Construction of intervention program for physical and mental adjustment for primary caregivers of cancer patients based on network cognitive behavior therapy / 中国实用护理杂志

Objective:Based on cognitive behavioral therapy, to construct a physical and mental adjustment intervention plan for the main caregiver of cancer patients through the network platform.Methods:Through evidence-based literature published from July 2012 to July 2022 screening and evaluation, combined with qualitative interviews for 10 primary caregivers of cancer patients, the intervention plan for physical and mental adjustment of the main caregivers of cancer patients was preliminarily formulated. After consultation with Delphi experts (15 cases) through two rounds, the intervention plan was finally determined.Results:In the two rounds of expert letter inquiries, 15 questionnaires were distributed and 15 valid questionnaires were recovered. The effective recovery rate was 100.00% and the expert authority coefficient were 0.89 and 0.90 in the two rounds of expert letter inquiries respectively, the Kendall harmony coefficients were 0.279 and 0.323 respectively, and the differences were all statistically significant ( P<0.01). The intervention plan for physical and mental adjustment ofthe main caregivers of cancer patients included 5 first-level indicators (basic knowledge, symptom education, home care knowledge, relaxation training, social support), 27 second-level indicatorsand 54 third-level indicators. Conclusions:The method of the psychosomatic regulation intervention program is scientific and practical, which can be initially applied to the psychological adjustment of the main caregivers of cancer patients, so as to provide a reference for improving their negative emotions.

Emerging role of miRNAs, lncRNAs, and circRNAs in pregnancy-associated diseases / 中华医学杂志(英文版)

Accumulating studies have demonstrated that non-coding RNAs (ncRNAs), functioning as important regulators of transcription and translation, are involved in the establishment and maintenance of pregnancy, especially the maternal immune adaptation process. The endometrial stromal cells (ESCs), trophoblast cells, and decidua immune cells that reside at the maternal-fetal interface are thought to play significant roles in normal pregnancy and pregnancy-associated diseases. Here, we reviewed the up-to-date evidence on how microRNA, long non-coding RNA, and circular RNA regulate ESCs, trophoblast cells, and immune cells and discussed the potential applications of these ncRNAs as diagnostic and therapeutic markers in pregnancy complications.

Research advance in the mechanism exploration of traditional Chinese medicine regulating mucus barrier and interfering with ulcerative colitis based on the “thickening intestine”theory / 中国药房

Ulcerative colitis （UC） is a clinical chronic intestinal disease， and the damage of the intestinal epithelial mucus barrier is an important pathological mechanism of UC. Mucin 2 （MUC2） is a major component of the intestinal mucus barrier， and goblet cells are the “main force” of MUC2 secretion， maintaining and renewing the intestinal mucus layer to ensure its integrity. Therefore， repairing the intestinal mucus barrier by promoting the synthesis of MUC2 by goblet cells is an important strategy for the treatment of UC. Traditional Chinese medicine scholars believe that there is an inherent layer of “lipid membrane” or “fat paste” in the intestine， and pathological factors such as moisture and heat lead to the thinning of this structure， which is the fundamental pathogenesis of “diarrhea” and “intestinal dysentery”. It coincides with the damage of intestinal mucus barrier leading to UC in modern medicine. Based on this， this paper summarized the mechanism of Chinese herbal compounds or Chinese herbal active components in regulating intestinal mucus barrier to interfere with UC. It was found that Chinese herbal compounds such as Huanglian jiedu decoction， Shaoyao decoction and Compound Kusen decoction， as well as Chinese herbal active ingredients such as volatile oil of Atractylodes lancea， paeoniflorin and papaya triterpenes could promote the synthesis and secretion function of goblet cells， and achieve the purpose of “thickening intestine”， thus relieving UC symptoms.

The interaction between 5-HTT gene rs6354 polymorphism and family factors on the adaptability of Mongolian school-age children / 中华行为医学与脑科学杂志

