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Objective To investigate the effect of acute or chronic administration of eseitalopram(ESC)on behavior of mice,which suffered from chronic unpredictable mild stress(CUMS).Methods Mice were exposured to CUMS for 8 weeks,then the behavior of mice were investigated every 2 weeks,and the effect of acute and chronic administration of escitalopram on behavior was compared.Results (1)The body weight of all stressed mice were lighter than control group(18.5±1.1)g from 2nd to 8th week(P＜0.01).After chronic administration of escitalopram,the body weight of cms+Cesc group(18.5±0.6)g were increased relative to other stressed groups(P＜0.01).(2)In open-field test for 15min,the total distance and central distance of stressed groups were further,and numbers of rear were more than control group(P＜0.05)from 2nd to 4th week,but then these indexes were decreased from 6th to 8th week(P＜0.05).After chronic administration,the total distance(57.4±11.0)m,central distance(12.0±3.0)m and numbers of rear(74.2±6.1)of cms+Cesc group increased(P＜0.05).(3)In sucrose preference test,the preference percentage of stressed groups was less than control group(P＜0.05)from 6th to 8th week at 8th week,the preference percentage of cms + Cesc group((79.0±2.7)%)was more than other stressed groups(P＜0.05).(4)In forced swimming test,compared with control group,immobility time of stressed groups became longer from 4th to 8th week..After chronic administration,immobility time of cms + Cesc group((124.7±8.00)s)was shorter than other stressed groups.(5)After acute administration,the behavior of cms + Aesc group was not different relative to pure stressed group(P＞0.05).Conclusion Chronic administration of escitalopram show up efficacy on depression behavior of CUMS mice,but acute administration is ineffective.

Objective:To explore the brain function asymmetry characters of the patients with major depressive disorder (MDD).Methods:The study examined the ear advantage of 58 healthy subjects, 115 patients with MDD using two kinds of rhyming words by the method of focused attention. Results:1.In healthy group, no ear advantage was found in true words test, but appeared significant right ear (left-hemisphere) advantage in pseudo-words test. 2.In MDD group, there was also no ear advantage in true words test, but appeared enhanced right ear (left-hemisphere) advantage in pseudo-words test. There was a significant difference between the MDD and healthy subjects. Among patient group, 3. by true words test, no ear advantage was found in those with a comorbid anxiety disorder, but those without comorbid anxiety appeared right ear advantage. By pseudo-word test, both patients with or without comorbid anxiety appeared right ear (left-hemisphere) advantage, and those without had larger advantage. there was a significant difference between this two groups. 4.HAMD, HAMA and SCL-90 ratings had no relation to asymmetry scores of true words or that of pseudo-words.Conclusions:1. both healthy control and MDD patients have no ear advantage for process and cognition of true words in, but as for that of pseudo-words, both of them appear right ear (left-hemisphere) advantage, with the MDD patients have greater advantage. 2.The patients with or without a comorbid anxiety disorder were different in response, patients with comorbid anxiety appear more close to normal control. 4. Asymmetry scores don’t correlate significantly with the scores of HAMD, HAMA or SCL-90. 5.The pseudo-words is the better choice as stimuli for dichotic listening test.

BACKGROUND: Family factor is the main reason for children's psychological and behavioral problems. Seen from the view of systemic family theory, in any circumstances, children's behavioral problems reflect various interpersonal systemic networks among society, school, family, relatives and friends and the relationship of complicated interactions among individuals.Family therapy is an important way to cure children's behavioral problems.OBJECTIVE: To observe whether systemic family rehabilitation is adequate for intervening in children's behavioral problems.DESIGN: Cluster sampling; Contrast observationSETTING: Department of Psychiatry, Kunming Medical College.PARTICIPANTS: A total of 276 students in grade four from Mingtong primary school of Kunming City were selected along with their parents from May 2004 to March 2005. A survey was conducted on students and their parents according to the principle of cluster sampling.METHODS: Self-rating family dynamics scale was used to investigate the characteristics of family dynamics of 276 students in grade four. Achenbach child behavior checklist for parents was adopted to investigate the situation of their children' s behaviors. 57 cases of children with behavioral problems were detected out, and took the families in which the whole family members voluntarily participated in the intervention as interventional group and the families in which any one of the family members did not want to participate in the intervention as abnormal control group. The students and their parents in interventional group were treated with 4-month systemic therapy. 4 months later, resent the above rating scales.MAIN OUTCOME MEASURES: Comparison of family dynamics and children's behaviors between interventional group and abnormal control group before and after intervention.RESULTS: After intervention, changes of family dynamics and children's behaviors in interventional group had taken place, which had statistical difference. The changes as follows: family atmosphere changed from "depressive and hostile" to "harmonious, pleasant, equal and exoteric"; the degree of individuation of family members changed from low level to high; disease concept changed from "regarding the patients as helpless victims" to "regarding them as helpful doers", which realize "softening of disease concept". The total scores of Achenbach child behavior checklist for parents decreased [The scores of questionnaire for fathers before and after intervention were (42.20±22.58) and (28.95±21.90) respectively, and scores of questionnaire for mothers before and after intervention were (50.95±14.60) and (36.40-±15.36) respectively, P ＜ 0.05]. There was no significant difference between the changes of children's behaviors assessed by fathers and mothers in abnormal control group [The scores of questionnaire for fathers before and after intervention were (38.32±17.30) and (37.57±16.45) respectively, and scores of questionnaire for mothers before and after intervention were (45.54±16.02) and (40.14±17.95) respectively, P ＞ 0.05].CONCLUSION: Using the idea and technique of systemic family therapy ,it is feasible and effective to intervene in children's behavioral problems by family therapy.

