Nonetheless, the ablation strategies employed in our study (1) avoid common side effects described for DC ablation[26] due to our use of CD11c-DTR chimeric mice and 120G8 antibody, (2) address the role of both cDC and pDC, and (3) investigate the role of cDCs in

two common models of liver fibrosis. Our study contains several limitations. First, because we observed more than 1,400 HM-regulated genes, it is likely that genes besides NF-κB–regulated genes affect HSC responses. Further studies are required to unravel the relevance of NF-κB–independent genes and pathways regulated by HM. These may include additional mediators secreted from selleck chemicals HMs such as IL-6 and transforming growth factor β.[35, 42] Accordingly, our IPA analysis revealed Stat1/3/5 as an HM-activated pathway. Second, our studies were performed in mouse models, and further studies are required to determine whether HM-induced NF-κB activation plays a role in human fibrogenesis. As patients develop fibrosis slowly over decades, pathways that promote long-term myofibroblast survival may be particularly relevant. IL-1 and TNF inhibitors may be considered for antifibrotic therapies but may cause severe side effects. In conjunction with previous studies,[32, 43] our data support the concept that targeting the NF-κB pathway in HSCs and subsequent induction

of HSC apoptosis may be a more suitable antifibrogenic Acetophenone Selleck RG-7388 strategy. In conclusion, our study shows

that HMs provide a novel link between inflammation, HSC survival, and liver fibrosis and suggests that inflammatory signaling pathways may provide additional targets for antifibrotic therapies in the liver. Future studies are needed to determine whether macrophage-mediated promotion of myofibroblast survival also promotes fibrosis in other organs. Additional Supporting Information may be found in the online version of this article. “
“Background and Aim:  Insulin resistance and diabetes mellitus (DM) are known to contribute to the progression of non-alcoholic fatty liver disease (NAFLD). However, the relationship between glucose metabolism and NAFLD is not well known. In this study, we investigated whether secretion patterns of glucose and insulin could influence the histological severity in NAFLD patients without prior known type 2 DM. Methods:  A 75-g glucose tolerance test was performed on 173 biopsy-proven NAFLD patients without prior known type 2 DM. Plasma glucose and insulin levels were analyzed periodically for 3 h after oral glucose loading. Results:  Of the 173 NAFLD patients, 168 had non-alcoholic steatohepatitis, whereas no patient had cirrhosis. Irrespective of the hemoglobin A1c levels, impaired glucose tolerance, including DM, was detected in 60% of the NAFLD patients.

4–8 Recently, transient elastography (TE) using FibroScan (EchoSens, Paris, France) was introduced as a promising non-invasive device for assessing liver fibrosis, and it has shown considerable accuracy for predicting cirrhosis in patients with chronic viral hepatitis.9–11 For a better prediction of liver fibrosis, some studies suggested Vismodegib chemical structure the combined use of TE, serologic fibrosis markers, and demographic and serologic biochemical variables.12–14 In the current issue of the Journal

of Gastroenterology and Hepatology, Lee et al.13 proposed a new fibrosis prediction formula, called the HALF index, which incorporated serum haptoglobin, apolipoprotein A1, α-2 macroglobulin, and TE as constituent variables. The superiority of the HALF index was proved by internal validation. The authors demonstrated that the area under the receiver–operator characteristic curve (AUROC) of the HALF index for predicting significant

fibrosis (≥F2) was 0.915 (95% confidence ICG-001 order interval: 0.868–0.949), which was significantly higher than the AUROC of TE alone (AUROC: 0.877; 95% confidence interval: 0.825–0.918; P = 0.010). However, as the confidence intervals of the HALF index and TE overlap, the statistical significance is questionable. Thus, the clinical applicability of the HALF index needs an independent external validation with a large sample size. In general, most non-invasive serologic fibrosis markers, formulae, and TE or TE-based prediction models are better at predicting liver cirrhosis than “significant fibrosis.” Interestingly, the AUROC of the HALF index for predicting significant fibrosis was higher than that for predicting liver cirrhosis (0.915 vs 0.892) in

