Humans ; Hypertension, Portal ; etiology ; therapy ; Liver Cirrhosis ; complications ; therapy ; Portasystemic Shunt, Transjugular Intrahepatic

Objective To study on the cross-cultural adjustment and application of the Death Anxiety Scale based on the national culture and establish the Chinese version of this scale.Methods Through cross-cultural adaptation and formal investigation,the Chinese version of Death Anxiety Scale was established.A cross-sectional study was conducted among 450 medical college students and 50 hospice workers with multiple diagnoses to validate the Chinese version of the Templer's Death Anxiety Scale (T-DAS),after 7to 10 days,60 of them were retested.Reliability and validity of the Chinese version of Templer's Death Anxiety Scale (T-DAS)were evaluated according to the data.Results The Chinese version of the Templer's Death Anxiety Scale(T-DAS)was easy to understand.Most respondents finished the whole scale in 5 to10 minutes,and the effective recover rate of the scale was 97.4％.The correlation between the T-DAS and the single item test for the death anxiety was 0.516.Structural equation models and factor analysis displayed good construction of the T-DAS.The internal consistency reliability evaluated by Cronbach'α was 0.71 for the whole 15 items.The retest reliability was 0.831.Conclusions Based on the analysis,the Chinese version of the T-DAS has good reliability and validity,and should be a good instrument for the evaluation of the death anxiety.

Objective To investigate the effect of 20‐HETE on the isolated myocardial ischemia reperfusion injury and to ex‐plore its underlying mechanisms .Methods Experiments were performed in isolated rat hearts subjected to 35 min of ischemia fol‐lowed by 40 min of reperfusion in Langendorff preparations .HET0016 (1 μmol/L) and various concentrations (10 ,30 or 50 nmol/L) of 20‐HETE were infused 10 min before the onset of ischemia and throughout the reperfusion period .Cardiac hemodynamic changes and myocardial contractility were continuously recorded with the Powerlab /8P system .Myocardial infarct size was meas‐ured by TTC staining .The level of ROS and the protein carbonyl content were determined by DHE fuorescence and DNPH method , respectively .Results Perfusion with HET0016 significantly improved myocardial ischemia reperfusion injury reduction in cardiac contractility ,after inhibited the production of 20‐HETE significantly reduced the occurrence of myocardial infarction area (P<0 .05) ,but exogenous join 20‐HETE aggravated I/R‐induced myocardial injury (P<0 .05) .Myocardial ischemia reperfusion injury significantly increased production of ROS and oxidative stress ,both of which were significantly inhibited by HET 0016 and enhanced by 20‐HETE administration(P< 0 .05) .Conclusion 20‐HETE stimulates ROS production and enhance protein carbonylation , which aggravates myocardial ischemia reperfusion injury .

Objective To investigate the expression of FOXO3a and MMP 9 in colorectal cancer tissues and their relationship . Methods Tissue microarray and immunohistochemical SP methods were used to detect the expression of FOXO 3a and MMP 9 in 78 cases of colorectal cancer tissues and 69 cases of corresponding normal intestinal mucosa tissues ,then analyze the relation be-tween their expression and the clinicopathologic parameters of the patients ,and the relation between the expression of FOXO3a and MMP 9 .Results (1)The positive expression rate of FOXO3a in 78 cases of colorectal cancer tissues and 69 cases of normal intesti-nal mucosa tissues are 57 .69% (45/78)and 95 .65% (66/69) ,the positive expression rate of MMP 9 in 78 cases of colorectal cancer tissues and 69 cases of normal intestinal mucosa tissues are 85 .90% (67/78) and 15 .94% (11/69) ,and the difference is significant (P=0 .000) .(2)The decreased expression of FOXO3a and the increased expression of MMP 9 in colorectal cancer are significantly correlated with the depth of tumor invasion ,tumor histological differentiation ,metastasis of lymph node and TNM stage (P<0 .05) ,but there is no significant relationship with patients′age ,gender and tumor size (P>0 .05) .(3)There was a negative corre-lation between the expression of FOXO3a and MMP 9 (r=0 .272 ,P<0 .05) .Conclusion The decreased expression of FOXO3a and the increased expression of MMP 9 may be closely related with carcinogenesis ,invasion and metastasis of colorectal cancer ,and their combination may be an important indicator to evaluate the malignant degree and prognosis of the colorectal cancer .

