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Objective:To explore the value of shear wave elastography (SWE) for diagnosis of sural neuropathy in patients with type 2 diabetes mellitus (T2DM). Methods:From September to December, 2017, 119 patients with T2DM were divided into diabetic peripheral neuropathy (DPN) group (n = 61) and non-DPN group (n = 58) according to the diagnosic criteria. In the same period, other 60 healthy volunteers were also recruited as normal group. They were measured the thickness, width, circumference and cross-sectional area of sural nerve, as well as the Young's modulus and shear wave velocity (SWV) with SWE. Based on the results of electrophysiology, the receiver operating characteristic (ROC) curve was drawn to determine the cut-off of the Young's modulus and SWV to differentiate DPN from non-DPN, and their area under the curve was compared. Results:The thickness of sural nerve was more in DPN group than in the normal group (P < 0.05). There were significant differences among all the groups in width, cross-sectional area, circumference, Young's modulus and SWV of sural nerves (P < 0.05). For SWE image, it was yellow-green for DPN group, dark blue for non-DPN group, and uniform light blue for the normal group. The cut-off was 51.65 kPa for Young's modulus, with the area under the curve of 0.925, sensitivity of 86.9% and specificity of 89.7%; while it was 4.15 m/s for SWV, with the area under curve of 0.923, specificity of 89.7% and sensitivity of 85.2%. The diagnostic efficiency for DPN was similar between Young's modulus and SWV (Z = 0.556, P = 0.579). Conclusion:SWE can provide useful information for clinical diagnosis of sural neuropathy after T2DM.
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Objective:The present study aim to explore the difference and characteristics of disgust in obsessive-compulsive disorder(OCD) with/without contamination washing symptoms,adding to the growing literature on the heterogeneity and clinical treatment of OCD.Methods:Totally 66 patients with OCD meeting the criteria of International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10) and 51 healthy controls matched with gender,age and level of education were recruited.All patients were divided into two subgroups namely washing symptoms group(n =26) and other symptoms group(n =40) based on the contamination washing symptoms.Participants respectively completed the lexical decision task.The results of the tasks were indicators reflecting the disgust feelings,including the accuracy,reaction time to core disgust words,moral disgust words,neutral words,and the rating intensity of disgust provoked by all of the words.Results:The reaction time for core disgust words[(723 ± 89)ms,(746 ± 95) ms vs.(676 ± 96) ms] and moral disgust words[(772 ± 98)ms,(796± 92)ms vs.(723 ± 94)ms] were longer in both group of patients with OCD than in healthy controls.The patients also rated higher degree of disgust for core disgust words[(6.7 ± 1.5),(6.9 ± 1.6)vs.(5.8 ± 1.7)]and moral disgust words [(6.8 ± 1.7),(7.2 ± 1.3)vs.(6.3 ± 1.5)] than healthy controls (Ps ＜0.05).But there were no difference existed between patients with and without contamination washing symptoms on the results of lexical decision task(Ps ＜0.05).Conclusion:It shows that patients with OCD tend to experience intense disgust feelings,and there is no difference between contamination washing symptoms and other symptoms on disgust.These findings suggest that intense disgust feelings may play a role on the etiology and maintenance of OCD,and reducing disgust could be a potential approach for OCD treatment.
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AIM: To investigate the effect of problem - based learning ( PBL) used in the teaching of medical students'evidence-based medicine ( EBM) . METHODS: Five classes ( total 147 students ) were randomly selected as experimental ( PBL ) group, at the same time, another 5 classes ( total 149 students ) were also randomly selected as control group, using traditional teaching method ( lecture-based learning, LBL ) in 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self -administered questionnaire to obtain their evaluation for PBL practice. SPSS13. 0 software was used for statistical analysis. RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable (P>0. 05). Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students (P>0. 05), for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re - evaluating the evidence, and the total scores between the two groups, there were significant statistically differences (P0. 05) in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference ( PCONCLUSION: PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.
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This study investigated the effect of phloretin (Ph) on the proliferation, activation, and cell-cycle distribution of mouse T lymphocytes and NO production and phagocytosis of macrophages. Carboxyfluorescein diacetatesuccinimidyl ester (CFDA-SE) staining plus flow cytometry assay was employed to obtain the proliferation-related index (PI) of lymphocytes. The expression levels of CD69 and CD25 on T lymphocytes stimulated with Con A were evaluated with flow cytometry after staining with fluorescent monoclonal antibody. Cell-cycle distribution of T lymphocytes was analyzed by propidium iodide staining. Griess kit was used to evaluate the NO production and fluorescent microbeads were used to analyze the phagocytosis ability of macrophages. Our results showed that phloretin (40, 60, and 80 micromol x L(-7)) significantly inhibited the proliferation of T lymphocytes and the PI reduced from 1.41 +/- 0.13 to 1.34 +/- 0.16, 1.19 +/- 0.12 and 1.07 +/- 0.06, respectively. Phloretin significantly inhibited the expression of CD69 and CD25 (P < 0.01). The cell cycle distribution analysis showed that phloretin could induce a cell cycle arrest at G0/G1 phase. NO production of LPS +IFN-gamma group of macrophages was (26.72 +/- 3.57) micromol x L(-1), and was significantly reduced by phloretin (P < 0.01). And phagocytosis rate of macrophages was significantly reduced by phloretin (P < 0.01). The results demonstrate that phloretin might be developed into a new immuosuppressive drug.