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Objective To investigate the effects of anxiety ,depression and life events on patients with non-erosive gastroesophageal reflux disease (NERD) .Methods From November 2016 to December 2017 ,at The First Affiliated Hospital of the Medical College ,Shihezi University ,135 patients with NERD (NERD group) and 133 volunteers who received physical examination at the same period were enrolled (healthy control group) .The scores of self-rating anxiety scale (SAS) ,self-rating depression scale (SDS ) ,life event scale (LES ) and gastroesophageal reflux disease questionnaire (GerdQ ) of the enrolled individuals were obtained by questionnaire .Mann-Whitney ranking test ,chi square test and Spearman rank correlation test were performed for statistical analysis .Results The patients with anxiety in NERD group accounted for 46 .67％ (63/135) ,which was higher than that in healthy control group (1 .50％ ,2/133) ,and the difference was statistically significant (χ2 =74 .38 , P< 0 .01) .The patients with depression in NERD group accounted for 12 .59％ (17/135) ,which was higher than that of healthy control group (0 ,0/133) ,and the difference was statistically significant (χ2 = 17 .88 ,P< 0 .01) .The SAS score of NERD group was 48 points (45 points ,52 points) ,which was higher than that of healthy control group (37 points (33 points ,43 points)) ,and the difference was statistically significant (Z=-11 .03 ,P<0 .01) .The SDS score of NERD group was 46 points (41 points ,50 points) ,which was higher than that of healthy control group (36 points ,32 points to 40 points) ,and the difference was statistically significant (Z= -11 .03 , P<0 .01) .The LES score of NERD group was 32 points (10 points ,45 points) , which was higher than that of healthy control group (3 points ,0 points to 32 points) ,and the difference was statistically significant (Z= -2 .18 ,P=0 .03) .The score of LES negative events in NERD group was 21 points (3 points ,36 points) ,which was higher than that of the healthy control group (0 points ,0 points to 23 points) , and the difference was statistically significant (Z= -2 .19 , P=0 .03) .GerdQ score was positively correlated with SAS ,SDS ,LES scores and LES negative event score ,and the differences were all statistically significant (r=0 .65 ,0 .60 ,0 .29 and 0 .29 ,all P< 0 .05) .Conclusions Anxiety ,depression and life events are the influencing factors of NERD .The greater the impact of anxiety ,depression and life event (especially negative live events) ,the more severe the NERD symptoms .
RESUMO
Objective To establish the proper review rules for the microscopic screening of urine samples tested by automatic urinalysis work station.Methods A total of 3 154 random urine samples were enrolled to establish and validate review rules .All the samples were collected from the inpatients and outpatients of Shanghai First People′s Hospital from March to May 2013 and tested by urinalysis work station.Three thousands one hundred and fifty four urine samples were firstly tested by urinalysis work station,including both urine dry chemical analyzer and urine sediments analyzer .Then each urine sample was examined microscopically by two technicians-in-charge using double-blind method.The average results from the two technicians were used as review results .Compared with review results ,the review rules were set up.According to different test methods by automatic urinalysis work station , four microscopic review protocols were defined:(1)Protocol 1:based on chemistry results only ,microscopy review was performed when any of WBC,RBC,PRO and NIT was positive;(2)Protocol 2:based on urine sedimental analysis only ,microscopy review was performed when any of WBC ,RBC and CAST count was over upper limit of the reference range;(3)Protocol 3:if any of BLD ,RBC,LEU,WBC was different between two systems ,or quantitative results had two or more than two gradient differences ,microscopy review was performed;(4) Protoco1 4:if any of BLD, RBC,LEU ,WBC was different between two systems , or CAST was over upper limit of the reference range , or alarm appeared , microscopic review was performed .400 randomly selected urine samples were tested to validate the review rules .Omission diagnostic rate and review rate were used to evaluate the rules .Results According to the review rules,the positive samples rate was 43.47%(1 371/3 154) and the negative rate was 56.53%( 1 783/3 154 );Positive samples were composed of RBC ( 55.58%) , WBC ( 59.66%) and CAST(6.42%).The review rates of four protocols were 44.48%(1 403/3 154),45.69%(1 441/3 154), 26.09%(823/3 154),28.95%(913/3 154),respectively.The false negative rates (omission diagnostic rates)were 7.13%(225/3 154),4.53%(143/3 154),2.73%(86/3 154) and 1.02%(32/3 154), respectively .Protocol 4 was selected as an ideal plan.Additional 400 urine samples were tested using protocol 4 in order to confirm the review rule.The review rate, false negative rate were 26.25%(105/400), 0.75%( 3/400 ), respectively.After image review revised, the review rate was 14.50%(58/400).Conclusion This study formulates that the automatic urine analysis workstation review rules have clinical maneuverability and validity.