Objective:To investigate the incidence of anxiety and depression and explore the effects of psycho- logical intervention on anxiety and depression in geriatric patients with chronic heart failure (CHF).Methods:A to- tal of 190 geriatric inpatients were recruited.They were assessed with the self-rating anxiety scale (SAS) and the self- rating depression scale (SDS) before the psychological intervention.All subjects were divided into two groups (101 in case group and 89 in control group) randomly.The case group received relaxation therapy and basic psychological care lasting four weeks,while the control group only received basic psychological care.Relaxation therapies,including re- laxation training and music therapy,were offered to patients in case group one hour per day for four weeks.Then the changes of SAS score,SDS score,and length of hospital stay of patients in two groups after psychological intervention were observed.The re-hospitalization rate due to CHF after discharge was assessed at 6-month follow-up.Results:The SAS score,SDS score,age,gender,educational level,economic status,caregiver status,cardiac function-graded, free medical service,self-care ability,and course of CHF were balanced between two groups before psychological inter- vention.The incidence of depression and anxiety of geriatric patients in our hospital were higher than that of the general population (45.8% vs.5%,52.6% vs.5-10%,respectively).After psychological intervention,the SAS score and SDS score were reduced in both case and control groups;the reduced degree in case group was higher than that in control group,and there was significant difference between the two groups (P

[Objective]To discuss the effect of post-natal depression on vaginal bleeding and lactation.[Methods]A retrospective analysis of 100 cases with complete information,including 66 cases of the control group,34 cases of post-natal depression,record the post-natal vaginal bleeding and lactation situation.[Results]The post-natal depression group 24h amount of vaginal bleeding after childbirth and lactation period was significantly higher than control group,while the volume of lactation was significantly lower than control group(P

Objective To compare the effects of breast conservative therapy and radical mastectomy in treatment of patients with early stage breast cancer.Methods 76 patients with early breast cancer,informed consent by themselves and their families were divided into breast conservative therapy group(BCT group,2 1 cases)and breast radical group(RT group,55 cases),and BCT group was conducted breast conserving surgery,and RT group Was given radical surgery of breast cancer.The two groups were all given conventional postoperative chemotherapy and endocrine therapy.Then the therapeutic effects and complications were observed and compared.Following up for 1 to 6 years,the recurrence was compared.Results All patients were cured.In BCT group,5 cases of subcutaneous fluid,2 cases offat liquefaction of incision,1 ease of wound infection,1 case of upper limb edema,and in RT group,8 cases of subcu-taneous fluid occurred,5 cases of wound fat liquefaction,2 cases of wound infection,3 cases of upper limb edema,and the difference of complication rate between the two groups had no significant difference(P＞0.05).The scores of quality life of BCT group were significantly higher than those of RT group(t=3.42,3.18,4.07,3.09,2.87,3.26,all P＜0.05).All patients were regularly followed up for 1 to 6 years,local recurrence rate and survival rate of BCT group Was 4.8%(1/21)and 95.2%(20/21),and those of RT group Was 3.6%(2/55)and 96.4%(53/55),and the difference of local recurrence rate and survival rate between the two groups had no statistical significance(all P＞0.05).Conclusion Breast conserving surgery for early breast cancer was safe and feasible without increasing the relapse rate,and could get a good quality of life.

Treatment options are limited for triple negative breast cancer (TNBC)since endocrinother-apy and targeted therapy that aims directly at human epidermal growth factor receptor-2 (HER-2)are ineffec-tive.As such,in addition to surgical treatment,the mainstay of treatment of TNBC is systemic cytotoxic chemo-therapy.The targeted therapy of TNBC is becoming a research hotspot because of traditional chemotherapy cura-tive effect is not good enough.A large number of clinical trials have found that patients with TNBC can get ben-efits from targeted molecular strategies including poly-adenosine diphosphate glucose pyrophospheralase-ribose polymerase-1 (PARP-1 )inhibitor and epidermal growth factor receptor (EGFR)inhibitor.

Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

Objective To evaluate the efficacy and safety of common therapy and individualized treatment in newly diagnosed patients with Helicobacter pylori (H.pylori) infection.Methods From March 2008 to February 2010,September 2013 to April 2014,January to October 2015,a total of 1 440 patients with H.pylori infection who received eradication therapy and with complete clinical data were retrospectively enrolled.Each was 350 cases in individualized treatment group,clarithromycin and bismuth containing quadruple therapy group and concomitant therapy group.A total of 100 cases were in standard triple therapy group,90 cases in sequential therapy group,and 200 cases in levofloxacin and bismuth-containing quadruple therapy group.The eradication rate of H.pylori,incidence of adverse events and compliance rate were compared in the six groups.Chi square test was performed for statistical analysis.Results The results of intention-to-treat analysis indicated that there was no statistically significant difference in H.pylori eradication rates among six groups (x2 =0.985,P=0.323).However,the results of modified intention-to-treat analysis showed that H.pylori eradication rate of individualized treatment group was the highest (92.5％ (282/305) and 93.3％ (278/298)),second was levofloxacin and bismuth-containing quadruple therapy group (90.3％ (167/185) and 91.6％ (164/179)),and the differences were statistically significant (x2 =11.285 and 13.981,both P＜0.01).There was statistically significant difference in indcidence of adverse events among the six groups (x2 =5.692,P=0.018),the incidence of adverse events in levofloxacin and bimuth-containing quadruple therapy group was lowest (16.2 ％ (30/185)),and second was individualized treatment group (21.0％ (64/305)).There was statistically significant difference in compliance rates among the six groups (x2 =4.712,P=0.023),the compliance rates of standard triple therapy group and sequential therapy group were highest (100％ (100/100) and 100％ (90/90)),and second was individualized treatment group (97.7％ (298/305)).Conclusions Both the levofloxacin and bimuth-containing quadruple therapy group and individualized treatment group can effectively eradicate H.pylori infection.The former may be safe and effective to patients unable to receive individualized therapy.

OBJECTIVE To investigate the antimicrobial application in a hospital of traditional Chinese medicine(TCM).METHODS Data of antimicrobial application in patients who were discharged within a month were investigated.RESULTS The usage rate of antimicrobials was 62.62%,the surgical departments were higher in antibacterial use than departments of internal medicine;the pathogenic detection rate was 17.28%;the usage rate of combinations accounted for 34.14%;the duration of preoperative and postoperative antimicrobial use was long,some patients didn′t receive rationally preoperative prophylactic antimicrobials.CONCLUSIONS Management of clinical antimicrobial application in hospital of TCM should be strengthened,especially on the indication of antimicrobial and pathogenic detection.

OBJECTIVE:To provide the reference for the Chinese government to establish medication policy in paediatrics.METHODS:The paediatric medication strategy set up by British Drug and Health Product Administration Bureau was introduced,and the current situation and problems in paediatric medication were analyzed.RESULTS & CONCLUSION:China should learn from British experience,and establish our own medication strategy in paediatrics as soon as possible.

The higher medical education systemin China has experienced six significant curricular program changes within the last century. And these changes seem to run in a circle:from the pluralistic to the singleness,and then back to the pluralistic.The process repeated itself.These changes in history could provide some valuable insights into the future reform of the higher medical education system in China.

Objective:To assess the effect and mechanism of ClassⅢ malocclusions treatment with Frankel-Ⅲ appliance and reverse Twin-block appliance. Methods:Twenty subjects of ClassⅢ malocclusion were included in this study(9 males,11 females). Among them, 10 subjects were randomly selected for treatment with reverse Twin-block appliance (T group) and 10 subjects for Frankel-Ⅲ appliance (F group). All patients were treated all the day for total of 4-11 months. The cephalometric records of these subjects were examined before and after treatment. The acquired data were processed with SPSS 10.0. Results: The results showed a mandible receded backward in both groups. Both group could accelerate the development of the maxillary bone. But the Frankel-Ⅲ was more effective. F group had significant effects of uprighting upper frontal teeth and flaring lower teeth. the average treatment time was 6.5 months in reverse twin-block appliance therapy group and 9 months in Frankel-Ⅲ appliance group. Conclusion: Both reverse Twin-block appliance and Frankel-Ⅲ appliance can treat angle classⅢ malocclusions effectively. The effects of maxillary changes of Frankel-Ⅲ appliance is better than reverse Twin-Block. Treatment period is shorter in T group than in F group.