目的观察心理治疗“三步法”在肢体骨折康复期功能训练中的作用。方法将328例肢体骨折患者随机分为心理治疗组(168例)和常规治疗组(160例),心理治疗组除采用常规治疗和辅导患者进行功能锻炼外,增加了心理治疗“三步法”,常规治疗组仅采用骨科常规治疗方法,并辅导患者进行功能锻炼。对两组患者进行6—18个月的随访。结果心理治疗组的治愈率为99.4%,常规治疗组的治愈率为94.4%,两组间有非常显著性差异(P<0.01)。结论心理治疗“三步法”对骨折患者康复期的功能训练有促进作用。

Objective To investigate the expression and clinical significance of the estrogen receptor(ER) subsets ER?,ER? and Ki-67 in tissues of different thyroid diseases.Methods The pathological data of 93 patients with thyroid diseases were collected from Jun.2003 to Jun.2007,including thyroid carcinoma(56 cases),thyroid follicular adenoma(13 cases),nodular goiter(14 cases) and normal thyroid tissue(10 cases).S-P immunohistochemistry was performed to determine the expressions of ER?,ER? and Ki-67 in the thyroid tissues.Results ER? and ER? were expressed in the plasma and nuclei of thyroid epithelial cells,and ER? was also expressed in the stroma.The positive rates of ER? expression in cases with thyroid carcinoma,thyroid follicular adenoma,nodular goiter and normal thyroid tissue was 87.5%,69.2%,42.9% and 30.0%,respectively,with significant difference between carcinoma and goiter or normal thyroid tissue(P0.05).Conclusion ER? and ER? may play an aggravating effect on cell proliferation in the disease course of the thyroid carcinoma.The expressions of ER? and Ki-67 are related to invasion and metastasis of thyroid carcinoma.

Objective This test is focused on functional magnetic resonance imaging(fMRI) of visual cortex by using echo planar imaging(EPI) and blood oxygenation level dependent(BOLD) contrast. Methods 36 normal volunteers and 17 patients with lesions at occipital lobe were included in this test. The echo planar images of the occipital area were acquired at visual stimulation and rest phases. Results The primary visual cortex was located at the bilateral calcarine cortex, which belonged to Brodmann area 17. The functional areas showed displacement due to the mass effect of lesions near calcarine cortex in 3 patients. Conclusion fMRI can be used to study human functional cortex. A preliminary location of visual cortex can be acquired through visual stimulation. The invasion of the intracranial massive lesions to functional areas the disappearance of functional activation. The mass effect of intracranial lesions may lead to deformation or displacement of the near functional areas.

To improve 3-ketosteroid-△1-dehydrogenase (KSDH) activity and the transformation level for androst-4-ene-3,17-dione,3-ketosteroid-△1 -dehydrogenase gene (ksdD) from Arthrobacter simplex was cloned into plasmid pWB980 and expressed in B. subtilis WB600 under the control of promoter P43. The molecular weight of expressed enzyme was about 55kDa by SDS-PAGE analysis. The activitities assayed by spectrophotometrical method of intracellular and extracellular soluble enzyme were 110 ± 0.5mU and 15 ± 0.6mU per milligram of protein respectively. The transformation rate of androst-4-ene-3,17-dione by the B. subtilis recombinant cells was 45.3%. Compared with Arthrobacter simplex, the enzyme activity of KSDH expressed in B. subtilis was improved about 30 fold, and the transformation level of androst-4-ene-3,17-dione by the B.subtilis recombinant cells was improved about 10 fold. The recombinant B. subtilis cells used in biotransformation of steroids provided a new way for steroid medicines production.

Objective To evaluate the clinical diagnostic criteria of latent autoimmune diabetes of adults(LADA).Methods A total of 268 subjects consisted of 168 patients with type 2 diabetes(T2DM) and of 100 normal controls were involved in the study.The body mass index(BMI) was calculated by formula(kg/m~2) and the levels of fasting blood glucose(FBG),postprandial blood glucose(PBG),fasting C-peptide(FC-P),postprandial Cpeptide(PC-P),GAD antibody(GADA),ICA,IAA and IA-2 antibody were detected. The patients with positive antibody in T2DM group were considered as LADA and the others in T2DM group still as T2DM.Results The GADA,ICA,IA-2 antibody and IAA antibody were detected in 21.18%,14.29%,1.19% and 0.60% of patients with T2DM,respectively.The indexes such as the age of onset ≤ 40 years old,overt symptom,ketosis,without chronic complication and hypertension,BMI90.00%).Conclusion The GADA is the most specific antibody in the diagnosis of patients with autoimmune diabetes.The indexes such as the age of onset≤40 years,overt symptom,ketosis,without chronic complication and hypertension,BMI

