Establishment of organoid models for pancreatic ductal adenocarcinoma and screening of individualized therapy strategy

Background:Patients with pancreatic ductal adenocarcinoma(PDAC)who undergo surgical resection and receive effective chemotherapy have the best chance for longterm survival.Unfortunately,because of the heterogeneity of pancreatic cancer,it is difficult to find a personalized treatment strategy for patients.Organoids are ideal preclinical models for personalized medicine.Therefore,we explore the cultivation conditions and construction methods of PDAC organoid models to screen the individualized therapy strategy.Methods:Fresh PDAC tissues from surgical resection were collected and digested with digestive enzymes;then the tumor cells were embedded in Matrigel with a suitable medium to establish the PDAC organoid models.The genetic stability of the organoids was analyzed using whole exon sequencing;hematoxylin and eosin staining and immunohistochemistry of organoids were performed to analyze their consistency with the pathological morphology of the patient's tumor tissue;After 2 days of organoid culture,we selected four commonly used clinical chemotherapy drugs for single or combined treatment to analyze drug sensitivity.Results:Two cases of PDAC organoid models were successfully established,and the results of their pathological characteristics and exome sequencing were consistent with those of the patient's tumor tissue.Both PDAC organoids showed more sensitivity to gemcitabine and cisplatin,and the combined treatment was more effective than monotherapy.Conclusion:Both organoids better retained the pathological characteristics,genomic stability,and heterogeneity with the original tumor.Individual PDAC organoids exhibited different sensitivities to the same drugs.Thus,this study provided ideal experimental models for screening individualized therapy strategy for patients with PDAC.

Effect of cognitive behavioral group therapy on rehabilitation of community patients with schizophrenia:A short-term randomized control trial

BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.

Modeling and simulation for individualized therapy of amisulpride in Chinese patients with schizophrenia:focus on inter interindi⁃vidual variability,therapeutic reference range and laboratory alert level

OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese patients with schizophrenia was built based on therapeu⁃tic drug monitoring data to guide individualized therapy.METHODS Plasma concentration data(330 measurements from 121 patients)were ana⁃lyzed using a nonlinear mixed-effects model⁃ing approach with first-order conditional estima⁃tion with interaction(FOCE I).The concentra⁃tions of amisulpride were detected by HPLC-MS/MS.Age,weight,sex,combination medication history and renal function status were evaluated as main covariates.The model was internally val⁃idated using goodness-of-fit,bootstrap and nor⁃malized prediction distribution error.Recom⁃mended dosage regimens for patients with key covariates were estimated on the basis of Monte Carlo simulations and the established model.RESULTS A one-compartment model with first-order absorption and elimination was found to adequately characterize amisulpride concentra⁃tion in Chinese patients with schizophrenia.The population estimates of the apparent volume of distribution(V/F)and apparent clearance(CL/F)were 12.7 L and 1.12 L·h-1,respectively.Age sig⁃nificantly affected the clearance of amisulpride and the final model was as follow:CL/F=1.04×(AGE/32)-0.624(L·h-1).To avoid exceeding the lab⁃oratory alert level(640μg·L-1),the model-based simulation results showed that the recommended dose of amisulpride was no more than 600 mg per day for patients aged 60 years,800 mg per day for those aged 40 years and 1200 mg per day for those aged 20 years,respectively.CON⁃CLUSION Dosage optimization of amisulpride can be carried out according to age to reduce the risk of adverse reactions.The model can be used as a suitable tool for designing individual⁃ized therapy for Chinese patients with schizo⁃phrenia.

Impact of group music therapy on the depression mood of college students

The goal of this study was to examine the effects of group music therapy on depression and mental health among college students. 80 students participated in this study, with 40 assigned to control group and other 40 assigned to experimental group. The results showed that after the group music therapy, for the experimental group, the depression scores have reduced significantly and the mental health scores have improved, while for the control group, no significant difference was obtained on the de-pression and mental health scores. This indicates that group music therapy can effectively reduce depression and improve mental health.

Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study

Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cognitive behavioral therapy(CBT)for mood disorders.However,empirical support for nurse-led CBT for depression in Asian countries,especially in Japan,is still lacking.This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.Methods:In this single-arm study,we evaluated the effects of a 6-week group CBT,led by trained nurses,on patients with major depression.The primary outcome was the Beck Depression Inventory-Ⅱ(BDI-Ⅱ).Assessments were conducted at the beginning and end of the intervention.Results:Of 25 participants screened,23 were eligible for the study(of these,three dropped out during the trial but were included in the analysis).Nurse-led group CBT led to significant improvements in the severity of depression(BDI-Ⅱ,P<0.001).The mean total BDI-Ⅱscore improved from 23.1(SD=7.56)to 12.4(SD=8.57),and the pre-to post-effect size was large(Cohen's d=1.33).After CBT,45%of the participants were judged to be treatment responders,and 34%met the remission criteria.Conclusions:Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting.The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice.Further controlled trials that address the limitations of this study are required.

Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

Group Therapy in Adults with Obsessive-Compulsive Disorder: A Review

In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.

Effectiveness of Group Therapy Based on Transactional Analysis (TA) in Marital Burnout and Forbearance of Female Students

This research is a semi-experimental study (pretest-posttest design with unequal control group). This study aimed to investigate the effectiveness of the group therapy based on transactional analysis in marital burnout and forbearance of married female students. The research on statistical population comprised all married female students studying in humanities subjects in Neishabour Islamic Azad University in the academic year 2015-16. The sample included 24 of these students, who were selected voluntarily and through Random sampling method and were randomly assigned into two experimental and control groups. Measurement tools consisted of Couple Burnout Measure (CBM) and Evans marital forbearance questionnaire. The experimental group received 10 one-half hour sessions of the treatment based on the transactional analysis whereas in the meantime, the control group received nutritional trainings. The results indicated that the therapy based on the transactional analysis had been effective in reducing marital burnout and increasing the forbearance of couples.

Research Progress on Individualized Treatment of Splenic Aneurysm

Splenic artery aneurysm has a hidden onset and atypical symptoms.There are various diagnostic methods for splenic aneurysms,among which ultrasound is the first choice for aneurysm screening.The diagnostic rate of CTA and DSA reaches 100%.In clinical practice,it is necessary to integrate medical history,symptoms and signs,and multiple imaging results to improve the diagnostic rate.In terms of treatment plans,both intervention and surgical procedures have their strengths,and the application of intervention will be more extensive.We need to adhere to the principle of individualization and choose a reasonable treatment plan for patients.At present,there are many reports on pregnant women with large splenic aneurysms both domestically and internationally.Some scholars believe that large splenic aneurysms may be related to hormonal imbalances during pregnancy,and the specific pathogenic mechanism will become a hot topic in future research.

EFFICACY OF ACUPUNCTURE THERAPY ON A, B AND O BLOOD GROUPS ──Relationship between A, B, O blood groups and the acupuncture therapy

Efficacy of acupuncture therapy varies in patients with similar ailments. The present study was undertaken to search for a marker for better efficacy of acupuncture therapy. The study was made in 224 patients including osteoarthritis 141 (62.94 %), polyarthritis 23 (10.26 %), Bursitis & synovitis 15 (6.69 %) and others 45 (20.08 %). ABO blood groups were tested for each patient. It appears that patients belonging to group AB and B responded well to acupuncture therapy in proportionately more number. Good result was achieved in 47.82 % cases in group AB and 46.04 % cases in group B, whereas patients of group A and O showed good result in 27.65 % and 26.15 % cases respectively. Apparently it may be concluded that patients of AB & B blood groups would respond comparatively well to acupuncture therapy.

Application of donor dendric cell mediated recipieut lymphocyte reaction after related kidney transplantation in individualized immunosuppressive therapy

Objective To explore the feasibility of mediating recipient lymphocyte reaction with donor dendritic cells ( Dcs) in renal allograft recipients to guide individualized immunosuppressive therapy. Methods From Jan. 2008 to Jan. 2010,30 recipients received living related kidney transplantation were successively and divided into

The history of interventional therapy for liver cancer in China

In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, interventional therapy of liver cancer has swiftly progressed in China. Indeed, TAI, TAE, TACE and ablation therapy have witnessed great innovations in hardware facil ities, technical means, and therapeutic philosophy, while incorporating Chinese characteristics. As with the development of combined interventional therapy in China, interventional treatment of liver cancer has gradually started the process of precision and individualization. Actually, multidisciplinary, multimodal, and polymorphic treatments will be the most suitable pattern for liver cancer in the future, among which combination of interventional therapy with targeted, immunological treatments and information technology(IT) tools may bring a revolutionary breakthrough in liver cancer treatment.

