Objective:To investigate the effects of monotherapy of SSRI and SSRI with psychotherapy on patients of somatoform disorders.Methods:96 patients who met the criteria of CCMD-3 for somatoform disorders were divided into three groups:group one taking Fluoxetine only;group two taking Fluoxetine and a small dose of Olanzapine;group three combining the above two medicines with Gestalt psychotherapy.Before treatment and after three months' treatment,the effects of each group were evaluated by scores of HAMD.Results:According to the effective rate within each group(53.1%、61.8% and 96.7%),there was significantly differences in three groups after three months treatment(?2=15.5,P

Objective:To investigate the effects of deguelin on the viability and apoptosis of Neuro-2A ( N2A) cells. Methods:The cell viability of N2A cells with the density of 5 × 104 ·ml-1 on the time points of 6, 12, 24, 48 and 72 hours after 1 × 10 -8 mol ·L-1 deguelin treatment using CCK-8 kits was determined, and that on the time point of 48 hours after 0, 1 × 10 -11 , 1 × 10 -10 , 1 × 10 -9 , 1 × 10 -8 , 1 × 10 -7 , 1 × 10 -6 or 5 × 10 -4 mol·L-1 deguelin treatment was also detected. The activity of caspase 3 was deter-mined in N2A cells treated by 2 × 10 -8 mol·L-1 deguelin for 24 hours. Results:N2A cells with the density of 5 × 104 ·ml-1 reached the peak level in the growth curve 48 hours after the incubation in DMEM medium with 10% fetal bovine serum. The cell viability of N2A cells was decreased after the treatment of 1 × 10 -8 mol·L-1 deguelin for 24-72 hours in a time-dependant manner or after the treatment of 1 × 10 -8 ~1 × 10 -6 mol·L-1 deguelin for 48 hours in a dose-dependant manner (P<0. 05) with IC50 of 1. 6 × 10 -8 mol ·L-1 . The activity of caspase 3 was increased after the treatment of 2 × 10 -8 mol·L-1 deguelin for 24 hours, which was 5. 6-fold of that in the control group. Conclusion: Cell viability of N2A cells is inhibited by deguelin in a time- and dose-dependent manner, which may be related to the activity increase of caspase 3.

Objective To explore the relationship between the stress during pregnancy and the NMDA-induced spasm. MethodsThe pregnant rats were divided into two groups: pregnant control group(PC group)and pregnatal stress group(PS group). The rats in PS group were forced to swim in cold water of 4℃ for five minutes. Pups of the two groups were injected NMDA 7mg/kg intraperitoneally on postnatal day 13 to induced infantile spasm-like attacks. Then the clinical behavior of pups of the two groups were observed and recorded. The ultrastructure of mitochondria was detected with scanning electron and appearance of neurons was observed with HE staining. NMDA receptor and its subuniforms (NR2A, NR2B) in hippocampus, cerebral cortex, hypothalamus and raphe nucleus of brainstem were estimated by immunohistochemistry. Results The average score of pups in PS group is higher than in PC group(7.84 ±1.01 vs 5.90 ± 1.12). There were swelling neurons and no cytonecrosis in hippocampuss of both two groups. The uhrastructure of mitochondria in hippocampuss and raphe nucleus of brainstem showed great changes in pups of PS group as membrane in mitochondria of pups in PS group. NR1, NR2A and NR2B distributed mainly on the membrane and also in cytoplasm and cellular nucleus. The NR1 expressions in hippocampus, cerebral cortex, hypothalamus and raphe nucleus in pups of PS group were elevated than those of PC group and the P value is 0.001, 0.009, 0.015, 0.001 respectively. The NR2B expressions in hippocampus, cerebral cortex hypothalamus and raphe nucleus in pups of PS group were elevated than those of PC group and the P value is 0.004, 0.002, 0.003, 0.002 separately. NR2A expressed more in hippocampus in pups of PS group than that in PC group,but there was no difference in cerebral cortex, hypothalamus and raphe nucleus between two groups and the P value is separately 0.006,0.067, 0.7, 0.5. Conclusions The mitochondria of neurons in rat pup were hurt by maternal severe stress daring pregnancy, which made the energy metabolism of neurons changed. Maternal stress can also elevate the expression of NR1, NR2A and NR2B in cerebral cortex, brainstem and hippocampus and increase the morbidity of infantile spasm-like attacks.

Objective To explore the operative cooperation of the intra-extra cranial bypass operation of the intracranial giant aneurysms. Methods A retrospective analysis of 7 patients who had intracranial giant aneurysm and received the intra-extra cranial bypass operation from October 2014 to June 2016. All preoperative and intraoperative nursing points of operative cooperation were analyzed. Results The post-operative digital subtraction angiographies of 7 patients without any perioperative nursing complications showed enough flow in the bypass arteries. Conclusions Operative multi-incision managing, positive temperature intervening, special instruments using and thrombosis preventing play very important roles in the nursing points of the successful operative cooperation.

Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100％ at 6 weeks follow-up by POP-Q scoring.And 46.2％ (30/65) were followed up at range of 1 -3 years,recurrence rate were 10％ (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4％ (62/65).At 6 weeks after operation,6.2％ (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10％ (3/30),the new urinary incontinence 4.6％ (3/65),and the new dyspareunia 12.5％ (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

Objective To assess the effect of remote-interactive cognitive behavioral therapy in pa-tients with chronic insomnia.Methods A total of 62 patients with chronic insomnia were randomly divided into combined treatment group,cognitive behavioral therapy for insomnia ( CBTI) group and drug treatment group.The study lasted for 6-8 weeks.The curative effects were assessed using sleep diary and scales.Results The sleep onset latency (SOL) ((39.9±23.7)min) and wake time after sleep onset(WASO) ((79.1± 39.4) min) in the drug treatment group were higher than that in the combined treatment group ( ( 25.5 ± 11.2)min and (54.4±38.5)min,respectively) and CBTI group ((27.8±11.6)min and (51.8±29.0)min,re-spectively) at the end of treatment,the difference was statistical significance( P=0.018 and P=0.046 respec-tively).The sleep efficiency(SE) in drug treatment ((76.5±11.9)%) was lower than that in the other two groups((83.8±8.7)%and (82.8±7.0)%respectively),(P=0.042).And no similar difference were seen in TST after treatment(P>0.05).The Brief Version of Dysfunctional Beliefs and Attitudes about Sleep(DBAS-16) score in the drug treatment group (97.6±16.4) was higher than the other two groups((67.5±20.1) and ( 75.0±26.9) respectively) after treatment(P=0.000) .No significant difference was seen in scores of the oth-er scales among the three groups(P>0.05) .After treatment,a greater proportion of patients in the combined treatment group had withdrawn from hypnotics use completely (29%(6/20) vs 5%(1/18);odds ratio( OR ) was 7.286);and the combined treatment group produced significant reduction in frequency of hypnotics use ((3.35±3.05) nights/week) when compared with drug treatment group((5.56±2.33) nights/week, P=0.016) .Conclusions Remote-interactive cognitive behavioral therapy was effective and acceptable for treating pa-tients with chronic insomnia,combining drug treatment in the early period could quickly relieve the symptoms of in-somnia,and can avoid the adverse effect from the hypnotics.And the treatment method can reduce the dropout rate.

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.

Objective To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage Ⅲ-Ⅳ pelvic organ prolapse (POP).Methods A prospective cohort analysis was conducted in the Peking Union Medical College Hospital,between May 2007 and June 2015,enrolling 55 women with stage Ⅲ-Ⅳ POP who intended to receive SSLF.Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually.Exploratory outcomes included perioperative parameters and complications.Results Of these 55 POP patients enrolled,52 (95％,52/55) received SSLF using conventional surgical instruments,the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing.Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes).Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients,both recovered fully with conservative methods.All patients were able to micturate spontaneously after catheter withdrawal.One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy.The objective success rate was 100％ (52/52) at 3 months.With a medium follow-up time of 23.7 months,the objective success rate was 98％ (51/52),the recurrence rate was 2％ (1/52) and the satisfactory rate was 94％ (49/52).De novo urinary incontinence occurred in 6％ (3/52) of patients.Conclusion Most POP could be corrected with SSLF using conventional instruments which is a feasible,economic and effective procedure for Asian patients with medium compartment prolapse.

OBJECTIVE To study the radiose-nsitization by Topotecan on human nasopharyngeal carcinoma in nude mice. METHODS ①To study the maximum tolerance dose of TPT and detect the effective rate of TPT and RT on nude mice. ② Plan of radiosensitization practice:53 nude mice xenografts were distributed to 5 groups:RT 20 Gy group,RT 40 Gy group,TPT 12.5 mg/kg group,TPT 12.5 mg/kg+RT 20 Gy group and the controlgroup. After treatment,the volume of tumors were measured every 3 days in order to value the effective rate [complete remission(CR) + partial remission(PR) ]and regrowth delay time(TGD) and to fit the growth curve. RESULTS This study showed that the effective rates had significant difference among RT20 Gy+TPT 12.5 mg/kg group,RT20 Gy group and TPT12.5 mg/kg group,while that of RT20 Gy +TPT 12.5 mg/kg group and RT40 Gy group had no statistical difference. SER reached to 1.34. CONCLUSION Topotecan has been shown a radiosensitizing effect on human nasopharyngeal carcinoma in vivo.