目的 通过使用DRGs指标对医院消化内科5个主诊组进行医疗服务绩效评价的实践,为主诊组绩效考核提供管理依据.方法 根据DRGs临床医疗服务绩效评价的三个维度(能力,效率,安全)对消化内科主诊组进行评价.结果 消化内科治疗同类疾病整体费用和住院日指标低于分组器标杆.主诊组D收治的病组难度最高,收治的病组范围最广.同一组疾病在主诊组间进行比较中,HK29(肝胆胰系统的诊断性操作)病组,主诊组C费用和住院日控制良好,主诊组D的控费和住院日控制不佳.结论 DRGs指标对主诊组医疗服务绩效进行评价,能够为医院管理提供数据支持和有效依据.

Rigorous validation of the popular obsessive compulsive drug use scale (OCDUS) has been sparse, while the lack of valid and reliable measurement scales continues to be an obstacle to the study and control of heroin addiction in China. Based on data from 295 randomly-selected male Chinese heroin addicts, we examined the psychometric properties of the OCDUS in this population and the correlations of the OCDUS scores with key epidemiological characteristics. In the course of this analysis, one item was eliminated as the result of low test-retest reliability. Factor analysis on the remaining twelve items identified a 3-dimensional factor structure, which was similar to the original. These domains showed adequate reliability, with Cronbach’s α as 0.82, 0.81, and 0.66. The OCDUS scores were correlated with age, age of first heroin use, length of drug use, marriage, and primary route of administration. These findings suggest that the adapted OCDUS will prove to be a valid and reliable measure of heroin addiction among Chinese male addicts.

Introduction: New-type drugs are popular with adolescents and could lead to psychiatry disorders, but no medications have been proven to be effective for these disorders of new-type drug dependence. We aimed to evaluate the efficacy of tryptophan on sleeping disorders and mental symptoms in detoxified individuals with new-type drug dependence.Methods: This randomized, placebo-controlled trial included 80 detoxified individuals with new-type drug dependence, recruited successively from a Compulsory Residential Drug Abstinence Institution in Wuhan, China, from April 2012 to November 2012. Eligible participants were randomly allocated to be treated with tryptophan (1000mg/d, n=40) or placebo (n=40) for 2 weeks. The sleeping disorders and mental symptoms were assessed using Athens Insomnia Scale and Symptom Check-List-90 at baseline and 2 weeks. Results were analyzed according to the "intention-to-treat" approach.Results: Forty-five participants completed the 2-week study, 24 in the tryptophan group and 21 in the placebo group. There were no statistically significant differences in baseline characteristics between groups and the treatment adherence was similar between groups. The reduction in the Athens Insomnia Scale score in the tryptophan group was significantly greater than that in the placebo group (P=0.017). However, no significant differences were found in Symptom Check-List-90 scores (either by individual dimension or the overall score) between groups (all P>0.05). The frequency of adverse events was similar and no serious adverse events were reported during the study.Conclusion: Tryptophan was unlikely to be effective for mental symptoms, but could alleviate sleep disorders in short term among detoxified individuals with new-type drug dependence. Future large-scale trials are required to confirm findings from this study.

BACKGROUND:Depression and anxiety are common after stroke. There is inconclusive evidence of the benefit of psychotherapy for poststroke depression and anxiety. Here, we used a brief intervention, Neuro-Linguistic Programming (NLP) brief therapy plus health education, to evaluate the changes in patients with ischemic stroke. METHODS:One hundred eighty patients were randomly allocated to receive 4 sessions of NLP plus health education (n = 90) or usual care (n = 90). A set of questionnaires was used preintervention and postintervention as well as at the 6-month follow-up. The primary outcomes were the prevalence of depression and anxiety, and the awareness of stroke knowledge. RESULTS:More patients in the intervention group achieved remission of depressive (odds ratio [OR], 2.81; 95% confidence interval [CI], 1.41-5.59) and anxious symptoms (OR, 2.19; 95% CI, 1.15-4.18) after intervention. At the 6-month follow-up, we found no differences between groups in both the prevalence of depression and anxiety. After intervention, the intervention group had better awareness rates on most of the stroke knowledge items (P < .05). It also had better quality of life and physical function both after intervention and at the follow-up (P < .05). CONCLUSIONS:NLP plus health education could reduce depression and anxiety immediately after intervention, but not at the 6-month follow-up. The intervention could also improve the awareness of stroke knowledge and benefit patients on quality of life and physical function.

Objective:To evaluate the short term effects of motivation-skills-desensitization-mental energy(MSDE) model on abstinence rate among heroin addicts.Methods:Nity eight heroin addictive males were selected randomly in Xiangyang compulsory rehabilitation center,and divided into intervention and control groups equally and randomly.The intervention group was given MSDE psychology intervention and conventional abstinent education,while the control was given conventional abstinent education only.Forty-six heroin addicts in intervention group and forty-three in the control were followed by telephone to observe the abstinence rates at 1,3 and 6 months after release.Results:At 1,3 and 6 months,abstinence rates(71.74% vs.18.60%,P0.001;52.17% vs.6.98%,P0.001;41.30% vs.2.33%,P0.001) were statistically significant in the intervention group compared to the control.The multiple Logistic regression results showed that intervention factor played an important role for abstinence at 6 months(OR20,P0.01).Conclusion:The results suggest that Motivation-skills-Desensitization-mental Energy model can improve the short term abstinence rates for heroin addicts.

