Objective:To explore the impact of social support on cognitive function and depression in patients with mild cognitive impairment (MCI).Methods:From March to September 2018, 5 765 subjects over 60 years old from 52 villages in Yanlou Town, Yanggu County were selected and they were screened by mini-mental state examination (MMSE) and activities of daily living(ADL). Finally 4 750 valid questionnaires were recovered.According to the " Diagnostic and Statistical Manual of Mental Disorders" 4th Edition (DSM-Ⅳ), 733 patients with MCI (patient group) and 3 662 patients with normal cognitive function (healthy control group) were diagnosed.The social support rating scale (SSRS) and geriatric depression scale-15 (GDS-15) were used to evaluate the patients.SPSS 26.0 software was used for independent sample t-test, chi-square test, Pearson correlation analysis and linear regression analysis. Results:The total score of social support (48.55±9.72), objective social support (16.49±4.00), subjective social support (24.28±4.75) and social support utilization (7.78±2.85) in patients group were significantly lower than those in the healthy control group (total score of social support (50.94±7.66), objective social support (17.23±3.42), subjective social support (25.59±3.61) and social support utilization (8.13±2.71)). The differences were statistically significant ( t=-6.291, -4.363, -8.245, -3.068, all P<0.05) .All the dimensions of social support(total score, objective support, subjective support, support utilization) were positively correlated with cognitive function ( r=0.084, 0.062, 0.128, 0.011, all P<0.05), and negatively correlated with depression score ( r=-0.240, -0.195, -0.200, -0.169, all P<0.01). Subjective social support, objective social support and social support utilization could positively predict MMSE score of MCI patients( β=0.190, 0.007, 0.029, all P<0.05), while could negatively predict the GDS-15 score of MCI patients( β=-0.145, -0.098, -0.105, all P<0.05). Conclusion:Good social support is a protective factor for cognitive function and depression in MCI patients.

Objective:To investigate the cognitive status of the elderly in rural areas and explore the characteristics and influencing factors of subjective cognitive decline (SCD).Methods:A baseline survey was conducted among 5 765 rural elderly people aged 60 years old or above from March to September 2018.Subjective cognitive decline questionnaire(SCD-Q9), mini-mental state examination(MMSE), verbal fluency test (VFT), Chinese auditory verbal learning test (CAVLT), digital span test(DST)and activities of daily living(ADL)were used in the survey.The result of the survey indicated that there were 2 654 subjects with SCD (SCD group) and 1 008 subjects with normal cognitive function (NC group). Social support rating scale (SSRS) and short version of geriatric depression scale-15(GDS-15) were used to evaluate their psychosocial status.Descriptive analysis and Logistic regression analysis were conducted by SPSS 26.0 software.Results:(1) Compared with NC group, the SCD group had the following characteristics: delayed recognition rate(8.25 ±2.51), (12.38 ±2.53), reverse digit span (2.63±1.37), (3.69±1.45), social support (69.81±8.71), (64.40±9.44), GDS-15 (2.27±2.63), (1.31±2.17), and the differences were statistically significant (all P<0.05). However, there were no significant differences in the following characteristics: MMSE score (21.62±5.73), (21.47±5.84), speech fluency (27.80±7.35), (28.25±7.56), ADL score (20.70±1.35), (20.77±1.30), all P>0.05.(2) There were no significant differences in diet structure, blood glucose, blood lipid, cerebrovascular disease, diabetes, epilepsy and coronary heart disease between SCD group and NC group (all P>0.05). (3)SCD was mainly affected by age( β=0.06, OR=2.29, 95% CI=1.09-4.85), depression( β=-0.01, OR=2.96, 95% CI=0.68-4.94), hypertension( β=-0.17, OR=1.89, 95% CI=1.11-2.15), and low level of social support( β=2.07, OR=1.49, 95% CI=1.32-2.12) (all P<0.05). Conclusion:The scores of delayed recognition and reverse digit span in patients with SCD are lower than those with normal cognitive function.The other objective cognitive functions are basically normal.Old age, low social support level, depression, low education level and hypertension are the risk factors of SCD.

