BACKGROUND: The clinical manifestation of senile depression is not typical. The patients with senile depression seldom visit in general hospital, which is hard for clinical doctors to identify the disease at early time.OBJECTIVE: To research the traits of Coping style and social support in the recovered senile depressive patients.DESIGN: Case-control observation.SETTING: Department of Psychology in North China Coal Medical College.PARTICIPANTS: Ninety-six senile depressive patients at convalescent stage were selected for depressive group in clinic service of Beijing Anding Hospital from November 2004 to October 2005. Inclusion criteria: ①Aged≥60 years old. ② Coded with depression with DSM-Ⅳ. ③ Being the period of recovery, geriatric depression scale(GDS)≤10. ④Informed consent was obtained from each participant. Exclusion criteria: ① Depression resulted from other factors for instance substance abuse and schizophrenia,etc. ②Serious and instable body disease such as cerebrovascular disease,liver and kidney disease, falling sickness, disease of internal secretion. Totally 104 questionnaires were sent out, and 96 were qualified. 37 were male and 59 were female in the depressive group, aged 60-87 years old,with average of (68±6)years. The course of disease was 0.3-11 years, with mean of 2 years. The elderly from ordinary community of Beijing were invited for control group. Inclusion criteria: ①Aged ≥ 60 years old; ② No mental disease. ③ Informed consent was obtained from each participant.Exclusion criteria: The same to the depressive group. There are 100 participants in the control group, 44 were male and 56 were female, aged 60 to 84 years old, with average (67±5) years old. There were no significant differences between depressive group and control group in gender, age, education, living conditions and marriage status.METHODS: 96 senile depressive patients at convalescent stage and 100healthy aged were investigated with self-made questionnaire, Geriatric Depression Scale (GDS), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ).MAIN OUTCOME MEASURES: The scores of the self-made questionnaire, GDS, SSRS and SCSQ answered by participants in each group.RESULTS: All the 196 participants entered the result analysis. There was not disqualified questionnaire. There were significantly lower scores of positive coping style and higher scores of negative coping style in the depressive group than the control group(P ＜ 0.05 ). There was lower score of social support, subjective social support and use of social support in the depressive group than the control group (P ＜ 0.05). The scores of objective social support was not significantly different in each group. There was remarkable positive correlation between active coping style and score of social support, subjective social support and use of social support in recovered senile depressive group (P ＜ 0.01). Passive coping style was negatively correlated with score of social support, subjective social support and use of social support(P ＜ 0.01 ).CONCLUSION: Subjective social support and use of social support and negative coping style are the major risk factor in the onset of senile depression.

Objective To analyze the clinic and imaging features of Klebsiella pneumoniae liver abscess in diabetes mellitus patients with different levels of HbA1c.Methods One hundred and forty-six diabetes patients with KPLA were divided on the basis of their levels of HbA1c into three groups:complete glycemic controlled (HbA1c ≤ 7％);good glycemic controlled (7％ ＜HbA1c≤9 ％) ≤ bad glycemic controlled (HbA1c＞ 9 ％).Compared the patients' characteristics,clinic features,imaging features and complications among each group.Results Compared with patients in groups of complete and good glycemic controlled,patients in group of bad glycemic controlled tend to have younger age at onset[(with an average age of (59.1 ± 13.8)years],longer hospital stay[(with an average stay of (23.1 ± 7.6) day] and more experience complications such as:hyperlipoidemia(49 cases,77.8％),chronic renal failure(12 cases,19.2 ％),life-threatening clinical crisis,and higher infection rate.Patients in bad glycemic controlled also had high risk of biliary pneumatosis(18 cases,28.6 ％),hepatic venous thrombosis (20 cases,31.8 ％) and gas-forming pyogenic liver abscess(26 cases,28.6 ％)(P＜0.05).Conclusion The complications of hepatic venous thrombosis,gas-forming and infection in diabetes patients with KPLA were associated with glycemic uncontrolled.

