Combined fenestrated/chimney thoracic endovascular repair for the treatment of blunt traumatic aortic injury: A case report / 中华创伤杂志(英文版)

Blunt traumatic thoracic aortic injury (BTAI) is an extremely serious medical condition with a high rate of associated mortality. Recent advances in techniques such as thoracic endovascular repair offer new opportunities to manage the critical BTAI patients in an efficacious yet less invasive manner. A 65 year-old-male suffered from multiple injuries after a fall, including BTAI in the aortic arch, which resulted in dissection of the descending thoracic-abdominal aorta and iliac artery, development of an intimal flap in the left common carotid artery, and dissection of the left subclavian artery. Based on the imaging information of this patient and our clinical experience, the combined treatment of fenestrated thoracic endovascular repair and a chimney technique was immediately planned to fully repair these dissections and moreover prevent further dissection of the branching vessels, additionally to ensure sufficient blood flow in the left subclavian artery and left common carotid artery. The intervention yielded satisfactory early outcomes. Follow-up assessment at six months reported no symptoms or complications associated with the stent-graft. Computed tomography angiography further confirmed adequate stent-graft coverage of the aortic injury.

KCNJ11 rs5210 polymorphism and genetic susceptibility to nonalcoholic fatty liver disease and coronary artery disease / 临床肝胆病杂志

ObjectiveTo investigate the association of KCNJ11 rs5210 single nucleotide polymorphism with nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) in the Chinese Han population in Qingdao, China. MethodsA total of 246 patients with NAFLD who attended Qingdao Municipal Hospital from December 2018 to September 2019 were enrolled as NAFLD group, 201 patients with CAD were enrolled as CAD group, and 116 patients with NAFLD and CAD were enrolled as NAFLD+CAD group; 342 healthy individuals were enrolled as control group. Fasting venous blood samples were collected for biochemical analysis. Whole blood genomic DNA was extracted, and PCR was used to determine KCNJ11 rs5210 genotype. The chi-square test was used to analyze whether the distribution of KCNJ11 rs5210 gene frequencies met the Hardy-Weinberg equilibrium, in order to determine whether the tested samples could represent the population. The chi-square test was used to analyze the differences in sex and genotype/allele frequency between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Bonferroni method was used for further comparison between two groups. The unconditional logistic regression model was used to calculate odds ratio (OR) and 95% confidence interval. ResultsThree genotypes (AA, GA, and GG) of KCNJ11 rs5210 were found by gene sequencing. There were no significant differences in rs5210 allele frequency and genotype distribution between the control group, the NAFLD group, the CAD group, and the NAFLD+CAD group (all P＞0.05), and there were still no significant differences after adjustment for sex, age, and body mass index (BMI) (all P＞0.05). For all subjects, the subjects with AA genotype had a higher level of alkaline phosphatase than those with GA genotype (P=0.048); in the NAFLD group, the patients with GA genotype had significantly higher BMI and total bilirubin than those with AA genotype (P=0.042 and 0.002). The unconditional logistic regression analysis showed that elevated BMI was associated with the risk of NAFLD (OR=1.35, P＜0.01), while decreased high-density lipoprotein (HDL) might indicate an increase in the risk of NAFLD (OR=0.33, P＜0.01); elevated fasting plasma glucose and decreased HDL might indicate an increase in the risk of CAD (OR=1.51 and 0.11, both P＜0.01) and NAFLD with CAD (OR=1.46 and 0.06, both P＜0.01). ConclusionThere is no significant association between KCNJ11 rs5210 polymorphism and the risk of NAFLD and CAD in the Chinese Han population in Qingdao.

