Depression in modern medicine belongs to the depression syndrome in TCM. As early as the pre-Qin period, the ancient doctors recognized depression syndrome as a kind of disease associated with the function of visceral organs or emotional stimulation, which showed mood disorders and a variety of physical symptoms. The doctors in the past dynasties had explored different kinds of non-medicine therapies except for general medicine therapies, such as acupuncture and moxibustion, tuina, music and emotional therapy etc., which had obtained definite therapeutic effects. This article reviewed the non-medicine therapies for depression syndrome in ancient literatures and modern clinical researches, in order to provide some references for the treatment of depression.

Objective To determine how genetic polymorphisms in norepinephrine transporter (NET) gene influence the response of antidepressant treatment and how they interact with childhood trauma and recent life stress in a Chinese depressive patients.Methods 281 Chinese Han depressive patients received single antidepressant drugs for 6 weeks.Hamilton Depression Scale-17 (HAMD-17),the Childhood Trauma Questionnaire short term (CTQ-SF) and the Life Events Scale (LES) were used to evaluate severity of depressive symptoms and the occurrence of stressful life events respectively.Three single nucleotide polymorphisms (SNPs) in norepinephrine transporter were genotyped.Associations of single locus and haplotypes with antidepressant treatment response were analyzed using UNPHASED 3.0.13.The interaction of gene and life stress was analyzed by SPSS13.0 software.Results One NET SNP rs2242446 was significantly associated with antidepressant response in this Chinese male sample(0.4118vs0.2375,x2=7.046,P=0.0079,OR=0.445,95％ CI (0.243-0.815)),as was the haplotype CG(rs2242446 and rs5569;x2 =5.886,P=0.0153,OR=0.457,95％ CI (0.198-1.054)) and another haplotype CG-G(rs2242446,rs1532701 and rs5569;x2=5.360,P=0.0206,OR=0.530,95％ CI (0.202-1.386)) of NET in male samples.The NET SNPs rs5569 demonstrated interaction with childhood trauma to influence antidepressant response(β=-2.727,SE =1.195,P=0.023,OR=0.065,95％ CI (0.006-0.681)).Conclusion Antidepressant drug response was influenced by not only NET genetic polymorphisms in norepinephrine transporter gene but also interaction between the NET genetic polymorphisms and early life stress.

Objective:To evaluate the effect of miR-133b on the apoptosis and radiosensitivity of colon cancer cell line (SW620 cells), and to explore its mechanism.Methods:SW620 cells were transfected with miR-con (miR-con group), miR-133b mimics (miR-133b group), si-con (si-con group) and si-HER-2(si-HER-2 group) by the liposome method, and then irradiated with 0, 2, 4, 6, 8 Gy. The miR-133b protein expression, HER-2 protein expression, apoptosis, cell survival fraction and cytofluoroactivity in each group were evaluated by qRT-PCR, Western blot, flow cytometry, colony formation assay and dual luciferase reporter gene assay, respectively.Results:Compared with the pre-irradiation group, the expression level of miR-133b was significantly down-regulated ( P<0.05), whereas that of HER-2 was significantly up-regulated in SW620 cells after irradiation ( P<0.05). Overexpression of miR-133b and knockdown of HER-2 remarkably reduced the survival fraction (both P<0.05), and significantly promoted the apoptosis of SW620 cells ( P<0.05). miR-133b could considerably inhibit the fluorescent activity of wild-type HER-2 cells ( P<0.05) and negatively regulate the expression of HER-2 protein. Conclusion:miR-133b can inhibit the survival of colon cancer cells, promote the apoptosis and enhance the sensitivity of radiotherapy probably via the mechanism of targeting HER-2.

Objective To investigate the short-term acute rejection incidence of the recipients under the steroid-free immunosuppressive therapy after liver transplantation. Methods This retrospective study included 186 patients who were divided into two groups by random number table.The patients in no steroid group (the study group, n =94) received tacrolimus (Tac) with mycophemolate mofetil (MMF) or cyclosporine with MMF,and those in the steroid group (the control group,n =92) received the aforementioned immunosuppressive therapy combined with steroids.The acute rejection incidence was analyzed during six months post-transplantation.Results There was no significant difference in the gender,age,indication for transplantation,Child-Pugh score,MELD score,operating time,bleeding and transfusion volume during the operation,warm ischemia time and cold ischemia time between the two groups (P＞0.05).Liver biopsy was done on 9 cases of each group.The acute rejection incidence had no significant difference between the study group and the control group (5/94 vs 4/92,5.3％ vs 4.4％,P＞0.05).Conclusion The steroid-free immunosuppressive therapy after liver transplantation did not increase the short term acute rejection incidence.

