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OBJECTIVE@#To investigate the mental health status and its influencing factors among general population and healthcare professionals in Guangdong Province during COVID-19 pandemic.@*METHODS@#A online questionnaire-based survey was conducted from March 11st to March 15th, 2020.The questionnaire consisted of 4 parts to survey the participants'basic information, understanding of COVID-19 outbreak-associated information, cognition of COVID-19 pandemic and status of anxiety and depression.A total of 1433 valid responses were collected, including 706 from the general population and 727 from healthcare professionals.Cronbach's α coefficient and exploratory factor analysis were used for reliability and validity assessment.Chi-square, Wilcoxon and Kruskal-Wallis test were used for univariate analysis and ordinal or nominal logistic regression was used for multivariate analysis of the data.@*RESULTS@#There was no significant difference between the general population and the healthcare professionals in terms of anxiety, depression and cognition of COVID-19 outbreak after adjustment for demographic variables, but the levels of anxiety and depression of these participants were both higher than those before the pandemic.In the participants from the general population, multivariate logistic regressions showed an OR for anxiety of 1.93(1.18, 3.17) among those who spent 1-2 h a day in reading COVID-19-related news, while those who spent over 3 h had an OR value for anxiety of 1.88(1.14, 3.11);the unmarried individuals had a depression OR of 2.19(1.51, 3.18). Inaccurate cognition of COVID-19 outbreak was positive correlated with the occurrence of anxiety and depression.Unmarried individuals and those with higher educational levels had better cognition of COVID-19 outbreak.Among the healthcare professionals, multivariate logistic regressions suggested that insufficient rest time and worries about contracting the virus contributed to the occurrence of anxiety and depression.Among the nursing staff, the OR of obvious depression was 2.99(1.45, 6.18).Compared to healthcare professionals not working in designated hospital for COVID-19, those who work in the designated hospitals had ORs for obvious and severe depression of 0.48(0.25, 0.93) and 0.39(0.17, 0.89), respectively.Concerns over contracting the virus increased the possibility of incorrect cognition of COVID-19.@*CONCLUSIONS@#Psychological interventions are essential for both the general population and healthcare professionals, especially for unmarried individuals in the general population and the nursing staff.An excessive exposure to COVID-19-related information may have detrimental effects on the mental health.For healthcare professionals, sufficient rest needs to be ensured, and education programs on COVID-19 should be implemented among both residents and healthcare professionals to improve their mental health.
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Humans , Anxiety/epidemiology , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections , Health Status , Pandemics , Pneumonia, Viral , Reproducibility of Results , SARS-CoV-2ABSTRACT
Objective To investigate the clinical value of percutaneous gallbladder drainage in the treatment of severe acute pancreatitis(SAP). Methods A total of 65 patients treated for SAP in our hospital between January 2014 and April 2017 were analyzed retrospectively. The patients were divided into a gallbladder puncture group and a control group. Follow-up was performed for at least 6 months to monitor mortality and the incidence of complications, including pancreatic abscess, pseudocyst, renal failure, respiratory failure, heart failure, gastrointestinal bleeding, sepsis, and disseminated intravascular coagulation (DIC), The differences in mortality and complication rates between the two groups were statistically analyzed. Results Mortality in the gallbladder puncture group was significantly lower than in the control group (P ＜ 0. 05); the incidence of renal failure, respiratory failure, heart failure, gastrointestinal bleeding, and sepsis in the gallbladder puncture group was lower than in the control group (P ＜ 0. 05); the incidence of pancreatic abscess and pseudocyst in the gallbladder puncture group was similar to that in the control group, showing no significant difference (P ＞ 0. 05); the incidence of DIC in the gallbladder puncture group was lower than in the control group, but the difference was not statistically significant (P ＞ 0. 05). Conclusion Percutaneous gallbladder drainage can effectively reduce the incidence of renal failure, respiratory failure, heart failure, gastrointestinal bleeding, and sepsis in SAP, thereby reducing mortality. However, the incidence of DIC, pancreatic abscess, and pseudocyst is not reduced.
