Objective:To explore the efficacy of group cognitive-behavioral therapy (GCBT) to generalized anxiety disorder (GAD).Methods:In this randomized controlled trial,the control group (n =23) and the intervention group (n =33) were included,all of the participants received duloxetine (30-120 mg/d) as pharmacotherapy.The intervention group received 8 group cognitive-behavioral therapy sessions weekly,90 minutes for each time.Assessments were conducted with the Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HMAD) and Clinical Global Impression (CGI) at baseline,mid-treatmentand post-treatment.CGI included three factors,the severity of illness (SI),the globalimprovement (GI) and the efficacy index (EI).Results:The repeated measures analysis of variance of HAMA showed that,there were statistical significance on the HAMA for interaction between measure time and group processing (F =4.35,P ＜ 0.05).Compared with the control group,the intervention group got higher decreased scores of HAMA at the 4th week and 8th week,and higher prevalence of being cured and efficient at the 4th week.At the 8th week,the decreased scores of HMAD were higher in the intervention group than in the control group,and the scores of CGI-SI and the CGI-IE were lower in the intervention group.Conclusion:It suggests that group cognitive-behavioral therapy combined with pharmacotherapy could be earlier to be effective,and the symptoms of anxiety,depression and the state of illness could be improved more significantly compared with pharmacotherapy alone.

We established methods to isolate human amniotic fluid-derived progenitor cells (hAFPCs), and analyze the ability of hAFPCs to secrete human coagulation factor IX (hFIX) after gene modification. The hAFPCs were manually isolated by selection for attachment to gelatin coated culture dish. hFIX cDNA was transfected into hAPFCs by using a lentiviral vector. The hFIX protein concentration and activity produced from hAFPCs were determined by enzyme-linked immunosorbent assay (ELISA) and clotting assay. The isolated spindle-shaped cells showed fibroblastoid morphology after three culture passages. The doubling time in culture was 39.05 hours. Immunocytochemistry staining of the fibroblast-like cells from amniotic fluid detected expression of stem cell markers such as SSEA4 and TRA1-60. Quantitative PCR analysis demonstrated the expression of NANOG, OCT4 and SOX2 mRNAs. Transfected hAFPCs could produce and secrete hFIX into the culture medium. The observed concentration of secreted hFIX was 20.37% +/- 2.77% two days after passage, with clotting activity of 16.42% +/- 1.78%. The amount of hFIX:Ag reached a plateau of 50.35% +/- 5.42%, with clotting activity 45.34% +/- 4.67%. In conclusion, this study established method to isolate and culture amniotic fluid progenitor cells. Transfected hAFPCs can produce hFIX at stable levels in vitro, and clotting activity increases with higher hFIX concentration. Genetically engineered hAFPC are a potential method for prenatal treatment of hemophilia B.
Amniotic Fluid ; cytology ; Blood Coagulation ; Cell Culture Techniques ; Cell Separation ; methods ; DNA, Complementary ; Factor IX ; biosynthesis ; Genetic Engineering ; Genetic Vectors ; Humans ; Stem Cells ; cytology ; metabolism ; Transfection

Objective To explore the clinical feature of Kimura disease complicated with nephrotic syndrome in children. Methods The clinical data from 4 children with Kimura disease complicated with nephrotic syndrome were retrospectively analyzed. Results In all of the 4 male children, level of serum IgE was increased but level of eosinophils was not increased in peripheral blood. The renal pathological manifestations were different among them. Two cases had acute tubular injury, one case had pathological changes in repeated renal biopsy, and one case had a little of eosinophils infiltration in renal interstitium. All of them were sensitive to oral hormone treatment. Except that one case had no relapse yet in short follow-up period, the other 3 cases had relapsed and all manifested as positive urinary protein without lymphadenectasis. The 3 cases with recurrence were treated by combined immunosuppressive agents, the palindromia of two cases were reduced which were combined with tacrolimus. Conclusion The Kimura disease complicated with nephrotic syndrome in children has a long course and different renal pathological manifestations. It is sensitive to hormone treatment but easy to relapse, and the treatment should be combined with immunosuppressive therapy. Tacrolimus may have the effect on reducing relapse and delaying the progress of renal pathology.

