BACKGROUND:Oppositional defiant disorder(ODD) often occurs as a comorbid condition of attention deficit hyperactivity disorder(ADHD),characterized by defiant behaviors.ADHD children with ODD have more extensive impairments than those with ADHD alone. Some studies suggest that decreased serum 5 hydroxytryptamine(5 HT) level is related to aggressive behavior in ADHD, but no relevant report is available in China. OBJECTIVE:To investigate the clinical features of ADHD with ODD,and their relations with serum 5 HT. DESIGN:A randomized case controlled study taking the ADHD children with or without ODD as the subjects for study. SETTING:Mental Health Institute of the Second Xiangya Hospital. PARTICIPANTS:Sixty one ADHD children(53 boys and 8 girls) aged 7 to 14 years visiting the Children's Clinic of Mental Health Institute of Central South University from June 2002 to May 2003 were recruited and divided into two groups based on the symptomatic criteria of ODD recommended by the Diagnostic and Statistical Manual of Mental Disorder(DSM Ⅳ ):ADHD group(n=33,without ODD) and ADHD+ ODD group(n=28). INTERVENTIONS:The parents of the enrolled children(n=61) were asked to complete the Achenbach child behavior checklist (CBCL),and the teachers(n=31) completed the teacher's report form (TRF).Two milliliters of fasting venous blood was drawn from these children and the serum separated by centrifugation for quantification of 5 HT using external standard method,and whole blood 5 HT was analyzed by LD 10AD high performance liquid chromatography(HPLC). MAIN OUTCOME MEASURES:Scores of CBCL,TRF and Chinese Wechsler Intelligence Scale for Children(C WISC) and serum 5 HT levels. RESULTS:In the ADHD+ ODD group,the scores of CBCL and TRF for externalizing, aggressive behaviors and total scores for behavioral problems rated by the parents and teachers were significantly higher than those of the ADHD group(t=2.28 to 3.76,P< 0.05 to 0.01);the former group also had significantly higher scores of CBCL for anxiety/depression and internalizing(t=2.27 to 2.35,P< 0.05), but had significantly lower serum 5 HT level[(327.01± 164.84) μ g/L vs (451.11± 250.89) μ g/L](t=2.32,P< 0.05). CONCLUSION:Children with ADHD and comorbid ODD receive poorer ratings on all variables including externalizing and internalizing problems,adjustment variables and attention impairment. Increased aggressive behavior and lowered 5 HT level may be the biological markers of impulsive behavior in ADHD children with ODD.

s Objective: To investigate the comorbidity of depression and anxiety in primary school students. Methods:565 pupils ranged from 2 to 6 grade in a primary school were tested by The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Children (DSRSC). Results: There were 140 pupils with a total score higher than cut-off point of SCARED; 97 pupils with a total score higher than cut-off point of DSRSC; 43 pupils with total scores higher than cut-off point of both SCARED and DSRSC, and the positive rate of comorbidity of anxiety and depression was 7.61%. 30.71 percent of children with anxiety disorder was considered co-morbiding depression; 44.33 percent of children with depressive disorder was considered comorbiding anxiety. Chil-dren with comorbidities had higher scores in Withdrawn(mean rank 297.7 ) than Anxiety group(220.8) and Depressive group(202.2);Somatic Complaints(268.2)than Anxiety group (232.2 ) and Depressive group(206.2 ) , Anxious/Depressed (277.2 )than Anxiety group (227.7 ) and Depressive group(219.2 )of CBCL(?~2 =16.72～22.71,P

Objective: To explore the relationship between internet overuse and time management disposition in middle school students. Methods: Using Diagnostic Questionnaire for Internet Addiction (YDQ), Time Management Disposition Scale (TMDS), we investigated 2620 middle-school students.Results:The incidence rate of internet overuse among middle school students was 2.4 %. The difference of time management disposition between internet overuse group and control group was significant(129.7?25.3/150.0?28.5,t=4.27, P

Objective:To investigate the effect of group psychotherapy on middle school students with internet overuse(IOU).Methods:A total of 2620 middle-school students from four middle schools of Changsha City were surveyed using Diagnostic Questionnaire for Internet Addiction (YDQ), According to the YDQ criterion and clinical interview, 64 students who were diagnosed as Internet overuse. 29 middle school students with IOU from one regular middle school and one key middle school received group psychotherapy. 35 middle school students with IOU from the other two schools were taken as control(control group). All the students in both groups were assessed with Diagnostic Questionnaire for Internet Addiction(YDQ), Chen Internet Addiction Scale(CIAS), The Screen for Child Anxiety Related Emotional Disorders(SCARED), Strength and Difficulties Questionnaire(SDQ). Results: The scores 0f SCARD and SDQ subscale of emotional symptoms of experimental group decreased significantly (t=2.11～2.99,P

This article has reviewed aesthetic discipline development history of medical science and history of Medical aesthetic education in our country,and the current situation of medical aesthetic education,and has carried on rational thinking on how to improve the professional medical aesthetic education of medical universities.

