目的 探讨慢性阻塞性肺疾病(COPD)并发低氧血症患者抢救中使用小剂量肾上腺素及布地奈德的价值。方法 纳入50例COPD并发低氧血症患者研究(2018年4月—2021年4月),按双盲法分为对照组(n=25,采用布地奈德雾化吸入治疗)、观察组(n=25,在对照组基础上采用肾上腺素治疗),统计2组抢救成功率、临床指标、预后效果。结果 (1)抢救成功率:观察组(96.00%)高于对照组(76.00%),组间对比P<0.05。(2)临床指标:观察组PaCO₂(43.29±4.92 mmHg)低于对照组,PaO₂(86.77±8.25 mmHg)、SpO₂(92.14±2.82%)、pH(7.43±0.12)、FVC(2.41±0.28 L)、FEV1(1.72±0.72 L)、FEV1/FVC(70.95±8.22%)高于对照组,组间对比P<0.05。(3)预后效果:观察组气喘(3.22±1.08 d)、哮鸣音(5.21±1.11 d)消失时间及住院时间(9.61±2.24 d)短于对照组,组间对比P<0.05。结论 小剂量肾上腺素联合布地奈德在COPD并发低氧血症治疗中效果确切,可提高抢救成功率,亦可改善其肺功能及血气指标,值得临床参考。

Objective To explore the value of low dose epinephrine and budesonide aerosol inhalation in the rescue of patients with chronic obstructive pulmonary disease(COPD) complicated with hypoxemia. Methods Fifty patients with COPD complicated with hypoxemia(April 2018 to April 2021)were enrolled and divided into control group(n=25,treated with budesonide aerosol inhalation)and observation group(n=25,treated with epinephrine additionally)according to double-blind method.The rescue success rate,clinical indicators and prognosis of the two groups were statistically analyzed. Results (1)The success rate of rescue of the observation group(96.00%)was higher than that of the control group(76.00%,P<0.05). (2)Clinical indicators:PaCO₂(43.29 1±4.92 mmHg)in the observation group was lower than that of the control group,PaO₂(86.774±8.25 mmHg), SpO₂(92.14±2.82%), pH(7.43±0.12), FVC(2.41±0.28 L), FEV1 (1.72±0.72 L), FEV1/FVC (70.95±8.22%)were higher than that in the control group(P<0.05). (3)Prognosis effect:asthma duration in the observation group(3.22±1.08 d),wheezing disappeared time(5.211±1.11 d)and hospitalization time(9.611±2.24 d)were shorter than that of the control group(P<0.05). Conclusions Low dose epinephrine combined with budesonide in the treatment of COPD complicated with hypoxemia has definite effect, which can improve the success rate of rescue,also improve lung function and blood gas index. It is worthy of clinical reference.

目的 探究铁死亡相关的lncRNA在肺鳞状上皮细胞癌(简称肺鳞癌)患者中的预后意义。方法 从美国癌症和肿瘤基因图谱数据库(the Cancer Genome Atlas,TCGA)中下载肺鳞癌数据551例,包括49例正常对照样本和502例肺鳞癌患者样本。筛选出与铁死亡相关基因的共表达的lncRNA,使用单变量Cox回归进一步筛选lncRNA,然后,使用Lasso回归和多元Cox回归分构建铁死亡相关的lncRNA模型。建立基于模型的风险评分,并使用Cox回归测试其是否为独立的预后因素。铁死亡相关lncRNAs的功能富集使用基因本体(Gene Ontology)和京都基因和基因组百科全书(Kyoto Encyclopedia of Genes and Genomes)可视化。结果 4个预后铁死亡相关的lncRNA(AC253536.6,FLJ46906LUCAT,AC022150.2)显著不同,这构建了铁死亡相关的lncRNA模型。此模型将肺鳞癌患者分为低风险组和高风险组。基于模型的风险评分是肺鳞癌患者的显著独立因素(HR =2.116,95％CI=1.513~2.961;P<0.001)。此外,4个lncRNA在铁死亡过程,代谢和肿瘤经典途径中均显著富集。结论 4个铁死亡相关的lncRNAs可能是肺鳞癌患者的分子生物标志物和治疗靶标。

