Objective To study the psychological changes and the effect of psychological intervention and to discuss the influence of psychological rehabilitation on carcinoma patients after comprehensive interventional therapy.Methods 100 carcinoma patients were divided into two groups randomly:the psychological intervention group(50 casea) received both psychological intervention therapy and comprehensive intervention therapy;the control group (50 cases) received only comprehensive interventional therapy;Curative effects were assessed with the Symptom Checklist90(SCL-90) ,the Self Rating Depression Scale(SDS) and the Self Rating Anxiety Scale(SAS) for each patient. Results For the psychological intervention group, SCL-90 scores after therapy was significantly lower than that before therapy ( P < 0. 05 ), and were also significantly lower than that ( without anxiety agent) of the control group. The scores of SDS and SAS in post-therapy patients were significantly lower than that of pre-therapy patients in the psychological intervention group. The scores of SDS had no statistical difference between post-therapy patients and pre-therapy patients in the control group. The scores of SAS in post-therapy patients was significantly lower than that of pre-therapy patients in the control group. Both scores of SDS and SAS in the control group were significantly higher than that of the psychological intervention group after therapy. Conclusion Psychological intervention for carcinoma patients after comprehensive interventional therapy played an promotional role in psychological rehabilitation in the community.

Objective Analyze the amino acids and acylcarnitines in the blood of patients first diagnosed with uremia using tandem mass spectrometry in order to provide a basis for clinical diagnosis and treatment. Methods 30 patients with uremia were selected as the research objects,while 15 cases of healthy person were served as the control. The values of 11 kinds of amino acids and 2 kinds of acylcarnitines in the two groups were detected using tandem mass spectrometry,and the data were analyzed and compared. Results The levels of alanine(Ala)and tyrosine(Tyr)in uremia group were significantly lower than those in control group(P < 0.05),while the levels of citrulline(Cit),glycine(Gly)and proline(Pro)were significantly higher in uremia group than in control group (P < 0.05). The differences were mainly in non-essential amino acids between the two groups. The levels of free carnitines and total carnitines in uremia group were significantly higher than those in normal group(P < 0.05). Conclusion For the patients first diagnosed with uremia(not treated with replacement therapy),the disturbance of amino acid metabolism mainly in non-essential amino acids were found in their blood,and the carnitine levels were higher than normal levels. The results could provide the basis for clinical nutrition therapy for patients with uremia.

Hypoxic-ischemic encephalopathy (HIE) is the main reason of causing neonatal death and poor prognosis of the nervous system.The treatment of HIE has gone into the era of therapeutic hypothermia,the early,continuous,specification amplitude integrated electroencephalography(aEEG) monitoring for therapeutic hypothermia to screen appropriate cases,assess early the severity of HIE,provide early nerve protection treatment and evaluate the therapeutic efficiency,early intervention and improve the prognosis of the long-term HIE.This paper review the application of aEEG in the therapeutic hypothermia of HIE.

ObjectiveTo study the effect of behavior training on the expression of neural growth factor(NGF) in the dentate gyrus(DG) in rats with left lateral hippocampal infarction.Methods102 SD rats were randomized into fore-training,3 d,7 d,14 d,21 d,28 d,35 d,42 d,49 d training groups,fore-immobilization, 3 d、7 d,14 d,21 d,28 d,35 d,42 d,49 d immobilization groups and control group.Behavior training and immobilization were performed at 1st day after the infarction.Immunohistochemistry was used to detect the expression of NGF in the DG at different points of time.ResultsThe expression of NGF is certain in the normal DG of rats.The expression of NGF increased after infarction.However,the expression of NGF had obviously increased in fore-training groups compared with that in fore-immobilization groups.ConclusionBehavior training can accelerate the expression of NGF in the DG of rats with left hippocampal infarction.

