Objective To investigate the effect of programed training in the treatment of patients with chronic schizophrenia.Methods 88 patients with chronic schizophrenia were randomly divided into families involved in the training group and control group 44 cases,the training group for eight weeks of programmed training,and then all were followed up for 44 weeks.Positive and negative syndrome scale (PANSS),insight and treatment attitude questionnaire(ITAQ),Morningside Rehabilitation Status Scale(MRSS) were selected to assess.Results Total score of PANSS,negative symptoms and general psychopathology in The training group sub-section 20,32,44 weekend were cignificartly lower than in the control group(t =2.42 ～ 11.19,all P ＜0.01) ;positive symptoms points in 44 weekend the difference was significant(t =3.19,P ＜ 0.01) ; training group ITAQ score the weekend of the first 20,32,44 were significantly higher(t =3.13 ～ 8.32,all P ＜ 0.01) ;training group MRSS assessment dependent activities,the lack of capacity,the average social skills and the current symptoms and abnormal behavior in the 20 weeks were significantly lower than the control group.(t =1.67 ～4.31 ;2.37 ＞ t ＞ 1.664,P ＜ 0.05 ;t ＞ 2.374,P ＜ 0.01) ;relapse rate after 1 year of follow-up two groups by the x2 test (x2 =0.87 ;P ＜ 0.05) have significant differences.Conclusion The programmable training can significantly improve the effect of rehabilitation of patients with chronic schizophrenia,reduce the recurrence rate of chronic schizophrenia.

To observe whether Naomai Yihao (NM) Capsule, a compound traditional Chinese herbal medicine for regulating the "sea of blood in brain", and bone marrow stromal stem cell (BMSC) transplantation could improve angiogenesis in focal cerebral ischemia in rats.

Objective To observe the therapeutic effect of external application of herbal medicine for ankylosing spondylitis(AS).Methods Two hundred and seventy-nine AS patients were randomized into group A(N=175)and group B(N=104).The two groups received oral use of sulfasalazine,and group A additionally received external application of herbal medical ointment(mainly composed of Pheretima,Squama Manis,Rhizoma Dioscoreae Nipponicae,Radix Rehmanniae Preparata,Rhizoma Cibotii,Cortex Eucommiae,Radix Dipsaci)on 3~4 pairs of bilateral acupoints of Jiaji,dressing change once every three days,for continuous 6 months.After treatment,the therapeutic effect was evaluated.The primary outcome measures of health general score(BAS-G),disease activity index(BASDAI),function index(BASFI),Likert four-grade scores of general pain and rachialgia,duration of morning stiffness,general assessment by physician were observed before and after treatment.The secondary outcome measures of occiput to wall distance,finger to floor distance,chest expansion,Schober's test,spinal movement,"4"shape test were compared.The changes of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),complements 3 and 4(C3 and C4)as well as the adverse actions were also observed.Results After treatment,46 patients were clinically relieved,65 markedly effective,52 effective,12 ineffective,and the total effective rate was 93.14% in group A;11 patients were clinically relieved,27 markedly effective,48 effective,18 ineffective,and the total effective rate was 82.61% in group B.The difference of the therapeutic effect was significant between the two groups(P

Recent animal experiments demonstrated that neurogenesis mad angiogenesis involxed in mechanisms of stroke recovery.Transplanted stem cells can improve the neurological function after stroke.Vascular endothelial growth factor can also improve the neurological function after stroke via enhenceing angiogenesis.This article reviews the advances in combined treatment of stem cells and vascular endothelial growth factor in ischemic brain injury.

Objective To discuss the diagnosis, treatment and following up of the cervical lesions(CIN～cervical carcinoma Ia 1) during pregnancy. Methods Fifteen pregnant women with cervical lesions were reviewed from Jan 1998～Oct 2003 in our hospital. Results Among the fifteen cases, 11 were diagnosed as CIN～ cervical carcinoma Ia 1 based on biopsy results under copolscopy. Ten of the 11 cases had copolscopy repeated every 8 weeks and delivered at term. The left one woman terminated the pregnancy in the first trimester due to carcinoma in situ (CIS) invasion to glands. Among those 10 cases who progressed to term, four were stable during pregnancy (CINⅡ,CINⅢ,CIS and cervical carcinoma Ia1, one for each) and had the same pathology postpartum as antepartum; three had CIN I during pregnancy but changed to inflammation postpartum;one had CIS involved in glands prepartumly while CINⅡ～Ⅲ postpartumly; one had CINⅢ prepartumly and progressed to CIS involved in glands confirmed after conization postpartumly. One woman was missing after delivery. Conclusions Cervical lesions (CIN～Ia 1) less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy when necessary are available. Re examination is necessary within two months after birth. Routine examination for women who have no pap smear within the last one year period would be helpful in detecting cervical lesions during pregnancy.