Objective To explore the prognostic significance of ferroptosis related lncRNAs in patients with lung squamous cell carcinoma. Methods Data of 551 lung squamous cell carcinoma cases was downloaded from the Cancer Genome Atlas (TCGA) of the United States, including 49 normal control samples and 502 lung squamous cell carcinoma samples. The lncRNAs co-expressed with genes related to ferroptosis was screened out. Univariate Cox regression was used to further screen out the lncRNAs. Then, Lasso regression and multiple Cox regression were used to construct lncRNA models related to ferroptosis. A model-based risk score system was established and Cox regression was used to test whether it was an independent prognostic factor. The functional enrichment of ferroptosis related lncRNAs were visualized using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes. Results The four prognostic ferroptosis related lncRNAs (AC253536.6, FLJ46906 LUCAT, AC022150.2) were significantly different, and the ferroptosis lncRNAs model was constrncted with them. This model divided lung squamous cell carcinoma patients into low-risk group and high-risk group. The model-based risk score was a significant independent factor for patients with lung squamous cell carcinoma (HR=2.116, 95% CI=1.513-2.961; P<0.001). In addition, the four lncRNAs were significantly enriched in metabolism and tumor classical pathways during the ferroptosis process. Conclusions The four ferroptosis lncRNAs could be molecular biomarkers and therapeutic targets for patients with lung squamous cell carcinoma.

目的 分析76例工业区来源的结核性胸膜炎患者的患病相关因素及临床特征。方法 回顾性收集2018年1月—2020年12月于深圳市中西医结合医院住院的76例工业区来源的结核性胸膜炎患者(观察组)的病历资料和57例同期同区域来源的健康体检者(对照组)的病历资料。运用统计学分析工业区结核性胸膜炎的患病相关因素及临床特征。结果 2组的比较当中,年龄、白蛋白水平、身高、体质量、体质量指数之间的差异具有统计学意义(P<0.05);而多因素Logistic回归分析结果显示,年龄及白蛋白水平则是工业区结核性胸膜炎的独立保护因素(P<0.001,OR=0.728,95% CI:0.634～0.836以及P<0.001,OR=0.908,95% CI:0.874～0.944);工业区结核性胸膜炎的临床症状为咳嗽(71.05%)、发热(48.68%)、胸痛(47.37%),发病季节以春秋季节(27.63%和32.90%)为主。结论 工业区结核性胸膜炎的独立影响因素是年龄及白蛋白水平,临床症状主要为咳嗽、发热、胸痛,好发于春秋季节。

Objective To analyze the relative factors and clinical characteristics of 76 patients with tuberculous pleurisy from industrial area. Methods The medical records of 76 patients with tuberculous pleurisy from industrial areas (observation group) and 57 healthy subjects from the same period and region (control group) who were hospitalized in Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2020 were retrospectively collected. The correlative factors and clinical characteristics of tuberculous pleurisy in industrial area were analyzed by statistics. Results There were statistically significant differences in age, albumin level, height, weight and body mass index between the two groups (P<0.05). Multivariate logistic regression analysis showed that age and albumin level were independent protective factors for tuberculous pleurisy in industrial areas (P<0.001, OR=0.728, 95% CI: 0.634~0.836 and P<0.001, OR=0.908, 95% CI: 0.874~0.944). The clinical symptoms of tuberculous pleuritis in industrial areas were cough (71.05%), fever (48.68%) and chest pain (47.37%), and the onset season was mainly in spring and autumn (27.63% and 32.90%). Conclusions The independent influencing factors of tuberculous pleuritis in industrial area are age and albumin level. The main clinical symptoms are cough, fever and chest pain, which usually occur in spring and autumn.

