Toxicity Management and Efficacy Evaluation of BCMA-CART in the Treatment of Relapsed and Refractory Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the toxicity management and efficacy evaluation of BCMA-chimeric antigen receptor T cells(CART) in the treatment of relapsed and refractory multiple myeloma (MM).@*METHODS@#The efficacy and adverse reactions of 21 patients with MM who received BCMA-CART treatment at the First Affiliated Hospital of Wenzhou Medical University from December 2017 to September 2020 were evaluated, and the efficacy assessment and survival analysis for high-risk patients and non-high-risk patients were evaluated.@*RESULTS@#After infusion of BCMA-CART cells in 21 MM patients, the number of effective cases was 17, of which the complete remission (sCR/CR) was 10, and the partial remission (VGPR/PR) was 7. The median OS time for all patients was 19.4 months, and the median PFS time was 7.9 months. The number of patients with extramedullary disease(EMD), high-risk genetics, and ISS stage Ⅲ were 5, 15 and 8, and the effective number was 3, 11 and 6, respectively. The treatment of 3 patients without high-risk factors was effective. The median OS and median PFS of patients with EMD were 14.2 and 2.5 months, respectively, which were shorter than those of patients without EMD (19.4 months and 8.9 months, respectively). The median OS and median PFS of patients with high-risk cytogenetic factors and ISS Ⅲ were not significantly different from those of non-high-risk patients. Cytokine release syndrane (CRS) occurred in 20 patients, of which 14 cases were Grade 1 CRS, while 6 were Grade 2, no CRS of Grade 3 or above occurred. IL-6 receptor inhibitors were used in 9 patients. All CRS were controlled effectively, and no patients had neurological toxicity.@*CONCLUSION@#BCMA-CART is a certain curative effect in the treatment of relapsed and refractory multiple myeloma, and the adverse reactions can be well controlled through close monitoring and timely treatment.

Research Progress on Species Identification of Sarcosaprophagous Flies / 法医学杂志

Estimation of postmortem interval （PMI） has always been one of the difficult problems for forensic scientists. It is especially hard to estimate the PMI of highly decomposed corpses in the wild or in secluded houses with conventional methods. Therefore, application of insect evidence at the scene is usually required for estimation. Sarcosaprophagous flies of different species have totally different developmental rates. In actual cases, direct measurement of the body length of the larvae, calculation of accumulated temperature and succession stages without species identification, or calculation based on incorrect species identification would often lead to a large deviation between the calculated results and the real PMI. This mistake would also mislead the case investigation. Therefore, accurate species identification should be implemented before any PMI estimation of decomposed corpses with forensic entomological methods. This article reviews the general and ultramicroscopic species identification and molecular biological species identification methods of different stages of sarcosaprophagous flies, in order to provide new ideas and methods for related research and practice, and provide reference for the application and promotion of forensic entomology in the front line of public security.

Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging / 北京大学学报(医学版)

