Drug addiction is a major medical and social issue globally,but there is still a lack of ideal clinical treatments.Glucagon-like peptide-1(GLP-1),a key gut-brain peptide,and its receptor agonists have been approved for the treatment of type 2 diabetes and obesity.In recent years,the role of GLP-1 receptor agonists in combating drug addiction has received increasing attention.Based on an overview of the GLP-1 system and its receptor agonist,this article reviews the role of GLP-1 receptor agonists in drug addiction at both the nonclinical and clinical levels by focusing on addictive psychoactive substances(including alcohol,tobacco,cocaine,opioids,and amphetamines).Future developments are also predicted to provide new clues to the mechanism of drug addiction and development of therapeutic drugs.

Objective:At present,the doctor-patient relationship is tense.The prevalence of negative emotions,such as depression and anxiety,among healthcare workers is increasing every year.Negative attitudes of medical workers toward mental problems may aggravate the doctor-patient conflict and psychological problems of medical workers.This study aims to explore the complex network relationships between outpatient medical workers'attitudes toward mental problems,doctor-patient relationships,and their depression/anxiety levels. Methods:A total of 578 outpatient medical staff from the Second Xiangya Hospital of Central South University(167 males,411 females)completed questionnaires on their attitudes toward mental problems,doctor-patient relationships,and depression/anxiety symptoms.Network analysis was conducted separately to construct the"attitude towards mental problems-doctor-patient relationship network"and"depression-anxiety related network". Results:The edge between"M15(insulting words)"and"D8(waste time)"showed the strongest strength in the"attitude towards mental problems-doctor-patient relationship network",and"M15(insulting words)"had the highest bridge strength in the network.For the analysis of emotional variables,"P1(anhedonia)"showed the most obvious association with"D10(communication difficulties)"in the doctor-patient relationship and"M2(poor quality of life)"in the psychiatric attitudes,and"P1(anhedonia)"was the key bridge symptom in the network. Conclusion:The"insulting words"may be an intervention target for medical workers'attitudes toward mental problems.The"anhedonia"in depression is the potential symptom that needs to be treated.Intervention targeting these variables may be beneficial to improve the mental health level of medical workers and the doctor-patient relationship.

Hypercalciuria, as a common clinical feature of kidney stones, is a common feature of hereditary diseases such as idiopathic hypercalciuria, autosomal dominant hypocalcaemia, Bartter's syndrome, Dent disease, hereditary hypophosphataemic rickets with hypercalciuria, infantile hypercalcaemia, familial hypomagnesemia with hypercalciuria and nephrocalcinosis, hereditary distal renal tubular acidosis, However, the clinical phenotypes and genotypes of these hypercalciuric kidney stones have their own characteristics. We summarized the results of recent genetic studies on hypercalciuria to promote clinical screening, diagnosis and reasonable treatment.

With continuous improvement of people's living standards, great efforts have been paid to environmental protection. Among those environmental issues, soil contamination by petroleum hydrocarbons has received widespread concerns due to the persistence and the degradation difficulty of the pollutants. Among the various remediation technologies, in-situ microbial remediation enhancement technologies have become the current hotspot because of its low cost, environmental friendliness, and in-situ availability. This review summarizes several in-situ microbial remediation technologies such as bioaugmentation, biostimulation, and integrated remediation, as well as their engineering applications, providing references for the selection of in-situ bioremediation technologies in engineering applications. Moreover, this review discusses future research directions in this area.
Biodegradation, Environmental ; Humans ; Hydrocarbons ; Petroleum ; Soil ; Soil Microbiology ; Soil Pollutants

