Post-traumatic stress disorder (PTSD) has long been clinical practice to use a three-part phased model in the treatment of trauma and the dissociative disorders. The phased treatment is an intrinsic element of the model presented throughout this article, which integrates the eye movement desensitization and reprocessing (EMDR) standard protocol and additional components: ego state therapy, attachment theory, and dissociative disorder treatment interventions. Although the researches on this model are still in its infancy, it is the current standard of care because of its efficacy with traumatized and dissociative-disordered clients.

Post-traumatic stress disorder (PTSD) is the most serious post-disaster physical and mental barrier, and intellectual disabilities are more sensitive to the negative effects caused by trauma than the healthy population. The debate existing extensively makes the diagnosis of PTSD in patients with intellectual disability difficult to be understood. There is a need to use uniform diagnostic criteria, howere, it still remains a problem for less experienced clinicians.

ObjectiveTo observe the effect of occupational therapy (OT) on activities of daily living (ADL) of the children with cerebral palsy (CP).MethodsSixty-two CP children were treated with OT. The ADL scores of all children were assessed within one week after admission and training goal and plan were made according to evaluated result. The therapeutic effect was assessed before discharge.ResultsAfter OT treatment, the ADL scores of the children increased significantly ( P<0.01) and disable grades decreased (χ2=10.48, P< 0.01). The total effect rate was 87.1%.ConclusionOT training can improve ADL of the children with CP significantly.

Objective To investigate the risk factors of recurrent ischemic stroke, and evaluate the severity and short-term outcome. Methods From March, 2014 to March, 2015, 238 patients with recurrent ischemic stroke and 378 patients with initial ischemic stroke matched with gender and age were enrolled. The clinical data of two groups were compared and the non-conditional Logistic regression model was made to analysis the risk factors of recurrent ischemic stroke. The National Institute of Health Stroke Scale (NIHSS) score as ad-mission and discharge, and the neural function improvement rate of two groups were compared. Results The incidences of leukoarailsis (χ2=8.666), hypertension (χ2=8.189), smoking (χ2=6.973) and alcohol consumption (χ2=4.722) were higher in the recurrent group than in the pri-mary group (P<0.05). Logistic regression analysis showed that leukoarailsis (OR=1.690, 95%CI:1.198~2.384, P=0.003), hypertension (OR=1.715, 95%CI:1.135~2.592, P=0.010) and smoking (OR=1.896, 95%CI:1.233~2.915, P=0.004) were the independent risk factors of recur-rent ischemic stroke. The NIHSS scores as admission and discharge were significantly higher (t=-3.645, t=-4.675, P<0.001), and the neural function improvement rate was lower (t=2.643, P<0.01) in the recurrent group than in the primary group. Conclusion Hypertension, leuko-arailsis and smoking are independent risk factors for recurrent ischemic stroke. Recurrent ischemic stroke is more serious than initial isch-emic stroke, and the short-term neural function recovers more slowly.

Objective To investigate the relationship of the serum bilirubin level with acute ischemic stroke (AIS), and Chinese isch-emic stroke subclassification (CISS), stroke severity and short-term outcome of AIS patients. Methods 616 patients with AIS as well as 664 patients without stroke matched with gender and age were compared and analyzed with the non-conditional Logistic regression. The AIS pa-tients were divided based on the CISS, and their bilirubin levels were compared. The AIS patients were divided into high bilirubin group and normal bilirubin group, their scores of the National Institute of Health Stroke Scale (NIHSS) as admission and discharge, and neural func-tion improvement rate were compared. Results The levels of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were higher in the AIS group than in the control group (P<0.01), and the TBIL was the independent risk factors of AIS (OR=1.026, 95%CI 1.012-1.041, P<0.001). There was no significant difference of the levels of TBIL, DBIL and IBIL among the patients of CISS (P>0.05). The NIHSS score was higher in the high bilirubin group than in the normal bilirubin group as admission (P<0.05), but it was not significant as discharge (P>0.05), nor the rate of neural function improvement (P>0.05). Conclusion The serum bilirubin level elevated and correlated with the severity in the AIS patients, which might be the risk of pathogenesis and AIS. The bilirubin was not various with the CISS, and might be less involved in the short-term outcome of AIS.

Objective To investigate the feasibility and safety of percutaneous interstitial implantation of ~(125)I seeds into the pancreas of pig under CT-guidance. Methods Twelve healthy pigs were equally divided into 6 groups.~(125)I seed implantation into the pancreatic tail under CT-guidance was performed in pigs of study groups (group A-E), while ghost seeds that contained no radioactive materials were used in the control group (group F). Imaging examination and laboratory tests, including serum amylase, hepatic and renal functions, were conducted before and 1, 7, 15, 21, 30, 60 days after the procedure. Every two pigs (group A-E) were sacrificed each time at 15, 30, 45, 60, and 75 days after treatment, and specimens of pancreas, duodenum, liver, kidney, etc. were collected and sent for pathologic examination. Results The ~(125)I seeds were successfully implanted in all pigs. During the follow-up period, no severe complications occurred. Imaging and pathologic studies demonstrated that in study groups necrosis of pancreatic tissue appeared around the implanted ~(125)I seeds in 15 days, the necrosis area increased significantly in 45 and 60 days, and in 75 days the necrosis size remained quite the same as seen in 60 days. No necrosis was found in the control group (group F) 60 days after treatment. No serious complications, such as effusions, hemorrhage or necrosis of the adjacent duodenum, stomach, liver or kidney, occurred 75 days after the treatment. Conclusion Percutaneous interstitial implantation of ~(125)I seeds into the pig's pancreas under CT-guidance is safe and feasible.

