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.

Objective To investigate the categories of fetal anomalies detected by ultrasound scan in the third trimester.Methods From January 1,2012 to December 31,2013,492 singleton fetuses were found to have structural abnormalities on the first,second or third trimester ultrasound scan in the Peking University First Hospital,only 50 (10.2％) fetuses were detected on the third trimester (≥ 28 weeks of gestation) with no abnormalities detected on the first and second trimester scan,were enrolled.The categories of the fetal structural abnormalities were analyzed.Results The age of the mothers of the 50 fetuses with structural abnormalities was (35.7± 5.2) years (26-43 years) with an average gestation of (32.4±2.8) weeks (28.6-36.8 weeks).These abnormalities were seen in the central nervous system (42％,21/50),digestive system (28％,14/50),urinary system (16％,8/50),cardiovascular system (8％,4/50),respiratory system (4％,2/50) and facial structures (2％,1/50).Intrauterine death occurred in one case and 49 mothers had a live birth.After birth,14 neonates were normal,five needed further treatment,three cases were complicated by other abnormalities,23 had no dysfunction but need follow-up and four were lost to follow-up.Six of the 20 (30％) fetuses with central nervous system abnormalities and 2/4 fetuses with cardiovascular system abnormalities had an adverse prognosis,while 1/12 and 2/7 fetuses with digestive and urinary system abnormalities had an adverse prognosis.Conclusions The central nervous system and cardiovascular system should be examined in priority during the third trimester ultrasound scan.

There is an independent-regulated renin-angiotensin system(RAS)in kidney.Most of patients with hypertension or kidney diseases present increased renal RAS activity,which maintains body water and sodium balance,but contributes to the occurrence of hypertension and renal damage progression.The article reviewes some recent basic and clinical researches,focusing on the renal RAS activation mechanisms,consequences and clinical significance of the intervention of RAS blockers,which may help us recognize local RAS function of kidney,explore the treatment strategies to control hypertension and slow chronic kidney disease progression.

ObjectiveTo investigate the intervention effects of fluoxetine on hypothalamic-pituitary-thyroid (HPT) axis function changes in post-stroke depression (PSD) patients.MethodsMild to moderate stroke patients were enrolled and blood T3,T4,FT3,FT4 and TSH were measured at day 0,1,7,14,21 and 3 months.At day 7,thyroid hormone releasing hormone (TRH) stimulation test were performed.After evaluated with the anxiety scale screening using the HAMD scale assessment at day 21,the subjects were divided into simple stroke subgroup ( ＜8 points,25 cases) and PSD sub-group ( ≥ 8 points,18 cases),with 16 healthy age and sex matched individuals as control group.In the 2nd stage,TRH stimulation test were performed in PSD patients before and after 7 days of fluoxetine administration.ResultsCompared with control group,stroke patients presented lower FT3 (P ＜0.05 ) and higher serum TSH (P ＜ 0.05) at day 0,1,7,14.Furthermore,PSD patients presented lower FT3,TSH levels and higher FT4 levels than simple stroke patients did(P＜0.05).At day 21 and month 3,T3,T4,FT3,FT4 and TSH levels in stroke patients were not different from those in control group(P ＞ 0.05).TRH test showed that the responses in PSD patients were lower than those in simple stroke patients( (2.65 ±0.42)μIU/ml vs (5.31 ±0.68 ) μIU/ml,P ＜ 0.05 ).Correlation analysis showed HAMD scores correlated with TSH level changes and TSH0 ～30 in PSD subgroup closely( r=0.35,0.25,P＜0.01 ).In the 2nd stage,TRH test showed that PSD patients who took fluoxetine presented a lower TSH level change than PSD patients who did not( (4.61 ± 2.02) μIU/ml vs (7.05 ± 2.12) μIU/ml,P ＜ 0.05 ).ConclusionPSD patients present a long and severe HPT axis function inhibition,which may due to TRH deficiency,and fluoxetine may improve this abnormality.