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Objective To study the efficacy of percutaneous transhepatic cholangiodrainage (PTCD),percutaneous gallbladder drainage,and percutaneous transhepatic biliary stent implantation for the treatment of malignant obstructive jaundice in patients who are observed to fail endoscopic drainage. Methods We retrospectively analyzed 17 patients diagnosed with obstructive jaundice between August 2015 and July 2017 who were observed to have failed endoscopic drainage. Percutaneous puncture drainage had been performed in all patients-different methods were chosen based on the type of lesion and the patient's intraoperative condition. Among these patients, 9 underwent percutaneous transhepatic biliary stent implantation (53％),5 underwent PTCD (29％),and 3 underwent percutaneous gallbladder drainage (18％). The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were assessed a day preoperatively and a week postoperatively. The postoperative decrease (or drop) in the serum TBIL and ALT levels was used as a parameter to assess the efficacy of treatment. Patients were divided into a stent and a tube group. The therapeutic effects were compared between the groups in terms of the drop in the serum TBIL and ALT levels and the survival time of patients. Results The postoperative serum TBIL and ALT levels were significantly decreased in all patients (P < 0. 05). No statistically significant difference was observed between the stent and the tube group in terms of the decrease in serum TBIL and ALT levels (P > 0. 05). However,a statistically significant difference was observed between the stent and the tube group in terms of the survival time of patients (P < 0. 05). Conclusion Percutaneous puncture is an effective treatment modality to manage malignant obstructive jaundice in patients who fail endoscopic drainage. Compared to tube drainage,stent placement can prolong patient survival time. Regarding the decrease in serum TBIL and ALT levels,we conclude that stent implantation is not significantly better than tube drainage.
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Objective To explore the role of phospholipase A2 receptor 1 (PLA2R1) in the diagnosis,differential diagnosis and evaluation of idiopathic membranous nephropathy (IMN) in adult patients.Methods A total of 242 renal disease patients diagnosed by renal biopsy from March 2015 to January 2016 were enrolled,consisting of 90 IMN,20 secondary membranous nephropathy (SMN),82 IgA nephropathy (IgAN),30 minimal changed disease (MCD),16 focal segmental glomerulosclerosis (FSGS) and 4 membranoproliferative glomerulonephritis (MPGN).Their clinical data including age,sex,serum creatinine (Scr),serum albumin and 24 h urinary protein were collected.Serum PLA2R1 was measured by enzyme linked immunosorbent assay.PLA2R and IgG subclasses in glomeruli were detected by indirect immunofluorescence assay.The positive rate of serum PLA2R1 among those groups and its correlation with clinical-pathological parameters were analyzed.Results Compared with IMN patients,SMN,MCD and FSGS patients were younger (all P ＜ 0.01); IgAN patients were younger and had higher serum albumin and lower 24 h proteinuria (all P ＜ 0.001); MPGN patients had higher Scr (all P ＜ 0.01).The positive rate of serum PLA2R1 was 75.6％ in IMN patients,while it was 0.0％ in non-IMN patients.The distribution between serum PLA2R1 and pathological diagnosis had difference (P ＜ 0.001),their positive coincidence rate was 100％,negative coincidence rate was 87.4％,total coincidence rate was 90.9％ and their consistency was well (Kappa=0.795,P ＜ 0.001).Among IgG subtype comparisons between IMN patients and SMN patients in the glomeruli,only moderate or more positive IgG4 had statistical differences (82.2％ vs 5.0％,P ＜ 0.001); the positive rate of glomerular PLA2R1 was 41.1％ in IMN patients,higher than 10.0％ in SMN patients (P=0.009); positive PLA2R1 with moderate or more positive IgG4 in glomeruli in IMN patients was more than that in SMN patients (40.0％ vs 0.0％,P ＜ 0.001),which could improve the diagnostic specificity of IMN.In IMN patients serum PLA2R1 and glomerular PLA2R1 had statistical differences (P＜0.001).Spearman rank correlation analysis showed that serum PLA2R1 of IMN patients positively correlated with 24 h proteinuria (r=0.315,P=0.002),negatively correlated with serum albumin (r=-0.228,P=0.030) and didn't correlate with Scr (r=0.199,P=0.059).Conclusions Serum PLA2R can be used as the specific indicator for diagnosis,differential diagnosis of IMN and to reflect the severity of IMN in patients.
