Objective: To explore the effect of cognitive therapy on obsessional compulsive disorder (OCD). Method: Forty-seven patients with OCDO were randomly assigned to cognitive therapy group and conventional treatment group, the later with paroxetine treatment only as control. The results were assessed with Hamilton anxiety scale (HAMA), Yale-Brown Obsessional Compulsive Scale and social disability screening scale. Result: The cognitive therapy group had lower scores in HAMA and Y-BOCS than the control group after 8 weeks therapy, this difference remained in the follow-up after 6 months, when the cognitive group had also lower score in social disability. Conclusion: Cognitive therapy can benefit patients with OCD more than medication only.

Objective To compare different noninvasive models in diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).Methods A total of 838 CHB patients admitted in Shenyang Sixth People’ s Hospital during March 2003 and October 2013 were enrolled in the study.All the patients received liver biopsy, blood and ultrasound examinations; the AST-to-ALT ratio ( AAR), AST to platelet ratio index ( APRI) , age platelet index ( API) , cirrhosis discriminant score ( CDS) , spleen to platelet ratio index ( SPRI) and age-spleen to platelet ratio index ( ASPRI) were obtained.Area under receiver operating characteristic curve (AUROC) was used to assess the clinical value of noninvasive models in diagnosis of significant liver fibrosis (S2-4), advanced liver fibrosis (S3-4) and early liver cirrhosis (S4).Results Among six noninvasive models, APRI had the lowest value of AUROCs ( <0.7), while ASPRI had the highest AUROCs value in diagnosis of liver fibrosis.The AUROCs of ASPRI in diagnosing significant liver fibrosis, advanced liver fibrosis and early liver cirrhosis were 0.861, 0.873 and 0.881 with the sensitivities of 69.4%, 76.9%and 87.0%, the specificities of 87.9%, 81.5% and 75.8%, the positive predictive values of 90.9%, 74.9%and 46.1%and the negative predictive values of 62.2%, 83.1%and 96.1%, respectively.Taking<5.2 and≥9.7 as the cut-off values for exclude significant liver fibrosis and diagnosis of significant liver fibrosis, respectively, 49.4%(414/838) of the patients may avoid liver biopsy with an accuracy of 92.3%(382/414).Conclusion ASPRI is of value in diagnosing significant liver fibrosis and early liver cirrhosis in patient with chronic hepatitis B, and the number of liver biopsy can be reduced.

Objective To explore the effects of systemic lupus erythematosus (SLE) susceptibility gene IFIT1 on chemokine expression in RAW264.7 macrophages and its possible role in the pathogenesis of SLE. Methods The expression vector of pEGFP-N1/IFIT1 was transfected into RAW264.7 cells by electroporation. 24 h after transfection, cells were stimulated with LPS ( 1 μg/ml). The transcriptional levels of chemokine MIP-1α, RANTES, CCL9, CXCL2 and IP-10 were measured at various time points after stimu-lation using real-time quantitative PCR. The chemokine expression levels in the kidneys of 8 week-old NZB/NZW F1 mice were also determined by real time PCR. Results Compared with cells transfected with null vector, IFIT1 high RAW264.7 cells produced significantly increased levels of MIP-1α, RANTES, CCL9, CXCL2 and IP-10 both at 4 h and 24 h after stimulation (P<0.05). Chemokine expression levels were signi-ficantly elevated in kidneys of 8 week-old NZB/NZW F1 mice compared with those of 8 week-old BALB/c mice controls (P<0.05). Conclusion IFIT1 may participate in target organ damages in SLE via augmentation of chemokine production by macrophage cells.

BACKGROUND: Acute renal failure following heart failure assisted circulation have been extensively reported. However, little data have been available concerning morphological analysis of kidney tissues under that condition.OBJECTIVE: To observe morphological change of ischemia/reperfusion kidney in a sheep pulsatile catheter (PUCA) pump short-term support for heart failure model and explore causes of acute renal failure in assisted circulation patients.DESIGN, TIME AND SETTING: Self-contrast animal experiment was performed at the laboratory of Department of Cardiothoracic Surgery, Renji Hospital of Shanghai Second Medical University between July 2003 and April 2004.MATERIALS: PUCA pump was provided by Gerhard Rakhorst, Professor of Biomedical Engineering, University of Groningen.METHODS: After ischemic heart failure in 10 sheep was induced successfully and subsequently ischemia/reperfusion kidney was developed, PUCA pump was activated to support the hemodynamics for 3 hours.MAIN OUTCOME MEASURES: Hemodynamic parameters were monitored and recorded before thoracotomy, heart failure, and every 45 minutes after the support. Kidney biopsy specimens for light and electron microscopy were obtained 3 hours after support.RESULTS: PUCA pump support was successful in 7 of 10 sheep for 3 hours. During support with the PUCA pump,Hemodynamic parameters gradually restored to normal and stable condition, and blood pressure was close to baseline at the end of experiment. On both light and electron microscopy examination, mild acute kidney change was observed after ischemia/reperfusion. Cytosis in renal glomerulus associated with vasodilatation hyperemia, endepidermis in renal tubules hydropic degeneration, vasodilatation hyperemia and Interstitial edema in renal medulla were the main findings.CONCLUSION: PUCA pump could successfully maintain the hemodynamics for 3 hours in a sheep acute heart failure model,but pathological change in ischemia/reperfusion kidney was remained. It is impossible to predict prognosis of renal function on hemodynamic data alone during support.

