Objective:To explore the effects of internet-based group cognitive-behavioral therapy(IGCBT)on the depressive and anxiety symptoms in patients with major depressive disorder(MDD).Methods:Eighty pa-tients with MDD were recruited and randomly divided into IGCBT combined drug therapy group and control group with drug therapy.Blind assessments were performed using the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)three times at baseline,4 weeks after treatment and 8 weeks after treatment,respectively.Results:The effective rates of HAMD and HAMA at the end of the 4th and 8th week,and the effective rates of HAMA at the end of the 8th week were higher in the combined treatment group than those in the control group(Ps＜0.05).The total scores of HAMD and HAMA in the combined treatment group and the control group were lower at the end of the 4th and 8th week than those at baseline(Ps＜0.001).The total scores of HAMD and HAMA were lower in the combined treatment group than those in the control group at the baseline,4 weeks and 8 weeks after treatment(Ps＜0.01).Conclusion:It suggests that intemet-based group cognitive-behavioral therapy combined with antidepressant medication has a better effect on relieving depressive and anxiety symptoms in patients with ma-jor depressive disorder than drug therapy alone,and especially has a better effect on improving anxiety symptom.

Humans ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Cohort Studies ; Treatment Outcome ; Minimally Invasive Surgical Procedures ; Knee Joint/surgery* ; Knee Prosthesis ; Osteoarthritis, Knee/surgery*

This paper presents a systematic review of extant research investigating the effectiveness of Internet-based group cognitive behavioral therapy （IGCBT） for depression and anxiety symptoms with an emphasis on the treatment modalities， treatment protocols， efficacy and mechanism， together with a summary of research limitations and suggestions for future research. Cognitive behavioral therapy （CBT） is a structured， short-term and present-oriented psychotherapeutic treatment， its Internet- and group-delivered modalities have led to its wider application， and has proven to be clinically effective in alleviating depression and anxiety symptoms caused by different diseases， whereas some drawbacks have been reported. Thus this paper elaborates the clinical application， therapeutic effect and underlying mechanisms of IGCBT intervention for depression and anxiety symptoms， so as to provide references for its future application. ［Funded by the Natural Science Foundation of the Inner Mongolia Autonomous Region （number， 2019MS03038）

