Aged ; Coronary Artery Disease ; Female ; Heart Ventricles ; Humans ; Vascular Fistula

Objective To investigate curative effect thymoleptics with couple therapy for the patients with postpartum depression (PPD) Methods 27 patients first time diagnosed with PPD consistent with DSM-Ⅳwere randomly divided into study group and control group.The study group received regular thymoleptics with couple therapy,a control group were administered solo thymoleptics.Hamilton Depression Rating Scale(HAMD-17) and Edinburgh Postnatal Depression Scale (EPDS-10) and OLSON marriage quality questionnaire assessed the efficacy of each group before treatment and after 12 weeks treatment.Results (1) According to the total effective rate,there was no significantly differences in two groups after 12 weeks treatment from evaluation of HAMD-17>(P0.05),but complete remission of study group was higher than control group (78.6% ,46.2% ;P<0.05).(2) After 12 weeks treatment there were significantly differences in mean scores of HAMD-17 and EPDS-10 between two groups (P<0.05).The most decreased scores of HAMD-17 and EPDS-10 was found in the study group,and mean scores of each group was lower than pretherapy(P<0.05).(3) There was no significant difference on the scores of eight factors in OLSON marriage quality questionnaire between the two groups before treatment (P>0.05).After 12 weeks treatment the study group had higher score than control in seven factors in addition to sexual life factor (P<0.05).Conclusion Thymoleptics with couple therapy can improve the marriage quality and increase curative effects outstrip solo thymoleptics for the patients with postpartum depression.

Objective To investigate whether intrathecal administration of corticotrophin releasing factor(CRF) has an efficacy on visceral hypersensitivity in irritable bowel syndrome model rat.Methods Thirty rats were randomly divided into three groups(n=10 ).After establishment of irritable bowel syndrome rat model were intrathecal injected with CRF or preemptive peritoneal injected with CP-154526,which is inhibitor of CRF-1 receptor,and the control group to give saline.After experiment all rat with the method of rectal balloon distention,the perception thresholds and the number of abdominal withdrawal reflexes (AWR) of different balloon volume were observed.Results The perception threshold of intrathecal administration of CRF group was(0.62±0.10)ml and higher than other two groups [(0.52±0.09)ml,(0.56±0.08)ml;F=3.25,P＜0.05].At the same time,the number of AWR to the lower balloon content (1.0 ml) was(9.10±1.97)in intrathecal administration of CRF group slightly lower than other two groups[(14.4±1.71),(15.6±2.32);F=29.4,P＜0.01],but no difference was found to the higher balloon content (1.5 ml and 2.0 ml).Besides,the areas and OD value of c-fos positive neurons in cornu posterius medullae spinalis in group with intrathecal administration of CRF were significantly lower than other two groups (P＜0.05).Conclusion Intrathecal administration of CRF can degrade the visceral hyperensitivity in irritable bowel syndrome model rat,and lower expression of c-fos in CNS is probably involved in the process.

Objective To evaluate the effect of insulin pumps in diabetic patients. Methods Perioporative 37 diabetic patients in our hospital were randomly divided into two groups;19 patients were given continuous insulin pump subcutaneously(CS Ⅱ), 18 multiple subcutaneous injection(MS Ⅱ), comparing the level of blood sugar control, pre-operative time, control of blood sugar levels, wound healing, and so on, postoperative enteral nutrition. Results Two groups of blood glucose levels before treatment had no significant difference (P > 0.5), after treatment the de-creased level of blood sugar and blood sugar level of stability in the CS Ⅱ group better than the MS Ⅱ group, the differ-ence was signifieant(P <0.01). CS Ⅱ significantly shortened the pre-operative preparation time,before and after op-eration and postoperative enteral nutrition ,control of blood sugar stable ,the wound healed well and shortened hospital stay. Conclusion Insulin pump is an effective manner in the perioperative treatment of diabetes for smoothing opera-tion, reducing the burden on patients and complications.

ObjectiveTo examine the attachment style,the anxious and avoidant related attachment in adolescent patients with somatoform disorders.MethodsAll of the 66 patients who were diagnosed as somatoform disorder and 80 controls completed the assessments of common information,experiences in close relationships scales.All the data was analyzed by SPSS13.0.ResultsCompared with control group,somatofonn disorder group had higher ratio of insecure attachment,and there were statistically significant differences between them (29.5％vs 81％,x2 =40.584,P＜0.01 ).The scores of avoidant and anxious related attachment in somatoform group were significant higher than those in control group ( separately 70.51 ± 15.08 vs 62.58 ± 14.18,t =4.449,P ＜0.0l ;64.25 ± 18.91 vs 51.49 ± 14.13,t =3.210,P ＜ 0.01 ).ConclusionThere is a higher incidence of insecure attachment and higher level of anxious and avoidant related attachment in adolescent patients with somatoform disorder.The most common style is dismissing attachment.

