Objective To evaluate the significance of laparoscopy in the diagnosis and treatment of unexplained acute right lower abdominal pain in women. Methods Clinical data of 52 women with unexplained acute right lower abdominal pain from April 1999 to April 2004 were retrospectively analyzed. Results Diagnosis was clarified under laparoscope in all the 52 patients, including 28 cases of acute appendicitis, 18 cases of acute pelvic inflammatory disease, 3 cases of ovarian cyst pediculotorsion, 2 cases of right tubal pregnancy, and 1 case of Crohn’s disease with iliac perforation. With exception of a conversion to open surgery in 3 patients, laparoscopic treatment was successfully completed in the remaining 49 patients. No surgical complications occurred. The patients were discharged from the hospital 2~6 days postoperatively. Conclusions Laparoscopy is a timely, safe and effective alternative for the diagnosis and treatment of unexplained acute lower right abdominal pain in women.

Objective To explore the glomerular change of renin-angiotensin system (RAS) expression in ATIaR gene knockout mice and its effects on extracellular matrix (ECM) remodeling under diabetic condition. Methods ATlaR knockout mice were generated previously. Hyperglycemia was induced by peritoneal injection of streptozotocin in ATIaR knockout mice and wild type mice. Normal AT1aR knockout mice and wild type mice were used as control group. Twelve weeks later, kidneys were harvested and frozen quickly in dry ice-acetone. Glomendi were collected by laser capture microdissection and total RNA was extracted, mRNA expression of AT1aR, AT1bR, AT2R, angiotensinogen, ACE, renin, and CYP11B2 was assessed by real-time PCR. ECM accumulation was evaluated by PAS staining. Protein levels of transforming growth factor β1(TGF-β1), type 1 plasminogen activator inhibitor(PAI-1), monocyte chemotactie protein 1(MCP-1) and renin were semi-quantitated by immunostaining. Results Compared to the wild type, mRNA expression of AT1bR, angiotensinogen, renin, CYP11B2 within glomeruli was upregulated significantly in ATlaR knockout mice (P<0.05), but no change of ACE expression was found in these two groups. AT2R protein was poorly detected in AT1aR knockout glomeruli and downregulated in wild type glomemli. ECM accumulation was significanfly increased associated with the parallel increase in TGF-β1, PAI-1, MCP-1 and renin within glomendi (P <0.05). Conclusions AT1aR gene knockout cannot improve ECM deposition in diabetic nephropathy. The compensate change of RAS components may be involved in this scenario: upregulation of AT1bR, downregulation of AT2R. CYP11B2 and renin may function in a novel pathway.

Objective: To evaluate the feasibility and effect of transcatheter closure of ventricular septal defects(VSD) using the VSD occluder.Methods: From December 2003 to March 2005,13 VSD patients,8 males and 5 females,ranging in age from 4 to 35(15.2?10.7)years,underwent catheter closure using the VSD occluder.Tthe mean diameter of the VSD obtained by transthoracic echocardiography was 4-12(5.4?1.2) mm.Transcatheter closure was performed under transthoracic echocardiographic guidance after left ventriculography.All patients were followed up 1,3 and 6 months after the procedures. Results: The devices were successfully placed in 12 of the patients and complete closure achieved in 11.Trace residual shunt was observed in 1 patient but disappeared within 10 minutes.No severe complications were noted except 1 case of complete right bundle branch block revealed by electrocardiography. Conclusion: Transcatheter closure of VSD by the VSD occluder is a safe and effective procedure,with good immediate results.Further clinical trials are under way to assess its long-term effect.

Objective: To investigate the mechanisms of work-family conflict (WFC) and work-family enrichment (WFE) between job demands and subjective well-being (SWB) among nurses. Methods: A total of 1 420 nurses were selected as the study subjects from five tertiary public hospitals in Shandong Province using two-stage sampling method. Job Demands-Resources Scale, Work-Family Relationship Scale and General Well-Being Scale were used for investigating the job demands, job resources, WFC, WFE, and SWB. Results: The average score of SWB in nurses was (75.5±15.1). Job demands had a negative effect on SWB in nurses (standardized regression coefficient=-0.17, P<0.01). WFC and WFE played parallel mediating roles in the relationship between job demands and SWB, with the mediating effect values of -0.29 and -0.07, respectively (both P<0.01). The interaction of job resources and job demands positively affected WFC (standardized regression coefficient<0.01, P<0.01). Conclusion: Job demands affect SWB through the mediating roles of WFC and WFE, and the impact of job demands on WFC is moderated by job resources. The effect of job demands on WFC is relatively strong in nurses with high levels of job resources, but the difference in the effect of high and low levels of job resources is small.

