Objective:To explore the relationship between early maladaptive schemas, defense styles and mental health in patients with depression, and to investigate the mediating effects of defense styles between early maladaptive schemas and mental health.Methods:A total of 87 outpatients with depression were assessed with the Young schema questionnaire-short form 2(YSQ-SF2), defense style questionnaire(DSQ), symptom checklist-90(SCL-90) and Beck depression inventory(BDI). SPSS Process program and Bootstrap method were used to explore the mediating effect of defense styles.Results:The scores of abandonment/instability were higher in females than those in males (2(0.5, 4), 0(0, 1.25), Z=-2.963, P=0.003) while the score of emotional inhibition was higher in males than in females (1(0, 3), 0(0, 2), Z=-2.318, P=0.02). The total score of SCL-90 was positively predicted by vulnerability to harm or illness and emotional deprivation, with an explanatory variation rate of 27.7%.The number of SCL-90 positive items was positively predicted by social isolation/alienation and abandonment/instability, with an explanatory variation rate of 19.3%.Immature defense styles fully mediate the relationship between social isolation/alienation and mental health, as well as between abandonment/instability and mental health. Conclusion:Social isolation/alienation and abandonment/instability affect the mental health of patients with depression by the mediating effect of immature defense styles.

Objective:To explore the clinical value of point-of-care ultrasonography(PoCUS) in the diagnosis of acute pulmonary embolism(PE).Methods:Consecutive 196 patients suspected of acute PE were enrolled in East Branch, the Second Hospital of Hebei Medical University from January 2017 to November 2017. All the patients were categorized into no PE group( n=143) and PE group( n=53) based on CTPA results. PoCUS was performed and considered diagnostic for PE if one or more right ventricular dysfunction (right ventricular dilation, right ventricular free wall hypokinesia, increased tricuspid regurgitation velocity or decreased tricuspid annular plane systolic excursion), deep venous thrombosis(DVT) or subpleural infarcts were detected. Results:With CTPA as the gold standard for diagnosis, the sensitivity (94.34%), Youden index (0.531) and the area under the ROC curve(AUC) (0.765) of the combined diagnosis of PE by transthoracic echocardiography(TTE), lower limb vein compression ultrasonography(CUS) and lung ultrasonography (LUS) were the highest. The specificity (94.41%) and accuracy (81.63%) of LUS in the diagnosis of PE were the highest, and the misdiagnosis rate (5.59%) of LUS the lowest. The sensitivity of the combined triple PoCUS (TTE, CUS, and LUS) diagnosis of PE was higher than TTE and CUS combined diagnosis ( P=0.016), and the sensitivity and specificity were higher than TTE and CUS combined diagnosis as a whole ( P<0.005). Conclusions:The combined triple PoCUS (TTE, CUS, and LUS) has the highest accuracy in the diagnosis of PE, while LUS has a high specificity and a low misdiagnosis rate in the diagnosis of PE. Therefore, it is recommended to apply the combined triple PoCUS in clinical practice.

Objective To explore the diagnostic value of combined detection of CMV-IgM and CMVDNA in infantile cytomegalovirus hepatitis.Methods The serum CMV virus antibodies of 122 children diagnosed of cytomegalovirus hepatitis in Liaocheng People's Hospital was detected by chemiluminescence,while using fluorescent Probe PCR assay with serum and urine CMV-DNA,The other patients from the health examination center with no infection in children were subject to control group.The differences of CMV antibody and CMV-DNA positive rate were analyzed in infant of cytomegalovirus hepatitis.The diagnostic value of single and combined CMV-IgM and CMV-DNA in infant cytomegalovirus hepatitis was compared by ROC curve.Results Compared with the control group,There were significant differences in the positive rates of CMV-IgM and CMV-DNA (P＜0.01).According to the age group,the total positive rate of 1 days to 6 months group combined with CMV-IgM and CMV-DNA in the highest;clinical features of grouping,the total positive rate of CMV-IgM and CMV-DNA the highest jaundice group,the differences were statistically significart (P ＜0.05).Through the ROC curve analysis,the curve of the joint detection of CMV-IgM and CMV-DNA in the hepatitis group was the largest,and the sensitivity,specificity,positive predictive value and negative predictive value were the highest,and the diagnostic value was the highest.Conclusion Combined with CMV-IgM and CMV-DNA detection in infant of cytomegalovirus hepatitis has a better diagnostic value.

