Objective:Using a diagnostic test research,to explore the reliability and validity of the Patient Health Questionnaire (PHQ-9)on screening of depressive disorders in general hospital,and to determine the cut points for depressions with different severities.Methods:Three hundred and nineteen help-seekers (n =319)con-sulting the outpatient department of psychiatry in a general hospital were collected continuously.Among them,80 were people without any psychiatric diagnosis,239 were patients with mental disorders.All of subjects were asked to fulfill PHQ-9,and were assessed by psychiatrist with Mini-International Neuropsychiatric Interview (M.I.N.I.) and Hamilton rating scale for depression.M.I.N.I.was gold standard to diagnose depressive disorder,HRSD was used to assess the illness severity.Result:Factor analysis showed good structure validity of PHQ-9.46 patients were diagnosed depressive disorders.The area under the receiver operator characteristic analysis (ROC)of PHQ-9 was 0.94 (95%CI:0.91 -0.97)for depressive disorders.With 15 as the critical value for depression screening,the sen-sitivity was 0.83 and specificity was 0.90,respectively.By the result of HRSD as the standard to rank different lev-els of depression,the cut points of PHQ-9 for mild,moderate,and severe depression was 6,12,and 15.The consis-tency between results of PHQ-9 (with cut points of 6,12,15)and HRSD was moderate (with kappa =0.49).The kappa between results of PHQ-9 (with recommended cut points of 5,10,and 15)and HRSD was 0.46.Cronbach αcoefficient of PHQ-9 was 0.892.Conclusion:It suggests that PHQ-9 has satisfying reliability and validity,and is applicable for screening depression and assessment of its severity of outpatients in general hospital.The recommen-ded cut points of PHQ-9 are applicable to depressive outpatients in general hospital in China.

Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

302 teeth with wedge-shaped defect in 168 patients were restored by SDR(smart dentin replacement,n =112),glass ionomer (n =98) and light-cured composite resin(n =92) respectively.12 to 15 month follow-up showed the success rate was 96.2％,84.8％ and 86.2％ respectively(P ＜ 0.01).SDR is an ideal material in restoring wedge-shaped defect.

Objective To investigate the relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus (T2DM) patients with normal uric protein.Methods According to the coronary artery lesion diagnosed by 320-dynamic volume CT,the 126 T2DM patients with normal uric protein were divided into three groups:no coronary stenosis group (group A,32 cases),coronary atherosclerosis group(group B,38 cases),coronary heart disease group (group C,56 cases).Then the serum cystatin C etc were compared among the three groups.Results The levels of serum cystatin C in group A,B,C were (0.89 ± 0.27),(1.31 ± 0.53),(1.54 ± 0.62) mg/L.With the increase of coronary artery lesions,it gradually increased,there was significant difference among the three groups (P ＜ 0.05).The patients were divided into three groups according to the level of serum cystatin C quartile.The incidence of coronary artery lesion in creased with the increased levels of serum cystatin C.The level of serum cystatin C increased from 75th percentile to 100th percentile,the incidence of coronary heart disease increased significantly (OR =8.32,P ＜0.05).The result of multiple Logistic regression analysis showed that history of hypertension (regression coefficient 4.135,P =0.000),glycosylated hemoglobin (regression coefficient 1.257,P =0.002),low density lipoprotein-cholesterol (regression coefficient 3.381,P =0.015),cystatin C (regression coefficient 2.046,P =0.030) were the independent risks of coronary heart disease in patients with T2DM.Conclusion The level of serum cystatin C may be a predictor for coronary heart disease in T2DM patients with normal uric protein.

