Objective:To explore the effect of electroencephalographic (EEG) biofeedback combined with buspirone on patients with schizophrenia with anxiety, in order to provide evidence-based reference for clinical treatment.Methods:From January 2018 to January 2020, 80 patients with schizophrenia and anxiety in Jinzhou Kangning Hospital were prospectively selected and divided into the study group and the control group by simple randomization, each group with 40 patients. The control group was given buspirone, and the study group was given EEG biofeedback combined with buspirone. Both were treated for 8 weeks. The efficacy, adverse reactions and the Positive and Negative Symptoms Scale (PANSS) and Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Scale (PSQI), Scale of Social Function in Psychosis Inpatients (SSPI), Barthel Index (BI) score, and serum neuroendocrine index thyroid stimulating hormone (TSH), cortisol (Cor) levels before treatment, 4 weeks and 8 weeks after treatment were compared between the two groups.Results:After 8 weeks of treatment, the total effective rate in the study group was higher than that in the control group: 95.0% (38/40) vs. 77.5% (31/40), the difference was statistically significant (χ 2 = 5.16, P<0.05). After 4, 8 weeks of treatment, the PANSS scores in the study group were lower than those in the control group: (49.57 ± 5.65) scores vs. (57.96 ± 6.48) scores, (37.69 ± 4.35) scores vs.(45.07 ± 5.74) scores, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the HAMA and PSQI scores in the study group were lower than those in the control group, while the SSPI and BI scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the serum TSH and Cor levels in the study group were lower than those in the control group: after 4 weeks of treatment: (2.74 ± 0.84) mU/L vs. (3.35 ± 0.97) mU/L, (276.51 ± 45.96) μg/L vs. (346.42 ± 50.34) μg/L; after 8 weeks of treatment: (2.46 ± 0.72) mU/L vs. (2.82 ± 0.86) mU/L, (197.26 ± 36.84) μg/L vs. (264.19 ± 42.46) μg/L, the differences were statistically significant ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment ( P>0.05). Conclusions:EEG biofeedback combined with buspirone can enhance the therapeutic effect by regulating neuroendocrine, reduce the mental symptoms, anxiety and sleep disorders ofschizophrenia patients with anxiety. It can also improve social function and daily life ability, and have high safety.

Objective To explore the association,consistency and complications prognostic value of thromboelastography and conventional coagulation tests in detecting coagulation function of antiplatelet after endovascular treatments in patients with acute ischemic stroke.Methods A retrospective cohort survey of 240 patients,admitted to our hospital from September 2012 to December 2017,was performed.All acute ischemic stroke patients accepted coagulation function monitoring 5 d after aspirin and clopidogrel and endovascular treatments by thromboelastography (R time,K time,α angle,maximum amplitude [MA]) and routine coagulation tests (prothrombin time [PT],activated partial thromboplastin time [APTT],fibrinogen [FIB],international normalized ratio [INR],blood platelet count).The association,consistency,and sensitivity,specificity,positive predictive value,negative predictive value of complications prognostic value of thromboelastography and conventional coagulation tests were analyzed.Results (1) R time and APTT,K time and APTT,α angle and FIB,and α angle and PLT were positively correlated;K time and FIB,R time and PLT,and α angle and APTT were negatively correlated.(2) R time and APTT (κ=0.266,P=0.000),K time and APTT (κ=0.134,P=0.024),and α angle and FIB (κ=0.162,P=0.007) had agreement in identifying hypercoagulability;R time and APTT (κ=0.211,P=0.001),K time and APTT (κ=0.198,P=0.002),and blood platelet count and K (κ=0.388,P=0.000),and α angle and PLT (κ=0.099,P=0.041) had agreement in identifying hypocoagulability.(3) The sensitivity of thromboelastography and routine coagulation tests in identifying early neurological deterioration was 17.65％ and 58.82％,and the sensitivity in identifying symptomatic hemorrhages by thromboelastography and routine coagulation tests was 73.68％ and 47.39％.Conclusions Some parameters has correlations in peroperative period,and has agreement in identifying hypercoagulability and hypocoagulability.Accordingly,routine coagulation tests might be superior in evaluating early neurological deterioration,and thromboelastography might be superior in evaluating symptomatic hemorrhages in patients with acute ischemic stroke.

Objective:To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma.Methods:82 cases of pancreatic cancer combined with periampullary carcinoma patients admit ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group.The control group received palliative surgical treatment,while the observation group underwent pancreatoduodenectomy.The operation time,hospitalization time,intraoperative bleeding volume and the incidence of complications,1,2,3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups.Results:The amount of bleeding,operation time of observation group were significantly higher than those of the control group(P＜0.01),no signif icant difference was found in the hospitalization time between the two groups(P＞0.05);the incidence of complications in the observation group (41.46％) was significantly higher than the control group (22.96％)(P=0.03);the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P＜0.05),the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04),the tumor eradication rate was significantly higher in the observation group than that of the control group (P=0.04).Conclusion:Though pancreaticoduodenectomy could prolong the operation time,increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma,but it could effectively reduce the possibility of recurrence after operation,significantly improve the long-term survival rate.

