ObjectiveTo observe the clinical efficacy of duloxetine combined with psychological intervention in patients with somatoform disorder.Methods67 patients with somatoform disorder were randomly divided into two groups:study group (34 cases) treated with duloxetine and psychological intervention and control group (33 cases) treated with duloxetine only.And all the 67 patients in the study were assessed by symptom checklisth-90-R (SCL-90),hamilton anxiety scale(HAMA) and global assessment scale(GAS).ResultsAfter 8 weeks treatment,the results of SCL-90 showed that the scores of somatization,obsessive-compulsive,depression,anxiety and phobia factors in the study group ( 1.39 ± 0.45 ; 1.66 ± 0.52 ; 1.83 ± 0.69 ; 1.73 ± 0.66 ; 1.30 ± 0.48 )were notably lower than that in the control group ( 1.78 ± 0.61 ; 1.69 ± 0.47 ;2.39 ± 0.54 ; 2.1 1 ± 0.49 ; 1.49 ±0.78 ).And there were significant statistical differences (P＜ 0.01 ).At the end of the 2nd and 4th week the,scores of SCL-90 somatization,depression,anxiety and phobia factors were lower in the study group than the control group with statistical significance (P＜0.05).At the end of 8th week,the HAMA score in the study group( 10.20 ±3.70) was significantly decreased than the control group (13.07 ± 3.20 ),and with statistical significant (P ＜0.05 ).The response rate was 85.29％ in study group and 60.60％ in control group.And there was a statistically singnificant difference in complete remission ( χ2 =4.08,P ＜ 0.05 ) between the two groups.ConclusionThe study indicates that the combination of duloxetine and psychological intervention is more effective in treating somatoform disorder than using duloxetine only.So this combination treatment is worth generalizing and applying.

Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.