Objective To investigate the effect of thyroid hormone(T3)on the expressions of cytochrome c (CytC) and apoptosis?inducing factor(AIF) after cerebral ischemia reperfusion injury in rats and its mechanism. Methods SD male rats were randomly divided into four groups: sham operation group(sham1),sham operation group + T3(sham2) ,ischemia?reperfusion group (IR) ,and thyroid hormone treatment group(T3). A rat model of cerebral ischemia?reperfusion injury was established by right middle cerebral artery occlusion for 2 h,followed by reperfusion for 24 h. Thyroid hormones (10μg/100 g) or normal saline were given at 1 h after onset of ischemia and 6 h after reperfusionby intraperitoneal injection. Neurological deficit scores were evaluated 24 h after reperfusion. Cerebral infarction volume was evaluated by TTC staining. Histological changes was observed by HE staining. Expressions and mRNA levels of CytC and AIF in ischemic brain tissue were evaluated by immunohistochemistry and real?time fluorescent quantitative RT?PCR. Results Ascompared with those in sham operation groups ,the expressions and mRNA levels of CytC and AIFincreased significantlyin IR groups. As compared with those in IR groups ,the indexes were remarkably decreasedin T3 groups (P < 0.01). Nerve function was markedly improved andinfarction area narrowed.Conclusions Thyroid hormone plays a certain role in protection of cerebral ischemia?reperfusion injury in rats,whose mechanism may be associated with inhibition of the expression of apoptosis factors?CytC and AIF.

Objective To investigate the effect of thyroid hormone on the expression of NF-κB and TNF-oα in the ischemic cortex of rats after focal cerebral ischemia-reperfusion.Methods 96 male SD rats were randomly divided into sham-operation group,sham-operation+T3 group,IR group and IR+T3 group.Using suture legal method to establish a rat model of middle cerebral artery occlusion for 2 h followed by reperfusion.In sham-operation+T3 group and IR+T3 group,T3 was given 3 days before ischemia and 1 hour after ischemia,respectively,intraperitoneal injection T3 10 μg/100 g for rats.Rats in other groups were given the same volume normal saline at the same time.The infarct size was determined by TTC staining at 24 h after reperfusion.HE staining was used to observe the morphological and structural changes of brain tissue.Using Real-time PCR method and immunohistochemical staining method to detect the expression of NF-κB mRNA,TNF-α mRNA and protein in ischemic cortex of rats.Results Compared with sham-operation group and sham-operation+T3 group,the pathological damage of brain tissue in IR group was obvious,while the pathologic damage of IR +T3 group was less than that in IR group.Immunohistochemistry assay showed that the expression of NF-κB was(49.19±5.55)in sham-operation group,(45.75±2.12) in sham-operation+T3 group,(56.88±2.23)in IR group and(50.25±1.67)in IR +T3 group,the expression of TNF-α was (22.50±3.07) in sham-operation group,(24.13±2.03) in sham-operation+T3 group,(37.25±2.82) in IR group and (30.25±1.67) in IR +T3 group,and the NF-κB,TNF-α in IR group were obviously higher than that in sham-operation group and sham-operation+T3 group(P＜0.05),while IR+T3 group were lower than that in IR group(P＜0.05).Real-time PCR showed that NF-κB mRNA,TNF-α mRNA level in IR group was the highest,which was higher than that of sham-operation group and sham-operation+T3 group(P＜0.05),and the NF-κB mRNA,TNF-oα mRNA expression in IR+T3 group were significantly decreased compared with that in IR group(P＜0.05).Conclusion Thyroid hormone has a protective effect on cerebral ischenia reperfusion injury,which may be achieved by reducing the expression of inflammatory factor NF-κB and TNF-oα.

Objective To investigate the neuroprotective effect of thyroid hormones T3 on cerebral ischemia-reperfusion injury in rats and its mechanism.Methods SD rats were divided into four groups:sham+saline group,sham+T3 group,MCAO+saline group,MCAO+T3 group.The cerebral ischemia-reperfusion injury rat models were established by right middle cerebral artery occlusion.Thyroid hormones(10 μg/100 g)or normal saline were given respectively by intraperitoneal injection twice at 1 h after the onset of ischemia and 6 h after reperfusion.Neurobehavioral score was evaluated at 24 h after reperfusion;TTC staining was used to label infarction area;RT-PCR was used to detect the mRNA level of nerve growth factor(NGF)and brain derived neurotrophic factor(BDNF)in brain tissue;Western blot was employed to determine alterations in protein levels of NGF and BDNF.Results Compared with MCAO+saline group,the neurological deficit and the volume of cerebral infarction of MCAO+T3 group was decreased,and the mRNA and protein expression of NGF and BDNF of MCAO+T3 group were increased(P<0.05).Conclusion Thyroid Hormones could promote the nerve repair,stimulate the nerve regeneration and improve the nervous behavioral function by up-regulating the expression of NGF and BDNF.

