ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

ObjectiveTo investigate the depression and anxiety state of heart transplantation patients. MethodsFifty-weight heart transplantation outpatients were assessed by Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) in Zhongshan Hospital during October 2010 to April 2011.Those diagnosed with depression disorder should meet the criteria of depression in Chinese Classification of Mental Disorder-3nd version (CCMD-3) and the score of HAMD≥14,and those diagnosed with anxiety disorder should meet the criteria of anxiety disorder CCMD-3 and the score of HAMA≥ 14.The diagnoses of concurrent depression and anxiety were made.Results The prevalence of depression disorder and anxiety disorder was respectively 15.5％ (9/58) and 22.5％ (13/58).The prevalence of depression disorder and anxiety disorder within 12 months was respectively 16.7％ (2/12) and 33.3％ (4/12).The score of HAMD was positively related to HAMA score (P＜0.01 ).ConclusionThe prevalence of depression disorder and anxiety disorder is very high and the co-existence of depression and anxiety is very common.

Objective Although heart transplantation surgery has become more common,little is known about the psychological status of patients waiting for a heart transplant.Method Ninety-three patients registered for heart transplantation from March 2013 to March 2014 in a large general hospital in Shanghai were assessed by a psychiatrist using the Hamilton Depression Scale (17 items) and the Hamilton Anxiety Scale.Out of them 36 were preoperatively admitted to the Cardiac Surgery Department.The scales were assessed repeatedly at the 1st day,3rd day,7th day,10th day and so on until the operation took place.Result The mean scores of HAMD and HAMA of 93 patients in the waiting list were separately 13.11 ±3.81 and 14.20±4.57.Among them 18(19.4％) were classified as moderately depressed,31(33.3％) had moderately anxious symptoms,and 14(14.1％) had severe anxious symptoms.Thirty-six patients were preoperatively admitted to hospital.Their mean scores of HAMD and HAMA were separately 13.19-± 3.82 and 16.17 ± 4.35.Among them 7(19.4％) were classified as moderate depression at the time of admission,16 (44.4％) had moderately anxious symptoms and 9 (25.0％) had severe anxious symptoms.The scores of HAMD had significant difference (t =3.383,P =0.002) before and after admission.Paired t test was separately conducted to analyze the first assessment and the 3rd-day assessment of HAMA and HAMD total scores after admission of all the inpatients.The results showed the scores were statistically different (for HAMA,t =2.786,P =0.009; for HAMD,t =14.024,P =0.000).Repeated ANOVA was used to analyze the recipients who had three assessments.The results had statistical difference (for HAMA,F =4.568,P=0.020; for HAMD,F=5.626,P =0.034) and the difference of HAMD score at different time points had a linear trend (F =8.273,P =0.013).Conclusion After hospital admission,the depression symptoms will be significantly alleviated.When waiting for the transplant in the hospital,the anxiety symptoms alleviate slightly in three days and then aggravate significantly.The depression symptoms alleviate slightly continuously.

Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.

Objective:To study the metabolic effect in in-patients chronic schizophrenia receiving horticultural therapy.Methods:One hundred and ten in-patients with schizophrenia meeting the criteria and signed informed consent at the rehabilitation wards were included.The random-number methods were used to classify patients into either the intervention group or the control group.The two groups both received normal medications while the intervention group alsoreceived horticultural therapy.The body weight and waist circumference were recorded at baseline,6 and 12-week-follow-up.And fasting blood sugar,triglyceride values were tested at the baseline,4th,8th,and 12th week-session.Results:Fifty-two patients of each group finished the evaluation.Covariance analysis results showed that the average waist circumference was much shorter in the intervention group than in the control group at 12-week-follow-up (F =13.98,P ＜ 0.001).When divided into 3subgroups according to the different drugs,after repeated ANOVA,the average waist circumference of the intervention group became shorter after intervention (olanzapine F =3.62,P ＜ 0.05;risperitone,F =4.46,P ＜ 0.05;aripiprazole,F =4.14,P ＜ 0.05) no matter what the antipsychotics they took.Conclusion:It suggests that horticultural therapy could effectively narrow waist circumferences in hospitalized patients with chronic schizophrenia whatever the antipsychotics the patients take.

Objective To explore the effect of the expressive psychotherapy on the feeling of inadequacy and loneliness of inpatients with chronic schizophrenia.MethodsTotally 120 chronic schizophrenia inpatients met recruited criteria were randomly divided into study group(n=60) and control group(n=60) according to random number table.57 patients in each group finished all the follow-ups finally.The patients in two groups were received normal medications while the patients in intervention group also attended expressive psychotherapy.All the patients were assessed at baseline,6 weeks and 12 weeks of treatment with the feeling of inadequacy scale (FIS) and the status and trait loneliness scale (STLS).Results(1) The FIS score(F=225.19,P<0.01),STLS total score(F=225.20,P<0.01),STLS status score(F=240.40,P<0.01) and STLS trait score(F=106.75,P<0.01) decreased significantly in both groups after intervention.(2) The FIS score of study group was much lower than those of control group at the at 6-week-follow-up(4.93±20.86,57.89±20.48,t=-2.250,P<0.01) and 12-week-follow-up(38.43±17.50,57.21±22.98,t=-4.900,P<0.01).(3) After 6 weeks treatment and 12 weeks treatment,STLS total score(6 weeks:(54.32±12.30) vs (68.46±15.53),t=-5.425,P<0.01,12 weeks:(44.16±10.81) vs (65.75±16.26),t=-8.386,P<0.01),STLS status score (6 weeks:(25.95±6.41) vs (34.31±7.91),t=-6.239,P<0.01,12 weeks:(19.15±5.49) vs (32.58±8.45),t=-10.103,P<0.01) and STLS trait score (6 weeks:(28.37±6.73) vs (34.15±8.45),t=-4.138,P<0.01,12 weeks:(25.00±6.18) vs (33.15±8.22),t=-6.019,P<0.01) in study group were lower than those in control group,and the difference was statistically significant.ConclusionExpressive psychotherapy can effectively improve the loneliness and inadequacy of patients with chronic schizophrenia.