Objective:To investigate the neonatal outcomes and prognosis of fetuses who were prenatally diagnosed with intraventricular hemorrhage(IVH) to provide evidence for clinical consultation and management.Methods:Clinical data of fetal IVH cases ( n=89) diagnosed by fetal neurosonogram (NSG) in Peking University First Hospital from January 2012 to April 2020 were retrospectively collected, and neonatal outcomes were analyzed, involving fetuses with different grades of IVH and coexisting abnormalities. These patients were followed up for more than three months after birth. Two child development screening systems, Ages & Stages Questionnaires (Third Edition) (ASQ-3) and Ages & Stages Questionnaires: Social-Emotional (ASQ-SE), were used to assess the development of the patients from several aspects including physical growth, oral communication, motor ability and social emotions. Descriptive statistical analysis was used in this study. Results:(1) A total of 89 fetuses were enrolled and 66.3% (59/89) of them underwent fetal cranial MRI examination after ultrasound diagnosis. Among these 59 cases, 32(54.2%) had the same results with fetal NSG; 20(33.9%) with the diagnosis of remote ventricular cystic hemorrhage by fetal NSG, but misdiagnosed by MRI, were all confirmed by neonatal craniocerebral ultrasound; 7(11.9%) were lost to follow-up or terminated. In addition to IVH that was consistent with the ultrasound diagnosis, MRI also found three cases of cortical malformation, three cases of subdural hemorrhage and two cases of cerebral parenchymal hemorrhage. (2) Among the 89 cases, 37 (41.6%) underwent neonatal craniocerebral ultrasound examination after birth showing small amount of remote IVH, which was consistent with previous fetal NSG diagnosis. (3) There were 38 cases complicated by lateral ventricular widening (three lost to follow-up, 18 were terminated , one died in uterus, 15 with good and one with poor outcome), 10 cases by severe IVH sequelae (one lost to follow-up and nine were terminated) and 10 by craniocerebral malformation (one lost to follow-up, eight were terminated and one with poor neonatal prognosis). Two cases with extracranial malformation (ureteropelvic junction obstruction) were healthy after birth. (4) There were 29, 30, 16 and 14 cases of gradeⅠ,Ⅱ,Ⅲ andⅣ of fetal IVH, respectively. Among all cases, 12 were lost to follow-up; three died in uterus (all with gradeⅣ IVH); 31 were terminated and 43 were born and followed up. During the follow-up of the 43 cases, two (one grade Ⅰ case with corpus callosum dysplasia and one grade Ⅲ case with fetal cytomegalovirus infection) had poor prognosis, while the other 41 (one gradeⅢ, 17 gradeⅡ and 23 gradeⅠcases) showed no severe abnormalities.Conclusions:Fetal NSG is the first choice in screening fetal IVH and MRI can be a valuable aid. The neonatal prognosis may be associated with the grade of hemorrhage and coexisting abnormalities. Fetuses with isolated grade Ⅰ or Ⅱ IVH usually have a relatively good prognosis.

Objective: To examine the causal relationship between body mass index (BMI) and 25 types of autoimmune diseases (ADs) using Mendelian randomization (MR) study method. Methods: The genome-wide association study (GWAS) data for BMI and 25 types of ADs were obtained from IEU OPEN GWAS database. Single nucleotide polymorphisms (SNPs) related to BMI were used as instrumental variables, 25 types of ADs were used as study outcomes, and MR analysis was performed using inverse variance weighted (IVW) method. Heterogeneity was evaluated using Cochran's Q test, horizontal pleiotropy was tested using MR-Egger regression and MR-PRESSO, and results robustness was verified with leave-one-out method. Results: Cochran's Q test showed heterogeneity of MR analysis results (P<0.05), and a random effect model was employed. The results of MR analysis showed that elevated BMI increased the incidence risks of type 1 diabetes mellitus (OR=1.519, 95%CI: 1.281-1.801), IgA nephropathy (OR=1.227, 95%CI: 1.134-1.327), adult Still disease (OR=1.002, 95%CI: 1.001-1.003), multiple sclerosis (OR=1.303, 95%CI: 1.115-1.523), narcolepsy (OR=1.029, 95%CI: 1.017-1.040), Hashimoto thyroiditis (OR=1.561, 95%CI: 1.391-1.751), autoimmune hepatitis (OR=1.481, 95%CI: 1.076-2.038), rheumatoid arthritis (OR=1.209, 95%CI: 1.054-1.386), psoriasis vulgaris (OR=1.719, 95%CI: 1.427-2.070) and pernicious anemia (OR=1.001, 95%CI: 1.000-1.002). No causal relationship was found with other ADs (all P>0.05). MR-Egger regression identified no horizontal pleiotropy of instrumental variables (all P>0.05), while MR-PRESSO test identified partial horizontal pleiotropy (all P<0.05), which remained consistent with the original results after adjustment (P>0.05). Leave-one-out analysis showed results robustness. Conclusion There are causal relationship among BMI and type 1 diabetes mellitus, IgA nephropathy, adult Still disease, multiple sclerosis, narcolepsy, Hashimoto thyroiditis, autoimmune hepatitis, rheumatoid arthritis, psoriasis vulgaris and pernicious anemia.

