Objective To explore the characteristics of family functioning between parents and adolescent and the association of adolescents' self-esteem,and depression.Methods Data were collected from reports of 257 middle school students and their parents in Shanghai,and by self-evaluation questionnaires including the depression scale,the self-esteem scale,and the family adaptability and cohesion scale.Results ①Adolescent perceived more negative than parents in the family adaptability (69.02 ± 11.49),(70.60± 9.60) and cohesion (43.84 ± 9.25),(46.56±7.86),and the difference in family adaptability were significant (t=4.064,P＜0.01).② Adolescents' self-esteem positively related to their family cohesion(r=0.525) and adaptability (r=0.427,P＜0.01),while depression negatively related to family cohesion(r=-0.565) and adaptability (r=-0.475,P＜0.01).③Students in families with high adolescent-parent perceptual differences in family functioning showed more depressive symptom,lower level of self-esteem than those in low adolescent-parent perceptual differences,and the difference were significant (P＜0.05).Conclusion Adolescents' self-esteem,depression symptoms are significantly related to their familyadaptability and cohesion,the adolescent-parent perceptual differences in family functioning may also affect adolescents' psychological well being.

Aim To study the single nucleotide poly-morphism ( SNPs ) of AMP-activated protein kinase ( AMPK) ?2 subunit gene PRKAA2 ( rs2051040 and rs17848595) and its relationship with metformin response. Methods A total of 32 patients with type 2 diabetes( T2DM) were enrolled. All patients were required to take metformin for 1 week. The serum levels of FPG,TG,TC,LDL-C,HDL-C were assayed before and after therapy. The gene polymorphism of PRKAA2 was analyzed by PCR-DGGE,the effects of metformin were compared between patients with different phenotypes. Results FPG,TG,TC,LDL-C were significantly improved after therapy in wild genotype carriers( P 0. 05) . Conclusion The results of this study suggest that PRKAA2 polymorphism may be associated with metformin treatment effects in T2DM patients.

This paper briefly introduces the frame structure, design concept and main functional modules of outpatient emergency care information system developed by our hospital. This system can optimize the procedure when patients seek medical advice, create warm medical circumstances, increase work efficiency of medical care personnel, strengthen quality management of medical cases and promote hospital modern construction.

Objective:To investigate the characteristics of perceived stress and coping style and their relationship withsymptoms in college students with psychosis-risk syndrome (PRS).Methods:A two-stage screening process was conducted in 3160 college students.Participants were screened with 16-Item Version of the Prodromal Questionnaire (PQ-16).The students with scores of PQ-16 ≥9 were further interviewed with Structured Interview for Prodromal Syndromes (SIPS).Twenty-two individuals who met the criteria of PRS on SIPS were enrolled as the PRS group.The control group (n =22) were randomly selected from the participants with scores of PQ-16 ＜9 who were matched with age,gender and education level.Two groups were assessed with Chinese Perceived Stress Scale (CPSS),Trait Coping Style Questionnaire (TCSQ) and Self-rating depression scale (SDS) to measure subjective stress,coping style and depressive symptoms.Results:PRS group reported higher CPSS total scores [(34 ± 8)vs.(22 ± 8)] and negative coping styles scores [(35 ± 5)vs.(28 ± 7)],and lowerTCSQ positive coping styles scores [(31 ±6)vs.(37 ±4)] than the controls (Ps ＜0.05).The CPSS scores in PRS group were positively correlated with the scores of negative coping style (r =0.57,P ＜0.01),and the SDS scores were positively correlated with CPSS total scores and scores of negative coping style (r--0.86,0.66,Ps ＜ 0.01).There was no significant relation of psychosis-risk symptoms to scores of CPSS and TCSQ (P ＞0.05).Conclusion:It suggests that college students with PRS have a higher perceived stress and tend to use more negative coping style,which may be positively correlated with depression.

