Objective To study the treatment of elderly depression and anxiety in the treatment of depression and anxiety. Methods 76 cases of senile depression and anxiety co-morbidity were selected from our hospital from January 2016 to January 2017, and were randomly divided into control group and experimental group, with 38 cases in each group. The patients in the control group were treated with escitalopram, and the patients in the experimental group were treated with ascitalopram. The treatment time for both groups was two months. Comparative analysis was made on the clinical indicators of the experimental group and the control group. Results After treatment, the score of HAMD score and HAMA score in the experimental group was significantly lower than that in the control group, and the score of the experimental group was significantly lower than that in the control group, the differences were statistically significant (P< 0.05). The effective treatment efficiency of the patients in the experimental group was 86.84 ％ compared with the control group (73.68％), the differences were statistically significant (P< 0.05). There were 9 cases and 10 cases of adverse reactions between the experimental group and the control group, but there was no significant difference in the incidence of adverse reactions. Conclusion The liver capsule joint resolve depression escitalopram citalopram treatment of senile depression and anxiety comorbidities better clinical effect, can significantly improve the condition, improve the treatment efficiency, further promotion and application of clinical significance.

Objective To develop a rapid and specific method for identification of listerial species and differentiation of Listeria monocytogenes。 Method Primers targeting the iap and hly genes specific for listerial species and L monocytogenes were designed。 The dulplex PCR and triplex PCR were compared for their ability to identify and differentiate the listerial species。 Results Both dulplex PCR and triplex PCR are specific to all listerial reference strains. The dulplex-PCR could not identify some of the L. monocytogenes isolates while the triplex PCR did. Conclusion The triplex PCR method could be used not only for identification of listerial species but also for differentiation of L. monocytogenes from the mixed listerial suspensions.

Objective To explore main influencing factors of postgraduate entrance examination of medical students in medical universities and to provide guidance for postgraduate entrance examination and employment.Methods Totally 300 2008 and 2009 grade undergraduates of Kunming Medical University were enrolled and divided into postgraduate entrance examination group (n =181)and non postgraduate entrance examination group (n =97).Self-designed questionnaire was used.Intentions of postgraduate entrance examination of two groups and main factors of not taking postgraduate entrance examination were analyzed.Softwares of Excel 2003 and SPSS 17.0 were applied to do constituent ratio analysis and x2 test of gender and residence.Results Among all enrolled students,71.2％ paid attention to the entrance exam and 65.1％ said that they would take part in the entrance exam.There was no significant differences in taking entrance exam between males and females (x2 =3.213,P=0.073).Age (74.1％),family economic situation (71.1％) and current employment status (68.1％) were the main influencing factor of graduate entrance exam.There were significant differences between factors of age and family economic situation and factors of gender and census register (x2 =4.810,P =0.028 and x2 =9.612,P =0.002).There was no significant difference between factors of age and family economic situation and factor of current employment status (x2 =0.279,P =0.597).Conclusions Age,family economical situation and current employment situation are major influencing factors of postgraduate entrance examination for medical students.Postgraduate entrance examination for medical students needs positive guidance and more care from schools,society and family.Medical students should form correct view for employment and postgraduate entrance examination according to their own condition.

Objective To explore the effects of brain-derived neurotrophic factor (BDNF) on expression of apoptotic regulated genes (bcl-2 and c-jun) in hippocampus after status convulsivus (SC). Methods Seizures were induced in 32 adult Wistar rats with lithium-pilocarpine intraperitoneal injection (SC), the other 32 rats were as the normal controls (NC). The rats were sacrificed 6 h after injection of normal saline (NS), BDNF, or anti-BDNF in left lateral ventricle (or no injection). The expression of Bcl-2 and c-Jun protein and bcl-2 and c-jun mRNA were investigated with immunocytochemistry, RT-PCR and in situ hybridization. Results The expression of bcl-2 and c-jun (both protein and mRNA) was not significantly different in the hippocampus of both side in NC. In SC, the expression of bcl-2 ranged from more to less as BDNF>NS and non-injection>anti-BDNF in the hippocampus of non-injected side, while the expression of c-jun reversed. However,there was not significant difference in the expression of bcl-2 or c-jun in the hippocampus of non-injected side. Conclusion Exogenous BDNF can up-regulate the expression of bcl-2 and down-regulate the expression of c-jun in hippocampal cells, which may protect brain from apoptosis after after SC. The intraventricular injection of BDNF diffuses limited, which works less for clinical treatment.

