Aim To establish a postpartum depression animal model,assess the abnormal maternal behaviors of depressive dams,and observe the rapid antidepres-sant effects of the Yuejuganmaidazaotang (YG)on the PPD model.Methods Thirty-two female Balb /c were randomly assigned to two groups,the control group (Control,con)and the pre-pregnancy stressed group (Vehicle,veh),and vehicle was subjected to 3 weeks chronic restraint stress.After the last stressor,the pre-pregnancy stressed group was housed with a male.Af-ter about 4 weeks later,the mice gave birth to pups. Then at 3 weeks postpartum,we tested the maternal depressive-like behaviors,including sucrose preference test,forced swimming test and novelty suppressed feeding test.Both YG and Ketamine were single ad-ministered 24 hours before behavior test,with single saline for control group and PPD model group.Results After 3 weeks postpartum,the vehicle mice showed depression-like behaviors.Reduced preference in drinking sucrose solution was found in SPT (P <0.01 ).Immobility in FST was significantly increased in vehicle groups (P <0.01 ).In NSFT,the vehicle group displayed a significantly increased latency and reduced unit of food intake compared with control group(P <0.01,P <0.01 ).Acute YG improved per-formance in the SPT(P <0.01),FST (P <0.01)and NSF (P <0.01,P <0.01),which was similar to ket-amine.Conclusions Chronic pre-pregnancy stress can induce dams into postpartum depression.Acute YG exert fast antidepressant effect on this PPD model simi-lar to ketamine.

Objective To study the application value of endoscopic purse-string sutures with titanium clips and endoloops for the gastric wall defect during endoscopic full-thickness resection (EFTR). Methods Data of iffteen hospitalized patients with gastric submucosal tumor (SMT) undergone EFTR was reviewed. The patients were all applied with endoscopic purse-string sutures with titanium clips and endoloops, which was performed after the EFTR when the gastric walls were perforated artiifcially. Results The gastric tumors were complete successfully resected in the iffteen patients through endoscopic surgery, applied the purse-string sutures with titanium clips and endoloops after the EFTR when the gastric walls were perforated artiifcially. Approximately, ifve clips were utilized on average. Postoperative surgical wound healing was followed up for 6 months, no tumors recurred. Conclusion It is safe, minimally invasive treatment method for rapid rehabilitation in endoscopic full-thickness resection utilized purse-string sutures with titanium clips and endoloops.

Background The use of adaptive optics (AO) system in ophthalmic clinic and basic studies has increased in recent years.However,there are few reports on the stability of ocular aberrations after correction.Objective This study was to analyze the stability of aberration after correction by observing the repeatability of ocular aberration measurements.Methods Forty-one postgraduate school students and volunteers who meet the conditions were included from February to April 2014.The Zernike aberration coefficients including astigmatism (Z2-2,Z22),defocus (Z02),trefoil (Z33,Z3-3),coma (Z3-1,Z13),spherical aberration (Z40) and the value of root mean square (RMS) including 3rd-order to 7th-order aberrations,total higher-order aberrations (HOAs) and total ocular aberrations (TOAs) were measured by using AO system.The repeatability and stability of these data after corrected with AO system were analyzed.The repeatability was evaluated by ANOVA,within-subject standard deviation (Sw),repeatability (r) and intra-class correlation coefficients (ICC).The stability was evaluated by the nonparametric Friedman's rank test.Results AO system showed excellent repeatability on Z2-2,Z22,Z20 and TOA RMS (ICC＞ 0.9),good repeatability on Z13,Z33,Z3-3,Z40,3rd-order RMS,4th-order RMS,HOA RMS (ICC ＞ 0.75),poor repeatability on Z3-1,5th-order RMS,6th-order RMS,7th-order RMS (ICC ＜ 0.75).Repeatability (2.77 Sw) values ranged from 0.009 mm (7th-order RMS) to 0.163 mm (Z31).After low-order ocular aberrations were corrected,It was founded that Z2-2,Z22 reached stable state at the 4th second;Z02 was stable at the 6th second;Z3-3 and Z33 reached stable state at the 4th second and third second,separately;Z13 was stable from 3rd-second to 9th-second,Z3-1 was stable at the 4th-second.Z40 and HOA RMS were stable at the third second and fifth second,respectively.The Z2-2,Z02,Z22,Z3-3,Z3-1,Z33,Z40 and HOA RMS were significantly different among different time points before and after low-order aberrations correction (all at P ＜ 0.05).Z2-2,Z22,Z20 reached stable state at the 4th-second,3rd-second and 5th-second,respectively;Z3-3,Z33 reached stable state at the 2nd-second and 3rd-second,respectively;Z3-1and Z40 reached stable state at the 2nd-second;HOA RMS reached stable state at the 5th-second.Conclusions After correcting the human ocular aberration,different aberrations can reach stable state at different time.The time of Z02,Z22,Z3-3,Z3-1,Z40reaching stable state after 2nd-order to 5th-order ocular aberrations correction was earlier than those of lower-order aberrations correction.

