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Objective:To explore the correlation between self-efficacy and depression in patients with hematologic malignancy, and analyze the mediating role of social support and the moderating effect of resilience.Methods:From February to June 2017, a total of 284 patients with hematologic malignancy in Jining Medical University Affiliated Hospital completed Connor-Davidson resilience scale (CD-RISC), social support rate scale (SSRS), general self-efficacy scale (GSES), self-rating depression scale (SDS). SPSS 21.0 software was used for statistical analysis, and the correlation was obtained by Pearson correlation analysis, and PROCESS v3.4 macro program was used to test the mediating and moderating effects.Results:Self-efficacy played a significant negatively predictive effect on depression in patients with hematologic malignancy( β=-0.35, t=-6.16, P<0.01). Social support partially mediated the correlation between self-efficacy and depression(the mediating effect was -0.05, accounted for 14.29%(-0.05/-0.35) of the total effect). Resilience moderated the mediating effect of social support on the correlation between self-efficacy and depression.The self-efficacy had no predictive effect on social support when the level of resilience was low and it had a significant negatively predictive effect on social support when the level of resilience was high (simple slope=-0.28, P<0.01, 95% CI=-0.39- -0.18). Conclusion:Self-efficacy has a moderating effect on depression in patients with hematologic malignancy.Self-efficacy affects depression through social support, and resilience regulates the mediating role of social support in the relationship between self-efficacy and depression.
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In this paper， the latest research progress on the mechanism of comorbid alcohol use disorder and depressive disorder at home and abroad is elucidated from genetic， neurochemical， neuroendocrine and neuroimmunologic perspectives. It aims to identify the gaps in current research and predict future research directions， providing a further basis for the clinical management of comorbid alcohol use disorder and depressive disorder.
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In recent years， plenty of studies have demonstrated that deep brain stimulation （DBS） has potential efficacy for treatment-resistant depression. This paper reviews the worldwide research progress of DBS in the treatment of treatment-resistant depression， in which the DBS treatment mechanism， targets and outcomes are discussed， the limitations of current DBS treatment are summarized， and the development direction of DBS is also forecasted， therefore providing a factual basis for relevant experiments in China.
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Objective:To understand the quality of life in patients with hematologic malignancy, and to discuss the correlation among quality of life and social support and resilience in the patients, and to analyze the mediating effect of mental resilience.Methods:A total of 284 patients with hematologic malignancy from Affiliated Hospital of Jining Medical University completed social support rate scale(SSRS), Connor-Davidson resilience scale(CD-RISC) and European Organization for research and treatment of cancer quality of life questionnaires-core 30(EORTC QLQ-C30). SPSS 21.0 was used for descriptive statistics, single sample t-test, Pearson correlation analysis and SPSS macro program PROCESS v 3.4 was used for testing the mediating effect. Results:The general health level of quality of life in patients with hematologic malignancy(52.1±26.4)was significantly lower than the Norwegian norm(75.3)( t=-14.81, P<0.01). Social support was significantly positively correlated with resilience and quality of life( r=0.76, 0.31, P<0.01), and resilience was positively correlated with quality of life( r=0.45, P<0.01). Mental resilience played a partial mediating role between social support and quality of life, and the mediating effect accounted for 61% of the total effect. Conclusion:Mental resilience can be used as a mediating variable for social support which can affect quality of life.Improving the mental resilience and social support in patients with hematologic malignancy can effectively improve their quality of life.
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Objective:To identify the hub differentially expressed genes(DEGs)of glomerular pathological changes and potential pathways in molecular process of type 2 diabetic nephropathy(DN)based on bioinformatics technology.Methods:The differentially expressed genes of Gene Expression Omnibus(GEO)dataset GSE96804 in DN and normal kidney tissues were analyzed by R 3.6.2 software. DEGs were further assessed by Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signal pathway analysis. Subsequently, the hub genes and their associated pathways were analyzed using String 11.0 and Cytoscape 3.7.2 software.Results:A total of 168 DEGs were obtained in the dataset. Among them, seven hub genes were identified, including ALB, FN1, EGF, PTGS2, PLG, KDR, and LOX. Three hub genes, ALB, EGF, PLG, exerted a direct action on glomerulus. GO enrichment analysis of DEGs was mainly manifested in extracellular matrix organization, extracellular structure organization, platelet degranulation and other biological processes, extracellular matrix, secretory granule lumen, platelet alpha granule and other cell components, chaperone binding, copper ion binding, antioxidant activity, and other molecular functions. DEGs mainly regulated metabolic process, which was related to fatty acid degradation signal pathway, exogenous substance metabolism related to CYP enzyme and drug metabolism signal pathway.Conclusion:A bioinformatics analysis of DN from the perspective of glomerulopathy is helpful to understand the potential molecular mechanism of DN and provide reference for further validation.
