January 2020, Volume 23，No.2 Abstracts
Author：尹鹏 Source：CGP Published： [01-16] views： 186
Research Progress of Related Assessment Tools for Patient Medication Experience WANG Yongli，GUO Yawen，FU Bo，QI Bei，ZHANG Zhenxiang*
The Nursing College of Zhengzhou University，Zhengzhou 450001，China
*Corresponding author：ZHANG Zhenxiang，Professor，Doctoral supervisor；E-mail：email@example.com
【Abstract】 The medication experience of patients has much influence on their belief in taking medicine，behaviors and disease outcomes，while there are currently many kinds of assessment tools for patient medication experience that have not been unified.Therefore，this paper sorts out the related concepts of patient medication experience and the development process，content，reliability and validity，advantages and disadvantages of these assessment tools，in order to provide a scientific reference for the rational evaluation of patient medication experience.
【Key words】 Drug therapy；Medication experience；Assessment tools；Review
New Progress in the Application of Bibliotherapy in Patients with Schizophrenia XUE Man1，2，YAO Guizhong1*，CHENG Jia1
1.Peking University Sixth Hospital/Peking University Institute of Mental Health/National Clinical Research Center for Mental Disorders/Key Laboratory of Mental Health，National Health Commission （Peking University），Beijing 100191，China
2.The Fifth Department of Psychiatry，the Eighth Hospital of Shijiazhuang City，Shijiazhuang 050081，China
*Corresponding author：YAO Guizhong，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 The cognitive and social function of schizophrenics are severely damaged.Though drug treatment can effectively control positive symptoms，its effect on functional damage is not ideal.Bibliotherapy，as a non-drug treatment，can be used to improve the functional damage of patients with schizophrenia.And because of its low cost，easy implementation，and easy access，it has gradually attracted the attention of researchers.This paper further elaborated the overview，implementation process，research method of bibliotherapy and its application effect in patients with schizophrenia，in order to provide reference for future applications and research.
【Key words】 Schizophrenia；Bibliotherapy；Non-drug treatment；Review
Research Progress of Early Biomarkers of Alzheimer's Disease in Peripheral Blood WANG Xuesong，KONG Lihong*，YU Chaochao，WANG Yueshen
Hubei University of Chinese Medicine，Wuhan 430061，China
*Corresponding author：KONG Lihong，Professor，Doctoral supervisor，Research direction：mainly research in mechanism of acupuncture and moxibustion in prevention and treatment of encephalopathy；E-mail：email@example.com
【Abstract】 The onset of Alzheimer's disease is concealed，and a series of pathological changes have occurred in the body several decades before the onset of dementia symptoms.Once patients are in the dementia period，there are currently no ideal drugs and therapies to alleviate the condition.Alzheimer's disease is positively correlated with aging，and the older the patient，the higher the risk of this illness.Screening appropriate biomarkers of Alzheimer's disease for its early diagnosis，prevention，detection，and treatment is important for preventing and delaying the development of Alzheimer's disease.Peripheral blood biomarkers are easy and repeatable to collect and detect，which makes them the most ideal source of biomarkers.In this paper，based on the classical Aβ and Tau protein mechanisms of Alzheimer's disease，the potential biomarkers in peripheral blood were reviewed.
【Key words】 Alzheimer disease；Biological markers；Early diagnosis；Review
Community-based Management of Chronic Heart Failure Patients Using Heart Failure Inventory Project XU Xiaorong1，PING Pengna2，WANG Xin1，WANG Hua1，CHEN Pengxu3，HAN Mengmeng1，XU Lin1，YU Liping1*，ZHAO Wenshu1*
1.Heart Center & Beijing Key Laboratory of Hypertension Disease，Beijing Chaoyang Hospital，Capital Medical University，Beijing 100020，China
2.Department of General Medicine，Second Hospital of Shanxi Medical University，Taiyuan 030001，China
3.Department of General Medicine，Chaoyang District Sanlitun Community Health Center，Beijing 100027，China
*Corresponding authors:YU Liping，Chief physician；E-mail:firstname.lastname@example.org
ZHAO Wenshu，Chief physician；E-mail:email@example.com
XU Xiaorong and PING Pengna are co-first authors
【Abstract】 Background Active treatment and good management for patients with chronic heart failure（HF） can avoid exacerbation of the disease.But at present，there is no a unified，publicly recognized HF management model.Our research team used an HF inventory project to manage chronic HF patients in a unified way，aiming to provide a reference for the exploration of community-based management models of HF.Objective To evaluate the effect of community-based management of chronic HF patients with an HF inventory project，hoping to offer a basis for the development of a simple chronic HF management model that can be easily carried out and promoted.Methods We enrolled 200 HF inpatients from the Heart Center，Beijing Chaoyang Hospital，Capital Medical University during June 30，2016 to June 30，2017，and equally randomized them into the management group（n=100） and control group（n=100），treating with comprehensive management using an HF inventory project and follow-up once a month delivered by a general practitioner team，routine outpatient management without special interventions and follow-up once a month with recording of related data delivered by a general practitioner team，respectively.Intergroup comparisons were made in terms of baseline data obtained by searching the electronic medical record system，and NT-proBNP，left ventricular ejection fraction（LVEF），left ventricular end-diastolic diameter（LVEDD），left ventricular end-systolic diameter（LVESD），standard HF medication treatment，re-hospitalization rate and mortality rate at the end of 6-month follow-up.Results A total of 176 cases completed the follow-up（89 in the management group and 87 in the control group）.At the end of 6-month follow-up，the management group showed lower mean NT-proBNP，NYHA class，LVEDD and LVESD，and higher mean LVEF compared with the control group（P<0.05）.The use rates of ACEI/ARB increased while the use rate of spironolactone decreased significantly in the management group after intervention（P<0.05）.After management，the utilization rate of ACEI/ARB in the management group was higher than that in the control group（P<0.05）.However，there was no significant difference in the utilization rates of beta-blockers and spironolactone between the two groups（P>0.05）.Furthermore，the management group showed a lower rehospitalization rate due to HF〔11.2%（10/89）〕vs〔29.9%（26/87）〕（χ2=9.404，P=0.002），but a similar mortality rate〔9.0%（8/89）vs 11.5%（10/87），χ2=0.301，P=0.583〕.Conclusion By using our HF inventory project，the management effect of HF patients is increased significantly，suggesting that this simple project is feasible for community-based management of chronic HF.
