Objective The purpose of this study was to access the efficacy of Venlafaxine and Reboxitine on treatment of depressive patients who had not responded to selective serotonin reuptake inhibitors for eight weeks. Methods 117 cases depressive patients who had not responded to selective serotonin reuptake inhibitors for eight weeks were divided into three Venlafaxine group(n =41),Reboxitine group(n =39),Original medicine group(n =37) by randomly and were treated by corresponding drugs for 8 weeks. The therapeutic response and safety were evaluated by scale of HAMD and TESS at before and after treatment the end of 1,2,4,8 week. Results The score of HAMD in Venlafaxine and Reboxitine groups were significantly lower than Original medicine group at the end of 4,8 weeks after treatment and the score of HAMD in Venlafaxine group were significantly lower than Reboxitine group at the end of 8 weeks after treatment. The score of HAMD in Venlafaxine and Original medicine groups were marked descendanter than before treatment from after treatment second weekend(P <0.01),while reboxitine group did not marked descent until the 4th weekend after treatment. The reduce score of factors in cognition,retardition and desperation of Venlafaxine and Reboxitine groups were significantly higher than Original medicine group at the end of treatment. The curative effect of Venlafaxine group were supper than Original medicine group. The side reaction of three groups were not difference. Conclusions There are obviously curative effect using Venlafaxine to treat the depressive patients who had not responded to selective serotonin reuptake inhibitors. The time of initial effect in Venlafaxine were rapider than Reboxitine group.

Objective: To explore the significance of examination of spectrum ECG in patients with coronary heart disease (CHD). Methods: Spectrum ECG and ECG、 vectorcardiogram examination were meanwhile executed in 254 patients with coronary heart disease. Results: Diagnose coincidence rate of CHD was 66.9% by spectrum ECG and ECG、 vectorcardiogram examination. Conclusion: Spectrum ECG is a new detect method for electrocardiogram information.

Objective To assess the effect of arterial embolization in treating hyperthroidism by colour ultrasonography.Methods Forty two cases of hyperthyroidism were treated with thyroid arteries embolization. A few days before and 1, 3, 6 months after embolization, the echograms of thyroids were observed including the volumes of thyroids and the internal diameters of thyroid arteries were measured with colour ultrasonography respectively. The Vs, Vd, Vm, PI, RI were measured with the Doppler and the quantities of blood flow were calculated. The relationships of changes for all these parameters and T 3, T 4 and TSH were analysed. Results Before artery embolization all thyroids were enlarged with diffusely homogenous or heterogenous low echos and nodules in some patients accompanied by widenings of the thyroid arteries and their branches full of blood supply. The volume of thyroids decreased after artery embolization. 1 3 months later the echo of thyroids enhanced and got coarse with decrease of the thyroid vasculature and narrowing of vessel calibers except a few star or spot like blood streams were sometimes seen within the thyroids and no blood flow signals found in some cases. 3 6 months after embolization, the echo of thyroids decreased gradually or unevenly distribnted. All the parameters of blood flow before and after the treatment showed statistically significant differences( P

Objective To analyze the clinical features and its influencing factors of depression pa?tients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression ( PMD group,79 case) and nonpsychotic major depression ( NMD group,268 case) . All patients completed social demographic question?naire ( including gender,age,marital status,educational level,family history,positive family history of psychi?atric disorder,disease onset age,frequency of attack,times of hospitalization,etc.) and Hamilton's depression scale (HAMD?24). Results Positive family history(PMD group 47/79,NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79,NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29),NMD group(1.39±1.31), P<0.01) in the PMD group were signifi?cantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69),NMD total score (43.44±8.51), P<0.01),the factor score of anxiety/somatization(PMD group(11.40±3.28),NMD group (9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77),NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09 ±5.17),NMD group(35.95±9.06), P<0.01),the course of the disease(PMD group(1.58±0.76),NMD group(3.02±2.87), P<0.01),the factor score of day and night change(PMD group(0.76±0.46),NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression anal?ysis showed the major depression with positive family history of mental disorders( β=3.278) ,attack in early age( β=-2.524),seriously cognitive dysfunction in patients( β=3.836) may indicate the psychotic symp? toms( P<0.05).Conclusion PMD patients more positive family history,psychiatric disorder positive family history,likely to be hospitalization,severe symptoms and attack in early age compared with NMD. With posi?tive family history of mental disorders,attack in early age,seriously cognitive dysfunction in patients with ma?jor depression may indicate the psychotic symptoms.

