Treatment of depression is divided into drug treatment and non-drug treatment. Drug therapy including tricyclic、 tetracyclic antidepressant category、Serotonin reuptake inhibitors (SSRI)、Serotonin receptor antagonist and re-absorption inhibitors (SARI)、norepinephrine and dopamine reuptake inhibitors (NDRI)、 serotonin and norepinephrine reuptake inhibitors (SNRI)、 norepinephrine and specific serotonergic antidepressants (NaSSA) and synergist to support treatment; Non-drugs treatments include psychotherapy, electric shock therapy、transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)treatment.In clinical practice for a number of studies provide hope that patients with depression.

This paper briefly introduces some security issues in using Clinic Electronic Llinac and provides corresponding measures and suggestions,which give a reference for persons of the same occupation in security management and operation of Clinic Electronic Llinac.

Objective To investigate the factors related with final test for continued learning of rehabilitation. Methods The records of 511 continued learning students for physical therapy were analysed with linear regression, with the results of theoretical and operating test as independent variable, while sex, age, titles, profession, education, works, levels of hospital and evaluations as independent variable. Results The results of both theoretical and operating test related with profession, education, works levels and evaluation. Conclusion The models estimate the results of continued learning for rehabilitation has been established.

Acute Kidney Injury ; chemically induced ; Humans ; Paraquat ; poisoning ; Rhabdomyolysis ; chemically induced

Osteoarthritis (OA) is the most common form of arthritis, and is the major cause of pain and chronic disability worldwide, causing enormous social and economic burden.Once OA was considered as a 'wear-and-tear' condition and obesity is considered to be one of the most powerful predisposing factors of OA in the weight-bearing joints.However, studies have also linked obesity to OA in non-weightbearing areas, suggesting systemic effects exerted by metabolic factors other than simple local biomechanics perhaps play a role in the high prevalence of osteoarthritis in obese population.Recent studies have shown that systemic metabolic abnormalities, including obesity, diabetes, hypertension, lipid metabolism disorders, atherosclerosis and cardiovascular disease, play an important role in OA pathological process.Metabolic diseases promote the incidence and development of OA through a variety of ways, inducing causing low-grade systemic inflammation, increasing release of adipokines, anabolic cytokines and inflammatory mediators, leading to glucose and lipid metabolism disorders of chondrocytes, upregulating of cartilage extracellular matrix degrading enzymes, raising oxidative stress injury, increasing apoptosis of articular chondrocytes and reducing the cartilage and subchondral bone nutrition supply.These metabolic changes ultimately accelerate the damage of cartilage and promote the incidence and development of OA.Further research on OA and metabolic diseases, has the potential to provide new ideas and methods for the prevention and treatment of OA.

Objective To assess the effectiveness of Exenatide on non‐alcoholic fatty liver disease(NAFLD) with diabetes mellitus by evaluating fatty liver index(FLI) variation .Methods One hundred and two NAFLD patients with type 2 diabetes melli‐tus were enrolled and divided into two groups .One group were treated with Exenatide and another with Oral antidiabetic agents . The data of BMI ,blood fat ,HbA1c ,ALT ,AST ,GGT ,FLI and so on were collected at enrollment and the end point of 24 weeks treatment .The effectiveness of Exenatide were analysed by Kolmogorov‐Smirnov and Pearson correlation coefficient (r) analysis . Results The indicators of metabolic disorder ,the parameters of liver biochemistry and fatty liver disease (FLI) were significantly improved (P<0 .05) after 24 weeks treatment by Exenatide .While only BMI showed significant decrease after 24 weeks treatment with Oral antidiabetic agents(P<0 .05) .The rest of the parameters in oral antidiabetic agants group showed no significant differ‐ence (P>0 .05) .Conclusion Exenatide has a positive effect on non‐alcoholic fatty liver disease treatment who with type 2 diabetes mellitus ,especially for liver fat accumulation .

