Objective To investigate the role of psychological intervention on cosmetic plastic surgery.Methods 600 cosmetic plastic surgery were collected from cosmetic plastic surgery of Jinan Military General Hospital,then randomly divided into control group(n=300) and study group (n=300) according to odd and even on the first visit.Conventional treatmentand care were applied to control group before,during and after operation.For study group,in addition to giving a general treatment and care,preoperative consultation talks were given to understand the beauty of the psychological characteristics,and motivations and expectations were given to adjust;music and psychological support were presented intraoperative; rehabilitation guidance were given after operation.Symptom checklist 90( SCL-90),general psychological problems of body image self-rating scale and postoperative satisfaction scale were used to assess the the mental state,body image question and satisfaction of plastic surgery.Results Before intervention,the scores of SCL-90 and the general body image self-rating scale were ( 187.5 ±52.61 ),(12.1 ± 2.2) in study group and (179.87 ± 53.33 ),(12.9 ± 2.0) in control group,there was no significant differences(P＞0.05).After intervention,the scores of SCL-90 and the general body image self-rating scale ( 159.6 ± 31.3 ),(5.6 ± 0.5 ) in study group were lower than those in control group ( 167.4 ± 38.2 ),( 6.2 ±1.1 )(P ＜ 0.01 ).Before and after treatment,50％ reduced rate of 26％,25％ reduced rate of 41.6％,body-negative rate of 97.1％,overall satisfaction rate of 89％ of surgery in study group were higher than 14％,27.6％,84.3％ and 53.67％ in the control group,the differences were significant (P＜0.01 ).Conclusion Psychological interventions can improve the psychological state,body image disturbance and operative satisfaction in cosmetic plastic surgery.Psychological interventions should pay more attention to irrmprove the efficacy of cosmetic plastic surgery.

Immobilization osteoporosis (IOP)is a common complication in clinic and cosmonauts. It severely impaired the patients ant the cosmonauts. The causes of IOP are weightless,immoblization and bed rest.Excercise therapy is very important for IOP. The etiology andpathogenesis of IOP are introduced in this article. the effects, mechanism and methods of the exercise therapy for preventing and treating IOP arealso discussed.

Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During the follow-up period ,there were no tuberculosis recurrence ,no loosening of in-ternal fixation ,and no break of rod and nail ;the grafted bones were fused in all patients with an average time of 7 .5 months ;accord-ing to Frankel grade of nerves function ,only one patient was grade D ,while the other four cases recovered to grade E .The lumbosa-cral angle of patients was corrected from 23 .8° ± 4 .0°(19 .8°-27 .8°) before surgery to 29 .1° ± 3 .6°(25 .5°-32 .7°) after surgery , and the change was statistical significance(P<0 .05) .Conclusion The one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach inside of rectus abdominis is a safe and effective meth-od ,which can thoroughly remove the focus ,reconstruct the lumbosacral stability ,and prevent the loosening of bone grafting .

Objective To evaluate the results of the treatment and prevention measures for pathological dislocation of the hip following septic arthritis in the newborns. Methods Twenty cases undergone open reduction were studied restropectively. In addition, greater trochanterplasty was penformed in 15 cases, acetabularplasty in 14 cases, greater and lesser trochanterplasty in 2 cases. Rusults A successful rate of reduction achieved in 90％ of the patients; however, central reduction was achieved in only 38.8％ . 20 patients were followed-up for 6 months to 12 years. The stability and motility of the hip gradually improved in majority of the patients. The cases with severe destruction followed by absence of femoral head and neck had unsatisfactory results. Shortening deformity were found in six cases, and subluxation, dislocation, rigidity of the hip in one case each. Conclusion The greater trochanterplasty had a good result for reduction and maintaining the position. Early diagnosis and early open drainage were key measures for prevention of pathological dislocation of the hip resulting from the acute septic arthritis in the newborn.