Objective:To compare the results of high-resolution colonic manometry (HRCM) in patients with four subtypes of constipation: slow transit constipation(STC), outlet obstruction constipation (OOC), mixed STC and OOC, and normal transit constipation(NTC), and to explore the intestinal motility characteristics of patients with different subtypes of constipation.Methods:From 20th January 2017 to 20th September 2020, the HRCM results of 225 patients with functional constipation who visited the Department of Anorectal Surgery of Tianjin Union Medical Center were retrospectively analyzed. According to the results of colonic transit test, 225 patients were divided into STC group (108 cases), OOC group (36 cases), mixed group (28 cases) and NTC group (53 cases). General information such as Wexner constipation scores, clinical symptoms (decreased desire to defecate, sensation of anorectal blockage, hand-assisted defecation, spontaneous bowel movements frequency<3 times per week), the incidence, frequency within one day (hereinafter referred to as frequency), average velocity, average wave amplitude, average duration of contraction, average length of contraction, and the dynamic index (DI) of average pressure of high-amplitude propagating contraction (HAPC), as well as the frequency, average wave amplitude, average duration of contraction, and the DI of average pressure of low-amplitude propagating contraction (LAPC) were compared among the four groups. One-way ANOVA and multiple comparison, Kruskal-Wallis test and chi-square test were used for statistical analysis.Results:The Wexner constipation scores of the STC, OOC, mixed and NTC group were 13.17±4.04, 13.97±4.55, 11.36±4.03 and 11.58±4.06, respectively, and the difference was statistically significant ( F=3.879, P<0.05). The Wexner consipation scores of the STC and OOC group were both higher than the mixed and NTC group, and the difference were statistically significant (One-way ANOVA and multiple comparison, all P<0.05). The proportion of decreased desire to defecate, sensation of anorectal blockage, hand-assisted defecation, spontaneous bowel movements frequency<3 times per week of STC, OOC, mixed and NTC group were 47.2% (51/108), 36.1% (13/36), 14.3% (4/28), 20.8% (11/53); 42.6% (46/108), 75.0% (27/36), 46.4% (13/28), 64.2% (34/ 53); 31.5% (34/108), 38.9% (14/36), 3.6% (1/28), 18.9% (10/53); 90.7% (98/108), 77.8% (28/36), 82.1% (23/28) and 62.3% (33/53), and the differences were statistically significant ( χ2=17.093, 12.463, 13.437 and 18.927; all P<0.01). The proportion of decreased desire to defecate of STC group was higher than that of mixed and NTC group, and spontaneous bowel movements frequency<3 times per week was higher than that of OOC and NTC group, and the differences were statistically significant ( χ2=10.014, 10.518, 4.418 and 19.016; all P<0.05). The proportion of sensation of anorectal blockage of OOC group was higher than that of STC and mixed group, and the proportion of hand-assisted defecation was higher than that of the mixed and NTC group, and the differences were statistically significant ( χ2= 9.511, 5.486, 10.948 and 4.363, all P<0.05). The incidence of HAPC in STC, OOC, mixed and NTC groups was 39.8% (43/108), 36.1% (13/36), 57.1% (16/28), and 60.4% (32/53), respectively, and the difference was statistically significant ( χ2=8.880, P=0.031). The incidence of HAPC in STC group and OOC group were lower than that of NTC group, and the differences were statistically significant ( χ2=6.041 and 5.050, P=0.014 and 0.025). There were no statistically significant difference in the frequency, average velocity, average amplitude, average duration of contraction, average length of contraction and DI of pressure of HAPC in four groups, and there were no statistically significant difference in the frequency, average amplitude, average duration of contraction, and DI of pressure of LAPC in the four groups (all P>0.05). Conclusions:Doctors can more clearly and objectively observe the intestinal motility characteristics of patients with different subtypes of constipation through HRCM. HRCM provides a strong basis for the diagnosis and further treatment of functional constipation, and has a high clinical application value.

Objective To measure the body surface dose under different confinations of additional filters,tube voltage and tube current and discuss the lowest amount of different additional filters,tube voltage and tube current combination for crib side X-ray radiation dose while the quality of the image is guaranteed.Methods Japan Shimadzu wireless tablet mobile DR machine and Dutch Artinis CDRAD 2.0 phantom were used.The tube voltage and tube current for children's crib side X-ray normal work were 50 kV and 1.40 mAs to get the image quality figure inverse (IQFInv),respectively.Totally four filter combinations of 1 mm A1,2 mm A1,1+2 mm A1 and 0.3 mm Cu were added to the opening of collimator system by mobile DR machine.Phantom was shot by respectively combination of 50,66,83 and 100 kV tube voltages and different tube currents.All images to get the IQFInv value,Pearson correlation and regression analysis of the influence of tube voltage and current on IQFInv value were analyzed.The IQFInv value of the additional filter corresponds to the image quality of normal work.The combination of the additional filter with the tube voltage and the tube current was also found.Swedish RTI Barracuda diagnostic level dosimeter was used to measure the entrance surface dose of these combinations after filtration,20 times for each group.Results Comparisons among different filters,tube voltage and tube current combination with quality of daily work images:the tube voltage was positively correlated with IQFInv value in the test range(r=0.49,P＜0.05),and tube current was positively correlated with IQFInv value (r=0.36,P＜0.05).As the additional filters increase,it required greater tube current to acquire the desired value of images.Meanwhile,greater additional filters would increase the difference of IQFInv of tube voltage at each level.Comparisons among different filters,tube voltage and tube current combination with daily shooting dose,and after using additional filters,entrance surface dose changed from (30.58±0.21)to (10.49±0.09) μGy.There is a significant difference between each group (t=-15.306-514.585,P＜0.05).All additional filters effectively reduced entrance surface dose.Meanwhile,as the filter and tube voltage increased,entrance surface dose showed a more significant reduction.However,when the tube voltage exceeded 83 kV,all entrance surface dose of additional filters showed an increasing trend.Conclusions Additional filter is an effective method to reduce the crib side X-ray entrance surface dose.Under the premise of ensuring image quality,additional filter with high atomic number and second high kilovolt tube voltage with paired tube current is the best condition for crib side X-ray.

