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Objective@#To analyze the current status and equity of mental health resources allocation in Shanghai Municipality, so as to provide data supports to formulate mental health action plans and relevant policies. .@*Methods@#The data pertaining to mental health institutions, actual beds opened, certified or assistant psychiatrists and registered nurses was collected from the Survey of the Current Status on Mental Health Resources in Shanghai Municipality in 2020. The equity of mental health resources allocated by population and geographical area in Shanghai Municipality was evaluated with Lorenz curve and Gini coefficient@*Results@#There were 96 mental health institutions, 15 060 actual beds opened, 257 certified or assistant psychiatrists and 2 887 registered nurses in Shanghai Municipality in 2020, with a physician-to-nurse ratio of 1∶2.30. The greatest numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents and per km2 were all found the central urban areas. The numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents were 6.06 beds, 0.51 physicians and 1.16 nurses, with Gini coefficients of 0.36, 0.42 and 0.44, respectively, and the numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per km2 were 2.38 beds, 0.20 physicians and 0.46 nurses, with Gini coefficients of 0.72, 0.76 and 0.75, respectively. @*Conclusions@#There was a gross equity in mental health resources allocated by population and geographical area in Shanghai Municipality in 2020, which showed an improvement as compared to 2015. The equity in mental health resources allocated by geographical area was lower than that by population in Shanghai Municipality.
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Sixty-four healthy Wistar rats(18 days old),weighting 30 ～ 40 g,were randomly divided into two groups:control group and lipopolysaccharide(LPS) group. LPS group was intraperitoneally injected with 5 mg/ kg LPS to prepare rat sepsis model. The control group received intraperitoneal injection of saline of equal volume. All surving animals were anesthetized at the set time 2 h,4 h,6 h and 12 h after administration(8 rats at each time point),and craniotomy after taking blood from the heart. Myelin injury was staining by luxol fast blue. Immunohistochemical staining and Western blot were used to detect the expression of myelin basic protein(MBP) in rat brain at different time points. The expression of the MBP protein in serum detected by enzyme-linked immunosorbent assay( ELISA). Results Observed under light microscope after luxol fast blue staining,the myelin sheath of the white matter in the brain was disordered,sparse and stained lightly from 6 to 12 hours in LPS group. Western blot analysis and immunohistochemical test results showed that the expression of MBP protein in the LPS group was decreased compared with the control group at 2 h,4 h and 6 h after LPS administration ( P < 0. 05). The expression of MBP protein in LPS group at 12 h was not significantly different from that in the control group(P > 0. 05). The serum ELISA results showed that the serum MBP levels in the LPS group increased at 2 h,4 h,6 h and 12 h after LPS administration(P < 0. 05). Conclusion In rat sepsis model,MBP protein expression in the white matter decreases,serum MBP protein content increases,and the decreasing of MBP protein expression is associated with matter myelin injury.
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OBJECTIVE To investigate the relationship between the distribution of eosinophils(Eos) of nasal secretion and serum specific IgE(sIgE) titer in patients with allergic rhinitis, and to evaluate the diagnostic value of Eos in nasal secretion for allergic rhinitis. METHODS A total of 60 allergic rhinitis patients from Department of Otolaryngology, Beijing Shunyi Hospital of Traditional Chinese Medicine during Jan.2016 to June 2017 were selected as treatment group, and another 60 cases of non-allergic rhinitis and 30 normal persons in the corresponding time period were chosen as control group. Eos in nasal secretions and serum sIgE were measured in all the subjects and the relationship between Eos distribution and serum sIgE level was analyzed. RESULTS The Eos distribution and serum level of sIgE was consistent(κ=0.264, P=0.000) and statistical significance was found. The area of ROC of the Eos in nasal secretion was 0.881, the standard deviation was 0.025 and 95％ confidence interval was 0.841 to 0.924. The Udden index of ROC reached the maximum when the Eos in nasal secretion smear was graded as level 3, the sensitivity was 88.5％ and specificity was 99.4％. CONCLUSION Eos cytological examination of nasal secretions has some auxiliary value in the diagnosis of allergic rhinitis. It is a cheap, simple and rapid method, which can be used as an effective reference index for diagnosing allergic rhinitis in primary hospital.
