OBJECTIVE: To investigate the psychological statuses of Chinese adults with moderate-to-severe persistent allergic rhinitis, and evaluate the effects of nasal symptoms on their psychological statuseses. METHOD: The Symptom Checklist-90 (SCL-90) or self-reporting Inventory was employed to analyze the psychological statuses of 539 adults with moderate-to-severe persistent allergic rhinitis. RESULT: The SCL-90 scores of the adults with moderate-to-severe persistent allergic rhinitis were statistically higher than those of non-allergic adults in terms of somatization, depression, anxiety and hostility. No statistical discrepancies existed in gender or age. The course of disease contributed to somatization and compulsion. The effects of nasal symptoms included two aspects: nasal obstruction had a conspicuous impact on somatization, compulsion, interpersonal sensitivity, depression, anxiety and psychosis, while nasal itching contributed to somatization, depression and anxiety. CONCLUSION The psychological statuses of adults with moderate-to-severe persistent allergic rhinitis is evidently worse than that of non-allergic adults. Symptoms such as nasal obstruction and itching had an obvious impact on outpatients' psychological statuses.
Adult ; Humans ; Nasal Obstruction ; Rhinitis, Allergic, Perennial ; diagnosis ; psychology

Objective To investigate the associated effect of 125I implantation plus chemotherapy in local recurrent stage Ⅲ NSCLC patients.Methods From January 2006 to January 2009,34 patients documented with local recurrent stage Ⅲ NSCLC were divided into two groups by random number table.The treatment group was treated with 125I permanent implantation combined with DP regimen (docetaxel 60 mg/m2 + cisplatinum 75 mg/m2),while the control group received only DP chemotherapy.According to the TPS,the treatment group received CT-guided percutaneous implantation of 125 I seeds with a particle activity of 2.22 ×107-2.59 × 107 Bq.The prescribed dose was in the range of 90-110 Gy and the postoperatively matched peripheral dose (mPD) and D9o were verified by TPS.The control group received a DP chemotherapy regime for 4 cycles after the procedure.This study was approved by the ethics committee,and all patients signed informed consents.The follow up time was up to disease progression.Kaplan-Meier survival analysis was used to describe the local lesion control (LLC) time and progression free survival (PFS).Log-rank test was used in the comparison of the survival rates between the two groups.Fisher's exact test was used to analyze the differences of CR rate and recent efficiency between two groups.Results In the treatment group,postoperative mPD was 93.9-130.4 (M 116.7) Gy,and D90 was 103.6-148.2 (M 130.6) Gy.The LLC time was 4.7 to 24.0 months with a median of 11.6 (95％ CI:8.7-14.6) months.In two cases,there was no recurrence during the follow-up time of 24 months.PFS was 4.7 to 24.0 months with a median of 10.5 (95％ CI:7.4-13.6) months.The recent effective rate of the treatment group was 64.7％ (11/17).CR,PR,SD and PD were 41.2％ (7/17),23.5％ (4/17),23.5％ (4/17) and 11.8％ (2/17),respectively.In the control group,the LLC time was 4.5 to 11.4 months with a median of 7.5 (95 ％ CI:6.7-8.3) months,and the median of PFS was 6.5 (4.5-10.5) (95％ CI:5.7-8.3) months.The response rate,CR,PR,SD and PD were 41.2％ (7/17),5.9％ (1/17),35.3％ (6/17),35.3 ％ (6/17) and 23.5％ (4/17),respectively.There was no statistical significance of the recent effective rate between the treatment group and control group (P =0.30),but the LLC time (x2 =8.40,P ＜ 0.01),the median of PFS time (x2 =6.27,P ＜ 0.05) and CR (P =0.04) of the treatment group were all significantly higher than those of the control group.Concltusion The implantation of 125I seeds combined with chemotherapy for recurring stage Ⅲ NSCLC patients is safe and effective,and its efficacy is superior to the second line chemotherapy alone.

