ObjectiveTo explore the effect of various forms of psychological intervention on psychological stress,mental state and treatment process of out- patients. Methods 198 outpatients from February 2010 to July 2011 were randomly divided into the observation group and the control group with 99 cases in each group.The control group received conventional treatment and care.The observation group was given multiple forms of psychological intervention on the basis of conventional treatment and care.Both groups were taken with Zung Anxiety Rating Scale (SAS)and the Hamilton Anxiety Scale(HAMA)to measure the psychological stress and the degree of anxiety before and after treatment.The total efficiencies of various disorders for the two groups before and after the diagnosis and treatment were compared. ResultsThere were no significant differences in SAS score and HAMA scores before psychological intervention.After the intervention,the SAS score and HAMA score in the control group were significantly higher than the observation group.The total effective rate after a course of treatment in the observation group was 90.6％.The total efficiency in the control group was 78.8％,which was significantly lower than that of the observation group. ConclusionsThe multiple forms of psychological intervention can reduce the mental stress,ease the patients' emotional state and improve the patients' therapy effect at the same period for out-patients.

Objective To study the chemical constituents of the whole plant of Pholidota yunnanensis and to examine the inhibitory effects of the isolated compounds on nitric oxide(NO) production in activated rat macrophage-like cell line(RAW 264.7).Methods Various chromatographic techniques were used to separate and purify the constituents,and their structures were elucidated on the basis of spectroscopic analysis. The inhibitory effects of these compounds on NO production in RAW 264.7 cells of rats activated by lipopolysaccharide(LPS) and interferon-?(IFN-?) were tested in vitro by microplate ultraviolet-colorimetric method.Results Seven compounds were isolated and identified as trans-3,3′,5-trihydroxy-2′-methoxystilbene(Ⅰ),cis-3,3′-dihydroxy-5-methoxystilbene(Ⅱ),trans-3,3′, 5-trihydroxystilbene(Ⅲ),3,3′-dihydroxy-5-methoxybibenzyl(batatasin-Ⅲ,Ⅳ),3,4′-dihydroxy-3′,5-dimethoxybibenzyl(gigantol,Ⅴ),3,3′,5-trihydroxybibenzyl(Ⅵ),2,7-dihydroxy-4-methoxy-9,10-dihydrophenanthrene(coelonin,Ⅶ).Conclusion Compounds Ⅱ,Ⅳ,and Ⅵ show favorable inhibitory effects on NO production,compounds Ⅰ and Ⅱ are new compounds,and compounds Ⅲ-Ⅶ are isolated from this genus for the first time.

Objective To investigate the effects of Pravastatin on serum oxidative modified LDL (ox-LDL), tumor growth factor ?1 (TGF-?1), vascular cell adhesion molecule-1 (VCAM-1) and lipid levels in patients with acute cerebral infarction(ACI).Methods 114 cases with ACI were randomly divided into two therapy groups: (1) 56 cases were given Pravastatin combined with Aspirin;(2) 58 cases were treated with Aspirin only. The serum levels of ox-LDL, TGF-?1, VCAM-1 and lipid were detected 72 h after the onset of the disease and 3 months following the treatment. Meanwhile, the same were detected in the control group (50 healthy people). Results Within 72 h, the serum levels of ox-LDL, VCAM-1, cholesterol and LDL were higher in patients with ACI than those in control group(all P

Objective To explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Objective To observe the initial therapy outcomes of Valproic acid for childhood absence epilepsy (CAE),and to assess its therapeutic reaction and short-term prognosis,and to investigate the risk factors for initial therapy failure.Methods From January 2010 to December 2015,absence seizures as key words were used to search CAE in the video-electroencephalogram(VEEG) database of Children's Hospital Affiliated to Nanjing Medical University.Sixty-seven children fulfilled the CAE diagnosis criteria of International League Against Epilepsy in 1989.These patients were separated into 2 groups based on the therapy outcome after 6 months,including seizure control failure group and seizure control group.The patients' clinical characteristics and VEEG characteristics were reviewed.The gender,age of seizure onset,a family history of epilepsy or febrile seizures (FS),consistent with 2005 Panayiotopoulos diagnostic criteria,and VEEG findings were analyzed to evaluate the predictive ability of independent variables and the relationship between these features and treatment outcomes by using a stepwise multivariate Logistic regression model.Results The age at seizure onset was (5.89 ± 2.91) years old,and follow up duration was 6 months.Approximately 23 cases (34.3％) of CAE patients had poor response.No statistical correlation was made for gender,age at onset,the occurrence of generalized tonic clonic seizures,and family history of FS or epilepsy between 2 groups (all P ＞0.05).Compared with seizure control group,patients of the seizure control failure group had significantly higher rates of focal epileptic discharge (87.0％ vs.6.8％),higher rates of intermittent photic stimulation (IPS) induced seizures (52.2％ vs.6.8 ％),fewer rates of occipital intermittent delta activity (8.7 ％ vs.77.3 ％),and fewer rates of patients met the new diagnostic criteria proposed by Panayiotopoulos in 2005 (8.7％ vs.88.6％) (all P ＜ 0.001).The presence of occipital intermittent rhythmic delta activity during wake stage and the interictal focal epileptiform discharges on VEEG during sleep stage were significantly associated with the therapy outcomes in a multivariable Logistic regression analysis (OR =133.714,P ＜ 0.05;OR =0.068,P ＜ 0.05).Conclusions The presence of focal epileptiform discharges,and a typical absence induced by IPS are important factors for first-drug treatment failures with CAE,and conversely the occipital intermittent rhythmic delta activities have a good efficacy.There is no statistical correlation between clinical characteristics and treatment outcomes.

