Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To investigate the effect of tofacitinib on early atherosclerosis of patients with systemic lupus erythematosus and explore the possible relationship between lupus nephritis and early atherosclerosis of systemic lupus erythematosus.Methods:Sixteen 8-week-old female MRL/lpr mice with a body weight of 20~25 g were selected and randomly divided into the treatment group and placebo group, with 8 mice in each group. The treatment group diluted tofacitinib by normal saline, and given at a dose of 10 mg·kg -1·d -1, and the placebo group (starch tablets) administered the medication in the same way as the treatment group for a total of 8 weeks. The ELISA method was applied to detect serum anti-dsDNA antibody levels in the two groups of mice. Bradford method protein concentration was used to determine the level of urine protein in mice. Automatic biochemical analyzer was used to detect blood lipids, urea nitrogen, serum creatinine, complement C3, complement C4 levels. Western blotting was used to determine the protein expression levels of monocyte chemoattractant protein-1 (MCP-1), non-receptor protein tyrosine kinase family 1 (JAK1), signal transducer and activator of transcription 1 (STAT1) and signal transducer and activator of transcription 2 (STAT2) in aortic and kidney tissues. After the aortic arch section were prepared, oil red O was used to stain the sections, and the vascular plaque area and intimal thickness were evaluated by ImageJ software. The kidneys were dissected and stained with HE, and the active lesions of lupus nephritis were evaluated using the glomerular activity scoring system. SPSS 23.0 software was used for statistical analysis, in which the between-group comparison was performed using two independent samples t-test, and the correlation analysis was performed using the Spearman method. Results:①The serum anti-dsDNA antibody expression level in the treatment group [(5.2±1.0) U/ml] was lower than that in the placebo group [(6.9±1.2) U/ml], ( Z=-3.07, P=0.008), and the levels of complement C3 and complement C4 were higher than those in the placebo group [(293±10) mg/L vs. (260±19) mg/L, Z=2.72, P=0.017]; (16±6) mg/L vs. (8±9) mg/L, Z=3.78, P=0.006]. There was no significant difference in serum BUN and Scr between the treatment group and the placebo group [(10.6±0.7) mmol/L vs. (11.5±1.1) mmol/L, Z=-1.96, P=0.071; (17±5) μmol/L vs. (22±6) μmol/L, Z=-1.79, P=0.095]. ② Compared with the placebo group, the levels of LDL, TC and TG in the treatment group decreased [(0.83±0.15) mmol/L vs. (1.08±1.05) mmol/L, Z=-3.95, P=0.001; (2.90±0.08) mmol/L vs. (1.81±0.97) mmol/L, Z=-5.17, P=0.001; (1.10±0.08) mmol/L vs. (1.60±0.42) mmol/L, Z=-3.23, P=0.013], and HDL level increased [(2.02±0.99) mmol/L vs. (1.81±0.97) mmol/L, Z=4.42, P=0.001]. ③ Compared with the placebo group, the levels of aortic MCP-1, JAK1, STAT1 and STAT2 in the treatment group were reduced [(0.17±0.30) vs. (0.23±0.05), Z=-3.06, P=0.009; (0.83±0.09) vs. (1.05±0.19), Z=-3.07, P=0.008; (0.77±0.07) vs. (0.94±0.13), Z=-2.83, P=0.014; (0.70±0.07) vs. (0.82±0.09), Z=-2.83, P=0.013], the aortic plaque area and aortic intimal thickness were lower than those in the placebo group [(12±31) μm 2vs. (1 242±1 101) μm 2, Z=-3.12, P=0.016; (63±7) μm vs. (82.10±8.06) μm, Z=-5.13, P<0.001]. ④ Compared with the placebo group, the urine protein level and glomerulonephritis activity score in the treatment group were decreased [(0.08±0.03) mg/mL vs. (0.20±0.11) mg/mL, Z=-3.08, P=0.015; (1.79±0.38) vs. (2.79±0.14) points, Z=-7.08, P<0.001)], and renal tissue MCP-1, JAK1, STAT1.Compared with the placebo group, STAT2 levels were reduced [(0.364±0.040) vs. (0.425±0.021), Z=-3.85, P=0.003; (0.689±0.074) vs. (0.838±0.068), Z=-4.19, P=0.001; (0.508±0.070) vs. (0.646±0.019), Z=-2.85, P=0.015; (0.618±0.062) vs. (0.740±0.101), Z=-2.94, P=0.013. ⑤ The glomerular mobility scores of the two groups were positively correlated with LDL, TCHO, TG, aortic plaque area and aortic intimal thickness ( r=0.51, P=0.043; r=0.79, P<0.001; r=0.64, P=0.008; r=0.82, P<0.001; r=0.74, P=0.001), and negatively correlated with HDL ( r=-0.53, P=0.036). The urine protein levels in the two groups were positively correlated with LDL, TC, TG, aortic plaque area and aortic intimal thickness ( r=0.67, P=0.004; r=0.68, P=0.004; r=0.53, P=0.033; r=0.80, P<0.001; r=0.74, P=0.001), and negatively correlated with HDL ( r=-0.57, P=0.021). Conclusion:The severity of lupus nephritis is correlated with atherosclerosis and dyslipidemia in the early stage of systemic lupus erythematosus. Tofacitinib may reduce the degree of early arteriosclerosis and lupus nephritis in MRL/LPR mice, and reduce blood lipid levels, which may be effective in improving the prognosis of SLE and improving the survival rate of patients.

