Objective:To explore the rejuvenation effect of SMAS (Superficial musculoaponeurotic system) multi-vector suspension in the face and neck.Methods:From December 2019 to March 2023, the Plastic Surgery Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences implemented 34 cases of cheek rhytidectomy and 10 cases of cheek andneck rhytidectomy. Following general anaesthesia, liposuction is performed on the cheek and mandibular margins, and incisions are made anterior and posterior to the ear. At the end of the subcutaneous dissection, the SMAS in the region of the parotid gland is separated, and the SMAS is then secured by purse string multi-vector suture suspension. Intheend, excess skin is removed and the incision is reduced in tension.Results:All patients underwent successful surgeries and were satisfied with the postoperative follow-up results. The sagging soft tissues were effectively repositioned, resulting in natural facial and neck lift. There were no serious complications such as facial nerve injury, subcutaneous hematoma, incision infection, or skin flap necrosis.Conclusions:The utilization of MAS multi-vector suspension can significantly improve the relaxation of cheek and neck tissue, with fewer complications and satisfactory rejuvenation effect.

Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective:To observe the preventive effects of infliximab in autoimmune hepatitis (AIH) and to explore its mechanism.Methods:The mice AIH model was established by injecting concanavalin A (Con-A) into the caudal vein. Forty mice were divided into prevention group and control group, with 20 mice in each group. The mice of prevention group were injected intravenously with infliximab (20 mg/kg) one hour before Con-A injection and the mice of control group were administrated with 200 μL phosphate buffered saline (PBS). Serum was collected 3, 8, 12 and 24 h after Con-A/PBS injection. The serum level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was detected by colorimetry. The level of cytokine interleukin (IL)-6, IL-1β, interferon gamma (IFN-γ), IL-4, IL-17A, IL-10 and chemokine C-X-C motif ligand 10 (CXCL10) was measured by enzyme-linked immunosorbent assay (ELISA). Liver samples were taken 12 h after Con-A/PBS injection for hematoxylin-eosin staining. Liver infiltrated lymphocytes were assessed by flow cytometry. The expression of T-box transcription factor 21 ( TBX21), GATA binding protein 3 ( GATA3), RAR related orphan receptor C ( RORC) and CXCL10 at mRNA level was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of CXCL10 in liver was detected by Western blotting. Paired t test and one-way analysis of variance were used for statistic analysis. Results:At 8, 12, and 24 h after Con-A injection, the serum ALT level, AST level, IL-1β and IFN-γ of prevention group were all lower than those of control group ((545.8±190.3) U/L vs. (865.8±237.7) U/L, (947.6±267.9) U/L vs. (1 448.0±403.5) U/L, (508.6±131.1) U/L vs. (976.6±207.6) U/L; (620.7±132.0) U/L vs. (952.9±106.8) U/L, (801.6±212.0) U/L vs. (1 424.8±236.0) U/L, (632.1±117.8) U/L vs. (1 008.3±187.5) U/L; (31.38±10.12) ng/L vs. (48.12±11.53) ng/L, (39.34±11.40) ng/L vs. (60.00±14.17) ng/L, (29.49±8.22) ng/L vs. (46.89±5.50) ng/L; and (432.93±66.82) ng/L vs. (674.66±97.88) ng/L, (655.09±169.17) ng/L vs. (937.90±166.36) ng/L, (263.40±54.97) ng/L vs. (410.74±86.64) ng/L), and the differences were statistically significant ( t = 2.350, 2.308, 4.263, 4.374, 4.860, 3.806, 2.440, 2.541, 3.939, 4.560, 2.660 and 3.210; all P<0.05). The serum IL-6 levels 3, 8, 12 and 24 h after Con-A injection of prevention group were all lower than those of control group ((1 075.79±303.77) ng/L vs. (1 914.48±317.80) ng/L, (1 945.97±271.85) ng/L vs. (2 100.80±378.42) ng/L, (1 578.60±504.54) ng/L vs. (2 525.40±406.55) ng/L, (1 020.64±280.03) ng/L vs. (1 582.00±311.96) ng/L), and the differences were statistically significant ( t=4.266, 2.903, 3.267 and 2.994; all P < 0.05). At 3 h after Con-A injection, serum CXCL10 level and CXCL10 mRNA expression in liver tissues of prevention group were both lower than those of control group ((1 755.8±148.1) ng/L vs. (2 102.0±334.0) ng/L and 7.20±3.00 vs. 27.60±1.90), and the differences were statistically significant ( t=2.356 and 2.623, both P<0.05). At 3 and 8 h after Con-A injection, T- bet expression at mRNA level in liver tissues of prevention group was lower than that of control group (6.94±2.29 vs. 15.20±3.48 and 9.38±3.48 vs. 18.17±4.48), and the differences were both statistically significant ( t = 4.427 and 3.673, both P<0.05). However, 3, 8, 12 and 24 h after Con-A injection, there were no statistically significant differences in serum IL-4, IL-17A, IL-10, or GATA3 or RORC expression at mRNA level between prevention group and control group (all P > 0.05). Conclusions:Infliximab has certain preventive effects in mice AIH model, which may be achieved by antagonizing TNF-α and decreasing the expression of CXCL10 in liver, reducing the infiltration of T-helper 1 cells and CD8 + T cells into liver, and by reducing T lymphocyte activation induced by inflammatory cytokines thus alleviating the damage of T lymphocytes to hepatocytes.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

