OBJECTIVETo observe clinical therapeutic effect of fuzhong (supporting the middle-jiao) manipulation of tuina for infantile anorexia.

METHODSEighty-one children with anorexia were treated with fuzhong manipulation, including abdominal kneading, acupressure at Zhongwan (CV 12), Lanmen (Extra), Tianshu (ST 25), Zusanli (ST 36), Sanyinjiao (SP 6), spine pinching, warm moxibustion and warm scraping with supporting-yang cupping, three times a week, six times as a session. Onset time, therapeutic effect and TCM symptom scores before and after treatment were observed after two sessions and differences of therapeutic effect among different patterns were compared.

RESULTSSeventy-two children had the effect in one session while 41 children had the effect within half of a session. 38 cases were clinically cured, 15 cases were markedly effective, 23 cases were effective and 5 cases were failed. The total effective rate was 93.8%. Compared with before treatment, TCM symptom scores, including appetite, food intake, complexion and defecation, were all obviously improved after treatment (all P < 0.001). The clinical cured rate was 45.2% (19/42) in the pattern of dysfunction of spleen in transportation, 45.8% (11/24) in the pattern of qi deficiency of spleen and stomach, 50.0% (4/8) in the pattern of yin deficiency of spleen and stomach, 57.1% (4/7) in the pattern of liver sufficiency and spleen insufficiency, which had no obvious differences among different patterns (all P > 0.05).

CONCLUSIONThe fuzhong manipulation of tuina has quick onset time and satisfied clinical therapeutic effect, which could obviously improve symptoms and is fit for different patterns of infantile anorexia.

Adolescent ; Anorexia ; physiopathology ; therapy ; Child ; Child, Preschool ; Eating ; Female ; Humans ; Infant ; Male ; Massage ; Meridians ; Spleen ; physiopathology ; Stomach ; physiopathology ; Yin Deficiency ; physiopathology ; therapy

Objective To evaluate the placental characteristics in monochorionic (MC) twin pregnancy with selective fetal growth restriction (sFGR). Methods Fifty-five placentas from women with MC twin pregnancy were included, who had terminated pregnancy in the Peking University Third Hospital between June 1, 2013 and June 1, 2014, including 23 cases with sFGR and 32 uncomplicated cases as control group. We perfused the placentas within 24 h after delivery, and pigment of four different colors was used to perfuse the umbilical arteries and veins of both twins and determine the types of vascular anastomosis. Umbilical cord insertion, placental territory discordance (PTD, the territory difference between two placentas/the bigger one), and the type, number and diameter of placental superficial vascular anastomosis were analyzed using two independent samples t-test, nonparametric test,χ2 test or Fisher's exact test. Results The PTD was 0.60(0.10-0.80) vs 0.22(0.00-0.90) in sFGR group and control group (Z=-3.913) respectively, and the proportion of placenta with uneven share was 91.3%(21/23) vs 50.0%(16/32) (Fisher's exact test), which were significantly higher in sFGR group (both P < 0.01). The proportion of non-central cord insertion was 82.6% (19/23), 13.0% (3/23) and 40.6% (26/64), respectively, in smaller fetus of sFGR, bigger fetus of sFGR and control group, which was significantly higher in smaller fetus of sFGR than in the other two groups (Fisher's exact test, both P < 0.01). The proportion of arterioarterial (AA), arteriovenous (AV) and venovenous (VV) anastomosis in sFGR group and control group was 78.3%(18/23) vs 75.0%(24/32), 82.6%(19/23) vs 71.9%(23/32), and 17.4%(4/23) vs 15.6%(5/32);there were no significant differences between two groups (Fisher's exact test,all P>0.05). The number of AA, AV and VV anastomosis in sFGR group and control group was 1.0 (0.0-2.0) vs 1.0 (0.0-4.0), 3.0 (0.0-10.0) vs 2.0 (0.0-5.0), and 0.0 (0.0-1.0) vs 0.0 (0.0-3.0) (Z=-0.256, -0.142 and -0.123);the total diameter of AA, AV and VV anastomosis was 2.7 (0.0-7.0) vs 2.2 (0.0-9.7), 4.0 (0.0-13.7) vs 3.4 (0.0-11.5), and 0.0 (0.0-7.9) vs 0.0 (0.0-7.1) mm (Z=-0.070, -0.087 and -0.087);there were no significant differences between two groups (all P>0.05). The total number of all anastomosis was 3.5 (0.0-10.0) vs 3.5 (0.0-6.0) (Z= - 0.567); the total diameter of all anastomosis was 6.9 (0.0-22.4) vs 5.9 (0.0-17.1) mm (Z= - 0.556); there were no significant differences between two groups (all P>0.05). Conclusions Placental sharing discordance and non-central cord insertion may be the risk factors for MC pregnancies complicated with sFGR.