Objective To investigate the expression of Dickkopf-3 (Dkk-3) in esophageal cancer and normal esophageal tissue and the relationship between Dkk-3 expression and the biological behaveior of esophageal cancer. Methods Immunohistochemical method of S-P was used to examine Dkk-3 expression in 69 cases of esophageal squamous cell carcinoma and 5 cases of normal esophageal tissue with non-tumor tissue microarray and the results were analyzed and correlated with their clinical and pathological features. Results Positive Dkk-3 expression was observed in 65.7% (44/67) of the esophageal squamous cell carcinoma cases, but only one of the five cases with normal esophageal tissue showed positive microvascular expression of Dkk-3. In cases with positive expression of Dkk-3 significant differences were found in fiber membrane infiltration, depth of invasion, lymph node metastasis and TNM staging (P < 0. 05), while no significant differences were found in the age, gender and pathological grading (P > 0. 05). Conclusions The upregnlation of Dkk-3 expression in esophageal squamous cell carcinoma may contribute to tumor invasion and metastasis.

Objective To report the clinical observation and nursing points for recurrent or refractory and aggressive non-Hodgkin's lymphoma treated with MINE regimen. Methods Patients (46 cases) with recurrent or refractory and aggressive non-Hodgkin's lymphoma were given mental nursing,preparation and evaluation of the condition of patients before chemotherapy. Complications especially extravasation of infusion fluid should be prevented during chemotherapy and myelosuppression and long-term complications should be prevented after treatment. Results No patient died after treatment but several complications such as infection(14 cases), nausea and vomiting (grade Ⅰ～Ⅱ, 22 cases, grade Ⅲ,2 cases), alopecia (grade Ⅰ～Ⅱ, 27 cases), mucositis (grade Ⅰ～Ⅱ, 4 cases), liver function lesion (grade Ⅱ, 1 case) were found and improved after proper treatment. No nephrotoxicity and hemorrhagic cystitis were found. Conclusions Selective mental nursing,proper chemotherapy preparation,evaluation of patients' condidtion and positively prevention of chemotherapy-related complications could increase the chemotherapy effect of patients with recurrent or refractory and aggressive non-Hodgkin's lymphoma.

Objective To explore high-risk factors that affect the severity of diabetic foot ulcers and the relationship between the severity of diabetic foot ulcers and the general somatic conditions by analyzing clinical data of 218 diabetic foot patients.Methods A retrospective analysis of the clinical data of 218 diabetic foot patients,admitted from 2006 to 2010 was performed.Fasting and postprandial blood glucose ( FBG and PBG ),glycosylated hemoglobin,hemoglobin,serum albumin,serum creatinine,as well as serum urea nitrogen and fibrinogen were determined in patients with different Wagner levels.The effects of peripheral arterial disease,neuropathy,infections and other factors on severity of diabetic foot ulcers,and the prognosis of those patients with different Wagner levels were analyzed.Results ( 1 ) FBG and PBG in Wagner 5 patients were significantly higher than those in Wagner 1,but there was no statistical significance in HbA1C difference.(2) Hemoglobin,total cholesterol,serum albumin in Wagner 5 patients were decreased significantly ; white blood cells,serum creatinine and fibrinogen were increased significantly ( P＜0.01 ).(3) The intima-media thickness(IMT) of femoral artery in Wagner 2-and-above patients was increased significantly compared with that in Wagner 1 ( P＜0.05 ).( 4 ) Logistic regression analysis showed that hemoglobin,fibrinogen,glycated hemoglobin,femoral artery intima-media thickness,and bacterial infection were correlated independently with the severity of diabetic foot ulcers.(5) The hospitalized days were increased with rising Wagner levels ; the prognosis of Wagner 5 patients was the worst,with the highest mortality in the group.Conclusions Changes in blood level of hemoglobin,fibrinogen,along with higher HbA1C and femoral artery IMT,as well as infections are high-risk factors of severity in diabetic foot patients.HbA1C is not a good indicator of blood glucose control in patients with Wagner 5 grade.The higher the Wagner grade,the longer the time spent in hospital,and the worse the prognosis wouldbe.

