OBJECTIVE:To observe therapeutic efficacy and safety of escitalopram and fluoxetine in the treatment of depres-sion. METHODS:106 patients with depression were randomly divided into observation group and control group with 53 cases in each group. Observation group was given escitalopram 10-20 mg,qd,and control group was given 20-40 mg,qd. Both groups were treated with 6 weeks. The levels of IL-2,IL-6,TNF-α and Hcy were observed in 2 groups,and HAMD and TESS were re-corded in 2 groups. RESULTS:Total effective rate of observation group (86.79%) was higher than that of control group (77.36%),with statistical significance(P>0.05);after treatment,the levels of IL-2,IL-6,TNF-α and Hcy decreased significant-ly in 2 groups,the observation group was lower than the control group,with statistical significance (P<0.05). After treatment, emotion,mental anxiety,sleep disorder,cognitive disorder,somatic anxiety score and HAMD total score all decreased significant-ly in 2 groups,the observation group was significantly lower than the control group,with statistical significance(P<0.05). TESS score of observation group was significantly lower than that of control group 3 weeks and 6 weeks after treatment,with statistical significance (P<0.05). CONCLUSIONS:Escitalopram is similar to fluoxetine in the treatment of depression,but escitalopram can improve inflammatory response significantly and decrease the level of Hcy with mild ADR.

Objective To explore the effect of correcting astigmatism with corneal incision guided by the corneal topography preoperatively.Methods 97 patients(102 eyes) having undergone phacoemulsification and foldable introcular lens implanation,were divided into two groups according to the incision.Superior temple sclera tunnel incision was made on 51 eyes of the group A,and the clear cornea incision was made on the steepest meridian for the group B(51 eyes).The preexisting cornea astigmatism of all patients reneged from 0.25 D to 5.75 D.Corneal topography examination was made before the operation and one day,1 week,1 month and 3 months after surgery except for visual acuity,slit lamp and fundus examination.The value of surgical induced cornea astigmatism was observed.Results In the group A,the differences were not statistically significant between pre-operation and 1 day,1 week,1 and 3 months after surgery for the value of corneal astigmatism(P>0.05).In the group B,the value of corneal astigmatism in 1 day and 1 week after surgery were a little greater than that of pre-operation,but 1 month later,that was significant better than that pre-operation.The value of corneal astigmatism was reduced from 1.5 D before surgery to 0.52±0.14 D after surgery,from 1.5～2.5 D to 0.88±0.53 D and from over 2.5 D to 1.5±0.72 D respectively.Conclusion The incision guided by corneal topography can correct cornea astigmatism existed pre-operation and get the best visual outcome.

OBJECTIVETo investigate the incidence and risk factors for hypertension among taxi drivers working different shifts.

METHODSUsing the cluster sampling method, 415 day-shift and 304 night-shift taxi drivers in Jinan, China were selected and investigated. The influencing factors for hypertension were analyzed.

RESULTSThe incidence of hypertension in all taxi drivers was 33.2%. The incidence of hypertension in night-shift drivers was significantly higher than that in day-shift drivers (37.8% vs 29.9%, P<0.05). According to multivariate analysis, the incidence of hypertension in day-shift drivers was closely related to body mass index (BMI), working years, working hours, sleep duration, rest days, diet quality, water intake, and smoking, while the incidence of hypertension in night-shift drivers was closely related to BMI, working years, working hours, part-time job, sleep duration, rest days, and drinking.

CONCLUSIONBMI, working years, and working hours are the common risk factors for hypertension in day-shift and night-shift drivers. Sleep duration and rest days are the common protective factors. The risk factors for hypertension in taxi drivers vary with different shifts.

Automobile Driving ; Body Mass Index ; China ; epidemiology ; Humans ; Hypertension ; epidemiology ; Incidence ; Occupational Health ; Rest ; Risk Factors ; Time Factors ; Work Schedule Tolerance

OBJECTIVETo explore the incidence, degree, and pattern of rib cartilage calcification in congenital microtia patients, in order to provide reference for harvesting the rib cartilage, sculpturing cartilage framework.

METHODSFrom Jun. 2013 to Nov. 2014, 383 patients (age range, 6-45 years) underwent CT scans of the chest. 11 patients with bony diseases or traumatic history were excluded. The remaining 372 patients were divided by age into four groups as 6-15, 16-25, 26-35, 36-45 years old. Twenty patients (10 male and 10 female) were selected by the order of patient identification number in each age group, thus selecting a total of 80 patients (40 male and 40 female). Retrospective study of CT scans of the chest in 80 patients and the incidence, degree, and pattern of cartilage calcification of the sixth to eighth ribs were noted. A chi-square test is conducted to test whether there are significant difference between the variables through the SPSS 19.0 software.