目的 探讨不同浓度的青藤碱对肾癌细胞增殖、细胞周期及凋亡的影响。方法 以不同浓度的青藤碱处理肾癌细胞786-O,采用四氮唑蓝盐法检测细胞增殖能力,流式细胞术检测细胞周期分布,Annexin-v FITC/PI双染流式细胞分析仪检测细胞凋亡率;采用实时荧光定量PCR及蛋白免疫印迹(WB)检测c-myc、Bax、Caspase-3等细胞周期、凋亡相关基因表达情况。结果 青藤碱显著抑制786-O细胞的增殖能力,诱导细胞周期G1/S期阻滞及细胞凋亡;且随着青藤碱浓度的增加,其抑制率也逐渐增加;青藤碱显著下调c-myc蛋白表达,而诱导凋亡蛋白Bax、Caspase-3表达上调。结论 青藤碱可以显著抑制786-O细胞中c-myc表达,使其增殖能力减弱,诱导细胞周期阻滞及凋亡。青藤碱可能具有潜在的抑制肾癌生长作用。

Objective To investigate the effects of different concentrations of sinomenine on proliferation, cell cycle and apoptosis of renal carcinoma cells. Methods The renal carcinoma cells were treated with different concentrations of sinomenine. MTS was used to analyze the effects of sinomenine on proliferation in 786-O renal carcinoma cells, the cell cycle changes were determined using flow cytometry, while the changes of apoptosis were detected by Annexin V-FITC / PI double staining. The expression of apoptosis-related proteins such as c-myc, Bax and Caspase-3 were detected by Western blot. Results Sinomenine significantly inhibited the proliferation of 786-O cells and induced cell cycle arrest and apoptosis in G1/S phase. With the increase of sinomenine concentration, the inhibition rate increased gradually. Sinomenine significantly down-regulated the expression of c-myc protein, while the expressions of the apoptotic protein Bax, Caspase-3 were up-regulated. Conclusions Sinomenine can significantly inhibit the expression of c-myc in 786-O cells, reduce proliferation ability, and induce cell cycle arrest and apoptosis. Sinomenine may have a potential therapeutic effect on renal cancer.

目的 分析探讨健康驿站新冠病毒肺炎病例感染来源,评估驿站站内感染风险,规范驿站管理,降低感染风险。方法 对驿站2022年2月21日—3月9日全部14例新冠肺炎病例自入境到报告进行全链条风险分析。结果 14例病例为7批次不同时间入住,其中病例1、2、3、4、5、6、7、8、9、10、12、13共12例病例入境后即确诊,病例11入住5天(其共同入境、同住人员病例10,入境后即确诊)确诊、病例14入住10天发病确诊,其余病例均未呈现感染发病时间特异性,未呈现入境后交叉感染时间特异性,未见入住后空间、通风系统、排污系统交集,未见交叉感染情况。结论 该驿站目前报告新冠肺炎病例均有相关旅居史,主要在香港本土感染。13名病例大概率均在香港感染,入境隔离时发病确诊,其中病例1、2、3、4,病例6、7、8,病例10、11是3起呈现家庭聚集性感染发病,病例5、9是独立个案,病例14需要进一步排除,驿站未规范管理会导致误报及进一步扩大站内感染风险。

Objective To investigate and analyze the source of infection of COVID-19 cases in health station, assess the risk of infection, standardize the management and reduce the risk of infection. Methods From February 21 to March 9, 2022, the whole chain risk analysis of all 14 COVID-19 cases from entry to reporting was carried out. Results Fourteen cases were admitted in 7 batches at different times. Except for case 11 who diagnosed at the 5th day (the case of co-entry and co-resident case 10 was diagnosed after entry), and case 14 who diagnosed at the 10th day, the rest of the cases were diagnosed after entry, which did not show infection-onset time specificity, no time specificity of cross-infection after entry, no intersection of space, ventilation system and sewage system after entry, and no cross-infection. Conclusions The COVID-19 cases reported by the station were mainly infected in Hong Kong. Those 13 cases were highly likely infected in Hong Kong, all were diagnosed at the time of entry quarantine, while cases 1~4, cases 6~8, and cases 10~11 were 3 cases of family cluster infection, case 5 and 9 were an independent case, and case 14 needed to be further investigation. Failure to standardize the management of the station will lead to false alarms and further increase the risk of infection in the station.

