The integration of Chinese and Western Medicine(ICWM)in the diagnosis and treatment of depression has been a long-standing issue in the field of mental health.In order to maximize the benefits of this combined approach,the"2023 Guidelines for Diagnosis and Treatment of Depression with Integrative Chinese and Western Medicine"(GDTD-ICWM)has been developed based on organizing evidence-based and standardized workflows for ICWM.This article aims to discuss the background,highlights,summary and outlook of the"Guidelines",as well as offer operational suggestions to guide clinical practices in order to strengthen the implementation,practice and promotion of the"Guidelines".

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.

Objective:To design a multi-epitope antigen of norovirus(NoV)based on bioinformatics technology and to pre-pare and characterize it.Methods:Bioinformatics methods were used to construct and analyze the NoV multi-epitope antigen NoV-ZH.Recombinant proteins were prepared and characterized by prokaryotic expression system,and monoclonal antibodies were prepared by animal immunization and hybridoma technology,and initially applied in colloidal gold platform.Results:The designed multi-epitope antigen had a large proportion of random curls in the secondary structure,with theoretical molecular mass and isoelectric point(PI)of 13.1 ku and 7.16,which were stable and hydrophilic.It had good immunogenicity and could activate humoral and cellular immune re-sponses.The proteins prepared by ligating pET-28a(+)and pET-32a vectors with antigenic sequences were expressed as inclusion body proteins and soluble proteins,respectively.A pair of paired antibodies was obtained by animal immunization and hybridoma tech-nique,and applied to colloidal gold test strips with a sensitivity of 0.5 ng/ml,and the test strips could specifically bind two genotypes of NoV recombinant capsid proteins.Conclusion:The successful preparation and characterization of multi-epitope antigen of norovirus provides a reference for the subsequent exploration of NoV universal detection targets and the development of diagnostic raw materials.

Objective:To explore the effect of exercise therapy on the exercise capacity and quality of life of maintenance hemodialysis patients.Methods:A total of 90 patients who underwent regular dialysis in Henan Provincial People′s Hospital, People′s Hospital of Zhengzhou University from April to December, 2020 were selected as the research objects by convienient sampling method. They were divided into experimental group and control group by random number table method, with 45 cases in each group. The control group was given routine nursing, and the experimental group took exercise therapy on the basis of routine nursing. The intervention lasted for 12 weeks. The changes in the exercise capacity and quality of life of the two groups before and after the intervention were observed.Results:Finally, 43 patients were included in the control group and 41 patients in the experimental group. There was no significant difference in the exercise capacity and quality of life before the intervention between the two groups( P>0.05). After the intervention, the maximum oxygen uptake, anaerobic threshold, 6MWT distance were (15.22 ± 3.08) ml·kg -1·min -1, (620.70 ± 53.56) ml·kg -1·min -1, (475.36 ± 50.51) m in the experimental group, and (12.22 ± 2.46) ml·kg -1·min -1, (590.18 ± 52.07) ml·kg -1·min -1, (444.50 ± 46.09) m in the control group, the differences were statistically significant between the two groups( t=3.32, 2.68, 296, all P<0.05). After the intervention, the scores of physiological function, physiological intelligence, physical pain, overall health, vitality, social function, emotional function and mental health dimensions of the quality of life were (84.32 ± 18.53), (84.61 ± 25.80), (76.40 ± 18.15), (59.02 ± 15.38), (52.22 ± 13.68), (69.56 ± 17.29), (94.24 ± 29.47), (73.44 ± 12.86) points in the experimental group, and (76.25 ± 17.35) (66.37 ± 27.63), (65.68 ± 17.54), (47.26 ± 15.45), (44.86 ± 13.14), (61.82 ± 16.51), (76.30 ± 26.14), (64.17 ± 13.36) points in the control group, the differences were statistically significant between the two groups( t values were 2.08-3.54, all P<0.05). Conclusions:Exercise therapy during dialysis can enhance exercise capacity and improve quality of life in maintenance hemodialysis patients.

Objective: To report on clinical characteristics and genetic findings in 15 Chinese patients with methylmalonic acidemia (MMA). Methods: For the 15 MMA patients detected by tandem mass spectrometry, genetic analysis was carried out in twelve pedigrees. Clinical characteristics, genetic finding, treatment and outcomes were retrospectively analyzed. Results: The main features of the patients included poor feeding, recurrent vomiting, lethargy, seizure and development retardation. Blood propionylcarnitine (except for 3 patients), its ratio with acetylcarnitine, and urine methylmalonic acid were increased in all patients. Twelve patients were diagnosed genetically, which included 7 with MUT variants, 4 with MMACHC variants, and 1 with MMAB variant. Nine MUT variants were detected, among which c. 1159A>C, 753+ 1delGinsTGGTTATTA and c. 504del were novel. Six known pathogenic MMACHC variants and two novel MMAB variants (c.289_290delGG, c. 566G>A) were also detected. Seven patients died of metabolic crises within a year, others had improved effectively following the treatment, but had mild to severe growth delay and/or developmental retardation. Conclusion The clinical manifestation of MMA are complex. Most patients have variants of the MUT and MMACHC genes. High mortality may occur before one year of age.

