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Objective:To investigate the efficacy and safety of internet-based cognitive behavioral therapy for insomnia(iCBT-I) combined with estazolam for patients with chronic insomnia.Methods:Patients with chronic insomnia were randomly assigned to treatment group which were intervened with iCBFI combined with estazolam( n=46) and control group which were intervened with estazolam ( n=43) for 8 weeks according to random number table.Pittsburgh sleep quality index (PSQI) and state-trait anxiety inventory (STAI) were used to measure the anxious state, anxious trait and sleep quality at three time points: before intervention(T1), after one month(T2) and two months(T3). Treatment emergent symptom scale (TESS), blood routine, urine routine, liver and renal function and electrocardiogram were used to measure the safety.The dosage of estazolam was compared between the two groups after two months.χ 2 test and repeated measurement analysis of variance were performed by SPSS 19.0. Results:The PSQI scores of control group and treatment group were (10.41±2.48) vs (9.98±2.96) at T2 and (9.97±2.13) vs (7.82±1.57) at T3.The state anxiety scores of control group and treatment group were (57.27±2.74) vs (56.27±2.89) at T2 and (45.67±2.62) vs (42.67±2.97) at T3.The data of T2 and T3 were statistically significant compared with those before intervention(all P<0.05). Compared with the control group, the treatment group was better on treatment efficiency(86.96% vs 69.77%) at T3( P<0.05). PSQI score, subjective sleep quality, sleep efficiency, sleep disorders, sleep drugs, daytime dysfunction, drug maintenance and adverse reaction were significantly different between the two groups at T3 ( P<0.05). Conclusions:Internet-based cognitive behavioral therapy combined estazolam for insomnia can improve sleep quality, anxious state and trait for chronic insomnia patients.Good safety was improved, as well as reducing the need of drug.So it's worthy of clinic application.
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Objective To investigate the clinical and genetic features of Diamond-Blackfan anemia (DBA).Method The clinical manifestations and genetic tests of 2 cases with DBA were retrospectively analyzed,and the related literatures were reviewed.Results Two female patient (3-4 month old) with progressive ochriasis nearly a month was included.Fever,seizure,vomit and abnormal change in urine and stool routine test were not shown.Blood routine test:the number of RBC in the two patients was decreased (1.24 × 1012/L and 1.48× 1012/L),HGB (46 g/L and 39 g/L),and the number of RTC was also decreased (4.1 × 109/L and 4.3 × 109/L),RCV was normal (108.4 fl).Serum iron determination:Fe (44.3 mmol/L and 41.5 mmol/L) and ferritin (469.2 mmol/L and 491.7 ng/mL) were increased,transferrin was in the normal range.Erythrocyte fragility test resulted normal.Bone marrow examination found rarely erythroblasts.A novel heterozygous mutation in RPS19 gene,c.91C＞T (p.P31S),was found by genetic testing on patient 1.And we found a heterozygous mutation in RPL5 gene (c.472_473del) in patient 2.Conclusion The majority of onset age of childhood DBA was within a few months with a erythroid deficiency.And RPS19 gene mutation is a common cause of this disease.The mutation of c.91C＞T (p.P31 S) has not been reported.
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18 dogs with hemorrhagic shock were divided into 3 groups. Group Ⅰwascontrol, group Ⅱ and Ⅲ were jetted with air or oxygen respectively and continuouslyoutside the glottis by HFJV (frequency 80 beat/min, driving pressure 0.2 MPa, I:E timeratio=1:2) during the uncompensated period. Results: Not much difference was foundbetween group Ⅰand Ⅱ in their blood gas, acid-base balance and plasma malondialdehyde(MDA). However, the P_aO_2, P_aCO_2, CO_2, combining power and plasma MDA in group Ⅲwere markedly higher than those of group Ⅰand group Ⅱ (P