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Objective:To systematically evaluate the intervention effect of acceptance commitment therapy on anxiety disorder.Methods:The full-text databases of Web of Science Core Collection, MEDLINE, KCI-Korean Journal Database, SciELO Citation Index, SpringerLink, Pubmed, EMBASE, Cochrane Library, CNKI Wanfang and Weipu were searched and randomized controlled studies related to acceptance commitment therapy for patients with anxiety disorder were collected.All randomized controlled studies met the criterion were included.Meanwhile, the literature quality of the included literatures was evaluated.The outcome indicators such as anxiety index, psychological flexibility and quality of life index were selected, and RevMan 5.3 software was used to analyze the literature data that met the inclusion criteria.Results:A total of 12 studies with 1 062 patients were included, including 513 cases in ACT group and 549 cases in control group.Meta analysis showed that ACT can effectively reduce anxiety level of patients with anxiety disorder (MD=-0.58, 95% CI: -0.85- -0.32, P<0.001), anxiety level in follow-up period (MD=-0.42, 95% CI: -0.75- -0.08, P=0.01), improving psychological flexibility (MD=0.46, 95% CI: 0.24~0.68, P<0.001); In the study of CBT(cognitive behavioral therapy) as the control group, there was no significant difference between ACT group and control group, among which after intervention (MD =-0.06, 95% CI: -0.47- 0.36, P=0.79), follow-up period (MD = 0.17, 95% CI: -0.07-0.41, P=0.16) .In the study with the control group as the blank control, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.76, 95% CI: -0.97- -0.56, P<0.001), and the difference is statistically significant.Excluding the non-blank control study, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.82, 95% CI: -1.09--0.55, P<0.001) in the studies where the proportion of women is greater than or equal to 70%.In the study of 50%-70% females, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.68, 95% CI: -1.09 --0.28, P=0.01). All the differences were statistically significant.There was no significant difference between ACT and the control group for quality of life(MD=0.24, 95% CI: -0.01-0.49, P=0.06). Conclusion:ACT has a certain effect on patients with anxiety disorder, which not only improves the anxiety level of patients, but also keeps the effect of anxiety improvement during the follow-up period, and the improvement of psychological flexibility has also been verified.The immediate and long-term efficacy of ACT is similar to that of CBT, which further improve the reliability of ACT curative effect.Gender difference has not been confirmed for the therapeutic effect.ACT has no obvious improvement on the quality of life, and the conclusion of this study needs more randomized controlled studies with large samples and high quality to verify it.
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Borderline personality disorder (BPD) is characterized by emotional regulation, interpersonal relationship, self-image and impulse control instability. It is a mental disorder with high morbidity, high mortality and difficult treatment. Psychotherapy is the main treatment for this disease. However, current mainstream psychotherapy, such as dialectical behavior therapy (DBT), has certain limitations, so it is necessary to find a more convenient and effective treatment method. Acceptance and commitment therapy (ACT), as the representative therapy of the third generation of cognitive therapy, aims to make individuals accept inevitable pain, find their own value and commit to action, and finally improve their psychological flexibility to live a meaningful life. ACT has been used in the treatment of a variety of mental disorders, and the effect is significant. By expounding the pathogenesis of BPD and the theoretical model of ACT, this paper analyzed the rationality and feasibility of ACT intervention in BPD from the pathological model and treatment model of ACT. Finally, the research results of ACT treating BPD in recent years were summarized. The results show that ACT provides a promising method for the treatment of BPD patients, however, more studies are needed to prove its use in this group and its specific mechanism.
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Obsessive compulsive disorder (OCD) etiology has always been concerned. Some studies have found that biological and social psychological factors will affect the formation and development of OCD, and the cognitive and metacognitive model of OCD suggest that rumination may be a cognitive risk factor for OCD. Thus, clarifying the relationship between rumination and OCD will play an important role in exploring the etiology and treatment of OCD. Many literatures showed that there was a significant correlation between rumination and OCD, rumination could predict and maintain obsessive-compulsive symptoms, and OCD patients tended to use rumination strategies to reduce pain. In addition, there are common risk factors such as perfectionism and childhood trauma between rumination and OCD, and intervention training for rumination has also shown feasibility in the treatment of OCD. These findings suggest the possibility that rumination may influence OCD, but the causal relationship between the two needs to be further established. In the future, longitudinal studies on the relationship between rumination and OCD can be carried out in a larger sample to enrich and complement the etiology of OCD.
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Objective@#To explore the value of plasma cell-free DNA (cfDNA) in the assessment of inflammatory bowel disease (IBD) activity. @*Methods@#From July 2014 to June 2017, 145 IBD patients from the First Affiliated Hospital of Fujian Medical University were selected. The plasma content of cfDNA was detected by picogreen-based fluorescent quantitative method. At the same period, 37 healthy individuals were enrolled as control group. The correlation between cfDNA content and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IBD activity was analyzed. The diagnostic capability of cfDNA in IBD activity was assessed by the receiver operating characteristic (ROC) curve. T-test was performed for comparison between two independent samples, and Pearson correlation coefficient test was used for correlation analysis between two variants. @*Results@#The content of plasma cfDNA of patients with Crohn′s disease (CD) and patients with ulcerative colitis (UC) were (29.17±2.07) μg/L and (26.86±1.97) μg/L, respectively; which were both higher than those of healthy control group (21.10±1.02) μg/L, and the differences were statistically significant (t=2.609 and 2.082, both P<0.05). Moreover, the content of cfDNA of patients with active CD or UC were (35.72±3.26) μg/L and (32.37±3.42) μg/L, respectively, which were both higher than those of patients with CD or UC in remission ((21.12±1.43) μg/L and (20.82±1.02) μg/L), and the differences were statistically significant (t=3.806 and 3.116, both P<0.01). The cfDNA content of CD patients was positively correlated with CRP, ESR and disease activity (r=0.555, 0.393 and 0.400, all P<0.01). The cfDNA content of UC patients was also positively correlated with CRP, ESR and disease activity (r=0.640, 0.421 and 0.360, all P<0.01). The diagnostic capability of the combination of CRP and ESR was the highest in CD diagnosis, with the area under curve (AUC) value being 0.841, and the sensitivity and specificity being 81.4% and 74.3%, respectively. The diagnostic capability of the combination of cfDNA, CRP and ESR was the highest in UC diagnosis, with the AUC value being 0.851, and the sensitivity and specificity being 74.3% and 96.9%, respectively. @*Conclusions@#Increased cfDNA levels in IBD patients are correlated with IBD activity. Detection of cfDNA is helpful in the identification of active IBD, and the combination of ESR and CRP can improve the diagnostic efficiency of UC.
