Objective To study the correlation between the changes of sex hormone level in different perinatal periods and perinatal depression (PND). Methods Between February 2014 and February 2015, 300 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University were enrolled in this study. In the first trimester (12 weeks), the third trimester (34 weeks) and postpartum period (7 and 42 days), blood samples were collected and radioimmunoassay was performed to detect the levels of sex hormones, including estrogen, progesterone, prolactin, luteinizing hormone and follicle-stimulating hormone. Self Depression Scale and Edinburgh Postnatal Depression Scale were used for psychological assessment, and PND was diagnosed by psychiatrists as PND group, and non-PND cases served as control group. Two-sample t-test, variance analysis and Bonferroni test were used to compare the changes of sex hormones at different time points between the two groups. Results A total of 180 pregnant women completed the four stages of research. Fifity-four cases were diagnosed as PND, including 10 cases in the first trimester, 16 new cases in the third trimester, 14 new cases at postpartum 7 days, and 14 new cases at postpartum 42 days. (1) Comparison of the sex hormone levels between the two groups:The estrogen levels of the first trimester, the third trimester and postpartum 7 and 42 days in PND group were (4 107.30±344.68), (13 261.60±593.32), (1 281.70±151.54) and (161.40±12.21) pmol/L, and lower than in the control group [(8 619.60±514.92), (14 330.00±353.15), (3 585.90±150.83) and (270.50±11.86) pmol/L, respectively] (all P<0.05). The progesterone levels of the first trimester and postpartum 7 and 42 days in PND group were (105.49±20.40), (24.23±3.53) and (6.40±3.53) nmol/L, and higher than those in the control group [(85.80±19.06), (5.71±2.36) and (3.87±2.03) nmol/L] (t=-2.389, -2.660 and -2.103, all P<0.05). The prolactin and luteinizing hormone levels of the postpartum 42 days in PND group were lower than in the control group [(9.40±1.69) vs (17.50±1.64)μg/L, t=-4.059;(0.32±0.21) vs (2.21±0.17) mU/L, t=-12.302] (both P<0.05). The levels of follicle-stimulating hormone in the first trimester, the third trimester and postpartum 7 days were not detectable in both groups, but PND group had a lower level at postpartum 42 days than the control group [(2.22±0.58) vs (3.15±0.29) mU/L, t=-15.525, P=0.000]. (2) Sex hormone levels at different time points:There were significant differences in estrogen levels between the four time points in both groups. There was significant difference in progesterone in the PND group at four time points, while in the control group, significant differences were found between postpartum 42 days and the first and third trimester. Prolactin levels were lowest at postpartum 42 days in both groups among the four time points (Bonferroni test, all P<0.05). Conclusions Low estrogen levels and high progesterone levels and their changes in perinatal period may be correlated with PND.

Objective: To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound. Methods: From June 2016 to June 2018, 100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound-guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed. Results: Among 100 cases, 98 cases were successful, 2 cases failed, and the failure rate was 2%.The success rate of one-time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter(98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%), compared with two different diameter puncture catheterization, the difference was statistically significant(χ²=12.369, P<0.05). All 98 cases with successful puncture were followed up after operation (P<0.05), and there was no statistically significant difference between the two groups(P<0.05). The drainage tube was removed in 2 cases, bile duct infection was found in 2 cases, the remaining patients were unobstructed, and there were no obvious complications. Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple, reliable, safe and effective, and has a certain clinical value.It is worthy of popularizing and application.

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.