目的探讨心理支持对焦虑症患者康复的影响。方法60例焦虑症患者随机分为研究组和治疗组各30例,研究组接受药物和心理支持治疗,对照组采用单纯药物治疗,评定两组患者的疗效。结果治疗后,两组患者的焦虑自评量表(SAS)、汉密顿焦虑量表(HAS)评分均明显降低,但研究组的降低幅度明显大于对照组(P<0.01～0.001)。结论心理支持对焦虑症患者的康复有明显的促进作用,近期疗效明显。

Objective To investigate utilization of antenatal health care service,analyze its influential factors and intervention methods.Methtods 1685 pregnant women who were in hospitalization from January 2011 to July 2012 were selected.A self-designed questionnaire was conducted and case history information were collected,including general information,medical costs means,awareness of prenatal care knowledge,whether convenient to see doctor,the degree of attention paid to pregnant women,the utilization of antenatal health care.Results 81.19％(1368/1685)of the pregnant women used antenatal health care service.Multiple Logistic regression analysis showed that the difference between diverse age,medical costs means,the number of pregnancies,level of awareness of prenatal care knowledge,the degree of attention paid to pregnant women was significant.Conclusions The utilization of antenatal health care service in this area is on the low side.The critical of improving the utilization of prenatal care services is improving prenatal care service mode,increasing the quantity of health education,perfecting the medical security system,strengthening community health service consciousness and the improvement of technology.

BACKGROUND:Spinal cord ischemia-reperfusion injury is a serious secondary injury of the spinal cord. Multifactor could contribute to the mechanism of this injury, and many therapeutic measures emerge, but the therapeutic effect is not ideal.
OBJECTIVE:To investigate the protective effects and mechanism of hydrogen-rich saline on spinal cord ischemia-reperfusion injury in rabbits.
METHODS:ZIVIN method was adopted to prepare the model of spinal cord ischemia-reperfusion injury. The rabbit models were randomly divided into model group, sham operation group, and hydrogen-rich saline group.
RESULTS AND CONCLUSION:Improved Tarlov scores for the evaluation of motor function were significantly increased in hydrogen-rich saline group compared with the model group at 6, 12, 24, 72 hours after reperfusion (P<0.01). The contents of malondialdehyde were significantly lower (P<0.05), while catalase activity was significantly higher (P<0.05) in hydrogen-rich saline group than that in model group at 72 hours after reperfusion. Hematoxylin-eosin staining revealed that, spinal cord anterior-horn motor neurons maintained intact structure in sham operation group;more necrotic spinal cord anterior-horn motor neurons were found in model group, and granular-vacuolar degeneration occurred in the endochylema. In hydrogen-rich saline group, the structure of spinal cord anterior-horn motor neurons was basical y intact, only a smal amount of spinal cord anterior-horn motor neurons appeared vacuolar degeneration. TUNEL staining showed no apoptotic spinal cord anterior-horn motor neurons in sham operation group. Many inflammatory cel s and apoptotic neurons were found in model group. There were few inflammatory cel s and apoptotic neurons in hydrogen-rich saline group. Hydrogen-rich saline can prevent the apoptosis of spinal cord anterior-horn motor neurons in rabbits with spinal cord ischemia-reperfusion injury, and the underlying mechanism is associated with antioxidative effect.

Objective To investigate the prognostic value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole. Methods The expressions of CD44V6 MMP-9 and p57kip2 was detected by SP method and the serum hCG was detected with CLIA method in 55 cases of hydatidiform mole, 20 cases of abortion villi and 10 cases of normal villi, and the value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole was analyzed. Results There were 9 cases malignant transforming hydatidiform mole and 44 cases of non-malignant transforming hydatidiform mole(20 cases of complete hydatidiform mole, 26 cases of partial hydatidiform mole). The expression of CD44V6 MMP-9 and p57kip2 of malignant transforming mole was significantly higher than that of non-malignant transforming group (77.8 % vs 30.4 %, 77.8 % vs 34.8 %, 11.1 % vs 58.7 %) (P <0.05) and the expression difference of p57kip2 in complete mole and partial mole group (5.0 % vs 100.0 %) was statistically significant (P <0.05). HCG remained positive in 4 cases of hydatidiform mole and dropping and then rised in 5 cases. The sensitivity of p57kip2 in the diagnosis of partial hydatidiform mole was 100.0 %, the specificity was 95.0 %, the negative prediction was 100.0 %. The sensitivity of CD44V6 in the diagnosis of malignant hydatidiform mole was 77.8 %, specificity was 69.6 %, negative prediction was 94.1 %;The sensitivity of MMP-9 was 77.8 %, specificity was 65.2 %, negative prediction was 93.8 %. The sensitivity of the two combined detection (CD44V6 and MMP-9) was 88.9 %, negative prediction was 96.3 %. The sensitivity of combined detection (CD44V6, MMP-9 and hCG) was higher than any of them. Conclusion p57kip2 is an important marker in differential diagnosis of hydatidiform mole. CD44V6, MMP-9 play important roles in the process of transformation of hydatidiform mole. The combined detection of CD44V6, MMP-9, p57kip2 and hCG can help to diagnosis and differential diagnosis and predict biological behaviors and prognosis of hydatidiform mole.

