0.05). Conclusion: Bibliotherapy is helpful for mental health in the college students.

Objective: To evaluate the reliability and validity of the inventory of experience of close relationship-revised version (ECR-R).Methods:286 college students were collected for testing the internal consistency and structure validity of the inventory. Test-retest reliability was founded in 31 students. Criteria validity was also studied in 32 cases with anxiety neurosis. Results: The Cronbach ? of the ECR-R and its two subscales (anxiety and avoidance) were 0.87, 0.86 and 0.81 respectively. The test-retest reliabilities of them were 0.75, 0.82 and 0.61 respectively. The two subscales had good discriminating ability and were confirmed by factor analysis, anxiety and avoidance could explain 21.28 and 11.20 of the total variance. Conclusion: The ECR-R is psychometrically acceptable and may be applied to study attachment of Chinese adolescents.

Objective To investigate the effects of butylphthalide injection on serum levels of inflammatory factors and oxidative stress products in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction were selected in our hospital from March 2014 to September 2016. Patients were divided into conventional treatment group (n=56) and butylphthalide group (n=64) according the therapeutic methods. The conventional treatment group was treated with improving microcirculation and resisting blood platelet aggregation, while the butylphthalide group was injected with butylphthalide (100 mL intravenous drip, twice a day) on the basis of conventional treatment. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-17, IL-23 and methane dicarboxylic aldehyde (MDA) were detected before the treatment and 7 days,14 days after the treatment. The clinical efficacy was also accessed. Results The TNF-α, IL-6, IL-17, IL-23 and MDA levels were significantly decreased 7 days and 14 days after the treatment than those before the treatment in two groups of patients (P<0.05). And the above indexes were also decreased in butylphthalide group than those of conventional treatment group (P < 0.05). No obvious adverse reactions were observed in two groups. Conclusion Butylphthalide can improve the clinical symptoms through the inhibition of inflammation and oxidative stress in patients with acute cerebral infarction.

Objective To analyze and summarize the clinical effect of peripherally inserted central catheters (PICC) guided by B-ultrasound,and to discuss the catheterization skills of PICC guided by B ultrasound.Methods Retrospectively analyzed the clinical data of 102 patients recieved PICC guided by ultrasound in neurosurgery department of Chongqing emergency medical center from January 2016 to May 2017.The success rate of one-time puncture, the success rate of one-time catheter delivery and the number of complications were analyzed, and the causes and treatment methods of complications were analyzed.Results Of the 102 cases,94 cases were successfully punctured in one time,6 cases were punctured twice,and 2 cases were punctured more than 2 times.The one-time puncture success rate was 92.16%.Catheter misplacement occurred in 5 patients,and postoperative complications occurred in 2 patients.Conclusion Mastering the related angiotomy and imaging knowledge of PICC and using the B-ultrasound guidance system to insert the catheter can improve the success rate of catheterization and reduce the postoperative complications.

Objective To investigate the expression of six-transmembrane epithelial antigen of the prostate (STEAP) in prostate cancer and its relationship with prostate specific antigen (PSA).Methods A retrospective analysis was performed of 65 consecutive patients verified for prostate canc-er by prostate biopsy or post-operational pathological examination.The clinical stage was classified ac-cording to TNM system and the pathological grade was classified according to Gleason score.STEAP expression in 65 prostate cancer samples (T1 9,T2 14,T3 17,T4 25;high differentiation 37,moder-ate differentiation 12 and low differentiation 16) was studied by using STEAP monoclonal antibody (Santa Cruz Biotech,USA) and SP immunohistochemical staining.Positive staining gray values were introduced to describe the intensity of STEAP expression.STEAP expression level was analyzed with respect to stage,grade,serum total PSA and free/total PSA (f/t PSA) ratio respectively.Results The serum total PSA concentration and f/t PSA ratio in all cases was (27.65±8.34) ng/ml and 0.15～0.04 respectively.STEAP was positively stained in 63 patients (T1 7,T2 14,T3 17,T4 25; high differentiation 37,moderate differentiation 11 and low differentiation 15).The mean STEAP-positive staining gray values in stage T1,T2,T3 and T4 of prostate cancer were 26.8%,45.6%,62.3% and 76.5%,respectively and in high,moderate and low differentiation group were 71.2%,52.8%,and 34.4% respectively.The positive staining gray values of STEAP expression was posi-tively correlated to the clinical stage of cancer and negatively correlated to the Gleason score and the ratio of f/t PSA (P<0.01,respectively).There was no significant relationship between STEAP ex-pression and serum total PSA concentration (P>0.05).Conclusion STEAP expression may act as one of new markers to the invasion degree and pathological grade of prostate cancer.

