Objective To observe the efficacy of duloxetine combined with Bodhi Tree relaxation tech?nique in the treatment of generalized anxiety disorder ( GAD ) and the influence of heart rate variability ( HRV ) . Methods According to the standard of ICD?10,124 GADs were selected as study objects from March 2013 to March 2014. They were randomly divided into intervention group and control group. The intervention group fixedly received duloxetine ( 20 mg/day) and Bodhi Tree relaxation therapy,2 times / week,for 8 weeks;and the control group received only Duloxetine (20 mg/day) treatment. All patients were assessed with SAS,HAMA and Treat?ment Emergent Symptom Scale( TESS) at the baseline and at the end of the 2nd ,4th ,6th ,8th week of the treatment to evaluate the efficacy and side effects. The LF/HF of HRV were observed. Results 1.In both groups,SAS score and HAMA score remarkably decreased after intervention than before treatment( before intervention:control group (63.52±14.25,30.26±11.25) intervention group (64.35±14.33,29.83±10.85);after 8 weeks:control group (30.23±6.68,9.28±3.20) intervention group (25.14±5.59,7.70±2.87), P<0.05). There was statistical signifi?cant between the two groups in the therapeutic effects (χ2=4.09, P<0.05) ,and no significant difference between the two groups on the TESS (P>0.05). 2. The ratio of LF/HF showed significantly decrease in the intervention group than those in the control groupt 13?16=-2.806,-2.725,-3.572,-2.272;P13?16=0.006,0.007,0.001,0.025).The value of anxiety se?verity index and LF/HF was positively correlated ( r=0.342, P<0.05).Conclusion Duloxetine combined with Bodhi Tree relaxation technique can effectively improve the heart rate variability in patients,curative effect is better.

Objective:To investigate the expression and clinical significance of cell division cycle 42 (Cdc42) and WASP family verprolin-homologous protein l (WAVE1) in non-small cell lung cancer (NSCLC). Methods:The expression of Cdc42 and WAVE1 was detected in 106 paraffin-embedded NSCLC tissues and 46 adjacent normal lung tissues (control group) using immunohistochemis-try. Results:The expression levels of Cdc42 and WAVE1 was distinctly higher in NSCLC than in the control group. The expression of Cdc42 in NSCLC significantly correlated with tumor differentiation, TNM stage, and lymph node metastasis (P<0.05). The expression of WAVE1 in NSCLC was significantly correlated with TNM stage and lymph node metastasis (P<0.05 or P<0.01). The expression of Cdc42 was significantly correlated with WAVE1 in NSCLC (r=0.469, P<0.01). The 3-year survival rates were significantly lower in the group with high Cdc42 expression (44.16%) than in the low expression group (72.41%;P<0.01). Similarly, the 3-year survival rates were significantly lower among patients with high WAVE1 expression (39.44%) than in those with low expression (77.14%;P<0.01). Lymph node metastasis and the common high Cdc42 and WAVE1 expression were independent prognostic factors for NSCLC. Conclu-sion:The Cdc42 expression is correlated with WAVE1 expression. They may act together and have an important function in NSCLC. The expression of both Cdc42 and WAVE1 in NSCLC tissue may be used as markers for assessing the clinicopathologic features and prognosis.

ObjectiveTo assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement ofhepatocellularcancer( HCC )aftertransarterialchemoembolization( TACE )treatment.Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced,arterial,portal,and delayed phases scanning after TACE treatment.Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images.DSAs were performed in all these patients.Two blinded and independent readers evaluated the data in 2 reading sessions:standard nonenhanced,arterial phase,portal phase,and delayed phase images were read in session A,and virtual nonenhanced,arterial phase,portal phase,and delayed phase images in session B.Sensitivity and specificity were calculated,with the DSA data set as the reference standard.The sensitivity and specificity were compared with Chi-square test.Results DSA revealed 63 lesions in 27 patients,and 39 of them had blood supply.Overall sensitivity and specificity were 74.4％ (29/39) and 83.3％ (20/24) for session A,and 94.9％ (37/39),95.8％ (23/24) for session B,respectively.The sensitivity of the two reading sessions was significantly different (x2 =6.303,P ＜ 0.05 ),while the specificity was insignificantly different ( x2 =2.009,P ＞ 0.05 ).Conclusion Compared with standard dynamic protocols,an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.

Objective To investigate the clinical features, therapeutic strategy and prognosis of pediatric benign cerebellar astrocytomas (BCAs). Methods 101 children with BCAs diagnosed histopathologically were analyzed retrospectively and followed up. Results There were 50 boys and 51 girls with a median age of 9.8 years old. The sizes of tumors were 3～7.5 cm. 46 cases were with solid-tumor, 24 with the tumor in the cyst, 31 with the cysty in the tumor. 39 cases were located in cerebellum vermis, 58 cases were in the cerebellar hemisphere and 9 cases were adhesive with brain stem located in the forth ventricle. 92 cases were total removed and 9 cases were subtotal removed. 87 patients were followed up for 1～5 years, and all of them has survived, without radiotherapy or chemotherapy. Conclusion Pediatric benign cerebellar astrocytomas mostly grows in cerebellar hemisphere， also in vermis frequently. Neuroimaging and pathology may conduce to the diagnosis. Microsurgical resection may result in optimal outcome.