OBJECTIVE@#To investigate the correlation between the quadriceps cross-sectional area (CSA) and quadriceps muscle volume (QMV) at different horizontal levels from the upper edge of the patella, and to determine the best observation position.@*METHODS@#Thigh magnetic resonance imaging (MRI) images of 22 Chinese young men [age: (29±6) years] with anterior cruciate ligament (ACL) rupture were examined. The CSA was measured at 18, 15, and 12 cm above the upper edge of the pate-lla (denoted by CSA-18, CSA-15 and CSA-12 respectively), and the QMV and CSA were determined by semiautomatic segmentation. A curve model was established to estimate QMV. Bland-Altman analysis was performed to determine the confidence limits of the volumes.@*RESULTS@#On the unaffected side, the mean QMV was (1 944.45±323.77) cm3. The quadriceps CSA at the upper edge of the patella at 18, 15, and 12 cm was (80.80±12.16) cm2, (77.53±12.03) cm2, and (72.68±10.51) cm2, respectively. The coefficients of determination (R2), ascertained using curve estimation models, for the 3 positions were 0.819, 0.755, and 0.684 (P < 0.001), and the standard deviations of the volume estimated value (SEE) were 7.4%, 8.7%, and 9.8%. The fitting equations of the three horizontal positions were all good, but the fitting degree of CSA-18 was the highest. The Bland-Altman scatter plot showed that the arithmetic means of the QMV at 18, 15 and 12 cm from the upper edge of the patella 0.8 cm3, -1.1 cm3, and 0.9 cm3 and 95% limits of agreement (LoA) were (-268.8, 270.5), (-315.2, 313.1), and (-355.7, 357.5), respectively. The estimated QMV was in good agreement with the measured value. The difference between the estimated CSA-18 and measured values was the smallest. The results on the affected side were consistent.@*CONCLUSION@#The correlation between QMV and CSA in the young men with the upper edge of patella as baseline was reliable and consistent. Among them, CSA-18 had the highest correlation with the QMV. However, different observation sites could be selected for different injuries of the quadriceps.

Establishment of high-fat diet-induced obesity and insulin resistance model in rats / 北京大学学报(医学版)

OBJECTIVE@#To investigate the appropriate conditions and duration for establishing a high-fat diet-induced obesity and insulin resistance model in rats.@*METHODS@#Forty-five 6-week-old male Sprague-Dawley (SD) rats were randomly assigned into 2 groups: (1) control group (CON), (2) high-fat diet group (HFD). HFD was fed with a high-fat diet (45% kcal from fat) while CON with chow diet. After four-weeks of high-fat diet feeding, the rats of obesity resistance (OR) were eliminated according to body weight sorting, whereas obese (OB) rats were continued feeding a high-fat diet until 12 weeks. Body weight and food intake were recorded weekly. Glucose tolerance was evaluated by oral glucose tolerance test (OGTT) in 4 weeks, 8 weeks and 12 weeks. At the end of 12 weeks, insulin releasing test and visceral fat mass were measured and HE staining of the liver, adipose tissue and pancreatic tissue were conducted.@*RESULTS@#After 4 weeks of a high-fat diet, the body weight of HFD was 17.8% higher than that of CON (P=0.001), and the rate of obesity was 67.6%-78.4%. Glucose tolerance of OB rats was impaired with a higher blood glucose concentration at 120 min (P<0.001) and a higher area under the curve (AUC, P=0.037) in OGTT compared with CON. The rate of obesity and insulin-resistance rats was 79.3%. After 8 weeks of feeding, the body weight in OB was 30.4% higher than CON (P<0.001). In OGTT, blood glucose levels at 60 min and 120 min were 35.6% and 36.4% higher than those in CON (both P<0.001), and AUC was 21.7% (P<0.001) higher than that of CON. The rate of obesity and insulin-resistance rats was 100.0%. After 12 weeks of feeding, the body weight in OB was 36.9% higher than that in CON (P<0.001). In OGTT, the blood glucose levels at 60 min and 120 min were 24.8% (P=0.001) and 34.6% (P<0.001) higher than those in CON, and AUC was 16.1% (P=0.019) higher than that of CON. The rate of obesity and insulin-resistance rats was 93.3%. The insulin releasing test showed that serum insulin concentration at each time point (0, 30, 60, 120 min) was higher than that in CON, with a 6.3-times higher than that in CON at 120 min (P=0.008). Pathological changes were observed in islets and liver in the OB rats.@*CONCLUSION@#After 4 weeks of a high-fat diet (45% kcal from fat) feeding in six-weeks SD rats, the rats of OR were eliminated. Impaired glucose tolerance was found in OB rats after 4 weeks of feeding, and the rate was higher after 8-12 weeks of high-fat diet feeding.