Objective To explore the abnormally functional brain regions of female patients with depression by resting state functional magnetic resonance imaging (fMRI),and analyze the correlation with the severity of depressive symptoms.Methods 32 female patients diagnosed with depressive disorder and 40 matched healthy controls completed resting state fMRI scans.The whole brain's regional homogeneity (ReHo) and amplitude of low-frequency fluctuation(ALFF) were calculated,and the correlation analysis be tween ReHo and ALFF of brain regions with significant difference and the severity of depressive symptoms was conducted.Results Compared with control group,the left precuneus/left cuneus (MNI:-18,-81,45),bilateral precentral gyrus (MNI:-58,-5,35 and 57,-6,33),left inferior parietal lobule (MNI:-42,-36,45) and right inferior temporal gyrus(MN1:60,-45,-18) (P＜0.05,corrected by AlphaSim)in the case group showed significantly decreased ReHo,with statistical significance.Compared with control group,the left cuneus(MNI:-3,-87,30),right inferior temporal gyrus(MNI:60,-48,-18) and left precentral gyrus(MNI:-63,-3,26) (P＜0.05,corrected by AlphasSim)in the case group showed significantly decreased ALFF.The ReHo in the right inferior temporal gyrus was negative correlated with the HAMD-17 total score and retarda tion factor(r=-0.484,P=0.017;r=-0.408,P=0.048),the ALFF in the right inferior temporal gyrus was positively correlated with weight factor(r=0.574,P=0.003),and negative correlated with the number of depressive episodes(r=-0.416,P=0.043).Conclusion Female with depression in resting state have several abnormally functional brain regions and the extent of damage is correlated with the severity of depressive symptoms.Combination of the two parameters may yield a more comprehensive pathophy-siological mechanism for depressive disorder.

Objective To compare the effects of three kinds of Oncomelania hupensis RNA extraction methods,namely a modified SDS method,TRIzol reagent method,and CTAB method,so as to obtain an economical and efficient method for RNA extraction from O. hupensis. Methods The modified SDS method,TRIzol reagent method and CTAB method were applied to ex-tract the RNA from O. hupensis. A nucleic acid protein analyzer was used to measure the concentration and purity of RNA. The yields were calculated by the concentration of the products. The purity was indicated by A260/A280 and A260/A230. The quality of RNA was inspected by 1% agarose gel electrophoresis. The β-acting gene was selected as the target gene for RT-PCR analysis. Re-sults The RNA yields obtained by using the three kinds of extraction methods were significantly different(F = 16895.85,P <0.01)according to the analysis of variance. The LSD test showed that the yields obtained by using the modified SDS method were the highest,and those obtained by the CTAB method were the lowest. The purity of RNA extracted by the CTAB method was su-perior to that by the other two methods,and the A260/A280 and A260/A230 ratios of the CTAB method were in the range from 1.8-2.0 and 2.0-2.2. The A260/A230 ratios of the other two methods were both lower than 2.0. The RNA extracted by the modified SDS meth-od had the better integrity. The electrophoresis results showed that the 28S rRNA band,18S rRNA band and 5S rRNA band were clear,and there was no obvious smear between each band. The RNA obtained by the TRIzol reagent method had no 28S rRNA band,and that obtained by the CTAB method had no 28S rRNA and 5S rRNA bands. The β-acting gene of the RNA ex-tracted by all the three methods could be amplified by RT-PCR. The costs and time-consuming of the modified SDS method were less than those of the other two methods. Conclusion The modified SDS method is an economic and efficient method,and it is suitable for extracting the RNA of O. hupensis,especially for large sample preparation.

Objective:To establish the determination method for four lurasidone hydrochloride enantiomers by HPLC. Methods:Lurasidone hydrochloride enantiomers were separated on a CHIRALPAK AD-H column (250 mm × 4. 6 mm, 5μm). The mobile phase consisted of hexane-ethanol-diethylamine ( 90∶10∶0. 1) at a flow rate of 1. 0 ml·min-1 and the column temperature was at 40℃. The detection wavelength was 230nm. Results:The resolution of lurasidone hydrochloride enantiomers was above 2. 0. The linear calibra-tion curves were obtained over the range of 5-120 μg· ml-1 for all the enantiomers (r=0. 999 9). The recovery was above 99. 0%with RSD below 0. 5%. The detection limits were 5ng. Conclusion:The method is simple, accurate and rapid, and suitable for the de-termination and quality control.

