Objective·To understand the current situation of psychotherapy applied and relevant personnel's working in psychiatric hospitals, and provide advice to facilitate and promote the integrated service team building of domestic mental health institutions and the industry development of psychological treatment. Methods·Ninety-six psychiatric hospitals in China were selected and self-compiled questionnaire was used during the investigation. The actual feedback was collected from 52 hospitals in 25 provinces. Results·① According to the classification criteria of ICD-10 mental disorder, patients mainly suffered from schizophrenia, schizotypal disorder and delusional disorder, followed by affective disorder, in the psychiatric hospitals. ② There were 50 (96.2％) hospitals with psychological outpatient clinics, and 37 (71.2％) hospitals were equipped with mental wards. ③ The main types of patients who came to the psychology department in the psychiatric hospitals were emotional disorders, neurosis, stress-related and physical form disorders. ④ The composition of psychotherapists was 6 physicians, 2 clinical psychologists, and 1 nurse. ⑤ The top five psychotherapy techniques used by the psychiatric hospitals were cognitive therapy, supportive psychotherapy, behavioral therapy, group therapy, and family therapy. ⑥ 44.2％ of the practitioners working in this filed thought that the income had been too low if they only engaged in psychological treatment. Conclusion·In the staffing of mental health agency, compared to previous studies, the number of the psychology specialists increases, but it still makes up a small percentage, which does not match the needs of outpatient and ward patients. Psychological practitioners who rely on psychological treatment alone are in a lower income, and the gap between the expected income and actual income is too large. Government, health administration departments and hospitals should provide more support to psychological services and promote the development of institutions and personnel.

Objective·To investigate safety of laparoscopic surgery in diagnosis and treatment of gynecologic diseases in elderly women over 70 years old. Methods·A total of 420 cases of elderly patients over 70 years old from January 2009 to December 2016 were retrospectively analyzed in Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. According to ages, the patients were divided into elderly group (70-80 years old,including 70 years old) and advanced age group (80 years old and above); according to surgical methods, the patients were divided into laparoscopy group and laparotomy group. The ages, American Society of Anesthesiology (ASA) classifications, body mass indexes (BMI), preoperative complications, surgical methods, intraoperative circumstances, postoperative pathology results and postoperative complications were analyzed. Results·There were no significant differences in age, ASA classification and BMI between laparoscopy group and laparotomy group in the same age group (P<0.05). Most patients had various chronic diseases before operations. Taking total hysterectomy as an example, laparoscopy groups in the two age groups were superior to laparotomy groups in the comparison of surgical time, bleeding volume, anal evacuation time and length of hospital stay (P<0.05). In the two age groups,laparoscopic malignant tumor radical surgery took less time, less bleeding and shorter anal evacuation time than laparotomy (P<0.05). Elderly laparoscopy group had less poor wound healing cases than elderly laparotomy group (P<0.05), while there was no statistical difference in other postoperative complications (P>0.05). All the patients completed the surgeries without perioperative deaths. Conclusion·Laparoscopy is safe in the diagnosis and treatment of gynecological benign and malignant diseases in elderly women with shorter operation time, less bleeding and faster postoperative recovery compared with laparotomy.

Objective·To investigate the characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) findings of patients with uveitis. Methods·The clinical data of 84 patients (135 eyes) diagnosed as uveitis in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Apr 2015 to Aug 2017 were studied retrospectively. FFA and OCT examinations were performed. Results·Of 84 patients, the average age was (44±10) years old. There were more males than females. Fifty-one patients (102 eyes) were affected bilaterally, and 33 patients (33 eyes) were affected unilaterally. Optic fluorescence leakage was found in 73％ of patients, and retinal vascular wall staining was found in 50％ of patients by FFA. Cystoid macular edema was found in 23％ of patients, and neuroepithelial detachment was found in 21％ of patients by OCT. The proportion of common positive manifestation by OCT (10％–40％) was lower than that by FFA (23％–100％) (χ2=33.8, P=0.000). Conclusion·The uveitis usually occurs in young and middle-aged male patients. The most common features of the uveitis patients are optic fluorescence leakage and retinal vascular wall staining by FFA, and cystoid macular edema and neuroepithelial detachment by OCT.

Objective·To explore the correlation of etomidate dose and bispectral index (BIS) in children with congenital heart disease shunting from left to right during anesthesia induction. Methods·After general anesthesia induction to 24 children with congenital heart disease shunting from left to right, sevoflurane inhaling was stopped in order to make the BIS value gradually return to 80. Intravenous injection of etomidate was sustained by 0.3 mg/(kg·min) until the BIS value reached 40. The heart rate (HR), arterial blood pressure (ABP) and central venous pressure (CVP) of the patients were recorded when BIS value was 80, 70, 60, 50,and 40, respectively.The correlation of etomidate dose and BIS value in the children during anesthesia induction was analyzed. Results·There were no significant hemodynamic changes when the BIS value were from 80 to 40. The amount of etomidate was highly negatively correlated with the BIS value (r=-0.769, P<0.01), the average dose of etomidate in children under 2 years of age was significantly higher than that in children over 2 years old (P=0.034). Conclusion·The etomidate dose is highly negatively correlated with the BIS value. Etomidate has less influence on hemodynamic parameters of children with congenital heart disease shunting from left to right. The BIS value may have relationship with patients'age.