Objective To compare the therapeutic effects of CT-guided ~(125)I seed implantation with simple Gemcitabine chemotherapy for the treatment of unresectable pancreatic carcinoma. Methods Forty-six untreated patients with unresectable advanced pancreatic carcinoma were randomly divided into two groups: group A (n = 22), treated with ~(125)I seed implantation and group B (n = 24), treated with intravenous chemotherapy using Gemcitabine only. The clinical benefit response (CBR), objective tumor response (OTR), safety and the improvement of living quality were evaluated and analyzed. Results Three months after the treatment, the OTR rate of group A and group B was 45.5% and 8.33% respectively (P < 0.05). The CBR rate of group A and group B was 47.1% and 25% respectively (P < 0.05). No significant difference in PFS between group A and group B (P > 0.05). And also, the incidence of hematological toxicity and complication between two groups were of no significant difference. Conclusion For the treatment of advanced unresectable pancreatic carcinoma, both simple Gemcitabine chemotherapy and ~(125)I seed implantation are able to obtain a moderate objective response, although ~(125)I seed implantation seems to be more effective than Gemcitabine in improving the living quality and survival rate.

Objective To explore the correlation between the serum levels of fibrinogen (FIB), C-reactive protein (CRP) and homocysteine (Hcy) with the carotid vulnerable plaque in patients with large artery atherosclerosis (LAA) stroke.Methods The patients with acute ischemic stroke (AIS) admitted to the Department of Neurology in The Second Hospital of Lanzhou University from Mar. 2014 to Feb. 2015 were collected continuously, and 273 patients with anterior circulation of LAA stroke were selected based on the TOAST classification. These patients were classified as non-plaque group (n=84), stable plaque group (n=42) and vulnerable plaque group (n=147) according to the carotid ultrasonography examination. Another 182 patients without carotid disease of non-stroke selected simultaneously from our department were regarded as controls. The 19 demographic parameters and hematological indices were compared among the four groups. The logistic regression was used to screen the independent risk factors for carotid vulnerable plaque in LAA stroke patients. The Spearman rank correlation was performed to analyze the correlation between the carotid plaque vulnerability in LAA stroke patients with all the indicators.Results The levels of FIB, CRP and Hcy in the four groups showed statistically signicantcant differences (P<0.05). The multivariate logistic regression analysis revealed that FIB (OR=1.408, 95% CI 1.028-1.927,P=0.033) was the independent risk factor for carotid vulnerable plaque in patients with LAA stroke. The Spearman correlation analysis presented a positive correlation between carotid plaque vulnerability in LAA stroke patients with FIB (r=0.292;P=0.000) and Hcy (r=0.172;P=0.000). Conclusions The serum FIB and Hcy levels may be the meaningful biomarkers to predict the vulnerable carotid plaque in patients with LAA stroke. The serum level of CRP has no obvious correlation with carotid plaque vulnerability in LAA stroke patients.

Objective To observe the effect of trichostatina to induce mesenchymal stem cells(MSCs) differentiating into cardiomyocyte cells and to explore the potential interference approaches.Methods MSCs were incubated with different concentrations of TSA and different time,then to detecte the histone deacetylase(HDAC) activity;the differentiation of MSCs was observed by phase-contrast mictmcopy;fluorescence immunohistochemistry assessed cardiac troponin T and RT-PCR detected the expression of Nkx-2.5,GATA-4 genes.Results HDAC activity was the lowest when incubated with 300 nmol/L TSA for 24 hours,expression of cTnT of the cells was enhanced after incubation with TSA.The expression of Nkx-2.5,GATA-4 genes was enhanced before interference.ConclusionTSA can promote MSCs to differentiate into cardiomyocyte cells in vitro in an optimized condition.

OBJECTIVE To investigate the clinical application of antibiotic agents in a hospital.METHODS A cross section investigation method was used to survey the clinical application of antibiotic agents for emergency,out-patient clinic and hospitalization patients in a hospital within a day.RESULTS The usage rate of antibiotic agents for emergency patients was the maximum(54.67%) and the percentage of drug combination was multitude(23.42%).It was involved in 10 categories of antibiotic agents,cephalosporin was used at most(61.92%).The usage rate of antibiotic agents in Department of Gynecology and Obstetrics(OG) was the maximum(37.96%).Department with top defined DDD rate was Respiration Medical Department(RMD,39.90%).The average rate of etiological examination in the whole hospital was 6.67%.CONCLUSIONS It is higher in the usage rate of antibiotic agents for emergency patients.It is much more usage of antibiotic agents in OG and RMD,furthermore,the antibiotic agents are excessively used and the rate of etiological examination is low.Management should be further strengthened for rational use of antibiotic agents.