Objective:To establish a nomogram prediction model for the risk of postoperative delirium in elderly patients with chronic subdural hematoma.Methods:A total of 450 elderly patients with chronic subdural hematoma who were admitted into Shengjing Hospital of China Medical University from January 2017 to January 2020 were selected as the research objects. The patients were divided into the delirium group ( n=135) and the non-delirium group ( n=315) according to whether they had delirium. The indexes of patients in two groups were compared and analyzed. Univariate analysis and multivariate Logistic regression analysis were used to investigate the independent risk factors for postoperative delirium in elderly patients with chronic subdural hematoma, and a prediction model for the risk of delirium was establish based on independent risk factors. ROC curve and calibration curve were used to evaluate the discriminant ability and predictive effectiveness of the model. Results:In 450 elderly patients with chronic subdural hematoma after surgery, 135 cases of delirium occurred postoperatively, and the incidence of delirium was 30.0%. Univariate analysis showed that there were statistically significant differences in delirium incidence among patients with different ages, alcoholism history, Markwalder grade and postoperative pain grade (χ 2=23.069, 27.325, 36.081, 44.834; P<0.05) . Logistic regression analysis showed that advanced age, preoperative Markwalder grade Ⅳ, history of alcoholism and severe postoperative pain were independent risk factors for postoperative delirium ( P<0.05) . A nomogram prediction model for postoperative delirium risk in elderly patients with chronic subdural hematoma was established based on independent risk factors. The Bootstrap internal verification method proved that the prediction accuracy of the model was good ( C- index was 0.904) , and the area under the ROC curve calculated by the Nomogram model was 0.904. Conclusions:The delirium risk nomogram prediction model constructed in this study has good accuracy, discrimination and good predictive ability. It can improve the screening efficiency for elderly patients with chronic subdural hematoma who are at high risk of developing delirium after surgery.

Objective:To investigate the positive rates of 2019-nCoV nucleic acid in different specimens from confirmed COVID-19 cases during hospitalization and after discharge.Methods:Patients with confirmed COVID-19 were enrolled from designated hospitals. Nasal swabs, throat swabs, and specimens of stool, urine and blood were collected during hospitalization. After the patients were discharged, nasal swabs, throat swabs and stool specimens were collected during follow-up. Real-time RT-PCR was used to detect 2019-nCoV nucleic acid.Results:This study involved 25 confirmed COVID-19 cases. During hospitalization, all patients tested positive in both nasal and throat swab 2019-nCoV nucleic acid tests, and nine of them (36.00%) were positive in stool specimen test. Urine and blood specimen test results were all negative. Nasal swabs, throat swabs and stool specimens were collected from each patient 7 d and 14 d after discharge. Two patients (8.00%) tested positive for 2019-nCoV nucleic acid again in nasal and throat swab tests on 7 d, while all stool specimen tests were negative. No 2019-nCoV nucleic acid was detected in nasal swabs, throat swabs or stool samples on 14 d.Conclusions:2019-nCoV nucleic acid was detected in stool samples of confirmed COVID-19 cases during hospitalization. Nasal and throat swab nucleic acid tests turned positive again in some patients after discharge.

Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.

