Construction of machine learning models for predicting the risk of postoperative distant metastasis recurrence in serous ovarian cancer / 国际肿瘤学杂志

Objective:To develop a machine model to predict the risk of postoperative distant metastasis recurrence in serous ovarian cancer (SOC) based on routine clinical data.Methods:Participants included 687 patients with recurrent SOC who underwent surgery at Yunnan Cancer Hospital from January 2010 to December 2020. According to the recurrence status, the patients were divided into the distant metastasis group ( n=105) and the non-distant metastasis group ( n=582). Logistic regression was used to screen the variables related to distant metastasis of SOC. Based on these selected variables, five machine learning methods including K-nearest neighbor (KNN), logistic regression (LR), random forest (RF), support vector machine (SVM) and extreme gradient boosting (XGBoost) were used to develop the postoperative distant metastasis risk prediction model of SOC. For model validation, the 10-fold cross-validation method was used for internal validation. The performance of the models was evaluated using the receiver operating characteristic curve. Results:There were statistically significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage ( Z=-3.81, P<0.001), perioperative chemotherapy cycle ( t=-5.11, P<0.001), lymph node metastasis ( χ2=5.98, P=0.014), peritoneal effusion cytology ( Z=-2.22, P=0.026), and neoadjuvant chemotherapy ( χ2=5.29, P=0.021) between patients in the distant metastasis group and the non-distant metastasis group. Multivariate regression analysis showed that the FIGO stage ( OR=1.54, 95% CI: 1.07-2.22, P=0.019) and perioperative chemotherapy cycle ( OR=1.22, 95% CI: 0.09-0.36, P<0.001) were independent influencing factors for postoperative distant metastasis recurrence in SOC. Peritoneal effusion cytology ( OR=1.20, 95% CI: 0.71-1.89, P=0.180) was not an independent influencing factor for distant metastasis of SOC. It was ultimately included in the construction of the model, for its inclusion could improve the area under the curve (AUC) of the model. Among the five machine learning models constructed based on the above three variables, the KNN-based model had the best performance in identifying distant metastasis of SOC, with the AUC of 0.750, sensitivity of 0.591, specificity of 0.786, and accuracy of 85.0%. The AUC of the LR model was 0.679, the sensitivity was 0.545, the specificity was 0.765, and the accuracy was 84.3%. The AUC of SVM model was 0.634, the sensitivity was 0.240, the specificity was 0.968, and the accuracy was 84.7%. The AUC of RF model was 0.575, the sensitivity was 0.905, the specificity was 0.245, and the accuracy was 84.7%. The AUC of XGBoost model was 0.704, the sensitivity was 0.567, the specificity was 0.745, and the accuracy was 84.9%. Conclusion:FIGO stage and perioperative chemotherapy cycle are independent influencing factors for postoperative distant metastasis recurrence in SOC. The KNN model established based on FIGO stage, perioperative chemotherapy cycle and peritoneal effusion cytology has high discrimination degree and accuracy rate in predicting postoperative distant metastasis recurrence of SOC.

The Clinical Manifestation, Executive Dysfunction, and Caregiver Strain in Subthreshold Attention-Deficit/Hyperactivity Disorder

Objective@#Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a “morbid condition” which also needs medical attention. @*Methods@#The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire. @*Results@#For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC. @*Conclusion@#Our present findings supported the suggestion of subthreshold ADHD as “morbid condition,” which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.

Artificial Intelligence in the Prediction of Gastrointestinal Stromal Tumors on Endoscopic Ultrasonography Images: Development, Validation and Comparison with Endosonographers

Background/Aims@#The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. @*Methods@#We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. @*Results@#A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. @*Conclusions@#We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Parenting characteristics of children with attention deficit hyperactivity disorder and conduct problems / 中华实用儿科临床杂志

