ObjectiveTo study the state of depression emotion,personality and quality of life of patients with digestive system tumor undergoing chemotherapy, and the correlation of depression emotion with personality and quality of life.MethodsUsing cross-sectional survey methodology, 261 digestive system tumor patients were investigated by schedule table SDS, EPQ-RSC and EORTC QLQ-C30. These cases were also used to study the correlation of depression emotion with personality and quality of life.ResultsThe digestive system tumor patients undergoing chemotherapy investigated had a high score in depression than domestic norm, and the incidence of depression of these cases was 19.5％.The cases were divided into two groups(the depression group and the non-depression group). There were significant differences in N and P dimensionalities of personality and in physical function, role function, cognitive function, emotional function,and overall well-being, fatigue, economic difficulties, nausea and vomiting, pain, insomnia, loss of appetite,constipation and diarrhea. There were various degrees of difference in depression, personality and quality of life.ConclusionsDepression, personality and quality of life are closely related in digestive system tumor patients undergoing chemotherapy. The medical staff should pay more attention to the patients quality of life and personality to make a better nursing intervention and improve their quality of life.

Objective In order to know preoperative gastrointestinal cancer patients' quality of life and the related factors. Methods A cross-sectional study was conducted in 356 preoperative gastrointestinal cancer patients. The data were analyzed using descriptive, linear correlation and multiple regression analysis. Results The total number of valid return was 323, and the valid usable return rate was 90.7%.The preoperative gastrointestinal cancer patients' quality of life reached the middle level and varied with gender, age, residence, income and psychological state. Emotional function, physical function and fatigue were influencing factors of total quality of life. Conclusions Anxiety and emotional function were the main influencing factors of preoperative gastrointestinal cancer patients' quality of life.

BACKGROUND: Clinical studies have discovered heart rate variability (HRV) is closely correlated with autonomic nervous system, sub-health and sudden death. Medical studies have summarized some chaotic medical science and homeostasis relevance theory. But so far the combination could still not systematically explain the clinical manifestation or summarize the diagnostic standards for sub-health and effective index to prevent sudden death. OBJECTIVE: To elucidate the correlation among autonomic nervous system, sub-health and sudden death by using chaotic medicine and homeostasis, so as to provide theoretical basis for evaluating sub-healthy state using HRV and preventing sudden death HRV. RETRIEVAL STRATEGY: A computer-based online search of Pubmed was undertaken to identify the articles published in English between January 1995 and June 2007 with the keywords of "chaotic medicine, heart rate variability (HRV), Sudden death, Sub-health, homeostasis". Meanwhile, the Weblog and CNKI database were searched for relevant articles dated from January 1995 and June 2007 with the same keywords in Chinese. Fifty-six papers were searched. After the first trial, only articles ①closely correlated with chaotic medical science, sudden death and sub-health, and ②published recently or in authority magazine in same field were selected. Repetitive studies were excluded. LITERATURE EVALUATION: The review articles, basic and clinical experiments about chaotic medical science, HRV, sudden death, sub-health, and homeostasis as well as articles published in related weblogs were selected. DATA SYNTHESIS: ①In any individual composed of multi-cells and multi-system, there are at least three-level chaotic system: overall chaotic system, cardiovascular chaotic system maintaining the blood pressure and cell chaotic system. Healthy state is that the three chaotic systems are in normal condition. Disease and sub-healthy state is the sub-stable state of chaotic system caused by the overstress of central nervous system, overexcitation of autonomic nerves and HRV decrease when there is some cell or cardiovascular system malfunction, and the information is feedback to central nervous system. ②Based on the theory about chaotic medicine and homeostasis, there are four states in individual chaotic motion: health, disease, sub-health, and homeostasis border before sudden death. The health is the homeostasis of body; disease and sub-health are the sub-homeostasis and may develop from healthy state because various factors; they may transform each other and both of them may lead to sudden death for unsteady. ③The extreme tension of central nervous system and over-excitation of autonomic nerves result in the destabilizing overall chaotic motion. Stimulation induces system destabilizing and sudden death because the patient cannot maintain arterial blood pressure. CONCLUSION: Long-term healthy state is unpredictable, but we can forecast 1-2 days situations by short-term HRV testing for 512 times in the early morning of every day, and judge the healthy state after sleep, and the change tendency of healthy state. Accordingly, we could predict person is in healthy state, sub-healthy state or unsteady border state that could cause sudden death.

