Objective To establish a prediction model for the occurrence of non-occupational carbon monoxide poisoning events in Beijing, and to provide scientific basis and theoretical support for the prevention and warning of poisoning events. Methods Based on the monitoring data of non-occupational carbon monoxide poisoning events in Beijing from 2016 to 2024, the seasonal ARIMA model and seasonal index model were established to analyze the data and predict the occurrence of events. Results Between 2016 and 2024, a total of 436 cases of non-occupational carbon monoxide poisoning were reported in Beijing, showing a downward trend. The established SARIMA model and seasonal index model were SARIMA (1,0,0) (1,1,0) 12, Yt = (-0.0339t+5.8863) × St, and the average relative errors were 65.42% and 29.19%, respectively. In terms of months, the SARIMA model had better predictive performance during April and summer (June to August), while the seasonal index model was superior in other months. By combining the two models, the predicted number of events in 2025 was as follows: 3, 2, 2, 3, 1, 5, 2, 7, 1, 1, 1, and 2. Conclusion The seasonal index model has the best prediction effect on the non-occupational carbon monoxide poisoning events in Beijing throughout the year, and the number of summer events predicted by SARIMA model is closer to the actual values. The two models can be combined to predict the trend of non-occupational carbon monoxide poisoning, which provides a scientific basis for the prevention and control of carbon monoxide poisoning in the future.

Objective:To analyze the temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Beijing and provide reference evidence in HFMD prevention and control.Methods:The monthly incidence data of HFMD in Beijing from 2008 to 2023 were collected from Notifiable Disease Management Information System of the Chinese Information System of Disease Control and Prevention, and the epidemiological characteristics of HFMD were analyzed by the methods of time series seasonal decomposition graph, concentration degree, and circular distribution.The WPS office software 2019 was used to clean the data, Python software 3.12 was used to analyze and make statistical charts.Results:The monthly incidence fluctuation of HFMD in Beijing from 2008 to 2015 was higher than that from 2016 to 2022. From 2016 to 2022, the fluctuation range of monthly incidence showed a gradually decreasing trend.From 2008 to 2015, the concentration ( M) was 0.58, indicating a relatively strong seasonality; the mean angle ( α) calculated by the circular distribution method was 174.95°, and the mean angle standard deviation ( s) was 60.43°. The annual incidence peak occurred on June 27, and the incidence peak period was from April 27 to August 27. From 2016 to 2019 and 2023, the M was 0.57, indicating a relatively strong seasonality. The α was 228.05°, and s was 61.44°. The annual incidence peak occurred on August 20, and the incidence peak period was from June 18 to October 21. From 2020 to 2022, the M was 0.42, indicating a seasonality, the α was 238.27° and s was 76.35°. The annual incidence peak occurred on July 15, and the incidence peak period was from June 14 to November 14. The α of 2008-2015, 2016-2019 and 2023, and 2020-2022 were tested by the Watson-Williams method and the difference was statistically significant ( F=33 443.09, P<0.001). In 2023, the M was 0.77, indicating a strong seasonality. The incidence peak occurred on September 16, and the incidence peak period was from August 5 to October 28. Conclusions:The seasonality of HFMD in Beijing was obvious from 2008 to 2023, and the incidence peak day and peak period overall had rearward shifts. It is necessary to strengthen the comprehensive analysis of the distribution characteristics at different dimensions and the comprehensive prevention and control in key areas, places, and populations during the peak incidence period.

Objective:To analyze the clinical characteristics of patients with spontaneous splenorenal shunt (SSRS) in liver cirrhosis, and to compare the effects and prognosis of different treatments.Methods:The data of cirrhotic patients with SSRS at the First Affiliated Hospital of Zhengzhou University between 2016-2022 were retrospectively analyzed.Patients were divided into Group A receiving conservative treatment, Group B by simple embolization, Group C undergoing TIPS combined with embolization, and Group D given liver transplantation. Life status, liver function changes, incidences of adverse events, and survival between groups were compared.Results:SSRS diameter was positively correlated with blood ammonia ( R=0.478) and negatively correlated with portal vein diameter ( R=-0.301). SSRS diameter is a protective factor for gastrointestinal hemorrhage and ascites and a risk factor for hepatic encephalopathy; Blood ammonia decreased and prothrombin time prolonged after treatment in group A ( P<0.05), blood ammonia decreased and albumin increased in group B ( P<0.05). Hemoglobin and bilirubin increased in group C ( P<0.05), blood ammonia and bilirubin decreased and platelets and albumin increased in group D ( P<0.05); Survival analysis showed that the prognosis of groups A and C was related to liver function, and the survival rate of group D was the highest of all ( P<0.05). Conclusions:SSRS embolization is safe and effective, and liver transplantation improves patient survival. Individualized treatment should be selected based on patient symptoms, liver function, and shunt diameter.

