As social views on disability changed,how to support intellectual disabled adult so they can be involved in ordinary social life is not only the hot topic of special education and rehabilitation service system,but also the concern of psychologists.For the improvement of social inclusion,psychologists should provide assessment,intervention and support for intellectual disabled adults at personal and social supportive levels,and relative policy advices for the government should be included.

Objective To discuss the value of joint detection in patients with progressive cerebral infarction (PCI) on high sensi‐tivity c‐reactive protein(hs‐CRP) ,and homocysteine(Hcy) ,D‐Dimer ,Fibrinogen(Fib) ,ferritin(SF) .Methods According to the de‐velopment and evolution of the 156 patients with acute cerebral infarction were divided into progressive cerebral infarction group and non‐progressive cerebral infarction group ,to determine the level of serum hs‐CRP ,Hcy ,one or two D‐Dimer ,Fib ,SF .Results hs‐CRP ,Hcy ,D‐D ,Fib ,SF in the PCI group were higher than those in the control group ,the difference was statistically significant (P<0 .05) .Conclusion Between the development of the PCI with hs‐CRP ,Hcy ,D‐D ,Fib and SF ,there is a close relationship ,to detect the level has a certain significance to the prediction of progressive ischemic stroke .

Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; surgery ; Alkaline Phosphatase ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Endodermal Sinus Tumor ; metabolism ; pathology ; surgery ; Female ; GPI-Linked Proteins ; metabolism ; Glypicans ; metabolism ; Humans ; Isoenzymes ; metabolism ; Keratin-7 ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; secondary ; Middle Aged ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism

Amyloidosis ; Cardiomyopathy, Hypertrophic ; Humans

Objective To investigate the value of the automated breast volume scanning (ABVS) combined with virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of benign and malignant breast lesion.Methods Five hundred and seven patients with a total of 675 breast nodules were detected using ABVS and VTIQ technique.Of them,coronal plane imaging,SWVmax,SWVmin,and SWVmean (in m/s) for each nodule was acquired three days before operation or core needle biopsy.According to pathological results,the receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of the ABVS alone (retraction phenomenon on coronal plane),VTIQ alone and their combination in the diagnosis of breast lesions.Results Among all nodules,504 lesions were benign,and 171 were malignant.The rate of retraction phenomenon on coronal plane in malignant lesions was significantly higher than that in benign lesions (x2=279.89,P ＜ 0.001).The value of SWVmax,SWVmin,SWVmean (6.79± 1.71 m/s,5.03 ± 1.24 m/s,5.74± 1.36 m/s) in malignant nodules were higher than that of benign nodules [(3.41 ±1.51) m/s,(2.46± 0.87) m/s,(2.65 ± 1.23) m/s],the differences were statistically significant (t=32.43,33.85,26.77,all P ＜ 0.001).The AUC of malignant nodules for SWV (maximum,minimum,and average) were 0.922,0.934 and 0.937,respectively.With cut-off value of 4.045 m/s,SWVmean showed the best diagnostic performance.The sensitivity,specificity and accuracy of the retraction phenomenon on coronal plane,SWVmean and their combination in diagnosing malignant breast lesion were (39.65％,94.39％,95.78％),(97.50％,94.39％,95.53％) and (82.84％,93.51％,94.25％),respectively.And the SWVmean showed significant higher sensitivity than that of retraction phenomenon.The diagnostic capacity significantly improved when the two approaches were combined.Conclusion Both the retraction phenomenon on coronal plane and VTIQ had high diagnostic value,combining the two methods can improve the differential diagnosis ability for breast lesions.

Objective:To investigate the clinical efficacy and possible mechanism of bifidobacterium tetralogy combined with escitalopram oxalate in the treatment of patients with depression and to provide evidence for further clinical research.Methods:A total of 100 patients with depression who received treatment in Taizhou Second People's Hospital from September 2019 to March 2021 were included in this study. They were randomly assigned to receive either escitalopram oxalate and placebo (control group, n = 50) or escitalopram oxalate and bifidobacterium tetralogy (observation group, n = 50). All patients received 9 weeks of treatment. Psychological status pre- and post-treatment was evaluated using the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Serum cortisol, inflammatory factors interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels were detected using the enzyme-linked immunosorbent assay. Results:Physiological status scores in each group were significantly lower after treatment compared with before treatment. Scores of the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety scores post-treatment in the observation group were (10.78 ± 2.03) points and (6.37 ± 2.58) points, which were significantly lower than those in the control group [(16.78 ± 2.85) points, (13.23 ± 2.95) points, t = 11.40, 13.38, both P < 0.001]. Serum levels of cortisol, inflammatory factors IL-1β and TNF-α in each group were significantly decreased after treatment compared with before treatment. Serum levels of cortisol, inflammatory factors IL-1β and TNF-α post-treatment in the observation group were (137.34 ± 63.29) μg/L, (14.38 ± 6.08)ng/L, (13.95 ± 6.46) ng/L, which were significantly lower than those in the control group [(181.22 ± 59.27) μg/L, (25.94 ± 6.92) ng/L, (20.44 ± 6.24) ng/L, t = 15.29, 6.16, 9.24, all P < 0.001). Conclusion:Bifidobacterium tetralogy combined with escitalopram oxalate is highly effective on depression. The combined therapy can remarkably reduce depression and anxiety symptoms and greatly decrease serum cortisol, IL-1β, and TNF-α levels.

