Objective To explore the characteristics of family functioning between parents and adolescent and the association of adolescents' self-esteem,and depression.Methods Data were collected from reports of 257 middle school students and their parents in Shanghai,and by self-evaluation questionnaires including the depression scale,the self-esteem scale,and the family adaptability and cohesion scale.Results ①Adolescent perceived more negative than parents in the family adaptability (69.02 ± 11.49),(70.60± 9.60) and cohesion (43.84 ± 9.25),(46.56±7.86),and the difference in family adaptability were significant (t=4.064,P＜0.01).② Adolescents' self-esteem positively related to their family cohesion(r=0.525) and adaptability (r=0.427,P＜0.01),while depression negatively related to family cohesion(r=-0.565) and adaptability (r=-0.475,P＜0.01).③Students in families with high adolescent-parent perceptual differences in family functioning showed more depressive symptom,lower level of self-esteem than those in low adolescent-parent perceptual differences,and the difference were significant (P＜0.05).Conclusion Adolescents' self-esteem,depression symptoms are significantly related to their familyadaptability and cohesion,the adolescent-parent perceptual differences in family functioning may also affect adolescents' psychological well being.

This paper briefly introduces the frame structure, design concept and main functional modules of outpatient emergency care information system developed by our hospital. This system can optimize the procedure when patients seek medical advice, create warm medical circumstances, increase work efficiency of medical care personnel, strengthen quality management of medical cases and promote hospital modern construction.

Aim To study the single nucleotide poly-morphism ( SNPs ) of AMP-activated protein kinase ( AMPK) ?2 subunit gene PRKAA2 ( rs2051040 and rs17848595) and its relationship with metformin response. Methods A total of 32 patients with type 2 diabetes( T2DM) were enrolled. All patients were required to take metformin for 1 week. The serum levels of FPG,TG,TC,LDL-C,HDL-C were assayed before and after therapy. The gene polymorphism of PRKAA2 was analyzed by PCR-DGGE,the effects of metformin were compared between patients with different phenotypes. Results FPG,TG,TC,LDL-C were significantly improved after therapy in wild genotype carriers( P 0. 05) . Conclusion The results of this study suggest that PRKAA2 polymorphism may be associated with metformin treatment effects in T2DM patients.

Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.

Objective To explore an ideal surgical treatment for cervical sear eontraeture. Methods From January, 2005 to December, 2008, 11 eases of cervical sear contraeture (Ⅱ-Ⅲ) were treated with the expanded flaps based on the cervical cutaneous branch of transverse cervical artery. At the first step, one or two soft tissue expanders were implanted beneath the skin at the clavicular-pectoral region. At the second step, after fully expanding, an expanded clavicular-pectoral flap that based on the cervical cutaneous branch of transverse cervical artery was designed and raised completely according to cervical cutaneous defect. And then, the flap was transferred to reconstruct the defect in cervix. The donor area was closed directly or covered with graft. Results The 11 cases were performed with unilateral flaps based on the cervical cutaneous branch of transverse cervical artery. No necrosis occurred. And the cervical contour and function have been mended. All of them had been followed up for 6-18 months with satisfactory results. Conclusions This procedure can be very useful for the plastic and reconstruction surgeons who are confronted with a difficult case of cervical scar contracture. By this means, a lot of materials of reparation with similar color, and texture can be obtained. And this method is simple, safe, and effective.

Objective To explore the effects of Medpor in surgical treatment of craniofacial de-pressed deformities. Methods Combining with other surgical methods, 37 patients with craniofacial de-pressed deformities were treated with Medpor. Of them, 29 cases of craniofacial depression and defects subjected to trauma, 6 cases were progressive facial hemiatrophy and 2 case were angle of mandible de-formity. All were followed up from three months to four year. Results Facial configurations and func-tions of all the 37 cases were greatly improved after the treatment, without any complication of infection or rejection;patients were all very satisfactory or relatively satisfied with the results. Conclusion Med-por is an ideal implant material to correct the deformity of earaniofacial, and combining with others methods, the treatment of earaniofacial deformity can obtain good results.

Objective To investigate the association between serum homocysteine (Hcy) level and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods The 123 patients from January 2007 to June 2010 were recruited and divided into the elderly OSAHS group (n=55) and the non-elderly OSAHS group (n=68). One hundred healthy subjects were selected and divided into the elderly control group (n=52) and the non-elderly control group (n=48). The PSG variables were recorded and the levels of Hcy, malondialdehyde (MDA) and glutathione (GSH) were detected after sleep in all subjects. Serum Hcy level was measured by cyclophorase, MDA and GSH levels were measured by spectrophotometer. Results There were statistical differences in Hcy concentration between four groups (F=28.26, P=0.000). The Hcy concentration was higher in elderly OSAHS group than in other groups, and was higher in elderly control group than in non-elderly control group, and was higher in non-elderly OSAHS group than in non-elderly control group. There were statistical differences in MDA and GSH concentrations between the four groups (F=5.56, P=0.002;F=4.79, P=0.004). The concentrations of MDA and GSH were higher in elderly OSAHS group than in other groups. Multiple regression analysis indicated a statistically significant relationship of Hcy concentration with age, MDA, GSH and AHI (β=0.07, 0.50, 0.23 and 2.00). Conclusions The concentration of Hcy increases and oxidative stress enhances with aging, especially in the elderly patients with OSAHS. The mechanism of high level of serum Hcy in elderly patients with OSAHS may be the high oxidative stress.

