This paper will address the development of disaster psychology and its important contribution regarding its theoretical and practical frameworks as it applies to the psychological counseling for survivors suffering from the consequences of natural disasters.This paper will also analyze how the approach of disaster psychology can be applied to work with survivors suffering from natural disasters and to alleviate psychological challenges and its influential factors which affect these individuals.Several strategies have been discussed and proposed.In addition,relevant theoretical and integrated approaches for psychological intervention support and guidance,and rehabilitation have been established.

Children are in the stage of mental and behavior development and easily sufferd from physical and psychological barriers after disaster.This paper uses the theories and methods of the developmental psychology,disaster psychology and rehabilitation psychology to analyze the psychological and behavior barriers of the disaster survivors and to discuss the psychological intervention and rehabilitation approaches.

Objective To explore the mechanism of the Jiedu Huayu Ⅱ Decoction in actue hepatic failure.MethodsThe acute hepatic failure rat models were induced with thioacetamide (TAA).84 SPF Wistar rats were divided into 7 groups randomly:blank group,model group,low dose group,middle dose group,high dose group,lactulose group,and the Angong Niuhuang Pill group.The drugs were administrated by gavage 3 d before model-making,5.5 d in total.The expression of Bcl-2,cytochrome C in mitochondrial and cytoplasm were measured with Western Blot.ResultsThe expression of Bcl-2 reduced in mitochondrial,the expression of cytochrome C increased in cytoplasm and reduce in mitochondrial in model group compare with that of blank group.Jiedu Huayu Ⅱ Decoction was able to enhance the expression of Bcl-2 and restrain cytochrome C release from mitochondrial to cytoplasm.Moreover,it shows dose-effect relation.ConclusionThe protection of Jiedu Huayu Ⅱ Decoction for hepatocyte in acute hepatic failure rats maybe relate to the increase of Bcl-2 in mitochondrial,blocking the mitochondrial permeability transition pore to arrest cytochrome C releasing.

Objective At present, there are few studies about myelolipoma within adrenal cortical adenoma.Our aim was to provide more basis for correct diagnosis and treatment by investigation into its clinical and pathological features.Methods The clinical and pathological data were retrospectively reviewed in 11 patients of myelolipoma within adrenal cortical adenoma, along with relative literature reviews.Results The median age of 11 patients (7 females, 4 males) was 49±9.5 years, among whom 3 patients presented Cushing's syndrome, 1 patient with more than 10 years' recurrent dizzy with hypertension, other 7 patients were found coincidently by routine examination.Adrenal mass were found by imaging examination.Pathologically, myelolipomas were in solitary nodule distribution and/or admixed with adrenal cortical adenomas.Myelolipomas were composed of variable admixture of mature adipose tissue and hematopoietic elements.Surgical treatment was performed for all 11 patients, and no relapse was found in 2 months' to 11 years' follow-up.Conclusion Myelolipoma within adrenal cortical adenoma is extremely rare, which is common in females.The patients may present with Cushing's syndrome, hypertension or without obvious clinical syndrome.All the patients are in favorable prognosis after surgical resection.

