Effects of group cognitive behavioral therapy on clinical efficacy and executive function in patients with generalized anxiety disorder / 四川精神卫生

BackgroundPrevious studies have found that patients with generalized anxiety disorder （GAD） have impaired performance in executive function， and group cognitive behavioral therapy （CBT） has been shown to be effective in alleviating negative affect in patients with GAD， while its efficacy on executive function remains unclear. ObjectiveTo explore the efficacy of group CBT on anxiety symptom and executive function in GAD patients， so as to provide references for the rehabilitation program for GAD. MethodsA total of 80 consecutive patients with GAD who were hospitalized in Sleep and Psychosomatic Medical Center of Shiyan Taihe Hospital from March 2021 to August 2022 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for GAD were enrolled， and they were assigned into study group （n=40） and control group （n=40） using random number table methods. All patients were subjected to routine medication treatment and regular health education， based on this， study group received group CBT once a week （6 weeks， 60 to 90 minutes per session）. At the enrollment and after 6 weeks of treatment， patients were assessed using Hamilton Anxiety Scale （HAMA） and Frontal Assessment Battery （FAB）. ResultsANOVA with repeated measures on HAMA score revealed a significant time effect （F=1 870.320， P<0.01）， no significant group effect and no significant time×group interaction effect （F=1.254， 0.293， P>0.05）. Significant time effect， group effect and time×group interaction effect were reported on FAB scores （F=311.190， 4.399， 7.021， P<0.05 or 0.01）. Further analysis indicated that FAB scores of both groups after treatment were higher than those at baseline （t=200.569， 115.401， P<0.01）.And the FAB score of study group was higher than that of control group after treatment （t=-3.211， P<0.01）. ConclusionGroup CBT combined with medication treatment for GAD may alleviate the anxiety symptoms and improve executive function in GAD patients. ［Funded by Shiyan Science and Technology Bureau Pilot Scientific Research Project （number， 21Y21）］

Use of indocyanine green fluorescence navigation in laparoscopic anatomical hepatectomy / 中华外科杂志

Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ2 test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.

Exosomal MicroRNA-10a Is Associated with Liver Regeneration in Rats through Downregulation of EphA4 / 中华医学杂志(英文版)

<p><b>Background</b>MicroRNAs (miRNAs) have been reported to play vital roles in liver regeneration. Previous studies mainly focused on the functions of intracellular miRNAs, while the functions of circulating exosomal miRNAs in liver regeneration remain largely unknown. The aim of this study was to identify the key exosomal miRNA that played vital roles in liver regeneration.</p><p><b>Methods</b>The Sprague-Dawley male rats were assigned to 70% partially hepatectomized group (n = 6) and sham surgery group (n = 6). The peripheral blood of both groups was collected 24 h after surgery. The exosomal miRNAs were extracted, and microarray was used to find out the key miRNA implicated in liver regeneration. Adenovirus was used to overexpress the key miRNA in rats, and proliferating cell nuclear antigen (PCNA) staining was applied to study the effect of key miRNA overexpression on liver regeneration. Western blotting was used to validate the predicted target of the key miRNA.</p><p><b>Results</b>Exosomal miR-10a was upregulated more than nine times in hepatectomized rats. The level of miR-10a was increased in the early phase of liver regeneration, reached the top at 72 h postsurgery, and decreased to perioperative level 168 h after surgery. Moreover, enforced expression of miR-10a by adenovirus facilitated the process of liver regeneration as evidenced by immunohistochemical staining of PCNA. Erythropoietin-producing hepatocellular receptor A4 (EphA4) has been predicted to be a target of miR-10a. The protein level of EphA4 was decreased in the early phase of liver regeneration, reached the bottom at 72 h postsurgery, and rose to perioperative level 168 h after surgery, which was negatively correlated with miR-10a, confirming that EphA4 served as a downstream target of miR-10a. Moreover, inhibition of EphA4 by rhynchophylline could promote the proliferation of hepatocytes by regulating the cell cycle.</p><p><b>Conclusion</b>Exosomal miR-10a might accelerate liver regeneration through downregulation of EphA4.</p>

Effect of Kangmin Xiaoyan Lotion Combined with Levocetirizine Hydrochloride on Facial Recurrent Dermatitis in 40 Cases / 医药导报