the study of Lee et al.,13 albeit minimally, whereas the AUROC of TE remained similar (0.877 vs 0.878). In a further analysis, the study population was stratified into two groups according to their serum ALT levels (high- and low-ALT groups) to check the influence of necroinflammation Teicoplanin on the HALF index, which includes TE as a constituent factor. Importantly, the HALF index was not influenced by a high ALT, whereas the performance of TE increased significantly in the low ALT group, compatible with other reported findings. Conclusively, all these data indicate that the HALF index can predict significant fibrosis accurately, possibly better than TE, free of the influence of a high ALT in causing unreliable estimations of liver fibrosis. Therefore, if the HALF model can be validated sufficiently, it would be a useful tool for detecting significant fibrosis in patients with chronic viral hepatitis and for deciding when to start antiviral treatment. When we interpret the results of cross-sectional studies on non-invasive fibrosis prediction models, several issues should be considered.

This article historically contextualizes the text, offers a valid classification of headaches in 17th-century England, and describes the composition of the

homemade pharmaceutical forms recommended to female caregivers, the guidelines for administration and its potential pain-relieving effects. “
“(Headache 2010;50:808-818) Objective.— To assess the efficacy and safety of naproxen sodium in the treatment of acute migraine attacks. Background.— Non-steroidal anti-inflammatory drugs including naproxen sodium have been used in treating migraine attack. A number of clinical trials of naproxen sodium in migraine have been reported. However, it remains to be established whether Wnt activity Rucaparib in vivo naproxen sodium unequivocally offers clinical benefits taken into account the desired outcomes in acute migraine therapy as recommended by the International Headache Society. Methods.— Clinical trials were identified through electronic searches (MEDLINE, EMBASE, EBM review, and the Cochrane Library) up to June 2009 and historical searches of relevant articles. Studies were included in the meta-analysis if they were (1) double-blind, randomized, placebo-controlled trials that evaluated naproxen sodium tablet in moderate or severe migraine attacks in adult patients, and (2) reporting the efficacy in terms

of headache relief, pain-free, relief of migraine-associated symptoms, sustained headache relief, sustained pain-free, or headache recurrence. Data extraction and study quality through assessment were performed independently by 2 investigators. Disagreements were resolved by a third investigator. Treatment effects and adverse effects were expressed as risk ratio. A random effects model was used when significant heterogeneity existed, otherwise the fixed effects model was performed. Results.— We identified 16 published randomized controlled trials of naproxen

in the treatment of migraine. Four trials met the inclusion criteria and were included in the meta-analysis. Naproxen sodium was more effective than placebo in reducing pain intensity and providing pain-free within 2 hours in adults with moderate or severe migraine attacks. The pooled risk ratios were 1.58 (95% confidence interval [CI] 1.41-1.77, P < .00001), and 2.22 (95% CI 1.46-3.37, P = .0002), respectively, for headache relief at 2 hours and pain-free at 2 hours. It was also effective in achieving headache relief at 4 hours, relief of migraine-associated symptoms, sustained headache relief, and sustained pain-free responses. There was no significant difference in headache recurrence rate between naproxen sodium and placebo. The risk of any adverse event was greater with naproxen sodium than with placebo (pooled risk ratio 1.29, 95% CI 1.04-1.60, P = .02).

6 (95%CI 1.0, 2.6). In multivariate analysis controlling for socioeconomic variables, H. pylori infection was associated with 2.8 higher prevalence of anemia only in school-age children: adjusted PR 2.8 (95% CI 0.9, 9.3). The adjusted mean difference in hemoglobin levels between H. pylori infected school-age children and uninfected ones was −0.372 gr/dL (95% CI −0.704, −0.039) (p = .04). The respective mean ferritin difference was −6.74 μg/L (95% CI −13.38, −.011) (p = .04). Such differences were not found in infants.

Conclusions: H. pylori infection is associated with higher prevalence of anemia in school-age children independently of socioeconomic variables. Such association PARP inhibitor was not observed in infants. These findings are of clinical and public health importance. “
“In endemic settings, Helicobacter pylori infection can occur shortly after birth and may be associated with a reduction in childhood growth. This study investigated what factors promote earlier age of first H. pylori infection and evaluated the role of H. pylori infection in infancy (6–11 months) versus early childhood (12–23 months) on height. We included 183 children near birth from a peri-urban shanty town outside of Lima, Peru. Field-workers collected data on socioeconomic

status (SES), daily diarrheal and breast-feeding history, antibiotic use, anthropometrics, and H. pylori status via carbon 13-labeled urea breath test up to 24 months after birth. We used a proportional hazards model to assess risk factors for earlier age at first detected infection and linear selleck products mixed-effects models to evaluate the association of first detected H. pylori infection during infancy on attained height. One hundred and forty (77%) were infected before 12 months of age. Lower SES was associated with earlier age at first detected

