Objective To research the changes of regional gray matter volumes in first-episode, medication naive females with major depressive disorder. Methods Magnetic resonance imaging and voxel-based mor-phometry were used to compare regional gray matter volumes between 14 medication-naive female participants with a first episode of major depressive disorder ( MDD) ( age( 29. 5 ±6.8) years, number of education years(11.4 ± 2. 7) years, duration of iIIness(5.4 ±5. 2 ) months, H AMD score(27.6 ±5.5)) and 14 female healthy comparison participants (HC) (age(29.5 ±6.9)years,number of education years( 12. 2 ±3. 3)years,HAMD score(2. 1 ± 1.9)). Results Volumes of bilateral anterior cingulate cortex ( ACC) and right amygdala were significantly smaller in the MDD group than those in the HC group. Conclusion These results suggest that volume reductions in ACC and amygdala in females with MDD are present at illness onset.

Objective To investigate the value of CT perfusion imaging in evaluation of therapeutic effect and prognosis in radiotherapy for lung cancer.Methods Fifty-one cases of lung cancer who were unable or refused to be operated on,36 males and 15 females,aged 37 - 80,underwent CT perfusion imaging,29 of which only before radiotherapy and 22 before and after radiotherapy twice.The images were collected by cine dynamic scanning (5 mm/4 slices ) and input into the GE AW4.0workstation for data processing.The slice positions of CT imaging were determined according to the largest tumor size in CT scan.Regions of interest of tumor were drawn at the region corresponding to the original images of CT perfusion.Radiotherapy was performed after CT perfusion imaging.Relevant parameters,including blood flow ( BF),blood volume ( BV),mean transit time ( MTT),and permeability surface (PS) were calculated.The treatment response after radiotherapy was evaluated by RECIST.At 2 -4 weeks after the treatment,CT examination was conducted once more.Results The tests of the 51 patients showed that the BV was 13.6 ml·100 g-1,the BF was 129.5 ml·min-1 ·100 g-1,the MTT was 9.1 s,and the PS was 10.0 ml· min- 1· 100 g-1 before radiotherapy.The tests of the 22 of the 51 patients showed that the values of BV and BF after radiotherapy were 7.6 ml· 100 g-1 and 97.8 ml·min-1· 100 g-1,respectively,both lower than those before radiotherapy (11.2 and 108.7 ml·min-1·100g-1,respectively),however,both not significantly ( t =1.28,0.40,P ＞ 0.05 ) ; and the values of MTT and PS after radiotherapy were 8.9 s and 7.8 ml·min-1· 100 g-1,respectively,both not significantly higher than those before radiotherapy ( 7.2 s and 6.8 ml· min -1· 100 g-1,respectively,t =- 1.15,- 0.57,P ＞0.05 ).The mean area of tumor after radiotherapy was 1189.6 mm2,significantly less than that before radiotherapy ( 1920.3 mm2,t =3.98,P ＜0.05).The MTT of the SCLC patients was 12.9 s,significantly longer than that of the NSCLC patients (6.5 s,t =2.54,P ＜0.05).The MTT of the tumor with the area ≤ 10 cm2 was 11.2 s,significantly longer than that of the tumors with an area ＞ 10 cm2(5.8 s,t =2.59,P ＜ 0.05 ).The BV of the responder group was 19.2 ml· 100 g- 1,significantly higher than that of the nonresponder group (4.6 ml· 100 g - 1,t =3.62,P ＜ 0.05 ).There were not significant differences in all the perfusion characteristics between the cases with the disease-free advanced survival time ≤ 10 months and those with disease-free advanced survival time ＞ 10 months.Conclusions CT perfusion imaging helps in diagnosis and radiotherapy of lung cancer to a certain degree.