Objective To compare the complications of end colostomy and loop colostomy for preventive colostomy,then to evaluate which one is superior to the other.Methods Studies and relevant literatures comparing end colostomy with loop colostomy for defunctiong colostomy were searched by PubMed,Springer and Embase Library.The rates of complications were pooled and compared using a Meta analysis.The risk ratios were calculated with 95％ confidence intervals to evaluate the safety and efficacy of each teachnique.Results Six nonrandomized studies were included,with 1999 patients in total.The Meta-analysis of the non-randomied studies showed a lower risk of stoma retraction (RR:0.21,95％ CI:0.04 ～ 0.99,P =0.05) and stoma prolapse (RR:0.23,95 ％ CI:0.05 ～0.99,P =0.05) in the end colostomy group,but the higher risk of ischemia and necrosis (RR:5.08,95％ CI:1.94 ～ 13.22,P =0.05).No other statistically significant difference was observed for other complications.Conclusions Each type of defuncyioning stoma has its advantages and disadvantages.The study endorses end colostomy stoma over loop colostomy.However,there is not a strong evidence for the superiority of one colostomy over another for colostomy patients.So,large scale RCTs and high quality studies are needed.

Objective:The paper aims to provide recommendations for improving the essential medicines’ cen-tralized bidding procurement and quantity-based pricing policy. Methods: Based on the documents and literature on essential medicines’ centralized bidding procurement, we analyzed the factors which have a great impact on implemen-tation of the quantity-based pricing in essential medicines’ centralized procurement using the text research, semi-structured interview questionnaire and on-phone interviews. Results:The quantity-based pricing needs to define a ge-neric name and specific dosage form of drugs in the essential medicines’ centralized procurement. Its implementation was mainly influenced by the following factors:the procurement area accessibility, the pharmaceuticals category, dis-ease and drug alternative procurement methods and cycle, the payment and settlement time, and irregularities in the procurement process. Suggestions:During this implementation, we also need to clearly predict the quantity and pro-curement method, set up a proper policy environment for a quantity-based pricing, cancel the price linkage mecha-nism, strictly put into practice the payment deadline, employ a unique billing method and strengthen the information construction for the provincial centralized procurement platform. Some medicines’ quantity-based pricing should be carried out in the chosen pilots for laying a good foundation for its promotion.

Objective To compare the consistency between interstitial fluid glucose and arterial blood glucose in septic shock patients with different tissue perfusion levels.Methods A prospective investigative study was conducted. Sixty-one septic shock patients with ages above 18 years old admitted to the Department of Critical Care Medicine of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from April 2013 to December 2013 were enrolled. The real-time continuous glucose monitoring system (RTCGMS) and arterial blood gas analyzer were used to measure the patients' interstitial fluid glucose and arterial blood glucose, and according to the criteria of International Organization for Standardization (ISO) and the median of relative absolute difference (Median RAD), the consistency between interstitial fluid glucose and arterial blood glucose was calculated. Based on the lactate (Lac) level and pulse oxygen perfusion index (PI), the septic shock patients were divided into groups with different degrees of tissue perfusion, the consistency between the interstitial fluid glucose and arterial blood glucose among septic shock patients with different degrees of tissue perfusion was compared by using Bootstrap re-sampling technique.Results Negative correlation existed between PI and Lac (r= -0.272,P < 0.001), which showed the opposite change tendency of organism tissue perfusion. In patients with Lac > 8 mmol/L, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with Lac > 2-4 mmol/L, and the 95% credibility intervals (CI) of ISO standardized deviation value was 0.026-38.710 (P < 0.05). In patients with PI ≤ 0.7%, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with PI > 0.7%-1.4%, the 95%CI of median RAD difference value was 0.002-0.076, and the 95%CI of ISO standardized deviation value was -27.000 to -0.583 (allP < 0.05); in patients with PI > 3.0%, their consistency between interstitial fluid glucose and arterial glucose was better than that in those with PI ≤ 0.7%, PI > 0.7%-1.4% and PI > 1.4%-3.0%, and the 95%CI of ISO standardized deviation values were 3.322-28.302, 11.988-40.265 and 5.170-33.333 respectively (allP < 0.05).Conclusions When septic shock patients were under low tissue perfusion (Lac > 8 mmol/L or PI ≤ 0.7%), the worse the tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose; when septic shock patients were under normal local tissue perfusion (PI > 3.0%), the better the local tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose.