Objective To investigate the association between serum homocysteine (Hcy) level and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods The 123 patients from January 2007 to June 2010 were recruited and divided into the elderly OSAHS group (n=55) and the non-elderly OSAHS group (n=68). One hundred healthy subjects were selected and divided into the elderly control group (n=52) and the non-elderly control group (n=48). The PSG variables were recorded and the levels of Hcy, malondialdehyde (MDA) and glutathione (GSH) were detected after sleep in all subjects. Serum Hcy level was measured by cyclophorase, MDA and GSH levels were measured by spectrophotometer. Results There were statistical differences in Hcy concentration between four groups (F=28.26, P=0.000). The Hcy concentration was higher in elderly OSAHS group than in other groups, and was higher in elderly control group than in non-elderly control group, and was higher in non-elderly OSAHS group than in non-elderly control group. There were statistical differences in MDA and GSH concentrations between the four groups (F=5.56, P=0.002;F=4.79, P=0.004). The concentrations of MDA and GSH were higher in elderly OSAHS group than in other groups. Multiple regression analysis indicated a statistically significant relationship of Hcy concentration with age, MDA, GSH and AHI (β=0.07, 0.50, 0.23 and 2.00). Conclusions The concentration of Hcy increases and oxidative stress enhances with aging, especially in the elderly patients with OSAHS. The mechanism of high level of serum Hcy in elderly patients with OSAHS may be the high oxidative stress.

Objective To explore the effects of Medpor in surgical treatment of craniofacial de-pressed deformities. Methods Combining with other surgical methods, 37 patients with craniofacial de-pressed deformities were treated with Medpor. Of them, 29 cases of craniofacial depression and defects subjected to trauma, 6 cases were progressive facial hemiatrophy and 2 case were angle of mandible de-formity. All were followed up from three months to four year. Results Facial configurations and func-tions of all the 37 cases were greatly improved after the treatment, without any complication of infection or rejection;patients were all very satisfactory or relatively satisfied with the results. Conclusion Med-por is an ideal implant material to correct the deformity of earaniofacial, and combining with others methods, the treatment of earaniofacial deformity can obtain good results.

Objective To explore an ideal surgical treatment for cervical sear eontraeture. Methods From January, 2005 to December, 2008, 11 eases of cervical sear contraeture (Ⅱ-Ⅲ) were treated with the expanded flaps based on the cervical cutaneous branch of transverse cervical artery. At the first step, one or two soft tissue expanders were implanted beneath the skin at the clavicular-pectoral region. At the second step, after fully expanding, an expanded clavicular-pectoral flap that based on the cervical cutaneous branch of transverse cervical artery was designed and raised completely according to cervical cutaneous defect. And then, the flap was transferred to reconstruct the defect in cervix. The donor area was closed directly or covered with graft. Results The 11 cases were performed with unilateral flaps based on the cervical cutaneous branch of transverse cervical artery. No necrosis occurred. And the cervical contour and function have been mended. All of them had been followed up for 6-18 months with satisfactory results. Conclusions This procedure can be very useful for the plastic and reconstruction surgeons who are confronted with a difficult case of cervical scar contracture. By this means, a lot of materials of reparation with similar color, and texture can be obtained. And this method is simple, safe, and effective.

Objective · To detect the vitamin D2 and D3 levels in the patients with moderate and severe depression. Methods · Eighty-five patientswho met the criteria for major depressive disorder were recruited (53 patients with moderate depression, 32 patients with severe depression). Fifty agematchedhealthy volunteers were recruited as controls. Serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels were detected by using liquidchromatography-tandem mass spectrometry (LC-MS/MS). The risk factors which might influence the severity of depression were screened by Logisticregression analysis. Results · The serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in the case group was lower than those in the controlgroup (P=0.012, P=0.000, P=0.000). The patients with moderate depression presented significantly lower serum 25 (OH) D3 and total 25 (OH) D2/D3 levelsthan the controls did (P=0.000), although no significant difference in serum 25 (OH) D2 levels was found between these two groups. As well, the serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in patients with severe depression were significantly lower than those in patients with moderate depression and controls (P<0.05). The body mass index of severe depression group was much higher than that of moderate depression group and control group (P=0.002). Both overweight/obesity and the concentration of vitamin D may be the major influencing factors of depression severity (P=0.034, P=0.011). Conclusion · Vitamin D2 and D3 deficiency in depressive patients, particularly in those patients with severe depression, was shown in the present study. In addition, overweight/obesity as well as the concentration of vitamin D may exert the significant influence on the severity of depression. Vitamin D supplementation and weight control may be needed to be considered in making therapeutic strategies of major depressive disorder.

