BACKGROUND: There is a complicated relation between somatic disease and mental disorder. Somatic disease may induce functional disorder of brain, and generate psychiatric symptoms due to the change of psychological and social environment. The proportion of depression in elder people based on the chronic somatic disease is much higher, and thus the fatality of them increases.OBJECTIVE: To investigate the influence of single antidepressant, and therapeutic alliance of psychological and drug treatment on the rehabilitation of patients with elderly chronic somatic disease complicated with depression. DESIGN: Randomized and controlled grouping experiment.SETTING: Department of Senile Disease of Tongji Hospital Affiliated to Huazhong University of Science and Technology.PARTICIPANTS: Totally 102 patients were hospitalized in the Department of Senile Disease of Tongji Hospital Affiliated to Huazhong University of Science and Technology from March 2000 to January 2003, and all the patients had sleep disorder to a different extent, and suffered from symptoms of heart and alimentary tract which could not be explained as organic diseases, and chronic pain or systemic symptom. Their score of Zung scale was ＞ 40 points with average of (48.83±4.15)points. The patients were randomly divided into the drug group (n=46) and the combined treatment group (n=56). Each patient had more than two somatic symptoms in the two groups and more than 81.0% of them had three somatic symptoms. METHODS: According to the different primary diseases in patients of the two groups, regular treatment was given routinely. Oral thymoleptics fluoxetine of 20 mg/d 5-hydroxyltryptamine reuptake restrainer with 20 mg/d was administered, the dose of which could be added to 40 mg/d according to the pathogenetic conditions. At the beginning of the administration of oral antidepressant drugs, the patients in the combined treatment group were The focal point of depression and fear was identified, and the comfort and edge related to the disease was supplied, and the pathogenetic condition and the prognosis were told to the patients objectively. The family and society were encouraged to learn the rehabilitative skill and improve their possible, and the family and society were encouraged to give the patients adequate psychological support and life support. The patient and the family were assisted to establish favorable communication. The feeling of loneliness and isolation was reduced, and the sense of safety was increased. The depression status and the quality of life of the patients in the two groups were evaluated before the treatment and at 2 and 8 weeks after treatment with the Zung scale and the Spitzer quality of life index score (QLI), including 5 aspects: Activity, daily life, health, support and perspective. The highest score was 10 points. The lowest was 0, and the higher the score, the better the quality of life is.MAIN OUTCOME MEASURES: The results of the Zung scale and the QLI score evaluated before the treatment and at 2 and 8 weeks after the treatment.RESULTS: The treatment of the patients in the two groups was all finZung scale in the drug group and the combined treatment group at 2 weeks after the treatment indicated that there was significant difference in comparison with those before the treatment (41.12±2.60,48.83±4.15,t =10.67,P ＜ 0.05); (40.88±3.43,49.03±4.21 ,t=11.24,P ＜ 0.05). There was not significant difference in group comparison. The total points of Zung scale at 8 weeks were significantly decreased (36.11 ±2.87 ), (30.71±3.62),and there was significant difference in comparison with that before the treatment. The combined treatment group was better than the drug group in difference of QLI score at 2 weeks between the drug group and combined treatment group before and after the treatment (5.47 ± 1.33,5.32 ± 1.04,5.55±1.18,5.27±1.35). The QLI score of drug group and combined treat ment group at 8 weeks after treatment began to rise 7.21±0.13 and 8.83 ±0.32 ,respectively, and there was significant difference in comparison withthose before the treatment, and there was also significant difference in group comparison.CONCLUSION: The positive and effective combined therapy of anti-depression significantly improved the somatic symptoms of patients, no complications appeared, and most patients presented optimistic attitude to the prognosis of the primary disease. To identify the depression of elder people in earlier period is very important to promote rehabilitation of the primary disease.