目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ²检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。

Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ² test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.

目的 利用网络药理学技术,分析黄甲软肝颗粒治疗肝纤维化的作用网络,以及黄甲软肝颗粒治疗肝纤维化的潜在作用机制,并在体内动物实验进行初步验证。方法 采用中药系统药理学分析平台中寻找黄甲软肝颗粒中10味中药相关的化学成分和作用靶点,通过GeneCards等数据库筛选肝纤维化疾病相关的靶标;对药物与疾病靶点相映射得到黄甲软肝颗粒治疗肝纤维化的作用靶点,运用cytoscape将疾病靶点与复方活性成分靶点的交集-交集部分对应的活性成分”构建“C(成分)-T(靶点)”作用网络。将交集靶点利用 DAVID数据库进行GO富集分析和KEGG富集分析,以获得其潜在作用机制。最后,通过黄甲软肝颗粒防治CCl₄导致SD大鼠肝纤维化的体内实验进行初步验证,考察末次给药后大鼠体质量和肝脏指数,采用微板法检测SD大鼠血清中天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平,苏木精-伊红染色观察肝脏病理学变化。结果 预测筛选得到黄甲软肝颗粒共有117个潜在活性成分,266个活性成分对应靶点,161个交集靶点,关键成分有槲皮素、山奈酚、丹参酮IIA、芒柄花黄素等,关键靶点有PTGS2、PTGS1、NCOA1、ACHE、HTR、RXRA、ADRB2、IL1B等。GO 分析共包含 960条富集结果,其中生物过程845 条,分子功能 63条,细胞组成 52 条;KEGG 分析共得出68条通路,与本次研究较相关的通路主要包括TNF信号通路、Toll样受体信号通路、Rap1信号通路、胞质DNA传感途径、ErbB信号通路、VEGF信号通路等。体内动物实验研究表明,黄甲软肝颗粒能显著降低大鼠的肝脏指数和血清ALT、AST,改善肝组织病理学指标。结论 黄甲软肝颗粒可通过多成分、多途径、多靶点协同发挥治疗肝纤维化的作用,本研究为黄甲软肝颗粒治疗肝纤维化疾病的物质基础、作用机制及临床应用的进一步研究奠定基础。

