Cognitive flexibility is a kind of ability to convert mental representation,including reactive flexibility and spontaneous flexibility,and as the vital components of executive function.The experience of the childhood maltreatment may damage both reactive flexibility and spontaneous flexibility and result in cognitive flexibility dysfunction.Prefrontal cortex is the main brain regions of cognitive flexibility,childhood maltreatment experience through injuring the growth of frontal lobe leading to the cognitive flexibility dysfunction.Future research could combine the method of behavioral test and brain damage measurement,to carry on minute research on the two components of cognitive flexibility and brain mechanisms at the same time.

Objective: To observe the therapeutic effect of treating postoperative gastrointestinal syndrome with combined needles and herbs. Method: Altogether 117 in-patients were randomly allocated into the treatment group of 86 cases and control group of 31 cases. Point injection was mainly adopted in the treatment group plus Chinese herbal decoction, while Western medicine was adopted in the control group. And then the therapeutic effect of the two groups was compared. Result: The total effective rate of the treatment group and control group were 96.5% and 80.6% respectively, and the treatment course of the treatment group was significantly shorter than the control group (P ＜ 0.01). Conclusion: Combined needles and herbs have excellent effect in treating postoperative gastrointestinal syndrome and were superior to Western medicine.

Objective: Moderate and severe behavioral and psychological symptoms of dementia (BPSD) often need medical treatment to improve symptoms. Agomelatine is a selective melatonergic (MT1/MT2) agonist that has normalizing effects on disturbed circadian rhythms and disrupted sleep−wake cycles. Its activity of 5HT-2C receptor antagonism is associated with lessening depression and anxiety and increasing slow-wave sleep. Based on past clinical records and current findings it suggests that agomelatine can improve BPSD for patients. This retrospective cohort study was designed to compare the BPSD before and after using agomelatine. Methods: Records of dementia cases who had ever received agomelatine treatment for BPSD in a general hospital setting during the past 2.5 years were identified and reviewed. Scores from before and after 3 months of treatment with agomelatine were collected for Neuropsychiatric Inventory (NPI), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression (CGI) to compare and analyze the difference of psychological and behavioral symptoms pre- and post-agomelatine used. Results: Records of 144 cases of dementia with BPSD who had ever used agomelatine from January 2015 to June 2017 were collected. All of the 112 cases had BPRS and CGI scores, of which 75 cases had additional NPI scores. Among these 112 cases, the BPRS and CGI scores were significantly improved in all types of dementia. NPI scores indicated that the use of agomelatine alleviated obvious symptoms and decreased overall distress, especially in the depression/poor mood, anxiety, and sleepight behavior. Conclusion It is consistent with an effective result of agomelatine in improving BPSD.

Objective Using maestro software to analyze the application of electrically elicited stapedius reflex and auditory nerve response in assessing acoustic function intraoperatively .Methods 20 SONATATI100cochlear im-plant patients participated in this study .Both ESRT and ECAP were recorded intraoperatively by using MED -EL Maestro software and analyzed .Results 96 .67% typical ESR and 95 .0% typical ECAP were recorded .Certain properties of ECAP recordings varied depending on the stimulation sites in the cochlea .There was strong relation-ship between ESRT and ECAP thresholds .Conclusion ESR and ART were proved to be most beneficial in assessing the functions of the implanted as well as proving that the auditory pathway is stimulated during the cochlear implan-tation surgery .

OBJECTIVE: The purposes of this study were to measure the orthodontic forces generated by thermoplastic aligners and investigate the possible influences of different activations for lingual bodily movements on orthodontic forces, and their attenuation. METHODS: Thermoplastic material of 1.0-mm in thickness was used to manufacture aligners for 0.2, 0.3, 0.4, 0.5, and 0.6 mm activations for lingual bodily movements of the maxillary central incisor. The orthodontic force in the lingual direction delivered by the thermoplastic aligners was measured using a micro-stress sensor system for the invisible orthodontic technique, and was monitored for 2 weeks. RESULTS: Orthodontic force increased with the amount of activation of the aligner in the initial measurements. The attenuation speed in the 0.6 mm group was faster than that of the other groups (p < 0.05). All aligners demonstrated rapid relaxation in the first 8 hours, which then decreased slowly and plateaued on day 4 or 5. CONCLUSIONS: The amount of activation had a substantial influence on the orthodontic force imparted by the aligners. The results suggest that the activation of lingual bodily movement of the maxillary central incisor should not exceed 0.5 mm. The initial 4 or 5 days is important with respect to orthodontic treatment incorporating an aligner.
Incisor* ; Relaxation

