Objective The purpose of the present study was to examine the reliability and validity of the Chinese version of the impulsive-premeditated aggression scale (IPAS) in a sample of Chinese adolescents with aggression. Methods 126 adolescents completed the IPAS,Barratt impulsive scale and self-report questionnaires. In order to assess test-retest reliability, the IPAS was re-administered to 30 participants 3 weeks later.Results Item analysis showed that IPAS had satisfactory item discrimination, 6 items were excluded in the later analysis. The internal consistency of the IPAS Cronbach alpha was 0.77 and the test-retest reliability was 0.74.Exploratory factor analysis demonstrated two stable factors of aggression with good internal consistency and construct validity, the value of KMO was 0.646, the χ2 value of Bartlett test was 691.93 ( P <0.001). The confirmatory factor analysis showed that the value of χ2/df,GFI,AGFI,RMSEA were 1.42,0.874,0.837 and 0.058 respectively.The whole scale and the two secondly scales all correlated with BIS-11 and MOAS.Conclusion The results of the current study indicate that the Chinese version of the IPAS is a useful tool to subtyping aggressive behavior among adolescents, but it still need to be modified to apply in China.

BACKGROUND: Since the diagnostic unit is established in "mental disorder due to Qigong", it has been lack of comparative analysis of experimental observation on whether Qigong exercise affects physiological state in central nerve system, on what the difference are between Qigong and hypnotic induction in the effects on central system.OBJECTIVE: To observe the changes in brain evoked potentials in "normal state", "Qigong meditation" and "hypnosis" so as to analyze the difference between Qigong release and hypnotic induction in cerebral physiological effects in normal adults.DESIGN: Brain evoked potential experiment was designed, in which, normal adults were employed.SETTING: Shanghai Mental Health Center.PARTICIPANTS: They were staffs, interns and volunteers in Shanghai Mental Health Center, of either gender, at any age and with any educational background, totally 52 people.METHODS:① American Nicolet Spirit evoked brain electrophysiological meter was used. The electrodes were attached according to 10/20 system on Cz, C3, C4, Pz and Fz of scalp. Verbal or fixation inductive hypnosis was applied. Hypnosis lasted 20 to 30 minutes, in which, the induction lasted 10to 15 minutes. The experimental observation were performed when the receptors were determined to be in hypnosis.② The Qigong meditation was co-performed by the Qigong masters from Shanghai Qigong Institute or Qigong folk masters. They released "external qi" to the receptors. The degree of "Qigong meditction" was based on folk standards. The observation was carried on when the receptors were identified to be in theQigong state.The entire process lasted 20 to 30 minutes.③ To observe successively the latency and amplitude of the event related potentials [contingent negative variation (CNV), P300 ] and sensory evoked potentials [visual evoked potentials (VEP), auditory evoked potentials (AEP), auditory brainstem reaction (ABR)] of receptors in "normal state", "Qigong meditation" and "hypnotic state". The observed values were performed multiple analysis of variance of single-factor quantitative linear model in 2 × 2 factorial design.MAIN OUTCOMES MEASURES:① Observation of event related potentials. ② Observation of sensory evoked potentials RESULTS: Due to limited result of hypnotic induction and incomplete record of brain-evoked potentials, 3 cases were lost. Terminally, 49 cases entered statistical analysis. ①Observation of event related potentials: under hypnotic state, the amplitude of P300 (target stimuli-P3) was decreased compared with normal state [(4.18±2.23), (6.07±3.23) μV, P ＜ 0.01]. The amplitude of AEP (P2) in hypnotic state and normal state was decreased compared with Qigong meditation [(2.01±1.28), (2.71±1.83), (2.73±1.34)μV, P＜0.05].The amplitude of CNV(M2) was decreased comparedwith normal state and Qigong meditation[(5.93±3.36),(7.83±4.59),(7.76±4.42) μ,V,P ＜ 0.05].②Observation of sensory evoked potentials: The amplitude of VEP (P2, P3) in hypnotic state was reduced compared with normal state and Qigong meditation [(3.47±2.69), (4.76±2.78), (4.30±2.64) μV; (1.18 ±1.08), (1.68±0.95),(2.01±1.48) μV, P ＜ 0.05].CONCLUSION: In hypnotic state, sensory evoked potentials presented low amplitude and such alternation did not appeared in Qigong meditation and normal state. It is explained that there are differences between hypnotic induction and Qigong release in the influence on cerebral physiological process. The extensively recognized hypothesis in Qigong field that "Qigong state" is "hypnosis" cannot be verified by above-mentioned experiment.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

