Objective To explore the effects of clinical psychological intervention on anxiety and depression in hemodialysis patients .Methods Hemodialysis patients were randomly divided into two groups:psychological inter-vention group and control group ,25 patients in each group .In intervention group ,besides routine clinical treatment and nursing measures ,we analyzed the clinical information of the patients ,consulted the relevant documents ,combined the evidence and clinical experience ,and finally conducted the psychological intervention .Self-Rating Anxiety Scale and Self-Rating Depression Scale of these patients were analyzed .Results Before the intervention , the SAS and SDS scores of intervention group and control group were (57.3 ±1.5) versus (56.9 ±1.6) and (55.3 ±2.3) versus (56.1 ±3.5),respectively.The t values were 0.912(P>0.05) and 0.955(P>0.05),respectively.After interven-tion,the score before and after the trial between these two groups were significantly different (P<0.05).The SAS and SDS scores of intervention group and control group were (16.4 ±0.9) versus (10.1 ±1.3) and (14.3 ±2.1) ver-sus (9.7 ±1.5),respectively.Conclusion Clinical psychological intervention can effectively relieve anxiety and depression in hemodialysis patients .

During the foreign aid mission against Ebola,the 302 Military Hospital of PLA strengthened emergency science research management according to the features of this task and the reality,and toke effective measures in research direction selection,human resources concordance,scientific potential transformation and other aspects,which contributed to the successful completion of this mission.They gathered experiences in emergency science research management and gave recommendations for similar tasks in the future.

ObjectiveTo evaluate the protective effect of Xuebijing injection against renal injury in patients with sepsis, and to explore its possible mechanism.Methods A prospective randomized controlled trial (RCT) was conducted in which 62 severe patients with sepsis and septic shock admitted in Department of Critical Care Medicine of Jiangsu Province Traditional Chinese Medicine Hospital from June 2013 to December 2013 were randomly divided into control group and Xuebijing group, with 31 patients in each group. The patients in both groups received basic treatment for sepsis, and the patients in Xuebijing group were additionally given intravenous injection of Xuebijing 100 mL once a day for 7 days. In both groups, the changes in acute physiology and chronic health evaluationⅡ (APACHEⅡ) score were observed before treatment and 1, 3, 7 days after treatment, and the changes in the levels of interleukins (IL-6, IL-10), prothrombin time (PT), fibrinogen (Fib), activated partial thromboplastin time (APTT), serum creatinine (SCr), and Cystain C (Cys C) were determined before treatment and 1 day and 3 days after treatment.Results There was no statistically significant difference in APACHEⅡ score before treatment between two groups, however, the APACHEⅡ scores were significantly decreased in both groups 3 days and 7 days after treatment compared with those before treatment, and the degree of decrease in Xuebijing group was more obvious 7 days after treatment (13.61±7.62 vs. 16.34±8.70,P< 0.05). Serum concentrations of Cys C, SCr, IL-6, IL-10, PT, APTT, and Fib showed no difference between two groups before treatment (allP> 0.05), while after treatment the degrees of improvement of above indexes in Xuebijing group were obviously superior to those in control group, especially 3 days after treatment[Cys C (mg/L):1.12±0.11 vs. 1.35±0.14, SCr (μmol/L): 115.0±31.0 vs. 135.0±24.0, IL-6 (ng/L): 54.27±28.79 vs. 73.35±31.01,PT (s): 13.50±0.11 vs. 15.71±0.11, APTT (s): 43.66±0.31 vs. 48.03±0.55, Fib (g/L): 1.91±0.51 vs. 1.51±0.52, P< 0.05 orP< 0.01].ConclusionXuebijing injection has certain renal protective effect in patients with sepsis, and its mechanism is possibly related to the regulation and improvement of uncontrolled inflammatory response and coagulation function in sepsis.