Objective:To explore the effects of rs6354 polymorphism of 5-HTT gene and family factors on the adaptability of Mongolian school-age children.Methods:The adaptability of 453 primary school students was assessed based on the middle childhood temperament questionnaire(MCTQ). The polymorphism of 5-HTT gene rs6354 was determined by improved multiple ligase detection reaction(iMLDR) technology. SPSS18.0 statistical software was used for data processing and analysis.Results:(1) The adaptability scores of children with GG/GT and TT genotype at rs6354 locus of 5-HTT gene were(2.88±0.73) and(3.03±0.76). (2) Univariate analysis showed that the adaptability scores of Mongolian school-age children were significantly different among different education levels of their parents (father F=2.580, P=0.037; mother F=3.245, P=0.012). (3) Multiple regression analysis showed that mother's educational level( B=-0.079, P=0.010) and rs6354 polymorphism( B=0.165, P=0.041) were inflencing factors of the adaptability score of Mongolian school-age children. (4) Logistic regression analysis showed that father's education level was a significant impact factor of the adaptive level of Mongolian school-age children( B=0.453, P<0.05, OR=1.573, 95% CI=1.023-2.417). Conclusion:rs6354 polymorphism is weakly correlated with children's adaptability, and the education level of parents, especially fathers, may be an important factor affecting the adaptability of Mongolian school-age children.

The associations of muscle size and density with handgrip strength and timed up and go test / 中华老年医学杂志

Objective:The aim of this study was to explore the associations of muscle size and density with handgrip strength(HGS)and the Timed Up and Go(TUG)test.Methods:Totally 301 participants living in the Xinjiekou community near Beijing Jishuitan Hospital were recruited for CT imaging of the hip and a 1-cm slice of the mid-thigh.The cross-sectional area and density of the gluteus maximus and the mid-thigh muscles were estimated by the Osirix viewer based on CT images.HGS and TUG were also performed in these subjects.Logistic regression analysis was used to evaluate the correlations of muscle density and size with TUG and grip strength.Results:In women, after adjustment for age and BMI, the density of the gluteus maximus was negatively correlated with TUG( P trend=0.0366), while the size of the gluteus maximus and the mid-thigh muscles was not correlated with TUG.In men, the density or size of these muscles was not correlated with TUG.After adjustment for age and BMI, the density of the gluteus maximus was positively correlated with grip strength( P trend=0.0334)and the size of the mid-thigh muscles was also positively correlated with grip strength( P trend=0.0155)in men, but they were not correlated with grip strength in women. Conclusions:There were sex differences in the relationship between muscle size or density and grip strength or timed up and go.The density of the gluteus maximus is associated with muscle strength and physical performance while the size of the mid-thigh muscles is correlated with muscle strength.

Bibliometric analysis of nutrition researches in inflammatory bowel disease retrieved from Web of Science / 中华临床营养杂志

Objective:To explore the research trends, research advances and future orientations in the field of inflammatory bowel disease (IBD), so as to inform future researches.Methods:Web of Science database was searched from 2000 to 2021. CiteSpace software was used for visual and quantitative analysis.Results:A total of 3 582 articles were included. Publications on nutrition science in IBD showed a rising trend. The United States ranked first according to number of publications by country, the University of Toronto ranked first by institution, Inflammatory Bowel Diseases ranked first by journal and Li J from Nanjing University was the very author with the highest number of relevant publications. Research hotspots mainly focused on risk, gut microbiota and pediatric population. Research fronts mainly focused on the gut microbiota. Conclusion:Visual analysis shows the research trend in the field of nutrition in IBD, with gut microbiota as the research hotspots in the future.

Relationship between disrupted-in-schizophrinia-1 polymorphism and the abnormal brain structure in childhood and adolescence with schizophrenia / 中华实用儿科临床杂志