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Objective To explore the clinical characteristics and the levels of interleukin-17 (IL-17) in Mycoplasma pneumoniae (MP) pneumonia patients with atopic sensitization.Methods One hundred and sixty-two patients with MP pneumonia were hospitalized at the Department of Pediatrics,Tianjin Nankai Hospital from October 2015 to December 2016.All children with MP pneumonia were evaluated and divided into 2 groups:the atopic group (atopic MP pneumonia children,n =50) and the non-atopic group (non-atopic MP pneumonia children,n =112).Furthermore,30 healthy children were also included in this study as healthy control group at the Department of Pediatrics,Tianjin Nankai Hospital at the same time.The clinical characteristics and laboratory data of MP pneumonia patients of 2 groups were recorded and analyzed.The levels of serum IL-17 of MP pneumonia patients were measured by using enzyme-linked immunosorbent assays.Results Children with atopic MP pneumonia had more severe pneumonia.At the same time,the number of cases of oxygen therapy and glucocorticoid treatment,the duration of glucocorticoid treatment and the history of previous asthma in the atopic group were higher than those in the non-atopic group,and there was statistical difference between 2 groups(all P ＜ 0.05).The level of serum total immunoglobulin E in the atopic group [230.5 (120.8,421.5) IU/mL] was higher than that in the non-atopic group [79.9 (46.1,125.3) IU/mL],and the level of serum lactate dehydrogenase(LDH) in the atopic group [(319.3 ± 118.9) IU/L] was higher than that in the non-atopic group [(255.5 ± 66.6) IU/L],and there were statistical differences between 2 groups (all P ＜0.01).The levels of serum IL-17 in the healthy control group,atopic group and non-atopic group were (60.2 ± 15.7) ng/L,(382.2 ± 181.7) ng/L and(532.3 ± 169.1) ng/L,respectively,and there were statistical differences among the 3 groups (F =105.668,P =0.000).Whereas,the level of serum IL-17 in the atopic group was lower than that in the non-atopic group,there was statistical difference between 2 groups (t =-3.861,P ＜ 0.01).Conclusion Atopy mav cause adverse effects on the childhood MP pneumonia.It was likely to be relevant to low levels of IL-17.
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Objective To explore the effect of 20°trendelenburg position on hemodynamics during induction of general anesthesia of patients under gastrectomy.Methods One hundred and eighteen patients (77 males and 41 females,aged 50-60 years,ASA physical status Ⅰ or Ⅱ),scheduled for elective radical gastrectomy,were randomly divided into group A (n=40),group B (n=38) and group C (n=40).In group A,patients were placed in the supine position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In group B,patients were placed in the supine position during induction of anesthesia and was placed in the 20°trendelenburg position when hypotension occurred,and vasopressor would be administered if blood pressure was not restored.In group C,patients were placed in the 20°trendelenburg position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In all groups Lactated Ringer′s was infused at 15 ml·kg-1·h-1in 30 min before induction.Anesthesia was induced with propofol 2 mg/kg,sufentanil 0.5 μg/kg,rocuronium 0.9 mg/kg.The occurrence of hypotension and the total amounts of drug administrations were doccumented.Results Nineteen patients (47.5%) in group A,fourteen patients (36.8%) in group B and six patients (15.0%) in group C developed hypotention.The incidence of hypotension in group A and B was significantly higher than that in group C (P<0.05).In all groups the total dosage of ephedrine was used.Phenylephine was only used in the group A at a dose of 26.5±0.14 μg.The amounts of drug administrations in group B and C were significantly lower than that in group A (P<0.05).Two patients in group A went into a refractory hypotensive state.However,no patients in all groups fell into a serious arrhythmia state,so atropine was not used.Conclusion The 20°trendelenburg position during induction of general anesthesia of patients during gastrectomy can prevent hypotension during induction.This position is effective in the management of hypotension after the induction of general anesthesia and can decrease the amounts of drug administrations during induction of general anesthesia.
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Objective To identify the relationship among serum 25-hydroxyvitamin D[25(OH)D] level, chronic inflammation state and malnutrition in maintenance hemodialysis (MHD) patients. Methods The serum 25 (OH)D level of 119 patients on MHD was detected. All the patients were divided into three groups according to the serum 25(OH)D level. Vitamin D deficiency: 25(OH)D ≤ 15 ng/mL, vitamin D insufficiency: 15 ng/mL 30 ng/mL. Inflammatory factor and nutritive index were compared among the three groups. Result The average of serum 25 (OH)D level was 3.4~45.3 ng/mL (22.5~14.8 ng/mL), and the prevalence of 25 (OH)D deficiency and insufficiency was 88.2%. Significant differences existed in age, inflammatory factor (IL-6, TNF-α, CRP) and nutritive index (Alb, PA, SGA) between 25(OH)D deficiency, insufficiency groups and normal group (P<0.05). Conclusion The serum 25(OH)D level is possibly related to the malnutrition in MHD patients. It may inhibit chronic inflammation state , in which it can promote state of nutrition of MHD patients.