Objective To investigate the effect of the pregnancy factor on the line drawn between the highest points of the two iliac crests ( T line) corresponding to the vertebral level in a multicenter clini?cal comparative study. Methods Hospitalized patients selected from the obstetric department or gynecolog?ical department, of American Society of Anesthesiologists physical statusⅠorⅡ, were divided into preg?nancy group ( group P ) and non?pregnancy group ( group NP ) . The patients were placed in the lateral posi?tion with their back vertical to the bed surface, the patient′s thighs were at an angle of approximately 90 de?grees to the trunk, and hip flexion was employed by flexing the patient′s knees to the chest. To determine the highest points of the two iliac crests, a line ( T line) was drawn between the highest points using a wire?reinforced epidural catheter. And another vertical line ( T′line) was made between the highest point of the iliac crest on the upper side ( not the side in the lateral position) and the ground. Ultrasonography was per?formed to identify and record the level of T line and T′line corresponding to the spinous process and lumbar interspace. Results A total of 1 763 cases completed the study, and there were 905 cases in group P, and 858 cases in group NP. Compared with group NP, the rate of T line at L3 spinous process and L3,4 in?terspace was significantly increased in group P ( P<0.05) . Compared with T′line, the rate of T line at L2,3 interspace and L3 spinous process was significantly decreased, and the rate of T line at L4 spinous process, L4,5 interspace and L5 spinous process was significantly increased in group P, and the rate of T line at L3 spinous process, L2,3 interspace and L3,4 interspace was significantly decreased, and the rate of T line at L4 spinous process and L4,5 interspace was significantly increased in group NP (P<0.01). Conclusion The level of T line corresponding to the vertebral level is significantly higher in the pregnant patients than in the nonpregnant patients.

Objective To analyze the efficacy and tolerance of methotrexate(MTX)in remission maintenance of Crohn′s disease (CD).Methods From June 2012 to August 2015 ,49 CD patients who received MTX as mainly treatment medication to maintain remission were enrolled.The pre-medication history,efficacy,dosage and side effects of MTX were analyzed.The effects of inducing strategy on disease recurrence were analyzed.Chi-square test and t test were used for statistical analysis.Results Among the 49 patients,34 (69.4%)received steroids for remission inducing,nine (18.4%)received infliximab for remission inducing and six (12.2%)achieved remission after operation.In the 44 patients treated with azathioprine (AZA)before,the median treatment time was one month and the dosage for withdrawal of AZA was (42.0 ± 14.8)mg/d.The most common reason was leucopenia (81 .8%, 36/44).Till the time point of follow-up,46 of the 49 CD patients still took MTX orally with a median treatment time of 16 months,and the weekly dosage was (12.7 ±2.0)mg.Thirty-one cases (67.4%) achieved clinical stability,while 15 cases (32.6%)underwent clinical recurrence.The median Crohn′s disease activity index (CDAI)was 123.5 ± 66.6.The weekly dosage of clinical stability group was (12.5 ±2.1)mg,and that of clinical recurrence group was (13.0 ±1 .7 )mg,there was no statistically significant difference between the two groups (t =0.802,P =0.426 ).The recurrence rate of steroids-induced remission group was 41 .2% (14/34 ),which was higher than that of infliximab and surgery-induced remission group (1/15),and the differnce was statistically significant (χ2 =5 .177,P =0.023 ). The common side effects were gastrointestinal reaction (26.5 %, 13/49 ), impaired liver function (20.4%,10/49)and leukopenia (12.2%,6/49).Only three cases could not tolerate the side effects and underwent medication withdrawal.Conclusions As a second-line immunosuppressant for maintanence remission in CD,MTX is effective and well-tolerated in patients.So it can be an important option during the long course of CD.

