The coronavirus disease 2019 (COVID-19) pandemic poses negative impacts on psychological health among healthcare workers. If timely diagnosis and interventions are not given, the pandemic not only threatens physical and psychological health among healthcare workers, and greatly reduces the quality and efficiency of medical treatment. Based on review of national and international publications pertaining to psychological problems and interventions among healthcare workers during the COVID-19 pandemic, this article describes the prevalence of psychological problems among healthcare workers, influencing factors and psychological interventions, so as to provide insights into the protection of psychological health among healthcare workers.

Objective To evaluate the accuracy of dual-source CT (DSCT) in diagnosing the degree of coronary artery stenosis,and compare it with coronary artery angiography (CAG).Methods One hundred patients with suspected coronary heart disease,clinical diagnosis of angina pectoris,myocardial infarction and patients after percutaneous coronary intervention,were given DSCT and CAG examination.The CAG results were considered as the reference standard,and the results of the two examinations were compared.The sensitivity,specificity,positive predictive value and negative predictive value of DSCT in diagnosing coronary artery stenosis (mild ＜ 50％,middle 50％-75％,severe ≥75％) were computed.Results CAG displayed coronary artery 1320 segments,DSCT displayed coronary artery 1287 segments,the appreciable rate was 97.5％.The sensitivity of DSCT in diagnosing mild,middle and severe coronary artery stenosis were 64.4％ (105/163),88.7％ (235/265) and 97.4％ (187/192),specificity all were 99.7％ (617/619),positive predictive value were 98.1％ (105/107),99.2％ (235/237) and 98.9％ (187/189),negative predictive valne were 91.4％ (617/675),95.4％ (617/647) and 99.2％ (617/622).There was significant correlation between DSCT and CAG in diagnosing coronary artery stenosis by Spearman test (P＜ 0.01).Conclusions The results of DSCT have high accordance with CAG in diagnosing coronary artery stenosis.It is a kind of non-invasive examination with low cost,and could reduce the pain of invasive examination.So DSCT is a good choice in diagnosing coronary artery disease.

Objective To analyze the CT manifestations of mesenteric panniculitis,so that to improve CT diagnosis of mesenteric panniculitis.Methods Seven patients with mesenteric panniculitis,which were diagnosed according to the CT criteria,were analyzed.Results The fatty masses with defined margins and around the root of the jejunum were found in all patients at CT scan,and there were no enhancement after administration of contrast medium.The masses were sharply defined with abdominal and retroperitoneal fat.There were pseudo-capsule in 7, "arcus adiposus sign" in 5. Enlargement of lymph nodes in the masses and retroperitoneum in 2 cases were seen,respectively.4 patients had abdominal operations,one patient was in combination with carcinoma of head of pancrease.Conclusion Certain features of the CT manifestations of mesenteric panniculitis can be found,CT is effective for the diagnosis of mesenteric panniculitis.

Objective To compare the clinical outcomes of segmental pulmonary veins isolation (SPVI) and circumferential pulmonary veins ablation (CPVA) for patients with paroxysmal atrial fibrillation. Methods Sixty-eight patients with paroxysmal atrial fibrillation from January 2004 to April 2008 were divided into SPVI group (30 cases) and CPVA group (38 cases).The mean procedure time,the mean fluoroscopy time and relapse rate were compared. Results The mean procedure time in CPVA and SPVI group had no significant difference [(171.0 ± 25.8) min vs (168.2 ± 21.7) min, P = 0.579], but the mean fluoroscopy time in CPVA group [(38.5 ± 8.4) min]was less than that in SPVI group [(45.8 ± 16.1) min (P= 0.019). Mean term of the follow up was (17.1 ± 7.8) months. Relapse rate in CPVA group was less than that in SPVI group (5.3% vs 23.3%, P= 0.029). Both groups had no severe complications. Conclusion In patients with paroxysmal atrial fibrillation, CPVA strategy provides a more favourable clinical outcomes and less fluoroscopy time.

