Objective: To observe the clinical effect of Sertraline in treatment of dysthymia. Methods:63 outpatients diagnosed as dysthymia according to ICD-10 were randomly assigned to study group (n=33) and placebo group. Randomized double blind control study was done for 8 weeks with Sertraline from 50-200 mg/d. HAMA and HAMD were used to assess the effect.Results:At the end of 8 weeks, 54 patients completed the trial. Patients of both groups had lower HAMD scores than baseline from 2 weeks, and this trend continued through the 8 weeks observation. During this period, HAMD score of the study group declined more significantly than that of the placebo group. At the end of 8 weeks, the score of HAMA of the study group was also lower than that of the placebo group. The side effects of Sertraline were mild.Conclusion:Sertraline is effective in treatment of psychiatric outpatients with dysthymia.

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

Objective To explore the mechanisms of mesenchymal stem cells (MSC) in the treatment of concanavalin A (ConA)-induced acute immune liver injury in mice.Methods MSC were isolated and cultured from bone of the four limbs of three-week-old C57BL/6 mice.The specific surface markers were identified and osteogenic,adipogenic differentiation ability were tested.A total of 15 six to seven-week old C57BL/6 mice were divided into control group,MSC treatment group and phosphate buffer saline (PBS) treatment group,five mice in each group.The mice of MSC treatment group was injected through tail firstly with ConA and then MSC,PBS treatment group was injected through tail firstly with ConA and then PBS,control group was injected through tail with PBS twice.The mice were sacrificed in 14 to 16 hours after injection.The level of alanine aminotransferase (ALT),aspartate transaminase (AST) in peripheral blood were detected and the pathological change in liver tissue was scored by Knodell score system.Activation rate of splenic CD4+ T cells and the proportion changes of T hepler cell (Th)1,Th2,Th17 and regulatory T cells (Treg) were detected by flow cytometry and the ratio of Th17/Treg was calculated.The levels of tumor necrosis factor α (TNF-α),interferon (IFN)-γ and interleukin (IL)-4 in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA).Independent-sample t test was used for comparison between groups of measurement data.Results ALT,AST and Knodell score of MSC treatment group was (174.2± 46.9) U/L,(185.6± 71.6) U/L and 3.4±1.3,respectively,which were better than those of PBS treatment group ((647.0± 118.0) U/L,(749.0± 104.0) U/L and 5.2 ±0.8,respectively),and the differences were statically significant (t =8.33,9.98 and 2.55,all P＜0.05).The activation rate of splenic CD4+ T cell of PBS treatment group was (26.10±2.17) ％,the proportion of Th1 and Th2 in CD4+ T cell was (5.81±0.79) ％ and (5.98± 1.22)％,the ratio of Th17/Treg was 0.29±0.03,the levels of TNF-α,IFN-γ and IL4 in peripheral blood were (1 281.95±88.61) U/L,(1 838.66±196.91) U/L and (1 192.36±163.94) U/L,which were higher than those of control group ((13.74±1.59)％,(1.35±0.17)％,(2.13±0.17)％,0.15± 0.05,(21.71±2.50) U/L,(11.84±1.28) U/L and (24.46±3.96) U/L),and the differences were statistically significant (t=10.26,12.37,7.02,5.30,31.79,15.93 and 20.75,all P＜0.01).There was no statistically significant difference in the activation rate of splenic CD4+T cell between MSC treatment group and PBS treatment group ((26.20±3.09)％ vs (26.10±2.17)％,P＞0.05).However,in MSC treatment group,the proportion of Th1 and Th2 in CD4+ T cell ((1.83±0.52) ％ and (2.75±1.06％)),the ratio of Th17/Treg (0.18±0.02) and the levels of TNF-α,IFN-γ and IL-4 in peripheral blood ((760.71± 73.19) U/L,(742.49±76.46) U/L and (825.76±101.74) U/L) significantly decreased compared with those of PBS treatment group,and the differences were statistically significant (t=9.45,4.48,6.41,10.14,5.56 and 10.22,all P＜0.01).There was no significant difference in the ratio of Th17/Treg between MSC treatment group and control group (P＞0.05).Conclusions The therapeutic effects of MSC on ConA induced acute immune liver injury were through influence splenic CD4+ T cell subsets by decreasing the proportion of Th1 and Th2 and then declining the levels of secreted cytokines such as TNF,IFN-γ and IL-4 in peripheral blood,increasing the proportion of Treg and decreasing the proportion of Th17 and keeping the balance of Th17/Treg.

Objective To investigate the characteristics,treatment and prognosis of the gastrointes-tinal iatrogenic perforation resulting from endoscopic operations.Methods The clinical data of the 107 pa-tients with gastrointestinal iatrogenic perforations caused by endoscopic operations from October 2003 to Octo-ber 2013 were retrospectively studied,and the characteristics,treatment and prognosis of these patients were analysed.Results The incidence of the gastrointestinal iatrogenic perforation resulting from endoscopic oper-ations was 0.041%(107 /263 549,among which 0.006% was diagnostic(13 /232 011),and 0.298% was therapeutic (94 /31 538).A total of 107 patients with gastrointestinal iatrogenic chose conservative medical management,endoscopic clipping or surgery according to different conditions after perforations.All patients had good prognosis.Conclusion Endoscopic therapeutic operations are more likely to lead to the occurrence of iatrogenic gastrointestinal perforations compared with diagnostic operations.And most patients could get good prognosis as long as the appropriate treatment is performed when the perforation occurs.