Objective To investigate prenatal diagnosis and prognosis of fetus with hyperechogenic kidney.Methods Clinical data of 65 cases prenatally diagnosed with fetal hyperechogenic kidney in Peking University First Hospital between July,2009 and May,2015 were retrospectively analyzed.Results of fetal ultrasound screening and pregnancy outcomes were analyzed and Growth and development status of those babies were followed up until December,2015.Independent-sample-t,Chi-square or Fisher's exact test was applied for statistical analysis.Results Among the 65 cases,including 48(73.8％) bilateral and 17 (26.2％) unilateral,34 cases (52.3％) were diagnosed as non-isolated and 31 cases (47.7％) as isolated fetal hyperechogenic kidney.The primary associated malformations with non-isolated fetal hyperechogenic kidney included cardiac abnormality (14 cases,41.2％),urinary system abnormality (12 cases,35.2％),skeletal system abnormality (nine cases,26.5％),central nervous system abnormality (eight cases,23.5％) and Meckel-Gruber sydrome (one case,2.9％).Amniotic volume,the size and numbers of affected kidney between non-isolated and isolated groups showed no significant differences (all P＞0.05).Twenty out of the 65 cases (30.8％) received fetal karyotyping and one received non-invasive prenatal testing,and no abnormality was detected.Three cases received cord blood array comparative genomic hybridization with negative results.Pathogenic genes were found in two cases who received targeted exome capture with high throughput sequencing,including a TTC21B mutation in cord blood in one case and a HNF1β deletion mutation in peripheral blood after birth in the other.There were 23 (35.4％) terminations of pregnancy and 42 (64.6％) live births among which three died after birth.The rate of live birth was significantly higher in the isolated group than in the non-isolated group[87.1％(27/31) vs 44.1％(15/34),x2=13.101,P＜0.01].Of the fifteen live births in the non-isolated group,there were fourteen survived symptomfree except that one lost to follow-up.Of the 27 live births in the isolated group,follow up study revealed 23 symptom-free survivors,one lost,two neonatal deaths (one died of volvulus neonatorum,and the other due to unknown causes) and one death of renal and liver function failures at the age of two-and-a-half.ConclusionsFetal hyperechogenic kidney is an important prenatal ultrasound marker for congenital renal anomalies,and the prognosis of non-isolated fetal hyperechogenic kidney is poor.The current rate of abnormal karyotype in fetus with hyperechogenic kidney is very low.However,the rate of prenatal genes screening should be encouraged.

Objective To evaluate the effect of 6% hydroxyethyl starch 130∕0. 4 on acute kidney injury in elderly patients in a prospective, multicenter, randomized, double?blind, controlled clinical tri?al. Methods A total of 120 patients of both sexes, aged 65-82 yr, weighing 56-83 kg, of American So?ciety of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective orthopaedics and hernia surgery, were divided into either hydroxyethyl starch group ( group HES) or lactated Ringer′s solution group ( group LR) , with 60 patients in each group. Hydroxyethyl starch and lactated Ringer′s solution were infused intra?venously at a rate of 7. 5 ml∕kg during 1st hour of surgery in HES and LR groups, respectively. Lactated Ringer′s solution was then infused at a rate of 5 ml∕kg starting from 2nd hour of surgery until the end of sur?gery in both groups. Before surgery, at the end of surgery and at 1, 3 and 5 days after surgery, blood sam?ples and urine specimens were collected for determination of the concentrations of neutrophil gelatinase?asso?ciated lipocalin, interleukin?18 (IL?18), plasma creatinine, urine β2 microglobulin and urine albumin.
The estimated glomerular filtration rate was calculated. Results The level of urine IL?18 was significantly higher at each time point after surgery than before surgery and immediately after the end of surgery ( P<0.05) . There were no significant differences between the two groups in the levels of urine IL?18, plasma creatinine, plasma and urine neutrophil gelatinase?associated lipocalin, plasma IL?18, urineβ2 microglob?ulin and urine albumin and estimated glomerular filtration rate at each time point ( P>0.05) . Conclusion Compared with lactated Ringer′s solution, 6% hydroxyethyl starch 130∕0.4 does not aggravate acute kidney injury in elderly patients.

