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.

Background and objective Low-dose spiral computed tomography(LDCT)has been recommended for lung cancer screening in high-risk populations.However,evidence from Chinese populations was limited due to the dif-ferent criteria for high-risk populations and the short-term follow-up period.This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013.Methods A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017.Results of LDCT examination,and screen-detected cancer cases in all participants were obtained from the Report-ing System of the Lung Cancer Screening Program.The newly-diagnosed cases and their vital status up to December 31,2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics.Standardized incidence ratio(SIR)and 95％CI were calculated using the local population at ages of 40 or above as the reference.Proportions of early-stage cancer(stage 0-Ⅰ),pathological types,and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations.Cox regression models were applied to evaluate the hazard ratio(HR)and 95％CI of LDCT screening with all-cause death of the lung cancer cases.Results The crude and age-standardized incidence of lung cancer in screened population were 373.3(95％CI:343.1-406.1)and 70.3 per 100,000 person-years,respectively,with an SIR of 1.8(95％CI:1.6-1.9),which was observed to decrease with following-up time.The early-stage cancer accounted for 49.4％of all lung cancer cases derived from the screened population,significantly higher than 38.4％in cases from the non-screened population during the same period(P＜0.05).The proportion of lung adenocarcinoma(40.7％vs 35.9％)and 5-year survival rate(53.7％vs 41.5％)were also significantly higher in the cases from the screened popu-lation(all P＜0.05).LDCT screening was associated with 30％(HR=0.7,95％CI:0.6-0.8)reduced all-cause deaths of the cases.Conclusion The participants of the screening program are at high-risk of lung cancer.LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases,indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.

Objective:To investigate effect of inhibiting nuclear transcription factor-E2 related factor 2(Nrf2)pathway on metastasis and secretion of immune escape factors of pancreatic cancer cells under high glucose state.Methods:Human pancreatic cancer cell line Panc-1 was cultured,and treated with 5.5,10,25 and 50 mmol/L glucose.Cell proliferation rate was detected by MTT at 12 h,24 h and 48 h,respectively,and at 24 h,changes of intracellular Nrf2 expression were detected by RT-qPCR and Western blot;experimental groups included control group,high glucose(HG)group,Nrf2 inhibitor ML385+high glucose(ML385+HG)group,MTT was used to detect cell proliferation rate,cell colony formation assay was used to detect number of colonies formed,Tran-swell was used to detect number of cell migration and invasion,in vitro scratch assay was used to detect cell wound healing,ELISA was used to determine contents of vascular endothelial growth factor(VEGF),IFN-γ,transforming growth factor-β1(TGF-β1)and IL-6,distribution of intracellular Nrf2 was observed by immunofluorescence staining,Western blot was used to detect protein expres-sions of Nrf2 and heme oxygenase-1(HO-1)in cells.Results:Compared with 5.5 mmol/L glucose group,proliferation rate of Panc-1 cells was increased when treated with 10,25 and 50 mmol/L glucose for 12 h and 24 h,expressions of Nrf2 mRNA and protein were increased(P<0.05);compared with control group,proliferation rate of cells in HG group was increased,number of colonies formed was increased,numbers of migration and invasion were also increased,and rate of wound healing was increased,contents of VEGF,IFN-γ,TGF-β1 and IL-6 in cell culture supernatant were increased,Nrf2 fluorescence staining was significantly enhanced,expres-sion of Nrf2 in nucleus was increased,and protein expressions of Nrf2 and HO-1 were up-regulated(P<0.05);compared with HG group,cell proliferation rate in ML385+HG group was decreased,number of colonies formed,numbers of migration and invasion were also decreased,wound healing rate was decreased,VEGF,IFN-γ,TGF-β1 and IL-6 contents in cell culture supernatant were also decreased,intracellular Nrf2 fluorescent staining was weaken,and protein expressions of Nrf2 and HO-1 were down-regulated(P<0.05).Conclusion:Nrf2 is highly expressed in pancreatic cancer cells under high glucose state,inhibiting Nrf2 can inhibit prolifera-tion,migration and invasion of pancreatic cancer cells promoted by high glucose,and reduce secretion of immune escape factors.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

