0bjective To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals.Methods A cross-sectional investigation was used to screen the outpatients,and depression was diagnosed according to Mini International Neuropsyehiatric Interview (MINI).Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics.Results Among 248 cases of depression,30(12.1%)were referred to psychiatrists,28(8.9%)managed with antidepressant or sedative hypnotics.The identification rate of depression by physicians was 21.0%.and the identification rate by neurologist was 40.4%,which is higher than the rate by cardiologist(22.4%),gastrointestinal physician(3.8%)and gynecologist(2.0%)(χ2=61.077,P<0.05).Visiting neurology department,severity of life impairment,with psychotic distress history,hadpsychological complaints.co-morbidity with anxiety related to the physician's identification of depression.Among the psychological complaints.only mood disorder and insomnia were related to the physician'sidentification of depression.Conclusions The level of depression identification by physician was low,the level of neurologist wag higher than that of cardiologist,gastrointestinal physician and gynecologist.The patient with serious life impairment,psychotic distress history,mood disorder and insomnia complaints was asily to be identified.

Objective To evaluate the clinical results of free vascularized fibular associated with iliac graft in treatment of old femoral neck fracture.Methods From 1994 to 1997,76 cases of old femoral neck fracture were treated with free vascularized fibular associated with iliac graft,they were followed up for observ- ing fracture healing,hip function and femoral head necrosis.Results Sixty-eight of these 76 cases were fol- lowed up with detail data with the main term as 10.5 years.All fractures healed within 4 to 6 months.63 cases got a almost normal hip function with the Harris score was 87.5,in these cases,the structure of femoral head were normal and the grafted fibular and iliac bone healed with the femoral.4 cases got to femoral head necrosis and 1 experienced hip dislocation.Conclusion Free vascularixed fibular associated with iliac graft is a good method to treat these cases with old femoral neck fracture who want reserve their femoral head.

Myelodysplastic syndrome (MDS) is one of the most prevalent haematological malignancies originating from haemopoietic stem/progenitor cells. MDS characterized by morbid haematopoiesis of bone marrow and peripheral blood cell reduction and mainly occurs in the elders. The dangerous factors of MDS include chemotherapy, radiotherapy, benzene, other organic solvent, immune depressants and so on. Following the recent progress of medical sciences, a large number of new regimens of chemotherapy, radiotherapy and immune therapy against carcinomas generate and lead the development of therapeutics for malignancies. It is worried that the incidence of MDS still increases year by year and the patient age becomes younger. Although many agents are used to MDS, curative effect is not as good as expect. Amifostine, a kind of pancytoprotector also used in treatment of MDS. This review summarizes the mechanism of amifostine in MDS therapy which possesses a challenge binding with the current related investigations.
Amifostine ; therapeutic use ; Humans ; Myelodysplastic Syndromes ; drug therapy ; Radiation-Protective Agents ; therapeutic use

OBJECTIVETo find sensitive and specific micro-metastic markers for prostate cancer.

METHODSUsing nested reverse transcription-PCR, we examined the expression of PSA, hK2 and PSMA mRNA in peripheral blood mononuclear cells of 51 patients with prostate cancer, 33 patients with benign prostate hyperplasia (BPH) and 32 normal young people.

RESULTSThe expression rates of PSA, hK2 and PSMA mRNA were 52.9%, 43.1% and 64.7%, respectively in prostate cancer group, and 6.2%, 7.7% and 4.6%, respectively in control group (BPH patients and normal young people) with statistical significance (P < 0.01). Although the expression rate of PSA and hK2 mRNA increased with cancer progression, there was no statistical significance among patients in different stages. The expression rate of PSMA mRNA was higher than that of PSA and hK2 mRNA in each clinical stage.

CONCLUSIONPSMA mRNA expression detected by nested RT-PCR is of greater value for the diagnosis, therapy choice and prognostic evaluation of prostate cancer patients.

Aged ; Antigens, Surface ; blood ; Biomarkers, Tumor ; blood ; Glutamate Carboxypeptidase II ; blood ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; pathology ; Prostatic Neoplasms ; blood ; pathology ; Tissue Kallikreins ; blood

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.

OBJECTIVETo detect the COL1A1/PDGFB fusion transcripts and discuss its clinicopathological significance in dermatofibroscoma protuberans.

METHODSFormalin fixed, paraffin-embedded tumor specimens from 12 patients with DFSP were reviewed by light microscope and the expression of COL1A1/PDGFB mRNA resulting from the reciprocal translocation t(17;22) (q22;q13.1) was detected by one-step revers transcriptase-polymerase chain reaction. The following tumor specimens were included as controls: 2 fibrosarcoma, 2 malignant fibrous histocytoma, 3 leiomyosarcoma, 1 dermarofibroma and 1 nerve shealth tumor.

