Objective To explore the changing indications of visual P300 evoked by facial expression stimulus in social anxiety disorder (SAD). Methods 30 patients with SAD were consecutively recruited, and matched with 30 normal controls (NC). They were evaluated by self-designed demographic questionnaire and Liebowitz Social Anxiety Scale (LSAS), Meanwhile the examination of the visual P300 evoked by five facial expression stimulus included sad, happy, surprise, angry and disgust was administrated to SAD patients and normal controls. Results Compared with NC group, SAD group had higher target P2 amplitudes ( ( 3.73 ± 3.06 ) μV )and higher target P3 amplitudes( ( 9.43 ± 4.01 ) μV ) evoked by angry facial expression (P＜ 0.05 ) and higher target P3 amplitudes( (9.57 ±4.42) μV) evoked by disgust facial expression (P＜0.05). The scores of LSAS in SAD was positively correlated with target P2 amplitudes (P＜0.05). Conclusion SAD group has abnormal changing indications of visual P300 evoked by facial expression stimulus.

Objective 　The study aimed to measure the prevalence of postpartum depression, as well as their relevant psychosocial and biological factors. Methods　A sample of 299 women were prospectively studied at 3 day postpartum and 117 were reassessed at 42 day postpartum. They completed EPDS, some self-designed demographic and psychological investigation questionnaires. Results　23.08% suffered from postpartum depression. Some psychosocial factors such as support system were signigicantly related to the postnatal depression. Conclusions　Postpartum depression has social and psychological causal factors.

Objective：To explore the distribution of personality disorder tendency of outpatients in psychological counseling departments.Methods：Systematic sampling was used to get the sample population from Shanghai Psychological Counseling Center.The Personality Diagnostic Questionnaire(PDQ~(+4))was administered to 1402 clients to screen personality disorders.Results：The subscales for different type of personality disorder(PD)and total score of PDQ~(+4) were higher than normal sample(e.g.total score of PDQ~(+4):client(38.23±17.04)vs.normal sample(22.79±14.10),P<0.001).The score of borderline subscales in female clients were higher than that of males [borderline:female(4.25±2.48)vs.male(3.97±2.41),P<0.05],the score of antisocial,paranoid and schizotypal subscales in male clients were higher than that of females [antisocial:female(1.31)vs.male(1.71),P<0.001;paranoid:female(2.75)vs.male(3.02),P<0.01;schizotypal:female(3.31)vs.male(3.56),P<0.05].Age stratification showed that the subscales for different type of PD of PDQ~(+4) were decreased with age [e.g.,total score of PDQ~(+4):18～24 years(41.73)vs.25～34 years(39.46)vs.35～44 years(33.88)vs.≥ 45 years(30.64),Ps<0.001],the positive rate of PDQ~(+4) subscales of obsessive-compulsive(58.5%)and avoidant PDs(54.0%)were higher than others,followed by borderline PD(44.4%).Factor analysis was used for the score of PDQ~(+4),factor 1 to 3 corresponded to cluster C,B and A personality disorders respectively,and the total variance explained 67%. Conclusion：There are different rates of personality deviation between psychological counseling clients and normal sample in China.Some traits of personality disorders can be improved with the increasing of age.The abstracted factors by factor analysis are very consistent with what originally proposed in the theory of personality disorder.It should be paid attention to PD tendency of clients during psychological counseling.

Objective To investigate the difference of quality of life in patients with different symptom dimensions of obsessive-compulsive disorder(OCD).Methods Collected 54 cases of outpatient and the first inpatient with OCD to be the research group and 54 normal persons were the control group.The quality of life was assessed with SF-36,and compared the scores.An analysis was performed on the major categories of the YBOCS-SC to derive symptom dimension scores.Results Compared to the control group,patients with OCD showed significant impairment in seven domains of quality of life,especially in the mental health(t=12.474,P＜0.01),the roleemotional(t=9.407,P＜0.01),the social functioning(t=8.862,P＜0.01) and the vitality(t=8.057,P＜0.01).The patients with distinct symptom dimensions of ①symmetry/order,contribution rate 21.60％ ; ②contaminate/clean,contribution rate 16.37％; ③ aggression/religion,contribution rate 12.34％; ④ sex/check,contribution rate 10.90％.They showed different severity of the impairments in four domains of quality of life,the role-physical(F=5.199,P=0.004),the bodily pain (F=3.169,P=0.034),the role-emotional (F=9.350,P=0.000),the mental health(F=4.854,P=0.005).The differences mainly found between the ①②③group and the ④group by LSD multiple testing.Conclusion The mental health is severely damaged with OCD patients.There is stability with the structure of the symptom dimensions of OCD.And it maybe showed the heterogeneity of the symptoms for the significant difference of impairments of quality of life in patients with OCD.