Objective To compare the outcomes of selective feticide by umbilical cord ligation (UCL),bipolar cord coagulation (BCC) and radiofrequency ablation (RFA) in the treatment of complicated monochorionic twins.Methods We retrospectively analyzed all cases of complicated monochorionic twin pregnancies treated at Peking University Third Hospital from August 2008 to December 2014.The indications for surgery included severe twin-to-twin transfusion syndrome (TTTS),selective intrauterine growth restriction (sIUGR) (type Ⅱ and Ⅲ),twin reversed arterial perfusion sequence (TRAP) or discordant anomaly.One-way ANOVA,LSD t test,Mann-Whitney U test,Chi-square or Fisher's exact test were used for statistical analysis.Results (1) A total of 68 patients chose selective feticide by different techniques,including fetoscopic UCL (n=18,UCL group) and ultrasound-guided RFA (n=46,RFA group).The other four patients treated by bipolar cord coagulation (BCC) were excluded.The maternal age,proportion of assisted reproductive technology,indications,gestational age and mean birth weight all showed no differences between the two groups (P＞0.05).One case of anterior placenta was found in UCL group,fewer than in the RFA group (27 cases,36.9％)(x2=4.853).No fetal loss occurred within two weeks in UCL group,but there were seven cases (seven cases,15.2％) of earlier fetal loss in RFA group (x2=4.952).The median operation time was (63.2±22.5) min in UCL group,and longer than in the RFA group (33.3 ± 11.4) min (t=5.165),all P＜0.05.(2) The gestational age of TTTS and TRAP patients for feticide was older than patients with sIUGR and discordant anomaly [(22.7± 3.0),(22.8±3.2),(20.3 ± 2.5) and (20.4± 3.6) weeks,respectively,F=2.957,P=0.040].Fetal loss rate within two weeks in patients with discordant anomaly was higher than in other groups (4/11 vs 1/10,0/23 and 1/15,P＜0.05).The survival rate,gestational age at delivery and mean birth weight showed no significant differences among the four groups.(3)Compared with feticided fetuses at the upper uterine cavity,the fetal loss rate was higher,and the operation time,gestational age at delivery,birth weight and neonatal survival rate were lower than those performed at the lower uterine cavity,but the difference was not significant.Conclusions RFA provides similar outcomes of selective feticide in complicated monochorionic twins compared with UCL,while RFA is easier to operate.

Objective To study the symptom dimensions of Chinese patients with obsessive-compulsive disorder(OCD). Methods Symptom checklist in expert versions of Dimensional Yale-Brown Obsessive-Compul-sive Scale (DY-BOCS) was used to assess the symptom dimensions of 139 OCD patients. Results Nearly half of the patients had one dimension (50.4%). The frequency of patients with two or three dimensions was 24.5% and 14.4%. Patients with four to seven dimensions were very few and the frequency were 5.8% ,3.6% ,0.7% and 0.7% ,respectively. The most common symptom dimensions were symmetry (67.6%), contamination (43.2%) and aggressive (31.7%). The frequency of patients with miscellaneous, somatic, sex and religious, hoarding di-mension were 18.7%, 11.5% , 10.8% ,8.6% ,respectively. The frequency of male patients with symmetry dimen-sion was higher than that of the female patients(75.8%/52.1%, P<0.01), and the frequency of female patients with contamination dimension was higher than that of male patients (56.3%/36.3%, P<0.05). There were no differences in other dimensions between male and female patients. The early-onset patients had a greater of symp-toms in the symmetry dimension than late-onset patients and there were no differences between these two groups in other dimensions (77.6% vs 60.5%, P<0.05 ) . Conclusion Preliminary data suggest that the symptom di-mension approach may aid in the identification of subtype of OCD.

