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    Translational medicine
    2016, 36 (06):  783. 
    Abstract ( 312 )   PDF (1441KB) ( 887 )  
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    Original article (Basic research)
    Effects of triclosan on expression of 11β-HSD2 and HLA-G in human first trimester trophoblasts
    YANG Qian-lan, WANG Yu
    2016, 36 (06):  787. 
    doi: 10.3969/j.issn.1674-8115.2016.06.001

    Abstract ( 744 )   PDF (1899KB) ( 757 )  

    Objective To investigate the effects of triclosan on expression of 11β-HSD2 and HLA-G in human first trimester trophoblasts. Methods First trimester trophoblasts were isolated and purified with modified Kliman method, including villous cytotrophoblasts and extravillous cytotrophoblasts. Villous cytotrophoblasts fused to form syncytiotrophoblasts during culture in vitro. First trimester trophoblasts were treated with different concentrations of triclosan (0, 0.000 1, 0.001, 0.01, 0.1, and 1 μmol/L) for 24 h after three days of culture. The expression of 11β-HSD2 in syncytiotrophoblasts and HLA-G in extravillous cytotrophoblasts was detected by Western blotting. The gel zymography was used to detect the enzymatic activity of MMP2/9 in extravillous cytotrophoblasts. Results The expression of 11β-HSD2 in syncytiotrophoblasts and HLA-G in extravillous cytotrophoblasts was significantly decreased and the enzymatic activity of MMP2/9 in extravillous cytotrophoblasts was reduced after triclosan treatment. Conclusion Triclosan can inhibit the expression of 11β-HSD2 and HLA-G and the  enzymatic activity of MMP2/9 in human first trimester trophoblasts, suggesting excessive exposure to triclosan may have adverse effects on the reproductive health in females.

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    Influence of adoptive transfer of FTY720-DC on the embryo loss rate in mice of spontaneous abortion model
    XIONG Miao, ZHU Jie-ping, LI li, LIU Yang, JI Yu-qin, WANG Jun
    2016, 36 (06):  793. 
    doi: 10.3969/j.issn.1674-8115.2016.06.002

    Abstract ( 767 )   PDF (1140KB) ( 741 )  

    Objective To observe the effect of adoptive transferring FTY720-dendritic cells (FTY720-DCs) on the embryo loss rate in the mouse model of spontaneous abortion and explore the mechanism of inducing maternal-fetal immune tolerance. Methods The mouse models of spontaneous abortion (CBA/J×DBA/2) and normal pregnancy (CBA/J×BALB/c) were constructed. Mice were assigned to six groups, i.e. normal pregnancy group (CBA/J×BALB/c),  spontaneous abortion with no intervention group (CBA/J×DBA/2), abortion with DC cells culture medium (DCCM) injection group, abortion with adoptive transferring DC group, abortion with FTY720 injection group, and abortion with adoptive transferring FTY720-DC group. The embryo loss on 12th-14th day of gestation was observed. The proportions of Treg and Th17 cells in peripheral blood mononuclear cells were measured with flow cytometer. Results The embryo lost rate in mice with adoptive transferring FTY720-DC was significantly lower as compared with mice in the spontaneous abortion with no intervention group and the abortion with DCCM injection group (P=0.00), as well as the abortion with adoptive transferring DC group and the abortion with FTY720 injection group (P=0.01). There was no significant difference in the embryo lost rate between the abortion with adoptive transferring FTY720-DC group and the normal pregnancy group (P>0.05). The proportion of peripheral blood Treg cells was remarkably increased and the proportion of Th17 cells was significantly decreased after adoptive transferring FTY720-DC. The differences were statistically significant as compared with the spontaneous abortion with no intervention group and the abortion with DCCM injection group (P=0.00) and the difference was not statistically significant as compared with the normal pregnancy group (P>0.05). Conclusion Adoptive transfer of FTY720-DC can induce immune tolerance in pregnancy and decrease the embryo loss rate in mice of spontaneous abortion model. The mechanism may be associated with the reverse of the imbalance of Treg/Th17 in mice of spontaneous abortion model.

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    Comparative study on efficacy of 41 ℃ or 43 ℃ mild hyperthermia with pegylated liposomal doxorubicin for treatment of rabbit VX2 tumor
    DING Ang-ang, XIONG Ping, SHEN Guo-feng, CHEN Ya-Zhu
    2016, 36 (06):  799. 
    doi: 10.3969/j.issn.1674-8115.2016.06.003

    Abstract ( 649 )   PDF (602KB) ( 721 )  

    Objective To investigate the difference in efficacy between doxorubicin released by 41 ℃ and 43 ℃ mild hyperthermia (MH) triggered-pegylated liposomal doxorubicin (PLD) for the treatment of rabbit VX2 tumor. Methods Twelve rabbits with VX2 tumor transplanted into the superficial muscle of the hind limb were randomly assigned to 2 groups, i.e. the 41 ℃ MH+PLD group (n=6) and the 43 ℃ MH+PLD group (n=6). To achieve complete tumor remission, multiple high-dose administrations (5 mg/kg, once per week for 3 weeks) were given by intravenous injection. An embedded ultrasound tumor hyperthermia instrument was used to perform local MH at tumor sites for 30 min. Results At the endpoint, the 41 ℃ MH+PLD group had lower vascularization index, tumor weight, and levels of GOT, LDH and CPK in peripheral blood as compared with the 43 ℃ MH +PLD group. Conclusion In comparison with 43 ℃ MH for 30 min, 41 ℃ MH for 30 min plus PLD can significantly improve the antitumor efficacy, and reduce the systemic toxicity.

