Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD) ,and explore the correlation between them.Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116).TABP,Social Support Scale, MMSE, NIHSS,mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80);fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls (NC group).Results (1) The incidence of acute PSD was 31.03％.(2)The constituent ratio of type A behavior(83.33％ vs 57.50％), CH scores, TH +CH scores were significantly higher in PSD group than NPSD group(P＜0.01).Social Support Scale scores,MMSE scores were significantly lower in PSD group than NPSD group(P＜0.01, P＜0.05).NIHSS scores,mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P＜0.01).(3) The levels of serum BDNF,hs-CRP in the PSD group,the NPSD group and the normal control group were respectively (BDNF (617.24(274.98,976.22)) pg/ml, (938.19(615.88,1 714.76)) pg/ml, (4 149.46(1 658.83,7 583.34)) pg/ml);(hs-CRP(6.47(2.66,11.21)) mg/L, 1.77(0.74,6.51) mg/L, (0.86(0.47,1.59)) mg/L).The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group (P＜0.01).(4) The severity of depression was positively correlated with CH,TH+CH scores(r=0.38, P＜0.05;r=0.43, P＜0.01).CH scores were negatively correlated with social support(r=-0.38, P＜0.05),and were positively correlated with hs-CRP levels(r=0.34, P＜0.05).Conclusion In patients with post stroke depression,the BDNF levels decrease and hs-CRP levels increase,but severity of depression and cognitive function are not correlated with BDNF levels.Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support.Hostility and excessive competition are psychosocial risk factors occurring PSD.

Objective To evaluate clinical risk factors that can predict brain metastasis after complete resection of small cell lung cancer (SCLC) and to assess the role of prophylactic cranial irradiation (PCI) in such kind of patients.Methods Eighty-eight patients with completely resected stage Ⅰ - Ⅲ SCLC from Jan.2000 to Dec.2009 in our hospital were retrospectively analyzed.Kaplan-Meier was used to compare the differences in the incidence of metastasis free survival in different groups.Logistic model was used to assess the independent risk factors for brain metastasis.Results The follow-up rate is 100％,and 37 patients were followed up for more than three years.None of the 3 patients who received PCI developed brain metastasis,while for patients without receiving PCI,24％ developed brain metastases.The incidence of brain metastasis for stage Ⅰ,Ⅱ and Ⅲ SCLC after surgery were 4％,26％ and 29％ ( x2 =7.57,P =0.023),respectively.The median survival time and the 3-year survival rate were 18 months and 25％ for patients who developed brain metastasis,and 48 months and 59％ for those without brain metastasis ( x2 =10.63,P =0.001 ).Both univariate and multivariate analyses showed that pre-treatment disease stage wasindependent risk factor for brain metastasis ( x2 =7.57,8.52 ; P =0.023,0.004 ).Age,sex,tumor location,pathological type,induction chemotherapy,and postoperative chemotherapy/radiotherapy were not significantly correlated with the incidence of brain metastasis ( x2 =0.03,0.00,0.00,2.58,0.01,1.23,0.84;P =0.869,0.998,0.992,0.109,0.936,0.266,0.361,respectively).Conclusions Pre-treatment disease stage was independent risk factor for brain metastasis in SCLC.PCI may be important for stage Ⅱ -Ⅲ SCLC but not for stage Ⅰ disease.<英文关键词>=Carcinoma,small cell lung/surgery; Neoplasm metastasis,brain/prophylactic irradiation; Factors analysis

Objective:To explore therapeutic effects of sodium nitroprusside (SNP) combined verapamil on no-reflow during percutaneous coronary intervention (PCI).Methods: A total of 106 patients, who suffered from no-reflow during PCI in our department from Jan 2011 to Dec 2013, were selected.According to random number table method, patients were divided into SNP group (n=55, received SNP based on routine treatment) and combined treatment group (n=51, received verapamil based on SNP group).Cardiac troponin I (cTnI) level before and 16h~18h after PCI, cardiac function indexes after 12-month follow-up, incidence of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before PCI, there were significant rise in cTnI level in both groups on 16~18h after PCI, P=0.001 both;compared with SNP group, there were significant reductions in cTnI level [(1.31±0.44)μg/L vs.(0.11±0.02)μg/L] and percentage of cTnI>0.10μg/L (94.5% vs.54.9%) in combined treatment group, P=0.001 both.Compared with SNP group after 12 months, there was significant rise in left ventricular ejection fraction [(62.29±3.06)% vs.(65.65±3.94)%], and significant reductions in left ventricular end-diastolic dimension[(50.24±3.73)mm vs.(47.60±4.72)mm] and left ventricular end-systolic dimension [(33.29±2.11)mm vs.(31.00±4.33)mm] in combined treatment group, P<0.05 all.There were no significant adverse reactions during hospitalization and follow-up in both groups.Conclusion: When no-reflow occurs during PCI, intracoronary injection of SNP combined verapamil can improve cardiac function, and its safety is good, which is worth extending.

