On the basis of medical literature review and clinical research experience, the authors analyzed the reasons for low recognition rate of depression and poor progress of traditional Chinese medicine (TCM) differentiation of depression in this paper and put forward that depressive episode symptoms and the corresponding common terminology classification of Chinese and Western medicine should be the breakthrough points. Through symptom stratification and combination, as well as distinguishing between primary and secondary symptoms, the comprehensive integrative medicine clinical assessment of depression was explored so as to further obtain expert consensus and provide a methodology reference for the TCM differentiation of depression and the research of etiology and pathogenesis.

Objective To observe the effects of electro-acupuncture on behavior and the level of brain-derived neurotrophic factor(BDNF) in the hippocampus of rats with chronic stress depression. Methods Forty Sprague-Dawley male rats were randomly divided into four groups:a normal control group, a model control group, an electro-acupuncture group and a fluoxetine hydrochloride control group. All rats except the control groups were singly test and by the volume of sugar solution drunk in 24 hours. The levels of BDNF in the CA1 and CA3 pyramidal and dentate gyrus of the hippocampus were investigated immunohistochemically. Results Compared with the normal control group, the model rats'crossing squares, rearing, and grooming in the open field test and the volume of sugarsolution drunk were all less, while their time in the central square was clearly greater. Fluoxetine or electro-acupuncture could significantly improve behavior. Compared with the model group, BDNF immunoreactivity in the hippocampal neurons of the electro-acupuncture group was increased significantly and the average gray value of neurons decreased.Conclusions Electro-acupuncture can improve behavior and the level of BDNF in the hippocampal neurons of depressed rats. It has a significant antidepressant effect.

Objective To investigate the activities associated with nurses’occupational exposure to bloodborne pathogens and the source patients’infection status during blood collection process,so as to provide a basis for developing occupational exposure prevention strategies.Methods Data about occupational exposure to bloodborne pathogens during blood collection process in a hospital from August 2011 to September 2013 were monitored.Results A total of 89 times of bloodborne ex-posure occurred among HCWs,including 75 times of arterial blood collection and 14 venous blood collection.The top three procedures of occupational exposures were rebounding of needles after needles were pulled out (28.09%,n=25),concen-trated cleaning up of rubbish at the end of blood collection (20.22%,n=18),and touching blood and body fluids by skin and mucous membrane (14.61%,n=13).48.31% (n=43)source patients infected with at least hepatitis B virus,hepati-tis C virus ,hepatitis E virus,Treponema pallidum,and human immunodeficiency virus ,51.69%(n=46)source patients were not infected ,after proper handling,none of nurses were infected during blood collection .Conclusion Developing safe blood-withdraw needle,putting sharp instrument into sharp instrument container,wearing gloves,and intensifying training of standard and occupational precaution are important strategies for the reducing of the occurrence of bloodborne exposure of clinical nurses during blood collection process .

Objective To study mRNA expression of neuroglobin (NGB) in thalamus of DAI rats and explore the relation between NGB and heed injury. Method 46 male SD rats were randomly divided into four groups. The DAI model was established according to modi-fied Mamamu method. The mRNA expression of NGB in thalamus at different time point after injury was detected by RT-PCR method. All data were analyzed with statistical software. Result The mRNA expression of NGB in thalamus increased obviously from 30 minutes after in-jury while decreased at the 24th hour after injury. But the expression increased again and reached peak at the 48th hour after injury. Conclu-sion The mRNA expression of NGB in thalamus increased after DM. Those changes suggested NGB might participate in the response mech-anism of stress, secondary ischemia and hypoxic brain injury after neuron injury.

Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.

To investigate the effects of Chaihu Shugan San (CHSGS), a compound traditional Chinese herbal medicine, on behavior and plasma levels of corticotropin releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) of rats with chronic mild unpredicted stress depression.

Objective To establish two-dimensional electrophoresis(2-DE) profiles with high resolution and reproducibility in analysis of hypothalamuses in the spontaneous hypertension rats(SHR) with hyperactivity of liver-yang to analyze the difference on the total proteins of hypothalamuses between the SHR and normal rats.Methods The total proteins of hypothalamuses in the rats were separated by immobilized pH gradient-based two-dimensional gel electrophoresis.With coomassie blue staining,the 2-DE image was analyzed by PDQuest 7.0 software.Results The average matching rate of the 2-DE images of hypothalamuses in the two kinds rats was 92% with good reproducibility.Proteins were mainly displayed at range of pI3-8,Mr(14.4～75) kD.The average spots in the SHR with hyperactivity of liver-yang and in the normal rats were 777?27 and 780?31 respectively.There were 22 spots of proteins up-regulated more than two times and 25 spots down-regulated more than two times in the SHR with hyperactivity of liver-yang than those of the normal rats.Conclusion There are 22 spots of proteins up-regulated and 25 spots of proteins down-regulated in the SHR with hyperactivity of liver-yang,which may be involved in the development of hyperactivity of liver-yang.

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease characterized by the production of a wide range of autoantibodies, resulting in tissue damage. Although the susceptibility to SLE has been attributed to complex interactions between genetic and environmental factors, the influence of a genetic predisposition to SLE is supported by observations of familial aggregations. Family studies have found that siblings with an SLE-affected relative have a 20-fold higher risk of developing SLE compared with the general population. Here, we present a rare case of two male siblings with SLE. The clinical, laboratory, and histopathological findings of these individuals showed the characteristic features of SLE. Human leukocyte antigen (HLA) typing revealed that the brothers and their mother shared the common HLA haplotype of DRB1*1501 and DQB1*0602, which is significantly associated with disease susceptibility in both family-based and casecontrol studies. This report provides an opportunity to reveal the role of genetic factors in the development of SLE.
Autoantibodies ; Autoimmune Diseases ; Child ; Disease Susceptibility ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Leukocytes ; Lupus Erythematosus, Systemic ; Male ; Mothers ; Siblings