Objective To explore the relationship between dysfunctional beliefs and attitudes on sleep and sleep disturbances before and after a short-term pharmacotherapy in patients with major depression. Methods Sixty-six (29 male, 37 female, 34.0±9.5 years old) patients with major depression were recruited before the treatment. Dysfunctional Beliefs and Attitudes about Sleep (DBAS) questionnaire, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Scale (HAMA) were assessed before and after a 4-week antidepressant treatment. Results After the 4-week antidepressant treatment, depressive and anxiety symptoms were alleviated significantly, whereas sleep disturbance still persisted. And sleep quality was closely related with problematic sleep beliefs after the treatment.Conclusion Some evidences are provided for cognitive behavioral therapy during antidepressant therapy, and the therapy should be matched with problematic beliefs and attitudes.

Objective: To investigate the effect of the enteral nutrition therapy on complication and the recovery in the severe stroke patients.Methods: 116 patients received enteral nutrition therapy and 91 patients accepted fluid food were involved in this trail.The complication,duration in intensive care unit,survival days,hospital costs,blood sugar level and serum albumin level were compared.Results: Compared with control group,the probability of complications,the hospital costs,the duration staying in intensive care unit,the survival days,the blood sugar and the serum albumin were significantly better.Conclusion: It is a proper and essential way to use the enteral nutrition in the patients with severe stroke in the early stage.

Objective　To investigate the effect of ipratropi um bromide and atropine on airway mucin hypersecretion in the chronic bronchiti s model of rats. Methods　The model was established by intratrac heal instillation of small dose of lipopolysaccaride (200 μg) ipratropium bromi de and atropine were administrated 3-21 d after the model was established. Patho logical changes, mucin in bronchoalveolar lavage fluid (BALF) and tracheal ring culture medium were examined before and after the adnsinistration of iprat ropium bromide and atropine. Results　Characteristic pathologica l manifestions of chronic brochitis were found after instillation of LPS. Sig nificant decrease in the number of tracheal epithelia goblet cells, secretion of mucin were observed in ipratropium bromide and atropine treated rats. The eff ect of inhibiting the secretion of mucin of ipratropium bromide was higher than atropine. Conclusion　It suggests that muscarinic acetylcholine receptor plays an important role in airway mucin hypersecretion in chronic bro nchitis model of rat. Ipratropium bromide exhibit a stronger inhibition effect on mucin hypersecretion than atropine, moreover no inhibition effect on mucocil iary clearance which was observed in atropine.

BACKGROUND:Bone marrow mesenchymal stem cels transplantationvia the trachea can relieve the lung injury of rats exposed to silica dust, but their distribution and migrationin vivois stil unclear. OBJECTIVE:To investigate the distribution and homing of bone marrow mesenchymal stem cels transplanted via the trachea into rats exposed to silica dust. METHODS: Bone marrow mesenchymal stem cels from Sprague-Dawley rats were isolated through bone marrow adherent method and transfected with lentivirus carrying enhanced green fluorescent protein gene (Lv-eGFP). Trypan blue staining and cel counting kit-8 were applied to assay the viability and proliferation of the transfected and untransfected cels. Sprague-Dawley rats, SPF level, were randomized into control group and silica dust exposure group. Rats in the two groups were respectively injectedvia the trachea with 1 mL of sterile silica dust suspensions (40 g/L) and 1 mL of normal saline. At 2 days after modeling, 2.2×106 transfected bone marrow mesenchymal stem cels were injected via the trachea into the rats of control group and silica dust exposure group. Rats were kiled at weeks 1, 2, 3, 4 after transplantation, and the distribution and intensity of green fluorescence in the lung, heart, liver, spleen, kidney, and brain tissue were observed under the fluorescence microscopy by frozen sections and analyzed using imaging analysis software. RESULTS AND CONCLUSION: When the multiplicity of infection was 50, there were no significant differences between the viability and proliferation activity of the transfected and untransfected cels (P > 0.05). After transplantation of transfected bone marrow mesenchymal stem cels, strong green fluorescence was observed widely in the lung, especialy around the bronchus and blood vessels, and stil obvious at the 4th week. The fluorescence of other organs also could be observed at the 1st week. It was strong and wide in the liver, spleen and heart, while faint and less in the kidney and brain, and al reduced with time. It shows bone marrow mesenchymal stem cels transplantedvia the trachea into rats exposed to silica dust can be homing to the injured lung of rats.

Objective To assess the myocardial strain in patients with coronary artery disease by two dimensional strain echocardiography.Methods Forty-three patients with coronary artery disease and thirty five healthy subjects were included.High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex,and the apical four chamber view,two-chamber view and long-axis view of the left ventricle respectively.The longitudinal strain was measured in the apical views,radial strain and circumferential strain were measured in the left ventricular short-axis views using two-dimensional strain software.Results There were 96 segments whose flow was provided by coronary artery with stenosis＜75%,147 segments whose flow was provided by coronary artery with stenosis≥75%.The peak systolic longitudinal strain of different segments in patients with stenosis≥75% significantly reduced when compared with the control group(P＜0.05).The peak systolic radial strain and circumferential strain of different segments in patients with stenosis≥75% had no statistical difference compared with the control group(P＞0.05).When taking peak systolic longitudinal strain≥-16.1% as cut-off value for coronary artery stenosis of≥75%,the sensitivity and specificity were 78.7% and 76.4% respectively.There was no significant difference in systolic longitudinal strain,radial strain and circumferential strain between normal myocardium and stenosis＜75%(P＞0.05).Conclusions Although there are no evident regional wall motion abnormalities by two dimensional echocardiography,in patients with severe coronary artery stenosis,the longitudinal strain which can reflect the subendocardial myocardial function significantly reduced.