Objective To investigate the relationship between acute radiation proctitis and radiation dose,volume as well as radiation time,in the process of intensity-modulated radiation therapy (IMRT) for the cervical cancer patients.Methods A total of 51 patients with locally advanced cervical cancer were enrolled from January 2011 to December 2013.Those patients were then classified into grade 1 to 4 groups,according to the RTOG/EORTCtoxicity grading standard.The exposure dose volume and the average dose of rectum under the standard plan were evaluated with dose-volume histogram (DVH).The ANOVA test was used for analyzing Dmax,D mean,D1 cm3,D2cm3,D40 and V40 values of rectum and the average exposure dose of rectum.Results The average time of acute radiation proctitis with clinical symptoms was (23.06 ± 12.01) d after radiotherapy.Dmaxvalues of rectum in grade 2 group was lower than those in grade 3 and 4 groups (F =5.268,P ＜ 0.05).Moreover,D1 cm3 and D2 cm3 values of rectum in grade 1 and 2 groups were also lower than those in grade 3 and 4 groups (F =4.893,4.406,P ＜ 0.05).There was no statistically significant difference between D40 and V40 values.Conclusions The acute radiation proctitis could be frequently found around 20 days during the IMRT for cervical cancer patients.Mild and moderate acute radiation proctitis are more common,while severe acute radiation proctitis is rare.Minimizing Dmax,D1 cm3 and D2 cm3 values of rectum might reduce the incidence of severe acute radiation proctitis in cervical cancer patients receiving IMRT.

Objective To investigate the effects of environmental hypothermia on hemodynamics and oxygen metabolism in unanesthetized swine model of hemorrhagic shock.Methods A total of 16 Bama pigs provided by animal experiment centre of the General Hospital of Shenyang Military Command were randomized into two groups ( n =8,each):ambient temperature (A) and hypothermia ( H ).Venous blood (30 mL/kg) was continously withdrawn over 15 minutes to establish hemorrhagic shock model.Core temperature,heart rate,mean arterial pressure,central venous pressure,cardiac output,saturation of mixed venous blood and blood gas analysis were recorded at the baseline and different hemorrhagic shock time.DO2I and VO2I,and the O2 extraction ratio (O2ER) were calculated.Results Core body temperature in group A decreased slightly after hemorrhagic shock model had established and environmental hypothermia resulted in more reduction in core body temperature.The mortality rate was significantly higher in group H (50％) than in group A (0％) (P ＜0.05).DO2I and VO2I decreased significantly after hemorrhage.No difference was found in hemodynamics,DO2I and VO2I between group A and group H,but the difference of pH,lactic acid and O2ER were significant between the two groups (P ＜ 0.05 ).conclusions Environmental hypothermia aggravated the disorder of oxygen metabolism after hemorrhagic shock,which was associated with poor prognosis.

Objective:To analyze the distribution and drug sensitivity of pathogens in bronchoalveolar lavage fluid(BALF)of children with severe community acquired pneumonia(CAP)in Qingdao from 2018 to 2020.Methods:The clinical data of 482 children with severe CAP in Qingdao admitted to Women and Children′s Hospital of Qingdao University were collected.BALF was collected by bronchoscopy for detection of bacteria and mycoplasma.Results:(1)Bacterial infection was detected in 139 cases(27.84%), mycoplasma infection in 119 cases(24.69%), and virus infection in 141 cases(29.25%). (2)The detection rates of bacteria and virus infection in the 1-12 months old group were higher.The detection rate of mycoplasma pneumoniae was the highest in the group over 5 years old.(3)A total of 139 strains were positive in bacterial culture of lavage fluid under bronchoscope: 55 strains(39.57%) of gram-negative bacilli and 84 strains(60.43%) of gram-positive cocci.Streptococcus pneumoniae was the most common gram-positive bacteria.Haemophilus influenzae was the most common gram-negative strain.(4)Streptococcus pneumoniae and Staphylococcus aureus were highly sensitive to amoxicillin clavulanate potassium, vancomycin and linezolid.The resistance rate to erythromycin was high(100%). (5)Haemophilus influenzae, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly sensitive to meropenem and cefoperazone sulbactam.They were highly resistant to amoxicillin, ampicillin and cefuroxime(>80%).Conclusion:Severe CAP in Qingdao area is mainly caused by virus and bacteria within 1 year old.Mycoplasma pneumoniae infection is the main cause of children over 5 years old.Respiratory syncytial virus, adenovirus and parainfluenza virus are main causes of virus infection.Streptococcus pneumoniae and haemophilus influenzae are the main pathogens, which are more sensitive to vancomycin, linezolid, meropenem and cefoperazone sulbactam, but resistant to erythromycin and amoxicillin.