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    Construction of the GRP78 over-expressed vector and its expression in human umbilical vein endothelial cells
    LI Yuan-yuan, ZHANG Guang-ya, CHEN Feng-ling
    2016, 36 (06):  803. 
    doi: 10.3969/j.issn.1674-8115.2016.06.004

    Abstract ( 716 )   PDF (3407KB) ( 701 )  

    Objective To construct the glucose-regulated protein 78 (GRP78) over-expressed plasmid, transfect human umbilical vein endothelial cells (HUVECs) in vitro, and observe its expression and location. Methods Primers were designed according to the gene information on GRP78 in PubMed, and the GRP78 gene was amplified by Polymerase Chain Reaction (PCR). By using the gene recombination technology, the double enzyme digested GRP78 gene was cloned into the pLVX-IRES-ZsGreen1 vector with GFP and the CMV-10 vector with Flag tag. Recombined plasmids were identified with enzyme digestion and sequencing and were transfected into HUVECs. Immunofluorescence assay was used to detect its expression and location. Western blotting was used to confirm its over-expression. Results The results of enzyme digestion and sequencing revealed that the recombinant plasmids pLVX-GRP78-IRES-ZsGreen1 and CMV-Flag-GRP78 were successfully constructed. After transfecting HUVECs with the successfully constructed plasmid pLVX-GRP78, a large amount of green fluorescence was observed. After transfecting HUVECs with plasmid Flag-GRP78, immunofluorescence assay revealed that Flag-GRP78 protein located in endoplasmic reticulum. Western blotting showed the successful over-expression of pLVX-GRP78 and Flag-GRP78. Conclusion The recombinant plasmids pLVX-GRP78-IRES-Green1 and CMV-Flag-GRP78 were successfully constructed and were transfected into HUVECs. Flag-GRP78 protein was observed to locate in endoplasmic reticulum.

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    Correlation between polymorphism of single nucleotide gene rs2910164 in miR-146a and incidence and metastasis of colorectal cancer
    ZHANG Hai-feng, CUI Shi-yun, LIN Yong-qing, YANG Ying, LAI Wei, LUO Nian-sang, WANG Jing-feng
    2016, 36 (06):  809. 
    doi: 10.3969/j.issn.1674-8115.2016.06.005

    Abstract ( 964 )   PDF (890KB) ( 826 )  

    Objective To investigate the correlation between colorectal cancer (CRC) and the single nucleotide polymorphism (SNP) in miR-146a C→G (rs2910164), as well as the expression level of miR-146a. Methods Colorectal cancer and adjacent normal tissues in 106 CRC patients (the CRC group) and normal tissues in 53 healthy controls (the control group) were obtained. Alleles of SNP were determined with gene sequencing method and the correlation between different genotypes and the occurrence and metastasis of CRC was analyzed. Patients with or without metastasis were assigned to the T1 group or the T0 group. Real-time-PCR was used to measure and compare miR-146a expressions in colon tissues with different genotypes. miR-146a expressions in cancer and adjacent normal tissues were compared and miR-146a expressions in cancer tissues were compared between the T1 group and the T0 group. Results The distribution of miR-146a genotypes in the CRC group was different from that in the control group. The Logistic regression analysis showed that GG and GC genotypes were risk factors for CRC. The controls carrying GG and GC genotypes had lower miR-146a expressions in colon tissues as compared with those carrying CC genotype. Cancer tissues in CRC patients had lower miR-146a expressions as compared with adjacent normal tissues. The distribution of genotypes in the T1 group was also different from that in the T0 group. The T1 group had a higher proportion of GG genotype. The Logistic regression analysis showed that GG genotype was a risk factor for CRC metastasis. Patients in the T1 group had lower miR-146a expressions in cancer tissues. GG genotype carriers had higher expression levels of EGFR and IRAK-1. Conclusion The G allele in the SNP of miR-146a is a risk factor for the incidence and metastasis of CRC. The mechanism may be related to lower miR-146a expression caused by the SNP and resulting higher expressions of EGFR and IRAK-1.

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    Correlation and function of NK cells and NKDCs
    FU Yu-jie, GAO Jian-xin, LI Lin-feng, ZHAO Xiao-jing
    2016, 36 (06):  814. 
    doi: 10.3969/j.issn.1674-8115.2016.06.006

    Abstract ( 636 )   PDF (2122KB) ( 678 )  

    Objective To investigate the changes in natural killer (NK) cells and natural killer dendritic cells (NKDCs) during immune system rebuilding, and explore the correlation between NKDCs and NK cells. Methods A mouse model of bone marrow reconstruction was used, and NK cells, dendritic cells (DCs) and NKDCs were sorted with flow cytometry. NK cells and NKDCs were stimulated with the immunologic adjuvant CpG in vitro, and the secretion of cytokine IFN-γ was detected. Results In the process of rebuilding the immune system, the numbers of both NK cells and NKDCs in bone marrow or spleen increased within one week, and returned to normal at week 4, suggesting that innate immune function was rebuilt first in bone marrow rebuilding. NK cells and NKDCs were functionally different. NKDCs produced more IFN-γ as compared with NK cells. CpG stimulated NKDCs to produce IFN-γ, but it was not the case for NK cells. INF-γ production was not associated with B220 expression in NK cells or NKDCs. Conclusion NKDCs may play a key role in the innate anti-tumor immunity.

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    Study on the effects of breviscapine on rats with insulin resistance and related mechanism
    ZHAO Dong-liang, WU Li, LI Jin-ping, ZHANG Xing-yuan, FENG Ji-bo
    2016, 36 (06):  820. 
    doi: 10.3969/j.issn.1674-8115.2016.06.007

    Abstract ( 728 )   PDF (2050KB) ( 724 )  

    Objective To investigate the effects of breviscapine on rats with insulin resistance (IR) and possible mechanism. Methods Fifty SD male rats were randomly assigned to the normal control group (NC group, n=10, fed with a normal diet) and IR model group (n=40, fed with a high fat and high sugar diet for 12 weeks for establishment of IR model). Thirty rats in IR model group were selected and randomly assigned to blank control model group (HFD group), high-dose breviscapine group (High group), and low-dose breviscapine group (Low group) with 10 rats in each group. The serum fasting insulin (FINS) and fasting blood glucose (FBG) were measured and the homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. The protein expression of ribosomal protein S6 kinase 1 (S6K1) and phosphorylation of insulin receptor substract-1 (IRS-1) tyrosine in liver tissues of IR rats after breviscapine treatment were detected with Western blotting and immunohistochemistry (IHC). Results The HOMA-IR index in HFD group was significantly higher as compared with NC group (P=0.000). The HOMA-IR indexes in High group and Low group were significantly lower as compared with HFD group (P=0.000). The results of Western blotting and IHC showed that the expression of S6K1 protein in High group and Low group were lower (P<0.01) and the phosphorylation of IRS-1 tyrosine was higher as compared with HFD group (P<0.01, P<0.05). Conclusion Breviscapine can significantly ameliorate insulin resistance in IR rats. The mechanism may be related to the decreased expression of S6K1 and increased phosphorylation of IRS-1 tyrosine in rat liver tissues.