Objective To evaluate the application of atherogenic index of plasma (AIP) and intima-media thickness of carotid artery (CA-IMT) in renal arteriolar sclerosis patients with chronic renal failure.Methods One hundred and twenty nine patients with chronic renal failure patients underwent ultrasound-guided percutaneous renal biopsy from October 2013 to June 2014,the biopsy results showed that renal arteriolar sclerosis was identified in 72 patients (atherosclerosis group) and no renal arterioles sclerosis was detected in 57 patients (non-atherosclerosis group);71 healthy adults were enrolled in the study as controls.The age,height,body weight,systolic and diastolic blood pressure,the indexes of blood lipid and renal function were documented and compared among three groups.The correlation of AIP and CBMmax of common carotid artery and carotid bifurcation with blood lipid level and renal function was analyzed.Results There was significant difference in body weight among patients with atherosclerosis [(70.77 ± 14.27) kg],without atherosclerosis [(60.63 ± 12.12) kg] and the controls [(64.20 ± 8.13) kg] (t =3.071,3.391,all P ＜ 0.05).The TG [(2.43 ± 1.61) mmol/L vs.(1.02 ± 0.37) mmol/L],TC [(7.40 ± 8.80) mmol/L vs.(4.53 ±0.67)mmol/L],LDL-C[(4.40 ±2.13) mmol/L vs.(2.85 ±0.70) mmol/L],AlP[(0.15 ± 0.351) vs.(-0.127 ± 0.184)] of the atherosclerosis group were higher than those of control group (t =5.975,2.252,2.614,-5.467,all P ＜ 0.05).The HDL-C of atherosclerosis group was lower than that of control group [(0.78 ±0.16) mmol/L vs.(1.29 ±0.21) mmol/L,t =4.750,P ＜0.05].The Scr[(117.24 ± 94.27) mmol/L vs.(64.16 ± 13.42) mmol/L],BUN [(6.73 ± 3.58) mmol/L vs.(4.66 ± 1.08) mmol/L] of the atherosclerosis group were higher,and the GFR was lower [(65.60 ±23.00)ml · min-1 · 1.73 m-2 vs.(124.78 ± 24.35)ml · min-1l.73 m-2,t =5.118] than those of control group (t =4.730,4.702).The Scr of the atherosclerosis group was higher,and the GFR was lower [(65.60 ± 23.00) ml · min-1 · 1.73 m-2 vs.(95.60±53.00)ml · min-1 · 1.73 m-2,t =3.514] than those of the non-atherosclerosis group [(117.24 ± 94.27) mmol/L vs.(71.35 ± 42.18) mmol/L,t =3.690].There were positive correlation between TG and LDL-C (r =0.828,0.323,P ＜ 0.05) and negative correlation between AIP and HDL-C (r =-0.489,P ＜0.05).There was positive correlation of CBMmax with Scr,BUN and AIP (r =0.394,0.289,0.528,all P ＜ 0.05),and negative correlation between CBMmax and GFR (r =-0.277,P ＜ 0.05).Conclusion Body weight,GFR,AIP and CBMmax are useful indicators in evaluation of renal arteriolar sclerosis in patients with chronic renal failure.AIP is a sensitive index for abnormal blood lipid level.AIP and CBMmax are important risk factors in chronic renal failure patients with renal arteriolar sclerosis.