Objective To investigate the therapy efficiency and complication prevention in patients undergoing radiofrequency current catheter ablation combined with multiple X-ray projecting angles.Methods Two hundred and six atrioventricular nodal reentrant tachycardia (AVNRT) patients were involved in this study. The distance between the tip of His and the ostium of coronary sinus were measured under different X-ray projecting angles respectively, including posterior anterior (PA), right anterior oblique 30° (RAO 30° ) and left anterior oblique 45° (LAO 45° ) in each patient, and mapping was proceeding under the corresponding X-ray projecting angles with the longest distance. The distance between ablating catheter and His was confirmed again before powering by the other two X-ray projecting angles. Results The longest distance between the tip of His and the ostium of coronary sinus were obtained in 66,75 and 65 patients under PA,RAO 30° and LAO 45° respectively(P＞ 0.05 ),and the data were (2.94 ± 0.87), (2.98 ± 0.76)and (2.91 ± 0.52) cm(P＞ 0.05). Transient first or second degree of atrioventricular blocking was observed in 4 cases among 22 high risk patients in which the powering sites were above the medium level of the distance between the tip of His and the ostium of coronary sinus under three kinds of X-ray projecting angles obviously.However,only 1 case was observed in other 184 patients(P＜ 0.01 ). All patients were cured successfully and no permanent atrioventricular blocking occurred. Conclusion Radiofrequency current catheter ablation combined with multiple X-ray projecting angles is helpful to increasing the successful rate and preventing complication in ablating therapy.

Neurofibroma is an autosomal dominant genetic disease which is originated from the abnormal differentiation of neural crest cells and would cause system damage.NF can occur at most organs in the body,while it is rarely seen in the common bile duct.In February 2007,1 old patients with NF was admitted to the Lishui Central Hospital of Zhejiang Province.The results of preoperative magnetic resonance cholangiopancreatography (MRCP) revealed that the common bile duct was slightly dilated,and the diameter of the common bile duct was 1.2 cm.A nodular short T2 signal lesion was detected at the middle part of the common bile duct with the size of 1.4 cm × 1.6 cm.The results of intraoperative rapid frozen section pathological examination showed that the lesion was cholangiocarcinoma,then cholangiocarcinoma resection + biliojejunal Roux-en-Y anastomosis was applied to the patient.Postoperative pathological examination confirmed that the lesion was neurofibroma.The patient was followed up for 7 years and died of pulmonary infection in June 2014.The clinical presentation of neurofibroma of the common bile duct is untypical.Space-occupying lesions detected in the patients with history of bile duct injury or operation should be considered to be diagnosed as neurofibroma.Special attention should be paid to the accuracy of the results of rapid frozen section pathological examination in order to avoid missdiagnosis.

Objective To determine the mutant status of BRAF gene in Chinese colorectal cancer (CRC) patients and analyze the association with clinicopathological parameters.Methods 676 CRC samples were collected in Cancer Institute/ Hospital,Chinese Academy of Medical Science from December 2009 to December 2011.The direct sequencing was conducted to detect mutations in the BRAF (exon 15 and exon 11).The correlation between mutant status with clinicopathological parameters were analyzed.Results Beside 10 colorectal cancer samples,among the 666 colorectal cancer patients 4.35％ (29/666) of the tumors harbored a BRAF mutation,of which 1.94％ (13/669) in exon 15 (V600E),2.39％ (16/670) in exon 11.Statistical analysis revealed that BRAF15 mutations appeared to occur more frequently in poor-differentiation tumors than high or moderate-differentiation tumors (5.81％ vs 1.46％,r =0.105,P=0.040).But BRAF15 mutations were not correlated with age,gender,smoking and drinking history,tumor site,tumor type,tumor(T/N) staging,histological type,or distant metastasis [r equals to 0.007,-0.018,-0.049,-0.023,-0.098,-0.038,0.040(0.034/0.059),0.065,0.042,respectively,P ＞ 0.05] ; BRAF11 mutations appeared to occur more frequently in patients with drinking history (6.02％vs 1.81％,r =0.093,P =0.035).However,age,gender,smoking history,tumor site,tumor type,tumor differentiation,tumor(N) staging,histological type,or distant metastasis showed no significant correlation with this mutation [r equals to-0.004,0.047,0.020,0.042,0.029,0.040,0.006 (-0.008),0.008,0.030,respectively,P ＞ 0.05].Conclusion A higher proportion of BRAF15 (V600E) mutations occurred in poor-differentiation tumors among the Chinese patients with CRC; BRAF11 mutations appeared more frequently in patients with drinking history.

