BACKGROUND: Psychological disorders, such as depression and anxiety are relevant to pathogenesis and management of type 2 diabetes mellitus.OBJECTIVE: It was designed to investigate the influence of improving depression and anxiety in diabetes on metabolism of blood glucose.DESIGN: It was a randomized controlled comparative study.SETTING: It was conducted at the Cousulting Center for Clinical Psychology and the Endocrinology Department of Southwest Hospital Affiliated Third Military Medical University of Chinese PLA .PARTICIPANTS: Totally 43 inpatients with type 2 diabetes mellitus in the Endocrinology Department of Southwest Hospital Affiliated toThird Military Medical University of Chinese PLA were selected from October, 1999 to November 2000. All of them participated the investigation voluntarily, 24males and 19 females, with an age of 51±9 years old. They were randomly divided into 2 groups, 23 in experimental group and 20 in control group.METHODS: For experimental group, besides routine medications for diabetes, patients also Accepted anti-depression and anti-anxiety treatment, including paroxetine (20 mg, taking after breakfast everyday) and Alprazolam (0.4 mg, taking at noon, at evening and before sleep everyday). For control group, patients only Accepted routine medication for diabetes. Patients in the two groups were assessed before medication and after 4 weeks medication by Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS). They were identified as depression and anxiety according to the Scales. Reduction rate of SDS/SAS score was used to assess the therapeutic effects: When the reduction rate was 50%-100%, the medication was significantly effective, when it was 25%-49% the treatment was effective, and when it was less than 25%, the treatment was noneffective.Reduction rate =(pre-treatment score-post-treatment score)/post-treatment score×100%. The fasting blood glucose level, 2-hour postprandial blood glucose level and the Glycosylated Hemoglobin (GHB, HbAl) were measured before treatment and after 4 weeks medication. Meanwhile, preprandial blood glucose level and 1-hour postprandial blood glucose level (6 times per day) were detected before treatment and at the 10th, 20th and 30th day during treatment. Reduction rate of blood glucose-(pre-treatment blood glucose level-post-treatment glucose level)/pre-treatment blood glucose level.MAIN OUTCOME MEASURES: These were main outcome measureglucose ①SDS/SAS scores, fasting blood glucose, 2-hour postprandial blood glucose and GHB before treatment and after 4 weeks treatment were measured in two group, ② and reduction rate of blood glucose.RESULTS: Six cases were omitted, 5 was in experimental group for financial pressure, intolerance to side effects of paroxetine and fears of the addiction of psychotropic drugs; the other one was in control group due to drop-out. There were 37 patients finished the investigation, 18 in experimental group and 19 in control group.①Comparison of SDS score/SAS core: After 4 weeks medication, it was observed that the post-treatment scores were significantly lower than pre-treatment scores in experimental group compared to control group[(41.05±7.05,41.88±10.57); (59.80±10.24,55.03±8.31 ), (t=2.41, 2.21, P ＜ 0.05)].②Comparison of fasting blood glucose, 2-hour postprandial blood glucose and reduction rate of blood glucose: After 4 weeks medication, the fasting blood glucose and 2-hour postprandial blood glucose in experimental group were significantly lower than those in control group(t=2.11,2.98, P ＜ 0.05-0.01)and the reduction rate of fasting blood glucose and 2-hour postprandial blood glucose in experimental group were significantly greater than those in control group (t=2.94,2.93,P ＜ 0.01). ③Comparison of GHB:After 4 weeks medication,the posttreatment GHB level in experimental group were significantly lower than pre-treatment GHB level[(8.2±2.0)%,(9.1±1.9)%, (t=2.14, P ＜ 0.05)].CONCLUSION: Anti-depression and anti-anxiety drugs not only can alleviate depression and anxiety symptoms significantly, but also can improve blood glucose metabolism. This may be attributed to an effect of anti-depression and anti-anxiety drugs in increasing the compliance of the patients to the medication for diabetes and decreasing the insulin resistance induced by negative moods.