OBJECTIVETo establish a method for efficient induction and expansion of Epstein Barr virus (EBV)-specific cytotoxic T lymphocytes (CTL) in vitro and evaluate the possibility of using this strategy for treatment of nasopharyngeal carcinoma (NPC).

METHODSEBV-transformed B lymphoblastoid cells (BLCLs) were used as the antigen stimuli and antigen-presenting cells. EBV-specific CTL was induced by co-culture of the autologous peripheral blood mononuclear cells (PBMCs) and the irradiated BLCLs, and expanded with a cocktail method consisting of OKT-3, irradiated homologous PBMC, and IL-2. The specific activity of the CTL against the NPC cells was measured with MTT assay.

RESULTSEBV-specific CTL was successfully induced and expanded by 600 folds. The killing efficiency of the CTL was 76% for autologous BLCLs, 13% for homologous BLCLs, 51% for autologous NPC cells, and 27% for homologous CNE cell line, and after expansion, the corresponding killing efficiencies were 63%, 25%, 49%, and 33%, respectively. The non-specific killing only slightly increased after the expansion.

CONCLUSIONEBV-specific CTL can be successfully induced and expanded in vitro for specific killing of autologous NPC cells, suggesting the potential of this strategy in the treatment of NPC.

Antigen-Presenting Cells ; cytology ; immunology ; Antigens, Viral ; immunology ; B-Lymphocytes ; cytology ; immunology ; virology ; Cells, Cultured ; Coculture Techniques ; Herpesvirus 4, Human ; immunology ; Humans ; Immunotherapy, Adoptive ; Nasopharyngeal Neoplasms ; immunology ; pathology ; therapy ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; virology ; Tumor Cells, Cultured

OBJECTIVETo evaluate the effect of perioperative continuous epidural morphine administration on plasma D-dimer level in patients undergoing total hip replacement.

METHODSForty ASA I-II patients undergoing total hip replacement under epidural anesthesia were randomized into two groups. In one group, the patients were given epidural administration of morphine 15 min before operation at 4 mg (in 10 ml normal saline) and for 48 h after the operation at 80 microg/h, while those in the other group received epidural injection of the same amount of normal saline before operation and 0.15% ropivacaine 2.0 ml/h for 48 h in the same manner after operation. Blood samples were taken before anesthesia (T(0)), at the end of operation (T(1)), and 24 h and 48 h after operation (T(2) and T(3)) for determination of plasma IL-6 and D-dimer levels.

RESULTSIn both groups plasma IL-6 and D-dimer levels showed significant increase at T(1), T(2) and T(3) in comparison with those at T(0), and their levels were significantly lower in morphine group than in ropivacaine group at T(1), T(2) and T(3).

CONCLUSIONEpidural morphine can lower plasma IL-6 and D-dimer levels and correct blood hypercoagulability in patients undergoing total hip replacement.

Aged ; Arthroplasty, Replacement, Hip ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Injections, Epidural ; Interleukin-6 ; blood ; Male ; Middle Aged ; Morphine ; administration & dosage ; Perioperative Care ; Postoperative Period

Objective: To understand cognitive flexibility among college students with childhood neglected experience, and to provide a thoretical basis and data reference for the study of cognitive characteristics of neglected people and its intervention. Methods: A total of 719 college students were surveyed using the Childhood Neglect Scale, and were screened through Childhood Neglect Scale. Wisconsin Card Sorting Test (WCST) and Verbal Fluency Test(VFT)were adminstered among those with childhood neglect to understand the responding flexibility and spontaneous flexibility. Results: The proportion of subjects with neglect experience was 43.74%. Boys,non-only children,students in rural areas neglect experience were higher(P<0.05). The neglect experience of childhood affects the individual’s response flexibility(t=2.22, P<0.05), as well as spontaneous flexibility(t=-2.17, P<0.05). Conclusion Childhood neglect experience has a negative impact on cognitive flexibility.