Objective:To investigate the influence of peer education based on WeChat support on the social support, mental flexibility and rehabilitation self-efficacy of patients after laparoscopic radical prostatectomy.Methods:A total of 82 patients after laparoscopic radical prostatectomy who were admitted from January 2018 to December 2019 were selected as the research objects. According to the operation time, they were divided into the treatment group (January 2019-December 2019) with 43 cases and the control group (January 2018-December 2018) with 39 cases. The control group was given regular health education, and the treatment group jointly applied peer education based on WeChat support. Followed up for 2 months, the two groups of patients were evaluated the degree of social support, psychological flexibility, and rehabilitation self-efficacy by Social Support Rating Scale, Connor-Davidson Resilience Scale, General Self-Efficacy Scale and compared.Results:There was no significant difference in the degree of social support, psychological flexibility, and rehabilitation self-efficacy before intervention between the two groups( P>0.05). The objective support, support utilization, and social support scores in the treatment group after intervention were (9.12±1.12), (10.45 ± 0.75), (32.49 ± 4.56) points, and the control group were (7.45 ± 1.36), (8.74 ± 1.43), (29.84 ± 4.45) points, and the differences were statistically significant ( t values were 6.091, 6.681, 2.658, P<0.01). The scores of toughness, self-improvement, optimism, and mental resilience in the treatment group after intervention were (28.21 ± 4.25), (20.32 ± 3.54), (9.36 ± 1.12), and (57.89 ± 7.21) points, and the control group were (24.36 ± 4.34), (17.14 ± 3.21), (7.84 ± 1.23), (49.34 ± 6.55) points, and the differences were statistically significant( t values were 4.056-5.857, P<0.01). The scores of physical exercise self-efficacy, coping self-efficacy, and rehabilitation self-efficacy in the treatment group after intervention were (43.43 ± 5.38), (54.45 ± 6.32), (97.88 ± 7.45) points, and the control group were (37.45 ± 5.42), (48.65 ± 6.45), (86.10 ± 9.12) points, and the differences were statistically significant ( t values were 5.009, 4.110, 6.430, P<0.01). Conclusions:Peer education based on WeChat support helps to enhance the degree of social support for patients after laparoscopic prostate cancer surgery, improve the level of mental flexibility, and promote the development of rehabilitation self-efficacy.

Fas-associated death domain (FADD) is a signal connection protein in Fas/FasL apoptotic path which might play a key role on apoptosis by transferring apoptotic signal. To reveal the intracellular signal transduction molecules involved in the procedure of follicular development in bovine ovary, we cloned FADD gene in bovine ovary tissue with RT-PCR, deleted the termination codon in its cDNA and directionally cloned the amplified FADD gene into eukaryotic expression vector pAcGFP-N1 including AcGFP, successfully constructed the fusion protein recombinant plasmid. After identifying by restrictive enzyme Bgl II/EcoR I and sequencing, transfected pAcGFP-bFADD into CHO-K1 cell mediated by Lipofectamine 2000, observed the expression of AcGFP and detected the transcription and expression of FADD by RT-PCR and Western blotting. The results showed that the cattle FADD was successfully cloned, the pAcGFP-bFADD fusion protein recombinant plasmid was successfully constructed by introducing Bgl II, EcoR I cloning site at two ends of FADD open reading frame and inserting a Kozak sequence before start codon. AcGFP expression was detected as early as 24 h after transfection. The percentage of AcGFP positive cells reached about 65% after 24 h. A 654 bp transcription was amplified by RT-PCR, and 51.4 kD target protein was detected by Western blotting. Construction of pAcGFP-bFADD recombinant plasmid should be helpful for further understanding the mechanism of regulation of FADD on bovine oocytes formation and development.
Animals ; Base Sequence ; CHO Cells ; Cattle ; Cloning, Molecular ; Cricetinae ; Cricetulus ; DNA, Complementary ; genetics ; Fas-Associated Death Domain Protein ; biosynthesis ; genetics ; Female ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Molecular Sequence Data ; Oocytes ; cytology ; Open Reading Frames ; Ovary ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transfection

Objective To observe the expressions of oxidized low density lipoprotein ( OxLDL ) receptor CD36 in kidney tissue of diabetic rats and in tubular cells incubated with OxLDL, and to explore the association of CD36 with the tubular injury and renal fibrosis in the process of diabetic nephropathy. Methods Diabetic rat model with hyperlipidemia was established by feeding with high sugar and fat diet and injection of low dose streptozotocin intraperitoneally. The expression of CD36 in kidney tissues was analyzed immunohistochemically. Meanwhile, the tubular sclerosis and fibrosis injury index were estimated and calculated. NRK-52E cells were stimulated with 50 mg/L OxLDL for 5, 10, 24, and 48 h, or 100 and 150 mg/L OxLDLs for 2 and 3 days. The protein expression of CD36 was detected by Western blot. Results The expression of CD36 in the renal tubulointerstitium of diabetic rats was increased comparing to that in control rats, and was localized mainly at tubular region. The renal tubular damage index(STI)ofdiabetesgroupwashigherthanthatincontrolgroup(5.54±1.5vs0.65±0.15,P<0.05). OxLDL stimulated CD36 expression in NRK-52E cells in a dose-and time-dependent manner. Conclusion The expression of CD36 was increased in renal tubular of diabetic rats, in consistent with STI. OxLDL increased CD36 expression in NRK-52E cells. These results suggest that the expression of CD36 is associated with renal tubular damages in experimental rat diabetes.