Objective To study on postpartum obsessive compulsive disorder at home and abroad,and to provide new idea of diagnosis,evaluation and treatment on postpartum obsessive compulsive disorder.Method A search using Medline,Embase,EBSCO,Cochrane Library,Web of Science (ISI),Pubmed databases and Google Scholar was carried out using the key words:obsessive compulsive disorder (and derivatives),perinatal,pregnancy,postnatal,postpartum,mothers (and derivatives),anxiety disorders and subtypes. These articles and their references were reviewed.Results Twenty-seven papers were incorporated,but no Chinese paper.The life prevalence of postpartum OCD was 2.3％-11.0％.The most common obsessions were aggressive,contamination and miscellaneous,and compulsion for washing/cleaning and checking.Cognitive behavioural therapy and SSRIs have been suggested as a fist-line treatment of postpartum OCD.Conclusion OCD is more prevalent in the postpartum period.The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling.Collaborative,international,prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.

The paper covered the selection of clinical trial diseases in the clinical pathway experiment in the hospital in the recent two years.It also introduced such management measures as making clinical pathway texts,the rate of cases into clinical pathways,emphasis of variation management,and enhanced clinical pathway data analysis.A comparison between the groups before and after clinical pathway management,found that the clinical pathway can reduce the average days of stay and total patient costs by 3.4 days and 1519 yuan respectively.Both patients and hospitals benefit from clinical pathways.The paper also advocates continuous and dynamic management at various stages of clinical pathway management.

Neoadjuvant chemotherapy is widely used in the therapy of locally advanced breast cancer.In the recent studies,the expressions of ER,PR and C-erbB-2 in tumor may change in different scheme preand post-neoadjuvant chemotherapies for breast cancer.It is obviously changed in the neoadjuvant chemotherapy scheme of anthracyclines and paclitaxel/docetaxel,but hardly changed in anthracycline-based neoadjuvant chemotherapy scheme.

Objective To explore the clinical features of meningeal carcinomatosis (MC). Methods The clinical data of 3 male patients with MC, administered to the authors' hospital within one-year period, were retrospectively analyzed. The pathological mechanism, clinical manifestations, diagnosis, treatment and the prognosis were summarized and relevant literature was reviewed. Results All the three patients presented neurological symptoms at the onset. Case 1, 52-year-old having a history of radical resection for gastric cancer 3 years ago, suffered from headache for 2 months without apparent digestive symptoms. Case 2, 71-year-old, presented diplopia for 2 months. Case 3, 46-year-old, complained diplopia for 3 months, followed by left hip pain and urinary retentions. For case 1, examinations after admission suggested no signs of local recurrence or systemic metastasi. For case 2 and 3, lung tumors were detected and then pulmonary carcinoma was diagnosed. Cerebrospinal fluid (CSF) of the three patients showed similar changes, including mild increase of protein, decrease of glucose and chlorides. Carcinous cells (heterocyst, signet-ring cell and large round heterocyst) were found and cells with positive tumor markers were found in the CSF of all the three patients. MRI also showed specific enhancement on meninges. All these patients, died on day 7, 47 and 24 respectively, after the diagnosis was established. Conclusions Neurological symptoms might be the earliest or the exclusive clinical features of meningeal carcinoma metastasis. A detailed neurological and oncological examination is necessary for the patients with progressive neurological lesions without obvious precipitating cause.

Objective To investigate the protective effect of sevoflurane on acute intracranial hemorrhage craniotomy patients. Methods 60 acute intracranial hemorrhage craniotomy surgery patients were randomly divid?ed into control and experimental group of 30 patients under general anesthesia to have craniotomy. The patients in control group was operated by propofol and remifentanil as a inhalation anesthesia ,while patients in experimental group received sevoflurane ,propofol and remifentanil as a mixed anesthesia. Then intracranial pressure ,serum C?reactive protein(CRP),serum S?100β,NSE,IL?6 and TNF?α levels of different time points were deternmined. Results Serum CRP in experimental group were significantly decreased than the control group(P<0.05)1 d af?ter operation. T0~T3 levels of serum S?100β,NSE,IL?6 and TNF?α in two groups were both increased(P <0.05),and the experimental group was significantly lower than the control group(P < 0.05). The intracranial pressure of control group was significantly higher than the experimental group(P < 0.05). Conclusion Sevoflu?rane has a brain protective role in inhibiting acute inflammation in intracranial hemorrhage craniotomy patients.

Objective To evaluate the effect of rediological intervention on thrombotic membranous obstructive Budd-Chiari syndrome(TMOB-CS) .Methods Seventeen cases of TMOB-CS were treated with mutliple stent inplantation to press the thrombus with PTA.Results The inferior vena cave(IVC) pressure declined from(29.4?3.13)cm H 2 O to (3.45?3.20)cm H 2 O after the multiple stent inplantation.There was no severe complication such as pulmonary thrombembolism occurrence in this series.All the patients had been followedup for 3 to 40 months and showed good results.Conclusion Multiple stent inplantation pressing the thrombus with PTA can be used to treat the patients with TMOB-CS.

