Investigation and analysis of anxiety/depression in patients with asthma-COPD overlap / 中国医师杂志

Objective:We aimed to estimate the incidence of anxiety or depression in asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients and explore its related factors.Methods:Stable patients who were treated or followed up in the outpatient department of respiratory medicine in the First Hospital of China Medical University from March 2018 to March 2019 were enrolled, including 53 ACO patients, 74 asthma patients, and 138 patients with COPD. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluating the anxiety and depression status of the three groups of patients, and the risk factors of anxiety and/or depression in ACO patients were analyzed.Results:There were 33 cases (62.3%), 35 cases (47.3%) and 69 cases (50.0%) combined with anxiety in ACO, asthma and COPD group; there were 29 cases (54.7%), 25 cases (33.8%) and 58 cases (42.0%) combined with depression in ACO, asthma and COPD group, respectively. The patients with depression in ACO were significantly higher than those in asthma group ( P<0.05). There were 28 patients (52.8%), 24 patients (32.4%) and 52 patients (37.7%) combined with anxiety and depression in ACO, asthma and COPD group, respectively, with significant difference in ACO group and asthma group ( P<0.05). Multivariate logistic regression analysis showed that chronic obstructive pulmonary disease assessment test (CAT) score≥10 was associated with anxiety ( OR=15.00, P<0.01) or depression ( OR=8.667, P<0.01) in patients with ACO. Conclusions:Anxiety/depression is common in chronic airway disease. Compared with asthma, anxiety and/or depression is more frequent in the patients with ACO. ACO patients with high CAT scores should pay attention to screening for anxiety/depression.

Relationship between classroom lighting and poor vision of students in primary and secondary schools in Tianjin / 中国学校卫生

Objective@#To investigate the relationship between classroom lighting and poor vision of students in primary and secondary schools in Tianjin, and to provide reference for targeted prevention measures for comprehensive school eye health programmes.@*Methods@#A total of 623 classrooms and 24 713 students in 89 primary and secondary schools in Tianjin were selected using stratified cluster sampling method in Sep.to Oct. of 2020. The illuminometer was used to monitor the lighting environment of the classroom, and the standard logarithmic vision light box was used to detect the naked eye vision of students. Chisquare test, variance analysis and binary Logistic regression were used in SPSS software.@*Results@#Rate of low vision among primary and secondary school students in Tianjin was 67.86%. The qualification rate of blackboard reflectance, blackboard average illumination, blackboard illumination uniformity, desk average illumination and desk illumination uniformity were 58.11%, 53.13%, 73.19%, 66.61% and 75.12%, respectively. Univariate analyses showed that the blackboard reflectance, blackboard average illumination, desk average illumination, and desk illumination uniformity were associated with low vision among students(χ 2=311.29, 62.54, 61.71, 6.59, P<0.05). Multivariable Logistic regression analysis showed that blackboard reflectance, average illumination of blackboard and desk were associated with higher risk of poor vision[OR(95%CI)=1.19(1.11-1.27),1.27(1.17-1.37),1.11(1.02-1.20), P<0.05].@*Conclusion@#Prevalence of low vision among primary and secondary school students in Tianjin is relatively high. Blackboard reflectance, average illumination of blackboard and desk are the important determinants for poor vision of primary and secondary school students. Creating effective classroom lighting scheme is crucial for vision health among students.

Effectiveness evaluation of comprehensive measures reducing mosquitoes in the underground garages at residential areas in Jiaxing， Zhejiang Province， China / 上海预防医学