Age and Gender-Related Differences in Physical Functions of the Elderly Following One-Year Regular Exercise Therapy

Reports on physical functions during maintenance period of the elderly with cardiac and other serious diseases are limited. This study aims to clarify age and gender-related differences in their physical functions. Participants included 167 elderly individuals (males, 78;mean age, 76.5 years;SD = 6.0 years;females, 89;mean age, 75.5 years;SD = 4.5 years) who participated in a 1-year regular exercise therapy twice a week. The following eight physical function tests were selected: grip strength, 10-m obstacle walking time, one-legged balance with eyes open, sit-ups, sitting trunk flexion, 6-min walk, stepping by sitting position, and a timed up & go (TUG). Two-way analysis of variance was used to examine mean differences by gender and age: young elderly group (aged 65 - 74 years) and old elderly group (aged ≥ 75 years). In the grip strength, sit-ups, 6-min walk, 10-m obstacle walking time, stepping by sitting position, and sitting trunk flexion tests, males were superior in the former four tests, and females were superior in the latter two tests. The young elderly group was superior in all tests except for sit-ups compared with the old elderly group. The balance during one-legged with eyes open test was superior in males compared with females in the young elderly group, but decreased in males in the old elderly group. In conclusion, physical functions of the elderly during maintenance period are different between genders. Muscle strength, muscle endurance, whole-body endurance, and walking ability are superior in males, whereas flexibility and agility are superior in females. The old elderly group was inferior in all the elements of physical function except muscle endurance.

短程焦点解决团体疗法对脑瘫患儿父母创伤后成长体验病耻感及照顾能力的影响

目的探讨短程焦点解决团体疗法对脑瘫患儿父母创伤后成长体验、病耻感及照顾能力的影响。方法将脑瘫患儿的81名父母按照随机数字表法分为研究组(40名)和对照组(41名)。对照组患儿父母给予常规心理护理,研究组患儿父母在对照组基础上给予短程焦点解决团体疗法,观察3周。比较干预前后两组患儿父母焦虑自评量表(SAS)、抑郁自评量表(SDS)、创伤后成长量表(PTGI)、连带病耻感量表(ASS)、家属照顾者照顾能力量表(FCTI)评分及护理满意度。结果干预后两组患儿父母SAS评分、SDS评分、ASS各维度评分、FCTI各维度评分均较干预前降低,研究组患儿父母低于对照组(P<0.01)。干预后两组患儿父母PTGI各维度评分均较干预前升高,研究组患儿父母高于对照组(P<0.01)。研究组患儿父母护理总满意度高于对照组(P<0.05)。结论短程焦点解决团体疗法能缓解脑瘫患儿的父母焦虑、抑郁情绪,减轻其病耻感,促进其创伤后成长,提升其照顾能力,有利于提高护理满意度。

CHS-DRG付费制度下药物治疗路径化管理在骨科围手术期合理预防性使用重组人促红细胞生成素的应用效果研究

目的:探讨基于国家医疗保障疾病诊断相关分组(CHS-DRG)付费方式改革下,围手术期重组人促红细胞生成素(rhEPO)路径化管理在骨科的应用效果。方法:采用德尔菲法,经过2轮计划-执行-检查-行动(PDCA)循环优化,制定了rhEPO药物治疗路径。以2022年3—7月该院骨科住院患者为管理前组,2023年3—7月的患者为管理后组。选取rhEPO使用率最高的8个DRG病种,比较管理前后的效益指标(次均住院费用、次均药品费用、平均住院时间、rhEPO使用合理率、输血率)改善程度。结果:与路径化管理前比较,路径化管理后骨科住院患者的次均住院费用由58 829.79元降至48 259.29元(P<0.05),次均药品费用由3 311.23元降至2 987.52元(P<0.05),平均住院时间由10.1 d缩短至8.05 d(P<0.01),差异均有统计学意义;rhEPO使用合理率由26.27%(62/236)提高至91.54%(238/260),输血率由34.66%(165/476)降至25.57%(169/661)。结论:通过路径化管理模式制定药物标准化方案,可优化资源配置,提高医疗质量,有效改善DRG病种效益指标。