【Key words】 Heart failure；Community management；Heart failure checklist；Adverse cardiac events
Improvement Effects of Self-management Programs on Quality of Life and Negative Mood in Patients with Stroke：a Meta-analysis DUAN Hongwei，WANG Xiaoxiao，WANG Aihong*
School of Nursing，Nanjing University of Chinese Medicine，Nanjing 210023，China
*Corresponding author：WANG Aihong，Associate professor，Master supervisor；E-mail：firstname.lastname@example.org
【Abstract】 Background Modern rehabilitation theory and practice have shown that effective rehabilitation training can alleviate the functional disability of stroke patients，accelerate the recovery and reduce medical costs.As a new type of health management method，self-management project has the advantage of “low input and wide coverage”，which provides a way for stroke survivors to promote rehabilitation.The rehabilitation basis of stroke patients depends on their health self-management abilities.Objective To systematically assess the improvement effects of self-management interventions on the quality of life and negative mood in patients with stroke.Methods We searched the databases such as PubMed，Web of Science，EBSCO，Cochrane Register of Controlled Trials （CENTRAL），EMBase，China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform，CBM，and VIP from inception to May 2018 for RCTs conducted in adults with stroke receiving organized，systematic self-management interventions（experimental group） and those receiving usual care or receiving no interventions（control group） with outcome evaluation indicators consisting of changes in quality of life，negative mood，self efficacy and activities of daily living （ADL）．Data were analyzed with RevMan 5.3.Results Nine RCTs with 694 participants were included.The quality of all of them was evaluated as “B”，and the overall level of quality was intermedium.Meta-analysis showed that the overall QOL score in the experimental group was much higher than that of the control group 〔SMD=0.32，95%CI（0.15，0.49），P=0.000 2〕.Subgroup analyses showed that mean SSQOL score and SF-36 score of the experimental group were both higher than those of the control group 〔SMD=0.35，95%CI（0.13，0.57），P=0.002；SMD=0.29，95%CI（0.02，0.56），P=0.04〕.The experimental group showed much lower mean HADS score than the control group 〔MD=-1.01，95%CI（-2.00，-0.02），P=0.05〕.The mean self-efficacy score of the experimental group was higher than that of the control group 〔SMD=0.45，95%CI （0.21，0.69），P=0.000 3〕；there was no significant difference in the mean score of the Stroke Self-efficacy Questionnaire（SSEQ） between the two groups 〔SMD=0.31，95%CI（-0.11，0.73），P=0.15〕；the experimental group obtained much higher mean General Self-efficacy Scale （GSES） score than the control group 〔SMD=0.52，95%CI （0.22，0.81），P=0.000 6〕.The experimental achieved significantly higher mean ADL score than the control group 〔SMD=0.84，95%CI（0.07，1.61），P=0.03〕；there were no significant differences in mean ADL score between the two groups either after short-term interventions or long-term interventions 〔SMD=0.70，95%CI（-0.15，1.54），P=0.11；SMD=1.00，95%CI （-0.52，2.52），P=0.20〕.Conclusion Self-management programs can effectively improve the quality of life and negative mood，as well as general self-efficacy and ADL in stroke patients.However，the effects on the SSEQ score and other health related behaviors need to be verified by further studies.
【Key words】 Stroke；Self management；Negative mood；Quality of life；Meta-analysis
Translation and Reliability and Validity of Colorectal Cancer Health Belief Scale WU Xiaodan1，ZHANG Meifen2，ZHENG Meichun1，PAN Zhizhong1，CHEN Jingyu2，JIA Shumin2，QIN Huiying3*
1.Department of Colorectal Surgery，Cancer Center of Sun Yat-sen University，Guangzhou 510060，China
2.School of Nursing，Sun Yat-sen University，Guangzhou 510080，China
3.Department of Nursing，Cancer Center of Sun Yat-sen University，Guangzhou 510060，China
*Corresponding author：QIN Huiying，Chief superintendent nurse；E-mail：email@example.com
【Abstract】 Background Accurate and effective evaluation of individual health belief characteristics is the premise of effective intervention.Mature scales for evaluating health belief of hypertension，breast cancer and other diseases has been developed in China.As a common malignant tumor，colorectal cancer is a national focus in terms of prevention and control.However，there is no reliable，valid and mature Chinese evaluation scale for health belief of colorectal cancer.Objective To introduce and translate Colorectal Cancer Health Belief Scale and examine its reliability and validity in Chinese population in order to provide an effective scale for measuring the health belief in patients with colorectal cancer in China.Methods According to Brislin translation model，we translated the English Colorectal Cancer Health Belief Scale into Chinese version following the forward-translation and back-translation and the Chinese version of Colorectal Cancer Health Belief Scale was cross-culturally adjusted by expert review and a pilot study.A total of 200 relatives of patients with colorectal cancer from the Department of Colorectal Surgery，Cancer Center of Sun Yat-sen University in 2017 completed the scale and we tested its reliability and validity.Results Six dimensions （36 items），the severity of colorectal cancer，knowledge of the susceptibility to colorectal cancer，the benefits of colorectal cancer screening，the obstacles in colorectal cancer screening，health motivation and self-efficacy of colorectal cancer screening，were included in the Chinese version of Colorectal Cancer Health Belief Scale.The Pearson correlation between item and total score of the scale ranged from 0.349-0.726.The content validity index of the scale （S-CVI） was 0.98.Content validity index of each item （I-CVI） ranged from 0.84 to 1.00.Six common factors were abstracted by principal component analysis and they explained 66.645% of total variance，and each item had a high rotated component matrix （>0.400）． The test-retest reliability was 0.848.The Cronbach's α coefficient of the total scale and its dimensions were 0.881 and 0.801-0.944，respectively.Conclusion The Chinese version of Colorectal Cancer Health Belief Scale has been proved to be reliable and valid.It is a valuable tool for evaluating health belief of colorectal cancer in mainland China.
【Key words】 Colorectal neoplasms；Health Belief；Reliability；Validity；Methodology research
Effects of Smoking on Adverse Events in Patients with Heart Failure with Preserved Ejection Fraction WANG Qi*，LIN Zhen，ZHOU Yanhui，MA Tianyi
Department of General Practice，Central South University Xiangya School of Medicine Affiliated Haikou Hospital，Haikou 570208，China
*Corresponding author：WANG Qi，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background Smoking is an important risk factor in the development of heart failure with preserved ejection fraction（HFpEF），and previous studies have identified that smoking is a significant predictor of death in HFpEF population.However，the relationship between smoking and adverse events of heart failure has not been examined in patients with HFpEF.Objective To analyze the relationship between smoking and adverse events of heart failure in patients with HFpEF.Methods Patients with HFpEF diagnosed in Department of Cardiovascular Medicine and Department of General Practice of Central South University Xiangya School of Medicine Affiliated Haikou Hospital from 2013 to 2018 were selected as study subjects，and their baseline data，previous medical history and drug treatment data were collected.According to the smoking situation，all patients were divided into never smoking group，former smoker group，and current smoking group，and differences among the three groups were compared.Kaplan-Meier analysis was used to analyze the unadjusted cumulative incidence and survival probability of patients with heart failure requiring hospitalization，and the difference was compared using the Log-rank test.Multivariate Cox proportional hazard regression was used to analyze the risk of hospitalization for heart failure，death，and cardiac death among patients in three groups.Results A total of 1 717 patients aged 58-87 with HFpEF were enrolled with an average age of（72.2±10.3）．There were 116 ( 6.7% ) current smoking，872 ( 50.8% ) former smoking，729 ( 42.5% ) never smoking. The median follow-up time was 2.9 years.And 387 patients ( 22.5% ) suffered from hospitalization for heart failure.There were 374 ( 21.8% ) deaths and 218 ( 12.7% ) cardiac deaths.There was a statistically significant difference in the unadjusted cumulative incidence and survival probability of hospitalization for heart failure among patients in three groups（Log-rank P=0.003，0.044）．Multivariate Cox proportional hazard regression analysis showed that current smoking was an influencing factor for hospitalization for heart failure〔HR=1.680，95%CI（1.083，2.606）〕，death〔HR=1.820，95%CI（1.195，2.773）〕，and cardiac death 〔HR=1.850，95%CI（1.092，3.133）〕in patients with HFpEF（P<0.005）．Conclusion Current smoking is associated with an increased risk of adverse clinical outcomes for HFpEF，especially the hospitalization for heart failure.Smoking cessation strategies possibly have a role in reducing the risk of adverse cardiovascular outcomes in patients with HFpEF.