Objective To evaluate the impact of flash glucose monitoring(FGM)system on glycemic control and adverse pregnancy outcome in pregnant women with type 2 diabetes mellitus(T2DM).Methods This prospective,open-label,randomized,controlled clinical trial involved 109 women with T2DM at 16～18 weeks of gestation who visited Liaocheng People's hospital and Liaocheng Women and Children Hospital from June 2018 to June 2022.They were randomly assigned to FGM group(54 cases)and control group(55 cases).The FGM group wore FGM at 20,24,28 and 32 weeks of pregnancy respectively.The Con group underwent self-monitoring of blood glucose(SMBG).Both groups adjusted insulin doses based on blood glucose monitoring results.HbA1c was measured at 18 weeks and 36 weeks of pregnancy.Information related to adverse pregnancy outcomes was compared between the two groups.Results Fasting and postprandial glucose and HbA1c were significantly lower in FGM group compared with con group(P<0.05).Neonatal hypoglycemia was significantly lower in FGM group(P<0.05).There was no difference between the two groups in terms of BMI,insulin dose,gestational week of delivery,Apgar score,neonatal weight and the incidence of preeclampsia,premature delivery,polyhydramnios,cesarean section,SGA,macrosomia and postpartum hemorrhage(P>0.05).Time in range(TIR),time below range(TBR),time above range(TAR),and mean amplitude of glucose excursion(MAGE)were significantly improved at 32 weeks compared to 20 weeks in FGM group(P<0.05).Conclusions Repeated intermittent use of FGM in pregnant women with T2DM could reduce the blood glucose level and the incidence of neonatal hypoglycemia.

RBM46 is a germ cell-specific RNA-binding protein required for gametogenesis, but the targets and molecular functions of RBM46 remain unknown. Here, we demonstrate that RBM46 binds at specific motifs in the 3'UTRs of mRNAs encoding multiple meiotic cohesin subunits and show that RBM46 is required for normal synaptonemal complex formation during meiosis initiation. Using a recently reported, high-resolution technique known as LACE-seq and working with low-input cells, we profiled the targets of RBM46 at single-nucleotide resolution in leptotene and zygotene stage gametes. We found that RBM46 preferentially binds target mRNAs containing GCCUAU/GUUCGA motifs in their 3'UTRs regions. In Rbm46 knockout mice, the RBM46-target cohesin subunits displayed unaltered mRNA levels but had reduced translation, resulting in the failed assembly of axial elements, synapsis disruption, and meiotic arrest. Our study thus provides mechanistic insights into the molecular functions of RBM46 in gametogenesis and illustrates the power of LACE-seq for investigations of RNA-binding protein functions when working with low-abundance input materials.
