Objective To investigate the value of serum thyroid hormone (Thyroid hormone, TH) levels on prognosis in patients with treatment-resistant depression ( Refractory depression, RD) .Methods 108 cases of RD patients collected in Hangzhou First People's hospital from March 2014 to February 2016 were divided into observation group and control group according to the method of random numbers, and each had 54 patients.Patients in the observation group were given antidepressant treatment program and the control group a placebo.Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) score changes, and TSH, T3, T4, FT3, FT4 levels of two groups pre-and post-treatment were compared.Results After treatment, the HAMD and HAMA scores in observation group were (14.4 ±2.5) and (15.2 ±2.7) significantly lower than that in control group, which were (25.6 ±5.2) and (25.9 ±4.8),separately, the differences were significant(P<0.05);the TSH, T3, T4, FT3, FT4 levels in observation group post-treatment were (4.54 ±0.68) mIU/L, (1.21 ±0.56) nmol /L, (55.4 ±6.1) nmol/L, (3.16 ±0.42) pmol/L and (8.53 ±0.62) pmol/L, TSH decreased significantly, and T3, T4, FT3 , FT4 were significantly increased than pre-treatment(P<0.05); the indexes in control group were (5.16 ±0.62) mIU /L, (0.91 ±0.42) nmol/L, (51.9 ±3.2) nmol /L, (2.82 ±0.40) pmol/L and (7.76 ±0.64) pmol/L (P<0.05), the differences with observation group were significant ( P <0.05 ) .Conclusion The severity of the symptoms of patients is closely related with TH RD level, antidepressant therapy can improve TH, thereby improving the patient's symptoms, so it is important to pay attention to TH levels in the treatment process of RD.

In surgery operations, wound should be cleaned with warm sterilized saline solution. In order to reach rapidly warming the washing solution from the room temperature during the surgery, we designed a thermostatic medical infusion pump. The present paper mainly presents researches on the two temperature control methods in the standby mode and in the flushing mode of the system. In the standby mode, the traditional proportional-integral-derivative (PID) control algorithm was adopted. In the flushing mode, dynamic characteristics of the system was changed in real time, which made the thermostatic control process more complex, and the fitted control function combined with the PID control algorithm was adopted in this mode. The temperature control parameters were adjusted in real time according to the initial temperature and the flow rate of the washing solution to obtain a constant temperature of the washing solution, no matter how the initial temperature and the flow rate are changed. The experiment results showed that this kind of control system performed well with a high accuracy.
Algorithms ; Equipment Design ; Infusion Pumps ; Sodium Chloride ; Solutions ; Temperature

Objective To study the expression levels of inducible costimulator (ICOS) on CD4+ T cells in peripheral blood in patients with chronic hepatitis B and its change after treated with interferon.Methods All 56 patients were divided into two groups (interferon group has 28 cases,lamivudine group has 28 cases),and interferon group treated by PEG-IFN-α 2a,lamivudine group treated by lamivudine,respectively.There were 20 healthy individuals as control group.The levels of ICOS on CD4+ T cells of patients with chronic hepatitis B were kinetically detected by flow cytometry.The copies of HBV DNA in sera were dynamically detected by real-time PCR.Results The levels of ICOS on CD4+ T cells in patients with chronic hepatitis B was higher than that of normal controls(P＜0.001 ).However,the expressions of ICOS on CD4+ T cells in patients could be deduced by PEG-IFN-α 2a and obviously decreased after treatment.There was significant difference between interferon group and lamivudine group (P＜0.05 in 24 weeks,and P＜0.01 in 48 weeks).After treatment,the change values of ICOS in interferon group was positively correlated with the change copies of HBV DNA (r =0.972,P＜0.001 ).However,the change values mentioned above that did not find correlation in lamivudine group(r=-0.101,P=0.608).Conclusion The study shows the patients with chronic hepatitis B have disordered in cellular immunity and increased with the expression of ICOS on CD4+ T cells.PEG-IFN-α 2a could decrease the expression of ICOS on CD4+ T cells in patients,and correct the Th2 type immune polarization to some extent,and that plays a positive role in antiHBV.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Object To investigate the chemical constituents from the whole plant of Notoseris gracilipes Shih Methods Compounds were isolated by various column chromatography and identified by spectral analysis Results Eight sesquiterpene lactones and four other compounds were isolated and identified as jacquilenin (Ⅰ), scorzoside (Ⅱ), ixerisoside D (Ⅲ), austricin (Ⅳ), notoserolide A (Ⅴ), crepidiaside A (Ⅵ), crepidiaside B (Ⅶ), and lactuside B (Ⅷ) The other four were 6, 7 dihydroxycoumarin (Ⅸ), cichoriin (Ⅹ), luteolin 7 glucoside (Ⅺ), and daucosterol ( ⅩⅡ ) Among them, compounds Ⅰ and Ⅱ showed antibacterial activity against Bacillu cereus AS 1 1688 Conclusion All compounds were isolated from this plant for the first time