Objective:To explore the relationship between human papilloma virus (HPV)-DNA and cytomegalovirus (CMV)-DNA virus content and the risk factors of endometrial cancer (EC) and their prediction models.Methods:Fifty-eight patients with EC from January 2017 to June 2020 in Suzhou Hospital Affiliated to Anhui Medical University were selected as the observation group, and 58 patients with endometrial hyperplasia (EH) during the same period were selected as the control group according to the 1∶1 matching case control principle. The clinical data, HPV-DNA, CMV-DNA positive rate and virus content of the two groups were compared, and the independent variables with P<0.05 were included in the Logistic regression model through single factor analysis. The risk factors of EC were analyzed, and the correlation between HPV-DNA, CMV-DNA and EC risk factors were evaluated. Logistic regression model was evaluated using the likelihood ratio chi-square and goodness-of-fit test, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the model to EC. Results:The proportion of patients with age ≥ 55 years old, body mass index (BMI)≥ 24 kg/m 2, a history of hypertension and diabetes, malignant tumor family history and hormone replacement therapy history in the observation group were higher than those in the control group: 72.41%(42/58) vs. 39.66%(23/58),70.69% (41/58) vs. 43.10%(25/58), 36.21%(21/58) vs. 10.34%(6/58), 31.03%(18/58) vs. 8.62%(5/58),29.31%(17/58) vs. 5.17%(3/58), 27.93%(17/58) vs. 8.62%(5/58), and the differences were statistically significant ( P<0.05). The positive rates of HPV and CMV, the contents of HPV-DNA and CMV-DNA in the observation group were higher than those in the control group: 62.07%(36/58) vs. 29.31%(17/58),81.03%(47/58) vs. 41.38%(24/58), (471.16 ± 33.58) copies/ml vs. (240.08 ± 17.41) copies/ml, (256.19 ± 24.77) copies/ml vs. (132.27 ± 13.20) copies/ml, the differences were statistically significant ( P<0.05). Age ≥ 55 years, BMI ≥ 24 kg/m 2, history of hypertension and diabetes, family history of malignant tumors, history of hormone replacement therapy, HPV positive, CMV positive were risk factors for EC ( P<0.05). HPV-DNA virus content was positively correlated with the age of EC patients, family history of malignant tumors, and history of diabetes ( P<0.05), the viral content of CMV-DNA was positively correlated with age, family history of malignant tumors, and history of hypertension ( P<0.05). According to the ROC curve drawn by the predicted value and the true value of the Logistic regression model, the area under the curve was 0.930 (95% CI 0.885 - 0.976), when the predictive probability of individual nosocomial infection>0.528, the prediction sensitivity was 84.48%, and the specificity was 89.66%. Conclusions:The occurrence of EC is related to many factors, and the content of HPV-DNA and CMV-DNA viruses are the risk factors of its occurrence. The overall predictive value of a Logistic regression model constructed based on EC pathological characteristics and the virus content of HPV-DNA and CMV-DNA is high, and it has clinical application prospects.

BACKGROUND: Color Doppler flow imaging can exam the early myocardial disorder in type 2 diabetic patients. What does exercise tolerance test work for the examination of such disorder in combination with color Doppler flow imaging (CDFI) ?OBJECTIVE: To analyze in comparison the early evaluation on reduced diastolic function in left ventricle in patients with type 2 diabetes between the examinations of exercise tolerance test combined with color Doppler flow image and simple color Doppler flow imaging.DESIGN: Cases-controlled comparison and self-comparison.SETTING: Department of electrodiagnosis and department of Endocrinology in a municipal hospital.PARTICIPANTS: Thirty-six cases of inpatients with type 2 diabetes were selected from Department of Endocrinology of Shenyang Red Cross Hospital from March to December in 2004, of which, 25 cases were males and 11cases females. The diabetic patients included had no cardiac vascular complications and participated in the study in volunteer. Thirty-two patients who received annual routine health check at the same period were selected as the control, of which, 20 cases were males and 12 cases females.METHODS: Metronics treadmill exercise test equipment was used for exercise tolerance in two groups. Before exercise(at quiescent state) and after exercise tolerance, Vivid 4 CDFI was used to determine flow velocity at E and A peak values respectively, ratio between flow velocities at E peak value and A peak value as well as isovolumtric relaxation time (IRT).MAIN OUTCOME MEASURES: Comparison of cardiac functional indexes before and after exercise tolerance in two groups.RESULTS: Thirty-four diabetic patients accomplished exercise tolerance test, of which, 1 case presented frequent ventricular extrasystole, another one presented precordial pain and stopped the test. In the control, all of 32 cases ratio between flow rates of E peak value and A peak value was remarkably lower than that in the control (0. 90 ± 0. 25, 1.40 ± 0.30, P ＜ 0.05 ); IRT was remarkably longer than that in the control [ (112. 07 ± 20. 16),imental group, the ratio between flow rates of E peak value and A peak value was remarkably lower than that in the control (0.62 ±0. 12, 1.28 ±0.87, P＜ 0.01 ); IRT was remarkably longer than that in the control[ (138. 10± 19.21), (97.37±9.61) ms, P ＜0.01].CONCLUSION: CDFI can supervise and evaluate at early stage the cardiac functional changes in type 2 diabetic patients. Due to the induction of exercise tolerance, the combination of exercise tolerance test and CDFI provides more accurate, objective and valuable conclusions at early stage.