Objective To study the status of helicobacter pylori (Hp) infection and its correlation with gastroesophageal reflux disease(GERD) .Methods The Physical examination and digestive internal medicine outpatients was chosen for the detailed ques-tionnaire and 14C breath test detection of Hp infection ,investigation of GERD prevalence ,analyzed the relations between Hp infec-tion and GERD sick .Results In 220 cases of healthy check-up person ,Hp positive in 108 cases .There were 238 cases of Hp posi-tive in all GERD patients ,the positive rates of Hp infection for 0 - ≤3 months ,3 - ≤6 months and >6 months GERD patients were 47 .8% 、44 .1% and 27 .5% ,respectively .The positive rates of Hp infection for >6 months were significant lower than other groups (P<0 .01) .Health people who check -up with Hp positive were given Hp eradication therapy ,and emphasized the optimi-zation of self -management behavior ,4 weeks after the review ,eradication rate was 100% ,no obvious adverse reaction in the process of taking the medicine .GERD Hp was given conventional acid and increase the stomach power for 2 weeks ,symptoms after joining Hp eradication therapy ,also emphasized the self - management behavior optimization ,without symptoms worsen . Conclusion Hp infection in patients with different degrees at different stages of GERD .Severe symptoms ,repeated visits patients with low Hp infection rate .There is no GERD related cases after Hp eradication in positive health check-up person .

Objective To establish a method for efficient,accurate genotyping and nucleoside drug-resistant mutation analysis for hepatitis B virus ( HBV ).Methods The 48 HBV serum samples were collected from the Third People's Hospital of Taiyuan from July to August 2011,and HBV DNA were extracted using the commercial kit.The HBV whole genome and P gene were amplified and sequenced.Each HBV sample was genotyped by both constructing phylogenetic trees and genotyping software analysis.The results from two strategies were compared for every sample.Results A total of 48 HBV full genome sequences were identified into 12 B and 36 C genotype's by both constructing phylogenetic trees and genotyping software analysis,which was exactly the same as the analysis using P gene fragment sequencing.Seven forms of nucleoside drug-resistant mutation were found in the P gene for all the samples,with the ratio of 27.1％ ( 13/48 ),in which all the mutation forms were associated with lamivudine or adefovir,and no other nucleotide drugs-related resistance mutations existed.In addition,there were 11 B and 35 C genotype and 2 B/C hybrid type with the analysis using Real-time PCR genotyping for the 48 samples.Conclusion P gene sequencing can be used as a new clinical method for efficient,accurate HBV genotyping and resistant mutation analysis,which provides guidance for hepatitis B treatment.

Objective:To study the expression of CD137L in laryngeal carcinoma, and to analyze its clinicopathological significance.Method:The expression of CD137L in 50 laryngeal carcinoma specimens and 9 normal laryngeal mucous tissues were detected by immunohistochemical staining.Result:The positive CD137L staining were found in all 50 cases of laryngeal carcinomas (100%), while its staining were negative in normal laryngeal mucous. There was significant difference between two groups(P<0.01). The positive ratio of CD137L staining had no relationship with the factors such as age, sex and tumor site, while it had significant correlation with the pathological stage,T stage and lymph node metastasis.Conclusion:The expression of CD137L might play an important role in the development of laryngeal carcinomas.

目的观察旋转振动扫痰仪预防长期卧床老年患者坠积性肺炎的临床效果。方法将182例老年脑卒中偏瘫患者(年龄56～91岁)分为治疗组(117例)和对照组(65例)。治疗组采用旋转振动扫痰仪治疗,每次10min,1～2次/d;对照组采用传统护理方法预防坠积性肺炎。结果对照组发生坠积性肺炎5例,治疗组无1例发生,治疗组治疗效果优于对照组(P<0.05)。结论旋转振动扫痰仪对预防长期卧床老年患者坠积性肺炎有良好效果。

This paper summarized perioperative nursing care of three patients undergoing surgical tumor resection and anterolateral femoral skin flap repair,with tumors involving intra-and extra-cranial regions from scalp squamous cell carcinoma breaking through the skull directly into the brain. Three surgical procedures were successfully per-formed by cooperation between two surgical departments and the average duration was 7 hours. The effective preop-erative infection control,perfect surgical plan,intraoperative team collaboration,effective aseptic technique and tumor-free technique were key points for the success of the operations. Close postoperative observation and positive psy-chological nursing also guaranteed operation success.

Objective To evaluate the efficacy of balloon dilatation in the treatment of intrahepatic biliary strictures in patients with liver transplantation. Methods Of the 100 patients with liver transplantation, 16 patients had intrahepatic biliary strictures and received balloon dilatation treatment. Results Initial technical balloon dilatation was successful in 14 cases but failed in 2 cases. There were no procedure-related complications. 4 restenosis occurred and they were treated with repeated balloon dilatation treatment. Conclusion Balloon dilatation represented an effective and relatively safe treatment for biliary stricture in liver transplant recipients. For restenosis, balloon dilatation was also an effective treatment.