Duloxetine hydrochloride,a serotonin-norepinephrine reuptake inhibitor(SNRIs),is a commonly used antidepressants.Its mechanism of action involves increasing synaptic monoamine neurotransmitters concentration,leading to antidepressant effects.While gastrointestinal reactions and elevated blood pressure are common side effects,duloxetine can rarely induce syndrome of inappropriate antidiuretic hormone secretion(SIADH).This case report presents a patient with depression who developed SIADH following duloxetine hydrochloride initiation,with the main clinical manifestation being restless thirst and excessive drinking.This case is presented to raise awareness among clinicians of this rare yet potentially serious adverse effect of duloxetine treatment.

Objective To investigate the effects of the order of individual liquid on the survival of skin flap in patients after free flap transplantation .Methods From March 2013 to March 2016, 102 patients with trauma in extremities and underwent free flap transplanation in our hospital were randomly assigned to the study groupand the control group , with 51 cases in each group .Patients in the study group were treated with adjusted liquid order according to physiological and biochemical indexes .Patients in the control group were treated according to the order of medical orders .The occurrence of vascular crisis 48 h after operation and flap necrosis that 10 days after free flap transplantation were compared .Results 48 h after operation , there were 6 cases of postoperative vessel thrombosis and 3 cases of necrosis in the study group (χ2=5.795,P<0.05).10 d after operation , there were 11 cases of postoperative vessel thrombosis and 3 cases of necrosis in the control group (χ2=5.299,P<0.05).Conclusions The individualized order liquid infusion can effectively reduce the occurance rate of vascular crisis and necrosis after free flap transplantation .

Objective?To explore the effects of early cold compress post injury and operation for patients with ankle peripheral fracture. Methods?From January 2015 to January 2016, we selected 152 selective operation patients with ankle peripheral fracture from Xi'an Honghui Hospital, the Affiliated Hospital of Xi'an Jiaotong University. All of the patients were randomly divided into control group and observation group, 76 cases in each group. Patients of observation group accepted continuous cold compress around ankle and routine orthopaedics treatment post injury and 24 hours after operation. Patients of control group were treated with routine orthopaedics treatment. We compared the degree of swelling, Face Rating Scale (FRS), hospital days, incidence of tension blister and the score of ankle hindfoot scale of American Orthopaedic Foot & Ankle Society (AOFAS) of patients between two groups after injury and operation. Results?The added value of limb circumference of patients of observation group one day before surgery and the third day after surgery was (17.1±5.7) mm and (14.1±5.9) mm respectively lower than those of control group (t=8.566, 5.065; P＜0.01). The score of FRS the first after surgery was (2.8±0.9) in observation group and (3.3±1.1) in control group with a significant difference (t=3.067, P＜ 0.01). There were three patients with tension blister in observation group and 13 patients in control group with a significant difference (χ2=6.985, P＜0.01). The difference in hospital days between observation group [(6.8±1.3) days]and control group [(8.9±2.6) days]was significant (t=6.298, P＜0.01). There was a significant difference in the score of ankle hindfoot scale of AOFAS three months after surgery between observation group (80.5±15.1) and control group (74.2±11.8) (t=2.866, P＜ 0.01). Conclusions?The early cold compress post ankle peripheral fracture and operation has advantages in reducing fracture and surgery injury complications, shortening average hospital stay, speeding up postoperative rehabilitation and so on. It is the practical application of fast track surgery in nursing of traumatology orthopaedics.

ObjectiveTo investigate the mental health status of the front-line anti-epidemic medical staff during the COVID-19 outbreak， so as to provide references for the targeted psychological intervention and improvement of mental health status. MethodsA total of 162 front-line medical staff who worked in Lanzhou Heavy Particles Hospital of Gansu Province from October to December 2021 were were enrolled， and assessed using self-designed general information questionnaire， Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）. ResultsA total of 144 medical staff completed the valid questionnaire survey， and 17 （11.81%） and 19 （13.19%） cases were found to have anxiety and depression， respectively. The detection rate of anxiety yielded statistical difference among medical staff with different anti-epidemic working hours （χ²=10.602， P<0.01）， and the detection rate of depression demonstrated statistical differences among medical staff with different occupations， family history of depression and anti-epidemic working hours （χ²=5.486， 4.039， 7.526， P<0.05）. ConclusionDuring the COVID-19 outbreak， front-line medical staff develop varying degrees of anxiety and depression. Furthermore， the detection rate of anxiety is relatively high among the staff with long anti-epidemic working hours， and the detection rate of depression is relatively high among the doctors， the staff with family history of depression and long anti-epidemic working hours.