Effects of chlorogenic acid on glucose tolerance and its curve characteristics in high-fat diet-induced obesity rats / 北京大学学报(医学版)

OBJECTIVE@#To observe the effect of chlorogenic acid (chlorogenic acid, CGA) on the glucose tolerance and its curve characteristics in high fat diet-induced obesity (diet-induced-obesity, DIO) rats, so as to provide scientific grounds for the development and utilization of CGA in early prevention and reversal of prediabetes.@*METHODS@#Eight of forty-six male Sprague-Dawley rats were randomly selected as the normal diet group (CON group), and the rest were fed with high-fat diet. After 4 weeks, 24 high-fat-induced obese rats were screened according to the criteria and then randomly divided into high fat diet group (HFD group), 50% CGA group and 98% CGA group. The CGA groups received intragastric administrations of 50% CGA and 98% CGA orally via a gavage needle once a day for 8 weeks, respectively, while the CON and HFD groups received a carrier solution (phosphate buffer saline, PBS). Their body weights were measured weekly and oral glucose tolerance test (OGTT) was performed every 4 weeks. Fasting insulin and insulin release were measured at the end of the study. Meanwhile, HOMA-IR and visceral fat percentage were calculated. Histopathological examination by hematoxylin and eosin staining method were evaluated in the pancreatic tissues.@*RESULTS@#Before the intervention of chlorogenic acid, blood glucose levels 120 min after glucose loading (P<0.05) and AUC-G (P<0.05) were increased in the HFD group when compared with the CON group, and the time to glucose peak was delayed after 4 weeks of chlorogenic acid intervention (P<0.05). After 8 weeks of intervention, the HOMA-IR index, the insulin levels at 0 min, 30 min, 60 min, and 120 min after glucose loading and AUC-I increased (P<0.05), and the histopathological examination showed obvious hyperplasia of pancreatic islets (P<0.05). Compared with the HFD group, there was no significant change in glucose tolerance and glucose peak time in 50%CGA and 98%CGA groups at the end of 4 weeks of intervention. However, after 8 weeks of intervention, OGTT-60min,OGTT-120min blood glucose (P<0.05) were lower, HOMA-IR index and OGTT-0min, OGTT-120min serum insulin level decreased (P<0.05), the time to glucose peak shifted to an earlier timepoint (P<0.05), abnormal islet hyperplasia attenuated (P<0.05) in 50% CGA and 98% CGA groups. Also, the OGTT-30min serum insulin level was decreased (P<0.05) in 50% CGA group.@*CONCLUSION@#Delay in time to glucose peak during the OGTT was one of the manifestations of impaired glucose tolerance in DIO rats, and 50% and 98% CGA could improve the glucose tolerance and delay in glucose peak time.

Effect of Shaoyaotang on Expressions of TLR4, NF-κB p65 and IL-6 in Rats with Damp-heat Ulcerative Colitis / 中国实验方剂学杂志

Objective:To explore the mechanism of Shaoyaotang in the treatment of ulcerative colitis (UC) based on toll-like receptor 4 (TLR4)/nuclear factor kappaB (NF-κB) signaling pathway. Method:A total of 50 Wistar rats were selected, including half male and half female. The damp-heat UC rat model was replicated by the methods of the combination of diseases and syndromes and the combination of 2, 4, 6-nitrobenzene sulfonic acid (TNBS) and ethanol. After the successful modeling, the model rats were randomly divided into model group, salazulesulfonate group, and low, medium and high-dose Shaoyaotang groups, and 10 rats (half male and half female) were selected as the blank control group. Low, medium and high-dose Shaoyaotang groups were given 6, 12, 24 g·kg-1 by gavage, and salazonyl arsenic group was given 1 g·kg-1 by gavage. Blank control group was given the equal volume of normal saline for 21 consecutive days. Colon samples were collected after the last administration, and the expressions of TLR4, NF-κB p65 and IL-6 mRNA in colon tissues were detected by fluorescent quantitative polymerase chain reaction (Real-time PCR）, and the expressions of TLR4, NF-κB p65 and IL-6 protein in colon tissues were detected by Western blot. Result:Compared with the blank control group, the relative expressions of TLR4, NF-κB p65, IL-6 mRNA and protein in the model group were significantly increased (P<0.05). Compared with the model group, the expression levels of TLR4, NF-κB p65 and IL-6 mRNA and protein in the salazopyridine group and Shaoyaotang groups were significantly decreased (P<0.05). Conclusion:Shaoyaotang can inhibit the development of UC by regulating the expressions of TLR4, NF-κB p65 and IL-6 mRNA and proteins in the TLR4/NF-κB pathway.