Objective To investigate the relationship between plasma homocysteine (Hey) level and ankylosing spondylitis (AS).To analyze the association between the NS,N10 methylenetetrahydrofolate reductase (MTFHR) gene polymorphism and AS.Methods One hundred patients with AS and 60 healthy controls were included in the study.The plasma Hey level was examined by enzyme-linked immunoadsorbent assay and MTHFR gene polymorphism was analyzed by the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).Results Compared with heahhy controls,the plasma Hey level in AS patients was significantly higher than that of the controls (P＜0.01).There was no significant difference in the frequen-cies of MTHFR genotype and alleles between AS and the controls (P＞0.05),But the ratio of T/T genotype mutation was different between AS and the controls (P＜0.05).The plasma Hey level of T/T genotype was significantly higher than that of C/T or C/C genotype in AS and the controls (P＜0.01).Logisticalregression analysis indicated that Hey was an independent risk factor for AS (P＜0.01,0R=4.582,95%CI=1.984～10.585).Conclusion The plasma homocysteine level is significantly increased in AS patients.Hyperhomo-cysteinemia is an independent risk factor for AS.MTHFR T/T genotype mutation is an important mechanism of hyperhomocysteinemia and may be related with AS.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of partial and intermediate atrioventricular septal defect (AVSD). MethodsUltrasound images of11casesof partialandintermediateAVSDconfirmedbyautopsy orpostnatal echocardiography were retrospectively analyzed and the characteristics were summarized. Results Fetal echocardiography of seven cases of partial AVSD and four cases of intermediate AVSD at fourchamber view showed ostium primum atrial septal defect and the mitral and tricuspid valves attaching at the same level on the interventricular septum. Atrio-ventricular valves took on a straight, bar-liked appearance when closed and constituted a “T” shape with interventricular septum. One partial AVSD case showed left ventricle-right atrium canal. All intermediate AVSD cases showed upper ventricular septal defect. There were four cases associated with mitral reflux, one associated with mitral and tricuspid reflux and one with bilateral radius absence. Conclusions “T” shape image is of great clinical value in prenatal diagnosis of fetal partial and intermediate AVSD. The coronary sinus may lead to false positive diagnosis.

Objective To observe the effect of treating Diabetic Peripheral Neuropathy with Acupoint Injection. Methods 65 patient with DPN were randomly recruited into a control group and a treatment group after adjusting stage. The control group was treated with acupuncture, while the treatment group was treated with the Safflower inoculation fluid acupuncture point injects. Nerve function parameter (MDNS、 NCV) and clinical symptoms were observed after 3 therapeutic courses. Results Nerve function parameter (MDNS、 NCV) and clinical symptoms in the treatment group were apparently improved after treatment (P<0.05) . Conclusion Acupuncture point injected with Safflower inoculation fluid may improve clinical symptoms and nerve functions of DPN patients.

Objective To evaluate the clinical efficacy and safety of tapering the dosage of recom-binant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc) combined with DMARDs in the treatment of peripheral joints involvement of ankylosing spondylitis. Methods Sixty patients who met the classification criteria of ankyloding spondylitis were enrolled. Meanwhile, all patients had one or more of the following joint involvement: hip, knee, ankle, and shoulder. Their BASDAI was higher than 4, joint pain VAS≥4, ESR ≥30 mm/1 h and CRP≥8 mg/L. Tuberculosis, hepatitis B, hepatitis C infection or other microorgan-isms infections were excluded. All enrolled patients had no serious heart,liver,kidney, or other internal organ involvement. During the first stage (The first eight weeks patients were matched by age and, disease activity, then randomly divided into the rhTNFR-Fc (the control group) treatment group in which patients were treated with 25 mg rhTNFR-Fc subcutaneous injection twice per week for 4 months) and rhTNFR-Fc dosage tapering group in which 25 mg rhTNFR-Fc were subcutaneously injected once per week for 4 weeks and then followed by 12.5 mg per week for 4 weeks, then once every 10 days for 6 times. Then the dosage of rhTNFR-Fc dosage of the dosage tapering group (the experimental group) was changed to 12.5 mg subcutaneous injection once every 15 days for another 4 times combined with methotrexate 7.5 mg per week and Salfasalazine 2 g daily and thalidomide 100 mg per night. The second stage started from week 9 to 24. In addition to the 30 cases at the first stage, 42 cases were included based on the same inclusion criteria for stage one. Patients' clinical and laboratory parameters were evaluated at week 0, 4, 8, 16 and 24. Results During the first four weeks, all patients of both control group and experimental group reached ASAS20, 97% (29/30) patients reached ASAS50 in the control group, 83% (25/30) patients reached ASAS50 in the experimental group. At week 8, patients in both groups maintained at 100% ASAS20 improvement, 100% (13/13) patients in the control group reached ASAS50, and that of the experimental group was 97% (29/30), the differences between the two groups were not statistically significant (P>0.05). In the second stage, 72 cases (100%) could achieve ASAS20, 63 cases (88%) achieved ASASSO at week 16. At week 24, 72 cases (100%) remained to achieve ASAS20, 71 cases (99%) achieved ASAS50. The safety and compliance of the two groups were good. Two cases developed infection, one patient had mild elevation of serum transaminase. Conclusion Tapering the dosage combined with DMARDs is an effective and safe approach in the treatment of peripheral joints involvement of ankylosing spondylitis. The compliance of this strategy is good and only few patients have serum transaminase elevation. But attention should be paid to the increased rate of infection.