Animals ; Mice ; 3' Untranslated Regions/genetics* ; Cell Cycle Proteins/metabolism* ; Gametogenesis/genetics* ; Meiosis/genetics* ; Nuclear Proteins/genetics* ; RNA-Binding Proteins/genetics*

Objective:To analyze the serum levels of integrin-associated proteins (CD47) in patients with rheumatoid arthritis (RA), and to explore its association with disease activity and bone destruction in RA.Methods:Serum and clinical data were collected from 65 RA patients and 25 healthy subjects. RA patients were grouped into low, moderate, and high bone erosion groups according to 7-joint ultrasonography score (US7). The levels of serum CD47, thrombospondin-1 (TSP-1) and receptor activator of nuclear factor-κB ligand (RANKL) were measured by enzyme-linked immunosorbnent assay (ELISA) in patients with RA and healthy subjects. The statistical analysis was carried out with independent t-test, analysis of variance, nonparametric rank sum test, pearson or Spearman correlation and logistic regression. Results:① The Serum levels of CD47, TSP-1, and RANKL were higher in the RA group than in the healthy controls ( P<0.01). ② In RA patients, serum CD47 level was positively correlated with disease course ( r=0.301, P<0.05), C-reactionprotein (CRP)( r=0.316, P<0.05), number of tender joints (TJC) ( r=0.254, P<0.05), number of swollen joints (SJC) ( r=0.316, P<0.05), disease activity score in 28 joints (DAS28) ( r=0.255, P<0.05), RANKL ( r=0.252, P<0.05) and TSP-1 ( r=0.260, P<0.05). Serum TSP-1 level was positively correlated with CRP ( r=0.299, P<0.05), TJC ( r=0.335, P<0.01), DAS28 ( r=0.315, P<0.05), RANKL ( r=0.305, P<0.05). ③ The disease course [ OR(95% CI)=1.048(1.033, 1.017)] and TSP-1 [ OR(95% CI)=1.013(1.000, 1.026)] were independently relevant factors affecting bone destruction. Conclusion:CD47 levels is significantly higher in RA patients than in healthy controls, and is associated with disease activity and bone destruction. CD47 may be involved in the bone destruction process of RA by acting on TSP-1.

Hepatic alveolar echinococcosis (AE) is a parasitic disease with biological characteristics similar to malignant tumor. It has no obvious clinical symptoms in the early stage. Most patients have complications such as jaundice, ascites and gastrointestinal bleeding when they see a doctor. At this time, the course of disease is at an advanced stage. In addition, the incomplete resection of the AE lesion(s) leads to a high postoperative recurrence rate, which has a serious impact on the physical and mental health of patients. Based on the summary of the latest research at home and abroad and the analysis of blood supply, microvascular invasion and vascular growth factor expression in the "infiltrating zone" adjacent to the lesions of hepatic AE, this article has a deep understanding of the occurrence and development process of hepatic AE, aiming to better guide clinical practice and improve the quality of life of patients.
Humans ; Echinococcosis, Hepatic/surgery* ; Quality of Life ; Physical Examination

Objective:To Studythe extracellular matrix metalloproteinase inducer (CD147) changes in patients with systemic lupus erythematosus (SLE), and to study thecorrelation of CD147 level and athero-sclerosis in SLE.Methods:Eighty patients with SLE in total were divided into intimal thickening group, (24 cases, group A) and normal intimal group (56 cases, group B) according to carotid intimamedia thickness (IMT) checked by carotid ultrasonography. In addition, their age, bodymass index, blood pressure, seral total cholesterol (TC), high density liptein cholestero (HDL-C), low density lipoprotein cholestero (LDL-C), triglyceride (TG), urinary protein quantitative test(24 h), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anticardiolipin antibody, serum creatinine level, course of the disease, and treatment regimens were collected. Thirty-five healthy people were set as the control group (group C). The levels of serum CD147 were measured by enzyme-linked immuno sorbent assay (ELISA) in 3 groups. The correlation between the serum CD147 level of SLE patients and atherosclerosis was analyzed. The statistical analysis was carried out with independent t-test, chi-square test, analysis of variance, Spearman correlation and Logistic regression. Results:① Levels of serum CD147 in group A [ (238±30) pg/ml] were significantly higher than those in group B [(198±30) pg/ml] and group C [(150±26) pg/ml, F=67.908, P<0.01]. ② Body mass index, hypertensive ratio,total blood cholesterol,urine protein quantitative test (24 h), systemic lupus erythematosus disease activity index (SLEDAI), serum CD147 index in group A were significantly higher than those in group B ( P<0.05). ③ In Logistic regression analysis, serum CD147 [ OR (95% CI)=1.039(1.014, 1.065), P<0.05], urine protein quantitative (24 h) [ OR (95% CI)=2.598(1.033, 6.534), P<0.05] were independently relevant factors affecting carotid artery IMT. Conclusion:Serum CD147 is an independent risk factor for carotid intimamedia thickness in SLE patients.