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Objective To investigate the effect of vascular inner diameter and artery flow velocity on the flow of internal arteriovenous fistula. Methods Sixty-two patients received the operation of internal fistula were enrolled. According to the inner diameter (Group A: d ≤ 1.5 mm, Group B: 1.5 mm 3.0 mm), the patients were divided into four groups in terms of artery flow velocity (Group a: v ≤ 20 cm/s, Group b:20 cm/s 100 cm/s), the differences of fistula and dialysis flow for two months were analyzed among various groups. Results Compared with Group B/b, patients in Group A/a had higher risk of operation failure, with lowered inner fistula flow and dialysis flow. In terms of inner venous diameter , there were significant differences between Group B and C. Conclusions It is not recommended to carry out the inner vascular fistula operation. Followed with the thickening and increasing of inner artery diameter and artery flow , the inner fistula flow and the dialysis flow increase. The inner venous diameter has no significant impact on the inner fistula flow.
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Objective To observe the clinical efficacy and adverse reaction of Chuanxiongqingnaokeli for children with migraine. Methods One hundred children patients with migraine were randomly divided into treatment group( n = 50 ) and control group( n = 50 ). Patients in treatment group were given Chuanxiongqingnaokeli,10 g/once,and three times one day,while in control group were given Flunarizine Hydrochloride Capsules,2. 5 mg/once,and who's body mass ﹥50 kg with 5. 0 mg/once,and one times each night. Three months as one course of treatment,and compared the efficacy of two groups after tree course of treatment. Results The hemodynamics of two groups all decreased after treatment compared with before treatment,but ACA,MCA,PCABA and VA in treatment group(( 81. 10 ± 11. 95 ),( 93. 3 ± 14. 16 ),( 70. 2 ± 11. 57),(70. 6 ± 13. 02),(65. 5 ± 12. 6)cm/s respectively)decreased more significantly than that of control group(( 104. 2 ± 12. 63 ),( 116. 2 ± 15. 82 ),( 93. 5 ± 11. 91 ),( 93. 5 ± 12. 71 ),87. 4 ± 12. 92 ) cm/s respectively),and the differences were significant( P﹤0. 05). The headache frequency and duration in treatment group were(1. 0 ± 0. 6)and(3. 3 ± 1. 0),less than that of control group((2. 3 ± 0. 9)and(5. 6 ± 1. 7);t= -3. 345,-3. 269;P﹤0. 05). The total effective rate in treatment group was 90. 0%(45/50),higher than that of control group(74. 0%(37/50);χ2 =4. 336,P﹤0. 05). There was no severe adverse reaction in both two groups. Conclusion The Chuanxiongqingnaokeli is safe and effective for treatment of children with migraine.
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Objective To explore the diffusion-weighted magnetic resonance imaging (DWI) and apparent dispersion coefficient(ADC) value in cerebral infarction diagnosis and judgment of cerebral infarction outcome and staging of the value.Methods According to different stages,26 patients were divided into 3 phases,phase Ⅰ (6 ～72 h) had 11 cases,phase Ⅱ (4 ～ 10 d) had 12 cases,phase Ⅲ (10 d later) had 9 cases,of which 3 cases were reviewed,3 cases were recurrence of cerebral infarction.Each patient's MRI included T1 weighted imaging,T2 weighted imaging,DWI and ADC sequence scan image reconstruction,the ADC map obtained one regions of interest (ROI),and the mean ADC value of ROI were calculated,the average ADC value of the corresponding contralateral area were also calculated by the same method,and then the mean relative ADC value were calculated.Results DWI image of all cases showed high signal,11 cases showed high signal and 1 case showed low signal in phase Ⅱ.In phase Ⅲ,1 case showed normal signal and 1 case showed high signal,2 cases showed mixed signal,1 case were reduced,and the rest were all low signal.Compared with the contralateral corresponding region,the average ADC values were reduced in phase Ⅰ.The infarction average ADC values were 0.434 × 10 3mm2/s,0.653 × 10-3mm2/s,1.600 × 10-3mm2/s in phase Ⅰ,Ⅱ,Ⅲ respectively,and the average ADC values of contralateral corresponding region were 0.938 × 10-3 mm2/s,0.814 × 10-3 mm2/s,0.757 × 10-3 mm2/s respectively; the mean relative ADC values were (51.5 ±16.8)％,(79.2 ±30.0)％,(210.9 ±45.1)％ in phase Ⅰ,Ⅱ,Ⅲ respectively (P ＜ 0.05).Conclusion ADC value of cerebral lesions area and relative ADC value of the variation in time provides an objective basis for the diagnosis of DWI,contributes to timely and accurately determine the age of cerebral lesions and pathophysiology of the changes.