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Brain renin-angiotensin system (RAS) is closely associated with many pathophysiological processes of cardiocerebrovascular diseases,including stroke.The activation of the different components in RAS will produce specific biological effects.This article reviews the roles of brain RAS in the pathophysiological processes of ischemic stroke,especially the neuroprotective effect of ACE2/Ang-(1-7)/Mas axis.
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Objective To determine the potential correlation of 5-HTT gene polymorphisms (5-HTTLPR and STin2) with clinical manifestations in depression.Methods A total of 401 depressed patients,all of Chinese Han region,were collected and genotyped by polymerase chain reactions (PCR).All patients were evaluated using a 17-item Hamilton depression rating scale (HAMD-17) and Hamilton anxiety rating scale (HAMA),and then associated analysis was applied.Results (1) The age of onset in patients with L/S genotype of 5-HTLPR polymorphism were much younger than that of patients with L/L and S/S genotype (F=3.281,P=0.039).Besides,there was also a significant difference of HAMA1 (anxious mood) scores among patients with different genotypes for 5-HTTLPR polymorphism,where the scores of those with L/S genotype were the highest (2.34±0.80,P=0.010).(2) The scores of HAMD10 (mental anxiety),HAMA1 (anxious mood),HAMA3 (fear) and mental anxiety factor were higher in patients with 12/10 genotype than patients with 12/12 and 10/10 genotype for STin2 polymorphism (2.40±0.83,2.38±0.90,1.42± 1.04,14.60±4.26 respectively;P value:0.014,0.044,0.03 and 0.006 respectively).The scores of HAMD10(mental anxiety) and mental anxiety factor were (2.11±0.77),(12.96±3.78) in the 12/12 genotype patients,and significantly lower than that in the 12/10 genotype patients (adjustedPvalue:0.018,0.006).Conclusions A positive association of the 5-HTT polymorphisms with anxious symptoms in depressed patients is revealed.These findings might provide some evidences for the clinical phenotype and optimization of depression treatment.
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Objective To evaluate the effect of perioperative administration of Ambroxol combined with Ipratropium on elderly lung cancer patients undergoing thoracoscopic surgery.Methods 82 lung cancer patients aged ≥70 years who were scheduled for thoracoscopic lung resection were randomly assigned into 2 groups:the observation group(n=42) and the control group(n=40).Patients in the observation group were treated with 90 mg Ambroxol(mucosolvan) by intravenous drip and Ipratropium(atrovent) by atomizing inhalation,while patients in the control group were treated with an equal volume of 0.9％ sodium chloride solution.Pulmonary function and changes of arterial blood gases at admission,before surgery and 5 days after surgery,incidences of postoperative atelectasis and pulmonary infection,the rate of return to the intensive care unit(ICU),and the length of postoperative hospital stay were compared between the 2 groups.Results Compared with the control group,the percent predicted forced expiratory volume in 1 second (FEV1％),the ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC％),the percent predicted maximum ventilation volume per minute (MVV％),and the arterial oxygen pressure (PaO2) were increased in the observation group before surgery [(87.0±8.2)％ vs.(80.6±7.6) ％,(90.4±6.4)％ vs.(81.4±7.0)％,(87.1±5.6)％ vs.(74.6±6.9) ％,(86.6±6.2) mmHg vs.(81.7±6.9)mmHg,t=2.477,2.588,2.937,3.405,respectively,allP＜0.05].TheFEV1％,FEV1/FVC％,MVV％ and PaO2 were higher in the observation group than in the control group 5 days after treatment [(76.4±9.2) ％ vs.(67.3±10.2) ％,(74.7±9.1) ％ vs.(63.0±11.2) ％,(69.5±9.2)％ vs.(60.1±9.2) ％,(79.5±11.5) mmHg vs.(70.1±11.8) mmHg,t 2.583,2.987,2.778,2.666,respectively,all P＜0.05].The incidences of postoperative atelectasis,pulmonary infection and the length of postoperative hospital stay were lower or less in the observation group than in the controlgroup[7.1％ vs.25.0％,11.90％ vs.32.50％,(8.5±1.8) days vs.(12.1±2.6) days,x2=4.897,5.072,2.351,respectively,all P＜0.05].No significant difference in the rate of return to ICU was found between the two groups(P＞0.05).Conclusions The combination of perioperative Ambroxol and Ipratropium can effectively improve lung function by improving ventilation and gas exchange function,reduce postoperative pulmonary complications and shorten the length of postoperative hospital stay in lung cancer patients aged 70 years and over.
