Objective To assess the latency and amplitude changes in P300 in senile patients with depression.Methods 13 domestic published study literatures meeting our criteria were searched from CBM,CNKI,and a meta-analysis on P300 latency and amplitude was performed with RenMan 4.1 soft ware.Results 1.The P300 latency in senile patients with depression was significant longer than that in senile normal controls in N1,P2,N2,P300 (N1:WMD=3.07,95 ％ CI:0.7～5.42,Z=2.55,P=0.010;P2:WMD=18.41,95％CI:15.11～21.71,Z=10.93,P＜ 0.01;N2:WMD=25.41,95％CI:12.80～29.02,Z=13.80,P＜0.01;P3:WMD=32.14,95％CI:24.14～34.88,Z=23.04,P＜0.01).2.The amplitude in senile patients with depression was significant lower than that in senile normal controls in N2,P2,P3 (P2:WMD=-0.83,95％CI:-1.07～-0.59,Z-6.78,P＜0.01; N2:WMD＝-0.34,95％CI:-0.59～-0.08,Z=2.57,P=0.01;P3:WMD=-2.54,95％CI:-2.75～-2.33,Z=23.99,P＜0.010).Conclusions P300 longer latency and lower amplitude are the statistically characterized features for senile depressive patients.

Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.

Objective To investigate the value of EBUS-TBNA (endobronchial ultrasound-guided trans-bronchial needle aspiration) in diagnosis of lung cancer and analyze its complications. Methods A retrospective study was carried out in our hospitalfrom March 2013 to March 2015. A total of 171patients received C-TBNA (Con-ventional transbronchial needle aspiration) first and got negative results. Therefore, they received EBUS-TBNA next. Weanalyzedthe sensitivity, specificity, accuracy of malignancy with EBUS-TBNA and positive (malignant) lymph node sites biopsied with EBUS-TBNAand the incidence of its complications. Results Lung cancer was proven in 107 patients who had received EBUS-TBNA, while 16 were benign cases. Thirty-onenegative patients received CT guided needle biopsy or surgeryfor finally pathology. Based on above statistical data , we calculated EBUS-TBNA′s sensitivity, specificity and accuracy in 88.42%, 100.00%and 94.21%respectively. A totalof 818 lymph nodes were punctured by EBUS-TBNA, 408 were malignancy. The rate of diagnosis for malignancy was 49.88%. The complica-tioncontained 1 in hemorrhage, 1 in infectionand no life-threatening conditionandno death. Conclusion The value ofdiagnosis in lung cancerisrelatively high with EBUS-TBNAin safety and efficient.

Objective:To compare the differences in incidences of insomnia,anxiety(irritability)and manic ep- isode induced by fluoxetine and amitriptyline in treating depression.Method:CBM discs were selected for the data sources. The rates of insomnia,anxiety(irritability)and manic episode from published clinical control trials on depression treated by fluoxetine and amitriptyline were analyzed by applying fixed effect model(FEM)of evidence-based medicine(EBM). Result:Of 1205 cases in 15 studies,the rates of insomnia induced by fluoxetine or amitriptyline were 21.71% and 1.80% ,OR 9.39(95 %CI 5.37-16.44),P0.05.Conclusion:Fluoxetine induces in- somnia and anxiety(irritability)more easily than amitriptyline when treating depression.

目的探索脑瘫患儿早期发现、早期干预的工作模式。方法临床、保健、康复相结合 ,采用产前检查、孕妇学校、产时儿科医生进产房、新生儿行为神经评定测定、高危儿抚触训练室、婴儿期儿童保健监测、各街道防治站常规体检筛查转诊等多种形式结合早期发现并干预脑瘫高危儿。结果此工作模式较模式前显著提高了脑瘫的早期诊断率及康复疗效。结论临床、保健、康复相结合的方式整合了医疗资源,起到了促进脑瘫早发现、早诊断、早治疗的作用 ,值得推广。