Objective To assess the effect of the pulsatile catheter (PUCA) pump support on cardiac resuscitation in sheep,and to provide a new approach for saving cardiac arrest patients. Methods Cardiac arrest was induced by ventricular fibrillation in 11 sheep. These sheep were divided into three groups including no support (n=3), delayed support (n=2) and immediate support (n=6). Time for cardiac resuscitation and the ratio of success to failure in each group were recorded. Hemodynamic parameters including heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure(CVP),right ventricular end-diastolic pressure (RVEDP),left atrial pressure (LAP), and left ventricular end-diastolic pressure (LVEDP) were monitored and recorded at 5, 60 and 180 min after cardiac resuscitation with PUCA pump. Results Time for cardiac resuscitation in no support group, delayed support group and immediate support group was (38.3±5.8),(43.5±9.2) and (48.7±23.8)minutes, respectively(P＞0.05),and the ratio of success to failure was 0/3,0/2 and 5/1, respectively ( P＜0.05). After cardiac resuscitation with the PUCA pump support, MAP, SBP and DBP increased gradually(P＜0.05).Conclusions PUCA pump can maintain the hemodynamic stability in a sheep model of cardiac arrest,and can thus increase the success rate of cardiac resuscitation. It may be suitable for resuscitating cardiac arrest patients.

Objective To explore the effect of 1-alpha,25-dihydroxy-cholecalcifero(1,25(OH)2D3)on liver fibrosis and its mechanism. Methods Degree of liver fibrosis was assessed through pathological detection and blood biochemical examination of liver function. Immunohistochemical assay was used to detect expressions of α-SMA,TGF-βand collagen I to observe activation level of hepatic stellate cells. Impact of 1,25(OH)2D3 on CD4+T cell differentiation was analyzed by flow cytometry,ELISA,and RT-PCR. Results 1,25(OH)2D3 improved the structure of the liver tissue and liver fibrosis. Expressions of collagen I ,TGF-βandα-SMA were significantly ele-vated in the liver tissue in rats with fibrosis(P < 0.05)but were markedly decreased after treatment with 1,25 (OH)2D3(P < 0.05). After 1,25(OH)2D3 treatment,the proportion of Th17 cells reduced while that of Th2 in-creased;concentration levels of IFNγ,IL-17A,and IL-22 markedly declined but IL-4 elevated(P>0.01);and ex-pressions of RORγt and T-bet decreased whereas GATA3 expression increased(P>0.01);as compared with those in the control group. Conclusions 1,25(OH)2D3 can alleviate the degree of liver tissue by lowering HSC activation and regulating Th cell differentiation.

Objective:To discuss the occurrence, treatment and prevention of benign anastomotic stenosis after radical resection for rectal cancer.Methods:The clinical data of 63 patients with benign anastomotic stenosis from Jan. 2016 to Dec.2020 at Department of Gastrointestinal Surgery, Renji Hospital Shanghai Jiaotong University School of Medicine, were retrospectively analyzed, including general conditions, intraoperative conditions, postoperative complications, anastomotic stenosis, treatment process and outcome. The relationship between stenosis type and treatment and outcome were analyzed.The measurement data obeying normal distribution was expressed by ( Mean± SD), and the t test was used comparison between groups. The chi-square test was used comparison between enumeration data. Results:Of all the 63 patients, 22 (34.9%) cases presented with membranous stenosis, 30 (47.6%) cases with tubular stenosis, and 11 (17.5%) cases with diffused stenosis. Three of the 9 patients with high stenosis underwent balloon dilatation through endoscopy, 3 were placed with self-expandable metal stent and the rest 3 patients underwent resection and reconstruction of the anastomosis. All the 54 patients with low stenosis underwent digital anal expansion, and finally the effective rate was 53.7% (29/54). Endoscopic balloon dilatation was successfully performed in 8 cases, including 4 cases were placed metal stent throngh endoscopy. Eight patients underwent trans-anal stricturotomy. In 5 patients with low diffused stenosis, either ileostomy was preserved or permanent colostomy was performed due to failure to treatment. There were more male patients, protective ileostomy, anastomotic leakage and low stenosis in patients failed to treatment than in the cured patients ( P>0.05). However, all the 5 patients who failed to treatment were suffered from diffused stenosis, and the difference was statistically significant compared with those who were cured ( P<0.05). Conclusions:Postoperative anastomotic stricture after anterior rectectomy requires different treatment strategies according to the location and types of stricture. Endoscopic balloon dilatation is preferred for high stenosis, and metal stents can be placed optionally. Digital anal expansion is preferred for low anastomotic stenosis, and endoscopic or minimally invasive transanal surgery is feasible if digital anal expansion fails.