ObjectiveTo observe the effects of mechanical ventilation with different tidal volumes (VT) on coagulability and fibrinolytic characteristics in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hits with oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male rabbits were randomly divided into five groups (8 rabbits in each group): sham operation group, model group, low VT group (6 mL/kg), rontine VT group (10 mL/kg), high VT group (15 mL/kg). ARDS model was reproduced by sequential injection of 0.1 mL/kg OA and 500μg/kg LPS via auricular vein, and the rabbits in sham operation group received normal saline in same volume. Mechanical ventilation was performed in different VT groups after model reproduction, and the end of the experiment was determined as 6 hours after LPS injection. Blood was collected from the carotid artery at 30 minutes and 360 minutes after LPS injection, with which arterial partial pressure of oxygen (PaO2) was determined, and oxygenation index was calculated. Internal jugular vein blood was collected at 5, 120, 240, and 360 minutes after LPS injection, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and antithrombinⅢ(AT-Ⅲ) were determined. The blood was collected at the end of the experiment, and then the rabbits were sacrificed, and serum levels of procollagen typeⅢ (PⅢP), plasminogen activator inhibitor-1 (PAI-1) as well as PⅢP level in lung tissue were determined. The wet/dry weight ratio (W/D) of lung tissues was calculated.Results Compared with sham operation group, oxygenation index at both 30 minutes and 360 minutes were significantly decreased in model group, while W/D ratio was significantly increased. PT and APTT at 5 minutes were significantly shortened followed by a gradual increase. Fib and AT-Ⅲ showed no change at 5 minutes followed by a gradual decrease, while serum PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly increased. There was no significant difference in oxygenation index between all VT groups and model group, with a tendency to increase in low VT group. W/D ratio in low VT group was the lowest (5.09±0.19), and it was significantly lower than that of the model group (6.02±0.27, P< 0.01), while it was the highest in high VT group (6.27±0.32). PT and APTT in all VT groups were gradually prolonged, and Fib and AT-Ⅲ were gradually decreased. PT and APTT in low VT group were significantly shorter than those in model group from 120 minutes on [PT (s): 120 minutes: 8.90±0.28 vs. 11.43±0.28, 240 minutes: 9.18±0.21 vs. 11.99±0.50, 360 minutes: 9.25±0.15 vs. 12.49±0.29; APTT (s): 120 minutes: 69.09±3.91 vs. 76.08±4.21, 240 minutes: 67.53±2.14 vs. 79.71±2.25, 360 minutes: 66.95±1.13 vs. 83.21±4.01, allP< 0.05], Fib (g/L) was significantly elevated (120 minutes: 3.80±0.09 vs. 3.38±0.15, 240 minutes: 3.91±0.05 vs. 2.47±0.16, 360 minutes:4.06±0.13 vs. 2.39±0.16, allP< 0.05), and no significant difference was found in AT-Ⅲ. Serum contents of PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly lowered [serum PAI-1 (ng/L): 1.14±0.26 vs. 1.63±0.91, serum PⅢP (ng/L): 1.62±0.52 vs. 2.91±0.64, lung PⅢP (ng/L): 4.40±0.58 vs. 5.75±0.47, allP< 0.01]. The change tendency of all parameters in routine VT group was lower than that in low VT group, PT at 120 minutes and 360 minutes, APTT at 240 minutes and 360 minutes was significantly shorter than that in model group, and Fib at 120 minutes and 240 minutes were significantly higher than those in model group (allP< 0.05). No significant difference was found in AT-Ⅲ, serum PAI-1 and PⅢP as well as lung PⅢP as compared with model group. PT and APTT at 360 minutes in high VT group were significantly longer than those in model group, Fib at 360 minutes was significantly lower than that in model group, and lung PⅢP was significantly higher than that in model group. Conclusions There are some important changes in coagulability which changes from a hyper state into a hypo coagulate state, while fibrinolysis is inhibited during the pathological process of ARDS produced by two-hit of OA and LPS. Mechanical ventilation with low VT can obviously improve coagulability and fibrinolytic status, while ventilation with routine VT has little effect on coagulability and fibrinolytic status. Mechanical ventilation with high VT, however, will greatly deteriorate the coagulability and fibrinolytic function in ARDS.

Objective To investigate the current situation of healthcare-associated infection (HAI)management in basic level private medical institutions.Methods 118 basic level private medical institutions in a district of Chengdu were investigated through visiting and questionnaire.Results Of 118 medical institutions,only 2 had HAI manage-ment personnel,4 had HAI management system.22.03% had hand washing facilities in therapeutic rooms and con-sulting rooms,37.29% of institutions stored aseptic items in accordance with the requirements,55.93% of institu-tions disposed medical waste at disposal center;99.15% handled reusable items by users.Conclusion HAI manage-ment status is worried,health administrative department should strengthen support and supervision,especially in-tensified the supervision of private dental clinics.

OBJECTIVE: To introduce the type and biological properties of medical polymer vehicle materials, and to evaluate its application in anticancer drugs. METHODS: A computer-based on-line research was performed in China Journal Full-text Database and Pubmed database published from 1990 to 2009. The key words were "polymer, anticancer drug, carrier". Articles concerning biological properties of medical polymer vehicle materials and its application in anticancer drugs were included. Meta analysis and repetitive studies were excluded. RESULTS: Quality of articles was assessed, and a total of 24 articles were included. Biological properties of medical polymer vehicle materials and its application in anticancer drugs were summarized. Medical polymer vehicle materials are novel technique with the development of pharmacological study, biomaterial study and clinical medicine. Good biocompatibility, biodegradability, regulation of degradation rate and good workability of polymer materials provided convenience and possibility for innovation of pharmaceutical preparation. Structure of drug carrier material, elevation of drug-loading efficiency, in vivo distribution, biodegradation function and effects of degradation product on bodies deserved further investigations. The study focus of anticancer drug high polymer carrier lies in the search of carrier materials with strong choice and good outcomes. CONCLUSION: Medical polymer carrier materials can control drug release speed by dosage form changes, which induced a stable drug concentration in vivo. The medical polymer carrier materials also can send drugs to a certain part of the body by release system, which cannot affect other regions in the body.

Objective To compare the long-term effects between procedurefor prolapse and hemorrhoids(PPH) and Milligan-Morgan hemorrhoidectomy( MMH ) in the treatment of Ⅲ and Ⅳ degree of hemorrhoids. Method The clinical data of 43 cases with Ⅲ and Ⅳ degree hemorrhoids received PPH (PPH group)and 71 cases received MMH (MMH group) were analyzed retrospectively from October 2001 to July 2003. Results Late bleeding in 5 cases of PPH group and no one of MMH group (P ＜0.05).Hemorrhoidal recurrence prolapsed in 9 cases of PPH group and 5 cases of MMH group (P ＜ 0.05). The rectal neck pressure preoperative,after 6 months, 1 year and 3 years were (122.0 ± 11.3), (90.0 ± 10.4),(103.0 ± 13.8) and (113.0 ± 11.2) cm H2O (1 cm H2O =0.098 kPa) of PPH group,after 6 months was decreased obviously than preoperative (P＜0.05),and they were ( 126.0 ± 13.5), (91.0 ± 12.4), (78.0 ±9.8) and (81.0 ± 7.5 ) cm H2O of MMH group,after 6 months, 1 year and 3 years were decreased obviously than preoperative (P ＜ 0.05). Conclusion PPH is safety and effect at short time,but it brings more late bleeding and anal pain,and its rate of prospective hemorrhoidal recurrence is more higher than MMH.