ObjectiveTo explore the influences of age and duration of status convulsivus （SC） on mitochondrial membrane potential (△Ψm） in hippocampus. MethodsConvulsive seizures for 30 min or 3 h (30 min SC or 3 h SC) were induced in 80 infant (20 d after birth) and 80 adult Wistar rats (IRs ＆ ARs respectively) with lithium-pilocarpine ip. The rats were sacrificed at 6 different time points from the 3rd hour to 7th day after SC termination. The mitochondrial △Ψm in hippocampal cells was determined with flow cytometry. ResultsThe mitochondrial △Ψm in hippocampal cells started to decrease at the 3th hour after SC in both IRs and ARs. The bottom level was reached at the 6th hour after SC ［(6.08±0.43) in IRs and (5.70±0.63) in ARs ) ］. Both of them were significantly lower than that of control group (P<0.01） and began to increase at 12th hour after SC. On the 7th day after 30 minutes SC, the level of mitochondrial △Ψm in IRs increased to the level of control, while the level in ARs was still lower than that of control (P<0.05）. At the 3rd hour, the 3rd and the 7th day after SC, the levels of mitochondrial △Ψm in IRs were obviously higher than those in ARs. Compared with the same time point after 30 min SC, the levels of mitochondrial △Ψm at the 3rd and the 6th hour after 3 h SC were much lower in different age groups (P<0.05）. Except the effect of the age-related difference, there was a positive correlation between the duration of SC and the changes of mitochondrial △Ψm in partial correlation analysis （r=0.71，P<0.05）. ConclusionSevere seizure could induce the mitochondrial △Ψm decreased in hippocampus. Age and duration of SC were important factors associated with the mitochondrial △Ψm decrease. There may be an internal protective response against brain damage in premature brain.

AngiotensinⅡ( AngⅡ) is the main functional bioac-tive peptide of the renin angiotensin system,and its basic function is to regulate salt-water homeostasis and blood pressure. Howev-er,recent studies have shown that AngⅡ plays a very important role in tumor formation and angiogenesis by acting on its type 1 receptor (AT1R) as a kind of potential growth factor. This arti-cle is a brief overview of the research on effects of AngⅡ-AT1R system in the process of tumor angiogenesis in recent years.

OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50~70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection. The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.

OBJECTIVE: To analyze the conservative management and outcomes of pharyngocutaneous fistula after total laryngectomy. METHOD: Twenty-one patients with postoperative fistulas were identified and treated by conservative therapy. RESULT: Different treatment were given basing on the three stages of pharyngocutaneous fistula: drainage and cleaning stage, pressure bandaging stage and healing stage. Fourteen patients (66.7%) with the conservative therapy resumed oral feeding after closure of fistula, the other 7 patients had to be cured by further operation. CONCLUSION Management basing on the stages of pharyngocutaneous fistula can achieve satisfied outcome. It can provide important information for pharyngocutaneous fistula's treatment.
Carcinoma, Squamous Cell ; surgery ; Cutaneous Fistula ; therapy ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; adverse effects ; Pharyngeal Diseases ; therapy ; Postoperative Complications ; therapy

Objective:To systematically evaluate of the impact of non-specific soft tissue manipulation on pain severity in patients with chronic neck pain.Methods:Trials included in Meta-analysis were determined by searching PubMed, Embase, Cochrane Library, Web of Science and 5 English databases in the U.S. Clinical Trial Registry. The search terms include the subject terms of neck pain, soft tissue treatment, massage, and myofascial release. Two reviewers independently selected studies, extracted data and assessed the quality of the studies. The included trials were assessed by using the Cochrane risk-of-bias tool. STATA statistical software 16.0 was used for statistical analysis. Additionally, subgroup analysis and sensitivity analysis were performed to analyze the sources of heterogeneity and assess the stability of research results. Begg funnel plot and Egger′s publication bias plot were used to assess potential publication bias.Results:This systematic review included a total of 12 randomized controlled trials (566 patients in total). The participants were 18 to 85 years old. Most of the included studies were of medium quality. This Meta-analysis validated the effectiveness of soft tissue manual therapy on alleviating pain symptoms in patients with chronic neck pain ( ES =-0.83, 95% CI -1.15 to -0.51, P = 0.001). The Begg funnel plot indicated that there may be potential publication bias. Conclusions:This Meta-analysis found that soft tissue manual therapy has a significant effect on alleviating the pain of patients with chronic neck pain. However, different pain assessment tools could have a certain impact on the Meta-analysis results.

Objective: To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus. Methods: The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded. Results: Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications. Conclusions SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.