Objective: To explore the effect of cognitive therapy on obsessional compulsive disorder (OCD). Method: Forty-seven patients with OCDO were randomly assigned to cognitive therapy group and conventional treatment group, the later with paroxetine treatment only as control. The results were assessed with Hamilton anxiety scale (HAMA), Yale-Brown Obsessional Compulsive Scale and social disability screening scale. Result: The cognitive therapy group had lower scores in HAMA and Y-BOCS than the control group after 8 weeks therapy, this difference remained in the follow-up after 6 months, when the cognitive group had also lower score in social disability. Conclusion: Cognitive therapy can benefit patients with OCD more than medication only.

Objective] To observe the clinical efficacy of Agkistrodon in treating Sjogren's syndrome. [Methods] 52 patients were randomly divided into two groups: Treatment of 26 patients taking Agkistrodon and the basic prescription medicine(YIQIYANGYINQUYU drugs); 26 patients in the control received the basic prescription medicine. The clinical symptoms,the disease activity score of SSDAI,the score of TCM symptom and life quality and the index of serology were recorded in this clinical observation. [Results] The treatment group had better results of immune function than the control group after treatment, in particular had a substantial decrease in IgG. In addition, the clinical symptoms, the disease activity score of SSDAI, the score of TCM symptom and life quality were improved. [Conclusion] Agkistrodon has significantly immunosuppressive effects on the patients with Sjogren's syndrome , thus improving the patients' condition,the standard of living and the quality of life.

Objective To search a kind of ideal seeded cell of bone tissue engineering. Methods Bone marrow tissue was fetched from rabbit,got bone marrow stromal cells by the method of density centrifuge,observed the conformation,growing feature and osteogeneric capability of the cells during culture in vitro by light microscope,transmission electron microscope and measure of osteogeneric capability. Results Most of the cultivated bone marrow stromal cells were triangle-like or shuttle-like cells. They growed and breeded rapidly,and had osteogeneric capability. They were easy to differentiate to osteoblasts. Conclusion The cultivated bone marrow stromal cells are matured ones,and could become the more ideal seeded cells for bone tissue engineering.

Objective To investigate healthcare-associated infection(HAI)in different departments in a children’s hos-pital,and provide scientific basis for effective prevention and control of HAI in children.Methods By bed-side visiting and medical record reviewing,survey on HAI prevalence rate was conducted among hospitalized patients in a given day in 2012, 2013,and 2014 respectively,and surveyed data of three years were analyzed.Results HAI prevalence rates in 2012,2013, and 2014 were 6.52%,5.59%,and 5.85% respectively,there was no significant difference (χ2 =1.02,P =0.60);the average HAI prevalence rate in three years was 5.98%,there was significant difference in average HAI prevalence rate among different departments(χ2 =291.83,P <0.001 ),the top 4 departments of HAI prevalence rate was hematology (27.49%),cardiothoracic surgery (21.13%),neonatal intensive care unit (16.43%),and pediatric intensive care unit (12.76%);the main infection sites were lower respiratory tract (58.44%),upper respiratory tract (22.63%),and gas-trointestinal tract (6.58%);the main pathogens causing HAI was Klebsiella pneumoniae (n=32,28.32%),followed by Acinetobacter baumannii (n=9,7.96%),Escherichia coli (n=9,7.96%),and Pseudomonas aeruginosa (n=7,6.19%). Conclusion Strengthening prevention and control intervention of HAI in high risk departments has important significance to reduce the incidence of HAI in children’s hospital.

