Objective:To investigate the feature of depression in patients with Parkinson's disease(PD) and the related factors.Methods:Use Hamilton Depression Scale(HAMD) to measure the level of depression of 60 patients with PD.Functional state of the patients was evaluated by Motor Dysfunction Rating Scale for Parkinson's Disease(MDRSPD).Results:29 cases(48.3%) were identified to have depression,among whom 40% were of minor or moderate degree,8.3% were severe.The main manifestations of depression were anxiety/body,retardation,hopelessness and insomnia.Scores of hopelessness,retardation,and insomnia factor were significantly higher in the rigidity and tremor combining rigidity patients than those in tremor patients.The level of depression positively correlated with the duration of disease and degree of dysfunction due to PD,and it has no relation with age,sex,and education.Conclusions:The incidence of depression was higher in patients with PD.PD patients of different clinical types had different characteristics of depression.The rigidity type is more likely to get depression.The degrees are closely related to duration of disease and degree of dysfunetion.

Objective To identify the related factors of PICC malposition.Methods The domestic published literature about the related factors of PICC malposition were collected from 2001 to 2014.Analysis of heterogeneity was performed and cumulative effects were calculated using either fixed or random effects models by RevMan 5.0.Results The incidence of PICC malposition in patients with median cubital vein or cephalic vein was obviously higher than that in patients with basilic vein,the incidence of PICC malposition in patients with cephalic vein was significantly higher than that in patients with median cubital vein; the incidence of PICC malposition in patients with recumbent position was significantly higher than that in patients with seat position; the incidence of PICC malposition in the older than sixty years patients was significantly higher than that in younger than sixty years patients; the incidence of PICC malposition in male and female patients was not discrepant.Conclusions The vein,position and age of patient are the related factors of PICC malposition,while sex factor has nothing to do with the occurrence of PICC malposition.

Maternity insurance is a policy support of China for women of child-bearing age.Given its good outcomes since it is enforced clinically,such insurance has been confronted with challenges as well.Doctors and nurses of Ob/Gyn departments serve as both protectors of parturient women's interests and practioners of the economic and social interests of the hospital.This paper summarized the experiences of maternity insurance of the Ob/Gyn department of the hiospital in rencent 6 years.The hospital has had 2026 inpationts covered by maternity insurance,without any medical disputes and harvesting a cash surplus of 657145 yuan.Such doctors and nurses are found to play a key role in ensuring a good doctor-patient relationship,and serve as clinival references for the single-disease management and teaching of the hospital.

Objective Objective Structured Clinical Examination (OSCE) is one of the most important methods for evalua-ting the medical students′clinical ability .The aim of this study was to analyze the value of OSCE on practice examination in the depart -ment of cardiothoracic surgery . Methods Through the use of standardized patients and the six-station clinical examination , we as-sessed the clinical skills of interns in the department of cardiothoracic surgery . Results OSCE could appraise interns′clinical ability objectively and accurately , which obtained the recognition from students . Conclusion OSCE is applicable to the clinical skills tes-ting in the department of cardiothoracic surgery .

Objective To summarize the clinical characteristics and causes of ischemic cerebrovascular disease(ICD)in children.Methods A retrospective analysis was conducted on the clinical data of 53 cases with ICD from Feb.2002 to Jun.2008 at the department of neurology in Wuhan Children's Hospital.The self-designed questionnaire of children with ICD was used,whose items included patients' age,gender,personal history,clinical features,cerebrospinal fluid examination,neurological imaging,immunologic examination,metabolic examination,and so on.Results Of 53 children with ICD,30 cases(56.6%)were male,and 23 cases(43.4%)were female.Patients' age varied from 9 months to 12 years old,in which 45 cases(84.9%)were less than 6 years old.Patients from rural area(60.4%)were more than those from city(39.6%).Ratio of limb paralysis was 75.5%(40 cases)in first clinical symptomatology of children with ICD,including hemiplegia in 32 cases(60.4%),alternate hemiplegia in 5 cases(9.4%)and monoplegia in 3 cases(5.7%).Skull CT/MRI scan was performed to reveal 27 cases(50.9%)with basal ganglia region infarction and secondly 15 cases(28.3%)with multi-lobar infarction.Forty cases were found in abnormal cerebrovascular image by means of magnetic resonance angiography/digital subtraction angiography,in which middle cerebral artery and its branches were involved in 21 cases(52.5%).There were 41 cases(77.4%)of patients to be found with clear causes,of which 13 cases(24.5%)were of infections,8 cases(15.1%)of moyamoya disease,5 cases(9.4%)of cerebral vascular malformations,4 cases(7.5%)of head trauma.However,another 12 cases(22.6%)of patients had unknown etiology.Conclusions Children with ICD had characteristics themselves.The limb paralysis was mostly the first symptoms,and the middle cerebral artery and its branches lesions were the most common locations in children with ICD,and next the internal carotid artery involvement,anterior cerebral artery involvement,posterior cerebral artery involvement,cerebral vascular malformations,and so on.Their major cause was infection,followed by Moyamoya disease,cerebrovascular malformations and head trauma,and there were still some unknown causes.