Objective To identify the risk factors associated with cardiovascular and cerebrovascular disease (CCVD) in maintenance hemodialysis (MHD) patients. Methods We analyzed all of the patients undergoing maintenance hemodialysis in the dialysis center of the 3rd Affiliated Hospital of Sun Yat-sen University for at least 3 months from Jan 1st, 2009 to Dec 31st, 2014. Baseline and yearly interval clinical data were recorded and patients were followed up until morbidity or death of CCVD. Cox proportional hazard regression and time-dependent Cox regression were used to estimate the relative risk of outcomes associated with clinical measurements. Results There were 243 patients enrolled in the study, with a mean age of (53.2 ± 16.4) years old, and 138 of them were male (56.8%). The multivariate Cox proportional model revealed that age (HR=1.040, 95%CI:1.015-1.065, P=0.002), Erythropoietin (EPO) dose (HR=0.914, 95%CI: 0.846-0.987, P=0.022) and history of cardiovascular and cerebrovascular disease (HR=4.045, 95%CI: 2.074-7.890, P<0.001) were independent predictors of CCVD in MHD patients. After adjusting for baseline predictors, time-dependent serum phosphorus level (HR=1.722, 95%CI: 1.034-2.866, P=0.037) was significantly associated with CCVD. Conclusion Older age, decreases in EPO dose and history of cardiovascular and cerebrovascular disease were associated with increased risks of CCVD in MHD patients. Increase in serum phosphorus level was associated with increased risks of CCVD in a time-dependent manner.

Objective To observe changes in the working memory and brain functional imaging on functional magnetic resonance imaging(fMRI) after 36 hours sleep deprivation (SD) in healthy volunteers and to explore the possible mechanism of the changes.Methods FMRI scannings were performed in ten male healthy young volunteers before and after 36 hours SD and results were analyzed using SPM2 software.Subjects were also tested LTR and PLUS task to measure the persistence and operation of working memory before and after 36 hours SD.Results The reaction time of LTR task after 36 hours SD ( (866 ± 102) ms)was significantly longer than that before SD ( (754 ± 91 ) ms, t = 2.59, P < 0.01 ).The reaction time of PLUS task after SD ( (848 ± 94) ms) was significantly longer ( t = 2.37, P < 0.05 ) than that before SD ( (756 ± 79) ms).The error rate of LTR task after SD (95.3% ± 3.56% ) was significantly higher (t=3.52,P < 0.01 ) than that before SD (84.8% ± 8.71% ).The error rate of PLUS task after SD (95.7% ±4.72% ) was significantly higher (t =3.38 ,P <0.01 ) than that before SD (84.2% ±9.66% ).There were no significant differences between the two tasks.The frontal and parietal lobes, anterior cingulate gyrus and thalamus were activated during memory tasks testing before SD.Brain activation was broader and stronger in PLUS task than in LTR task.After SD, activation in parietal lobe was decreased and activation in prefrontal and thalamus was increased significantly.Conclusions The working memory performance decreased after SD.Both LTR and PLUS tasks of working memory activate frontal and parietal lobes, anterior cingulate gyrus and thalamus.The activation of parietal lobe decreased and the activation of prefrontal lobe and thalamus increased after 36 hours SD.This is the possible mechanism of SD to causes the cognition decline.