Objective The purpose of this study was to use diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) alone or in combination to observe the distribution of white matter lesions and cortical malfunctional areas in human immunodeficiency virus (HIV) infected patients with mild cognitive decline and to explore the relationship between the DTI and the rs-fMRI methods.Methods Twenty-six HIV infected patients with mild cognitive impairment and 30 healthy volunteers were selected by Montreal Cognitive Asessment (MoCA) scale evaluation.DTI data and rs-fMRI data were obtained,fractional anisotropy (FA) value images were obtained with voxel based analysis and the resting-state default mode network (DMN),functional connectivity images were obtained with cingulate gyrus as a seed point.Overlay images were obtained with FA,DMN and Ch2 standard images.Results Compared with the control group,the white matter FA values were significantly decreased in the left precuneus(t=4.0499,P＜0.005) and right precuneus (t=5.1553,P＜0.005),right superior frontal gyrus(t=5.1517,5.1484,P＜0.005),right middle frontal gyrus (t=4.1444,P＜0.005),right precentral gyrus (t=3.7395,P＜0.005),right occipital lobe (t=7.2236,P＜0.005),and right inferior parietal lobule (t=4.1450,P＜0.005) in acquired immunodeficiency syndrome (AIDS) patients.In resting-state default mode network,areas significantly related to cingulate gyrus seed point included the left cingulate gyrus (t =32.78,P＜0.005),left precuneus (t =4.51,P＜0.005),left superior frontal gyrus (t =14.33,4.53,P＜0.005),left middle temporal gyrus (t =10.01,5.72,P＜ 0.005),left inferior temporal gyrus (t =5.99,P＜0.005),left parahippocampal gyrus (t =7.63,P＜0.005),right posterior cingulate (t =34.81,P＜0.005),right precuneus (t=32.09,P＜0.005),right superior frontal gyrus(t =14.12,P＜0.005),right middle frontal gyrus (t=17.71,P＜0.005),right superior temporal gyrus (t=14.59,P＜0.005),and right middle temporal gyrus (t=11.83,P＜0.005); while areas not significantly related to the cingulate gyrus seed point included the left precuneus (t =5.39,P＜0.01),left anterior cingulate gyrus (t =3.66,P＜0.01),left cerebellar tonsils (t =7.51,P＜0.01),right superior parietal lobule (t=4.44,P＜0.01),right parahippocampa gyrus (t =3.69,P＜0.01),and right cerebellar tonsil (t=6.15,P＜0.01).Overlayed images showed that the white matter FA value of the left precuneus were decreased and the functional activitis of the corresponding cortex were significantly decreased; while the white matter FA values of the left precuneus,right precuneus,right superior frontal gyrus,right middle frontal gyrus were decreased without affection of the functional activity of the corresponding cortex in AIDS patients.Conclusion White matter nerve fiber disconnection of multiple brain regions and its corresponding cortical function decline with compensatory activity co-participated in the pathogenesis of AIDS mild cognitive decline.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

OBJECTIVETo analyze the efficacy and safety of bicyclol combined with thymosin in treatment of chronic viral hepatitis B (CHB).

METHODSA total of 135 patients with CHB were randomized into experimental group and control group. The patients in the experimental group received bicyclol orally 75 mg daily and thymosin 20 mg intramuscular injection once every 2 days for 24 weeks and those in control group received bicyclol orally 75 mg daily alone for 24 weeks. The levels of serum aminotransferase (ALT/AST), HBV-DNA, HBeAg /antiHBe were observed.

RESULTSCompared with pre-treatment levels, the serum aminotransferase levels decreased significantly in both groups, but there were no statistically significant differences between them. HBeAg negative conversion rate was significantly higher in the experimental group than in the control group (35.3 percent vs.19.4 percent, P less than 0.05). HBV DNA negative conversion rate was significantly higher in the experimental group than in the control group (36.7 percent vs. 20.9 percent, P less than 0.05). No obvious adverse events which were probably related to the drugs were observed in this study.

CONCLUSIONThe combination of bicyclol with thymosin had better effect in treatment of chronic hepatitis B ias compared with bicyvlol alone.

Adolescent ; Adult ; Biphenyl Compounds ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Thymosin ; administration & dosage ; adverse effects

To develop a parent-metabolite pharmacokinetic model for risperidone (RIP) and its major active metabolite (9-hydroxyrisperidone) and investigate their pharmacokinetics characteristics in healthy male volunteers, twenty-two healthy volunteers were orally given a single dose of 2 mg RIP. Plasma samples were collected in the period of 96 hours and concentrations of RIP and 9-hydroxyrisperidone were measured by a validated HPLC/MS method. CYP2D6 phenotypes were identified by the T1/2 of RIP and 9-hydroxyrisperidone according to the literature. Model structure identifiability analysis was performed by the similarity transformation approach to investigate whether the unknown parameters of the proposed model could be estimated from the designed experiment. Pharmacokinetics parameters were estimated using weighted least squares method, and the final pharmacokinetics model were tested and evaluated by Monte Carlo simulation. Eighteen volunteers were phenotyped as extensive metabolizers (EM) and four volunteers were identified as intermediate metabolizers (IM). The final model included central and peripheral compartment for both parent (RIP) and metabolite (9-hydroxyrisperidone) respectively. Model structure identifiability analysis indicated that the proposed model was local identifiable. However, if the ratio of RIP converted to 9-hydroxyrisperidone was assumed to be 32% in EM, and 22% in IM, the model could be globally identifiable. The predicted time-concentration curve and AUC(0-t), C(max), T(max) of RIP and 9-hydroxyrisperidone estimated by the established model were in agreement with the observations and noncompartment analysis. Rate constant of RIP conversion to 9-hydroxyrisperidone was (0.12 +/- 0.08) h(-1) and (0.014 +/- 0.007) h(-1) for EM and IM, respectively. Elimination rate constants of RIP were (0.25 +/- 0.18) and (0.05 +/- 0.23) h(-1) for EM and IM, respectively. Model validation result showed that all parameters derived from the concentration data fitted well with the theoretical value, with mean prediction error of most PK parameter within +/- 15%. The established model well defined the disposition of RIP and 9-hydroxyrisperidone simultaneously and showed large inter-individual pharmacokinetics variation in different CYP2D6 phenotype. The model also provide a useful approach to characterize pharmacokinetics of other parent-metabolite drugs.
Adult ; Cytochrome P-450 CYP2D6 ; physiology ; Humans ; Isoxazoles ; pharmacokinetics ; Male ; Models, Biological ; Monte Carlo Method ; Paliperidone Palmitate ; Pyrimidines ; pharmacokinetics ; Risperidone ; pharmacokinetics