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Objective To observe the expressions of interferon gamma (IFN-γ) and IFN-γ-inducible protein 10 (IP-10) at different stages of chronic hepatitis B virus (HBV) infection,and to investigate the relationship between IP-10 with hepatic inflammation activity and hepatitis aggravation.Methods Fifteen chronic hepatitis B (CHB) patients,15 asymptomatic HBV carriers (AsC) and 15 chronic severe hepatitis B (CSHB) patients were enrolled in the study from January 2010 to December 2011 in the Third Hospital of Hebei Medical University.The liver samples were collected by percutaneous needle biopsy or from liver transplantation.The IFN-γ and IP-10 mRNA expressions were measured by quantitative real-time polymerase chain reaction (PCR).Localization and hemi-quantitative analysis of IFN-γand IP-10 proteins were performed by immunohistochemistry staining.Concentrations of serum IFN-γ and IP-10 were quantified by enzyme linked immunosorbent assay (ELISA).HBV markers and liver function were also evaluated for each patient.Results Serum IFN-y and IP-10 concentrations increased significantly in CHB [(415.27±145.52) ng/L and (6.98± 1.12) ng/L,respectively] and CSHB [(658.33 ± 213.52) ng/L and (10.78 ± 1.19) ng/L,respectively] patients compared with AsC [(142.09 ± 47.64) ng/L and (2.4 7 ± 0.60) ng/L,respectively] patients,and were highest in CSHB patients (F=43.48,256.98 ;both P＜0.05).Meanwhile,intrahepatic IFN-γ and IP-10 mRNA and protein expressions paralleled with IFN-γ and IP-10 concentrations in the serum,which was highest in CSHB patients,followed by CHB and AsC patients (F＝693.85,210.21,433.05,214.46; all P＜0.05).Furthermore,Spearman linear correlation analysis showed that serum IP-10 level was positively correlated with both hepatic inflammation activity and serum IFN-γ concentration in CHB and CSHB patients (r =0.76 and r 0.77,respectively;both P ＜ 0.05).Conclusions IP-10,one important immunologic marker of regulating anti HBV activation,indicates progression from immune tolerance phase to immune clearance phase.Furthermore,it may affect the degree of inflammation and hepatitis aggravation.
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Objective To compare the noxious stimulations induced by insertion of Proseai laryngeal mask airway(PLMA)and classic laryngeal mask airway(CLMA)in children.Methods Forty-seven ASA Ⅰ or Ⅱ children,aged 3-12 yr and undergoing surgery under general anesthesia,were randomly divided into 2 groups:PLMA group(group P,n =23)and CLMA group(group C,n =24).General anesthesia was induced with target-controlled infusion(TCI)of propofol.When the effect-site concentration of propofol was equal to the plasma concentration predetermined.PLMA or CLMA insertion was attempted.The target plasma concentration of propofol was predetermined according to Dixon's up-down method,with 0.2 μg/ml as a step size.The initial target plasma concentration of propofol was 6 μg/ml and 4.4 μg/ml for groups P and C,respectively.The preedetermined target plasma concentration of propofol and the satisfaction of insertion conditions for each child were recorded.Results The 50％ effective concentration(EC50)of propofol to achieve satisfied condition of PLMA and CLMA insertion were 5.87(95％ CI,5.62-6.11)and 4.53(95％ C1,4.38-4.69)μg/nl,respectively,and the difference was significant(P ＜ 0.01).Conclusion The noxious stimulation induced by insertion of PLMA in children aged 3-12 years is stronger than that of CLMA.