Objective To study the affecting factors of the activities of daily living in patients after abdominal surgery.Methods Using survey methodology,95 abdominal surgery patients were investigated br general condition questionnaire and Barthel index scales.The data were analyzed using descriptive analysis,t test,variance analysis and multiple regression analysis.Results The total number of valid return was 91.and the valid usable return rate was 95.8% .The affecting factors of recovery to ADL2 of abdominal surgery patients after operation were gender,age,education level,economic condition,type of illness,postoperation complications,operation times,nutrition risk scores and activities of daily living of preoperation,and the differences were significant.The affecting factors of recovery to ADL1 of abdominal surgery patients after operation were age,education level economic condition,marital status,type of illness,postoperation complications,nutrition risk scores and activities of daily living of preoperation,the differences wen significant.Conclusions The affecting factors of ADL of abdominal surgery patients after operation were gender,age,education level economic level,type of illness,postoperation complications,marital status,operation times,nutrition risk scores and activities of daily living of preoperation.

Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.

Objective To evaluate the effect on the reversal of left ventricular aneurysm (LVA) and on heart function of percutaneous coronary intervention (PCI) therapy at different time of acute myocardial infarction (AMI). Methods A total of 326 patients with primary anterior AMI-accompanied LVA diagnosed by left ventriculography (LVG) from January 2001 to July 2004 were enrolled in this study. They were randomized into 4 groups according to the time of accepting PCI:≤3 h group, 4-6 h group, 7-12 h group and one week group. At the baseline and 6 months after AMI, the parameters of left ventricular diastolic volume index (LVEDVI), left ventricular systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score (LVWMS) and left ventricular end diastolic pressure (LVEDP) were measured by LVG. The paradox volume index (PVI) was measured by equilibrium radionuclide at one week and 6 months after AMI.At 3 year following up to, the major adverse cardiac events (MACE) were recorded. Results At 6 months after PCI, the LVESVI, LVEDVI, WMS and LVEDP were all decreased while LVEF was increased in the four groups as compared with pre-PCl (P<0.05, respectively). Those parameters changed most obviously in ≤3 h group. At the 6th month after PCI, the PVI was lower in ≤3 h group (12.1±2.1)% than in 4-6 h, 7-12 h and one week group [(15.4±2.4)%, (16.5±2.5)% and (20.4±3.7)%, all P<0.05]. Within the 3 years follow-up, the MACE was significantly lower in 3 h, 4-6 h and 7-12 h groups than in one week group, and the mortality was lower too [(2.8%, 3.0% and 3.1% vs. 17.9%, all P<0.05]. Conclusions The early, fully and permanent open of the infraction-related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve LV function and prognosis.

Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.

Objective:To explore the effects of Onodera′s prognostic nutritional index (PNI) on the prognosis of locally advanced oropharyngeal squamous cell carcinoma (LA-OPSCC) after induction chemotherapy followed by sequential chemoradiotherapy.Methods:A retrospective analysis was conducted on the clinical data of 52 LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy in The Affiliated Cancer Hospital of Guizhou Medical University during 2014-2018. The PNI values of all the patients at different treatment phases were statistically analyzed, and the ROC curve was employed to determine the optimal critical value of PNI. The patients in this study were divided into a well-nourished group ( n = 27) and a poorly-nourished group ( n = 25). The Kaplan-Meier method was used for survival analysis. The Cox proportional hazards model was utilized to analyze the relationships between different nutritional status and prognosis. Clinical features and adverse reactions were compared between the two groups. Results:The PNI values decreased significantly after radiotherapy, with an optimal critical value of 42.4. The 5-year overall survival (OS) and progression-free survival (PFS) of the well-nourished group (PNI ≥ 42.4) were 62.6% and 60.9%, respectively, which were significantly higher than those (30.1% and 29.7%) of the poorly-nourished group (PNI < 42.4, χ2 = 11.12, 5.74, P < 0.05). The multivariate analysis showed that PNI was an independent prognostic factor for the OS after radiotherapy ( HR = 2.752, 95% CI: 1.095-6.917, P = 0.031). The LA-OPSCC patients aged over 60 years or those who did not respond to induction chemotherapy accounted for a higher proportion of malnutrition after chemoradiotherapy ( χ2 = 4.89, 5.05, P < 0.05). Conclusions:PNI after radiotherapy can be used as a prognostic factor in the evaluation of LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy. The LA-OPSCC patients aged over 60 years or those who do not respond to induction chemotherapy should receive more nutritional support during the chemoradiotherapy.

