Objective To explore the relationship between dysfunctional beliefs and attitudes on sleep and sleep disturbances before and after a short-term pharmacotherapy in patients with major depression. Methods Sixty-six (29 male, 37 female, 34.0±9.5 years old) patients with major depression were recruited before the treatment. Dysfunctional Beliefs and Attitudes about Sleep (DBAS) questionnaire, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Scale (HAMA) were assessed before and after a 4-week antidepressant treatment. Results After the 4-week antidepressant treatment, depressive and anxiety symptoms were alleviated significantly, whereas sleep disturbance still persisted. And sleep quality was closely related with problematic sleep beliefs after the treatment.Conclusion Some evidences are provided for cognitive behavioral therapy during antidepressant therapy, and the therapy should be matched with problematic beliefs and attitudes.

Objective To improve the accuracy of early diagnosis and choose suitable management for duodenal injury. Methods Clinical experience was summerized during recent 25 years. Results Of the 19 patierts, 14(74%) had multiple injuries. All patients were treated by operations, including 10 with primary repair , 3 with repair plus duodenumcele, and 3 with Roux-en-y duodeno-jejunostomy, 1 with pancreatoduodenectomy, 2 with modified Cogbill's method. Seventeen patients were cured successfully,and 2 died of multiple organs injuries, septic shock and multiple organ failure. Conclusions Correct treatment and appropriate operation are essential for duodenal rupture in severe multiple injuries.

Objective To study the proliferation and differentiation patterns of hepatic stem cells from mice cultured in vitro isolated identify their characteristics.Methods Mice were divided into 5 groups according to the pregnant (embryo days,ED13,ED15 and ED18) or born age (day0 and 3).Hepatic stem cells were isolated and cultured in vitro.The amount of the stem cells as well as their growing situation and differentiation pattern were observed and compared among different groups and markers of stem cells (CD117,CD90.1,CD49f,c-Met),hepatic cells(AFP) were used to identify the cultures.Resulls The cells with best situation of growing as colonies were obtained from ED15 group.Their expression of specific markers suggested that they were hepatic stem cells.The stem cells isolated from ED15 mice in subculturing proliferated in line pattern and differentiated in reverse line pattern.The expression of AFP varied as normal distribution as cell differentiation development.Conclusion Most cells have characteristics of hepatic stem cells isolated from fetal liver and the number of these cells decreases gradually as embryo duration prolongs.The hepatic stem cells proliferate in line pattern and differentiate into hepatic cells after in vitro culture.

Objective To construct a sequence tag library of HepG2 cells by serial analysis of gene expression (SAGE). Methods Total RNA of HepG2 cells was extracted using a Trizol agent. The double strand cDNA were reverse-translated from mRNA which was isolated from total RNA. According to the protocol of SAGE, a sequence tag library of HepG2 cells was constructed. The transcript, which was represented by each tag, was analyzed by consulting the GenBank and UniGene, and the abundance of the tags was analyzed by SAGE analysis software. Results A total of 14 181 SAGE tags out of 15 586 tags were steadily and effectively amplified and the lengths of the tags were between 200-3000 bp. After sequence analysis of the tags, 2023 specific genes were revealed. Conclusions The use of improved reverse transcription agent kit may guarantee obtaining the full length cDNA, which provides materials for the construction of SAGE library. SAGE is a powerful method to investigate the gene expression profile, and it establishes a foundation for gene researches.

Minimally invasive surgery has been one of the main trend of surgical practice in 21 century,while the laparoscopic technique,as one of the product of high-tech,shows the minimally invasive surgery a more lactiferous prospect.However,with the popularity of laparoscopic technique,its high complications rate is gradually being highly regarded.By analyzing various causes comprehensively,we found that the complications rate had direct correlation with the operant level of the operator.Combining the successful experience of twice laparoscopic technique training courses,which were conducted by our department,this article will give rise to a discussion about the training of the general surgery doctor.

Objective To evaluate surgical mangement of femoral pseudoaneurysm caused by injection of addictive drugs. Methods The clinical data of 13 cases with femoral pseudoaneurysm resulted from drugs injection were retrospectively analyzed. All cases underwent operation treatment. 1 case received aneurysmectomy and lacerative repair, and 13 cases received aneurysmctomy and vascular grafting. The grafts included autogenous saphenous vein, artificial blood vessel and so on. Results The postoperative color ultrasound Doppler detection showed that all of the vascular grafts were patent, and the limbs of all the 13 patients were salvaged. Conclusion Complete debridement,vascular reconstruction and proper treatment of complications were the key factors of treating successfully the femoral pseudoaneurysm resulted from drugs injection.

Objective Detecting the level of IDO and KYN in ulcerative colitis (UC) patients; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of dis-ease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent (ELISA) methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression (P<0.05). There was a positive correlation between KYN level and IDO expression (P<0.05). ②The levels of IDO and KYN in UC group were higher than those of disease control group and health control group (P<0.05). ③The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC (P<0.01), and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels (P<0.05). ⑤The IDO,KYN and CRP area under ROC curve were 0.976, 0.856 and 0.864;best cut-off point were 53.66 U/L, 2.34 nmol/L and 1.75 mg/ml;sensitiv-ity were 90.5%, 78.65% and 100.0%; specifity were 94.4%, 83.3% and 61.1%; Youden index were 0.839 2, 0.619 0 and 0.611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

Objective:To analyze the clinical characteristics and treatment effect between bilateral(bi-)and unilateral(uni-) sudden sensorineural hearing loss(SSNHL).Method:Four hundred and eighty cases of SSNHL were retrospective study,which were divided into two groups of bi-SSNHL(n=40) and uni-SSNHL(n=440).Clinical characteristics and treatment effects were compared of the two groups.Result:The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%),compared with 56.4 percent of patients with uni-SSNHL.Conclusion:Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect,that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.

Objective To assess the value of ultrasonic probe (USP) in the diagnosis of Submucous eminence of colorectume.Methods Sixty-eight patients with colorectal submucous eminence in 70 areas received USP under colonoscope.The accuracy of diagnosis was evaluated.Results Twenty carcinoid tumor were detected which manifested submucous hypoechoic ; Lipoma 12,located in right half colon which manifested submucous layer,clear boundaries hyperechoic; Cyst 12 manifested single or multi lattices no-echo on submucous which have integrated involucrum.Mesenchymoma or myoma levicellulare 12,most of them located inthe rectum manifested uniform or no-uniform hypoechoic on the muscularis mucosa or below and were difficult to discriminate.Malignant lymphoma,3 manifested muscularis mucosa and submucosa thickening,muscularis propria were seldom affected.Vascular diseases (hemangioma,varicosity) 3,manifested no-echoic on mucosa or submucosa,some medium,high echoic,circular or irregular,and also endometriosis 2,pigment deposition 1,appendix abscess 1,extramural compression 2,ultrasonic test is marched with clinic diagnosis.Accuracy rate is 100％.Conclusion USP can diagnose colorectal submucous eminence with high accuracy,and even provide information about the size,layer of origin,border of the colorectal submucous eminence and can distinguish benign or malignant tumor according to ultrasonic check,at the same time provide differentiation with extramural compressive lesions.

In this paper, the authors analyzed the clinical features and the psychological characteristics of pa-tients with vitiligo: nervousness and inferiority, urgent treatment, high expectation , disappointed feelings of the failtreatment. Aimed at these psychological problems, the medical ethics requirements in the process of diagnosis and treatment were proposed:respect for the patient, protect of the patient′s privacy, patient communication and regular follow-up and health education.