Objective To explore the sensitivity and specificity of near-infrared spectroscopy ( NIRS) in the diagnosis of depression. Methods From March 2013 to August 2013,62 patients with de-pression and 70 normal controls were collected from Peking University Sixth Hospital. Optical Tomography System (52 channels) was used to collect the NIRS data during the Verbal Fluency Test (VFT),and the number of words produced during VFT task was recorded. The wave analysis was performed by a professional psychiatrist. Results There was statistical difference in the number of words produced during VFT task be-tween the patients with depression (8.65±0.49)and control group(10.19±0.43) ( t=2.385, P<0.05). Through the wave analysis of NIRS to test patients with depression,the results demonstrated that the sensitivi-ty was 66.1% and the specificity was 91.4%. Conclusion The results of NIRS test display high specificity in the diagnosis of depression,which can be used as an objective index for clinical auxiliary diagnosis.

Objective To explore the effects of emotion on cognitive function in patients with depression.Methods Self-rating anxiety scale(SAS),self-rating depression scale (SDS) and the typical one-back task were done by 397 patients with depression in Peking University Sixth hospital out-patient and hospitalization during 2012 June to 2013 October.Results Both of the SAS standard score (51.81 ± 11.50) and SDS standard score (62.94 ± 13.06) were significantly related (r=0.125,P＜0.05.r=0.176,P＜0.01) to the reaction time of one-back task ((590.27±213.96)ms),and the correlation between SAS standard score and SDS standard score was significant (r=0.682,P＜0.01).The results of regression analysis suggested that,only SDS score could predict the reaction time of one-back task.Conclusion The emotion of anxiety and depression in patients with depression are correlated with cognitive function,and the emotion of depression is the main factor to affect the cognitive function.

Objective:To know the clinical characteristics, seasonal pattern and influencing factors of atypical depression(AD) patients.Methods:A total of 203 depressed outpatients of Peking University Sixth Hospital from January 2021 to August 2021 were included.They were assessed with demographic questionnaire, inventory of depressive symptomatology self-report(IDS-SR30) and seasonal pattern assessment questionnaire(SPAQ). According the score of IDS-SR30, all patients were classified as atypical depression(AD) and non-atypical depression(non-AD). The data were analyzed by t-test, non-parametric test and Logistic regression using SPSS 26.0 software. Results:The prevalence of AD among depressed patients was 36.0% (95% CI=29.3%-42.6%). The IDS-30 score of the AD group was (41.59±10.59), and IDS-30 score of the non-AD group was (36.08±13.17), and the difference between the two groups was statistically significant ( t=3.062, P<0.05). The global seasonal score of the AD group was 6 (3, 9), and 17.8% of the AD group had seasonal pattren.The global seasonal score of the non-AD group was 5 (3, 8), and 14.6% of the non-AD group had seasonal pattern.There was no significant difference in the global seasonal score and the proportion of seasonal pattern between the two groups ( Z=0.389, χ2=0.359, P>0.05). Depression patients who were females ( β=1.08, OR=2.95, 95% CI=1.32-6.59, P<0.05), low self-evaluation ( β=0.82, OR=2.27, 95% CI=1.12-4.59, P<0.05)and psychomotor retardation ( β=0.93, OR=2.54, 95% CI=1.33-4.85, P<0.05) were more likely to be diagnosed as AD, and depression patients having mood variation ( β=-0.94, OR=0.39, 95% CI=0.19-0.81, P<0.05) were more likely to be diagnosed as non-AD. Conclusion:Women, low self-evaluation, psychomotor retardation and unobvious mood variation can predict and help to diagnose atypical depression in depressed patients.

OBJECTIVETo describe the prevalence and characteristics of mental disabilities in China.

METHODSThe data from the Second National Sample Survey on Disability were analyzed with descriptive epidemiological method and the overall prevalence rates of mental disabilities were statistically calculated.

RESULTSAmong 2 526 145 respondents, 15 155 of them more than 15 years old were diagnosed as mental disabilities, with the prevalence rate as 6.01‰. The prevalence rate of disabilities caused only by mental disorders was 4.57‰ with 11 501 more than 15 years old. The prevalence rate of disability caused only by mental disorders was 4.67‰ with 11 501 adults. Of the disability cases that exclusively caused by mental disorders, 64.58% of them were attributable to schizophrenia, schizotypal or delusional disorders, 6.28% were mood disorder, and 6.27% were epilepsy disability, followed by neurotic, stress-related and somatoform disorders (5.95%), dementia (5.19%), and other disabilities (less than 11.74%). Disabilities that attributable to schizophrenia, schizotypal and delusional disorders caused most severe impairments of functions in daily and social activities, followed by disabilities attributable to dementia, non-dementia organic mental disorder and epilepsy disability. Dementia caused the most severe grade of disability, accounted for 44.89% of all the cases. The data also showed that the disabilities attributable to mood disorder and neurotic, stress-related and somatoform disorder showed more impairments among mental disabilities.

CONCLUSIONPrevalence of mental disability in the second sample survey was higher than that of the first survey. Schizophrenia accounted for most of the mental disabilities but dementia caused the severest disability among all the cases with mental problems. As two of main causes of mental disabilities, neurosis and anxiety disorders should also be paid attention to.

Adolescent ; Adult ; China ; epidemiology ; Disabled Persons ; statistics & numerical data ; Humans ; Intellectual Disability ; epidemiology ; Mental Disorders ; epidemiology ; Middle Aged ; Prevalence