Objective To investigate the role of outer membrane protein in clinical isolated car-bapenem resistance Acinetobacter baumannii. Methods Carbapenem resistance and sensitive strains were collected from the same patient. After MIST and REP-PCR analysis, carbapenemases were detected by isoe-lectric focusing. Different expressed membrane proteins were identified by two-dimension electrophoresis and mass spectrometry analysis. We also used efflux pump inhibitor PAβN(Phe-Arg-β-naphthylamide) to con-firm the phenotype. Results Carbapenem resistance and sensitive strains were attributed to the same pat-tern. At positions of P17.6 and P19.0, two β-lactamases were expressed in two investigated strains, no cabapenemases were detected. Six differential expressed membrane proteins were identified, a 34 × 10~3 membrane protein that was confirmed by efflux pump inhibitor PAβN experiment (imiponem MIC decreased from far above 32 μg/ml to 8μ/ml) and OprD and CarO. Conclusion Up-regulation of exported protein accompanied with down-regulation of OprD and CarO other than carbaponemases are responsible for carbap-enem resistance in A. baumannii.

Objective To establish a reverse transcription nested polymerase chain reaction ( RT-nPCR ) assay for detection of tree shrews orthoreovirus (TRV).Methods Three strains of TRV were respectively isolated from fresh feces of three tree shrews that came from the same field at different times .We designed and synthesized two pairs of MRV L1 gene nested primers and established the system of RT-nPCR.The TRV RNA was extracted and reversely transcribed to cDNA as a template for nested-PCR amplification.The developed RT-nPCR was optimized.The specificity and sensitivity were tested.Finally, the RT-nPCR was used to detect TRV in 25 tree shrew samples.Results Taking the genomic RNA of TRV as template, the RT-nPCR was able to amplify a specific fragment band targeting the L 1 gene, while there were no target bands in the normal cell control , ( Wa strain rotavirus , hepatitis A virus , and herpes simplex virus ) .The RNA of TRV was diluted by 1:10 to 1:109 .Each dilution sample was analyzed by the RT-nPCR.The minimum detectable concentration of RNA was 0.01 pg/μL.The results of RT-nPCR detection showed that 4 of the 15 tree shrews were TRV-positive in the survival group , and 10 of 10 tree shrews were TRV-positive in the death group . Conclusions The RT-nRCR assay established in this study is accurate , specific and sensitive .Therefore, it can be used for routine detection of TRV in quality assurance testing .

Objective To discuss the treatment of periprosthetic femoral fractures (PFF) with unstable prosthesis by replacement of long-stem femoral prosthesis and internal fixation.Methods From December 2005 to December 2014,15 PFF patients with unstable prosthesis (15 hips) following were treated at our department.They were 10 men and 5 women,aged from 64 to 89 years (mean,76.2 years).Their primary surgeries included total hip arthroplasty in 13 cases and biological bi-polar replacement of femoral head in 2.Two prostheses were cement and 13 biological.By Vancouver classification,9 cases were type B2,and 6 type B3.The unstable prostheses in the 15 cases were replaced by long-stem femoral ones,followed by internal fixation.At the last follow-ups,clinical outcome were evaluated by Harris scoring and images of PFF by Beals & Tower criteria.Complications were documented.Results One died 4 months after operation.The other 14 patients were followed up for an average of 4.5 years (from 6 months to 9 years).Fracture union was achieved in 12 cases after an average of 3.9 months (from 3 to 9 months).Nonunion occurred in 2 cases.Imaging evaluation revealed 9 excellent cases,3 good ones and 2 poor ones.The Harris scores at the last follow-up averaged was 82.3 points (from 50 to 100 points).Deep vein thrombosis occurred preoperatively in one case and posterior tibial vein thrombosis occurred in 2 cases respectively on day 3 and day 10 postoperatively.No such complications occurred as malunion,fixation failure,dislocation or prosthesis loosening.Conclusion Satisfactory outcomes can be achieved by replacement of long-stem femoral prosthesis combined with appropriate fixation for treatment of PFF with unstabrosthesis.