BACKGROUND: It is difficult to cover aneurysm-like ventricular septal defect (VSD) of large inlet and multiple outlets completely with symmetrical type occluders or eccentric type occluders. OBJECTIVE: To investigate the feasibility of A4B2 occluder devices for covering aneurysm-like VSD, and to observe the effects of proper occhiders selected according to pseudoaneurysm size on coveting aneurysm-like VSD. DESIGN: Case analysis.SETTING: the First Hospital of Hebei Medical University. PARTICIPANTS: From August 2004 to May 2006, 226 patients with the pseudoaneurysm of petimembranous VSD, who underwent interventional therapy in the First Hospital of Hehei Medical University, were recruited in the study. According to the results of the left ventricular angiography, 36 patients of pseudoaneurysm of petimembranous VSD with large inlet and multiple outlets were closured with A4B2 occluder devices. According to the results of the left ventricular angiography, the mean diameter of the left inlet of VSD was (10.6+8.7) mm (ranged from 8 to 21 mm), the mean diameter of the right outlet of VSD was (3.1 ± 2.9) mm (ranged from 2 to 8 ram). Main materials: Occluder device and delivery mechanism were offered by Shanghai Shape Memory Alloy Materials Company and Beijing Starway Medical Technology Inc. They were processed into double disks using nickel-titanium shape memory alloy wires by a special technology to close VSD by a transcatheter approach. The size of the occluder was denoted with the diameter of the waist, and the Size ranged from 4 to 16 mm in the present study. METHODS: All the occluders were transferred by a 7-10 F transferring sheath from right heart system, and the mean diameter of the occluders was (6.364-2.48) nun (ranged from 4 to 16 ram). Fifteen minutes after the procedure, left ventricular angiography and transthoracic echocardiography (TIE) were performed again to evaluate the efficacy. After the procedure, electrocardiogram (ECG) monitoring lasted for 5 successive days in all patients, and ECG and TIE were performed 1, 3, 6 and 12 months later. MAIN OUTCOME MEASURES: Residual shunt, arrhythmia and valve function as well as blood compatibility. RESULTS: Sixteen cases were closured by placing the occhiders into left inlet of VSD, 16 cases were closured by placing the occluders into the pseudoaneurysm completely, and 4 cases were closured at the outlet of the defects. The results of the left ventricular angiography and TTE that performed fifteen minutes after the procedure demonstrated that 32 cases were completely closured and slightly residual shunts (< 3 mm) was found in other 4 patients. And confirmed by TIE, the residual shunts completely disappeared in 2 of the 3 patients 24 hours later while in the other one in 1 month after the procedure. Temporary left bundle branch block was found in 3 cases while temporary right bundle branch block was found in 2 cases, and all of them recovered within one week. Without severe complications, all of the 36 patients were treated successfully with A4B2 (thin waist shape) occluder devices made in China. Critical appraisal in blood compatibility of the implantation materials used in this research had been performed. The hemolysis ratio was less than 5%, the platelet adhesion was less, and the blood coagulation function ,the immune system response( immunoglobulin and complement)and the re-endothelialization of material surface were all normal. CONCLUSION: Transcatheter interventional therapy with domestic A4B2 occluder devices for VSD with pseudoaneurysm is safe, effective, promising, and has fewer complications. The key to the procedure is to select suitable occluders and suitable positions where to plant them according to the size, morphologic characteristics, position, and maturity of the pseudoaneurysm.