Objective To study the clinical significance of monitoring the urine iodine level in pregnant women.Methods The urine iodine levels were detected in 391 cases of pregnant women.The relativity was analyzed among the pregnancy gestation,pregnancy complications and the urine iodine levels.The corresponding health educa-tion of iodine nutritional knowledge was conducted according to the results of the determination.Results (1 )The urine iodine value was (124.73 ±70.61)μg/L in 391 pregnant women.The severe deficiency iodine rate,deficiency iodine rate and appropriate iodine rate of pregnant women were 37.85%,64.70% and 25.06%,respectively.(2) There was no significant difference in values of urine iodine among the pregnant women during the first,second and third trimester of pregnancy[(121.76 ±71.81)μg/L,(125.52 ±69.28)μg/L,(129.30 ±75.19)μg/L](t≤0.59, all P >0.05).The mean values were all lower than the appropriate values of WHO(150 ~249 μg/L).The low iodine rates were 67.20%,63.23% and 65.12%,respectively.There was no significant difference among them(χ2 =0.56, P >0.05 ).(3 )The urine iodine value of the pregnant women complicated with hyperthyroidism [(85.76 ± 53.09)μg/L]was significantly lower than that of primary hypothyroidism combined with pregnancy [(133.65 ± 73.41)μg/L],pregnancy combined with subclinical hypothyroidism[(136.50 ±79.19)μg/L]and no pregnancy complication[(119.34 ±66.43)μg/L](t≥2.76,P <0.01).The rate of iodine deficiency(87.88%)was highest (χ2 =8.72,P <0.05).(4)The urine iodine value after iodine nutrition intervention was significantly higher than those before in 77 pregnant women[(129.74 ±68.04)μg/L vs.(107.01 ±74.36)μg/L,t =1.98,P <0.05].The iodine deficiency rate dropped from 79.22% to 63.64%(χ2 =4.58,P <0.05).Conclusion In order to improve the appropriate iodine rate of pregnant women,it should be very important significance on monitoring the urine iodine level of pregnant women in particular with a complication of pregnancy and conducting iodine nutrition intervention in whole pregnancy gestation.

Objective To evaluate the epileptic focus localization value of MSI in patients with refractory epilepsy and encephalomalacia. Method MSI examination was proceeded in 11 patients with refractory epilepsy and encephalomalacia. Five of them were treated with gamma-knife; the others were treated with surgery. Results In the five patients treated with gamma-knife, the result was satisfied in 3 patients, one patient improved significantly, the other one useless. The distance between the encephalomalacia and the epileptic focus was 4cm in one patient; one patient′s encephalomalacia was located in right frontal-parietal lobe but the epileptic focus mainly located in right temporal lobe, only a little located around the encephalomalacia. Overall agreement among VEEG,ECoG and MEG (presence of concordant spikes with the same localization shown by three techniques) was obtained in three patients, the areas localized by ECoG were larger than VEEG and MSI in two patients. The localization was different in VEEG, MSI and ECoG in one patient, then he was given a resection of bilateral occipital epileptic focus. The results of patients treated with surgery were satisfied. Conclusion The MSI localization of epileptic focus in patients with refractory epilepsy and encephalomalacia is precise, and it can direct the advanced clinical treatment.

Objective: To evaluate the knowledge, attitude and behavior on blood lipid among people in Changsha and to provide evidences for prevention and control of blood lipid abnormality. Methods: A total of 400 cases were randomly selected on the questionnaire of the knowledge, attitude and behavior on blood lipid in ordinary adults who participate in health examination in Xiangya Hospital. Blood lipid related physical examination was conducted at the same time. hTe health examination participants were divided into several groups according to their sex, age, degree of education, marriage and family income. The influential factors for knowledge, attitude and behavior were analyzed. Results: hTe knowledge score of blood lipid for health examination participants was 18.33±8.67 (total score 37), the attitude score was 6.63±2.45 (total score 9) and the behavior score was 8.32±2.65 (total score 16). hTe scores of female was higher than that of male in the terms of knowledge and behavior (bothP<0.05); the scores in the 40–49 age group were lower than those in the other age groups (all P<0.05); the scores in the junior high school group were lower than those in the other education groups (allP<0.05); the scores in the family group with less than 2 000 yuan income were lower than those in other family groups with different income (allP<0.05). The multiple stepwise regression analysis showed that: 1) the knowledge on blood lipid score was inlfuenced by ages and education background (bothP<0.05); 2) while the attitude of blood lipid was inlfuenced by four factors such as education background, systemic blood pressure, blood sugar and triglyceride(allP<0.05); 3) the behavior on blood lipid was inlfuenced by ifve factors such education background, triglyceride, systemic blood pressure, blood sugar and ages (allP<0.05). Conclusion: The knowledge, attitude and behavior on blood lipid among health examination participants were mostly influenced by education background, gender and ages. Thus, clinical medical staff should prevent the blood lipid abnormality through the health education and improve the knowledge in normal people. hTe group of 40–49 age male should be thought as the primary intervention subjects. hTe knowledge, attitude and behavior on blood lipid among the general population is also related to individual’s blood pressure, blood sugar and triglyceride. So the clinical medical staff should also improve the knowledge of blood lipid, blood pressure and blood sugar in general population for improving their attitude and unhealthy habits. In addition, the active control of blood sugar and blood pressure can enhance the overall health status of the general population.

