Antipsychotic Medications in Major Depression and the Association with Treatment Satisfaction and Quality of Life： Findings of Three National Surveys on Use of Psychotropics in China Between 2002 and 2012

Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns ofantipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life （QOL）. Methods： A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients＇ socio-demographic and clinical characteristics including psychopathology, medication side effects. satisfaction with treatment and QOL were recorded using a standardized protocol and data collection. Results： The frequency ofantipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively （χ^2 = 90.3, df= 2, P 〈 0.001 ）. Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals （i.e., Level-Ⅲ hospital）. Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups. Conclusions： Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients＇ and relatives＇ satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.

The Perturbed Problem on the Boussinesq System of Rayleigh-Bénard Convection

In this paper,the infinite Prandtl number limit of Rayleigh-B′enard convection is studied.For well prepared initial data,the convergence of solutions in L∞（0,t;H2（G）） is rigorously justified by analysis of asymptotic expansions.

Study of Clinical Practical Model of Urinary System Injury

Background： In order to improve the clinical treatment level of urinary system injury, it is necessary to build tip an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical. Methods： We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination. Results： The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g ofnitrocotton. All rabbits survived the procedures and stayed alive until they were killed, h!juries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy restdts showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 11.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal. Conclusions： The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.