Objective:To determine the effect of comprehensive measures at reducing mosquito density in residential parking lot， and to provide scientific evidence for exploring a new mosquito density control mode in parking lot. Methods:During April to October in 2018， a package of measures were implemented in the observation group， including designating a full-time staff， combination of property management and mosquito eradication work， continual clean-up of breeding ground， appropriate use of pesticide， education and training of pest control knowledge， and so on. No intervention was conducted in the control group. Then we observed the effect of the above measures in reducing mosquito density. Results:After the implementation of the comprehensive measures， the average adult mosquito density and infant positive rate of ponding mosquitoes in the residential parking lot in the observation group were significantly lower than those in the control group. The mosquito positive rate in rainwater well， sewage well， drainage ditch and intercepting ditch in the observation group was significantly lower than that in the control group. There were no statistically significant difference between the observation group and the control group in the adult mosquito density and the infant positive rate of ponding mosquito in April. Conclusion:Through a package of comprehensive prevention and control measures， mosquito density in the parking lot at residential areas can be effectively reduced. However， there are still some resistances in the implementation process of measures， which need to be constantly optimized to achieve better on-site prevention and control effect.

Analysis on Metabolites of Major Components of Shaoyao Gancaotang in Urine and Feces of Normal and Polycystic Ovary Syndrome Rats / 中国实验方剂学杂志

Objective::To analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and polycystic ovary syndrome (PCOS) rats, and to explore the effect of PCOS on the metabolism of Shaoyao Gancaotang. Method::Female SD rats were randomly divided into normal group and PCOS group. PCOS rat model was prepared by administration of letrozole solution for 21 days, and the estrous cycle of rats was observed. UHPLC-QTRAP-MS/MS technique and LightSight 2.3 software were used to analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and PCOS rats. The mobile phase was water-methanol for gradient elution, the flow rate was 0.3 mL·min-1, electrospray ion source was employed under negative ion mode. Result::Phase Ⅰ and phase Ⅱ reactions mainly occurred in drug metabolism. A total of 27 metabolites were detected in urine of normal rats, and 34 metabolites were detected in urine of PCOS rats. A total of 29 metabolites were detected in feces of normal rats, and 27 metabolites were detected in feces of PCOS rats. Conclusion::The metabolites in the urine of PCOS rats are more diverse than those of normal rats, and the disease status of PCOS may affect the in vivo metabolic pathway of active ingredients in Shaoyao Gancaotang.

Current status of blood lipids in people with hypertension and diabetes in Henan province / 中华心血管病杂志

Objective@#To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province.@*Methods@#From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (n=29 427), hypertension group (n=21 965), diabetes group (n=8 009) and hypertension-diabetes group (n=11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed.@*Results@#The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all P<0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(P<0.01 or <0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (OR=1.221, 95%CI 1.113-1.339, P<0.01), diabetes (OR=1.636, 95%CI 1.461-1.833, P<0.01) and hypertension-diabetes (OR=1.832, 95%CI 1.658-2.023, P<0.01) were independent risk factors for TC abnormality. Hypertension (OR=1.566, 95%CI 1.478-1.659, P<0.01), diabetes (OR=2.182, 95%CI 2.031-2.342, P<0.01) and hypertension-diabetes (OR=2.655, 95%CI 2.492-2.829, P<0.01) were also independent risk factors for TG abnormality. Diabetes (OR=1.510, 95%CI 1.309-1.742, P<0.01) and hypertension-diabetes (OR=1.461, 95%CI 1.285-1.661, P<0.01) were independent risk factors for LDL-C abnormality. Diabetes (OR=1.261, 95%CI 1.180-1.346, P<0.01) and hypertension-diabetes (OR=1.195, 95%CI 1.126-1.268, P<0.01) were independent risk factors for HDL-C abnormality.@*Conclusion@#The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.

Case-control study on self-setting calcium phosphate cement and allograft for Sanders II-IV fractures of calcaneus / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical results of Sanders II-IV fractures of calcaneus treated by self-setting calcium phosphate cement and allograft with locking reconstruction bone plate internal fixation.</p><p><b>METHODS</b>From March 2012 to December 2015, 48 patients with Sanders II-IV fractures of calcaneus were treated by open reduction and internal fixation through L-shape incision, bone grafting were performed on reserved bone defect of calcaneal fracture. The patients were divided into self-setting calcium phosphate cement and allograft group according to different materials. Twenty-eight patients in self-setting calcium phosphate cement group, including 23 males and 5 females aged from 22 to 52 years old with an average of (34.46±7.33) years old; 8 cases were type II, 11 cases were type III and 7 cases were type IV according to Sanders classification. Twenty patients in allograft group, including 17 males and 3 females aged from 24 to 55 years old with an average of(36.40±7.93) years old; 6 cases were type II, 7 cases were type III and 9 cases were type IV according to Sanders classification. Postoperative wound complications, Böhler angle before and after operation and 12 months, Maryland functional score were evaluated.</p><p><b>RESULTS</b>All patients obtained bone union, and were followed up from 12 to 42 months with an average of 25 months. There were no statistical significance in Böhler angle and Manyland score before and after operation and 12 months between two groups. Five patients occurred wound complications in allograft group and 2 cases occurred wound complications in self-setting calcium phosphate cement and allograft group.</p><p><b>CONCLUSIONS</b>Both of open reduction bone grafting and reconstructive plate internal fixation have good effective results for calcaneal fracture. Compared with allograft, self-setting calcium phosphate cement, which has no rejection response and less complications, has equal effects for calcaneal fracture and deserves to be popularized.</p>

Clinical observation on the treatment of low-dose oral theophylline in patents with COPD / 中国医师杂志

Objective To investigate the effects of low-dose,sustained release oral theophylline on the chronic obstructive pulmonary disease (COPD) patient.Methods Fifty-six patients with stable COPD were randomly divided into two group:theophylline group (n =35) that was treated with slow-release theophylline(100 mg,twice daily),and control group (n =21) that was given with placebo.A series of parameters including lung function,quality of life scores,body mass index,airflow obstruction,dyspnea,and exercise capacity index (BODE) score,exercise tolerance,exacerbations,satisfaction with treatments and adverse effects were tested before and 12 weeks after the treatments.Results Forty two patients completed the study,25 cases in the slow-release theophylline group,and 17 cases in the placebo group.The differences of two groups before the treatment were not prominent except the age (P ＞ 0.05).After treated with slow-release theophylline,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC) and the symptom score were slightly increased,but there were no statistically significant differences (P ＞0.05).After theophylline therapy,the quality of life score,including activity ability score,disease activity score and total score,and BODE index score were significantly decreased(P ＜0.05),but 6 minutes walk test (6 MWT) differences were no significant (P ＞0.05).The differences in pulmonary function test,the quality of life score,BODE index score and 6 minutes walk test were no significant between before and after the treatment with the placebo (P ＞ 0.05).Compared to the cases who treated with the placebo group,the patients in slow-release theophylline group reduced the frequencies of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (3/25 vs 7/17,x2 =4.748,P ＜0.05),and increased the efficacy satisfaction (Z =-2.579,P ＜ 0.05).Slightly adverse reaction was observed in 3 cases in slow-release theophylline group,but it could relieve by oneself,and not affect the common treatment.There was no adverse reaction in the placebo group.Conclusions Low dose,sustained release oral theophylline was efficient in improvement of the quality of life scores and BODE index score.

Effects of low-dose of oral thephylline on sputum inflammatory cells and inflammatory mediators in patients with COPD / 中国医师杂志