Determination of six compounds in Berberidis Cortex and comparative study of its different species / 中国中药杂志

In order to clarify the characteristic components of Berberidis Cortex,the preparative liquid chromatography and spectral analysis methods were used to separate and identify the unknown components in the water extract of Berberidis Cortex. Two compounds were isolated and identified as bufotenidine and ferulic acid 4-O-β-D-glucopyranoside. They were both isolated for the first time from Berberidis Cortex and Berberis. In addition,an HPLC method was successfully established for simultaneously determination of six compounds in Berberidis Cortex,and chemometric methods were used to study the chemical differences among three main species of Berberidis Cortex. The results suggested that jatrorrhizine and bufotenidine are the main difference compounds among the three species.Compared with B. kansuensis and B. diaphana,B. vernae contains significantly more jatrorrhizine(P<0. 01),and the content of bufotenidine in B. vernae was significantly higher than that in B. kansuensis(P<0. 05). Considering these results,further research is necessary to reveal the pharmacological activities of bufotenidine and the pharmacodynamic differences between the three species. The results could provide a reference for quality control,the basic research on effective substances,and development of Berberidis Cortex.

Icariin protects vascular endothelial cells from oxidative stress through inhibiting endoplasmic reticulum stress / 中西医结合学报

OBJECTIVE@#To investigate the protective effect and underlying mechanism(s) of icariin (ICA) in preventing hydrogen peroxide (HO)-induced vascular endothelial cell injury via endoplasmic reticulum stress (ERS).@*METHODS@#To study the effects of ICA on HO-induced damage, we used the cell counting kit-8 assay to detect cell viability and the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay to determine cell adhesion and apoptosis, respectively. Spectrophotometry and enzyme-linked immunosorbent assay were used to measure the expression levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Subsequently, glucose-regulated protein 78 (GRP78), activating transcription factor-4 (ATF4) and eukaryotic initiation factor-2α (eIF2α) were detected using Western blotting.@*RESULTS@#In human umbilical vein endothelial cells, different concentrations of ICA exhibited multiple effects, including reduced HO damage, improved cell viability and adhesion, reduced cell apoptosis and increased SOD and GSH-Px activity. Among the ICA concentrations used, only the HO + 100 μmol/L ICA group had significant differences compared to the HO group. ERS activators HO and dl-dithiothreitol (DTT) significantly increased GRP78, ATF4 and eIF2α expressions, decreased cell activity and reduced SOD and GSH-Px activity. In contrast, the HO + 100 μmol/L ICA and HO + 100 μmol/L ICA + DTT groups had significant inhibitory effects on the expressions of GRP78, ATF4 and eIF2α proteins, showing enhanced cell viability and SOD and GSH-Px activity.@*CONCLUSION@#The results showed the dose-dependent effects of ICA against HO-induced injury in vascular endothelial cells. The inhibition of GRP78, ATF4 and eIF2α protein expressions in the ERS, and the subsequent alleviation of oxidative stress damage, might be the molecular mechanism.

Construction of clinical medical engineering emergency support mode in medical rescue / 医疗卫生装备

Objective To explore the construction of clinical medical engineering emergency support mode in medical rescue. Methods The deficiencies of emergency support mechanism were discussed from the aspects of support requirements, planning, personnel training, equipment and materials reserve. From the aspects of basic function mode, emergency support commanding mode, personnel allocation the framework design of the support mode was carried out with the principles of quickness, high quality, obedience and initiative. Results The mode completed medical emergency support mechanism and enhanced the efficiency of emergency medical treatment during disasters and etc. Conclusion Emergency support is of great significance for medical rescue, which has to pose emphases on military-civilian integration, research and planning.

One Case Analysis of Insect Bites Induced Rhabdomyolysis Complicated with Acute Renal Failure / 中国药师

Objective: To reveal the harm seriousness of bug bites induced rhabdomyolysis complicated with acute renal failure to human body and provide case evidence for clinical workers to improve the understanding and treatment level of insect bites related diseases.Methods: The clinical diagnosis and treatment of one case of insect bites induced rhabdomyolysis complicated with acute renal failure was tracked, and the individualized diagnosis and treatment were performed and summarized according to the clinical symptoms and the conditions of the patient.Results: All the indicators of the patient returned to normal with satisfactory curative effect and promising prognosis.Conclusion: The treatment of rhabdomyolysis complicated with acute renal failure needs quick identification and reversible factors correction, which are beneficial to the improvement of organ function and prognosis.

Efficacy of telephone follow-up on glycemic control in patients with diabetes mellitus:a Meta-analysis / 中国实用护理杂志

Objective To evaluate the efficacy of telephone follow-up on glycemic control in patients with diabetes mellitus. Methods Randomized clinical trials that assessed the effectiveness of telephone follow-up in patients with diabetes mellitus were selected in the databases of Cochrane library, JBI, PubMed, Medline, EMBASE, EBSCO, OVID, Springer, China National Knowledge Infrastructure, China Biomedical Literature Database, VIP , Wangfang Data. At the same time manual retrieval of relevant professional information to collect randomized clinical trials that met the inclusion criteria. The searching time was from database establishment to June 2016. RevMan5.2 software was used to analyze the data after quality assessment. Results A total of 12 randomized controlled trials were included in a total of 1905 patients. Meta-analyses showed that, compared with the conventional nursing group, the telephone follow-up could significantly reduce the level of glycosylated hemoglobin (weighted mean difference was-0.49, 95% confidence interval was-0.52--0.46, P<0.01), the level of fasting blood glucose (weighted mean difference was-0.99, 95% confidence interval was-1.16--0.83, P<0.01). Conclusions Telephone follow-up can improve blood glucose control in patients with diabetes, it is worth to be popularized in clinical practice.

Pharmaceutical Care for One Case of Rheumatoid Arthritis Complicated with Severe Pneumonia / 中国药师

Objective:To explore the role of clinical pharmacists in the drug treatment of one patient with rheumatoid arthritis and severe pneumonia. Methods: The drug treatment of one patient with rheumatoid arthritis and severe pneumonia involved in clinical pharmacists was retrospectively analyzed. Clinical pharmacists provided rational suggestions for the adjustment of anti-infection treat-ment,selection of medication, evaluation of therapeutic effect and monitoring of adverse drug reactions. Results: Clinical pharmacists participated in the whole medication treatment process, and their suggestions on anti-infection drugs choices, dose adjustment and ad-verse reactions treatment were accepted by doctors. Conclusion:Taking use of self professional competence, clinical pharmacists play a positive role in the optimization and adjustment of drug treatment regimen, which provides security for the medication safety and clini-cal rational drug use.

The application of the PET/CT technology in the diagnosis of atypical spinal tuberculosis / 预防医学

Objective To explore the diagnostic value of PET/CT technique in the atypical spinal tuberculosis. Methods A total of 60 patients who had suffered from spinal tuberculosis and spinal metastasis confirmed by surgical interventions from 2010 to 2016 were retrospectively analyzed. 18F-FDG PET/CT examination was made at our department. Image data of X-ray, CT, and PET/CT were compared in the diagnosis accuracy. Results A total of 52 males and 8 females, aged from 38 to 82 years (mean, 50.2 years) were collected. The statistical analysis showed PET/CT technology with sensitivity of 85%, and specificity of 95%, which were significantly higher than those of X-ray and CT (AUC=0.900, P<0.05) . 18F-FDG PET/CT can find more lesions than X-ray and CT, find "cold abscess" and "cold zone" of spinal tuberculosis, that was an exclusive value of PET/CT diagnosis for atypical spinal tuberculosis. Conclusion 18F-FDG PET/CT shows an important clinical diagnostic value for the atypical spinal tuberculosis.

Development of portable efficacy detector for battlefield treatment training / 医疗卫生装备

Objective To develop a portable pressure detector to facilitate the battlefield self and buddy aids training for dressing,hemostasis and fixation.Methods The changes of pressure were converted into the ones of electric current with the pneumatic cuff,catheter and membrane pressure sensor,and then transmitted to the panel display by Bluetooth.The efficacy for the training was determined based on the acquired data.Results The detector implemented quantifying of the pressures during dressing,hemostasis and fixation,and non-medical staff obtained the results of battlefield treatment training easily to execute rapid assessment of battlefield self and buddy aids training.Conclusion The device gains advantages in visualized data,portability,easy operation and accurate measurement,and contributes to battlefield self and buddy aids training.

