Objective: To compare the efficacy of paroxetine and amitriptyline in the treatment of primary fibromyalgia syndrome.Methods:46 out- and in-patients with primary fibromyalgia syndrome were randomized to two groups and treated respectively with amitriptyline 25mg~50mg per day and paroxetine 10mg~20mg per day. The Visual analogue scales(VAS) was used to evaluate the efficacy and adverse effects were recorded at baseline, month 1 and month 3.Results:In both groups pain was alleviated with statistical significance after 1 month of treatment. However the efficacy of amitriptyline and paroxetine was not statistically significant at different time points. The occurrence of adverse effects in paroxetine group was less than in amitriptyline group and the difference was statistically significant, especially dry mouth and palpitation.Conclusion:Paroxetine is as effective as amitriptyline in the treatment of primary fibromyalgia syndrome but with a better safety profile.

Shenzhen Eye Hospital took the lead to launch the time interval outpatient clinic appointment registration,for easing the difficulty of seeing doctors and shortening outpatient waiting time.With 30min as a registration interval,the hospital calls into play a variety of means to provide this service to outpatients.This service benefits the outpatients with comfortable hospital environment and promotes hospital efficiency.On this basis,the paper probed into existing problems in the appointment system and proposed improvement suggestions.

Objective To explore the construct validity of the Chinese version of Kinesthetic and Visual Imagery Questionnaire (KVIQ)-20 and KVIQ-10 in stroke patients and normal people. Methods From October, 2012, to March, 2014, 60 stroke patients and 60 nor-mal people with matched gender and age participated in this study. They were assessed with the Chinese version of KVIQ-20 and KVIQ-10. The construct validity was investigated with factor analysis. Results Two factors were extracted from KVIQ-20 for stroke patients after vari-max rotation, that accounted for 62.4%of the variance, as well as KVIQ-10 with 67.6%of the variance. Two factors were extracted from KVIQ-20 for normal people with 76.1%of the variance, as well as the KVIQ-10 with 69.6%of the variance. The factors could be named as visual imagery and kinesthetic imagery. Conclusion The Chinese version of KVIQ-20 and KVIQ-10 has good construct validity for assess-ing motor imagery from the dimensions of visual imagery and kinesthetic imagery, both in patients with stroke and normal people.

Objective: To study the characteristics of P300 and topographic dist ribution mapping in obsessive-compulsive patients. Methods: The P300 and topog raphic distribution mapping were recorded in 36 patients, using a Bneuro Galileoinstrument. Results: Compared with normal subjects, the wa ve patterns of obsessi ve-compulsive patients were unstable; the frontal wave variation and dissymmetry between the two sides was 63.9%; the N2 and P3 latency was prolonged; the P2 an d P3 amplitude was decreased; the P3 topographic distribution mapping was uneven ly distributed, the normal high amplitude in the parietal region was absent. For the patient group, energy levels below grade 5 in the left brain area, the fron tal area, and for both were 42.3%, 30.3%, 15.15% respectively. Conclu sion: P300 and topographic distribution might be served as an objective index for reflectin g cognitive activity in obsessive-compulsive patients.

Objective To investigate the short-term and long-term effect of motor imagery training on visual imagery and kinesthetic imagery of athletes.Methods Twenty athletes majoring in the sports training of Capital University of Physical Education were selected into the experimental group,while 20 counterparts majoring in the human kinetic science were selected into the control group.All subjects received motor imagery training,and were assessed their visual imagery and kinesthetic imagery at three before the training,as well as ten minutes and 48 hours after the training.Results The repetitive measurement and analysis of variance showed that the visual imagery and kinesthetic imagery scores had the main effect of time factor [FvI (2,37)=7.57,P＜0.01;FK1 (2,37)=ll.75,P＜0.01)],as the scores were the highest at ten minutes after training,the second highest at 48 hours after training and the lowest before training.The visual imaginary scores increased significantly after the training,but had no significant difference 48 hours after the training compared to that before the training.After the training the kinesthetic imagery scores increased significantly and then declined slowly,and there were significant differences in the score before and 48 hours after the training (P=0.009).The experimental group and the control group had the same change trend in the visual and kinesthetic imagery scores.The average scores of the former group were higher than the latter at the same time points but without significant differences.The visual and kinesthetic imagery scores had no main effect of group factor,and there was no interaction effect of time factor and group factor.Conclusion Motor imagery training could increase the ability of visual and kinesthetic imagery of people never participating in motor imagery training and the short-term effect was more obvious.The long term effect of motor imagery training was more significant on kinesthetic imagery than visual imagery.

