Objective To evaluate the clinical efficacy of Yixin Bardiranjibuya Keli combined with escitalopram in the treatment of somatoform disorders.Methods 90 patients with somatoform disorders from March 2014 to March 2015,were recruited in our hospital as the subjects of this study.According to the random number method,the observation group and the control group were divided into observation group(45 cases)and control group(45 cases).The control group was treated with escitalopram,and the observation group was treated with Yixin Bardiranjibuya Keli on the basis of the control group.(SCL-90),Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale(HAMA),Health Status Questionnaire(SF-36PCS),Mental Health Overall Evaluation(SF-36PCS)before and after treatment,MCS score,adverse reaction,and curative effect.Results After treatment,the scores of SCL-90,HAMD and HAMA in the observation group were significantly lower than those in the control group [(2.40±0.53)vs.(2.47±0.56),(7.32±1.08)vs.(13.69±2.81),(4.82±1.21)vs.(9.93±2.02)],respectively(P<0.05),and the scores of SF-36PCS and MCS were significantly higher than those of the control group(P<0.05).The total effective rate was 95.55(48.38±11.02)points(P<0.05),and the adverse reactions were significantly lower than those in the control group [8.88％(4/45)vs 24.44％(11/45)％,Significantly higher than the control group 73.33％(P<0.05).Conclusion Yixin Bardiranjibuya Keli combined with escitalopram for the treatment of somatosensory disorder is significant and effective in relieving anxiety and depression of the patients and improving the physical symptoms of the patients,which can be used as the first choice of treatment.

Objective:To investigate the curative effect and prognosis of schizophrenia patients treated with paliperidone extended -release tablets.Methods:Totally 72 cases of patients with schizophrenia were divided into the observation group (n=35) and the control group ( n=37 ) according to the order of admission .The obsevation group was treated with paliperidone extended-release tab-lets, while the controll group was treated with risperidone tablets , and both groups were treated for 8 weeks.The positive and negative syndrome scale(PANSS) was used to assess the effect of the two groups , the social function defect scale (SDSS) and prognosis of the two groups were compared.Results: After the 2-week treatment, the PANSS score, positive symptom score, negative symptom score and general symptom score were all decreased in the two groups when compared with those before the treatment (P<0.05),and the scores in the observation group were lower than those in the controll group (P<0.05).After the treatment, the SDSS was significantly reduced in the two groups when compared with that before the treatment (P<0.05), and the reduction in the observation group was more notable than that in the control group (P<0.05).The total effective rate of the observation group was 94.3%, which was higher than that (67.6%) of the control group (P<0.05).The incidence of adverse reactions, such as anxiety and akathisia, and the total adverse drug reactions in the observation group were both lower than those in the control group (P<0.05).Conclusion:Paliperidone extended-release tablets can effectively relieve suffering from schizophrenia with quick effect , few adverse reactions , high safety and good effect , which is worthy of promotion in clinical use .

Objective    To study the clinical characteristics, therapy strategies and the outcomes of female patients with acute aortic dissection during late pregnancy and puerperal period. Methods    We retrospectively analyzed the clinical data of 7 patients with acute aortic dissection during late pregnancy and puerperal period in Shanghai Changhai Hospital between August 2012 and June 2017. Five of the 7 patients were late stage pregnancy, 2 were puerperal period (1 at the postpartum night, 1 in 18 days after delivery). There were 6 patients of Stanford type A aortic dissection (85.7%), and 1 patient of type B aortic dissection (14.3%). The age of the patients ranged from 26 to 34 (30.8±3.1) years. Cardiac ultrasonography of patients with type A showed that the maximum diameter of the ascending aortas was 4.2–5.7 (4.7±0.6) cm, of which 2 patients were aneurysm of aortic sinus, 3 patients were with Marfan syndrome. Bentall procedure was conducted in 1 patient, Bentall+Sun’s surgery in 2 patients, ascending aorta replacement+Sun’s+coronary artery bypass grafting surgery in 1 patient, aortic root remodeling+ascending aorta replacement+Sun’s surgery in 2 patients. One patient with Stanford type B acute aortic dissection was performed with thoracic endovascular aortic repair (TEVAR) after cesarean section. Results     Aortic blocking time ranged from 51 to 129 (85.5±22.9) min.  Cardiopulmonary bypass time was 75–196 (159.0±44.0) min. Moderate hypothermic circulation arrest with selective cerebral perfusion time was 20–30 (23.8±3.5) min. All maternal and fetuses survived. The infant whose mother received aortic repair in early stage and then received cesarean section was diagnosed with cerebral palsy. Maternal and fetuses were followed up for 9 months to 4 years. During the follow up period, all the fetuses grew well except the cerebral palsy one, and all maternal recovered well. The patient who received aortic repair in the early stage, had a sigmoid rupture during cesarean section and was treated with sigmoid colostomy. Another patient with Stanford type A dissection was diagnosed as left renal vein entrapment syndrome after 2 years. Conclusion    Type A aortic dissection is more common in late pregnancy and puerperal patients. And Marfan syndrome is a high-risk factor for acute aortic dissection in pregnancy women. Early and appropriate surgical treatment strategy based on the type of aortic dissection and gestational age are the key points to achieve good outcomes both for maternal and fetus.

Objective     To compare the clinical efficacy and safety of da Vinci robot with totally no tube (TNT) versus subxiphoid video-assisted thymectomy surgery (SVATS) in the treatment of thymic tumors. Methods     From 2019 to 2021, a retrospective analysis was conducted on patients with thymic tumor resection in the Department of Thoracic Surgery, General Hospital of Northern Theater Command. All patients underwent total thymectomy and mediastinal fat removal, and they were divided into a TNT group and a SVATS group according to the operation method. The intraoperative blood loss, conversion rate, postoperative visual analogue score (VAS), postoperative hospital stay time and postoperative complications were compared between the two groups. Results     We finally included 435 patiets. There were 168 patients with 83 males and 85 females at an average age of 61.920±9.210 years in the TNT group and 267 patients with 147 males and 120 females at an average age of 61.460±8.119 years in the SVATS group. There was no death or postoperative myasthenic crisis in both groups. There was no statistical difference in postoperative hospital stay (1.540±0.500 d vs. 3.400±0.561 d, P=0.000), intraoperative blood loss (13.450±5.498 mL vs. 108.610±54.462 mL, P=0.000), postoperative 24 h VAS score (4.960±1.757 points vs. 3.600±1.708 points, P=0.000), or postoperative complication rate (3.0% vs. 11.6%, P=0.001). Conclusion     TNT is a more efficient, safe, and effective surgical approach for treating thymic tumors, which can shorten hospital stay time and reduce postoperative complications. However, SVATS can minimize postoperative pain.