Objective To investigate the protective effects of N-acetyl-L-tryptophan (L-NAT) on intestinal damage after rat hepatic ischemia reperfusion.Methods Twenty-four healthy adult rats were divided into the sham operation group (Sham),ischemia reperfusion group (IR),ischemia reperfusion and N-acetyl-L-tryptophan group(IR+L-NAT).The hepatic ischemia reperfusion model was established by occluding the afferent vessels of the left and middle lobes.The morphological structures of the small intestine were observed by hematoxylin-eosin (HE) staining.The expressions of active caspase-3,Bax and Bcl-2 were detected by immunohistochemistry staining.Results (1) In the IR group,the structure of intestinal villis was destroyed,the intestinal mucosa showed congestion and exfoliation,the epithelial cells had degeneration and necrosis,and infiltration of inflammatory cells appeared;which could be alleviated by L-NAT.(2)The immunohistochemistry showed that compared with the Sham group,the expression of active caspase-3,Bcl-2 and Bax in the IR group was increased,after L-NAT intervention,the Bax and caspase-3 expression was decreased,while the Bcl-2 expression was further increased.Conclusion L-NAT could inhibit the apoptosis of small intestinal epithelial cells caused by liver ischemic reperfusion and attenuates intestinal epithelial damage.

Objective To study the biological behavior of peripheral blood mesenchymal stem cells (PBMSCs) in 3D composite scaffolds.Methods The proliferation and chondrogenesis of rabbit PBMSCs seeded on porcine cancellous bone (DCB) scaffolds were evaluated,and bone marrow mesenchymal stem cells (BMMSCs) and articular chondrocytes (ACCs) were used as controls.Cell morphology and distribution in scaffolds were observed using scanning electron microscopy (SEM).Live/Dead staining was employed to detect cell viability,Hoechst 33258 method to measure DNA content,dimethylmethylene blue (DMMB) assay to detect glycosaminoglycan (GAG),enzyme-linked immunosorbent assay (ELISA) and immunofluorescence to detect the content of type 2 collagen (COL 2),and RT-PCR to analyze chondrogenesis-related gene expression.Results SEM showed that three kinds of cells uniformly adhered and evenly distributed in DCB scaffolds.Live/Dead staining observed the similar viability of the three kinds of cells three days after seeding (P＞0.05).There was no significant difference in the proliferation ability and DNA content among three kinds of cells after seven days of in vitro culture.After 21 days of chondrogenic culture,both PBMSCs and BMMSCs secreted more GAGs than ACCs,while the secretion of COL 2 was similar to that of ACCs.Moreover,the gene expression of AGC,COL 2 and alkaline phosphatase (ALP) were significantly up-regulated (P＜0.05) in PBMSCs and BMMSCs but significantly down-regulated in ACCs (P＜0.05).The expression of COL 1 in MSCs groups displayed an increasing trend but a decreasing trend in ACCs group (P＞0.05).The gene expression of COL 2 and ALP,but not of AGC and COL 1,in PBMSCs and BMMSCs was higher than those in ACCs (P＜0.05).Conclusions PBMSCs and BMMSCs have similarly excellent proliferation and chondrogenesis potential in 3D porous DCB scaffolds.However,hypertrophic gene expression is still observed under in vitro culturing condition,suggesting the need to further optimize the culture system.