Objective To analyze the effective network of Huangjia Ruangan Granules in treating liver fibrosis and its potential mechanism by using network pharmacology, and preliminary verify by animal in vivo experiments. Methods From the Chinese Medicine System Pharmacology Analysis Platform, we searched for the chemical constituents and targets of 10 Chinese herbs in Huangjia Ruangan Granules, and screened the targets related to liver fibrosis diseases through GeneCards and other databases. The drug and disease target were mapped to the target of Huangjia Ruangan Granules for the treatment of liver fibrosis, and the active component corresponding to the intersection of the disease target and the compound active component target was constructed using cytoscape “C (component)-T (target)” action network. The intersection target was used for GO enrichment analysis and KEGG enrichment analysis with DAVID database to obtain its potential mechanism of action. Finally, through the in vivo experiment of using Huangjia Ruangan Granules to prevent and treat CCl₄ leaded liver fibrosis in SD rats, the rats' body weight and liver index after the last dose were recorded, and the levels of aminotransferase (AST) and alanine aminotransferase (ALT) in the serum of SD rats were detected by the microplate method, hematoxylin-eosin staining were used to observe liver pathological changes. Results Predictive screening showed that Huangjia Ruangan Granules had 117 potential active ingredients, 266 active ingredients corresponded to targets, and 161 intersection targets. The key ingredients was quercetin, kaempferol, tanshinone IIA, formononetin, etc. The key targets were PTGS2, PTGS1 NCOA1, ACHE, HTR, RXRA, ADRB2, IL1B, etc. GO analysis showed a total of 960 enrichment results, including 845 biological processes, 63 molecular functions, and 52 cell compositions; KEGG analysis revealed a total of 68 pathways, the related pathways included TNF signaling pathway, Toll-like receptor signaling pathway, Rap1 signaling pathway, cytoplasmic DNA sensing pathway, ErbB signaling pathway and VEGF signaling pathway, etc. In vivo animal experiments had shown that Huangjia Ruangan Granules could significantly reduce the liver index and serum ALT and AST levels of rats, and improve liver histopathological indicators. Conclusions Huangjia Ruangan Granules treated liver fibrosis through multi-component, multi-pathway and multi-target synergy. This research laid the groundwork for the material basis, mechanism and clinical application of Huangjia Ruangan Granules in treating liver fibrosis diseases.

目的 分析ABCC2基因表达水平与肺腺癌预后之间的关联性,并对其影响机制进行初步探索。 方法 采用TCGA数据库和HPA数据库对肺腺癌病人癌组织和癌旁组织基因表达数据进行差异性分析,单因素及多因素COX回归评估ABCC2与肺腺癌预后之间的关联性,GSEA用于探讨与ABCC2显著关联的信号通路。 结果 ABCC2在肺腺癌肿瘤组织中存在过表达现象,Kaplan-Meier生存分析曲线结果显示ABCC2基因过表达使肺腺癌病人的死亡风险显著升高(HR=1.46,95%CI=1.09~1.95; P=0.010)。单因素及多因素COX回归结果显示ABCC2基因过表达是肺腺癌病人不良预后的独立危险因素。GSEA结果显示ABCC2可能通过调节药物代谢从而对肺腺癌的发展进行调控。 结论 ABCC2基因过表达使肺腺癌病人的死亡风险显著升高,ABCC2可能是肺腺癌不良预后的潜在分子生物标志物。

Objective To estimate the association between ABCC2 mRNA expression and the prognosis of lung adenocarcinoma and explore the potential influencing mechanism.Methods Difference analysis was used to evaluate the gene expression in tumor tissues and adjacent normal tissues based on The Cancer Genome Atlas database and Human Protein Atlas database.Multivariate COX regression and Kaplan-Meier analysis were performed to evaluate the association between ABCC2 gene expression and the prognosis of lung adenocarcinoma.Gene-set enrichment analysis (GSEA) was performed to screen differentially enriched pathways associated with the ABCC2 high expression phenotype.Results ABCC2 was overexpressed in lung adenocarcinoma tumor tissues compared with adjacent normal tissues.Kaplan-Meier survival analysis showed a significant relationship between ABCC2 mRNA expression and lung adenocarcinoma prognosis (HR=1.16,95% CI=1.09-1.95; P=0.010).Univariate and multivariate Cox regression analysis showed that ABCC2 mRNA expression was an independent risk factor affecting the survival of patients with lung adenocarcinoma.The results of GSEA suggested that ABCC2 may influence the development of lung adenocarcinoma by regulating the metabolism of targeted drug the treatment.Conclusions ABCC2 overexpression can significantly increase the risk of death in patients with lung adenocarcinoma,ABCC2 may be a potential molecular marker for poor prognosis in lung adenocarcinoma.