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Objective To investigate the application of left transthoracic small incisions in combination with tubular gastrectomy for radical esophageal cancer surgery in elderly patients.Methods Clinical data of 83 patients with carcinoma in the middle or lower third of the esophagus aged ≥ 70 years who had undergone radical surgery at our hospital from January 2012 to September 2014 were collected.Patients were divided into two groups:the tubular gastrectomy group (n=38) which had undergone radical surgery through left transthoracic small incisions in combination with tubular gastrectomy and the stomach group (n =45) which had been treated with esophagectomy through conventional left posterolateral incisions and esophageal reconstruction with the remnant stomach.Clinical outcomes were compared between the two groups.Results Compared with the stomach group,operative blood loss [(204.3±75.4) ml vs.(258.4±80.2) ml,t=2.720,P＜0.05],chest drainage on the first and second postoperative day [(201.7±82.6) ml vs.(320.5±78.1) ml,(150.8±83.0) ml vs.(244.6 ± 81.2) ml,t =3.221 and 3.189,respectively,each P＜0.05],pain scores on the third postoperative day [(3.73 ± 1.02) vs.(0.24 ± 1.15),t =2.858,P ＜ 0.05],incidence of arrhythmia (13.2％ vs.33.3％,x2 =4.585,P＜0.05),pulmonary complications (18.4％ vs.46.7％,x2=7.353,P＜0.05) and incidences of gastroesophageal reflux and gastric emptying disorders (23.7％ vs.55.6％,0.0％ vs 11.1％,x2 =8.654 and 4.493,both P＜0.05) were less or lower in the tubular gastrectomy group.The two groups had no significant difference in operation time,length of hospital stay,anastomotic leakage,anastomotic stenosis or 1-year survival rate (each P ＞0.05).Conclusions Radical surgery with small incisions through the left chest combined with tubular gastrectomy shows highly favorable clinical outcomes in elderly patients with middle or lower esophageal cancer,and can significantly reduce surgical trauma,decrease postoperative complications,improve the quality of life,and help patients recover after surgery.
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Objective To explore the serum levels of cytokines in patients with depression and their correlations with sex,age,depression severity and anxiety severity.Methods After enrolling subjects into the corresponding patient group and control group,the same trained researcher should continue to collect general information of the enrolled subjects as well as the HAMA and HAMD scoring results collection and assessment;And the serum levels of interlukin-1β (IL-1β),interlukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with the method of enzyme-linked Immuno-sorbent assay (ELISA) in two groups.Results ① The serum levels of IL-1β,IL-6 and TNF-α of depression group were significantly higher than these in control group (P＜0.05),which were ((5.45±3.60) pg/ml vs(2.63± 1.92) pg/ml,(5.09±3.74) pg/ml vs (3.83±2.71) pg/ml,(5.77±3.94) pg/ml vs (4.05±3.25) pg/ml) respectively.②There was no significant difference in serum levels of IL-1 β,IL-6 and TNF-α between male and female patients with depression (P＞0.05).③ No conspicuous differences were found between the young group and the middle-aged group in serum levels of IL-1β,IL-6,TNF-α (P＞0.05).④ Serum level of IL-6 in major depressive disorder group((6.24±4.68) pg/ml) was more higher than that in mild to moderate depression group((3.95± 1.97)pg/ml),and the difference was statistically significant (t=2.467,P＜0.05).⑤There was significant differences in serum level of IL-6 between two groups,which were depression patients with and without anxiety (separately(5.80±4.37) pg/ml vs(3.87±1.80) pg/ml) (t=2.397,P＜0.05).Conclusions ①There is a phenomenon of immune activation,and levels of blood cytokines are raised in patients with depression.②Age and gender have no impact on depression in the level of cytokines.③IL-6 may be an important biological index that reflected the severity of depression and anxiety.
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Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.
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ObjectiveTo Investigate the influencing fators of somatoform disorder and combidity with depressive-anxiety disorders in general hospital patients.MethodsA multi-center,hospital-based cross-sectional study was conducted.A total of 2044 subjects were screened by using general questionnaire,self-made investing scale related somatoform disorder,hospital anxiety and depression scale(HADS) and general health condition survey.Hamilton anxiety scale (HAMA),hamilton depression scale (HAMD),mini international neuropsychiatric interview (MINI)was used to evaluate by psychiatrists for the subjects who scored≥ 9on HADS.Results 16.24％ of all the patients with stamic have been diagnosed and confirmed with depression and anxiety.Possible causes for depression and anxiety included family depression history(P＜ 0.001,OR=83.481 ),past incidence of the disease (P =0.012,OR =4.758),weak ability in handling it (P ＜ 0.001,OR =3.790),bad health condition(P ＜ 0.0001,OR =5.283 ),aggravation of disease(P ＜ 0.001,OR =2.840),bad martial condition (P =0.009,OR =1.805 ),multiple intercurrent diseases (P =0.001,OR =2.051 ),and dissatisfaction of the salary(P ＜0.001,0R=2.362) and tiredness of working(P=0.0054,OR=3.136).ConclusionThe risk factor of somatic patients with the depression and anxiety include family depression history,past incidence of the disease,weak ability in handling it,bad health condition,aggravation of disease,bad martial condition,multiple intercurrent diseases,and dissatisfaction of the salary and tiredness of working.