Objective:To discuss the effect of sarcopenia (Sa) on the prognosis of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension (PHT).Methods:Totally 131 PHT patients treated with TIPS were retrospectively collected from August 2013 to December 2017 in the First Affiliated Hospital of USTC, and were divided into the Sa group [maximum transverse diameter of the psoas major muscle/height (TPMT/H) ≤16.8 mm/m, n=60] and the control group (TPMT/H>16.8 mm/m, n=71). The patients were followed up with a median time of 42 months. The Kaplan-Meier method was used to calculate the incidence of hepatic encephalopathy, recurrence rate of PHT-related complications and survival rate of PHT patients after TIPS, and the differences were compared by Log-rank test. Results:The incidences of hepatic encephalopathy within 6 months after TIPS and severe hepatic encephalopathy requiring hospitalization in the Sa group [36.7% (95%CI 24.5%-48.8%) and 15.0% (95%CI 6.0%-24.0%)] were higher than those of the control group [15.7% (95%CI 7.3%-24.1%) and 2.8% (95%CI 0-6.7%)], with statistically significant differences (χ2=7.843, 16.442, P=0.005, 0.001). The 5-year overall recurrence rate of PHT-related complications of the Sa group after TIPS [15.8% (95%CI 6.4%-25.2%)] was higher than that of the control group [5.7% (95%CI 0.2%-11.2%)], with a statistically significant difference (χ2=4.431, P =0.035. The 1, 3 and 5-year survival rates in the Sa group were 88.3% (95%CI 80.3%-96.3%), 86.7% (95%CI 78.1%-95.3%) and 77.8% (95%CI 65.1%-90.5%) respectively, which were all lower than those of the control group [97.2% (95%CI 93.3%-100%), 95.8% (95%CI 91.1%-100.0%) and 93.7% (95%CI 87.6%-99.87%) respectively], and the difference was statistically significant (χ2=5.055, P=0.025). Conclusion:Sa has a higher incidence in PHT patients, which can increase the incidence of hepatic encephalopathy and recurrence rate of PHT-related complications, and can decrease the survival rate in PHT patients after TIPS. Hence, the Sa is an indicator of the poor prognosis in PHT patients with TIPS.

Objective To explore the expression of vascular endothelial growth factor (VEGF) and apoptosis of the tumor cells in the different regions of rabbit liver VX2 tumor after radiofrequency ablation (RFA).Methods Forty-eight experimental rabbits were implanted with VX2 tumor.After successfully established the model,the rabbits were randomly divided into control group (n=6) and RFA group (n=42).In the RFA group,7 rabbits at each time point were killed at immediately,1 day,2 days,1 week,2 weeks,3 weeks after RFA,and the tumor specimens were retained and performed with HE staining,VEGF,Annexin V-FITC/PI labeling,flow cytometry analysis.The changes of VEGF and apoptosis of the cells in different periods and different zones after RFA were observed.Results After the operation,the difference of the VEGF value of the needle zone,coagulation necrotic zone and junction zone had statistically significant (all P＜0.05).The difference of the VEGF value in each zone between immediately and the other time points after operation by pairwise comparisons were significantly different (all P＜0.05).The VEGF value of the needle zone and coagulation necrotic zone reached the peak after operation immediately,which declined from 1 day to 3 weeks after operative.And VEGF of the junction zone increased from immediately to 1 week after operation,and declined 2 weeks after operation.There were significant differences in the apoptosis rate of the three zones after RFA compared with control group (all P＜0.05).The apoptosis rate in all zones were at the peak on the 1 day after operation,and then showed a downward trend.Conclusion The reduction of VEGF and apoptosis of tumor cells in the needle zone and coagulation necrotic zone are significant,but tumor remnant remains visible in the junction zone.In the third week after RFA,the proliferation of the remaining tumor cells can be recurrent to preoperative levels,which suggests that the further treatment should be performed at this period.