BACKGROUNDThe tibial plateau is asymmetric with a larger medial plateau. We observed from clinical practice that the shape of the tibial plateau does not always present a larger medial plateau. Tibial plateau also showed other shapes. The purpose of this study was to analyze the anthropometric data of the proximal tibia in a large group of Chinese patients undergoing total knee arthroplasty and to investigate the morphology of the resected proximal tibial surface and its gender differences.

METHODSA total of 822 knees (164 males, 658 females) from the Chinese population were measured intraoperatively for medial anteroposterior (MAP) and lateral anteroposterior (LAP) dimensions of the resected proximal tibial surface. The difference of MAP and LAP (DML) was also calculated as MAP minus LAP. We then classified the data into three groups based on the DML (<-2, -2 to 2, and >2 mm) to analyze the morphology of the proximal tibia and its distribution between male and female.

RESULTSThe shape of proximal tibial plateau was of three types: larger medial plateau type, symmetric type, and larger lateral plateau type. There were significant differences between males and females in relation to the shape distribution of the proximal tibial plateau (P < 0.05). Most of the proximal tibial plateau was asymmetric, with 517 of 822 (62.9%) tibia having a DML >2 mm and 120 of 822 (14.6%) tibia having a DML<-2 mm. Only 185 of 822 (22.5%) tibia had a DML between -2 and 2 mm.

CONCLUSIONThe results of this study can be used as a guideline to design tibial components with different DMLs to better match the different anthropometry of the resected tibial surface.

Aged ; Anthropometry ; methods ; Arthroplasty, Replacement, Knee ; methods ; Asian Continental Ancestry Group ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Sex Factors ; Tibia ; surgery

Objective To detect the expressions and clinical significance of Nanog and CD44 protein in lung cancer. Methods The expressions of Nanog and CD44 were detected by immunohistochemistry in 50 cases of lung cancer, 32 cases of benign lesion lung tissue and 18 cases of paraneoplastic normal lung tissue. Then their relationships with clinicopathological factors were analyzed. Results The expression of Nanog in lung cancer was significantly higher than those in benign lesion lung tissue and paraneoplastic normal lung tissue (P < 0.05). There was no significant difference of the expression of CD44 among the three groups (P > 0.05). The expressions of Nanog and CD44 in squamous cell carcinomas were higher than those in adenocarcinomas and small cell lung carcinomas (P < 0.05). The expressions of Nanog and CD44 were significantly correlated with lymph node metastasis (P < 0.05), but were not correlated with age, gender, tumour size, TNM stage and differentiation of lung cancer (P>0.05). The positive correlation was also noted between the expressions of Nanog and CD44 in lung cancer (r = 0.564, P < 0.05). Conclusion Nanog and CD44 proteins may participate in the genesis and progression of lung cancer. Nanog protein is a potential diagnostic marker and therapeutic target for lung cancer.

Objective:To analyse the biological function of anti-IL-6Rβ(gp130) monoclonal antibody and its regulatory effect on IL-6 signaling.Methods:Biological characteristics of anti-IL-6Rβ(gp130) mAb were assessed by Western blot analysis, capture ELISA and peptide ELISA .The phosphorylation of STAT 3 was tested by Western blot analysis in IL-6-stimulated U266/RA-FLS/RA-PBMC with or without anti-IL-6Rβ(gp130) mAb treatment.Results:3 strains of mouse anti-human gp130 mAb were with high affini-ty and different binding epitopes , the kaff of 10A1 was 2.62E-10.In U266, RA-PBMC and RA-SFMC, IL-6 signaling highly activated STAT3 which could be inhibited by anti-gp130 mAb.Conclusion: Anti-IL-6Rβ( gp130 ) mAb might have different binding epitopes and could affect IL-6 stimulated phosphorylation of STAT3, which provides a preliminary experiment for analyse the correlation of IL-6 signaling and RA .