Objective:To investigate the relationships of rs4658971 polymorphism of disrupted-in-schizophrinia-1 ( DISC1) gene with schizophrenia in children and adolescents and with the brain structure of such patients. Methods:(1) A total of 577 children and adolescents with schizophrenia were recruited from the Inpatient Department of the Second Affiliated Hospital of Xinxiang Medical University from October 2010 to December 2018, and 516 healthy children were selected as the control group.The rs4658971 polymorphism of DISC1 gene was detected by restriction fragment length polymorphism (PCR-RFLP). The differences of DISC1 genotype and allele frequencies between schizophrenia patients and healthy children were compared by Chi-square test.(2)One hundred and eighteen patients with the first-episode schizophrenia whose illness duration was no more than 12 months and 101 healthy children and adolescents were detected by 3.0T magnetic resonance imaging (MRI). The craniocerebral structures of patients with different DISC1 genotypes were analyzed by covariance with age as the covariant. Results:(1) The rs4658971 genotype frequencies(TT 6.6% vs.5.2%, TC 37.4% vs.38.4%, CC 56.0% vs.56.4%, χ2=0.91, P=0.63) and allele frequencies(C 74.70% vs.75.58%, T 25.30% vs.24.42%, χ2=0.23, P=0.63) of DISC1 gene in children and adolescents with schizophrenia were not significantly different from those in the healthy children.(2) Compared with the control group, the transverse diameter of the third ventricle was significantly enlarged in children and adolescent with schizophrenia [(4.68±1.41) mm vs.(4.06±1.36) mm, F=8.534, P=0.004], while the distance between the anterior feet of the lateral ventricle, the width of the caudate nucleus head and the thickness of the hippocampus were significantly reduced [(30.69±2.51) mm vs.(32.02±2.41) mm, (8.17±1.01) mm vs.(9.22±1.14) mm, (8.93±0.97) mm vs.(9.93±1.14) mm], and the differences were statistically significant( F=15.435, 40.201, 44.650, all P<0.001). The covariance analysis (with age as the covariant) showed that there was significant difference in the width of the caudate nucleus head between patients with CC genotype and those with CT+ TT genotype[(8.73±0.85) mm vs.(7.39±0.61) mm, F=41.376, P<0.001]. Conclusions:There are multiple brain structural changes in children and adolescents with first-episode schizophrenia.T allele carriers of DISC1 gene rs4658971 locus may be related to the reduced width of the caudate nucleus head in patients.

D-RADA16-RGD-Reinforced Nano-Hydroxyapatite/Polyamide 66 Ternary Biomaterial for Bone Formation

BACKGROUND: Nano-hydroxyapatite/polyamide 66 (nHA/PA66) is a composite used widely in the repair of bone defects. However, this material is insufficient bioactivity. In contrast, D-RADA16-RGD self-assembling peptide (D-RADA16-RGD sequence containing all D-amino acids is Ac-RADARADARADARADARGDS-CONH2) shows admirable bioactivity for both cell culture and bone regeneration. Here, we describe the fabrication of a favorable biomaterial material (nHA/PA66/D-RADA16-RGD). METHODS: Proteinase K and circular dichroism spectroscopy were employed to test the stability and secondary structural properties of peptide D-RADA16-RGD respectively. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to characterize the surface of these materials. Confocal laser scanning (CLS), cell counting kit-8 tests (CCK-8), alizarin red S staining, cell immunofluorescence analysis and Western blotting were involved in vitro. Also biosafety and bioactivity of them have been evaluated in vivo. RESULTS: Proteinase K and circular dichroism spectroscopy demonstrated that D-RADA16-RGD in nHA/PA66 was able to form stable-sheet secondary structure. SEM and TEM showed that the D-RADA16-RGD material was 7–33 nm in width and 130–600 nm in length, and the interwoven pore size ranged from 40 to 200 nm. CLS suggests that cells in nHA/PA66/D-RADA16-RGD group were linked to adjacent cells with more actin filaments. CCK-8 analysis showed that nHA/PA66/D-RADA16-RGD revealed good biocompatibility. The results of Alizarin-red S staining and Western blotting as well as vivo osteogenesis suggest nHA/PA66/D-RADA16-RGD exhibits better bioactivity. CONCLUSION: This study demonstrates that our nHA/PA66/D-RADA16-RGD composite exhibits reasonable mechanical properties, biocompatibility and bioactivity with promotion of bone formation.

The interaction between DRD4 gene rs1800955 polymorphism and negative life events on the personality characteristics of Mongolian adolescents / 中华行为医学与脑科学杂志

Objective To investigate the interaction between rs1800955 polymorphism of dopamine D4 receptor(DRD4) gene and negative life events on personality characteristics of Mongolian adolescents.Methods A total of 239 Mongolian adolescents aged 12-15 were assessed with Eysenck Personality Questionnaire(EPQ) and Adolescent Self-Rating Life Events Check List(ASLEC).The polymorphism of DRD4 gene rs1800955 was determined by improved multiple ligase detection reaction(iMLDR) technique.Results (1) The rs1800955 polymorphism of DRD4 gene was significantly correlated with psychoticism score of EPQ.The psychoticism score of individuals with CC genotype (4.94 ± 3.19) was higher than that of TT genotype (3.38±2.29),and the difference was statistically significant (P＜0.05).(2) The scores of psychoticism and neuroticism in Mongolian adolescents were positively correlated with the factors of negative life events(r=0.154-0.375,P＜0.05 or 0.01).(3) The interaction between the rs1800955 polymorphism of DRD4 gene and negative life events significantly affected the scores of psychoticism in Mongolian adolescents (C C genotype x interpersonal factor:B =-2.689,95 ％ CI =-4.589--0.789,x2 =7.695,P＜ 0.01).In individuals with CC genotype,the scores of psychoticism in those with high scores of interpersonal relatioriship factors were significantly higher than those with low scores of interpersonal relationship factors ((3.01 ± 0.71) vs (2.61 ±0.67);t =-3.066,P＜ 0.01).Conclusion The polymorphism of DRD4 gene rs 1800955 and its association with interpersonal factors play an important role in the psychoticism of Mongolian adolescents.The CC genotype is a risk factor of psychoticism,and the poor interpersonal relationship may increase the risk of individuals with CC genotype.

