Background During the past two decades, a number of rating scales were developed to facilitate diagnosis and assessment of subjects with social anxiety disorder. One of the most commonly used scales for the assessment of social anxiety disorder is the Liebowitz social anxiety scale (LSAS). The LSAS is widely used in epidemiologic investigations and clinical researches,and its assessment in the pharmacotherapy efficacy for social anxiety disorder is superior to any other scale. So we designed this study to explore the validity and reliability of the LSAS in Chinese patients with social anxiety disorder and normal control, and to find the difference of the scores between the patients self -report version and clinician-administered version. Methods Fifty five patients meeting the DSM-Ⅳ diagnostic criteria for social anxiety disorder and 168 normal controls who were screened from 222 college students were rated by LSAS, social phobia scale and self-made General Information Forms. Results The Cronbath α of LSAS for the patients and the normal controls was 0.83 and 0.77, respectively. The 4-week test-retest reliability for total scores and its factors scores of LSAS in 31 normal controls were ranging from 0.68 to 0.79. The ROC area under curve value in discriminating the patients from normal controls was 0.87±0.03; the total score of 35 was considered to be the best cut-off score for LSAS, then its sensitivity was 0.77 and its specificity was 0.81; and no significant difference between the self-report version and clinician-administered version. Conclusions The LSAS is good in internal consistency and test-retest reliability, and has high sensitivity and specificity in discriminating the patients and the controls. There is no significant difference in the total score and each factor scores of LSAS between self-report version and clinician-administered version.

Objective To explore the effect of early comprehensive rehabilitation therapy on dysphagia after stroke. Methods A total of 120 stroke patients with dysphagia were collected from December 2006 to May 2009 and divided into 3 trial groups and a control group randomly.No treatment was given to patients in the control group.Patients in trial group 1(T1)were given rehabilitation training,while patients in trial groups 2(T2)and 3(T3)were treated with VitalStim and electrical acupuncture,respectively,in addition to the rehabilitation training.A standardized swallowing assessment (SSA) and the swallowing quality of life(SWAL-QOL) scale were used to evalu-ate all the patients before and after 4 weeks of treatment. ResuIts No statistically significant difference was re-vealed before the treatment among the groups in terms of the patients'sex,age,course of disease,SSA or SWAL-QOL results.Statistically significant improvement was observed after treatment in the 3 trial group,but not in the control group with regard to the SSA and SWAL-QOL scores compared with those before treatment.The trial groups all had higher scores than the control group after treatment.while T2 and T3 had higher scores than T1 after treatment.There was no statistically significant difference between groups T2 and T3.Conclusions Early compre-hensive rehabilitation therapy can improve swallowing and the quality of life of stroke patients with dysphagia.Reha-bilitation combined with neuromuscular electrical stimulation provides effects similar to that of training combined with electrical accupuneture,and is more effective than simple training in treating dysphagia.

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.

OBJECTIVETo investigate the influence of total flavonoids of epimedium (TFE) on the streptozocin (STZ)-induced kidney injury in diabetic rats and discuss the possible mechanism.

METHODSDiabetes was produced by a single injection of streptozocin (40 mg/kg, iv) in male SD rats. The rats were randomly divided into three groups (n = 10): control group, model group and TFE group (100 mg/kg, ig). Animals were sacrificed 12 weeks later. The level of blood glucose, blood urea nitrogen (BUN) and creatinine (Cr) as well as the renal index were determined. Detect the specific biochemical of renal tissue: superoxide dismutase (SOD), malondialdehyde (MDA). Use masson staining to observe the morphology of the renal tissue. Immunohistochemistry was employed to determine the protein levels of transforming growth factor-beta1 (TGF-beta1).

RESULTSCompared to control group, the enhancement of blood glucose, renal index, BUN and Cr was found in model group, which was significantly attenuated by treatment with TFE. Meanwhile, elevated MDA level in renal tissue as well as decreased SOD activities in renal tissue were significantly remitted by TFE. Furthermore, TFE decreased the expression of TGF-beta1.

CONCLUSIONTFE can evidently relieve renal damage in rats with diabetic nephropathy induced by STZ, which might be related to antioxidation and modulating the expression of TGF-beta1 protein.