[Objective] To investigate the clinical characteristics and risk factors of lower-extremity arterial disease in the patients with newly diagnosed type 2 diabetes mellitus combined with nonalcoholic fatty liver disease (NAFLD). [Methods] One hundred fifty-one patients were investigated respectively. The patients were divided into two groups (NAFLD-Group and non-NAFLD group) by liver ultrasonography and disease history, then their clinical data were collected and compared in order to find the differences of biochemical indicators and the morbidity of lower-extremity arterial disease between two groups. [Results] Ninety-two cases (60.93%) were complicated with NAFLD. NAFLD group had higher levels of fast insulin and C peptide level, postprandial insulin and C peptide level, uric acid, body mass index (BMI), homeostasis model assessment (HOMA-IR) and lower level of high-density lipoprotein cholesterol and insulin sensitive index than those of without NAFLD (P<0.05). One hundred and one cases(66.89%) were complicated with lower-extremity arterial disease. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group (75% vs. 54.24%, P<0.01). [Conclusion] Both lower-extremity arterial disease and NAFLD are common complicated with type 2 diabetes. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group.

ObjectiveTo investigate the clinical significance of inflammatory factors and adiponectin in type 2 diabetes milletus complicated with non-alcoholic fatty liver disease.Methods Two hundred and ten subjects aging from 25.0 to 65.0 years old,including 106 men and 104 women,were recruited into this study.They were divided into four groups: Forty cases of healthy control (NC),60 cases with newly-diagnosed type 2 diabetes (T2DM),65 cases with simple non-alcoholic fatty liver disease (NAFLD) and other 45 cases with newly-diagnosed T2DM complicated with NAFLD.The physical examination was performed for each patient.Serum levels of alanine aminotransferase (ALT),gamma-glutamyl transpeptidase (GGT),fasting plasma glucose (FPG),glycation hemoglobin A 1 c ( GHbA1c ),creatinine ( Cr),uric acid ( UA ),2 hours postprandic plasma glucose (2hPG),fasting insulin (FINS),lipid profiles were measured.Insulin resistance index (HOMAIR) was calculated.Tumor necrosis factor-α (TNF-α),high sensitive C-reactive protein (hs-CRP) and adiponectin were also detected.Results The serum levels of ALT and GGT,body mass index and waist/hip ratio were higher in the NAFLD,T2DM with NAFLD patient groups than that in T2DM and NC group ( P ＜0.05or P ＜0.01 ).The serum levels of TG and LDL-C were significantly higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.And serum TG levels in T2DM with NAFLD group were higher than that of T2DM group (P ＜ 0.05).FPG and GHbAl c were higher in T2DM and T2DM with NAFLD groups than that of NAFLD and NC groups.The serum levels of TNF-α,hs-CRP and HOMA-IR were higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.T2DM with NAFLD group had higher levels of TNF-α,hs-CRP and HOMA-IR compared with T2DM group.However,serum adiponectin levels of T2DM,NAFLD and T2DM with NAFLD groups were lower than that of NC group.And it was lower in T2DM with NAFLD group when compared with NC group ( P ＜ 0.05 ).Adiponectin was negatively associated with TNF-α,hs-CRP and HOMA-IR (r =-0.635,-0.668,-0.752 respectively,P ＜ 0.0l ).But HOMA-IR was positively associated with TNF-α,hs-CRP( r =0.667,0.706 respectively,P ＜ 0.01 ).ConclusionInflammatory factors and adiponectin may play important roles in the pathophysiology and progression of T2DM and NAFLD.The protective effects of adiponectin may come from its anti-inflammatory activity to relieve insulin resistance for NAFLD.

Objective:To provide a potential platform for transferring specific antigen against fish bacterial diseases based on attenuated Lm (EGDe-ΔactA/ΔinlB).Methods: Attenuated Lm (EGDe-ΔactA/ΔinlB) was used to express outer membrane protein K (Ompk),a conserved and effective vaccine candidate in vibrio.The identification of recombinant strains and detection of antigen genes were operated with PCR and RT-PCR,respectively.Results: The results of PCR showed that Lm-Ompk (L-O),Lm-Lmo0576-Ompk (L-L-O) and Lm-P-Ompk (L-P-O) were constructed successfully.The identity of foreign gene was 100％ compared with sequence of NCBI.The analysis of transcription showed that the expressions of Ompk in L-O,L-L-O and L-P-O were significant (P<0.001).Moreover,the expression of Ompk in the condition of antibiotic was higher than that in the BHI without antibiotic (P<0.05).Conclusion: Lm-Ompk (L-O),Lm-Lmo0576-Ompk (L-L-O) and Lm-P-Ompk (L-P-O) were constructed successfully.