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 change of microalbuminuria (MA) in patients with RA and its clinical significance.Methods:From January 2018 to December 2019, data of 75 cases of RA patients were collected from outpatient and inpatient wardsof our hospital, and the data of 75 cases of physical examination wascollected as control. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) anti-cyclic citrullinated peptide (CCP) antibody, blood lipid, Homeostasis model assessment for insulin resistance (HOMA-IR), rheumatoid factor (RF), anti-CCP antibodyand MA levels were measured respectively. RA patients were obtained by ultrasound Carotid intima-media thickness (cIMT) and brachial artery flow mediated diastolic function (FMD) were measured. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and multiple stepwise regression. Results:The MA level of RA patients was significantly higher than that of the healthy control group [(31±5) mg/L vs (25±4) mg/L, t=5.982, P<0.05]. In RA patients, MA level was positively correlated with course of disease ( r=0.327, P=0.015), HOMA-IR ( r=0.576, P<0.01], CRP ( r=0.212, P=0.027), RF ( r=0.585, P<0.01), disease activity score in 28 joints (DAS28) ( r=0.472, P=0.013), cIMT ( r=0.611, P<0.01) and duration of nonsteroidal anti-inflammatory drugs (NSAIDs) use ( r=0.274, P<0.01), and urineMA level( OR=1.763, P<0.01) were independent correlation factors affecting cIMT. Conclusion:The level of MA in RA patients is significantly higher than that in normal controls, and is correlated with disease activity and subclinical atherosclerosis, which could be another important predictor of disease follow-up and early screening of subclinical atherosclerosis in RA patients.

Background and purpose:In recent years,domestic radiotherapy equipment and related software have made great progress,and testing the functionality and stability of the equipment and software is an essential step.This paper focused on comparing the differences in intensity-modulated radiation therapy(IMRT)plans dosimetry and organ at risk(OAR)volume calculations for common cancers between uRT-treatment planning system(TPS)and Monaco-TPS,and to evaluate the feasibility of dose calculation for Infinity linac(linear accelerator,Elekta,Sweden)using uRT-TPS.Methods:Twenty cases of rectal cancer,lung cancer,breast cancer and nasopharyngeal carcinoma were selected.The IMRT plans were completed in uRT-TPS and Monaco-TPS.The dose uniformity and conformity,mean dose,maximum dose of planning target volume(PTV)and OAR between two plans under the same prescribed dose of PTV were compared.And the pass rates of two TPS plans validated at the same linear accelerator were compared.Meanwhile,monitor units(MU),source skin distance(SSD)and the volume of OAR in uRT-TPS and Monaco-TPS were compared.Results:Wonderful plans that met the clinical requirements were obtained in uRT-TPS and Monaco-TPS.Comparable uniformity and conformability was received in PTV,and the maximum dose of PTV was reduced by 1.1 Gy for uRT-TPS(P = 0.006).For breast cancer and lung cancer,the dose in lung was lower for Monaco-TPS(P＜0.05).For nasopharyngeal carcinoma,the dose indicators that oral cavity and throat in the uRT-TPS was reduced by 9.2%and 5.1%,respectively.The verification results of absolute point dose(＜3%)and three-dimensional surface dose(＞95%)for both plans met the clinical requirements.The region of interest in uRT-TPS was smaller compared with Monaco-TPS(P＜0.05).Conclusion:A comparable IMRT plan was obtained for common tumors in uRT-TPS and Monaco-TPS.It is feasible to calculate the dose of Infinity linac using uRT-TPS.

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.