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 observe the effect of grape seed proanthocyandin extract(GSPE) on aged patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods One hundred and one cases aged patients with OSAHS who were treated in the Affihated Hospital of North China University of Science and Technology from December 2012 to December 2014 were randomly divided into control group,GSPE group A and GSPE group B,36 cases of each group.The apnea hypopnea index (AHI),rapid eye movement (REM) and micro-arousal index(MAI) were observed by polysomnography (PSG);the fatigue,sleepiness of patients were conducted with fatigue severity scale (FSS) and epworth sleepiness scale (ESS);the peripheral blood malondialdehyde(MDA) levels and superoxide dismutase (SOD) level of before and after treatment were observed by enzyme-hnked immunosorbent (ELISA) method.The control group received continuously positive airways pressure (CPAP) treatment,while GSPE group A and GSPE group B received low and high dose of GSPE treatment oral besides CPAP respectively.Results Before the treatment,there were no significant differences in the terms of AHI,REM,MAI,FSS,ESS,MDA and SOD among the three groups(P＞0.05).After treatment,the scores of FSS,ESS,MAI and MDA in GSPE group B were (2.27±0.84)points,(6.20± 1.16)points,(8.42± 3.27) times/h,(69.40 ± 13.70) nmol/L respectively,lower than that of GSPE group A ((3.84 ± 1.20) points,(8.14± 1.26) points,(10.34± 3.48) times/h,(85.38 ± 12.22) nmol/L respectively) and control group((5.02 ± 1.14) points,(9.40 ± 1.14) points,(13.84 ± 4.08) times/h,(97.96 ± 13.24) nmol/L respectively),the differences were significant(P=0.000).The REM in GSPE group B was (18.28±2.54)％,higher than that of GSPE group A ((15.74 ± 4.32) ％) and control group ((12.38 ± 3.77) ％),there were significant differences among the three groups (P =0.000).While there were no significant differences on SOD levels among the three groups(P＞0.05).The rate of effectiveness in control group,GSPE group A and GSPE B were 70.5％,79.4％ and 90.9％ respectively,the rate of effectiveness in GSPE B was significant higher than GSPE group A and control group,and the difference was significant(P＜0.05).Conclusion GSPE can improve the sleep quality and weaken oxidative stress reaction,and has a good clinical effects for aged patients with OSAHS.

Radiotherapy alone and local excision combined with radiotherapy have been alternative treatments of early rectal carcinoma resection.Compared with radical surgery,both radiotherapy alone and local excision combined with radiotherapy can get satisfactory effect,and prevent the high rate of complications and adverse reactions,which will improve the quality of life for patients with rectal carcinoma and should be recommended.

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.

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.