Objective·To study the imaging of subcutaneous lymph-vessels and lymph-nodes in sentinel lymph node biopsy (SLNB) with different concentrations of indocyanine green (ICG), and to find the best concentration to improve the success rate of SLNB. Methods·A total of 339 primary breast cancer patients with clinical negative axillary lymph node were enrolled in the study. Double tracer method [ICG and methylene blue (10 mg/mL)] was used for sentinel lymph node biopsy. 1.25 mg/mL ICG was diluted to difference concentration. The injection volume was 1 mL for ICG and 1 mL for methylene blue. The imaging of subcutaneous lymph-vessels and lymph-nodes and the success rate of SLNB were recorded after injection of different concentrations of ICG. Results·The concentration of ICG had significant effect on lymph-vessels and lymph-nodes imaging rate and SLNB success rate (P=0.001). In the group that breast tumors not located in the external upper quadrant (needle biopsy or excisional biopsy) and tumor located in the external upper quadrant without excisional biopsy (needle biopsy), concentration of ICG reached 80％ subcutaneous lymph-vessels imaging rate is 0.723 mg/mL (95％ CI 0.595-0.915 mg/mL). In this group, in this concentration range, the imaging rate of subcutaneous lymph node was 28％-53％, and the success rate of SLNB was 88％-92％. In the group that breast tumors located in the external upper quadrant and had been resected, the imaging rate of subcutaneous lymph-vessels and lymph-nodes was 50％-69％ and 20％-42％, respectively, and the success rate of SLNB was 76％-81％. The difference of subcutaneous lymph-vessels imaging rate between two groups was statistically significant (P=0.014), but the difference of lymph-nodes imaging rate and SLNB success rate had no significance (P=0.628, P=0.232). Conclusion·Using double tracer (ICG and methylene blue) in SLNB is simple and feasible. The best concentration of ICG is 0.723 mg/mL, which can improve the imaging rate of lymph nodes and lymph nodes.

A 24-year-old male suffered from acute nephritic syndrome, liver dysfunction, and mesenteric mass. Laboratory examination showed a variety of autoantibodies (ANA, SM, and A-β2-GP1) were positive. The biopsies of the kidney and the mesenteric mass were performed. The diagnosis was typeⅤ + Ⅲ lupus nephritis accompanied with Castleman's disease. Then the patient was given induction therapy of glucocorticoids and cyclophosphamide for the first 3 months, followed by rituximab as maintenance therapy. The patient was followed up after 0, 3, and 9 months. After 3-month treatment, lupus nephritis was partially remitted, and systemic lupus erythematosus disease activity index (SLEDAI) decreased to 4 scores in an inactivity phase from 20 scores in a serious activity phase at baseline. Nine months later, lupus nephritis was completely remitted and 50％ mesenteric mass was regressed through CT scanning. Lupus nephritis can accompany with multicentric Castleman's disease. Due to lack of clinical specificity and effective therapy, patients may have a high misdiagnosis rate and poor prognosis. The most reliable way to establish a definitive diagnosis relays on histopathologic confirmation. The management of induction therapy of glucocorticoids and cyclophosphamide, followed maintenance therapy of rituximab may become a beneficial treatment.

Retinoblastoma (RB) is one of the most common primary intraocular malignant tumors of children. With improvement of the medical care, the goal of RB treatment is saving the eyeball and even the vision. In the process of globe-salvaging treatment, complicated cataract has been a serious problem which affects the treatment and follow-up. It is important to operate a cataract surgery timely and safely. In this paper related research advances were summarized.

Renal transplantation is still the most effective treatment for end stage renal disease up to date. Immunosuppression therapy can complicate the rejection and severe complications if it is used insufficient or excessive, which may lead to poor survival of patients and grafts . Currently and in the future, discovery of more sensitive biomarkers and better detection methods of allograft rejection and renal function is a major subject of clinical investigation and transplant medicine. This paper reviews the latest research progress in assessment of immune state and renal function after kidney transplantation.

With the rising detection rate of strains with extensive drug resistance clinically, there is an increasingly urgent need of novel anti-microbial agents. More and more researchers put emphasis on bacteriophage therapy and have made great progress in this field. A large number of studies showed that some bacteriophages could produce enzymes which killed the host bacteria by degrading polysaccharides in their extracellular polymeric substances (EPS). This review introduces the classification of phage polysaccharide depolymerases and their action mode, the methods to determine whether the phage produces depolymerases, and their applications in anti-bacterial treatment, biofilm degradation and bacterial capsule typing.

Bipolar disorder (BD) is a kind of psychiatric disorder with wildly alternating emotion and complicated symptoms. Subjects with BD had a significantly higher prevalence of metabolic syndrome when compared to subjects with major depressive disorder and non-psychiatric controls, with risk related to a higher depression score and abdominal obesity. Gender difference in the patients with BD and obesity may be related to childhood adversity, migraine, hormonal alterations, psychotropic medications, diet and lifestyle factors. This article reviewed clinical features and the potential mechanism of gender difference in bipolar disorder with comorbidity of obesity.