Application of Internet-based Interventions in Weight Management / 中国医学科学院学报

Overweight and obesity are associated with a range of chronic diseases and have become a major global health concern. With the progress of Internet technology,electronic health care has emerged,providing new tools and Methods for weight management. Internet-based technology has shown certain effectiveness in facilitating interventions on overweight,obesity,and their associated diseases. This article reviews the recent advances in these interventions and evaluates their effectiveness,efficiency,and feasibility.

Effect of Cognitive Behavioral Therapy Versus Interpersonal Psychotherapy in Patients with Major Depressive Disorder: A Meta-analysis of Randomized Controlled Trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Practice guidelines have recommended cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) as the treatment of choice for major depression disorder (MDD). However, whether one therapy is better than the other remains inconclusive. The aim of this study was to compare the treatment efficacy of the two treatment approaches for MDD.</p><p><b>METHODS</b>Using the terms "cognitive behavior therapy or cognitive therapy or CBT or CT or cognitive behavioral therapy" and "interpersonal psychotherapy or IPT," we systematically searched PubMed, Psyclnfo and Chinese National Knowledge Infrastructure databases up to February 2017. The language was restricted to be English and Chinese. Therapeutic outcomes, characteristics, and research quality were then extracted and analyzed independently. In accessing the included studies, we followed the criteria suggested by the Cochrane Handbook for Systematic Reviews of Interventions.</p><p><b>RESULTS</b>Data for 946 patients from 10 randomized controlled trials were included in the study. Methodological quality was not optimal in most trials. Meta-analysis showed a mean difference (MD) of -1.31, 95% confidence interval (CI) (-2.49, -0.12) (P < 0.05) in favor of CBT according to the Beck Depression Inventory (BDI), and however, we did not found any statistically significant difference between CBT and IPT on the Hamilton Rating Scale for depression (HRSD) (MD -0.90, 95% CI [-2.18, 0.38]). Subgroup analyses for the studies in which patients were treated only by psychotherapy (MD -1.26, 95% CI [-2.78, 0.35]) and for those which offered more sessions of therapies (MD -0.82, 95% CI [-2.23, 0.59]) showed there was no significant difference between CBT and IPT according to BDI.</p><p><b>CONCLUSIONS</b>Differences in treatment efficacy seem to vary according to different outcome measures. CBT shows an advantage over IPT for MDD according to BDI, and there is no significant difference between the two according to HRSD. These results should be interpreted with caution.</p>

Effects of Preoperative Isokinetic Eccentric Training and Whey Protein Isolate Supplement on Quadriceps Strength and Knee Function in Patients with Anterior Cruciate Ligament Rupture / 中国医学科学院学报

