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Objective:To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of Burkitt-like lymphoma with 11q aberration (BLL-11q).Methods:The clinical manifestations,histological morphology,immunophenotype and molecular genetic changes of 2 cases of BLL-11q admitted to the department of pathology of The First People's Hospital of Lianyungang in 2020 and 2021 were analyzed retrospectively,and the relevant literatures were reviewed.Results:Patients were found with right neck masses inadvertently and grew rapidly. They presented with localized disease with Ann Arbor stages IA and IIA. Microscopically, the normal structure of the lymph node disappeared and was replaced by a diffuse proliferation of lymphocytes, with consistent morphology and medium size. And the presence of "star-sky" phenomenon was obvious, the morphological characteristics were similar to Burkitt lymphoma. Immunophenotypically, tumor cells were diffusely positive for CD20, CD79α, PAX5, CD10 and Bcl-6, partly moderately positive for C-MYC and MUM-1, however, CD3, Bcl-2, CD30 and TDT were negative,Ki-67 positive index was more than 95%, and EBER was negative. FISH detection showed that MYC, Bcl-2, and Bcl-6 were negative. Both cases had the 11q23.3 gain and 11q24.3 loss. Both patients were treated with chemotherapy and followed up for 10-22 months,and achieved complete remission and disease-free survival.Conclusion:BLL-11q is a rare germinal center B-cell lymphoma with abnormal long arm of chromosome 11 and lack of MYC gene rearrangement. It should be distinguished from Burkitt lymphoma, diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, large B-cell lymphoma with IRF4 rearrangement and high-grade B-cell lymphoma. On the basis of morphology and immunophenotype, the diagnosis depends on genetic detection. There may be a better prognosis.
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OBJECTIVE：To investigate the role of clinical pharmacists on the individualized treatment of children with subglottic Talaromyces marneffei infection. METHODS ：The clinical pharmacists participated in the medication procedure for a case of subglottic T. marneffei infection child . The clinical pharmacists suggested that Budesonide suspension for inhalation should be stopped，according to the subglottic infection pathogen type （T. marneffei ）；Itraconazole oral solution should be chosen and taken orally 2.5 mg/kg，q12 h，and indicators as liver function ，blood potassium should be monitored regularly. However ，as Itraconazole oral solution needed to be applied for temporary purchase ，Itraconazole capsules 2.5 mg/kg，q12 h，p.o.，was administrated temporarily ；clinical pharmacists suggested that Itraconazole capsules should be taken after meal ，and the doctor changed the feeding mode of milk from q 4 h to continuous pumping. After purchased ，Itraconazole oral solution was used instead 2.5 mg/kg，q12 h in fasting state ，and according the clinical pharmacist ’s suggestion ，the doctor changed the nursing method to q 4 h milk pumping. After purchasing and using oral solution instead ，clinical pharmacists suggested taking it at fasting state ；according to the monitoring results and target range （0.5-1 mg/L），oral dose of Itraconazole oral solution was finally adjusted to 8.3 mg/kg， q12 h. In view of the diarrhea during the treatment ，clinical pharmacists suggested to continue the original treatment after considering the effectiveness and importance of the treatment ；at the same time ，discharge medication education should be carried out. RESULTS ： The doctors adopted the suggestions of the clinical pharmacists. The child got a clinical improvement and was discharged after 48 days. CONCLUSIONS ：Clinical pharmacists participate in the treatment of children with T. marneffei infection，timely assist physicians to adjust and improve the medication regimen ，which improve the efficacy and safety of medication for children.
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Mental health is key to public health, as building and developing a mental health service system is legally required in the Mental Health Law of China. The authors probed deep, by means of questionnaire, field survey and group interview, into the characteristics and setbacks of the resources available, organizational framework and operations of the system in China. As found in the study, given a framework in place, this system is plagued by insufficient human resources, weak infrastructure, unreasonable input and compensation mechanism, as well as poor management at community level. These problems are common nationwide. On this basis and with reference to experiences of developed countries, policy proposals are raised in terms of integrated system building, capacity building and assurance mechanism, for framework building and supportive policies of other cities in China.