Objective To analyze the hemodynamic parameters of anomalous origin of the right coronary artery from the left coronary artery sinus (AORL) based on computational fluid dynamics (CFD), so as to make an evaluation of the disease. Methods A normal right coronary artery (RCA) case and an AORL case were selected. Two models were reconstructed in Mimics software and imported into ANSYS CFX software for hemodynamics simulation. The hemodynamics of normal RCA model and AORL model were compared. Results AORL model had a smaller volume flow (9.35 cm3/s), which might lead to insufficient blood supply downstream of the RCA; the pressure at the acute corner of AORL model (13.78 kPa) was lower than normal RCA model (14.9 kPa); the wall shear stress (WSS) of AORL model (12.83 Pa) was larger than that of normal RCA model (9.74 Pa); the total deformation of AORL model was relatively large. Conclusions The entrance velocity and pressure of AORL were lower than those of normal RCA, which might lead to ischemic symptoms. The research findings are of theoretical significance for the effective evaluation of ischemia and other diseases in clinic.

Objective:To study the distribution of FC γ receptor ⅢB gene polymorphism in the Han population in the Yellow River Delta, and to explore the correlation between the gene polymorphism of multiple loci and the susceptibility and clinical phenotypes of systemic lupus erythematosus (SLE).Methods:From January 2017 to December 2017, 144 SLE patients in the Affiliated Hospital of Binzhou Medical College of Shandong Province were selected as the experimental group and 150 healthy people as the control group. Whole blood samples, clinical data and laboratory examination test data were collected. Genomic DNA was extracted by single base extension polymerase chain reaction (PCR) technology and single nucleoside was extracted by mass spectrometry. The relationship between the polymorphism of each point of FC γ receptor ⅢB gene and the susceptibility and clinical phenotypes of SLE was analyzed by χ2 test with SPSS 25.0 software. Results:① The frequencies of CT and TT genotype at rs115878669 were 50.7%, 64.0%, 23.6% and 10.0% respectively in the test group and the control group, the difference was statistically significant ( χ2=5.3, P=0.021; χ2=9.8, P=0.002); The frequencies of TT genotype at rs147574249 were 17.4% and 8.0% respectively in the test group and the control group, the difference was statistically significant ( χ2=5.9, P=0.016); The frequencies of GG and GA genotype at rs199705513 were 20.8%, 10.0%, 59.0%, 70.0%, the difference was statistically significant ( χ2=6.7, P=0.010; χ2=3.9, P=0.049); The frequency of CA genotype at rs77717968 was 30.6% and 46.0% in the test group and the control group, respectively, the difference was statistically significant ( χ2=7.4, P=0.007). ② In the experimental group, the frequencies of heterozygous CT genotypes at rs115878669 were 37.2% and 56.4% in the blood system affected group and the unaffected group, respectively, the difference was statistically significant ( χ2=4.5, P=0.035). In the thrombocytopenia group and the normal platelet normal count group, the frequencies of AG genotypes at rs114531649 were 79.2% and 50.0%, respectively, the difference was statistically significant ( χ2=6.8, P=0.009) and GG genotypes were 4.2% and 25.8%. The difference was statistically significant ( χ2=4.3, P=0.039). The frequency of CC genotype at rs147574249 was 4.2%, 25.8% respectively. The difference was statistically significant ( χ2=5.4, P=0.020). The frequency of CT genotype was 79.2%, 56.7% respectively. The difference was statistically significant ( χ2=4.2, P=0.040). The frequency of CT geno-type at rs115878669 was 70.8%, 46.7%, respectively. The difference was statistically significant ( χ2=4.7, P=0.031). The frequency of AA genotype at rs199705513 was 4.2%, and 23.3%, the difference was statistically significant ( χ2=4.6, P=0.033), the frequency of AA genotype at rs77717968 was 4.2%, 26.7%, and the difference was statistically significant ( χ2= 4.5, P=0.033), the frequency of TT genotype was 25.0%, 9.2%, the difference was statistically significant ( χ2=4.8, P=0.028). There was no statistical significance