RESULTSOverall, 40.4% (194/480) cartilage was calcified; female patients (47.50%, 114/240) showed higher frequency of calcification than male patients (33.33%, 80/240, P = 0. 025). Calcification rates of all age groups are 1.7% (2/120), 46.7% (56/ 120), 49.2% (59/120), 64.2% (77/120). Calcification rate of 6-15 years group is lowest in all groups (P < 0.05) while other three groups have no statistical significance (P > 0.05). Calcification rates of the sixth and sevent rib cartilage were higher than those of the eighth rib cartilage in all age groups except 6-15 years group, who had a similar rate of all three ribs. Calcification rate of all three rib cartilage was significantly increased with age. Calcification rates of the amle's rib cartilage and the female's in all age groups are 3.3% (2/60) and 0.0% (0/60) (6-15 years): 33.3% (20/60) and 60.0% (36/60) (16-25 years): 40.0% (24/60) and 58.3% (35/60) (26-35 years), 56.7% (34/60) and 71.2% (43/60) (36-45 years). In 6-15 years group calcification rates of male and female had a similar rate, while female's rates were higher than male's rates in other three groups. Male and females mainly had the granular type of calcification [70.0% (56/80), 63.2% (72/114)].

CONCLUSIONSFemales who are over 16 years old should pay more attention to the possibility of middle-severe calcification before harvesting rib cartilage. These patients should take CT examination if necessary. In addition, the patients who had previous operation, or traumatic history, rib deformity, or spine deformity should select the CT examination.

Adolescent ; Adult ; Age Factors ; Calcinosis ; diagnostic imaging ; epidemiology ; Cartilage Diseases ; diagnostic imaging ; epidemiology ; Child ; Congenital Microtia ; Costal Cartilage ; diagnostic imaging ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Tomography, X-Ray Computed

Objective To compare the immunostaining of human epidermal growth factor receptor-2(HER-2) among three different clones,and to compare with the results of fluorescence in situ hybridization(FISH) detection,to provide evidences for pathological department to select appropriate antibodies.Methods 268 cases of invasive breast cancer were examined by immunohistochemistry using antibodies for HER-2 of 3 different clones.The results were compared with those done by FISH.Results Immunostaining using antibody clone SP3 showed 3+ reactions in 66 cases;Immunostaining using antibody clone EP3 showed 3+ reactions in 53 cases,while using polyclonal HER-2 antibody,80 cases showed 3+ reactions.There was statistical significance between those groups using different clones(P<0.05).Consistent with the FISH results,the Kappa values are 0.76,0.67,and 0.56,respectively.Conclusion It suggests detection of HER-2 using immunohistochemistry should prioritize selecting monoclonal antibodies,especially clone SP3.

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Purpose To detect the incidence rate, average age and the expression of hMLH-1 and hMSH-2 of sporadic colorectal carci-noma ( SCC) with Han and Uygur patients. Methods The expression of hMLH-1 and hMSH-2 was detected in SCC for 60 cases of Uygur and 196 cases of Han by immunohistochemical method, including 60 Uygur and Han cases normal colorectal mucosa ( NCM) . Results The positive rate of hMLH-1 and hMSH-2 proteins expression in the NCM was 100%. There was a marked difference in the positive rate of hMLH-1 in SCC between Han (93. 4%, 183/196)and Uygur (75%, 45/60) (P<0. 05). There was no significance in the positive rate of hMSH-2 in NCM between Han (94. 4%, 185/196) and Uygur (91. 7%, 55/60) (P>0. 05). The average age of Han and Uygur SCC patients were 65. 64 years, 57. 63 years, respectively, and Uygur SCC cases were more likely to be diagnosed at less 40 years old (P<0. 05). The positive rate of hMLH-1 and hMSH-2 expression in the tubular adenoma was 100%. The positive rate of hMLH-1 and hMSH-2 expression in the tubulovillous adenoma in Uygur and Han were 66. 7%( 2/3 ) and 66. 7%( 2/3 ) , and 74. 2%(23/31) and 90. 3%(28/31), respectively, significantly lower than those of tubular adenoma (P<0. 05). The expression of hMLH-1 was positively correlated with that of hMSH-2 in SCC in Han(rs =0. 737, P<0. 05). The expression of hMLH-1 was positive-ly correlated with that of hMSH-2 in SCC in Uygur(rs =0. 383, P<0. 05). There exists marked difference in the positive rate of hM-LH-1 and hMSH-2 among difference age groups (P<0. 05). Conclusion There is a certain loss of hMLH-1 and hMSH-2 expression in SCC in Han and Uygur Chinese, which is related to adenoma and age. The expression of hMLH-1 in SCC tissue among Uygur pa-tients is not resemble to those of Han patients. The average age of Uygur SCC patients is younger than Han, and the positive rate of hMLH-1 is higher. Combined detection of hMLH-1 and hMSH-2 proteins may be used for judging the severity and prognosis of SCC in Xinjiang, which helps improve patients’ treatment program and rationalize their choices.

Domestic and overseas studies onthe prominent eartreatment were reviewed and analyzed.Current progress of clinical therapy for prominent ear was summarized.The uniform clinical diagnosis and therapy of prominent earhave not been determined, due to its complicated and various therapeutic methods and unclear etiology. Reported therapies mainly include: (1)surgical therapy, which attains satisfactory therapeutic effect by adopting improved approaches, i. e. the combination of operations or the innovative methods based on Mustarde′s, Sterstrom′s and Converse′s surgical methods. (2)Non-surgical therapy, including ear splinting or molding, and laser-assisted cartilage reshaping(LACR). The non-surgical therapyisa hot research field, and is going to bepopularizedin the future.Research of etiology and non-surgical treatments may be helpful to provide abetter therapy strategy for prominent ear.