Objective To examine the changes of histological parameters of radial artery in uremia,and to explore their effects on arterial stiffness.Methods Sixty uremic patients underwent arteriovenous fistula surgery for hemodialysis and 20 healthy subjects received healthy examination were collected as uremia group and control group, respectively.Segments of radial arteries were obtained from all of uremic subjects and were evaluated by HE, Masson, van Kossa staining and electron microscopy.The expressions of osteopontin (OPN), α-SMA and elastin in arterial wall were detected by immunostaining, and apoptotic cells were determined by TUNEL assay.All of the subjects in the two groups received brachial ankle pulse wave velocity (baPWV) examination and the results were compared.The associations among histological parameters and baPWV were analyzed.Results More than one half (34/60) of artery samples presented uniformly thickening intima, in which most of cells expressed α-SMA and a few cells underwent apoptosis.The subendothelial matrix was abundant in collagen fibers, and no calcium deposition was found.The media thickened obviously, with increased collagen fibers, reduced elastin, unchanged α-SMA expression, and a few apoptotic smooth muscle cells.Two thirds uremic arteries expressed OPN, of which only one half had significant calcium deposition.The adventitia thickened and no calcium deposition was found.The baPWV level in uremic subjects was ( 18.5 ± 3.2 ) m/s, far greater than that in control subjects ( P ＜ 0.001 ).Statistical analysis showed that baPWV value was correlated with media thickness, calcification degree, and collagen content positively, and with elastin expression negatively.For diabetic uremic subjects, the OR values of vascular calcium deposition and remarkably-elevated baPWV value were 3.1, 2.3, respectively.Conclusions Radial arterial intima often presents hyperplasia which is not related with baPWV increment in uremia.Arterial media calcification and collagen content incremental are the most two protuberant characteristics in uremia, especially in ones accompanied with diabetes.Medical calcification, collagen accumulation, and e]astin reduction may contribute to the increased arterial stiffness in uremia.

Objective To investigate the expression of inflammatory mediators in renal tubular epithelial cells in patients with diabetic nephropathy (DN) and to explore the possible clinicopathological significance. Methods Twenty-three patients with DN diagnosed by renal biopsy and 10 patients with renal cell carcinoma undergone nephrectomy were allocated into DN group and control group, respectively. The renal expression of NF-κB p50, NF-κB p65, NF-κB p65 mRNA, MCP-1, OPN, α-SMA, and FN was detected by immunohistochemical or in situ hybridization assay. Serum creatinine, urinary N-acetylglucosaminedase (NAG), urinary albumin and 24-hour urinary protein were detected. The correlation between these inflmmnatory markers and clinicopathological data were analyzed. Results (1)Among all the 23 DN patients, granular degeneration of the renal tubular epithelium, focal tubular atrophy, infiltration of inflammatory cells and interstitial fibrosis were apparent, and none of these were found in control group. (2) Immunohistochemical and in situ hybridization assay showed that, compared with control group, expression of these factors increased significantly in renal tubular cells or interstitium in DN patients, and expression of α-SMA or FN was not found in tubular epithelial cells. (3)Statistics assay showed the tubular NF-κB p65 protein expression was correlated with all of the following factors: NF-κB p50 protein (r=0.792) and NF-κB p65 mRNA (r=0.763), tubular MCP-1 (r=0.825) and OPN (r=0.869) expression, interstitial α-SMA (r=0.327) and FN (r=0.432) expression, proteinuria(r=0.710), estimated glomerular filtration rate (eGFR) (r=-0.728), and urinary NAG (r= 0.930), P<0.01 respectively. Conclusion Tubular inflammation may play a role in the pathogenesis and progression of DN.

Objective To investigate the clinical and laboratory features of severe cases of hand,foot and mouth disease (HFMD) in Wenzhou, Zhejiang Province. Methods Clinical data of 107 children with HFMD, including 97 severe and 10 critical cases treated in Children' s Hospital Affiliated to Wenzhou Medical College during January and May 2010 were retrospectively analyzed. One hundred and fifty children with mild HFMD were also selected as the controls. Clinical features and laboratory results were compared between the two groups. Results Fever, rash and infection in central nervous system were observed in all patients with severe HFMD, and symptoms on respiratory, digestive and cardiovascular systems were more serious than those of mild HFMD cases. White blood cell counts (WBC) were higher in severe group than those in controls (t = 12.72, P ＜0.01). Hyperglycemia (9. 2 mmol/L) and abnormal troponin (0. 3 -9. 0 ng/mL) were presented in all the critical patients. Cerebrospinal fluid WBC counts were raised in 97 severe HFMD patients (98.5 × 106/L for average) with predominance of lymphocytes. Among 107 severe patients, EV71 was positive in 70, including all 10 critical cases. Conclusion Involvement of nervous,respiratory and digestive symptoms is common in severe cases of HFMD, and EV71 is the predominant pathogen.