Objective: To investigate the efficacy and safety of sertraline combining with quetiapine in the treatment of obsessive-compulsive disorder (OCD) .Methods: A total of 86 patients who met the criteria for OCD in International Classification of Diseases (ICD-10) were randomly assigned to two groups. One group was treated with sertraline combining with quetiapine and die other with sertraline only for 8 weeks. The efficacy was measured wim the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Hamilton Depression Scale (HAMD) . The side effects were assessed with the Treatment Emergent Symptoms Scale (TESS) . Results: One patient in sertraline group fell off and was out of statistical analysis. At endpoint the significant improvement rate in the combining group was higher than that in the sertraline group (72.1% vs. 47.6% , P = 0.021) . In combining group, the YBOCS score [(25.00 ± 5.19) vs. (11.74 ± 4.50), P < 0.01] and HAMD score [(14.47 ± 4.05) vs. (6. 86 ±2.61), P < 0.001] were decreased after treatment In sertraline group, the YBOCS score [(24.55 ± 3.60) vs. (14.38±4.18), P<0.001] and HAMA score [(14.79 ± 3.77) vs. (8.29 ±3.04), P <0.001] were also decreased after treatment There were significant differences between the two groups (Ps < 0.05) . There were no significant differences between the two groups in the TESS score at the end of 2, 4, 6 and 8 weeks (Ps > 0.05) . The incidence of drowsiness and tachy-heart rate in the combining group was high than that in the control group (37.2% vs. 4.8% , P <0.001; 27.9% vs. 4. 8% , P=0.004) . But most patients with these two kinds of side effects were disappeared in 2 weeks. There were no significant differences between the two groups in other side effects such as nausea, anxiety, headache, and constipation (Ps > 0.05) .Conclusion: The addition of quetiap-ine to sertraline therapy has been found to be effective and well-tolerated approach in patients with OCD.

Objective To compare the genetic polymorphism of 34 Yersinia pest strains of 3 kinds of ecotypes(Microtus fiscis,Qilian Mountain and Qinghai-Tibet Plateau ecotype)that isolated from the Sanjiangyuan area in Qinghai Province and Shiqu County in Sichuan Province,in order to know the ecotype relationship among the strains.Methods Thirty-four strains were amplified using the application of random amplified polymorphism DNA(RAPD)and were detected with agaroge gel electmphoresis.Results Amplified products by ngarose gel electrophoresis method showed same stripes in 31 strains,only 3 strains had slight differences.Conclusion The Microtus fuscas,Qilian Mountain and Qinghai-Tibet Plateau ecotype strains isolated from Sanjiangyuan area are genetically homologous.

Objective To analyze human plague from 2001 to 2011 in Qinghai Province and to provide a scientific basis for formulating prevention and control measures.Methods Using the descriptive epidemiological methods,epidemiological field survey data and medical records of each case of human plague were collected from 2001 to 2011 in Qinghai Province.Human plague was judged in accordance with the Plague Diagnostic Criteria (WS 279-2008).Results From 2001 to 2011,human plague was reported 14 times,with incidence of 38 cases,17 dead and death rate was 44.74％ in Qinghai Province.Epidemic areas mainly distributed in the 12 townships of 9 counties.Prevalent season was from May to October,September and October accounted for 57.89％ (22/38).There were cases of Tibetan herders and Han farmers,accounting for 76.32％ (29/38) and 23.68％ (9/38),respectively;onset age from 5 to 67 years,mainly around the age of 20-45 [68.42％ (26/38)].The most prevalent clinical types were pneumonic and septicemic plague and initial case was caused by actively contact with infected plague animals.Conclusions Qinghai human plague is mainly caused by approaching the plague infected animals,human plague in Qinghai Province is on the rise,the risk of long-distance transmission of the plague is significantly increased.

Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.

Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P<0.05). The incidence of mild CRBD in LB group was significantly lower than that in C, L and B group:10%(2/20) vs. 45%(9/20), 35%(7/20) and 40% (8/20), and there were statistical differences (P<0.05). There were no statistical differences in dosage of fentanyl among the 4 groups (P>0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.