Objective: To explore the intervention effect of health education combined with aerobic exercise on adolescent depression,and to provide a reference for depression prevention of adolescents. Methods: A total of 84 adolescent patients with depression in Wuhan Mental Health Center were selected by convenient sampling method. They were divided into two groups according to the order of patients visits (n=42). The control group received routine health education. The experimental group received group health education of emotional intelligence, and cooperated with moderate intensity aerobic exercise. The changes of depression, emotional intelligence and serotonin (5-HT), cortisol and norepinephrine (NE) levels before and after intervention were compared between the two groups. Results: Before intervention, there was no significant difference in scores of Hamilton Depression Scale (HAMD) and Social Disability Screening Schedule (SDSS) between the two groups (t=0.62，1.02，P>0.05). The scores of HAMD and SDSS in the experimental group were significantly lower than those before intervention (t=9.62, 10.05, P<0.05). The scores of HAMD and SDSS in the experimental group were significantly lower than those in the control group (t=-6.95，-7.32，P<0.05). The scores and total scores of emotional perception, self-management and other management in the experimental group after intervention were significantly higher than those before intervention (t=6.54, 7.21, 5.33 ，6.60, P<0.05). The scores of emotion perception, self-management, others’ management and total scores in the experimental group were significantly higher than those in the control group(P<0.05). compared with before intervention, the levels of 5-HT and NE in the experimental group after intervention were significantly higher, the levels of cortisol were significantly lower (t=4.62, 5.36，-16.54, P<0.05)，and the level of 5-HT and NE in the experimental group was significantly higher than that in the control group, and the level of cortisol was significantly lower than that in the control group (t=15.25，8.74，-26.54，P<0.05). Conclusion The implementation of emotional intelligence group health education and aerobic exercise can effectively reduce the level of 5-HT, improve the level of cortisol, enhance the emotional intelligence of adolescents with depression, and alleviate their depressive mood.

Objective To observe the effects of chronic arsenic exposure on estrogen receptor-binding fragment-associated gene 9 (Ebag9) and estrogen-responsive finger protein (efp) mRNA expression in female rat' s myocardium.Methods Fifty female Wistar rats were randomly divided into five groups according to arsenic (As2O3) concentrations in drinking-water:0.00(control),0.05,0.10,0.20,0.40 mg/L groups and RT-PCR was used to detect Ebag9 and efp mRNA expression of myocardium at the 32 weeks of experiment.Results Ebag9 and efp mRNA expression levels in 0.00,0.05,0.10,0.20,0.40 mg/L groups were respectively as follows:0.54 ±0.14,0.52 ± 0.10,0.48 ± 0.24,0.58 ± 0.13,0.45 ± 0.19 and 0.85 ± 0.14,0.86 ± 0.12,0.87 ± 0.09,0.99 ±0.10,0.86 ± 0.19.Compared to the control group,Ebag9 mRNA level of the 0.20 mg/L group was increased,and decreased in other groups,but the difference between two groups was not significant(all P ＞ 0.05).Compared to control group,the efp mRNA level of 0.20 mg/L group increased significantly(P ＜ 0.05),and showed increased tendency in other arsenic groups,but the difference between two groups was not significant (all P ＞ 0.05).Conclusions Ebag9 and efp mRNA expression have changed in myocardium of rats exposed to chronic arsenic.Arsenic may has endocrine disruptor effect to female rat's myocardium.

Objective To evaluate the effect of multiplex polymerase chain reaction(Multiple-PCR) in identification of Brucella strains.Methods Six standard Brucella strains (Brucella abortus,Brucella melitensis,Brucella suis,Brucella canis,Brucella ovis,Brucella neotomae) were used as positive controls and Escherichia coli O∶157 and Yersinia enterocolitica O∶9 were used as negative controls.A total of 29 Brucella strains were tested.Brucella strains were amplified by BCSP31-PCR and the species of Brucella with positive results were identified with Multiple-PCR method.Results The results of all 29 amplified Brucella strains were positive with BCSP31-PCR.The identified results of all Brucella strains were positive with Multiple-PCR,including 20 strains of Brucella melitensis,5 isolates of Brucella suis,3 strains of Brucella abortus and 1 strain of Brucella canis.Conclusion Multiple-PCR method is a rapid,specific,simple and low risk method for identification of Brucella species.