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer with a very poor prognosis.In order to guide better clinical management of ICC patients,the American Joint Committee on Cancer (AJCC) cancer staging manual (7th edition) have established a unique TNM staging scheme for separating ICC from hepatocellular carcinoma (HCC) for the first time,and reflected a difference between risk factor of ICC and HCC.This TNM staging system for ICC has been most recently updated by the AJCC cancer staging manual (8th edition),in which T staging has been redefined without gross features,and lymph node metastasis (N1) in N staging has been grouped as stage Ⅲ B,but not stage Ⅳ as required by the 7th edition of AJCC cancer staging manual.In addition,region lymphatic and distant metastases have been clearly redefined by the AJCC cancer staging manual (8th edition) that also requires recovering at least 6 lymph nodes for the N staging scheme.The apparent advantages of the AJCC cancer staging manual (8th edition) for ICC pathologic staging may better stratify the prognosis of ICC patients and provide an improved guidance in clinical practice.

Objective: To investigate clinicopathologic features and prognosis of adenoid cystic carcinoma (ACC) involving external auditory meatus. Methods: The clinical presentation and follow-up data of 63 patients with ACC of external auditory canal were collected from January 2006 to February 2017 at PLA General Hospital and Hainan Branch of PLA General Hospital. The clinicopathologic features and prognostic factors of external auditory canal ACC were analyzed. Results: (1) There were 28 males and 35 females and the average age of the first diagnosis was 48.9 years (22-81 years). The tumors showed cribriform pattern in 35 cases (15 cases of late stage), tubular pattern in 14 cases (8 cases of late stage), and solid pattern in 14 cases (9 cases of late stage). Cases with solid pattern was relatively more frequent than that of cribriform pattern and tubular pattern, but the difference was not statistically significant (P>0.05). (2) The average follow-up time was 62.4 months (2-228 months) in the 57 available cases. Among the 33 cases with recurrence, 18 cases had local recurrence and 15 cases had distant metastasis. The mean recurrence time was 40.6 months (2-204 months). Nine patients died of ACC: 2 cases in early stage (died at 48 and 102 months after the first treatment), 7 cases in late stage and 57 with (died at 9, 30, 32, 60, 72, 94 and 228 months). (3) Among the 37 patients with perineural invasion, there were 21 cases of cribriform pattern, 4 cases of tubular pattern and 12 cases of solid pattern; the number of cases in early stage and late stage were 15 and 22, respectively; and the differences were statistically significant (P<0.05). In addition, 31 cases had otalgia among the 37 patients with perineural invasion, where differences were not significant (P>0.05). (4) Thirty of 45 cases with tumor resection or partial resection of temporal bone had recurrence, whereas 3 of 12 cases of tumor combined with superficial lobectomy of parotid gland had recurrence. The difference was statistically significant (P<0.05). Postoperative adjuvant radiotherapy was given in 19 cases, including 7 cases of early stage (2 cases of recurrence), and 12 cases of late stage (8 cases of recurrence), among which there was no significant difference (P>0.05). Conclusions ACC occurring in external auditory canal frequently recurs. Superficial parotid lobectomy at the first operation is necessary to prevent tumor recurrence. Postoperative adjuvant radiotherapy has certain curative effect on patients with early stage tumor, but it does not affect the recurrence rate. Patients at late stage are more prone to perineural invasion than those in early stage. In addition, cribriform and solid patterns are more common that tubular pattern, and there is no significant correlation between perineural invasion and otalgia.