Recent studies have shown that berberine is hypoglycemic and capable of improving insulin resistance,but the exact mechanism remains unknown.This article reviews the papers published in recent years concerning the clinical efficacy of berberine and its relevant mechanisms in improving insulin resistance.

ObjectiveTo observe the therapeutic efficacy of warm needling plus acupoint injection in treating post-stroke urinary retention.MethodSeventy eligible subjects with post-stroke urinary retention were randomized into a treatment group of 35 cases and a control group of 35 cases. The treatment group was intervened by warm needling plus acupoint injection, while the control group was by warm needling alone. The relevant symptoms of urinary retention were observed before and after treatment.Result After 1-week treatment, the retention condition was improved in both groups, and the treatment group was significantly superior to the control group (P<0.05); The 2-week and 1-month follow-up studies showed that the retention condition in the treatment group was significantly better than that in the control group (P<0.05). The adverse events in the treatment group were significantly less than that in thecontrol group (P<0.05).ConclusionWarm needling plus acupoint injection can produce a satisfactory efficacy in treating post-stroke urinary retention and is worth application in clinic. However, this method still needs improving as its effect on initialurination and urination duration is not significant.

Abstract College students are a vulnerable population for psychological problems, who are facing challenges from environmental adaptation, career planning, peer competition and interpersonal relationships. In recent years, the state attaches great importance to psychological health education of college students. Virtual reality technology (VR) has been widely used in clinical psychology with the development of techology. In order to enrich channels of psychological health education of college students, the paper summarizes the methods, advantages and future direction of its application in promoting mental health of college students, providing reference for expanding the intervention ways of college students psychological health education and promotion.

This article reported a case of a male patient with primary hyperparathyroidism(PHPT) caused by an ectopic parathyroid adenoma in the anterior superior mediastinal. Hospital routine examinations indicated hyperlipidemia, hyperuricemia, type 2 diabetes with nephropathy, chronic kidney disease in stage Ⅳ, elevated PTH, hypercalcemia, hypophosphatemia, clinically highly suspected hyperparathyroidism. There was no obvious abnormality of parathyroid ultrasound, while 18F-FDG systemic metabolic imaging and 99mTc-MIBI dual-phase parathyroid imaging suggested that an ectopic parathyroid gland in the anterior superior mediastinal which was hyperactive. Evaluations of anterior pituitary function, pancreas, and endocrine-related hormones showed no obvious abnormalities, and thus we ruled out the possibility of multiple endocrine adenomas, combined with the patient′s symptoms and previous medical history, and ruled out the possibility of tertiary hyperparathyroidism, the patient was diagnosed as PHPT caused by the anterior superior mediastinal ectopic parathyroid adenoma. To restore the blood calcium to normal, the patient was treated with intravenous rehydration, diuresis, calcitonin to promote urinary calcium excretion, and zoledronic acid to inhibit bone resorption. Further thoracoscopic mediastinal tumor resection was performed, and the diagnosis of parathyroid adenoma was confirmed by pathology. All the indicators were normal and no recurrence of hyperparathyroidism was found during the follow-up. Integration of the patient′s clinical manifestations, biochemical indicators, and imaging examinations are necessary to diagnose PHPT qualitatively and location-specifically. In particular, it is necessary to pay attention to whether there is the possibilities of ectopic adenoma and multiple endocrine adenomas, to reduce the rates of missed diagnosis and recurrence.

Objective To evaluate the dynamic contrast-enhanced MRI (DCE-MRI)in detecting experimentally induced testicular ischemia. Methods Thirty healthy male New Zealand rabbits were randomly assigned into 6 groups. There were 5 rabbits in each of the following experimental groups: ( 1 ) Normal control, (2) Sham-operated, (3) ischemia of 3 h group, (4) ischemia of 6 h group, (5) ischemia of 12 h group, (6) ischemia of 24 h group. In all experiment groups, the right testis served as the internal control while the left testis served as the experimental side. DCE-MRI for each animal lasts about 10 minutes. Signal enhanced ratios (SERs) of ROI for both sides of each group were calculated by a computer, and parameters of SERs of 30 s, 75 s, 120 s and maximal SER were used for statistical analysis.Time intensity curves (TICs) were made for two sides of each group via Excel 2003 software and classified into 4 types. Statistical analysis was performed to compare the differences of SERs between left and right testis by two independent Kolmogorov-Smirnov test. Results In group I and 2, significant enhancement was observed on both testes of 10 rabbits. The enhancement decreased gradually with the elongation of ischemia in torsion groups. Three cases of type Ⅰ and 2 cases of type Ⅱ were observed in group 1,5 cases of type Ⅰ in group two, 2 cases of type Ⅰ and 3 cases of type Ⅱ b in group three, 2 cases of type Ⅰ and 2 cases of type Ⅱ b in group four, 5 cases of type Ⅱ b in group five and 5 cases of type Ⅲ in group six were noticed in the left testes. And in TICs of right testes, all cases showed TICs of type Ⅰ except 2 cases of type Ⅱ a in group six. In four torsion groups, the values for SER75 of the left side were 0. 084%, 0. 076%, 0.164% and 0.065%, while the right side were 0.255%, 0.410%, 0.586% and 0.302% (P ＜0.05). The values for SER120 in group three, five and six were 0.221% , 0.158% and 0.059% for the left side, and 0.405%,0.522% and 0.207% for the right side(P ＜0.05). The values for MSER in group three, five and six were 0.217% ,0.164% and 0.072% for the left side, and 0.405%, 0.586% and 0.302% for the right side(P ＜0.05). Conclusion DCE-MRI technique may be useful in the diagnosis of testicular torsion, which shows potential in the clinical application.