目的 分析中山市博爱医院妊娠合并哮喘急性发作患者相关危险因素。方法 选取2019年7月—2021年2月中山市博爱医院收治100例的妊娠合并哮喘患者作为研究对象,将100例妊娠合并患者分为哮喘急性发作组(n=46)与未发作组(n=54),采用多因素Logistic回归分析进行调查分析。结果 100例患者中发作人数为46例,占46.0%。Logistic回归分析显示孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的危险因素(P<0.05)。发作组剖宫产率发生率、住院时间以及并发症发生率均高于未发作组,差异有统计学意义(P<0.05)。结论 孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的独立危险因素,应对此类患者给予高度重视。

Objective To analyze the risk factors of pregnancy complicated with acute attack of asthma in Zhongshan Bo'ai Hospital.Methods A total of 100 patients with pregnancy complicated with asthma treated in Zhongshan Bo'ai Hospital from July 2019 to February 2021 were selected as the research objects.Patients were divided into acute attack group (n=46) and no attack group (n=54).Multivariate logistic regression analysis was used for investigation and analysis.Results The patient number of attack was 46,accounting for 46.0%. The incidence of cesarean section,length of hospital stay and complications in the attack group were higher than those in the no attack group,and the difference was statistically significant (P<0.05).Conclusions Gestational age,use of asthma drugs,anxiety and IL-17 level were independent risk factors for pregnancy complicated with acute attack of asthma.Great attention should be paid to these patients.

目的 探究青少年首发抑郁症患者治疗中联合应用艾司西酞普兰与重复经颅磁刺激(rTMS)的总疗效及应用价值。方法 选取东莞市第七人民医院2020年5月—2021年10月80例青少年首发抑郁症患者,参考“数字双盲法”,分为对照组和观察组(各40例)2组,对照组接受伪rTMS+艾司西酞普兰治疗,观察组接受rTMS+艾司西酞普兰治疗。评价指标:临床总疗效、抑郁评分(17项汉密尔顿抑郁量表,HAMD-17)、认知功能评分(威斯康星卡片分类测验,WCST)、生活质量(SF-36评分),不良反应发生率(副反应量表,TESS)。结果 观察组患者总有效率95.00%较对照组80.00%明显高(P＜0.05);且2组不良反应率比较(P＞0.05)。观察组治疗1周、2周、4周HAMD-17评分均较对照组低,同时治疗4周后WCST项目中完成分类评分较对照组更高(P＜0.05)。观察组SF-36(角色、社会、躯体、认知)评分均较对照组高(P＜0.05)。结论 青少年首发抑郁症患者,在艾司西酞普兰用药基础上联合rTMS,可获取更为显著的治疗效果,控制病情进展,减轻抑郁症状,同时对认知功能无影响,促进生活质量大幅度提高,且用药安全性有保障。

Objective To explore the total efficacy and application value of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of adolescent patients with first-episode depression.Methods A total of 80 adolescent patients with first-episode depression in Dongguan Seventh People's Hospital from May 2020 to October 2021 were selected.Referring to the “digital double-blind method”,they were divided into control group and observation group (40 cases each).The control group was treated with pseudo rTMS and escitalopram,and the observation group was treated with rTMS and escitalopram.Evaluation indexes: total clinical efficacy,depression score (17-item Hamilton Depression Scale,HAMD-17),cognitive function score (Wisconsin Card Sorting Test,WCST),quality of life (SF-36 score),adverse reaction rate (Treatment Emergent Symptom Scale,TESS).Results The total effective rate of 95.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05); the incidence of adverse reactions was compared between the two groups (P>0.05).The HAMD-17 scores of the observation group at 1 week,2 weeks and 4 weeks were significantly lower than those of the control group.At the same time,the classification scores of WCST items after 4 weeks of treatment were higher in observation group (P<0.05).The SF-36 (role,society,body and cognition) scores in the observation group were higher than those in the control group (P<0.05).Conclusions Adolescent patients with first-episode depression treated with rTMS on the basis of escitalopram can obtain more significant therapeutic effect,control the progress of the disease,reduce depressive symptoms,have no effect on cognitive function,greatly improve the quality of life,and ensure the safety of medication.