Objective:To explore the parenting characteristics of children with attention deficit hyperactivity disorder (ADHD) and conduct problems.Methods:This was a cross-sectional study involving 84 ADHD children with conduct problems and 75 ADHD children without conduct problems treated in the Outpatient Department of Children′s Health and Mental Health Center, Shenzhen Children′s Hospital from September 2017 to December 2019, and 54 healthy control children (healthy children in ordinary primary and secondary schools in Shenzhen) were included.The Egna Minnen av Barndoms Uppfostran (EMBU) scale was used to access the parenting styles of participants. ANCOVA was used to compare the different score of all factors in EMBU among these 3 groups and Tukey′s post-hoc comparisons were also performed.All comparisons were corrected for age and sex. Results:Among the factor scores of EMBU scale, ADHD children with conduct problems scored significantly higher on parental and maternal harsh/punishment [Parental (22.10±4.92) scores vs.(19.40±4.01) scores vs.(17.40±2.51) scores; Maternal (15.10±3.54) scores vs.(13.70±2.78) scores vs.(12.40±1.97) scores] and the reject/deny factors [Parental(10.60±2.49)scores vs.(9.40±2.06)scores vs.(8.90±1.61)scores, Maternal(13.90±3.28)scores vs.(12.40±2.64)scores vs.(11.60±2.19)scores] than ADHD children without conduct problems and the healthy control group (all P<0.001). On parental overprotection factors, both ADHD groups scored higher than the healthy control group [(10.30±2.03) scores vs.(9.80±2.13) scores vs.(8.70±1.92) scores, P<0.001], while on maternal over-interference factor, ADHD children with conduct problem scored significantly higher than ADHD children without conduct problems and the healthy controls [(36.00±4.64) scores vs.(34.60±4.38) scores vs.(33.30±4.92) scores, P=0.009]. Conclusions:Parents of ADHD children with conduct problems tend to use more negative parenting skills like punishment, over-interference, rejection and denial.This kind of negative parenting style, to some extent, causes the conduct problems in children with ADHD.

Complex total knee arthroplasty assisted by a 3D printed patient-specific guider / 中华创伤骨科杂志

Objective:To explore the application of a 3D printed patient-specific guider (3D-PSG) in complex total knee arthroplasty (TKA).Methods:A retrospective analysis was performed of the data of 44 patients who had received complex artificial TKA for articular and extra-articular deformities of the knee from January 2016 to October 2019 at Department of Orthopaedic Surgery, Nanjing First Hospital. According to whether a 3D-PSG had been applied, the patients were divided into 2 groups. In the 3D-PSG group of 23 patients, there were 11 males and 12 females, with an age of 63.7 years ± 10.2 years (from 53 to 81 years); in the conventional group of 21 cases, there were 10 males and 11 females, with an age of 64.2 years ±12.1 years (from 51 to 79 years). In the 3D-PSG group, the preoperative CT data were 3D reconstructed for measurement of a full lower limb and design of a 3D-PSG and TKA was assisted by a 3D-PSG which had been manufactured by a 3D printer using the STL files of the 3D-PSG imported. In the conventional group TKA was performed in a standard manner. In the 3D-PSG group, the TKA surgical parameters in the preoperative plan were compared with actual surgical measurements. The 2 groups were compared in terms of operation time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, visual analogue scale (VAS), Knee Society Score (KSS), hip knee ankle (HKA), frontal femoral component (FFC), frontal tibial component (FTC), lateral femoral flexion (LFF) and lateral tibial component (LTC).Results:There were no significant differences between the 2 groups in the preoperative general data, showing comparability ( P>0.05). In the 3D-PSG group, no significant differences were found between preoperative parameters designed and actual intraoperative measurements in the prosthetic type of femoral condyle (3.4±1.1 versus 3.5±0.9) or of tibial plateau (3.1±0.9 versus 3.3±1.2), or in the filler thickness (10.6 mm ± 3.2 mm versus 10.9 mm ± 4.7 mm) ( P>0.05). The 44 patients were followed up for an average of 10.8 months (from 7 to 13 months). The 3D-PSG group had significantly less operation time (65.7 min ± 10.5 min), intraoperative blood loss (19.8 mL ±7.3 mL), postoperative drainage volume (124.6 mL ± 27.9 mL) and hospital stay (7.3 d ± 2.5 d) than the conventional group (82.4 min ± 11.7 min, 86.5 mL ± 35.7 mL, 154.6 mL ± 21.3 mL and 10.6 d ± 3.1 d) ( P<0.05). The VAS and KSS scores at postoperative day 1, week 1 and week 2 in the 3D-PSG group were significantly better than those in the conventional group ( P<0.05). Significantly more patients in the 3D-PSG group achieved approximately ideal values in HKA, FFC, FTC, LFF and LTC than those in the conventional group ( P<0.05). Conclusion:A 3D printed patient-specific guider may improve surgical accuracy, reduce operation time and achieve better surgical outcomes in complex total knee arthroplasty.