关注儿童食物过敏管理中的热点问题

临床上食物过敏的管理主要包括回避过敏食物和多学科合作对症治疗。低敏配方是牛奶蛋白过敏婴幼儿重要的营养来源,医生应合理选择并规范使用低敏配方。食物阶梯疗法已应用于管理轻中度非IgE介导食物过敏儿童。开展食物过敏个体化治疗是未来的方向。

短程团体认知行为治疗联合计算机化认知行为治疗对青少年抑郁的改善作用

目的探讨短程团体认知行为治疗(Group Cognitive Behavioral Therapy,GCBT)对青少年抑郁症患者的疗效,观察短程GCBT和计算机化认知行为治疗(Computerized Cognitive Behavioral Therapy,CCBT)联合对青少年抑郁治疗疗效。方法随机选取2022年8月—2023年8月福建省福州神经精神病防治院精神科门诊及医学心理咨询中心门诊收治的90例青少年抑郁症患者为研究对象,通过随机数表法分为CCBT组(n=30,因未完成5次治疗脱落19例,最终11例)、GCBT组(n=30,因未完成5次团体治疗脱落3例,最终27例)及CCBT+GCBT组(n=30)。在服用抗抑郁药物基础上,CCBT组合并5周的CCBT,GCBT组合并5周的GCBT,CCBT+GCBT组合并5周的GCBT及CCBT。治疗频率均为1次/周。比较3组治疗前、后汉密尔顿抑郁量表(24 Items Hamilton Depression Scale,HAMD-24)评分及减分率,中学生心理健康量表(Mental Health Scale for Middle School Students,MSSMHS)总均分及各因子分。结果5周治疗后,3组HAMD-24评分[CCBT组16(9,18)分、GCBT组18(13,21)分、CCBT+GCBT组13.5(8,20.25)分]均有明显下降,差异有统计学意义(Z=-2.847、-4.545、-4.784,P均<0.05)。3组HAMD减分率比较,差异无统计学意义(P=0.069)。CCBT+GCBT组MSSMHS总均分及强迫、敌对、人际关系敏感、抑郁、焦虑、情绪不平衡及心理不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05);GCBT组MSSMHS总均分及强迫、敌对、抑郁及情绪不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05)。CCBT+GCBT组MSSMHS人际关系敏感及心理不平衡因子分较GCBT组明显改善,差异有统计学意义(P均<0.05)。结论短程CCBT及GCBT等治疗能有效改善青少年患者的抑郁症状,且CCBT与GCBT联合治疗疗效更优于单纯GCBT,且能有效降低CCBT高脱失率。

团体接纳与承诺疗法联合有氧运动对血液透析患者的影响

目的:探讨团体接纳与承诺疗法联合有氧运动对血液透析患者的影响。方法:选取2021年2月—2022年2月厦门大学附属第一医院肾内科血透室收治的94例血液透析患者。根据随机数表法将其分为对照组和研究组,各47例。对照组实施常规护理,研究组在对照组基础上给予团体接纳与承诺疗法联合有氧运动。比较两组干预前后疲乏情况、希望水平、应对方式、睡眠质量。结果:干预后,两组积极态度、积极行动、亲密关系评分均升高,研究组积极态度、积极行动、亲密关系评分均高于对照组,差异有统计学意义(P<0.05)。干预后,两组多维度Piper疲乏修订量表(PFS-R)、匹兹堡睡眠质量指数量表(PSQI)评分均降低,研究组PFS-R评分、PSQI评分均低于对照组,差异有统计学意义(P<0.05)。干预后,两组面对应对评分升高,回避、屈服应对评分均降低,研究组面对应对评分高于对照组,回避、屈服应对评分均低于对照组,差异有统计学意义(P<0.05)。结论:团体接纳与承诺疗法联合有氧运动能够有效缓解血液透析患者的疲乏程度,改善患者的心理状态,提高患者的希望水平,使患者积极应对疾病,改善睡眠质量。