【Key words】 Heart failure；Smoking；Heart failure with preserved ejection fraction；Adverse events；Root cause analysis；Proportional hazards models
Efficacy Analysis of Tenofovir on HBV-related Decompensated Liver Cirrhosis Patients Experiencing Antiviral Treatment Failure ZHAO Yang1，LI Ye2，ZHAO Chen3*
1.Department of Infectious Diseases，No.965 Hospital of PLA Joint Logistic Support Force，Jilin 132012，China
2.Infirmary of No.93038 Troops of PLA，Liuhe 135300，China
3.School of Clinical Laboratory，Jilin Medical University，Jilin 132013，China
*Corresponding author：ZHAO Chen，Associate professor；E-mail：email@example.com
【Abstract】 Background Antiviral treatment is an important means of treating HBV-related liver cirrhosis.Classical antiviral drugs are prone to drug resistance.Tenofovir is a new antiviral drug that can be used to save HBV-related decompensated liver cirrhosis patients experiencing antiviral treatment failure.Objective To evaluate the clinical efficacy of tenofovir on HBV-related decompensated liver cirrhosis patients experiencing treatment failure with lamivudine alone or combined with lamivudine and adefovir dipivoxil.Methods 37 decompensated HBV-related decompensated liver cirrhosis patients who experienced treatment failure with lamivudine alone or combined with lamivudine and adefovir dipivoxil were selected from No.965 Hospital of PLA Joint Logistic Support Force from December 2014 to October 2017.The treatment regimen was changed to a 48-week course of oral administration of adefovir dipivoxil（300 mg，once daily）.And they were treated with oral TDF（300 mg/times/day） for 48 weeks.The level of HBV-DNA，HBV-DNA negative conversion rate，HBeAg negative conversion rate，liver functions，FibroScan values and incidence of complications were compared before and after the treatment.Results The levels of HBV-DNA，ALT，total bilirubin（TBiL） and FibroScan values were lower，and levels of albumin（ALB），cholinesterase（CHE） and prothrombin activity（PTA） after 24-week and 48-week treatments were higher than those before the treatment（P<0.05）.And 48-week treatment further decreased HBV-DNA and FibroScan values，and increased ALB and CHE in comparison with 24-week treatment（P<0.05）.The negative conversion rates of HBV-DNA and HBeAg were 34.3%（12/35） and 11.4%（4/35），respectively after 24-week treatment，and were 60.0%（21/35） and 22.9%（8/35），respectively after 48-week treatment.Compared to baseline status，the incidence of peritoneal effusion and spontaneous peritonitis after 24-week treatment was lower（P<0.01），and further decreased after 48-week treatment（P<0.01）.There was no significant difference in the incidence of digestive tract hemorrhage，hepatic encephalopathy and hepatorenal syndrome before and after the treatment（P>0.05）.During the treatment, 1 case died of digestive tract hemorrhage, 1 case died of primary liver cancer.Conclusion Tenofovir dipivoxil could continuously inhibit the replication of HBV，increase the negative conversion rate of HBV-DNA，improve liver function effectively，and lower the degree of hepatic fibrosis and incidence of complications.It may be an ideal alternative medicine for HBV-related decompensated liver cirrhosis patients experiencing antiviral treatment failure with lamivudine.
【Key words】 Hepatitis B；Liver cirrhosis；Tenofovir；Lamivudine；Adefovir；Antiviral agents；Treatment outcome
Risk Factors and Predictive Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease PENG Yu，LIU Xiaohui*，DUAN Zhao，ZOU Zheng
Department of Rheumatology，Jiangxi Provincial Children's Hospital，Nanchang 330006，China
*Corresponding author：LIU Xiaohui，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background At present Kawasaki disease （KD） has become the leading cause of acquired heart disease in children.Although intravenous immunoglobulin （IVIG） combined with aspirin were commonly adopted as the standard therapy protocol in KD which can effectively decrease the incidence of coronary artery lesions （CALs），some KD patients are resistant to IVIG therapy and they are at higher risk of developing CALs than patients who response to IVIG therapy.Therefore，it is very important to predict IVIG-resistance indicators in patients with KD.Objective To analyze the risk factors of IVIG resistance in KD，develop a new predictive model to identify IVIG resistance，and evaluate the efficacy of the new predictive model compared with other four existing predictive models（Egami，Kobayashi，Fu and Lin）.Methods A retrospective analysis was made on the clinical data of 173 KD children diagnosed，treated and followed up in Jiangxi Provincial Children's Hospital from January 2016 to June 2018.The patients were divided into IVIG resistant group and IVIG response group.Multivariate Logistic regression was used to analyze the independent risk factors of IVIG resistance.A new predictive model was established by assignment.Four other predictive models were used to evaluate the subjects.The predictive efficacy of the new model was compared with the other four predictive models through the receiver operating characteristic （ROC） curve.Results Of the 173 cases with KD，31 cases（17.9%）were IVIG resistance and 142（82.1%）were IVIG response.Compared with the IVIG response group，IVIG resistance group had significantly higher percentage of male and higher white blood cell count （WBC），neutrophil count （N），percentage of neutrophils ，C-reactive protein （CRP） and ferritin （SF） levels and lower serum sodium level（P<0.05）.Multivariable Logistic regression analysis showed that male〔OR=5.151，95%CI（1.583，16.756）〕，CRP〔OR=1.166，95%CI（1.070，1.272）〕，sodium level〔OR=0.837，95%CI（0.719，0.914）〕 and SF〔OR=1.192，95%CI（1.079，1.318）〕 were independent risk factors of IVIG resistance in KD（P<0.05）.The cut-off values of each indicator were calculated by ROC curve.The results showed that the cut-off values of CRP，blood Na and SF were 94 mg/L，135 mmol/L and 148 μg/L，respectively.Taking 4 point as the cut off value，and the sensitivity and specificity were 79.9% and 53.3%.The sensitivity and specificity of the Egami model for the data were 38.7% and 73.8%，respectively.The sensitivity and specificity of the Kobayashi model were 35.5% and 88.7%，respectively.The sensitivity and specificity of the Fu model were 48.4% and 78.7%，respectively.The sensitivity and specificity of the Lin model are 77.4% and 55.3%，respectively.Conclusion Male，sodium，CRP and SF are independent risk factors of IVIG resistance in KD.The new predictive model have a higher sensitivity and prediction efficacy than models of Egami，Kobayashi，Fu and Lin.
