Efficacy of cognitive behavioural therapy in medicated adults with attention-deficit/hyperactivity disorder in multiple dimensions: a randomised controlled trial.

The study aimed to evaluate the efficacy of group cognitive behavioural therapy (CBT) in medicated adults with attention-deficit/hyperactivity disorder (ADHD) with a multidimensional evaluation and follow-up to week 36. Ninety-eight adult ADHD were randomly allocated to the CBT combined with medication (CBT + M) group or the medication (M) only group. The primary endpoint was the ADHD-Rating Scale (ADHD-RS). Secondary endpoints included emotional symptoms, self-esteem, automatic thoughts, quality of life (QoL), and executive function (EF). The outcome measures were obtained at baseline (T1), after the 12-week CBT treatment (T2), and at two follow-up time points (week 24, T3, and week 36, T4). Compared to the M-only group, the patients in the CBT + M group showed an overall significantly greater reduction from baseline in ADHD core symptoms (ADHD-RS total score at T3, and inattention subscale at T2 and T3), depression and anxiety symptoms (T2-T4), state anxiety (T2 and T3) and trait anxiety (T2), automatic thoughts questionnaire at T3, and QoL (physical domain, psychological domain, and social domain, most significant at T3 and weakened at T4). These findings further confirmed the efficacy of CBT on multiple dimensions and verified improvements in automatic thinking in adult ADHD. The superiority of the combination treatment mainly manifested in reduced inattention, emotional symptoms, and maladaptive thoughts and improved QoL. Trial registration number ChiCTR1900021705 (March-05-2019).

Imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma.

PURPOSE: The purpose of this study was to analyze the imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma. PATIENTS AND METHODS: The clinical, radiographic, and pathological data of 9 patients of lymphoplasmacyte-rich meningioma were analyzed retrospectively. RESULTS: All cases were solitary; 8 patients with headache, dizziness, and vomiting; 2 patients with vision loss and one with progressive hearing loss; and 4 cases of secondary anemia, 3 of them with secondary hyperplasia of polyclonal immunoglobulin. In the plain CT scan of 6 cases, all masses showed higher density and without clear boundary, and 5 masses accompany obvious peritumoral edema. In plain MRI scan, all of the tumors appeared with irregular shape and unclear boundaries, 8 of the masses with obvious peritumoral edema. Enhanced scan showed all cases were significantly enhanced and the meninges in 7 cases thicken irregularly and extensively. The pathology showed that the tumors were irregularly shaped with grayish red or grayish white cut surfaces. Histological examination showed that the tumors consisted of abundant and diverse cells and different numbers of spindle tumor cells, and meningeal epithelial cells in the background of abundant inflammatory cells could be seen. The 9 cases all had surgery; only 1 case of recurrence in the first year after the operation was noted in the follow-up over 1 to 4 years, and no recurrence could be found after the second surgery. CONCLUSION: Lymphoplasmacyte-rich meningioma is a seldom-seen subtype meningioma of WHO grade I, often accompanying anemia or polyclonal immunoglobulin hyperplasia, which can recover to normal state after removing the masses. The masses showed higher density and without clear boundary in plain CT scan, and most of the tumors appear with irregular shape, obvious edema, and significant enhancement in the MRI scan. The prognosis is favorable after surgical resection and the recurrence rate is low.

Bidirectional associations between maladaptive cognitions and emotional symptoms, and their mediating role on the quality of life in adults with ADHD: a mediation model.