The online teaching quality assessment system that was established by embedding the professional knowledge into the teaching of literature retrieval course, can help the students master the methods and skills to ac-cess and use the literature information they need and the basic knowledge of subjects in which they major .

Objective To explore the relationship between vicarious traumatization and personality in trauma helpers. Methods Questionnaire about vicarious traumatization and Revised eysenck personality questionnaire short for Chinese(EPQ-RSC) have been carried out on a random sample of 86 trauma helpers in Wenchuan earthquate region from Tangshan. And all the data of the questionnaire scales will be dealt with by the software SPSS11.5. Results ( 1 ) There were significant gender differences on vicarious traumatization of trauma helpers in emotional reaction( famale :20.03 ± 4.92; male: 15.09 ± 3.93 ), behavioral reaction ( famale: 16. 43 ± 4. 49;male: 12.11 ± 2.57 ), cognitional reaction( female: 10.27 ± 3.28; male: 8.29 ± 2.81 ), faith of life ( famale: 14.17± 3.53; male: 11.20 ± 3.37 ), physiological reaction ( female: 21.23 ± 5.31; male: 17.32 ± 4.80) and the total core of vicarious traumatization( famale: 82.70 ± 17.74; male: 64.00 ± 12.49) (P＜0.01). (2) There were significant differences of vicarious traumatization of trauma helpers on professional training and experience of trauma help (P ＜ 0.05 ). ( 3 ) Comparing to helpers of non-vicarious traumatization, the helpers of vicarious traumatization were high in N scale questionnaire (P＜ 0.01 ). Conclusion Vicarious traumatization of trauma helpers are affected by sex, professional training and experience of trauma help. The best choice of trauma helper is steady emotion personality..

Objective To evaluate the protective effect of adiponectin in early atherosclerosis and the diagnostic value of adiponectin in metabolic syndrome in obese children. Methods Total 176 obese children and 88 normal weight children aged 9-12 years were included in the present study. All participants underwent hematologic and biochemical tests including serum adiponectin, high sensitivity C-reactive protein (hsCRP),fasting blood glucose, insulin, and plasma lipids. Homeostasis model assessment of insulin resistance (HOMA-IR)was calculated. Noninvasive ultrasound measurement including intima-media thickness of the common carotid artery(IMT), brachial flow-mediated dilatation (FMD), carotid artery compliance (CAC), and the maximum fatthickness ahead of peritoneum (Pmax) were obtained to investigate arterial mechanical properties and endothelial function. Results (1) The level of adiponectin was negatively correlated with obese index, blood pressure,fasting insulin, hsCRP, HOMA-IR, and IMT(P<0.05 or P<0. 01 ); but not with triglyceride, fasting blood glucose, CAC, high-density lipoprotein-cholesterol (HDL-C), and FMD. (2) The risk of metabolic syndrome increased 3.43 times in children with adiponectin level <7. 060 mg/L compared with ＞7. 060 mg/L. (3)Receiver operating characteristic( ROC ) curve was used to choose the optimal cutpoint of adiponectin to identify obese children with the metabolic syndrome. The area under the curve (AUC) for adiponectin to discriminate the sensitivity of metabolic syndrome was 0. 769 (95% CI0. 714-0.816, P< 0. 0 1 ). (4) The obese children were divided into three groups according to the cut-off value for adiponectin (high, middle, low groups). There were significant differences in the prevalences of severe obesity, visceral fat accumulation, hypertension, insulinemia,low HDL-C, metabolic syndrome among three groups (P<0.05). Conclusions High levels of serum adiponectin could prevent early stage of atherosclerosis. The lower the adiponectin level, the higher the incidence of metabolic syndrome.