Study progress of cranioplasty for the skull defect in children / 中华实用儿科临床杂志

Skull defects in children can be caused by a variety of congenital and acquired factors.Cranioplasty is an important surgical method to reconstruct the cranial integrity, protect brain tissue and maintain the beautiful appearance of skull, which are very important to ensure the normal development of brain and psychology of children with skull defect.Due to the dynamic development of brain and skull in children, there are great controversies about the opportunity, method and material selection for repairing the skull defect.Now, the domestic and foreign research on the application of childhood cranioplasty was reviewed to provide references for further improving the treatment decisions of children with skull defects.

Efficacy of the plastic repair for over-wide eyelid fold after double eyelid plasty / 中华医学美学美容杂志

Objective:To investigate the key points of reparation and clinical effects of the over-wide eyelid fold after double eyelid plasty.Methods:The widths of double eyelids were measured for 28 patients who were unsatisfied with their over-wide double eyelids even after surgery. The maximum width was 12 mm, the minimum width was 6.5 mm, with average of 8.59 mm. The major repair methods of simply over-wide double eyelids were used to release adhesion and reduce the width. The repair methods of complexly over-double eyelids were to release adhesion, and to reduce the width; at the same time, fat transplantation and filling, orbital septal fat transfer, shortening of levator palpebrae superioris muscle, anterior fixation of levator palpebrae superioris muscle aponeurosis or correction of upper eyelid retraction should be also performed.Results:After the over-wide double eyelids were repaired, the width of double eyelids was obviously reduced; the double eyelids were more natural and asymmetrical. The upper eyelid was no longer sunk and the cornea exposure rate was greatly improved. 26 patients were satisfied with their surgical results. One patient was dissatisfied with the surgical result affected by the skin which was thin and not elastic. One patient required doctors to get the eyelids slight wider.Conclusions:It is of referential significance to define the clinical characteristics and major shortcomings of over-wide double eyelid for determining surgical plan, surgical items, consultation and preoperative communication with patients.

Clinical efficacy of five-flap method in epicanthus correction / 中华医学美学美容杂志

Objective:To explore the clinical application of five flaps method in epicanthus correction.Methods:From May 2009 to July 2016, 39 surgical cases were collected, including 2 males and 37 females, aged 18-55 years, with an average age of 32 years. Patients with single eyelid accompanied by epicanthus and epicanthus alone were treated with the five-flap method to correct epicanthus combined with double eyelid plasty or the five-flap method to correct epicanthus. Postoperative follow-up was conducted for 2 weeks to 10 years.Results:All incisions healed in one stage without triangular flap necrosis. From 2 weeks to 3 months after operation, the medial canthus had slight scar hyperplasia reaction. Three months after operation, the scar hyperplasia reaction subsided without complications, no obvious scar, epicanthus correction, natural shape of the inner canthus angle, obvious narrowing of the distance between the inner canthus, and increased length of bilateral eyelid fissure. The eyelid shape was natural, and the inner canthus connected smoothly and naturally.Conclusions:Five-flap method for correction of epicanthus can effectively alleviate the tension of epicanthus skin by lengthening the main axis of epicanthus, relax the tension-free cross-joint of local tissues, relieve epicanthus, fully expose the angle of epicanthus, enlarge the transverse diameter of palpebral fissure, and avoid contracture of arc scar of epicanthus.