PURPOSE: Several studies have shown that the oral cavity is a secondary location for Helicobacter pylori colonization and that H. pylori is associated with the severity of periodontitis. This study investigated whether H. pylori had an effect on the periodontium. We established an invasion model of a standard strain of H. pylori in human periodontal ligament fibroblasts (hPDLFs), and evaluated the effects of H. pylori on cell proliferation and cell cycle progression. METHODS: Different concentrations of H. pylori were used to infect hPDLFs, with 6 hours of co-culture. The multiplicity of infection in the low- and high-concentration groups was 10:1 and 100:1, respectively. The Cell Counting Kit-8 method and Ki-67 immunofluorescence were used to detect cell proliferation. Flow cytometry, quantitative real-time polymerase chain reaction, and western blots were used to detect cell cycle progression. In the high-concentration group, the invasion of H. pylori was observed by transmission electron microscopy. RESULTS: It was found that H. pylori invaded the fibroblasts, with cytoplasmic localization. Analyses of cell proliferation and flow cytometry showed that H. pylori inhibited the proliferation of periodontal fibroblasts by causing G2 phase arrest. The inhibition of proliferation and G2 phase arrest were more obvious in the high-concentration group. In the low-concentration group, the G2 phase regulatory factors cyclin dependent kinase 1 (CDK1) and cell division cycle 25C (Cdc25C) were upregulated, while cyclin B1 was inhibited. However, in the high-concentration group, cyclin B1 was upregulated and CDK1 was inhibited. Furthermore, the deactivated states of tyrosine phosphorylation of CDK1 (CDK1-Y15) and serine phosphorylation of Cdc25C (Cdc25C-S216) were upregulated after H. pylori infection. CONCLUSIONS: In our model, H. pylori inhibited the proliferation of hPDLFs and exerted an invasive effect, causing G2 phase arrest via the Cdc25C/CDK1/cyclin B1 signaling cascade. Its inhibitory effect on proliferation was stronger in the high-concentration group.
Blotting, Western ; CDC2 Protein Kinase ; Cell Count ; Cell Cycle ; Cell Proliferation ; Coculture Techniques ; Colon ; Cyclin B1 ; Cytoplasm ; Fibroblasts ; Flow Cytometry ; Fluorescent Antibody Technique ; G2 Phase ; Helicobacter pylori ; Helicobacter ; Humans ; Methods ; Microscopy, Electron, Transmission ; Mouth ; Periodontal Ligament ; Periodontitis ; Periodontium ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; Serine ; Tyrosine

Objective: To evaluate the possible mediation effect of DNA methylation in the associations between birth weight and adulthood obesity in women in China. Methods: A cross-sectional survey was conducted in 1 602 women with genetic relationship in urban area of Shanghai during March-December 2016. Information about their birth weight, birth length, current lifestyle and disease history were collected and body measurement was conducted at the interview. DNA methylation at specific sites of GNASAS, IGF2, IGF2-R, IL10 and LEP were measured using bisulphite pyrosequencing. Generalized estimating equations models with restricted cubic spline functions were used to estimate the associations of birth weight with BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-hip ratio (WHtR) in adulthood, and their associations with DNA methylation were evaluated using multilevel linear models. Multilevel structural equation models were used to evaluate the mediation effect of DNA methylation. Results: A significant non-linear association was observed between birth weight and WC as well as WHtR (P<0.05). Lower birth weight was associated with higher level of methylation at IGF2-DMR (CpG1, 2), IGF2-R (CpG8, 10, 13, 16 and 17), with β coefficients and 95%CI being -4.35 (-7.30- -1.39), -4.50 (-7.59- -1.41), -2.33 (-4.60- -0.05), -1.78 (-3.88- -0.33), -2.58 (-4.82- -0.34), -2.03 (-4.00- -0.06) and -1.87 (-3.73- -0.01), respectively, but related with a lower level of methylation at LEP CpG16 (β=4.19, 95%CI: 0.37- 8.00). Lower level of methylation at IGF2-DMR (CpG7), IGF2-R (CpG3, 5, 8, 9, 10, 14, 17, 19) and LEP (CpG3, 8, 10) was associated with larger WC, with β coefficients ranging from -0.016 to -0.040 (all P<0.05). Methylation at IGF2-R CpG8 was observed to mediate the association of birth weight and WC, and could explain 3.3% of the association. Conclusion Our results suggested that DNA methylation might mediate the effect of nutrition in uteri on adulthood central obesity in women in China.