Objective:To investigate the efficacy and cognitive function of 3 new antiepileptic drugs Oxcarbazepine (OXC), Lamotrigine (LTG) and Levetiracetam (LEV) in children with self-limited epilepsy with centrotemporal spikes (SeLECTS).Methods:This was a prospective study.A total of 98 children with SeLECTS who were treated in the Second Affiliated Hospital of Xinxiang Medical University from January 2014 to June 2020 were divided into OXC group, LTG group and LEV group according to the applied therapeutic drugs.Video electroencephalograph (EEG), Wechsler Intelligence Scale for Children (WISC) and event-related potentials (ERPs) of the children were collected before treatment and 48 weeks of treatment.Clinical efficacy and impact on cognitive function among the 3 groups were compared.Results:(1)Efficacy: There was no significant difference in the effective rate of seizure reduction after treatment among the 3 groups( χ2=0.808, P=0.668). There was no significant difference in EEG remission rate among the 3 groups( χ2=0.763, P=0.683). (2)Cognitive function: ①Intragroup comparison of WISC findings showed that the full scale score (FIQ) and verbal intelligence quotient (VIQ) were significantly enhanced, and the scores of comprehension, vocabulary, arithmetic, decoding and spelling subtests were more significantly enhanced in OXC group after treatment (all P<0.05). In the LTG group, FIQ, VIQ and operational intelligence quotient (PIQ) were significantly enhanced after treatment (all P<0.05), and the subtest scores of comprehension, vocabulary, arithmetic, mapping and layout were significantly enhanced (all P<0.05). In LEV group, FIQ, VIQ and PIQ were significantly enhanced after treatment (all P<0.05), especially the increase in the VIQ, and the scores of vocabulary, understanding, similarity, arithmetic, decoding and puzzle subtests were significantly enhanced (all P<0.05). Pairwise comparison of WISC findings showed that there were no significant differences in the FIQ, VIQ, PIQ and subtest scores before treatment among the 3 groups (all P>0.05). After treatment, the arithmetic and decoding scores of OXC group were significantly higher than those of LTG group (all P<0.05), which were comparable between OXC group and LEV group (all P>0.05). The PIQ and the scores of mapping and layout in LTG group were significantly higher than those of the other 2 groups (all P<0.05). The LEV group had higher scores in vocabulary, comprehension and spelling than those of the other 2 groups (all P<0.05), which had higher decoding scores than those of the LTG group (all P<0.05). No significant differences were found in decoding scores between LEV and OXC group (all P>0.05). Higher VIQ and FIQ were detected in LEV group than those of the other 2 groups (all P<0.05). ②Intragroup comparison of ERPs showed that the latency of LEV group after treatment was significantly shorter than that before treatment ( P<0.05), and there was no significant difference between the other 2 groups before and after treatment (all P>0.05). Pairwise comparison of ERPs showed that before treatment, there were no significant differences in P300 amplitude and latency among the 3 groups (all P>0.05). After treatment, the latency of LEV group was significantly shorter than that of the other 2 groups ( P<0.05), and there was no significant difference in the amplitude between the 3 groups before and after treatment ( P>0.05). Conclusions:(1)In the treatment of SeLECTS in children, OXC, LTG and LEV have reliable and equivalent effects.(2)OXC, LTG and LEV have protective effects on cognitive function in children with SeLECTS.After treatment, LEV provides the strongest protective effect on FIQ, and the protective effect on VIQ is equivalent to OXC, but better than LTG.LTG is superior in protecting spatial perception and PIQ.

Objective: To understand the exposure to second hand smoking (SHS) and associated factors among middle school students in Beijing, and to provide data support for tobacco control. Methods: The two stage stratified cluster random sampling method were used to select 10 532 students from 370 classes in 48 junior middle schools, 34 senior high schools and 14 vocational high schools in 16 districts of Beijing. The national unified paper questionnaire was used to collect the information. Results: During the past 7 days, 71.5% (95% CI =70.2%-72.7%) of students reported exposure to SHS. The proportion of exposure was highest (60.3%) in outdoor public places, followed by indoor public places (48.9%), at home (34.1%), and public transport (19.1%). About 31.6% of students reported people smoking in the campus in the past 30 days. Risk factors of SHS exposure included one or more parents was smoker( OR =2.62), friends who smoked( OR =2.13), received education on tobacco hazards in school( OR = 0.74 ), and senior high school( OR =0.68-0.73)( P <0.05). Conclusion High exposure to second hand smoking among middle school students in Beijing is common. Implementation of the regulations and the publicity of tobacco hazards and tobacco control in schools should be strengthened. Smoke free household should be advocated, and middle school students, especially junior middle school students, should be protected from the harm of SHS.