Mechanism of GPR119 in regulating lipid metabolism and anti-atherosclerosis by hypoxia-inducible factor-1α/ vascular endothelial growth factor pathway / 中华内分泌代谢杂志

Objective@#To investigate the effect and mechanism of G protein coupled receptor 119 (GPR119) in regulating lipid metabolism.@*Methods@#(1) Macrophage THP-1 was induced by oxidized low density lipoprotein (oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter.@*Results@#Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL (P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased (P<0.01). The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased (P<0.01). On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased (P<0.05). After GPR119 were co-expressed with HIF-1α and VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited.@*Conclusion@#GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1α and VEGF.

Mechanism of GPR119 in regulating lipid metabolism and anti-atherosclerosis by hypoxia-inducible factor-1α/ vascular endothelial growth factor pathway / 中华内分泌代谢杂志

Objective To investigate the effect and mechanism of G protein coupled receptor 119 ( GPR119) in regulating lipid metabolism. Methods ( 1) Macrophage THP-1 was induced by oxidized low density lipoprotein ( oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α(HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. Results Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL ( P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased ( P<0. 01 ) . The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased ( P<0.01) . On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased ( P<0.05) . After GPR119 were co-expressed with HIF-1αand VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited. Conclusion GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1αand VEGF.

Initial research on the brain functional magnetic resonance imaging induced by olfactory stimulations in multiple sclerosis / 中华神经科杂志

Objective To observe the characteristics of brain activation of multiple sclerosis (MS) patients and healthy controls at functional magnetic resonance imaging (fMRI) with olfactory stimulation,determine the locations of activation in areas of olfactory center and explore the MS olfactory related network.Methods Eighteen MS patients from the Affiliated Hospital of North Sichuan Medical College from February 2017 to March 2018 were enrolled as MS group,and 20 matched healthy adults during the same period served as controls.The Visual Analogue Scale was used to evaluate olfactory function in all subjects,the rest structure MRI was performed first,and volatile gases of lavender and rose solution were used to alternately stimulate olfactory during fMRI scanning.The brain activation was obtained by using matlab2013a and SPM8 softwares.The distribution and quantity of demyelination lesions were counted on T2 weighted image,and Spearman correlation analysis was done with SPSS 17.0 software package.Results The activated brain areas in the healthy control group included bilateral middle frontal gyrus,bilateral insula,bilateral supramarginal gyrus,bilateral orbitofrontal gyrus,right thalamus,right central anterior gyrus,bilateral cingulated gyrus,bilateral hippocampus,bilateral amygdala and bilateral superior frontal gyrus (t =2.11,P＜0.05).The activated brain areas in the MS group included right cerebellum,left insula,left superior temporal gyrus,right inferior frontal gyrus (t=2.19,P＜0.05).Compared with the control group,the MS group showed statistically significant decrease in activated values in right insula,right amygdala,right inferior frontal gyrus,right frontal middle gyrus,and the left supramarginal gyrus (t=2.04,P＜0.05).The distribution and number of demyelination lesions and major activation of brain regions with olfactory in the MS group demonstrated no significant correlation (r=-0.524,P=0.054).Conclusions Multiple brain areas involved in the olfactory processing and olfactory-related brain network existed.The activation of olfactory center had dominance in the right brain.The activation of the brain area in the MS group was significantly reduced,and the activation voxel and activation intensity were weakened.The olfactory-related brain network changed in MS patients.The distribution and number of demyelination lesions had no significant effect on the major activation of brain regions with olfactory stimulation.

Sensory disorders and electrophysiological study in Parkinson's disease / 中华神经科杂志

Parkinson's disease (PD) is one of the most common forms of neurodegenerative diseases and increases in incidence with aging.Low mortality and high disability rates bring huge economic and psychological burden to society and families.PD manifested as motor symptoms and non-motor symptoms.Recent studies have shown that non-motor symptoms,such as sensory disorder,are the significant symptoms in early stages of PD and influence quality of life of PD patients.This review focuses on the characteristics and electrophysiological changes of sensory disorders (olfactory,visual,auditory,vestibule function,pain,etc) in PD patients to provide help for the early diagnosis,disease monitoring and efficacy evaluation of PD.