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Objective To detect the expression of DBC2 and the methylation status of its gene promoter region in gastric cancer,so as to analyze their correlation. Methods Gastric cancer tissues and adjacent normal tissues were collected from 92 cases as research subjects. The DBC2 mRNA expression and the methylation status of DBC2 gene promoter region in gastric cancer were detected by using RT?PCR and MS?PCR respectively. In addition,the correlation of DBC2 gene methylation status with clinicopathological parameters was analyzed. Results In comparison with adjacent normal tissues,gastric cancer tissues displayed a low expression level of DBC2mRNA and a high methylation level of gene promoter region. Besides, the methylation level was significantly correlated with tumor invasion depth,differentiation and TNM staging(P<0.05). With deep invasion,poor differentiation or higher TNM staging,methylation level of gene promoter region was more significant in gastric cancer tissues. Conclusion High methylation of DBC2 gene promoter region may be a significant contributing factor leading to low DBC2 expression.
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Objective To conduct a Meta?analysis to compare the safety and short?term efficacy of laparoscopic assisted distal gastrectomy (LADG)and open distal gastrectomy(ODG)in D2 radical surgeries for locally advanced distal gastric cancer. Methods The literatures from Janurary,1990 to August,2014 on the evaluation of safety and short?term efficacy of LADG versus ODG in D2 radical surgeries for locally advanced distal gastric cancer were collected. The quality of the enrolled articles was evaluated and the software Revman 5.2 was adopted to analyze the cura?tive effect. Results Totally 25 articles met the inclusion criteria,including 5 044 patients with treatment of D2 radical surgeries for locally advanced distal gastric cancer. There was no significant difference in the cleaning number of lymph nodes between LADG and ODG in patients undergoing D2 radical surgeries for locally advanced distal gastric cancer. The operation time was longer for LADG than ODG,but the postoperative evaluation in?dexes such as the intraoperative blood loss and the short?term efficacy of LADG were superior to ODG. Conclusion In the treatment of locally ad?vanced distal gastric cancer,there were differences in the safety and short?term efficacy between LADG and ODG,and surgeons should give concern to these differences in clinical practice to select appropriate surgical approaches. Further research is still needed to explore the long?term efficacy.
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Objective To investigate the incidence and influencing factors of aldosterone breakthrough during therapy with angiotensin Ⅱ receptor blockers (ARB) alone,or combined with angiotensin-converting enzyme inhibitors (ACEI) in Chinese patients with non-diabetic nephropathy.Methods A total of 144 patients with non-diabetic nephropathy were treated with ARB or combination therapy of ACEI and ARB for a mean follow-up period of 12 months.Aldosterone breakthrough was determined according to the change of plasma aldosterone concentration before and after treatment during 6-month and 12-month ACEI/ARB treatment.Results In 6 months,aldosterone breakthrough occurred in 21 patients,corresponding to 14.58％,while in 12 months,occurred in 39 patients,corresponding to 27.08％.Although the overall urinary protein excretion (UPE) decreased after treatment in both groups (P＜0.05),non-breakthrough group had a more remarkable reduction in UPE (P＜0.05).Univariate Logistic regression demonstrated that risk factors of aldosterone breakthrough included pre-treatment values of UPE (OR=3.643,P=0.073) and eGFR (OR=0.980,P=0.025).Multivariate Logistic model revealed pre-treatment values of eGFR was positively associated with aldosterone breakthrough (OR=0.980,P=0.025).Conclusions The incidence of the aldosterone breakthrough increases with duration of treatment.The patients with aldosterone breathrough have higher level of UPE,and enhanced decline in eGFR.Pretreatment value of eGFR is independent risk factor of aldosterone breakthrough.
