OBJECTIVETo analyze the relationship of anxiety state with CD4(+) level and CD4(+)/CD8(+) ratio and to observe the effect of Chinese medicine (CM) treatment on anxiety in chronic hepatitis B (CHB) patients.

METHODSThe anxiety state of 120 CHB patients was evaluated based on Hamilton Anxiety Scale (HAMA) scoring. According to the scores, 63 patients with scores ≥14 were classified to anxiety and 57 patients with scores <14 to non-anxiety. The differences in CD4(+) cells and CD4(+)/CD8(+) ratio between patients with anxiety and non-anxiety were analyzed. Moreover, 63 patients with anxiety were randomized into two groups: 31 in the control group were treated with lamivudine (100 mg per day) alone and 32 in the observation group were given equal dosage lamivudine combined with CM treatment depending on syndrome differentiation, all for 12 weeks. The effects of treatment on anxiety state and T-lymphocyte subsets as well as its impact on some CHB-related indices were observed and compared.

RESULTSThe anxiety state of CHB patients was negatively correlated with CD4(+) and CD4(+)/CD8(+); the level of CD4(+) in patients with anxiety was significantly lower than that in non-anxiety patients (P<0.01 or P<0.05). After treatment, anxiety state in the observation group was significantly improved, with their HAMA scores significantly lowered (P<0.01), and the levels of CD4(+) and CD4(+)/CD8(+) were significantly higher than those in the control group (P<0.05 or P<0.01). Moreover, the alanine transaminase recovery rate and the HBV-DNA-negative conversion rate in the observation group were significantly higher than those in the control group, respectively (P<0.05).

CONCLUSIONSThe anxiety state of CHB patients was related to CD4(+) and CD4(+)/CD8(+) levels. CM treatment could improve the anxiety state and showed certain regulatory effect on the patients' immune system.

Anxiety ; immunology ; therapy ; CD4-CD8 Ratio ; Hepatitis B, Chronic ; immunology ; psychology ; therapy ; Humans ; T-Lymphocyte Subsets

Objective To study the middle ear damage caused by high pressure.Methods The finite element model of human middle ear was established based on CT scanning,and the change of stress,strain and displacement of the tympanic membrane and stapes footplate was analyzed when the model was applied with timevarying pressure.Results The satisfactory agreement between the computational results and the corresponding experimental data in the literature could indicate the validity of the model.High pressure would cause damage to middle ear,and the damage would be aggravated with the pressure increasing.Rapid pressurization could make severely damage to middle ear,but have minor effect on inner ear.Slow pressurization could also lead to middle ear damage,but inner ear might be damaged before the injury to middle ear.Conclusions High pressure can easily lead to the ear damage;therefore,the pressurized rate should be controlled strictly to protect the hearing during pressurization.

Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.

Infantile neuroaxonal dystrophy (INAD) is a rare autosome-recessive disease characterized by progressive motor and cognitive regression.The PLA2G6 gene is its causative gene,which encodes calcium-independent phospholipase A2 enzyme (iPLA2-VIA).The diagnosis of INAD is difficult because of its clinical heterogeneity,and the rate of misdiagnosis is high.The purpose of this study is to describe the clinical characteristics,molecular genetics,treatment and prognosis of INAD to improve the acknowledgement of INAD in medical workers and to help make an early diagnosis of INAD.

Objective To investigate the full-term newborn′s weight in Zhengzhou city and nearby areas around Zhengzhou in Henan province.Methods Each group newborn′s weight was divided with sex and city.We studied the regularity of full-term newborn′s weight,and examined the cause of the newborn′s weight rising.Results The average newborn′s weight in Zhengzhou was (3449.06?453.97) g,which in nearby areas around Zhengzhou was (3352.07?429.91) g.The average newborn′s weight in Zhengzhou was 86.97 g higher than other cities (P

Objective To study the middle ear damage caused by high pressure. Methods The finite element model of human middle ear was established based on CT scanning, and the change of stress, strain and displacement of the tympanic membrane and the stapes footplate was analyzed when the model was applied with time-varying pressure. Results The satisfactory agreement between the computational results and the corresponding experimental data in the literature indicated the validity of the model. High pressure would cause damage to the middle ear, and the damage would increase with the pressure increasing. Rapid pressurization could severely damage the middle ear, but with a small effect on the inner ear. Slow pressurization could also lead to the middle ear damage, but the inner ear might be damaged before the damage to the middle ear. Conclusions High pressure can easily lead to the ear damage; therefore, the pressurized rate should be controlled strictly during pressurization in order to protect the hearing.

Adenoma ; genetics ; metabolism ; pathology ; surgery ; Adult ; Carcinoma, Papillary ; genetics ; metabolism ; pathology ; Diagnosis, Differential ; Exons ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Mutation ; Nuclear Proteins ; metabolism ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

OBJECTIVETo investigate the clinicopathological features of primary gastrointestinal non-Hodgkin's lymphomas (PGI-NHL) and their prognostic values.

METHODSThe clinical and pathological data of 216 patients diagnosed as PGI-NHL from Zhejiang Cancer Hospital were analyzed retrospectively. χ² test, log-liner model analysis, COX proportional hazard regression analysis and Life-table survival analysis were used to analyze the survival status of the patients by SAS 8.2 software, and Log-rank test was performed to couple the overall survival rates with different prognostic factors.

