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*

Objective To observe the feasibility of 5.0T MR for cardiac imaging.Methods Three patients with heart diseases and 17 healthy volunteers were prospectively enrolled.Cardiac MR(CMR)cine sequence and black blood sequence imaging were performed using 5.0T and 3.0T MR scanner,respectively.The image quality and artifacts degrees were compared between 5.0T and 3.0T CMR images,and the consistency of left ventricular parameters obtained using 5.0T and 3.0T scanners was analyzed.Results No significant difference of image quality nor artifacts degrees was found between 5.0T and 3.0T CMR images(all P＞0.05).The left ventricular end diastolic volume(EDV),end systolic volume(ESV),ejection fraction(EF),stroke volume(SV)and end diastolic mass(EDM)derived from cine images acquired at different fields were in a good agreement(all ICC＞0.75,all P＜0.001).Conclusion 5.0T MR could be used for cardiac imaging,with image quality of cine and black blood sequences comparable to that of 3.0T MR.

OBJECTIVETo observe the efficacy of acupuncture combined with acupoint catgut embedding sequential therapy and medication for mild and moderate ulcerative colitis.

METHODSOne hundred and twenty patients were randomized into an acupuncture and acupoint catgut embedding sequential therapy group (a combination group) and a mesalazine group, 60 cases in each one. Fifty-seven cases in the combination group and 55 cases in the mesalazine group were included into analysis. In the combination group, acupuncture was applied at Tianshu (ST 25), Shangjuxu (ST 37), Quchi (LI 11) during the activity period, and acupoint catgut embedding was applied at Pishu (BL 20), Zusanli (ST 36), Guanyuan (CV 4) during the alleviate period. The patients in the mesalazine group were treated with mesalazine orally. The treatment was given for 12 weeks. The scores of TCM symptoms, colonoscopy, mucosa healing rate were compared before and after treatment in the two groups. The effects, adverse reactions and the recurrent rates during 1-year follow-up were observed.

RESULTSAfter treatment, the scores of TCM symptoms decreased in the two groups (both <0.05), and the result in the combination group was better than that in the mesalazine group (<0.05). The total effective rate in the combination group was 87.7% (50/57), which was better than 70.9% (39/55) in the mesalazine group (<0.05). The colonoscopy scores decreased after treatment in the two groups (both <0.05). There was no significant difference between the two groups on colonoscopy score and mucosal healing rate [50.9% (29/57) vs 34.5% (19/55), both >0.05]. The recurrent rate in the combination group was 8.5% (4/47)，which was lower than 32.4% (11/34) in the mesalazine group (<0.05). No severe adverse reaction was found during the treatment in the two groups.

CONCLUSIONAcupuncture combined with acupoint catgut embedding sequential therapy can improve mild and moderate ulcerative colitis and reduce the recurrent rate.

Acupuncture Points ; Acupuncture Therapy ; Catgut ; Colitis, Ulcerative ; therapy ; Humans

OBJECTIVETo observe the effects of Qingyi Granule (QYG) on the changes of total protein expressions in the pancreatic tissue of rats with severe acute pancreatitis (SAP) induced by sodium taurocholate (STC).

METHODSSAP was induced by retrograded injecting 5% STC from the gut-pancreatic duct in 36 Sprague-Dawley (SD)rats. Then they were randomly divided into the SAP group and the QYG treatment group (abbreviated as the QYG group), 18 in each group. After successful modeling, rats in the QYG group were administered with QYG water solution (W: W = 1:1) once with an interval of 12 h (1 mL/100 g), while rats in the SAP group were administered with normal saline. The medication was performed four times. The total proteins were extracted from the pancreatic tissue of all rats to perform two-dimensional electrophoresis, fluorescent staining, and atlas analysis. The protein dots with differential expressions more than four times between each other in 48 h gel pictures were chosen and used for MALDI-TOF/TOF mass chromatographic analysis and biological information analysis.

RESULTSThe 5% STC induced SAP model rats had typical pathological changes in the pancreatic tissue. The proteomics changes of the pancreatic tissue were analyzed by gel image manipulation software. Twenty two disparate points were detected between two groups at 48 h, 5 points of the protein were up-regulated and 17 points were down-regulated of the total after QYG intervention. Nine protein spots expressed differently more than 4 times and stably at 48 h, 7 kinds of proteins have been identified by mass chromatographic analysis and Data Base Retrieval, and they were Serpinb1a 39 kDa protein, Serpinb1a 43 kDa protein, Prdx4 Prx IV, Clps, gamma-actin (Actg1), Eprs and Hadhsc. Those proteins were involved in signal transmit during the process of SAP pancreas--pathological injury analyzed from their functions.

CONCLUSIONSProteomics can well reflect the effects of QYG on differential expression proteins in the pancreatic tissue of rats with SAP. Studying differential expression proteins may provide a new theoretical basis and molecule target for QYG treating SAP.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Pancreas ; metabolism ; Pancreatitis ; chemically induced ; metabolism ; prevention & control ; Proteome ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo assess the influence of photoselective vaporization of the prostate (PVP) on the erectile function of the patient with benign prostatic hyperplasia (BPH).