Objective To explore the clinical effects of laparoscopic surgery combined with marvelon,gestrinone and leuprolide in treatment of chronic endometriosis.Methods 50 cases of endometriosis were collected.They were randomly divided into observation group and control group,each group having 25 cases.The control group underwent laparoscopic surgery and the observation group underwent laparoscopic surgery combined marvelon,gestrinone and leuprolide for 3 months.The two groups were compared in clinical effects,recurrence and pregnancy rate,as well as the operation situation.Results The effective rate was 92.0％ (23/25) in the observation group and 64.0％ (16/25) in the control group.The effective rate of observation group was obviously higher than that of the control group(P ＜ 0.05).The recurrence rate was 8.0％ (2/25)in the observation group,and 32.0％ (8/25) in the control group.The recurrence rate of combination group was obviously lower than that of the simple surgical group(P ＜ 0.05).The pregnancy rate was 80.0％ in the observation group;and 48.0％ in the control group after treatment.The pregnancy rate of the observation group was obviously higher than that of the control group(P ＜ 0.05).Liver damage or other adverse reactions didn't occur to any group after the treatment.The mean time of leaving bed was (1.4 ± 0.4) d after operation in the observation group vs (3.6 ± 1.5) d after operation in the control group.Length of hospital stay was (7.6 ± 3.5) d in the observation group vs (11.5 ± 3.9) d in the control group.The difference had statistical significance(all P ＜ 0.05).Conclusions Laparoscopic surgery combined with marvelon,gestrinone and leuprolide is superior to pure surgery group in treatment of endometriosis.It can improve the effective and pregnancy rate,and reduce the recurrence rate.No obvious adverse reactions can be found,thus it is worth of clinical promotion.

Objective To explore the value of multislice spiral computed tomography ( MSCT ) in predicting the resectability of pancreatic cancer ( PC) .Methods The MSCT images of 102 PC patients ( 62 men, mean age, 61 ±9 years;40 women, mean age, 60 ±9 years) confirmed by postoperative pathology were analyzed retrospectively .The images were analyzed and evaluated by 2 senior radiologists who were double blinded.The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014 .The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC . Image analysis included the lesion location , size and density , the characteristics of pancreatic and bile ducts , relationship of tumor and adjacent vessels , the extrapancreatic findings as well as T staging and resectability.Results The locations of PC were found in the pancreatic head (n=71,69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%).The long-and short-axis diameter were (28.9 ±8.8)mm and (23.8 ±8.0)mm in head, and respectively, (31.2 ±11.0)mm and (23.8 ±6.3)mm in body and tail, respectively.The imaging findings included hypo-(n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra-and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2).T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively.MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05).MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%).Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0%and 92.2%, respectively.Conclusions MSCT could improve the diagnostic accuracy for T Staging and resectability of PC .

Objective To investigate the characteristics of marital quality and social support status of the patients with breast cancer during the period of chemotherapy and the correlation of both factors.Methods Seventy-seven patients with breast cancer were divided into beginning-, middle-and final-staging groups of chemotherapy.And they were studied with Olson marital quality questionnaire and Social Support Rating Scale.Results The total scores of marital quality and other factors were the lowest in the mid-chemotherapy group.Among three groups,the mean of the objective support and availability were gradually increased with the chemotherapy going.The score of objective support was higher in the final than beginning chemotherapy groups (P =0.009).There was a positive correlation between marital satisfaction and the objective support (r =0.248, P =0.036), and between the total score of quality of marriage and subjective support (r =0.286, P = 0.015).Conclusion The marital quality of breast cancer patients receiving chemotherapy is poor,and subjective or and objective support might improve the patient's marital quality.

Objective To compare the clinical effects and safety of treating newly diagnosed type 2 diabetes patients by combining Glargine insulin with Metformin or/and Acarbose. Methods 84 patients with newly diagnosed type 2 diabetes ,who have a history of weight loss, body mass index( BMI )23 ～ 28kg/m2 and poorly controlled blood glucose in Metformin at least a month ,were randomly divided into three groups. Glargine insulin plus Mefformin were used in group A. Glargine insulin plus Acarbose(without mefformin)were used in group B, Glargine insulin, Acarbos and metformin were used in Group C. All three groups were given a 12-week follow-up. Results FBG,2hBG and HbA1c levels were lower in the patients after treatment( P ＜0. 05 ). HbA1c of patients was partly up to the standard in group A and group B,but HbA1c of patients was all up to the standard in group C. The effects in group C were better than those in group A and group B. It had the shortest time to achieve the target and the smallest dose of insulin in group C. BMI in group A and B did not change but decreased in group C(P＞0.05).The incidence of low blood sugar in all three groups was low and no significant difference observed among three groups (P＞0.05). And in all three groups no severe hypoglycemia occurred. Conclusion The method of combining Glargine insulin with Mefformin or/and Acarbose could effectively control blood sugar had little impact on body weight of the newly diagnosed type 2 diabetes patients, and moreover, the incidence of low blood sugar in the newly diagnosed type 2 diabetes patients was lower. It would be the ideal method to treat newly diagnosed type 2 diabetes patients considering the general safety and effectiveness and convenience.

Stress cardiomyopathy is an atypical myocardial disease induced by emotional or physical stress, with the characteristic of left ventricular systolic dysfunction, transient imaging and electrocardiogram (ECG) changes. Sudden cardiac death can occur in severe cases. Clinical symptoms are likely to appear on acute myocardial infarction, but the exact pathological mechanism is unclear. In the present study, we perform a systematic review of the literature on the clinical manifestations, epidemiological characteristics, ECG, imaging and laboratory tests of stress cardiomyopathy, in order to provide the values for forensic pathology diagnosis.
Death, Sudden, Cardiac ; Diagnostic Imaging ; Electrocardiography ; Humans ; Myocardial Infarction ; Stress, Psychological ; Takotsubo Cardiomyopathy/physiopathology*