Objective To observe the effect of SSRI combined with TCM on the treatment of depression of different TCM types. Methods 70 depressive patients of stagnation of liver qi (SLQ) were randomly recruited into a study (34 cases) and a control group (36 cases); 60 depressive patients of spleen deficiency and liver qi stagnation (SDLQS) were randomly recruited into a study (30 cases) and a control group (30 cases); and SO depressive patients of deficiency of both heart and liver (DBHL) were randomly recruited into a study (24 cases) and a control group (26 cases). Patients in the study group were treated with SSRI and TCM; with the control group was only treated with SSRI. All patients were assessed with HAMD, HAMA and CGI before treatment and after treatment at 1st weekend, 2nd weekend, 4th weekend and 6th weekend. Differences of effective rate and full remission rate were contrasted. Results ①Scores of depression scale decreased in both the study group and the control group of patients with SLQ and SDLQS at the 4th [SLQ study group: (9.01±3.45), control group (13.02±4.54); SDLQS study group (10.22±3.23)、 control group (14.12±3.87)] and 6th [SLQ study group (6.02±2.20), control group (10.22±2.10); SDLQS study group (7.25±2.20) control group (10.68 ± 3.45)] weekend, showing statistical differences; anxiety state has been improved since the 1st weekend; no obvious changes of HAMD and HAMA showed in both the study group and the control group of patients with DBHL; ②Therapeutic effects in the study group were higher than the control group of both patients with SLQ and SDLQS, showing statistical significance; while no difference can be seen between the two group of patients with DBHL; ③ No differences of full remission rate between the study group and the control group of 3 TCM types were found(SLQ:41.1%v30.6%,χ2=0.859,P>0.05; SDLQS:40.0%v33.3, χ2=0.287,P>0.05; DBHL: 33.3%v26.9%,χ2=0.244,P>0.05). ④Significant differences of HAMD and HMDA between the study and the control group of 3 TCM types were found before and after treatment Conclusion SSRI integrated with TCM may promote effective rate and decrease anxiety in patients with SLQ and SDLQS.

Objective: To detect the mutation of epidermal growth factor receptor (EGFR) gene in peripheral blood of non-small cell lung cancer (NSCLC) patients in Yunnan area with Super-ARMS, and to explore its correlation with clinicopathological characteristics. Methods: A total of 222 blood samples from patients with NSCLC were collected between January 2017 to December 2018 in the Molecular Diagnostic Center of Yunnan Cancer Hospital. The EGFR gene mutation in peripheral blood samples was detected by SuperARMS, and the relationship between EGFR gene mutation and clinicopathological features was analyzed. Meanwhile, the independent risk factors influencing EFGR mutation were also analyzed. Results: In the peripheral blood of 222 NSCLC patients, there were 81 cases (36.5%) with EGFR gene mutation. Among them, exon 19 deletion and L858R gene point mutation were the most common (75.3% of total mutation); female patients had a higher mutation rate than male patients (45.9% vs 27.0%); patients <60 years old had a higher incidence of mutation than patients≥60 years old (43.2% vs 28.8%) (P<0.05 or P<0.01); moreover, patients with no history of smoking, no history of radical surgery, adenocarcinoma, advanced stage and no history of chemotherapy had higher incidence of EGFR mutation (43.9% vs 21.6%, 39.2% vs 21.2%, 43.9% vs 4.8%, 39.7% vs 23.3% and 44.0% vs 23.5%) (P<0.05 or P<0.01). Multivariate logistic analysis showed that young, no smoking history, adenocarcinoma and no surgical history were independent risk factors for EGFR gene mutation (all P<0.01). Conclusion: In the peripheral blood of patients with NSCLC in Yunnan, the mutation rate of EGFR gene is higher in patients with age<60 years old, adenocarcinoma and non-smoking. Super-ARMS method is more sensitive in the detection of EGFR mutation in peripheral blood of lung cancer patients.

Objective To explore the clinical efficacy and safety of hyper-early embolotherapy in treatment of intracranial ruptured aneurysm.Methods A retrospective analysis was made on 33 patients with intracranial ruptured aneurysm.Preoperative Hunt-Hess grade:grade Ⅰ-Ⅱ in 16 patients,gradeⅢin 5 patients,grade Ⅳ in 9 patients,grade Ⅴ in 3 patients.All patients were confirmed with subarachnoid hemorrhage (SAH) by angiography and then underwent embolization under general anesthesia by detachable coils within 6 h from onset.Results After operation,25 patients (75.8％) recovered well,4 patients (12.1％) were with mild disability with paralysis and aphasia,4 patients (12.1％) were dead (1 patient for intraoperative aneurysm rupture,1 patient for postoperative pneumonia,1 patient for infection of hematoma at puncture site and 1 patient for postoperative gastrointestinal bleeding).Followed up 1-6 months,no rebleeding occurred.Conclusions Hyper-early embolotherapy could avoid rebleeding of the aneurysm,and relieve the vasespasm,without increasing the intra-operative rebleeding rate.Moreover hyper-early embolotherapy could greatly decrease the mortality of poor-grade SAH patients.