RESULTSTotally, the age of onset was 8 to 89 years with the median age of 56.5 years. Male versus female was 1.27∶1(121∶95). The most frequently involved location was stomach (147 cases, 68.1%), followed by ileocecus (25 cases, 11.6%), large intestine (20 cases, 9.3%), small intestine (17 cases, 7.9%) and multiple GI involvement (5 cases, 2.3%). 182 cases were classified as B cell lymphomas, 22 cases as T cell lymphomas, and 12 cases not classified exactly due to insufficient data. The 3-year and 5-year survival rates of the patients were 69.4% and 53.3%, respectively. Univariate analysis revealed that age＞60 years, ECOG≥2, high LDH level, stage Ⅲ-Ⅳ, IPI≥2, T cell type and intestinal involvement were predictors for poor prognosis. IPI≥2, T cell type and intestinal involvement were independent adverse predictors for prognosis by multiple COX proportional hazard regression analysis. Among different treatment groups, cases received chemotherapy combined with local radiotherapy gained the best survival status.

CONCLUSIONB-cell lymphoma was the main pathological type in PGI-NHL; IPI≥2, T-cell type and intestinal involvement are independent adverse predictors for prognosis; chemotherapy combined with local radiotherapy might be the choice of approach for advanced stage and aggressive PGI-HNL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; pathology ; Humans ; Lymphoma, Non-Hodgkin ; drug therapy ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

Purpose To study the clinical features, immunophenotypes and prognostic factors of primary breast diffuse large B-celllymphoma (PBDLBCL). Methods The clinical pathological data of 49 cases of PBDLBCL during January 2006 to December 2016 were retrospectively analysed, and the basic clinical and pathologic data, pathologic types and the immunohistochemical slides by EnVision method for staining were summarized. Results 47 cases were women and 2 cases were men. The age ranged from 24 to 79 year old with the median age of 48 year old. On microscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mammary gland, around the duct, interstitial and fat tissue, some were single file cord pattern. The immunophenotype showed 37 cases were of non-GCB, 12 cases were GCB type. Ki-67 index were greater than 40％. According to Ann Arbor staging, 16 cases were stage I EA, 28 cases were stage Ⅱ EA, 5 cases were stage Ⅳ E. IPI score: 30 cases with 0 ～1 score, 10 cases with 2 score, 9 cases with 3 score. Patients were followed up from 5 to 146 months, The 3-year overall survival (OS) rate was 51.2％ and 5-year OS rate was 36.7％, Single factor analysis showed that there were statistically significant difference in clinical stage, levels of LDH, IPI score, BCL-2 protein expression, and BCL-6 protein expression in 3 and 5 years of OS rate. The multiple factor analysis of Cox regression showed that the increase of IPI risk classification was the independent adverse prognostic factor of primary breast diffuse large B-cell lymphoma. Conclusion The diagnosis of PBDLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including surgery, chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively evaluated by multiple factors. IPI increase risk classification is the independent adverse prognostic factor.

OBJECTIVETo observe the intervention effect of acupuncture on early onset of selec- tive serotonin reuptake inhibitors (SSRIs) in treating depressive disorder, and to study its effect on ser- um 5-HT and unbalanced inflammatory cytokines secreted by TH1/TH2.

METHODSTotally 90 patients with depressive disorder were randomly assigned to the drug control group (as the control group, 45 cases) and the acupuncture combined drug treatment group (as the treatment group, 45 cases). All patients were treated for 4 consecutive weeks. Another 45 healthy subjects were recruited as a healthy control group. The effect of acupuncture on early onset of SSRls in treating acute phase depressive disorder pa- tients was evaluated by HAMD score in the control group and the treatment group before treatment,and at weekends of the 1st, 2nd, and 4th week after treatment. Besides, their serum levels of 5-HT, IL-1β and IL-6 (secreted by TH1), and IL-4 and IL-10 (secreted by TH2) were detected before treatment and after treatment at the weekend of the 4th week.

RESULTSCompared with the healthy control group,serum lev- els of 5-HT, IL-4, and IL-10 decreased in the two drug-treated groups before treatment (P < 0.01); serum levels of IL-1β and IL-6 increased (P <0.01). Compared with before treatment in the same group, HAMD score decreased in the control group at weekends of the 2nd and the 4th week after treatment (P < 0.01); HAMD scores decreased in the treatment group at weekends of the 1st, 2nd, 3rd,and 4th week after treatment (P < 0.01); serum levels of 5-HT, IL-4, and IL-10 increased,serum levels of IL-1β and IL- 6 decreased in the two drug-treated groups after treatment (all P < 0.01). Compared with the control group at the same time point,HAMD scores decreased in the treatment group at weekends of the 1st, 2nd,3rd,and 4th week after treatment (P < 0.01),serum levels of 5-HT, IL-4, and IL-10 increased (P < 0.05, P < 0.01), serum levels of IL-6 decreased (P < 0. 01).

CONCLUSIONAcupuncture could accelerate early onset of SSRIs in treating acute phase depressive disorder, and effectively regulate serum 5-HT levels and inflammatory cytokines secreted by TH1/TH2.

Acupuncture Therapy ; Cytokines ; Depressive Disorder ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Interleukin-10 ; Interleukin-1beta ; Interleukin-4 ; Interleukin-6 ; Serotonin Uptake Inhibitors ; therapeutic use