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Objective:To evaluate the validity and reliability of the Chinese version of the Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) in female patients with eating disorders.Methods:A total of 239 patients with eating disorder and 142 healthy controls who were recruited consented to participate in the study and completed Chinese EDE-Q 6.0.Confirmatory factor analysis was used in patients to compare the original 4-factor model,1-factor model and 3-factor model.The criterion validity was tested with the Eating Disorder Inventory (EDI).Mann-Whitney U analysis was used to compare the differences of EDE-Q 6.0 scores on the two samples to test the empirical validity,and ROC analysis was used to determine the cut-off value.The internal consistency of the scale was tested in two samples.Among all participants,89 patients and 31 healthy controls were retested 1 month later.Results:The original 4-factor model fit better than the other two.The EDE-Q 6.0 total score and the EDI total score had a high consistency in the total sample,patients and controls,respectively (ICC =0.88,0.87,0.73).Patients had higher scores on the EDE-Q 6.0 than controls (Ps ＜0.01).The mean area under the curve (AUC) of EDE-Q 6.0 was 0.91,the optimal cut-off point of EDE-Q 6.0 was total score ≥ 1.27,sensitivity and specificity were 79.4％ and 88.2％ respectively.The Cronbach α coefficients were 0.95,0.91,and 0.88 for the total sample,patients and controls respectively.The test-retest reliabilities were 0.73 for the total scale,0.58,0.68,0.69 and 0.71 for the 4 factors.Conclusion:The Chinese version of the Eating Disorder Examination Questionnaire 6.0 have good psychometric properties and diagnosis accuracy,and it could be used to assess the severity of clinical symptoms.
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OBJECTIVE:To investigate the effects of UGT1A4142T>G polymorphism and blood concentration of valproic ac-id(VPA)on blood concentration of lamotrigine(LTG)in southern Chinese Han children with epilepsy,and to establish the predic-tion equation for quantitatively estimating blood concentration of LTG. METHODS:A total of 72 southern Chinese Han children with epilepsy selected from Guangzhou Women and Children's Medical Center during Jan. 2010-Sept. 2016 were given LTG+VPA. LC-MS/MS and enzyme amplified immunoassay were adopted to determine the blood concentration of LTG and VPA. RFLP-PCR was adopted to determine UGT1A4142T>G polymorphism. The relationships of age, gender, blood concentration of VPA, UGT1A4142T>G polymorphism and LTG concentration-to-dose-ratio (CDR) were also investigate. The prediction equation for blood concentration of LTG was established by multiple linear regression analysis. RESULTS:Age and blood concentration of VPA were positively related to CDR of LTG(r=0.225,0.300,P0.05). UGT1A4 TT,TG and GG genotypes were detected in 39,29,and 4 cases respectively;the frequencies of each genotype were in line with the Har-dy-Weinberg balance(P>0.05). CDR of LTG of TT genotype was significantly lower than those of TG and GG genotype,with sta-tistical significance(PG polymorphism(x4)were all related to blood concentration of LTG(PG polymorphism may associated with blood concentration of LTG. Established prediction equation can provide reference for precise medication in south-ern Chinese Han children with epilepsy.
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Objective To investigate the effect of age,gender,weight and UGT1A4142T>G gene poly-morphism on the efficacy of LTG in epileptic children treated with valproic acid ,and to determine the effective se-rum concentration of LTG in children with epilepsy in south China. Methods A total of 72 pediatric patients with epilepsy received LTG and VPA treatments were enrolled in this study. Patients were treated from January 2010 to September 2016 in Guangzhou women and childrens′medical center. Serum concentration of LTG was measured by using the liquid chromatography-tandem mass spectrometry. UGT1A4142T > G was genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The correlations between the efficacy of LTG and age,gender,weight were analyzed by chi-square test,non-parametric test and logistic regression analysis,respec-tively. Results The curative effect of patients who were younger and with lighter weight were relatively poor ,and men were better than women in the curative effect. UGT1A4142T > G was not related with LTG efficacy. When combined with VPA,the effective serum concentration of LTG in children with epilepsy was more than 2 g/mL. Conclusion There is a good correlation between age and LTG curative effect. The effective serum concentration of LTG in children with epilepsy,who were co-treated with VPA,was more than 2 g/mL. This study provides a refer-ence for the individual administration of children with epilepsy in south China.