Objective To explore the correlation between psychological health service demand and loneliness and anxiety depression in rural left-behind women.Methods 260 left-behind wo nen in Hebei province were surveyed by psychological health service demand scale,UCLA loneliness scale,trait anxiety scale and the center for epidemiologic studies depression scale (CES-D).Results There were statistically significant differences between the only child and non-only child left-behind women in mental health service demand ((131.72±13.91) vs (122.94±14.76)),loneliness ((52.94±5.65) vs (49.864±5.90)) and anxiety ((50.97±6.38) vs (47.16±4.80)) (t=3.313,2.899,4.151,P＜0.01).The mental health service demand,loneliness,anxiety and depression of left-behind women were different in the age of marriage (F=6.196,9.441,5.257,4.221,all P＜0.01),husband go out time (F=2.761,27.020,4.550,2.830,all P＜0.05) and degree of farm work (F=12.142,6.403,4.115,5.366,all P＜0.001).The anxiety of left-behind women was positively correlated with service content,service demand and depression (r=0.138-0.221,P＜0.01).Depression was negatively correlated with mental health service demand and service teams (r=-0.352--0.223,P＜ 0.01).Loneliness was positively correlated with service content,anxiety and depression (r=0.177-0.262,P＜ 0.01).Multiple linear regression showed that husbands go out time (β=0.326),farm work in very heavy degree (β=-0.376) and relatively heavy degree (β=-0.281),depression (β=-0.194) had a predictive effect on mental health services.Conclusion The mental health service demand of left-behind women are affected by their age,whether the only child,the age of marriage,their husbands' go out time and the degree of heavy farm work.

OBJECTIVE:To systematically evaluate the monitoring system for global short drugs,and provide evidence-based reference and policy recommendations for developing the short drug monitoring in China. METHODS:Relevant literatures pub-lished in PubMed,Embase,CNKI,Wanfang,VIP database from building to Apr. 3rd in 2017 were retrieved by using"Drugs (cheap drugs,essential medicines,emergency drugs) storage""Short drugs""Insufficient supply of drugs""Drug shortage"as Chinese keywords,and"Drug storage""Out-of-stock drug""Stortage of medicine""Stock out of medicine"as English keywords. Literatures about monitoring system for short drugs in Baidu,Google and national or regional health administration websites were collected,and general information,data collection,data validation,data reporting method,feedback and improvement measures of monitoring system were extracted. RESULTS & CONCLUSIONS:Totally 25 literatures were included,20 national or regional health administration websites were retrieved. 11 countries and European Union had established monitoring system for short drugs. The main reporting agencies in each country were different,which were production enterprises,business enterprises and medical in-stitutions. It was mainly reported by network. Data validation was mainly conducted by specialized departments or groups for short drugs in each country. The monitoring reporting included information of short drugs and discontinued drugs. Countermeasures in each country mainly included looking for alternative drugs,encouraging production,temporary import,looking for new or other sources of raw materials and speeding up the approval of short drugs. Besides, precautions included implementation relevant laws and guidelines for short drugs,and increasing the cooper-ation with non-government departments,etc. Monitoring sys-tem for short drugs needs to be further improved in China. Itis suggested to establish monitoring and early warning platform for short drugs,and hierarchical intervention mechanism,improv-ing relevant laws and developing guidelines on managing short drugs.