OBJECTIVETo evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB device in recanalization of patients with acute ischemic stroke of posterior circulation.

METHODSThe clinical data of 17 consecutive patients with acute ischemic stroke of posterior circulation, treated with the Solitaire AB device from August 2011 to August 2015 in Department of Neurosurgery, the Military General Hospital of Beijing People's Liberation Army, were extracted and then retrospectively analyzed. There were 12 male and 5 female patients with a median age of 60 years (ranging from 44 to 75 years). Among them, 8 cases occluded in basilar artery, 4 cases occluded in vertebral artery and 5 cases occluded in vertebral plus basilar artery. Recanalization rate as well as complications after treatment were analysized. Also, neurological functions of the patients before and after treatment, measured by National Institute of Health stroke scale (NIHSS) score, were compared via t test and the clinical outcomes were assessed by modified Rankin score (mRS) at 90 days after treatment.

RESULTSFifteen patients resulted in successfully recanalization, and 2 cases failed both of whose onset to sheath time were above 7.5 hours. The NIHSS score at 7 days was 11±10, which was significantly decreased compared to the admission NIHSS score 17±5 (t=2.949, P=0.009). No symptomatic intracranial hemorrhage case was found after thrombectomy. At 90 days, one patient died(mRS 6), one patient seriously disabled (mRS 5), two patients moderately seriously disabled (mRS 4), four patients resulted in moderate outcome (mRS 3) and the other 9 patients achieved good outcome (mRS 0 to 2). The dead and seriously disabled cases were both due to failure in recanalization. Two moderately seriously disabled cases were probably attributed to their severe admission condition (NIHSS >20) and prolonged time (onset to sheath time >6 hours).

CONCLUSIONMechanical thrombectomy with the Solitaire AB device contributes to a high rate of recanalization with a low probability of complication and improves functional outcome in patients with acute ischemic stroke of posterior circulation.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Stroke ; surgery ; Thrombectomy ; Treatment Outcome

Objective To observe the influence of carotid endarterectomy in cognitive functions of patients with symptomatic carotid stenosis.Methods Forty-three patients admitted to our hospital and performed carotid endarterectomy from February 2013 to August 2014, were enrolled in the study.Cognitive functions of the patients were evaluated by Montreal cognitive function assessment (MoCA) and cerebral blood flow (CBF) by cerebral perfusion CT scan three days before and three months after operation, respectively.According to the MoCA scores after operation, the patients were divided into significant improvement group and non-significant improvement group, and their cerebral hemodynamics indexes were compared.Results (1) As compared with those before operation (24.1±2.2, 0.97±0.08), the MoCA scores (26.02±2.9) and relative cerebral blood volumes (rCBV, 1.00±0.08) three months after operation were significantly different (P＜0.05).(2) The postoperative relative CBF, rCBV and relative mean transmit time in the significant improvement group were significantly improved as compared with those preoperative indexes (P＜0.05);whereas, these values in the non-significant improvement group didn't show significant difference between preoperative and postoperative indexes(P＞0.05).Conclusion Carotid endarterectomy may help to improve the cognitive function in those patients with symtompatic carotid stenosis, and the effect might be associated with the improvement of cerebral perfusion.

10.3969/j.issn.2095-4344.2013.23.010

Objective To study the positive influence of a standard trauma system on the care of severely injured patients.Methods The severely injured patients (NISS≥16 points)were divided into study group ( in 2006-2008,after the establishment of trauma center in our hospital) and control group (in 2001-2005,before the establishment of trauma center),which was bound by the establishment of the trauma center in our hospital in January 2006.The injury severity,care and outcomes were recorded by using China Trauma Database and changes in efficiency and quality of injury care were compared.Results The study group (66 patients) and control group (260 patients) with NISS of (20.59 ±4.63)points and (20.57 ± 5.38 ) points respectively,were similar in the distribution of severity ( P ＞ 0.05 ).The emergency care time was (0.33 ± 0.03) hour in the study group,which was significantly shortened compared with (0.57 ±0.35 ) hours in the control group (P ＜ 0.01 ).The length of hospital stay was (27.64 ±29.01 ) days in the study group,which was shorter than (30.84 ± 32.87 ) days in the control group (P ＞ 0.05 ),while the length of ICU stay was (2.98 ± 5.77 ) days in the study group,longer than (2.65 ± 7.00) days in the control group (P ＞ 0.05 ).The recovery rate was significantly increased from 76.5％ to 87.9％ (P ＜0.05) and mortality was significantly decreased from 20.8％ to 9.1％ (P ＜0.05).Conclusion The study indicates that the standard first aid model can notably improve the trauma care in our hospital.