OBJECTIVETo study the effects of Chaiqiyigan Granula (CG) and Taxol on the growth of hepatocellular carcinoma (HCC) xenografts and expression of Bax, p53 and VEGF in nude mice.

METHODSWhole-body fluorescence imaging was used to visualize the growth of HCC in nude mice bearing hepG2/EGFP cell xenograft. Immunohistochemistry was used to determine the content of Bax, p53 and vascular endothelial growth factor (VEGF) in the tumor tissues.

RESULTSCompared with normal saline, Taxol alone and in combination with CG significantly inhibited the growth of HCC xenografts in the nude mice. The combined treatment with CG and Taxol produced a stronger inhibitory effect on the tumor growth than Taxol alone in the third and fourth weeks. The volume and weight of the xenografts were decreased in the combined treatment group compared with those in saline treatment group. CG combined with Taxol increased the expression of Bax and reduced the expression of p53 and VEGF in the tumor xenografts.

CONCLUSIONCG can enhance the inhibitory effects of Taxol on the growth of HCC xenografts, and this effect is related to the up-regulation of Bax and down-regulation of p53 and VEGF expression in the tumor.

Animals ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Mice ; Mice, Nude ; Optical Imaging ; Paclitaxel ; pharmacology ; Tumor Suppressor Protein p53 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays ; bcl-2-Associated X Protein ; metabolism

Objective To explore the effects of solution-focused approach on improving negative emotions among chronic subdural hematoma patients with trepanation and drainage.Methods From January to December 2017,a total of 100 chronic subdural hematoma inpatients in Beijing Tiantan Hospital of Capital Medical University were divided into control group and observation group by the random number table,50 cases in each group.Control group carried out routine nursing.On the basis of that in control group,observation group provided health education by five-step of solution focused approach.Patients of two groups were evaluated with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) on admission and at discharge.Results The scores of SAS and SDS of patients in observation group were (35.00±5.222) and (37.28±5.091) respectively at discharge lower than those [(38.40±6.550) and (41.26±7.001)]in control group with significant differences (P＜0.05).Conclusions Solution-focused approach can improve negative emotions among chronic subdural hematoma patients with trepanation and drainage.It is worth to be popularized and applied in clinic.

Objective:To construct Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on Delphi method, providing a basis for early prediction and assessment of the risk of hyperoxemia in patients after cardiac surgery. Methods:A research team was established. Based on the characteristics of extracorporeal circulation cardiac surgery, the Chinese and English literature published by each database until October 2022 was retrieved and the opinions of relevant professional clinicians were combined to screen the risk factors of hyperoxemia in patients after cardiopulmonary bypass heart surgery, and the preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was drawn up. The Delphi method was used to conduct two rounds of expert letter consultation to supplement and improve the initial draft and finally established the final draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery. Results:The preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was constructed according to the literature review and the opinions of relevant professional clinicians, which contained 4 dimensions and 21 items. A total of 14 experts were consulted by letter, including 5 senior titles and 9 associate senior titles. Six of them major in critical care and the other eight major in cardiovascular surgery. The effective response rates for the two rounds of questionnaire surveys were 100% and 85.71%, expert familiarity levels were 0.81 and 0.80, judgment coefficients were 0.94 and 0.92, respectively. Expert authority coefficients were both 0.86. Coefficients of variation for the importance and feasibility items in the two rounds ranged from 0.13 to 0.32 and 0.11 to 0.32, 0.06 to 0.26 and 0.06 to 0.35, respectively. The Kendall's W for importance and feasibility in the two rounds were 0.264 and 0.162, and 0.258 and 0.144 respectively, indicating statistically significant (all P < 0.05). After two rounds of expert consultations, a comprehensive evaluation and selection process resulted in the final establishment of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery, consisting of 4 dimensions and 23 items, which included general data, past history, operation-related data and postoperative data. Conclusion:The Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on the Delphi method is highly scientific and feasible, which can provide reference for clinical assessments of the risk of hyperoxemia in such patients.

