Objective To explore the effect of mediastinal drainage on the treatment for intra -thoracic anastomotic leak in esophageal cancer patients after esophagectomy .Methods One hundred and thirty -four e-sophageal cancer patients underwent esophagectomy and a mediastinal drainage tube was routinely placed intro -operatively ( observation group ) .Other 150 esophageal cancer patients underwent esophagectomy without mediasti -nal drainage were retrospectively set as control group .The following factors in the two groups were compared:in-cidence of anastomotic leak,and mortality rate,incidence of respiratory failure,incisional infection,rate and dura-tion of moderate or high fever ( T≥38℃) , duration of antibiotic use , duration of anastomotic leak healing and length of hospital stay of anastomotic leak patients .Results There was no significant difference in incidence rate of anastomotic leak between observation and control groups .There was no death ,no respiratory failure in observa-tion group;rate of chest incisional infection in observation group was 18.2%(2/11).Mortality rate,respiratory failure rate and chest incisional infection rate in control group were 33.3%(3/9)、44.4%(4/9)and 77.8%(7/9)respectively.Incidence and duration of moderate or high fever (36.4%and 2.3 ±1.2d respectively)in obser-vation group were significantly lower than those in control group (100 % and 8.6 ±2.3 d respectively)(P<0.05).Duration of antibiotic use,duration of leak healing and length of hospitalization (9.6 ±3.2 d,23.6 ±5.5 d and 22.6 ±5.7 d respectively)were significantly shorter than those in control group (21.3 ±6.8 d,38.3 ±8.4 d and 38.5 ±9.6 d,P<0.05)respectively).Conclusion Although mediastinal drainage could not prevent anasto-motic leak in patients underwent esophagectomy ,it could definitely decrease death and respiratory failure resulted from anastomotic leak .Mediastinal drainage could also decrease severity of intrathoracic infection caused by anas -tomotic leak and shorten the duration of leak healing .

Objective To investigate the status of the non-psychiatrist' s diagnostic and therapeutic ability of depression/anxiety disorders in 57 General Hospitals.Methods 1 152 non psychiatric clinicians in 57 general hospitals were surveyed.A custom-made questionnaire included the training of mental health-related knowledge which the general hospital physicians received and typical anxiety/depression case analysis.Results Among 1 521 non-psychiatric clinicians,596 (51.74％) clinicians participated the training of psychiatry,562 (48.78％) participated the training of medical psychology and 230(20.97％) clinicians participated the training of Healthy Psychology.In professional setting,59 (5.12％) clinicians participated the training of psychotherapy,255 (22.14％) clinicians had attended related academic symposiums.80(6.94％) clinicians believed that they understand the clinical display of anxiety/depression disorders,52 (4.51％) clinicians expressed the understanding of diagnostic criteria of anxiety/depression disorders and its treatments,while 44(3.82％) clinicians only possessed the knowledge of anxiety/depression disorder treatment.In the typical case analysis,it revealed that 794 (68.89％) clinicians made accurate diagnosis,458(57.68％)clinicians made a choice of medical treatment,764(96.22％) clinicians chose psychotherapy,29 (3.65％) clinicians applied physical therapy,while 438 (55.16％) clinicians combined drug therapy with one or more other therapeutic methods.Binary logistic regression analysis showed that the age(P=-0.093,Exp(B)=0.911)and work experience(P=-0.002,Exp(B) =1.080)significantly contribute to the diagnostic accuracy of non-psychiatrists.Conclusion The non-therapeutic psychiatric clinicians in general hospitals have certain basic knowledge of depression/anxiety disorders with lower level of diagnosis and treatment diagnosis and treatment.And there is bigger difference among different hospitals.

