BACKGROUND:Oppositional defiant disorder(ODD) often occurs as a comorbid condition of attention deficit hyperactivity disorder(ADHD),characterized by defiant behaviors.ADHD children with ODD have more extensive impairments than those with ADHD alone. Some studies suggest that decreased serum 5 hydroxytryptamine(5 HT) level is related to aggressive behavior in ADHD, but no relevant report is available in China. OBJECTIVE:To investigate the clinical features of ADHD with ODD,and their relations with serum 5 HT. DESIGN:A randomized case controlled study taking the ADHD children with or without ODD as the subjects for study. SETTING:Mental Health Institute of the Second Xiangya Hospital. PARTICIPANTS:Sixty one ADHD children(53 boys and 8 girls) aged 7 to 14 years visiting the Children's Clinic of Mental Health Institute of Central South University from June 2002 to May 2003 were recruited and divided into two groups based on the symptomatic criteria of ODD recommended by the Diagnostic and Statistical Manual of Mental Disorder(DSM Ⅳ ):ADHD group(n=33,without ODD) and ADHD+ ODD group(n=28). INTERVENTIONS:The parents of the enrolled children(n=61) were asked to complete the Achenbach child behavior checklist (CBCL),and the teachers(n=31) completed the teacher's report form (TRF).Two milliliters of fasting venous blood was drawn from these children and the serum separated by centrifugation for quantification of 5 HT using external standard method,and whole blood 5 HT was analyzed by LD 10AD high performance liquid chromatography(HPLC). MAIN OUTCOME MEASURES:Scores of CBCL,TRF and Chinese Wechsler Intelligence Scale for Children(C WISC) and serum 5 HT levels. RESULTS:In the ADHD+ ODD group,the scores of CBCL and TRF for externalizing, aggressive behaviors and total scores for behavioral problems rated by the parents and teachers were significantly higher than those of the ADHD group(t=2.28 to 3.76,P< 0.05 to 0.01);the former group also had significantly higher scores of CBCL for anxiety/depression and internalizing(t=2.27 to 2.35,P< 0.05), but had significantly lower serum 5 HT level[(327.01± 164.84) μ g/L vs (451.11± 250.89) μ g/L](t=2.32,P< 0.05). CONCLUSION:Children with ADHD and comorbid ODD receive poorer ratings on all variables including externalizing and internalizing problems,adjustment variables and attention impairment. Increased aggressive behavior and lowered 5 HT level may be the biological markers of impulsive behavior in ADHD children with ODD.

Objective: To explore the relationship between internet overuse and time management disposition in middle school students. Methods: Using Diagnostic Questionnaire for Internet Addiction (YDQ), Time Management Disposition Scale (TMDS), we investigated 2620 middle-school students.Results:The incidence rate of internet overuse among middle school students was 2.4 %. The difference of time management disposition between internet overuse group and control group was significant(129.7?25.3/150.0?28.5,t=4.27, P

This article has reviewed aesthetic discipline development history of medical science and history of Medical aesthetic education in our country,and the current situation of medical aesthetic education,and has carried on rational thinking on how to improve the professional medical aesthetic education of medical universities.

Objective:To investigate the effect of group psychotherapy on middle school students with internet overuse(IOU).Methods:A total of 2620 middle-school students from four middle schools of Changsha City were surveyed using Diagnostic Questionnaire for Internet Addiction (YDQ), According to the YDQ criterion and clinical interview, 64 students who were diagnosed as Internet overuse. 29 middle school students with IOU from one regular middle school and one key middle school received group psychotherapy. 35 middle school students with IOU from the other two schools were taken as control(control group). All the students in both groups were assessed with Diagnostic Questionnaire for Internet Addiction(YDQ), Chen Internet Addiction Scale(CIAS), The Screen for Child Anxiety Related Emotional Disorders(SCARED), Strength and Difficulties Questionnaire(SDQ). Results: The scores 0f SCARD and SDQ subscale of emotional symptoms of experimental group decreased significantly (t=2.11～2.99,P

s Objective: To investigate the comorbidity of depression and anxiety in primary school students. Methods:565 pupils ranged from 2 to 6 grade in a primary school were tested by The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Children (DSRSC). Results: There were 140 pupils with a total score higher than cut-off point of SCARED; 97 pupils with a total score higher than cut-off point of DSRSC; 43 pupils with total scores higher than cut-off point of both SCARED and DSRSC, and the positive rate of comorbidity of anxiety and depression was 7.61%. 30.71 percent of children with anxiety disorder was considered co-morbiding depression; 44.33 percent of children with depressive disorder was considered comorbiding anxiety. Chil-dren with comorbidities had higher scores in Withdrawn(mean rank 297.7 ) than Anxiety group(220.8) and Depressive group(202.2);Somatic Complaints(268.2)than Anxiety group (232.2 ) and Depressive group(206.2 ) , Anxious/Depressed (277.2 )than Anxiety group (227.7 ) and Depressive group(219.2 )of CBCL(?~2 =16.72～22.71,P

