Objective To study the influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography (ERCP) patients. Methods A total of 292 patients with ERCP were randomly divided into control group and observation group with 146 cases in each group by the randomized block design method. The control group was given the conventional nursing care. The observation group was given the high quality nursing care based on the conventional nursing care. The score of Quality of Life of the World Health Organization (WHOQOL- 100), Quality of Life Index of Gastrointestinal Tract (GIQLI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale(VAS) before and after nursing care were observed and compared. The difference impact of two kinds of nursing mode on nursing quality between two groups was evaluated. Results WHOQOL-100 score in the observation group after treatment, including physiology and psychology and environment and social relations state such as grading, was respectively (59.3 ± 6.0), (61.8 ± 7.2), (60.3 ± 6.2), (62.8 ± 7.3) points and GIQLI index included self-conscious symptom and body physiological status and daily and social activities,such as state of emotional and psychological and the overall score, was respectively (79.8±4.9), (19.8±1.8), (14.7±1.9), (19.2±2.8), (105.7±6.6) points, which was (50.9±6.3), (52.5±6.7), (51.4±5.6), (53.4±7.1), (67.2±4.8), (15.6±1.9), (10.2±1.8), (16.3±2.3), (94.4 ± 6.2) points in control group, the difference between two groups was statistically significantly(t=1.876-2.327, P<0.05). HAMA score and SAS scores and SDS score and VAS score in the observation group after nursing was respectively (24.28 ± 4.78), (29.48 ± 6.54), (30.55 ± 7.32), (4.55 ± 1.18) points and respectively (36.68 ± 5.39), (41.72 ± 6.03), (42.65 ± 7.21), (6.07 ± 1.17) points in the control group, the difference between two groups was statistically significantly(t=2.876-4.012, P<0.05). Conclusions High quality nursing mode of ERCP in patients with perioperative patients of psychological and physiological all have different degrees of improvement and is suitable for popularization and application in clinic.

Objective To investigate the clinical efficacy and safety of six-hole moxibustion box therapy for stable chronic obstructive pulmonary diseases(COPD).Methods Sixty patients with thoracic facet joint disorder were randomly allocated to treatment and control groups, 30 cases each. The control group inhaled tiotropium bromide inhalation powder spray and the treatment group received six-hole moxibustion box therapy in addition. The COPD Assessment Test (CAT) score and the dyspnea score were recorded and peripheral blood oxygen saturation was measured in the two groups before and after treatment. The adverse reactions were monitored in the two groups. Results There were statistically significant pre-/post-treatment differences in the CAT score and the dyspnea score in the two groups (P<0.05). There were statistically significant post-treatment differences in the CAT score and the dyspnea score between the treatment and control groups (P<0.05). There were statistically significant differences in pre-/post- treatment CAT score difference value and dyspnea score difference value between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in peripheral blood oxygen saturation in the treatment group (P<0.05). There was a statistically significant post-treatment difference in peripheral blood oxygen saturation between the two groups (P<0.05).Conclusion Six-hole moxibustion box therapy plus tiotropium bromide inhalation powder spray is safe and effective in treating stable COPD.

Objective To explore the current condition of psychological problems of patients in cardiology clinic. Methods A total of 347 patients in the cardiology clinic of Prof. HU Da-yi were screened by self-rating depression scale(SDS),Self-rating anxiety scale(SAS),Hamilton rating scale for depression(HRSD)and Hamilton anxiety scale(HAMA). Results The rates of patients with somatic disease only or with psychological disorder only were 52.4%and 12.7%, the rate of somatic disease accompanied with psychological disorder was 27.7%. For the patients with psychological problems, there were 31 cases with depression(8.9%),62 cases with anxiety(17.9%),and 28 cases(8.1%) suffering from mixed depression and anxiety the diagnosis of cardiovascular disease,functional disease or digestive disease was always used by doctors for the patients with psychological problems only,as they always did not accept the diagnosis of psychological disorder. Conclusions It is very common that patients in cardiology clinic department suffered from psychological problems. The patients with psychological disorder only were easily misdiagnosed as somatic disease especially cardiovascular disease.

Objective To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. Methods A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Results Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12. 0%, anxiety disorders were 6. 4%, depression combined anxiety disorder was 3. 0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (x2 = 0. 874, x2 = 1.797,x2 =0.518, P >0.05) and among different age group ( 18-34, 35-54, ≥55 years old) (x2 = 1. 084,2 = 2. 735, 2 = 0. 350, P 0. 05 ). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30. 6% and 26. 4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2. 8%. Conclusion Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.

Objective To observe the clinical effect of Guizhi Fuling pill in the treatment of interstitial tubal pregnancy.Methods80 cases with interstitial tubal pregnancy in Hangzhou obstetrics and gynecology hospital from August 2015 to December.2016 were randomly divided into the observation group and the control group, 40 cases in each group.The control group were given methotrexate and mifepristone, at this basis, the observation group were given Guizhi Fuling pill.The effect was analyzed in the two groups.Results①β-HCG negative time in the observation group were significantly shorter than that in the control group(P<0.05).②Adverse reactions rate in the observation group was significantly lower than that in the control group(P<0.05).ConclusionIt can shorten the treatment time, reduce the adverse reaction which Guizhi Fuling pill was used in the adjuvant treatment of interstitial tubal pregnancy.