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Objective To investigate the effect of small interfering RNA (siRNA) targeting cytoplasmic domain of tissue factor on apoptosis of vascular endothelial cells. Methods Specific siRNA targeting cytoplasmic domain of tissue factor were designed, and synthetic oligos were inserted into plasmid DNA. The siRNA constructs were transfected into human umbilical vascular endothelial cells (HUVEC) with liposome. The HUVEC were transfected with the constructs encoding siRNA Ⅰ, siRNA Ⅱ and pcDNA~(TM)6.2 GW/-miR plasmid separately. The transfected HUVEC were mixed with CD8~+ T lymphocytes. The apoptotic rate of tranfected HUVEC mixed with lymphocytes was analyzed by flow cytometry. Magnetic beads were used to measure PT of the supematant in the mixed lymphocytes culture. Results The siRNA constructs were confirmed by DNA sequence analysis. The apoptotic rate of HUVEC transfected with siRNA Ⅰ and Ⅱ plasmids was decreased significantly as compared with the empty control group (P<0.01). The apoptosis rate of HUVEC transfected with siRNA Ⅰ plasmid was lower than that of HUVEC transfected with siRNA Ⅱ plasmid (P<0.05). APTT of the culture supernatants in the three transfection groups was lower in the control groups (P <0.05), but there was significant difference among the three transfection groups. Conclusion The siRNA targeting cytoplasmic domain of tissue factor were successfully constructed, siRNA can protect HUVEC, and reduce the apoptotic rate of endothelial cells in mixed lymphocyte reaction without influencing the coagulation function.
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Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.
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OBJECTIVE: To explore the application of biological patches in tension-free inguinal hernia repair. METHODS: Totally 29 Chinese references and 1 English article regarding tension-free repair for inguinal hernia with biological patches were retrieved from 1999 to 2008. Then the retrieved information was summarized from clinical data, surgical results, complication, and recurrence rate to report the biological patches in tension-free inguinal hernia repair. RESULTS: The biological patch in tension-free inguinal hernia repair was characterized by little trauma, simple operation, rapid recovery and less complication with lower recurrence rate, especially obtained an excellent result in treating recurrent hernia. CONCLUSION: Tension-free repair for inguinal hernia with biological patches is an ideal operative method.
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The expression of paired immunoglobin-like receptors A (PIR-A) and B (PIR-B) and their relationship with tolerogenic dendritic cells (T-DC) in mice were investigated. The mouse DCs line, DC2.4 cells were cultured with the recombinant murine interleukin-10 (IL-10) and recombinant human transforming growth factor beta1 (TGF-beta1) respectively to develop the T-DC and stimulated with lipopolysaccharide (LPS) for 48 h to induce the mature dendritic cells (LPS-DC). Special small interfering RNAs (siRNA) molecule for PIR-B was chemically synthesized and transfected into DC2.4 cells (Si-DC) by lip2000. The expression of PIRs on DC2.4 cells were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR), flow cytometry (FCM) and Western blot. Realtime reverse transcriptase-polymerase chain reaction (Realtime-PCR) was applied for measurement of PIR-A and CD80, CD86, MHC-II mRNA expression. The allogeneic stimulating capacity of DCs was measured by mixed lymphocyte reaction (MLR) using (3)H-thymidine incorporation test. The concentration of IFN-gamma in supernatants of MLR from distinct groups was analyzed by ELISA. The