Objective To investigate the risk factors and clinical characteristics of gastric inflammatory fibroid polyp(GIFP)for gastrointestinal hemorrhage.Methods 66 patients(68 lesions in total)with GIFP diagnosed by endoscopic or surgical resection from January 1,2013 to September 30,2022 were collected.According to the presence or absence of gastrointestinal hemorrhage,the patients were divided into bleeding group(n = 16)and non-bleeding group(n = 50).Collect clinical data on gender,age,clinical manifestations,lesion location and size,endoscopic characteristics,Helicobacter pylori infection,surgical methods and pathological results of each group of patients.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of endoscopic characteristics of GIFP for gastrointestinal hemorrhage,and summarize the clinical characteristics of GIFP with gastrointestinal hemorrhage,then calculate the rate of correct diagnosis.Results The age of the bleeding group was significantly younger than that of the non-bleeding group,and the lesion size was significantly larger than that of the non-bleeding group,with statistically significant differences(P＜0.05).The incidences of endoscopic neoplasm-like elevation of lesions,surface with erosion or ulceration,accompanied by ballvalve syndrome and ultrasonic gastroscopy with blood flow signals in the bleeding group were significantly higher than those in the non-bleeding group,and the differences were statistically significant(P＜0.05),but there were no statistical differences in other indicators between the two groups(P＞0.05).In order to further investigate the relationship between endoscopic characteristics and gastrointestinal hemorrhage,multivariate Logistic regression analysis showed that neoplasm-like elevation,submucosal eminence,ulcer or erosion on the surface and ball valve syndrome were risk factors for gastrointestinal hemorrhage in GIFP(O(R)＞1,P＜0.05).The overall rate of GIFP correct diagnosis before surgery was 27.94%.The rate of diagnosis in patients echoendoscope before surgery was 38.78%,it was significantly higher than that without undergoing echoendoscope(χ2 = 20.82,P = 0.000).Conclusion The shape of the lesion,presence of ulcers or erosion on the surface,and presence of ball valve syndrome are risk factors for gastrointestinal hemorrhage.Preoperative endoscopic ultrasonography can improve the accuracy of preoperative diagnosis.When there is a risk of gastrointestinal hemorrhage in GIFP,early endoscopic diagnosis and therapeutic resection should be performed to avoid unnecessary surgical procedures,which can improve prognosis and improve patient quality of life.

Objective:To analyze the distribution of pathogenic bacteria in bile culture in patients with common bile duct stones and biliary tract infections, in order to guide clinical optimization of antibiotics application.Methods:From March 30, 2017 to December 31, 2021, at Affiliated Hospital of Qingdao University, 753 patients with common bile duct stones and biliary tract infections and received endoscopic retrograde cholangiopancreatography were selected. Bile samples were obtained for bacterial culture, strain type identification and drug sensitivity test in order to analyze bile pathogenic bacteria distribution, change trend and drug resistance. Chi-square test was used for statistical analysis.Results:From 2017 to 2021, the total positive rate of bile culture in 753 patients with choledocholithiasis complicated with biliary tract infection was 90.17% (679/753). From 2017 to 2021, the positive rates of bile culture were 82.05% (64/78), 88.81% (119/134), 88.03% (125/142), 93.87% (199/212), and 91.98% (172/187), respectively, and the difference was statistically significant ( χ2=10.78, P=0.029). The positive rate of bile culture in 2017 was lower than those in 2020 and 2021, and the differences were statistically significant ( χ2=9.43 and 5.57, P=0.002 and 0.018). There were no significant differences in the positive rates of bile culture among the other years (all P>0.05). A total of 1 033 pathogenic bacteria were detected in the 679 bile specimens with positive bile culture results. Among which the total proportion of Gram-negative bacilli was 57.02% (589/1 033), and from 2017 to 2021 the proportions were 66.38% (77/116), 66.47% (111/167), 59.43% (104/175), 54.75% (173/316), and 47.88% (124/259), respectively. The total proportion of Gram-positive cocci was 41.05% (424/1 033), and from 2017 to 2021 the proportions were 31.90% (37/116), 31.74% (53/167), 38.86% (68/175), 44.30% (140/316), and 48.65% (126/259), respectively. The total proportion of fungus was 1.94% (20/1 033), and from 2017 to 2021 the proportions were 1.72% (2/116), 1.80% (3/167), 1.71% (3/175), 0.95% (3/316), and 3.47% (9/259), respectively. From 2017 to 2021, the proportion of Gram-negative bacilli gradually decreased, while the proportion of Gram-positive cocci gradually increased, and the differences were statistically significant ( χ2=20.14 and 17.91, P<0.001 and =0.001). From 2017 to 2021, the change in the proportion of fungus was not statistically significant ( P>0.05). The main Gram-negative bacilli in the bile culture were Escherichia coli (31.36%, 324/1 033) and Klebsiella pneumoniae (12.68%, 131/1 033); the main Gram-positive cocci were Enterococcus faecalis (14.04%, 145/1 033) and Streptococcus salivarius (4.36%, 45/1 033). From 2017 to 2021, the proportions of Escherichia coli were 39.66% (46/116), 38.92% (65/167), 33.14% (58/175), 28.48% (90/316), and 25.10% (65/259), respectively, with gradual decrease and the difference was statistically significant ( χ2=14.34, P=0.006). From 2017 to 2021 the detection rates of extended-spectrum β-lactamase (ESBL) in Escherichia coli and Klebsiella pneumoniae were 30.43% (14/46), 26.15% (17/65), 29.31% (17/58), 38.89% (35/90), 40.00% (26/65), and 4/15, 20.00% (5/25), 20% (5/25), 24.32% (9/37), and 31.03% (9/29), and there were no significant differences in the detection rates of ESBL between different years (both P>0.05). Conclusions:From 2017 to 2021, the positive rate of bile culture in patients with choledocholithiasis complicated with biliary tract infection showed an overall increasing trend. Gram-negative bacilli were still dominated in bile pathogenic bacteria, while the proportion of Gram-positive cocci remarkably increased, and the bile bacterial spectrum significantly changed. Clinicians should adjust the antibiotic dosing regimens according to the variation of bacterial spectrum and drug resistance.