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury:A multicenter randomized controlled clinical trial / 吉林大学学报(医学版)

Objective:To discuss the curative effect of Chinese medicine synthesis rehabilitation in the treatment of neurogenic bladder dysfunction after incomplete spinal cord injury, and to provide the clinical evidences for its application.Methods:A total of 184patients meeting the inclusion criteria were randonly divided into trial group (n=89) and control group (n=95) with central area group method.The patients in two groups were given the intermittent catheterization and the urinary functional training.The patients in trial group were treated by the electricity needle (20min/time, one time a day, 6dper week) and the massage (20min/time, one time a day, 6d per week) .All patients in two groups were treated for 4courses (2 weeks for a course) .The residual urine volumes, the bladder securiey capacities, and the intravesical pressures of the patients in two groups were measured before and after treatment, and the curative effects were evaluated.Results:Compared with before treatment the residual urine volume of the patients in trial group was reduced significantly after treatment (P＜0.01) , the bladder security capacity was significantly increased (P＜0.01) , and there was no significant change in intravesical pressure (P＞0.05) ;the residual urine volume of the patients in control group was reduced significantly after treatment (P＜0.01) , there were no significant changes in the bladder security capacity and intravesical pressure (P＞0.05) .After treatment, the residual urine volume of the patients in trial group was significantly lower than that in control group (P＜0.01) , while there were no significant differences in the bladder security capacities and intravesical pressures between two groups (P＞0.05) .Conclusion:Chinese medicine synthesis rehabilitation may reduce the residual urine volume of the patients with neurogenic bladder urinary retention after incomplete spinal cord injury, and its curative effect is superior to modern rehabilitation of intermittent catheterization and urinary bladder function training.

A review of family and parenting interventions in children with attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Family environment plays an important part of the occurrence,development and outcome of attention-deficit/hyperactivity disorder (ADHD).Family and parenting interventions focus on the inter environment,aiming at forming an effective behavioral management,a better communication strategy,which will be conductive for child's symptoms as well as functions.Parents'emotion and self-efficacy as well as family functioning will be affected also.Common family and parenting skills include parent training and systematic family therapy,which respectively focus on behavior management and the whole family in view of system.The Multimodal Treatment Study of Children with ADHD (MTA) may have potential effects compared with single medical treatment and behavioral treatment.In China,parent training and structural family therapy have been proved to be effective.However,further consideration and experiments are necessary,especially on the long-time ending and individual management.

Association between set shifting in attention deficit/hyperactivity disorder (ADHD) and NRXN1 gene / 中国心理卫生杂志

Objective:To study the association between set shifting in ADHD and NRXN1 gene.Methods:According to the diagnostic standard of the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ).Totally 756 Han Chinese ADHD children and 133 Han Chinese unaffected children were involved in the analysis.Set shifting,including number connection time (NOTIM),number connection error times (NOERR),number and letter alternant connection time (LETIM),number and letter altemant error times (LEERR),and shifting time(each value was the difference between LETIM and NOTIM),was recorded by trail making test (TMT).Two SNPs (Single Nucleotide Polymorphisms) of NRXN1 gene,rs1592728 and rs4971652,were chose to detect genotype using Sequenom Mass ARRAY system by real time quantitative polymerase chain reaction.Linear regression analysis was applied to explore the influence of set shifting,then,stratified analysis was used to study the association between set shifting and rs1592728 as well as rs4971652 in ADHD cases and controls separately.Results:Linear regression analysis showed that there was a negative correlation between set shifting and month (β =0.42,P ＜0.001),IQ (β =0.34,P ＜ 0.001),group (β =0.08,P =0.004),GG genotype of rs4971652 (β =0.06,P =0.039).Among ADHD children,there was a negative relationship between set shifting and month (β =0.46,P ＜0.001),IQ (β =0.32,P ＜ 0.001),GG genotype of rs4971652 (β =0.07,P =0.018),a positive association was found between set shifting and ADHDSUB (β =0.06,P =0.033),set shifting damaged higher with ADHD-Ⅰ children than ADHD-C children.While,in controls,set shifting was in inverse relation with month (β =0.25,P =0.002) and IQ (β =0.40,P ＜ 0.001).Conclusion:It suggests that the association between shift in ADHD children and polymorphism of NRXN1 gene is existed,set shifting deficit less seriously in GG genotype.