【Key words】 Mucocutaneous lymph node syndrome；Intravenous immunoglobulin resistance；Risk factors；Predictive models；ROC curve
Application Effect of Transcranial Magnetic Stimulation Combined with Core Strength Training in Children with Spastic Cerebral Palsy BAI Yan，WANG Xiuxia，CHEN Haiying*
The Second Hospital of Hebei Medical University，Shijiazhuang 050000，China
*Corresponding author：CHEN Haiying，Chief physician；E-mail：email@example.com
【Abstract】 Background Rehabilitation treatment is of vital importance to both physical and mental health of children with spastic cerebral palsy.But responses to regular comprehensive training are not satisfactory in such patients.Transcranial magnetic stimulation can promote the recovery of brain functions by using magnetic fields to stimulate the central nervous system.Core strength training is a kind of rehabilitation targeting on resultant strength of core muscles，which can systematically improve the physical and mental state.Objective To explore the application value of transcranial magnetic stimulation combined with core strength training in children with spastic cerebral palsy.Methods 448 children with spastic cerebral palsy were recruited from the Second Hospital of Hebei Medical University from 2016 to 2017，and were divided into routine group （148 cases），control group （150 cases） and study group （150 cases） by a random number table，receiving routine rehabilitation treatment，routine rehabilitation treatment with core strength training，routine rehabilitation treatment with core strength training and transcranial magnetic stimulation，respectively.Muscle spasticity measured by the Modified Tardieu Scale （MTS），and gross motor function measured by the Gross Motor Function Measure （GMFM） at baseline，at the end of 1-month and 3-month treatment were collected.And ankle joint motion and gait speed were evaluated at the end of the treatment.Results Intervention method and time showed interactive effect on MTS score and GMFM score （P<0.001）．And both of them exerted significant main effects on MTS score and GMFM score（P<0.05）．Compared with baseline，MTS score decreased and GMFM score increased significantly at 1 and 3 months after treatment in all groups（P<0.05）．Moreover，MTS score decreased and GMFM score increased significantly at 3 months after treatment in all groups compared with at 1 month after treatment （P<0.05）．Intergroup comparisons indicated that at 1 and 3 months after treatment，higher MTS score and lower GMFM score were found in routine group than other two groups，and were also found in study group instead of control group（P<0.05）．At the end of treatment，ankle joint motion was found to be better than the baseline in all groups（P<0.001）．But it differed significantly across the groups（P<0.001）．In particular，it was improved less in routine group than in other groups（P<0.05），and improved less in control group compared with study group （P<0.05）．Post-treatment gait speed differed significantly across the groups（F=111.695，P<0.001）．Specifically，it was slower in routine group than in other groups（P<0.05），and was slower in control group than that of study group （P<0.05）．Conclusion Routine rehabilitation training combined with transcranial magnetic stimulation and core strength training can improve the muscle spasticity and gross motor function，and increase the ankle motion and gait speed，so it is worthy of extensive use.
【Key words】 Cerebral palsy；Transcranial magnetic stimulation；Muscle strength；Muscle spasm；Motor function；Rehabilitation
Value of Circulating Tumor Cells in Chemotherapy Efficacy Monitoring and Prognosis Prediction of Advanced Non-small Cell Lung Cancer ZHANG Xiaoqin*，CHEN Xuanyi，WU Shengchang
Department of Respiratory Medicine，Zhejiang Provincial People's Hospital/People's Hospital of Hangzhou Medical College，Hangzhou 310014，China
*Corresponding author：ZHANG Xiaoqin，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background The evaluation of chemotherapy efficacy of advanced non-small cell lung cancer（NSCLC） relies on pre-and post-treatment comparison of CT lung lesions，lacking of effective short-term efficacy assessment methods.It is of great significance to find an index that can dynamically and real-timely monitor the efficacy of chemotherapy to guide the individualized treatment of lung cancer.Objective To explore the value of circulating tumor cells（CTCs） in monitoring chemotherapeutic effect and predcitng prognosis in advanced NSCLC.Methods Participants were selected from Zhejiang Provincial People's Hospital from December 2015 to December 2016，including 50 cases of advanced NSCLC（lung cancer group），and 50 healthy examinees who volunteered to be controls（control group）.The expression of CTCs in NSCLC patients before and after chemotherapy and in the control group were detected by immunomagnetic bead enrichment technique combined with fluorescence cytochemical staining.The follow-up ended by December 2018，during which the overall survival and progression-free survival of the lung cancer group were collected.The relationships of the expression of CTCs with clinical characteristics，therapeutic effect and prognosis of lung cancer group were analyzed.Results The prevalence of positive CTCs was 78.0%（39/50），and 0 in lung cancer group，and the control group，respectively，showing a significant difference（χ2=63.934，P<0.001）.There were no significant differences in gender ratio，distributions of age，smoking prevalence，pathological type，differentiation degree and lymph node stage between NSCLC patients with positive CTCs and those with negative（P>0.05）.CTCs positive patients showed higher rate of distant metastasis，and advanced clinical stage than CTCs negative patients（P<0.05）.The prevalence of positive CTCs after one cycle of chemotherapy was lower than that before chemotherapy 〔36.0%（18/50） vs 78.0%（39/50），χ2=4.432，P=0.035〕.The evaluation of CTCs after 1-cycle chemotherapy was in good agreement with that assessed by RECIST 1.1 after 2-cycle chemotherapy（Kappa=0.528，P<0.001）.18 cases were assessed with disease progression by imaging after chemotherapy，including 14 with positive CTCs，and 4 with negative，and the rate of distant metastasis between these two subgroups was significant（12/14 vs 0，χ2=10.286，P=0.001）.The progression-free survival and overall survival of CTCs positive patients were both significantly shorter than those of CTCs negative patients（P<0.05）.Conclusion It is feasible to detect CTCs by immunomagnetic bead enrichment combined with fluorescence cytochemical staining.The positive expression of CTCs is related to clinical stage and distant metastasis.CTCs are related to the chemotherapy effect and prognosis of advanced NSCLC，which can be used as a sensitive indicator for monitoring the curative effect of chemotherapy and predicting prognosis.