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    Original article (Clinical research)
    Study on the changes in CD4+CXCR5+ follicular helper T lymphocytes in peripheral blood of patients with chronic hepatitis C
    YIN Wen-wei, TONG Shi-wen
    2016, 36 (06):  825. 
    doi: 10.3969/j.issn.1674-8115.2016.06.008

    Abstract ( 786 )   PDF (2251KB) ( 726 )  

    Objective To investigate changes in characteristics of CD4+CXCR5+ follicular helper T lymphocytes (TFH cells) in peripheral blood of patients with chronic hepatitis C virus (HCV) infection and its correlation with the disease characteristics. Methods Twenty-three patients with HCV infection and 20 healthy controls were enrolled and 4 patients received a pegylated interferon-α and ribavirin combination treatment. The changes in the proportion of peripheral blood CD4+CXCR5+ TFH cells were assessed by flow cytometry. Results The percentage of CD4+CXCR5+ TFH cells in peripheral blood mononuclear cells was 5.845% (2.680%-14.200%) for patients with chronic HCV infection and 3.765% (1.200%-8.520%) for healthy controls (u=124.5, P=0.010 6). The proportion of TFH cells in CD4+T cells was 14.800% (8.440%-36.600%) for patients and 9.550% (2.700%-21.800%) for healthy controls (u=132.0, P=0.017 6). The proportion of CD4+CXCR5+ TFH cells were negatively correlated to HCV RNA load (r=-0.432 8, P=0.039 1) and showed no correlation with serum glutamic pyruvic transaminase or glutamic oxaloacetic transaminase levels. The anti-HCV therapy decreased the proportion of CD4+CXCR5+ TFH cells in HCV-infected patients. Conclusion CD4+CXCR5+TFH cells may participate in the anti-viral immune response in the process of chronical infection with HCV.

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    Analysis of risk factors for recurrent Hirschsprung-associated enterocolitis
    LI Yu-qing, YAN Zhi-long, FENG Yi, PAN Li-ya, XIE Zhou-long-long, HONG Li
    2016, 36 (06):  830. 
    doi: 10.3969/j.issn.1674-8115.2016.06.009

    Abstract ( 748 )   PDF (591KB) ( 701 )  

    Objective To investigate non-surgical risk factors for recurrent Hirschsprung-associated enterocolitis (HAEC). Methods A retrospective analysis was conducted on clinical data of 67 cases with Hirschsprungs disease (HD) treated by the radical operation between January 2007 and January 2014 at Shanghai Childrens Medical Center affiliated to Shanghai Jiao Tong University School of Medicine. Patients suffered 3 or more episodes of enterocolitis were assigned to the recurrent HAEC group (HAEC-R group). Patients with 1 or 2 episodes were assigned to the HAEC group. Patients without enterocolitis were assigned to the control group. The non-surgical risk factors for recurrent HAEC were analyzed. Results Gender and age at radical surgery had no statistical differences among three groups (P>0.05). Clinical types of HD and the incidence of hypoalbuminemia had no statistical differences between the HAEC-R group and the HAEC group (P>0.05), but had significant statistical differences between the HAEC-R group and the control group (P<0.05). The differences in the incidences of preoperative malnutrition, enterocolitis, upper respiratory tract infection, and pneumonia between the HAEC-R group and the HAEC group were statistically significant (P<0.05) and the differences between the HAEC group and the control group were not statistically significant (P>0.05). The multivariate logistic regression analysis showed that preoperative malnutrition and enterocolitis were independent risk factors for recurrent HAEC (OR=9.000, 95%CI=1.355-59.783; OR=8.667, 95%CI=1.526-49.220). Conclusion The preoperative malnutrition and enterocolitis may be risk factors for recurrent HAEC.

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    Comparative study on the level of salivary glycoproteins in 6-7 years old caries free and caries active children
    WANG Yan, LI Cun-rong, ZENG Xiao-li, XU Wei, WANG Xun, JIANG Yi-wei, ZHANG Ying
    2016, 36 (06):  835. 
    doi: 10.3969/j.issn.1674-8115.2016.06.010

    Abstract ( 599 )   PDF (981KB) ( 647 )  

    Objective To explore the glycoproteins level in unstimulated whole saliva from 6-7 years old caries active children and compare the glycoproteins level between caries active children and caries free children. Methods Two milliliter unstimulated whole saliva was collected from each of 50 caries free (dmft/DMFT=0) and 50 caries active (dmft/DMFT≥6) children aged 6-7 years. The supernatant of the saliva underwent SDS-PAGE protein electrophoresis. Then PAS alcian blue staining was used to stain glycoproteins. The number of stained glycoprotein bands in each sample was recorded. Mann-Whitney U test was used to analyze the difference in the numbers of stained glycoprotein bands between the caries free group and the cares active group. Results The glycoproteins bands in samples were stained blue after PAS alcian blue staining for the gel undergoing SDS-PAGE electrophoresis. Mann-Whitney U test revealed that rank means of the numbers of glycoprotein bands in unstimulated whole saliva from the caries free group and the cares active group were 42.63 and 58.37 respectively and the difference was statistically significant (P=0.004).  Conclusion The glycoproteins level in unstimulated whole saliva in 6-7 years old caries active children is significantly higher as compared with age-matched caries free children, suggesting that elevated glycoproteins level may be associated with increased caries incidence in children aged 6-7 years.

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    Clinical analysis of sequential therapy with partial splenic embolization in decreasing postoperative adverse reactions
    SHI Min, WANG Yu-gang, WEI Jue, WANG Ting, MENG Wen-ying, MA Jun
    2016, 36 (06):  839. 
    doi: 10.3969/j.issn.1674-8115.2016.06.011

    Abstract ( 805 )   PDF (717KB) ( 736 )  

    Objective To explore the clinical value of sequential therapy with partial splenic embolization (PSE) in reducing postoperative adverse reactions. Methods Medical data of 98 patients with portal hypertension complicated with hypersplenism were retrospectively reviewed, which were divided into the sequential group (sequential PSE) and the control group (single PSE). The results of routine blood test, liver function, and incidence rate of post embolization syndrom,and postoperative complications were analyzed in patients of the two groups before and after the treatment. Results Compared with those before the treatment, white blood cells and platelets were significantly increased 2 weeks and 1 months after the treatment (P<0.01). Incidence rate of moderate and severe pain and high fever of the sequential group was obviously lower than that of the control group (P<0.01). The duration of moderate and severe pain and fever, and hospitalization day of the sequential group were relatively shorter (P<0.01). And the incidence of postoperative complications of the sequential group was obviously lower than that of the control group (P<0.01). Conclusion Sequential PSE can effectively improve the symptom of hypersplenism, and reduce the postoperative adverse reactions and complications of PSE.