Animals ; Diabetes Mellitus, Experimental ; metabolism ; Diabetic Nephropathies ; metabolism ; prevention & control ; Epimedium ; chemistry ; Flavonoids ; pharmacology ; Kidney ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the efficacy and safety of different operation time for acute spinal cord injury(SCI) based on systematic review.

METHODSPubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to February 2017 for relevant randomized clinical trials on the treatment of acute spinal cord injury with different intervention times.

RESULTSFour randomized clinical trials of total 156 cases were included. Early surgical intervention for the patients with incomplete spinal cord injury can improve the ASIA motor function score [MD=3.29, 95%CI(-7.90, 14.49), =0.56] and overall Frankel score[=7.65, 95%CI(2.69, 21.74), =0.000 1]. There was no significant difference in the improvement of the overall Frankel score[=4.88, 95%CI(0.74, 32.09), =0.10] for the patients with complete spinal cord injury between the early surgery and delayed surgery group. There was no significant difference in hospitalization time[MD=-3.4, 95%CI(-8.12, 1.32), =0.16], death rate [=1.07, 95%CI(0.21, 5.56), =0.93]and incidence of decubitus[=1.07, 95%CI(0.17, 6.69), =0.94] between the early surgery and delayed surgery group.

CONCLUSIONSEarly surgical intervention can promote the nerve function recovery after spinal cord injury, whithout further incidence of complications, but random control trails with higher quality are still required for this conclusion.

Humans ; Randomized Controlled Trials as Topic ; Recovery of Function ; Spinal Cord Injuries ; surgery ; Time Factors

[Objective]To investigate the diagnostic characteristics of optic chiasm-hypothalamic glioma (OCHG) and the reasons for its high misdiagnosis rate.[Methods]Retrospective analysis was performed on the clinical features and imaging findings of 32 patients with OCHG,admitted to our hospitals from October 1999 to December 2011 and proved by pathology.Being compared with those features of other diseases in the sellar region,the reasons for high misdiagnosis rate of OCHG were analyzed.[Results] Among the 32 patients,18 were diagnosed correctly before surgery.However,in the other 14,lesions were misdiagnosed as craniopharyngioma in 8,germ cell tumor in 4,pituitary adenoma in 1,and chordoma in 1 with a total misdiagnosis rate reaching 43％.All patients suffered craniotomy surgery for tumor removal.Among the 4 patients misdiagnosed as having germinoma,2 underwent preoperative radiotherapy and 2 performed preoperative EP regimen chemotherapy.According to the features of the CT and MR images,the OCHG were divided into 3 presentations:solid,solid and cyst mixture and round enhanced tumors.The solid lesions (n=10) were easily misdiagnosed as germinoma (4/10,40％);however,the round enhanced tumors (n=5),especially combined with huge calcification (n=4),were extremely easily misdiagnosed as craniopharyngioma (4/5,80％ ).[Conclusion] Comprehensive understanding the growth and image features of OCHG and summing up the misdiagnosis points when comparing to the other diseases in the sellar region are indispensable in improving the presurgical diagnosis accuracy for OCHG.

OBJECTIVESTo investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins.

METHODSA retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis.

RESULTSThe median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor.

CONCLUSIONSRe-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Female ; Follow-Up Studies ; Frozen Sections ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; surgery

OBJECTIVETo detect the expression of VEGF-C mRNA and to investigate its relationship with clinicopathological parameters in esophageal squamous cell carcinoma (ESCC).

METHODSReal-time quantitative reverse transcriptase-PCR was used to measure the level of VEGF-C mRNA in the tumor tissue and corresponding normal mucosa in ESCC patients.

RESULTSThe VEGF-C mRNA expression in tumor tissue was significantly higher than that in the corresponding normal mucosa (6.30 vs. 2.81, P = 0.02), and also significantly higher in the patients with lymph node metastasis than that in those without lymph node metastasis (10.11 vs. 4.15, P = 0.04). Among the patients with metastatic lymph nodes, VEGF-C mRNA expression was 62.19 in the patients with > or = 4 metastatic lymph nodes versus 6.30 in those with < 4 (P = 0.01), and 18.98 in the patients with > or = 3 metastatic lymph node stations versus 4.92 in those with < 3 (P = 0.04). In terms of stage, VEGF-C mRNA expression was significantly higher in the stage II b + III + IV than that in the stage I + II a (9.99 vs. 3.80, P = 0.03). Logistic binary regression analysis showed that VEGF-C mRNA was an independent risk factor for lymph node metastasis in ESCC (P = 0.01). In survival analysis, 2-year survival rate was not related with VEGF-C mRNA expression (P = 0.46). It was showed by COX regression model that the number of metastatic lymph node stations was the only independent risk factor for survival (P < 0.01).