Objective To observe the effect of Ningxia aqueous extracts of fruitless lycium sprout (AEFLS) on cardiomyo cyte antioxidation and apoptosis-related protein expression in aging mice.Methods The natural aging C57BL/6J mice with 13 months old were randomly divided into aged control group,AEFLS low dose group (AEFLS1),AEFLS middle dose group (AEFLS2)and AEFLS high dose group(AEFLS3).The AEFLS1,AEFLS2 and AEFLS3 groups were respectively given with 5,10,20 mg/kg AEFLS gavage,while the aged control group was given with the normal saline gavage,for continuous8 weeks.The xan thine oxidase assay and thiobarbituric acid method were used for the determination of SOD and MDA in heart tissues.Western-blot and immunohistochemical method were used to detect the expressions of Bcl-2,Bax and Capase-3 in heart tissue.Results Compared with the aged control group,the MDA level in the AEFLS2 and AEFLS3 groups was decreased,while the SOD activity was increased,the difference was statistically significant (P＜0.01).The Western-blot result showed that compared with the aged control group,the optical density value of Bcl-2 in the AEFLS2 and AEFLS3 groups was increased,but the optical density values of Bax and Capase-3 were decreased (P＜0.01);the immunohistochemical results showed that compared with the aged control group,the immunopositive(IP) expressions of Bcl-2 protein in heart tissues in the AEFLS2 and AEFLS3 groups were increased (P＜0.01),while the IP expressions of Bax and Capase-3 were decreased (P＜0.01).Conclusion Middle and high doses of AEFLS can increase the antioxidative ability of myocardial tissue,up-regulates the Bcl-2 expression,down-regulates the Bax and Capase-3 expressions and plays anti-cardiomyocyte apoptotic role.

OBJECTIVETo localize the language cortex associated with Chinese word processing by magnetic source imaging (MSI).

METHODSEight right-handed and one left-handed healthy native Chinese subjects were examined by magnetoencephalography (MEG) and a 1.5T magnetic resonance imaging (MRI) unit. All subjects were given pure tone stimuli 50 times, 150 pairs of Chinese words (meaning related or unrelated) auditory stimuli, and pure tone stimuli subsequently 50 times. Evoked response fields time locked to the pure tone and Chinese words were recorded using a whole-head neuromagnetometer in real-time. The acquired data were averaged by the acquisition computer according to the response to the pure tone, related pairs of words and unrelated pairs of words. The data obtained by MEG were superimposed on MRI, using a GE Signa 1.5T system.

RESULTSMEG, showed there were two obviously higher magnetic waves named M50 and M100, which were localized in the bilateral transverse temporal gyri in all subjects. The responses to the pairs of Chinese words (meaning related or unrelated) were similar in the same hemisphere of the same subjects. There was a higher peak during 300 - 600 ms in the right hemisphere of one left handed subject, but no peak in the left hemisphere, indicating that the language dominant hemisphere was localized in the right hemisphere. Superimposing the MEG data on MRI, the language area was localized in the Wernicke's areas. A 300 - 600 ms response peak was obsarved in each hemisphere (the amplitude of the 300 - 600 ms response peak in each hemisphere was almost the same) in two right-handed subjects, showing that the language area was localized in the 2 hemispheres in the two subjects. There was one peak in each hemisphere (300 - 600 ms response) in 6 subjects, but the amplitude of the wave in the left hemisphere in the 6 subjects was much higher than that in the right hemisphere. By choosing randomly from the later component (300 - 600 ms response) several time points and superimposing them on MRI, all time points were localized in the posterior part of the superior temporal gyri, which is the Wernicke's areas.

CONCLUSIONSComparing with the later component of the bilateral hemispheres, the wave amplitude in the language dominant hemisphere was much higher than that in the non-language dominant hemisphere. The language areas could be identified by judging whether meanings of pairs of Chinese words were related or not.

Adolescent ; Adult ; Cerebral Cortex ; anatomy & histology ; Female ; Humans ; Language ; Magnetic Resonance Imaging ; Magnetoencephalography ; Male