Objective To summaize the experience of application of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of residual bile duct stones.Methods A retrospective analysis of clinical records of 60 patients with residual bile duct stones treated in our hospital from 2003 to 2006 was made.Results In 59(95.9%) of 60 cases the stones were removed completely,including successful removal in one time of application of this method in 57 Patients(95.0 %),and 2 applications in 2 Patients ﹙3.3 %).One case with bile duct stone complicated with dile duct cancer was unsuccessful.The biggest stone was 3.5 cm?2.5 cm?2.0 cm.No serious complications occurred and changed to operation.The 59 cases were followed up for 6 mo to l yr,and all had a successful outcome.Conclusions The method of combination of direct digital radiography and electrohydraulic shockwave lithotripsy in treatment of postoperative residual bile duct stones after operation can facilitate removal of residual bile duct stones.The procedure is a safe way of treating residual stones.

Objective To investigate the use of component N400 of the event-related potentials (ERPs) elicited by Chinese idioms ending with matching and nonmatching words to explore the cognitive patterns and processing mechanisms elicited by Chinese characters. Methods Sixty-two right-handed healthy adults (age 19-50 years) , were presented with Chinese idioms ending with words with the same pronunciation but different form and meaning, words with similar forms but different pronunciation and meaning, words with same meaning but different pronunciation and form, and words with different pronunciation, form and meaning. A Guangzhou Runjie WJ-1 instrument was used to record component N400 of the potentials evoked. Results N400 showed a midline distribution , and could be detected under electrodes Fz, Cz and Pz. Significant differences were found in N400 latencies and amplitudes between matching and nonmatching ending-words. Compared with idioms with matching ending-words, N400 latencies were prolonged and amplitudes increased in nonmatching cases. The observed changes in N400 latencies and amplitudes were related to stimulus types, and the longest latency and largest amplitude were e-licited by ending-words with different pronunciation, form and meaning. No gender difference in N400 latency or amplitude was observed. Conclusions Compared with Western phonetic words, Chinese ideographic words are more flexible stimuli for N400 research, offering 3 dimensions for change: pronunciation, form and meaning. The N400 features elicited by matching and nonmatching ending words in Chinese idioms are mainly determined by the meaning of the word.

Objective To explore the rationality of pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy through comparing the short-term effects between pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy.Methods A retrospective review was performed for 38 patients who were underwent pancreaticoduodenectomy at the second affiliated hospital of Kunming Medical University from January 2010 to December 2012.Results All 38 pancreaticoduodenectomy were performed successfully.The pancreatic fistula (0％),operationtime [(327.50±32.56) min],postoperative hospital days [(10.31 ±2.44) d] were found to be significantly lower in double purse embedded pancreaticogastrostomy group than those of pancreaticojejunostomy group [3/12,(425.83 ± 33.77) min,(14.33 ± 4.14) d],which has statistical significance(P＜0.05).Although the incidence of bile leakage,postoperative abdominal bleeding,delayed gastric emptying,infection of incision,infection of lung,intraoperative amount of bleeding are also lower than that of pancreaticojejunostomy group,which has no statistical significance.Conclusions Double purse embedded pancreaticogastrostomy is a digestive tract reconstruction which is safer and more reasonable than pancreaticojejunostomy.The former one is operated simply and the operation time is shorter.There are great advantages in the prevention of complications such as pancreatic fistula after pancreaticoduodenectomy.

Objective To investigate the factors which may affect the secretions of human leptin and free fatty acids (FFA) by measuring plasma glucose, serum insulin, leptin and FFA levels during reduced sample number intravenous glucose tolerance tests (IVGTT) in the subjects with different status of insulin resistance and ? cell function. Methods According to oral glucose tolerance test, 7 normal, 10 overweight/obese individuals, 12 subjects with impaired glucose tolerance (IGT) and 11 with type 2 diabetes mellitus (DM) were recruited. During IVGTT, serum insulin, leptin and FFA levels at 12 time points were simultaneously measured. Results Compared to the stable secretion of leptin, during 180 min in the IVGTT, the FFA secretion showed a "U" shape profile. The correlation analysis showed that the average serum leptin and FFA levels in 3 h were independent to fasting plasma glucose concentration. The partial correlation coefficient of leptin and insulin decreased after being adjusted for FFA (before r=0.77, P0.05). Conclusion The changes of serum FFA levels in IVGTT are more significant than those of leptin after glucose loading. Fasting plasma glucose levels do not significantly affect the average serum levels of leptin and FFA. On the contrary, insulin manifests such action but does not affect the secretion profile of these parameters.

