Treatment of depression is divided into drug treatment and non-drug treatment. Drug therapy including tricyclic、 tetracyclic antidepressant category、Serotonin reuptake inhibitors (SSRI)、Serotonin receptor antagonist and re-absorption inhibitors (SARI)、norepinephrine and dopamine reuptake inhibitors (NDRI)、 serotonin and norepinephrine reuptake inhibitors (SNRI)、 norepinephrine and specific serotonergic antidepressants (NaSSA) and synergist to support treatment; Non-drugs treatments include psychotherapy, electric shock therapy、transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)treatment.In clinical practice for a number of studies provide hope that patients with depression.

This paper briefly introduces some security issues in using Clinic Electronic Llinac and provides corresponding measures and suggestions,which give a reference for persons of the same occupation in security management and operation of Clinic Electronic Llinac.

Objective To investigate the factors related with final test for continued learning of rehabilitation. Methods The records of 511 continued learning students for physical therapy were analysed with linear regression, with the results of theoretical and operating test as independent variable, while sex, age, titles, profession, education, works, levels of hospital and evaluations as independent variable. Results The results of both theoretical and operating test related with profession, education, works levels and evaluation. Conclusion The models estimate the results of continued learning for rehabilitation has been established.

Objective By analyzing the correlation between Doppler spectrum of extracranial cerebral vessels ECV and intracranial arterial stenosis IAS to identify the value of hemodynamic change of ECV in predicting IAS Methods One hundred and four patients with moderate to severe IAS or intracranial arterial occlusion were enrolled in the case group while 32 patients without obvious cerebrovascular disease in the same period were enrolled in the control group Ultrasound examinations of ECV were performed for all patients the hemodynamic parameters of bilateral common carotid artery CCA internal carotid artery ICA and vertebral artery VA were recorded and compared between case and control group Results Compared with control group the ECV of patients with IAS had lower velocity and higher resistance index RI Of all the parameters end diastolic velocity EDV of ICA and EDV of VA were most accurate in predicting IAS with best cut off value of 21 3 cm/s 9 6 cm/s and accuracy of 76 1 % 81 0% respectively Conclusions The ECV of IAS patients tend to have lower velocity and higher RI Analysis of hemodynamic parameters of ECV might be useful in predicting IAS.

Objective To investigate the current situation of healthcare-associated infection (HAI)management in basic level private medical institutions.Methods 118 basic level private medical institutions in a district of Chengdu were investigated through visiting and questionnaire.Results Of 118 medical institutions,only 2 had HAI manage-ment personnel,4 had HAI management system.22.03% had hand washing facilities in therapeutic rooms and con-sulting rooms,37.29% of institutions stored aseptic items in accordance with the requirements,55.93% of institu-tions disposed medical waste at disposal center;99.15% handled reusable items by users.Conclusion HAI manage-ment status is worried,health administrative department should strengthen support and supervision,especially in-tensified the supervision of private dental clinics.

Objective]To explore the relationship between Yin-wei theory and clinical practice ,and to discuss how to apply Yin-wei theory to solve practical problems in clinical situation.[Methods]We start from the Traditional Chinese Medicine(TCM) classics Nei Jing(the Canon of Internal Medicine) and Nan Jing(Canon On Eighty-One Difficult Issues),combined with Zhang Zhongjing’s application of Guizhi decoction in his book“Treatise on Febrile and Miscellaneous Diseases”to explore the cause and effect of Yin-wei theory and to comprehensively analyze its underlying thought .[Results]We found that Guizhi decoction in the“Treatise on Febrile Diseases”was not only applied in the chapter Taiyang disease,but also involved in other four chapters of Shaoyin disease and the chapter of cholera disease.In“Synopsis of Golden Chamber”,Guizhi decoction was used to treat vomitus gravidarum and affection by cold after delivery,while in Zhongjing’s practice,Guizhi decoction derived formula was widely used in the treatment of consumptive internal injuries miscellaneous disease,indicating that many internal injuries miscellaneous diseases were closely related to external infection .Tonic medicines were rarely seen alone in classical consumptive disease treatment.[Conclusion]Practice has proven that deep learning and understanding of Yin-wei theory has great guiding significance for us to put knowledge in TCM classic theories into clinical practice .Yin-wei theory opens an important window to learn“Treatise on Febrile and Miscellaneous Diseases”and trains clinical thinking,which is worth further discussion.