Objective To explore the immune property and possible mechanism of the CD71+ CD235a+ nucleated erythroid cells from peripheral blood in elderly,as compared with those of healthy young.Methods Peripheral blood obtained by venipuncture from healthy young(n=59,mean age=28 years) and elderly(n=78,mean age=68 years)donors were measured by flow cytometry to evaluate the frequency of the CD71+ CD235a+ cells in peripheral blood mononuclear cells (PBMC).In vitro assays,CD71+ CD235a+ cells were sorted by flow cytometry and T cells were sorted using CD4+T cell isolation kit,then the T cell proliferation assays were conducted by following groups:T cell + CFSE group;T cell +CFSE co-cultured with CD71+ CD235a+ cells from the young donors;T cell + CFSE co-cultured with CD71+ CD235a+ cells from the older donors.Real-time PCR were used to identify the expression of the immune cytokine secreted by CD71+ CD235a+ cells.Results (1)the results showed a significant increase in the percentage of CD71+ CD235a+ cells in the elderly compared with the young [(9.93± 2.95)％ vs (1.96 ± 1.16)％,t =3.37,P ＜ 0.001];(2)the CD71+ CD235a+ cells from the older donors could suppress the proliferation of the T cells (t =2.91,P＜ 0.05)while from the young group we could not observe this phenomenon(t =0.387,P＞0.05).(3)The results of Real-time PCR revealed that,compared with CD71+ CD235a+ cells from the young,CD71+ CD235a+ cells from the elderly expressed higher levels of Arg-2 (t =9.04,P＜0.01),IL-1β,IL-6 and TGF-β(t =4.51,5.46,6.92,all P＜0.05).Conclusions There are higher frequencies of CD71+ CD235a+ cells in aged samples than the young.And the CD71+CD235a cells from the elderly could secrete more Arg-2,IL-1β,IL-6 and TGF-β to suppress the T cell proliferation.

Objective To determine whether rTFPI could inhibit vascular thrombosis and salvage random pattern skin flaps following AIRC in rat models.Methods From April,2013 to June,2015,30 adult male Sprague-Dawley rats were randomized into 3 groups;a control group,an avulsion injury with roll compaction (AIRC) group,and an AIRC plus rTFPI therapy group.An 8.0 cm× 2.5 cm random flap was raised on the dorsum of each rat.The AIRC and AIRC plus rTFPI flaps were then altered with a device designed to simulate avulsion injury with roll compaction.After flap closure primarily,treatment was initiated immediately and continued for 3 days.Phosphate buffered saline was used in the control group and the AIRC group,while the AIRC plus rTFPI group received the recombinant Tissue Factor Pathway Inhibitor.Laser Doppler flowmetry and infra-red thermalgraphy were used on postoperative day three to assess nicrocirculatory blood flow and viability of the avulsed flaps.At postoperative day seven,final flap survival was determined.Using SPSS19.0 statistical analysis.Results The flap survival in AIRC group was only (32.7 ± 5.2)％ versus (62.5 ± 6.5)％ in control group,but the flap survival significantly increased (51.6 ± 8.2)％ after topical injecting rTFPI in experimental group.Statistically significant differences exist (P ＜ 0.05) between every two groups.The detection results of Laser-Doppler flowmetry and infra-red thermography showed that perfusion arrived the centre of the flaps in experimental group,while perfusion only arrived the proximal part of the flaps in the AIRC control group.Conclusion rTFPI therapy is effective in reducing ischemic necrosis of random pattern flaps following avulsion injury in the rat model.It suggests that rTFPI therapy may play an important role in clinical salvage of the failing avulsion injuries with roll compaction.