Objective To investigate the role of individualized psychological intervention in gastroscopy.Methods 286 patients first underwent gastroscopy were randomly divided into the intervention and control groups,143 patients in each group. Individualized psychological intervention were provided for intervention group,and the patients of control group were just given routine nursing care. All the patients were measured by self rating anxiety scale (SAS) ,which were as measuring standards before and after intervention. At the same time,the blood pressure and heart rate were compared before and after intervention. Visual analogue scale (VAS) was observed to investigate the satisfaction of patients after operation. Results Compared with control group,anxiety rate and degree,blood pressure and heart rate in intervention group were lower( P ＜ 0. 05 ). The test of VAS revealed that the satisfaction of patients in intervention group was significantly higher than that in control group ( P ＜ 0. 05). Conclusion Individualized psychological intervention could improve negative emotion and relieve anxiety and affliction of patients underwent gastroscopy, and the satisfaction degree for gastroscopy was improved.

Objective To study the effects of BCG-PSN on the expression of the receptor of selectins——one of the important cell adhesion molecules, and the characteristics of cytoskeleton structure in lung cancer cells. Methods The effects of BCG-PSN on the expression of sialyl Lewis X (slex) and the cytoskeleton structure of highly metastatic human pulmonary giant cell carcinoma (PG) cells and lowly metastatic human pulmonary adenocarcinoma (PAa) cells were observed by flow cytometry and transmission electron microscopy. Results Flow cytometric results showed that the expression of slex on the surface of PAa cells (66.8%) was higher than that on PG cells (5.72%). After treatment with BCG-PSN, the expression of slex on PAa cells decreased in a dose-dependent manner. Transmission electron microscopy showed that the microtubules and microfilaments were sparse in the PAa cells and diminished in PG cells. After treatment with BCG-PSN, the microfilaments were more abundant than before in PG cells and showed a branch-like appearance, but still remained sparse in PAa cells. Conclusion Changes in the components of the cytoskeleton structure are associated with the ability of the migration and movement of the tumor cells. The inhibitory effect of BCG-PSN on the adhesiveness of lung cancer cells may not be the cytoskeleton-mediated enhancement of adhesion, but the start-up process resulted from the down-regulation of cell adhesion molecules on the surface of lung cancer cells.

Objective To investigate the application of non-invasive ventilation in children with airway obstructive diseases,especially those who had obstructive sleep apnea syndrome(OSAS).Methods A case follow-up study was conducted between October 2005 and October 2013 in children who had airway obstruction that led to OSAS or chronic respiratory failure and had been given non-invasive ventilation therapy.Children received non-invasive ventilation support,and pressure titration was performed manually in the sleep center while the mode was chosen according to their disease condition.Pulse rate,oxygen saturation or polysomnography were monitored during the treatment.Some patients went on receiving ventilation support when discharged home depending on their disease status.Patients were followed up every 3,6,or 12 months.Results Thirty-seven patients received non-invasive ventilation treatment till October 2013.Thirty-two cases were boys,and 5 cases were girls.The age ranged from 1 year old and 2 months to 12 years old and 6 months.The underlying diseases included OSAS with adenotonsillar hypertrophy,OSAS with mucopolysaccharidosis,mental retardation,cerebral palsy,morbid obesity,and bronchiolitis obliterans.All the OSAS patients had their snoring and apneas relieved,and respiratory distress and daytime symptoms were improved.Regarding the sleep study parameter,the apnea hypopnea index (P ＜ 0.001),obstructive apnea index (P =0.001),oxygen desaturation index(P =0.001),minimum oxygen saturation (P ＜ 0.001) were improved.Till the end of the study,18children (49％)were still receiving non-invasive ventilation,9 children (24％)stopped ventilation after discharge home,4 children (11％)ceased treatment as their symptoms disappeared and polysomnography data was normal,4 children (11％) lost follow-up 3 months after treatment,and 2 children (5％) died of underlying disease.Conclusions Some children with airway obstruction need non-invasive ventilation support.Non-invasive ventilation therapy can be successfully performed in pediatric population.