Polymeric micelles have exhibited attractive properties as drug carriers, such as high stability in vivo and good biocompatibility, and been successfully used to dissolve various drugs of poor aqueous solubilities. In this study, we developed a new type of polymeric micelles with mannose-mediated targeting and pH-responsive drug release properties for anticancer drug delivery. The polymeric micelles were prepared from an amphiphilic polymer, poly (glycidyl methacrylate)-g-mannose (PGMA-Mannose). An anticancer drug, doxorubicin (DOX), was encapsulated into the micelles during the micellization, and could be released rapidly under acidic condition. The specificity of cellular uptake of the micelles by two different cell lines was studied using confocal laser scanning microscopy and the MTT assay. DOX-loaded micelles were efficiently trapped by mannose-receptor-overexpressing cancer cells MDA-MB-231, whereas mannose- receptor-poor cells HEK293 showed much lower endocytosis towards the micelles under the same conditions. Thus, DOX-loaded micelles displayed higher cytotoxicity to MDA-MB-231 cancer cells as compared with free DOX. The present study demonstrates that PGMA-Mannose micelles are a promising targeted drug delivery system for cancer therapy.
Cell Line, Tumor ; Doxorubicin ; pharmacology ; Drug Delivery Systems ; HEK293 Cells ; Humans ; Lectins, C-Type ; metabolism ; Mannose ; chemistry ; Mannose-Binding Lectins ; metabolism ; Micelles ; Receptors, Cell Surface ; metabolism

In recent years,some critical investigations have compelled us to improve the early recog-nition rate and treatment rate of mental disorders. Unhealthy lifestyles have become major influencing factors of health and longevity. With the effort of all practitioners,behavioral medicine has thrived in the latest dec-ades. In the future,we should put more energy in education,investigation and propagation. In short,emo-tion,behavior and health are the invariable themes of behavioral medicine.

Objective:To investigate the effect of horticultural therapy on social function of elderly inpatients with cognitive dysfunction.Methods:Ninety inpatients with cognitive dysfunction who met the diagnostic criteria of ICD-10 were randomly divided into horticultural research group and control group, with 45 patients in each group.Finally, totally 82 completed the test with 41 in each group.Patients in the two groups were both given drug therapy according to clinical symptoms.At the same time, patients in the research group were given horticultural therapy 3 times a week, 90 minutes each section, for 12 weeks.Scale of social function in psychosis inpatients(SSPI) was used to assess the social function of the patients in the two groups were at baseline, 4, 8 and 12 weekends of the treatment.SPSS 25.0 software was used to conduct chi-square test and independent sample t-test for demographic data of the two groups, and repeated measures ANOVA was performed for SSPI score. Results:The results of repeated measure analysis of variance showed that the group main effect ( F=7.226, F=13.428, F=24.817, F=19.793) and interaction effect between time and group were all statistically significant ( F=29.644, F=42.937, F=53.246, F=67.215)(all P<0.01) in daily living ability (factor Ⅰ), mobility and interaction (factor Ⅱ), social activity skills score (factor Ⅲ) and total score.Simple effect analysis showed there were no statistically significant differences in each factor score and total score between the two groups at the baseline ( P>0.05), and there were statistically significant differences in each factor scores and total score at the end of the 8th weekend ((9.95±2.41), (10.39±3.38), (6.56±3.24), (26.90±7.88) vs (8.10±2.45), (6.88±3.48), (2.81±2.50), (17.78±6.96))and 12th weekend((10.27±2.16), (11.61±3.07), (7.88±3.08), (29.76±7.40) vs (7.56±2.41), (5.78±3.21), (2.34±2.02), (15.68±6.24)) (all P<0.01). The pair-to-pair comparison within the group showed that the differences in factor Ⅱ, factor Ⅲ and total score of the research group at the end of the 12th weekend ((11.61±3.07), (7.88±3.08), (29.76±7.40)) were higher than those at the baseline((8.59±3.93), (4.56±3.32), (22.02±8.35)), 4th weekend((9.07±4.14), (5.12±3.35), (23.59±8.51)), and 8th weekend((10.39±3.38), (6.56±3.24), (26.90±7.88))(all P<0.05). Factor Ⅰ (10.27±2.16) showed a statistically significant difference compared with the baseline (8.88±2.65) and 4th weekend (9.39±2.63)(both P<0.05). All the scores showed an upward trend. Conclusion:Horticultural therapy can improve the social function of elderly inpatients with cognitive impairment.

" Behavior determines health" is the theoretical and practical basis of behavioral medicine. Maladpative lifestyle is not only an important risk factor for many non-communicable diseases, but also an important influencing factor for recurrence and prognosis of emotional disorders. More and more meta-analyses have confirmed the role of behavioral lifestyle in the treatment and prevention of emotional disorders such as depression. Some authoritative treatment guidelines now recommend lifestyle changes as one of the firstline treatment recommendations and given some specific modalities in detail. There is relatively less evidence for treatment of anxiety disorders and bipolar disorder, but there are several well-designed and high-quality studies that confirm the therapeutic and preventive role of lifestyles, particularly circadian rhythms, life regurality and exercises, as part of routine management measures for maintaining stable mood and alleviating anxiety symptoms.