Objective To investigate the efficacy observation of transcranial direct current stimulation (tDCS)for improving the attention in patients with infarction in basal ganglia area. Methods Sixty consecutive patients with basal ganglia infarction admitted to the Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanchang University from May 2015 to May 2016 were enrolled. They were randomly divided into either a control group or a test group according to the random number table (n = 30 in each group). The patients in both groups received routine rehabilitation training,and those in the test group received tDCS therapy synchronously,and the control group received the sham tDCS stimulation. The evaluations and analyses were conducted with the Montreal cognitive assessment (MoCA),d2 test of attention,and event-related potential-P300 (ERP-P300),respectively in all patients before intervention and 4 weeks after intervention,and they were compared between the groups. Results There was no significant difference before intervention between the two groups (all P > 0. 05). Compared with before intervention,the ERP-P300 latencies were reduced,the amplitudes were increased after intervention in the patients of the test group and the control group (all P < 0. 05). The MoCA total scores (the test group:22. 7 ± 2. 7 vs. 15. 5 ±
2. 4;the control group:17. 2 ±2. 5 vs. 15. 6 ±2. 3),attention dimension scores (the test group:4. 6 ± 1. 2 vs. 2. 4 ± 1. 6;the control group:3. 6 ± 1. 5 vs. 2. 5 ± 1. 5),and the total completion of d2 attention test task, total scores,and concentration degree scores (the test group:295 ± 31 vs. 250 ± 45,279 ± 38 vs. 223 ± 52, 97 ± 22 vs. 75 ± 25;the control group:276 ± 33 vs. 247 ± 45,257 ± 39 vs. 211 ± 56,84 ± 23 vs. 71 ± 24) were all increased (all P < 0. 05),and all the indexes of the test group were better than those of the control group (all P < 0. 05). Conclusion tDCS contributes to the improvement of the attention in patients with infarction in the internal capsule-basal ganglia region.

Objective To explore clinical characteristic of metal-on-metal hip joint prosthesis with large heads(ASRTMXL).Methods Total hip arthroplasty(THA)with ASRTMXL was performed in 14 patients including two with ankylosing spondylitis combined with hip amalgamation,three with avascular necrosis,two with secondary osteoarthritis and seven with femoral neck fractures.Based on shortterm follow-up results,we analyzed its design characteristic and clinical properties.Results All patients walked with crotches one week after operation and began weight bearing without support six weeks later.An improvement was seen on the average range of motion of the hip including anteflexion,retroextension,internal rotation,external rotation,adduction and abduction.The mean Harris score was increased from precperative 30 points(13-50 points)to postoperative 90 points(75-100 points),with statistical difference.Postoperative X-ray showed right positions of the prostheses,normal abduction angle and anteversion angle,without complications cccurred.Condusion Short-term follow-up results show that metal-on-metal hip joint prosthesis with large heads has advantages of lower wearing,large range of motion,few dislocation and small deformation of acetabular cup.

Objective To investigate the influence of diameter of liver outflow vein on portal hypertension and artificial blood vessel (ABV) patency rate in Budd-Chiari syndrome (BCS) patients undergoing atrial caval shunting (ACS).Methods We recruited 209 patients,who had undergone ACS for Ⅱ type of BCS.Those patients with unobstructed liver outflow vein were included into group A and the patients with stenosed liver outflow vein into group B.Free portal pressure (FPP) was measured before and after ABV opening.Portal vein velocity (Vpv),liver function,spleen volume and function,esophagogastric varices and ABV patency were evaluated postoperatively.Results After ABV opening,FPP decreased significantly in group A than group B (t =10.45,P ＜ 0.05).Vpv accelerated significantly in group A 2 weeks after operation than group B (t =12.81,P ＜ 0.05).Apparent improvement of liver function,spleen function and esophagogastric varices and reduction of spleen volume were observed in group A patients than group B patients (P ＜ 0.05).Reduction of esophagogastric varices in group A was better than in group B (x2 =44.73,P ＜ 0.05).By postoperative follow up,ABV patency of group A was higher than group B (P ＜ 0.05).Conclusions Patency status of liver outflow vein significantly influences postoperative portal vein pressure and closely correlats to ABV patency rate after ACS.

Objective To investigate the change of inferior vena cava pressure (IVCP) in type Ⅱ Budd-Chiari syndrome patients undergoing atrial caval shunting and its relationship with postoperative artificial blood vessel (ABV) patency rate.Methods We recruited 209 patients who had undergone atrial caval shunting for type Ⅱ Budd-Chiari syndrome and evaluated IVCP,right atrial pressure (RAP) and free portal vein pressure (PFP) before and after ABV opening.Presure changes were compared by t-test.These patients were followed up by color Doppler ultrasonograthy for ABV patency.The correlation between IVCP and postoperative ABV patency were analyzed By Kaplan-Meier test.Results IVCP (t =0.56,P ＜ 0.05)and PFP (t =0.72,P ＜ 0.05) decreased and RAP increased significantly after ABV opening (t =0.52,P ＜ 0.05).Follow up result showed that ABV patency rate was lower in patients with IVCP descent ＜ 1 kPa than those with IVCP descent ＞ 1 kPa (P ＜ 0.05).Conclusions Significant IVCP descent correlates with high ABV patency rate after atrial caval shunting in type Ⅱ Budd-Chiari syndrome patients.

OBJECTIVE: To investigate the status of anxiety and depression in field training military officers and soldiers and analyze the impact of coping styles and personality traits.METHODS: Self-rating Anxiety Scale, Self-Rating Depression scale, Simple Coping Style Questionnaire and Eysenck Personality Questionnaire were used to evaluate 494 field training military officers and soldiers by judgment sampling method. RESULTS: The rates of anxiety and depression symptoms of the officers and soldiers in field training were 13.0% and 23.1%, respectively. The results of multivariate logistic regression analysis showed that the higher the negative coping style, mental quality and neurotic scores of the officers and soldiers in the field, the lower the scores of internal and external, the worse the interpersonal relationship and family relationship, the higher the risk of anxiety(P<0.05). The higher the mental quality and neurotic scores of the officers and soldiers in the field, the lower of the position, the lower the scores of positive coping style and internal and external, the worse the interpersonal relationship and family relationship, the higher the risk of depression(P<0.05). CONCLUSION: Anxiety and depression are the main negative emotions in the field training officers and soldiers. Negative coping style, pathological personality tendency and interpersonal relationship are the main influencing factors of negative emotion.

Objective:To explore the influence of online and offline family therapy based on the Satir model on emotions of adolescents with depressive disorder and their parents in remote areas.Methods:A total of 98 cases adolescents with depressive disorder treated in the psychosomatic medicine of the Second Affiliated Hospital of Nanchang University from January 2021 to June 2021 and their parents were selected as the objects. The adolescents with depressive disorder and their parents were randomly divided into the control group (49 parents and 49 adolescents) and the observation group (49 parents and 49 adolescents). The control group received the medical treatment (sertraline 100 mg/d) and the routine health education, while the observation group received the online and offline Satir family therapy on the basis of the intervention of the control group. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to investigate the negative emotions of the parents of the two groups before and 12 weeks after the intervention. The screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for childhood (DSRS) were used to investigate the negative emotions of the adolescents before and 12 weeks after the intervention.The SPSS 20.0 software was used for statistical analysis. t test was used to compare the SCARED scale score and DSRS score changes of the adolescents in the two groups, and χ 2 test was used to compare the proportional changes of parents' anxiety and depression. Results:The scores of SCARED (51.55±12.69 vs 36.82±7.69, t=15.839) and DSRS (25.08±4.81 vs 16.88±2.16, t=13.047) of adolescents in the control group were significantly different before and after the intervention (both P<0.05). The scores of SCARED (51.16±15.84 vs 31.31±7.72, t=14.385) and DSRS (24.12±4.81 vs 14.08±2.03, t=14.723) of adolescents in the observation group were significantly different before and after the intervention (both P<0.05). After the intervention, the scores of SCARED and DSRS in the observation group were lower than those in the control group ( t=3.540, 6.609, both P<0.05). Before intervention, there was no significant difference in the proportion of anxiety and depression between the parents of the two groups (χ 2=1.837, 3.547, both P>0.05). After 12 weeks of intervention, there was a statistically significant difference in the proportion of anxiety and depression between the two groups, which were lower in the observation group than those in the control group (χ 2=5.995, 4.009, both P<0.05). Conclusion:Online + offline family therapy based on the Satir model can not only effectively reduce anxiety and depression of adolescents, but also effectively reduce anxiety and depression of their parents.It is especially suitable for outpatient management of children with depressive disorder in remote areas.