Objective To evaluate the diagnostic value of multislice CT(MSCT)in multilocular cystic real cell carcinoma(MCRCC).Methods Imaging features of 22 patients with MCRCC proved by histopathologic examinations,these patients were underwent non-enhanced and dual-phase contrast-enhanced CT scans and evaluated CT signs.Results 22 tumors all appeared as well defined multilocular cystic mass.The cystic wall presented with irregular thicking in 14 cases and regular thicking in 8 cases.The tumors with thin coarse septum in 6 cases(the transverse diameter ≤2 mm),irregular thicking septum in 11cases(2mm ＜the transverse diameter ≤ 5 mm)and septum with nodule in 5 cases(the transverse diameter ≤ 5 mm).Cystic wall and septum enhancement were detected with dual-phase contrast-enhanced CT.Cystic ares and hemorrhagic areas and calcification were no enhanced.Calcification of cystic wall were found in 2 cases and cyst in 3 cases.Conclusion MSCT imaging appearances have typical features.It has great important value in the preoperative diagnosis of MCRCC with non-enhanced and dual-phase contrast-enhanced CT scans.

Objective To evaluate the clinical efficacy and safety of chemotherapy weekly in the chemoradiotherapy of cervical cancer.Methods Between Jan 2003 and Oct 2007,168 patients with stage Ⅲ B squamous cell carcinoma of the uterine cervix in Chongqing Cancer Hospital were divided into two groups randomly.The observation group,total 86 patients receiving radiotherapy concomitant with weekly cisplatin and taxol;the matched group,total 82 patients,receiving radiotherapy concomitant with cisplatin plus taxol every 3 weeks.There were no statistical difference in the clinical and pathological characteristics between the two groups. We compare the 5 years survival rate and side reaction of the two groups.Results The 5 years survival rate of the observation group and the matched group were respectively 52.3%(45/86)and 42.7%(35/82),in which there was no significant difference (P >0.05).The response rate(CR+PR)were respectively 94.2%(81/86)and 92.7%(76/82)in the observation group and the matched group,in which there was no significant difference (P >0.05).Grade Ⅲ acute gastrointestinal toxicities (nausea and vomi-ting)in the matched group were exactly higher than that in the observation group [19.5%(16/82)vs.8.1% (7/86),P <0.05]. Moreover,Grade Ⅲ myelosuppression in the matched group were exactly higher than that in the observation group [20.7%(17/82) vs.9.3% (8/86),P <0.05].there were no significant difference of the incidence of the radiocystitis,radiation proctitis and radio-dermatitis between the two groups.But the Radiotherapy completion time in the matched group were exactly longer than that in the observation group [(61.12±6.71)days vs.(54.72±4.76)days,P <0.05].Conclusion The toxicity of the observation group was lower than the matched group.Moreover the efficacy of observation group is similar to the matched group.

Objective To detect the application value of the apparent diffusion coefficient (ADC) values using diffusion weighted imaging (DWI) in detection of fetus with enlargement of cisterna magna.Methods Sixteen fetuses with enlargement of cisterna magna (group 1) and other sixteen healthy controls (group 2) were scanned by DWI.The ADC values were measured and compared between two groups at the same regions, and between left and right brain in group 1.The correlations between ADC values,the enlarged degree of cisterna magna and gestational age were calculated respectively.Results The ADC values were lower in the white matters of bilateral frontal lobes and parietal lobes, bilateral thalami and cerebellum in group 1 than those in group 2.There were no significant differences in ADC values between left areas and right areas in group 1 (P>0.05).The ADC values in bilateral basal ganglia and thalami were negatively correlated with the gestational age (P<0.05).There was no correlation between the enlarged degree of cisterna magna and gestational age (P>0.05).Conclusion The ADC values were decreased in certain regions in fetuses with enlargement of cisterna magna, which suggested that ADC value might be more sensitive for detecting potential damage of brain.Combined with conventional MRI, DWI and ADC values could be regarded as accurate protocols for the detection of fetus abnormalities.