The correlation between the volume of brain white matter and cognitive function in childhood and adolescence-onset schizophrenia / 中华行为医学与脑科学杂志

Objective To investigate the relationship between brain white matter volume (WMV) and cognitive function (CF) in childhood and adolescence-onset schizophrenia (CAOS).Methods Forty childhood and adolescence-onset first-episode schizophrenia patients (case group) and thirty-nine healthy volunteers (control group) were selected.All subjects underwent a 3.0 T magnetic resonance imaging(MRI) scans for data acquisition.The Chinese version of MATRICS consensus cognitive battery(MCCB) was used to assess the cognitive function.The psychiatric symptoms of schizophrenia were assessed with the positive and negative syndrome scale (PANSS).And t test was applied to compare whether there were differences in WMV,CF between the two groups.Pearson correlation analysis was used to analyze whether the differences were related with cognitive function and mental symptoms.Results Compared with healthy controls,the case group exhibited WMV deficits in the region of left frontal lobe (LFL) (MNI:x =-27,y =12,z =21),right side limbic lobe (RSLL) (MNI:x =18,y =-9,z =39) and left cingulate gyrus (LCG) (MNI:x =-21,y =-18,z=45) (P＜0.05).The WMV of LFL was negatively related with the total score (r=-0.344,P＜0.05) and the WMV of LCG was negatively related with the positive symptoms score (r=-0.326,P＜0.05) and total score (r=-0.348,P＜0.05) of the PANSS.Besides,compared with the controls,the patients showed significant increase in the scores of Trail Making Test (t =3.56,P＜ 0.01),while significant decrease in the scores of the HVLT-R and BVMT-R(t=-5.67,-8.66,P＜0.05).The WMV of RSLL was positively correlated with verbal fluency test in the case group (r=0.40,P＜0.05).Conclusion CAOS patients exist multiple reduced WMV and cognitive impairment,suggesting the importance of the WMV abnormalities in the pathophysiological mechanism of cognitive impairment.

Psychological assessment and hierarchical management for non-psychiatric inpatients at general hospitals / 中华医院管理杂志

Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.

Effectiveness of general practitioner team contracted service in management of patients with type 2 diabetes mellitus / 中华全科医师杂志