Objective To discuss the difference of cognitive function in patients of first-episode schizophrenia with and without metabolic syndrome.Methods Event related potential detection and Wechsler Memory Scale (WMS) was determined in 57 patients of first-episode schizophrenia with metabolic syndrome (research group) and 57 patients of first-episode schizophrenia without metabolic syndrome (control group),and the psychiatric symptom in two groups was assessed by the application of the positive and negative symptoms scale (PANSS).Results The memory quotient score was (78.51 ± 12.54) scores in research group,and (92.01 ± 17.49) scores in control group,and there was significant difference between two groups (t =-2.130,P=0.047).The short-term memory,instantaneous memory impairment in research group were lower than those in control group(t =2.151-3.054,P=0.007-0.046).The latency of P300 was (325.10 ±22.46) ms in research group and (284.60 ±22.46) ms in control group,and there was significant difference (t =3.454,P =0.003).The amplitude was (6.56 ± 1.61) μ V in research group and (9.78 ±1.73) μV in control group,and there was significant difference (t =-4.307,P =0.000).Conclusion The patients of first-episode schizophrenia with metabolism syndrome has more severe cognitive impairment than those without metabolism syndrome.

Objective To identify the candidate genes in the vicinity of a susceptibility locus (urinary albumin 1,UA-1) contributing to the development of albuminuria in type 2 diabetic KK/Ta mice. Methods Total RNA was extracted from the kidneys of KK/Ta (n=3) and BALB/c (n=2) mice at 20 weeks of age.The gene expression profile in kidney was investigated using the Affymetrix Murine Genome U74Av2 array.Competitive RT-PCR was used to confirm the differential expression of syndecan-4 which located in the vicinity of UA-1.Genome DNA was extracted from KK/Ta and BALB/c mice.DNA sequence analysis of the coding and promotor region of syndecan-4 gene was conducted. Results In the vicinity of the susceptibility locus (UA-1)contributing to the development of albuminuria in type 2 diabetic KK/Ta mice,10 candidate genes that showed differential expression were identified.Among them,the gene expression of syndecan-4in KK/Ta kidneys at 20 weeks of age was up-regulated by 26.1 times of age-matched BALB/c kidneys.Sequence analysis revealed two synonymous polymorphisms in the coding region (A93C and T216C) and three polymorphisms in the promoter region (-T263C,-T396C and -G669A) of the syndecan-4 gene.The TATA box was found at 321 bp upstream from the transcription start site,and the T263C polymorphism was located in the binding site of transcription factor Clox.Conclusions Syndecan-4 gene is mapped in the vicinity of the susceptibility locus contributing to the development of albuminuria in type 2 diabetes.The gene expression of syndecan-4 in KK/Ta kidneys is up-regulated than that in age-matched BALB/c kidneys at 20 weeks of age.Thus syndecan-4 may be one of the potential candidate genes responsible for diabetic nephropathy.Sequence differences in the promoter region influence the expression levels of syndecan-4 genes in KK/Ta kidneys.

Objective : To investigate the status of occupational stress and analyze its influencing factors among frontline employees working in a chemical fiber manufacturing enterprise, so as to provide insights into the development of occupational stress interventions. Methods : The frontline employees working in a chemical fiber manufacturing enterprise were selected as the study subjects using a cluster sampling method in October 2018. The status of occupational stress was investigated using the Chinese version of the effort-reward imbalance ( ERI ) questionnaire. The influencing factors for occupational stress were identified using a multivariable logistic regression model. Results : A total of 1 780 questionnaires were sent out, and 1 115 valid ones ( 62.64% ) were recovered. Among the 1 115 respondents, there were 427 men ( 38.30% ) and 688 women ( 61.70% ), and 71.22% were at ages of 21 to 39 years. There were 561 respondents with < 1 year of service ( 50.31% ), and the longest length of service was 11 years. In addition, there were 1 069 respondents ( 95.87% ) exposed to high noise, and 346 respondents ( 31.03% ) were diagnosed at a high occupational-stress state and 769 ( 68.97% ) at a low state. Multivariable logistic regression analysis identified 5 years or longer of service ( OR=1.540, 95%CI: 1.057-2.245 ) and exposure to high noise ( OR=1.917, 95%CI: 1.004-3.659 ) as risk factors for occupational stress among frontline employees in the chemical fiber manufacturing enterprise. Conclusions There are 31.03% of frontline employees at a high occupational-stress state in the chemical fiber manufacturing enterprise, and a high occupational-stress state is associated with exposure to high noise and 5 years or longer of service.