Objective To investigate the association between the single nucleotide polymorphisms (SNP)in-308 loci of tumor necrosis factor-α(TNF-α)gene promoter region and chronic hepatitis B (CHB).Methods Genotypes of-308 loci of the TNF-αpromoter were examined by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP)in 142 patients with chronic hepatitis B (CHB group)and 150 healthy controls (HC group).The indexes for evalua-ting the curative effect were the ALT,AST,HBeAg,HBV-DNA and the viral load weight,HBV-LP and HBV-PreS1,mean-while,the correlations between related indexes and SNP in TNF-α308 loci were explored as well.Results There was no sta-tistical significance in frequency distribution difference of the genotypes and alleles of-308 loci between CHC and HC groups (P>0.05),the protective factors of TNF-α308 allele A may be not associated with CHB (OR=1.529,OR95%CI:0.872~2.684).There was no association between TNF-αgene promoter-308G/A polymorphism and the positive rates of AST, ALT,HBV-LP and HBV-PreS1 (P>0.05),however,TNF-α-308G/A polymorphism associates with the positive rates of HBeAg and HBV-DNA,and A-allele of 308 loci may increase the risk of HBeAg and HBV-DNA positive expression (HBeAg:OR=3.256,OR95%CI=1.105~9.594;HBV-DNA:OR=2.847,OR95%CI=1.059~7.655).Furthermore,A-allele compared with Gallele,statistically significant differences were observed in the certain HBVDNA viral load range of104~107 copies/ml (P <005).Conclusion TNFαgene promoter308G/A polymorphism would not be associated withCHB,but the TNFα308 gene G mutation of Aallele,which was associated with HBVDNA viral load,may be the susceptible factors of HBV infection.

The current treatments of metastatic malignant melanoma include chemotherapy,targeted therapy,immune therapy and radiation therapy,but the treatment outcome is far from optimism.In order to im-prove the treatment efficiency,it is urgent to improve early diagnosis,and develop more effective treatment drugs and delivery systems.The application of nanotechnology in the diagnosis and therapy of melanoma can re-duce the resistance to the drugs,increase efficacy and reduce side effects.

Objective To investigate the status of professional self-concept of nurses and its influencing factors of Clinical registered nursing major in Guangdong. In order to provide the basic theory of improving the level of professional self-concept of nurses. Methods A total of 280 nurses were investigated from different levels and deployment of hospitals by convenient sampling method and with Nursing Professional Self-concept Scale (PSCNI).With variance analysis, two-sample t test and multiple stepwise regression analysis to analyze the influence of professional self-concept of nurses by demographic questions. Results The score of professional self-concept of nurses was (85.79±9.23) points, the project average score was (2.86 ± 0.31) points which were positive. Dimension score of flexibility was the highest which was (3.23±0.44) points. Dimension score of communication skills was the lowest which was (2.62± 0.38)points. Age、years of work, marital status, job title, whether hold executive duties、the choice of career, job satisfaction (t/F=1.29, 1.53, -3.13, 1.88, 3.68, 3.59, 1.68, P<0.01)all had a significant impact on professional self-concept of nurses. And age, the choice of career and job satisfaction (t=4.385,-2.889,-2.268, P=0.000, 0.004, 0.024)were three main related factors of the score of professional self-concept. Conclusions The professional self-concept of nurses was positive, but it is also unbalanced. Nursing managers should be concentrate on increasing the level of professional self-concept of young and involuntary nurses, and also according to the characteristics of hospitals and departments to improve the job satisfaction of nurses to achieve the purpose of improving the professional self-concept of nurses themselves.