Hepatitis B-related acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by jaundice, coagulopathy, ascites and hepatic encephalopathy and with a high mortality rate of 65% to 93%. It involves significant ethical issues when a randomized, double-blinded, placebo-controlled clinical study is conducted to such a serious disease. Therefore, a prospective cohort study design was utilized to explore a new treatment modality of applying integrated traditional Chinese and Western medicine.

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.

Objective To characterize the feasibility, key technology, indications and clinical outcome of percutaneous lumbar interbody fusion. Methods Clinical data from 32 cases [16 made, 16 female, age range 31-77 years, average disease duration (5.0±2.0) years ] underwent percutaneous nucleotomy and endplate curettage was retrospectively analyzed. After percutaneous nucleotomy and endplate curettage, one expandable spinal spacer B-twin was introduced into the intervertebral space and some allograft cancellous bone implanted around the B-twin. Indications for treatment included degenerative lumbar disc herniation (LDH) with intervetebral distability or Ⅰ degree spondylolythesis (21 cases), LDH with intervetebral space collapse (10 cases) and lumbar discogenic pain (1 case). The symptoms and function of all patients were evaluated before, 3 months and 12 months after the operation by clinical outcome judgment criterion of surgical treatment for low back pain formulated by JOA, and the rate of clinical improvement and treatment efficacy were calculated. The JOA scales preoperatively, postoperatively and on the final follow-up was compared using ANOVA in SPSS. The changes before and after surgery with the JOA score and the the rate of clinical improvement between 3 months and 12 months after the operation was also compared using χ~2 test. Results The average operation time 1 hour and blood loss < 20 ml, Surgical site: L3-4 4 cases, L4-5 19 cases, I5-S1 6 cases, L3-4 and L4-5 3 cases, B-TWIn were implanted fusion cage 35, in three cases of intervertebral space with two implantso Average in Hospital time was (10.0±2.1) d . Complication included 1 case with displacement and 1 case with secondary instability of next intervertebral space. All the patients were evaluated after a follow-up of 3-36 months (average 13 months) 32 cases of patients with low back pain JOA score: before surgery is(4.1±1.8), 3 months after surgery is (11.9±3.9), 1 year after surgery of the 22 cases is (12.0±3.2). Score before and after surgery were statistically significant differences (F = 5.67, P < 0.01). The rate of clinical improvement After surgery there was no significant difference (F = 4.18, P > 0.05). Conclusions Percutaneous posterior lumbar interbody fusion with B-twin expandable fusion cage could lead to satisfactory outcome in the treatment of degenerative disc disease and intervertebral instability,which minimize surgical soft tissue and trauma spinal damage, does not destroy the structure of spinal stability. The technique The long-term outcome, complications and fusion rate need further observing.

Objective To conduct a meta?analysis of literatures to explore the relationship of UGT1A1*6 gene polymorphism and irinotecan toxici?ty,so as to guide clinical treatment. Methods Papers were searched by PubMed database and manual search. The inclusion and exclusion criteria of studies were formulated and the methodologies quality was assessed,data were extracted and the statistical analysis was made using STATA12.0 software. Results A total of 12 articles were included according to the inclusion and exclusion criteria. Patients with mutated UGT1A1*6 showed an increased risk for neutropenia compared to wild UGT1A1*6(OR=2.37,95%CI 1.58?3.55,P=0.001). Both homozygous and heterozygous muta?tion showed an increased risk for neutropenia compared to wild type and the homozygous mutation(OR=5.09,95%CI 2.74?9.45,P<0.001) showed an even higher risk for neutropenia compared to the heterozygous mutation(OR=2.07,95%CI 1.37?3.13,P=0.001). For severe diarrhea, mutated UGT1A1*6 showed an increased risk compared to wild type(OR=1.48,95%CI 0.86?2.55,P=0.153),though without statistical signifi?cance. The homozygous mutation performed a significantly increased risk(OR=3.51,95%CI 1.33?9.25,P=0.011)and the heterozygous mutation also showed increased risk,however,the difference between them was not statistically significant. Conclusion UGT1A1*6polymorphisms can pre?dict irinotecan toxicity,especially for incidence of neutropenia.

Objective To investigate the correlation and clinical diagnosis significance between ultrasound elastography and the distribution of myofibroblast in breast tumor.To assess the value of ultrasonic elastography and myofibroblast in the diagnosis of breast cancers.MethodsThree-hundred and fifteen patients recruited from May 2009 to November 2010 were divided into benign group and malignant group according to postoperative pathological diagnosis results considered as gold standard.The clinical value of the score of ultrasonic elastography was evaluated.The expression levels of CD34 and α-SMA protein in breast tissues were examined by immunohistochemistry.ResultsThe difference was statistically significant for the expression level of CD34 and α-SMA between malignant breast tumor patients compared with benign ( P ＜0.05).The expression level of CD34 was lower,but α-SMA was higher in the patients of breast cancer compared with benign tumor.However,the expression level of CD34 and α-SMA was just the opposite in the patients of benign tumor.The expression level of CD34 was the negative correlation with the elastography score ( P ＜0.05) in the breast tumor,but α SMA just the opposite situation.Conclusions The score of ultrasound elastography can represent MFS distribution characteristics in breast tumors in the result that α-SMA +/CD34- can determine the existence of myofibroblast.