Objective To assess the therapeutic effect and influencing factors of TACE for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).Methods Data of 685 patients with HCC and PVTT were retrospectively analyzed.There were 475 patients treated with TACE (TACE group) and 210 patients treated with supportive treatment (supportive treatment group).The survival time of two groups were observed and compared.The multivariate Cox regression analysis was used to analyze the prognostic factors.Results The median survival time of all 685 patients was 6.3 months.The median survival time of patients in TACE group and supportive treatment group was 7.1 months and 5.2 months,respectively (P=0.002).The 6-,12-and 24-month survival rates were 57.30％,27.30％ and 12.10％ in TACE group,and 37.90％,12.20％ and 3.10％ in supportive treatment group,respectively.Univariate analysis showed that the Child-Pugh classification,the diameter of lesion,gamma-glutamyl transferase level and type of PVTT might be significant prognostic factors for overall survival.Multivariate Cox proportional hazard model analysis showed the Child-Pugh classification and type of PVTT were independent prognostic factors for overall survival.Further analysis showed that the median survival time of patients with type Ⅰ or Ⅱ PVTT in TACE group was 7.8 months,and that in supportive treatment group was 5.5 months.There were statistical differences of 6-,12-and 24-month cumulative survival rate between the 2 groups (P =0.001).The median survival time of patients with type Ⅲ or Ⅳ PVTT in TACE group was 5.3 months,and that in supportive treatment group was 4.5 months.There was no statistical difference of the 6-,12-and 24-month cumulative survival rate between the 2 groups (P=0.662).Conclusion TACE is effective in the treatment of HCC with PVTT.The major influencing factors for survival time of patients with HCC and PVTT are Child-Pugh classification and type of PVTT.The effect of TACE for HCC patients with type Ⅲ or Ⅳ PVTT is unsatisfied.

Objective:The purpose of this study was to evaluate the effect of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures.Methods:A retrospective analysis was performed on the patients suffering from unilateral zygomatic complex fractures treated by computer-aided surgical navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2013 to December 2017. Spiral CT was used before surgery, the data was imported into BrainLAB navigation workstation or AccuNavi—a navigation workstation to design the surgery plan, and then the surgery plan was imported into the surgical navigation workstation to assist the reduction and fixation of the zygomatic complex fracture. Three-dimensional CT was used within 1 week after surgery to measure the reference values of the postoperative healthy and affected zygomatic prominence, which were analyzed by the paired t-test. At the same time, the reduction of the fracture was evaluated by the difference of the bilateral reference values of the zygomatic prominence, and the absolute value of the difference less than 2 mm was judged as exact reduction. All patients underwent postoperative follow-up, and wound healing and facial appearance and functional recovery were evaluated. Results:A total of 45 patients were involved in this study, including 39 males and 6 females, aged 21-68 years old. The postoperative zygomatic prominence values of the healthy side and affected side were (80.78±6.14) mm and (80.85±6.10) mm, respectively. There was no statistical significance ( t=0.362, P=0.719) between the reference values of the bilateral zygomatic prominence after operation. The absolute value of the difference between the zygomatic prominence of the healthy and the affected sides after operation was (0.92±0.68) mm. Fourty-three cases achieved exact reduction of the fracture. In the other 2 cases, the absolute value of the zygomatic prominence difference was 2.3 mm and 2.2 mm, respectively. The surgical incisions of all patients healed well without complications such as infection, accompanying with satisfactory facial appearance and function recovery. Conclusions:The application of computer-aided surgical navigation in unilateral zygomatic complex fracture surgery can effectively ensure the accuracy of fracture reduction, and it is a valued application.

Objective:The purpose of this study was to evaluate the effect of computer-assisted surgical navigation in the reduction and fixation of unilateral zygomatic complex fractures.Methods:A retrospective analysis was performed on the patients suffering from unilateral zygomatic complex fractures treated by computer-aided surgical navigation technology in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University from January 2013 to December 2017. Spiral CT was used before surgery, the data was imported into BrainLAB navigation workstation or AccuNavi—a navigation workstation to design the surgery plan, and then the surgery plan was imported into the surgical navigation workstation to assist the reduction and fixation of the zygomatic complex fracture. Three-dimensional CT was used within 1 week after surgery to measure the reference values of the postoperative healthy and affected zygomatic prominence, which were analyzed by the paired t-test. At the same time, the reduction of the fracture was evaluated by the difference of the bilateral reference values of the zygomatic prominence, and the absolute value of the difference less than 2 mm was judged as exact reduction. All patients underwent postoperative follow-up, and wound healing and facial appearance and functional recovery were evaluated. Results:A total of 45 patients were involved in this study, including 39 males and 6 females, aged 21-68 years old. The postoperative zygomatic prominence values of the healthy side and affected side were (80.78±6.14) mm and (80.85±6.10) mm, respectively. There was no statistical significance ( t=0.362, P=0.719) between the reference values of the bilateral zygomatic prominence after operation. The absolute value of the difference between the zygomatic prominence of the healthy and the affected sides after operation was (0.92±0.68) mm. Fourty-three cases achieved exact reduction of the fracture. In the other 2 cases, the absolute value of the zygomatic prominence difference was 2.3 mm and 2.2 mm, respectively. The surgical incisions of all patients healed well without complications such as infection, accompanying with satisfactory facial appearance and function recovery. Conclusions:The application of computer-aided surgical navigation in unilateral zygomatic complex fracture surgery can effectively ensure the accuracy of fracture reduction, and it is a valued application.