CONCLUSIONThe expression of VEGF-C mRNA play an important role in lymph node metastasis of human ESCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Esophageal Neoplasms ; metabolism ; pathology ; surgery ; Esophagectomy ; methods ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Logistic Models ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; RNA, Messenger ; metabolism ; Survival Rate ; Vascular Endothelial Growth Factor C ; metabolism

Objectives To screen the high-risk population of stroke in China using color Doppler flow imaging (CDFI)and to establish a stroke risk prediction model in Chinese population in order to prevent and treat stroke early. Methods Forty-one base hospitals and 715 286 people in the project areas of the first 6 provinces of China conducted routine physical examinations and investigated the related risk factors for cardiocerebrovascular diseases from July 2011 to April 2012 using a cross-sectional study,among them 61 860 patients underwent carotid CDFI screening,and 49 386 of them were high-risk population (exposed to≥3 risk factors). The bilateral common carotid interma-media thickness (IMT),the number of plaques and the degree of carotid stenosis were screened and documented. And whether carotid IMT thickening or not,with or without carotid plaques,and degree of carotid artery stenotic rate 0-49% and≥50% were performed by multivariate logistic regression analysis with the risk factors for stroke,respectively. Results (1)Logistic regression analysis showed that hypertension,atrial fibrillation,smoking,and lack of physical exercise were the independent risk factors for carotid IMT thickening (hypertension:OR,1. 17;95%CI 1. 12-1. 22;atrial fibrillation:OR,1. 15;95%CI 1. 09-1. 21;smoking:OR,1. 13;95%CI 1. 08-1. 17;and lack of physical exercise:OR,1. 12;95%CI 1.08-1. 16). (2)Hypertension,atrial fibrillation, smoking,and diabetes were the independent risk factors for carotid plaque and carotid artery stenosis rate≥50%(carotid plaque,hypertension:OR,1. 55;95%CI 1. 47-1. 62;atrial fibrillation:OR,1. 13;95%CI 1.06-1. 21;smoking:OR,1. 16;95%CI 1. 11-1. 22;and diabetes:OR,1. 30;95%CI 1. 24-1. 37). Carotid stenosis rate≥50%,hypertension:OR,1. 78;95%CI 1.55-2. 03;atrial fibrillation:OR,1. 59;95%CI 1. 39-1. 81;smoking:OR,1. 33;95%CI 1. 20-1. 48;and diabetes:OR,1. 30;95%CI 1. 17-1. 45. Simple obesity did not increase the incidences of carotid atherosclerotic plaque and carotid artery stenosis ≥50%(OR,0. 78, 0.83;95%CI 0. 75-0. 82 ,0. 75-0. 92,respectively). Conclusions Neck vascular ultrasound can be used as a valuable means for screening high-risk population and detecting risk factors of stroke. It has an important clinical significance for the early diagnosis and treatment of carotid atherosclerosis disease.

OBJECTIVETo compare the results of detecting HIV-1 load by using NucliSens HIV-1 QT and Amplicor HIV-1 monitor 1.5 assays.

METHODSEighty-two clinical samples were collected and HIV viral load was determined with the above-mentioned two methods.

RESULTSThe number of samples in which values obtained by NucliSens HIV-1 QT and Amplicor HIV-1 monitor 1.5 differed by <0.5 log10 RNA copies/ml and in which the viral load was undetectable accounted for 88.9 percent of the measures. The correlation coefficient between the two methods was 0.956 in 56 samples of Deltalog10 VL<0.5.

CONCLUSIONThe results of HIV-1 viral load determination with the two methods are highly comparable.

HIV Infections ; virology ; HIV-1 ; genetics ; isolation & purification ; Humans ; Nucleic Acid Amplification Techniques ; instrumentation ; methods ; RNA, Viral ; genetics ; Viral Load