Objective To evaluate the efficacy of eszopiclone for patients with acute insomnia and the impact of premedication with eszopiclone on sleep structure of patients with acute insomnia.Methods In an open-label,self-control trial was conducted at Changzheng Hospital Sleep Centers,and patients (n =32) with acute insomnia (12 men,20 women; mean age,36.2 years) were administered eszopiclone 3 mg for three consecutive nights.Sleep was monitored via polysomnography.The insomnia severity index (ISI),and mini-mental state examination (MMSE) were used to assess the degree of insomnia and impact of drugs on cognitive function during the day.Results Eszopiclone can shorten sleep latency ( before treatment:(52.92 ± 11.71 ) min,after treatment:(28.2 ± 10.11 ) min; t =-4.376,P ＜0.01 ),prolong total sleep time(before treatment:(365.22 ±30.13) min,after treatment:(429.18 ±26.93 ) min; t =4.102,P ＜ 0.01 ),decrease wake up times( before treatment:( 5.00 ± 1.92 ) times,after treatment:( 2.73 ± 0.91 )times; t =- 4.592,P ＜ 0.01 ),improve sleep efficiency ( before treatment:72.69％ ± 6.32％,after treatment:82.67％ ± 4.16％ ; t =3.371,P ＜ 0.01 ),reduce awake time ( before treatment:( 88.51 ±17.48) min,after treatment:(65.93 ±21.l0)min; t =-4.592,P ＜0.01 ),decrease light sleep ( NREM1 period) the percentage of time ( before treatment:12.54％ ± 2.10％,after treatment:7.30％ ± 2.90％ ;t=-3.155,P ＜ 0.01 ),and increase the percentage of slow wave sleep (before treatment:8.03％ ±5.37％,after treatment:9.31％ ±5.29％; t =4.228,P ＜0.01).No effect was observed on the percentage of NERM2 period (t =0.731,P ＞0.05) and REM period (t =-0.813,P ＞0.05).Eszopiclone can improve the quality of subjective assessment of sleep ( ISI score decreased,t =- 2.551,P ＜ 0.05) and has no significant effect on cognitive function on first the morning after patients taking the medication.Conclusion Eszopiclone can positively regulate the sleep structure in patients with acute insomnia and improve subjective assessment of sleep quality.It is safe and has no significant effect on cognitive function.

Objective To investigate the impact of prior cerebral infarction (PCI) on in-hospital mortality in patients with Acute Myocardial Infarction (AMI).MethodsA retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan.1 to 2009 Dec.31 were performed.Results There were 564 patients ( 15.8% )with PCI.Compared with the group of without PC1,the group with PCI were substantially older[(69.4 ±9.9) vs (64.2 ± 12.9)years,P =0.000],and had a higher prevalence of hypertensive disease,diabetes mellitus,prior myocardial infarction (MI) and non-ST-segment elevation myocardial infarction(NSTEMI)( respectively,71.0% vs 57.3%; 41.0% vs 25.7%,12.9% vs 9.5%; 14.9% vs 10.7%,P ＜ 0.01 ),and a higher in-hospital mortality ( 16.5% vs 10.0%,P= 0.000).Univariate analysis demonstrated that in-hospital mortality associated with age,gender,extensive anterior MI,anterior MI,diabetes mellitus,prior cerebral infarction,prior myocardial infarction,coronary angiography and percutaneous coronary intervention.Logistic regression analysis found that risk factors were age,extensive anterior MI,anterior MI,diabetes mellitus and prior cerebral infarction,and protective factors were coronary angiography and percutanous coronary intervention.PCI was independently associated with in-hospital mortality,OR 1.368,95% CI 1.047-1.787,P = 0.022.Conclusion In patients with acute myocardial infarction,the presence of PCI increases the risk of worse in-hospital outcome.

Objective To investigate the association of nitrotyrosine with coronary heart disease (CHD) in type 2 diabetes mellitus.Methods The nitrotyrosine levels were determined in 109 patients of type 2 diabetes mellitus without CHD (T2DM).One hundred and fifty-two patients of type 2 diabetes mellitus with CHD (T2DM-CHD) and 103 healthy control subjects by ELISA.Results T2DM-CHD patients had significantly increased nitrotyrosine compared with T2DM group and the control group [ ( 78.17±10.68 )nmol/L,(70.50 ± 9.13) nmol/L vs ( 63.23 ± 11.55 ) nmol/L,Ps ＜ 0.01 ].Nitrotyrosine was correlated with total cholesterol,triglyceride,fasting glucose and Gensini Score (r=0.361,P=0.009;r =0.206,P=0.001 ;r=0.347,P=0.026; r=0.466,P ＜ 0.001 ).Multivariable logistic regression showed nitrotyrosine was independently associated with CHD combined with type 2 diabetes mellitus ( OR=1.094,95％ CI:1.053-1.137 ; P ＜ 0.01 ).Conclusion Nitrotyrosine plays an important role in the formation and development of cardiovascular disease in tvoe 2 diabetes.

Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.