Objective To investigate the relationship between metabolic syndrome (MS) and education level in Su-Xi-Chang area to provide evidence for healthcare policy making. Methods A clustered sampling of 6798 subjects from Su-Xi-Chang areas of Jiangsu Province was included. Questionnaires and physical examinations were completed to collect clinical data. Logistic regression was used to analyze weather education level could be an independent risk factor of MS. Results Significant differences were found in waist circumstance (WC) ,systolic blood pressure (SBP) and fasting blood glucose (FBG) among participants with different education level. Significant differences were also existed in triglyceride and diastolic blood pressure (DBP) between subjects with higher and lower education level ( P＜0. 05 ). In single-factor or multivariate analysis, education level was negatively correlated with the prevalence of MS (P＜0. 05 ). Conclusions Education level may be an independent risk factor of MS. People with low and moderate education level have higher risk of MS. Therefore,it is recommended that health-related information should become an integral part of the compulsory education system.

OBJECTIVETo evaluate the mechanism and influence of thalidomide on interleukin-6 (IL-6), IL-6 receptor (IL-6R) and its transmitting chain in multiple myeloma patients.

METHODSSerum level of IL-6, expression of IL-6R on myeloma cells and IL-6R beta mRNA in multiple myeloma patients were measured by enzyme linked immunosorbent assay (Elisa), flow cytometry and reverse transcription polymerase chain reaction (RT-PCR).

RESULTSSerum level of IL-6 in multiple myeloma patients was 564.8 +/- 319.4 ng/L, with a positive rate on the myeloma cells of 33.6% before oral 200 mg/d thalidomide. They were 560.3 +/- 414.8 ng/L and 31.8% on D14 after oral 200 mg/d thalidomide, which were not significantly different as compared with those before (P > 0.05). On D14, 28, 42, 56 and 84 after oral 400 mg/d thalidomide, the serum level of IL-6 in multiple myeloma patients were 516.7 +/- 131.9 ng/L, 426.7 +/- 180.4 ng/L, 387.9 +/- 187.4 ng/L, 350.1 +/- 85.5 ng/L and 212.3 +/- 92.5 mg/L, with positive rates on the myeloma cells of 28.5%, 24.3%, 21.3%, 12.6% and 10.1%, which were all lower than those before oral 200 mg/d thalidomide (P < 0.05 or P < 0.01). Ratios before and on D14 after oral 200 mg/d thalidomide were 7.8 and 6.9, with no statistical significance (P > 0.05). Ratios on D14, 28 after oral 400 mg/d thalidomide were 5.3 and 2.7, which were lower than those before oral 200 mg/d thalidomide (P < 0.01).

CONCLUSIONReduction of serum level of IL-6 in multiple myeloma patients and decrease in IL-6R expression on the myeloma cells and IL-6R beta mRNA occur on D14 after oral 400 mg/d thalidomide. These changes become more obvious with time. The antitumor mechanism of thalidomide may be related to reduction of IL-6 serum level in multiple myeloma patients and decrease in IL-6R expression on the myeloma cells and IL-6R beta mRNA.

Aged ; Angiogenesis Inhibitors ; pharmacokinetics ; pharmacology ; Female ; Humans ; Interleukin-6 ; blood ; genetics ; Male ; Middle Aged ; Multiple Myeloma ; blood ; metabolism ; RNA, Messenger ; drug effects ; metabolism ; Receptors, Interleukin-6 ; metabolism ; Thalidomide ; pharmacokinetics ; pharmacology

AIM: To observe the cytotoxicity on myeloma cells mediated by anti-CD20 monoclonal antibody-mabthera, after heightening level of CD20 expression on myeloma cells membrane by ?-interferon. METHODS: 10 untreated(UT) and 10 relapsed or refractory(RR) MM patients'myeloma cells were cultured with human recombinant ?-interferon (hr?-IFN) at concentrations of (0-800)?10~3 U/L to heighten level of CD20 expression, then complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC) on myeloma cells mediated by mabthera were studied through MTT methods. RESULTS: When CD20 expression of UT MM and RR MM patients' myeloma cells increased after treated by hr?-IFN, 12 mg/L and 16 mg/L mabthera mediated ADCC and CDC (against) myeloma cells in group UT patients and group RR patients, respectively. CONCLUSION: After heightened level of CD20 expression on myeloma cells membrane by hr?-IFN, mabthera mediated ADCC and CDC against myeloma cells in vitro.