Objective:To explore the clinical effect of mycophenolate mofetil combined with glucocorticosteroid on the children with anaphylatic purpura nephritis.Methods:70 cases of children treated and diagnosed as anaphylatic purpura nephritis in our hospital from March,2012 to September,2015 were enrolled in this study.They were randomly divided into the observation group and the control group.Conventional therapy was applied to both groups,the observation group was treated by mycophenolate mofetil combined with prednisone,the control group was given cyclophosphamide combined with prednisone.The total effective rate,disappearence time of clinical symptoms,biochemical indicators,immune function as well as the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 94.29％,which was 85.17％ in the control group,no statistical difference was found between two groups(P＞0.05).After therapy,the disappearence time of albuminuria,hematuria in observation group showed no significant difference compared with those of the control group,the level of 24 h urine protein quantitation and CD19+ of both groups were significantly decreased,and the level of CD19+ of observation group was significantly lower than that of the control group (P ＜0.05),the level of albumin,total protein and CD3+,CD3+CD4+ of both groups were significantly increased,and the level of CD3+,CD3+CD4+of observation group were significantly higher than those of the control group (P＜0.05).The incidence of adverse reactions in observation group was significantly lower than that of the control group (P ＜0.05).Conclusion:Mycophenolate mofetil combined with glucocorticosteroid was more effective and safe on the children with anaphylatic purpura nephritis than that of cyclophosphamide combined with prednisone.

Objective To provide the scientific basis for realizing the inter-accreditation of laboratory electrolyte detection results by comparing the electrolyte detection results in 5 grade 3A hospitals of Zhuhai city .Methods Each 10 serum samples with low , middle and high concentrations of electrolyte were collected for simultaneously detecting the electrolyte kalium (K) ,natrium (Na) and chlorinum (Cl) .The detection results were performed the statistical analysis and comparison .The mutual bias within 1/2 of al-lowable error of CLIA′88 indicated that the detection results were mutually accredited ,if the mutual bias exceeding 1/2 of allowable error ,the detection results could not be mutually accredited .Results The difference of electrolyte detection results in 5 hospitals accorded with the stipulation requirement of CLIA′88 .Conclusion The electrolyte detection results of 5 hospitals could be mutually accredited .

Objective To explore the effect of general intervention in improving the psychological condition of healthy pregnant women. Methods Totally 96 pregnant women who made prenatal visits in our obstetrics and outpatient department were divided into the control and the intervention group stochasti-cally. The intervention group started from first prenatal visit. The general intervention measures included cognitive intervention, the behavioral intervention, family coping intervention and psychological intervention with self-designed relaxation exercises. While conventional prenatal visit, propaganda and nursing were im-plemented to the control group.Self-made general questionnaire and symptom checklist 90 (SCL-90)were used to survey and analyze the results. Results Post-natal depression and anxiety of the control group was obviously higher than that of the prenatal. The Post-natal obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility, terror and bigotry in the intervention group were greatly alleviated. Com-pared with the control group, obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility and terror of the intervention group were significantly different (P<0.05). The depression improved while the difference was not evidently differenL Conclusions Delivery had great influence on the psychological status of women,especially anxiety and depression. General intervention measures like psychological relax-ation exercises can improve the psychological condition of healthy pregnant women obviously,especially de-pression.

Objective To compare the intraradicular bacterial community structures of teeth with or without post-treatment periapical periodontitis and to explore the suspicious microorganisms that is related to persistent periapical infection.Methods The intraradicular biofilm samples were collected from 10 post-treatment periapical periodontitis teeth(apical periodontitis group) and 10 teeth without post-treatment periapical periodontitis(without apical periodontitis group).The V 1-V3 hypervariable regions of bacterial 16S rRNA genes were amplified,and the high-throughput pyrosequencing was performed.The composition and structure characteristic of intraradicular microbiome were revealed by bioinformatic analysis.Results Total sequences were taxonomically classified into 132 species-level bacteria belonging to 96 genera and 21 phyla.The most representive phyla in apical periodontitis group were Firmicutes[32％ (18 534/58 688)],Proteobacteria[27％(15 626/58 688)],Actinobacteria[15％ (8 685/58 688)],Bacteroidetes [11％ (6163/58 688)],Fusobacteria[8％ (4761/58688)] and Spirochaetes[3％(1 785/58 688)].While the most representive phyla in without apical periodontitis group were Firmicutes[31％(16 941/55 480)],Proteobacteria [27％(14 748/55 480)],Bacteroidetes [18％(9 948/55 480)],Fusobacteria[10％(5 307/55 480)],Actinobacteria [9％(4 761/55 480)],Chloroflexi[3％(1 785/55 480)].The abundance of actinobacteria in apical periodontitis group was significantly higher than without apical periodontitis group(P＜0.01).The detection rates of actinomycetes in apical periodontitis group and without apical periodontitis group were 100％ and 50％.Conclusions The diversity of intraradicular bacterial community in teeth with apical periodontitis was higher than those without apical periodontitis.Actinomycetes may be related to post-treatment periapical periodontitis.

