Objective To explore abnormalities in functional connectivity of the affective network (AN) in relapse of major depressive disorder (MDD) after antidepressant treatment combined with resting state functional connectivity analysis.Methods Eleven recurrent MDD subjects after treatment,seventeen non recurrent MDD subjects after treatment and seventy-two healthy controls underwent fMRI scan.The amygdala,the pallidum,the insular cortex and the anterior cingulate cortex of the AN were selected as the template.Group independent component analysis (ICA) was performed to decompose the fMRI images into spatially independent components and the independent component which fit this template best was selected as AN.Two-sample t-tests were performed to investigate the changes in functional connectivity of the AN.Finally,the right amygdala and the medial prefrontal cortex were defined as seed regions.Results Compared with healthy control subjects and non-recurrent MDD group,recurrent MDD group showed significantly increased functional connectivity in the right amygdala in AN(P＜0.001).Meanwhile,the functional connectivity between the right amygdala and the medial prefrontal cortex was significantly decreased in recurrent MDD group(P ＜0.05).Conclusion Abnormal resting-state functional connectivity of the right amygdala after antidepressant treatment in MDD was found,suggesting that altered amygdala functional connectivity may serve as a predicator of relapse of the MDD.

Objective To explore the effects of abnormal effective connectivity within the default mode network (DMN)in relapsed patients with major depressive disorder.Methods Resting-state functional magnetic resonance imaging (rs-fMRI)data were collected from 21 patients of first-episode depression and 16 patients with relapsed depression,and 37 matched healthy controls.The effective connectivity within the DMN was investigated with spectral dynamic causal modeling (spDCM)method.Results spDCM analysis showed that the effective connections from left parietal cortex(LPC)to right parietal cortex(RPC)and medial frontal cortex(mPFC)were significantly decreased,while the connection from posterior cingulate cortex(PCC)to mPFC was increased in patients of first episode depression compared to healthy controls.Furthermore,the connectivity between mPFC and LPC were enhanced in patients with recurrent depression compared withhealthy control subjects,as well as PCC.Meanwhile,the connectivity between mPFC and PCC was enhanced in patients with relapse depression compared with patients of first episode depression.Conclusion Both first-episode and relapsed patients demonstrated abnormal effective connectivity of LPC,implicating that abnormal LPC connectivity may be associated with the neural substrates of depression.In contrast,the patients with relapsed depression showed aberrant connectivity with the mPFC,suggesting that abnormal effective connectivity of the mPFC may play an important role in the relapse of depression.

Objective:To reduce the occurrence of false alarm of vital signs during the use of ECG monitor by using stress ring to fix the lead wire of ECG monitor. Methods 200 patients who used ECG monitor in our department from March 2018 to February 2019 were intervened by two methods. The control group ( n=100) was connected and observed by routine method. The experimental group ( n=100) was added with lead wire to form "stress loop" on the basis of this method. Methods:The connection and fixation of ECG monitors were carried out. The differences of vital signs, heart rate/rhythm and respiratory false alarm between the two groups during ECG monitoring were compared, and the changes of nurses' workload, Hamilton anxiety score and satisfaction were compared.Results:There were significant differences in heart rate/rhythm and respiratory false alarm between the two groups ( P < 0.05). The scores of anxiety, nurses' workload and satisfaction in the experimental group were significantly improved. Conclusion:During the application of ECG monitor, the lead wire coiled into "stress ring" can effectively reduce the ECG monitor vital signs monitoring center rate/rhythm, respiratory false alarm phenomenon, reduce the workload of nurses, improve the satisfaction of nurses, and reduce anxiety of patients.

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.