Objective To investigate the low hemoglobin density (low haemoglobin density,LHD) and red blood cell volume distribution width (red blood cell volume distribution width,RDW) in iron deficiency anemia (iron-deficiency anemia,IDA)in children with the value of diagnosis and treatment.Methods From February 2016 to May 2017,in the Second People's Hospital of Longgang District in Shenzhen City,86 cases of children with iron deficiency anemia for IDA group,and 120 cases of healthy children (as the control group) at the same time were confirmed.Blood routine of children with IDA were detected before and after treatment hemoglobin concentration and the results were analyzed statistically.Results 120 cases of healthy children in the peripheral blood LHD value was 2.74 ％ ± 0.90 ％ and the boy was 3.07 ％ ± 0.81％,higher than that of 2.26 ％ ± 0.69 ％ of the girls.Between them,there was statistically significant difference (t=3.815,P＜0.05).The value of RDW was 12.37 ％ ± 2.84 ％,12.09 ％ ± 2.80 ％ for the boys and 12.56 ％ ± 2.87 ％ for the girls,there was no statistically significant difference between the them (t=0.517,P＞0.517).Before treatment,86 cases of children with IDA LHD and RDW values in peripheral blood were 30.67 ％ ± 20.12 ％ and 16.62 ％ ± 3.27 ％,significantly higher than the control group,the difference was statistically significant between (t=4.025 ～ 4.025,P＜0.05 ～ 0.01),and there was no statistically significant difference between male and female children (t =0.761 ～ 0.917,P＞ 0.05).After treatment L HD and RDW values were 10.65 ％ ± 8.92 ％ and 14.02 ％ ± 2.93 ％,significantlylower than before the treatment,between them was statistically significant difference (t=2.912～9.675,P＜0.05).Conclusion Children with iron deficiency anemia treatment before the LHD and RDW values significantly elevated in the blood,significantly decreased after treatment,the LHD and RDW values for diagnosis and treatment of children with iron deficiency anemia dynamic monitoring has certain application value,worthy of popularization and application.

OBJECTIVE:To provide reference for clinical rational use of curcumae rhizoma. METHODS:According to litera-ture retrieval,the chemical structures,ingredient and efficacy difference of curcumae rhizoma with different sources and difference processed products were summed up. According to literature retrieval,telephone consultation and network retrieval,the production status of products with different sources and difference processing and the application in clinic and preparations in Jiangsu province were analyzed. RESULTS:The volatile oil content was the highest in Curcuma wenyujin;curcumin content was the highest in Cur-cuma phaeocaulis;the contents of 4 main active ingredients(curdione,curcumol,germacrone and curcumin)were relatively lower in Curcuma kwangsiensis,and there were quite different ingredients in the C. kwangsiensis from different producing areas. Results of investigating the annual output of medicinal materials in Sichuan,Guangxi and Zhejiang in 2016 showed,the annual output of C. kwangsiensis was the highest,and C. wenyujin and C. phaeocaulis were relatively lower. In the investigated 14 manufacturers producing curcumae rhizoma oil in China,12 took C. wenyujin and 2 took C. phaeocaulis as raw material. While the 9 manufactur-ers in Jiangxi province mostly took C. wenyujin(locally produced)as raw material,which was not from the genuine producing ar-ea-Zhejiang province. In the 10 third-grade class-A TCM hospitals and 20 retail TCM pharmacies in Jiangsu province,the C. phaeo-caulis and C. kwangsiensis were mainly used,in which,the use proportion of C. kwangsiensis accounted for about 70%,and C. wenyujin used little in clinic. The main processed product in clinic was curcumae rhizoma processed by vinegar,and crude product was rarely used. CONCLUSIONS:Currently,the clinical use of curcumae rhizoma shows problems in narrow selection of pro-cessed products and uneven quality,which can be solved by cultivating fine varieties in producing areas,increasing the planting amount of C. phaeocaulis,drug regulatory authorities'strict rules for processed products of curcumae rhizoma in hospitals and re-tail pharmacies.