OBJECTIVETo investigate the association between oral neoplasm genetic susceptibility and genetic polymorphism of p53 intron 7.

METHODSThe intron 7 ApaI polymorphism of p53 was analyzed in 95 oral neoplasm patients and 105 healthy individuals by utilizing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genotyping assay technique, and direct sequencing was performed in 30 cases which were selected from the patients and controls by random sampling.

RESULTSIn oral neoplasms cases, haplotype combinations were T-G 43.2%, C-T 56.8%, and frequencies of genotype were T-G/T-G 15.8%, C-T/T-G 54.7%, C-T/C-T 29.5%, while in controls they were T-G 30.9%, C-T 69.1% and T-G/T-G 10.5%, C-T/T-G 41.0%, C-T/C-T 48.5%. There was a significant difference in the allelic frequency and the genotypical distributions between the oral neoplasm patients and the controls. The individuals with the T-G allele had a slight increasing neoplasm risk than individuals with C-T allele; the OR for T-G versus C-T was 1.69 (95% CI, 1.12 - 2.51). The risk of suffering from oral neoplasms was higher in the individuals of T-G/T-G genotype and of T-G/C-T genotype than in individuals of C-T/CT genotype with odds ratio of 2.48 versus 2.20.

CONCLUSIONSThere are two polymorphic points in the 7th intron of human p53 gene, which could be associated with genetic susceptibility of oral neoplasms. T-G allele may be the risk factor of oral neoplasms.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Introns ; Male ; Middle Aged ; Mouth Neoplasms ; genetics ; Polymorphism, Genetic ; Tumor Suppressor Protein p53 ; genetics

Objective To understand the status and influential factors of those neglect of left-behind children in rural area,and to provide bases for the development of intervention measures.Methods 2917 students were selected as the study subjects from Changfeng county of Anhui province with cluster sampling method and were evaluated by a Parents-Child Conflict Tactics Scales and questionnaire on influential factors.Results 1694 left-behind children,accounted for 58.1％ of the total students,were surveyed in this investigation.The prevalence rates of neglect,among total children,left-behind children,non-left-behind children were 67.4％,70.2％,63.5％,respectively.The prevalence of neglect among left-behind children was higher than that among non-left-behind children (x2=14.322,P＜0.000).There were no significant associations with the neglect rate of left-behind children regarding gender or age differences.Result from multivariate logistic regression analysis indicated that the neglect among the left-behind children were associated with family dysfunction(OR values of moderate and serious family dysfunctions compared to good family function were 1.628 and 2.341,respectively)and the rate of keeping in touch with parents(OR values of sometimes and seldom keeping in touch compared to regular in touch were 1.299 and 1.844,respectively).The starting age of being left-behind(OR values of starting age that being left-behind from 6 to 10 and ≤5 years relative to starting age of left-behind ≥11 years were 0.703 and 0.630,respectively)appeared to be the protection factor to the neglect of those left-behind children.Conclusion Our findings indicated that the status of neglect among the left-behind children was serious.Prevention programs on the issue should target on a number of factors,including the characteristics of the chldren them-selves,as well as on the family of the children.

OBJECTIVETo review a group of clinical data of pedicle screw implantation in the treatment of middle-upper thoracic fracture and dislocation and explore these clinical effect.

METHODSThrough the retrospective analysis of 23 patients (31 vertebraes) of middle-upper thoracic fracture and dislocation included 21 male and 2 female,aged from 20 to 47 years in average of 33.5 years. The location and type of fractures were as follows: 2 in T2, 2 in T3, 5 in T4, 6 in T5, 10 in T6, 4 in T7, 2 in T8. Three cases were compression fractures, 7 burst fractures, 9 fracture-dislocations, 4 burst-dislocations.

RESULTSAfter a followed-up from 3 to 48 months, average 25.5 months, all cases had no serious complications. Anterior height of affected vertebral bodies had been restored from 40.4% to 90.3% after operation. Patients with incomplete spinal cord injuries improved one to two grades according to ASIA grade of spinal cord injury. Patients with complete spinal cord injuries improved 21.7 scores on average according to Sensory and Motion Scores.

CONCLUSIONMulti-segmental pedicle screw implantation for the injuries of vertebral body may get satisfactory reduction and fixation effects, and prevent the long-term loss of the vertebral body height and implanting failure.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery