The characteristics and risk factors of cardiovascular diseases and psychological status in science and technologyists / 中华内科杂志

Objectives:To investigate the prevalence and related factors of cardiovascular diseases (CVD) and psychological problems in Chinese science and technology workers.Methods:The investigation was organized and conducted by the Innovative and Development Institute of China Association of Senior Scientists and Technologists and Capital Medical University Affiliated Beijing Anzhen Hospital, and included science and technology workers from research institutions and medical institutions in China by random sampling methods through face-to-face and online questionnaire investigation from July 1, 2019 to March 31, 2021. Information including age, sex, work stress status, CVD history, sleep, depression, and anxiety were included in the questionnaire.Results:This survey included 14 552 subjects. Among them, 25.5% were suffered from CVD, 48.6% were with insomnia, 28.8% experienced depression/anxiety (including only depression, only anxiety, depression combined with anxiety), and 15.6% had CVD in combined with depression/anxiety. Taking those without CVD and depression/anxiety as reference group, multiple logistic regression analyses showed that work stress increased the risk of depression/anxiety in subjects without CVD (manageable work stress, OR=2.253, 95 %CI 1.583-3.206, overwhelming work stress OR=7.899, 95 %CI 5.094-12.250), and drinking increased the risk of CVD ( OR=1.978, 95 %CI 1.382-2.833). Moreover, overwhelming work stress ( OR=4.012, 95 %CI 2.515-6.399) and smoking ( OR=2.342, 95 %CI 1.603-3.421) increased the risk of depression/anxiety in subjects with CVD (all P<0.001). Conclusion:The high morbidities of depression/anxiety, CVD, and CVD in combination with depression/anxiety urge us to take actions to protect the heart and mental health of scientific and technological workers.

The relationship between Tp-ec, Tp-e/QT ratio and the degree of vein bridge vessel stenosis after CABG and the predictive value of malignant electrophysiological events / 中华胸心血管外科杂志

Objective:To analyze the relationship between corrected Tp-e interval(Tp-ec), Tp-e/QT ratio and the degree of vein bridge vessel stenosis after coronary artery bypass grafting(CABG) in patients with left main coronary artery stenosis, and its predictive value for malignant electrophysiological events.Methods:Patients admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to August 2019 were selected, coronary angiography was performed 5-7 years after coronary artery bypass grafting(CABG) due to recurrence of symptoms. 169 patients with >50% restenosis in SVG were selected. According to the degree of bridge angiography stenosis, the patients were divided into group A(50%-70% SVG restenosis, 105 cases) and group B(SVG restenosis >70%, 64 cases), routine electrocardiogram examination, measurement and correction of QT interval(QTc), Tp-ec and Tp-e/QT ratio were made. Patients were followed up 6 months, the occurrence of malignant ECG events is observed, and the area under the receiver operating characteristic( ROC) curve( AUC) was used to quantitatively evaluate the predictive power of Tp-ec and Tp-e/QT ratios for malignant ECG events. Results:The QTc, Tp-ec and Tp-e/QT ratios in group B were significantly greater than those in group A, and the differences were statistically significant( P<0.05). After multivariate logistic regression analysis, both the Tp-ec and Tp-e/QT ratios were independent influencing factors for the degree of vein bridge vessel stenosis>70%( P<0.05). After Pearson correlation analysis, both the Tp-ec and Tp-e/QT ratios were positively correlated with the degree of vein bridge vessel stenosis( r= 0.384 and 0.457, both P=0.000). A total of 162 cases(95.86%) were followed up, 25 cases of malignant electrophysiological events occurred. After ROC curve analysis, Tp-ec combined with Tp-e/QT ratio predicted coronary malignant electrophysiological events in patients with left main artery stenosis after GABG with AUC=0.924, which was significantly greater than 0.698 of the single index Tp-ec and 0.712 of the Tp-e/QT ratio, the differences were both statistically significant( P<0.05). Conclusion:Tp-ec and Tp-e/QT ratios are both positively correlated with the degree of vein bridge vessel stenosis after CABG in patients with left main coronary artery stenosis, the combined effect of them in predicting the occurrence of malignant electrocardiological events is good, and it is worth further research and application.

Progress in feeding recommendations for small for gestational age infants / 国际儿科学杂志

As a special group of newborns, small for gestational age (SGA) has high morbidity and mortality in perinatal period, and survivors often leave many health problems and sequelae.Early active nutritional support is beneficial to improve physical growth and nervous system development, and improve immunity, but rapid growth is also associated with obesity, insulin resistance, metabolic syndrome and so on.How to balance the advantages and disadvantages and achieve optimal catch-up growth is an important challenge for SGA nutritional support.This paper reviews the characteristics of SGA growth and development, nutritional requirements, feeding strategies and growth rate, in order to provide a basis for further research on feeding guidelines for children younger than gestational age.

Effects of trimetazidine, a myocardial metabolism agent, on regulating 5-hydroxytrytamine system of rats with myocardial infarction and/or depression / 中华内科杂志

Objective 5-Hydroxytrytamine (5-HT) system was reported to be associated with myocardial infarction (MI) and depression. The aim of the present study was to study the effect of trimetazidine on 5-HT in MI and/or depression rats.Methods Ninety rats were divided into three groups:trimetazidine, sertraline and saline groups (n=30 in each group), and pretreated with trimetazidine, sertarline, or saline, respectively, by gavage once a day for 4 weeks. Thereafter, each group was further divided into three subgroups: MI subgroup, depression subgroup, and MI + depression subgroup. Serum 5-HT,platelet 5-HT,5-HT2A receptor(5-HT2AR),and serotonin transporter(SERT)were detected by enzyme linked immunosorbent assay. Results Similar to sertarline, comparing to saline, trimetazidine treatment increased serum 5-HT [(221±23) pg/ml vs. (176±11) pg/ml; (395±31) pg/ml vs. (195±5) pg/ml; (348±28) pg/ml vs.(183±10)pg/ml],platelet 5-HT[(305±22)pg/ml vs.(130±27)pg/ml;(252±18)pg/ml vs.(175±5) pg/ml;(241±26)pg/ml vs.(181±11)pg/ml],and platelet 5-HT2AR levels[(247±13)pg/ml vs.(197±12)pg/ml;(320±13)pg/ml vs.(193±18)pg/ml;(334±17)pg/ml vs.(206±15)pg/ml]),and lowered platelet SERT levels [(248±11)pg/ml vs.(323±36)pg/ml;(188±7)pg/ml vs.(278±20)pg/ml;(170±23)pg/ml vs.(282±22)pg/ml] in MI,depression and MI+depression subgroups,respectively(all P<0.05).When compared the effect of trimetazidine and sertarline treatment, serum 5-HT and platelet 5-HT2AR in MI group were significantly lower in trimetazidine than in sertraline group (P<0.05), while serum 5-HT and platelet 5-HT, 5-HT2AR in depression group rats were significantly higher in trimetazidine than in sertraline group (P<0.05).Interestingly,platelet 5-HT2AR in MI+depression rats was much higher in trimetazidine than in sertraline group(P<0.05).Conclusions Trimetazidine,a kind of myocardial metabolism agent,could play a role on the regulation of 5-HT,5-HT2AR,and SERT levels in rats with MI and/or depression.

A clinical study of mental stress-induced myocardial ischemia in patients with stable coronary artery disease and depression/anxiety / 中华内科杂志

Objectives Exploring the association between depression/anxiety and mental stress-induced myocardial ischemia (MSIMI) in patients with stable coronary artery disease (CAD). Methods A total of 178 subjects was enrolled according to the inclusion and exclusion criterion with 88 men and 90 women at age of (54±12)years. The subjects were divided into four groups including CAD with depression/anxiety, CAD without depression/anxiety, depression/anxiety without CAD, and control group based on the state of coronary artery, the scores of Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item(GAD-7). MSIMI was diagnosed by echocardiography. Data were analyzed by SPSS19.0. Results The incidence of MSIMI in all CAD patients was 17.24%. Within each group, 35.00% patients were MSIMI in CAD with depression/anxiety, 2.13% were in CAD without depression/anxiety, 14.29% were in depression/anxiety without CAD, and 2.38% were in control group. The risks of MSIMI in depression/anxiety without CAD and with CAD groups were 6.83 (P>0.05) and 22.08 times (P<0.05) higher than that in control group, respectively. Logistic regression showed that a 1-point increment in the GAD-7 score, but not PHQ-9 score [ OR=0.95, 95% CI (0.77-1.17), P=0.63], was associated with 1.22-fold increase in the likehood of MSIMI [95% CI (1.07-1.38), P=0.00]. Conclusions The MSIMI rate is much higher in patients with CAD comorbid depression/ anxiety compared with CAD without depression/anxiety. Anxiety, but not depression, is an independent risk factor of MSIMI in CAD patients.

Coronary microvascular resistance and its relevant factors in patients with moderate coronary stenosis and chest pain / 中华内科杂志

Objective To evaluate the impact of cardiovascular risk factors on index of microvascular resistance (IMR)and coronary flow reserve (CFR) and to explore the characteristics of IMR and CFR and the relationship between IMR and angiographic features in patients with intermediate coronary stenosis and chest pain.Methods Fractional flow reserve (FFR),CFR,and IMR were measured in patients who underwent invasive coronary angiography with 40％-70％ stenosis by visual assessment.All patients with FFR＞0.75 were enrolled and grouped with the cut-off points of IMR≥25 and CFR≤2.0.Patients with IMR≥25 were group H,including two sub-groups (high IMR-low CFR,group H1 and high IMR-high CFR,group H2),while those with IMR＜25 were group N.The thrombolysis in myocardial infarction (TIMI) frame were counted.Results A total of 34 patients with FFR＞0.75 were enrolled with 61.8％(21 cases) of males and 38.2％ (13 cases) of females.The mean age was (57.3±8.1) years old.High IMR accounted for 47.1％ of all cases.There was significant difference between group H and N in TIMI frame (33.0 vs.20.8,P=0.031).There were significant differences between group H1 and H2 in homocysteine (17.8 μmol/L vs.12.0 μmol/L,P=0.005) and IMRcorr (58.0 vs.36.1,P=0.002).IMRcorrwas correlated to TIMI frame (r=0.40,P=0.012) for all cases.The sensitivity and specificity of inferring IMR≥35.3 by TIMI frame were 0.75 and 0.65 (P=0.049) with TIMI frame over 40.5.Conclusions High IMR may be one of the reasons for chest pain in patients with intermediate coronary stenosis.There is no correlation between vascular risk factors and IMR or CFR,while there is positive correlation between TIMI frame and IMR.The specificity is 65％ for inferring IMR rise with TIMI frame over 40.5.

Impact of trimetazidine pre-treatment on 5-hydroxytryptamine and serotonin transporter in rats with experimental myocardial infarction and depression / 中华心血管病杂志

Objective@#To explore the effect of trimetazidine pre-treatments on serum 5-hydroxytryptamine (5-HT) and serotonin transporter (SERT), platelet 5-HT and SERT in the Sprague Dawley rats with myocardial infarction(MI), depression, and myocardial infarction co-exist with depression (MI+ depression) and in sham operated rats.@*Methods@#Eighty rats were divided into treatment group and placebo (saline) group by the random number table method (n=40 each group). After 4 weeks′ treatment with trimetazidine, or saline, these rats were assigned to respective sham subgroup, depression subgroup, MI subgroup, MI + depression subgroup (n=10 each subgroup). All rats were sacrificed 3 days later. 5-HT in serum and platelet, and SERT in serum and platelet of the rats were tested by enzyme linked immunosorbent assay (ELISA). Data were analyzed by SPSS 17.0.@*Results@#In saline group, serum and platelet 5-HT levels were significantly lower in MI, depression and MI+ depression subgroup compared to sham subgroup (all P<0.01). In trimetazidine pre-treatment group, serum and platelet 5-HT levels were significantly higher in the depression subgroup, MI subgroup, MI + depression subgroup than respective subgroups of saline pretreated rats (all P<0.01). In saline group, SERT in serum and platelet were higher in MI, depression, MI+ depression subgroup than the sham subgroup and statistical significance was found between MI+ depression subgroup and sham subgroups. Serum SERT level was significantly lower in the treatment group compared to saline group for sham rats (P<0.01). In treatment group, serum SERT level was higher in MI, depression and MI+ depression subgroups compared to respective subgroup treated with saline while the statistical significance was found in depression subgroup between trimetazidine pre-treatment and saline control groups. Platelet SERT was higher in MI, depression and MI+ depression subgroups compared to sham subgroup post saline treatment. Platelet SERT was significantly lower in MI, depression and MI+ depression subgroups post trimetazidine pre-treatment than in respective subgroups post saline treatment (all P<0.01).@*Conclusions@#Our study results indicate that trimetazidine pretreatment could increase the levels of 5-HT and SERT in serum and 5-HT in platelet, and decrease the level of SERT in platelet in the rat MI and depression model.

Effect of ginsenoside pre-treatment on 5-hydroxytryptamine system in SD rats with myocardial infarction and depression / 中华内科杂志

Objective To evaluate the effect of ginsenoside pre-treatment on serotonin (5-hydroxytryptamine,5-HT),5-HT2A receptor (5-HT2A R),and 5-HT transporter (serotonin transporter,SERT) in serum,platelet lysate and brain tissue homogenates in SD rats with myocardial infarction (MI) or depression.Methods Eighty SD rats were randomized treated with ginsenoside or normal saline (NS).After 4 weeks,the rats were,then,randomized to four subgroups:the MI,the depression,the MI in combination with depression and sham subgroups.5-HT,5-HT2A R and SERT levels were detected in serum,platelet or brain.Results In the NS pre-treatment groups,serum 5-HT levels in sham rats (237.1 ± 32.0)pg/ml were higher than in MI (58.0 ± 11.6) pg/ml,depression (72.8 ± 2.3) pg/ml,and MI with depression rats (62.5 ± 10.2) pg/ml (all P =0.000).Pre-treatment of ginsenoside increased serum and platelet 5-HT in MI,depression and MI with depression rats compared with each corresponding NS treated subgroups (all P ＜ 0.005).However,treatment of ginsenoside lowered the 5-HT2A R expression in MI,depression,and MI with depression subgroups both in platelet and brain tissue homogenates compared with each corresponding NS treated subgroups (all P ＜ 0.05).As to SERT in platelet,treatment of ginsenoside increased its levels in depression rats (P =0.019),but lowered the levels in MI rats (P =0.001) compared with NS treated rats.There were no differences in brain 5-HT and SERT between ginsenoside and NS treated groups.Conclusions The 5-HT system responses differently to ginsenoside treatment under different cardiac and mental stress conditions.Ginsenoside plays an important role in regulation of 5-HT system.

Analysis of Regularities in Clinical Point Selection for Acupuncture Treatment of Gouty Arthritis / 上海针灸杂志

Objective To statistically analyze clinical research literature on acupuncture treatment of gouty arthritis, explore regularities in its point selection and provide a basis for clinical point selection and reasonable point combination.Method Gouty arthritis, acupuncture, warm needling moxibustion, electroacupuncrue and fire needling were used as key words. January 1990 to May 2014 China HowNet (CNKI) full-text database and Wanfang academic periodical full-text database were searched to retrieve, sort out and analyze clinical literature on acupuncture treatment of gouty arthritis at home and abroad. Acupoints included in the literature were sorted out. Statistical analysis was made of the categories, meridians, use frequencies and positions of selected acupoints.Result One hundred and thirty-five articles with a total of 120 acupoints were included. From the analysis of point selection, the acupoints most frequently used to treat gouty arthritis were, arranged in order, Taichong (91), Sanyinjiao (87), Zusanli (80), Yinlingquan (58), Quchi (52), Taixi (51), Yanglingquan (45), Xuehai (44), Taibai (44) and Hegu (44). From the analysis of pertaining meridians, the meridians of more frequently used acupoints were the spleen meridian of foot-taiyin (323), the stomach meridian of foot-yangming (209), the large intestine of hand-yangming (143), the liver meridian of foot-jueyin (140), the gallbladder meridian of foot-shaoyang (134), the kidney meridian of foot-shaoyin (84) and the bladder meridian of foot-taiyang (80). From the analysis of point selection from different places, the part where acupoints were most distributed was the lower limb.Conclusion For acupuncture treatment of gouty arthritis, local and along-meridian point selections are main ones, selected points are relatively scattered and often located in the lower limb, and point selection is partly combined with syndrome differentiation, which provide a clinical reference.

Clinical intervention research on mental stress-induced myocardial ischemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the impact of Xinkeshu on top of standard medication on psychological stress-related emotional and biophysiological parameters in patients with mental stress-induced myocardial ischemia (MSIMI).</p><p><b>METHODS</b>A randomized controlled clinical trial was conducted on 40 patients with MSIMI and patients were randomized into treatment group (n = 21) and control group (n = 19) by random number table method. Patients in the treatment group received Xinkeshu (12 capsules/d) on top of standard therapy, and the control group received placebo on top of standard therapy. Serum homocysteine (Hcy), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were compared between the groups at baseline and after 8 weeks therapy.</p><p><b>RESULTS</b>(1) Baseline data were similar between the 2 groups (all P > 0.05). (2) After 8 weeks, LVFS was significantly increased (from (34.62 ± 5.76)% to (35.90 ± 4.99) %, P = 0.027) and serum Hcy (from (18.08 ± 1.81) µmol/L to (16.06 ± 10.10) µmol/L), PHQ-9 (from 8.14 ± 3.98 to 6.28 ± 2.87) and GAD-7 (from 9.52 ± 4.98 to 6.48 ± 3.84) were significantly reduced in treatment group (all P < 0.05) compared to baseline. In the control group, only GAD-7 was significantly reduced (from 8.89 ± 5.06 to 6.74 ± 4.80, P = 0.003) after 8 weeks therapy compared to baseline (P < 0.05) while other parameters remained unchanged (all P > 0.05).</p><p><b>CONCLUSION</b>Xinkeshu on the top of standard therapy can improve the emotional state and left ventricular systolic function in patients with MSIMI.</p>

Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities.</p><p><b>METHODS</b>A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up.</p><p><b>RESULTS</b>A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123).</p><p><b>CONCLUSION</b>There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.</p>

Effect of ouabain on the pathogenesis of hypertension in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Ouabain and digoxin are important cardiac glycoside and related to many cardiovascular diseases. The purpose of this study was to investigate the changes of sodium pump α-subunit expression in rats and compare the effects of ouabain (OUA) and digoxin (DIG) on the development of hypertension.</p><p><b>METHODS</b>In situ hybridization was performed. Specific sequence oligonucleotide probe tailing with a Dig-dUTP hybrid to target nucleic acids of the sodium pump α-subunit. According to counting positive particles sodium pump subunit expression was analyzed with statistical methods.</p><p><b>RESULTS</b>On day 16 of drug administration, the blood pressure of rats increased significantly in the OUA group. In the DIG group, the blood pressure revealed no significant difference when compared to the control group. In addition, the effects of OUA and DIG on sodium pump α-subunit RNA expression in tissues differed.</p><p><b>CONCLUSIONS</b>OUA and DIG can not only change the configuration of the sodium pump to depress their activity, but also influence their gene expression which is important in the mechanism of hypertension. This may be a key point in the pathogenesis of hypertension in the manner in which OUA differs from DIG and changes the sodium pump gene expression in the arteries and kidneys of rats.</p>

Correlation analysis between the degree of anxiety and serum homocysteine level patients with essential hypertension / 中华检验医学杂志

Objective To study the correlation between the degree of anxious state in patients with hypertension and the serum homocysteine level.Methods This is a case-control study in Beijing Anzhen Hospital from January to May in 2013.164 cases of essential hypertension with continuing unstable blood pressure after being treated for nearly a week were include.They have been analysed with GAD-7 and PHQ-9 evaluation scale for anxiety and depression state.According to the anxiety status,patients were devided into three groups:Group Ⅰ (28 cases without anxiety),Group Ⅱ (81 cases with mild anxiety),group Ⅲ (55 cases with moderate-to-severe anxiety).Results (1) Correlation analysis showed,the GAD-7 anxiety scale score related with age,PHQ-9 Depression Scale and Hcy level (P ＜ 0.05),PHQ-9 Depression Scale score and Hcy levels were correlated (P ＜ 0.05).(2) Multiple stepwise regression showed that PHQ-9 Depression Scale entered the regression equation,while GAD-7 anxiety scale,age and the level of hcy were risk factors.Conclusion Hcy level is a risk factor for hypertension patients with depression,there is correlation with the severity of anxiety.Mental health should be paid attention to patients with essential hypertension.

Prevalence of depression in coronary heart disease in China: a systematic review and meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary heart diseases (CHD) have been identified as one of topmost diseases affecting the Chinese population. However, depression in CHD has not been reported and there are limited high quality empirical studies in China focused on the prevalence of the comorbidity. This study aimed to estimate the pooled prevalence of depression with CHD in China.</p><p><b>METHODS</b>Systematic review and meta-analysis of published epidemiologic studies on the depression in CHD patients in China were conducted. The research findings dated before 30 September 2013 were obtained from Ovid Medline, EMBASE and two Chinese electronic publication libraries WANFANG and CNKI. We used "cardiovascular disease", "depression" and "China" as the search themes in Ovid Medline and EMBASE and "cardiovascular disease" and "depression" in WANFANG and CNKI. Random-effects meta-analysis was used to estimate the prevalence of depression in CHD patients.</p><p><b>RESULTS</b>Twenty-seven studies were included in the review. Twenty-three studies had 5 236 participants who were hospitalized and four studies had 1 353 participants from community. The overall prevalence of depression in CHD from hospital was 51% (95% CI: 0.43, 0.58; I-squared = 97%, P = 0.000).The prevalence of depression in CHD from community ranged between 34.6% to 45.8%, and the severe depression was found ranging between 3.1% to 11.2%.</p><p><b>CONCLUSIONS</b>On comparing data with other countries, the prevalence of depression in CHD among admitted patients in China was found to be high. The physicians and healthcare providers should pay more attention to the "physical-mental" health of the CHD patients.</p>

Comparison of therapeutic effect of laparoscope and open operation in treatment of adrenal pheochromocytoma / 中国基层医药

Objective To compare the clinical efficacy of laparoscope and open operation in treatment of adrenal pheochromocytoma.Methods 52 cases with adrenal pheochromocytoma were randomly divided into two groups,they were treated with laparoscope or open operation.Intraoperative blood loss,intraoperative blood pressure and heart rate fluctuations,operation time,drainage,hospitalization and postoperative complications were compared between two groups.Results Intraoperative comparison:In laparoscope group,operative blood loss was (65.7 ± 50.2) ml,blood pressure fluctuations in 1 case (3.8％),heart rate variability was (18.7 ± 6.1)/min and the operation time was (93.7 ± 21.7) min; in the open operation group,amount of bleeding during the operation was (240.4 ± 150.5) ml,blood pressure fluctuations in 7 cases(26.9％),heart rate variability was (25.6 ± 6.3)/min and the operation time was (137.7 ± 30.5) min,the differences between the two groups was significant (t =3.15,x2 =5.32,t =3.65,t =4.16,all P＜0.05).The maximum tumor diameter of open operation group was (7.3 ± 1.4) cm,which was bigger than that of the laparoscope group (6.6 ± 1.2) cm,but no significant difference between two groups (P ＞ 0.05).Postoperative comparison:in the laparoscope group,postoperative drainage was (174.3 ± 121.3)ml,drainage time was (4.3 ± 1.3) d and time of hospitalization was (8.4 ± 1.2) d,which were significantly less than those in open operation group(318.5 ± 132.6)ml,(8.7 ±2.3)d and (11.4 ±3.2)d(t =2.54 3.13,2.12,all P ＜0.05).No serious complications were observed in two groups,laparoscope group 1 case,open operation group 5 cases had postoperative pain,after the corresponding symptomatic treatment was improved.After 3 months of follow-up,clinical symptoms were significantly improved or disappeared,ultrasound or CT reexamination found no recurrence.Conclusion Laparoscope in treatment of adrenal pheochromocytoma not only has definite curative effect,but also has small trauma,shorter operation time and less complications,it is worth clinical application.

Interpretation of the third universal definition of myocardial infarction / 中华检验医学杂志

Myocardial infarction (MI) is a major cause of death and disability worldwide.The definition of myocardial infarction has been updated.Released in 2012,Third Universal Definition of Myocardial Infarction of ESC/ACCF/AHA/WHF Expert Consensus,made the clinical application value of troponin clear and suggested to monitor the dynamic changes of cTn in patients with suspected,emphasized the importance of clinical differential diagnosis.In consensus,it also noted that the application of high sensitive troponin can lead to false positives results,and pointeds out that in the assessment of cardiac injury associated with percutaneous or surgical coronary procedures,the rational cut-off value of cTn remains controversival.In addition to acute coronary syndrome,cTn elevations are common in many disease states,and with the improvement of detection sensitivity,low level increase of cTn,will be more.In acute and chronic heart failure,the cTn is elevated,and ACS may be the cause of worsening heart failure,So we should identify whether the cTn elevation is pure from the myocardial injury of heart failure or myocardial necrosis caused by ACS.Nowadays,the increased incidence of myocardial infarction has much to do with the wide application of cTn.Clinical applications of cardiac biomarkers and imaging techniques are flexible as the differences in the diagnostic techniques of myocardial infarction among countries and regions result.

Recognition of depression and related risk factors among non psychiatric doctors in tertiary general hospital outpatients in Beijing / 中华内科杂志

0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.

Influencing factors for plasma natriuretic peptide and N-terminal pro-B-type natriuretic peptide levels in senior patients with heart failure / 中华老年医学杂志

Objective To investigate the relationship of plasma brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels with the severity of heart dysfunction in elderly patients with heart failure. Methods BNP levels were measured by immunofluorescence in 106 hospitalized patients with heart failure, while NT-proBNP levels were measured by electrochemiluminescence immunoassay in 48 patients. The severity of heart dysfunction was determined by NYHA classification. The left ventricular ejection fraction (LVEF) measured by Color Doppler Ultrasound was used to show the left ventricular systolic function. Results In patients with BNP≤400 ng/L versus BNP>400 ng/L, the rates of LVEF≤45% were 16.4% versus 46.8% (χ~2= 13. 93, P=0. 001), the rates of E/A<1 were 62.3% versus 40. 4% (χ~2 =22. 19,P = 0.024) and the rates of Cr>107 μmol/L were 13.1% versus 38.3% (χ~2 = 11. 31, P = 0. 002) . In patients with NT-proBNP≤400 ng/L versus NT-proBNP>400 ng/L, the rates of LVEF≤45% were 25. 0% versus 58. 3% (χ~2 = 10. 00,P = 0. 019) and the rates of Cr>107 μmol/L were 20. 8% versus 50.0% (χ~2=8. 50,P = 0. 035). Conclusions BNP or NT-proBNP levels increase significantly along the deterioration of the heart failure severity, and it may be important to use BNP or NT-proBNP to predict left ventricular function.

cDNA microarray technique on screening multi-drug resistance-related genes of human non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>The aim of this study is to screen for multi-drug resistance-related genes of human non-small cell lung cancer (NSCLC), and provide the evidences for drug-sensitive predicting genes of different NSCLC patients treated with chemotherapeutic drugs.</p><p><b>METHODS</b>Sensitivity and inhibition ratio of five antitumor drugs (NVB, GEM, TAL, DOC, CDDP) on 75 fresh NSCLC samples from different individuals were studied by means of culturing primary tumor cells and MTT assay. After the five chemotherapeutic drugs were used, multi-drug resistance-related genes of NSCLC with cDNA microarry on the samples which were all high sensitive and those resistant were screened.</p><p><b>RESULTS</b>cDNA microarray analysis screened out 212 genes, 168 of which were up-regulated while the other 44 were down-regulated in the group of highly sensitive compared with the group of resistance.</p><p><b>CONCLUSION</b>The multi-drug resistance of NSCLC may be correlative with the 212 genes screened by cDNA microarray; the detailed mechanisms of the genes still need to be detected in the future.</p>

The prevalence of depression and anxiety in gastrointestinal out-patients of tertiary general hospitals in Beijing / 中华内科杂志

Objective To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. Methods A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Results Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12. 0%, anxiety disorders were 6. 4%, depression combined anxiety disorder was 3. 0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (x2 = 0. 874, x2 = 1.797,x2 =0.518, P >0.05) and among different age group ( 18-34, 35-54, ≥55 years old) (x2 = 1. 084,2 = 2. 735, 2 = 0. 350, P 0. 05 ). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30. 6% and 26. 4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2. 8%. Conclusion Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.