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Passive leg raising is widely used in clinic, but it lacks of specialized mechanical raise equipment. It requires medical staff to raise leg by hand or requires a multi-functional bed to raise leg, which takes time and effort. Therefore we have developed a new medical electric leg-raising machine. The equipment has the following characteristics: simple structure, stable performance, easy operation, fast and effective, safe and comfortable. The height range of the lifter is 50-120 cm, the range of the angle of raising leg is 10°-80°, the maximum supporting weight is 40 kg. Because of raising the height of the lower limbs and making precise angle, this equipment can completely replace the traditional manner of lifting leg by hand with multi-functional bed to lift patients' leg and can reduce the physical exhaustion and time consumption of medical staff. It can change the settings at any time to meet the needs of the patient;can be applied to the testing of PLR and dynamically assessing the hemodynamics; can prevent deep vein thrombosis and some related complications of staying in bed; and the machine is easy to be cleaned and disinfected, which can effectively avoid hospital acquired infection and cross infection; and can also be applied to emergency rescue of various disasters and emergencies.
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Objective To investigate the short-term efficacy and safety-related factors of the complete mesocolic excision and traditional operation for treating colon cancer. Methods The data of 38 patients with colon cancer who received complete mesocolic excision and 47 ca-ses who treated by traditional operation were analyzed retrospectively,and the short-term efficacy and relative factors were compared. Results The average cleaned lymph nodes of CME group and traditional group were respectively (21. 6 ± 7. 5) and (13. 9 ± 7. 1),and the number of cleaned lymph nodes at every stage of surgery in CME group was significantly more than that in traditional group. The survival rates and the recurrence rates of two groups were respectively 100% vs. 80. 9%,10. 5% vs. 46. 8%. There was no significant difference in the postopera-tive exhaust,defecation and hospitalization time. But the rate of complications in CME group was lower than that in traditional group. Conclu-sion For patients with colon cancer,the complete mesocolic excision can clean the surrounding lymph nodes,improve the survival rate,re-duce the relapse rate,which enhances the quality of operation,improves surgical safety,with reliable efficacy,and worthy of further research and extension in clinic.
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Objective To evaluate the efficacy of different surgical treatments for 60 cases of gastric stump cancer patients and their prognostic factors. Methods Retrospectively analyze the clinical data of 60 cases of gastric stump cancer patients,and divided them into rad-ical surgery group (38 cases) and non-radical surgery group (22 cases) in accordance with the surgical methods. Survival rate and prognostic factors of 1,3 and 5 years after operation were compared. Results As of May 2007,a total of 7 patients of radical surgery group survived. Survival rate of 1,3 and 5 years after operation were respectively 89. 5%,44. 7%,and 18. 4% in the radical surgery group while 40. 9%, 1. 0%,0. 0% in the non-radical surgery group. Median survival time was 22 months in the radical surgery group and 14 months in the non-radical surgery group. The survival rate of the two groups were of a significant difference (P<0. 05). Conclusion Survival rate,TNM stage, radical surgery,degree of differentiation,lymph node metastasis,peritoneal metastasis,and liver metastasis are all independent prognostic fac-tors which affect gastric stump cancer.
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Anastomotic leakage was one of the severe complications after anterior resection of rectal cancer.Its occurrenc was correlated with age,weight and nutrtion,basic diseases,preoperative radio-chemotherapy,surgical technique and stage of the tumor.Anastomotic leakage could be diagnosed by symptoms,physical signs,drainagefluid and imaging examinations.Most of the anastomotic leakage could be cured non-operatively.Much attention should be pay on the prevention of anastomotic leakage,protective stomy should be made in high risk population,while the complications of protective stomy should be pay attention to.
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The intellectual property rights weight much in the research capacity of a university.This article focuses on the practice and achievements of Southern Medical University in the field of intellectual property management after the transformation of the university.
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Objective:To observe the expression of Clusterin in colorectal cancer tissues and study its relationship with the development and progression of colorectal cancer.Methods:Fifty-eight colorectal cancer tissues samples(32 rectal cancer tissues,26 colon carcinoma tissues) of patients with completed clinic data were obtained after surgery from the Affiliated Hospital of Guangdong Medical College.Immunohistochemical staining(SP method) was used to detect the expression of Clusterin in colorectal cancer tissue,adjacent normal tissue of colorectal cancer and normal tissue.Flow cytometry was used to examine the apoptosis of colorectal cancer cells.Results:The expression of Clusterin in colorectal cancer tissues was significantly higher than those in the adjacent tissues of colorectal cancer and normal colorectal tissue(P