Objective To guide bracing treatment for adolescent idiopathic scoliosis (AIS). Methods A total of 68 AIS patients with apex vertebrae (AV) under T6 had received the improved Cheneau bracing treatment between March 2008 and June 2010. All patients were divided into two groups. There were 16males and 35 females, with a mean age of 13.6 years (range, 10.6-17.2) in the intervention group. The mean Cobb angle was 29.5° (range, 20°-38°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the group;while there were 6 males and 11 females, with a mean of 13.2 years (range, 10.8-16.8) in the control group.The mean Cobb angle was 28.7° (range, 20°-37°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the control group. All patients in control group were informed standardized bracing treatment method. But we gave patients in intervention group two copies of "The Form of Guiding Bracing Treatment" treatment of patients with AIS, and informed that they carried out the bracing treatment according requirement of the form.Cobb angle was measured before the treatment and at 6th, 12th, 18th month after treatment. Results Sixtyfive cases were followed up for 18-27 months. However, one female in control group and two females in intervention group were lost during follow-up. Coefficient and intraclass correlation coefficient of form were both over 0.60. The acceptance rate of the table was 97.54%(199/204), qualified rate was 100.00%( 199/199), and with good content validity. The mean Cobb angle decreased gradually from 28.71° to 25.76° in control group and from 29.47° to 21.59° in intervention group. Four cases in control group and 34 cases in intervention group had reduced more than 5° at 18 months after treatment. There was significant difference regarding Cobb angle between two group. Conclusion The form of guiding bracing treatment has good reliability and validity and can guide bracing treatment of AIS correctly and effectively.

Objective To study the effects of high concentration oxygen exposure on the Sox17 expression of vascular endothelial cells of neonatal mice lungs,and to explore the pathogenesis of blocked lung vascular development.Methods Thirty two C57B1/6J newborn mice within six hours after birth were randomly divided to hyperoxia group (n=16) and room air group (n=16).Mice of hyperoxia group were exposed to 85％ oxygen.Eight mice of either group were sacrificed at 7 and 14 days after birth respectively to observe the lung morphology and calculate radial alveolar counts (RAC),which is the number of alveoli on the straight line from the center of respiratory bronchioles to the nearest fibrous septa or the pleura.Sox 17 expression in the pulmonary vessels was detected by immunohistochemical staining.Sox17 mRNA was measured by reverse transcription polymerase chain reaction.Sox17 protein level was measured by Western blot.Two independent samples t-test was used for statistical analysis.Results Compared with day 7,the lung structures matured with more uniformed alveoli and the septas became thinner on day t4 in room air group.However,the lungs developed slowly with simplified and non-uniformed alveoli on day 14 in hyperoxia group.The Sox17 protein was positive on endothelial cells of pulmonary arteries,veins and alveolar capillarys,as well as the alveolar epithelial cells.The RAC on day 7 and day 14 in hyperoxia group were both lower than that in room air group (3.7±0.7 vs 5.0±0.8,5.3±0.6 vs 8.3±0.9,respectively,t=3.057 and 8.148,both P ＜ 0.01).Sox17 mRNA on day 7 and day 14 in hyperoxia group were both lower than that in room air group (0.62±0.10 vs 0.88±0.11,0.44±0.06vs 0.90±0.15,t=3.607 and 6.926,both P ＜ 0.01).Sox17 protein level on day 7 and day 14 in hyperoxia group were both lowered than that in room air group (0.32±0.04 vs 0.76±0.04,0.36±0.07 vs 0.96±0.06,t=3.102 and 8.421,both P ＜ 0.01).Conclusions Exposure of high concentration of oxygen may cause impairment of lung vascular development by inhibiting Sox17 expression in lungs of neonatal mice.