Relationship Between Acute Cerebral Infarction and Serum Inflammatory Cytokines / 沈阳医学院学报

Objective:To investigate the changes of serum inflammatory cytokines in patients with acute cerebral infarction (ACI) and its clinical significance by detecting the serum levels of homocysteine (Hcy),cystatin C (Cys C),high-sensitivity C-reactive protein (hs-CRP) . Methods:A total of 82 ACI patients (ACI group) and 50 healthy persons (control group) were selected,the serum Hcy,Cys C,hs-CRP levels of all subjects were determined,the relationship between inflammatory cytokines and USA National Institutes of Health Stroke Scale (NIHSS) was analyzed. Finally,the roles of inflammatory cytokines in diagnosis of ACI were evaluated. Results:The levels of Hcy,Cys-C and hs-CRP in ACI group were significantly higher than those in control group (P<0.01) . The serum levels of these factors had significant difference among different neurological deficiency groups (P<0.05), and had a positive correlation with NIHSS score (r=0.396, 0.445, 0.391, P<0.01), hs-CRP had the highest sensitivity (72.0%) and specificity (82.0%) for diagnosis of ACI. Conclusions:The hs-CRP, Hcy and Cys C play important roles in the onset and development of ACI and can reflect the severity of ACI. Among them,Hcy is the important dangerous factor of ACI,the level of Cys C reflectes the degree of the vascular inflammatory injury,and hs-CRP can be used as an index to diagnose and evaluate the severity of ACI.

Construction and identification of lentiviral vector over-expressing Staphyloco-ccus aureus enterotoxin C3 / 中国免疫学杂志

Objective:To construct the lentiviral vector over-expressing Staphylococcus aureus enterotoxin C3 and detect the expression of target gene in vitro.Methods:SEC3 gene were amplificatied by polymerase chain rcaction( PCR).The GV365 lentiviral vectors were digested by AgeⅠenzyme,which was linked to SEC3 gene and then constructed the GV365-SEC3 lentiviral vetor.Positive clones of vectors were identificd by PCR.Then the positive lentiviral vectors were transfected into 293T cells for lentivirus package.The expression of lentiviral vectors was tested by observating cell fluorescence and Western blot.The virus titer was determined by HIV-1 p24 ELISA.Results: SEC3 gene was amplified and successfully bound to the GV365 lentivirus vectors.The sequences of the recombinant plasmid were confirmed correct by PCR and DNA scqucncing.A large mass of green fluorescent cells were observed after transfecting.And the resulting size of 29 kD protein band of protein electrophoresis, which was consistent with the target gene protein.Viral vector titer was 5×108 TU/ml by ELISA detection.Conclusion: Lentiviral vector over-expressing Staphylococcus aureus enterotoxin C3 was successfully constructed,laid the foundation of observing its effect and mechanism against to tumor in vivo and in vitro for later research.

Dickkopf-1 has an Inhibitory Effect on Mesenchymal Stem Cells to Fibroblast Differentiation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mesenchymal stem cells (MSCs) are bone marrow stem cells which play an important role in tissue repair. The treatment with MSCs will be likely to aggravate the degree of fibrosis. The Wnt/β-catenin signaling pathway is involved in developmental and physiological processes, such as fibrosis. Dickkopfs (DKKs) are considered as an antagonist to block Wnt/β-catenin signaling pathway by binding the receptor of receptor-related protein (LRP5/6). DKK1 was chosen in attempt to inhibit fibrosis of MSCs by lowering activity of Wnt/β-catenin signaling pathway.</p><p><b>METHODS</b>Stable MSCs were randomly divided into four groups: MSCs control, MSCs + transforming growth factor-β (TGF-β), MSCs + DKK1, and MSCs + TGF-β + DKK1. Flow cytometry was used to identify MSCs. Cell viability was evaluated by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide test. Immunofluorescence was used to detect protein expression in the Wnt/β-catenin signaling pathways. Western blotting analysis was employed to test expression of fibroblast surface markers and, finally, real-time reverse transcription polymerase chain reaction was employed to test mRNA expression of fibroblast surface markers and Wnt/β-catenin signaling proteins.</p><p><b>RESULTS</b>Cultivated MSCs were found to conform to the characteristics of standard MSCs: expression of cluster of differentiation (CD) 73, 90, and 105, not expression of 34, 45, and 79. We found that DKK1 could maintain the normal cell morphology of MSCs. Western blotting analysis showed that fibroblast surface markers were expressed in high quantities in the group MSCs + TGF-β. However, the expression was lower in the MSCs + TGF-β + DKK1. Immunofluorescence showed high expression of all Wnt/β-catnin molecules in the MSCs + TGF-β group but expressed in lower quantities in MSCs + TGF-β + DKK1 group. Finally, mRNA expression of fibroblast markers vimentin, α-smooth muscle actin and Wnt/β-catenin signaling proteins β-catenin, T-cell factor, and glycogen synthase kinase-3β was significantly increased in MSCs + TGF-β group compared to control (P < 0.05). Expression of the same fibroblast markers and Wnt/β-catenin was decreased to regular quantities in the MSCs + TGF-β + DKK1 group.</p><p><b>CONCLUSIONS</b>DKK1, Wnt/β-catenin inhibitors, blocks the Wnt/β-catenin signaling pathway to inhibit the process of MSCs fibrosis. It might provide some new ways for clinical treatment of certain diseases.</p>