Objective To evaluate the clinical effects of Anisodamine on neurological function as well as the safety of using it after cerebral resuscitation. Methods The data of CNKI (from January 1979 through January 2011 ) and Pubmed (from January 1978 through January 2011 ) were searched.The Cochrane Library was applied for identifying randomized controlled trials (RCTs) about effects of Anisodamine on neurological function after cerebral resuscitation.The methodological quality was assessed and the data were collected according to the criteria defined in Cochrane Reviewer' s Handbook for meta-analyses with RevMan 5.0.25 package.Results Data of 327 patients from 4 eligible studies were included in this analysis.The results of meta-analyses showed that Anisodamine used after cerebral resuscitation improved Glasgow coma scale (GCS) in the early stage [ MD =1.4,95％ CI (0.98,1.82),P ＜0.01 ] and lessen neurological deficit (ND) in the later stage [ MD =-4.38,95％CI ( -5.26, -3.51 ),P ＜0.01 ].Meanwhile,the reduction of long-term ND of patients was documented in two studies ; the improvement of ability of daily life of patients in 2 ～ 3 months after anisodamine used was reported in two studies; the improvement of patients' quality of life (QL) was recorded in one study and the inhibited release of excitatory amino acid (EAA) was reported in one study.All eligible studies did not report any serious adverse effects of Anisodamine used after cerebral resuscitation. Conclusions Anisodamine used after cerebral resuscitation can improve patients'status of neurological function with relative safety of administration.

AIM:To be one of the primary cause injury to multiple sites of ocular of glaucoma which affects over 70 million people worldwide. We applied data mining techniques, linear and the matrix operations, efficiently calculated the network and estimated the possible function of the“node” genes of the retina and optic of glaucoma, in order to provide new thought and method on the pathogenesis of glaucoma.
METHODS: The data in this study is from Gene Expression Omnibus ( GEO ) which belong to Nation Center for Biotechnology Information ( NCBI) , the quality of the raw data CEL files was processed and analyzed by the Expression software which belong to Affymetrix Inc. , Santa Clare, CA, USA. Significant analysis method ( SAM) which base on the T test was used to identified the significant genes. Based on GRNInfer and Gvedit soft we set up gene networks of optic and retina of mice and further more enriched analysis which based on DAVID and MAS3. 0 online software were processed.
RESULTS:The analysis between the group of the optic nerve heads and retinas in different stage of glaucoma showed that the amount of significant different expressed genes in the optic never head group increased significantly comparing with the group of retina in the early stage of glaucoma, the analysis of the genes network construction show that:the node genes of optic nerve heads included Unc13c、Kif5a、TRPM1、PANX; and the node genes of retina include POU4F1, NEFL, BC03870, CALB2. Metabolic pathways enrichment analysis which based on MAS3. 0 online platform show that there was mainly the amyotrophic lateral sclerosis, tyrosine metabolism, melanogenesis, Nitrogen metabolism, Gap junction, Leukocyte transendothelial migration metabolism pathway enriched out in optic nerve head; and there was mainly amyotrophic lateral sclerosis, neurodegenerative disorders, prostate cancer, leukocyte transendothelial migration metabolism pathway enriched out in retina.
CONCLUSION:By understanding bioinformatics result, it seems optic were more sensitive than the retina to high intraocular pressure, and weather high expression of TYrp1 gene can be as a sensitive diagnostic item require more evidence back up. Functional enrich analysis of node gene showed that cytoskeleton reconstructed, molecular motor and nutrients transport function improve in optic; and in retina, the most prominent finding in retina was enrichment function modules were focus on regeneration, repairing and differentiation of cells, which remind that we should reinforce research on reparation of retina of primary glaucoma. Metabolic pathways enrichment analysis show that inflammatory response plays prominent place in optic and retina of primary glaucoma, because of the optic narrow and crowed anatomic shape, nutrient metabolism and substances transfer enrichment modules play an important role in optics of primary glaucoma.

