Objective To investigate the correlation between family environment,cognitive disposition,self-esteem and adolescent social phobia.Methods 110 adolescents with social phobia and 142 healthy control subjects were selected.They were surveyed by Family Environment Scale of Chinese version (FES-CV),cognitive appraisal orientation test (CAOT),and Self-Esteem Scale (SES).Moreover,the adolescents with social phobia were administered with Social Avoidance and Distress Scale (SAD).Results When compared with the controls,the score of adolescent social phobia group showed significantly lower score in total and optimistic factor of CAOT,cohesion,expressiveness,achievement,activerecreational orientation,organization and self-esteem; but higher in conflict factor.The analysis of the results showed that SAD was significantly and negatively correlated with the score of total and optimistic factor of CAOT,cohesion,expressiveness and SES,while was significantly and positively correlated with the score of conflict factor.The seriousness of the condition was significantly negatively related to the score of optimistic factor,cohesion,expressiveness and SES,while the onset age was significantly positively related to them.The clinical course was significantly negatively related to the cohesion,expressiveness and self-esteem,while was significantly positively related to the score of conflict.Conclusions Negative cognitive disposition,lower cohesion,less expressiveness,higher conflict and lower self-esteem are the major factors that could affect the onset of adolescent social phobia.The more negative the cognitive disposition is,the lower the cohesion,the expressiveness and the self-esteem are,the earlier the onset age and the more serious the illness is.The longer clinical course is in ration to lower cohesion,less expressiveness,higher conflict and lower self-esteem.

Objective To study the relationship between QT interval and the compements of antipsychotic-induced metabolic syndrome in schizophrenic patients. Methods Totally 460 schizophrenic patients(240 men and 220 women)aged 19～60 from the study cohort of the schizophrenic patients in treatment with antipsychotant were recruited in the study for epidemiologic examinations,involving anthropometry and measurements of blood pressure,fasting ang 2hr plasma levels of glucose and insulin and serum levels of lipid.A standard 12-lead ECG was recorded and the corrected QT (QTc)was calculated accordingly by Bazett formula.HOMA-IR index was calculated for estimating individual insulin resistance.Metabolic syndrome(MS)was diagnosed according to the definition issued by the International Diabetes Federation(IDF)in 2005.Results The prolonged QT interval was found in 124 of the 460 cases(27.0%),and the rates of prolonged QT interval being 21.7% and 32.7% in men and women respectively (χ2=7.13,P<0.01).The prevalences of MS,IR,central obesity,IFG,higher serum level of triglyceride(TG)and lower serum level of high-density lipoprotein cholesterol(HDL-C) were 39.3%,38.7%,35.4%,34.1%,31.3%,29.8% and 27.0% in schizophrenic patients population respectively.The prolonged QT interval was significantly associated with MS,IR,IFG,higher serum level of triglyceride(TG)and central obesity respectively(χ2=4.95～13.63,P<0.05).Conclusion The prolonged QT interval was significantly correlated with antipsychotic-induced metabolic syndrome(MS) and components of abnormal metabolism.

Objective To describe the design and application of a new fork interlocking in-tramedullary nail(FLN).Methods The anti-compression,anti-bendin g,anti-torsion and rigidity of the FLN were compared with those of recta ngle nail(RN),plum blossom nail(PBN),Ender nail(EN),GK nail(GK)and 8-hole plate biomechanically an d 169case of tibial fractures treate d with the FLN from September1998to May 2001were reviewed.Results The anti-compression,anti-bendin g,anti-torsion and rigidity of the FLN were similar to those of GK and significantly stronger than those o f RN,PBN,EN and 8-hole plate.Of 169cases,147were followed up for more than 3months.Among them,97nails have been removed.The average healing period was 19.6week s(11-31weeks)and the complications include 5exte rnal rotation deformities(from 10?to 15?),4valgus deformities,2varus deform ities,6shortening-displacements,16pain at the nail-entry points,1common peroneal nerve injury(healed 3months later)and 3delayed postoperative infection(1case one month later,2cases five mo nths later).The infection rate was 1.6%.Based o n Johner and Wruhs standard,the excellent ra te was 96.5%,fair 1.3%and failure 2.2%respectively.Conclusion1)FLN is an effective and convenient im plant to treat tibial fracture.2)In severely comminuted fractures an d distal shaft fractures,the distal h ole could be inserted with two transv erse screws similar to GK,which can widen its indication.[