OBJECTIVESTo investigate whether the administration of recombinant human B-type natriuretic peptide (rhBNP) before primary percutaneous coronary intervention (PCI) could further limit the infract size, improve left ventricular function, and alleviate cardiac dilation in patients with acute ST-segment elevation myocardial infarction(STEMI).

METHODSA total of 93 consecutive patients presenting chest pain within 12 hours from the onset, suspicious of first STEMI located at anterior wall undergoing primary PCI, were eligible for enrollment and randomly assigned to either rhBNP group (rhBNP administration starting at 5 min before PCI, 1.5 µg/kg bolus intravenous injection followed by 0.007 5-0.03 µg·kg(-1)·min(-1) for up to 120 hours, n=48) or nitroglycerin (NIT) group (NIT treatment starting at 5 min before PCI, 10-100 µg/min intravenous infusion for 120 hours, n=45). Primary PCI was performed in both groups using post-conditioning (PC) technique. TIMI flow grade, corrected TIMI frame count, and TIMI myocardial perfusion grade were compared between the two groups at the time of infarct related artery (IRA) re-patency. The levels of serum creatine kinase MB isoenzyme (CK-MB) and troponin I (TnI) were measured. Echocardiography was performed at baseline 7 days and 6 months later.

RESULTSBaseline characteristics were similar between the two groups. The percentage of TIMI grade 3 and TIMI myocardial perfusion grade 3 after PCI both tended to be higher in rhBNP group than those in NIT group (95.8%(46/48) vs. 86.7%(39/45), P=0.162) and (72.9%(35/48) vs. 62.2%(28/45), P=0.500). The corrected TIMI frame count was significantly decreased in rhBNP group (21.0±8.7 vs. 28.2±14.8, P=0.005). The myocardial infarct size expressed as the AUC of CK-MB ((3 249±1 101) U/L vs. (4 474±1 661)U/L, P=0.010) or AUC of TnI ((3 670±942) µg/L vs. (4 541±1 098) µg/L, P=0.021) was significantly decreased in rhBNP group compared with those in NIT group. At 7 days after primary PCI, the left ventricular ejection fraction (LVEF) tended to be higher (P>0.05), while the E/e' index and wall motion score index (WMSI) ((11.95±3.31 vs. 14.60±4.09, P=0.030) and (1.74±0.17 vs. 2.40±0.55, P<0.001)) were significantly improved in rhBNP group compared with those in NIT group. BNP level was also significantly lower in rhBNP group compared that in NIT group ((68.3±37.8) ng/L vs. (129.4±64.4) ng/L, P<0.001). During 6-month follow-up, LVEF and WMSI were significantly improved in rhBNP group compared those in NIT group(51.7%±12.7% vs. 46.9%±9.6%, P=0.024 and 1.69±0.35 vs. 1.92±0.47, P=0.020).

CONCLUSIONAdministration of rhBNP before PCI with post-conditioning procedure can further improve myocardial perfusion, limit myocardial infarct size, ameliorate cardiac dysfunction and postpone left ventricular early-stage and long-term remodeling in STEMI patients undergoing primary PCI.

Acute Disease ; Creatine Kinase, MB Form ; Echocardiography ; Humans ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Percutaneous Coronary Intervention ; Troponin I ; Ventricular Function, Left