H. pylori infection (low vs middle-to-high SES Hazard ratio (HR) 1.59, 95% CI 1.16, 2.19; p = .004), and greater exclusive breast-feeding was associated with reduced likelihood (HR 0.63, 95% CI 0.40, 0.98, p = .04). H. pylori infection in infancy was not independently associated with growth deficits (p = .58). However, children who had their first detected Cediranib (AZD2171) H. pylori infection in infancy (6–11 months) versus early childhood (12–23 months) and who had an average number of diarrhea episodes per year (3.4) were significantly shorter at 24 months (−0.37 cm, 95% CI, −0.60, −0.15 cm; p = .001). Lower SES was associated with a higher risk of first detected H. pylori infection during infancy, which in turn augmented the adverse association of diarrheal disease on linear growth. “
“Background: Helicobacter pylori infection is declining in developed and developing countries. The aim of this study was to retrospectively evaluate over an 8-year period the rate of H. pylori infection in children with gastrointestinal symptoms from Buenos Aires, Argentina.

Immunoglobulin G-4 disease represents a unique inflammatory condition that induces tumorous swelling of affected organs, histologically characterized with diffuse lymphoplasmacytic infiltration of affected organ, occasional eosinophils, storiform fibrosis, obliterative phlebitis, infiltration by numerous IgG4-bearing plasma cells, and marked clinically by dramatic response to steroid therapy [53]. Autoimmune pancreatitis (AIP) seems to be the prototype

of an IgG4-related disease, suggesting that gastric H. pylori infection triggers AIP in genetically predisposed individuals through molecular mimicry with plasminogen-binding protein of H. pylori exhibiting homology to ubiquitin-protein ligase E3 component n-recognin 2, an enzyme expressed

in pancreatic acinar cells [54]. However, serum IgG4 levels were elevated in only 53% of patients in the mentioned study, suggesting CYC202 in vitro that the cohort assessed might, in substantial part, represent non-IgG4-related AIP (type II AIP). An interesting study by Bago et al. [55] involved 56 patients with UBT-proven H. pylori infection, and 41.1% of patients harbored the bacterium in oral cavity, as detected by PCR. Three months after the learn more triple eradication therapy (PPI twice daily/amoxicillin/clarithromycin), the eradication rate in stomach was 78.3%, and surprisingly, H. pylori was not detected in any sample from oral cavity. The results of this study are not in agreement with the hypothesis that the oral cavity may represent the reservoir for gastric reinfection. A Polish study Montelukast Sodium by Burduk et al. [56] investigated on the possible H. pylori colonization in chronic rhinosinusitis and benign laryngeal diseases. This prospective, controlled study involved a series of 30 patients with nasal polyps and normal nasal mucosa and 30 patients with benign laryngeal diseases who underwent endoscopic sinus and endolaryngeal surgery. DNA was extracted from fresh tissue samples and subjected to PCR analysis for detection of ureA and cagA

H. pylori gene. Tissue samples were positive for ureA in all the patients involved in the study, and cagA+ was identified in 23.3% of patients with laryngeal disease while no positive result for cagA+ was observed in patients with nasal polyps and concha bullosa. In a review, Bulajic et al. [57] examined the studies conducted in the last 10 years, in regard to possible correlation between Helicobacter spp. and extragastric malignancies of digestive system. The PCR subtype most widely used in evaluated studies was nested PCR, and genes targeted most frequently for amplification were 16S rDNA of Helicobacter spp and ureA or cagA genes of H. pylori. A strong correlation between Helicobacter spp.

On the other hand, 11 of 14 rats in the retired breeder group fed CDE had these tumors. The reason for the low number of such tumors in the younger rats is not clear, but could be due to sampling error or the fact that rats receiving CDE die at an earlier age than the controls or retired breeders fed CDE and thus could be dying before the interstitial cell tumors develop. Other find more cancers found in single

rats (Supporting Information Table 2, Supporting Fig. 2B-F) included leukemia, lung adenocarcinomas, renal cell carcinoma, mucinous carcinomatosis of the peritoneum, transitional cell carcinoma of the bladder, and an osteogenic sarcoma. These tumors are also found characteristically in aged Fischer 344 rats25 and did not show any clear association with CDE feeding.