[Objective]To explore the operating methods and key points of bysteel-wire guiding fixative steel-wire repearing tibial intercondylar eminence avulsion fractures under arthroscope.[Method]From February 2006 to August 2006,14 patients with tibial intercondylar eminence avulsion fractures were treated in bysteel-wire guiding fixative steel-wire method.Among them,there are 9 males and 5 females with an average age of 32.6 years,aged from 5 to 40 years.Injury cause:7 of road accident,5 of falling down while moving and 2 of falling from height.The results of preoperative x-Ray and Artoscan of all patients suggested the avulsion fracture of anterior cruciate ligament from the tibial spine.In the operation,firstly,fixative steel-wire cross the avulsion fracture tendon-bone joint zone.Then,make each side of avulsion fracture a bone tunnel on the tibial plateau.Finally,guide fixative steel-wire out of these two bone tunnels and then fix this steel-wire with the help of guiding steel-wires.After operation,fix the knee joint with plaster slab bended at 20? in three or four weeks.Remove the plaster slab and do functional exercise after 4 weeks.And move with walking stick 8 weeks later.[Result]All 14 patients were available at follow up with mean duration of 10.5 months.The X-Ray suggested bone healed at about 5.5 months after operation.We got the excellent in 8 cases,good in 4 and fair in 2 according to the advanced Lyshdm's classification at the last follow up.The excellent and good rate was 85.1%.[Conclusion]The technique needn't traditional cut,and has many advantages,such as micro injury,rapid recovery and few complications.And it is good to master the main points of this technique for applying it.

Objective To study the characteristic and manifestations in the middle aged and elderly peoplewith discoid meniscus injury and the outcome of the arthroscopic surgery. Methods Twenty-nine patients with discoid meniscus injury were treated by the arthroscopic surgery from January 2009 to May 2013. According to the injury of discoid meniscus in operation, 6 cases (6 knees , 20.69%) underwent meniscal plasty, 16 cases (16 knees, 55.17%) underwent subtotal meniscectomy, and 7 cases (7 knees, 24.14%) underwent meniscectomy. The Ikeuchi and Lysholm evaluation system was used to assess knee joint function and compared. Results All the postoperative patients were followed up for 12-18 months, and the average was 14 months. According to Ikeuchi knee rating, 5 cases were excellent, 17 cases were good, 4 cases were fair, 4 cases were poor and the rate of excellent and good was 75.86%. Lysholm scores 3, 6 and 12 months after operation were (65.76 ± 5.35), (70.27 ± 4.73) and (77.81 ± 6.24) scores, and before operation was (55.47 ± 3.63) scores. Three, 6 and 12 months after operation, Lysholm scores were significantly higher than those before operation (P<0.05). Conclusions The middle aged and elderly people discoid meniscus injury has its own characteristics compared with adolescent patients in symptoms, signs, and treatments. Arthroscopic surgery is an effective treatment for discoid meniscus with minimal.

Objective To investigate the therapeutic effects and adverse drug reactions of different doses of rosuvastatin in patients with acute ST segment elevation myocardial infarction (STEMI). Methods A total of 115 patients with STEMI were collected from Department of Cardiology, the Second Hospital of Tianjin Medical University. According to different oral doses of rosuvastatin, patients were divided into two groups including 5 mg/d rosuvastatin treatment group (low-dose group, n=44) and 10 mg/d Rosuvastatin treatment group (moderate-dose group, n=71). Patients of two groups were treated with Rosuvastatin at least 1 month after discharge. Data of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed and compared before and after treatment between two groups. The major cardiovascular adverse events (MACE) and adverse reactions were recorded in two groups of patients. Results There were no significant differences in blood lipid and liver function levels before and after one month treatment between the two groups. After one month treatment, levels of TC, LDL-C, ALT and AST were significantly decreased in both groups of patients compared with those before treatment (P<0.05). There were no significant differences in levels of TG, and HDL-C before and after treatment between two groups. The incidence of MACE (heart failure and angina pectoris) was significantly lower in moderate-dose group than that in low-dose group (P<0.05). There was no significant difference in the proportion of malignant arrhythmia between the moderate-dose group and the low-dose group (P<0.05). No target vessel repair and death were found in the two groups. No obvious adverse drug reactions were found during the follow-up period. Conclusion The hypolipidemic effects are epuivalent between 5 mg/d rosuvastatin and 10 mg/d on the basis of conventional treatment for STEMI patients, but the moderate dose can reduce the incidence of MACE and improve prognosis.