Objective To investigate the risk factors of progressive motor deficit (PMD) in patients with acute middle cerebral artery occlusion (MCAO) beyond thrombolysis time.Methods The clinical data of 123 patients with acute MCAO beyond thrombolysis time,admitted to our hospital from March 2015 to March 2017,were analyzed retrospectively.According to whether patients having National Institute of Health Stroke Scale (NIHSS) scores increased＞2 within 5 d of admission and continued for 24 h,these patients were divided into two groups:PMD group and non-PMD group.Single factor analysis was performed on all clinical parameters that might influence PMD;in addition,the influencing factors of PMD were analyzed by multiple factor Logistic regression analysis.Results Fifty-one patients (41.5％) had PMD and 72 patients (58.5％) did not have PMD.Single factor analysis showed that the differences of randomized blood glucose level,ratio of patients with PH2 type hemorrhagic transformation,intracurricular infarct pattern,radiation crown infarct and collateral circulation pathway between the PMD group and the non-PMD group were statistically significant (P＜0.05).Multiple factor Logistic regression analysis showed that ratio of patients with PH2 type hemorrhagic transformation,radiation infarct site,internal watershed infarct model and collateral circulation pathway were significantly correlated to PMD (OR=2.857,95％CI:1.037-7.869,P=0.042;OR=2.585,95％CI:1.219-5.481,P=0.013;OR=2.876,95％CI:1.327-6.232,P=0.007;OR=2.332,95％CI:1.120-4.867,P=).024).Conclusion PH2 type hemorrhagic transformation,corona radiate infarct,intemal watershed infarct model and insufficient collateral circulation pathway are the important risk factors of PMD in patients with acute MCAO beyond thrombolysis time.

OBJECTIVE: To provide prenatal diagnosis, pedigree analysis and genetic counseling for a pregnant woman who had given birth to a child featuring global developmental delay. METHODS: A pregnant woman who underwent prenatal diagnosis at the Affiliated Hospital of Southwest Medical University in August 2021 was selected as the study subject. Peripheral blood samples were collected from the woman, her husband and child, in addition with amniotic fluid sample during mid-pregnancy. Genetic variants were detected by G-banded karyotyping analysis and copy number variation sequencing (CNV-seq). Pathogenicity of the variant was predicted based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). Candidate variant was traced in the pedigree to assess the recurrence risk. RESULTS: The karyotypes of the pregnant woman, her fetus, and affected child were 46,XX,ins(18)(p11.2q21q22), 46,X?,rec(18)dup(18)(q21q22)ins(18)(p11.2q21q22)mat and 46,XY,rec(18)del(18)(q21q22)ins(18)(p11.2q21q22)mat, respectively. Her husband was found to have a normal karyotype. CNV-seq has revealed a 19.73 Mb duplication at 18q21.2-q22.3 in the fetus and a 19.77 Mb deletion at 18q21.2-q22.3 in her child. The duplication and deletion fragments were identical to the insertional fragment in the pregnant woman. Based on the ACMG guidelines, the duplication and deletion fragments were both predicted to be pathogenic. CONCLUSION The intrachromosomal insertion of 18q21.2-q22.3 carried by the pregnant woman had probably given rise to the 18q21.2-q22.3 duplication and deletion in the two offspring. Above finding has provided a basis for genetic counseling for this pedigree.
Child ; Female ; Humans ; Pregnancy ; DNA Copy Number Variations ; East Asian People ; Pedigree ; Prenatal Diagnosis/methods* ; Chromosomes, Human, Pair 18/genetics* ; Male ; Fetus ; INDEL Mutation