Objective:To study the effect of sertraline plus cognitive behavior therapy in treatment of panic disorder Method:14 outpatients with panic disorder according to crteria of CCMD-2-R were collected as our sample All of them were given sertraline 50 mg/d for 6 months in addition to cognitive behavior therapy The clinical effect was assessed at the end of 1 month,3 months and 6 months Results:At the end of 1 month,3 patients were assessed as markedly improved,9 as improved At the time of 3 months,10 patients were assessed as markedly improved,2 as improved At the end of 6 months,12 markedly improved,2 improved There were 3 patients had mild side effects,which faded with time Conclusion:Sertraline plus cognitive behavior therapy has good effect in treatment of panic disorder with good compliance and little side effect

0.05).In 25.28% of the population in the Second Songhua River region,the hair Hg content exceeded 1 mg/kg.In 21.85% and 16.67% of the population of Wujiazhan town and Songyuan city,the hair Hg content exceeded 1 mg/kg.Conclusion In the investigated area,the level of hair mercury shows a downtrend,but there still is health risk from mercury exposure.

Objective To evaluate the changes in the epidemiology and clinical characteristics of cervical carcinoma over the past 50 years, and to explore the equitable treatment corresponding to these changes. Methods The clinical and pathological data of 1557 patients with invasive cervical carcinoma from January 1955 to December 2004 were retrospectively analyzed. Results (1) The average age of cervical carcinoma onset gradually decreased over the past 50 years, from 56.27?8.45 in years 1955~1964 to 43.81?8.9 in years 1995~2004. At the same time, the radio of clinically early (stages Ⅰ-Ⅱ) and non-squamous cancer also steadily increased. (2) Young patients (≤35 year old) had higher ratios of non-squamous, poorly differentiated and late stage (Ⅲ-Ⅳ) cancers, with a higher rate of lymphatic metastasis compared with other ages. (3) Because of the changes in epidemiology and clinical characteristics of cervical carcinoma, it′s necessary to alter the traditional model of treatment and to explore equitable therapy corresponding to these changes. Conclusions The average age of cervical carcinoma onset gradually decreased and simultaneously the ratio of clinically early (stages Ⅰ-Ⅱ) and non-squamous cancer also steadily increased over the last 50 years. Patients aged 35 and younger of cervical carcinoma had some obvious clinical characteristics compared with that of older patients. Preservation of reproductive endocrine function ought to be deliberated on in cervical carcinoma treatment of women with fecundity. Neoadjuvant intraarterial chemotherapy (NAIC) is an useful method for cervical carcinoma at present

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

The method of PBL (problem based learning) teaching in China is widely recognized. However, the characteristics of Vocational Medical Education limit its wider application. The paper discusses the mode which is suitable for our country by analyzing the major issues,improving methods of teaching and doing experiments.

Substantial evidence supports the relationship between chronic inflammation and cancer development. Numerous studies suggest that chronic inflammatory disease, such as periodontitis, contributes to head and neck squamous cell carcinoma development. Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial regions. Porphyromonas gingivalis, one of the most important pathogens in association with periodontal disease, might have a potential correlation with OSCC. Along with the development of molecular biological techniques, the association between Porphyromonas gingivalis and OSCC has been greatly emphasized in recent years. This review summarizes the association between these variables and the potential mechanisms involved in such relationship.
Carcinoma, Squamous Cell ; pathology ; Humans ; Mouth Neoplasms ; pathology ; Periodontal Diseases ; Periodontitis ; Porphyromonas gingivalis ; Research

OBJECTIVETo compare the difference in the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency electric-pulsing apparatus was used at Dazhui (GV 14) and Shenshu (BL 23), once a day; the treatment of 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time. In the placebo group, starch capsules were taken orally, 1 capsule each time. All the drugs were taken before sleep every night, continuously for 15 days as one session, and 2 sessions were required. PSQI changes and clinical efficacy were observed before and after treatment in each group.

RESULTSPitlsburgh sleep quality index (PSQI) score was reduced in every group after treatment (all P < 0.01). In the low-frequency electric stimulation group and medication group, the score was reduced much more significantly as compared with the placebo group (both P < 0.01). In the placebo group, 1 case was rejected. The total effective rates were 95.0% (38/40), 92.5% (37/40) and 17.9% (7/39) in the low-frequency electric stimulation group, medication group and placebo group separately. The efficacy in the low-frequency electric stimulation group and medication group was better apparently than that in the placebo group (both P < 0.01).

