Objective: To analyze the burden of bipolar disorder among adolescents aged 10-24 in China from 1990 to 2021 and its trend of change, so as to provide theoretical basis for the prevention and treatment of bipolar disorder. Methods: The latest data from the Global Burden of Disease (GBD) database in 2021 were selected. The Joinpoint regression model, age-period-cohort (APC) model, and bayesian age-period-cohort (BAPC) model were used to analyze and predict indicators such as the age standardized incidence rate and age standardized disability adjusted life year (DALY) rate of bipolar disorder among Chinese adolescents, and the average annual percent change (AAPC) was calculated. Results: From 1990 to 2021, the overall age standardized incidence rate (1990:22.92/100 000, 2021:23.17/100 000) showed an upward trend ( AAPC=0.03, t=8.20, P <0.01) and change trend of age standardized DALY rate (1990:33.61/100 000, 2021:33.76/100 000) was relatively flat ( AAPC=0.01, t= 0.99 , P =0.32). From 1990 to 2021, age standardized incidence rate and age standardized DALY rate of girls were higher than boys ( χ 2=16.38, P <0.01). The net drift values for the incidence rate and DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years were -0.23% and -0.22%, respectively. The highest incidence rate of bipolar disorder among Chinese adolescents aged 10-24 years was observed in the 15-19 age group, with a rate of 33.14/100 000; the highest DALY risk was in the 20- 24 age group, with a rate of 57.26/100 000. The lowest incidence risk and DALY risk RR values for bipolar disorder among Chinese adolescents aged 10-24 years were observed in 2017-2021, with RR values of 0.99 (95% CI =0.97-1.00) and 0.98 (95% CI = 0.97- 0.99), respectively ( P <0.05). Similarly, the lowest incidence risk and DALY risk RR values for this age group were observed in the 2000-2004 birth cohort, both of which were 0.86 (95% CI =0.84-0.87) ( P <0.05). It was projected that the overall age standardized incidence rate and age standardized DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years will continue to increase from 2022 to 2031, reaching 24.10/100 000 and 34.90/100 000, respectively, by 2031. Conclusions From 1990 to 2021, both the age standardized incidence rate and age standardized DALY rate of bipolar disorder among Chinese adolescents shows an upward trend. Special attention should be given to female adolescents, with a focus on controlling the age standardized incidence rate of bipolar disorder among 15-19 year-old adolescents and the age standardized DALY rate among 20-24 year-old ones. Efforts should be enhanced to increase awareness and screening for bipolar disorder among adolescents.

To compare the differences in clinical features and treatment choices between peripheral spondyloarthritis(pSpA) and axial spondyloarthritis(axSpA), and better understand the clinical characteristics and medication needs of pSpA.