Objective To investigate the anti-inflammatory effects of low-dose and sustained release oral theophylline on the chronic obstructive pulmonary disease (COPD) patients.Methods Thirty four patients with stable COPD were randomly divided into two groups:theophylline group (n =18) was treated with slow-release theophylline (100 mg,twice daily),and placebo group (n =16) was given with placebo.Healthy non-smokers (n =12) were taken as control.The course of treatment was 12 weeks both of theophylline group and placebo group.The percentages of Neu/Leu and Mφ/Leu in sputum were detected before and after treatment and the concentrations of interleukin (IL)-17,IL-8,and tumor necrosis factor-α (TNF-et) were detected with enzyme linked immunosobent assay (ELISA).Results (1) Compared to pretreatment with theophylline group,the Neu/Leu was increased [(89 ±4.14)％ vs (83.4 ±6.98)％,P ＜0.05] and the Mφ/Leu was decreased [(6.4 ± 4.11) ％ vs (12.3 ± 6.96) ％,P ＜ 0.05] in the post-treated theophylline group.No significant changes in both Neu/Leu and Mφ/Leu were observed before and after placebo-treatment (P ＞ 0.05).(2) Compared to the control group,the concentrations of TNF-α,IL-8,and IL-17 in the sputum supernatant were significantly increased in both pretreatment and posttreatment with the theophylline or the placebo.Sputum TNF-α,IL-8,and IL-17 levels were significantly decreased in COPD patients who were given theophylline.Compared to pre-treatment with placebo group,the IL-8 and IL-17 levels were significantly increased in the post-treated placebo group (P ＜0.01).There was no significant change in TNF~ level between before and after treatment with the placebo.(3) The concentrations of IL-17,IL-8,and TNF-α in the sputum supernatant were positively correlated with the Neu/Leu counts (r =0.471,0.652,0.466,respectively,all P ＜0.01),negatively correlated with the forced expiratory volume in one second (FEV1 ％) (r =-0.516,-0.652,-0.496,respectively,all P ＜ 0.01).Conclusions Low-dose and sustained-release oral theophylline was efficient in improving airway inflammatory cells and inflammatory mediators,which plays an anti-inflammatory effect.

Analysis of posterior lumbar interbody fusion (PLIF) in treating lumbar degenerative disease in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of PLIF surgery for elderly patients with lumbar degenerative disease.</p><p><b>METHODS</b>From March 2010 to May 2013, 28 patients with lumbar degenerative disease, aged more than 80 years were treated with PLIF surgery. There were 10 males and 18 females, aged from 80 to 93 years old with an average of (85.44±3.66) years. Course of disease was from 3 to 20 years. The operation time, intra-operative blood loss, operation complications were recorded and JOA scores and Macnab criteria were used to evaluate the clinical outcomes.</p><p><b>RESULTS</b>All patients were followed up from 12 to 40 months with an average of 26.5 months. The average operation time was (150.00±26.42) min and the average intra-operative blood loss was (373.33±99.88) ml. The pre-operative JOA score was 12.30±2.43, and the corresponding postoperative JOA score at the final follow-up was 24.81±2.09 which was much higher than the preoperative one (P<0.01). According to the modified Macnab criteria to evaluate at the final follow-up, 16 patients got an excellent result, 10 good, 2 fair. In the weeks postoperatively, injuries of nerve root happened in 3 cases, superficial wound infection with delayed healing in 3 cases, and tear of the dural sac accompanied with cerebrospinal fluid leakage in 1 case. After long term follow-up, adjacent segment degeneration and the corresponding spinal canal stenosis occurred in 1 case at 34 months after operation. All cases got successful fusion without any displacement of internal fixation and pseudoarthrosis formation.</p><p><b>CONCLUSION</b>With proper cases, fully preoperative preparation, perfect intra-operative manipulation and active treatment after operation, even advanced ages older than 80 years with lumbar degenerative disease could get satisfactory outcomes after PLIF surgery.</p>

Surgical revision of lumbar vertebrae using transforaminal endoscopic spine system / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of transforaminal endoscopic spine system in surgical revision of lumbar vertebrae.</p><p><b>METHODS</b>From January 2012 to October 2013,14 patients who needed reoperations of lumbar vertebrae were treated using transforaminal endoscopic spine system (TESSYS). There were 8 males and 6 males, aged from 27 to 84 years old with an average of (50.4 ± 18.9) years. Visual analogue scale (VAS) and Japanese Orthopaedic Association Scores (JOA) were compared before and after surgical revision. Macnab standard was used to assess the clinical effect.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 27 months with the mean of 18 months. Preoperative VAS score was 6.79 ± 1.31, and in a week,3 months and 6 months after operation were 2.50 ± 1.29, 2.21 ± 1.53, 1.64 ± 1.08, respectively, which were all much lower (P < 0.01) than preoperative score. Preoperative JOA score was 12.43 ± 1.95, and the above corresponding postoperative JOA scores were 21.50 ± 3.78, 21.93 ± 4.55, 23.36 ± 4.33, respectively, which were all much higher than preoperative score (P < 0.01). According to the modified Macnab criteria, 5 patients got an excellent results, 7 good, 1 fair and 1 poor. The nerve root injury of L5 occurred in 1 case during paracentesis and no other complications were found.</p><p><b>CONCLUSION</b>Selecting the appropriate indications using TESSYS in surgical revision of lumbar vertebrae can successfully avoid the operation scar, reduce the surgical complications and obtain satisfactory clinical outcomes.</p>