Angiotensin (Ang Ⅱ),a main effector peptide of the renin-angiotensin system (RAS),mediates a hormonal action in the maintenance of blood pressure and electrolyte levels,and thus fluid homeostasis.Recent studies have implicated that it correlates with tumor growth,angiogenesis,metastasis and it has drawn more and more attention.Many studies show that Ang Ⅱ-AT1R/AT2R play crucial roles in tumor growth,metastasis,invasion and tumor angiogenesis,which are formed new targets for treating malignant tumors.

BACKGROUND: Monosialotetrahexosylganglioside plays an important role in a variety of physiological processes, such as the nerve cel growth and development, differentiation, regeneration and intracel ular and extracel ular information transmission. OBJECTIVE: To investigate the effects of monosialotetrahexosylganglioside on the changes of gene expression and calcium ion concentration in the course of inducing the mesenchymal stem cells into neuron-like cells with Woodbury’s method. METHODS: The mesenchymal stem cells from Sprague Dawley rats were cultured after isolated and purified, After 5 passages in culture, the cel integrated into a dense monolayer, and treated with 50 mmol/L monosialotetrahexosylganglioside for 24 hours as the monosialotetrahexosylganglioside group; then the mesenchymal stem cells were induced into neuron-like cells with the methods of Woodbury after pre-cultured for 24 hours, and set the control group. The protein and mRNA expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin were detected by immunocytochemistry and real-time PCR, respectively. The fluorescence intensity of intracel ular free calcium ion before and after inducing was detected by laser scan confocal microscope. RESULTS AND CONCLUSION: After induction, the expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin of the mesenchymal stem cells in the monosialotetrahexosylganglioside group were higher than those in the control group (P < 0.05), demonstrating that monosialotetrahexosylganglioside could promote the differentiation of mesenchymal stem cells into neuron-like cells. The fluorescence intensity in mesenchymal stem cells was increased gradual y in two groups after the medium was replaced by the induction medium, attained its peak value at 100 seconds and then decreased gradual y, but the fluorescence intensity was stil higher than that before the induction at 20 minutes. The fluorescence intensity of intracel ular free Ca2+ was increased significantly in the monosialotetrahexosylganglioside group when compared with the control group (P < 0.05), suggesting that monosialotetrahexosylganglioside could increase the concentration of intracel ular free Ca2+, and intracel ular free Ca2+ may be useful in the course of induction. The changes of protein expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin were not significant after induction, indicating that Woodbury classic induced programme could regulate the post-transcriptive protein level.

Objective To explore the splenic macrophages phenotype and secretory function of mice with periodontitis, so as to explore effects of periodontitis on macrophages. Methods 22 mice were randomly divided into periodental ligation group (group P10d ) and pseudo periodental ligation control group (group C), with 11 mice in each group. The experimental periodental ligation on mice lasted for 10 days before they were sacrificed. Flow cytometry was applied to detect the expression of M1 and M2 in mononuclear macrophages. Real-time PCR was applied to detect the relative expression of pro-inflammatory cytokines IL-1β and anti inflammatory cytokines IL-10. Results Compared with the control group C, the proportion of M1 macrophages in the periodontitis group decreased, and the ratio of M1/M2 was also decreased significantly, and IL-1β mRNA also down-regulated. Conclusions Chronic periodontal infection could down regulate the proportion of M1 macrophages , decrease ratio of M1/M2 and the expression of inflammatory cytokines IL-1βmRNA.

Objective To assess the cesarean section scar morphology and size with transvaginal ultrasound and the healing of incision diverticulum after the repairing operation.Methods Forty cases with cesarean section scar defects needed repairing operation,40 cases of cesarean section without symptoms and 40 cases of vaginal delivery were involved.The scar condition and measured the size of cesarean section defects were observed.For the 40 cases needed repairing operation,the healing of the scar and measured the size of the defects were observed which still existed before and after the surgery.For the transvaginal delivery cases the thickness of uterine isthmus were measured.Results After the scar defects repairing operation,there were 9 cases who still had diverticulum,but the defects were smaller than that before operation (P <0.05).The symptoms were relieved.Among the 40 asymptomatic cases,there were 1 1 cases had defects,but the diverticulum were smaller than that of needed operation patients (P < 0.05 ). Conclusions The transvaginal ultrasound is a noninvasive and convenient method to observe the cesarean section scar.