Objectives To assess the effect of onset age on prefrontal activation during a working memory task in patients with bipolar disorder using a 52 multichannel functional near-infrared spectroscopy (NIRS).Methods Sixteen patients with early-onset (EO,onset age≤24 years old) and 14 with non-early-onset (NEO,onset age＞24 years old) bipolar Ⅰ disorder were consecutively recruited from wards of Peking University Sixth hospital between October 2013 and May 2014,also including 16 healthy controls (HC) from community.Three groups of participants were diagnosed using MINI,then accepted a cross-sectional comparison of the relative changes in oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) during 1-back working memory task.Results Results from single factor analyses suggested that EO group showed a significantly reduced activation in deoxy-Hb in the right inferior prefrontal gyrus region than HC (CH34:-0.091 vs.0.009,Z=-2.542,P=0.033),while a significant increase of deoxy-Hb changes in the right dorsolateral prefrontal cortex (CH13:0.145 vs.-0.025,Z=2.412,P=0.048) and right frontopolar cortex (CH15:0.053 vs.-0.032,Z=2.890,P=0.012) regions than NEO group.There were no significant differences in the oxy-Hb changes among three groups in any channel during task.After being adjusted by multiple factor analyses,no significant difference in prefrontal activation among three groups was observed in any channel.Conclusions Similar pattern of prefrontal activity during 1-back working memory task exits between EO and NEO group,indicating that onset age may have no effect on NIRS prefrontal activation under low memory load in patients with bipolar disorder,which provides a reference for further NIRS studies in bipolar disorder.

Objectives To assess the effect of onset age on prefrontal activation during a working memory task in patients with bipolar disorder using a 52 multichannel functional near-infrared spectroscopy (NIRS).Methods Sixteen patients with early-onset (EO,onset age≤24 years old) and 14 with non-early-onset (NEO,onset age＞24 years old) bipolar Ⅰ disorder were consecutively recruited from wards of Peking University Sixth hospital between October 2013 and May 2014,also including 16 healthy controls (HC) from community.Three groups of participants were diagnosed using MINI,then accepted a cross-sectional comparison of the relative changes in oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) during 1-back working memory task.Results Results from single factor analyses suggested that EO group showed a significantly reduced activation in deoxy-Hb in the right inferior prefrontal gyrus region than HC (CH34:-0.091 vs.0.009,Z=-2.542,P=0.033),while a significant increase of deoxy-Hb changes in the right dorsolateral prefrontal cortex (CH13:0.145 vs.-0.025,Z=2.412,P=0.048) and right frontopolar cortex (CH15:0.053 vs.-0.032,Z=2.890,P=0.012) regions than NEO group.There were no significant differences in the oxy-Hb changes among three groups in any channel during task.After being adjusted by multiple factor analyses,no significant difference in prefrontal activation among three groups was observed in any channel.Conclusions Similar pattern of prefrontal activity during 1-back working memory task exits between EO and NEO group,indicating that onset age may have no effect on NIRS prefrontal activation under low memory load in patients with bipolar disorder,which provides a reference for further NIRS studies in bipolar disorder.