Comparison of two modalities of minimally invasive surgery in treatment of acute biliary pancreatitis / 中华全科医师杂志

Objective To compare the therapeutic efficacy of laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC),and endoscopic retrograde cholangiopancretography (ERCP) plus endoscopic sphinetemtomy (EST) plus laparoscopic cholecystectomy (LC) in treatment of acute biliary pancreatitis.Method One hundred and six patients with acute biliary pancreatitis and biliary obstruction underwent minimally invasive surgery between January 2012 and February 2016 in our hospital,including 54 cases received LCBDE + LC (LCBDE group) and 52 cases received ERCP + EST + LC (ERCP group).The operation time,intraoperative blood loss,length of hospital stay,medical expenses and postoperative complications were compared between two groups.Results The operating time in LCBDE group was longer than that in ERCP group [(110.2 ± 11.2) min vs.(100.8 ±22.8) min,x2 =-2.11,P ＜ 0.05],the length of hospital stay was shorter [(10.3 ± 3.8) d vs.(12.6 ±3.4) d,x2 =2.32,P ＜ 0.05],the medical expense was less [(31 245.3 ± 1 237.2) Yuan vs.(42 342.2 ±1 354.3)Yuan,x2 =2.82,P ＜ 0.01].There were no significant differences in intraoperative blood loss [(40.2 ± 10.3) ml vs.(39.3 ± 10.4) ml,x2 =0.88,P ＞ 0.05],the rate of postoperative analgesic use [11.11％ (6/54) vs.13.46％ (7/52),x2 =0.102,P ＞0.05] and the incidence of postoperativecomplications [9.26％ (5/54) vs.11.54％ (6/52),x2 =0.080,P ＞0.05] between two groups.Conclusion laparoscopic common bile duct exploration plus laparoscopic cholecystectomy has advantages of shorter hospital stay and lower medical expenses in treatment of acute biliary pancreatitis combined with biliary infection.

School-based intervention study on personality disorder inhigh school students in Beijing / 中国心理卫生杂志

Objectives: To establish an intervention model of mental health education for personality disorders through community intervention study and to provide scientific basis for the early intervention of personality disorders. Methods: In Beijing, students from 25 high schools were selected as subjects of the study. Random cluster sampling method was used to divide all the schools into intervention group (13high schools) and non-intervention group (12 high schools), when the students werein the first grade. All of the schools were followedup for three years. According to the ICD-10 and DSM-IV criteria, PDQ-4 and the International Personality Disorder Checklist (IPDE) were used to screen and diagnose personality disorder. Associated influencing factors were collected using the Parental Rearing Questionnaire (Egma Minnen av Bardndosnauppfor-stran, EMBU) and the General Information Questionnaire. Univariate and multivariate analysis were used to analyze the data. Results: PDQ-4 scores of the intervention group were significantly lower than those of the non-intervention group. PDQ-4 scores and incidence rates of PD at the third grade were significantly lower than those at the first grade. Logistic regression analysis yielded risk factors of overall PD including poor parental relationship, parental rejection and over-protection. The incidence rate of personality dysfunction was 3. 4％ in the intervention group, and 4. 0％ in the non-intervention group. The incidence rate of PD was 0. 8％ in the intervention group, and 1. 1％ in the non-intervention group without statistical significance. The PDQ-4 score showed significant decline trend during the three years. But the prevalence rates had no statistical significant difference between intervention and non-intervention groups. Moreover, the prevalence rate of personality dysfunction significantly decreased after three years. The incidence rates of cluster C, as well as paranoid, narcissistic and borderline PD were statistically significantly decreased after the intervention. Conclusion:The mental health education during adolescence is effective and contributes to the promotion of mental health for adolescents.