Objective:Based on the data compilation and analysis of the disease burden of esophageal cancer attributed to alcohol consumption in China over the past three decades(1990-2019),this study aims to explore how to strengthen the formulation and management of public health policies to control the disease burden caused by this disease. Methods:Based on the data from the Global Burden of Disease(GBD)2019 study database,indicators such as mortality rate and disability-adjusted life years(DALYs)were used to assess the disease burden of esophageal cancer attributed to alcohol consumption in China.Joinpoint regression software and the age-period-cohort model were employed to analyze the trends in disease burden and mortality rates over time by age,period,and cohort.Bayesian age-period-cohort analysis was used to predict the mortality rates of esophageal cancer attributed to alcohol consumption in China from 2020 to 2030. Results:From 1990 to 2019,the number of deaths from esophageal cancer attributed to alcohol consumption increased from 33 800 cases to 61 900 cases,while the standardized mortality rate decreased from 3.95 per 100 000 to 3.04 per 100 000.DALYs increased from 934 000 person-years to 1 512 600 person-years,and the DALYs rate decreased from 101.36 per 100 000 to 71.39 per 100 000.In 2019,both the number of deaths and DALYs reached their peak in the age group of 65-69 years with 58 800 deaths and a standardized mortality rate of 6.21 per 100 000 for males,and 3 100 deaths and a standardized mortality rate of 0.31 per 100 000 for females.Both the mortality rates and the DALYs rates increased with age.The Joinpoint regression analysis showed that the average annual percentage change(AAPC)of mortality rates attributed to alcohol consumption-related esophageal cancer was-0.97%[95%confidence interval(CI):-1.2%--0.8%],with an AAPC of-2.32%(95%CI:-2.6%--2.1%)for females and-0.81%(95%CI:-1.0%-0.6%)for males.The age-period-cohort analysis of mortality rates attributed to alcohol consumption-related esophageal cancer showed a net drift of-1.301%(95%CI:-1.577%--1.025%,P＜0.05).It is predicted that the burden of esophageal cancer mortality attributed to alcohol consumption will steadily increase during the period of 2020-2030. Conclusion:Compared to the overall trend of esophageal cancer burden,the burden of esophageal cancer attributed to alcohol consumption is declining at a slower rate.The burden of the disease is higher in the male population than that in females,and higher in the middle-aged and elderly population compared to the younger population.It is expected that in the coming years,the burden of esophageal cancer mortality attributed to alcohol consumption in China will steadily increase,suggesting that while focusing on the intervention for males and the middle-aged and elderly population,relevant departments should also strengthen health education in the entire population,formulate public health policies,and raise awareness of early prevention and risk factors of esophageal cancer among residents.

Objective:To investigate the clinical significance of autologous platelet separation (APS) in different time courses of cardiovascular surgery.Methods:The relevant data of 75 patients with cardiovascular surgery from September 2019 to August 2021 in Hunan Provincial Peoples′ Hospital were collected retrospectively. They were divided into two groups according to whether APS was used during the operation: group A used APS (37 cases) and group B did not use APS (38 cases). The two groups were divided into subgroups according to the length of cardiopulmonary bypass (CPB): A1 and B1 were medium and short-term groups (CPB bypass time ≤200 min), and A2 and B2 were long-term groups (CPB bypass time >200 min). Blood routine, postoperative drainage volume, postoperative blood product infusion volume and thromboelastogram at different time points were recorded and compared.Results:The postoperative drainage volume, red blood cell infusion volume and ventilator assisted time in group A were less than those in group B (all P<0.05); The postoperative drainage volume [(645.79±205.25)ml vs (886.67±360.96)ml, P=0.006], erythrocyte infusion volume [(3.24±2.53)U vs (4.77±1.97)U, P=0.016], platelet infusion volume [0.00(0.00, 0.00)U vs 1.00(0.125, 2.00)U, P=0.002] and thromboelastogram coagulation reaction time [(7.38±1.74)min vs (9.09±3.57)min, P=0.047] in group A2 were significantly better than those in group B2 (all P<0.05); There were no significant difference in the above indexes between A1 and B1 group (all P>0.05). Conclusions:APS can improve the coagulation function of patients undergoing cardiopulmonary bypass and reduce the amount of bleeding and blood products. Its protective effect is more prominent in high-risk cardiovascular surgery with long cardiopulmonary bypass and complex operation.

OBJECTIVE: To investigate the levels of cortisol and inflammatory factors and their influencing factors in patients with occupational noise-induced hearing loss(ONID). METHODS: A total of 106 ONID patients were selected as the ONID group, and 50 healthy participants without noise exposure were selected as the control group by judge sampling method. The levels of salivary cortisol in the two groups were detected by enzyme-linked immunosorbent assay.The serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) in the peripheral blood were detected by electrochemiluminescence assay. Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus in ONID patients. RESULTS: The level of salivary cortisol in the morning and in the nighttime, and cortisol, TNF-α, IL-6 in the serum were higher in the ONID group compared with that in the control group(P<0.05). There was no significant difference in the serum level of CRP between these two groups(P>0.05). Spearman correlation analysis results showed that the level of cortisol in the saliva and in the serum was not correlated with TNF-α and IL-6(P>0.05). Analysis of multiple linear regression showed that the levels of serum cortisol and salivary cortisol in the morning in the ONID patients were positively correlated with noise exposure level(P<0.05). The level of TNF-α in the serum was positively correlated with tinnitus score(P<0.05). CONCLUSION: Hyperactivity of hypothalamus-pituitary-adrenal axis and inflammation activation may exist in patients with ONID. The cortisol can be used as a biomarker for the effect of noise-stress.