Objective To evaluate the effectiveness of general practitioner contracted service in management of patients with type 2 diabetes mellitus (T2DM) in the community. Methods From January 2012 to April 2017, 1625 patients of T2DM (766 males and 859 females with an average age of 62.9 years) were treated in Xinjiekou Community Health Service Center. They were managed by a contracted general practitioner team for one consecutive year, including initial assessment, patient education, disease follow-up and annual assessment. Four classes of diabetes and hypertension knowledge were given, patient self-assessment and nursing scoring were conducted before and after the education, including healthy life habits, diet and exercise. Family self-assessment, knowledge and skills in monitoring blood pressure, blood glucose, drug use, and risk prevention were carried out. Data collection and analysis were based on quarterly and annual follow-up tables. Results Before and after management, the mean BMI of 1625 patients was (25.0± 3.1) and (24.6 ± 3.1) kg/m2 (t=13.25, P=0.001), systolic blood pressure was (133.3 ± 10.0) and (122.7 ± 7.7) mmHg (1 mmHg=0.133 kPa, t=43.84, P=0.001), diastolic blood pressure was (82.7 ± 22.1) and (76.1 ± 13.5) mmHg (t=10.46, P=0.001), fast blood glucose was (7.2±2.5) and (6.2±0.9) mmol/L (t=18.50, P=0.001), 2 h-postprandial blood glucose was (9.1±2.1) and (7.8±1.9) mmol/L (t=23.39, P=0.001) and glycated hemoglobin (HbA1c) was (6.8 ± 1.1) and (6.3 ± 2.2) ％ (t=8.68, P=0.001), all were decreased significantly after management. After management the rates of HbA1c, fasting blood glucose and 2 h-postprandial blood glucose reached the standard were increased (χ2=345.57, P=0.001;χ2=235.13, P=0.001;χ2=354.28, P=0.001). The rates of aerobic exercise, the proportion of 3-5 times a week, exercise time 30-60 minutes/time increased (χ2=1245.58, P=0.001; χ2=158.38, P=0.001; χ2=264.26, P=0.001). The rates of smoking, drinking, eating fried food, saltiness food, sweetness food decreased (χ2=13.92, P=0.001; χ2=23.88, P=0.001; χ2=311.71, P=0.001; χ2=674.31, P=0.001; χ2=247.86, P=0.001). After management, the rates of blood pressure, blood glucose and waist circumference self-measurement; using food scales, staple measuring, salt spoon, oil spoon and kettle, pedometer were increased significantly. The scores of health, ability, knowledge and comprehensive evaluation after management were also increased significantly (40.3± 6.0 vs. 20.9±11.0, t=76.46, P<0.001;36.4±7.8 vs. 19.4±9.2, t=75.99, P<0.001;14.8±3.3 vs. 7.6±4.4, t=51.03, P<0.001;91.5±11.7 vs. 48.0±20.3, t=89.54, P<0.001). Conclusion The general practitioner team can effectively improve the self-management ability and achieve better clinical effect in T2DM patients.

Summarization of the Experience of Luteinized Unruptured Follicle Syndrome's Treatment by Professor TAN Yong / 浙江中医药大学学报

[Objective] This paper introduces the experience of Professor TAN Yong's treatment of the luteinized unruptured follicle syndrome(LUFS) with a view to provide references for the related study.[Methods]Through studying with Professor TAN, collecting and analyzing clinical case data, researching editorial book and articles. From the etiology, pathogenesis and drug selection of the LUFS, the clinical experience of the teacher was discussed, Professor TAN's academic characteristics on the treatment of LUFS were summarized, and a medical case was provided to support the idea.[Results]Professor TAN believes that the pathogenesis of this disease is mostly due to deficiency of the kidney Yin, the weak Yang qi, Yin and Yang conversion is unfavorable during intermenstrual period, combined with pathological factors such as liver depression, blood stasis, and phlegm dampness. Unsmooth running of Qi and blood, so that the follicular can not be discharged smoothly, the disease occurs. In the treatment of combination of Traditional Chinese Medicine(TCM) and western Medicine, in the intermenstrual period attach importance to the function of the heart and brain, to tonifying kidney and blood circulation as a method, the use of "Tonifying Kidney Stimulating Ovulation" medicine treatment, combined with western medicine, in the clinically achieved good results. The medical case was based on the "Tonifying kidney Stimulating Ovulation" medicine as the basis for the successful pregnancy after the treatment, which fully proved the above mentioned dialectical thinking and treatment experience. [Conclusion]It is worthwhile to learn and promote the treatment of LUFS with tonifying kidney and blood circulation therapy.

Relationship between function and resting state functional magnetic resonance imaging amplitude of low-frequency fluctuations in childhood and adolescence-first-onset obsessive-compulsive disorder / 中华实用儿科临床杂志