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    Correlation between serum 25-hydroxy vitamin D concentration and blood viscosity in type 2 diabetic patients
    LI Qin, YANG Li-Zhen
    2016, 36 (06):  843. 
    doi: 10.3969/j.issn.1674-8115.2016.06.012

    Abstract ( 664 )   PDF (1795KB) ( 819 )  

    Objective To explore the correlation between serum 25-hydroxy vitamin D [25(OH)VitD] concentration and blood viscosity in type 2 diabetic (T2DM) patients. Methods Two hundred and thirteen T2DM patients were enrolled and the serum 25(OH)VitD concentration and whole blood viscosity at different shear rates (1/s, 5/s, 30/s, and 200/s) were measured with enzyme-linked immunosorbent assay and electronic blood rheology analyzer. Biochemical indexes such as plasma glucose and serum lipids were also measured. Patients were assigned to Q1 group (53 cases), Q2 group (54 cases), Q3 group (53 cases), and Q4 group (53 cases) according to the quartiles of serum 25(OH)VitD levels. The correlation between serum 25(OH)VitD concentration and blood viscosity at different shear rates was analyzed and a gender-stratified analysis was performed. Results The whole blood viscosity at different shear rates in Q4 group was significantly higher as compared with other three groups (P<0.0001) in T2DM patients, especially in female patients. The results of Spearman correlation analysis showed that serum 25(OH)VitD concentration was positively correlated to the whole blood viscosity at different shear rates (P<0.05). Multivariate stepwise regression analysis suggested that serum 25(OH)VitD concentration in female patients was independently correlated to the blood viscosity at different shear rates (1/s, 5/s, and 30/s) (P<0.05). Conclusion In T2DM patients, especially in female patients, serum 25(OH)VitD concentration is positively correlated to the blood viscosity. Clinical indexes such as blood viscosity and 25(OH)VitD should be comprehensively evaluated during the diagnosis and treatment of diabetes mellitus.

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    Evaluation of short term efficacy of the stabilized splint and the combination of manipulative and physical therapies for temporomandibular joint disc #br# displacement without reduction

    YU Chun-hua, QIAN Hai-xin
    2016, 36 (06):  850. 
    doi: 10.3969/j.issn.1674-8115.2016.06.013

    Abstract ( 907 )   PDF (1013KB) ( 986 )  

    Objective To explore short term efficacy of the stabilized splint and the combination of manipulative and physical therapies for temporomandibular joint (TMJ) disc displacement without reduction. Methods One hundred and sixty-eight patients with TMJ disc displacement without reduction who visited the Department of Prosthodontics of Shanghai Ninth Peoples Hospital affiliated to Shanghai Jiao Tong University School of Medicine from Feb. 2013 to Mar. 2015 were enrolled and randomly assigned to stabilized splint group (group 1), combination of manipulative and physical therapies group (group 2), stabilized splint and combination of manipulative and physical therapies group (group 3), and control group (group 4). The degree of pain and pain-free maximum active mouth opening among all patients were evaluated before treatment and every three weeks during three months of treatment. Results For VAS values of spontaneous masseter pain, the differences in group 1, group 2, and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05) and the difference in group 4 before treatment and 12 weeks after treatment was statistically significant. For VAS values of palpation pain, the differences in group 2 and group 3 before treatment and 6 weeks after treatment were statistically significant (P<0.05), the difference in group 1 before treatment and 9 weeks after treatment was statistically significant (P<0.05), and the difference in group 4 before treatment and 12 weeks after treatment was statistically significant (P<0.05). For VAS values of chewing pain, the differences in group 1 and group 2 before treatment and 6 weeks after treatment were statistically significant (P<0.05), the difference in group 3 before treatment and 3 weeks after treatment was statistically significant (P<0.05), and the difference in group 4 before and after treatment was not statistically significant (P≥0.05). For pain-free maximum mouth opening, the difference in group 1 before treatment and 9 weeks after treatment was statistically significant (P<0.05), the differences in group 2 and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05), the differences in group 2 and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05), and the difference in group 4 before and after treatment was not statistically significant (P≥0.05). Conclusion Both splints and the combination of manipulative and physical therapies can alleviate most muscle and joint pain in short term. Health education may partly alleviate pain. Splints and the combination of manipulative and physical therapies can rapidly improve the mouth opening of patients and satisfy the basic physiological function.

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    Investigation of metabolic diseases and quality of life in patients with schizophrenia
    ZHU Yun-cheng, CAO Ai-ai, WANG Fang, XUE Lian-xue, CHEN Xuan-xuan, JIANG Xi-xi, JI Wei-dong
    2016, 36 (06):  856. 
    doi: 10.3969/j.issn.1674-8115.2016.06.014

    Abstract ( 667 )   PDF (588KB) ( 651 )  

    Objective To investigate the current situation and correlation of metabolic characteristics and quality of life (QOL) in patients with schizophrenia by assessing metabolic indexes and QOL. Methods One hundred and seventy-four patients were assigned according to the diagnoses of non-metabolic syndrome (Non-MS group), high-risk-metabolic syndrome (HR-MS group), and metabolic syndrome (MS group). The correlations between metabolic indexes (body mass index, mean arterial pressure, cholesterol, triglyceride, and fasting blood glucose) and the WHO Quality of Life-BREF (WHOQOL-BREF) score were analyzed. Results The differences in the WHOQOL-BREF score among groups were statistically significant (F=5.903,P=0.000). Post-Hoc test showed that the WHOQOL-BREF score was lower in the Non-MS group than in the HR-MS group and the MS group (P=0.009, P=0.002). The difference in the WHOQOL-BREF score between the HR-MS group and the MS group was not statistically significant (P=0.153). The mean arterial pressure and fasting blood glucose were negatively and linearly correlated to the WHOQOL-BREF score (r=-0.183,P=0.015;r=-0.168, P=0.026).  Conclusion The abnormality of any one of metabolic indexes can cause synergistic changes in associated metabolic indexes with decreased QOL in patients with schizophrenia. The effects of diabetes and hypertension on QOL of patients are more significant as compared with obesity and hyperlipemia.