The main pathogenesis of learning and memory disorders lies in the brain,closely related to dysfunction of the spleen,heart,kidney,and liver,especially concerning the spleen,which governs the ascending and descending of qi and facilitates the circulation of qi and blood throughout the body to nourish the brain.This article discussed the physiological function of"spleen governing the ascendant of usable substances"and explored its role in learning and memory disorders.The Warburg effect generates energy rapidly and efficiently to maintain normal brain function,which to some extent aligns with the function of the spleen governing the ascendant of usable substances in TCM.Therefore,by emphasizing the role of"spleen governing the ascendant of usable substances",this article explored the pathological basis of learning and memory disorders.It also discussed the disruption of the Warburg effect was an important feature of this condition from both TCM and Western medicine perspectives,which could help to explore in depth the role of the method of promoting spleen in governing the ascendant of usable substances in the treatment of learning and memory disorders,and provide new ideas for its TCM treatment.

OBJECTIVE: To investigate the effects of sera from rats fed with tablets (HGT) on endoplasmic reticulum (ER) stress in a steatotic hepatocyte model of free fatty acids (FFAs)-induced nonalcoholic fatty liver disease (NAFLD) and explore the possible mechanism. METHODS: FFAs prepared by mixing oleic acid and palmitic acid at the ratio of 2:1. HepG2 cells were treated with the sera from rats fed with low-, moderate-or high-dose HGT (HGT sera) or sera of rats fed with fenofibrate (fenofibrate sera), followed by treatment with 1 mmol/L FFAs for 24 h to induce hepatic steatosis. Oil red O staining was used to observe the distribution of lipid droplets in the cells. The biochemical parameters including triglyceride (TG), lactated hydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured using a commercial kit. The morphological changes of the ER in the cells were observed using transmission electron microscopy. The protein/mRNA expressions of ER stress-related signal molecules including GRP78, PERK, p-PERK, ATF6, ATF4, CASPASE-12, CHOP, XBP-1, PKC, and p-PKC-δ were detected using Western blotting and/or quantitative real-time PCR (qRT-PCR). The changes in the protein expressions of GRP78, p-PERK, CASPASE-12 and CHOP were also detected in cells with transient transfection of PKC-δ siRNA for PKC-δ knockdown. RESULTS: Compared with the control cells, the cells treated with FFAs showed significantly increased levels of TG, AST, and ALT ( < 0.05). Compared with FFAs-treated cells, the cells pretreated with HGT sera or fenofibrate sera all showed significantly decreased TG, AST and ALT levels ( < 0.05), reduced accumulation of the lipid droplets ( < 0.05), and lowered protein or mRNA expression levels of GRP78, p-PERK, ATF6, ATF4, CHOP, CASPASE-12, XBP-1 and p-PKC-δ ( < 0.05). PKC-δ knockdown caused significantly reduced protein expressions of GRP78, p-PERK, CASPASE-12 and CHOP in the cells with FFA-induced hepatic steatosis ( < 0.001); treatment with high-dose HGT serum more significantly reduced the expressions of GRP78 ( < 0.001) and P-PERK ( < 0.01) in FFAs-induced cells with PKC-δ knockdown. CONCLUSIONS HGT serum can effectively prevent FFAs-induced steatosis in HepG2 cells by alleviating ER stress, in which PKC-δ may act as an important target.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Endoplasmic Reticulum ; ultrastructure ; Endoplasmic Reticulum Stress ; drug effects ; Fatty Acids, Nonesterified ; Fenofibrate ; administration & dosage ; Hep G2 Cells ; Humans ; Hypolipidemic Agents ; administration & dosage ; Microscopy, Electron, Transmission ; Non-alcoholic Fatty Liver Disease ; blood ; etiology ; prevention & control ; RNA, Messenger ; blood ; Rats ; Serum ; Tablets ; Triglycerides ; blood