The value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of sarcoidosis / 中国医师杂志

Objective To investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of sarcoidosis.Methods Twenty-two cases of clinically suspected sarcoidosis underwent bronchoscopy and ultrasound bronchoscopy examination,including endobronchial biopsy (EBB),transbronchial lung biopsy (TBLB),and EBUS-TBNA.The biopsy samples of EBB,TBLB,and EBUS-TBNA were paraffin-embedded for hematoxylin eosin (HE) staining and acid-fast staining,respectively.Differences in the diagnosis of sarcoidosis were compared among EBB,TBLB,and EBUS-TBNA.The diagnostic performance of EBUS-TBNA was evaluated.Interventional pulmonology diagnostic strategy of sarcoidosis was analyzed.Results Among all the 22 patients with suspected sarcoidosis,20 cases were diagnosed as sarcoidosis,1 case was small cell lung cancer,and 1 case was lymphoma.The number of patients who were diagnosed by EBB,TBLB,and EBUS-TBNA was 6 cases,9 cases,and 16 cases,respectively;and their diagnostic yield was 30.0％,45.0％,and 80.0％,respectively.The diagnostic yield of EBUS-TBNA was significantly better than the other two (P =0.005).Combined EBB and EBUS-TBNA,the diagnostic yield was 85.0％.Combined TBLB and EBUS-TBNA,the diagnostic yield was 90.0％.Combined those three,the diagnostic yield was 95.0％.EBUS-TBNA diagnostic yield was affected by the location and size of lymph nodes.The diagnostic yield of subcarinal lymph nodes and paratracheal lymph nodes by EBUS-TBNA was significantly better than that of Hilar lymph nodes (x2 =4.29,P ＜0.05),EBUS-TBNA showed better diagnostic yield for the lymph nodes whose diameter was greater than 2cm (x2 =4.067,P ＜ 0.05).EBUS-TBNA had fewer complications.Most patients only had a little bleeding in puncture site.Conclusions EBUS-TBNA contributed to diagnose sarcoidosis,while TBLB and EBB had a complementary value in the diagnosis of sarcoidosis by EBUS-TBNA.

The Protective Effect of Co-Treatment with Antioxidants against IH-Induced Pancreatic Injury in Mice / 天津医药

Objective To explore the protective effect of co-treatment with antioxidants 4-hydroxy-2,2,6,6-tetra-methylpiperidine 1-oxyl (TEMPOL) and reduced glutathione (GSH) in pancreatic injury induced by intermittent hypoxia (IH) in mice. Methods Fifty male C57BL/6J mice were randomly divided into control group(CON), IH group (IH), IH+TEM-POL group (IH+TEMPOL), IH+GSH group (IH+GSH) and IH+TEMPOL+GSH group (IH+TEMPOL+GSH). After successful-ly prepared animal model, the insulin resistance (IR) level, pancreatic malondialdehyde (MDA) level,superoxide dismutase (SOD) activity,glutathione reductase (GR) concentration and pancreatic β-cell apoptosis were detected in five groups. Re-sults The blood glucose level was significantly increased in IH group than that in CON group (P0.05). Conclusion The co-treatment with the antioxidant TEMPOL and GSH can obviously protect IH-induced pancreatic injury in mice. However, there was no significant protective effect of TEMPOL or GSH alone on pancreatic injury.

Applications of proteomics in the research of tumors / 国际肿瘤学杂志

Proteomics is an emerging discipline which studies the composition of proteins and their transformation rules at the cellular level and the overall level.Recently,proteomics has been used in a variety of studies of tumors.And it has made some progresses in explaining the mechanisms of tumors' genesis and development,discovering new specific markers for tumors and new targets for drug treatment,and forecasting tumors' biological behaviors.