CONCLUSIONThe low-frequency electric stimulation at the acupoints effectively and safely treats post-stroke insomnia and the efficacy of it is similar to that of estazolam.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Female ; Humans ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; etiology ; therapy ; Stroke ; complications ; Treatment Outcome

Child ; Gene Rearrangement, T-Lymphocyte ; Humans ; Neoplasm, Residual ; diagnosis ; Polymerase Chain Reaction ; methods ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; Receptors, Antigen, T-Cell ; genetics

OBJECTIVETo evaluate the efficacy and safety of percutaneous pedicle screw fixation (PPSF) and open pedicle screw fixation (OPSF) in the treatment of single level of thoracolumbar fracture.

METHODSDatabases including Pubmed, Embasem, CNKI were searched to collect clinical trials of the clinical safety and efficiency of PPSF and OPSF for single level of thoracolumbar unstable fracture, relevant proceedings and references were also retrieved manually. Studies from 1990 to 2014 that met the inclusion and exclusion standards were researched. The data were extracted and the methods from the studies were also evaluated. Data analysis was conducted with the Review Manager 5.3 software. Observation targets included operation time, intraoperative bleeding, postoperative bleeding, hospitalization time, the bed time, postoperative vertebral Cobb angle, vertebral body height, pain score and the length of incision operation.

RESULTSFifteen papers were finally studied, including 2 randomized controlled trials (RCT) and 13 case-control studies, involving 789 patients. Compared with OPSF, the PPSF in treating thoracolumbar fracture had shorter operation time, smaller operation incision, less intraoperative and postoperation bleeding, shorter hospitalization days, fewer pain (P<0.00001), the less improvement in the change of Cobb angle (P=0.0006). There was no significant difference in the improvement of vertebral body height (P=0.36), the bed time from operation to exercise (P=0.38) between OPSF and PPSF.

CONCLUSIONCompared with OPSF, PPSF is better, safer, and has fewer pain. But there is no evidence that the PPSF is better in the recovery of the spinal height, and they have the same effect in the long-term follow-up for thoracolumbar fractures. PPSF brines minimally invasive to patients with better effect. It is worth further study and clinical research.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Pedicle Screws ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; surgery ; Treatment Outcome

Objective To evaluate the clinical outcome of lumbopelvic reconstruction in treatment of unstable sacral fractures.Methods A retrospective study was performed on 17 cases (12 males and 5 females； at 23-55 years of age,mean 35.5 years) of unstable sacral fractures treated from January 2007 to June 2012.There were 11 cases of zone Ⅱ fracture and six zone Ⅲ fracture according to Denis classification and nine cases of type B fracture and eight type C fracture according to Tile classification.Sacral nerve injury assessed by Gibbons criteria was 3 points in seven cases and 4 points in 10 cases.Lumbar-pelvic ring stability of the patients was restored by posterior decompression and lumbar pedicle screw fixation combined with sacral pedicle screw or iliac screw fixation.Fracture reduction and healing were measured by X-ray film or CT scan； functional outcomes by Majeed scale； neurological outcome by Gibbons criteria.Results All the cases were followed up for mean 16 months (range,8-24 months).X-ray and CT follow-up revealed all fractures had bone union at average 6 months in the absence of remnant sacrum malformation,pseudarthrosis and fracture redisplacement.Iliac screw loosening not yet breakage happened to one case.In total,12 cases had full recovery of neurological function； four significant improvement,but experienced different degree of footdrop and hypoesthesia of lower extremities； one poor improvement and experienced not only lower extremity dysfunction but also bladder and bowel dysfunction.According to Majeed scale in the final follow-up,clinical functional outcome was excellent in 12 cases,good in three,fair in one and poor in one,with excellent-good rate of 88％.Gibbons score improved from preoperative (3.29 ±0.47) points to postoperative (1.53±0.94) points (t=12.94,P＜0.01).Conclusion Posterior decompression plus lumbar pedicle screw fixation combined with sacral pedicle screw and/or iliac screw fixation is an effective method for treatment of unstable sacral fracture,for it can restore general stability of spine-pelvis,facilitate neurological function recovery and allow early weight-bearing.