To explore the relativity between alexithymia and cognitive function in somatoform disorder patients.A total of 40 patients aged 18-65 years fulfilling the criteria of ICD-10 for somatoform disorders were recruited as research group.And 40 normal healthy subjects were selected as control group.Toronto alexithymia scale-20 (TAS-20) was employed to examine the alexithymia.And cognitive abilities screening instrument (CASI) was used to measure their cognitive ability.The 9-factor scores and total score of CASI test in patients with somatoforill disorder were significantly lower than those in the normal controls (P ＜ 0.05 or ＜ 0.01).The 3-factor scores and total score of TAS-20 test in patients withsomatoforill disorder were significantly higher than those in the normal controls (P ＜ 0.05 or ＜ 0.01).In research group,CASI scores were negatively correlated with the TAS-20 scores (P ＜0.05 or 0.01).

Objective To investigate the social cognition and its correlation with social function for attenuated psychosis syndrome (APS). Methods From August, 2014 to December, 2015, 39 patients with APS were recruited as research group. Another 40 normal healthy persons with similar gender, ages, and education levels were selected as control group. The Faux Pas Recognition Test (FPR) and Yoni Task Test were used to evaluate the social cognition, and Social Disability Screening Schedule (SDSS) was used to evaluate the social function. The correlation between FPR, Yoni Task Test and SDSS in the research group was analyzed. Results In FPR test, the faux pas questions score, control questions score and total score of FPR were significantly lower in the research group than in the normal control group (t>2.378, P<0.01). In Yoni Task Test, the cognitive theory of mind total score (Cog), cognitive theory of mind first-level score (Cog1) and cog-nitive theory of mind second-level score (Cog2), and affective theory of mind total score (Aff), affective theory of mind first-level score (Aff1) and affective theory of mind second-level score (Aff2) were significantly lower in the research group than in the normal control group (t>2.341, P<0.01). There was no significant difference in control theory of mind total score (Phy), control theory of mind first-level score (Phy1) and control theory of mind second-level score (Phy2) between two groups (t<1.430, P>0.05). The SDSS total score was signifi-cantly higher in the research group than in the normal control group (t=13.032, P<0.001). In the research group, FPR's faux pas questions score and FPR's total score were negatively correlated with SDSS score (r>0.473, P<0.01); in Yoni task test, Cog's total score and factor scores, Aff's total score and factor scores were negatively correlated with SDSS score (r>0.448, P<0.01). Conclusion Social cognition func-tion in APS is impaired. It is associated with social dysfunction in APS.

Objective To discuss the methods of the heat preservation performance monitoring of the blood transport case and to provide the technical support for the safety of blood transportation.Methods At the different environment temperature,the amount of the cold resource was decided by the mass ratio of cold resource to blood and the temperature was automatically recorded by the intelligent temperature chip continuously,to monitor the changes of each monitoring point in the blood transport case.Results When the mass ratio of cold resource to blood was fixed at 1∶6,the cold chain of the blood transport case could keep the tempera-ture of 2-10 ℃ for 8 hours at the environment temperature of 12 ℃,It could keep the temperature of 2-10 ℃ for 4.5 hours at the environment temperature of 25 ℃,and it could keep the temperature of 2-10 ℃ for 2 hours at the environment temperature of 44℃.Conclusion When the mass ratio of cold resource to blood is fixed,as the environment temperature changes,the available time that the blood transport case keeps with the cold-chain requirement varies according to the results of the heat preservation per-formance monitoring of the blood transport case.

Objective To observe the effect of dexamethasone(Dex)on the proliferation and os- teogenic differentiation of human marrow stromal cells(MSCs)in vitro.Methods The primary human MSCs were isolated and cultured by Ficoll seperation culture in vitro.In subcultures,human MSCs were respectively treated with dexamethasone 10~(-9),10~(-8) and 10~(-7) mol/L.The proliferation of human MSCs was measured using MTF method;cytoplasmic alkaline phosphatase(ALP)activity was measured;the osteogenic marker osteopontin (OPN)mRNA were examined by reverse transcriptase polymerase chain reaction(RT-PCR).Results The op- tical density values in cultures treated with dexamethasone 10~(-8) and 10~(-7) mol/L for 8 days were significantly lower than those in the controls(P＜0.05).Treatment of cells with Dex for 12 days led to a significant increase in cytoplasmic ALP activity(P＜0.05)in a dose-dependent manner.Dex induced OPN mRNA.Conclusion Dex inhibits the proliferation of human MSCs and dexamethasone 10~(-7) mol/L leads to a strong decrease in cell number.Dex induces human MSCs differentiate to osteoblastic cells.

OBJECTIVETo investigate the effect of (AT)n repeat polymorphism of the 3'untranslated region in cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) gene on CTLA-4 mRNA stability and full length (flCTLA-4) and soluble CTLA4 (sCTLA-4) expression in ulcerative colitis (UC).