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Objective To investigate the effect of age,gender,weight and UGT1A4142T>G gene poly-morphism on the efficacy of LTG in epileptic children treated with valproic acid ,and to determine the effective se-rum concentration of LTG in children with epilepsy in south China. Methods A total of 72 pediatric patients with epilepsy received LTG and VPA treatments were enrolled in this study. Patients were treated from January 2010 to September 2016 in Guangzhou women and childrens′medical center. Serum concentration of LTG was measured by using the liquid chromatography-tandem mass spectrometry. UGT1A4142T > G was genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The correlations between the efficacy of LTG and age,gender,weight were analyzed by chi-square test,non-parametric test and logistic regression analysis,respec-tively. Results The curative effect of patients who were younger and with lighter weight were relatively poor ,and men were better than women in the curative effect. UGT1A4142T > G was not related with LTG efficacy. When combined with VPA,the effective serum concentration of LTG in children with epilepsy was more than 2 g/mL. Conclusion There is a good correlation between age and LTG curative effect. The effective serum concentration of LTG in children with epilepsy,who were co-treated with VPA,was more than 2 g/mL. This study provides a refer-ence for the individual administration of children with epilepsy in south China.
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Objective To analyze the differentially expressed genes between the NCAM + c-Kit +RBE and NCAM-c-Kit-RBE of intrahepatic cholangiocarcinoma (ICC) cell lines,and to screen out the differentially expressed genes that are related to the stem cell signaling pathways.Methods Magnetic activated cell sorting was used to isolate the NCAM + c-Kit +/NCAM-c-Kit-subset cells,and then Agilent Whole Human Genome Microarray Kit was used to test the difference in gene expressions between the NCAM + cKit + and NCAM-c-Kit-subset cells.The difference in gene expressions related to the stem cell signaling pathways was analyzed by the SAS system.The result of the microarray was further confirmed by RT-PCR.Results The total differentially expressed genes which could be found through gene microarray were 7270 [foldchange(fc) ≥2 or fc ≤0.5].Compared with the NCAM-c-Kit-RBE,3572 genes were upregulated while 3698 genes were downregulated.The differences in gene expressions related to the stem cell signaling pathways were 421 (fc ≥2 or fc ≤ 0.5),among which 231 genes were upregulated while 190 genes were downregulated.Conclusions High-flux microarray could be used to screen out lots of differentially expressed genes between the NCAM + c-Kit + and NCAM-c-Kit-RBE cells.The differences in gene expression in the stem cell signaling pathways could also be further analyzed using the SAS system.
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Objective To identify the features of the NCAM+ c-Kit+ subset of hepatic progenitor cells in the intrahepatic cholangiocarcinoma (ICC) cell line RBE.Method Magnetic activated cell sorting was used to isolate NCAM+ c-Kit+/NCAM-c-Kit-subset cells,which were tested for hepatic progenitor cell properties and proliferation,colony formation,and invasive abilities in nude mice.Resuits The cell proliferation ability of NCAM+c-Kit+ subset cells was stronger than that of NCAMc-Kit-subset cells (P＜0.01).In serum-free condition,the number of colonies formed by NCAM+c-Kit+ subset cells was more than that of NCAM-c-Kit-cells (P＜0.01).1 × 104 NCAM+c-Kit+ cells were enough to form tumors in nude mice after subcutaneous inoculation for two weeks,while 1 × 106 NCAM-c-Kit-cells were necessary to form tumors for three weeks.The tumor formation rate of NCAM+c-Kit+ cells was higher than that of NCAM-c-Kit-cells (P=0.04).Conclusions It is possible that NCAM+c-Kit+ subset cells in RBE have the properties of hepatic progenitor cells,and NCAM combined with c-Kit might be a valuable marker for isolating and purifying ICC stem/progenitor cells.