Objective To investigate the reliability and validity of the Chinese version of the schizophrenia cognition rating scale ( SCoRS) . Methods 112 cases of schizophrenia or schizophreniform disorder inpatients were recruited and assessed using the SCoRS( Chinese version) ,the brief assessment of cognition in schizophrenia (BACS) and personal and social performance scale(PSP). The principle component analysis,reliability analysis and correlation analysis were used to analyze the data. Results Standardized Cronbach α = 0.964. All the 20 i-tems were significantly correlated. Except item 1 ,9,18,19 ( r=0. 830,0. 890,0. 871,0. 890) ,the interrater correlation coefficiency (ICC) of the rest of the items was over 0.9. The ICC of global rating scores between two raters was 0. 921. Factor analysis procedure identified three factors. Factor 1 reflected the neurocognitive state; factor 2 reflected the social cognitive state;and factor 3 mainly reflected the daily life function. The SCoRS rating scores were significantly correlated with the BACS and PSP scores. Conclusion The validity and reliability of SCoRS are acceptable. SCoRS is a useful tool for assessing the deficits of the cognitive function for Chinese schizophrenia patients.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the depressive like behaviors and expression of brain derived neurotrophic factor (BDNF),IL-1β and NF-κB of hippocampal in chronic unpredictable mild stress (CUMS) rats.Methods Thirty-two adult male rats were randomly divided into four groups (n =8):Control group,Control + rTMS group,CUMS group and CUMS + rTMS group.The sucrose preference test,forced swim test and open field test were used to evaluate depressive like behaviors for each groups.In addition,the expression of BDNF,NF-κB and IL-1 β in hippocampal were detected by western blot and ELISA after behavioral test,respectively.Results 1.The effects of rTMS on depressive like behaviors of CUMS rats:in the sucrose preference test,the sucrose preference rate of CUMS rats (0.67 ± 0.06) was significantly lower than Control group (0.91 ± 0.04),which was higher in the CUMS + rTMS group (0.83 ±0.08).In the forced swim test,the immobility time of CUMS group ((26.88 ± 11.33) s) was longer than Control group ((15.22 ± 6.75) s) and CUMS + rTMS group ((18.41 ± 6.95) s).In the open field test,both the total distance travelled and number of central area entry times of CUMS group((849.165 ± 769.01) cm,(7.42 ± 5.68))were significantly shorter ((6224.81 ± 1403.2) cm) and smaller (22.86 ± 3.72) than Control group,and those of the CUMS + rTMS were longer ((4105.57 ± 1516.92)cm) and larger (21.25 ± 3.45).All the behavioral results were statistically significant (P＜ 0.05).And of all the aforementioned behavioral parameters,there were no significant differences between Control group and Control + rTMS group(P＞0.05).2.The effects of rTMS on the hippocampal expressions of BDNF,NF-κB and IL-1β in CUMS rats:compared with Control group,the hippocampal expression of BDNF in CUMS rats was significantly decreased,while the expressions of NF-κB and IL-1β in the hippocampus were significantly increased (P＜ 0.05).Compared with CUMS group,the hippocampa expression of BD-NF in the CUMS + rTMS group was increased,and the expressions of NF-κB and IL-1β in the hippocampus was significantly decreased (P ＜ 0.05).The expressions of BDNF,NF-κB and IL-1β had no differences between Control group and Control + rTMS group.Conclusion rTMS increased the expression of BDNF,reduced the production of NF-κB and IL-1β,and alleviated depressive like behaviors in CUMS rats.

Objective To investigate the feasibility and effectiveness of C57 mice depression model established by chronic unpredictable mild stress (CUMS) and separation.Methods 30 male C57 mice were randomly divided into three groups:CUMS + separation group (group CS),CUMS + separation + fluoxetine group (group CSF),and control group (group C).The mice of group CS and group CSF were fed with chronic unpredictable mild stress (CUMS) and separation for 3 weeks.Then,the mice of group CSF were given fluoxetine.To record the food intake/body weight,liquid consumption and field test of the mice at relevant time point.Results Compared with control group,the food intake/body weight,total route in the field test,and the sucrose solution consumption in liquid consumption test of group CS and group CSF decreased significantly (P＜0.05) at the 21th days.But after giving fluoxetine for 14 days,group CSF had no significant differences with group C except sucrose solution consumption.Although the difference of sucrose solution preferences was significant compared with control group(P＜0.05),it was improved significantly compared with CS group (P＜ 0.05).Conclusion The C57 mice depression model established by CUMS and separation are feasible and effective,and it is the ideal animal model of depression.