Objective:To determine the biomechanical stability of atlantoaxial and occipitocervical fixations with unilateral spinous process screw plus contralateral pedicle screw.Methods:After nonlinear finite element models of the intact upper cervical spine (C0-3) were constructed and validated, they were processed into 3 kinds with normal axis anatomy, a high-riding vertebral artery and a thin axis lamina, re-spectively.In the models, the odontoid fracture stabilized by atlantoaxial fixation and the atlas fracture sta-bilized by occipitocervical fixation were simulated.In the atlantoaxial fixation, the group of unilateral spinous process screw+contralateral pedicle screw+bilateral atlas lateral mass screws (spinous process screw group) was compared with that of bilateral axis pedicle screws+bilateral atlas lateral mass screws (pedicle screw group); in the occipitocervical fixation, the group of unilateral spinous process screw+contralateral pedicle screw+occipital screws (spinous process screw group) was compared with that of bilateral axis pedicle screws+occipital screws (pedicle screw group).Three different techniques in insertion of spinous process screws (horizontal, oblique and vertical) were applied.The range of motion (ROM) was measured in extension-flexion, lateral flexion and rotation of occipitocervical bodies (C0-C3) after internal fixation.Results:Compared with the intact models, the ROMs of extension-flexion, lateral flexion and rotation of C1-C2 were obviously reduced in the spinous process screw group and the pedicle screw group in the models with atlantoaxial and occipitocervical fixations.In the atlantoaxial fixation, the ROMs of extension-flexion, lateral flexion and rotation of C1-C2 were greater in the spinous process screw group than in the pedicle screw group; in the occipitocervical fixation, the spinous process screw group had greater ROM of lateral flexion of C1-C2 and greater ROM of rotation of C0-C2 than the pedicle screw group.There were unobvious differences in insertion of spinous process screws between the horizontal, oblique and vertical techniques.Conclusions:In the atlantoaxial and occipitocervical fixations, the unilateral spinous process screw plus contralateral pedicle screw can provide as fine stability as the bilateral axis pedicle screws.In the atlantoaxial fixation, the bilateral axis pedicle screws may lead to better stability of C1-C2 than the unilateral spinous process screw plus contralateral pedicle screw.In the occipitocervical fixation, the bilateral axis pedicle screws may lead to better stability of C1-C2 in lateral flexion and rotation than the unilateral spinous process screw plus contralateral pedicle screw. The 3 different techniques in insertion of spinous process screws lead to an unobvious difference in the stability of C1-C2.

Objective To report the clinical results of surgical treatment of fracture of the anteromedial facet of the coronoid process in terrible triad injury.Methods Of the 59 patients with terrible triad injury of the elbow,17 were surgically treated for fracture of the anteromedial facet of the coronoid process from July 2010 to July 2014.They were 12 men and 5 women,from 29 to 70 years of age (average,50 years).By the Mason classification for the radial head fractures,2 cases were type Ⅰ,13 type Ⅱ and 2 type Ⅲ;by the O'Driscoll classification for coronoid process fractures,one was type Ⅰ,14 were type Ⅱ and 2 type Ⅲ.All patients were treated through combined approaches.The lateral Kocher approach was used to fixate or replace the radial head and to repair the lateral ligament complex;the anteromedial approach was used to fixate the coronoid process fracture and to explore and repair the medial collateral ligament if necessary.Fracture union,implant loosening,ectopic ossification,regression and articular alignment were assessed on the postoperative X-rays.At final follow-ups,the elbow function was evaluated using Mayo elbow performance score (MEPS) and Broberg & Morrey grading system for traumatic arthritis.Results The average follow-up duration for the 17 patients was 32 months (range,from 24 to 60 months).Final follow-ups showed that the mean arc of flexion-extension was 97° (from 70° to 120°),the mean extension limitation 23° (from 0 to 40°),the mean arc of forearm rotation 139° (from 90° to 145°),the mean pronation 71° (from 60° to 90°)and the mean supination 67° (from 60° to 85°).The MEPT scores averaged 87 points (from 80 to 100 points),yielding 7 excellent,8 good and 2 fair cases.By the Broberg & Morrey grading,there were 4 cases of grade 1 and one of grade 2.No evidence of elbow instability,nonunion or implant failure was found.Ectopic ossification around the elbow happened in 4 cases,transient ulnar nerve palsy was found in one,and the Kirschner wire was removed operatively in 2 because it had loosened after fracture union.Conclusion The treatment of anteromedial coronoid fractures in terrible triad injury should be anatomically reduced through direct exposure and fixated rigidly.