OBJECTIVE: To construct antimicrobial peptides with potent antimicrobial activity, low cytotoxicity and efficient killing rate of for prevention and treatment of dental caries. METHODS: We exploited the existing design strategies to modify reutericin 6 or gassericin A produced by species in the oral cavity based on their cationicity, amphipathicity and -helical structure. We examined their antimicrobial activities using bacterial susceptibility assay, their cytotoxicity through cytotoxicity assay and their killing rate of with time-kill assay. We further evaluated the candidate derivatives for their killing rate against , their antimicrobial activity against different oral pathogens and the development of drug resistance. RESULTS: We constructed 6 AT-1 derivatives, among which AT-7 showed an MIC of 3.3 μmol/L against , and with a killing rate of 88.7% against within 5 min. We did not obtain strains of resistant to AT- 7 after induction for 10 passages. CONCLUSIONS Hydrophobicity and imperfect amphipathic structure are two key parameters that define the antimicrobial potency of the antimicrobial peptides. The imperfectly amphipathic peptide AT-7 shows the potential for clinical application in dental caries treatment.
Anti-Infective Agents ; Dental Caries ; Humans ; Microbial Sensitivity Tests ; Peptides ; Streptococcus mutans

Objective: To study the effects of hedysarum polybotys saccharides (HPS) and selenizated hedysarum polybotys saccharides (SE-HPS) on the oral squamous cancer cell line SCC25. Methods: Different concentrations (0, 10, 25, 50, 100, 200, 400 μg/ml) of HPS and SE-HPS were added to SCC25 cells in the logarithmic growth stage. Cell proliferation was detected by the CCK-8 method, apoptosis was detected by flow cytometry, and apoptosis-related indexes were observed by RT-qPCR and Western blotting. Results : The concentrations of HPS and SE-HPS inhibited the proliferation of SCC25 cells. The inhibitory effect of 50 μg/mL HPS and SE-HPS on the proliferation of SCC25 cells was the strongest and was time-dependent. The inhibition effect significantly increased within 48 h, and the effect was achieved after 48 h. At the plateau stage, SE-HPS inhibited the proliferation of SCC25 cells more strongly than HPS (P < 0.05). The results of flow cytometry showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the apoptotic rates were 25.8% and 30.8% respectively. Compared with the control group (0 μg/mL HPS and SE-HPS), the difference was statistically significant (P < 0.05). RT-qPCR and Western blotting showed that 50 μg/mL HPS and SE-HPS acted on SCC25 cells for 48 h, and the mRNA and protein expression levels of the apoptosis gene Fas/FasL were upregulated. The difference was statistically significant (P < 0.05). Conclusion Both HPS and SE-HPS can inhibit the proliferation of SCC25 oral cancer cells, but SE-HPS is superior to HPS and can induce apoptosis through the Fas/Fasl pathway.