OBJECTIVE:To investigate the utilization and trend of bisphosphonates drugs in patients with bone metastasis of breast cancer from Zhejiang province,so as to provide reference for the further promotion of their rational use. METHODS:The utilization of this type of drugs in 11 hospitals of Zhejiang province during 2010-2015 was analyzed statistically,counted and ranked by using the method of cost ranking analysis and DDDs analysis in the respect of amount,DDDs,DDC,etc. RESULTS:The amount of bisphosphonates drugs was increased steadily in 6 years(increasing greatly in 2011),increased by 96.26% in 2015,compared to 2010. Top 3 drugs in the list of amount were Zoledronic acid for injection(imported),Zoledronic acid for injection(domestic)and Pamidronate disodium for injection. Among them,Zoledronic acid for injection(imported)basically showed an upward trend,while Pamidronate disodium for injection showed decline trend. Top 3 drugs in the list of DDDs were Zoledronic acid for injection(domestic),Zoledronic acid for injection(imported)and Pamidronate disodium for injection;DDDs of Zoledronic acid for injection(domestic)and Zoledronic acid for injection(imported)were generally on the rise,while that of Pamidronate disodium for injection showed an overall downward trend. B/A value of bisphosphonates ranged 0.33-2.00,among which B/A value of Zoledronic acid for injection(domestic)was 2.00 and that of Zoledronic acid for injection(imported)was 0.50 during 2012-2015. The first and second drugs in the list of DDC were Clodronate disodium for injection and Zoledronic acid for injection(imported). CONCLUSIONS:The total amount of bisphosphonates drugs in patients with bone metastasis of breast cancer from 11 hospitals of Zhejiang province during 2010-2015 was increased steadily. Some varieties of second and third generation bisphosphonates with definite curative effect,good safety and reasonable price are dominant in clinical use. The selection and use of bisphosphonates is basically reasonable,but price is still the primary factor restricting the further wide application of some varieties.

Objective:To explore the effect of gemcitabine-associated thrombocytopenia on the survival time of patients with ad-vanced non-small cell lung cancer (NSCLC).Methods: The data of patients with advanced non-small cell lung cancer treated with gemcitabine from January to December 2011 were retrospectively collected. According to the lowest platelet (PLT) value of the first treatment of gemcitabine,the patients were divided into two groups,PLT higher than 50 × 109·L-1group(43 cases) and PLT lower than 50 × 109·L-1group(24 cases). The survival time was retrieved by referring to the electronic medical records. The relevant in-dices in the two groups were compared and analyzed by COX multiple factors. Results:A total of 67 patients were enrolled in the stud-y. Except for the pathological type,there were no significant differences in gender,age and chemotherapy cycle between the groups(P>0.05). There was significant difference in the survival time between the groups (P<0.05). The median survival time of the pa-tients with PLT higher than 50 × 109·L-1was significantly longer than that of the patients with PLT less than 50 × 109·L-1. Con-clusion:Compared with the patients with mild thrombocytopenia(I/II),gemcitabine induced severe thrombocytopenia(III/IV) in the patients with advanced non-small cell lung cancer(NSCLC) has effect on the survival time of the patients. Therefore,it is necessary to do a good job in the prevention and treatment of thrombocytopenia.