Objective To explore the classification system and outcomes of surgical treatment for terrible triad of the elbow.Methods Data of 42 patients with terrible triad elbow injuries who were surgically treated between 2009 and 2015 were retrospectively analyzed.There were 29 males and 13 females with a mean age of 47 years at the time of injury.42 patients of terrible triad injuries were classified into four types:type ⅠA,ⅠB,Ⅱ,Ⅲ,and Ⅳ injuries.Type ⅠA and Ⅱ injuries were treated through an isolated lateral approach,while type ⅠB,Ⅲ and Ⅳ injuries were treated by a combined lateral and anteromedial approach.Operative treatment consisted of repair or replacement of the radial head,repair of the lateral collateral ligament (LCL) and coronoid fracture fixation.Type ⅠA injuries were treated with radial head and LCL repair without coronoid fixation.Type Ⅳ elbow injuries were treated with medial collateral ligament (MCL) repair.Elbow functional status was evaluated using the Mayo elbow performance score (MEPS).Results There were three patients with type ⅠA injuries,7 patients type ⅠB injuries,15 type Ⅱ injuries,10 type Ⅲ injuries,and 7 type Ⅳ injuries.The average follow-up period was 30 months (range,24-56 months).All fractures of coronoid got union at average 11.5 months except for type ⅠA injuries.40 patients with fractures of radial head got union at average 12.4 months and two patients underwent radial head replacement without loosening.The mean flexion-extension arc was 107°±22°,the mean flexion contracture was 20°±10° and the mean flexion was 127°±14°.The average forearm rotation arc was 145°±14°,which included an average pronation of 73°±8° and an average supination of 71°±9°.The mean MEPS was 89±9 points (range,55-100 points),with excellent results in 24 elbows,good result in 17 and poor result in one;the excellence rate was 97％ (41/42).Thirteen patients had radiographic signs of arthrosis according to the Broberg-Morrey system (9 elbows were grade 1 and 4 were grade 2).5 patients had evidence of heterotopic ossification,of which four had minimal periarticular ossification and did not require additional surgery.The remaining patient showed significant heterotopic ossification and required an elbow release.1 patient with type Ⅲ injury developed transient median nerve paralysis and got full recovery after conservative treatment for 8 weeks.1 patient with type Ⅲ injury developed ulnar neuropathy and required an anterior ulnar nerve transposition.2 patients,who had shifting hardware but still achieved union,required a second surgery to remove the implant:one patient had a Kirschner wire shift from the radial head at 6 months after surgery,and the other had a loose screw in the coronoid process at one year after surgery.Conclusion Our classification system of terrible triad of the elbow may provide a guide for the selection of an ideal surgical approach and treatment modality.

Japanese gastric cancer treatment guidelines list options for treatment of each stage of early gastric cancer (EGC).The treatment of EGC is closely related to the lymph node metastasis, and the accurate prediction of lymph node metastasis is related to the choice of the treatment options and the prognosis of the patients.The lymph node metastasis of EGC is evaluated according to the clinicopathological factors, imaging,molecular markers and sentinel lymph node (SLN) tracer biopsy.A two-step method for the management of EGC treated with endoscopic mucosal resection/endoscopic submucosal dissection (EMR/ESD) is recommended.While for those EGC patients not suitable to receive EMR/ESD, imaging or molecular marker and SLN tracer biopsy technology are applied to determine lymph node status.

OBJECTIVETo analyze interpersonal sensitivity level and influencing factors among patients in methadone maintenance treatment.

METHODSFrom 2010 June to 2011 June, the research was performed in Center of Methadone Maintenance Treatment of Nanjing Baixia District Hospital. A total of 272 methadone maintenance treatment was studied using a self-designed questionnaire, interpersonal sensitivity scale in symptom check list (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS). If interpersonal sensitivity level ≥ 2 points, it was positive. In this study, through independent sample t test, analysis of the social demographic characteristics, depression and anxiety, interpersonal sensitivity level. Non conditional logistic regression analysis was used to explore a variety of factors, and the relationship of these factors with interpersonal sensitivity.