BACKGROUND:Currently, transplantation of bone marrow mesenchymal stem cel s into the spinal cord is very limited to the recovery of animals fol owing spinal cord injury. Methylcobalamin is a common drug for the treatment of neurological diseases and injuries, but its effects on bone marrow mesenchymal stem cel s are unclear. OBJECTIVE:To study the feasibility of bone marrow mesenchymal stem cel s differentiating into neuron-like cel s induced by methylcobalamin in vitro and to observe the cel viability and proliferation of differentiated cel s. Methods:Rat bone marrow mesenchymal stem cel s were isolated, cultured and purified by density gradient centrifugation and adherent culture. The fourth to fifth generation of bone marrow mesenchymal stem cel s were treated for 24, 48 and 72 hours with different concentrations (25, 50 and 100 mg/L) of methylcobalamin. The morphological changes and cel growth were continuously observed under an inverted phase constract microscope. The viability of induced cel s was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expressions of Nestin and neuron-specific enolase were identified by reverse transcription PCR and western blot. RESULTS AND CONCLUSION:Most of bone marrow mesenchymal stem cel s could differentiate into neuron-like cel s after induction with methylcobalamin. The expressions of Nestin and neuron-specific enolase were up-regulated after 48 hours of methylcobalamin treatment at different concentrations, especial y after treatment with 100 mg/L methylcobalamin. Similarly, the expressions of Nestin and neuron-specific enolase could be increased significantly after 100 mg/L methylcobalamin treatment for 24, 48 and 72 hours, especial y for 72 hours. It is indicated that methylcobalamin can induce bone marrow mesenchymal stem cel s differentiating into neuron-like cel s, and the optimal concentration of methylcobalamin is 100 mg/L.

Objective To explore the effect of meropenem on the treatment of children with severe infection and the effect on the level of PCT.MethodsThe clinical data of patients with infectious diseases treated in our hospital from December 2013 to February 2016 were retrospectively analyzed.According to the anti infective drugs were divided into control group and observation group, the control group was given routine antibiotic treatment, the observation group was given meropenem treatment.The treatment effect of the two groups were observed, the difference of serum PCT, cytokine level and blood gas indexes before and after treatment in the two groups were compared, correlation analysis with PCT level and serum levels of inflammatory cytokines and blood indexes of severe infection.ResultsIn the control group, 50 cases were successful, the observation group was successful in the treatment of the patients, there were no significant differences in the success rate between the two groups.Two groups of patients before treatment PCT and inflammatory cytokines level no difference, after treatment, the observation group PCT, IL-18, IL-6 and hs-CRP levels were lower than the control group;Two groups of children before treatment blood gas index no difference, after treatment, the observation group SpO2 level higher than the control group, P ETCO2 level was lower than the control group.PCT levels in children with severe infection were positively correlated with IL-18, IL-6, hs-CRP and P ETCO2 levels and negatively correlated with SpO2 levels.ConclusionMeropenem has better therapeutic effect in the treatment of children with severe infection, can significantly reduce the serum PCT level, has the value of clinical application.

Objective To explore the clinical characteristics of infratentorial primary angiitis in central nervous system (PACNS).Methods A total of 5 cases diagnosed as infratentorial PACNS in the neurology department of Navy General Hospital of PLA in 2015 were enrolled in the study.The clinical,imaging and pathological data were collected and analyzed.Results All the 5 cases were male with the median onset age of thirty-four.Five cases presented with dizziness,two with headache,three with walking unstable,two with facial numbness and one with dysarthria.Rising pressure of cerebrospinal fluid (CSF) (190-245 cmH2O,1 cmH2O =0.098 kPa) was found in 4 cases by the lumbar puncture,mildly increased number of leukocyte in 2 cases [(12-28) × 106/L],increased CSF protein in 3 cases(540-979 mg/L) and increased IgG index in 3 cases (0.84-1.45).Pons lesions were revealed by magnetic resonance imaging(MRI) in 4 cases,brachium pontis lesions in 2 cases,cerebellum lesions in 2 cases,one with midbrain lesion in 1 case,unilateral lesions in 4 cases and bilateral lesion in 1 case.Different degree of edema and mass effect were shown in all lesions by MRI.Patch like enhancement was found by contrast MRI in 5 cases and meningeal enhancement in 2 cases.Elevation of choline (Cho) peak was found by magnetic resonance spectroscopy (MRS) in 4 cases,reduction of N-acetyl aspartate (NAA) peak in 3 cases,appearance of lactate peak in 1 case and lipid peak in another case.Arterial spin labeling (ASL) was performed in 4 cases and no hyperperfusion was found.Susceptibility weighted imaging(SWI) was performed in 3 cases and microhemorrhage in the lesions was found in 2 cases and normal in 1 case.Magnetic resonance arteriography(MRA) was performed in 1 case and no stenosis was found.Digital subtraction arteriography(DSA) was performed in 1 case and multiple stenosis of the intracranial arteries was showed.Two cases had taken the stereotactic brain biopsy and the histopathologic diagnosis was angiitis.Five cases were treated with methylprednisolone and cyclophosphamide was added on in 1 case.Good prognosis was found in all cases.Conclusions Infratentorial PACNS mostly attacks middle-aged males.The lesions tend to locate in unilateral pons,brachium pontis,cerebellum and midbrain.Hemorrhage or microhemorrhage in lesions is often found by SWI and no hyperperfusion is shown by ASL,which would be useful to distinguish PACNS from malignant tumors.Given the limitations of brain biopsy in clinical practice,clinical and imaging features would be helpful to diagnose PACNS.