Objective To evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) and its characteristics in elderly patients with cardiovascular diseases, and provide reference for the clinical decisions. Methods All patients who were hospitalized in department of cardiovascular medicine from January to June in 2007 were invited to participate in the current study. A total of 317 hospitalized elderly patients were recruited into this study. All participants were assessed by portable bedside nocturnal polysomnograph and Epworth sleepiness scale (ESS). Results Among 317 patients, 281 cases (88.6%) met the criterion of obstructive sleep apnea (OSA) [apnea and hypopnea index (AHI)≥5] and 47 cases (14.8%) met the criteria of obstructive sleep apnea syndrome (OSAS) (AHI≥5 and ESS≥9). When the severity of OSA (as indicated by AHI) was considered as a dependent variable, multiple regression analysis indicated that it was significantly associated with minimal SaO2 and the oxygen desaturation index, while age, habitual snoring, ESS, BMI, mean SaO2 and the duration of SaO2≤ 90% did not show significant effects on the severity of OSA. Conclusions High prevalence of obstructive sleep apnea syndrome (with daytime sleepiness) is found in elderly hospitalized patients and the rate of obstructive sleep apnea is much higher in patients without daytime sleepiness symptoms. Minimal SaO2 and the oxygen desaturation index are the important predicting factors for the severity of OSA, while age, BMI, habitual snoring, sleepiness are not correlated with the severity of OSA after adjusting minimal SaO2 and oxygen desaturation index.

Objective To investigate the effects of sevoflurane anesthesia on learning and memory functions and S100β protein in anaplasis in the 7-day-old rat.Methods 48 SD rats of both sexes aged 7-day-old weighing 1 2-1 6 g were randomly divided into 3 groups (1 6 rats in each group):group A and group B inhaled 3 ％ sevoflurane in oxygen(1L/min) for 6h and 2h respectively; group C inhaled oxygen(1L/min) only.After inhalation,the effects of sevoflurane anesthesia on learning and memory function were assessed by Morris water-maze test and Y-maze test from 16d to 24d.The rats were killed in the day of 8d and 25d respectively,and the blood were collected for the expression of serum concentration S100β protein by enzyme-linked immunosorbent assay.Results (1) Results of Morris water-maze test:Compared with group C,escape latency prolonged in group A and group B in 17-20d(P ＜ 0.05 or 0.01) ;escape latency prolonged in group A compared with group B in 19-20d(P ＜ 0.01) ;but there were no significant differences in the probe time in original platform quadrant and the frequency of crossing original platform among three groups(P ＞0.05).(2) Result of Y-maze test:In 22d,the total reaction time of group A and B were longer than group C (P ＜0.05 or 0.01),and the error number was increased in group A and B compared with group C(P ＜ 0.01) ; while in 23-24d,there were no significant differences between every index of each groups (P ＞ 0.05).(3) Results of the blood serum index:In 8d,serum concentration of S100β protein was significantly increased in group A and B compared with group C (P ＜0.01),and serum concentration of S100β protein was significantly increased in group A compared with group B (P ＜ 0.05) ; But there were no significant differences in serum concentration of S100β protein of each groups in 25d(P ＞ 0.05).Conclusion Sevoflurane anesthesia in the 7-day-old rat can temporarily decrease the ability of learning and memory functions in the length of inhalation time dependent manner,and the mechanism may be related to the increased expression of serum concentration of S100β protein transiently.

Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.

Novel cancer immunotherapy can treat tumors through regulating innate immunity and adaptive immune system. cGMP-AMP synthase (cGAS) is a key regulator of innate immune response to both exogenous and endogenous DNA. After recognizing the cytoplasmic DNA, cGAS produces the second messenger cyclic GMP-AMP (cGAMP), which subsequently combines with the adaptor STING (also known as MITA, MPYS and ERIS) to mediate innate immunity by inducing the production of type I interferons and inflammatory cytokines. Recent studies have revealed that the cGAS/STING signaling pathway can be activated by tumor-derived DNA and by-products of genomic instability and affect the incidence and development of tumors, which plays a critical role in the natural antitumor immunity across cancer types and immune checkpoint blockade therapy. In this article, current understanding of cGAS/STING signaling pathway in tumors was summarized, the pivotal role in tumor immunity and radiotherapy was highlighted, and the potential targeted or alternative therapy of this signaling pathway was reviewed.

Objective To observe the effect of low intensity pulsed ultrasound (LIPUS) on chondrocytes co-cultured with infrapatellar fat pads.Methods Twenty-four infrapatellar fat pads and cartilages from female knee trauma patients aged between 25 and 35 were cut and stained using hematoxylin-eosin staining.Chondrocytes were isolated from part of the integrated surface of the cartilages to be cultured in vitro.They were then randomly divided into a normal chondrocyte group (the control group),a normal chondrocyte+FCM (fat conditioned medium) group (the model group),a normal chondrocyte+ FCM + LIP US group (the treatment group),and a normal chondrocyte+ FCM + LIPUS + GRGDSP (an integrin inhibitor) group (the inhibited group).The treatment group and inhibited group received LIPUS at 40 mW/cm2 for 20 min once a day,while the other groups received sham LIPUS treatment.Five days later,the cells were collected and western blotting was used to examine the expression of type Ⅱ collagen (COL2),aggrecan (Acan),matrixmetalloproteinase (MMP)-13,integrin β1,phosphorylation-focal adhesion kinase (p-FAK) and phosphorylation p38 (p-p38).Results Western blotting showed that compared with the control group,the expression of COL2 and Acan was significantly lower in the model group,but that of MMP-13,integrin β1,p-FAK and p-p38 was significantly higher.As compared with the model group,the expression of COL2,Acan,integrin β1 and p-FAK was significantly higher,and that of MMP-13 and p-p38 was significantly lower in the treatment group.The expression of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 showed no significant difference between the inhibited and model groups,but that of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 was significantly different between the control and treatment groups.Conclusions LIPUS provides a protective effect on chondrocytes through inhibiting the expression of MMP-13 induced by adipokines and the degradation of COL2 and Acan through activating the integrin-FAK-p38 MAPK pathway.