Objective To determine the etiology and clinical characteristics of children with dilated cardiomyopathy.Methods 112 children with DCM from January 2002 to December 2011 were studied.The age,cause and the clinical manifestations were analyzed.According to the children with heart function,they were divided into four groups,the incidence and type of arrhythmia were compared.Results In 112 cases of DCM in children,＜ 1 year old diagnosed 52 cases (46.42％),107 cases (95.53％) with heart failure,25 cases (22.32％) with chear causes,96 cases(85.71％) children with a variety of arrhythmias.According to cardiac function in Ⅰ,Ⅱ and Ⅲ and Ⅳ level,they were divided into four groups.The incidence of one kind of arrhythrnia were 20.00％,31.25％,36.17％ and 42.85％.The incidence with two or more kinds of arrhythmia was 0,18.75％,38.29％ and 50.00％ respectively.The incidence of malignant arrhythmia was 0,12.50％,40.42％and 67.85％ in different groups.There was significant differences among the groups of Ⅱ and Ⅲ and Ⅳ level (P ＜ 0 05).Conclusion Children with dilated cardiomyopathy disease younger than I year old had the highest incidence.The major causes were myocarditis,hereditary and congenital metabolic diseases.The incidence of arrhythmia in DCM were high and diverse,often exist for a variety of arrhythmia,and arrhythmia have closely relation with heart function.The embolism in children with DCM was very rare.

Objective To evaluate the structure and stiffness of the common carotid artery (CCA) in patients with obstructive sleep apnea syndrome (OSAS) by RFQIMT and RFQAS technology and analyze the relationships between the parameters of CCA and cardiovascular risk factors.Methods 113 participants with habitual snoring suspected OSAS were divided into control group,mild,moderate and severe OSAS groups according to apnea hypopnea index(AHI)＜5,5-20,20-40,＞40 event/hour respectively.Carotid parameters included intima-media thickness (IMT),diameter (D),distension (Dis),distensibility coefficient (DC),compliance coefficient (CC),pulse wave velocity (PWV),stiffness index α and β were collected by RFQIMT and RFQAS.Multivariate linear regression analysis was applied to analyze the relationships between CCA parameters and cardiovascular risk factors.Results ①The clinical characteristics:blood pressure had significant difference among the four groups (P ＜0.05).SO2,SO2 min decreased and T90,ODI increased significantly in mild,moderate and severe group (P ＜0.05).②The structure parameters of CCA:IMT,D and plaques had no significant difference among the four groups (P ＞0.05).③The elasticity parameters of CCA:Compared with control group,Dis increased significantly in mild group (P ＜0.05).PWV,α,β increased significantly in moderate group (P ＜ 0.05).Compared with mild group,PWV,α,β increased significantly in moderate group (P ＜0.05).Compared with moderate group,α,β increased significantly in severe group (P ＜0.05).④By multivariate linear regression analysis,age was an independent predictor of IMT,Dis,D,CC,PWV,α,β(P ＜0.05).A blunted nocturnal fall was an independent predictor of D,DC,CC,PWV (P ＜0.05),SBP,DBP and PP of daytime had an important effect on D (P ＜0.05).SO2 was independently correlated with PWV (P ＜0.05).PP was an independent predictor of PWV,α,β (P ＜0.05).Smoking was an independent predictor of plaque (P ＜0.05).Conclusions ①Stiffness is damaged earlier than morphology of CCA in patient with OSAS.②PP,a blunted nocturnal fall and SO2 are correlated with stiffness of CCA significantly.It indicates that abnormal circadian blood pressure rhythm and hypoxia are associated significantly with stiffness of CCA in patient with OSAS.

Flexible matching has recently been proposed as a method of improving interactions efficiency. In this study, the concept of flexible matching has been introduced, and the applicability of this strategy has also been described based on the power calculation of interaction between HER-2 polymorphism and smoking with breast cancer. A large-sample approximation method is used to estimate the power and efficiency of gene-environment interactions. In the basic scenario, power of interaction between HER-2 polymorphism and smoking of unmatched case-control study appears to be 30% while in the frequency matching case-control study it is 56%. However, when increasing the smoking prevalence in controls, greater power can be obtained (power=74%). Conclusions: Flexible matching strategies can increase the power and efficiency of case-control studies to detect and estimate the gene-environment interactions when compared with traditional frequency matching and it is especially useful under those scenarios when low environmental exposure of population, adverse gene-environment interactions or less paired controls are seen. Optimal matching design should be made available by weighing the benefits and loss due to flexible matching.