Objective To study on the endoscopic resection of submucosal tumors (SMT) in gastro-intestinal tract with especial regards to the effectiveness and safety, and the value of endoscopic ultrasonogra phy ( EUS) in SMT before endoscopic resection. Methods Endoscopic therapy was performed in 71 patients with gastrointestinal SMT diagnosed by endoscopy, and of them 64 patients (90. 1 % ) were examined by EUS before the procedure. The SMT located in the esophagus 36 cases, stomach 29 cases, duodenum 3 cases and rectum 3 cases. The median tumor diameter was 14. 2 mm ( ranged 6-20 mm). Endoscopic mucosal resection was performed using a two-channel endoscope after submucosal injection of saline solution in 55 cases, then the SMT resected. In 16 patients, the SMT was resected completely with one-step standard procedure using cap-fitted endoscope ( 10 cases, the SMT less than 10 mm in diameter) or two-channel endoscope (6 cases). Results Sixty-eight of seventy-one solid SMT were removed completely under endoscopy and 2 SMT (one ectopic pancreas and one gastric leiomyoma) were resected incompletely; the findings were showed at 4th week by repeated endoscopy. One patient with rectal leiomyoma required surgical resection after unsuccessful endoscopic resection. The follow up period was 18. 7 months on average, no recurrences were found in 67 cases. Histological results showed 51 (71. 8% ) leiomyomas, one granular cell tumor, 4 fibromas, 3 ectopic pancreas, 3 lipomas, 2 stromal tumors and 2 carcinoids in the SMT. Five tumors of mesenchymal tissue , their histological origin cannot be firmly defined due to lack of immunoassayed specimen. Bleeding occurred in only 9 of 71 cases and was easily managed with endoscopic haemostatic measures. One patient with stromal tumor suffered from gastric perforation after the procedure. Conclusions Endoscopic resection of gastrointestinal SMT is a safe and effective procedure and obtains the histological diagnosis simultaneously. EUS is helpful in selecting indicated cases for endoscopic resection.

ObjectiveA survey of the status quo of community nursing health resources in Shao xing countryside was carry out in order to rationally allocate medical resource,optimize quality of medical employees and construct modern rural community nursing patterns.MethodsA survey for 19 health service organizations and 381 nurses in rural communities was carried out with questionnaires.Results There existed regional differences in medical resources.The medical resources per ten thousand people were limited,only 0.7 health education room,1.2 recovery rooms,0.4 women and children′s health center.There was 1 nurse for every 1877 rural residents.The average age of nurses was (30.84±6.88) years old.Nurses on professional health education,community arevention of diseases only accountel for 43.8％.Community nuses of different ages and with different degrees had different knowledge requirements.ConclusionsThe medical resources are limited and imbalanced.The employees are too young and they have only low level of education and are not professional enough.Rational allocation of resources,optimization of personnel structure and abundance of on-the-job training is urgently needed.

Objective To investigate safety and efficacy of hysteroscopy in treatment of cesarean scar pregnancy(CSP).Methods From Aug.2003 to Dec.2011, 33 cases with CSP treated by hysteroscopy guided by transabdominal ultrasound or laparoscopy were studied retrospectively in Women's Hospital,School of Medicine, Zhejiang University.The clinical characteristics including gestational age, myometrial thickness anterior to the CSP, β-hCG level before treatment,success rate, cure rate, operative time, blood loss, time of serum β-hCG resolution and CSP mass clearance, and complication were collected and analyzed.Results Median gestational age was 54 days (range, 37 - 140 days).Median level of β-hCG before treatment was 15 000 U/L( range,3.3 - 151 747 U/L).Mean thickness of anterior myometrium was 3.3 mm.Twenty-nine cases underwent uterine artery embolism (UAE) before hysteroscopy.Pouch in the anterior uterine isthmus with gestation masses implanted were observed in 30 cases (91%, 30/33 ).CSP masses progressed toward the pouch or uterine cavity in all cases was removed by cutting wire loop electrode combined with curettage.The mean operative time was (34 ± 10) minutes.Both success rate and cure rate were 94% ( 31/33 ) .Salvage methotrexate ( MTX ) therapy was administrated in one case.Complication occurred in three cases (9%, 3/33 ).Both massive hemorrhage rate and hysterectomy rate were performed in two cases (6%, 2/33).No uterine perforation occurred.The mean time of hCG resolution was (22 ± 10)days.The mean time of CSP mass clearance was (21 ± 12) days.Four pregnancies were achieved in four cases:one term pregnancy and three abortions.No recurrent CSP occurred.Conclusion Management of CSP by hysteroscopy combined with UAE is safe and effective.