For example, we found two leukemias in the control groups and one in the experimental. The incidence of leukemia here was lower than what has been reported in the literature, but we found that a number of both control and experimental rats showed extramedullary hematopoiesis in the liver; that condition could have been reported as leukemia in other studies. Localization of EpCAM, HNF6, and C-Met were done to determine expression in oval cells, cholangiofibrosis (CF), and CAA (Supporting Information Table 3, Supporting Fig. 5). EpCAM was present in normal ducts, oval cells, epithelial cells in CF, and CAA, but not in normal or reactive hepatocytes, MK-8669 thus showing consistency of expression in biliary cell types. HNF6 was present in oval cells and CF, but unexpectedly not in CAA. C-Met was expressed weakly in normal hepatocytes, but was highly expressed in focal hepatocytes (notably in mitotic hepatocytes) N-acetylglucosamine-1-phosphate transferase in CDE-fed rats, as well as in oval cells, CF, and CAA. The cellular response of rats to a hepatocarcinogenic regimen is age-dependent. When fed five cycles of CDE diet beginning at age 3 weeks, seven of eight rats developed CCA, preceded by florid oval cell proliferation.

In rats fed the CDE diet beginning at 8 weeks of age, the oval cell response was much lower and a CCA developed in only 1 of 15 rats. When rats were fed the diet beginning at 1 year of age, there was minimal oval cell proliferation and no bile duct carcinomas were seen. This result supports the concept that cancers arise from tissue-determined stem cells, and that the number or potential, or both characteristics, of tissue stem cells to respond to carcinogens declines with aging. Unexpectedly, our cyclic CDE-fed rats did not develop either HBs, as predicted by our working hypothesis, or HCCs. In the literature, oval cell proliferation has generally been considered to be a precursor for development of HCC (for an extensive review, see Sell16).

In addition, in a similar study in Austrian children, antibiotic resistance was monitored between 2002 and 2009 showing high resistance rates to clarithromycin and metronidazole (21.6% for both), which are both still increasing [32]. Oleastro et al.[33] detected even higher resistance rate to clarithromycin (34.7%) in children from Portugal. In addition, they showed an increasing trend of resistance to fluoroquinolones and of double-resistant clarithromycin-metronidazole

strains. A Croatian study also reported high percentage of resistant strains (22.4%), with primary resistance rate to azithromycin (17.9%) higher than to clarithromycin (11.9%) and metronidazole (10.1%) [34]. The primary resistance rate reported in Beijing, China, for azithromycin 87.7% and clarithromycin 84.9% is quite surprising and deserves verification

while it was 61.6% for metronidazole Trichostatin A [35]. This could be explained by a wide use of macrolides for respiratory diseases and metronidazole for parasitic infections. On the basis of these results, in China, macrolides and metronidazole could be used only after susceptibility testing. In areas with high or unknown primary clarithromycin resistance rate, culture and susceptibility testing should be performed to select proper treatment regimen [13]. On the basis of these results novel, noninvasive tests that estimate antibiotic susceptibility are emerging; recent study evaluated accuracy of a new real-time PCR Selleckchem INCB024360 stool test for H. pylori detection and clarithromycin susceptibility testing [36]. The sensitivity, specificity, and test accuracy for detection of clarithromycin resistance were

83.3, 100 and 95.6%, making it a very promising tool if confirmed by further investigations [36]. The increasing number of children infected with resistant H. pylori strains promotes evaluation of new treatment protocols. Unfortunately, some of the second-line antibiotics, such as tetracycline, are not approved for use in children. In a multicenter trial, Schwarzer et al.[37] showed that high dose therapy with amoxicillin, metronidazole and esomeprazole during 2 weeks was a good treatment option in children infected with double-resistant strains. Furthermore, several recently published articles confirmed the efficacy of sequential therapy in children and found it even more efficacious Fludarabine than standard triple-therapy regimen, especially in areas with low clarithromycin resistance [38-40]. Helicobacter pylori infection differs in children compared to infected adults in respect to prevalence and pathophysiology, diagnostic tests accuracy and applicability, and antibiotic resistance rates. Although many uncertainties still prevail and there is lack of randomized pediatric trials, recently published studies provide further insight into the clinical implications of H. pylori infection, enabling development of the most recent diagnostic and therapeutic guidelines for children.

