Objective:To explore characteristics of family function in patients with major depressive disorder (MDD),and to evaluate relationships between family function and prognosis of major depressive episode (MDE).Methods:Forty-six patients with MDD were recruited in the outpatient or inpatient departments of Wuhan Mental Health Center from September 1,2014 to August 31,2015.At the baseline,the patients and their co-resident family members were interviewed for psychiatric screening and diagnosis,and the family function of each patient's family was assessed by Family Assessment Device (FAD).After clinic service or hospitalization,the patients were followed up by telephone until they recovered from the MDE (within 12 months since the follow-up) or for 12 months if they had not achieved remission.Forty-two mentally healthy subjects,with no family members diagnosis for psychiatric diseases,and matched with MDD patients for age,sex,number of children,family roleand socioeconomic status,were recruited from a community.The family function of the MDD families and the controls were compared by independent sample-T test,and the relationship between family function and duration of the MDE was analyzed by Pearson's correlation.Results:MDD families exhibited higher FAD scores in 5 dimensions than control families except for affective involvement and behavior control (P＜0.01).Patients with relatively good family function showed significantly shorter duration of MDE and higher proportion of remission within 6 months since the follow-up (P＜0.01 and P＜0.05).All the dimensions of FAD demonstrated significant positive correlation with the duration of MDE except for the behavior control.Conclusion:Families with MDD patients show impairments in multiple dimensions of family function,and the family functions of MDD patients are correlated with the prognosis of MDE.Improvement of family function may contribute to better prognosis of MDD.

Objective To explore the reasonable clinical target volumes by analyzing the characteristic of mediastinal lymph node metastases in non-small-cell lung cacer (NSCLC).Methods 291 NSCLC patients was performed pre-therapy CT scans,and the incidence of mediastinal lymph node metastases was analysed.Results Among the 152 patients with right lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (24/152),and the incidence of involvement of the contralateral lymph nodes was 6.6 ％ (10/152).The highest incidence of mediastinal nodal involvement occurred in the ipsilateral hilar nodes (59.2 ％),followed by area 4R (56.6 ％),area 1-2R (36.2 ％),area 7 (33.6 ％),area 4L(20.4 ％),area 10-11L (5.9 ％),area 6 (3.9 ％),area 5 (2.0 ％),area 1-2L (2.0 ％),respectively.Among the 139 patients left lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (23/139),and the incidence of involvement of the contralateral lymph nodes was 5.8 ％ (8/139).The highest incidence of mediastinal nodal involvement occurred also in the ipsilateral hilar nodes (54.0 ％),followed by area 7 (33.8 ％),area 4R (26.6 ％),area 4L (24.5 ％),area 1-2R (15.8 ％),area 5 (10.8 ％),area 6 (9.4 ％),area 1-2L (5.8 ％),area 10-11R (5.0 ％) respectively.Conclusion The right side primaries or left side primaries of NSCLC have different high risk lymph node areas for metastasis,and selective irradiation to these lymph node areas maybe increase the tumor control rate and reduce the recurrence rate.

BACKGROUND:A high incidence of deep vein thrombosis after total hip replacement does great harm to patients,so it is necessary to look for a safe and effective prevention program after total hip replacement to reduce the harm of deep vein thrombosis.OBJECTIVE:To observe the influence of comprehensive prevention scheme on deep vein thrombosis after total hip replacement.METHODS:102 cases undergoing total hip replacement were randomly divided into observation group and control group with 51 cases in each group.Patients in the observation group received the comprehensive prevention program,which is composed of three interventions: sequential cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia.In the control group,patients received low-molecular-weight heparin for anticoagulation therapy by the doctor according to his clinical experience,or intermittent pneumatic pressure therapy.The occurrence and distribution of deep vein thrombosis were compared in patients of both groups.At the same time,platelet and hemoglobin were recorded.RESULTS AND CONCLUSION:In the observation group,three patients suffered from deep vein thrombosis with an incidence of 6％.In the control group,11 patients affected deep vein thrombosis,with an incidence of 22％.There were significant differences between the two groups (P＜ 0.05).No significant difference in constituent ratio of the distribution of deep vein thrombosis was detected in the distal vein and proximal vein in patients of both groups (P＞ 0.05).Hemoglobin value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＜0.05).Platelet value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＞0.05).No significant difference in hemoglobin and platelet values was detected between two groups at 1 and 6 days after surgery (P＞ 0.05).Results indicated that the comprehensive prevention program containing the sequential and cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia can significantly reduce the incidence of deep vein thrombosis,and no serious complications occurred,and the effects are affirmative and reliable.

Objective To investigate the diffusion-weighted imaging (DWI)characteristics and the correlation of diffusion coeffi-cient (ADC)and differentiation grade of rectal tubular adenocarcinoma.Methods The DWI characteristics of thirty-eight patients pathologically comfirmed rectal tubular adenocarcinomas were evaluated respectively.There were 9 highly differentiated tubular ade-nocarcinomas,1 5 moderately differentiated tubular adenocarcinomas and 14 poorly differentiated tubular adenocarcinomas.The ADC value was calculated from two different factors (0 and 1 000 s/mm2 ).The correlation between ADC value and the differentiated de-gree of tumour was statistically analysed.Results The mean ADC for highly differentiated group was (0.92±0.05)×10 -3 mm2/s, and the mean ADC for moderately differentiated group was (0.79 ± 0.10)× 10 -3 mm2/s whereas that for poorly differentiated group was (0.71±0.06)×10 -3 mm2/s.The difference among three groups was statistically significant(P <0.05).The ADC value and the differentiated degree of tumour were negatively correlated(Spearman r =-0.704)P<0.01.Conclusion DWI and ADC value can be a useful estimating for the differentiation of rectal tubular adenocarcinoma.