Objective To discuss the clinical therapeutic effect of Kangmin xiaoyan lotion combined with levocetirizine hydrochloride in the treatment of facial recurrent dermatitis. Methods Eighty cases of facial recurrent dermatitis were randomly divided into treatment group and control group,40 cases in each group.The treatment group was given Kangmin xiaoyan lotion with wet compression for 20 min in the morning and evening,and levocetirizine hydrochloride 10 mL orally once daily;the control group was only given levocetirizine hydrochloride orally once daily.One month later,the symptoms and signs of skin lesions and adverse reactions in each group were observed. Results One month after the treatment,the scores of symptoms and signs were significantly decreased in the two groups (P<0.05).After the treatment,the scores were significantly different between the two groups (P<0.05).Clinical efficacy of the treatment group and control group was 92.5% and 65.0%,with significant difference(P<0.05). Conclusion Kangmin xiaoyan lotion can be effective in the treatment of facial recurrent dermatitis,and it is worthy of clinical application.

Transcatheter Arterial Chemoembolization Plus ¹³¹I-Labelled Metuximab versus Transcatheter Arterial Chemoembolization Alone in Intermediate/Advanced Stage Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

OBJECTIVE: The aim of the study was to compare transcatheter arterial chemoembolization (TACE) plus ¹³¹I-labelled metuximab with TACE alone for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A comprehensive search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Chinese BioMedical Literature Database with published date from the earliest to February 29th, 2016. No language restrictions were applied, but only prospective randomized controlled trials (RCTs) or non-RCTs were eligible for a full-text review. The primary outcome was the overall survival (OS) and effective rate (the rate of partial atrophy or complete clearance of the tumor lesion). The odds ratios (ORs) were combined using either the fixed-effects model or random-effects model. RESULTS: Eight trials (3 RCTs and 5 non-RCTs) were included, involving a total of 1121 patients. Patients receiving combined therapy of TACE plus ¹³¹I-labelled metuximab showed significant improvement in effective rate {OR = 4.00, (95% confidence interval [CI]: 2.40–6.66), p < 0.001}, 1-year OS (OR = 2.03 [95% CI: 1.55–2.67], p < 0.001) and 2-year OS (OR = 2.57 [95% CI: 1.41–4.66], p = 0.002]. CONCLUSION: TACE plus ¹³¹I-labelled metuximab is more beneficial for treating advanced HCCs than TACE alone in terms of tumor response and OS. Large, multi-center, and blinded randomized trials are required to confirm these findings.

Study on changes of coagulation, fibrinolysis, platelet and tumor markers in patients with advanced lung cancer by chemotherapy / 中国生化药物杂志

Objective To investigate effect of coagulation, fibrinolysis, platelet and tumor markers in patients with advanced lung cancer by chemotherapy.Methods 21 cases of advanced lung cancer patients were selected to be the experiment group, and 20 healthy people were selected to be the control group.The experiment group were treated by chemotherapy,coagulation, fibrinolysis, platelet and tumor markers were compared before and after the treatment.ResuIts Compared with experiment group before chemotherapy, PT, APTT, TT levels of the patients after chemotherapy were lower, serum FIB concentrations were higher (P<0.05); PC and FPS were lower , D-D, PAI-1 concentration level were higher (P<0.05); PLT, MPV, PDW levels were lower (P<0.05); CEA, CYFRA21-1, NSE, CA125 levels were lower (P<0.05).ConcIusion Chemotherapy can enhance the effect of coagulation system in patients with advanced lung cancer, inhibit the fibrinolytic system and reduce the level of tumor markers.

An epidemiological survey of snoring disease and OSAHS among 374 truck drivers in Guangzhou, China / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the prevalence rates of snoring disease and obstructive sleep apnea-hypopnea syndrome (OSAHS) and their risk factors among truck drivers in Guangzhou, China.</p><p><b>METHODS</b>A questionnaire survey was conducted in 374 truck drivers who were selected from 5 logistics companies in Guangzhou by cluster sampling. Those who had potential snoring disease or OSAHS underwent polysomnographic monitoring at night. The obtained data were analyzed to calculate the prevalence rates of snoring disease and OSAHS and determine the risk factors for OSAHS.</p><p><b>RESULTS</b>A total of 335 subjects completely questionnaires, with a response rate of 90%. Among the 335 subjects, 125 (37.3%) had habitual snoring, and 42 (12.5%) had OSAHS according to the diagnostic criterion (apnea-hypopnea index ≥ 5 times/h). The multiple stepwise regression analysis showed that the risk factors for OSAHS were age, alcohol use, family history of snoring, body mass index, and upper airway abnormality. Of the subjects with grade ≥ 2 snoring and OSAHS, 65.4% often felt sleepy when driving during daytime, and 42% had suffered or nearly suffered traffic accidents due to sleepiness when driving. Moreover, 95.5% (320) of the 335 truck drivers did not consider snoring a disease, and 98% did not think traffic accident might be related to snoring.</p><p><b>CONCLUSION</b>The prevalence rates of snoring disease and OSAHS among truck drivers are 37.3% and 12.5%, respectively. Therefore, prevention measures should be established according to the epidemiological characteristics to help the truck drivers realize the hazards of snoring disease and OSAHS, thus minimizing the prevalence and hazards of the diseases.</p>