Objective To evaluate the application value of the micro movement sensitive mattress sleep monitoring system(MSMSMS) in the diagnosis of children with obstructive sleep apnea syndrome (OSAS).Methods One hundred and twenty-nine children aged from 3 to 14 years who visited the sleep center of Beijing Children's Hospital Affiliated to Capital Medical University from June 2013 to June 2015 due to sleep snoring were enrolled.Children with acute respiratory infection,cranial facial abnormalities,chronic lung diseases and neuromuscular diseases were excluded.According to the criteria,36 children were diagnosed as OSAS with average age of (7.3 ± 2.5) years,including 28 males and 8 females.Ninety-three non-OSAS children were recruited with average age of (6.3 ± 2.3) years,including 61 males and 32 females.Subjects were monitored with polysomnography(PSG) and MSMSMS simultaneously.Apnea/hypopnea index (AHI) ＞ 5 or obstructive apnea index (OAI) ＞ 1 were used to define whether OSAS existed.The consistency between MSMSMS and PSG in the diagnosis of OSAS and the determination of sleep efficiency were compared.Results The Kappa consistency coefficient of MSMSMS and PSG in the diagnosis of OSAS was 0.70(95％ CI:0.57-0.84),Z =7.99,P ＜ 0.000 1,which indicated the consistency between PSG and MSMSMS was good.The consistency of sleep efficiency of MSMSMS and PSG were compared.Bland-Altman results showed that there were 3％ (5/129 cases)points out of 95％ consistency bound and the interclass correlation coefficient (ICC) was 0.69 which indicated the consistency of 2 methods was good in determination of sleep efficiency.MSMSMS was able to detect respiratory event that was associated with sub-cortical arousals with no electroencephalogram arousal or blood oxygen reduction.Conclusions There is an adequate consistency between MSMSMS and PSG in the diagnosis of children with OSAS and determination of sleep efficiency.The MSMSMS has an advantage in detection of sub-cortical arousals and respiratory event.

BACKGROUND:Severe acute respiratory syndrome (SARS),an acute infection with a mutant coronavirus,is characterized by acute pulmonary inflammatory injury accompanied by possible multiple organ injuries. Besides somatic symptoms,affective disorder constitutes an obvious neuropsychiatric symptom in SARS patients.OBJECTIVE:To analyze the clinical features of SARS with neuropsychiatric involvement.DESIGN:A retrospective case analysis.SETTING:Department of Neurology,Department of Respiratory Diseases and Department of Radiology of Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS:Totally 325 SARS patients treated in the Second Affiliated Hospital of Sun Yat-sen University and the 8th People's Hospital of Guangzhou from February 2003 to May 2003 were involved,including 173cases who developed neuropsychiatric symptoms.METHODS:The clinical data of 325 of SARS including 173 cases with neuropsychiatric symptoms were retrospectively analyzed.MAIN OUTCOME MEASURES:Clinical neuropsychiatric symptoms,ophthalmoscopic examination,and pathological findings in autopsy.RESULTS: ①The incidence of neuropsychiatric involvement was about 53.2% in SARS patients. The manifestations consisted mostly of headache (67.1%),dizziness(28.9%),conscious-ness disturbance(10.4%),mental disorder(4.6%), local orientational disorder(0.6%),seizures(1.2%),and affective disorders (30.6%);anxiety occurred in 20.2%,depression in 6.4%,suicidal tendency in 1.2%,and phobia in 7.5% of the patients with neuropsychiatric involvement. ②Among the 325 patients,56 were in critical condition of whom 47 had accompanying neuropsychiatric impairment,with significantly greater incidence than that in mild cases (P＜0.01). ③Ophthalmoscopic examination performed in 4 patients showed blurred margin of the optic disc with retinal venous congestion. ④Autopsy in 2 cases identified edema of the perivascular tissue and vascular wall of the small veins with mononuclear cell and lymphocyte infiltration,neuron degeneration and demyelination in focal brain tissues.CONCLUSION:The manifestations of neuropsychiatric involement can vary in association with the severity of SARS,and the typical pathological changes include edema,neuronal demyelination etc.in the brain.