Objective To investigate the effect of recombinant human interleukin 11(rhlL-11)in the treatment of idiopathic thrombocytopenic purpura(ITP)on the levels of Th1,Th2 and the expression of their transcription factors T-bet mRNA,GATA-3 mRNA.Methods Fifty-six cases adult ITP patients hospitalized in the department of hematology of the Second People's Hospital of Datong from May 2015 to December 2016 were collected,including 21 males and 35 females,aged 29~73 years; 10 healthy people in the same period were enrolled as control group,4 males and 6 females,aged 20~52 years.Th1 and Th2 cell ratio and Th1/Th2 ratio of ITP patients were detected by flow cytometry before and after treatment.The expression levels of transcription factor T-bet and GATA-3 were measured using real-time fluorescence quantitative reverse transcription polymerase chain reaction(RT-PCR)before and after treatment.Results The effective rate of rhlL-11 in ITP treatment was 76.8%(43/56).For the effective patients,the median PLT after treatment increased(25.0(15. 0,36.0)×109/L vs.68.0(49.0,108.0)×109/L,Z=-5.712,P<0.001); Th1 cells decreased,compared with that before the treatment(14.8 %(12.6%,17.6%)vs.10.6 %(9.8%,12.6%),Z=-4.825,P<0.001);Th2 cell increased,compared with that before the treatment(0.4%(0.3%,0.5%)vs.1.2%(0.9%,1.4%), Z=-5.720,P<0.001); Th1/Th2 decreased,compared with that before the treatment(40(30,49)vs.10.6(7.8,12.0),Z=-5.711,P<0.001];the expression level of T-bet mRNA decreased(0.36(0.18,0.51)vs 0.09(0.05,0.13),Z=-2.668,P=0.008);the expression level of GATA-3 mRNA increased,compared with that before treatment(0.04(0.03,0.05)vs.0.12(0.09,0.15),Z=-2.366,P=0.018).For ineffective patients,the median PLT before treatment was(11.0(8.0,15.5)×109/L),and the median PLT after treatment was(15.0(10.0,19.5)×109/L)(Z=-3.027,P=0.002); there was no significant difference in Th1,Th2, ratio of Th1/Th2 and T-bet and GATA-3 mRNA expression level before and after treatment in patients with ITP (P>0.05).Conclusion rhIL-11 can effectively correct the imbalance in Th1 and Th2 cells and the imbalance of T-bet and GATA-3 in ITP patients,but it has no obvious therapeutic effect on a small number of patients

Objective To investigate the clinical distribution and drug resistance of carbapenemsresistant Klebsiella pneumoniae (CRKP).Methods A total of 134 clinical strains of CRKP were collected from inpatients in our hospital from January 2014 to December 2016.VITEK-2 compact automatic microbiological analyzer was used to identify the bacteria and the supporting gram-negative bacterial drug susceptibility card was used for susceptibility testing.The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method.And the clinical distribution of CRKP and its resistance to antimicrobial agents were investigated and analyzed.Results The clinical strains of CRKP were isolated mainly from urine (n=70,52.2％) and sputum (n=38,28.4％).Klebsiella pneumoniae was identified in samples from the department of neurosurgery,including neurosurgery ICU (47.8％,64/134),ICU (23.9％,32/134),department of hepatobiliary surgery (8.2％,11/134) and department of urology (6.0％,8/134).Among all 22 antimicrobial agents tested,the resistant rates of CRKP to 16 antimicrobial agents were ＞90％,especially for ampicillin it was 100％,and those to 19 antibiotics were ＞80％,only for tigecycline it was 23.1％.There were 16 strains of CRKP with positive extended spectrum β-lactamases (ESBLs) (11.9％).All the CRKP strains were resistant to more than three kinds of antimicrobial agents,except one strain that was resistant to two kinds.Conclusion There is a wide range of clinical distribution of CRKP,which is resistant to most of antimicrobial agents,while tigecycline still has a strong antibacterial activity to CRKP.