results showed that PIR positive rate was (28.65+/-8.12)% examined by FCM on DC2.4 cells. PIR positive rate was increased dramatically to (54.21+/-6.34)%, (58.78+/-4.70)%, (48.24+/-6.75)% respectively for IL-10, TGF-beta1 and LPS induction (P0.01). The semi-quantitative RT-PCR and Western blot revealed that IL-10 and TGF-beta1 induced the higher PIR-B level and lower PIR-A level. On the contrary, the LPS down-regulated the PIR-B expression and up-regulated the PIR-A expression. Realtime PCR examination demonstrated that PIR-A and co-stimulating molecules such as CD80, CD86 and MHC-II were increased significantly after stimulation with LPS. Compared with the DC2.4 cells and the LPS-DC, the T-DCs inhibited alloactivated T cell proliferation and down-regulated the IFN-gamma secretion in MLR supernatant. Si-DC promoted the T cell proliferation (P<0.01) and enhanced the IFN-gamma secretion (P<0.01). It was concluded that up-regulating the PIR-B and down-regulating the PIR-A expression were the general feature of phenotype and constructed the new targets for dendritic cells to acquire immune tolerance in mice. Overexpression of PIR-B can inhibit the up-regulation of the PIR-A, CD80, CD86 and MHC-II expression, which might be the molecular mechanism for the T-DC.
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The expression of paired immunoglobin-like receptors A (PIR-A) and B (PIR-B) and their relationship with tolerogenic dendritic cells (T-DC) in mice were investigated. The mouse DCs line, DC2.4 cells were cultured with the recombinant murine interleukin-10 (IL-10) and recombinant human transforming growth factor β1 (TGF-β1) respectively to develop the T-DC and stimulated with lipopolysaccharide (LPS) for 48 h to induce the mature dendritic cells (LPS-DC). Special small interfering RNAs (siRNA) molecule for PIR-B was chemically synthesized and transfected into DC2.4 cells (Si-DC) by lip2000. The expression of PIRs on DC2.4 cells were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR), flow cytometry (FCM) and Western blot. Realtime reverse transcriptase-polymerase chain reaction (Realtime-PCR) was applied for measurement of PIR-A and CD80, CD86, MHC-Ⅱ mRNA expression. The allogeneic stimulating capacity of DCs was measured by mixed lymphocyte reaction (MLR) using 3H-thymidine incorporation test. The concentration of IFN-γ in supernatants of MLR from distinct groups was analyzed by ELISA. The results showed that PIR positive rate was (28.65±8.12)% examined by FCM on DC2.4 cells. PIR positive rate was increased dramatically to (54.21±6.34)%, (58.78±4.70)%,(48.24±6.75)% respectively for IL-10, TGF-β1 and LPS induction (P＜0.01), but there was no significantly different among the three groups (P＞0.01). The semi-quantitative RT-PCR and Western blot revealed that IL-10 and TGF-β1 induced the higher PIR-B level and lower PIR-A level. On the contrary, the LPS down-regulated the PIR-B expression and up-regulated the PIR-A expression.Realtime PCR examination demonstrated that PIR-A and co-stimulating molecules such as CD80,CD86 and MHC-Ⅱ were increased significantly after stimulation with LPS. Compared with the DC2.4 cells and the LPS-DC, the T-DCs inhibited alloactived T cell proliferation and down-regulated the IFN-γ secretion in MLR supernatant. Si-DC promoted the T cell proliferation (P＜0.01) and enhanced the IFN-γ secretion (P＜0.01). It was concluded that up-regulating the PIR-B and down-regulating the PIR-A expression were the general feature of phenotype and constructed the new targets for dendritic cells to acquire immune tolerance in mice. Overexpression of PIR-B can inhibit the up-regulation of the PIR-A, CD80, CD86 and MHC- Ⅱ expression, which might be the molecular mechanism for the T-DC.