BACKGROUND: Memory loss is the main presentation during the earlier stage of radiative eneephalopathy, and it was reported that ganglioside (GM1) played important role in neural rehabilitation, particular in the improvement of memory.OBJECTIVE: To study the improving effect of GM1 on spatial learning and memory retardation in rats following radiative encepholopathy. DESIGN: Randomized control and comparative observing study based on the experimental animals.SETTING: Department of Neurology and Department of Radiation of Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Laboratory of the Second Hospital Affiliated to Sun Yat-sen University between March 2001 and May 2002. Tctally 80 SD rats were randomly selected and divided into control group, GM1 treatment group, physiological saline group and non-intervention group with 20 rats in each group.INTERVENTIONS: Rats in GM1 group, physiological saline group and non-intervention group subjected to head 60Coγ irradiation of 7Gy each time after anesthesia, once a day for consecutive 6 days, and the total dosage was 42Gy while rats in control group did not receive irradiation after anesthesia. Rats in GM1 and physiological saline(PS) group were given intraperitoneal injection of GM1 and physiological saline of 30 mg/kg respectively at 1 hour after each time of radiation, once a day for consecutive 6 days but not in control group and non-intervention group. Evaluation: ①After irradiation, morris water labyrinth navigation test was used to assess the capability of learning and memory of rats by the time for reaching platform (latency); ② Spatial searching test was used to detect their spatial memory after learning how to reach the platform by recording the way of rats searching the platform in 120 s and calculating the percentage of swimming distance in platform quadrant in the total distance; ③ After labyrinth test, brains were taken out of the rats in GM1 group, PS group and non-intervention group for observing the histological and pathological changes in rat brains.RESULTS: ① The latency become stable form onset of the 4th day in each group. On the 5th day, the searching platform latency in GM1 group was(13.6±1.4) s, shorter than(17.1±2.9) s of PS group and [(15.8±2.2) s, (P＜0.05)] of non-intervention group; ② Rats in GM 1 and control group were found capable of searching platform according to their spatial memory, presented by swimming trail most located in platform quadrant while rats in PS and non-intervention groups were found mostly swimming around the pool with moving trails distributed randomly. The percentage of swimming distance in platform quadrant was found higher in GM 1 treatment group than in the PS group and non-intervention group, but lower than that in the control group; ③ Histological examination revealed slight neuronal degeneration in PS group, part of which was changes of vacuolar degeneration with cell shrank, chromosome concentrated and nuclei gathered aside, and the number of astrocytes also decreased; the pathological changes in non-intervention group and PS group were similar; in GM1 group, part neurons became smaller with peripalsm turning red but the pathological changes, such as the number of cells,neuclei shrank and gathered aside, and vacuolar changes were less than those of the former two groups.ONCLUSION: Radiative encephalopathy would result in obvious learning nd memory impairments in rats but histological and pathological changes due o brain radiation injury can be attenuated with the treatment of GM1, implying that GM1 may play important role in the improvement of radiation-induced spatial learning and memory loss.

Objective To assess the value of multi-slice spiral CTA in the diagnosis of iliac vein compression syndrome(IVCS)and secondary thrombosis.Methods The CTA data of 80 controls and 31 patients with IVCS conformed by DSA were retrospectively studied.The inner diameters of the compressed iliac vein in two groups were measured and compression ratios were calculated.The data were compared using t test and Wilcoxon test.The findings of CTA were compared with that of DSA and the accuracy of CTA was analyzed.Results For the control group,the inner diameters of left iliac vein in female group(7.0±2.5)mm were significantly less than that in male group(8.1±2.5)mm(t=2.42,P＜0.05).For the control group,the inner diameters of left iliac vein was(7.6±2.0)mm,and the compression ratios were 0 to 65.41%(median 27.65%).The compression ratios were no statistical differences between male group(0 to 61.36%,median 26.82%)and female group(0 to 65.41%,median 28.75%)(Z=-0.59,P＞0.05).For the patients group,the inner diameters of compression iliac vein was(2.7±1.1)mm.The compression ratios were 55.18% to 100%(median 76.12%).Both inner diameters and compression ratios were statistically different between the control and patients group(t=12.78,P＜0.05;Z=-8.18,P＜0.05).Fifteen of 31 cases with IVCS were accompanied with deep vein thrombosis.The left iliac veins were compress in 28 cases,while right iliac veins were compressed in 2 cases.The left and right iliac common veins were compressed by the left and right jliac common arteries in one case.The results of CTA were consistent with that of DSA in all cases.Conclusions CTA can not only measure the inner diameters of iliae vein compression and calculate compression ratios,but also demonstrate secondary thrombosis clearly.CTA is an effective examination in diagnosis of IVCS and secondary thrombosis.