Predictive value of radiological parameter for re-displacement of conservative treatment of distal radius fracture / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the radiological parameters of the conservatively in treating distal radius fracture and investigate whether the final re-displacement can be predicted after primary reduction.</p><p><b>METHODS</b>From January 2013 to June 2014,212 patients with distal radial fracture conservatively were treated in our hospital, 107 patients of them were excluded because of their incomplete radiological parameters;the remaining 105 patients were available for radiological were assessed after injury, there were 56 male patients and 49 female patients in this study, the average age of the patients was 51 years old (ranged from 22 to 80 years). According to AO classification, there were 47 cases of type A2 and C1, and 58 cases of type A3, C2, C3. All patients were treated by closed reduction and below-elbow cast immobilization for 4 to 6 weeks. All patients were followed up for 3 to 6 months (means 4.5 months) by X-ray, all fractures were healed. Standard AP and lateral radiographic examination was conducted before reduction and after reduction and bony consolidation,the dorsal angulation and the radial angle were measured at each time point. The linear regression was used for the analysis to find out whether the final re-displacement can be predicted after primary reduction.</p><p><b>RESULTS</b>Among 105 patients,the significant correlations were found for the dorsal angulation between the reduction time and the end time (r = 0.82) and for the radial angulation between the reduction time and end time (r = 0.85).</p><p><b>CONCLUSION</b>The dorsal angulation and the radial angulation after complete healing can be predicted from linear the regression functions. Due to the possibility of predicting the end result, whether the fracture should receive further conservative treatment or surgical treatment can be decided immediately.</p>

Clinical research of vacuum sealing drainage combined with artificial dermis for the treatment of ankle and foot soft tissue defects / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of vacuum sealing drainage (VSD) combined with artificial dermis for treatment of the ankle and foot soft tissue defects.</p><p><b>METHODS</b>A total of 15 patients with skin and soft tissue defect of ankle and foot were treated from January 2011 to December 2013, including 10 males and 5 females, with an average age of 32.5 years old ranging from 3 to 55 years old, involving 8 cases by traffic accident, 2 cases by machine accident, 5 cases by crush injury;8 cases with soft tissue exposure, 2 cases with tendor exposure, 5 cases with bone exposure. VSD was used to cover the wounds and continuous negative pressure drainage after debridement, the wounds covered with artificial dermis after the second granulation tissue grew well, again VSD was used to cover the wounds and negative pressure suction was applied, after 7 to 14 days negative pressure closed drainage was removed, free skin graft was transplanted above the artificial dermis, sterile gauze was used to compression bandage.</p><p><b>RESULTS</b>All cases were followed up for 3 to 14 months with an average of 6.5 months. Skin graft of 15 of patients survived after transplantation, artificial dermis graft interval was 7 to 14 days with an average of 9.5 days. There was no obvious scar hyperplasia and contracture, no obvious pigmentation, appearance and functional recovery.</p><p><b>CONCLUSIONS</b>After the implantation of artificial dermis and traditional skin graft method need for 2 to 3 weeks, vacuum sealing drainage technique combined with artificial dermis in treatment of soft tissue defect of foot and ankle skin has advantages of simple operation, significantly shorten the time of the second phase of the skin, without flap to repair, little injury to donor skin area, wound healing quality high, clinical effect of satisfaction.</p>