001) than patients with diverticular bleeding. In diverticulitis, 215 patients (91.5%) recovered with conservative treatment. 19 patients (8.1%) required surgical intervention (9 patients [18.4%] in the left side [n = 49], 10 patients [5.4%] in the right [n = 186]) Doxorubicin due to peritonitis 6, perforation 7, abscess 2, stricture 1, and others 3. Patients with diverticulitis in the left side required surgical intervention more frequently than in the right (P < 0.01). 2 patients including one patient who required surgical intervention

died due to sepsis. In diverticular bleeding, 84 patients (97.7%) recovered with non-surgical treatment. One patient with diverticulitis and diverticular bleeding required surgical intervention due to perforation. One elderly patient died due to diffuse cerebral infarction. 22 patients (25.6%) required blood transfusions. 44 patients Sorafenib order (51.2%) required therapeutic

barium enema. The median period from the onset of bleeding to hemostasis was 3 days (range 1–14). Conclusion: Diverticulitis was more commonly found in the right side and diverticular bleeding more so in the left. Patients with diverticulitis were more frequent, younger and more commonly found in the right side than patients with diverticular bleeding. Diverticulitis in the left side required more careful observation than in the right due to a greater necessity of surgical intervention. 97.7% patients with diverticular bleeding recovered with non-surgical treatment. However, an elderly patient or a patient with diverticulitis and diverticular bleeding would require more careful observation.

Key Word(s): 1. diverticulitis; 2. diverticular bleeding; 3. diverticulum Presenting Author: KEN ICHI MIZUNO Additional Authors: JUNJI YOKOYAMA, MASAAKI KOBAYASHI, YOSHIFUMI TAKAHASHI, KAZUYA TAKAHASHI, YUKI NISHIGAKI, TAKASHI YAMAMOTO, YUTAKA HONDA, SATORU HASHIMOTO, MANABU TAKEUCHI, YUICHI SATO, YOICHI AJIOKA Corresponding Author: KENICHI MIZUNO Affiliations: Graduate School of Medical N-acetylglucosamine-1-phosphate transferase and Dental Sciences, Niigata University Medical and Dental Hospital, Graduate School of Medical and Dental Sciences, Ni, Graduate School of Medical and Dental Sciences, Ni, Graduate School of Medical and Dental Sciences, Ni, Niigata University Medical and Dental Hospital, Niigata University Medical and Dental Hospital, Niigata University Medical and Dental Hospital, Graduate School of Medical & Dental Sciences, Niiga, Graduate School of Medical & Dental Sciences, Niiga, Graduate School of Medical and Dental Sciences Objective: Dysplasia in ulcerative colitis (UC) has become an important problem as the incidence increases. However, there is substantial inter- and intra-observer variability in the assessment of dysplasia among pathologists. Biopsy specimens should therefore be of adequate size for the correct diagnosis of dysplasia. Endoscopic submucosal resection (ESD) is useful for lesions with submucosal fibrosis.

Resin infiltration enhanced the SBS of porcelain discs bonded to demineralized enamel when compared with the other demineralization-inhibiting methods. Clinical Relevance: Resin infiltration could be useful to enhance adhesion of glass-ceramics to teeth with white spot lesions. “
“Although milled titanium may be used as a substructure in fixed and implant prosthodontics, the application of the veneering porcelain presents particular challenges compared to traditional alloys. To address these challenges, some Ti ceramic systems incorporate the application of a bonding agent

prior to the opaque layer. Vita Titankeramik’s bonding agent is available as a powder, paste, and spray-on formulation. We examined the effect of these three application methods on the https://www.selleckchem.com/products/LBH-589.html bond strength. Four titanium bars were milled from each of 11 wafers cut from grade II Ti using the Kavo Everest milling unit and a custom-designed milling toolpath. An experienced technician prepared the 25 × 3 × 0.5 mm3 metal bars and applied bonding agent using one of three application methods, and then applied opaque, dentin, and enamel porcelains according to manufacturer’s instructions to a 8 × 3 × 1 mm3 porcelain. A control group received no bonding

