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 effect of swallowing different viscosities and volumes on the swallowing of dysphagic stroke survivors, and also penetration and aspiration.Methods:A total of 59 stroke survivors with dysphagia were evaluated using videofluoroscopy while completing the Chinese version of the volume viscosity swallow test. They were required to swallow 3, 5 and 10ml of food of medium, low, zero and high viscosity. Modified barium swallowing impairment profiles (MBSImPs) and the Rosenbek penetration aspiration scale were used for quantitative analysis.Results:Tongue control, initiation of the pharyngeal swallow and larynx closure showed the worst performance when swallowing zero-viscosity food. Oral residue performance was poor when swallowing large volumes and pharyngeal peristalsis was poor with small volumes. The risk of penetration and aspiration was greater with low-viscosity, large-volume swallowing tasks. There was a significant positive correlation between the penetration aspiration grade and total pharyngeal score. Larynx closure was especially strongly correlated with the penetration aspiration grade.Conclusions:The characteristics of physiological swallowing are closely related to the viscosity and volume of the material being swallowed. The risk of penetration and aspiration is greater with large volumes of low-viscosity food.

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 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.

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.

Antibody drugs often show "heterogeneity",including the related isomers differing from one another in glycosylation,charge or molecular size.Most of these isomers come from post-translational modifications,such as aggregation,degradation,glycosylation,oxidation,deamidation or disulfide misfolding,of the recombinant protein in the "cell factories".These modifications not only influence the quality,safety and efficacy of the antibodies,but also serve as an important indication of product quality throughout the whole process of antibody production.This paper reviews the relationship between glycoslation,charge and size heterogeneities of monoclonal antibodies and drug efficacy,safety,pharmacokinetics as well as immunogenicity,contributing to a better understanding of the relationship between antibody structure and function.It will provide some support and guidance for the research and development of antibody drugs,especially biosimilars.

Objective:To analyze the situation of off-label drug use in fertility clinic of one hospital to provide scientific evidence for clinical rational drug use and further standardize the behavior of off-label drug use in clinical physicians. Methods:The outpatient prescriptions in the reproductive center of the hospital during January and December in 2016 were randomly selected, the off-label drug use prescriptions were statistically analyzed according to the drug package inserts, and the rationality of the off-label drug use were e-valuated by searching the related literatures. Results:A total of 4176 off-label drug use prescriptions were collected, the primary types of off-label drug use were off-label indication, off-label dose and off-label administration. The top 3 drugs with off-label use were aspi-rin enteric-coated tablets (42. 05%), dydrogesterone tablets (27. 37%) and levocarnitine oral solution (16. 02%). The most of off-label use was supported by evidence-based medicines, while unreasonable use still existed. Conclusion: Off-label drug use is very common in the reproductive center of the hospital. The hospital should pay more attention to the phenomenon and establish relevant management system to standardize the behavior of off-label drug use in order to reduce the legal risk and promote clinical rational drug use.