectively.Finally, a nursing quality evaluation indicator system for comprehensive stroke center was constructed, including 3 first-level indicators, 13 second-level indicators and 46 third-level indicators. Conclusions:The established nursing quality evaluation indicator system for comprehensive stroke center covers the whole process of stroke emergency, stroke unit, and follow-up, which is scientific and reliable, and provides an evaluation tool for daily nursing quality monitoring and continuous quality improvement in comprehensive stroke centers.

Objective To understand the nutrition status in elderly patients with hip fracture, and clarify its effects on postoperative functional recovery,complications and mortality based on literature analysis of the past 10 years. Methods PubMed,Medline,Embase Database,Wanfang Database,Chinese National Knowledge Infrastructure(CNKI)and China Biology Medicine disc(CBMdisc)were searched,and relevant researches published from 1st January,2010 to 31th May,2019 were collected. Single rate Meta-analysis was used to integrate the prevalence and mortality of malnutrition. A qualitative systematic review was used to analyze the relationship between nutritional status and prognosis after surgery. Results A total of 11 articles was included,including 21791 patients. Meta-analysis showed that the mean prevalence of malnutrition during hospitalization in elderly patients with hip fracture was 46％(95％CI:45％-47％)using serum albumin(ALB),and was 17％(95％CI:12％-22％)assessing by the Mini Nutritional Assessment (MNA),and the risk of malnutrition prevalence was 42％(95％CI:45％-47％). The results of qualitative evaluation showed that compared with the well-nutrition group(Short-form MNA 12-14 points),the malnutrition risk group(Short-form MNA 8-11 points)had lower activity ability 4 months after the operation (OR=2.03,95％CI:1.24-3.31),and the MNA score decreased by 1 point,the risk of death increased by 15％(HR=0.869,95％CI:0.757-0.998). The malnutrition group(ALB<3.5 g/dl)had a higher incidence of sepsis (P< 0.001)and pulmonary infection(P=0.019),with every 1 g/dl reduction in ALB and 0.59-fold increased risk of death(RR=0.59,95％CI:0.53-0.65). Conclusions The incidence of hip fracture malnutrition or malnutrition risk is very high in the elderly patients with hip fracture. Both malnutrition and malnutrition risk have negative effects on postoperative functional recovery,complications and death rates,and the worse the nutritional status,the worse the prognosis. So,both ALB and MNA are recommended to be included in the care plan of elderly patients with hip fracture. When ALB is failed to diagnose malnutrition,the MNA evaluation method should be adopted to find the problems of nutrition and offer nutritional intervention in advance.

Objective:To construct the nutritional intervention regimen for elderly patients with hip fractures during the perioperative period and rehabilitation period.Methods:Based on Stetler evidence-based practice model, 151 elderly patients with hip fractures surgery who were admitted to Jiading District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January to May 2019 were investigated, and nutritional problems were found in the perioperative period and 3 months after surgery. Through systematic literature search, the best evidence was extracted to construct a nutritional intervention regimen for elderly hip fractures patients with oral nutrition supplements (ONS) . The expert meeting method was adopted to demonstrate the scheme and determine the final intervention scheme and process.Results:A total of 7 guidelines were included, and 25 recommendations were formed based on evidence, including 24 strong recommendations and 1 weak recommendation. Nutritional intervention scheme and process for elderly patients with hip fractures, mainly ONS, were determined. The expert authority coefficient was 0.89.Conclusions:In this study, the nutritional intervention regimen for elderly patients with hip fractures, mainly ONS, was constructed with a high degree of expert authority and reliable results, providing a theoretical basis for clinical nutrition intervention for elderly patients with hip fractures in the perioperative period.

Objective:To explore the influencing factors of fear of falling in patients with first cerebral infarction in recovery period.Methods:Using the convenient sampling method, a total of 221 patients with first cerebral infarction who were hospitalized and treated in Department of Neurology and Department of Cardiology in Qingdao Hospital of Shandong First Medical University from May 2017 to October 2019 were selected as research objects. Short Falls Efficacy Scale International (SFES-I) was used to evaluate the patients, and the influencing factors of the fear of falling in patients with first cerebral infarction in recovery period were analyzed.Results:The results of univariate analysis showed that SFES-I scores of patients with different ages, marital status, family monthly income, history of falls, number of chronic diseases, anxiety, depression, activity of daily living (ADL) limitation and walking ability had statistically significant differences ( P<0.05) . The results of multivariate logistic regression analysis showed that five variables including age (65-80) , marital status, history of falls, anxiety, and depression were retained in the regression model, and the differences were statistically significant ( P<0.05) . Among them, the marital status of the spouse was the protective factors of fear of falling of patients ( OR<1) , while the other 4 factors were risk factors of fear of falling of patients ( OR>1) . Conclusions:Age, marital status, history of falling, anxiety, and depression are the influencing factors of falling fear in patients with first cerebral infarction in recovery period, so targeted nursing measures should be taken according to different characteristics of patients.

Objective:The reliability and validity of the Chinese version of Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features- DSM-5 module (MINI-M) were tested in patients with a hypomanic or manic episode.Methods:After sinicization of MINI-M, a total of 110 patients with hypomanic or manic episode were recruited into this multiple-centre study through a convenience sampling, and completed the questionnaires by themselves. The reliability of MINI-M was analyzed with Cronbach′s α and Spearman′s r of item-to-total and test-retest correlations. Principal component analysis (PCA) and exploratory factor analysis (EFA) were conducted to explore the structural validity of MINI-M. questionnaire. The receiver operating characteristic curve (ROC) based on clinical diagnosis was used to analyze the predictive validity.Results:The internal consistency Cronbach′s α of the MINI-M was 0.840, the correlation coefficients of item-to-total were 0.549-0.834 ( P<0.05), the test-retest reliability over one-week interval was 0.621 ( P<0.05). The PCA and EFA supported a single factor with strong loadings for all 6 items, which could explain 55.795% of the total variance. The ROC analysis showed that the optimal cut-off was 2 for distinguishing mixed features from the manic episode with a sensitivity of 0.800 and a specificity of 0.711. The MINI-M determined 38.2%(42/110) of patients with mixed features, which was higher than 18.2% (20/110) diagnosed by routine psychiatric interview. Conclusions:The findings demonstrate that the Chinese version of MINI-M is a reliable and valid tool for recognizing mixed features in patients with a hypomanic or manic episode, and helpful for raising the clinical diagnosis of mixed features.