Objective To investigate the clinical efficacy and safety of carotid endarterectomy (CEA)and carotid artery stenting(CAS)for the treatment of carotid artery stenosis in the elderly.Methods Clinical data of 116 elderly patients aged over 65 years with carotid artery stenosis were retrospectively analyzed.Of 116 patients,73 patients underwent CAS(the CAS group) and 32 received CEA(the CEA group).The success rate,30-day perioperative complications and follow-up results were compared between the two groups.Results There was no significant difference in the success rate (96.8％ vs.100.0％,P ＞ 0.05),30-day perioperative complications,such as bradycardia (6.25％ vs.4.5％,x2 =0.228,P=0.663),acute myocardial infarction(0.0 vs.1.4％,x2 =0.432,P=0.511),transient hypotension(6.3％ vs.8.1％,x2 =0.114,P =0.735),ischemic stroke(6.3％ vs.6.8％,x2 =0.009,P =0.923),and cerebral hyperperfusion syndrome (18.8 ％ vs.10.8％,x2 =0.009,P =0.923),between the CEA and CAS groups.The incidence of persistent hypotension was lower in the CEA group than in the CAS group(3.1％ vs.17.6％,x2 =4.398,P=0.036).No significant difference was found in carotid artery restenosis(moderate:6.3％ vs.8.1％,x2 =0.114,P =0.735;severe:3.1 ％ vs.2.7％,x2=0.014,P=0.905)and ipsilateral stroke(3.1％ vs.5.4％,x2 =0.279,P=0.598)between the CEA and CAS groups at one-year fellow-up.Conclusions Both CEA and CAS have good effieacies in treating carotid artery stenosis in the elderly,while the incidence of persistent hypotension is higher with CAS than with CEA.

Objective:To investigate the related factors and prognosis of invasive Klebsiella pneumoniae liver abscess syndrome (IKLAS). Methods:The in-patients diagnosed with Klebsiella pneumoniae liver abscess in the Department of Infectious Diseases, Huashan Hospital, Fudan University from January 2015 to February 2021 were retrospectively enrolled. The patients were divided into IKLAS group and non-IKLAS group according to whether they had IKLAS or not. The clinical data between the two groups were compared, including the prevalence of diabetes mellitus, the details of liver abscess, clinical symptoms such as fever and abdominal pain, as well as laboratory tests such as glycosylated hemoglobin and hemoglobin. Statistical analysis was performed using chi-square test or independent sample t test. Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of IKLAS. Results:A total of 75 patients with Klebsiella pneumoniae liver abscess were enrolled, including 55 patients (73.33%) in the IKLAS group and 20 patients (26.67%) in the non-IKLAS group. Fifty-two point seven three percent (29/55) of the patients had diabetes mellitus and 12.73%(7/55) of the patients had abdominal pain in the IKLAS group, which were 20.00%(4/20) and 45.00%(9/20) in the non-IKLAS group, respectively, and the differences were both statistically significant ( χ2=6.38 and 7.28, respectively, both P<0.05). Most of liver abscesses were single (50/75, 66.67%), and more likely to occur in the right liver (50/75, 66.67%). The maximum diameter of liver abscess in the IKLAS group was (4.58±2.04) cm, which was smaller than that in the non-IKLAS group ((6.49±3.11) cm), and the difference was statistically significant ( t=2.82, P=0.011). Compared with those in the non-IKLAS group, patients in the IKLAS group had higher glycosylated hemoglobin (8.69%±2.64% vs 6.18%±1.31%) and hemoglobin ((112.25±22.04) g/L vs (100.05±18.59) g/L), and the differences were both statistically significant ( t=-4.25 and -2.21, respectively, both P<0.05). The proportion of patients using antibiotics combined with abscess drainage in the IKLAS group was 38.18%(21/55), and that in the non-IKLAS group was 85.00%(17/20). The difference between the two groups was statistically significant ( χ2=12.86, P<0.001). A total of 16 patients (21 eyes) were diagnosed as endogenous Klebsiella pneumoniae endophthalmitis (EKPE), and all of them were IKLAS patients, and 14 patients underwent monocular/binocular eyeball injection and/or vitrectomy and silicone oil filling. The visual acuity of 13 patients decreased significantly. Multivariate logistic regression analysis showed that complicated with diabetes mellitus was an independent risk factor for IKLAS (odds ratio ( OR)=5.02, 95% confidence interval (95% CI) 1.01 to 25.03, P=0.049). The large diameter of liver abscess was a protective factor for IKLAS ( OR=0.64, 95% CI 0.47 to 0.86, P=0.003). Conclusions:The patients with IKLAS have less abdominal pain, and most of them complicate with diabetes mellitus. Diabetes mellitus is an independent risk factor for the occurrence of IKLAS, while the large diameter of liver abscess is a protective factor. EKPE is associated with poor visual prognosis.