Image and pathology features of primary adrenal lymphoma / 中华泌尿外科杂志

Objective To evaluate the CT features of primary adrenal lymphoma and its relationship with pathology.Methods Pathologically proven primary adrenal lymphoma 6 cases were reviewed.There were 4 males and 2 females.The age was 18-62 years,average age was 51 years.5 cases was single tomur in unilateral,1 case was bilateral disease.The main clinical manifestations were abdominal pain,abdominal discomfort.All patients had CT scan and were treated surgically.Results CT scan showed the characters of adrenal little low-density soft tissue mass:the maximum diameter of 3-11 cm,irregularly shaped or ovalshaped,multi-state a clear,homogeneous or slightly inhomogeneous density,CT value was 30-40 HU.Lesions could be embedded or close to blood vessels and the ipsilateral kidney.The lesions were not enhanced arterial phase enhancement,CT value was 39-50 HU.The lesions showed vein phase of mild to moderate enhancement,CT value was 47-66 HU.At the delay of continuing to strengthen phase,CT value was 60-78 HU.The pathology charaters showed that:Diffuse of tumor cells under light microscope dense,more uniform size,and a large,granular chromatin,tumor stromal components was relatively small.There was no significant bleeding,necrosis and calcification.one lesion showed sheet,tumor cell necrosis.Conclusions CT scan characteristics and pathological features of primary adrenal lymphoma might have a certain correlation.

Clinical analysis of alveolar hemorrhage in acute leukemia induction therapy and literatures review / 白血病·淋巴瘤

Objective To analyze the clinical manifestation of diffusive alveolar hemorrhage in acute leukemia induction therapy.Methods Clinical data of two diagnosed cases of diffusive alveolar hemorrhage secondary to acute leukemia were collected.Clinical data of eight cases of diffusive alveolar hemorrhage secondary to acute leukemia which were published were also collected by searching in Medline database.The clinical manifestation,diagnosis,strategy of differential diagnosis and treatment of diffusive alveolar hemorrhage secondary to acute leukemia were analyzed.Results Diffusive alveolar hemorrhage was a rare but fatal complication of acute leukemia.The common clinical manifestations included hemoptysis,progressive dyspnea and progressive decrease in concentration of hemoglobin.The analysis of blood gas showed type Ⅰ respiratory failure.The manifestations of chest computed tomography included diffusive ground glass opacity and infiltration of parenchyma.The bronchoalveolar lavage fluid was bloody.And lung biopsy showed congestion of alveoli and capillaritis.The detection for pathogens,vasculitis related antibodies,brain natrium peptide were negative.The mortality of those cases was 40 ％ (4/10).Corticosteroids therapy was effective.The mortality of patients received corticosteroids therapy was 25 ％ (2/8).Conclusion Diffusive alveolar hemorrhage is a rare but fatal complication of acute leukemia.The mortality is high.The key points of therapy are early diagnosis and corticosteroids therapy.

Effect of brain-derived neurotrophic factor Val66Met polymorphism and environmental factors on antidepressant treatment / 中华行为医学与脑科学杂志

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.

Investigation of the Prevalence of Pulmonary Function Test in Liaoning Province and the Cognition of COPD Patients to the Test / 中国医科大学学报

Objective To survey the prevalence of the pulmonary function test in Liaoning province and investigate the cognition of chronic obstructive pulmonary disease（COPD）patients to the test.Methods One hundred and twenty nine comprehensive hospitals of Grade Three and Grade Two have been included to survey the prevalence of the pulmonary function test by telephone.A cross-sectional study was carried out among 206 COPD outpatients to investigate their cognition to the pulmonary function test.Results The total prevalence of the hospitals with the equipment and ability to do pulmonary function tests was only 51.2%.The prevalence of the hospitals of Grade Three（79.4%）was higher than that of the hospitals of Grade Two（24.2%）.In 206 COPD patients,100 cases（48.5%）had been provided with pulmonary function test,53 cases（25.73%）had been diagnosed as COPD in the past.The patients diagnosed as COPD accounted for 33.8% of all chronic bronchitis patients surveyed.The span during the diagnosis of chronic bronchitis and the definitive diagnosis of COPD was 11.79±10.96 years.Conclusion The prevalence of pulmonary function test in Liaoning province is relatively low,especially in the comprehensive hospitals of Grade Two.Few chronic bronchitis patients received pulmonary function test.Thus the time span from the diagnosis of chronic bronchitis to definitive diagnosis of COPD is long as well.