Objective To analyze the timing and frequency of spontaneous gasping during cardiopulmonary resuscitation in a rat model,and evaluate its value bearing some relation to duration of cardiac arrest (CA ) in predicting the severity of post-resuscitation myocardial dysfunction.Methods Twenty-seven healthy Sprague-Dawley rats were randomly (random number)divided into 3 groups according to different durations of CA:CA 4 min (n=9),CA 6 min (n=9)and CA 8 min (n=9).CA of rats was electrically induced and untreated for 4,6 or 8 min respectively in the corresponding groups,and then cardiopulmonary resuscitation (CPR)was initiated and continued for 8 min in all animals.The emergence timing and frequency of spontaneous gasping during cardiopulmonary resuscitation and resuscitation outcomes were documented.Myocardial function such as cardiac output,ejection fraction and Tei index was measured by echocardiography prior to CA and at 1 h,2 h and 4 h post-resuscitation.Results The earliest appearance of gasping with highest frequency was observed in the CA 4 min group during CPR.Gasping appeared later with decreased frequency observed following longer duration of CA.There were statistically significant differences in the timing and frequency of gasping among the 3 groups.In the CA 4 min group with frequent gasping,all animals were successfully resuscitated with 8-min CPR with the least number of defibrillation,which was significantly better than that in the CA 8 min group.During the evaluation of post-resuscitation myocardial function,cardiac output,ejection fraction and myocardial work index (Tei index) were better in the CA 4 min group with frequent gasping,worse in the CA 6 min group and worst in the CA 8 min group, showing statistically significant differences in cardiac function among the 3 groups. Conclusions The spontaneous gasping appeared sooner with higher frequency during cardiopulmonary resuscitation indicated shorter duration of CA,and predicted better success of resuscitation and post-resuscitation myocardial function.

Aim To investigate the effects of(S,S)ZX-5 and(R,R)ZX-5 on eNOS mRNA and protein levels.Methods Cell culture was used for the experiments in vitro.The effects of eNOS mRNA were investigated by RT-PCR.The effects of eNOS protein levels were investigated by Western blot.Results(S,S)ZX-5 in concentration of 30 mg?L-1 up-regulated eNOS expressions at protein and mRNA levels significantly in cultured ECV304(P

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

Objective To evaluate the effectiveness of regional electrocardiographic consultation network for primary medical institutions.Methods A distance electrocardiographic ( ECG ) consultation center was established in Yuyao People′s Hospital in September 2012, which was connected to 56 regional primary medical through internet.The online consultation was provided by ECG specialists in the center for general practitioners in regional primary health care institutions.Additionally, the ECG training course was also conducted monthly for general practitioners.The 2-year data of ECG consultation were retrospectively reviewed and the effectiveness of the consultation network was evaluated.Results During the past two years, 86 593 electrocardiograms were uploaded by primary medical institutions, in which 3 976 were required for consultation. The monthly number of electrocardiograms sent by general practitioners was increased from 3 269 ±290 in the first year to 3 947 ±376 in the second year ( P<0.01 ) .However, the requirements of ECG consultation were not significantly different between two years.Compared to the first year, the rates of consultation requirements, misdiagnosis and missed diagnosis for ECGs of atrial and ventricular premature beats, atrial fibrillation, supraventricular tachycardia, left and right bundle branch blocks,ⅠandⅡdegree atrioventricular blocks and myocardial infarction were significantly decreased ( all P<0.05) in the second year;meanwhile there was a tendency towards the reduction for ECGs of atrial flutter and Ⅲ degree atrioventricular block in the second year.Conclusion The regional electrocardiographic consultation network is effective to improve the capability of primary medical institutions in electrocardiographic diagnosis.

This study explored the possibility of using event-related potentials (ERP) for the measurement of picture-recognition memory and examined its correlation with the Chinese Wechsler Memory Scale-revised (WMS-RC) in patients with memory disorder caused by severe traumatic brain injury (sTBI). The subjects included 20 sTBI patients with memory disorder and 22 healthy individuals. Memory function was measured by using WMS-RC. Behavioral and ERP responses were recorded on-line during performance on a battery of picture recognition and the responses were analyzed off-line for recognition memory effects. Mean memory quotient (MQ) of patients with sTBI was significantly lower than that of the control group. Mean reaction time (RT) was significantly longer and the mean correctness rate (CR) of picture recognition was significantly lower in sTBI group than that of the controls. In controls, the main components of average ERP of picture recognition includes two positive-going waves, designated as P(170) and P(500), that appear 170 ms and 500 ms after stimulation when the subject could later successfully recall and recognize the pictures. P(500) amplitude of target stimulus was significantly higher than that of non-target stimulus. Compared to controls, P(500) responses of sTBI group were significantly delayed in latency (P<0.001) and lower in amplitude (P<0.001). P(500) latency showed significant negative correlation with MQ and the scores of "addition", "visual recognition", "picture recall", "visual reproduction" and "tactile memory" in WMS-RC. ERP of picture recognition provides a neurophysiological approach to directly assess memory impairment, and P(500) may serve as a helpful index for memory disorder caused by sTBI in forensic practice.
Brain Injuries/*complications ; Case-Control Studies ; Evoked Potentials/*physiology ; Memory Disorders/*etiology ; Memory Disorders/*physiopathology ; Pattern Recognition, Physiological/*physiology ; Wechsler Scales ; Young Adult