To describe the effects of endogenous testosterone levels on the visuospatial ability.Thevisuospatial ability,testosteronewere included as the key words,retrieving 46 papers in the database.35 relevant papers have been reviewed in the paper,as the results,we have found that the visuospatial ability of male was better than female.The performances of the visuospatial tasks in males were associated with the lev-els of endogenous testosterone,and the effects comprised two aspects:the organizational function and activa-tional function of the testosterone.The latter have received more attention from researchers.Until now,most studies of activational effects of testosterone on visuospatial ability remained on the level of behavioral re-search.The mental rotation task,navigation task and virtual reality scenes tasks were implied in these stud-ies.A nonlinear relationship has aroused a great controversy.Latest research suggests that further investiga-tion of the neural mechanisms related to visual-spatial ability is needed,using ERP and MRI techniques,to assess the relationship of endogenous testosterone levels with the relevant neural basis of visuospatial ability.

Objective:To explore the diagnostic value of chest CT imaging in differential diagnosis between common-type COVID-19 and mycoplasma pneumonia (MP).Methods:From the January to February 2020, the clinical and imaging data of COVID-19 patients (diagnosed in the Affiliated Hospital of Jining Medical University, the Fourth People's Hospital of Jining and the Second People's Hospital of Jining) and MP patients (diagnosed in the Affiliated Hospital of Jining Medical University) were retrospectively collected and analyzed. Forty-three patients with common-type COVID-19 (28 males, 15 females, 43±14 years old) and 50 patients with MP (19 males, 31 females, 37±14 years old) were enrolled as COVID-19 group and MP group, respectively. The clinical manifestations, laboratory results and chest CT findings of these two groups were analyzed and compared.Results:(1) Clinical manifestations: there were more patients with muscle ache and asthenia in COVID-19 group than in MP group (χ 2=5.110, 4.834, P<0.05). No significant difference was found in fever and cough between two groups (χ 2=0.378, 0.097, P>0.05). (2) Laboratory examination: the procalcitonin level of cases in COVID-19 group was significantly lower than that in MP group (χ 2=12.263, P=0.001). No significant difference was found in leukocyte count, lymphocyte count, C-reactive protein level and erythrocyte sedimentation rate ( Z=-1.117, χ 2=2.410, 0.787, 0.800, all P>0.05) between two groups. (3) Chest CT findings bilateral lung involvement was found more in COVID-19 group than in MP group (χ 2=30.012, P<0.001); while the one lobe of ipilateral lung involvement was less in COVID-19 group than in MP group (χ 2=19.927, P<0.001); there was no significant difference in multiple lobes of ipilateral lung involvment between the two groups (χ 2=1.366, P>0.05). Ground glass, paving stone sign and air bronchus sign were found significantly more in COVID-19 group than in MP group (χ 2=30.171, 19.119, 9.790, all P<0.05); while the pulmonary consolidation, central lobular nodule and centripetal thickening of bronchus wall were found significantly less in COVID-19 group than in MP group (χ 2=25.450, 33.532, 48.553, all P<0.001). Conclusions:The clinical manifestations and laboratory examination have limited value in the differential diagnosis of common-type COVID-19 and MP, while chest CT imaging might be more valuable in the early differential diagnosis of these two diseases.

【Objective】 To explore the correlation between CSAG1 expression and the prognosis and tumor-infiltrating lymphocytes in renal clear cell carcinoma (RCCC), and to predict the survival and tumor progression. 【Methods】 The gene expression profiles and clinical information of CSAG1 were downloaded from the Cancer Genome Atlas (TCGA). Based on the differential mRNA expression, GO annotation and KEGG pathway analysis were performed. The relationship between CSAG1 and tumor immune infiltration was assessed with Tumor Immunoassay Resource (Timer 2.0) database. The mRNA expression of CSAG1 in human RCCC specimens was validated with qRT-PCR. 【Results】 CSAG1 expression was significantly higher in RCCC tissues than in normal tissues (P<0.05). The qRT-PCR results revealed that the mRNA level of CSAG1 was consistent with that predicted by bioinformatic analysis. The KEGG analysis and GO annotation indicated high GSAG1 expression in RCCC was related to transmembrane transport, tricarboxylic acid cycle and lysosome. CSAG1 expression was positively related to the infiltration of pDC, aDC, CD8⁺ T cells, cytotoxic cells, TFH, TH1 cells, Tem, NK CD56^dm cells, Treg and T cells, but negatively correlated with macrophage infiltration. 【Conclusion】 CSAG1 may be associated with poor prognosis of RCCC and become a potential immunotherapy target.

Adult ; COVID-19 ; China/epidemiology* ; Epidemics ; Female ; Humans ; Male ; SARS-CoV-2