Objective To investigate the characteristics and relationship of cognitive function and resting state functional magnetic resonance imaging(fMRI) amplitude of low-frequency fluctuations (ALFF)in childhood and adolescence-first-onset obsessive-compulsive disorder(OCD).Methods Twenty-four childhood and adolescence-first-onset OCD patients (patient group) and thirty-three age/gender/education-matched healthy controls (healthy control group) were enrolled in this study.The participants' cognitive function was tested with trail making test (TMT),symbol coding,Hopkins verbal learning test-revised (HVLT-R),brief visuospatial memory test-revised (BVMT-R),verbal fluency test (VF),digital span test,maze test and Stroop test.Then a resting-state fMRI scan was conducted for each participant.Amplitude of low-frequency fluctuation approach was used to explore the differences of resting-state brain function between patients and controls,and analyze the significant brain regions by adopting t test.The cognitive functions of patients and healthy control group in the significant brain regions were compared by using Pearson correlation analysis.Results The patient group had lower scores than healthy control group in symbol coding,BVMT-R and digital span test,and the differences were statistically significant [(45.24 ± 10.32)scores vs.(56.85 ± 9.57) scores,(21.94 ± 6.99) scores vs.(30.58 ± 3.92) scores,(64.06 ± 20.00) scores vs.(78.03 ±18.08) scores;t =3.96,4.90,2.50;all P ＜ 0.05].Corrected by Alphasim,patient group showed significantly increased ALFF in the left and fight temporal lobe,left and fight posterior lobe of cerebellum,right middle temporal gyrus,but ALFF decreased in the area of left and right lenticula,left putamen compared with the healthy control group (all P ＜ 0.05).The patients group showed that TMT scores were positively correlated with the value of ALFF in the right temporal lobe (r =0.67),and color scores were positively correlated with the value of ALFF in the right middle temporal gyrus (r =0.53),but colour scores were negatively correlated with the value of ALFF in the right tcmporal lobe (r =-0.54);the healthy control group showed that BVMT-R and digital span test scores were positively correlated with the value of ALFF in the left temporal lobe (r =0.47,0.41),but digital span test scores were negatively correlated with the value of ALFF in the right temporal lobe (r =-0.49),and colour scores were negatively correlated with the value of ALFF in the left temporal lobe (r =-0.35),while word and color-word scores were negatively correlated with the value of ALFF in the right middle temporal gyrus (r =-0.39,-0.36);the correlation coefficient above had statistical significance (all P ＜ 0.05).Conclusions The childhood and adolescence-first-onset OCD patients had cognitive impairment,including speed of processing,visual learning and memory,working memory;and the patients showed abnormal spontaneous neural activity at some brain regions.The cognitive dysfunction may be associated with abnormal spontaneous neuronal activity in childhood and adolescence-first-onset OCD.

Relationship of the functional polymorphism of dopamine D4 receptor gene with behavioral problems in school-age twins / 中华行为医学与脑科学杂志

Objective To investigate the correlation and characteristic of the functional polymorphism of the dopamine D4 receptor gene on the behavioral problems in school-age twins.Method The behavioral problems were assessed among a total of 147 twin pairs aged 6-12 years with the Achenbach Child Behavior Checklist (CBCL).The DRD4 gene polymorphism was applied for different types with polymerase chain reaction.The generalized estimating equations model was used to analyze the effect of DRD4 gene polymorphism and the interaction of DRD4 gene polymorphism with children age,gender,monozygotic/dizygotic on twins' behavioral problems.Results (1) School-age children's anxiety/depression,withdrawn,thought problems,attention problems,social problems,delinquent problems,aggressive behavior and total variance mainly were correlated with DRD4 gene polymorphism (P＜0.05),and physical discomfort might be related with DRD4 gene polymorphism (P=0.067).Except social problems,the detection rate of behavioral problems of the twins with 4/6 genotype (Gene type carrying 5 or more repeated sequences) of DRD4 gene (6.25％-21.25％) was higher than those with other genotypes (0-14.74％).(2) Withdrawal was related to children age (x2=4.348,P＜0.05),and twins aged 6-10 might lead to withdrawal.(3) The interaction of DRD4 gene polymorphism and children age had a significant effect on withdrawal (x2=4.348,P＜0.05) and physical discomfort(x2 =5.189,P＜0.05),and the elder age (11-12 years) children had a certainly protective effect on the withdrawal and physical discomfort with 4/6 genotype in twins.The detection rates were 3.54％ and 2.65％ in the younger-age (6-10 years) twins,while all 0 in the elder-age (11-12 years) for the withdrawal and the physical discomfort respectively.Conclusions The DRD4 gene polymorphism may be correlated with behavioral problems in school-age twins.The interaction of DRD4 polymorphism and children age had a significantly effect on withdrawal and physical discomfort.