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    Effect of magnetic field on guide wire in model of subclavian vein catheterization
    WANG Jin-hui, HAN Lü-lu, XING Shun-peng, Wen Da-xiang
    2016, 36 (06):  860. 
    doi: 10.3969/j.issn.1674-8115.2016.06.015

    Abstract ( 677 )   PDF (1526KB) ( 720 )  

    Objective To investigate the effect of magnetic field on guide wire during subclavian vein catheterization (SVC) and decrease the rate of misplacing a catheter. Methods A magnet field model of vein catheterization was built. The magnet field guide method was used to avoid misplacing a catheter, i.e. the direction of guide wire was guided by the attraction of a NdFeB magnet. The effects of different venous angles, wire tips, and directions under the action of magnetic field on the successful puncture rate were explored. Results A NdFeB magnet placing 46 mm away from veins could increase the successful puncture rate when the venous angle was not less than 110° and the ‘J’ tip turned towards the brachiocephalic vein, as well as when the venous angle was less than 110° and ‘J’ tip turned towards the chest. However, the magnet had no effect for any venous angles when ‘J’ tip turned towards the back. The successful puncture rate was increased for some venous angles when ‘J’ tip turned towards ipsilateral internal jugular vein. The effective area for magnet-guided SVC was an 80 mm by 90 mm rectangle with one short side close to the venous junction and two long sides being about 40 mm away from the brachiocephalic vein. Conclusion The presence of magnetic field during SVC can effectively raise the successful puncture rate.

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    Study on the correlation between body composition and renal damage indexes in patients with type 2 diabetes mellitus
    GU Ting, JIANG Bo-Ren, HAN Bing, YANG Li-Zhen
    2016, 36 (06):  866. 
    doi: 10.3969/j.issn.1674-8115.2016.06.016

    Abstract ( 655 )   PDF (636KB) ( 746 )  

    Objective To investigate the correlation between body composition and renal damage indexes in patients with type 2 diabetes mellitus. Methods One hundred patients with type 2 diabetes mellitus were randomly enrolled, including 45 male ones and 55 female ones. The body composition related parameters (including body fat percent, body muscle percent, and body water percent, etc.) were measured with a body composition analyzer and renal damage related parameters (including serum urea nitrogen, uric acid, creatinine, estimated glomerular filtration rate, 24 hours urine protein, microalbumiuria, urinary beta2 microglobulin, N-acetyl-beta-D-glucosaminidase, and transferrin, etc.) were detected. The correlation between body composition and renal damage indexes was analyzed. Results For male patients, the serum uric acid level was positively correlated to the body fat percent and negatively correlated to the body muscle percent, and the 24 hours urine protein was negatively correlated to the extracellular water percent. For female patients, the serum uric acid was positively correlated to the body fat percent and negatively correlated to the body muscle percent and the extracellular water percent, and 24 hours urine protein was positively correlated to the body fat percent and negatively correlated to the body muscle percent and extracellular water percent. Conclusion Body fat percent, body muscle percent, and body water percent may be important factors influencing uric acid and proteinuria, which are associated with renal damage in patients with type 2 diabetes mellitus.

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    Protective effect of perioperative low-dose dexamethasone on sore throat after thyroidectomy
    ZHANG Hui-wen, FAN You-ben, LU Jie, WU Bo, XU Cheng, ZHOU Quan-hong
    2016, 36 (06):  870. 
    doi: 10.3969/j.issn.1674-8115.2016.06.017

    Abstract ( 845 )   PDF (653KB) ( 788 )  

    Objective To analyze the protective effect of perioperative low-dose dexamethasone on sore throat after thyroidectomy by the use of the pain rating scale. Methods Patients who underwent the thyroid surgery and met the inclusion criteria were randomly assigned to the dexamethasone group (n=103) and the saline group (n=130). Patients were intravenously injected with 0.1 mg/kg of dexamethasone or same volume of saline at the induction of general anesthesia. The visual analogue scale (VAS) was used to assess incision pain and throat pain (at rest and in swallow) of patients after thyroid surgery. The incidences of postoperative nausea and vomiting were recorded and assessed with the verbal rating scale (VRS). Blood glucose levels before and after surgery were measured and postoperative incision infections were observed. Results The proportion of patients receiving antiemetic drugs after surgery was markedly lower in the dexamethasone group (18.4%) than in the saline group (58.5%) and the difference was statistically significant (P=0.000). The proportion of patients receiving analgesic drugs after surgery was lower in the dexamethasone group (1.0%) than in the saline group (6.2%) and the difference was statistically significant (P=0.041). The blood glucose levels in the dexamethasone group were markedly higher than those in the saline group 1 d after surgery (P=0.000) and returned to the baseline level on the next day. The difference in the rate of postoperative incision infections between two groups was not statistically significant (P=0.848). Conclusion Perioperative low-dose dexamethasone can reduce incision pain and throat pain, as well as incidences of nausea and vomiting after thyroidectomy. The blood glucose level 1 d after thyroidectomy was elevated with no high blood glucose adverse events.

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    Comparison of the prognosis in patients with diabetic nephropathy undergoing different phases of hemodialysis
    BIAN Zhi-xiang, CHEN Pei-hua, GU Hui-yi, HU Chun, PAN Yu
    2016, 36 (06):  875. 
    doi: 10.3969/j.issn.1674-8115.2016.06.018

    Abstract ( 665 )   PDF (1053KB) ( 640 )  

    Objective To compare the survival rate of patients with diabetic nephropathy (DN) who underwent different phases of hemodialysis (i.e. emergency hemodialysis and planned hemodialysis). Methods Patients with DN who underwent emergency hemodialysis or planned hemodialysis between June 1, 2008 and June 31, 2015 were enrolled. Patients were assigned to the emergency hemodialysis group and the planned hemodialysis group and their demographic and clinical data were collected. Patients were followed up till January 31, 2016. Kaplan Meier method and log rank test were used to analyze the survival rate of the patients. Results A total of 117 DN patients undergoing hemodialysis were enrolled and assigned to the emergency hemodialysis group (n=62) and the planned hemodialysis group (n=55). The mortality rate was significantly higher in the emergency hemodialysis group (38.7%) than in the planned hemodialysis group (21.8%)(P=0.043). Eliminating patients died within three months, the differences in survival rates at each stage from 6 months to 5 years after hemodialysis between the two groups were not statistically significant. Kaplan-Meier survival curve analysis revealed that the overall mortality rate in the planned hemodialysis group was higher as compared with the emergency hemodialysis initially (P=0.034). Conclusion For patients with DN, the overall survival rate in patients undergoing the planned hemodialysis was higher as compared with patients undergoing the emergency hemodialysis. Most deaths in DN patients undergoing emergency hemodialysis occured within beginning three months after hemodialysis.