METHODSflCTLA-4 mRNA in colonic biopsies and sCTLA-4 mRNA stability in peripheral blood mononuclear cells of UC patients were measured by quantitative PCR and half-life, respectively. The protein expression of flCTLA-4 in colonic biopsies and sCTLA-4 in sera of UC patients were determined by immunohistochemistry and enzyme-linked immunosorbent assay, respectively. The polymorphism of CTLA-4 (AT)n repeats in 300 UC and 700 age and sex matched healthy controls was genotyped by fluorescent PCR.

RESULTSAmong the UC patients, sCTLA-4 mRNA expression levels were decreased in active disease compared to non-active disease (P= 0.004). Carriers of the longer alleles of the (AT)n repeats expressed lower levels of flCTLA-4 and sCTLA-4 mRNA and sCTLA-4 protein than those of the shorter alleles in UC (all P< 0.01), and mRNA with long (AT)n repeat alleles has shorter half-life than mRNA with short alleles and, hence, are unstable. The frequency of long allele carriers of CTLA-4 (AT)n repeats was significantly higher in UC patients than in the healthy controls (22.0% vs. 6.3%, P< 0.01, OR= 4.21, 95% CI: 2.79-6.33), and associated with extensive colitis (P= 0.008).

CONCLUSIONCTLA-4 gene expression levels were associated with (AT)n repeat polymorphisms in UC patients. The expression of CTLA-4 mRNA and protein were decreased in carriers of the longer alleles of the (AT)n repeats of CTLA-4 gene. This study suggests that CTLA-4 plays an important role in genetic risk and pathophysiology for UC in central China.

Adult ; Antigens, CD ; chemistry ; genetics ; metabolism ; CTLA-4 Antigen ; Case-Control Studies ; Colitis, Ulcerative ; genetics ; metabolism ; Female ; Gene Expression Regulation ; Genotype ; Humans ; Male ; Phenotype ; Polymorphism, Genetic ; RNA Stability ; genetics ; RNA, Messenger ; chemistry ; genetics ; metabolism ; Solubility

OBJECTIVETo discuss the clinical effectiveness in treating thoracolumbar fractures adopting the rehabilitation exercise utilizing knee pads on the orthopedic traction bed.

METHODSFrom June 1996 to June 2006, we studied the clinical effectiveness of thoracolumbar fractures utilizing knee pads on the orthopedic traction bed for rehabilitation exercise. The cases surveyed total 209, 163 of which had full data. There were 98 males and 65 females with the age from 17 to 74 years (mean, 14.5 years). Consulting time after injury from 30 min to 7 days. Fracture site in T11 had 8 cases, in T12 24 cases, in L1 73 cases, in L2 33 cases, in L3 8 cases, in L4 3 cases, in T12 and L1 14 cases. Compression degree of vertebral anterior border: full compression had 1 case,more than 4/5 had 23, more than 2/3 had 67, more than 1/2 had 40, in 1/3 had 46.

RESULTSAmong them, 8 cases with legs paresis no recovery in nerval function or stopping recovery changed methods, and underwent surgical treatment. Others 155 cases were followed up from 2 to 12 years with an average of 3 years and 4 months. The average height of vertebral anterior borders of the 169 injured compressed had increased from 1.55 cm before treatment to 2.70 cm after treatment with an average of 1.15 cm. The height of the injured vertebral anterior borders had recovered from 50.5% (1.55/3.07) before treatment to 89.4% (2.70/3.02) after treatment. Kyphosis angle of the injured vertebral bodies had recovered from 13.25 degrees to -1.6 degrees in average. Twenty-three cases associated with dislocation basic reduction.

CONCLUSIONRehabilitation exercise using knee pads on the orthopedic traction bed can obtain satisfactory clinical effect in treating thoracolumbar fractures, the method is easy. At 3, 7, 10 days after treatment, the height of bed should be adjusted according X-ray.

Adolescent ; Adult ; Aged ; Exercise Therapy ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; injuries ; physiopathology ; surgery ; Male ; Middle Aged ; Orthopedic Equipment ; Recovery of Function ; Spinal Fractures ; physiopathology ; rehabilitation ; surgery ; Thoracic Vertebrae ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the immunity of morbid obesity (MO) before and after laparoscopic adjustable gastric banding (LAGB).

METHODS15 cases, with a mean body mass index (BMI) of 35.8 kg/m(2), were treated by LAGB from Jun. 2003 to Oct. 2003 in our department. Patients' immune parameters were determined preoperatively and 1, 3 and 6 months postoperatively. 15 cases with a normal BMI (23.6 kg/m(2)) were set as controls.

RESULTSBefore surgery, the MO had a significant lower level of CD(4)(+), CD(4)(+)/CD(8)(+) and a higher level of serum interleukin-2 (IL-2), Interleukin-6 (IL-6) than the controls (P < 0.01). There was a significant reduction of weight and BMI 6 months postoperatively (P < 0.01). At the same time, CD(4)(+) increased and serum IL-2 decreased significantly. But CD(4)(+)/CD(8)(+)and serum IL-2, IL-6 were still abnormal compare to the controls.