Objective To explore the diagnostic value of ADC values in fetus with mild ventriculomegaly.Methods Fifteen fetuses with mild ventriculomegaly (mild ventriculomegaly group) and fifteen healthy controls (control group) were scanned with DWI.The ADC values in bilateral frontal lobes,parietal lobes,temporal lobes,occipital lobes,basal ganglia,thalamus and cerebella were measured.The ADC values of mild ventriculomegaly group were compared with those of control group.And the ADC values in left regions were compared with those in right regions of fetuses with mild ventriculomegaly.The correlation between ADC values of all fetuses and gestational age,as well as the correlation between the diameters of ventriculomegaly in feutes with mild ventriculomegaly and gestational age were analyzed.Results Compared with control group,ADC values were lower in bilateral frontal lobes and parictal lobes in mild ventriculomegaly group (all P＜ 0.05).There were no significant differences of ADC values between left regions and right regions (all P＞0.05).Correlation analysis showed that ADC values of all fetuses in bilateral occipital lobes,basal ganglia,thalamus,cerebella and left temporal lobe were negatively correlated with gestational age.The diameters of ventriculomegaly were positively correlated with gestational age (r=0.635,P=0.011).Conclusion The ADC values decrease in frontal lobes and parietal lobes in fetuses with mild ventriculomegaly.The ADC value may be more sensitive for detecting potential damage of brain,which is helpful for the diagnosis of fetus ventriculomegaly.

Objective To study the characteristics of life events, coping styles and social supports in anxiety disorders patients. Methods 50 patients with generalized anxiety disorders (GAD), 44 patients with obsessivecompulsive disorders (OCD),23 patients with social anxiety disorders (SAD) and 99 healthy people were assessed by life event scale(LES),simplified coping style questionnaire(SCSQ) and social support rating scale (SSRS). Results Compared with healthy people, patients with GAD, OCD and SAD were all had higher scores of total life events (GAD 22.46±18.44;OCD 23.68±28.31;SAD 17.22±14.97;Healthy People 6.64±9.71)( F =14.216,P =0.000) and negative life events(GAD 18.76±17.99;OCD 20.02±24.98;SAD 12.00±13.16;Healthy People 4.56±7.51)( F =14.391,P =0.000).All patients were apt to choose positive styles less( F =16.505,P =0.000) and got less social supports totally ( F =26.506,P =0.000). The objective social supports( F =7.494,P =0.000)and subjective social supports ( F =26.985,P =0.000) were less and the utilization of social supports was lower ( F =13.931,P =0.000) in patients.Conclusions 1. Anxiety disorders patients often experience more or more serious life events, especially negative life events, are more likely to choose negative coping styles, and get less social supports. 2. Anxiety disorders may be related with people's characteristics of life events, coping styles and social supports.

Objective To understand the clinical characteristics of systemic lupus erythematosus with Antiphospholipid syndrome (SLE-APS).Methods The clinical data of 39 cases of SLE-APS were collected and analyzed retrospectively. Results Thirty-one patients had 48 thrombosis episodes in total, among which the most common presenting manifestations were deep venous thrombosis and stroke. 12 of 26 married women had fetal morbidity. The prevalence of anticardio lipin antibody (aCL) and lupus anticoagulant ( LA) was 72% and 41% , respectively. 24 patients had SLE at first,on an average of 9. 5 years later they had the characteristics of APS, 12 patients had thrombosis episodes or fetal morbidities ,4. 8 years later they developed into SLE,and 3 patients had the characteristics of SLE and APS from the onset The SLEDAI was less than 5 in five cases when they had thrombosis episodes or fetal morbidities.Conclusions The incidence of thrombosis episodes or fetal morbidities increased in SLE-APS patients. APS occurred before, after or at the same time with SLE. SLE patients might have the clinical features of APS during the steady stage. It's very important to ask the medical history in detail and measure aCL in lupus patients to find the risk factor of APS and prevent the APS' occurrence.