A rapid method for authenticity detection of grapeseed oil was proposed based on Ion Mobility Spectrometry ( IMS) . After optimization, the inlet temperature was set at 170 ℃, drift tube temperature was set at 60 ℃. In this method, the oil sample was diluted in hexane (50-fold, V/V) and then directly analyzed in IMS. The detection time was 20 s. To establish an adulteration detection model, recursive Support Vector Machine ( R-SVM) was applied to classifying pure and adulterated grape seed oils. The result of 10-fold cross validation showed that the accuracy of discrimination was up to 91 . 2%. The results in study indicate that IMS method is a new, fast and convenient technique for the adulteration detection of edible oil.

Objective To investigate the efficacy of transarterial chemoembolization (TACE) combined with autologous DC-CIK cells in treating hepatocellular carcinoma(HCC) of BCLC C-stage. Methods A total of 60 cases with HCC in BCLC C-stage were randomly and equally divided into the study group (n=30) and the control group (n=30). TACE combined with autologous DC-CIK cells was employed in the patients of the study group, while only TACE was adopted in the patients of the control group. The immune function, six-month and one-year survival rates were determined, and the results were compared between the two groups. Results In the study group, the blood T lymphocyte subsets of CD3+CD8+ were significantly increased, while CD3+CD4+ were obviously decreased. When compared with the pretreatment levels, the differences were statistically significant (P<0.05). The six-month survival rate of the study group and the control group was 67.9% and 48.1% respectively (P<0.05), and the one-year survival rate of the study group and the control group was 53.6%and 29.6%respectively (P<0.05). Conclusion For the treatment of HCC in BCLC C-stage, the therapeutic effect of TACE combined with autologous DC-CIK cells is much better than that of pure TACE. Therefore, this therapy is an effective treatment for HCC in BCLC C-stage.

Fatigue, which is one of the most commonly reported symptoms in cancer, can negatively impact the functional status and the health-related quality of life of individuals. Although awareness and
study of CRF have grown in recent years,the biological mechanisms and risk factors that induce CRF remain unclear.This paper systematically reviews the available evidence on the biological mechanisms and the risk factors to guide the development of targeted, individualized interventions for cancer-related fatigue.

Objective To evaluate the value of combined hepatectomy in radical resection for hilar cholangiocarinoma. Methods The clinical data and follow-up data of 67 patients of resection for hilar cholangiocarinoma in Henan Tumor Hospital from June 2005 to october 2008 were retrospectively analyzed. Results According to intraoperative exploration situation and bismuth types, tumor resection was combined performed with hepatectomy (n＝38)or non-hepatectomy (n＝29). The rate of R0 resection was 55.3% in hepatectomy group(n＝21) and 34.5% in non-hepatectomy group(n＝10), and the difference was significant（P＝0.024）. The incidence of complications were 39.5% in hepatectomy group(n＝15) and 13.4% in non-hepatectomy group(n＝4), and one patient with liver and kidney failure died in hospital. The 1, 3, 5 years of survival rate were 89.3%,53.6% and 32.1% respectively in R0 group (n＝31) and 69.7%,30% and 10% respectively in R1～R2 group(n＝36), there were significant differences in the postoperative survival rate between both groups（P＝0.018). The 1, 3, 5 years of survival rate were 81.8%,48.5% and 24.2% in hepatectomy group and 75%,32% and 16% in non-hepatectomy group respectively, and the differences were significant（P＝0.037). Conclusions Aggressive resection including combined hepatectomy for hilar cholangiocarcinoma can play an important role for curative effect and long term survival rate.

Objective To predict the value of advanced glycation end products (AGEs) in the risk and severity of coronary heart disease in diabetic patients.Methods Totally 120 cases were divided into 3 groups.Group A had no diabetes mellitus (DM) and no coronary atherosclerotic heart disease (CAD).Group B had DM without CAD.Group C had DM with CAD.The levels of AGEs,low density lipoprotein cholesterol (LDL-C),glycosylated hemoglobin,and the severity of coronary stenosis were detected.Receiver operating characteristic (ROC) curve was used to evaluate the sensitivities and specificities of AGEs for the diagnosis of DM with CAD.Results The highest level of AGEs,LDL-C,glycosylated hemoglobin and carotid plaque was in the C group,with a statistically significant difference (P ＜ 0.05).The severity of AGEs was significantly correlated with the severity of CAD and the Gensini score of AGEs (r =0.445).ROC curve showed that the sensitivity,specificity and area under ROC curve of AGEs determination of DM with CAD were 80.0％,75.0％,and 0.86,respectivity.Conclusions The level of AGEs is significantly correlated with atherosclerosis and prognosis in DM.The severity of CAD was higher in the patients with higher AGEs,and the incidence and severity of restenosis increased.