【Key words】 Carcinoma，non-small-cell lung；Neoplastic cells，circulating；Antineoplastic combined chemotherapy protocols；Treatment outcome；Prognosis
Effect of Intrauterine Transplantation of Bone Marrow Mesenchymal Stem Cells on the Expression of Bone Morphogenetic Protein 4 in Spinal Cord of Fetal Rats with Spina Bifida Aperta JIANG Mingyu*，ZHANG Jianbai，REN Mingyong，LIU Haichun
Department of Pediatrics，the First Clinical College，Harbin Medical University，Harbin 150001，China
*Corresponding author：JIANG Mingyu，Lecturer，Attending physician；E-mail：email@example.com
【Abstract】 Background Bone morphogenetic proteins-4 （BMP4） plays an important role in forming dorsal ventral axis pattern in neural tube，cell apoptosis as well as differentiation and transformation of stem cells.If BMP4 is transferred into bone marrow mesenchymal stem cells（MSCs）by transgenic method，whether it can secrete a certain level of BMP4，so that stem cells can replace damaged nerve cells as well as reconstruct collateral circulation and neuroprotection，is an urgent problem to be solved.Objective To observe the expression of BMP4 in spinal cord of fetal rats with spina bifida aperta before and after MSCs transplantation.Methods From November 2017 to October 2018，a total of 50 Wistar rats （8 males and 42 females） were purchased from the Laboratory Animal Center of the First Clinical College，Harbin Medical University.Five Wistar rats aged 10 days after birth were retained as stem cell sources.Feeding under normal conditions，cage closing at midnight and mating were confirmed.The rat fetuses with spina bifida were established by a teratogenic drug named as retinoic acid.MSCs were transplanted into rat fetuses by microsurgical injection.The fetuses from the same pregnant rat were divided into five groups:retinoic acid-free malformation group （n=10），spina bifida malformation group （n=12），stem cell transplantation group with retinoic acid-free malformation （n=10），stem cell transplantation group with spina bifida malformation （n=10） and blank transplantation group with spina bifida malformation （n=8）.Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of BMP4 and antagonist Noggin in each group.Results The expression of BMP4 mRNA in spina bifida malformation group was higher than that in retinoic acid-free malformation group，and the expression of Noggin mRNA was lower than that in retinoic acid-free malformation group（P<0.05）.The comparisons of BMP4 and Noggin mRNA expression in spina bifida malformation group，stem cell transplantation group and blank transplantation group with spina bifida malformation also showed significant statistical differences（P<0.05）.The expression of BMP4 mRNA in stem cell transplantation group with spina bifida malformation was higher than that in spina bifida malformation group and blank transplantation group with spina bifida malformation.The expression of Noggin mRNA was lower than that in spina bifida malformation group and blank transplantation group with spina bifida malformation（P<0.05）.However，The comparisons of BMP4 and Noggin mRNA between retinoic acid-free malformation group and stem cell transplantation group with retinoic acid-free malformation confirmed no statistical differences （P>0.05）.Conclusion BMP4 is related to the pathogenesis of spina bifida aperta.Furthermore，MSCs transplantation can up-regulate BMP4 mRNA expression to promote the recovery of neurological function so as to achieve therapeutic efficiency of congenital spina bifida malformation.
【Key words】 Mesenchymal stem cell；Spina bifida aperta；Bone morphogeneric protein 4；Stem cell transplantation；Real-time polymerase chain reaction
Responsibilities of General Practitioners in the Prevention and Treatment of Sudden Cardiac Death in China LIU Xiaoyu，ZHAO Jingyu，LI Bing，WANG Liuyi*
Department of General Practice，Henan Provincial People's Hospital/People's Hospital of Zhengzhou University/School of Medicine，Henan University，Zhengzhou 450003，China
*Corresponding author：WANG Liuyi，Chief physician，Professor；E-mail：firstname.lastname@example.org
【Abstract】 Sudden cardiac death （SCD） is one of the most common causes of death with the rapid onset and extremely dangerous conditions.The incidence of SCD in China is on the rise and the number of deaths ranks first in the world.The general practitioner，as a gatekeeper，plays an increasingly important role in the healthcare system of China.This study focuses on the responsibilities of general practitioners may have in the SCD control system from the aspects of preventing risk factors，managing first aid treatment，referral，health education and patient management.
【Key words】 Sudden cardiac death；General practitioners；Risk factors；Health education；Community management
Current Status and Thinking of Helicobacter Pylori-negative Gastric Cancer WANG Jiong1，2，GUO Qinghong1，2，JI Rui1，2，CHEN Zhaofeng1，2，WANG Yuping1，2，GUAN Quanlin3，ZHOU Yongning1，2*
1.Department of Gastroenterology，the First Hospital of Lanzhou University，Lanzhou 730000，China
2.Gansu Key Laboratory of Gastroenterology，Lanzhou University，Lanzhou 730000，China
3.Department of Oncological Surgery，the First Hospital of Lanzhou University，Lanzhou 730000，China
*Corresponding author：ZHOU Yongning，Professor，Chief physician，Doctoral supervisor；E-mail：email@example.com
【Abstract】 Helicobacter pylori-negative gastric cancer （HpNGC） is a disease entity that is different from Helicobacter pylori-positive gastric cancer （HpPGC），with its uniqueness in definition，diagnosis，clinicopathological features，and prognosis.The incidence of HpNGC is low，and its clinical case data is small.There is still no relevant research in China.Therefore，it is necessary to review researches on HpNGC and clarify its research status，in order to improve its understanding，draw more attention，and provide some reference for subsequent research.
【Key words】 Stomach neoplasms；Helicobacter pylori；Helicobacter pylori-negative gastric cancer；Helicobacter pylori-positive gastric cancer；Diagnosis；Prognosis
The Influence and Thinking of Different Surgical Methods on Postoperative Pain of Anal Fistula LI Lei1，YAN Guilin1，FAN Wenbin1，KANG Jian2*
1.Chengdu University of Traditional Chinese Medicine，Chengdu 610075，China
2.Hospital of Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China
*Corresponding author：KANG Jian，Associate chief physician，Associate professor；E-mail：firstname.lastname@example.org
【Abstract】 Anal fistula surgery，like other surgical operations，is impossible to avoid postoperative pain，which seriously affects the quality of life of patients after surgery.As the most effective way to cure anal fistula，there are hundreds of clinical operations for anal fistula，and the pain degree of patients after each operation is also different.In addition to the patient's own tolerance to pain and the type of anal fistula，surgery is the most important factor affecting the patient's postoperative pain.By searching relevant domestic and foreign literatures，this paper analyzed the commonly used clinical procedures of anal fistula，explored the influence of different surgical methods on postoperative pain of patients with anal fistula to reflect and find the most suitable method and provide reference for the surgical treatment of anal fistula.