Case-control study on therapeutic effects of different fixation methods for the treatment of olecranon fracture / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects by comparing three different fixation methods: tension band, hollow lag screw and anatomical plate.</p><p><b>METHODS</b>From January 2010 to January 2012, 82 patients with olecranon fractures who underwent surgical treatments were followed-up. All the patients were divided into three groups: tension band fixation group (group A), hollow lag screw fixation group (group B), anatomical plate fixation (group C). In group A, there were 35 patients, including 19 males and 16 females, ranging in age from 32 to 49 years old, with an average of (43.6 ± 8.7) years old, and the patients were treated with tension band fixation. According to Colton classification, there were 5 cases of type I, 3 cases of type II A,19 cases of type II B, and 8 cases of type II C in group A. Among 20 patients in group B, there were 13 males and 7 females, ranging in age from 27 to 50 years old, with an average of (41.5 ± 9.3) years old. The patients in group B were treated with hollow lag screw fixation. According to Colton classification, there were 4 cases of type I, 4 cases of type II A, and 12 cases of type II B in group B. In group C, there were 27 patients totally, including 15 males and 12 females, ranging in age from 30 to 55 years old, with an average of (38.2 ± 6.2) years old. The patients in group C were treated with anatomical plate fixation. According to Colton classification, there were 4 cases of type II B, 13 cases of type II C, and 10 cases of type II D in group C. The Fracture healing time, complications and functional recovery were retrospectively observed and recorded.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 8 to 24 months, with an average of 15 months. The average healing time of patients in group C was the longest among three groups. The flexion-extension and rotation activities of elbow joint in group B and C were better than that in group C. According to Broberg & Morrey score system, the therapeutic effects of patients in group A and B were better than that of group C. In group C, 2 patients had incision infections, 6 patients complained of foreign body sensation, 1 patient got a delayed fracture healing, and 1 patient had the heterotopic ossification. There were no occurrences of incision infections in group A and B; internal fixation loosening occurred in 3 patients in group A and 2 patients in group B; delayed fracture healing occurred in 2 patients in group A and 2 patients in group B; and skin bursa formation occurred in 6 patients in group A and 1 patient in group B.</p><p><b>CONCLUSION</b>All the three ways are effective methods for the treatment of olecranon fractures. Fixation methods should be selected depending on the type of fracture.</p>

Investigation of mental health and its influence on Chinese cancer patients using a multidisciplinary screening flow: an epidemiological survey in the west of China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Despite psycho-oncological concerns and studies having thrived these past decades, sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems. To investigate the mental health condition of cancer patient, as well as its possible impacts on prognosis, the first large-scale survey was performed in the west of China.</p><p><b>METHODS</b>For standardizing and facilitating the assessment of mental illness in inpatients with cancer, a multidisciplinary rating flow was designed and established. On the basis of this system, between May 1st and 31st 2009, 2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ), Zung self-rating depression scales (SDS), Zung self-rating anxiety scale (SAS), and posttraumatic stress disorder checklist-civilian version (PCL-C). Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS). We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening, and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions. The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later, by comparing the survival rate, progression of disease, and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.</p><p><b>RESULTS</b>In preliminary screenings, 26.1% (595/2279) yielded positive results. Further symptom conclusions confirmed 15.8% (359/2279) with clinical syndrome of mental disorder. Regarding specific type of syndrome, the occurrence rates of depression, anxiety, psychotic symptoms, and stress-related disorders were 13.3%, 10.2%, 2.8%, and 1.4%, respectively. Follow-up assessments were successfully performed in 1918 subjects (84.2%). Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression, cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P < 0.05) in five domains of QoL (scored by QLQ-C30).</p><p><b>CONCLUSION</b>In China, at least 26% of cancer patients experienced impaired mental health, of which 60% already had a detectable clinical syndrome of mental disorder, which could significantly undermine their QoL.</p>

Management window for patients with atrial fibrillation in community health center / 中华全科医师杂志