Objective To investigate the accuracy and applied value of measurement of pulmonary flow velocity with phase-contrast MRI(PC-MRI).Methods ①42 healthy volunteers were divided into 2 groups randomly,one group was examined by PC-MRI,another was examined by doppler ultrasound.The inner diameter,maximum velocity and mean velocity of main pulmonary artery(MPA) were measured;②The flow volume of MPA in a cardiac cycle was calculated with formulation.Results ①The inner diameters of MPA measured with PC-MRI and doppler ultrasound were(24.4?3.41) mm and(21.5?2.55) mm respectively;②The maximum velocity and mean velocity of MPA measured by PC MRI were(79.9?24.0) cm/s and(50.3?7.71) cm/s respectively;③The maximum velocity and mean velocity of MPA gained by doppler ultrasound was(88.8?8.33) cm/s and(53.7? 5.04) cm/s resepectively;④The flow volume of MPA in a cardiac cycle measured by PC MRI and doppler ultrasound was(73.5?6.60) ml and(69.0?10.6) ml respectively.The results were analyzed by group sample t-test,and the level of test was 0.05.Conclusion The blood flow velocity and volume of pulmonary artery can be measured accurately by PC-MRI,it is of certain applied value in assessing the pulmonary blood flow dynamics changes.

Objective To evaluate the effectiveness and safety of mouse nerve growth factor in treating dysphagia in patients with nasopharyngeal carcinoma after radiotherapy.Methods Fifty-eight post-radiotherapy nasopharyngeal carcinoma patients with dysphagia were randomly divided into an observation group and a control group.Both groups received routine treatment,but the observation group was additionally injected with mouse nerve growth factor intramuscularly every day for four weeks.Before and after the 4 weeks of treatment,both groups were evaluated using Kubota's water drinking test,videofluoroscopy and the brief version of the WHO's Quality of Life scale.Results After 4 weeks,the patients in the observation group displayed significantly greater improvement in swallowing compared with the control group.There was a significant difference in the groups' average scores on the drinking water test and in the videofluoroscopy results.Moreover,the patients in the observation group had significantly higher quality of life scores than those in the control group,on average.Conclusions Mouse nerve growth factor may have a rapid and safe therapeutic effect on dysphagia induced by radiation.No obvious adverse reactions were observed.

Objective:To explore the value of detecting plasma donor-derived free DNA (dd-cfDNA) fraction in distinguishing antibody mediated-rejection (ABMR) and T cell-mediated rejection (TCMR) of renal allografts.Methods:Patients with acute rejection confirmed by allograft biopsy in the First Affiliated Hospital of Medical College of Zhejiang University from December 1, 2017 to July 18, 2019 were retrospectively included. Based on pathological classification of Banff renal allograft rejection in 2017, the patients were divided into ABMR group and TCMR group, and the latter was subdivided into TCMR Ⅰ subgroup and TCMR Ⅱ subgroup. The second generation sequencing and target region capture were used to detect candidates' peripheral blood dd-cfDNA. The demographic and clinicopathological data of the two groups were compared. The receiver operating characteristic curve (ROC) was used to evaluate the differential value of plasma dd-cfDNA and serum creatinine levels in two kinds of acute renal allograft rejection.Results:A total of 60 patients with acute rejection of renal transplantation were enrolled in this study, including 42 patients in TCMR group and 18 patients in ABMR group. The plasma dd-cfDNA percentage (%) in the ABMR group was significantly higher than that in the TCMR group [2.33(1.19, 4.30)% vs 0.98(0.50, 1.82)%, P=0.001]. The absolute value of dd-cfDNA in ABMR group was obviously higher than that in TCMR group [0.94(0.60, 2.27) ng/ml vs 0.43(0.20, 0.96) ng/ml, P=0.003]. ROC analysis to discriminate TCMR from ABMR showed that, the area under the curve ( AUC) of dd-cfDNA% was 0.76(95% CI 0.64-0.88), when the threshold was 1.11%, the sensitivity and specificity were 88.89% and 59.52%, respectively; the AUC of absolute value of dd-cfDNA was 0.74(95% CI 0.61-0.86), when the threshold was 0.53 ng/ml, the sensitivity was 88.89% and the specificity was 54.76%. TCMR subgroups were further analyzed, there was no significant difference between TCMR subgroups on the absolute value and percentage of dd-cfDNA (both P>0.05); dd-cfDNA% in ABMR group was apparently higher than that in TCMRⅠ subgroups ( P=0.008) and TCMRⅡsubgroup ( P=0.030). The absolute value of dd-cfDNA in ABMR group was significantly higher than that in TCMRⅠsubgroups ( P=0.003). Conclusion:Plasma dd-cfDNA level may help to distinguish between ABMR and TCMR rejection.