Objective To evaluate the method and effect of double-bundle posterior cruciate ligament (PCL) reconstruction using bone-semitendinosus and gracilis tendons under arthroscope.Methods The data of 16 patients was reviewed,who had underwent arthroscopic PCL reconstruction using the bone-semitendinosus and gracilis tendons from March 2004 to March 2007.A special technique using trephine was allowed for the cylindrical bone plugs attached to the semitendinosus and gracilis tendons.The femoral double-tunnel and the tibial tunnel were prepared,and the adequate press-fit fixations of tendon grafts were ensured within them.Results All patients were followed up.Before operation,the mean Lysholm score was 57 points (43-65 points).While 12 months later after operation,the mean Lysholm score was 86 points (68-92 points).The excellent and good results were obtained in 87.5%.Conclusions Arthroscopic PCL reconstruction using bone-semitendinosns and gracilis tendons can effectively improve the stability of the knee joint.The key to achieve a good treatment is that precise positions of femoral and tibial tunnels in operation and systematic rehabilitation trainings after operation were performed.

ObjectiveTostudytheinhibitioneffectof c-mycASODN(antisense oligodeoxynucleotide) and 5-FU (5-fluorouracil) on the expression of c-myc gene and the proliferation of human hepatomacellsHEPG-2. MethodsAfter treatedbyliposomemediatedc-mycantisense phosphorothioate oligodeoxynucleotide (APSODN) and 5-FU, the growth inhibition rate was detected by MTT assay, the expression of c-myc mRNA was detected by RT-PCR and immunohistocehemical methods HEPG-2cells. The cell cycle was analyzed by flow cytometric analysis. The morphological changes were observed by fluorescence staining and cellular genome electrophoresis. ResultsAfter sealing c-myc gene with ASODN,the growth of cells was repressed and the effect was time-dependent and dose-dependent ( P = 0. 02 ). The ability of proliferation decreased, the expression of c-myc gene was inhibited on transcription and translation levels; 5-FU can induce apoptosis of hepatoma cells HEPG-2 dramatically with the dose of 10 μ mol/L, when treated by both c-myc ASODN and 5-FU, HEPG-2 cells was induced apoptosis in a cooperative style ( P =0. 01 ).ConclusionsThe liposome mediated c-myc (APSODN) and 5-FU can inhibit the proliferation of HEPG-2 cells by inhibiting the expression of c-myc gene and can induce apoptosis of hepatoma cells HEPG-2 in a cooperative style. c-myc ( APSODN ) can increase the sensitivity of 5-FU to hepatoma cells and decrease the effective concentration of 5-FU.

Objective To assess quantitative and subjective image quality in computed tomography pulmonary angiography (CT-PA)with dual-energy subtraction methods,and to select the best dual-energy subtraction method.Methods 30 consecutive patients underwent CTPA using a single tube,fast voltage switching technique.One set of routine poly-chromatic images (RPI),two sets of monochromatic images with different optimal contrast-to-noise ratios (OCNR)and three sets of dual-energy subtraction images (DE-SI)were obtained by a dedicated workstation with dual-energy software (AW4.5 Advantage WS;GE Healthcare).For all the six sets of images,CNR and the score of global subjective image quality were calculated.Results DESI 3 got the highest CNR,and DESI 1 got the next high CNR.In global subjective image quality,DESI 1 got the highest score.However,when compared with DESI 2,no significant difference was found.Conclusion CTPA with dual-energy subtraction technique is feasible.DESI 1 affords the best bal-ance between quantitative analysis and subjective evaluation compared with other sets of images.

Objective To explore the accuracy of high definition computed tomography angiography (HDCTA)in the evaluation of coronary in-stent restenosis.Methods 93 patients with 159 implanted coronary stents who underwent both HDCTA and CAG were included in the study.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV)and diag-nostic accordance rate of HDCTA were calculated.The imaging quality was analyzed by visual estimation.Possible factors that in-fluenced the diagnostic accuracy of HDCTA were evaluated,which included stent location,stent diameter and heart rate in the pa-tients with left anterior descending branch stents.Results Restenosis was found in 21 stents by CAG and 19 stents by HDCTA.The false positive and false negative were 5 and 3,respectively.Sensitivity,specificity,PPV,NPV and diagnostic accordance rate were 90.5%,96.4%,79.2%,98.5% and 95.6% respectively.The image quality was 4 score in 75 stents (47.1%),3 score in 33 (20.8%),2 score in 27 (17%),≤1 score in 24 (15.1%).The image quality of proximal segments,large stents (≥3.0 mm)and slow heart rate (<66 beast per minute)was significantly better than that of distal segments,small stents (<3.0 mm)and fast heart rate (≥6 6 beast per minute).Conclusion HDCTA is a convenient,efficient and non-invasive method for follow-up after im-plantation of the coronary artery stents.