RESULTSThe depression score, the anxiety score and the level of interpersonal relationship sensitivity in 272 methadone maintenance treatment (1.65 ± 0.51, 47.66 ± 8.58, 42.38 ± 9.40) was higher than the national norm (1.65 ± 0.51, 41.88 ± 10.57, 29.78 ± 0.46) (t values were 8.23, 17.63 and 22.27, respectively; all P values < 0.001). In 272 methadone maintenance treatment, the percentage of men was 75.0% (204/272) and the percentage of women was 25.0% (68/272). SDS score of male and female was (48.38 ± 8.30) and (45.90 ± 9.34) points (t = 5.67, P = 0.037); Aged 20-29, 30-39, 40-49 and ≥ 50 years old group, SDS scores were (48.26 ± 7.59), (47.73 ± 8.38), (47.79 ± 9.22) and (48.09 ± 6.33) points (F = 3.90, P = 0.046); According to the drug's time, divided into 1-3, 4-6 and ≥ 7 years group, SDS scores were (45.92 ± 7.47), (47.41 ± 7.57) and (48.07 ± 8.57) points (F = 4.49, = 0.039). SAS score of male and female was (41.21 ± 9.53) and (42.91 ± 9.42) points (t = 2.23, P = 0.043). The positive rate of interpersonal sensitivity was 47.1% (128/272). Multivariate analysis showed that, with SDS and SAS scores increased by 1, respectively, interpersonal sensitivity increased 23.23 (8.62-96.68) and 11.97 (6.42-19.27) points.

CONCLUSIONInterpersonal sensitivity level in methadone maintenance treatment was higher than normal and depression; anxiety and depression both were the risk factors of interpersonal sensitivity level.

Adult ; Anxiety ; Depression ; Female ; Humans ; Interpersonal Relations ; Male ; Methadone ; therapeutic use ; Middle Aged ; Opiate Substitution Treatment ; psychology ; Risk Factors ; Surveys and Questionnaires ; Young Adult

Objective To analyze interpersonal sensitivity level and influencing factors among patients in methadone maintenance treatment. Methods From 2010 June to 2011 June, the research was performed in Center of Methadone Maintenance Treatment of Nanjing Baixia District Hospital. A total of 272 methadone maintenance treatment was studied using a self-designed questionnaire, interpersonal sensitivity scale in symptom check list (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS). If interpersonal sensitivity level ≥2 points, it was positive. In this study, through independent sample t test, analysis of the social demographic characteristics, depression and anxiety, interpersonal sensitivity level. Non conditional logistic regression analysis was used to explore a variety of factors, and the relationship of these factors with interpersonal sensitivity. Results The depression score, the anxiety score and the level of interpersonal relationship sensitivity in 272 methadone maintenance treatment (1.65 ± 0.51, 47.66 ± 8.58, 42.38 ± 9.40) was higher than the national norm(1.65 ± 0.51,41.88 ± 10.57, 29.78 ± 0.46) (t values were 8.23, 17.63 and 22.27, respectively; all P values<0.001). In 272 methadone maintenance treatment, the percentage of men was 75.0% (204/272) and the percentage of women was 25.0% (68/272). SDS score of male and female was (48.38 ± 8.30) and (45.90 ± 9.34) points (t=5.67,P=0.037);Aged 20-29, 30-39, 40-49 and ≥50 years old group, SDS scores were (48.26 ± 7.59), (47.73 ± 8.38), (47.79 ± 9.22) and (48.09 ± 6.33) points (F=3.90, P=0.046); According to the drug's time ,divided into 1-3, 4-6 and ≥7 years group, SDS scores were (45.92 ± 7.47), (47.41 ± 7.57) and (48.07 ± 8.57) points (F=4.49,=0.039). SAS score of male and female was (41.21 ± 9.53) and (42.91 ± 9.42) points (t=2.23, P=0.043). The positive rate of interpersonal sensitivity was 47.1%(128/272). Multivariate analysis showed that, with SDS and SAS scores increased by 1, respectively, interpersonal sensitivity increased 23.23 (8.62-96.68) and 11.97 (6.42-19.27)points. Conclusion Interpersonal sensitivity level in methadone maintenance treatment was higher than normal and depression;anxiety and depression both were the risk factors of interpersonal sensitivity level.