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    Analysis of risk factors and pathogenic bacteria for severe bacterial keratitis
    SUN Jing-fen, ZHOU Zheng-shen
    2016, 36 (06):  880. 
    doi: 10.3969/j.issn.1674-8115.2016.06.019

    Abstract ( 782 )   PDF (535KB) ( 603 )  

    Objective To investigate epidemiology, microbiology, and clinical manifestations and progression for severe bacterial keratitis and identify its risk factors and pathogenic bacteria. Methods Data of 221 cases (228 eyes) of severe bacterial keratitis treated at the Department of Ophthalmology in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine between January 2009 and June 2015 were analyzed retrospectively. The bacterial keratitis was confirmed in most patients by bacterial culture for corneal tissues and the secretion from ocular surface. No bacterium was found through bacterial culture in the remainder cases that were highly suspected of bacterial keratitis and responsive to antibiotic treatment. The average follow-up period was (8.55±6.92) months. Results The bacteria detection rate was 75.57% and the major pathogenic bacteria were gram positive cocci (42.54%) and gram negative bacilli (26.32%). The difference in the prognosis of bacterial keratitis caused by these two types of bacteria was not statistically significant (P=0.152). The systemic or ocular risk factors were found in 205 eyes (89.91%), two or more risk factors were identified in 9 eyes (3.94%), and no obvious risk factors were found in 23 eyes (10.09%). Wearing corneal contact lens was the most common risk factor and was accounted for 46.92% (107 eyes, P=0.001). Conclusion The most common risk factor for bacterial keratitis is wearing corneal contact lens. The most common pathogenic bacteria are gram positive cocci and gram negative bacilli. Bacterial keratitis caused by wearing contact lens has the best prognosis.

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    Evaluation of the effect of postprandial hypotension on left ventricular myocardial strain by 2D speckle tracking imaging
    LIN Yi-tong, WANG Hai-ya
    2016, 36 (06):  884. 
    doi: 10.3969/j.issn.1674-8115.2016.06.020

    Abstract ( 689 )   PDF (1428KB) ( 679 )  

    Objective To quantitatively evaluate the early injury in left ventricular myocardial strain in patients with postprandial hypotension (PPH) by using 2D speckle tracking imaging (2D-STI). Methods Twenty patients who were first diagnosed with PPH (PPH group) and 21 patients without PPH (NPPH group) were recruited. The global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of left ventricle were measured before and 1.5 h after meal with 2D-STI. Meanwhile, cardiac structure and function were evaluated by conventional method. Results There was no significant difference in heart structure evaluated by conventional method between two groups. Before meal, GLS in the PPH group was significantly lower as compared with the NPPH group (P=0.02), but there was no significant difference in GCS and GRS. GLS in the PPH group was significantly decreased 1.5 h after meal as compared with that before meal (P=0.045), whereas there was no significant change in the overall myocardial strain in the NPPH group after meal. Logistic regression analysis showed that GLS before meal (P=0.02,OR=0.46), and GLS (P=0.001, OR=0.27), GCS (P=0.008,OR=0.41), and GRS (P=0.004,OR=0.33) after meal were significantly correlated to PPH. The area under the ROC curve of GLS after meal (AUC=0.86, P=0.001) was significantly greater than 24 h average SBP (AUC=0.66, P=0.08) and LVEF (AUC=0.44, P=0.47). Conclusion PPH may result in occult cardiac function injury. STI is superior to conventional echocardiography in detecting the early injury in left ventricular myocardial function for patients with PPH.

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    Study on the serum irisin level in patients with polycystic ovary syndrome
    SONG Meng-ge, QIU Yan
    2016, 36 (06):  890. 
    doi: 10.3969/j.issn.1674-8115.2016.06.021

    Abstract ( 713 )   PDF (1067KB) ( 676 )  

    Objective  To investigate the correlation between the serum irisin level and the metabolic parameters in patients with polycystic ovarian syndrome (PCOS) and observe changes in the serum irisin level before and after metformin treatment.  Methods A total of 79 patients with PCOS (the PCOS group) and 57 patients with tubal infertility and regular menstruation (the control group) were enrolled. Twenty-six PCOS patients with obesity or insulin resistance (IR) received 6 months treatment of oral metformin (500 mg tid). The serum irisin level and relevant indexes were compared between the two groups and their changes before and after treatment with metformin were observed.  Results The serum irisin level in the PCOS group was significantly higher than that in the control group (P=0.000) and the serum irisin level in PCOS patients with obesity was higher than that in PCOS patients without obesity (P=0.001). After 6 months of metformin treatment, PCOS patients had a significant decrease in serum irisin level and improved IR. Correlation analysis revealed that the serum irisin level had a positive correlation with HOMA-IR (r=0.240, P=0.033). Conclusion The serum irisin level in PCOS patients significantly increases and has a positive correlation with HOMA-IR, which may be associated with the occurrence and development of IR. The metformin treatment can significantly decrease the serum irisin level in PCOS patients.