BACKGROUND: Macrophage migration inhibitory factor (MIF) is mainly concerned with macrophage mobilizing function, as the upper stream cytokine of tumor necrosis factor-α(TNF-α), interleukin-1β (IL-1β), which may have critical effect in the process of the onset of rheumatoid arthritis. OBJECTIVE: To explore the correlations between the change of serum MIF and the activity of rheumatoid arthritis (RA) disease.DESIGN, TIME AND SETTING: Non-randomized control and case study, which was carried out in the Bethune International Peace Hospital of Chinese PLA from September in 2005 to October in 2006.PARTICIPANTS: Sixty RA patients were included in this study, and other thirty healthy subjects were selected as the control group. There were significant differences in age and sex between the two groups. METHODS: Clinical data of sixty RA patients were selected by carrying out retrospective analysis, then on the basis of disease activity score (DAS) accumulated points, they were divided into active and inactive group respectively, who were contrasted with 30 health adults. MAIN OUTCOME MEASURES: ① Morning stiffness (in minutes), joint tenderness index, arthrocele index, semi-quantity rheumatoid factor (RF), C-reactive protein concentration (CRP), erythrocyte sedimentation rate (ESR), and platelet count (PLT) were recorded; ② To compare the level of serum MIF, IL-1β and TNF-α among active group, inactive group, and control group; ③ The correlation analysis was carried out among the level of serum MIF, inflammatory index and clinical observation index.RESULTS: There was significantly increased in serum MIF of patients in the active group compared to of inactive and normal groups (P < 0.05), but there were no significantly differences between inactive and control groups (P > 0.05). There were significant correlations between the serum MIF concentration and active inflammatory index of RA disease, blood sedimentationrate (ESR), C-reactive protein (CRP), platelet counting (PLT), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), swell joint index (SJI) and tenderness joint, but no significant difference was observed between the serum MIF, age, disease course, morning stiffness and rheumatoid factor (RF).CONCLUSION: The serum MIF concentration is significantly increased in patients with RA, and it may be a useful parameter for monitoring disease activity of RA.

BACKGROUND: The concern over the use of electroencephalogram (EEG)diagnosis and biofeedback training as a viable option for children with attention deficit hyperactivity disorder(ADHD) has grown gradually.OBJECTIVE: To evaluate the diagnostic accuracy and therapeutic efficacy of A620 EEG system to ADHD children.DESIGN: Prospective observation and comparative study on ADHD children.SETTING: Psychological department of a municipal hospital.PARTICIPANTS: From October 2003 to May 2004, 113 outpatient children in Psychology Hyperactivity Department of the Central Hospital of Anshan City were selected. Inclusion criteria: 6 to 14-year-old outpatient children in Hyperactivity Department. Exclusion criteria: nervous system organic diseases, pervasive developmental disorder(PDD), mental retardation, epilepsy, psychotic disorder, acoustical and visual abnormalities,etc. Of all the ADHD children, 88 were male and 25 were female, with the mean age of(10 ± 3) years.METHODS: A620 EEG system was applied to examine the 113 participants. According to the Diagnostic Criteria for ADHD in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ), published by American Psychiatry Association, ADHD children were diagnosed and then the EEG diagnostic accuracy and specificity were calculated. The System was also used for biofeedback treatment on 27 ADHD children. Fluctuation of EEG θ/β value was measured both before and after treatment, and the change of hyperactivity index was investigated by Conners Parent Symptom Questionnaire as well.MAIN OUTCOME MEASURES: EEG θ/β value, Conners index of hyperactivity (CIH).RESULTS: The diagnostic sensitivity of EEG on ADHD was 83.58%, and the specificity of it was 82.61%; EEB θ/β value of post-treatment was 8.26 ±4.05, which decreased significantly compared with pre-treatment value (12.38 ± 7.96) ( t = 2. 39, P ＜ 0.05); CIH was also dramatically declined from(24. 73 ± 10. 96) (pre-treatment) to( 12.05 ± 8.63)(post-treatment) ( t= 4.72, P ＜ 0. 01 ).CONCLUSION: EEG can be used as an accessory method in ADHD diagnosis due to its high sensitivity and specificity. Abnormalities of brainwave and hyperactivities of ADHD patients can be greatly ameliorated by EEGbiofeedback treatment.