Objective To investigate the effect of ovulation induction of letrozole and clomiphene on the treatment of polycystic ovary syndrome.Methods From February 2014 to February 2014 80 cases with polycystic ovary syndrome in Hangzhou maternity hospitalas the research object were divided into two groups: the control group and the observation group.The control group were treated with clomiphene;the observation group were treated with letrozole.The clinical effect in the two groups were compared.Results The total effective rate was 95.0% in the observation group, which was higher than 67.5% in the control group, the difference was statistically significant(P<0.05).The thickness of endometrium in the observation group was(9.10±1.32)mm and(5.38±0.61)mm in the control group at the HCG injection day, the difference between the two groups was statistically significant (P<0.05).Conclusion Letrozole can be used in the treatment of polycystic ovary syndrome, can get high quality treatment effect, worthy of promotion.

0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.

Objective To investigate the effect of euphorbiasteroid on inducing the apoptosis of HL-60 cells and demonstrate whether the Fas/FasL signaling pathway is involved in the induction of apoptosis. Methods HL-60 cells were treated with dose of 2.5,10,40 μg/ml of euphorbiasteroid in vitro for 24 h respectively.After that,cell counting Kit-8 was used to detect cell proliferation.The morphology of HL-60 cells were observed under light and fluorescent microscopy.The early cell apoptosis was detected by using flow cytometry with Annexin Ⅴ-FITC /PI double staining.The expressions of Fas,FasL,caspase-8 and caspase-3 mRNA were analyzed by the method of RT-PCR.The activities of caspase-8 and caspase-3 were examined by chromatometry.Results Compared with 1640 control group,HL-60 cell proliferation was inhibited significant-ly by euphorbiasteroid.The inhibition rates were (34.9 ±3.7)%,(54.6 ±5.2)% and (61.3 ±4.3)%respectively.Moreover,HL-60 cells exhibited typical morphological features.Early cell apoptosis rates of HL-60 cells were (23.4 ±3.1)%,(35.7 ±4.3)% and (53.2 ±3.9)% respectively.Furthermore,the expressions of Fas,FasL,caspase-3 and caspase-8 mRNA were up-regulated significantly after euphorbiasteroid administration in a dose-dependent manner (P<0.01 ).After treated with euphorbiasteroid,the activities of caspase-8 and caspase-3 were significantly enhanced (P<0.01 ).Conclusion The up-regulation effect of euphorbiasteroid on Fas/FasL signaling pathway might contribute to the apoptosis of HL-60 cells.

Twin-twin transfusion syndrome is the specific complication in monochorionic diamnionic twin pregnancy with the higher morbidity and mortality.Now,the progress in the clinical manifestation,complications,diagnosis and treatment of the twin-twin transfusion syndrome are introduced,in order to arouse clinicians to put importance on the diagnosis of chorion and amnion,specially monochorion,and provide help for the early management and intervention of twin pregnancy.

Objective:To investigate the effects of letrozole combined with human menopausal gonadotropin (HMG) on pregnancy rate and prognosis in patients with refractory polycystic ovary syndrome (PCOS).Methods:A total of 102 patients with refractory PCOS who received treatment in Jinhua Hongyue Women's and Children's Hospital between May 2019 and May 2020 were included in this study. They were randomly assigned to observation and control groups ( n = 51/group). All patients received the same treatment in the early period. During later ovulation induction period, patients in the control group were administered HMG and those in the observation group were given letrozole combined with HMG. Before treatment and 3 months after treatment, sex hormones [follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2), testosterone (T)], arterial hemodynamic indicators around the follicle [end diastolic velocity (EDV), peak systolic velocity (PSV), pulsation index (PI)], endometrial thickness and classification were compared between the two groups. The ovulation rate and pregnancy rate as well as pregnancy outcomes at 6 months of follow-up were recorded in each group. Results:After 3 months of treatment, FSH, LH, E 2 and T levels in each group were significantly decreased compared with those before treatment (all P < 0.05). FSH, LH, E 2 and T levels in the observation group were (1.85 ± 0.45) U/L, (9.86 ± 1.47) U/L, (81.25 ± 10.47) pmol/L, (1.75 ± 0.26) nmol/L, respectively, which were significantly lower than those in the control group [(3.12 ± 1.47) U/L, (12.58 ± 2.14) U/L, (109.25 ± 27.14) pmol/L, (3.58 ± 0.76) nmol/L, t = 5.90, 7.48, 6.87, 16.27, all P < 0.05). EDV in each group was significantly decreased after 3 months of treatment compared with that before treatment (both P < 0.05). After treatment, EDV in the observation group was significantly lower than that in the control group [(3.12 ± 1.42) cm/s vs. (5.14 ± 1.89) cm/s, t = 21.14, P < 0.001]. PSV in each group was significantly increased after treatment compared with that before treatment (both P < 0.05). After treatment, PSV in the observation group was significantly higher than that in the control group [(13.36 ± 2.01) cm/s vs. (10.24 ± 2.47) cm/s, t = 4.21, P < 0.001]. In each group, PI measured after treatment was not significantly different from that measured before treatment (both P > 0.05). After treatment, endometrial thickness in the observation group was significantly higher than that in the control group [(9.09 ± 1.58) mm vs. (8.41 ± 1.42) mm, t = 2.28, P < 0.05]. Ovulation rate in the observation group was significantly higher than that in the control group [88.24% (45/51) vs. 70.59% (36/51), χ2 = 4.85, P < 0.05]. There were no significant differences in endometrial type, biochemical pregnancy, clinical pregnancy rate, abortion rate, and premature delivery rate between the two groups (all P > 0.05). Conclusion:Letrozole combined with HMG has an ideal effect on refractory PCOS. It can improve the levels of sex hormones, restore the hemodynamic status in ovarian stroma and increase ovulation rate.