Head and neck tumors often have complex anatomical structures and are adjacent to important organs. Radiation injury caused by conventional radiotherapy technology is the main dose-limiting factor. Carbon ion beam has become the most ideal radiation to replace photon due to its excellent relative biological effect and Bragg peak. By 2019, 32 000 people worldwide have received carbon ion radiotherapy (CIRT). Despite the efficient tumor killing ability of this technology, radiation injury cannot be avoided. This article reviews the types and incidence of moderate to severe radiation injury caused by CIRT in head and neck cancer to provide a comprehensive understanding of the potential risks in CIRT.

Objective To observe the outcomes of living donor liver transplantation (LDLT) for children with biliary atresia (BA) and to summarize the clinical experiences. Methods Forty-four BA patients (26 boys and 18 girls) underwent LDLT between October 2006 and December 2010. Mean (SD) and median (range) age at operation was (12.1 ± 9.0) months and 9 (6-60) months,respectively. The 44 donors were lineal relatives to the consorted recipients. Their mean (SD) and median (range) age at operation was (32. 7 ± 8. 0) months and 31 (20～54) years, respectively. All donor graft types were the left lateral segments with compatible ABO blood groups. Clinical data,including pre-operative evaluations, surgical technique, postoperative management and outcomes in all donors and recipients were retrospectively analyzed. Results All donors were followed up for (17. 5 ± 13. 3) months. No donor mortality was encountered, with a minimal morbidity and no long-term sequelae. Nine out of 44 recipients died. Three patients died of portal vein thrombosis (PVT), one of hepatic artery thrombosis (HAT), two of biliary complications, one of surgical site infections, one of abdominal bleeding and one of pulmonary infection. The overall 1-year and 2-year cumulative survival rate in recipients was 81. 2% and 76. 1 %, respectively. No re-transplantation was done. Postoperative complications included PVT, HAT, biliary leakage and refluxing cholangitis, pulmonary infections,surgical site infections and acute rejection. Conclusion LDLT has been the effective treatment for pediatric recipients with BA and provides favorable prognosis. To improve prognosis of recipients, the key points are pre-operative evaluations, surgical technique, and postoperative management

Objective To characterize the clinical course of biliary complications after right lobe living donor liver transplantation (RL-LDLT) and to identify the independent risk factors for biliary strictures.Methods 105 consecutive RL-LDLT recipients operated from April 2007 to April 2010 were followed up. The clinical and operative data were reviewed. The biliary complications and independent risk factors of biliary stricture were studied.Results The median follow-up duration was 49.5 months ranging from 562 to 1675 days.A total of 40 patients (38.1 ％) experienced 11 bile leak episodes (10.4％ ) and 37 (35.2％) biliary stricture episodes after transplantation.Bile leaks occurred at a median time of 9 days ranging from 4 to 54 days after transplantation.For biliary strictures,the occurring time was delayed and scattered wide with a median of 7.6 months ranging from 12 to 790 days after transplantation. Moreover, the biliary stricture incidence in the first year after transplantation was significantly higher than later.The independent risk factors for biliary strictures were CMV infection,bile leaks and bile duct size (≤3 mm).Conclusion The independent risk factors for biliary strictures after RL-LDLT were CMV infection,bile leaks and bile duct size (≤3mm).In order to avoid biliary complications,careful preoperative evaluations are necessary. The dissection of bile ducts should be meticulous to protect its blood supply.CMV infection should be prevented after transplantation.Close surveillance of biliary complications should be given to RL-LDLT recipients during the first year after transplantation.

Objective:Based on the analysis of case report and case series studies involving COVID-19 pregnant women in China, we aimed to discuss the updated management requirements for publication of scientific papers at hospitals in the new circumstances and context.Methods:The case report and case series studies published by domestic scholars in the early stage of COVID-19 outbreak were retrieved. Bibliometrics were used to analyze the research time, research content and research objects of the included literatures.Results:Nearly 200 cases (55%) of the 360 cases of COVID-19 pregnant women could not be clearly excluded from the possibility of repeated reporting. However, all these cases were not disclosed in the paper for possible repeated report.Conclusions:Potential repeated report problem may cause trouble for later meta-analysis, which also may have negative impact for the development of clinical guidelines. The departments of scientific research management at hospital should pay more attention to the management of patient′s data in scientific papers, so that it can better serve the accurate assessment of disease characteristics and epidemic situation, as well as the scientific formulation of clinical guidelines and control strategies.