Objective:To investigate the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with rosacea, and to analyze the relationship between breath test results and the occurrence of rosacea.Methods:Patients with rosacea were enrolled from the outpatient department of Xiangya Hospital from March 2022 to June 2023. The methane-hydrogen breath test was used to detect intestinal levels of methane and hydrogen in all patients to investigate the prevalence of SIBO. The basic information, clinical symptoms and severity, quality of life scores, gastrointestinal symptoms, and past medical history of the patients were collected. Statistical analysis was carried out by using the chi-square test, nonparametric test and multivariate logistic regression models to investigate the relationship between SIBO and the occurrence of rosacea.Results:A total of 116 patients with rosacea completed the methane-hydrogen breath test. They were aged 18 to 56 years (median [ Q1, Q3]: 25 [22, 33] years), and included 7 males (6.0%) and 109 females (94.0%) ; there were 43 cases (37.1%) of erythematotelangiectatic rosacea, and 73 (62.9%) of papulopustular rosacea. As the breath test showed, 94 patients were diagnosed with SIBO (81.0%, 95% CI: 72.7% - 87.7%) based on the breath tests, 84 showed positive hydrogen breath test results (72.4%, 95% CI: 63.3% - 80.3%), and 47 had positive methane breath test results (40.5%, 95% CI: 31.5% - 50%). Among the 67 patients with moderate to severe erythema, 33 (49.3%) showed positive methane breath test results, and 14 of 49 (28.6%) patients with mild erythema showed positive methane breath test results, with a rate difference of 20.7% ( P = 0.025, 95% CI: 13.9% - 27.5%) ; there were no significant differences in the positive rates of SIBO and hydrogen breath test results between the patients with moderate to severe erythema and those with mild erythema (both P > 0.05). No significant differences were observed in the age, gender, clinical subtypes, severity of papulopustules, flushing and burning sensation, or rosacea quality of life index scores between the SIBO-positive and -negative groups, between hydrogen-positive and -negative groups, and between methane-positive and -negative groups (all P > 0.05). Multivariate logistic regression analysis showed that methane positivity on breath test was associated with the severity of erythema in rosacea ( OR = 2.495, 95% CI: 1.102 - 5.649, P < 0.05) . Conclusions:The prevalence of SIBO was relatively high in the patients with rosacea. However, only the positive rate of methane breath test differed between the rosacea patients and non-rosacea controls, and there was some correlation between methane positivity on breath test and increased severity of rosacea erythema.