Objective To investigate the prevalence, molecular mechanism and genetic characteristics of azithromycin-resistant Neisseria gonorrhoeae (N.gonorrhoeae) strains isolated in Shenzhen.Methods N.gonorrhoeae strains were collected in Shenzhen from 2011 to 2015.Agar dilution method and E-test were used to detect the minimum inhibitory concentrations (MIC) of these strains to azithromycin.All azithromycin-resistant (AZM-R) strains (MIC≥2 μg/ml) and some azithromycin-sensitive strains (MIC≤0.25 μg/ml) which were randomly selected as the control group were screened for mutations in 23S rRNA, mtrR and erm genes and genotyped by using N.gonorrhoeae multi-antigen sequence typing (NG-MAST).Results A total of 788 N.gonorrhoeae strains were collected, 148 (18.8%) of which were AZM-R strains (MIC≥1 μg/ml).Eighteen out of 21 high-level AZM-R (AZM-HLR) strains had A2143G mutations in the four copies of the 23S rRNA gene.Twelve out of 29 middle-level AZM-R (AZ-MLR) strains had missense mutations, among which C2611T mutations in the four copies of the 23S rRNA were detected in 10 strains.Incidence of G45D/Y105H mutation in AZM-HLR strains was higher than that in AZM-MLR (χ2=12.702, P=0.000) or AZ-S (χ2=4.462, P=0.035) strains according to the analysis of the promoter and coding region of mtrR gene.PCR analysis revealed that only one strain carried ermB gene (MIC=2 μg/ml).The 788 N.gonorrhoeae strains were typed into 81 sequence types (STs) by NG-MAST, most of which were represented by one strain only.STs of ST3356 and ST1866 that were identified in the AZ-R strains in the current study had been noted in a previous report of emerging AZM-R N.gonorrhoeae strains in Nanjing, Chongqing and Guangzhou.Neighbor-joining (NJ) phylogenetic tree showed that the resistant strains did not form a separate cluster.Conclusion Currently, it is not suitable to use azithromycin as a monotherapy for gonorrhea in Shenzhen.Mutations of A2059G and C2611T in 23S rRNA of N.gonorrhoeae were respectively responsible for high-level and middle-level resistance to azithromycin.Repeated emergence of ST1866 and ST3356 will help us monitor and analyze the epidemiological characteristics of N.gonorrhoeae strains resistant to azithromycin in Shenzhen.

The 2016 conference on iodine and thyroid disease is aimed to establish a platform for sharing the achievement on fundamental,preventive and clinical research of iodine and thyroid disease,for exchanging information between producer and consumer on iodized salt,iodine additive and iodine determination,for communication on policy and measures concerning iodine deficiency disorders (IDD) prevention and control,for promoting the exchange of experience between international and domestic scholars in IDD prevention and control and the clinical,fundamental research update and achievement,and for discussing the key and difficult problems.After communication and discussion,the participants at the 2016 conference drafted a consensus on iodine and thyroid disease.Through incorporating the current IDD prevention and control schedule and task,this article describes,elaborates and explains the key items of the consensus with expectation of a better utilization and application of the consensus in the future in IDD prevention and control.

Objective To reasonably confirm the target of 3-dimensional conformal radiation therapy (3DCRT) for lung cancer. Methods While a patient was breathing, the motion of the primary lesion in the lung was observed by fluoroscopy. The extent of motion of the primary lesion during irradiation was evaluated by portal films. Three 3DCRT plannings for lung cancer, in which gross tumor volume (GTV) decided by a group of radiation oncologists and implemented, were taken as the standard. The GTV delineated by five radiation oncologits was compared with the standard by computing the radial line measurement variation (RLMV). Results From fluoroscopic observation in fifty-nine patients, the extent of lesion motion was the largest in cephalo-caudal direction, with 14.3 mm for lesions in the lower and 7.1 mm (median) for middle part of the lung. In lateral and antero-posterior directions, it was within 4. 0 mm. The motion error during irradiation was 4. 2 mm in lateral direction and 4.6 mm in cephalo-caudal direction. The random error, system error and total error for set-up uncertainty were 3.4 mm, 6.0 mm, and 6.9 mm. Compared to the standard, the discrepancy of GTV could be as large as 150% . The largest RLMV was observed in the area of lung hilar nodes. Conclusions The target of 3-dimensional conformal radiation therapy for lung cancer should be confirmed individually and delineated by a group of radiation oncologists. A more efficient fixing device is needed owing to the large total error for set-up.