【Key words】 Anal fistula；Pain，postoperative；Colorectal surgery
Effect of Sleep Duration and the Time of Falling Asleep on Yin-deficiency Constitution XIE Yisha1，ZHU Yanbo1*，XU Jia2，MENG Lingjie1，JIA Liyan3，LYU Xiaoying3
1.School of Management，Beijing University of Chinese Medicine，Beijing 100029，China
2.Third Affiliated Hospital，Beijing University of Chinese Medicine，Beijing 100029，China
3.School of Traditional Chinese Medicine，Beijing University of Chinese Medicine，Beijing 100029，China
*Corresponding author：ZHU Yanbo，Professor，Doctoral supervisor；E-mail：email@example.com
【Abstract】 Background Sleep is vital to people's health.Studies have shown that sleep time is related to traditional Chinese medicine（TCM） constitution.However，there is a lack of research on the influence of sleep time and time of falling asleep on Yin-deficiency constitution.Objective To explore the effects of sleep time and the time of falling asleep on Yin-deficiency constitution.Methods The cross-sectional survey method was adopted in people who took health examination in Beijing and Shijiazhuang，Hebei Province from March 2015 to December 2016.The Yin-deficiency subscale of TCM constitution scale was used to evaluate the degree of Yin-deficiency constitution，and the subjects were divided into high score group and low score group according to the mean score.The information on sleep time and time of falling asleep is collected by the investigator asking“How much do you sleep on average per day”and“When do you usually fall asleep”.The sleep time was divided into <6.0 h/d，6.0-6.9 h/d，7.0-7.9 h/d，8.0-8.9 h/d and ≥9.0 h/d.The time of falling asleep was divided into <23：00，23：00
-23：59，≥24：00.Logistic regression analysis was used to explore the influence of sleep time and time of falling asleep on Yin-deficiency constitution.Results A total of 2 170 questionnaires were distributed，2 170 questionnaires recovered，442 deleted，and 1 728 were included，with an effective recovery rate of 79.6%.The score of the Yin-deficiency subscale of 1 728 patients were（23.5±15.0），the score ≥23.5 was set as high，and the score <23.5 was classified as low.Among them，884 were in high score group and 844 were in low score group.Multivariate Logistic regression analysis showed that sleep time 7.0-7.9 h/d was taken as the reference group，sleep time <6.0 h/d〔OR=1.926，95%CI（1.014，3.658）〕，6.0-6.9 h/d〔OR=1.503，95%CI（1.115，2.027）〕，≥9.0 h/d〔OR =1.975，95%CI（1.087，3.589）〕were risk factors for Yin-deficiency（P<0.05）．The time to falling asleep≥24:00 was taken as the reference group，<23：00〔OR=0.576，95%CI（0.413，0.803）〕and 23：00-23：59〔OR=0.579，95%CI（0.438，0.765）〕were protective factors of Yin-deficiency（P<0.05）．Conclusion Insufficient or too much sleep time，and falling asleep after early morning（24：00）will increase Yin-deficiency.
【Key words】 Body constitution；Yin deficiency；Sleep time；The time of falling asleep
Effect of TCM-based Body Constitution on Sleep Quality：an Age-specific Analysis WANG Lerong，ZHU Yanbo*，SHI Muran，MENG Lingjie，XIE Yisha，ZHENG Kun
School of Management，Beijing University of Chinese Medicine，Beijing 100029，China
*Corresponding author：ZHU Yanbo，Professor，Doctoral supervisor；E-mail：firstname.lastname@example.org
【Abstract】 Background Nowadays，sleep problems are a common disease.Studies have shown that sleep quality is closely related to TCM-based body constitution.Sleep quality in people of different ages may vary by body constitution.But there is lack of studies about the influence of TCM-based body constitution on sleep quality in different age groups.Objective To investigate the influence of TCM-based body constitution on sleep quality in different ages.Methods The data were obtained from a cross-sectional survey conducted in a convenience sample of 1 029 Beijing's residents during March 2015 to May 2016.The Constitution in the Chinese Medicine Questionnaire （CCMQ） and Pittsburgh Sleep Quality Index （PSQI） were adopted in the survey.Scores of nine constitutional types，including gentleness type，Qi-deficiency type，Yang-deficiency type，Yin-deficiency type，phlegm-wetness type，wet-heat type，blood-stasis type，Qi-depression type and special diathesis type，were obtained by CCMQ.High score is associated with a more obvious tendency of constitution.The PSQI score is negatively correlated with sleep quality.Results The scores of Qi-deficiency type，Yin-deficiency type，phlegm-wetness type，wet-heat type，blood-stasis type and Qi-depression type varied significantly among the respondents by age（P<0.05），but the scores of gentleness type，Yang-deficiency type and special diathesis type and total PSQI score did not （P>0.05）．There was a negative correlation between the score of gentleness type and the total PSQI score （P<0.001），indicating that sleep quality increased with the growth in gentleness of constitution.The scores of 8 types of pathological constitutions were positively correlated with the total PSQI score （P<0.001），showing that if body constitution was more pathologic，the quality of sleep would be worse.The results of multiple linear regression analysis showed that all the types of constitution had effects on the overall sleep quality of different age groups but with differences（P<0.001）．The top three types of constitutions influenced the sleep quality most were gentleness type，blood-stasis type and Qi-depression type in 18-30-year-old respondents，and gentleness type，Qi-deficiency type and Qi-depression type in 31-44-year-old respondents，and gentleness type，blood-stasis type and phlegm-wetness type in respondents aged ≥45.The sleep quality in 31-44-year-old respondents was affected more significantly by TCM-based body constitution compared with those aged 18-30 or those aged ≥45.Conclusion The effects of gentleness type constitution on the sleep quality among people of different ages are the biggest.The influences of pathological constitutions on the sleep quality are different among people of different ages.To improve the sleep quality of people of different ages，targeted interventions based on age for ameliorating the pathological constitutions or enhancing the level of gentleness of constitution，may be an effective method.