Objective To explore the influence of management style through clinical nursing path-way (CNP) on improvement of occupational pride in nurses. Methods 40 clinical nurses from the gyne-colog-ic and obstetrics departments were set as the experimental group,40 others from the surgical and pe-diatric departments were named as the control group.The two groups were given work education through CNP pattern and routine pattern respectively.Self- designed questionnaire was used to investigate the influ-ence of two work patterns on the occupational pride of nurses.The results underwent X2 and t test. Results The score of every evaluation index in the experimental group was better than that of the control group. Conclusions The appli - cation of management pattern with clinical nursing pathway in clinical nursing work can improve the occupational pride of nurses.

OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in cardiac functions and blood lipids in 2 groups(P>0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.

Objective To study the relationship among hydrops fetalis(over 28 gestational weeks),Mirror syndrome and preeclampsia(PE). Methods Clinical data of 13 cases of hydrops fetalis were analyzed and relative publications were reviewed. Results Eight out of the 13 cases were diagnosed as PE,and 5 were Mirror syndrome.Serious maternal complications occurred in all cases with either Mirror syndrome or PE. ConclusionsFetaland placental hydrops was closely related with maternal symptoms.Clinicians should be aware of this condition and detect Mirror syndrome in time so as to prevent its progress to PE.However,the pathogenic mechanism remains to be fully elucidated.More attention should be paid to both mothers and the hydrops fetalis.

Objective To study the prevalence of anxiety and depression in the retired veterans of the armed force and its related factors.Methods Prevalence of anxiety and depression was studied in 836 veterans aged 60 or over retired from the armed force living in Fuzhou City, Fujian Province by physical checks-up and questionnaire. Data were analyzed with SPSS software in a microcomputer.Results Among 836 retired veterans investigated, 296 (35.4%) were in slight anxiety, 58 (6.9%) in moderate or severe anxiety, 336 (40.2%) in slight depression and 63 (7.5%) in moderate or severe depression, with those aged 60~64 and 75~79 years more liable to suffering. Personality disposition was closely related with anxiety and depression ( P

?-Synuclein (?-SYN ) .previously identified as a breast cancer specific gene, has a wildly tumor expression profile mainly in advanced stage. As a special chaperone,?- SYN stimulates the proliferation and metastasis of tumor cells through interacting with estrogen receptor and (or) BubR1. Meanwhile, it is also detectable in the serum or urine from tumor patients, which indicates that?- SYN could be potential as a tumor marker for diagnosis and prognosis.

Humans ; Myocardial Infarction ; complications ; therapy ; Myocardial Reperfusion Injury ; etiology ; therapy

objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

To explore the impact of normal range plasma calcium level changes on fibrinogen and homocysteine (Hcy) in non-diabetic elderly patients. Methods: A total of 1030 non-diabetic patients≥65 years were retrospectively studied. According to adjusted plasma calcium concentration (Cac), the patients were divided into 4 quartiles as Q1 group, Q2 group, Q3 group and Q4 group. The relationship between Cac and plasma levels of fibrinogen and Hcy were compared. Results: ① Plasma levels of fibrinogen and Hcy were increased by Cac elevation accordingly, P=0.010 and P<0.001 respectively. ② Cac was obviously related to the prevalence of high fibrinogen (OR=1.75, P=0.019) and high Hcy (OR=1.82, P=0.026). ③ Cac was positively related to fibrinogen (Standardized β=0.15, P<0.001) and Hcy (Standardized β=0.08, P=0.009). Conclusion: Normal range plasma calcium level changes were related to the elevation of plasma fibrinogen and Hcy in non-diabetic elderly patients.

Reactive oxygen species(ROS)play an important role in the cardiac ischemic and reperfusion injury.However,accumulating evidences have demonstrated that ROS are pivotal components of redox signaling cascade relevant to cardioprotection induced by either preconditioning or postconditioning. In this review,the definition, source and detection methods of ROS are introduced.Besides,the role of ROS in the cardioprotection offered by preconditioning or postconditioning and the effects of either preconditioning or postconditioning on ROS are summarized.