BACKGROUND:Bone marrow mesenchymal stem cel s transplanted into rats exposed to silica dust can home to the injured lung, but the homing effects via different ways are stil unclear.
OBJECTIVE:To comparatively observe the distribution of bone marrow mesenchymal stem cel s transplanted via different ways into rats exposed to silica dust.
METHODS:Bone marrow mesenchymal stem cel s of donor rats were isolated through whole bone marrow adherent method and transfected by Lv-eGFP. Receptor rats were exposed to silica dust through windpipe injection and randomly divided into intravenous injection and intratracheal injection groups. Then, transfected bone marrow mesenchymal stem cel s were injected via the vein and trachea into acceptor rats. The acceptor rats were kil ed at weeks 1, 2, 3, 4 after transplantation to take the lung, heart, liver, spleen, kidney, and brain tissue that were made into frozen sections and observed under fluorescence microscopy. The intensity of green fluorescence (absorbance value) was analyzed using image analysis software.
RESULTS AND CONCLUSION:Strong, wide and lasting green fluorescence was both observed in the lung tissue of intravenous injection and intratracheal injection groups, which was especial y remarkable around the bronchus and blood vessels. The fluorescence intensities of both two groups were slightly decreased with time, but there was no difference between the two groups (P>0.05). The fluorescence in the other organs of both two groups was also observed at early stage. It was stronger and wider in the liver, spleen and heart, while fainter and less in the kidney and brain, and reduced with time in al the organs. Fluorescence could be observed few and faint only in the liver and spleen at late stage, and could hardly be seen in the brain. The fluorescence intensities of the liver, spleen, heart, kidney and brain had no significant difference between the two groups at the same time (P>0.05), but the fluorescence intensity in the brain at the 1st week showed significant difference between the two groups (P<0.05). These findings indicate that the intravenous injection and intratracheal injection of bone marrow mesenchymal stem cel s have similar homing effects in rats exposed to silica dust.

Objective To discuss the value of double contrast-enhanced ultrasound(DCEUS) as a method to predict the pathologic grade of regression to preoperative neoadjuvant chemotherapy(NAC) in advanced gastric cancer(AGC) patients,the contrast parameters of gastric carcinoma were measured and its correlation with pathologic response degree was analyzed.Methods Fifty seven patients with endoscopic biopsy-proven AGC were considered for a complete resection of the lesion and had a DCEUS prior to and following XELOX pre-operative NAC therapy for 3 cycles.The arrival time (AT),time-to-peak (TTP), baseline intensity(BI) and peak intensity(PI) of the primary gastric tumor were measured.The enhanced intensity(EI)was defined as PI minus BI.The percentage of change of DCEUS parameters before and after NAC therapy and its correlation with phathologic grades of regression was calculated.Patients were divided into responder and nonreponder group according to different pathologic response grade.The differences of DCEUS parameters between two groups were compared.The diagnostic accuracy of DCEUS in prediction of benefit from preoperative NAC was represented by means of receive operating characteristic(ROC)curves. Results After NAC,the PI and EI values of local gastric cancer were significantly lower than before NAC. There were significant differences in PI and EI after NAC between the responder and nonresponder groups. Among the DCEUS parameters showed significant correlation with pathologic grade of regression,the correlation factor was highest in percentage of EI reduction of primary gastric tumor(ρ= -0.501 ,P =0.007).When the optimal cutoff value of EI reduction rate of gastric tumor determined was 27%,a sensitivity of 81 .8% and specificity of 66.7% were achieved.Conclusions DCEUS might be a novel, noninvasive,liable and potential method to select the benefit responder from the preoperative NAC in AGC patient.

In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (DeltaLVEF, DeltaLVESV and DeltaLVEDV) between two groups; (4) The linear regression analysis between DeltaLVEF, DeltaLVESV, DeltaLVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI1.5 was obviously larger than that in those with MPSI1.5 and those with MPSI Echocardiography/*methods ; Infusions, Intravenous ; Myocardial Infarction/*diagnosis ; Myocardial Infarction/pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Reperfusion ; Myocardium/*pathology ; Perfusion ; Regression Analysis ; Time Factors ; Ventricular Remodeling

The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.
Angioplasty, Transluminal, Percutaneous Coronary ; Cell Survival ; Coronary Artery Bypass ; Echocardiography/*methods ; Models, Statistical ; Myocardial Infarction/*pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Revascularization ; Myocardium/*pathology ; Perfusion ; Time Factors

As a widely recognized public health problem as well as prevalent and challenging to modern society, chronic insomnia is involved in wide brain areas (such as prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, and thalamus) and emotion-cognition neuro-circuit. It is closely related to the conditioned hyperarousal and the increased information process and/or the impaired inhibitory ability to withdraw from awaking state. Thus, some specific abnormal mode may exist in the emotion-cognition circuit, which is associated with abnormal cognition load, such as repeated retrieval/intrusion of aversive memories during night. Studies through the combination of multiple techniques including psychology, electrophysiology and neuroimaging methods are needed to further enhance the understanding of chronic insomnia.
Brain ; physiopathology ; Electrophysiology ; Gyrus Cinguli ; Hippocampus ; Humans ; Neuroimaging ; Prefrontal Cortex ; Sleep Initiation and Maintenance Disorders ; pathology ; Thalamus