Adult ; Cytokines ; metabolism ; Female ; Gene Expression ; Humans ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Male ; Semaphorins ; genetics ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism ; Thrombocytopenia ; genetics ; metabolism

Objective To investigate the clinical effect and safety of EEG biofeedback therapy combined with mirtazapine in the treatment of depressive disorder.Methods 124 patients with depressive disorder were selected and randomly divided into the observation group and the control group,62 cases in each group.The control group was given mirtazapine treatment,while the observation group was given EEG biofeedback therapy combined with mirtazapine.All the two groups were treated for 8 weeks.Before and 2,4,8 weeks after treatment,the clinical effects in the two groups were evaluated by Hamilton depression scale (HAMD),Montgomerie depression rating scale (MADRS) and the clinical global impression scale (CGI).The side effects scale(TESS) assessment was used to assess the side effects.And the serum norepinephrine (NE),5-hydroxytryptamine (5-HT) and dopamine (DA) levels were measured before and 8 weeks after treatment.Results The total effective rate of the observation group was 87.5％,which was significantly higher than 66.1％ in the control group (x2 =7.213,P ＜ 0.05).In the two groups,2,4,8 weeks after treatment,the HAMD scores were significantly lower than those before treatment (t =9.391,19.349,26.349,5.026,12.610,19.518,all P ＜ 0.05),the M ADRS scores were significantly lower than those before treatment (t =8.646,22.190,33.101,4.986,13.185,25.959,all P ＜ 0.05),and the CGI scores were significantly lower than those before treatment(t =17.471,29.482,42.256,13.136,28.358,35.661,all P ＜ 0.05).In the observation group,after treatment for 2,4,8 weeks,the HAMD scores were significantly lower than those in the control group(t =4.093,4.537,5.655,all P ＜ 0.05),and the MADRS scores were significantly lower than those in the control group (t =3.622,9.740,7.490,all P ＜ 0.05),while the CGI scores were significantly lower than those in the control group(t =8.608,11.024,12.598,all P ＜ 0.05).After treatment,the levels of 5-HT,NE and DA were (148.5 ± 4.9) ng/mL,(60.6 ± 4.2) ng/L and (78.0 ± 4.1) ng/L in the observation group,which were significantly higher than before treatment [(79.8 ± 4.3) ng/mL,(30.3 ± 4.0) ng/L and (43.5 ± 4.0) ng/L,t =82.977,41.134,46.837,all P ＜ 0.05].In the control group after treatment,the levels of 5-HT,NE and DA were (125.4 ± 4.1) ng/mL,(40.2 ± 4.0)ng/L and (50.3 ± 4.3)nig/L,which were significantly higher than those before treatment [(79.2 ± 3.9)ng/mL,(30.5 ±4.1)ng/L and (43.2 ±3.6)ng/L,t =64.287,13.334,9.969,all P ＜0.05],but which those in the observation group increased more significantly (t =28.469,27.695,36.286,all P ＜ 0.05).4 weeks and 8 weeks after treatment,the TESS scores in the observation group were (3.0 ± 1.0) points and (4.3 ± 1.2) points,which in the control group were (2.8 ± 1.2) points and (4.1 ± 1.3) points,there were no significant differences in terms of TESS scores (t =1.150,0.846,all P ＞ 0.05).Conclusion EEG biofeedback therapy combined with mirtazapine in the treatment of depression is better,the adverse reactions is not significantly increased,and it also has higher clinical safety compared with mirtazapine alone.

Objective To elucidate the clinical and pathological features, diagnosis, treatment and prognosis of nodal marginal zone B-cell lymphoma (NMZL). Methods 2 patients, with NMZL who has extremely elevated monoclonal IgM were analyzed and review were included. Results The common pathological diagnosis caused by the association of monoclonal gammopathy with indolent B-cell non-Hodgkin lymphomas was marginal zone lymphoma or B small cell lymphocytic lymphoma/B-cell chronic lymphocytic leukemia. According to our cases and literatures, the main distribution of involved sites in NMZL were lymph nodes, spleen and bone marrow. Sixty percent of the NMZL patients presented with advanced stage with, high risk of IPI. The diagnosis of NMZL was based on pathology of the lymph node. The proliferation and distribution of the differentiation monocytoid cell had a specified significance. Prognosis of early stage ( I or Ⅱ) NMZL were much better than that of advanced stage NMZL even the patients had received chemotherapy.Conclusion NMZL mainly involved lymph nodes, bone marrow and spleen, sporadically associated with the elevated monoclonal IgM. Most of the NMZL patients presented with advanced stage.The prognoses were poor.

Objective To study the differences in clinical characteristics and etiology in bronchopneumonia and lobar pneumonia,and provide the basis for the clinical diagnosis and treatment.Methods A retrospective study was performed on 100 children with lobar pneumonia and 200 children with bronchopneumonia from Dec.2005 to Dec.2007.Antibodies of mycoplasma(MP) and chlamydia(CP) were detected with quantitative enzyme linked immunosorbent assay of serum samples which were collected on addmission.On the second day morning,axenic sputum samples of laryngeapharyngis at pars were collected with onetime asepsis aspiration sputum tube by negative pressure for bacterial culture,and the common seven viruses were detected with direct immunofluorescence,and MP DNA,CP DNA were detected.The results and the clinical data and the characters of sternum were analyzed.Results Lobar pneumonia was more in the elder children,and the features were fever and cough in clinic,absence in physical sign of bellow,and inflammation of one pulmonary lobe in X-ray.Sixty-one percent of childhood lobar pneumonia had MP infection in laboratory examination.But bronchopneumonia was found more in infants and young children,whose features were cough,dyspnea and catarrhus in clinics,wheezy phlegm and stridor in physical sign of bellow,pulmonic shadow of spot and lamellar in X-ray.Bacteria were the most common pathogen in bronchopneumonia.Conclusions Lobar pneumonia was different from bronchopneumonia in age and clinic features and sternum characters of patients,and much more different in etiology.Bacterial infection was important in bronchopneumonia.But in lobar pneumonia,MP infection occupied 61.0%,which was different from traditionaletiology.Moreover,the MP infection rate in infant and young children tend to increase obviously.

Objective To study the incidence of malposition of catheter at different body positions during the operation of peripherally inserted central catheter (PICC),and then select the optimum position to increase the success rate of insertion. Methods 155 patients were randomly divided into the horizontal position group (55 cases),the semi-reclining position group (49 cases) and the sitting position group (51cases).They all used chest X-ray to conffirm the position of top end of the catheter after insertion and then comparing the incidence rate of malposition of catheter among three groups. Results After insertion,11 patients' catheters were found malposition.Among them,8 patients were in the semi-reclining position group (incidence rate 16.3％),2 patients were in the horizontal position group (incidence rate 3.6％) and only one patient was in the sitting position group (incidence rate 1.9％ ).Incidence rate of catheter malposition in the semi-reclining position group was significantly higher than other two groups. Conclusions The best position for PICC is the horizontal position.If the patient has expiratory dyspnea or need to adjust the malposition catheter,sitting position can be used.Semi-reclining position should be avoided in the operation of PICC.