A cohort study of personality disorder among senior high school students in Beijing / 中国心理卫生杂志

Objectives: To prove the environmental etiological hypothesis of personality disorder and to evaluate the relative risk(RR) of family environmental risk factors for personality disorder. Methods: By means of cohort study, about 9200 senior high school students and their parents had been followed-up for three years by Personality Disorder Questionnaire-fourth edition (PDQ-4), Parental Rearing Questionnaire (Egma Minnen av Bardndosnauppfor-stran, EMBU), General Information Questionnaire, and International Personality Disorder Examination (IPDE) to diagnose PD according to the criteria of ICD-10 and DSM-IV. The univariate and multivariate analysis methods were applied for data processing. Results: The incidence rate of personality dysfunction and personality disorders were 4. 0％ and 1. 1％, respectively. Univariate analysis indicated that the incidence of personality dysfunction had significant statistical association with male, the parental rejection and over-protection, with the Relative Risks being 0. 64, 2. 60 and 2. 31, respectively. Univariate analysis indicated that the incidence of PD had significant statistical association with the parental rejection and over-protection, with the RR being 2. 45 and 2. 80, respectively. Conclusion: The family environmental risk factors are significantly associated with personality disorders.

A case-control study of personality disorder among senior high school students in Beijing / 中国心理卫生杂志

Objectives: To explore genetic and environmental risk factors of personality disorder (PD). Methods:By means of case-control study, 10003 senior high school students and their parents were investigated twice in first and third grades using Personality Disorder Questionnaire-fourth edition (PDQ-4), Parental Rearing Questionnaire (Egma Minnen av Bardndosnauppfor-stran, EMBU), General Information Questionnaire, and InternationalPersonality Disorder Examination (IPDE) to diagnose PD according to the criteria of ICD-10 and DSM-IV. The univariate and multivariate analysis methods were applied for data processing. Results: In the students of first grade, the risk factors of personality dysfunction were poor parental relationship, rural residential area, parental rejection, overprotection, favoring subject, non-emotional warmth, shorter time of living with parents, and male. Similar results were yielded instudents of third grades. The risk factors of PD were poor parental relationship, parental rejection, and over-protection. The heritability of overall PD of father and mother were 0. 84 and 0. 85, respectively. The heritability of each PD cluster was higher than 0. 6. Conclusion: The genetic factor plays an important role in the development of PD. Family environmental risk factors include poor parental relationship, parental rejection and over-protection.

A cross-sectional study of personality disorder in senior high school students in Beijing / 中国心理卫生杂志

Objectives: To describe prevalence of personality dysfuction and personality disorders (PD) and their distribution in senior high school students in Beijing. Methods: By means of cross-sectional study, 10003 senior high school students were investigated by Personality Disorder Questionnaire-fourth edition (PDQ-4), Parental Rearing Questionnaire (Egma Minnen av Bardndosnauppfor-stran, EMBU), General Information Questionnaire, and International Personality Disorder Examination (IPDE) to diagnose PD according to the criteria of ICD-10 and DSM-IV. Results: In the students of first grade, the mean score of PDQ-4 was (25. 38 ± 9. 64). Male students had higher PDQ-4 scroes than those of female. Students in rural high schools had higher PDQ-4 scroes than those of students in urban high schools. Students in general high schools had the highest PDQ-4 scroes, followed by students in disctrict-level key high schools, and the students from city-level key high schools had the lowest PDQ-4 scroes. The prevalence rate of personality dysfunction was 8. 3％ with similar distributions of PDQ-4 scroes by gender, residential area, and rank of school. In the students of third grade, the mean score of PDQ-4 was (23. 10 ± 10. 20). Male students had higher PDQ-4 scroes than those of female. The prevalence rates of personality dysfunction and PD were 5. 8％ and 1. 83％, respectively. The correlation coefficients of EMBU had statistical significances and four common factors were identified by factor analysis. The heritability of overall PD of father and mother were 0. 71 and 0. 72, respectively. The heritability of each PD cluster was higher than 0. 6. Conclusion: The prevalence rates of personality dysfunction and personality disorder in Beijing, China is lower than those in other countries. The genetic factor plays an important role in the development of PD.