【Key words】 Body constitution；Sleep quality；Age；Regression analysis
Traditional Chinese Medicine Constitution Features of Different Obesity Phenotypes MENG Lingjie1，ZHU Yanbo1*，XU jia2，JIA Liyan3，LYU Xiaoying3，4，XIE Yisha1，ZHENG Kun1，ZHANG Hui1，LIU Han1
1.School of Management，Beijing University of Chinese Medicine，Beijing 100029，China
2.Third Affiliated Hospital，Beijing University of Chinese Medicine，Beijing 100029，China
3.School of Traditional Chinese Medicine，Beijing University of Chinese Medicine，Beijing 100029，China
4.Institute of Basic Research in Clinical Medicine，China Academy of Chinese Medical Sciences，Beijing 100700，China
*Corresponding author:ZHU Yanbo，Professor，Doctoral supervisor；E-mail:email@example.com
【Abstract】 Background Studies have shown that there are certain similarities in the types of TCM constitutions between obese people and those with metabolic disorders，but the risk of metabolically unhealthy in different obese people is not exactly the same.However，it is still unknown whether this difference is essentially related to TCM constitution.Objective To explore the TCM constitution features of different obesity phenotypes.Methods During June 2012 to January 2014，from the database of 1 814 physical examinees recruited from Preventive Treatment Center，Beijing Tongren Hospital，the First Affiliated Hospital of Anhui University of Chinese Medicine，and Zhuhai Branch，Guangdong Provincial Hospital of Traditional Chinese Medicine，1 267 normal-weight and obese cases were included after excluding those who were less than 18 years old，underweight，overweight，and had missing data.According to metabolic and obese phenotypes，they were divided into four groups:metabolically healthy normal weight（MHNW），metabolically unhealthy normal weight（MUNW），metabolically healthy obesity（MHO），and metabolically unhealthy obesity（MUO）.The TCM Constitution Questionnaire was used to investigate the TCM constitution.Partial least squares regression was used to calculate the scores of 9 types of TCM constitution for different obesity phenotypes after controlling sociodemographic and behavioral factors，including constitution of gentleness，Qi-deficiency，Yang-deficiency，Yin-deficiency，phlegm-dampness，damp-heat，blood stasis，Qi depression，and allergic.Results The number of cases in groups of MHNW，MUNW，MHO，and MUO was 584（46.1%），207（16.3%），174（13.7%），and 302（23.9%），respectively.The mean scores of constitution of gentleness，Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype（P<0.05）.To be specific，MUO group showed higher mean score of gentleness constitution，and lower mean score of Yang-deficiency constitution compared with MHNW and MUNW groups（P<0.05）.MHO and MUO groups showed higher mean score of phlegm-dampness constitution compared with other two groups（P<0.05）.Sex-based analysis showed that，the mean scores of constitution of gentleness，Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype in males（P<0.05）.Specifically，males in MUO group demonstrated higher mean score of gentleness constitution，and lower mean score of Yang-deficiency constitution compared with those in MHNW and MUNW groups（P<0.05）.Moreover，males in MHNW group demonstrated lower mean score of phlegm-dampness constitution compared with those in other three groups（P<0.05）.The mean scores of constitution of Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype in females（P<0.05）.Specifically，females in MUO group demonstrated lower mean score of Yang-deficiency constitution compared with those in MHNW group（P<0.05）.And they also showed higher mean score of phlegm-dampness constitution compared with those in MHNW and MUNW groups（P<0.05）.Conclusion In the case of similar metabolic status，obese people have a higher tendency to develop phlegm-dampness constitution，and gentleness constitution，but the tendency of developing Yang-deficiency constitution is lower.When people's body weights are similar，metabolic status is not associated with significant differences in TCM constitution.However，conditions are different in males and females.Males who are obesity and metabolically unhealthy all showed higher tendency to have phlegm-dampness constitution，but in females，only the obese ones tend to show higher tendency of having phlegm-dampness constitution，those with unhealthy metabolism have no the tendency.
【Key words】 Obesity phenotype；Metabolically healthy obesity；Metabolically unhealthy obesity；Constitution in Chinese Medicine Questionnaire；Phlegm-dampness constitution
Efficacy of Chinese Medicine Therapies on Insomnia Associated with Coronary Heart Disease：a Network Meta-analysis ZHENG Yawei1，2，WU Lifei2，ZHANG Xingxing2，GU Dongmei2，ZHANG Siqi3，LIU Ming3，FANG Zhuyuan1，3*
1.Affiliated Hospital of Nanjing University of Chinese Medicine，Nanjing 210029，China
2.Nanjing University of Chinese Medicine，Nanjing 210023，China
3.Jiangsu Province Hospital of Chinese Medicine，Nanjing 210029，China
*Corresponding author：FANG Zhuyuan，Professor，Chief TCM physician；E-mail：firstname.lastname@example.org
【Abstract】 Background Coronary heart disease（CHD） with insomnia can be called a "psycho-cardiological disease"，and the persistent existence of insomnia can induce the onset of CHD or aggravate the development of the condition.In recent years，there have been continuous reports on TCM treatment of CHD with insomnia，but the sample size is small and the relevant evidence-based evaluation is insufficient.Objective To systematically review the efficacy of Chinese medicine therapies and sedative hypnotic drugs on insomnia associated with CHD.Methods Databases including CNKI，CBM，Wanfang Data Knowledge Service Platform，VIP，PubMed，Web of Science，EMBase and Cochrane Library were searched from inception to September 2018 for randomized controlled trials （RCT） about insomnia associated with CHD treated with TCM therapies.RCT screening and enrollment，data extraction，and quality assessment were performed by two researchers independently.Meta-analysis was performed with RevMan 5.3，Stata 15.1 and ADDIS （V.1.16.8）．Results A total of 21 studies with 2 496 patients were included，involving 11 interventions（including 9 kinds of TCM therapies）．Traditional meta-analysis found that either Chinese patent medicine plus routine treatment or compound Chinese medicine plus routine treatment was associated with better efficacy compared sedative hypnotic drugs plus routine treatment（P<0.05）．Network meta-analysis demonstrated that for treating insomnia associated with CHD，massage plus five-tone therapy and routine treatment，Chinese patent medicine plus routine treatment，compound Chinese medicine plus routine treatment，and compound Chinese medicine plus massage，five-tone therapy and routine treatment had better efficacy than sedative hypnotic drugs plus routine treatment（P<0.05）．Moreover，the efficacy of routine treatment was inferior to that of moxibustion with moxa plus routine treatment，baduanjin plus massage and routine treatment，massage plus five-tone therapy and routine treatment，finger-pressure therapy plus routine treatment，Chinese patent medicine plus routine treatment，compound Chinese medicine plus routine treatment，compound Chinese medicine plus massage，five-tone therapy and routine treatment（P<0.05）．Of all the interventions，compound Chinese medicine plus massage，five-tone therapy and routine treatment showed best efficacy，while sedative hypnotic drugs plus routine treatment ranked 10th，only superior to routine treatment alone.Conclusion Available evidence shows that Chinese medicine therapies have certain effects on insomnia associated with CHD，and the regimen of compound Chinese medicine plus massage，five-tone therapy and routine treatment may be an optimal selection.However，due to limited number and quality of included studies，this conclusion needs to be confirmed by more high-quality multicenter RCT with larger sample sizes.
