Objective To evaluate the rate of depression in adult rheumatoid arthritis (RA) patients in China.Methods Literature search was conducted to collect studies on the prevalence of depression in adult RA patients in Cochrane library, Medline, EMbase, China National Knowledge Internet (CNKI),China Biology Medicine (CBM), Chinese science & technology journal database (VIP) and Wanfang database.Data were analyzed by R 3.2.0 software after evaluating all data.Results A total of 25 studies, including a total size of 4 830 and 2 712 patients of depression, were eligible for inclusion in the review.The prevalence of depression by analyzing the effect size was 44.7％ [95％CI (37.5％, 52.0％)], which was close to the median of 43.0％ from all studies included and higher than the global rate 38.8％ [95％CI (34％, 43％)].Eight studies, including the sample size of 1 028 cases, 311 cases of mild depressive disorders and 219 cases of moderate or severe depressive disorders, reported the prevalence levels of 30.2％ [30.2％CI (22.1％, 40.0％)] and 16.5％ [95％CI (9.6％,26.9％)], respectively.Subgroup analysis showed that the depression rate of female RA patients was higher than male, the depression rate in the central and western areas were higher than that of the eastern region, the prevalence level estimated by the Geriatric Depression Scale (GDS) was higher than estimated by other tools.Sensitivity analysis showed that the pooled effect size had good stability and reliability.Conclusion The prevalence rate of depression in adult RA patients is 44.7％, suggesting that medical staff should pay much attention to depression in adult RA patients.

Objective To evaluate of the clinical efficacy and side-effect of 595nm tunable pulsed dye laser in treatment of children heamangioma of skin. Methods A retrospective study was conducted according to 76 children patients with heamangioma of skin (including 53 cases of nevus flammenus, 20 strawberry hemangioma and 3 cavernous hemangioma) treated with 595nm tunable pulsed dye laser. We evaluated the efficacy and side-effect of the treatment. Results The effectiveness rates were 83.2% and 86.63%, respectively, in nevus flammenus and strawberry hemangioma, but there were disappointed efficacy obtained in patients with cavernous hemangioma treated with 595nm tunable pulsed dye laser. There was 7.9% of the side-effect rate in the children with heamangioma of skin treated by 595 nm tunable pulsed dye laser. Conclusion There is satisfactory clinical efficacy and lower side-effect for children hemangioma treated by 595nm tunable pulsed dye laser.

Objective To explore a surgical method for the treatment of lumbosacral spinal tuberculosis by combination of one-stage focus debridement with anterolateral incision, bone graft fusion with titanium mesh cage and internal fixation with double pedicle crew system.Methods From Sep.2009 to Dec.2012, a total of 8 patients with lumbosacral spinal tuberculosis which included 5 cases of male, 3 cases of female.The age ranged from 20 to 65 years, with a mean of 51.6 years.All patients presented with persistent back pain, 4 patients with radiating pain of unilateral lower limb, 3 with weakness and numbness and 5 with constitutional symptoms including low-grade fever and weight loss.All patients were not associated with active tuberculosis in oth er parts of the body.The patients were given regular anti-TB treatment for at least 4 weeks.By anterolateral incision, common iliac and iliac arteries and veins were dissociated extraperitoneally.The focus was completely debrided through the inferior part of vessels.Then the bone graft fusion was performed with the titanium mesh cage and the internal fixation with a double pedicle crew system was accomplished.After the surgery, patients were treated with continuous anti-TB drugs and with antibiotics to prevent infection.Patients were allowed to move with the protection of waist early and regular follow-up.Results Operation time was 180-360 min, with an average of 225 min.Operative blood loss was 624 ml and drainage volume was 150 ml on average.All cases were cured after surgery.No severe complications were observed during the surgeries.After follow-up of 8 to 30 months (averaged 12months), no recurrence of the tuberculosis was found.The lumbocrural pain improved in all the patients.Complications such as migration, loosening and breaking of the implants were not observed.The vertebral bodies were fused in all patients with an average time of 8.3 months.No case occurred angiemphraxis or internal bleeding.Conclusion The method debrids the focus of lumbosacral spinal tuberculosis thoroughly and implements titanium mesh cage and double pedicle crew system simultaneously.The pedicle screw system is implemented in anterior lumbosacral vertebrae through the inferior part of iliac arteries and veins, which will not lead to angiemphraxis or vascular injuries.The early term outcome is encouraging.This technique is safe and effective to treat severe lumbosacral spinal tuberculosis.

Objective To analyze the clinic features and hereditary characteristics of three subtypes of porokeratosis, namely disseminated superficial actinic porokeratosis (DSAP), porokeratosis palmaris et plantaris disseminata(PPPD) and porokeratosis of Mibelli (PM) in five pedigrees with porokeratosis. Meth-ods After clinical and pathological diagnosis, every living family member of the five pedigrees with poro-kerotosis was undergoing medical examination and genetics analysis. These five pedigrees consisted of three DSAP pedigrees (totally 266 family members including 100 patients), and one PPPD pedigree (composing of 90 members including 26 patients), one PM pedigree (cornposing of 34 members including 17 patients). Results While diagnosed as porokeratosis, the five pedigrees included three distinctive variants, each with its own clinic characteristics. The lesions was initiated on the face in DSAP subtype, on palms and the flex-ion side of fingers in PPPD subtype; or involving sun-covered areas in PM subtype. Of the three subtypes of porokeratosis, the onset age in DSAP subtype was earliest, usually about 8-20 years old, about 14-20 years old in PPPD subtype, but PM subtype about 20-30 years old. Conclusions As a group of autosomal dominant genodermatosis, porokeratosis presented various clinic variants with different genetic basis. And, different subtype could be seen in a same patient or same pedigree.