Induced pluripotent stem cells (iPSC) technology play an important role in studying diseases in vitro. iPSC disease model was based on the iPSC technology, and has achieved important results in many diseases. For those spe-cific genetic diseases that are relatively easy to simulate, iPSC disease model is especially useful. This technology can direct-ly obtained required material from patients, which is free from ethical constraints and rich in cell sources . iPSC disease model as widely used in studying disease mechanism, drug screening, safety inspection, cell therapy, and so on. It is expect-ed to be used in gene correction, gene repair and to obtain the required target cells for the treatment. Cells modification caused by reprogram, lacking of optimum experimental scheme for cell differentiation and difference in genetic backgrounde limit the application of iPSC disease model. More advanced nonintegrated programming technology, improvement of culture conditions, stricter quality control and setting up the standard for iPSC disease model will help to solve these problems.

Osteoarthritis (OA) is the most common form of arthritis, and is the major cause of pain and chronic disability worldwide, causing enormous social and economic burden.Once OA was considered as a 'wear-and-tear' condition and obesity is considered to be one of the most powerful predisposing factors of OA in the weight-bearing joints.However, studies have also linked obesity to OA in non-weightbearing areas, suggesting systemic effects exerted by metabolic factors other than simple local biomechanics perhaps play a role in the high prevalence of osteoarthritis in obese population.Recent studies have shown that systemic metabolic abnormalities, including obesity, diabetes, hypertension, lipid metabolism disorders, atherosclerosis and cardiovascular disease, play an important role in OA pathological process.Metabolic diseases promote the incidence and development of OA through a variety of ways, inducing causing low-grade systemic inflammation, increasing release of adipokines, anabolic cytokines and inflammatory mediators, leading to glucose and lipid metabolism disorders of chondrocytes, upregulating of cartilage extracellular matrix degrading enzymes, raising oxidative stress injury, increasing apoptosis of articular chondrocytes and reducing the cartilage and subchondral bone nutrition supply.These metabolic changes ultimately accelerate the damage of cartilage and promote the incidence and development of OA.Further research on OA and metabolic diseases, has the potential to provide new ideas and methods for the prevention and treatment of OA.

Objective To assess the effectiveness of Exenatide on non‐alcoholic fatty liver disease(NAFLD) with diabetes mellitus by evaluating fatty liver index(FLI) variation .Methods One hundred and two NAFLD patients with type 2 diabetes melli‐tus were enrolled and divided into two groups .One group were treated with Exenatide and another with Oral antidiabetic agents . The data of BMI ,blood fat ,HbA1c ,ALT ,AST ,GGT ,FLI and so on were collected at enrollment and the end point of 24 weeks treatment .The effectiveness of Exenatide were analysed by Kolmogorov‐Smirnov and Pearson correlation coefficient (r) analysis . Results The indicators of metabolic disorder ,the parameters of liver biochemistry and fatty liver disease (FLI) were significantly improved (P<0 .05) after 24 weeks treatment by Exenatide .While only BMI showed significant decrease after 24 weeks treatment with Oral antidiabetic agents(P<0 .05) .The rest of the parameters in oral antidiabetic agants group showed no significant differ‐ence (P>0 .05) .Conclusion Exenatide has a positive effect on non‐alcoholic fatty liver disease treatment who with type 2 diabetes mellitus ,especially for liver fat accumulation .