Background/objectives: Adults with attention-deficit/hyperactivity disorder (ADHD) have more maladaptive cognitions, emotional problems and a poorer quality of life (QoL). A verification of the psychological model in clinical samples is needed for a better understanding of the mechanisms of ADHD diagnosis on QoL via maladaptive cognitions, emotional symptoms, and their interactions. Methods: 299 ADHD participants and 122 healthy controls were recruited. ADHD core symptoms, maladaptive cognitions, emotional symptoms and psychological QoL were rated. Pearson's correlation and structural equation modeling were analyzed to explore the relationship and influence of ADHD diagnosis on QoL. Results: More maladaptive cognitions, emotional symptoms, and poorer QoL were found in the ADHD group, and the dysfunctional attitudes were on par between ADHD with or without medication (p = 0.368). Moderate to strong correlations were found between emotional symptoms, maladaptive cognitions and QoL, and ADHD core symptoms presented correlations among the above scores (r = 0.157 ~ 0.416, p < 0.01) in ADHD participants. The influence of ADHD diagnosis on QoL was mediated through maladaptive cognitions, emotional symptoms, and their bidirectional interactions (p < 0.05), especially those with stable medication. Conclusion: Our study is the first to verify the psychological model in adults with ADHD in China. The findings determined the direct influence of ADHD diagnosis on QoL and the indirect influence through maladaptive cognitions, emotional symptoms, and their interactions, emphasizing the importance of interventions for emotional symptoms and maladaptive cognitions for ADHD patients both with or without medication for a better QoL outcome.

Temperature sensor based on an isopropanol-sealed photonic crystal fiber in-line interferometer with enhanced refractive index sensitivity.

We fabricate a simple, compact, and stable temperature sensor based on a liquid-sealed photonic crystal fiber (PCF) in-line nonpolarimetric modal interferometer. Different from other reported PCF devices, it does not need expensive polarimetric devices, and the liquid is sealed in one fiber. The device consists of a stub of isopropanol-filled PCF spliced between standard single-mode fibers. The temperature sensitivity (-166 pm/°C) increases over an order of magnitude compared with those of the previous sensors based on air-sealed PCF interferometers built via fusion splicing with the same mechanism. In addition, the refractive index sensitivity also increases. Higher temperature sensitivity can be realized by infiltrating some liquid having a higher thermo-optic coefficient into the microholes of the PCF.

Demonstration of a compact temperature sensor based on first-order Bragg grating in a tapered fiber probe.

We experimentally demonstrate an all-silica first-order fiber Bragg grating (FBG) for high temperature sensing by focused ion beam (FIB) machining in a fiber probe tapered to a point. This 61-period FBG is compact (~36.6 µm long and ~6.5 µm in diameter) with 200-nm-deep shallow grooves. We have tested the sensor from room temperature to around 500 °C and it shows a temperature sensitivity of nearly 20 pm/°C near the resonant wavelength of 1550 nm. This kind of sensor takes up little space because of its unique geometry and small size and may be integrated in devices that work in harsh environment or for detecting small objects.

Miniature tapered photonic crystal fiber interferometer with enhanced sensitivity by acid microdroplets etching.

We fabricate a miniature tapered photonic crystal fiber (PCF) interferometer with enhanced sensitivity by acid microdroplets etching. This method is very simple and cost effective, avoiding elongating the PCF, moving and refixing the device during etching, and measuring. The refractive index sensing properties with different PCF diameters are investigated both theoretically and experimentally. The tapering velocity can be controlled by the microdroplet size and position. The sensitivity greatly increases (five times, 750 nm/RIU) and the size decreases after slightly tapering the PCF. The device keeps low temperature dependence before and after tapering. More uniformly and thinly tapered PCFs can be realized with higher sensitivity (∼100 times) by optimizing the etching process.

Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model.

BACKGROUND: Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL. METHODS: This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3). RESULTS: The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly. LIMITATIONS: The average age was young, the degree of education was high, and only self-reported scales were relied on. CONCLUSIONS: There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.

[Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis].

OBJECTIVE: To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis. METHODS: Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis. RESULTS: Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4+CXCR5+PD-1+ T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4+CXCR5+ICOS+PD-1+ T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis (P > 0.05). CONCLUSIONS: The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

[Analysis of related factors for hepatic alveolar echinococcosis and gallbladder complications of children in Qinghai Province].

OBJECTIVE: To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. METHODS: The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. RESULTS: The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257-2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. CONCLUSIONS: The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

[Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis].

OBJECTIVE: To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. METHODS: A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. RESULTS: The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). CONCLUSIONS: 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.