Effect of uvulopalatopharyngoplasty on obstructive sleep apnea hypopnea syndrome in patients with resistant hypertension / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of uvulopalatopharyngoplasty (UPPP) to obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with resistant hypertension (RH).</p><p><b>METHODS</b>UPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients, who also suffered from RH [who taking more than three kinds of antihypertensive drugs (including diuretics) and still not able to control blood pressure at 140/90 mm Hg (1 mm Hg = 0.133 kPa)]. Polysomnography monitoring, ambulatory blood pressure monitoring, apnea hypopnea index (AHI), lowest saturation of blood oxygen (SaO2) and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery.</p><p><b>RESULTS</b>Six months after surgery,the total efficiency was 61.1% (22/36). The AHI median [25 quartile; 75 quartile] from 37.5 [26.0; 48.3]/h to 9.5 [9.0; 21.3]/h, the lowest the SaO2 average (x(-) ± s, the same below) increased from 0.655 ± 0.114 to 0.860 ± 0.037, the differences were statistically significant (P value < 0.05). 24 h systolic blood pressure, daytime systolic blood pressure, night contraction, diastolic and mean arterial pressure decreased from (160.8 ± 6.8), (170.5 ± 2.5), (163.6 ± 10.5), (100.8 ± 5.6) and (96.8 ± 7.5) mm Hg to (142.5 ± 7.3), (150.8 ± 7.6), (140.1 ± 6.4), (81.8 ± 7.4) and (93.7 ± 2.4) mm Hg, the differences were statistically significant (P < 0.05). The degrees of AHI descent and the average SaO2 improvement were concerned with the degree of systolic blood pressure, diastolic blood pressure decent (r > 0.80 and r(2) > 0.50). The average numbers of antihypertensive drugs decreased form (3.6 ± 0.5) to (2.9 ± 0.5) compared preoperatively and postoperatively, the difference was statistically significant (t = 5.537, P < 0.01). The use of antihypertensive medication reduced in 23 cases (23/36, 63.8%) compared preoperatively and postoperatively.</p><p><b>CONCLUSIONS</b>The blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation.</p>

Professor XIAO Ji-fang's idea on acupuncture-moxibustion / 中国针灸

Professor XIAO Ji-fang, an experienced practitioner of Chinese medicine of Guangxi, is famous for his medical ethics, wide range of studies, comprehensive understanding of the classics, innovation, as well as u nique academic ideas. He focuses on mind-regulating in acupuncture and pulse diagnosis. At the same time, differentiation of syndromes, diseases and meridians are emphasized. The combination of acupuncture and moxibustion and integration of acupuncture and medicine are promoted. He is especially skilled at slow twisting needle insertion, Taiji needling therapy, scalp acupuncture and moxibustion with a herb prepared thread of Zhuang nationality, which all achieve remarkable effects.

AXON-PROJECTION OF ENDOMORPHIN-2-CONTAINING NEURONS IN THE TRIGEMINAL GANGLION TO THE MEDULLARY DORSAL HORN IN THE RAT / 解剖学报

Objective To observe whether endomorphin-2-immunoreactive(EM2-ir) neurons in the trigeminal ganglion(TG) project to the medullary dorsal horn(MDH) in the rat. Methods Fluoro-gold(FG) retrograde tracing and immunofluorescent histochemical staining for EM2 were applied. Results After FG was injected into the MDH,many FG labeled neurons with small,medium and large diameters were observed in the TG.There were also aboundant EM2-ir neurons with different diameters in the TG.The majority of FG labeled neurons in the TG showed EM2-immunoreactivities.Almost all of the EM2/FG double-labeled neurons were medium and small in size.Conclusion EM2-ir neurons in the TG project to the MDH in the rat.