BACKGROUNDPulmonary vein antrum isolation (PVAI) of pre-excited atrial fibrillation (AF) is controversial. This study aimed to observe the therapeutic effects of PVAI on pre-excited AF.

METHODSTwenty-nine patients with pre-excited AF were prospectively divided into a PVAI group (group I, 19 cases) and a control group (group II, 10 cases). To each case in group I, PVAI was performed, and then electroanatomical mapping of accessory pathways (AP) and ablation were constructed on a three-dimensional (3D) map of the valve annulus. Only AP ablation was performed in each case of group II.

RESULTSOf the 29 cases, three were found to have dual APs, two had intermittent APs, and the remaining 24 had single APs. All APs were successfully ablated after the procedure. There were no significant statistical differences in the AP procedure duration ((77.4 ± 21.3) minutes vs. (85.3 ± 13.1) minutes), the AP ablation time ((204 ± 34) seconds vs. (223 ± 62) seconds) and the AP X-ray exposure time ((18.6 ± 4.4) minutes vs. (19.1 ± 4.5) minutes) respectively between groups I and II. As compared with the control group (5 of 10 cases, 50%), the PVAI group had a significantly lower AF recurrence rate (2 of 19 cases, 11%; P < 0.05) during follow-up of (20.5 ± 10.0) months. All seven patients who recurred were successfully abolished by a second ablation.

CONCLUSIONSIn patients with pre-excited AF, PVAI is an effective therapeutic approach with a low AF recurrence rate. 3D electroanatomical maps of AP contributed to the high success rate of ablation without significantly prolonging of operational duration and X-ray exposure time.

Accessory Atrioventricular Bundle ; Adolescent ; Adult ; Aged ; Atrial Fibrillation ; physiopathology ; surgery ; Catheter Ablation ; methods ; Electric Countershock ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Veins ; surgery

BACKGROUNDA high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved, but some of them cannot be eliminated from endocardium. We investigated the association between adenosine sensitivity and ablation success/recurrence rates with a nonirrigated or an irrigated catheter.

METHODSAccording to adenosine test, all patients were divided into a sensitive group (S group) or an insensitive group (I group). The patients of each group were randomized into a nonirrigated catheter (NA) subgroup or an irrigated catheter (IA) subgroup with a 2:1 ratio.

RESULTSIn S group of 122 patients (84 in NA subgroup), the ablation success rate was similar between two subgroups (94.7% vs. 90.5%, P > 0.05), but in I group of 94 patients (60 in NA subgroup), it was higher in IA subgroup (94.1%) than that in NA subgroup (73.3%, P < 0.05). The success rate using nonirrigated catheter was significantly higher in S group (90.5%) than that in I group (73.3%, P < 0.01), and the recurrence rate was lower in S group than that in I group (1.3%, vs. 13.6%, P < 0.05). On the contrary, the success rate and the recurrence rate using irrigated catheter were similar between S group and I group (94.7%, 94.1%, P > 0.05, vs. 2.8%, 6.3%, P > 0.05).

CONCLUSIONSAdenosine insensitivity is associated with a lower success rate and a higher recurrence rate for VA patients undergoing nonirrigated catheter ablation. Thus, irrigated catheters should be the first choice for VA ablation in adenosine insensitive patients.

Adenosine ; therapeutic use ; Adult ; Aged ; Animals ; Catheter Ablation ; Heart Ventricles ; drug effects ; surgery ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; drug therapy ; surgery ; Treatment Outcome ; Ventricular Premature Complexes ; drug therapy ; surgery