Objective To analyze the urine trace albumin(mALb)/creatinine(Cr) ratio and blood uric acid(UA),and other various metabolic index level in patients with diabetic nephropathy(DN),combined with clinical data such as patients' age,body mass index(BMI),course of diseases,to explore the related mechanism of occurrence and development of DN.Methods 76 DN patients were selected.The microalbuminuria group(urinary mALb/Cr<300μg/mg) had 46 cases,the clinical albuminuria group(urinary mALb/Cr≥300μg/mg) included 30 cases,another 49 diabetic patients without kidney damage were seleted as control group.The urinary mALb/Cr,blood UA,fasting blood glucose(FBG),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein(HDL),low density lipoprotein(LDL),glycosylated hemoglobin(HbA1c) levels were determined.The BMI and the length of the course of the disease calculate.Results The patients' age,course of the disease,urinary mALb/Cr,blood UA,FBG,TC,TG,LDL,HbA1c and BMI level in the clinical albuminuria group and microalbuminuria group were significantly higher than those in the control group,the differences were statistically significant (F=6.18,12.48,141.43,12.48,8.49,4.98,6.18,3.89,3.17,3.89,all P<0.05).The high uric acid hematic disease rates of the clinical albuminuria group and microalbuminuria group were 26.09% and 26.09%,which were significantly higher than 10.20% of the control group,the differences were statistically significant(x2=4.074,24.833,all P<0.05).Urinary mALb/Cr was positively correlated with age,duration,BMI,UA,TG,TC,LDL,FBG,HbA1c(r=0.120,0.299,0.148,0.340,0.157,0.149,0.103,0.487,0.103).Multiple linear stepwise regression analysis suggested that duration,blood UA,FBG were independent risk factors of urinary mALb/Cr;TG,BMI,urinary mALb/Cr were independent risk factors for blood UA.Conclusion Urinary mALb/Cr and blood UA are the independent risk factors,high uric acid hematic disease may participate in the development process of DN,and diabetes duration,UA,BMI,TG,TC,LDL,FBG,HbA1C associated with increased urinary mALb/Cr excretory DN patients,the effective monitoring can improve the symptoms of DN and quality of life.

Objective To study the morphological changes of external eyes before and after epicanthoplasty combined with blepharoplasty and to explore a simple and efficient method to correct epicanthus. Methods A total of 120 eyes in 60 patients were operated on with the inverted L-sharp epicanthoplasty combined with double-eyelid blepharoplasty and the follow-up began 2 months after the surgery. The height and physiognomic length of the eyelid and the length and angle of the eyelash were measured and compared with preoperative meansurements, as well as the distance of the inner canthus. The ratios between the inner-canthus distance and the physiognomic eyelid breadth and the diameter of eyebrow and eye were also described. Results The contours of the eyelid fissure and the double-eyelid were natural and the surgical scare was seen unconspicuous 3 months after the operation. Changes in the palpebral fissure , the angel and length of the exposed eyelash were all significantly different by paired-sample t test (P < 0.01). The vertical and horizontal lines through the entocanthion and the vertical line through the gnomic ectocanthion combined with the horizontal line through the brow ridge formed a square structure. Conclusions This inverted L-shape epicanthoplasty combined with blepharoplasty may be effective in reconstructing the contours of the entocanthions as well as the shape of the double eyelids. It can also achieve better cosmetic effects in the proportional relation between the eyes and eyebrows. Therefore, it deserves clinical promotion.

Objective To explore current situation of hospital outpatient injection room infection and to discusse relevant countermeasures of infection control .Methods A retrospective analysis was conducted in 245 patients admitted and got infected in our hospital outpatient department injection room from October 2012‐to October 2013 .By analyzing its infection type ,treatment time ,age ,etc .,and in winter and items ,air ,medical staff hand in spring and summer and fall of hospital respectively we understand the hospital infection and the seasonal relationship ,the related factors of hospital infection ,and develop targeted and effective inter‐vention measures .Results The outpatient injection room infection were mainly occurred in respiratory system and digestive sys‐tem ,the occurrence rates were 54 .29% (133/245) ,25 .31% (62/245) ,respectively .The infection rate of treatment time> 7 d (2 .74% ) apparently higher than < 7 d (1 .09% ) (χ2 = 56 .246 ,P= 0 .000) .The infection rate of people whose age over 40 (1 .91% )apparently higher than age < 40 (1 .13% ) (χ2 = 12 .316 ,P= 0 .000) .The qualified rate of atmosphere in Winter and Spring (68 .46% ) was significantly lower than summer and autumn (89 .23% ) (P<0 .05) ,the qualified rates of surfaces and hands of medical staffs (84 .62% ,82 .31% ) were significantly higher than summer and autumn(63 .08% ,66 .15% ) .Conclusion The out‐patient injection room infections were related to a variety of factors ,we could carry on the comprehensive analysis and formulate specific interventions to reduce hospital infection .