Objective:To investigate the value of indocyanine green retention rate at 15 minutes (ICG R15) on postoperative day 3 combined with standard remnant liver volume (SRLV) in predicting the occurrence of liver dysfunction after hepatectomyin hepatocellular carcinoma (HCC).Methods:The clinical data of 61 HCC patients undergone hepatectomy in Xiangya Hospital of Central South University from January 2015 to February 2016 were collected and analyzed.The patients were divided into 2 groups:a normal liver function group (n=40) and a liver dysfunction group (n=21).Univariate analysis was used to evaluate the risk factors for postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was established,The receiver operating characteristic (ROC) curve was used to examine the regression equation and compare the value difference in predicting postoperative liver dysfunction between single and combined independent risk factors.Results:Postoperative liver dysfunction occurred in 21 of the 61 patients,with an incidence rate at 34.4％.There was no significant difference in the time of operation,time of hepatic portal occlusion,volume of tumor and volume of resected liver between the 2 groups (all P＞0.05),but there were significant differences in the ICG R15 on postoperative day 3,intraoperative blood loss and SRLV between the 2 groups (all P＜0.05).The ICG R15 on postoperative day 3,intraoperative blood loss,SRLV were the risk factors for postoperative liver dysfunction.Logistic regression analysis showed ICG R15 on postoperative day 3 and SRLV were the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was as follows:logit(P)=1.277+0.140×ICG R15 on postoperative day 3-5.125×SRLV.The area under the ROC curve ofICG R15 on postoperative day 3 combined with SRLV was more than that of single ICG R15 and single SRLV.Conclusion:ICG R15 on postoperative day 3 and SRLV are the independent risk factors for postoperative liver dysfunction.The regression equation,which is established by combination of ICG R15 with SRLV,can predict the occurrence of postoperative liver dysfunction.The accuracy of ICG R15 on postoperative day 3 combined with SRLV is better than that of single ICG R15 or single SRLV.

Objective To explore the influence of singing therapy on anxiety and depression of patients with stable COPD.Methods Toally 56 COPD patients were divided into intervention group and control group according to random digit table.The control group was provided health education and mental nursing.On the base of treatment for the control group,the intervention group received singing therapy for 24 weeks.The anxiety and depression scale was to measure the anxiety and depression before and 24 weeks after intervention.Results There were no differences in HAD score and HAD-A score and HAD-D score between the groups before intervention (P＞0.05),but after intervention,the differences were significant in terms of the HAD score and HAD-A score and HAD-D score (P＜0.01).The scores of intervention group were significantly lower than those of the control group.For the scores,there was no difference in the control group between pre-and post-intervention (P＞0.05),but the scores after intervention were significantly lower than those before intervention in the intervention group (P＜0.001).Conclusion Singing therapy can effectively alleviate anxiety and depression of COPD patients at the stable state.

Medical research has entered the era of mega-science.The multidisciplinary collaboration has attracted great attention.besides studies on genes and the environment interaction,multidisciplinary research between natural sciences has received widespread recognition.However muhidisciplinary researches on the interaction between the gene and social factors or behavioral factors on health science deserve more emphasis.This article described development of multidisciplinary research and its features;analyzed importants of conducting multidisciplinary research between natural and social disciplines,and finally provided suggestions on research organization reform in order to promote the multidisciplinary research.

This study was aimed to observe the promotion effect of wound healing retention enema for postoperative anal fistula by modifiedWu-Wei Xiao-Du(WWXD) decoction, in order to explore its mechanism. A total of 60 patients who met the inclusion criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Patients in both groups were diagnosed as simple low anal fistula and treated with low anal fistula incision. The retention enema of 30 mL modified WWXD decoction or complexHuang-Bai fluid were given once a day for postoperative dressing changes. Detailed observations and scores were made on wound exudate, color, and itching around the anus. The comparisons were made on carrion off time, new epithelium time, rate of wound-reducing, wound healing time, and the total clinical efficacy 21 days after operation. The results showed that the wound exudate on the 7th and 14th postoperative day was better than that of the control group. There was no significant difference on the 21st day between two groups. The wound color of the treatment group was better than that of the control group on the 7th and 14th postoperative day. The itching around anus of the treatment group was better than that of the control group on the 7th, 14th and 21st postoperative day. The carrion wound off time and new epithelium time of the treatment group were earlier than that of the control group. There was no significant difference on the rate of wound-reducing. There were no significant differences on the total clinical efficacy 21 days after operation as well as the total average healing time of both groups. It was concluded that modified WWXD decoction can shorten the inflammation phase, reduce the wound exudate and itching, promote early carrion fall and as well as the wound healing.