Objective:To see the influence of different antiplatelet therapies on stroke patients’ readmission by performing a deep data-mining into Beijing Healthcare Insuring Database,based on a large sample size.Methods:Aretrospective cohort study,was adopted to extract patients primarily diag-nosed as ischemic stroke from healthcare database.The first hospital records were considered as the pa-tient’s baseline in this study,who were divided into MAPT (aspirin)and DAPT (aspirin and clopi-dogrel)according to the patient’s baseline medications.A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication.The major re-sult events,included:(1 )recurrence of ischemic stroke;(2)hemorrhagic transformation of ischemic stroke;(3)myocardial infarction;(4)the digestive hemorrhage.The Kaplan-Meier figure was used to compare the survival situations between these two groups,the log-rank test was used to test the difference of the survival curve,and 1 ∶1 propensity score matching was calculated from the patients’baseline da-ta.Cox proportional hazards model was used to calculate the hazard ratio (HR).Results:A total of 27 695 patients From January 201 0 to September 201 3 were included,4 047 with DAPT,and 23 648 with MAPT.Because the baseline characteristics of the patients was disequilibrium,so we used 1 ∶1 pro-pensity score matching,after which,the number of the two groups was 4 046 each.Adjusted for the gen-eral demographic characteristics such as age,sex,nationality,complication and drug combination,no statistical significance was observed between the survival curves of the two groups (P =0.06).HR value of major result events between the groups was 0.91 (0.82 -1 .01 ,P =0.07),which was not statistically significant.The covariate gender HR =1 .36 (1 .20 -1 .55,P <0.05),accompanied by diabetes HR =1 .36 (1 .20 -1 .54,P <0.05 ),dyslipidemia HR =1 .1 3 (1 .00 -1 .27,P =1 .1 3),heart disease HR =1 .39 (1 .22 -1 .58,P <0.05)was statistically significant.Drug combination with other antiplate-let agents HR =1 .05 (0.95 -1 .1 7,P >1 .05)did not increase the risk of readmission.Conclusion:There was no difference in prevention of readmission between patients with DAPT and MAPT.Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

Objective To investigated cerebral structural connectivity and its relationship to neuroleptic-na?ve individuals with first episode early-onset schizophrenia using diffusion tensor imaging (DTI) which could demonstrate the white matter integrity . Methods We recruited subjects with first episode DSM-Ⅳearly-onset schizophrenia who had never been exposed to antipsychotic medication(n=19) and sex ,age-matched healthy volunteers (n= 19) .All subjects received DTI and structural magnetic resonance imaging scans .Voxel-based analysis was performed to investigate brain regions fractional anisotropy (FA) values .Results Statistics revealed that schizophrenia patients showed significant FA reduction in left inferior frontal gyrus ,left temporal gyrus ,left occipital lobe and right middle temporal gyrus as compared to healthy subjects .Conclusion Deficits of white matter integrity in widespread brain regions of the first episode neuroleptic-na?ve early-onset schizophrenia patients .The presence of white matter abnormalities in the early-onset patients is suggestive of being related to the etilology of schizophrenia .