Objective To compare the postoperative outcomes and early continence rate between conventional robot-assisted laparoscopic radical prostatectomy (RARP) and Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RSRARP).Methods The date from 50 patients who underwent RSRARP and 122 patients who underwent conventional RARP between 2016 September to 2017 included study.Ninety-two patients (forty-six patients in RARP group and forty-six patients in RSRARP group) were collected by propensity-score matching which were performed using eight preoperative variables.Preoperative data of patients in RSRARP group [patients age (67.1 ± 5.7) years,BMI (24.6 ± 2.7) kg/m2,tPSA 10.7 ng/ml (0-40.7 ng/ml),Gleason score 7 points (6-9 points),prostate volume 31.9 ml (10.0-95.4 ml),ECOG score 0 points (0-1 points),urinary domain of EPIC 94.8 points (63.9-100 points),clinical stage from T1cN0 M0 to T3a N0 M0] and conventional RARP group [patients age (67.2 ± 6.7) years,BMI (25.2 ± 3.1) kg/m2,tPSA 10.7 ng/ml (0-40.7 ng/ml),Gleason score 7 points (6-9 points),prostate volume 36.8 ml (8.9-81.0 ml),ECOG score 0 points (0-1 points),urinary domain of EPIC 95.8 points (63.9-100.0 points),clinical stage from T1c N0Mo to T3a N0M0] had no significant differences.We reviewed console time,estimated blood loss,the rate of leakage,complications,average daily drainage,pathological result,continence,urinary domain of EPIC one month,two months and three months after operation.Results All 92 cases were successfully performed robotically.Mean operation time was significantly more in RARP group than in RSRARP group [(223.9 ±48.9) min vs.(198.91 ±34.2)min,P ＜ 0.05)].There was no significant difference between the postoperative data of patients in RSRARP group [estimated blood loss 200 ml (50-1 200 ml),average daily drainage 82.5 ml (11.7-571.0 ml),the rate of leakage 6％,Clavien-Dindo grade Ⅰ (9％),Clavien-Dindo grade Ⅱ (4％),pathological stage pT1 (2％),pT2 (52％),pT3 (46％)] and RARP group [estimated blood loss 200 ml (100-1 200 ml),average daily drainage 102.9 ml (23.3-534.7 ml),the rate of leakage 4％,Clavien-Dindo grade Ⅰ (9％),Clavien-Dindo grade Ⅱ (2％),pathological stage pT1 (0),pT2 (46％),pT3 (54％)] (P ＞ 0.05).Early continence rate one week and one month after surgery was significantly higher in RSRARP group than in RARP group (78％ vs.35％,91％ vs.79％,P＜0.05).Urinary domain of EPIC one month and two months after surgery was significantly more in RSRARP group than in RARP group [(91.4±8.3) vs.(84.6±10.9),(95.0±7.5) vs.(91.6±7.8),P＜0.05].There was no significant difference in the rate of positive surgical margin between RSRARP group and RARP group (22％ vs.17％,P ＞ 0.05).Conclusions RSRARP were time-saving,safe and effective for the surgical treatment of localized prostate cancer.It seemed to yield a better outcome regarding early return to urinary continence postoperatively.

Objective:To explore the mediating roles of rumination and avoidance coping between information anxiety and suicidal ideation.Methods:In March 2022, a total of 896 college students were surveyed by the information anxiety scale(IAS), ruminative responses scale(RRS), coping style questionnaire(CSQ)and self-rating idea of suicidal ideation scale(SIOSS). The ANOVA analysis, Pearson correlation analysis and mediating effect analysis were performed by the SPSS 22.0 software.Results:The detection rate of suicidal ideation among college students was 9.15%(82/896). The information anxiety score was(73.84±17.29), the rumination score was(47.73±12.16), the avoidance coping score was(3.76±2.52), and the suicidal ideation score was(5.41±4.09). Information anxiety was significantly positively correlated with rumination, avoidance coping and suicidal ideation( r=0.49, 0.36, 0.37, all P<0.05). Rumination was significantly positively correlated with avoidance coping and suicidal ideation( r=0.42, 0.59, both P<0.05). There was a significantly positive correlation between avoidance coping and suicidal ideation( r=0.45, P<0.05). Information anxiety affected suicidal ideation of college students through four paths.The direct effect value of information anxiety on suicidal ideation was 0.06, accounting for 16.67% of the total effect. The effect values of the separate mediating effect of rumination and avoid coping were 0.22 and 0.04, and accounting for 61.11% and 11.11% of the total effect respectively. The chain mediating effect value of rumination and avoid coping was 0.04, accounting for 11.11% of the total effect. Conclusion:Information anxiety can directly affect suicidal ideation of college students and indirectly affect suicidal ideation through rumination and avoidance coping.