Objective To investigate the clinical,imaging,pathological and molecular biological features of mitochondrial encephalomyopathy with lactic acidosis and stroke -like episodes(MELAS)in children.Methods The clinical,imaging,pathological and molecular biological features of 1 2 children with MELAS diagnosed through muscle biopsy or gene sequencing in the Fifth Affiliated Hospital of Zhengzhou University from January 201 1 to December 201 5 were retrospectively analyzed.Results (1 )Clinical features:the main manifestations included headache and vomiting in 1 1 cases,epileptic seizures in 9 cases,short stature in 8 cases,hairy in 7 cases,intolerance fatigue in 7 cases,cogni-tive decline in 7 cases,visual disturbance in 6 cases,hearing disturbance in 6 cases,and 5 cases had positive family history.In addition,7 cases had the serum lactic acid level increase in a rest for 1 0 min after exercise.(2)Imaging fea-tures:4 cases showed bilateral basal ganglia calcification symmetry in 8 patients who underwent head CT scan.The most frequently involved parts of the lesion were occipital in 1 0 cases,temporal in 9 cases and parietal lobe in 7 cases in stroke -like episodes.The lesions were lamellar necrosis.The abnormal areas by MRI showed low signal intensity on T1 weighted imaging,high signal intensity on T2 weighted imaging and fluid attenuated inversion recovery,high or equal signal intensity on diffusion weighted imaging,high or low signal intensity on apparent diffusion coefficient;the lactate peak significantly increased on magnetic resonance spectroscopy.The distribution was not in accordance with the control region of the cerebral vessels.Dynamic observation revealed that the lesions were reversible and migratory.(3)Myo-pathological features:muscle biopsy was performed in all children,and ragged -red fibers were found in 1 0 cases by im-proved Gomori staining,strongly succinate dehydrogenase -reactive were found in 9 cases,and the lipid droplets slight-ly increased in 8 cases by oil red O staining.Besides,the crystalline inclusion bodies in mitochondria were arranged in a parking lotpattern in 9 cases by electromicroscope.(4)Molecular biological characteristics:the mitochondrial gene mutations were analyzed in peripheral blood of 9 children and their parents,including 8 cases with A3243G muta-tion and 1 case with G13513A mutation.Five mothers had the same A3243G mutation site in 8 cases.Conclusions Children with MELAS have complex and varied clinical manifestations and certain characteristic of neuroimaging.More-over,muscle pathology and gene sequencing have important diagnostic value.Fully understanding the clinical,muscle pathology,imaging and molecular biological characteristics of children with MELAS can be helpful to the early diagnosis and treatment,also reduce misdiagnosis.

Objective:To discuss dexamethasone on proliferation of mouse thyroid follicular cells and apoptosis. Methods:Taken BALB/c mice thyroid tissue to trypsin+Ⅱcollagenase digestion organizations get thyroid follicular cells,and expression of thyro-globulin determined whether or not the target cell. Then different concentrations of dexamethasone to stimulate target cells,and the use of MTT,flow cytometry cell proliferation rate,apoptosis rate and the apoptosis-related gene expression analysis. Results: Trypsin joint type Ⅱ collagenase treatment of thyroid tissue to obtain a stable passage of thyroid follicular epithelial cells,and cells stably expressing thyroglobulin. At the same time, different concentrations of dexamethasone on cell proliferation difference was statistically significant (F=8. 544, P<0. 05 ), and the suppression of drug action have interaction ( F = 4. 532, P<0. 05 );in addition, differently dexamethasone concentration 10-6 mol/L, 10-5 mol/L, 10-4 mol/L, the apoptosis rates were 13. 39% ± 0. 79%, 17. 43% ± 1. 38%, 26. 42%±1. 74%,both with 0 mol/L to plug betamethasone 4. 51%± 0. 06% apoptosis rate differences were statistically significant (P<0. 05,P<0. 01),while the difference in the expression of apoptotic genes trend still showed a dose-dependent manner. Conclusion:Dexamethasone can effectively inhibit thyroid follicular cell proliferation and induce apoptosis through a variety of apoptotic pathways.

BACKGROUND:Urine-derived stem cels are most likely to come from the kidney tissue, and therefore, these cels are more adaptable to kidney microenvironment, providing a new option for the treatment of kidney diseases.
OBJECTIVE: To explore the therapeutic efficacy of human urine-derived stem cels on chronic nephropathy rats.
METHODS:The fresh urine samples of healthy people were colected, and then human urine-derived stem cels were extracted and cultured in vitro. Twenty Sprague-Dawley rats were used to prepare chronic nephropathy models, and given injection of human urine-derived stem cel suspension (experimental) or normal saline (control) into the renal cortex, respectively. Another 10 healthy rats were used as controls. Therapeutic effects on renal function were assessed by detection of serum creatinine level and glomerular filtration rate in the three groups. The kidney tissues of rats were taken and observed histomorphologicaly in each group.
RESULTS AND CONCLUSION: Human urine-derived stem cels were found to remarkable improve rat’s renal function as wel as reduce the histomorphological changes in the kidney tissues of rats. Compared with the control group, the serum creatinine level was decreased while the glomerular filtration rate was increased significantly in the experimental group; CD68 expression and infiltration of interstitial inflammatory cels were also markedly reduced in the experimental group. To conclude, human urine-derived stem cels can improve the renal function of chronic nephropathy rats.