ABSTRACT
Objective: To analyze the associated factors of intraoperative hemodynamic instability (HI) in patients with incidental pheochromocytomas. Methods: The data of 104 patients with a pathological diagnosis of pheochromocytoma at Chinese PLA General Hospital between January 2011 and December 2016 was retrospectively analyzed. The patients were divided into hemodynamic stability (HS) group (n=56) and HI group (n=48) according to hemodynamic characteristics. The clinical features, biochemical test, preoperative and intraoperative hemodynamics were analyzed. Multivariate logistic regression analysis was used to explore the associated factors of HI. Results: The age [(44.7±12.7) years vs (52.1±12.8) years], tumor diameter [(47.9±16.3) mm vs (57.9±21.6) mm], preoperative blood pressure [(121.3±11.5) mmHg vs (127.2±13.3) mmHg] in HS group were less than those in HI group (all P<0.05). The proportion of age ≥ 50 years (28.6% vs 64.6%), tumor diameter ≥ 45 mm (48.2% vs 68.8%) and hematocrit < 0.38 (25.0% vs 51.3%) in HS group were less than that in HI group (all P<0.05). Multivariate logistic regression analysis indicated that age ≥ 50 years (OR=7.940, 95% CI: 2.480-25.417, P<0.001), tumor diameter ≥ 45 mm (OR=5.042, 95% CI: 1.482-17.156, P=0.010), blood pressure ≥ 130/80 mmHg (OR=3.127, 95% CI: 1.034-9.463, P=0.044) and hematocrit < 0.38 (OR=6.273, 95% CI: 1.893-20.788, P=0.003) were independent associated factors of HI. The proportion of HI ( χ(2)=9.033, P=0.003) and intensive care unit (ICU) admission ( χ(2)=16.641, P<0.001) increased along with increasing associated factors. Conclusion: Adequate preoperative medical preparation and volume expansion for appropriate blood pressure are important for elder patients with large tumor to prevent HI in patients with incidental pheochromocytomas.
Subject(s)
Adrenal Gland Neoplasms , Pheochromocytoma , Adult , Blood Pressure , Hemodynamics , Humans , Middle Aged , Retrospective StudiesABSTRACT
AIM: To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle-aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes. METHODS: A cross-sectional study was performed among 229,047 adults living in the community aged ≥ 40 years from 25 centres in China. The self-reported depression rating scale Patient Health Questionnaire 9 (PHQ-9) was used to diagnose probable and sub-threshold depression. Glucose metabolism status was determined according to World Health Organization 1999 diagnostic criteria. RESULTS: The numbers of participants with normal glucose regulation, impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes were 120,458, 59,512, 24,826 and 24,251, respectively. The prevalence of sub-threshold depression in the total sample of participants was 4.8% (4.8%, 4.8%, 4.4% and 5.6% from normal glucose regulation to previously diagnosed diabetes, respectively), and the prevalence of probable depression was 1.1% (1.1%, 1.0%, 0.9% and 1.8% from normal glucose regulation to previously diagnosed diabetes, respectively). Compared with participants with normal glucose regulation, those with previously diagnosed diabetes had increased odds of probable depression [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.39-1.87] and sub-threshold depression (OR = 1.14, 95% CI 1.06-1.24), after adjustment for multiple confounding factors. Newly diagnosed diabetes or impaired glucose regulation was not associated with depression. Among those with previously diagnosed diabetes, insulin treatment was associated with greater odds of depression compared with no treatment or oral anti-diabetic medicine. CONCLUSION: Previously diagnosed diabetes, but not newly diagnosed diabetes or impaired glucose regulation, was associated with a higher prevalence of depression. Patients receiving insulin were more likely to have depression than those not receiving treatment or being treated with oral anti-diabetic medicine.
Subject(s)
Cost of Illness , Depression/epidemiology , Diabetes Mellitus, Type 2/psychology , Glucose Intolerance/psychology , Prediabetic State/psychology , Adult , Aged , China/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Female , Glucose Intolerance/diagnosis , Glucose Intolerance/drug therapy , Humans , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Incidence , Insulin/adverse effects , Insulin/therapeutic use , Longitudinal Studies , Male , Middle Aged , Prediabetic State/diagnosis , Prediabetic State/therapy , Prevalence , Prospective Studies , Psychiatric Status Rating Scales , RiskABSTRACT
The objectives of this study were to observe the effects of immunization with mouse mature adipocytes for the prevention of obesity in rats and to investigate their mechanism of action. Mouse mature adipocytes (3T3-L1) were injected as a vaccine into the abdominal cavity of rats. Control rats were injected with fibroblast cell lines (MRC-5 or NIH/3T3) or with 0.9% saline. Rats were fed a high calorie diet and body weight changes were used to evaluate obesity prevention. Immunohistochemical and immunofluorescence assays were used to investigate the mechanism of action. Results showed that obesity in rats can be prevented by immunization with xenogeneic mature mouse adipocytes. Body weight gain was inhibited in rats in the treatment group but not in the control groups and was statistically significant between the groups over the 19-week observation period. The assays demonstrated the presence of autoantibodies in rat adipocytes. It was concluded that vaccines of xenogeneic adipocytes can effectively prevent obesity in rats.