Objective To investigate the influence of inclusive leadership on organizational performance of nurses and to test the mediating role of empowerment behavior. Methods From November to December 2016, 293 nurses from 2 public hospitals in Harbin were investigated with Inclusive Leadership Scale, Empowerment Behavior Scale and Team Performance Scale. A total of 293 questionnaires were distributed and 251 questionnaires were effectively recovered. Descriptive statistics, Pearson correlation analysis and multiple linear hierarchical regression analysis were performed to analyze and process data. Results The Score of Inclusive Leadership Scale, Empowerment Behavior Scale and Team Performance Scale was (5.28±1.184), (5.25±1.216) and (5.71±1.233) respectively. Inclusive leadership had a positive correlation with empowerment behavior and organizational performance of nurses (r=0.742,0.605;P＜0.05). In addition, there was a positive correlation between empowerment behavior and organizational performance of nursing staff (r=0.615,P＜0.05). Multivariate linear hierarchical regression analysis showed that inclusive leadership had a positive predictive effect on empowerment behavior and organizational performance, and empowerment behavior of nurses partially mediated between them. Conclusions Inclusive leadership can enhance subordinate nurses' high level of empowerment awareness, thereby directly or indirectly improving nursing organization performance.

Objective To explore the effects of inclusive leadership on affective commitment of nurses and to test the mediating effect of leader-member exchange. Methods From November 2016 to December 2016, we investigated 293 nurses from two Class Ⅲ Grade A governmental hospitals of Harbin with the Inclusive Leadership Scale, Leader-member Exchange Scale and Affective Commitment Scale. Pearson correlation analysis and multiple hierarchical linear regression analysis were used to test the correlations and mediating effect among the variables. A total of 293 questionnaires were sent out and 251 valid questionnaires retained finally. Results Among 251 nurses, the scores of inclusive leadership scale, leader-member exchange scale and affective commitment scale were (5.283±1.184), (5.216±1.139) and (4.902±1.061) respectively. Pearson correlation analysis showed that inclusive leadership had positive correlations with the leader-member exchange (r=0.771,P＜ 0.01) and affective commitment (r=0.537,P＜ 0.01);leader-member exchange had a positive correlation with affective commitment (r=0.543,P＜ 0.01). Multiple hierarchical linear regression analysis indicated that inclusive leadership had positive effects on leader-member exchange and affective commitment of nurses;leader-member exchange played a partial mediating role between them. Conclusions As a whole, the inclusiveness of nursing managers on nurses is in the upper level and the leader-member exchange of nurses has a high level. Inclusive leadership has positive correlations with the leader-member exchange and affective commitment of nurses. Nursing managers should lead nurses to contribute their wisdoms with the manner of inclusive leadership so as to provide the high quality of nursing service.

Objective To investigate the influence of inclusive leadership on job embeddedness of nurses and the mediating role of insider status.Methods A total of 293 nurses from two ClassⅢ Grade A public hospitals in Harbin City were recruited by convenience sampling method,and investigated with questionnaire survey from November to December 2016.Inclusive Leadership Scale,Job Embeddedness Scale and Insider Status Scale were used as evaluation tools.Data processing was done by descriptive statistics,Pearson correlation analysis and multiple linear regression analysis.A total of 293 questionnaires were distributed,and 251 valid questionnaires were collected.Results The total scores of Inclusive Leadership Scale,Insider Status Scale and Job Embeddedness Scale of the 251 nurses were (5.28±1.184),(5.57±1.185) and (4.81±1.027) respectively.Pearson correlation analysis showed that inclusive leadership was positively correlated with the insider status and job embeddedness of nurses (P＜ 0.01).At the same time,the insider status was positively correlated with the job embeddedness of nurses (P＜ 0.01).Multiple linear hierarchical regression analysis showed that inclusive leadership had a positive predictive effect on nurses' insider status (β=0.655,P＜0.01) and job embeddedness (β=0.557,P＜0.01).The insider status played a partial mediating role between inclusive leadership and job embeddedness.Conclusions Inclusive leadership can enhance the perception of insider status,thus directly or indirectly improve the job embeddedness level of nursing staff.