The implantation of Bonebridge in bilateral congenital malformation of external and middle ear / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the auditory efficacy of Bonebridge implantation in patients with bilateral congenital malformation of external and middle ear.@*Methods@#Eleven cases (6 males and 5 females) had unilateral Bonebridge implantation. The age ranged from 8 to 26 and the average age was 16.9. Seven to ten days after operation, the first fitting was undergone. In acoustic sound field, the average auditory thresholds were respectively measured for unaided ears and Bonebridge implanted ears by pure tone auditory (PTA, 0.25, 0.5, 1, 2 and 4 kHz). For the group over 12-year-old, MSTM was applied to evaluate speech discrimination score (SDS). For the other cases, MLNT was used as the test material. The auditory efficacy post Bonebridge implantation would be analyzed and evaluated by comparing the differences between unaided ears and Bonebridge implanted ears.@*Results@#The bone conduction audibility threshold after Bonebridge implantation was as well as the preoperative. The auditory threshold with Bonebridge aided was improved to 25-35 dB HL, when compared to that of the unaided ears in the sound field. The SDS in the group over 12-year-old was improved about 50%; the efficacy was slightly limited for the other two cases (both less than 12 years old). Statistical analysis showed that there were significant differences between unaided ears and Bonebridge implanted ears in the sound field and SDS(P<0.05).@*Conclusions@#The auditory efficacy of Bonebridge is significant and noticeable in patients with bilateral congenital malformation of external and middle ear. Bonebridge provides a new and effective way for patient with congenital malformation of external and middle ear to reconstruct hearing.

Clinical analysis of adult Philadelphia chromosome-positive acute lymphoblastic leukemia with p16 gene deletion / 中华血液学杂志

Objective@#To investigate the clinical implications of p16 gene deletion in adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) .@*Methods@#Retrospective analysis of clinical, immunophenotypic, cytogenetics, molecular characteristics and prognosis of 80 newly diagnosed Ph+ ALL patients with p16 deletion.@*Results@#Of 80 adult Ph+ ALL, the prevalence of p16 gene deletion was 31.3%. p16 gene deletion carriers frequently accompanied with high WBC counts (WBC≥30×109/L) and CD20 expression. The incidence of complex chromosome abnormality in p16 gene deletion group was higher than that in non-deletion group, with alternations in chromosome 7, 8, 19 and der (22) more frequently observed. There was no difference occurred between patients with or without p16 gene deletion in complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs) . However, after three cycles of chemotherapy, the MMR and CMR rate in the p16 gene deletion group was lower than patients with wild-type p16 gene (P=0.034, P=0.036) . The p16 gene deletion patients showed no significant differences in MMR, CMR and relapse rate between Imatinib or Dasatinib plus chemotherapy (P>0.05) . Deletion of p16 gene was significantly associated with poor outcomes including worse overall survival (OS) (37.1% vs 54.1%, P=0.037) , lower disease free-survival (DFS) (12.4% vs 45.9%, P=0.026) , and increased cumulative incidence of relapse (P=0.033) . Among the 25 patients with p16 deletion, 14 underwent allo-HSCT and the median survival was 21 months, better than that of patients received chemotherapy alone (12 months) (P=0.030) .@*Conclusion@#This study indicated that deletion of p16 was associated with poor prognosis in adult Ph+ ALL, and the utility of second-generation TKI (Dasatinib) does not necessarily have an edge on efficacy over Imatinib, but allo-HSCT has the potential of elongating life expectancy. It is an important significance to define the status of p16 in Ph+ ALL for predicting prognosis and guiding therapy decision-making.

Early Diagnostic Value of Serum PCT,CRP and Endotoxin in Patients with Sepsis Induced by Bacterial Bloodstream Infection / 现代生物医学进展

Objective:To explore the early diagnostic value of serum procalcitonin(PCT),C-reactive protein (CRP) and endotoxin in patients with sepsis caused by bacterial bloodstream infection.Methods:Retrospectively analyzed 123 cases of patients diagnosed with sepsis induced by bacterial bloodstream infection in our hospital from May 2010 to May 2015,detected their serum PCT,CRP and endotoxin levels,and analyzed the evaluation value of these three indexes for sepsis induced by bacterial bloodstream infection by receiver-operating characteristic curve (ROC).Results:Blood sample culture results showed that 123 cases of bacterial bloodstream infections caused by sepsis patients in the presence of infection of G+bacteria were 35 cases,G-bacteria infection of 88 cases;The levels of three index in the G+bacteria group were significantly lower than that in the G-bacteria group (P＜0.05);The serum PCT,CRP and endotoxin levels was positive correlated with each other among G+bacteria group,G-bacteria group and all bacteria group;ROC curves showed that the cutoff value of serum PCT,CRP and endotoxin for diagnosis of patients with sepsis induced by G+bacteria bloodstream infection were 1.58 μg/L,95.25 mg/L and 16.71ng/L,and their sensitivity and specificity were (65.92％,88.37％),(67.39％,84.38％) and (56.34％,78.93％) respectively;and the cutoff value for diagnosis of patients with sepsis induced by G-bacteria bloodstream infection were 2.45 μg/L,79.45 mg/L and 15.54 ng/L,their sensitivity and specificity were (78.73％,97.13％),(68.89％,92.38％) and (65.39％,95.33％)respectively.Conclusion:Detecting the serum PCT,CRP and endotoxin levels is helpful to identify patients with sepsis induced by G+ or G-bacteria bloodstream infection,with high sensitivity and specificity,which can be used in the early diagnosis of sepsis induced by bacterial bloodstream infection.