METHODSUsing IIEF-5, we conducted a questionnaire investigation among 210 BPH patients before and after treated by PVP (n = 80) and transurethral resection of the prostate (TURP, n = 130). We also reviewed the clinical data and compared the pre- and post-operative penile erectile function between the two groups of patients.

RESULTSFollow-up was completed in 76 cases of PVP and 123 of TURP. The baseline data showed no statistically significant differences between the two groups in age, prostate volume, IPSS, QOL, Qmax, post void urine residual volume and IIEF-5 scores (P>0.05). Compared with the IEFF-5 score at the baseline (21.88 +/- 2.46), those at 3, 6 and 12 months after PVP were 16.72 +/- 3.17, 19.34 +/- 2.46 and 19.29 +/- 2. 18, respectively, significantly decreased at 3 months (P = 0.042), but with no remarkable difference at 6 and 12 months (P >0.05). Nor were there significant differences in the IIEF-5 score between the PVP and TURP groups at any time points (P>0.05). At 6 months after surgery, the incidence rates of erectile dysfunction were 11.7% and 13.7% in the TURP and PVP groups, respectively (P>0.05).

CONCLUSIONPVP may reduce erectile function in some cases in the early stage after surgery, but this adverse effect does not last long and is basically similar to that of TURP.

Humans ; Laser Therapy ; adverse effects ; methods ; Male ; Penile Erection ; Prostatic Hyperplasia ; physiopathology ; surgery ; Surveys and Questionnaires ; Transurethral Resection of Prostate ; adverse effects ; Treatment Outcome

Objective to explore the rating scales capability of assessing competencies of ICU nurses ,forming and complementing the competency assessment system. Methods A purposive sample of 210 female clinical registered nurses working in 21 intensive care units were investigated using self-designed questionnaire.Factor analysis and item analysis were applied to establish the scale' s validity and reliability. Results The final scale consisted 3 dimensions with 72 items. The dimensions were coordination and communication, health cultivation and straining, the Cronbach' s α of which are 0.96, 0. 94 and 0. 90 respectively. And all the factor loadings to its items were above 0.4, which demonstrated that those dimensions and their items were consistent .Conclusions The rating scale is proved to be of great psychometric characteristics and it provides an essential way to structure evidence demonstrating evolving competency of nurses, especially with an intensive care context.

OBJECTIVETo developed a multiplex RT-PCR assay for simultaneous screening of type A, B and novel A (H1N1) influenza viruses.

METHODSTwo pairs of universal primers in were designed for amplifying the M gene and NS gene of type A and B influenza viruses, respectively. A pair of specific primers of HA gene was designed to detect novel A (H1N1) influenza virus. A one-step method was used to establish the multiplex RT-PCR system. A blinded experiment was carried out to validate the accuracy of this assay in comparison with the results of real-time fluorescence RT-PCR. The clinical practicability and efficacy of this assay was also evaluated.

RESULTSThe RT-PCR products were analyzed using agarose gel electrophoresis, which yielded distinct bands of the target fragments without non-specific reactions, suggesting the high efficiency and specificity of the multiplex RT-PCR. Blinded study of 50 samples demonstrated a concordance rate of 100%.

CONCLUSIONThis multiplex RT-PCR assay allows one-step simultaneous detection of type A, B and novel A (H1N1) influenza viruses rapidly and accurately, and provides a valuable low-cost screening technique for influenza epidemic monitoring and early diagnosis.

Humans ; Influenza A Virus, H1N1 Subtype ; genetics ; isolation & purification ; Influenza B virus ; genetics ; isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Time Factors ; Viral Matrix Proteins ; genetics ; Viral Nonstructural Proteins ; genetics

Objective To develop a PFGE protocol for Streptococcus suis.Methods We developed and optimized a PFGE protocol for S.suis,in terms of plug preparation,choice of restriction endonucleases and optimized electrophoresis parameters.By analyzing the genome sequences of S.suis P1/7 with Mapdraw of DNAStar.we found three restriction enzymes,Swa Ⅰ,Sma Ⅰ and Apa Ⅰ,were more suitable than others.Results Analysis of 100 isolates of S.suis including 34 of 35 serotypes identified,59,53 and 43 patterns were obtained from Swa Ⅰ,Sma Ⅰ and Apa Ⅰ restriction,respectively.The enzyme Swa Ⅰ had the greatest power for discrimination ability.Conclusion By optimization of the protocol at various conditions,a rapid,reproducible,economic and practical PFGE method for S.suis was developed.

Objective To establish the allocation model of nursing human resource in the second level general hospital by the study and make rational suggestions for Shanghai government.Methods The study was conduced by literature review, expert consultation, on-spot interview, nursing item timing and statistics, etc.Results The current nurse staff's situation was studied and a new rational coefficient (0.079) in allocation formula was proposed, the real bed to nurse ratio(1:0.56) and the standard bed to nurse ratio( 1:0.60 ) was put forward.Conclusions Hospitals may allocate the nursing staff according to the conclusion of this study in the second level general hospital.

Acupuncture ; Acupuncture Therapy ; Germany ; History, 20th Century ; Humans ; Moxibustion