Objective To investigate the general surgeon growth time, and to probe into the factors affecting the surgeon growth. Methods 72 surgeons who worked more than 15 years in the field of general surgery in 12 hospitals of Gansu Province were investigated, focusing on education, resident rotation train-ing, teachers' qualification, refresher training, the frequency of intra-hospital technical exchange, and scale of hospital employed. SPSS 18.0 statistical software was applied to analyze the data. t test was used in com-parison between groups, and multiple groups were compared by using single factor analysis of variance. Results The surgeon growth time was (9.84±1.51) years averagely. In the process of growing up, the growth time of the general surgeons who experienced hospital resident rotated training, refresher training, intra-hos-pital technical exchange was significantly shorter than that of no-related-experienced surgeons. The higher the education, the higher the quality of the teachers and the higher the level of medical institutions, the shorter the doctor's growth time. Conclusion In the same medical institutions, the resident rotated training, the teacher's qualification, higher hospital training, and the frequency of intra-hospital technical exchange have the positive function to the surgeon's general growth, so in making young doctor training plan we should consider the value of the above-mentioned factors.

ObjectiveTo study the characteristics in negative energy balance in different-aged patients with metabolic syndrome (MS) and come out with nursing countermeasures.Methods Twenty-four hour dietary data reviewing and the international physical activity questionnaire were used to investigate energy intake and consumption among 384 MS patients.The fat content,fat percentage and lean body mass were measured by the human body composition analyzer.Body mass index (BMI),waist/height,fat percentage,lean body mass,energy intake and energy consumption were compared between different ages and sexes.Results In the group aged over 51 years,the waist/height of female MS patients was significantly smaller than their male counterparts (P<0.05).For all groups of different ages,the percentage of fat in the female patients was significantly larger,their lean body mass was less(P<0.01), their intake of energy was significantly lower than that of the males (P<0.05).The intake of energy among the male patients at the group aged 21~30was significantly larger than the males of other age groups and so it was with the energy intake of the males aged 21-70 years as compared to the males aged 71~80 years (P<0.05).Conclusion Education on disease knowledge should be strengthened among healthy people so as to realize the negative energy balance based on the rate of waist/height,body composition,energy intake and energy consumption,which is of great significance for the prevention and control of metabolic syndromes.

Objective To investigate the expression of phosphorylated mammalian target of rapamycin (p-mTOR) and phosphorylated eukaryotic translation initiation factor 4E binding protein 1 (p-4EBP1) in pathologic scar,and comprehend its role and significance in the pathologic scar formation.Methods SP immunohistochemical method was used to detect the expression of p-mTOR and p-4EBP1 in 20 cases of keloid,20 cases of hypertrophic scar,20 cases of non-pathologic scar and 20 cases of normal skin tissue.The positive rates of expression in different tissues were analyzed,and the relationship in pathological scar was explored.Results The positive rates of p-mTOR and p-4EBP1 in keloidand hypertrophic scar were 75.0％ (15/20),60.0％ (12/20) and 60.0％ (12/20),50.0％ (10/20),nom-pathologic scars were 20％ (4/20),10％ (2/20);normal skin tissue were 10％ (2/20),5％ (1/20),which were higher respectively compared with the two control groups (P＜ 0.05);there was a highly positive correlation between p-mTOR and p-4EBP1 expression in pathologic scar (r=0.323,P＜0.05).Conclusions p-mTOR and p-4EBP1 might be involved and cooperated in promoting the progress of pathologic scars.

Objective : To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods: A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results: Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.

Objective To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. Methods This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 μg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 μg ethinylestradiol plus 150 μg desogestrel, 195 cases) with the ratio of 3: 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Results The values of basal features were similar between two groups (P> 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group ( -0. 297, -0. 057, 0. 033, 0. 150 respectively) was more obvious than that in the desogestrel group ( - 0. 108, 0. 023, 0. 231, - 0. 023 respectively) with a significant difference (P < 0. 05 ). Some other values which improved in beth two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12. 6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0. 57 kg) while it decreased in Yasmin group ( -0. 28 kg) with a significant difference (P < 0. 01 ). Conclusions Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.