Major depressive disorder (MDD) is a mental disorder with high prevalence,morbidity and recurrence rate.The treatment goal of acute stage is to achieve remission,which means asymptomatic.However,clinical treatments and studies found impairment of psychosocial functioning still exists even after remission,which means incomplete recovery.As is known,the normalization of psychosocial functioning is essential to the recovery and the recurrence prevention of MDD.In order to provide reference and guidance for the clinical treatments and studies,we reviewed the related studies and found many kinds of factors influencing the restoration of psychosocial functioning,including demographic factors,diseases related factors,psychological factors,social factors and therapeutic approaches.However,few interior studies focused on the recovery of MDD,and the results of foreign studies were inconsistent,while the understanding of how those factors influence the recovery of MDD is not clear enough.In order to make the characteristics of psychosocial functioning recovery and mechanisms of the influencing factors clear,more in-depth studies should be done in the future.

Objective To evaluate the development of cerebral anoxia during controlled hypoten-sion with nicardipine or urapidil after carotid endarterectomy in patients. Methods Forty-four patients of either sex, aged 48-64 yr, scheduled for elective carotid endarterectomy under general anesthesia, requi-ring controlled hypotension after operation, were divided into nicardipine group ( group N ) and urapidil group ( group U) using a random number table method, with 22 patients in each group. Nicardipine at 2. 5μg·kg-1 ·min-1 was intravenously infused in group N, and urapidil 2μg·kg-1 ·min-1 was intravenously infused in group U. After systolic blood pressure was decreased to 130-140 mmHg, the consumption of nicardipine was adjusted to 0. 2 - 0. 5 μg·kg-1 ·min-1 and the consumption of urapidil to 1-2μg·kg-1 ·min-1 in group N and group U, respectively, to maintain systolic pressure at 130-140 mmHg. Heart rate ( HR) , cardiac index ( CI) , bispectral index ( BIS) value, regional cerebral oxygen saturation (rSO2) and end-tidal pressure of carbon dioxide (PETCO2) were recorded after entering the operating room ( baseline) , at the beginning of controlled hypotension ( T1 ) , and at 5, 10, 20, 30, 60 and 120 min af-ter systolic blood pressure was decreased to the target hypotension ( T2-7 ) . Development of cerebral anoxia( the relative decrease in rSO2>12％ of the baseline value) was recorded in controlled hypotension period. Results Compared with the value at T1 , the HR at T2,3 and CI at T3-7 were significantly increased ( P<0. 05), and no significant change was found in rSO2, PETCO2 or BIS value at the other time points in group N (P>0. 05), and rSO2 was significantly decreased at T3-7 (P<0. 05), and no significant change was found in HR, CI, PETCO2 or BIS value at the other time points in group U (P>0. 05). Compared with group N, the HR at T2,3, CI at T3-7 and rSO2 at T3-7 were significantly decreased in group U (P<0. 05). The incidence of cerebral anoxia was significantly higher in group U than in group N ( P<0. 05) . Conclu-sion Controlled hypotension with nicardipine is recommended after carotid endarterectomy in order to avoid the development of cerebral anoxia in the patients.

Objective To investigate the mediating effects of self-evaluation of depressive symptoms between psychosocial function and negative automatic thinking in patients with depression in remission.Methods The Hamilton depression scale (HAMD-17),generic quality of life inventory(GQOLI),Beck depression inventory(BDI) and automatic thoughts questionnaire (ATQ) were applied to 122 subjects who were patients with depression in remission.Results (1) There was significantly negative correlation between self-evaluation of depressive symptoms and physical function and psychological function and social function(r=-0.559,r=-0.435,r=-0.388,all P＜0.01),and negative correlation between negative automatic thinking and physical function,psychological function and social function(r=-0.563,r=-0.449,r=-0.468,all P＜0.01).(2)The score of physical function,psychological function and social function in the group with low self-evaluation of depressive symptoms was higher than those in the group with high self-evaluation of depressive symptoms (low group:70.27±11.33,69.54±11.53,69.09±10.41;high group:53.33±9.32,57.24±13.80,57.69± 12.77),and the differences were statistically significant (t=7.40,4.82,4.48,P＜0.01).(3) Negative automatic thinking had a significant negative effect on physical function (B =-0.17,P＜0.01),which was affected by self-evaluation of depressive symptoms.The relationship between negative automatic thinking and psychological function was affected by self-evaluation of depressive symptoms.Conclusion Self-evaluation of depressive symptom plays a mediating role between negative automatic thinking and physical function,which also was a mediator in the relationship between negative automatic thinking and mental function.