difference in other comparisons ( P>0.05). The GG genotype frequencies of rs114531649 and the CC genotype frequencies of rs147574249 were 31.2% and 15.7%, respectively. The differences were statistically significant ( χ2=4.9, P=0.027). The AA geno- type frequencies of rs199705513 were 29.5% and 13.2%, the difference was statistically significant ( χ2=5.8, P=0.016), the CC genotype frequency of homozygote at rs61803007 was 32.8%, 16.9%, the difference was statistically significant ( χ2=4.9, P=0.026), the TC genotype frequency of heterozygote was 67.2%, 83.1%, the difference was statistically significant ( χ2=4.9, P=0.026), the AA genotype frequency of homozygote at rs77717968 was 31.2%, 16.9%, respectively, the difference was statistically significant ( χ2=4.1, P=0.044), and there was no significant difference in other comparisons ( P>0.05). The frequency of TC genotype in rs146653557 was 39.4% in serositis group and 75.0% in non serositis group, the difference was statistically significant ( χ2=4.3, P=0.037), the other differences were not statistically significant ( P>0.05). The frequency of CG genotype in rs428194 group and rs61803004 group was 53.8% and 22.9% respectively, the difference was statistically significant ( χ2=12.7, P=0.000 4). The frequency of GG genotype in rs428194 group was 46.2% and 77.1%, 46.2% and 78.1% in rs61803004 group respectively, the difference was statistically significant ( χ2=12.7, P=0.000 4; χ2=13.7, P=0.000 2). The frequencies of GT genotype were 46.2% and 21.0%. The differences were statistically significant ( χ2=9.0, P=0.002 7). The frequency of TT genotypes was 7.7% and 1.0%, the difference was statistically significant ( χ2=4.8, P=0.029). The frequencies of CT genotypes at rs61803008 were 46.2% and 23.8% respectively, the difference was statistically significant ( χ2=6.8, P=0.009 2). The frequencies of TT genotypes were 46.2% and 74.3%. The difference was statistically significant ( χ2=10.1, P=0.001 5). Conclusion:There is a significant correlation between Fc gamma receptor ⅢB gene related loci and SLE susceptibility and clinical phenotypes.

Objective To explore the level of serum hypoxia-inducible factor (HIF)-1α and the effect of pantoprazole on HIF-1α in patients with gouty arthritis.Methods Subjects were divided into acute gouty arthritis (group A),intermittent gouty arthritis (group B) and healthy controls (group C).Patients in group A were divided into mild (A1) and severe (A2) subgroups according to the severity of inflammation.Levels of serum HIF-1α in the three groups,and the levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in group A1 and group A2 were detected by enzyme-linked immunosorbent assay (ELISA).Patients in group A2 were randomly divided into three groups,saline 100 ml/twice a day,20％ pantoprazole 100 ml,twice a day and 40％ panto-prazole 100 ml,twice a day were administered respectively.After 7 days,the levels of serum HIF-1α were measured by ELISA.One-way analysis of variance (ANOVA) and two independent sample t test were conducted in this study.Results ① Levels of serum HIF-1α in group A [(48±13) ng/L] were significantly higher than those in group B [(40±12) ng/L,P＜0.01] and group C [(28±12) ng/L,F=29.838,P＜0.01].② Levels of serum HIF-1α [(56±10) ng/L],IL-1β [(51 ±13) ng/L] and TNF-α [(161 ±45) ng/L] in the experimental group A2 were higher than those in the experimental group A1 [HIF-1α:(42±11) ng/L,t=4.600,P＜0.01;IL-1β:(42±12) ng/L,t=2.552,P＜0.05;TNF-α:(122±34) ng/L,t=3.432,P＜0.01].③ Levels of HIF-1α [(26±6) ng/L],IL-1β [(23±4) ng/L],TNF-α [(92±6) ng/L] in the 40％ pantoprazole group were lower than those in 20％ pantoprazole 100 ml,twice a day group [HIF-1α:(33±4) ng/L];IL-1β:(30±5) ng/L;TNF-α:(102±7) ng/ L] and saline group [HIF-1α:(37±5) ng/L];IL-1β:(38±5) ng/L];TNF-α:(108±9) ng/L](all P＜0.05);Levels of HIF-1α,IL-1β and TNF-αin the 20％ pantoprazole group were lower than those in saline group (all P＜0.05).Conclusion ① HIF-1α may be one of the indicators of acute inflammation,which may reflect the degree of inflammation in patients with gout.② Pantoprazole can reduce the level of serum HIF-1α,IL-1β and TNF-α in patients with gouty arthritis,with a concentration dependent characterisit.