One-day-old unvaccinated chicks were inoculated with serotype I virulent strain GA and vaccine strain CVI988, serotype III vaccine strain HVT o f Marek's disease viruses(MDV). By using an indirect immunofluorescence assay of suspensions of peripheral blood mononuclear cells(PBMC) with monoclonal antibo dies(MAb) BA4 and BD8 specific to glycoprotein B of MDV, The dynamic course s of vir emia levels for each of 3 strains from 4 days to 45 days postinfection (PI) were determind. Viremia for virulent strain GA-infected chickens were detected from 4 days PI until days before death of infected chickens, it got its peak at abou t 14 days PI. Viremia in serotype 1 vaccine CVI988-inoculated chickens were mea sured between 4 to 22 days PI, it could be detected from 4 days PI and ended at 18 days PI, it got its peak at 8 days PI. For serotype 3 vaccine HVT-inoculated chickens, viremia could be detected beween 4 to 14 days PI, its peak happened a t about 6 days PI. Such IFA with MAbs BA4 and BD8 could be used to evaluate qu al ity of vaccination process in chicken flocks. The differential dynamic courses o f viremia for different strains may be used to diagnose virulent MDV infection i n vaccinated flocks. The viremia levels measured by IFA with the MAbs and co-cu ltivation assay for plague forming unit(PFU) were compared. The results indicate d that IFA assay of PBMC suspension was more sensitive and specific than co-cu ltivation assay, i.e. viremia levels measured by IFA were 30 to 100-fold higher than that by plague-forming assay in CEF for the same sample.

Objective To study the prevention and treatment of bile duct injury during laparoscopic cholecystectomy(LC). Methods 22 cases of bile duct injury during LC were reviewed retrospectively. The features, diagnosis, treatment and efficacy of injury were summarized. Results All patients were successfully treated by Roux-en-Y cholangio-jejunostomy. Besides, 8 patients underwent plastic operation of bile duct of hepatic portal and 3 patients middle lobectomy of liver. 22 cases were followed up at the 1st and 3rd year after surgery, and no bile duct stricture, recurrence of jaundice and cholangitis occurred. Conclusions It's a key to prevent bile duct injury during LC. The management of bile duct injury should be chosen according to injured time, sites and types.

On the basis of the system requirement on medical oxygen supply in modern hospital, from the aspects of rigorous installation, ensuring logical course environment, following related technological standard and enhancing personnel training, the whole quality course management is put up. It is indicate that proper equipment and quality control in evary link are the quarantee of clinical service.

Combined pulsed-field gradient, shaped pulses, and product operator calculations (algorithm), two-dimensional 1 H-31 P hetero-nuclear multiple quantum coherence ( HMQC) pulse sequence was established with the aid of C language. The result showed that coherent transfer path selection could be achieved by adjusting the ratio of two gradient strength ( g1 , g2 ) . The best ratio of g1 and g2 was -5:4 . The HMQC method based on the above sequence can be used for identifying the alkyl groups coupling with phosphorous nucleus. For the different alkyl groups, the sensitivity of this method decreased in the order methyl>isopropyl>ethyl>propyl. The limit of detection was about 10 mg/L. This method can be directly used for the screening and identification of phosphorus chemical warfare agents and related compounds.

Objective To explore the relation of the polymorphism of GSTT & GSTM1 genes with the susceptibility of breast cancer.Methods A hospital-based case-control study was conducted,and 105 normal women as a control group and 100 women cases with breast cancer were recruited.The polymorphism of GSTT1 and GSTM1 were assessed by polymerase chain reaction(PCR).Logistic regression was conducted to evaluate the odds ratio of breast cancer in relation to single,multiple gene and estrogen exposure factors.Results The results showed that significant difference was found in the distribution of GSTT1,GSTM1 between controls and cases.There was a negative correlation between CSTT1 & GSTM1 and the risk of breast cancer with OR of 2.133 and 2.458,respectively.Polygenic model analysis indicated that there was a statistically significant correlation of the vacancy of GSTT1 & GSTM1 with breast cancer.Furthermore,it was also revealed that individual in simultaneous lack of GSTT1 and GSTM1 would run 12 times as high risk as normal controls did(OR=12.338).Results from unconditional logistic regression analysis showed that GSTT1 and GSTM1 were significantly associated with the occurrence of breast cancer.Conclusion The study indicated that the polymorphisms of estrogen-metabolizing genes were related to the risk of breast cancer.