A management window model for patients with atrial fibrillation (AF) was established in Tilanqiao Community Health Service Center cooperated with tertiary hospitals.Patients were screened and treated in the community health service center,and a comprehensive management plan was conducted and patients were followed-up.A total of 105 patients with atrial fibrillation (97.2％) were effectively managed with an average follow-up of 10.6 months.The CHADS2 score ≥ 2 in 78 cases,including 11 cases with administration of warfarin (14.1％) and 26 cases with paroxysmal AF without transition to persistent atrial fibrillation.Compared to the data before management,the rate of taking aspirin and warfarin in managed patients was increased (all P ＜ 0.05),the international normalized ratio (INR) of patients receiving warfarin was improved (P ＜ 0.05) ; the ratio of receiving comprehensive treatment program,standardized treatment and health education were significantly increased (P ＜ 0.05) ; the awareness of the disease,treatment compliance and satisfaction of patients were improved significantly (all P ＜ 0.05).The results suggest that the management widow model is feasible and effective for management of patients with atrial fibrillation in community health service centers.

A case-control study on non-smoking primary lung cancers in Sichuan, China / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>The incidence of lung cancer in non-smokers is increasing in recent years. The aim of this investigation is to explore main risk factors of non-smoking primary lung cancers in Sichuan province in order to provide more accurate data for clinical.</p><p><b>METHODS</b>One hundred and fourty-five non-smoking pairs of cases and 145 of controls were matched by age and sex. The patients were newly-diagnosed definitely as primary lung cancer at West China Hospital of Sichuan University from March to December 2009.</p><p><b>RESULTS</b>Seventeen exposure factors were explored as epidemic agents for non-smoking lung cancer in Sichuan by using univariate analysis; mutivariate conditional Logistic regression analysis showed that passive smoking, moved into newly renovated homes over the past 10 years, family cancer history from second/ third-degree relatives, lack of emotion regulation, heavy work pressure and poor quality of sleep were main risk agents for the non-smoking lung cancer incidence with OR 2.267 (95% CI: 1.231-4.177), 5.080 (95% CI: 1.632-15.817), 7.937 (95% CI: 1.815-34.705), 2.491 (95% CI: 1.230-4.738), 5.769 (95% CI: 2.030-16.396), 2.538 (95% CI: 1.277-4.861), respectively. While higher body mass index, eating fruit and vegetable and regular participating in physical exercise might be protective factors with OR 0.419 (95% CI: 0.226-0.779), 0.344 (95% CI: 0.155-0.762), 0.507 (95% CI: 0.274-0.937), respectively.</p><p><b>CONCLUSION</b>The occurrence of non-smoking primary lung cancer associated with a variety of exposure factors including passive smoking, history of exposure to harmful environmental, family cancer history, mental and psychological factors in Sichuan Province.</p>

Value of combining 64 multi-slice spiral computer tomography and serum amyloid A protein in surgical decision-making in rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To determine the accuracy and clinical value of combining 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) in the preoperative staging of rectal cancer.</p><p><b>METHODS</b>Prospectively enrolled patients with rectal cancer from October 2007 to October 2008. The patients were randomly assigned into two groups: MSCT and SAA combined group: both MSCT and SAA combinative assessment were performed for preoperative evaluation; MSCT group: only MSCT was performed preoperatively for tumor staging. The accuracy of the preoperative T, N, M, and TNM staging and the concordance rate of predictive operative strategy were compared between the two groups.</p><p><b>RESULTS</b>Total of 225 cases with rectal cancer were enrolled in this study. There were 110 cases in MSCT and SAA combined group and 115 cases in MSCT group. The baseline characteristics was comparable between the two groups. For MSCT and SAA combined group, the accuracies of preoperative staging of T, N, M and TNM was 87.3%, 85.2%, 100% and 86.4%, respectively; and for MSCT group, the corresponding rates was 85.2%, 67.0%, 100% and 66.1%, respectively. Statistical differences was found in the accuracy of preoperative N and TNM staging between the two groups (P = 0.009 and 0.001, respectively). In addition, there was statistical difference in the accuracy of prediction to operative procedures between the two groups (94.7% vs. 81.7%, P = 0.003).</p><p><b>CONCLUSION</b>Combinative assessment of MSCT and SAA could improve the accuracy of preoperative staging, and thus provide higher predictive coincidence rate of operative procedures.</p>