Objective To evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) and its characteristics in elderly patients with cardiovascular diseases, and provide reference for the clinical decisions. Methods All patients who were hospitalized in department of cardiovascular medicine from January to June in 2007 were invited to participate in the current study. A total of 317 hospitalized elderly patients were recruited into this study. All participants were assessed by portable bedside nocturnal polysomnograph and Epworth sleepiness scale (ESS). Results Among 317 patients, 281 cases (88.6%) met the criterion of obstructive sleep apnea (OSA) [apnea and hypopnea index (AHI)≥5] and 47 cases (14.8%) met the criteria of obstructive sleep apnea syndrome (OSAS) (AHI≥5 and ESS≥9). When the severity of OSA (as indicated by AHI) was considered as a dependent variable, multiple regression analysis indicated that it was significantly associated with minimal SaO2 and the oxygen desaturation index, while age, habitual snoring, ESS, BMI, mean SaO2 and the duration of SaO2≤ 90% did not show significant effects on the severity of OSA. Conclusions High prevalence of obstructive sleep apnea syndrome (with daytime sleepiness) is found in elderly hospitalized patients and the rate of obstructive sleep apnea is much higher in patients without daytime sleepiness symptoms. Minimal SaO2 and the oxygen desaturation index are the important predicting factors for the severity of OSA, while age, BMI, habitual snoring, sleepiness are not correlated with the severity of OSA after adjusting minimal SaO2 and oxygen desaturation index.

Objective To investigate the effects of sevoflurane anesthesia on learning and memory functions and S100β protein in anaplasis in the 7-day-old rat.Methods 48 SD rats of both sexes aged 7-day-old weighing 1 2-1 6 g were randomly divided into 3 groups (1 6 rats in each group):group A and group B inhaled 3 ％ sevoflurane in oxygen(1L/min) for 6h and 2h respectively; group C inhaled oxygen(1L/min) only.After inhalation,the effects of sevoflurane anesthesia on learning and memory function were assessed by Morris water-maze test and Y-maze test from 16d to 24d.The rats were killed in the day of 8d and 25d respectively,and the blood were collected for the expression of serum concentration S100β protein by enzyme-linked immunosorbent assay.Results (1) Results of Morris water-maze test:Compared with group C,escape latency prolonged in group A and group B in 17-20d(P ＜ 0.05 or 0.01) ;escape latency prolonged in group A compared with group B in 19-20d(P ＜ 0.01) ;but there were no significant differences in the probe time in original platform quadrant and the frequency of crossing original platform among three groups(P ＞0.05).(2) Result of Y-maze test:In 22d,the total reaction time of group A and B were longer than group C (P ＜0.05 or 0.01),and the error number was increased in group A and B compared with group C(P ＜ 0.01) ; while in 23-24d,there were no significant differences between every index of each groups (P ＞ 0.05).(3) Results of the blood serum index:In 8d,serum concentration of S100β protein was significantly increased in group A and B compared with group C (P ＜0.01),and serum concentration of S100β protein was significantly increased in group A compared with group B (P ＜ 0.05) ; But there were no significant differences in serum concentration of S100β protein of each groups in 25d(P ＞ 0.05).Conclusion Sevoflurane anesthesia in the 7-day-old rat can temporarily decrease the ability of learning and memory functions in the length of inhalation time dependent manner,and the mechanism may be related to the increased expression of serum concentration of S100β protein transiently.

Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.

Objective To investigate the effect of valproic acid (VPA) on NKG2D-ligand expression in ARK,OPM2 human myeloma cell lines and their sensitization to natural killer (NK) cell-mediated Killing.Methods Different concentrations of VPA from 0-5.0 mmol/L were used to treat ARK,OPM2 cells respectively,then the cell viabilities were tested by flow cytometry (FCM).Real-time quantitative-PCR and FCM were used to detect the changes in mRNA,protein levels of NKG2D-ligand respectively in the two cell lines treated with 1 mmol/L VPA for 48 hours.The calcein-release-assay (CARE-LASS) was carried out to detect cytotoxic changes of NK cells against mydoma cells after VPA treatment.Results VPA induced the expression of MICA/B,ULBP2 (P ＜ 0.05) and in turn enhanced the NK cytotoxicity on myeloma cells.The enhancing effect of VPA was blocked by NK cells pretreated with anti-NKG2D mAb (P ＜ 0.05).The primary mechanism of NK cell killing of myeloma cells was perforin/granzyme-mediated.Conclusion VPA can induce the expression of MICA/B,ULBP2 in ARK,OPM2 cells,thereby enhancing the cytotoxicity against myeloma cells,which implies a new mechanism of anticancer approach and may be a new approach in myeloma immunotherapy.

Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .