Forty-eight patients with subclinical Cushing's syndrome(SCS)were evaluated.Eleven of them underwent adrenalectomy(Group 1)and the other 37 cases did not(Group 2).Serum and urine corticosol, plasma ACTH and parameters related to metabolic syndrome(such as waist circumference,blood pressure,blood lipids and fasting plasma glucose)were measured.The data at diagnosis were compared with those during the survey.The results indicated that patients with SCS had a significantly high prevalence of metabolic syndrome.The symptoms and signs of metabolic syndrome could be improved after removing the tumor.Otherwise there is no improvement,some patients will even develop into overt Cushing's syndrome.

OBJECTIVETo study the life events which are correlated with adolescent's emotion and behavior problems, and to provide evidence for clinicians and school staff to develop intervention for those problems.

METHODSYouth's Self Report (YSR) and Adolescent Self-Rating Life Events Check List (ASLEC) were used to assess adolescent's emotional and behavioral problems and life events by 'spot' study. The referred group consisted of 585 patients from 11 to 18 years old in a Mental Health Centre of West China Hospital of Sichuan University from July in 2002 to March in 2004. Level of IQ was above 5th grade of primary school among the study subjects who were willing to fill in the YSR and ASLEC. The non-referred group was selected in a 1280 students cluster-sample from the schools of Chengdu city, whose sex, age and father's career were matched with the referred group. Variance inflation factor (VIF) was used to verify that there was no collinearity to each other in the 6 factors of ASLEC: interpersonal relationship, learning pressure, being punished, losing good adaptation and other. Linear stepwise regression was adopted.

RESULTSThe YSR scores in referred group were higher than those in non-referred group, and the referred group had more emotional and behavioral problems than the non-referred one. Partial correlations ranged from 0.124 to 0.418 in referred group, and from 0.104 to 0.388 in non-referred group. Unsatisfied interpersonal relationship, heavy learning pressure, having been punished and poor adaptation were likely to increase the risk of youth's emotional and behavioral problems.

CONCLUSIONMore attention should be paid to help adolescents in the following areas: solving intrapersonal affairs, relieving pressure from learning, avoiding punishment, and improving ability to fit themselves to their surroundings.

Adaptation, Psychological ; Adolescent ; Adolescent Behavior ; Child ; Child Behavior Disorders ; epidemiology ; psychology ; China ; epidemiology ; Emotions ; Female ; Humans ; Interpersonal Relations ; Linear Models ; Male ; Mental Disorders ; epidemiology ; psychology ; Psychological Tests ; Punishment ; Stress, Psychological

OBJECTIVETo study the mental health problems in the adolescents aged 11-18 years in Chengdu, China.

METHODSYouth Self-Report (YSR) and the General Information Questionnaire were administered to 1802 students who were randomly selected from schools in Chengdu City.

RESULTSThe overall rate of mental problems was 15.1% in the adolescents, 15.2% in boys and 14.9% in girls if 90th percentile of total scores and/or 98th percentile of syndromes scores were assigned as the cutpoint of norms. The overall rate of mental problems was 27.2% in the adolescents, 27.6% in boys and 26.8% in girls if 75th percentile of total scores and/or 98th percentile of syndromes scores were assigned as the cutpoint of norms. The rates of mental problems were not significantly different between boys and girls (chi-squared = 0.042, P = 0.838; chi-squared = 0.126, P = 0.723). Mental problems tended to be increasing with age (P = 0.000). There were 29 items that the percentiles were higher than 50% but 5 items were under 10% in all the 101 items of YSR. 3.1% of the adolescents often had suicidal intention, and 6.1% of the adolescents often thought of becoming opposite sex identity.

CONCLUSIONThe rates of mental problems in adolescents aged 11-18 years in Chengdu, Chana were 27.2% or 15.1% respectively,if 75th or 90th percentile of the total scores were assigned as the cutpoint of total scores. The mental problems in the adolescents tended to be increasing along with age.

Adolescent ; Age Distribution ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; Sex Distribution ; Surveys and Questionnaires

OBJECTIVETo evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).

METHODSTotally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.

RESULTS(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).

CONCLUSIONSFloating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

Acupuncture Therapy ; methods ; Analgesics ; therapeutic use ; Anxiety Disorders ; Duloxetine Hydrochloride ; therapeutic use ; Follow-Up Studies ; Humans ; Needles ; Pain ; Pain Management ; methods ; Pain Measurement ; Psychiatric Status Rating Scales ; Somatoform Disorders ; therapy ; Treatment Outcome

OBJECTIVETo explore Chinese medical syndrome typing features of epigastric pain and its association with gastroscopic manifestations.

METHODSUsing associated rules data mining method, an analysis study was performed in 234 patients with epigastric pain by combining holistic Chinese medical syndrome typing and results of gastroscopic examinations.

RESULTSPi-Wei deficiency cold syndrome (PWDCS) was associated with pale gastric mucosa, or superficial ulcers accompained with unobvious redness and swelling. Inversed Gan-qi invading Wei syndrome (IGIWS) was associated with bile regurgitation. Damp-heat stagnating in the middle jiao syndrome (DSMJS) was associated with obvious redness and swollen mucosa, or ulcers accompanied with yellow and white fur. Wei-yin exhaustion syndrome (WYES) was associated with coarse mucosa and exposed blood vessels, or rare mucus. Retention of blood stasis in Wei syndrome was associated with bulged swelling and erosion. Indigestion impairing Wei syndrome (IIWS) was associated with retention of water and food, or more mucus attached. The endoscopic manifestations of PWDCS and DSMJS occurred most frequently, while PWDCS and IGIWS ranked the first place in macroscopic Chinese medical syndrome typing.

CONCLUSIONSThe manifestations of endoscopic features were closely associated with Chinese medical syndrome typing. The syndrome typing features of epigastric pain could be objectively and further grasped by summarizing syndrome typing laws using modern devices such as gastroscopic examinations, thus improving the accuracy of clinical syndrome typing.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastric Mucosa ; pathology ; Gastroscopy ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Pain ; diagnosis ; pathology ; Yang Deficiency ; diagnosis ; pathology ; Yin Deficiency ; diagnosis ; pathology ; Young Adult

OBJECTIVETo screen and determine the regions of copy number variation (CNV) associated with hepatocellular carcinoma (HCC) using SNP array and fluorescence quantitative PCR.

METHODSThe CNV from HCC cell line TJ3ZX-01 was analyzed using GeneChip Human Mapping 500K SNP array. According to the data obtained by SNP array analysis, four candidate amplification regions were verified in 41 primary HCC samples by fluorescence quantitative PCR.

RESULTSFour regions of copy number amplification at 1q21.2, 1q22 approximately 23.1, 7p22.1 and 22q13.1 were detected by SNP array analysis. The four candidate amplicons occurred in 56.1% (23/41) of HCC samples at 1q21.2; 80.5% (33/41) at 1q22 approximately 23.1; 75.6% (31/41) at 7p22.1 and 31.7% (13/41) at 22q13.1 analyzed with sequence tagged site (STS) markers by quantitative PCR.

CONCLUSIONIn four candidate amplification regions selected by SNP array analysis and detected by fluorescence quantitative PCR, three amplification regions show increased copy number in more than 50.0% HCC tissues. This result indicates that these amplification regions are associated with pathogenesis of hepatocellular carcinoma.

Carcinoma, Hepatocellular ; genetics ; pathology ; Cell Line, Tumor ; Chromosomes, Human, Pair 1 ; genetics ; Chromosomes, Human, Pair 22 ; genetics ; Chromosomes, Human, Pair 7 ; genetics ; DNA Copy Number Variations ; genetics ; Female ; Humans ; Liver Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Polymerase Chain Reaction ; methods ; Polymorphism, Single Nucleotide ; Sequence Tagged Sites

Objective To assess the relationship between the BMI and the brain DAT, and the influence of BMI on the brain SPECT imaging with 99Tcm-TRODAT-1. Methods MRI and 99Tcm-TRODAT-1SPECT imaging were performed in 31 healthy volunteers(16 males and 15 females), and then the three-dimensional reconstruction of SPECT images were completed. Based on the MRI images, right striatum (RST) and the left striatum (LST) were drawn as ROI on the 4 most clearly consecutive transverse slices.The cerebellum (CB) was taken as the background reference area and the corresponding uptake ratios of ST/CB, LST/CB and RST/CB were calculated. The Pearson correlation tests for radio-uptake ratios (ST/CB, LST/CB, RST/CB), BMI and age were performed, Then multiple linear regression analysis using ST/CB as dependent variable and BMI and age as independent variables was performed. SPSS 15.0 was used in data analysis. Results The ST imaging was symmetrical. The radioactivity was higher in the ST front area than that of the back area. The average uptake ratios of ST/CB, LST/CB, RST/CB were 1.71±0.16,1.70 ± 0. 16 and 1.72±0.17 respectively, in which the three ratios of the female were 1.74 ± 0. 18, 1.71±0. 19 and 1.76 ± 0. 19 respectively and those of the male were 1.68 t 0. 14, 1.68 ± 0. 13 and 1.69± 0.15respectively. ST/CB, LST/CB and RST/CB were negatively correlated with patients'BMI (r = -0. 53,-0.57,-0.47, all P＜0.05). The ST/CB was negatively correlated with patients' age(r=-0.39, P=0. 03). The multiple linear regression analysis showed that the BMI was significant independent variable (β=-0.53, t= -3.36, P=0. 002). Conclusions TheSTDAT,evel may decrease as patients' BMI and age increase. Females' DAT level is slightly higher than males'. For ST DAT imaging, age, gender and BMI should be all taken into consideration.

Objective To investigate the discrepancy of aldosterone synthesis process and potential regulation abnormality between aldosterone-producing adenoma(APA) and normal adrenal(NA) with microarray. Methods cRNA probes labelled with biotin were prepared from mRNA of APAs(APA group,n=10) or NAs(control group,n=7).The probes were hybridized with oligonucleotide microarray of target gene expression profile.Expression levels were read from the fluorescent intensity scanned.The difference of gene expression profile was analyzed by computer software.Differentially expressed genes were verified by real-time RT-PCR. Results Compared with control group,97 genes were up-regulated and 168 genes were down-regulated in APA group.In the genes related to steroid hormone synthesis,only CYP11B2 was significantly up-regulated.In the physiologic regulators of aldosterone synthesis,CYB5A,CYP17A1,DUSP1 and HMGCR were down-regulated,while RENBP and NR1H2 were up-regulated.As a key enzyme in the biosynthesis of cortisol,the expression of CYP17A1 gene was inhibited. Conclusion Among the aldosterone synthesis related enzyme and corresponding regulatory genes in APA,CYP11B2 may be a key synthetase,and the suppressed physiologic regulators of aldosterone synthesis may indicate the existence of neoplastic modulation.

OBJECTIVETo discuss the risk factors of splenic arterial steal syndrome (SASS) after orthotopic liver transplantation.

METHODSTwenty-four cases who confirmed SASS after liver transplantation in Tianjin First Central Hospital between June 2005 and June 2013 were analyzed retrospectively. Another 96 cases were selected randomly from those patients of the same time with no complication of SASS patients postoperatively as control group. Clinical data of two groups including diameter of splenic artery and hepatic artery preoperatively, weight of graft, weight of recipients, cold/warm ischemia time, an hepatic period and operation time and so on were collected. Others including hepatic artery peak systolic velocity (PSV), end diastolic velocity (EDV), blood flow resistance index and portal vein average velocity (PVF) on the first day after liver transplantation, the day before diagnosis, the day when diagnosed, the 1, 3, 7 days after treatment in SASS group and on 1, 3, 7, 9, 11, 14 days after liver transplantation in control group. Statistical analysis were made between two groups.

RESULTSThe splenic artery/hepatic artery ratio preoperatively and weight of donor liver,and the GRWR in SASS group and control group were 1.26 and 1.00, 1 032 g and 1 075 g, (1.40±0.30)% and (1.82±0.21)% respectively, with significantly statistical differences (Z=-6.40, Z=-2.22, t=-6.50; all P<0.05). The warm ischemia time, the cold ischemia time, the anhepatic period and operation time in SASS group and control group were 3.5 minutes and 4.0 minutes, 10.25 hours and 10.10 hours, 43 minutes and 45 minutes, 8.7 hours and 8.7 hours, with no significantly statistical differences (all P>0.05). RI of hepatic went up gradually in the early time after transplantation while dropped obviously when spleen artery spring coils embolization was received (P<0.01) and trended to stable two weeks later.

CONCLUSIONSSplenic artery/hepatic artery ratio and GRWR are the positive and negative risk factors respectively for SASS. The gradual rising of hepatic RI in the early time after transplantation may be the warning signal SASS and spleen artery spring coils embolization is the effective strategy for SASS after liver transplantation.

Cold Ischemia ; Embolization, Therapeutic ; Hepatic Artery ; pathology ; Humans ; Liver ; surgery ; Liver Transplantation ; adverse effects ; Retrospective Studies ; Risk Factors ; Spleen ; blood supply ; Splenic Artery ; pathology ; Vascular Diseases ; epidemiology ; Warm Ischemia

Objective To investigate the efficacy and safety of paroxe-tine combined with low dose of quetiapine in the treatment of generalized anxiety disorder.Methods One hundred and forty patients with gener-alized anxiety disorder were randomly assigned to treatment group ( parox-etine combined with low dose of quetiapine group , n =71 ) and control group ( paroxetine group , n =69 ).The efficacy was assessed by the Hamilton rating scale for anxiety ( HAMA ) , the Treatment Emergent Symptom Scale ( TESS ) for side effects , and Pittsburgh sleep quality in-dex(PSQI)for sleep qualities of all participants at baseline and at the end of 1st, 2nd, 4th, 6th, 8thweek.Results There were no significant differ-ences between two groups at cure rate ( 70.4%/68.1%) , notable im-provement rate ( 15.5%/13.0%) , progress rate ( 8.5%/10.1%) , and ineffective rate ( 5.6%/8.7%) overall the treatment course.Compare with the baseline , the treatment group showed notable decrease of HAMA at the 1 st weekend ( P<0.05 ) , and the control group showed that at the 2nd weekend (P<0.05).The treatment group had a more significant de-crease than the control group at the 1st, 2nd, and 4th week end(P<0.05 or P<0.01 ).The psychic anxiety score of the treatment group at the 1st, 2nd, 4th weekend and the somatic anxiety score at the 2nd, 4th weekend showed significant decrease ,compared with the control group ( P<0.05 or P<0.01 ).Both of the two group had no serious adverse events.Conclusion Paroxe-tine combined with low dose of quetiapine is an effective and safe way to treat generalized anxiety disorder , and patients have good compliance under the treatment.