Controlled study on the diurnal variation of neuroendocrine rhythm in depressed patients / 中华行为医学与脑科学杂志

Objective To study the function and diurnal variation of hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-thyroid(HPT) axis,and the relationship with clinical characteristics of di-urnal rhythm in depressed patients. Methods Forty-nine depressed patients met diagnostic DSM-Ⅳ criteria and thirty-eight normal controls were collected. The plasma levels of cortisol (CORT), adrenocorticotropic hormone (ACTH), T3, T4, thyroid-stimulating hormone (TSH) at 7 am and 7 pm were measured by radioimmunoassay, then the results concemed were compared among the depressed groups with and without diurnal variation and control group by multivariate analysis of variance. Results The plasma level of morning CORT, morning and evening TSH ((365.94±120.78) nmol/L; (6.24±2.47)μIU/ml; (6.68±2.42)μIU/ml; respectively) were respective-ly higher than those of control group((284.91±83.39) nmol/L; (3.82±1.75)μIU/ml;(4.01±1.69)μIU/ ml, P<0.05). The plasma levels of morning and evening T4 were significantly lower than those of control group(P <0.05). The CORT morning-evening difference variable distinguished between depressed and control group (P< 0.001),but no significant differences could be found between the depressed groups with and without diurnal varia-tion. There were no significant differences in the CORT, T3, T4, TSH morning-evening difference variable between various clinical subtypes of depressed patient (unipolar/bipolar; psychotic/nonpsychotic). Conclusion Abnormal CORT morning-evening difference variable was observed in the depressed patients compared with normal controls,and may be used as a special trait mark of depressed group.

Characteristic of sleep electroencephalograph in patients with depressions plus psychogenic anxiety / 中国医师进修杂志

Objective To describe characteristic of sleep electroencephalograph (EEG) in depressions with psychogenic anxiety. Methods It was estimated for sleep EEG in 7 depressive patients with psychogenic anxiety,11 depressive patients with non-psychogenic anxiety and 10 normal controls. Results (1)Time from awake to getting up was significantly longer in non-psychogenic anxiety group than the normal subjects [(12.0?8.4)min vs(3.1?2.8)min,P0.05]. Conclusion (1)Time from awake to getting up is longer in non-psychogenic anxiety group than the normal subjects.(2)The tension of REM is higher in non-psychogenic anxiety group than the normal subjects.(3)It has tendency to be lower for tension of Rapid Eye Move in psychogenic anxiety group than the normal subjects.

Application of new tissue microarrayer-ZM-1 without recipient paraffin block / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The ZM-1 tissue microarrayer designed by our groups is manufactured in stainless steel and brass and contains many features that make TMA (tissue microarray) paraffin blocks construction faster and more convenient. By means of ZM-1 tissue microarrayer, biopsy needles are used to punch the donor tissue specimens respectively. All the needles with the punched specimen cylinders are arrayed into the array-board, with an array of small holes dug to fit the needles. All the specimen cylinders arraying and the TMA paraffin block shaping are finished in only one step so that the specimen cylinders and the paraffin of the TMA block can very easily be incorporated and the recipient paraffin blocks need not be made in advance, and the paraffin used is the same as that for conventional pathology purpose. ZM-1 tissue microarrayer is easy to be manufactured, does not need any precision location system, and so is much cheaper than the currently used instrument. Our method's relatively cheap and simple ZM-1 tissue microarrayer technique of constructing TMA paraffin block may facilitate popularization of the TMA technology.