Objective To explore the effect of preoperative isokinetic eccentric training with or not whey protein isolate supplement before operation on lower limb muscle strength and knee function in patients with anterior cruciate ligament (ACL) rupture. Methods A total of 22 male volunteers aged 18-40 years with ACL rupture were recruited in outpatient service. With randomized block design,subjects were randomly assigned to isokinetic eccentric training (IE) group and isokinetic eccentric training with whey protein isolate supplement (IE+WPI) group. The IE group received isokinetic eccentric training of the injured limb on an isokinetic dynamometer under the guidance of physiatrist in laboratory before operation. There were 3-4 sets per day with 8-10 repetitions for each set,twice a week,with at least one day between sessions. The IE+WPI group were supplied with whey protein isolate 22 g per day on the basis of isokinetic eccentric training,taking breakfast or 30-60 minutes after the training. The intervention lasted for 6 weeks. Isokinetic muscle strength of limbs,the function and laxity of knee,the circumferences of thigh and knee,and the body composition were measured before and after the treatment. Results Compared with baseline,the peak torque (PT) of isokinetic-eccentric contraction (IE group:41.0%,P=0.018;IE+WPI group:46.7%,P=0.008) and the concentric contraction (IE group:29.6%,P=0.018;IE+WPI group:38.9%,P=0.038) of quadriceps in the two training groups significantly increased after isokinetic eccentric training. The Lysholm score increased significantly in IE+WPI group compared with baseline (P=0.018). Conclusions Isokinetic eccentric training before operation for ACL rupture patients can increase the strength of quadriceps and improve the function of knees. Protein isolate supplement can improve such effect.

Job burnout and its influencing factors among technical employees in enterprises / 中国职业医学

OBJECTIVE: To investigate the job burnout level and its influencing factors among technical employees in enterprises and to provide prevention and intervention measures. METHODS: Using the cross-sectional investigation method,849 mechanic employees in enterprises from 10 manufacturing companies in Guangdong province were selected as study subjects. The Maslach Burnout Inventory-General Survey was used to investigate their job burnout situation. RESULTS: Among the 849 technical employees in enterprises,the rate of job burnout was 65. 1%( 553 /849). The median and interquartile range of the job burnout total score,emotional exhaustion,cynicism,low sense of achievement scores were2. 6( 0. 9),2. 4( 1. 6),2. 0( 2. 0) and 3. 0( 1. 8) respectively. The binary logistic regression analysis results indicated that the risks of job burnout,emotional exhaustion and cynicism for the groups of employees who were not satisfied with their job and had no mental health education were increased( P < 0. 01). The risks of job burnout and low sense of achievement for the group of employees who didn't confide to others were increased( P < 0. 05). The risk of emotional exhaustion for the group of employees who ≤19. 0 years of age was increased( P < 0. 05). The risk of low sense of achievement for the male group of employees and who ≤2 years of seniority was increased( P < 0. 05). CONCLUSION: The main influencing factors of job burnout among the technical employees in enterprises are work satisfaction and psychological education experiences in technical schools. Thus,job satisfaction improvement as well as more experiences of psychological education in technical school can alleviate their job burnout.

An epidemiological survey of attention deficit hyperactivity disorder in school-age children in Shenzhen / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) and behavior problems among school-age children in Shenzhen City of Guangdong.</p><p><b>METHODS</b>A total of 10553 students in Grades 1-6 from different primary schools in Shenzhen City were assessed by Conners Parent Symptom Questionnaire (PSQ) and Conners Teacher Rating Scale (TRS). Children showing abnormalities according to PSQ or TRS were further assessed according to the diagnostic standard for ADHD as laid out in the diagnostic and statistical manual for mental disorders- 4th edition (DSM-Ⅳ).</p><p><b>RESULTS</b>A total of 8193 PSQ and TRS assessments were completed. The children were aged from 7 to 13 years. The total prevalence rate was 7.60% by PSQ and 5.59 % by TRS. Four hundred and forty-two children were diagnosed having ADHD by DSM-Ⅳ, with a prevalence rate of 5.39%. There were significant differences in the prevalence rate of ADHD among children aged 7 to 13 years (χ2=21.613, P<0.05). In children aged 7 to 9 years, the prevalence rate was higher (above 6%). The prevalence rate of ADHD in boys was significantly higher than in girls (6.65% vs 3.12%; P<0.05). Impulsion and hyperactivity (79.6%), learning (60.6%) and conduct disorders (52.0%) were the main behavioral problems in children with ADHD. The prevalence of learning disorders was higher in girls than in boys. Conclusions The prevalence rate of ADHD in children from primary schools in Shenzhen City is 5.39%, and it is higher in children aged 7 to 9 years. Boys have a higher prevalence rates of ADHD than girls. Impulsion and hyperactivity, learning and conduct disorders are common problems in children with ADHD.</p>