Objective To evaluate the clinical experience of applying the combined tacrolimus (FK506) and mycophenolate mofetil (MMF) in simultaneous pancreas and kidney transplantation (SPKT) with bladder drainage of pancreatic secretion. Methods SPKT was performed for 14 consecutive patients. On the first day after transplantation, triple immunosuppression therapy was appliedwith FK506(0.07-0. 15 mg·kg-1·d-1), MMF(1.0- 1.5 g/d) and prednisone (25 mg/d). The FKS06 blood concentration after oral administration was assayed by the means of MEIA. The occurrence of rejection and the drug toxicity were monitored and recorded. Results Nine recipients survived with the grafts and their general conditions were well. They were followed up for 18--70 months (mean 34 months). There was no early stage complication such as pancreatic fistula and thrombosis after operation. The blood glucose level returned to normal range after operation. All recipients survived over 1 year. Of them, 3 cases survived for 1-3 years,1 case survived for 3-4 years, 1 case survived 4-5 years and 4 cases survived over 5 years. All the cases had normal blood glucose level and early graft function. Removal of allograft pancreas was performed on one patient because of hyperacute rejection. There were 4 cases died. Of whom, one case was diagnosed with duodenal stump leak 45 days after transplantation and he died of corrosive hemorrhage 7 months after operation. One patient died of unexpected heart disease. The 3rd patient died ol multiple organ failure and the fourth case died of acute rejection. Four cases with acute rejection, 2 cases with renal toxicity and 1 case with hepatotoxicity were observed. Conclusions The combination of TAC/MMF has synergetic effect. The application of this combination has good immunosuppression result. It could effectively reduce the risk of acute rejection and improve graft survival in SPKT recipients.

Objective To investigate the changes of hippocampal neurogenesis and cognitive dysfunction induced by cranial radiation therapy.Methods C57BL/6J mice aged 10 d were subjected to 10 Gy whole brain irradiation with 6 MV X-rays to develop irradiation-induced brain injury model.Morris water maze was designed to estimate spatial learning and memory.At different time post irradiation,brain tissue was removed to stain with hematoxylin-eosin for the pathological results.DCX and PCNA immunohistochemical staining was used to mark the level of neurogenesis in the hippocampus,and ED1immunohistochemical staining to mark the activation of microglia.The TUNEL assay was used to assess the apoptotic neuron death in situ in the hippocampus.Real-time PCR was supplied to inspect the expression of TNF-α and IL-1 β mRNA.Enzyme Linked Immunosorbent Assay (ELISA) was tested for the concentration of TNF-αt in the plasma.Results Pathological studies demonstrated that radiation could induce interstitial edema,inflammatory cell infiltration,cell degeneration,necrosis,apoptosis in the acute phase,edema subsiding,reduction of inflammatory cells,and cytothesis in the dentate gyrus of the hippocampus.IHC studies revealed that,at different time post irradiation,the number of DCX-positive cells and PCNA-positive cells decreased (F =4.9-12.5,5.2-15.7,P ＜ 0.05) but ED1-positive cells increased significantly (F =20.8,P ＜ 0.05).TUNEL-positive cells began to appear in the dentate gyrus of hippocampus 6 h post-irradiation,and its number reached to the highest level at 48 h post-irradiation (F =15.1,P ＜ 0.05).The formation of γ-H2AX foci got at the top 0.5 h post-irradiation (F =18.4,P ＜0.05) and then decreased.After irradiation,the expressions of TNF-α and IL-1β mRNA in the the irradiated group was higher than those of the control group (t =16.3,12.7,P ＜ 0.05).The concentration of TNF-α in the plasma of the irradiated group was higer than that in the control group 3 h post-irradiation,and maximized at 1 week post-irradiation (F =10.5,P ＜ 0.05).Morris water maze tests showed that the latency had no significant differences between the irradiated group and the control group at 1,2,3 d postirradiation,but the latency in the irradiated group was longer than that in the control group with a significant differences at 4,5,6 d post-irradiation (F =7.01,8.17,4.22,P ＜ 0.05).Conclusions Irradiation-induced cognitive dysfunction may be caused by microglial activation and suppression in hippocampal neurogenesis following cranial radiation therapy.