agent prior to porcelain application. The four groups (n = 11) were blindly tested for differences in bond strength using a universal testing machine in a three-point bend test configuration, based ICG-001 concentration on ISO 9693–1:2012. The average (SD) bond strengths for the control, powder, paste, and spray-on groups, respectively, were: 24.8 (2.6), 24.6 (2.6), 25.3 (4.0), and 24.1 (3.9) MPa. One-way ANOVA and Tukey’s multiple comparison tests Docetaxel order were performed between all groups. There were no statistically significant differences among groups (p = 0.951). Titanium-porcelain bond strength was not affected by the use of a bonding agent or its application method when tested by ISO 9693–1 standard. “
“An edentulous patient’s

psychosocial attributes that may have influence on the oral health-related quality of life (OHRQoL) are given little consideration in therapeutic care. The aim of this study was to assess the impact of complete denture therapy on overall OHRQoL in elderly edentulous patients. The possible role of the patient’s initial expectation toward OHRQoL was also evaluated. OHRQoL was assessed using the OHIP-EDENT psychometric instrument, and 56 patients participated in the study. The assessment was done at three time points including pretreatment, after 1 month, and after 6 months. Significant differences in the OHIP-EDENT scores between pretreatment to after 1 month and pretreatment to after 6 months were calculated using Wilcoxon Signed Rank test (p < 0.05). Mann-Whitney test was used to analyze the association of patient expectations with OHIP-EDENT scores. Statistically significant improvement in OHRQoL after complete denture therapy at both 1 and 6 months postinsertion was evident.

40 healthy volunteers were chosen BGB324 as control. For the cases with clearly enlarged abdominal lymph nodes, the number, size and distribution range were measured and recorded. Results: Enlarged abdominal lymph nodes were observed in 68 cases of AILD (68/84, 80.95%), 4 of type B hepatitis (4/46, 8.70%) and 2 of control group (2/40, 5.00%). The number of cases of AILD with enlarged abdominal lymph nodes were significantly higher than that of type B hepatitis and control group (p < 0.01). There's no statistical differences between type B hepatitis and control group (p > 0.05). In the cases of AILD, 31 cases of AIH (31/39, 79.49%) and 26 of PBC (26/32, 81.25%) and 11 of AIH-PBC OS (11/13,

84.62%) were detected enlarged abdominal lymph nodes. There were no significant differences among those 3 diseases (p > 0.05). The number of cases of AIH with enlarged lymph nodes was significantly higher than that of type B hepatitis (p < 0.01). Conclusion: AILD may result in the abdominal Trichostatin A cost lymphadenopathys

that can be used as an espial cue of ultrasonic images for the diagnosis of AILD. However, Ultrasonography can’t further distinguish the three subtypes. Ultrasonic images of abdominal lymph nodes can be used as one of the differential diagnosis between AIH and type B hepatitis. Key Word(s): 1. Ultrasonography; 2. lymph nodes; 3. AILD; 4. AIH; Presenting Author: SHAN HONG Additional Authors: JIDONG JIA Corresponding Author: SHAN HONG Affiliations: Beijing Friendship Hospital Objective: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease. Studies from other countries have highlighted that emotional disturbance PLEKHB2 was common and impair patients’ quality of life. This

study aimed to screen anxiety and depression in Chinese PBC patients and to determine factors associated with them. Methods: Chinese PBC patients with the diagnosis of primary biliary cirrhosis meeting the criteria who were seen at Liver research centre in Beijing Friendship Hospital from August 2012 to January 2013 were recruited in this cross-sectional study. They were asked to complete the survey of Hospital Anxiety and Depression Scale (HADS) and demographic and clinical data were also recorded. Results: A total of 90 patients with primary biliary cirrhosis, predominant middle-aged women, were included. On HADS assessment, the mean HADS-A and HADS-D scores were 4.53 ± 3.75 and 5.96 ± 3.81 respectively. Twenty-two (24%) PBC patients had abnormal HADS-A scores and sixteen (17.8%) PBC patients had abnormal HADS-D scores, and 30 (33.3%) patients had anxiety or depression. There is slight difference of HADS-A scores between 29 non-fatigue patients and 59 fatigue patients (5 vs 6, p = 0.029), but numbers of the anxiety patients which is defined by HADS-A≥9, are not statistically different between these two groups.