Objective To investigate the effect of TanshinoneⅡA on nerve conduction of oxaliplatin induced peripheral neuropathy in rats. Methods Fifty Wistar rats were randomly divided into normal control group, model group, treatment group, prevention group, prevention and treatment group. Except for those in model group, Wistar rats were injected i.p. with oxaliplatin (20 mg/kg). The electrophysiological instrument were employed to detect the sciatic nerve conduction velocity, latency, amplitude 6 h, 24 h, 72 h and 7 d after modeling. Results In the model group, velocity of sciatic nerve conduction slowed, and latency prolonged 24 h after modeling (P<0.05) which continued to slow and prolong until 7 d after modeling (P<0.05). After the application of Tanshinone ⅡA, nerve conduction velocity became faster and latency shorter significantly (P <0.05), especially in the prevention and treatment group, in which no significant difference was found when compared with those in the normal control group (P > 0.05). Conclusions During the chemotherapy with oxaliplatin , TanshinoneⅡA can increase the conduction velocity of sciatic nerve , shorten the disease duration and play a protective role for peripheral nerve.

Acrosin ; immunology ; isolation & purification ; Humans ; Male ; Membrane Proteins ; immunology ; isolation & purification ; Protein Binding ; Spermatozoa ; metabolism ; Zona Pellucida ; metabolism

Objective To investigate the clinical value of blood oxygen level-dependent functional magnetic resonance imaging (BOLD-FMRI) in guiding the dose reduction and functional protection of the motor cortex during postoperative radiotherapy for brain astrocytoma.Methods This study included 27 brain astrocytoma patients with tumors near the motor cortex,who underwent routine MRI and BOLD-FMRI before postoperative radiotherapy.The location and scope of the motor cortex,which were acquired based on BOLD-FMRI results,were marked on positioning CT images,so that the motor cortex would be dealt with as organs at risk.The dose to the motor cortex was reduced as much as possible while ensuring the therapeutic dose to the target area.Finally,the radiotherapy plan that would reduce the mean received dose of the motor cortex was formulated and compared with the routine plan that could not reduce the received dose.Results With the protective radiotherapy plan,the mean received dose of the motor cortex decreased 0.76％-59.20％ (mean 30.78％) on the affected side and 23.33％-68.30％ (mean 48.07％) on the unaffected side;the coefficients of variation were 71.41％ on the affected side and 36.71％ on the unaffected side.Conclusions BOLD-FMRI can help to reduce the received dose of the motor cortex while ensuring the therapeutic dose to the target area when formulating the postoperative radiotherapy plan for brain astrocytoma,thus protecting the motor function and improving patients' quality of life.

Pure culture of Phlebopus portentosus was inoculated in the roots of coffee tree. The results indi-cated that the young fruit bodies would come out around the rhizomes of host tree after inoculation in 30 to 90 days, single or cluster, 3 to 4 days for mature, weight 20.0 g to 62.0 g. Brown rhizomorph and hyphae can be seen on the seedlings`rhizome, main root and side root while nothing is on the tip of the root.It was found that rhizomorph on the surface of roots would die after inoculation in 90 days in pot.

Objective To investigate the diagnostic value of serum Cystatin C for early detection of renal damage in patients with liver cirrhosis. Methods 24-h creatinine clearance (CCr), serum level of cystatin C (CysC) and serum creatinine were measured in 76 patients with cirrhosis and t-test,Pearson's correlation test and ROC curve were used to evaluate the diagnostic significance of Cys C.Results The increase in Cys C level was associated with a decrease of CCr in the patients. Both Cys C and SCr were inversely correlated with CCr ( CysC: r =- 0. 763, P ＜ 0. 001; SCr: r=-0. 571,P＜0.01). Meanwhile, the area under the ROC curve was significantly higher in Cys C than in SCr (0. 830 vs. 0. 612). Conclusion Cystatin C is a more accurate and sensitive marker of renal diagnosis in liver cirrhosis. Detection of Cys C level in cirrhotic patients is of great significance for the prevention of liver-kidney syndrome.