Objective To evaluate dynamic CT and PET-CT features of normal dog liver after radiofrequency ablation(RFA)correlated with the time-related histopathological changes.Methods Fifteen hybrid adult dogs in good health condition were evenly divided into 5 groups(the immediate,1 st,2 nd,4 th and 8 th week group)according to random digits table methods.Twice RFA was performed for each dog liver.The dogs after RFA underwent CT and PET-CT scanning respectively at the time point defined for each group.All dogs were executed through intravenous injection of klorvess liquid after scanning.Liver samples were histologically examined.All images were assessed to determine the ratios(r_(p/p))which referred to the comparison of rimlike enhancement or tracer uptake in the periphery of the necrosis to that in normal liver parenchyma.Those imaging results were compared and correlated with histopathological findings.Results For the immediate group after RFA procedure,central ablation lesions appeared coagulation necrosis and surrounding sinusoids engorged with blood.On the images of enhanced CT,marked rimlike enhancement was noticed in peripheral ablation lesions.While PET-CT showed decreased ~(18)F-FDG uptake surrounded by homogeneous tracer distribution.For the 1 st-4 th week group,central necrosis was gradually getting more severe.Infiltration of the inflammatory cells,granulation tissue formation and fibrous tissue restoration were noticed in peripheral ablation lesions.Rimlike enhancement and increased glucose metabolism appeared surrounding the lesions on CT and PET-CT,especially in the 1st to 2nd week groups.For the 8 th week group after RFA,the enhancement or hypermetabolism metioned above disappeared when perilesional tissue regeneration became more obvious.From the dynamic curve of changes on enhanced CT,marked enhancement occurred in the immediate group after ablation(r_(p/p)=1.34±0.21),reached its peak at the 1st week group(r_(p/p)=1.39±0.20),and then declined gradually.The metabolic changes on PET-CT showed a typical single peak curve,with the peak at the 1st week group(r_(p/p)=1.19±0.09)and similar even metabolism at the immediate and 8 th week group.Conclusions Both CT and PET-CT imaging can well correlate with the histopathological changes after RFA in the normal liver.To avoid the interference of inflammatory reaction when differentiating normal liver tissue from residual tumor,it is better to take radiology examination immediately and 8 weeks after RFA.PET-CT probably has advantages over CT immediately after RAF.After 1 week,PET-CT and CT may have similar diagnostic efficacy.

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression. Methods Sixty-nine cases of depression were randomly divided in?to study group (n=35 patients) and control group (n=34 patients). The study group received duloxetine combined with 1Hz rTMS treatment on the right dorsolateral prefrontal cortex area for 6 weeks whereas the control group received duloxetine combined with pseudo-rTMS treatment for 6 weeks. The Hamilton Depression Rating Scale (HAMD-24) and Treatment Emergent Symptom Scale (TESS) were used to assess the clinical efficacy and the adverse reactions before, 2, 4 and 6 weeks after the treatment, respectively. Results Four patients (two from each group) dropped out of the study. The main effects of time (P<0.001) and groups (P=0.029) were significant and so was the interactive effect of time and group (P<0.001). The clinical curative effect of the study group were significantly better compared with the control group at the 2, 4, 6 weeks following treatment (P<0.001). The adverse reactions were mild in these two groups. Conclusions The combi?nation of 1 Hz rTMS with duloxetine is superior to either medication alone for the treatment depression.

In order to make the shared traditional Chinese medicine （TCM） pharmacy develop more efficiently and normatively at the grass-roots level， using the “shared TCM pharmacy” as the retrieval word， this paper uses the literature research method to retrieve the reports， documents and policies from CNKI， the websites of people’s governments at all levels， the official websites of the State Administration of Traditional Chinese Medicine， people.com， China News Network， Xinhua News and other platforms before May 20， 2022， sort out the development mode and history of two “Internet plus” TCM pharmacies， namely “shared TCM pharmacies” and “smart TCM pharmacies”， and compare them with each other. Combined with the actual work of community hospitals and community service centers （stations）， the necessity and advantages （such as reducing the costs of the intermediate links of drug circulation and standardizing the grass-roots drug use process） of the development of “shared TCM pharmacy” are obtained from the perspective of primary medical care. Combined with the current situation of the promotion and application of shared TCM pharmacy in county medical communities， it is concluded that the shared TCM pharmacy should be further constructed from four aspects： improving the work process of drug centralized procurement under the background of normalization， improving the compatibility and synchronization of the whole process dispensing information system module， unifying pharmaceutical services and personnel training， defining the authority of data query and clarifying the boundaries of patient privacy to further build a shared TCM pharmacy. Finally， it integrates information technology， summarizes the definition of shared TCM pharmacy and its future construction direction， and provides reference for the next development of shared TCM pharmacy at the grass-roots level.