Effect of atorvastatin on adventitial fibroblast phenotype differentiation in atherosclerosis of apolipoprotein E-knockout mice / 中国病理生理杂志

AIM: To explore the effect of atorvastatin on the expression of α-SMA and TGF-β1 in the adventi-tia of ApoE-/-mice with atherosclerosis, and to investigate the underlying mechanism of atorvastatin therapy.METHODS:Male ApoE-/-mice (n =40) at 6-weeks of age were used to establish the atherosclerosis model by feeding with high fat diet. The mice were randomly divided into model group and atorvastatin group.In atorvastatin group, the mice were lavaged with atorvastatin at dose of 20 mg? kg-1? d-1 .The mice in model group were given normal saline.C57BL/6 mice of the same age served as control group, feeding with ordinary food.The mice were respectively sacrificed at the time points of 10 and 15 weeks after feeding with different diets.The ascending aorta was removed for serial sectioning.Some sections were per-formed with Movat staining in order to observe the morphological changes of the tissues, and to measure the relative athero-sclerotic plaque area and the thickness of the adventitia.Some sections were stained with Sirius red to identify the collagen synthesis.Immunohistochemistry assay was prepared to observe the expression of α-SMA and TGF-β1 in the adventitia at different time points.The expression of TGF-β1 at mRNA and protein levels in the thoracoabdominal aorta was measured by RT-qPCR and Western blot.RESULTS: Compared with model group, the formation of plaque in atorvastatin group signifi-cantly descended.Meanwhile the adventitial thickness and collagen synthesis also decreased.The results of immunohisto- chemical staining showed that compared with 10 weeks-model group, α-SMA and TGF-β1 in 15 weeks-model group was in-creased.The expression of α-SMA and TGF-β1 in atorvastatin group decreased significantly compared with model group. The expression of TGF-β1 at mRNA and protein levels in model group were higher than those in control group.They de-creased in atorvastatin group compared with model group.Compared with 10 weeks-model group, the mRNA and protein of TGF-β1 in 15 weeks-model group were increased.CONCLUSION: Atorvastatin modulates adventitial fibroblast phenotype differentiation by suppressing expression of TGF-β1 and intervenes atherosclerotic development in ApoE.

Correlation of 5-HTTLPR genetype and behavioral problems in school-age twins / 中华行为医学与脑科学杂志

Objective To analyze the correlation between 5-hydroxytryptamine transporter gene linked polymorphic region(5-HTTLPR) and twin children's behavioral problems and its interaction with environmental factors.Methods A total of 147 pairs of school-age twins aged 6-12 years were enrolled.The behavioral problems were assessed with the Child Behavior Checklist (CBCL).The genotype of 5-HTTLPR was detected by the method of PCR.The correlation of 5-HTTLPR and children's behavioral problems was performed using generalized estimating equation.Results (1) The overall incidence rate of behavioral problems in school-age twins was 24.15％ (27.94％ in the boys;20.89％ in the girls),in which the rate of thinking problems (15.31％) was the highest,and the rates of other problems were lower (3.40％-8.16％).(2) The results of correlation analysis showed that 5-HTTLPR was only related to the social problems (P＜ 0.05).The S allele of 5-HTTLPR maybe associated with the social problems.(3) The results of interaction of 5-HTTLPR with twin factors of themselves and family environmental factors showed that 5-HTTLPR was the main effect of the anxious/depressed problems,and S allele carriers were easier to occur anxious/depressed problems.Gender was the main effect of the social problems,and boys were easier to occur social problems.There was no significant interaction between 5-HTTLPR and twin factors of themselves and family environmental factors.Conclusion 5-HTTLPR genetype may have some relevance to the social and anxious/depressed problems,and S allele may be a susceptibility gene of social and anxious/depressed problems.