Objective To investigate behavior and hippocampal cytoskeletal alterations following re-exposure to chronic unpredictable mild stress(CUMS) and acute swimming stress,and explore the possible mechanism.Methods 40 Male Sprague-Dawley (SD) rats were divided into five groups,with 8 exposed to 21 consecutive days of chronic unpredicted mild stresses (CUMS) and treated with vehicle,8 exposed to CUMS and treated with fluoxetine,8 exposed to CUMS and treated with fluoxetine and re-exposed to acute swimming stress after washout,8 exposed to CUMS and treated with fluoxetine and re-exposed to CUMS after washout,and 8 as normal controls treated with vehicle.Behavioral changes in these rats were analyzed.The expressions of hippocampal cytoskeletal microtubulin were analyzed using Western Blot.Results ( 1 ) Compared with the control and CUMS group,sucrose preference (43.38 ± 7.84 ) ％,total traveling distance ( 859.21 ± 653.62 ) cm,velocity ( 2.05 ± 0.60 ) cm/s and frequencies of rearing(0.12 ±0.30) were reduced (P＜0.01 ) in the re-exposure to CUMS group.After re-exposed to acute stress,these behaviors did not differ from control rats.(2)Compared with the control and CUMS group,the Acet-Tub expression (244.24 ± 8.90 )％ of re-exposure to CUMS group showed a significant increase (P＜ 0.01 ) in rats submitted to re-exposure to CUMS and Tyr-Tub expression (30.92 ± 11.01 )％ was significantly decreased following re-exposure to CUMS (P＜0.01).At the same time,MAP-2 expression did not change while phospho-MAP-2 expression (24.75 ± 8.83 )％ decreased significantly.After re-exposed to acute stress,these prorein expressions did not differ from control rats.Conclusion These findings provide evidence that rats re-exposed to CUMS showed more impairment of cytoskeletal microtubular dynamic and structural neuronal plasticity,this effect appears to be mediated by the degree of phosphorylation of MAP-2.

The glutamate transporter EAAT 2 ( rodent nomencla-ture GLT-1:glutamate transporter 1), which is a predominantly astroglial glutamate transporter in the hippocampus and the pre-frontal cortex , is responsible for the majority of extracellular glu-tamate uptake .The glutamate transporter EAAT 2 can decrease the high levels of glutamate in the synaptic cleft , avoiding gluta-matergic excitotoxicity to damage the glial cells and neurons . Currently, the transporter EAAT2 has become a research hotspot of depression .This article aims to summarize roles of glutamate transporter EAAT2 in the occurrence and treatment of depres-sion.

A comprehensive physician authorization management system has been established at Renmin Hospital of Wuhan University in its effort of promoting the clinical standardization.This system covers authorization of prescription,disposition,surgery,and medical report among others,adhering to the principle of clear,complete quantitative competence-based,authorization.The training and assessment of physicians in parallel canimprove physicians' competence and quality of care.

Objective To investigate the effect of chronic infection of Toxoplasma gondii on the spatial learning and memory capability in mice.Methods Toxoplasma tachyzoites(RH strain)were reanimated at 37 ℃ after 15 days' storage at-20 ℃,and injected intraperitoneally to mice of the experimental group each with 7.7?105.Normal saline was given to the control group,0.5 ml per mouse.Two months later,all mice were tested in the Morris Water Maze.Smears of the mice brain homogenate and pathological sections were examined.Results ① The density of cysts in the brain homogenate was 15/HP,and there was no evident pathological change in the hippocampus and adjacent areas of mice in the brain in the experimental mice.② Latency to platform,cumulative distance to the platform,total distance traveled in both experimental and control groups decreased significantly with the increase of training days(P