【Key words】 Coronary disease；Sleep initiation and maintenance disorders；TCM therapy；Drug therapy（TCD）；Network meta-analysis；Traditional Chinese medicine therapy
Effects of Anxiety and Depression on Neuroendocrine Immune Network in Patients with Ulcerative Colitis ZHAO Changdong1*，ZHAO Hongyan2，KE Xiquan3，ZHANG Xiaojie1，ZHANG Hui1，WANG Shufang1，LI Xue1
1.Department of Gastroenterology，the Second People's Hospital of Lianyungang，Affiliated Hospital of Bengbu Medical College，Lianyungang 222023，China
2.Department of Ultrasound，Lianyungang Hospital of Traditional Chinese Medicine，Lianyungang 222004，China
3.Department of Gastroenterology，the First Affiliated Hospital of Bengbu Medical College，Bengbu 233004，China
*Corresponding author：ZHAO Changdong，Associate chief physician；E-mail：email@example.com
【Abstract】 Background Ulcerative colitis （UC） is a common disease in the Department of Gastroenterology.At present，the etiology and pathogenesis of UC are not very clear.In recent years，many studies have shown that psycho-psychological factors are involved in the occurrence of UC.Therefore，it is worth exploring the mechanism of psycho-psychological factors in the onset of UC.Objective To investigate the effect of anxiety and depression on neuroendocrine immune network in patients with UC.Methods A total of 198 outpatients and inpatients with UC in the Department of Gastroenterology of the Second People's Hospital of Lianyungang，Affiliated Hospital of Bengbu Medical College and the First Affiliated Hospital of Bengbu Medical College from January 2013 to November 2018 were divided into remission stage group （group A，57 cases） and active stage group （group B，141 cases）．Group B was divided into mild active stage （subgroup B1，83 cases） and moderate-severe active stage （subgroup B2，58 cases） according to the severity of the disease.Sixty-two patients with anxiety and/or depression among 121 patients with mild-moderate active stage were divided into control group（n=31） and intervention group（n=31） by random number table method.The control group was treated with mesalazine enteric-coated tablets and the intervention group was treated with psychological intervention+Flupentixol and Melitracen Tablets+mesalazine enteric-coated tablets.Thirty-two healthy persons were selected as the health examination group in the same period.The Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） were used to determine the anxiety and depression of the subjects after 4 weeks of treatment.The levels of serotonin（5-HT），interleukin（IL）-6，IL-8 and IL-2 were measured by enzyme-linked immunosorbent assay （ELISA）．Results The scores of HAMA，HAMD and levels of 5-HT，IL-6 and IL-8 in healthy examination group，group A and subgroup B1 were lower than those in case group，group B and subgroup B2，and the levels of IL-2 were higher than those in case group，group B and subgroup B2，respectively （P<0.01）．Pearson correlation analysis showed that HAMA and HAMD score were positively correlated with 5-HT，IL-6，IL-8 and negatively correlated with IL-2 （P<0.001）．After 4 weeks of treatment，HAMA and HAMD scores，5-HT，IL-6 and IL-8 levels in the intervention group were lower than those in the control group，and IL-2 level was higher than that in the control group （P<0.05）；HAMA and HAMD scores，5-HT，IL-6 and IL-8 levels in the control group and the intervention group after treatment were lower than those before treatment，and IL-2 levels were higher than those before treatment （P<0.05）．Conclusion Anxiety and depression are closely correlated to the pathogenesis of UC，which may participate in the pathogenesis of UC by affecting related indicators of neuroendocrine immune network.
【Key words】 Colitis，ulcerative；Anxiety；Depression；Neuroendocrine cells；Cytokines
Gender Difference in Conditional Extinction of Disgust and Fear ZENG Qing
Jinan University，Guangzhou 510632，China
【Abstract】 Background Significant differences were found between male and female in affective disorders.The reason may be that the emotion regulation strategies that men and women cope with negative experiences are different.Existing studies have shown that men and women use different brain regions in negative emotion regulation，but there is a lack of research on the time process of the relevant neural activities of the two genders.Objective To study gender differences in conditional extinction of disgust and fear by classical conditioned extinction model.Methods From January to July 2015，38 college students in Guangzhou were selected by using the method of recruiting，and 3 were excluded. The event-related potentials （ERPs） technique was used to study the gender difference in EEG of 35 college students after acquiring conditioned disgust and fear.Results The behavioral results showed that all subjects could successfully carry out conditioned regression.and compared with men，it was more difficult for women to extinct conditioned fear.The ERPs data indicated that in early brain ingredients，women's amplitude of P1，N1 and P2 were greater than those of men.For men，the amplitude differences of early ingredients caused by these three conditional stimuli were not significant（P>0.05）；but for women，the amplitudes of early ingredients induced by conditioned fear stimulus were smaller than those induced by conditioned disgust and conditioned neutral stimulus （P<0.05）．However，at the middle and late stage，the main effect of gender was not significant in ingredients，such as N2 and P3（P>0.05）．Conclusion Women's conditional fear is more difficult to extinct than that of men，but both genders can reach successful extinction.
【Key words】 Conditional extinction；Disgust；Fear；Neurofeedback；Male；Female
Investigation on Clinical Features and Drug Use of Hospitalized Patients with Bipolar Disorder CHEN Ce*，ZHENG Lidan，XIE Zuoliang，HUANG Ziye，TU Wenzhen，LIN Chongguang
Wenzhou Seventh People's Hospital，Wenzhou 325000，China
*Corresponding author：CHEN Ce，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background Bipolar disorder（BPD）is a severe mental disorder with a wide incidence and difficulty in treatment.Currently，clinical diagnosis and treatment guidelines in China are based on clinical survey data from foreign countries.Relevant data in China is rare.Objective To understand the diagnosis and medication situation of patients with BPD in Wenzhou in order to make up for the lack of regional data and provide references for the clinical guidelines based on China's national conditions.Methods A cross-sectional random sampling method was used to distribute a self-made questionnaire to doctors on duty in neurological/psychiatric departments randomly selected in 10 hospitals in Wenzhou from May 15 to 19 in 2017.The questionnaire was a mixed form that includes patients' essential information，initial onset status，age at which the diagnosis was determined，the time from the first diagnosis，drug use，doses，current adverse reactions，and the next medication plan.Results A total of 150 questionnaires were distributed and 127 valid questionnaires were returned.The effective recovery rate was 84.7%.The initial onset age was 8 to 56；the age at which the diagnosis was determined was 8 to 78；the time from the first diagnosis was 1 month to 33 years.The most commonly used pharmacological agent was quetiapine with 77 times.Obesity was the most common adverse reaction with 41 cases.There were 106 cases in the medication maintenance period.The average doses of quetiapine，magnesium valproate，and lithium carbonate in maintenance period were 0.50 g/d，1.00 g/d，and 0.85 g/d，respectively.Conclusion The situation in Wenzhou is different from what reported in other regions at home and abroad.Based on different regional situation，deeper and larger-scale investigations should be started as soon as possible to better provide more information for clinical diagnosis and treatment of BPD.
【Key words】 Bipolar disorder；Diagnosis；Depression；Medication used；Adverse reaction；Age at onset