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To construct the talent cultivating model of psychiatric major suited to our county's actual situation.Jining medical university has conducted explorations and practices persistently in aspects of cultivating objective,enrollment model,course system,teaching quality monitoring system and inspirational education through more than twenty years maneuver.Jining medical university has initially grasped the basic rules of cultivating talents of psychiatric major and has constructed talent cultivating model of psychiatric majors suited to our country's actual situation.
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Objective To explore the association between disrupted in schizophrenia 1(DISC1) genepolymorphism and schizophrenia and different subtype depression.To verify if DISC1 gene is the common predisposing gene for schizophrenia and depression.Methods The genotypes and alleles in 260 cases of schizophrenicpatients,96 cases of depressive patients with psychotic symptoms,124 cases of depressive patients without psychotic symptoms,and 100 normal controls were examined with polymerase chain reaction(PCR),denaturing polyacrylamide gel elcctmphoresis separation technique.The association was analyzed between DISC1 gene single nncleotide polymorphisms(SNP) locus rs821616 and schizophrenia and different subtype depression.Results The frequeneies of the genotypes T/T,A/T,and A/A were 3.5%,28.0%and 69.5%respectively,the frequencies of alleles T and A were 9.6%and 90.4% respectively in schizophrenia group.The frequencies of the genotypes T/T,A/T,and A/A were 3.1%,24.0% and 72.9% respectively,the frequencies of alleles T and A were 15.6% and84.4% respectively in depression 1 group;The frequencies of the genotypes T/T,A/T,and A/A were 2.4%,23.4% and 74.2% respectively,the frequencies of alleles T and A were 15.3% and 84.7% respectively in depression 2 group;The frequencies ofthe genotypes T/T,A/T,and A/A were 1.0%,16.0% and 83.0% respectively,the frequencies of alleles T and A were 17.0% and 83.0% respectively in control group.There were significant differences in the frequencies of the genotypes (Chi-Square=8.072,P=0.045)and alleles(Chi-Square=8.564,P=0.036) of DISC1 gene among the four groups with non-parametric Kruskal-Wallis test.After pairwisecomparison each other in the four groups we found that there were significant differences in the frequencies of thegenotypes(Z=-2.802,P=0.005)and alleles(Z=-2.837,P=0.005) of DISC1 gene between patients withschizophrenia and normal controls with non-parametric Mann-Whitney test(two-tailed),there were no significantdifferences between other groups(P>0.05).Conclusion Our results suggest that DISC1 gene polymorphism is associated with schizophrenia significantly,but it is not associated with different subtype depression.This finding do not support the viewpoint that DISC1 gene is the common predisposing gene for schizophrenia and depression.
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Objective To assess the associations of 5-HTT gene polymorphism with depression by Metaanalysis.Method A comprehensive search for articles from January 2000 to July 2009 was conducted from Chinese BioMedical Literature Database on disc (CBMdisc) and PubMed databases.All related case-control studies were collected and the results were analyzed using RevMan 4.2.2 software.Results A total of 1284 cases and 1243 controls were collected from 14 studies.The combined data statistics revealed that the pooled ORs ( 95%CI) for genotype SS,SL,LL were 1.64 ( 1.37 ～1.97) (P＜0.00001),0.82 (0.66 ～ 1.03) (P＞0.01) and 0.74 (0.61 ～ 0.90) (P ＜ 0.01 ) respectively.Conclusions Polymorphisms of 5-HTT gene have significant association with depression,SS genotype may increase the risk for depression,LL genotype may be protective factors for depression.
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Objective To investigate the status of metabolic syndrome(MS),chronic metabolic disease and insulin resistance(IR) in dwellers over twenty years old in Wulian County,Shandong province.Method 2 127 dwellers over twenty years old were investigated in three towns with multistage stratified sampling and cross sectional methods.Questionnaire was delivered to all the subjects,while physical examination and biochemical test were carried out.Result The prevalent rate of chronic metabolic diseases in dwellers over twenty years old in Wulian County was 64.34%.The prevalent rate of overweight/obesity,diabetes,hypertension and hyperlipemia were 36.24%,3.24%,38.98% and 31.26,respectively.The prevalence of MS having more than three above diseases was 7.9%.The prevalent rate of IR in obesity,diabetes,hypertension,dyslipidemia and MS patients were 43.34%,78.26%,29.79%,33.23% and 64.28%,respectively.Conclusion Near two-thirds of the dwellers over twenty years old in Wulian suffered chronic metabolic disease.IR was common in MS and chronic metabolic disease,especially in diabetes and MS.