ObjectiveTo investigate the P300 evoked by Stroop Color Word Task in children with emotional neglect, and to explore their implication for inhibition control. MethodsA cluster sampling was conducted for the first grade students of a middle school in Sanmenxia City, Henan Province. The students from 3 classes were assessed by standard Raven reasoning test and Child Neglect Scale (CNS), and a total of 147 eligible students were screened out. Children were divided into the emotional neglect group (n=40) and the control group (n=40) according to the 27% before and after the score of CNS emotional neglect factor. Both groups completed the Stroop Color word task, and EEG data were collected to compare the response time, accuracy, amplitude and latency of P300 between the two groups. ResultsThe CNS total score and the scores of safety neglect, communication neglect, physical neglect and emotional neglect factors in the emotional neglect group were significantly higher than those in control group (t=15.003, 4.301, 11.495, 4.803, 23.957, P<0.01). The average reaction time in the incongruent task of emotional neglect group was significantly longer than that in the control group [(879.02±101.52) ms vs. (756.93±113.91) ms, t=5.061, P<0.01]. Under incongruent task, the average amplitude of P300 in emotional neglect group was lower than that of the control group [(3.97±1.12) μV vs. (8.71±1.24) μV, t=-17.976, P<0.01]. The average latency of P300 of emotional neglect group was longer than that of the control group [(361.81±39.69) ms vs. (301.35±33.67) ms, t=7.346, P<0.01]. ConclusionUnder incongruent task, children with emotional neglect had longer response time, longer latency and lower amplitude of P300， which suggested that children with affective neglect may have inhibition and control disorder.

ObjectiveTo explore the effect of flipped classroom mode in the clinical probation teaching for undergraduate mental health students， so as to expand the new mode of clinical teaching in psychiatry department. MethodsA total of 85 undergraduate psychiatric students from Xinxiang Medical University in 2016 were selected. All participants were divided into experimental group （n=43） and control group （n=42） according to the random number table method. The flipped classroom clinical teaching mode was adopted to experimental group， and the traditional practice mode for control group. The probation lasted for 12 weeks. Theoretical knowledge of symptomology， psychiatric clinical skills （OSCE）， doctor-patient communication ability（SEGUE） and clinical thinking ability were assessed at the end of probation. ResultsAfter the probation， students in experimental group obtained higher scores in theoretical knowledge， clinical skills， doctor-patient communication ability and clinical thinking ability compared with control group. The differences were statistically significant ［（33.08±1.72） vs. （32.06±2.33）， （51.61±2.12） vs. （48.32±2.86）， （18.14±1.98） vs. （14.62±2.15）， （91.26±14.13） vs. （82.40±10.89）， t=2.307， 6.034， 3.230， 7.846， P<0.05 or 0.01］. ConclusionApplying the flipped classroom mode into the clinical probation teaching for mental health undergraduate students may help to improve students' theoretical knowledge level and clinical operation ability， faciliate doctor-patient communication， and have a positive impact on their clinical thinking ability.

Objective To systematically evaluate the efficacy and compliance of domestic ketogenic diet(KD) for children with refractory epilepsy (RE),in order to provide the basis for further improving the curative effect and compliance by finding out the factors influencing efficacy and compliance. Methods The effect of KD on children with RE was investigated by systematically searching China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(CSTJ),Wanfang Data Knowledge Service Platform and PubMed database from January 1, 1989 to January 17,2018. The relevant literature R3. 0. 2 software was used to combine the retention rate and therapeu-tic effect in different periods,based on the systematic analysis of the therapeutic efficacy and compliance literature. Results A total of 11 eligible documents were included. (1)The methodological index for non - randomized studies (MINORS)scores of included literature were rated from 10 to 18 points. (2)A secondary analysis of 9 literatures on the description of the subject′s composition showed that the proportion of male to female in children with RE ranged from 1. 441. 00 to 2. 731. 00,and that of 9 literatures included a total of 331 samples,there were 212 male and 119 female,the ratio of male to female was 1. 781. 00. (3)The sources of the included literatures were from Beijing, Shanghai,Changsha,Shenzhen,Nanchang,Zhengzhou,Suzhou,Chongqing,Shenyang and Xi′an. (4)The retention rates of 1 month(5 studies),3 months(10 studies),6 months(7 studies)and 12 months (6 studies)were respectively 93％ [95％ confidence interval (CI):88％ - 98％],80％ (95％ CI:71％ - 98％),70％ (95％ CI:61％ - 78％) and 54％ (95％ CI:37％ - 71％). (5)According to the Meta - analysis,the effective rate of 1 month(6 studies), 3 months(10 studies),6 months(7 studies)and 12 months (7 studies)were respectively 57％ (95％ CI:34％ -79％),68％ (95％ CI:57％ - 79％),76％ (95％ CI:62％ - 89％)and 80％ (95％ CI:68％ - 93％). (6)Through analyzing the adverse reactions and the causes of termination,the literature showed that common adverse reactions in-volved digestive system (72 cases),infection (23 cases),urinary calculus (4 cases),and the metabolic disorder. The reason of treatment termination was that the children were not cooperative (26 cases)and the parents had poor comp-liance (24 cases). Conclusion KD is one of the effective methods for treating RE in children. Reducing or relieving adverse reactions in KD to improve the treatment compliance of children with RE and their families is a subject worthy of further study and attention.