Objective To explore the use of CA199,CEA,CA50 and ALP combined with magnetic resonance imaging (MRI) in diagnosis of intrahepatic bile duct stones with early bile duct carcinoma.Methods The clinical diagnosis of 36 cases of patients with hepatolithasis-associated intrahepatic cholangiocarcinoma (HICC) and 118 cases with intrahepatic duct stone (IHDS) were analyzed retrospectively.Serum CA199,CEA,CA50,ALP and magnetic resonance (MRI,MRCP) were performed and the results were analyzed.Results Abdominal pain discomfort in Hepatolithasis-associated intrahepatic cholangiocarcinoma showed multiple symptoms.Three typical Charcot syndromes were rare.On the gender distribution,intrahepatic bile duct stones was frequently found in women,on the contrary,Hepatolithasis-associated intrahepatic cholangiocarcinoma was frequently more found in men (P ＜0.05) Abdominal pain and fever in patients of Hepatolithasis-associated intrahepatic cholangiocarcinoma was more than that of patients with Intrahepatic bile duct stone (P＜0.05) When alkaline phosphatase (ALP) was more than 169 U/L,significant difference was seen between two groups (P＜ 0.05) According to the diagnosis of HICC,the accuracy of CA199,CEA,CA50 combined with ALP was 88.6％,the accuracy of magnetic resonance examination alone was 90.2％,and the accuracy of multiple serological markers and magnetic resonance was 95.5％.Conclusion MRI combined with serum CA199,CEA,CA50 and ALP can effectively improve the HICC preoperative diagnosis rate.

Objective To evaluate the therapeutic effects of gemcitabine regional artery perfusion combined with systemic chemotherapy for late-stage cancer of pancreas.Methods Thirteen cases of late-stage cancer of pancreas proven by operation and pathology were treated with 5-FU+MMC as a combined system chemotherapy, and use of gemcitabine for regional artery perfusion chemotherapy.Results Among the 13 patients who could be evaluated for therapeutic effect, four cases had partial response (PR), six cases had (SD), three cases were PD, and the effective rate of the clinical benifical-reflected evaluation was 76.9%, pain releive rate 75.0% the median survival time was 6.3 months. None of the patients have had serious toxious side-effects.Conclusions The gemcitabine regional artery perfusion combined with systemic chemotherapy can relieve the cancer pain of patients with late-stage cancer of pancreas, improve their general condition, increase the survival quality of life, prolong the survival time. The drug tolerance of the patients is good.

Objective To explore the expression of chemerin and chemerin receptor ( chemokine-like receptor 1, CMKLR1) during different periods of non-alcoholic fatty liver disease ( NAFLD) rat model induced by methionine- and choline-deficient ( MCD) diet. Methods Thirty-six Wistar rats were divided into control group and MCD group in random. After one week quarantine and acclimation period, these two groups were fed either normal chow or MCD diet. The animals were respectively sacrificed at the first week, the forth week, and the tenth week. The levels of alanine transaminase (ALT), blood lipid profile, liver function, and the content of triglyceride in liver were detected. HE staining was done to observe the morphologic change of liver. The mRNA expression changes of chemerin and CMKLR1 in liver were measured using real-time PCR, and the change in chemerin mRNA level was further confirmed in liver by Northern blot. Finally, the concentration of chemerin in serum was measured by Western blot. Results The mRNA level of chemerin decreased significantly after four and ten weeks MCD feeding, although no obvious changes were found at first week, similar changes were found in serum chemerin (1.00±0.11 vs 0.96±0.39; 1.00±0.12 vs 0.21 ±0.77; 1.00±0.42 vs 0.21 ±0. 11). Contrasting with the change of chemerin(1.00±0.08 vs 0.72±0.10;1.00±0.24 vs 0.63±0. 31 ;1.00±0.05 vs 0.50±0.13), the mRNA level of CMKLR1 increased after MCD feeding( 1.00±0. 14 vs 0. 84±0. 26; 1.00±0. 38 vs 1. 51 ±0. 33; 1. 01 ±0. 13 vs 1. 84 ± 0. 39 ). Conclusion The change of chemerin and its receptor may participate in the process of the nonalcoholic fatty liver disease.