目的 了解武汉市初中生家长对孩子接种HPV疫苗的接受度,为在中国进行HPV疫苗接种提供科学依据.方法 采取整群抽样方法抽取某初中一、二年级学生家长进行问卷调查.结果 341名调查对象中,36.66％的人愿意孩子接种HPV疫苗.多元Logistic回归结果显示,家长的性别、HPV知晓情况和疫苗价格是影响家长对HPV疫苗接受度的主要因素.结论 初中生家长对孩子接种HPV疫苗的接受度不高,积极开展HPV及HPV疫苗的认知教育对今后HPV疫苗的预防接种有潜在意义.

Objective To assess mental health of middle occupational students and provide evidences for psychological health education in middle occupational school.Methods A total of 1220 students in a middle occupational school of Zhaoqing city were extracted by cluster sampling.Every participant was asked to finish symptom checklist 90(SCL-90).Results The proportion of students who had at least one factor scores greater than or equal to 2,3 and 4 were 70.65%,21.23%,4.10% respectively.The proportion of students who had one factor scores greater than or equal to 2 was relatively high.Obsession-compulsion and interpersonal sensitivity factors both accounted for more than 50%.Somatization factor accounted for 18.2%.Other factors accounted for 30% to 40%.Scores of somatization,obsession-compulsion,interpersonal sensitivity,depression,anxiety,hostility and phobic anxiety of girls were higher than those of boys(t=-2.70,-3.81,-2.56,-6.02,-6.20,-2.21,-10.40;P<0.05).Scores of obsession-compulsion,interpersonal sensitivity,depression,anxiety,hostility and psychoticism of junior students were lower than those of senior students(t=2.25,2.54,2.83,3.09,2.48,2.41;P<0.05).Scores of somatization and hostility were lower while the interpersonal sensitivity,phobic anxiety and paranoid ideation scores were higher than the norm of Chinese middle school students(t=-2.47,-1.98,10.03,15.34,2.30;P<0.05).Conclusion The detection rate of psychological problems of middle occupational students is high and the general level of mental health is relatively low.The psychological health education is urgently needed.

To reduce heroin relapse rate,our group developed a question-oriented Motivation-Skill-Desensitization-Mental Energy( MSDE) intervention model,operational guideline and procedure. We found that the clients were willing to accept and the abstinence rate in intervention group was much higher than that in the control by field trial and follow-up. This paper briefly introduces this intervention model, operational guideline and procedure, which includes methods of Motivational Interview( MI),Cognitive Behavioral Therapy( CBT),Neuro-Linguistic Programming( NLP),mindfulness,etc.,for patient group therapy,family therapy and follow-up encouragement. Patient group therapy contains the following three aspects:( 1) enhancing motivation and skills for abstaining by question-oriented discussions,activities or games,role play,offering some successful abstaining models,teaching new concepts and knowledge,sharing feelings,summary,homework and so on;( 2)desensitization by utilizing Eye Movement Desensitization and Reprocessing and asking patients to recall drug related feelings and circumstances simultaneously;( 3) increasing mental energy by promoting personal mental growth with the methods of evoking,feeling and releasing negative emotions,making psychic connections between themselves and others,recognizing their value and implanting positive belief,and so on.

Protein solubility plays a major role and has strong implication in the proteomics. Predicting the propensity of a protein to be soluble or to form inclusion body is a fundamental and not fairly resolved problem. In order to predict the protein solubility, almost 10,000 protein sequences were downloaded from NCBI. Then the sequences were eliminated for the high homologous similarity by CD-HIT. Thus, there were 5692 sequences remained. Based on protein sequences, amino acid and dipeptide compositions were generally extracted to predict protein solubility. In this study, the entropy in information theory was introduced as another predictive factor in the model. Experiments involving nine different feature vector combinations, including the above-mentioned three kinds of factors, were conducted with support vector machines (SVMs) as prediction engine. Each combination was evaluated by re-substitution test and 10-fold cross-validation test. According to the evaluation results, the accuracies and Matthew's Correlation Coefficient (MCC) values were boosted by the introduction of the entropy. The best combination was the one with amino acid, dipeptide compositions and their entropies. Its accuracy reached 90.34% and Matthew's Correlation Coefficient (MCC) value was 0.7494 in re-substitution test, while 88.12% and 0.7945 respectively for 10-fold cross-validation. In conclusion, the introduction of the entropy significantly improved the performance of the predictive method.