Objective To investigate the value and diagnostic efficiency of the quantitative dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion (IVIM) parameters using three dimention (3D)-histogram analysis for discriminating the Gleason score (GS) of prostate cancer. Methods A total of 53 patients pathologically confirmed as prostate cancer by systemic prostate biopsy who had routine , DCE and DWI-MRI scans were retrospectively analyzed. There were 15 cases for low-risk and 38 cases for intermediate/high-risk prostate cancer. The 3D ROI of all lesions based on T2WI was achieved by image registration to get the quantitative parameters of DCE-MRI and DWI-IVIM. The parameters of DCE-MRI contains: transfer constant (Ktrans), rate constant (Kep) and extracellular-extravascular volume fraction (Ve).The DWI-IVIM related quantitative parameters were ADC, diffusion coefficient (D), diffusion coefficient related to perfusion (D*) and perfusion fraction (f). Then the histogram analysis of these quantitative parameters was performed to get the mean, median, 25th percentile, 75th percentile, Skewness and Kurtosis. Using the Spearman rank correlation analysis to evaluate the correlation of these parameters and GS of prostate cancer. The diagnostic performance of these quantitative histogram parameters related to the GS in identifying low-risk and intermediate/high-risk of prostate cancer was carried by ROC. Results The Kep and Ktrans (mean, median, 25th, 75th) of DCE-MRI were positively correlated with GS (r value was 0.346 to 0.696, P<0.05). The ADC (mean, median, 25th, 75th), D (mean, median, 25th, 75th, Skewness, Kurtosis) and D*(25th) of DWI-IVIM were correlated with GS (r value was-0.544 to 0.428, P<0.05). The DCE-MRI quantitative parameters Kep (25th) had the highest area under curve (AUC, 0.961); The ADC (median) and D (25th) had higher AUC( 0.832, 0.888) in the quantitative parameters of DWI-IVIM, the difference between Kep(25th) and ADC (median) was statistically significant (Z value was 2.212, P value was 0.027). The difference of AUC between Kep (25th) and D (25th), D (25th) and ADC (median) was not statistically significant (Z values were 1.027 and 1.398, P values were 0.162 and 0.304, respectively).Conclusion DCE and IVIM quantitative parameters (Kep, Ktrans, ADC, D) histogram analysis results are correlated with GS, and can be used for distinguishing low-risk from intermediate/high-risk prostate cancer.

Objective To investigate the maternal and fetal outcomes of pregnant women with subclinical hypothyroidism, and clinical observation of thyroxine replacement. Methods From March 2014 to March 2015, the clinical records of 216 women with subclinical hypothyroidism(including 166 cases with thyroxine replacement), and hypothyroidism(n=69)during pregnancy who delivered at our hospital were reviewed. The maternal complications and neonatal outcomes were compared with 406 healthy women who delivered during the same period. Results The age, number of fetus, and morbidity rate of gestational hypertension were without significant differences in those groups. The morbidity of gestational diabetes in subclinical hypothyroidism group and hypothyroidism group were significantly higher than those in control group(13.4%, 17.4% vs 0.2%, P<0.05). The rate of thyroid peroxidase antibody and thyroglobulin antibody positive in subclinical hypothyroidism group and hypothyroidism group were significantly higher than those in control group(26.9%, 23.2% vs 9.9%; 15.7%, 23.2% vs 8.1%, all P<0.05). No matter treated or not treated in subclinical hypothyroidism group, the preterm birth, Apgar score, low birth weight, birth defects, and infant congenital hypothyroidism were without significant differences as compared to the control group(P>0.05). Further compared those between treated and untreated subclinical hypothyroidism, the results were also without significant difference(P>0.05). Conclusions Subclinical hypothyroidism had no significant influence on pregnancy outcomes and perinatal events. Thyroxine replacement in subclinical hypothyroidism pregnant women also had no significant influence on pregnancy outcomes and perinatal events.