Objective:To investigate the safety and effectiveness of dot matrix laser combined with transdermal administration in the treatment of hypertrophic scars.Methods:From January 2014 to December 2019, 123 patients with hypertrophic scars in the Dermatology Clinic, the Second Affiliated Hospital of Anhui Medical University. Observation group included 63 cases, 30 males and 33 females, aged 7 to 69 (31.7±14.6) years; given lomatasone cream for topical application, once in the morning and evening, combined with lattice laser transdermal administration, once a week for 3 months. There were 60 patients in the control group, 28 males and 32 females, aged 10-71 (32.8±15.1) years; topical lomidasone cream was given, one morning and one evening, with a course of 3 months.Results:Clinical trials were completed in 123 patients. The total effective rate in the observation group was 66.7% (42/63), of which 18 cases were cured, and 18 cases were markedly effective; 6 cases were effective, 21 cases were ineffective; the total effective rate in the control group was 20.0% (12/60), of which 0 cases were cured, and the effect was 7 Cases, and 5 cases were effective, 48 cases were ineffective. The effective rate of the observation group was significantly better than that of the control group ( P<0.05), and there were no adverse reactions in the observation group. Conclusions:Lattice laser transdermal administration combined with halomethasone cream for topical treatment of hypertrophic scars is effective, safe, and worthy of clinical application.

Objective To system review the effectiveness of rehabilitation exercise for preventing intensive care unit patients acquired weakness(ICU-AW).Methods A computerized database search was performed through the Cochrane Library,PubMed,EMBASE,Web of Science,CNKI,CBM,Wanfang and VIP database to find relevant studies. Two researchers independently selected the studies,evaluated the quality of the articles and extracted data according to the rigorous criterion,then we performed the Meta-analysis with the software RevMan5.3.Results Nine RCTs were included in this study. Comparing to routine care,Meta-analysis showed that rehabilitation exercise improved peripheral muscle strength in ICU-AW patients[MD=5.77,95%CI (2.36,9.18),P=0.0009],respiratory muscle strength[MD=20.38,95%CI(0.79,39.96),P=0.04],and quality of life[MD=27.96,95%CI(13.28,42.63),P=0.0002],shortened the duration of mechanical ventilation[MD=-2.73, 95%CI(-4.98,-0.48),P=0.02] and length of stay in hospital[MD=-1.99,95%CI(-3.28,-0.71),P=0.002], while it had no positive effect on mortality[OR=0.91,95%CI(0.51,1.62),P=0.74].Conclusions Rehabilitation exercise improves physical function of patients with ICU-AW,and reduces the bad clinically relevant indicators, and it doesn't influence the mortality,so it is worth being popularized.

Objective: This is a study to evaluate complication rate, satisfaction and quality of life after breast reconstruction under different classifications. The classification criteria are the timing of operation, surgical procedures, and patients′age. Methods: By reviewing the surgical cases from August 2004 to June 2018, the authors summarized the data of 102 patients with breast reconstruction of the same surgeon in Peking University People′s Hospital and Plastic Surgery Hospital (Institute) CAMS PUMC. Fifty-four patients who met the inclusion criteria and completed the BREAST-Q breast reconstruction module scale, were divided into immediate group or delayed group, according to the timing of operation; divided into abdomen group or other procedures group, according to the surgical procedure; and divided into the young patients′group or senior patients′group according to age. The index were (1) postoperative complication rate, (2)satisfaction with breasts, psychosocial well-being, physical well-being of chest and abdomen, sexual well-being, satisfaction with outcome, satisfaction with information, satisfaction with care (based on the BREAST-Q scale). Results: Complication rate was 9.1%(1/11) in the immediate group, 16.3%(7/43) in the delayed group, 14.7%(5/34) in the abdomen group, 15.0%(3/20) in other procedures group, 13.6%(3/22) in the young patients′group, and 15.6%(5/32) in the senior patients′group. There was no significant difference in the incidence of complications (P>0.05). The postoperative scores of satisfaction with breasts, psychological well-being and sexual well-being were significantly higher in the immediate group than in the delayed group(P=0.026, P<0.001 and P=0.001, respectively). The score of postoperative physical well-being of chest was significantly higher in the abdomen group than other procedures group(P=0.020). The score physical well-being of abdomen was lower compared with the preoperative in the abdomen group (P<0.001). The score of physical well-being of abdomen was lower in the senior patients′group than that of the young patients′group (P=0.010). Conclusions The complication incidence of breast reconstruction patients was similar among different groups. The breast reconstruction surgery can significantly improve satisfaction and quality of life of patients. To some extent, immediate breast reconstruction can reduce the psychological and physiological effects of breast loss on patients, leading to higher postoperative satisfaction. Breast reconstruction with abdominal flaps can provide patients with better chest health but poor abdomen health. Although elderly patients undergoing breast reconstruction will have poor physical well-being of abdomen, they can still achieve higher satisfaction of operation.