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Objective To investigate the effects of laparoscopic tube sparing operation in the treatment of tubal ectopic pregnancy. Methods Clinical data of 56 cases of tubal pregnancy undergoing laparoscopic conservative treatment were retrospectively reviewed. Results Salpingectomy was required in 8 cases because the electrocoagulation had proven ineffective for the bleeding of operated area, whereas the tube sparing surgery was accomplished successfully in the remaining 48 cases, in 3 of which one treatment course of MTX was administered on account of recurrent episodes. Hysterosalpingography with iodized oil at 1～2 postoperative months in 47 cases receiving conservative surgical treatment revealed that, the involved oviduct was patent in 36 cases, unobstructed but not patent in 8 cases, and obstructed in 3 cases, while the contralateral oviduct (which had been previously resected in 3 cases) was patent in 34 cases, unobstructed but not patent in 7, and obstructed in 3. Conclusions Under proper conditions, laparoscopic tube sparing operation is effective in the treatment of tubal ectopic pregnancy.
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Objective To investigate the effect of vitamin E supplementation on oxidative stress in hemodialysis patients. Methods Fifty-six uremic patients undergoing hemodialysis (HD) were involved in this self-controlled study. The patients were observed for one month to evaluate the status of oxidative stress and then divided into two groups randomly. Group A patients (n=28) received 200mg/d of vitamin E and Group B patients (n=28) were treated with 400mg/d of vitamin E. Vitamin E was supplied for one month in both groups. The serum levels of advanced oxidation protein products (AOPP), malondialdehyde (MDA), vitamin E and activity of glutathione peroxidase (GSHPx) were measured at the initial and the end of vitamin E supplementation respectively. Results Serum levels of AOPP and MDA were significantly higher in HD patients compared with healthy controls (n=56, P
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Objective To elucidate the mechanism of accelerated apoptosis of monocytes in patients with lupus nephritis (LN). Methods 17 LN patients were enrolled in the study and 15 healthy volunteers were selected as controls. The expression of Faa and Fas ligand (FasL) was examined by immunofluorescent staining and flow cytometer analysis. The apoptosis and survival rate of monocytes cultured in vitro with human FasL (rHu-FasL) was analyzed by flow cytometer analysis and 5-diphenyl tetrazolium bromide (MTT) staining, respectively. Results Faa expression on monocytes was significantly higher in LN patients than that in healthy subjects. There was no difference of monocytes Fas expression between active LN patients and silent LN patients. There was no detectable FasL expression on monocytes from both LN patients and healthy controls. When monocytes cultured in vitro with rHu-FasL, there was a significantly increasing apoptosis and a decreasing survival rate of monocytes in LN patients as compared to healthy controls. Conclusion The up-regulated expression of functional Fas on monocytes may contribute to the accelerated apoptosis of monocytes in LN patients.
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Objective To discuss the effects of peritoneal dialysate (PDS) on the expression of aquaporin-1 in rat peritoneal mesothelial cells (RPMCs). Methods The in vitro cultured RPMCs were divided randomly into 4 groups, and stimulated respectively with 1640 culture medium containing 10% fetal calf serum (negative control), and three kinds of PDS (containing respectively 4.25% glucose, 4.25% mannitol or 1.5% glucose) for 3 hours. Indirect immunofluorescence assay (IFA) and flow cytometry (FCM)were employed to detect the expression of aquaporin-1 in RPMCs stimulated by different kind of PDS as above. Results Compared with negative control and the group with PDS containing 1.5% glucose, the expression of aquaporin-1 on the mesothelial cells of the group with PDS containing 4.25% glucose and that containing 4.25% mannitol was significantly up-regulated (P0.05). Conclusion PDS with higher osmotic pressure (OP) can enhance the expression of aquaporin-1 in RPMCs. For PDS with same OP (PDS containing 4.25% glucose or PDS containing 4.25% mannitol), those containing glucose can enhance the expression of aquaporin-1 more effectively than that PDS containing mannitol. This result indicates that glucose or its degradation products may be the independent factors in enhancing the expression of aquaporin-1 of RPMCs.