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Objective To detect the expression of promyelocytic leukemia(PML)gene in peripheral blood lymphocytes from patients with psoriasis vulgaris,and to investigate the relationship between PML gene and psoriasis.Methods This study included 50 patients with vulgaris psoriasis who were aged between 18 and 65 years and had never received systemic treatment,as well as 45 healthy controls.Peripheral blood samples were collected from these subjects,and lymphocytes were separated by density-gradient technique.Then,RNA was extracted from the lymphocytes by using RNAprep pure blood kit followed by real time fluorescence-based quantitative reverse transcription-PCR for the detection of PML mRNA expression.Flow cytometry was performed to quantify the expression of PML protein in the lymphocytes.Independent samples t test was carried out to compare the differences in PML expression between the patients and controls.Results The relative quantity (RQ)of PML mRNA was 14.98 ± 3.64 in peripheral blood lymphocytes from the patients,significantly higher than that in the healthy controls(5.50 ± 1.10,t =16.79,P ＜ 0.05).Similarly,a significant increment was observed in the fluorescence intensity of PML protein in peripheral blood lymphocytes from the patients compared with the healthy controls(3.13 ± 0.27 vs.2.43 ± 0.21,t =6.93,P ＜ 0.05).Conclusions PML is overexpressed at the protein and mRNA levels in peripheral blood lymphocytes from patients with psoriasis vulgaris,hinting that PML may play a certain role in the development of psoriasis.
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ObjectiveTo help physicians improve detection rate of depressive and anxiety disorders by exploring the complaints of gastrointestinal(GI) outpatients with these disorders in the general hospitals.Methods A multicenter cross-sectional study was conducted from May to June in 2007.A total of 1995 subjects from 13 general hospitals in China were screened with the hospital anxiety and depression scale ( HADS ) and patient health questionnaire 15-item (PHQ-15).Meanwhile patients'complaints were recorded.Psychiatrists interviewed subjects scored ≥8 on HADS and made diagnoses by using the mini international neuropsychiatric interview(MINI).There were 323 outpatients diagnosed as depressive or anxiety disorders and 1287 outpatients without diagnosis of depressive or anxiety disorders.The complaints and PHQ-15 sores were compared between these two groups.The logistic regression analysis was used to determine the risk of having depressive or anxiety disorders with the number of complaints as an independent variable.ResultsSome symptoms between two groups were statistically significant,including weakness(34.1％ vs 18.8％ ;χ2 =18.04; P=0.000),fatigue(9.6％ vs 5.7％ ;χ2 =6.58,P=0.010)and insomnia( 7.1％ vs 3.4％ ; χ2 =8.87 ; P =0.003 ).Logistic regression analysis showed that with each additional complaint,the odds for an interview-based diagnosis of depressive or anxiety disorders increased,the odds ratio(OR) was 1.12(95％ CI,1.08 ～ 1.17,P=0.000).In comparison to the outpatients without depressive or anxiety disorders,outpatients with these disorders signifycantly had higher PHQ-15 scores (( 11.12 ± 4.92 ) vs (6.68 ± 4.05 ) ; t =16.84,P =0.000).ConclusionThe GI outpatients with depressive and/or anxiety disorders have worse mental heath and more complaints,compared to patients without these disorders.These results may help physicians to better identify depressive disorders and anxiety disorders.
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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.
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or physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.
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OMective In order to evaluate the long-term ocular safety of hydroxychloorqine,we prospectively study the ocular symptoms,routine ophthalmological screening tests and electrophysiological tests in patients taking hydroxychloroquine.Methotis 170 cases of autoimmune diseases patients who had taken hydroxychlon,qine during August,2005 to June,2007 were enrolled into the study.Visual acuity,intraocular pressure,and fundoscopy examination,visual field testing,electroretinogram (ERG) and electrooculogram (EOG) were examined every six months.Results The average duration of taking hydroxyehloroquine was 16.1 month,ranging from 0.5 to 48 months.The total dose ranged from 6 g to 584 g.All patients'visual acuity and intraocular pressure were normal.Fifty-two cases had performed ERG and EOG.The ERG tests were normal in 52 patients.The EOG test of 2 patients showed that the Arden ratio was lower than normal,in which one had severe myopia.Other tests done for these two persons were normal.Conclusion This observational study has shown that hydroxychloroquine has good ocular safety.Further studies with much longer follow-up period will be useful in evaluating the retinal toxicity of hydroxychloroquine.
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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.
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Objective To investigate the abnormality of electrocardiography (ECG) of patients with neoplasms after different chemotherapy. Methods The abnormality of ECG data in 632 patients with neoplasms after different chemotherapy in our hospital was analyzed. Results The changes of ST-T was found in 352 cases (55.70 %), arrhythmia in 197 cases (31.2 %), low QRS in 91 cases (14.4 %), cardiac infarction in 2 cases (0.32 %). Conclusion Different chemotherapy can induce abnormality of ECG, especially combined with anthracycline. Pay attention to potential cardiotoxicity of chemotherapeutics and do regular examination of ECG is very important.