Objective To realize the distribution and characteristics of Mycobacterium leprae (M.leprae) species and its single nucleotide polymorphisms (SNPs) spreading currently in China.Methods A total of 171 cutaneous lesion specimen of leprosy patients from 22 provinces were collected.The 16S rRNA conservative region of Mycobacterium leprae was amplified by nest PCR and the positive products were sequenced directly and aligned by BLAST.The SNPs of M.leprae were genotyped by restricted fragment length polymorphism for the PCR products.Results The 171 specimen were all Mycobacterium leprae since the amplified fragments of DNA samples were 99％ similar to the Br4923 of M.leprae from Brazil.No new species (M.lepromatosis) was found.Among the 85 samples genotyped for SNPs,SNP3,SNP1 and SNP2 accounted for 78.8％ (67/85),20％ (17/85) and 1.2％ (1/85) respectively.There was no sample with SNP4 genotype to be detected.Among the 171 sequencing specimen,130 showed mutation C-T at 251 bp of 16S rRNA.There was no difference for mutant rate of 16S rRNA gene and SNP genotype among the samples with different clinical pathological types.Certain associations between 16S rRNA C251T mutation and SNP genotype were found.Most of the samples with C251T mutations of 16S rRNA sequence were SNP3,only a few were SNP1 but not SNP2.There was significant difference of SNP genotype distribution among the patients from different regions.The distribution rate of SNP3 genotype in the samples from inland region (97.1％,34/35)was significantly higher than that from coastal region (66％,33/50) (x2 =11.96,P ＜ 0.01) . There was significant difference of the gene mutation rate of 16S rRNA sequence among the patients from different regions.The mutation rate of 16S rRNA in the samples from inland region (94.8％,92/97) was significantly higher than that from coastal region (51.4％,38/74) (x2 =43.56,P ＜0.01).Conclusion C251T mutation in 16S rRNA gene sequence of M.leprae may associate with SNP type suggesting that the characteristics of geographical distribution presented in different genotypes of M.leprae.No new species of M.leprae was found in this study.

Post-intensive care syndrome (PICS) is the most common complication in patients discharged from intensive care unit (ICU), which seriously affects the life quality of the patients. At present, there is still lack of standardevaluation methods for PICS. Continuous and dynamic assessment can earlyidentify PICS, moreover, early identification and intervention of PICS can improve the life quality of patients those patients, which is critical to improve the long-term outcome of the patients. In this paper, we reviewed the current research states of evaluation timing, contents, tools and modalities of PICS domestic and abroad, analyzed the problems and prospects of the existing evaluation methods, aiming to provide a reference for clinical staff to effectively and comprehensively evaluate PICS.

Objective:To clarify the operational definition of ICU cognitive impairment, so as to provide a reference for accurate assessment of ICU cognitive impairment.Methods:ICU cognitive impairment was conceptually analyzed by the conceptual analysis framework in the Construction Strategy of Nursing Theory (Fifth Edition). The studies about cognitive function of critical illness patients in PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang, Chinese Biomedical Database, and VIP were searched. The search time limit was from the establishment of the database to August 2021. Literature screening and data extraction were performed independently by two researchers.Results:A total of 5 754 articles were obtained, and 48 articles were finally included. Obtained 20 concepts and 9 commonly used assessment tools related to ICU cognitive impairment. Identifying the defining attributes, conceptual causes, and outcomes of ICU cognitive impairment.Conclusions:The operational definition of ICU cognitive impairment is determined, which is conducive to a comprehensive and intuitive understanding of the concept of cognitive impairment in ICU and accurate evaluation of cognitive impairment in ICU.

Objective To investigate the diagnostic value of hypersensitive troponin I (hs-cTnI) , homocysteine (Hcy) , hypersensitive C-reactive protein (hs-CRP) and calcitonin (PCT) detection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods Ninety-six patients with AECOPD were enrolled in this study.50healthy subjects were included in the healthy control group.Hs-cTnI was measured by electrochemiluminescence, Hcy level was measured by circulating enzyme method, hs-CRP level was determined by immunoturbidimetry, and colloidal gold blotting was performed.PCT levels, correlation analysis using Pearson correlation analysis, analysis of the correlation between the indicators and AECOPD, using ROC curve analysis of hs-cTnI, Hcy, hs-CRP, PCT diagnosis COPE acute exacerbation curve area (AUC) .Results The levels of hs-cTnI, hs-CRP and PCT in the AECOPD group were higher than those in the healthy control group (P<0.05) .The Hcy in the AECOPD group was lower than that in the healthy control group.The difference was not statistically significant (P>0.05) .Pearson correlation analysis shows that hs-cTnI, hsCRP and PCT were positively correlated with AECOPD (r=0.346, 0.401, 0.509) , and Hcy had a poor correlation with AECOPD (r=0.078) .In the ROC curve analysis, the area under the curve (AUC) for hs-cTnI, hsCRP, and PCT were 0.825, 0.834, and 0.922, respectively, The best diagnostic cut-off values were:0.082, 18.25, 3.075, and the sensitivities were 0.823, 0.802, and 0.781, respectively.The specificities were:0.92, 0.62, and 0.94.Youden′s index was 0.743, 0.422, and 0.721, respectively.The kappa values are:0.699, 0.423, 0.664.Conclusion The detection value of Hcy in the diagnosis of AECOPD is low.The detection of hs-cTnI, hsCRP and PCT has a certain diagnostic value in AECOPD.It can be used as an auxiliary diagnosis index of AECOPD.