Objective To explore the changes of serum amyloid A (SAA) level and its clinical significance in patients with post-stroke depression (PSD). Methods One hundred and sixty-four patients with acute ischemic stroke, admitted to our hospital from January 2016 to June 2017 were assessed with Hamilton Depression Scale-17 (HAMD-17) to evaluate the depression degrees, and accordingly, they were divided into PSD group (n=57) and non-PSD group (n=107). Healthy volunteers who were examined in the corresponding period were selected as healthy control group (n=50). The SAA level was determined with ELISA in subjects of the 3 groups. Clinical data were collected; single factor analysis and multivariate Logistic regression analysis were performed to select the risk factors of PSD. Results The SAA level in PSD group ([18.85±5.25] mg/L) was significantly higher than that in the non-PSD group ([15.25±5.75] mg/L) and healthy control group ([7.65±4.50] mg/L, P<0.05); that in the non-PSD group was significantly higher than that in the healthy control group (P<0.05). Single factor analysis showed that differences in education level, introversion, economic status, living alone, marital status, National Institutes of Health Stroke Scale (NIHSS) scores≥9 at admission, complications, and proportion of key area infarction (frontal lobe and basal ganglia) had statistical significance between PSD group and non-PSD group (P<0.05). Multivariate Logistic regression analysis showed that introversion, poor economic status, living alone, NIHSS scores≥9, infarction of key areas, and elevation of SAA level (OR=1.545, P=0.035, 95％ CI: 1.257-1.898) were independent risk factors for PSD (P<0.05). Conclusion SAA used as one of the detection biomarkers has great significance in early diagnosis, intervention and clinical prevention for PSD.

Objective To explore the rapid eye movement (REM) sleep characteristics of different episode types of depression and post-stroke depression (PSD) patients and provide support for clinical diagnosis,treatment and prognosis.Methods Patients with single-episode depression (group A,n =22),patients with recurrent depression (≥ 2 episodes,group B,n=26) and patients with PSD (group C,n=19)were included from Henan Provincial Mental Hospital.20 healthy volunteers were assigned to control group.Participants in the 4 groups were performed polysomnographic recordings (PSG) from 9 PM to 6 AM before treatment.The 3 patients groups were performed the second PSG recordings and HAMD score at the end of 6 week SSRIs treatment.The REM indexes of 4 groups were compared and analyzed.Results First PSG detection showed that REM sleep latencies (RL) were shorter in group A and B (A:(65.57±18.29) min,B:(66.32±15.46) min) than that in group C ((79.17±20.18) min) and control group((87.24±16.55)min);REM activity (RA) (A:(99.82±25.71) u,B:(104.70±28.23) u)and REM density (RD) (A:(81.06± 19.35)％,B:(86.61±23.83) ％) were increased more significantly in group A and B than those in control group ((79.61 ± 18.40) u;(68.11 ± 17.54) ％);REM sleep time (RT) were decreased more signifi-cantly in group C ((51.66±22.26) min) than that in group A((71.43±20.70) min),group B((74.81±17.52) min) and control group ((70.46±16.35) min)(P＜0.05).After treatment,REM sleep latency was prolonged in group A ((65.57±18.29) min vs (81.71±21.62) min),and REM activity was decreased in group A((99.82±25.71) u vs (83.58±27.19) u),the difference was statistically significant (P＜0.05).REMdensity was decreased,but the difference was not statistically significant (P＞0.05).There was no significant difference in the indexes of REM in group C;RT was prolonged ((51.66± 22.26) min vs (68.37 ± 20.16)min) in group C,the difference was statistically significant (P＜0.05).Conclusion Most of depression patients with different episode types have REM disinhibition phenomenon.RD increase may be REM characteristic type of depression patient.Sleep disorders of PSD patients are mainly poor sleep process and sleep continuity and have no characteristics of REM sleep disorder of depression ones.