Objective To study the clinical features and nursing strategy of rhinocerebral mucormycosis , and to improve the knowledge of the disease and the quality of care .Methods The data of 8 cases with rhinocerebral mucormycosis were reviewed and analyzed .The clinical features and nursing intervention were analyzed throughout the course of disease .Results The underlying immunosuppressive condition of the 8 cases of mucormycosis had diabetes , diabetic ketoacidosis , anaemia or adiotherapy with headache and orbitial apex syndrome as the early symptoms .Nurses focused on local signs observation , perioperative change of intracranial pressure and general conditions , drug adverse reaction observation and nursing care of original disease , mental care, and basic nursing care .There were certain effects for corresponding nursing measures without occurrence of nursing events duration of hospital stay .1 patient died within one week in hospital;4 patients had survived from 3 to 12 months; and 3 patients had been alive over 3 years until now.Conclusions Rhinocerebral mucormycosis was the secondary onset severe diseases for patients with poor immunologic function , implicated in the orbit and brain , and the fatality rate was high .It could hold the development of the disease by clearing up the focus and wiping off the condition of fungi thrive together with medical management and adequacy nursing intervention .

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data

NAS preparation, a kind of Chinese herbal medicine found by the Yunnan Eco-agricultural Research Institute, has potential antiviral activity. In this paper, the inhibiting effect of NAS preparation on H9N2 subtype Avian influenza virus (AIV) was investigated in vivo. Chickens infected with H9N2 virus were treated with NAS preparation for 4 days. The virus was then detected by hemoagglutination (HA) test and reverse transcription polymerase chain reaction (RT-PCR). The results showed that no H9N2 virus could be detected at the 7th day when the chickens were treated with 0.2g/kg/d or 0.1g/kg/d of NAS preparation. However the virus could be detected in other chickens without NAS preparation treatment. This result suggested that NAS preparation may be a potential drug candidate to control infection of H9N2 subtype AIV in chickens.

Objective To observe the influence of emergency PCI in different time windows to cardiac scar and cardiac function after myocardial infarction. Methods One hundred and twenty-seven patients with acute myocardial infarction, who were treated in different time windows by emergency PCI, were enrolled into this study. The cases were divided into two groups according to the time when they took PCI after onset;group 3 hPCI included 66 patients had PCI at 3 h after onset and group 6 hPCI included 61 patients had PCI at 6 h. At 4th, 8th and 12th weeks, the fragmented QRS (fQRS) were observed by twelve synchronization cardiogram; ventricle wall movement strain rate were determined by cardiac speckle tracking imaging;left ventricular ejection fraction (LVEF)were measured by cardiac ultrasound to evaluate cardiac events and cardiac function after myocardial infarction. Results At 4th,8th and 12th weeks,the fQRS positive leads were significantly more in 6 hPCI group than 3 hPCI group ( P ＜ 0. 05 respectively ) . The ventricle wall movements strain rate and LVEF improved significantly in 3 hPCI group compared with 6 hPCI group (P ＜ 0. 05 ). Conclusions The earlier emergency PCI treatment was applied and the earlier the"criminal"blood vessels were opened ,the more ischemic myocardial cells were restored. Combination use of fQRS、 STI and LVEF examination could improve the diagnosis of cardiac scar formation and direct protective therapy.

To explore new agents of quinolone derivatives with high antibacterial activity, 7-(4-alkoxyimino-3-methyl-3-methylaminopiperidin-1-yl)quinolones were designed and synthesized, and their activity against gram-positive and gram-negative strains was tested in vitro. Sixteen target compounds were obtained. Their structures were established by 1H NMR, HRMS and X-ray crystallographic analysis. Compounds 14k and 14m-14o show good antibacterial activity against the tested five gram-positive strains and five gram-negative strains (MIC: 0.25-16 micromg x mL(-1)), of which the most active compound 14o is 8-fold more potent than levofloxacin against S. pneumoniae (MIC: 4 microg x mL(-1)), and comparable to levofloxacin against S. aureus, S. epidermidis, E. faecalis and E. coli (MIC: 0.25-1 microg x mL(-1)), but generally less potent than gemifloxacin.