Objective To explore the expression of negative costimulatory molecule B7-H1 of myeloid derived suppressor cells(MDSCs) and its roles in age-related immunosuppressive functions.Methods 36 C57BL/6 mice were divided into 2 groups:the elderly group(12-month-old,n=18) and the young group(4-8-week-old,n=18).The expressive level of negative costimulatory molecules of MDSCs in the two groups was measured by flow cytometry(FCM).Besides,MDSCs were sorted by using MDSC isolation kit and T cells were obtained by grinding lymph nodes.To explore the influence of B7-H1 on the MDSCs' immunosuppressive functions,T cell proliferation and intervention assay was conducted using the five following groups:T cells group,T cells + CFSE group [T cells with carboxyfluorescein diacetate succinimidyl ester(CFSE)],T cells +-CFSE cocultured with MDSCs from the young group,T cells + CFSE cocultured with MDSCs from the elderly group,and T cells + CFSE cocultured with MDSCs from elderly group and anti-B7-H1 blocking antibody.The effect of B7-H1 on T cell proliferation in MDSCs were observed.Results The expression level of B7-H1 of the MDSCs was significantly increased in the elderly group as compared with the young group(t=3.27,P＜0.05).T cell proliferation assay revealed that T cells were remarkably suppressed by MDSCs in elderly group as compared to the youth group(t=5.42,P＜0.05).The suppression of T cells by MDSCs was dramatically reversed by anti-B7-H1 blocking antibody in elderly group(t=8.28,P＜0.05).Conclusions B7-H1,a molecule expressed on the surface of MDSCs,plays a key role in the age-related immunosuppressive function of MDSCs.

Objective To explore the influence of the combination therapy of probucol with atorvastatin on levels of serum high sensitivity C-reactive protein (hs-CRP), oxidized low-density lipoproteins (ox-LDL), and marix metallopro? teinase-9 (MMP-9) and resolution of carotid plaque in patients with acute cerebral infarction (ACI). Methods One hun? dred-six patients with acute cerebral infarction who had carotid artery color Doppler ultrasound-confirmed atherosclerot? ic plaques , were included in the present study. The patients were randomly divided into two groups: conventional treat? ment group ( 40 cases) which received atorvastatin (20mg/d) and co-treatment group (40 cases) which received Atorvas? tatin (20mg/d) and Probucol (500mg/d). Levels of hs-CRP, ox-LDL and MMP-9 were detected in all patients before treat? ment and 1, 6 and 12 months after drug therapy. The Intima-media thickness, area and numbers of carotid plaques were evaluated by using Doppler ultrasonography during a 12 months follow-up period. Results ① Serum hs-CRP and MMP-9 levels were significantly decreased at 1, 6 and 12 months after treatment, (conventional treatment group:t =14.662, 23.586, 28.179 and co-treatment group:t =47.023, 50.239, 50.774,P <0.01). The ox-LDL levels was obviously de? creased in the combined treatment group (t =4.592, 5.011, 5.892,P <0.01) but not in conventional treatment group (P > 0.05) at 1, 6 and 12 months after treatment. Serum hs-CRP, ox-LDL and MMP-9 levels were significantly lower in com? bined treatment group than in the conventional treatment group at all time points after treatment (t =7.655, 5.271, 2.492, t =4.927, 3.772, 4.673 andt =16.862, 4.251, 2.045.P <0.01 orP <0.05). ②There were not statistically differences in the IMT, plaque area and plaque numbers between these two groups before treatment (P >0.05). The IMT, plaque area and plaque numbers were significantly smaller in combined treatment group than in conventional treatment group (t =6.117, 3.290, 2.158,P <0.05). Conclusions The combination therapy of probucol with atorvastatin can greatly reduce levels of serunl hs-CRP,ox-LDL and MMP-9, indicating that the combination therapy has a strong anti-oxidant function, thereby reversing and stabilizing the atherosclerosis plaque.

Objective To explore the relationship between adipocyte fatty acid binding protein (A-FABP) and lower limb vascular disease (LLVD) in the elderly with type 2 diabetes(T2DM).Methods Bilateral lower limb vessels were checked by the High Resolution Color Doppler in all the subjects,including 40 healthy subjects as control (group A),126 T2DM patients.42 T2DM patients had no LLVD (group B),40 had mild LLVD (group C),and 44 had severe LLVD (group D).The levels of plasma A-FABP,blood glucose,lipid profiles,HOMA-IR,hypersensitive C reactive protein (hs CRP),and e-glomerular filtration rate were determined.Results The levels of plasma A-FABP were in the following ascending order of group A(4.5± 1.7)μg/L＜group B(6.1±2.1)μg/L＜group C (7.2 ± 2.3)μg/L ＜ group D (8.4 ± 3.2)μg/L (P＜ 0.01).A-FABP levels elevated along with the decrease of ABI and the increase of L IMT.Multiple logistic regression analysis showed that A FABP levels was main influencing factor of lower limb vascular disease (LLVD) in the elderly with type 2 diabetes.LDL C,HbA1c,HOMR-IR,hs-CRP were the predictive factors for the plasma A-FABP levels in the elderly with T2DM after multiple stepwise regression analysis.Conclusions For elder T2DM patients,the level of plasma A FABP is correlated with the degree of LLVD,and plays an important role in the progress of LLVD.