RESULTSThe COL1A1/PDGFB fusion transcripts were detected in 8 (67%) of 12 samples from patients with DFSP. Nucleotide sequence analysis using the PCR products confirmed that different regions of the COL1A1 gene, respectively, were fused with of PDGFB gene. No COL1A1/PDGFB fusion transcripts were detected in the control tumors.

CONCLUSIONDetection of specific COL1A1/PDGFB fusion transcripts in DFSP will help to diagnose the nature of DFSP and research the mechanism of its molecular histogenesis.

Adolescent ; Adult ; Aged ; Child ; Collagen Type I ; genetics ; Dermatofibrosarcoma ; genetics ; Female ; Genes, sis ; Humans ; Male ; Middle Aged ; Paraffin Embedding ; RNA, Messenger ; analysis ; Recombinant Fusion Proteins ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Skin Neoplasms ; genetics

OBJECTIVETo investigate the relationship among serum reproductive hormone levels, serum homocysteine (Hcy) levels, metabolic syndrome (MS), and the components of MS in middle-aged and elderly males.

METHODSUsing the cluster and stratified sampling methods and a unified structured questionnaire, we conducted a survey among 948 men aged 40 - 80 years in the rural community, measured their basic physical parameters, and obtained their reproductive hormone levels, serum Hcy concentrations, and metabolism-related indicators. We collected 868 valid questionnaires along with their serum samples, divided the subjects into an MS and a non-MS control group in a 1:1 ratio, and measured their serum Hcy concentrations.

RESULTSAmong the subjects included, 132 were diagnosed with MS. Nonparametric tests showed statistically significant differences between the MS and non-MS groups in the waist circumference (WC), waist-hip ratio (WHR), body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) (P < 0.05), but not in age (P > 0.05). Significant differences were also observed between the two groups in the levels of serum tT, SHBG, LH, and FTI (P < 0.05) , but not in the concentrations of serum Hcy (P > 0.05). The concentration of serum Hcy exhibited no correlation with BMI, SBP, DBP, FBG, TG, and HDL-C (P > 0.05) and had no influence on MS.

CONCLUSIONThe concentration of serum Hcy is not significantly correlated with MS, nor with its components. The levels of male serum reproductive hormones are associated both with MS and with its components.

Adult ; Aged ; Blood Pressure ; Body Mass Index ; Homocysteine ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Metabolic Syndrome ; blood ; diagnosis ; Middle Aged ; Reproduction ; Rural Population ; Sex Hormone-Binding Globulin ; metabolism ; Surveys and Questionnaires ; Testosterone ; blood ; Thyroxine ; blood ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVETo explore the brain natriuretic peptide (BNP) on prognostic value in patients with viral myocarditis.

METHODSA total of 48 patients with viral myocarditis and 42 healthy people were enrolled and followed up for two years. The NYHA class and LVEF were recorded and the concentration of BNP were measured.

RESULTSThe concentration of BNP were higher and EF were lower in patients with viral myocarditis (P < 0.01) than contrast people. Higher levels of plasma BNP were related to higher mortality.

CONCLUSIONLevels of brain natriuretic peptide measured in the plasma could be a useful biochemical marker for the myocarditis, and high concentration of BNP may correlate with poor prognosis in patients with myocarditis.

Adolescent ; Adult ; Biomarkers ; blood ; Child ; Female ; Humans ; Male ; Middle Aged ; Myocarditis ; blood ; mortality ; physiopathology ; Natriuretic Peptide, Brain ; blood ; Prognosis ; Ventricular Function, Left ; Virus Diseases ; blood ; mortality ; physiopathology

Idiopathic thrombocytopenic purpura (ITP) is a common hematological disease. It bleeds with peripheral blood platelet reduction as the main clinical manifestation, and manifests a chronic history in adult people. 11% - 35% ITP patients develop into a refractory course, which may be related with gene polymorphisms. There is currently no consensus on how best to manage refractory/relapsed ITP. In part, this reflects the need for individualized treatment due to the patients' requirements and their responsiveness to therapies. The objective of this review is to provide a clinically useful guide to current management strategies. This article summarizes all the treatment for refractory ITP, and highlights new therapies, including the anti-CD20 antibody, thrombopoietic agents, TPO receptor agonist and HSCT. The pancytoprotector shows good effect in the treatment of refractory and relapsed ITP in China. In a word, to give different treatments individually is most important.
Adult ; Humans ; Precision Medicine ; methods ; Purpura, Thrombocytopenic, Idiopathic ; therapy ; Recurrence

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4(+) helper T lymphocytes (Th1/Th2) and human leukocyte antigen (HLA)-DR expression on CD14(+) monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein (CRP) were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14(+) monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.
Aged ; Aged, 80 and over ; Cytokines ; immunology ; Female ; Humans ; Hyperglycemia ; drug therapy ; immunology ; Hypoglycemic Agents ; therapeutic use ; Immunity, Innate ; drug effects ; immunology ; Immunologic Factors ; immunology ; Insulin ; therapeutic use ; Male ; Treatment Outcome ; Wounds and Injuries ; drug therapy ; immunology