In order to explore the treatment of Her-2 positive breast cancer patients who failed in multi-line treatments, we retrospectively analyzed the clinical data of a patient with refractory Her-2 positive breast cancer.The patient was initially diagnosed as Her-2 positive advanced breast cancer.After six line treatment in the outer hospital, the patient′s condition was basically in a progressive state.The breast tumor was broken and purulent, the lung metastasis increased, and the patient′s quality of life was poor.The patient was admitted to Department of Breast Surgery of Affiliated Suqian Hospital of Xuzhou Medical University, after MDT discussion, we gave pyrrolotinib combined with capecitabine treatment, the chest wound healed gradually, the lung metastasis gradually reduced, and the quality of life was better.A retrospective analysis of this case showed that pyrrolidine combined with capecitabine may bring hope to Her-2 positive breast cancer patients who failed to receive multi-line therapies, especially those who failed to target therapy.

Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.

Treatment-resistant depression (TRD) is characterized by a high suicide rate and a high recurrence rate. The effect of the medicine on TRD is not ideal with obvious side effects. Psychotherapy is an important method recommended in many guidelines for the treatment of depression. However, previous studies and clinical applications have paid little attention to the application of psychotherapy in TRD. Therefore, based on recent studies, this paper reviews the effects of psychotherapy on the depressive symptoms, suicide risk, and recurrence risk in TRD. Further, the possible therapeutic mechanisms are discussed, including the improvement of interpersonal function by dealing with early trauma in TRD, therefore alleviating symptoms; intervening in the dysfunctional cognitive pattern of TRD to help them cope with negative life events, therefore reducing stress and depression. Combined with the limitations of existing studies, the following directions can be considered in the future: improving the research quality, measuring behavioral and physiological indicators to further clarify the therapeutic mechanism, identifying ways in which psychotherapy can be combined with other treatments, exploring the group and online therapy to increase accessibility of psychotherapy for TRD.

Objective To explore the application of paclitaxel or docetaxel combined with cisplatin (TP) with cyclophosphamide,pirirubicin and fluorouracil (FAC) in the primary tumor molecular typing Luminal A,axillary lymph node metastasis three negative breast cancer. Methods From January 2012 to January 2014, the clinical data of forty-nine patients with were selected. All patients were divided into two groups by balance randomization method, TP group and FAC group. Twenty-five patients were treated with TP regimen and 24 patients were treated with FAC regimen. The clinical efficacy was evaluated after six cycles of chemotherapy. Chemotherapy effects,adverse reactions and survival rates of two groups were compared. Results All patients were given intravenous chemotherapy according to the plan and were evaluated for clinical efficacy. The response rate (RR) was 64. 0％ in TP group,including 4 cases of complete remission (CR),12 cases of partial remission (PR),7 cases of stable disease(SD) and 2 cases of progressive disease(PD). The adverse reactions were gastrointestinal reactions and granulocytopenia. The median progression-free survival ( PFS) and overall survival ( OS) were respectively 12. 4 months and 34. 1 months. In FAC group,the response rate ( RR) was 33. 3％,including 2 cases of CR,6 cases of PR,11 cases of SD and 5 cases of PD. The adverse reactions were gastrointestinal reactions,granulocytopenia and premature atrial contraction. The median PFS and OS were 7. 2 months and 20. 7 months respectively. The effective rate of TP group was higher than that of FAC group (χ2=4. 608,P=0. 032),and the progression-free survival time and total survival time were longer than those of FAC group (χ2 =8. 317, 8. 563, P=0. 004, 0. 003 ) . Conclusion Compared to FAC regimen, TP regimen could improve the survival rate of patients better with breast cancer of Primary tumor Luminal A and Axillary Lymph Node Metastasis Triple negative type, and adverse reactions were tolerated, it may be an optimized chemotherapy.