Objective : To investigate the current status of gingival bleeding and dental calculus in the 12- to 74-year old population in Guangdong Province with the aim of providing information to support oral health care. Methods : A stratified, multistage, random sampling design was used to obtain 7 provincially representative sample groups consisting of 8, 544 Guangdong residents aged 12, 13, 14, 15, 35-44, 55-64 and 65-74 years old with a 50/50 gender ratio. The status of gingival bleeding and dental calculus in the whole mouth was assessed according to the Guidelines of the Fourth National Oral Health Survey using a CPI probe. The resulting data were analyzed using the SAS9.2 package. Results : The prevalence of gingival bleeding in residents aged 12, 13, 14, 15, 35-44, 55-64 and 65-74 years old was 43.75%, 42.76%, 49.06%, 39.38%, 81.94%, 90.97%, and 84.03%, respectively, while the average number of teeth with gingival bleeding per person was 1.95, 2.07, 2.59, 2.39, 9.62, 10.36, and 9.98, respectively. In the 12-, 13-, 14-, and 15-year-old groups, peak prevalence was observed at age 14 (P < 0.05). In the 35-74-year-old group, the prevalence and mean number of teeth with gingival bleeding per person increased with age, and both parameters reached a peak in the 55-64-year-old group. The prevalence of dental calculus in the 12-, 13-, 14-, 15-, 35-44-, 55-64- and 65-74-year-old group was 40.57%, 41.09%, 45.05%, 54.84%, 98.96%, 97.22%, and 92.01%, respectively, and on average, each person had 1.61, 1.71, 2.14, 3.52, 20.30, 20.55, and 17.26 teeth, respectively, with dental calculus. The prevalence and mean number of teeth with dental calculus increased with age. In the 35- to 74- year-old group, the prevalence of dental calculus was higher in urban areas than in rural areas and the mean number of teeth with dental calculus was higher in males than in females. Otherwise, there were no significant differences in the prevalence or the mean number of teeth with dental calculus or gingival bleeding between urban and rural areas or between males and females. Conclusion There is a high prevalence of both gingival bleeding and dental calculus in all 7 age groups in Guangdong, indicating that poor oral hygiene and gingival inflammation are common in Guangdong Province.

Objective: To evaluate the effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes (T2DM) in China. Methods: In this cluster randomized controlled trial, a total of 799 T2DM patients with most recent hemoglobin A1c (HbA1c) ≥ 7.5% (or fasting plasma glucose level ≥10 mmol/L) were recruited from 8 communities in Minhang and Changning districts of Shanghai, and randomized into a health literacy intervention group, an exercise intervention group, a comprehensive intervention group and a control group. After baseline survey and examination, a one-year intervention and 3 times (at 3(rd), 6(th), and 12(th) month) follow-up surveys were conducted. Results: The follow-up rates for all the subjects were 99.4%, 98.4% and 95.2%, respectively, at 3(rd), 6(th) and 12(th) month. Patients in intervention groups were more likely to achieve a goal HbA1c level (HbA1c <7.0%) than those in control group, with the highest glycemic control rate (25.3%) observed in comprehensive intervention group at 3(rd) month and then in exercise intervention group (25.3% and 34.6%) respectively, at 6(th) month and 12(th) month. The average levels of HbA1c in three intervention groups were lower at each follow-up time point than those at baseline survey. However, the decreases in HbA1c were obvious only at 6(th) month (P<0.001), with ls-mean (95%CI) of -0.48% (-0.71%, -0.25%), -0.33% (-0.55%, -0.11%) and -0.70% (-0.92%, -0.48%), respectively, in comprehensive, health literacy and exercise intervention groups, but it increased slightly by 0.03% (-0.19%, 0.25%) in control group. Compared with control group, the interventions were significantly associated with the decrease of HbA1c level, with the most improvement observed in comprehensive group (β=-0.47, 95% CI: -0.73, -0.20) at 3(rd) month, and in exercise intervention group at 6(th) month (β=-0.73, 95%CI: -0.98, -0.47) and at 12(th) month (β=-0.75, 95%CI: -1.05, -0.45) of follow-up. Stratified analyses showed that patients with lower health literacy level could benefit from any intervention, while those with higher numeracy skill benefited more from exercise intervention. Conclusion: Both health literacy and exercise-focused interventions may decrease HbA1c level in patients with T2DM, which would be helpful in reducing the risks of complications and deaths in diabetes patients.
Blood Glucose/analysis* ; China ; Diabetes Mellitus, Type 2/therapy* ; Disease Management ; Exercise ; Follow-Up Studies ; Glycated Hemoglobin/analysis* ; Health Literacy ; Humans ; Patient Education as Topic ; Self Care ; Surveys and Questionnaires ; Treatment Outcome