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    Original article (Public health)
    Analysis of the salary satisfaction among physicians in four third-class public hospitals in Shanghai
    YANG Tao, TAO Rong, LI Guo-hong
    2016, 36 (06):  896. 
    doi: 10.3969/j.issn.1674-8115.2016.06.022

    Abstract ( 798 )   PDF (831KB) ( 743 )  

    Objective  To survey and analyze the salary satisfaction, advices, and suggestions among physicians in public hospitals in Shanghai and provide reference for designing relevant policies via sampling survey. Methods Site survey was performed among physicians in four public hospitals in Shanghai. SPSS 18.0 was used to conduct statistical description and logistic regression analysis. Results The average salary satisfaction score of the respondents was 2.75±0.78. Logistic regression analysis showed that hospital type, sex, age, department, and title were main factors affecting the salary satisfaction in physicians. Most physicians deemed that guarantee and improvement of welfare, salary distribution considering department, post, and position differences and according to contribution and fairness, increase in the salary level and reflection of work value were helpful for improving the salary satisfaction. Conclusion At present, physicians in public hospitals in Shanghai have low salary satisfaction. The salary level is not the only aspect of salary satisfaction as physicians pay more attention to aspects such as welfare. Therefore it is necessary to maintain the current salary level, establish scientific and reasonable salary increase mechanism and salary structure, increase welfare, explore more advanced salary distribution mechanism, and ensure the progressiveness and scientificity of the salary system.

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    Study on the medication adherence in patients with type 2 diabetes by electronic monitoring and scale assessment
    LIU Hui-ming, LI Guo-hong, ZHAO Lie-bin, DONG Bin, LU Luo, ZHOU Ying-xia
    2016, 36 (06):  901. 
    doi: 10.3969/j.issn.1674-8115.2016.06.023

    Abstract ( 845 )   PDF (890KB) ( 730 )  

    Objective To assess the medication adherence in patients with type 2 diabetes with electronically monitored medicine bottles and the adherence scale and explore the association between results from electronic monitoring and the adherence scale. Methods The oral hypoglycemic medication in 373 patients with type 2 diabetes was monitored with electronic medicine bottles and related demographic and blood glucose data were collected. Patients were assessed with Chinese revised version of 8-item Morisky medication adherence scale (MMAS-8) and beliefs about medication questionnaire (BMQ-specific). Results ①The average medication adherence in patients monitored with electronic bottles was (80.5±24.8)%, 64.9% (242) of which had high medication adherence (medication rate≥80%). The medication adherence in patients taking 3 kinds of hypoglycemic medications or taking medications 3 times a day was the lowest. ②The average score of MMAS-8 was 7.06±1.13. Patients with low (<6), intermediate (≥6 and <8), and high (=8) medication adherence accounted for 11.8% (43), 58.3% (218), and 29.9% (112), respectively. The average score of BMQ-specific was 6.02±3.99 and the score of specific-necessity item was significantly higher compared with the specific-concerns item (P=0.000). ③The fasting blood glucose and glycosylated hemoglobin levels in patients with high medication adherence were lower (electronic monitoring, P=0.038, P=0.015, respectively). The differences in medication rate (electronic monitoring) and glycosylation level in patients with different levels of medication adherence assessed by questionnaires were not statistically significant (P=0.725). Patients with high medication adherence assessed by both scale and electronic monitoring had the best control over blood glucose with a glycosylated hemoglobin level of (6.79±1.12)%. Patients with high medication adherence assessed by scale and with low medication adherence assessed by electronic monitoring had the highest glycosylated hemoglobin level of (7.52±1.50)%. Conclusion Medication types and medication frequency affect the medication adherence. The scale assessment overestimates the actual medication adherence in patients. The consciousness of adhering to orders for rational and persistent medication in some patients still needs enhanced. Concerns of taking medication (such as adverse effects and drug dependence) greatly affect the medication behavior in patients, and psychological counseling and medication education need to be strengthened. Patients with low actual medication adherence and overestimated medication adherence have poor control over their blood glucose.

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    Analysis of the quality of life and its influencing factors for patients with type 2 diabetes mellitus in urban and rural areas in Chongqing
    SUN Zhen-xing, TANG Xiao-jun, JIN Ya-na, HE Miao, LONG Qian, TANG Sheng-lan
    2016, 36 (06):  906. 
    doi: 10.3969/j.issn.1674-8115.2016.06.024

    Abstract ( 651 )   PDF (692KB) ( 667 )  

    Objective To survey the quality of life in patients with diabetes from urban and rural areas in Chongqing, discuss associated influencing factors, and provide evidence for improving the quality of life in diabetic patients. Methods The multi-stage cluster random sampling was used to obtain 496 cases of type 2 diabetes and their quality of life was assessed with the General Information Questionnaire and the Diabetes Specific Quality of Life Scale (DSQL). The univariate analysis and multiple linear regression analysis were used to analyze the influencing factors for the quality of life in urban and rural dimensions .Results The average score of patients with type 2 diabetes was 62.80±14.47 and the quality of life in patients in rural areas was lower as compared with patients in urban areas (P<0.01). The most influenced dimension was psychological/spiritual dimension, followed by physiological function, social relations, and treatment dimensions (P<0.01). There are differences in psychological/spiritual, physiological function, and social relations dimensions between patients in urban and rural areas (P<0.01). Univariate analysis and multiple linear regression analysis showed that the total score of quality of life in patients with type 2 diabetes in urban areas was correlated to the duration of diabetes (β=0.169, P=0.004), education level (β=-0.105,P=0.043), and per capita monthly income (β=-0.126, P=0.007). The total score of quality of life in patients with type 2 diabetes in rural areas was correlated to the sex (β=0.157, P=0.040) and per capita monthly income (β=-0.116, P=0.025).  Conclusion In Chongqing, the quality of life among patients with type 2 diabetes in urban areas is better as compared with patients in rural areas. Purposeful interventions should be carried out according to different influencing factors for the quality of life among patients with type 2 diabetes in urban and rural areas in order to improve the quality of life.

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    Analysis of total factor productivity between 2003 and 2014 in tertiary hospitals in Shanghai based on Malmquist index
    CHEN Li-hong, TANG Lei, NI Wei-jie
    2016, 36 (06):  912. 
    doi: 10.3969/j.issn.1674-8115.2016.06.025

    Abstract ( 585 )   PDF (916KB) ( 776 )  

    Objective To measure the changes in total factor productivity (TFP) of tertiary hospitals in Shanghai and provide assessment indexes and decision making evidence for improving the performance of public hospitals. Methods Panel data (including 2 input and 2 output indexes) between 2003 and 2014 on 16 tertiary hospitals in Shanghai were collected and analyzed with Malmquist Index. Results The annual TFP growth rate in sample hospitals in 12 years was 7.2%, the annual technical progress growth rate was 6.4%, both technical efficiency and pure technical efficiency growth rates were 0.8%, and the scale efficiency remained unchanged. Conclusion The growth of TFP in tertiary hospitals in Shanghai is slow and the main contributor is technical progress. The growth rate of technical efficiency is very low. It is clear that the improvement of hospital performance should focus on enhancing the internal management, increasing the input-output efficiency of medical care resources, as well as integration of parametric and nonparametric methods for the comprehensive assessment of hospital performance.