Objective To investigate the prevalence of Alzheimer's disease (AD) in first-degree relatives of patients with affective disorders,and to evaluate the risk of AD in first-degree relatives of the patients with affective disorders.Methods Patients with affective disorders meeting DSM-Ⅳ-TR criteria (affective disorders group) and their healthy spouses (conrol group) were recruited in this study (n=109 each).The first-degree relatives inclusion criteria were biological relatives of both probands aged over 55 years.Subjects were investigated by neuropsychological assessment,imaging and clinical examinations,and were diagnosed as AD according to the criteria of the United States of America neuropathy language disorders and stroke research institute and Alzheimer's disease and Related Disorders Association (NINCDS-ADRDA).Results 284 first-degree biological relatives of affective disorders patients and 274 first-degree relatives of control group were selected.There were no statistically significant differences in demographic characteristics of the first-degree relatives between the two groups.The prevalence of Alzheimer's disease in the first-degree relatives had a significant difference between affective disorders group and control group [10.6％ (30/284) vs.4.4％ (12/ 274),x2=7.47,P=0.006].The prevalence of AD in the first-degree relatives was higher in bipolar disorder and depressive disorder patients than in control group [11.2％ (14/125) vs.4.4％(12/274),20.0％ (15/75) vs.4.4％(12/274),x2=6.80,20.56,OR=2.60,4.63,both P＜0.05],while there was no significant difference in the prevalence of AD in the first-degree relatives between mania patients and control group [1.1％ (1/87) vs.4.4％ (12/274),x2 =1.99,P＞0.05].Conclusions There is a high risk for Alzheimer' s disease in first-degree relatives of patients with affective disorders,particularly in first-degree relatives of patients with depression and bipolar disorders.

Objective: To evaluate efficacy and safety of retrograde intrarenal stone surgery for treatment of upper urinary calculi. Methods: The clinical data of 640 patients with upper urinary tract calculi treated by retrograde intrarenal stone surgery (RIRS) in Renmin Hospital of Wuhan University from April 2016 to January 2019 were retrospectively analyzed. There were 424 males and 216 females. The awerage age was (46.2±12.8) years old, ranging 18 to 76 years old. The maximum diameter of the stone is (1.4±0.7) cm, ranging 0.6-3.2 cm. There were 126 cases with inferior calculi and 514 cases with non-lurgical calculi. There were 196 cases with unilateral ureteral calculi, 118 unilateral ureteral calculi cases with renal calculi, 236 cases with unilateral renal stones, and 90 cases with double kidney stones. 104 cases were placed with double J tube before operation and 496 cases were not placed before operation. There were 8 cases of horseshoe kidney, 30 cases of isolated kidney with renal insufficiency, 4 cases of pelvic ectopic kidney with dysplasia, 6 cases of congenital ureteral malformation and 2 cases of sponge kidney. Preoperative average hemoglobin was (133.2±5.6)g/L, ranging 126-188 g/L.And average serum creatinine was (84.4±12.2)μmol/L, ranging 74-242μmol/L before operation. All patients were treated with general anesthesia under the lithotomy position. The ureteroscopy combined with holmium laser lithotripsy was performed.The 200μm fiber was used, which the parameters were set as 12-45 W(0.5-1.5 J/10-30 Hz). The stone baskets were used to take stones according to actual conditions. The operation was performed by doctors of the same qualifications. Results: All patients underwent successful operation. The mean operation time was (45.6±14.6)min. The average postoperative hospitalization was (4.8±1.5)d. The postoperative serious complication rate was 0.9%, including(2 cases of sepsis and 1 case of subcapsular hematoma. Of the 640 patients, 596 were admitted to the hospital for a double J tube and 44 were lost of follow-up. 552 patients met the stone removal criteria, 44 patients did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy or observed regularly. The stone-free rate (SFR) was 92.6% (552/596) after 1-3 months. On the first postoperative day, serum creatinine was (76.0±10.6)(58-156) μmol/L, and postoperative hemoglobin was (126.4±9. 6)(120-176) g/L. There was no significant difference in preoperative and postoperative hemoglobin (t=2.02, P=0.064). Preoperative and postoperative creatinine (t=64.76, P<0.05) was statistically significant. Meanwhile, the stone size (χ²=29.569, P<0.05) and position (χ²=44.949, P<0.05) versus SFR the impact was statistically significant. Multivariate regression analysis showed that stone size was not an independent risk factor for stone clearance (P=0.639). The stone position was an independent risk factor for stone clearance (P=0.013). Conclusions RIRS is a reliable treatment for small and medium calculi patients of the upper urinary tract. The curative effect of stone removal is clear, the complications are few, the safety is high. However, there are certain limitations to the efficacy in the treatment of large stones and lower calculi. Lower calculi is the independent risk factor for the treatment of efficacy.