ObjectiveTo observe the effects of mechanical ventilation with different tidal volumes (VT) on coagulability and fibrinolytic characteristics in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hits with oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male rabbits were randomly divided into five groups (8 rabbits in each group): sham operation group, model group, low VT group (6 mL/kg), rontine VT group (10 mL/kg), high VT group (15 mL/kg). ARDS model was reproduced by sequential injection of 0.1 mL/kg OA and 500μg/kg LPS via auricular vein, and the rabbits in sham operation group received normal saline in same volume. Mechanical ventilation was performed in different VT groups after model reproduction, and the end of the experiment was determined as 6 hours after LPS injection. Blood was collected from the carotid artery at 30 minutes and 360 minutes after LPS injection, with which arterial partial pressure of oxygen (PaO2) was determined, and oxygenation index was calculated. Internal jugular vein blood was collected at 5, 120, 240, and 360 minutes after LPS injection, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and antithrombinⅢ(AT-Ⅲ) were determined. The blood was collected at the end of the experiment, and then the rabbits were sacrificed, and serum levels of procollagen typeⅢ (PⅢP), plasminogen activator inhibitor-1 (PAI-1) as well as PⅢP level in lung tissue were determined. The wet/dry weight ratio (W/D) of lung tissues was calculated.Results Compared with sham operation group, oxygenation index at both 30 minutes and 360 minutes were significantly decreased in model group, while W/D ratio was significantly increased. PT and APTT at 5 minutes were significantly shortened followed by a gradual increase. Fib and AT-Ⅲ showed no change at 5 minutes followed by a gradual decrease, while serum PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly increased. There was no significant difference in oxygenation index between all VT groups and model group, with a tendency to increase in low VT group. W/D ratio in low VT group was the lowest (5.09±0.19), and it was significantly lower than that of the model group (6.02±0.27, P< 0.01), while it was the highest in high VT group (6.27±0.32). PT and APTT in all VT groups were gradually prolonged, and Fib and AT-Ⅲ were gradually decreased. PT and APTT in low VT group were significantly shorter than those in model group from 120 minutes on [PT (s): 120 minutes: 8.90±0.28 vs. 11.43±0.28, 240 minutes: 9.18±0.21 vs. 11.99±0.50, 360 minutes: 9.25±0.15 vs. 12.49±0.29; APTT (s): 120 minutes: 69.09±3.91 vs. 76.08±4.21, 240 minutes: 67.53±2.14 vs. 79.71±2.25, 360 minutes: 66.95±1.13 vs. 83.21±4.01, allP< 0.05], Fib (g/L) was significantly elevated (120 minutes: 3.80±0.09 vs. 3.38±0.15, 240 minutes: 3.91±0.05 vs. 2.47±0.16, 360 minutes:4.06±0.13 vs. 2.39±0.16, allP< 0.05), and no significant difference was found in AT-Ⅲ. Serum contents of PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly lowered [serum PAI-1 (ng/L): 1.14±0.26 vs. 1.63±0.91, serum PⅢP (ng/L): 1.62±0.52 vs. 2.91±0.64, lung PⅢP (ng/L): 4.40±0.58 vs. 5.75±0.47, allP< 0.01]. The change tendency of all parameters in routine VT group was lower than that in low VT group, PT at 120 minutes and 360 minutes, APTT at 240 minutes and 360 minutes was significantly shorter than that in model group, and Fib at 120 minutes and 240 minutes were significantly higher than those in model group (allP< 0.05). No significant difference was found in AT-Ⅲ, serum PAI-1 and PⅢP as well as lung PⅢP as compared with model group. PT and APTT at 360 minutes in high VT group were significantly longer than those in model group, Fib at 360 minutes was significantly lower than that in model group, and lung PⅢP was significantly higher than that in model group. Conclusions There are some important changes in coagulability which changes from a hyper state into a hypo coagulate state, while fibrinolysis is inhibited during the pathological process of ARDS produced by two-hit of OA and LPS. Mechanical ventilation with low VT can obviously improve coagulability and fibrinolytic status, while ventilation with routine VT has little effect on coagulability and fibrinolytic status. Mechanical ventilation with high VT, however, will greatly deteriorate the coagulability and fibrinolytic function in ARDS.