Studies have shown that plasma apolipoprotein B (ApoB) has a good predictive value for ischemic stroke and plays an important role in the prevention and treatment of ischemic stroke. More and more guidelines and consensus opinions began to recommend ApoB as a routine intervention target. This article reviews the biological characteristics, clinical detection advantages, and role and treatment prospect of ApoB in the prevention and treatment of ischemic stroke.

Objective To study the relationship between fibrotic focus ( FF ) and carbonic anhydrase ( CA) Ⅸin invasive ductal carcinomas ( IDC) of the breast.Methods In 167 cases of IDC, the FF was assessed morphologically, and expression of ER, PR and CA Ⅸ was evaluated using MaxVision immunohistochemistry.Results The expression of CAⅨin IDC with and without FF was 56.3%(45/80) and 28.7%(25/87) respectively, with significant difference (P=0.001).In IDC with FF, the CA Ⅸexpression of tumor cells in tumors with CAⅨ-positive fibroblasts (35/40, 87.5%) was significantly (P<0.001) higher than that in tumors with CAⅨ-negative fibroblasts (10/40, 25.0%).In IDC with FF, the CAⅨexpression of fibroblasts of FF in grade 3 IDC ( 23/33, 69.7%) was significantly ( P =0.006 ) higher than that in grade 1 +2 tumors (17/47, 36.2%).The ER and PR expression of tumor cells in tumors containing CA Ⅸ-negative fibroblasts was 72.5% ( 29/40 ) and 65.0% ( 26/40 ) respectively, whereas the ER and PR expression of tumor cells in tumors containing CAⅨ-positive fibroblasts was 50.0%(20/40) and 42.5% (17/40) respectively; the difference was statistically significant (for both ER and PR, P=0.04 ) .The age of patients with tumors containing CA Ⅸ-negative fibroblasts was significantly ( P=0.002) older than those containing CA Ⅸ-positive fibroblasts.The FF diameter/tumor diameter in tumors containing CA Ⅸ-positive fibroblasts was significantly larger than those containing CA Ⅸ-negative fibroblasts.(3) For the groups of tumor size≤2 cm and tumor size between 2 cm to 5 cm, the diameter of the fibrotic focus was significantly (P<0.01) smaller than the fibrotic focus size of tumors >5 cm in size. Conclusions CA IX expression is correlated with FF, and that in fibroblasts of FF correlated with patients′age, tumor grade, hormone receptors and FF diameter/tumor diameter.CAⅨexpression in FF might be a marker for poor prognosis in patients with breast cancer.

Objective To evaluate the preventive effects of predictive phased intervention on lower extremity deep vein thrombosis in ICU patients.Methods A total of 82 cases of critically ill patients admitted to our hospital from June 2013 to June 2016 were divided into observation group and control group according to the random number table method, with 41 cases respectively. Patients in the observation group received predictive phased intervention, while patients in the control group received routine nursing intervention. After 4 weeks of intervention, the lower extremity deep venous thrombosis rate, lower limb perimeter and blood flow velocity of lower extremity venous were compared between two groups.Results The incidence of lower extremity deep venous thrombosis was 2.44% in the observation group and 19.51% in the control group. The difference between two groups was statistically significant (x2=6.604,P<0.05). After the intervention, the lower limb perimeter of patients in the observation group was (30.01±2.34) cm, which was significantly lower than that of the control group; the venous blood flow velocity of the lower extremity of patients in the observation group was (25.43±3.01) cm/s, which was significantly higher than that of the control group (t=2.285, 2.357;P<0.05).Conclusions Predictive phased intervention has obvious advantages in the prevention of lower extremity deep venous thrombosis in ICU patients and it is worth clinical promotion.