Value of serum brain natriuretic peptide in the diagnosis of hyperthyroid heart disease in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the value of serum brain natriuretic peptide (BNP) in the diagnosis of hyperthyroid heart disease in children.</p><p><b>METHODS</b>Fifty-eight children with hyperthyroidism were assigned to two groups according to their cardiac functions: hyperthyroid heart disease (n=28) and hyperthyroidism alone (n=30). Thirty healthy children served as the control group. Serum BNP level, left ventricular ejection fraction (LVEE) and E/A ratio were measured before and after treatment. The diagnostic value of BNP was evaluated in children with hyperthyroid heart disease.</p><p><b>RESULTS</b>The serum BNP level in the hyperthyroid heart disease and the hyperthyroidism alone groups before treatment was significantly higher than that in the control group (P<0.05), while the LVEF and the E/A ratio were significantly lower than those in the control group (P<0.05). Serum BNP level was positively correlated with the TT3 (r=0.801, P<0.05) and TT4 levels (r=0.578, P<0.05) and negatively with the LVEF (r=-0.48, P<0.05) and the E/A ratio (r=-0.35, P<0.05) in the hyperthyroid heart disease group. The serum BNP, TT3 and TT4 levels in the hyperthyroid heart disease and the hyperthyroidism alone groups were reduced and the LVEF and the E/A ratio increased significantly three months after treatment (P<0.05). When serum BNP level of >323.62 pg/mL was proposed as a cutoff point, the sensitivity, specificity, positive predictive value and negative predictive value were 92.86%, 90.00%, 89.66% and 93.10% respectively for the diagnosis of hyperthyroid heart disease.</p><p><b>CONCLUSIONS</b>BNP may serve as a reliable marker for the diagnosis of hyperthyroid heart disease in children. Serum BNP level along with the LVEF and the E/A ratio may be useful in the evaluation of the severity and the cardiac function in children with this disease.</p>

Comparison of mental health state and psychological capacities between college students with and without siblings / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the differences in mental health state and psychological capacities between Chinese college students with and without siblings.</p><p><b>METHODS</b>The psychological status and capacities were evaluated with SCL-90, the Self-Esteem Scale, Spheres of Control Scale, Security Questionnaire and Cattell 16-PF Questionnaire in 427 college students, and among the students who presented valid responses, 139 with and 139 without siblings were selected for this comparative study.</p><p><b>RESULTS</b>The total score and average score of SCL-90 in college students without siblings were significantly lower than those in students with siblings (P<0.05); the scores of factors C, E, and F of 16-PF were significantly higher but the score of factor O significantly lower in the former group (P<0.05). The scores of certainty in control, interpersonal security and total score of security were significantly higher in the students without siblings (P<0.01).</p><p><b>CONCLUSION</b>The mental health state and some of the psychological capacities are generally better in college students with siblings than in those without siblings.</p>

Effects of doxazosin enantiomers on alpha-adrenoceptors of isolated rabbit blood vessels / 药学学报