Objective To explore the clinical application of extracorporeal membrane oxygenation (ECMO) assisted cardiopulmonary resuscitation (CPR)in the treatment of critically ill children with cardiac arrest.Methods The clinical data of critically ill children due to cardiac arrest who were treated with ECMO assisted CPR from June 2012 to December 2015 in Affiliated Bayi Children's Hospital,Clinical Medical College in Army General Hospital,Southern Medical University were retrospectively reviewed,and the datas were analyzed by SPSS 20.0 software.Results A total of 17 patients received ECMO assisted CPR treatment,13 cases were male,4 cases were female,aged from 5 hours to 5 years old,the weight ranged from 3 to 16 kg;5 cases survived,and the survival rate 29.41％;12 cases died,the mortality rate 70.59％,of which 5 cases died of hear failure in withdrawal of ECMO,and 7 cases died of complications after withdrawal of ECMO.The age,sex ratio,body weight and other demographic data between 2 groups were not statistically significant (all P ＞ 0.05).There was no significant difference in the primary diseases between 2 groups (P ＞ 0.05).There was no significant difference in CPR time and ECMO support time between 2 groups (t =1.541,0.375,all P ＞ 0.05).Among 11 cases of children with ECMO-related complications,the incidence rate was 64.71％,the incidence of complication in the survival group was significantly less than that in the death group (x2 =8.709,P =0.003).The common complications of ECMO were bleeding,acral necrosis,infection,multiple organ failure,nervous system injury and acute kidney injury.There was no significant difference in the level of lactic acid between the survival group and the death group (P ＞ 0.05) before ECMO support started,but after 24 h of ECMO support,the lactic acid level in the survival group was significantly lower than that in the death group (t =2.896,P =0.014).Conclusions ECMO assisted CPR can improve the survival rate of critically ill children who have cardiac arrest and have no response to the conventional CPR.The serum lactic acid level after 24 h ECMO support has a guiding significance for the prognosis assessment,and ECMO patients' complications are still the most important factor affecting the prognosis of ECMO assisted CPR patients.

Objective To explore the relationship between the overlap volume of organ at risk (OAR) and target (Voverlap) and the mean dose to OAR (DmOAR) in intensity-modulated radiotherapy (IMRT).Methods Fifty randomly selected patients undergoing IMRT for nasopharyngeal carcinoma (NPC) and an equal number of patients undergoing radical IMRT for cervical cancer in our hospital were enrolled as subjects.The relationship between Voverlap and DmoAR in IMRT was analyzed.The Matlab software was used to generate function to fit the relationship between Voverlap and DmOAR for different OARs.Results The Voverlap varied among patients with NPC or cervical cancer.The ratio of Voverlap to the volume of OAR (VOAR) was positively correlated with the ratio of DmOAR to the prescribed dose (Dp) (all P=0.01).A function was generated to fit the correlation between Voverlap/VOAR ratio and DmOAR/Dp ratio.Conclusions In IMRT,patients have different Voverlap/VoAR ratios due to varicd target volume,disease stages,OAR filling status,and OAR volume.As criteria for plan verification,a specific DmOAR value for each OAR should be calculated before radiotherapy planning based on the corresponding correlation function and the Voverlap/VoAR ratio with a fixed dose prescription.It can be used to reduce the subjective influence on the optimization of radiotherapy planning.

Objective:To introduce a novel surgical technique for dissecting perforator vessels (orderly retrograde four-side dissection) in anterolateral thigh perforator flap (ALTPF) and explore its clinical outcome.Methods:Respective analysis of 94 patients who underwent reconstruction of soft tissue defects with ALTPF which were dissected by orderly retrograde four-side dissection between June, 2013 and December, 2016. After surgery, the survival of flaps, recovery in shape and function of the recipient sites, and the effect on shape and function of the donor sites were observed.Results:The size of ALTPF ranged from 7 cm×5 cm to 32 cm×10 cm. Ninety-four perforators were included in 94 ALTPF, which were 89 perforators of the descending branch of circumflex femoral lateral artery, 4 perforators of the transverse branch of circumflex femoral lateral artery and 1 perforator of femoral medial artery. The time for flap harvesting was 35-95(54.39±16.39) min. Success rate of perforator harvesting was 98.9%, only 1 perforator was injured and another encountered vasospasm during surgery. Three cases had vascular crisis after flap transfer with 2 venous crises and 1 artery crisis. All of the flaps completely survived except 1 that had a partial necrosis. The follow-up time was (12.91±9.17) months. No muscular weakness on donor sites was shown in all cases.Conclusion:Orderly retrograde four-side dissection of perforator vessels in the ALTPF has achieved less donor site morbidity, shorter surgical time and is safer than the traditional techniques. It is a reliable technique to harvest perforator flaps.