CONCLUSIONSMO may combined with an abnormal immunity. But after enough weight loss induced by LAGB, it can be partly reversed.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Gastroplasty ; methods ; Humans ; Laparoscopy ; Male ; Obesity, Morbid ; immunology ; surgery ; Weight Loss

Objective To compare the efficacy and safety of diazepam combined with olanzapine in treatment of agitation symptoms in patients with alcohol withdrawal delirium tremors( DT) . Methods Total-ly 60 inpatients with DT according to CCMD-3 were enrolled in a 7-day,with 30 patients in the diazepam group ( control group) and 30 patients in diazepam combined with olanzapine group ( research group) . The delirium rating scale( DRS-R-98) was used to evaluate the severity of the delirium symptoms. The positive and negative syndrome scale excited component( PANSS-EC) was used to assess the agitation symptoms. The treatment emergent symptom scale ( TESS) was used to assess the safety and the vital signs. Results There was no significant difference in the delirium recovery time between the two groups(M(QR):24 h(24 h)vs 24 h(6 h))(Z=-0. 45,P=0. 65). The PANSS-EC score in research group(17. 00±2. 67) was significant low-er than that in control group(19. 80±2. 43) at the 6 hours after treatment(t=4. 26,P<0. 01),but there were no significant difference between the two groups at the baseline,24 h,48 h and 72 h(P>0. 05) . One case of dizziness,2 cases of lethargy in the control group;1 case of nasal congestion,5 cases of drowsiness,3 cases of constipation, 3 cases of dry mouth, 1 case of abnormal liver function in the research group. Conclusion The combination of olanzapine with diazepam can not reduce the recovery time of DT,but can quickly improve the agitation behavior.

Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism(VTE)in grassroots hospitals.Methods Based on rel-evant guidelines and expert consensuses on VTE prevention and treatment,domestic and foreign litera-ture was reviewed.A research and development team composed of clinical experts in VTE prevention and treatment,medical and nursing quality management experts,and information engineers conducted investigations and research in surrounding grassroots hospitals.Through evidence-based research and surveys,the team identified relevant business needs,user needs,and functional requirements of grass-roots hospitals,and finally formulated a detailed design plan.The main program of system was written in Java.The interface obtained data from the hospital's data platform through Webservice and view in-terfaces.To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion,the XXL-JOB distributed task schedu-ling platform was adopted to handle VTE assessments by medical staff.Results After the clinical ap-plication of the intelligent VTE prevention and treatment system,the bleeding risk assessment rate in-creased from 26.20％at the initial system launch in January 2023 to 83.04％by the end of 2023.In January 2023,the implementation rates of mechanical prevention,pharmacological prevention,and combined prevention for medium-to-high-risk VTE patients were 21.39％,16.39％,and 5.26％,re-spectively,which increased to 51.75％,25.50％,and 25.65％in December 2023.Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve devel-opment efficiency,enhance the clinical practicality of the system,reduce the workload of medical staff,promote standardization and normalization in VTE prevention and treatment,strengthen closed-loop management of medical quality for VTE as a single disease,and effectively improve the preven-tion and treatment capabilities and levels of VTE within hospitals.

Objective:To explore the clinical features of upper gastrointestinal tract involvement in systemic sclerosis (SSc),and analyze the influencing factors.Methods:Totally 52 hospitalized SSc patients in department of rheumatology of Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2011 to December 2015 were enrolled and divided into symptomatic group and asymptomatic group according to the gastrointestinal symptoms.All the cases underwent esophageal manometry,24 h esophageal pH monitoring,esophageal barium meal and (or) endoscopy.Meanwhile,data of esophageal manometry and 24 h esophageal pH monitoring of 18 outpatients with gastroesophageal reflux disease in the same period were collected.Results:In 52 SSc cases,there were 17 in asymptomatic group and 35 in symptomatic group.For skin changes,the incidences of finger skin sclerosis,finger tip damage and capillary dilation in symptomatic group were significantly higher than those in asymptomatic group (P＜0.05);the incidence of interstitial lung disease in symptomatic group was significantly higher than that in asymptomatic group (P＜0.05).There were no differences in levels of ANA,anticentromere antibody,anti Scl-70 antibody between two groups in SSc patients.For dynamic abnormalities,the UES relaxation rate was highest,and the LES pressure decay rate was the lowest in SSc patients.The Esophageal manometric parameters were not statistically different among three groups.The 24 h esophageal pH monitoring showed that DeMeester score in symptomatic group was significantly higher than that inasymptomatic group (P＜ 0.05).The positive rate of esophageal barium meal in symptomatic group was significantly higher than that in asymptomatic group (P ＜ 0.05),though the positive rate of gastroscopy was not statistically different.Conclusions:There are esophageal motility disorders and abnormal acid reflux in SSc patients with or without upper gastrointestinal symptoms,especially for those with upper gastrointestinal symptoms.For patients with long course of disease,finger skin sclerosis,finger tip damage,capillary dilation and interstitial lung disease,esophageal involvement should be alert.DeMeester score is helpful for early diagnosis.