OBJECTIVE To detect the condition of bacteria of the air in wards of our hospital in order to reduce the possibility of air spread. METHODS Ten tuberculosis wards were chosen at random for study.Detected the bacteria content of the air in wards used before and after respectively and analysed the results. RESULTS The average of backgroud bacteria was 164 CFU/m 3 before the wards were used.Two years later,the average of bacteria increased to 682 CFU/m 3.The ratio was 1∶3:2 on average.There were significant differences between them. CONCLUSIONS Humen are the main facters that make the air polluted in these wards.The bacteria content will decline by good environment cleaning sanitation,ventilation and strengthening steriling management.Infection will decline in the hospital.

Objective: To develop the Chinese version of the Neuropsychiatric Inventory Questionnaire (NPI-Q) and evaluate its reliability and validity. Methods: Three investigators assessed 10 dementia cases together with the NPI-Q to evaluate the inter-rater reliability. Eighty-six dementia cases and 30 healthy controls were assessed with the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD), the Brief Psychiatric Rating Scale (BPRS) and NPI-Q to evaluate the criterion validity. A subgroup of 30 dementia cases was tested with the NPI-Q again 24 h later to evaluate the test-retest reliability. Results: (1) Internal consistency. Cronbach's a coefficient of the severity subscale was 0.589, mean inter-item correlation coefficient of the severity subscale was 0.107. Cronbach's α coeffi-cient of the distress subscale was 0.612, and the mean inter-item correlation coefficient of the distress subscale was 0.114. (2) Inter-rater reliability. Intraclass correlation coefficient (ICC) of the severity subscale was 0.97, and ICC of the distress subscale was 0.94. (3) Test-retest reliability. The test-retest correlation coefficient of the severi-ty subscale was 0.89, and the test-retest correlation coefficient of the distress subscale was 0.86. (4) Criterion va-lidity. The severity subscale total score was correlated significantly with BEHAVE-AD (r=0.70, P <0.001) and BPRS(r=0.40, P<0.001) total score; the distress subscale total score was correlated significantly with the global ratings in part 2 of BEHAVE-AD (r=0.76, P<0.001) . (5) The severity subscale total score in demen-tia group was significantly higher than that in control group (median: 10 vs.1.5, P <0.001). The distress sub-scale total score in dementia group was significantly higher than that in control group (median: 10 vs 0; P< 0.001) . (6) Exploratory factor analysis identified 4 common factors, including psychosis, abnormal behavior,discontrol and affective symptoms, which explained 58.3% of total variance. All of the items loaded were between 0.596 and 0.803 on their conrresponding factor. Conclusion: The reliability and validity of the Chinese version of NPI-Q meet the psychometrics properties, and deserves to conduct further study in larger samples.

Objective To explore whether the polymorphism of human frizzled 3 (rs2241802 ,rs2323019,rs352203) is associated with schizophrenia in Yunnan Han population. Methods PCR-RELP was used to detect the polymorphism of human frizzled 3 (rs2241802 ,rs2323019, rs352203 ) in 153 patients and 100 controls. All patients were evaluated with positive and negative symptom scale(PANSS). Following a linkage disequilibrium test in the 3 loci ,association analysis was carried out between the polymorphism, including haplotype,and schizophrenia in all samples. Results No significant difference of genotype and allele frequency of the 3 loci were observed in 2 groups. There was no difference in genotype and allele frequency of rs2241802 ,rs2323019,rs352203 in Han samples (P＞0.05) . The polymorphisms of the 3 loci had been observed no difference in case-sibling control study of normal group. A-A-C haplotype and G-A-C haplotype were observed with a higher frequency in both samples (P＜0.05). There was no difference in patients and controls in PANSS scores (P ＞ 0.05 ). Conclusions There is no association between polymorphisms of human frizzled 3 ( rs2241802, rs2323019, rs352203 ) and schizophrenia in Han. A-A-C and G-A-C haplotype might possibly associate with schizophrenia in Yunnan Han population.