Objective: To explore the status of depressive symptoms among adolescents in different pubertal stages in a district of Chongqing. Methods: A self designed questionnaire and Children s Depression Inventory were administered among 1 001 students in a district of Chongqing. Score and associated factors of depressive symptoms of adolescents through descriptive statistical analysis, Chi square test, analysis of variance and Logistic regression analysis. Results: The detection rate of depressive symptoms among adolescents in a district of Chongqing was 17.3%, and the total score of depression scale was (12.02±6.72). There were statistically significant differences in the inefficiency subscale score of boys across stages of genital, pubic hair, armpit hair and beard, and whether the first spermatorrhea has occurred( t/F =7.08，5.46，5.18，4.21，5.84， P <0.05), while significant differences were found in the anhedonia and inefficiency subscales scores among girls across different stages of breast, pubic hair and armpit hair, and whether menarche has occurred( t/F =19.43，4.92，3.98，7.35， P <0.05). Multivariate Logistic regression analysis showed that the absence of first spermatorrhea and menarche were associated with lower prevalence of depressive symptoms in boys and girls ( OR=0.60, 95%CI=0.36-0.98; OR=0.46, 95%CI =0.22-1.00), while pubic hair development was associated with higher prevalence of depressive symptoms in girls ( OR=9.58, 95%CI =1.28- 71.71 ). Conclusion The detection rate of depressive symptoms among adolescents is relatively low. Boys who have had the first spermatorrhea, and girls with advanced pubic hair development or have had menarche are more likely to suffer from depressive symptoms.

Objective: This study explored the predictive effects of psychological stress in early and middle puberty on subsequent emotional and behavioral problems. Methods: A cohort of 911 boys and girls from primary and secondary schools in Chongqing was studied. Psychological stress was measured in early and middle adolescence, and the levels of emotional and behavioral problems were determined in one year follow up. Logistic regression analysis was used to analyze the effects of psychological stress in early and middle adolescence on subsequent emotional and behavioral problems. Results: The average psychological stress score in early and middle adolescence was (27.96±24.95), and the average scores of internalized and externalized behavioral problems and overall problems one year later were (8.21±8.46)(6.21±5.87) and (37.90±24.68) respectively. When grouped by gender, these scores, as well as the detection rate of anxiety and depression, withdrawal, physical discomfort, thinking problems, internalization problems and overall problems, were higher in girls than boys (t/Z=-6.38，-5.63，-6.06，-3.74，-6.80，-5.47， χ 2=15.88，12.01，3.92，6.64，24.67，15.88， P <0.05). Logistic regression showed that the psychological stress scale score was a risk factor for internalized and externalized behavioral problems and overall problems( P <0.05). Conclusion Psychological stress levels in early and middle puberty have a positive predictive effect on emotional and behavioral problems in the following year.

Objective: To explore whether psychological stress in early and mid puberty is predictive of adolescent healthrisk behaviors. Methods: In April 2018, a total of 1 046 primary and secondary school students from grade 5 to 8 were recruited through purposive sampling. The basic information and psychological stress of the respondents were collected by questionnaire and physical examination. In addition, self reports of health risk behaviors were collected in October 2018. Logistic multiple regression analysis was used to analyze the relationship between psychological stress and health risk behaviors of adolescents. Results: The reported health risk behaviors of the surveyed adolescents ranking from high to low were unreasonable physical activity (62.05%), food preferences (24.76%), fighting (21.03%), suicidal ideation (17.02%), ideation of running away from home (9.85%), low mood (8.80%), smoking (4.21%), drinking (3.73%), gambling (3.63%) and internet addiction (3.06%). Logistic multiple regression analysis showed that the high level of psychological stress was a risk factor for fighting ( OR =1.02, 95% CI =1.01-1.03), suicidal ideation ( OR =1.02, 95% CI =1.01-1.03), low mood ( OR =1.02, 95% CI =1.01-1.03), ideation of running away from home ( OR =1.02, 95% CI =1.01-1.03), unreasonable physical activity ( OR =1.01, 95% CI =1.00-1.02), smoking ( OR =1.02, 95% CI = 1.00-1.03), internet addiction ( OR =1.02, 95% CI =1.00-1.03), food preferences ( OR =1.01, 95% CI = 1.00-1.02) and gambling ( OR =1.02, 95% CI =1.01-1.04)( P <0.05). Conclusion Unreasonable physical activity and food preferences are most common health risk behaviors among adolescents. Psychological stress during early to middle puberty is predictive of adolescent health risk behaviors.