Objective To explore the relationship between the post-thoracotomic wound infection and nutritional status.Methods The patients treated with thoracotomy were divided into the simple wound infection group(n=15) as the experimental group and the phase Ⅰ healed group (n=15) as the control group.On the fifth day after operation, the sero-albumin quantity and cumulative nitrogen balance were recorded respectively. The statistical data were given the test.Results Every average index of sero-albumin in the experimental group was lower than the control group. Among them, the total protein comparison had statistical significance (P0 05) and transferrin comparison had statistical difference (P

Objective To evaluate the reliability of colony PCR in identifying the recombinant clones selected from phage antibody libraries. Methods The digested pComb3 vector and Lc fragments, Lc library plasmid, and Fd fragments were ligated successively. The ligation product was transformed into Escherichia Coli strain XL 1-blue bacilli by electroporation and thus murine Fab phage antibody library was constructed.The transformed recombinant clones selected randomly from libraries were identified simultaneously by colony PCR, plasmid PCR and restriction enzyme digestion. The identification consistency was analyzed. The interference was excluded by control PCR using the relevant constituents as template. Results The educed library content of Lc library was 1.175?10 6 CFU and the content of Fab antibody library was 1.02?10 6 CFU. Different recombinant percentages were obtained through three different identification methods (the Lc positive recombinant percentages by colony PCR, plasmid PCR and enzyme digestion were 100%, 78% and 78%, respectively; the Fd positive recombinant percentages by three methods were 90%, 66% and 66%, respectively; the dual positive recombinant (Fd and Lc insert simultaneously) percentages by three methods were 90%, 50% and 50%, respectively). A high frequency of false-positives appeared in colony PCR identification. Nonspecific amplification of control PCR was presumably induced by some intracellular components in XL 1-blue bacilli. Conclusion The identification of the recombinant clones selected from phage antibody libraries by colony PCR remains ambiguous. So it is our assertion that the traditional identification methods such as plasmid PCR or enzyme digestion are more accurate and will less false positive results.

[Objective]To evaluate the efficacy of nerve transfer for reconstructing the sensory function of the sole.[Method](1)Select saphenous nerve as donor nerve for the patients with the sensory loss beneath ankle level:dissect and cut off the saphenous nerve at the medialposterior aspect at upper-middle 1/3 of the leg and divide the gastrocnemius to expose the tibial nerve at the medialposterior aspect of the tibia, cut off partly nerve fibre of the tibial nerve and then end-to-end anastomose to the proximal end of the saphenous nerve. (2) Select sural nerve as donor nerve for the patients with sensory loss of sole only:dissect and cut off the sural nerve at the posterior aspect of the lateral malleolus, expose the tibial nerve at the posterior aspect of the medial malleolus and then cut off partly nerve fibre of the tibial nerve. The sural nerve was comdicted from the subcutaneous tunel at the anterior aspect of the Achilles's tendon to the posterior aspect of the medial malleolus and end-to-end anastomose to the partial nerve fibre of the tibial nerve. [Result]All the 9 cases were followed up from 1.5 to 2 years(mean 2 l months). The SCV(sensory conduction velocity) of the tibial nerve was ranged from 36.1 to 41.2 m/s, mean 38.3 m/s and the amplitude of wave (peak-to-peak amplitude) was a range from 7 to 15.3?V, mean 11.2 ?V by orthodromic electrophysiologic techniques. All 9 cases regained the sense of pain and touch of the sole.Three cases restored their sense of two point discrimination. All the patients expressed their satisfaction with their ability of walk and no muscles atrophy of the foot. The sensory loss in donor region was oberserved only lateral part of the foot beneath the lateral malleolus (sural nerve as donor nerve) and a small part of the anterior aspect of the ankle(saphenous nerve as donor nerve).[Conclusion]Nerve transfer can reconstruct the sensory function of the sole effectively.

Objective To investigate the dysfunction of gallbladder emptying in diabetic patients and its possible mechanism. Methods The postprandial gallbladder emptying function and the release of pancreatic polypeptide (PP), as well as the therapeutic effect of Cisapride on gallbladder contraction were observed in 50 diabetics without cholecystolithiasis and 15 normal controls. The distributions of nitric oxide synthase (NOS) and acetylcholinesterase (AChE) in the wall of surgical removal gallbladders of 7 diabetic patients with cholecystolithiasis were also studied by histochemistry method. Results (1) The function of gallbladder emptying was distinctly lower in diabetic patients with autonomic neuropathy (AN) than that of the healthy subjects and diabetic patients without AN (NAN). (2) The postprandial release of PP in AN group was significantly lower than those in NAN group and healthy subjects. (3) The gallbladder emptying function was improved after receiving Cisapride in patients with AN. (4) Both the amount and activity of NOS and AChE in the wall of gallbladders of diabetic patients were lower than that of the non-diabetic subjects. Conclusion The dysfunction of gallbladder emptying in diabetic patients is partly due to the impaired autonomic nerve. The administration of Cisapride will improve the gallbladder emptying function of diabetic patients with AN.