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Objective To summarize the clinical features and etiology of cerebral infarction in children.Methods The clinical data of 47 children with cerebral infarction who were hospitalized in Shengjing Hospital of China Medical University from Jan 2009 to Jul 2011 were analyzed retrospectively.Results There were 30 boys and 17 girls in all the 47 children.The median age of onset was 3.1 years(ranged from 2 months to 11 years old).Among 47 cases,the common neurological manifestations included limb paralysis in 32 cases(68.1％ ),central facial paralysis in 15 cases(31.9％ ),convulsion in 12 cases(25.5％ ),disturbance of consciousness in 10 cases(21.3％ ),and language disorders in 10 cases(21.3％ ).Among 47 cases,31 cases had basal ganglia infarction with neuronal imaging( CT or MRI),of whom 4 cases accompanied with other location infarction.Several lobes of infarction in 5 cases,hemispheric infarction in 3 cases,parietal infarction in 2 cases,frontal lobe infarction in 2 cases,temporal lobe infarction in 2 cases,and thalamic infarction in 2 cases.Nineteen cases were carried out blood vessel imageology examination,11 cases showed abnormality,the most common affected cerebral blood vessel were middle cerebral artery(5 cases).The common causes of 47 cases were trauma ( 19 cases,40.4％ ),infection( 12 cases,25.5％ ) and moyamoya disease (5 cases,10.6％ ).Ten children (21.3％) had no identifiable cause.Conclusion The common period of cerebral infarction is in infancy.The most frequent neurological symptom is hemiplegia.The most common region of infarction is in basal ganglia with neuronal imaging.The common causes of cerebral infarction are trauma,infection and moyamoya disease.
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Objective To investigate the effect of ERK in apoptosis of neuron induced by endotoxemia,provide the theory basis for the early intervention. Methods Wistar rats aged 10 day were randomly divided into two groups:LPS group and NS group. Neuron apoptosis at 6、12、72 h after abdomen injection were detected by TUNEL method, the expressions of ERK were measured by immunohistochemial method.Results ( 1 ) apoptosis cell appeared at 6 hour in LPS group, but the apoptosis index showed no difference from NS group( P ＞ 0. 05 ). The apoptosis cell obvious increased at 12 hour, peaked at 72 hour( P ＜ 0. 05 ,P ＜0. 01 ). (2) As compared with NS group, the expression of ERK increased at 6 h ( P ＜ 0. 01 ), obviously decreased at 12 h(P ＜0. 01 ) ,and reversed to the level of NS group at 72 h(P ＞0. 05). Conclusion LPS can induce the neuron apoptosis in young rats, the ERK is activated and could play role in apoptosis.
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Objective To investigate the prenatal emotional disorder of the primipame and the related factors,and to analyze its influence on the delivery mode.Methods In the prospective cohort study,590 healthy primiparase were asked to complete a self-compiled questionnaires for their general social mental state,state-trait anxiety inventory(STAI)and self-rating depression scale(SDS).Results Questionnaires of 159 patients were selected and these patients were divided into the anxiety group(114 cases)and the control group(455 cases),the depression group(159 cases)and the control group(410 cases).The ratio of selective cesarean section in the anxiety group was significantly higher(45.61%,32.53%,X2=6.85,P＜0.01),while the successful trial of labor were less than that of the control group(19.35%,47.88%,X2=26.30,P＜0.01).The ratio of selective cesarean section in the depression group was significandy higher than that of the control group(46.54%,31.95%,X2=10.21,P＜0.01),while the successful trial of labor were less than that of the control group(31.76%.46.59%,X2=9.13,P＜0.01).Single-factor analysis showed that prenatal anxiety related to the following factors:fear of childbirth,worried about their children,knowledge for childbirth,high economic status,maternal age and their own economic situation.Conclusions Higher incidence and risk factors of anxiety or depression before delivery,such as advanced delivery age,bad economic condition,weak family support,worrying about the safety of babies and themselves,are found in our study.Prenatal emotional disorder would affect the quality of labor and delivery options,and lead the high risk of cesarean section.
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Objective To investigate the immunoreactivity of platelet-derived growth factor-A (PDGF-A) and its receptor at human and mouse neuromuscular junctions and to explore their regulatory effects on neuromuscular junctions. Methods Specific polyclonal antibodies were used to detect PDGF-A and PDGF a-receptor expression. Double immunohistochemistry for platelet-derived growth factor and the acetylcholine receptor was performed on normal human muscle biopsy specimens. Double fluorescence labeling was applied to detect immunoreactivity for PDGF-A, its receptor and acetylcholine receptors. Results PDGF-A and its receptor was closely co-localized with acetylcholine receptors at human and mouse neuromuscular junctions. Conclusion PDGF-A and its receptor concentrated at human and mouse neuromuscular junctions. PDGF might be involved in the interaction between the presynaptic and postsynaptic components, PDGF-A and its receptor might play regulatory role in signaling at neuromuscular junctions in normal muscle.
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The co-existence of physician-patient disharmony and the high rate of cesarean section suggest that there must be some internal relationship between the two medical phenomena.The physician-patient disharmony not only increases the rate of non-indicative cesarean section,but also leads to artificial expansion of the cesarean section indicators.Building up a harmonious physician-patient relationship is an important safeguard to reduce the rate of cesarean section and protect the benefits of mothers and infants.