目的獉獉:评价动机-技能-脱敏-心理能量模式对戒毒人员短期操守率的影响。方法獉獉:选取襄阳市强制隔离戒毒所男性戒毒人员98名,随机分为试验组和对照组,试验组接受动机-技能-脱敏-心理能量模式和戒毒所常规戒毒教育,对照组接受戒毒所常规戒毒教育。对试验组46人以及对照组43人,在其出所后进行电话随访,评价两组人员出所满1个月、3个月和6个月的操守情况。结果獉獉:试验组出所满1个月、3个月和6个月时,操守人数（率）分别是33（71.74%）、24（52.17%）和19（41.30%）;对照组操守人数（率）分别是8（18.60%）、3（6.98%）和1（2.33%）。试验组操守率均远高于对照组（P＜0.001）。多元Logistic回归结果显示,6个月随访结果中只有干预因素是患者操守的重要影响因素（OR值大于20,P均＜0.01）。结论獉獉:本研究结果提示,动机-技能-脱敏-心理能量干预模式可促进戒毒患者保持操守。

为了降低海洛因依赖者戒毒后复吸率,本课题组开发了动机-技能-脱敏-心理能量干预模式和操作方案。现场试验发现,患者乐意接受;随访发现,试验组操守率明显高于对照组。本文简要介绍了该干预模式、操作方案和流程,包括:动机晤谈、认知行为疗法、神经语言模式、冥想等方法,对患者进行团体心理治疗和随访激励,对家庭成员进行心理教育与治疗。患者团体治疗包括:（1）提高操守的动机和技能,方式为以问题为导向的讨论、活动、游戏、角色扮演、提供榜样、教授知识、分享、小结和作业;（2）快速眼球移动脱敏,并同时引导患者自问吸毒时的感觉和情景;（3）提高操守的心理能量,包括个人心理成长（激发、感受和释放负面情绪,与自我和他人心理连接,认识自我价值,正面信念植入等）等内容。

Objective To investigate the high sensation seeking state and its possible related factors of secondary vocational school students.Methods A total of 1 443 secondary vocational school students were selected from one school of Zhaoqing city by cluster sampling.All the subjects completed the Sensation Seeking Scale(SSS),and unconditional Logistic regression was used to analyze the data.Results Of all the subjects,360(24.95%) got scores more than 18,and 721(49.97%) more than 15.The results of logistic regression indicated that living in rural area was a protective factor(OR=0.69,P=0.011);male(OR=1.65,P0.01),senior students(OR=2.11,P0.001) and living in single-parent family(OR=1.93,P=0.001) were risk factors of high sensation seeking.Conclusion The society should pay attention to the sensation seeking level of secondary vocational school students,and pointed measures need to be taken to promote their growth with the joint efforts of families,schools and society.

Objective The main purpose is to comprehensively understand the features of HIV/AIDS death,the survival time,and analyze the mortality trend before 2011 in Yichang city.Methods Data were collected from HIV/AIDS prevention and control information system from 1995 to 2011,and were dealt with SPSS12.0 software.Results The paid blood donors were the main death cases.Medical institutions played an important role in finding HIV/AIDS cases.44.86% of deaths occurred in the first three months after diagnosis.Annual mortality showed a wavy downward trend,however,the cumulative mortality remained high.Conclusions Health education should be promoted,detection should be expanded,so as to detect patients earlier and extend patients' life.

Objectives To probe the effect of the motivation-skill-mental energy(MSE) model on sentiments and motivational change tendency of compulsory rehabilitation patients. Methods Ninety-two drug addicts from the Xiangyang compulsory rehabilitation center were randomly divided into the intervention group and the control group.The forty-six members in intervention group received MSE psychology intervention and conventional abstinent education for one month,while those in the control group received conventional abstinent education.The self-developed sentiment and motivational change tendency questionnaire was used before and after the intervention to evaluate the effect of the intervention. Results As was revealed by the repeated measures analysis of variance and t test,there were not significant differences of the scores of positive sentiments,good mentality,rehabilitation attitude,skills of relapse prevention between the two groups before the intervention(P0.05),the scores in the intervention group improved more greatly than the control group(P0.001) after the intervention. Conclusions MSE is effective to improve the sentiments and motivational change tendency of heroin addicts in compulsory rehabilitation center,and it might have certain effect on relapse prevention.

Objective:To evaluate the effect of applying motivation-skills-desensitization-mental energy(MSDE) model on drug addicts' chronic craving and depression.Methods:Ninety eight male heroin addicts were selected randomly in Xiangyang compulsory rehabilitation center,and divided into intervention and control groups equally and randomly.The intervention group was given MSDE psychology intervention and conventional abstinent education,while the control was given conventional abstinent education only.And then the Obsessive Compulsive Drug Use Scale(OCDUS) and the Beck Depression Inventory(BDI-13) were used to evaluate the chronic craving and depression of two groups one month later.Results:As was revealed by the repeated measures analysis of variance,after the intervention,the score of the OCDUS of intervention group was lower than the control group(P0.01);the scores of the OCDUS and the BDI-13 of intervention group at the end of intervention were lower than those at the beginning of intervention(P0.01);the declining trend of the scores of the OCDUS and the BDI-13 of intervention group were more significant than the control(P0.01).Conclusion:MSDE model can help heroin addicts reducing chronic craving and depression.Theoretically,these study provide information to prevention of relapse.