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

ObjectiveTo investigate the genetic association between nonalcoholic fatty liver disease （NAFLD） and type 2 diabetes mellitus （T2DM） using bidirectional two-sample Mendelian randomization （MR）， as well as the causal relationship between NAFLD and T2DM across different body mass index （BMI） categories. MethodsThe data were derived from genome-wide association studies conducted in European populations， with a sample size of 32 941 cases for NAFLD， 312 646 cases for T2DM， and 681 275 cases for BMI. The univariate and multivariate MR methods were used to assess the bidirectional causal relationship between NAFLD and T2DM in the general population and across different BMI subtypes. The methods of inverse-variance weighting， MR-Egger regression， constrained maximum likelihood and model averaging， and weighted median were used to conduct the MR analysis， and MR-Pleiotropy Residual Sum and Outlier， radial MR， the MR-Egger intercept method， and the Cochrane Q test were used for sensitivity analysis. ResultsThe univariate MR analysis revealed a bidirectional causal relationship between NAFLD and T2DM in the general population （forward analysis： odds ratio ［OR］=9.75， 95% confidence interval ［CI］： 2.57‍ ‍—‍ ‍37.00， P<0.001； reverse analysis： OR=1.01， 95%CI： 1.00‍ ‍—‍ ‍1.01， P<0.01）. After adjustment for BMI， the multivariate MR analysis showed that the causal relationship between NAFLD and T2DM remained significant in the general population （OR=33.12， 95%CI： 7.57‍ ‍—‍ ‍144.95， P<0.000 1）. The subgroup analysis showed a causal relationship between NAFLD and T2DM across all BMI subtypes （lean subgroup： OR=12.19， 95%CI： 3.35‍ ‍—‍ ‍44.40， P<0.001； overweight subgroup： OR=4.30， 95%CI： 1.69‍ ‍—‍ ‍10.92， P<0.01； obese subgroup： OR=1.67， 95%CI： 1.14‍ ‍—‍ ‍2.44， P<0.01）. ConclusionThis study reveals the causal relationship between NAFLD and T2DM in the general population of NAFLD and across different BMI subtypes from a genetic perspective.

Objective To establish a postpartum depression animal model induced by pre-pregnancy stress,assess abnormal maternal depressive-like behavior,observe the expression of disrupted-in-schizophrenia 1 (DISC1) in the hippocampus,and detect serum estradiol and corticosterone.Methods A total of 32 female Balb/c were assigned to two groups using random number table:the control group and the pre-pregnancy stressed group(model group),and the model group was subjected to 3 weeks of chronic restraint stress. After the last stressor,the control group and the model group were housed with a male. About 4 weeks later,the mice gave birth to pups. Then at 3 weeks postpartum,open field test,tail suspension test,and sucrose preference test were carried out. The expressions of DISC1 mRNA and protein of hippocampus were detected by real-time quantitative polymerase chain reaction and Western blot,respectively. The serum levels of estradiol and corticosterone were detected with enzyme linked immunosorbent assay. Results After 3 weeks of postpartum,the model mice showed depression-like behaviors. In the open field test,there was no effect on the total distance moved or time spent in the center field (P>0.05). Immobility in tail suspension test was significantly increased (t=-4.950,P<0.001) and sucrose preference was significantly reduced in model group (t=2.475,P<0.05). There was significant statistical difference between control and model group on the expression of DISC1 mRNA (t=-8.915,P<0.001) and protein (t=-5.004,P<0.01) in hippocampus. There was no significant statistical difference on estradiol and corticosterone between two groups (P>0.05). Conclusion Chronic pre-pregnancy stress can induce dams into postpartum depression.The pathogenesis of postpartum depression may be related to the regulation of DISC1 in the hippocampus.