Doxazosin, a high selective alpha1-adrenoceptor antagonist, is considered as the first-line therapy for the patients with benign prostatic hyperplasia (BPH) and also produce several side effects in cardiovascular system. In this study, we observed the isometric vasoconstrictive responses of the rabbit isolated arterial rings to electric field stimulation and noradrenaline ( NA ) to study the effects of R-doxazosin ( R-DOX ) and S-doxazosin ( S-DOX ) on the alpha1-adrenoceptor-regulated vasoconstrictive responses in the rabbit isolated ear artery, mesenteric artery and pulmonary artery, and the effects of higher concentration of S-DOX and R-DOX on presynaptic alpha2-adrenoceptor-regulated purinergic vasoconstriction in the rabbit isolated saphenous artery. We found that R-DOX and S-DOX competitively inhibited the vasoconstriction induced by NA in the rabbit isolated ear artery, mesenteric artery and pulmonary artery. The pA2 values of R-DOX and S-DOX against NA in the rabbit isolated ear artery, mesenteric artery and pulmonary artery were 7. 91 +/- 0. 03 and 7. 53 +/- 0. 05, 7. 80 +/- 0. 05 and 7. 29 +/-0. 07, 8. 32 +/- 0. 06 and 7. 97 +/- 0. 07, respectively. The pA2 values of R-DOX in the three arterial preparations were significantly higher than those of S-DOX (P < 0. 01). R-DOX and S-DOX at the concentrations of 0. 1 - 10 micromol x L (-1) did not affect the vasoconstriction induced by electric stimulation in the rabbit isolated saphenous artery. R-DOX and S-DOX at 100 micromol x L(-1) in the rabbit isolated saphenous artery completely inhibited the vascular responses to exogenous NA, but did not affect the vascular responses to exogenous adenosine triphosphate (1 mmol x L(-1) ). It is reasonable to suggest that R-DOX and S-DOX competitively inhibit the vasoconstriction induced by NA in the rabbit ear artery, mesenteric artery and pulmonary artery, and the pA2 values of S-DOX are significantly lower than those of R-DOX. The higher concentration (10 micromol x L(-1)) of R-DOX and S-DOX does not affect the presynaptic alpha2-adrenoceptors at sympathetic nerve terminals of the rabbit saphenous artery.

A Survey about Psychosomatic Symptoms and Related Psychosocial Factors of Nursing Students in Military School / 中国心理卫生杂志

Objective:To study the relationship between psychosomatic symptoms and psychosocial factors of nursing students in military school.Methods:469 nursing students of a military medical school were investigated by SCL-90,EPQ,PSSS,Coping style inventory and self-esteem scale and so on.Results:Nursing students had lower SCL-90 score than the norm of Chinese female and that of military medical students.Their SCL-90 score correlated with EPQ-E、EPQ-L negatively and EPQ-N、EPQ-P positively.It also correlated with passive coping style positively; with positive coping style,self-esteem negatively.Conclusion:Nursing students of military school have less psychosomatic symptoms than medical students.The influential factors are similar to other populations.

Clinical Aspects and Treatment of Enuresis Companied with Spina Bifida Occulta in Children / 实用儿科临床杂志

Objective To investigate the clinical states of enuresis children companied with spina bifida occulta(SBO)and study the efficient way of treatment.Methods The children with SBO were check out by X ray from a total of 121 children with bedwetting.Their parents were asked to complete the enuresis questionnaires.Urine routine test and B-ultrasound examination about kidney,bladder and ureter were also asked to be done.The clinic data of the 49 children were attained and analyzed.They were randomly divided into 2 groups,and given the controlled treatment.Group A[used 1-deamino-8-D-arginine vas-opressin(DDAVP)only] and group B(used DDAVP plus oxybutynin plus bladder training)treated for 12 weeks.Results There were totally 49 bedwetting children companied with SBO,and most of them(44 cases,89.8%)were severe type(bedwetting times≥7 times/week).Some of them coexisted with frequency,urgency,gentle urgency incontinence and microscopic hematuria(22 cases).Thirty cases were found the functional bladder capacity(FBC)decrease by B-ultrasound.The cure rates were 58.3%(group A)and 88.0%(group B)respectively.The relapse rates were 36.8%(group A)and 12.5%(group B)respectively after stopping treatment for 3 months.Conclusions SBO accounts for considerably higher rate in enuretic children.It might cause the disability of bladder function.The treatment plan with DDAVP plus oxybutynin plus bladder training can not only increase the cure rate but also lower the relapse rate.