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OBJECTIVE:To study the enzyme kinetics of six specific substrates of cytochrome P450 enzymes. METHODS: The transforming amount of the corresponding metabolites of six substrates was determined by LC-MS/MS. The incubation conditions of substrates in human liver microsomes were optimized and the parameters of enzyme kinetics were calculated based on substrate concentration-reaction velocity curve. RESULTS: The optimal incubation time was 20 min and the optimal enzyme concentration was 0.25 mg protein?mL-1. The Km(?mol?L-1) values of phenacetin, tolbutamide, omeprazole, dextromethorphan,chlorzoxazone and nifedipine were 21.6,163.4,10.4,4.6,41.9 and 9.4 respectively. The Vmax (nmol?min-1?mg protein-1) values were 2.08, 0.52, 1.02, 0.40, 2.36 and 1.00 respectively. CONCLUSION: The enzyme kinetics of six specific substrates of cytochrome P450 enzymes has been investigated in this study, and the study serves as a reference and support for the study and application of substrates in CYP.
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<p><b>BACKGROUND</b>To evaluate the efficacy and toxicity of combination chemotherapy with navelbine (NVB) and cisplatin (DDP) in the treatment of advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>From 1998 to 2003, 46 patients with advanced NSCLC were treated with NVB plus DDP. NVB was given at a dose of 25 mg/m² on day 1 and 8, DDP at a dose of 65-80 mg/m² on day 1 or days 1-3. Twenty-one days was one cycle, each patient was treated at least for two cycles.</p><p><b>RESULTS</b>The overall response rate (RR) was 47.8% (22/46), 51.6% (16/31) for the first treated cases and 40.0% (6/15) for the retreated cases. RR of stage IIIB and IV was 54.5% (12/22) and 41.7% (10/24) respectively. RR for adenocarcinoma and squamous cell carcinoma was 50.0% (14/28) and 44.4% (8/18) respectively. The median survival time was 9.5 months. One-year survival rate was 39.1%. The common toxicities were myelosuppression, nausea/vomiting and phlebitis. Neutropenia accounted for 95.7% (grade III+IV was 28.3%), nausea/vomiting for 47.8% (grade III+IV was 8.7%) and phlebitis for 19.6%, but the last one were mild.</p><p><b>CONCLUSIONS</b>Combination chemotherapy with NVB and DDP is an effective regimen to treat advanced NSCLC, and the toxicities are tolerable.</p>
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The inorganic drug of the metal complexes has been a new anticancer drug of chemical therapy,since cisplatin was used in clinic as an anticancer drug.This review introduced the mechanism of anticancer action of the anticancer drugs of platinum and other metallic complexes and their pharmacological effect,and the research progress in anticancer drugs of the metallic complexes were reviewed in this article.
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<p><b>OBJECTIVE</b>To explore the impact of depressive symptoms on psychological and physical outcomes among elderly living in the residential areas.</p><p><b>METHODS</b>A five years follow-up survey of health outcome was carried out among people aged 55 years or above in community without dementia. The outcome measurements included CES-D (center for epidemiological survey, depression scale), MMSE (mini-mental state examination), ADL (activity of daily living), LSIA (life satisfaction index A), index of physical disease and self-rated health questionnaire. A multiple regression analysis was administered to explore the correlation between depressive symptoms and indices of psychological and physical outcomes.</p><p><b>RESULTS</b>(1) Data from 2 927 subjects having completed two surveys were analyzed. Baseline data showed significant distribution difference of MMSE, ADL, gender and education among the four CES-D score levels. (2) No significant correlation between CES-D score at baseline and MMSE, ADL, LSIA score at five-year follow up was found after controlling the age, gender, educational level and baseline score of MMSE and ADL. (3) Self-rated general health and memory change were significantly correlated to baseline CESD score under controlling the effects of other baseline variables. (4) The score of CESD was found to be a significant predictor for risks of physical disease and mortality by logistic regression model. The odds ratios were 1.52 (95% CI: 1.19 - 1.95) and 2.68 (95% CI: 1.41 - 5.06) respectively.</p><p><b>CONCLUSION</b>Depressive symptoms play an important role on both psychological and physical health outcomes among elderly living in the community.</p>