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    Review
    ACE2/Apelin signaling and atherosclerosis
    ZHANG Zhen-zhou, SONG Bei, ZHONG Jiu-chang
    2016, 36 (06):  917. 
    doi: 10.3969/j.issn.1674-8115.2016.06.026

    Abstract ( 743 )   PDF (498KB) ( 706 )  

    Atherosclerotic diseases have become the leading cause of human death. The renin-angiotensin system is an important factor for promoting the occurrence and development of atherosclerotic cardiovascular diseases. Studies have revealed that the ACE2/Apelin signaling plays a protective role in the cardiovascular system. This article reviews the latest research advances in ACE2/Apelin signaling and its regulatory role in atherosclerosis.

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    Research advances in the roles of ncRNAs in polycystic ovary syndrome
    YANG Qian, ZHOU Cheng-liang, PAN Jie-xue, HUANG He-feng
    2016, 36 (06):  921. 
    doi: 10.3969/j.issn.1674-8115.2016.06.027

    Abstract ( 658 )   PDF (765KB) ( 709 )  

    Polycystic ovary syndrome (PCOS) is a common reproductive system disease affecting approximately 5% to 10% of women of childbearing age. The pathogenesis of PCOS remains unclear despite increasing studies in recent years. ncRNAs are RNAs not translating into proteins and mainly involve in many important functions such as regulation of gene expression and epigenetics. ncRNAs become a research hotspot recently. Previous studies have found changes in expressions of various ncRNAs in serum, follicle fluid, and granulosa cells of PCOS patients. It may be a new target for the diagnose of PCOS and provide new idea for studying the pathogenesis of PCOS. This paper reviews recent research advances in the roles of ncRNA in the occurrence and development of PCOS.

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    Research advances in the roles of lipoxin in acute lung injury and its mechanisms
    ZHANG Rong, ZHANG Yi-wei, WANG Yan, QI Ai-hua, WANG Li, WANG Ai-zhong
    2016, 36 (06):  926. 
    doi: 10.3969/j.issn.1674-8115.2016.06.028

    Abstract ( 697 )   PDF (543KB) ( 742 )  

    Acute lung injury (ALI) and its severe phase, i.e. acute respiratory distress syndrome (ARDS), is a common critical disease characterized by noncardiac pulmonary edema and refractory hypoxemia with high mortality, which seriously threatens patients’ lives. As a potent endogenous counter-regulatory lipid mediator, lipoxin (LX) plays a key role in the pathogenesis of many diseases such as ALI/ARDS and becomes a research focus in recent years. This paper reviews research advances in the roles of LX in ALI/ARDS and its mechanisms.

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    Detection rate and associated influencing factors for fetal congenital heart diseases diagnosed with prenatal echocardiography
    ZHAO Li-qing, SUN Kun
    2016, 36 (06):  930. 
    doi: 10.3969/j.issn.1674-8115.2016.06.029

    Abstract ( 676 )   PDF (628KB) ( 701 )  

    Congenital heart disease (CHD) is among the most frequent anomalies at birth and the main cause for fetal and infant death. Fetal echocardiography is the most frequently used and reliable technique in prenatal diagnosis of CHD and is developing rapidly both in China and abroad. This paper reviews the detection rate and associated influencing factors for fetal echocardiography in order to understand the prenatal diagnosis value of fetal echocardiography and provide reference for diagnosis with fetal echocardiography.

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    Research progresses of relationship between autophagy and drug resistance of tumor
    XU Hong-ling, ZHANG Ping
    2016, 36 (06):  934. 
    doi: 10.3969/j.issn.1674-8115.2016.06.030

    Abstract ( 1147 )   PDF (597KB) ( 865 )  

    Autophagy is a highly conservative process of cell metabolism, which mainly involves the process that proteins and organelles in cells are wrapped in autophagies and transported to lysosomes for degradation. In recent years, the relationship between autophagy and tumor has become a research focus. A large number of studies have shown that a variety of chemotherapy drugs can induce the occurrence of tumor cell autophagy and the inhibition of tumor cell autophagy can lead to different outcomes: survival or death. Autophagy is an important potential approach to tumor treatment. But more studies are needed to improve the efficacy of tumor treatment via regulation of the autophagy process due to the roles of autophagy in tumor formation and development are still controversial.

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    Pathogenesis and relevant serum biomarkers of immunoglobulin A nephropathy
    ZHANG Li-wen, WANG Wei-ming
    2016, 36 (06):  939. 
    doi: 10.3969/j.issn.1674-8115.2016.06.031

    Abstract ( 787 )   PDF (667KB) ( 885 )  

    Immunoglobulin A (IgA) nephropathy is the most prevalent primary chronic glomerular disease worldwide. The autoimmune response caused by galactose-deficient polymeric IgA1 is the original mechanism triggering the IgA nephropathy. Significant research advances in pathogenesis and biomarkers of IgA nephropathy have been made in recent years and provide the basis for noninvasive diagnosis, monitoring of disease activity, and disease-specific therapies. The research advances in molecular mechanisms and key serum biomarkers in the pathogenesis of IgA nephropathy are reviewed in this paper.

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    Progresses of applying the cognitive behavior therapy to mental intervention for female prisoners
    LI Cui-ping, AI Jia, CHAI Xiao-dong, MENG Ying, CHEN Fu-guo
    2016, 36 (06):  944. 
    doi: 10.3969/j.issn.1674-8115.2016.06.032

    Abstract ( 883 )   PDF (714KB) ( 724 )  

    With the increasing number of female prisoners worldwide, their mental disorder and recidivism problem also become increasingly severe. Cognitive behavior therapy has significant effect on intervening mental and behavior problems among female prisoners. In addition to traditional cognitive behavior therapy techniques, some new techniques also have remarkable efficacy, such as dialectical behavior therapy and mindfulness therapy. Clinical studies have shown that the combination of cognitive behavior therapy with routine treatment is superior to routine treatment alone. The risk level of female prisoners is consistently associated with the efficacy of cognitive behavior therapy. Female prisoners are more likely to accept cognitive behavior therapy as compared with male prisoners.

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