OBJECTIVETo investigate the effects of the mixed endothelin receptor antagonist, bosentan, combined with the long-acting calcium channel blocker, amlodipine, compared to the angiotensin-converting enzyme inhibitor, cilazapril, on the progressive renal injury in spontaneous hypertensive rats (SHR) with diabetes.

METHODSDiabetic hypertensive rats (SHR-DM) were induced by streptozotozin injected in male SHR (7-week-old),and divided into an untreated and three treated groups: 1) cilazapril treated group; 2) bosentan+amlodipine treated group; and 3) amlodipine treated group. Wistar Kyoto rats (WKY) and SHR rats served as normotensive and hypertensive control, respectively. The mean arterial blood pressure, renal function, endothelin and angiotensin II levels as well as the protein expression of renal extracellular matrix components and transforming growth factor (TGF)-beta1 were determined at the end of the 4th week.

RESULTSMean arterial blood pressure significantly increased in SHR and SHR-DM rats compared to WKY rats. All the therapies reduced the blood pressure to normal levels. However, the enhanced urinary protein excretion, the decreased creatinine clearance as well as the increased plasma and intrarenal endothelin and angiotens in II levels were found in the untreated SHR-DM and prevented by treatment with bosentan+amlodipine and cilazapril. Similarly, these two kinds of therapies in SHR-DM abolished the overexpression of renal TGF-beta1 by Western blot analysis and reduced the accumulation of collagen type IV, laminin and fibronectin proteins by an immunochemical approach. Amlodipine monotherapy had no detectable effects on the above parameters.

CONCLUSIONBosentan combined with amlodipine can offer similar renoprotective effects on that of cilazapril and may be a potent therapy to attenuate renal injury by reducing renal protein levels of TGF-beta1 in diabetes with a hypertensive state.

Amlodipine ; administration & dosage ; Angiotensin II ; analysis ; Animals ; Calcium Channel Blockers ; administration & dosage ; Collagen Type IV ; analysis ; Diabetic Nephropathies ; prevention & control ; Drug Therapy, Combination ; Endothelin Receptor Antagonists ; Hypertension ; complications ; drug therapy ; Kidney ; drug effects ; Male ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Sulfonamides ; administration & dosage ; Transforming Growth Factor beta ; analysis ; Transforming Growth Factor beta1

Objective:To summarize the best evidence for anxiety and depression management in adults with coronary heart disease (CHD).Methods:Evidence regarding anxiety and depression management of adults with CHD was retrieved from the British Medical Journal best practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, the Joanna Briggs Institute (JBI), PubMed, Embase, Medline, Web of Science, China National Knowledge Infrastructure, and WanFang Data. These publications included guidelines, systematic reviews, expert consensus, and evidence summaries. The data retrieval time was from the establishment of the databases to September 13, 2021. The search terms included coronary heart disease, psychology, anxiety and depression, and the data was sorted on September 14-23, 2021. Two researchers evaluated the quality of the literature and extracted data independently according to both AGREE Ⅱ and the evaluation tools of the JBI evidence-based healthcare center. The evidence level was graded by using the evidence preliminary classification system and the evidence recommendation level system of the JBI evidence-based healthcare center. The recommended strength of the evidence was determined with the guidance of JBI′s evidence structure and the discussion within the research group and expert opinions, and then the best evidence for anxiety and depression management in adults with CHD were extracted, summarized and analyzed. Results:A total of 22 articleswere included, including 5 clinical guidelines, 14 systematic reviews, 2 expert consensuses and 1 evidence summary. Three articles of the guidelines were graded B with the up-mentioned recommendtation standard, and the other two were graded A. In the systematic reviews, five articles were rated as grade B, the other nine articles as grade A, and 95% of the items were evaluated as “yes”. The evaluation results of all items in the expert consensuses were “yes”, and the quality grade was A. The evidence summary involved 32 pieces of best evidence regarding five aspects (mental health management mode, risk factor assessment and prevention, psychological problem identification and screening, psychological adjustment and intervention, drug treatment), of which 60% were class 1 evidence, and 34% were recommended with strength A.Conclusions:The overall quality of the literature and the level of evidence regarding anxiety and depression management in adults with CHD are high. The key to anxiety and depression management in these patients is innovating the mode of mental health management and implementing effective risk factor assessment and prevention, psychological problem identification and screening, psychological adjustment and intervention, and drug treatment.

Objective:To analyze the ultrasonographic features of lymphadenitis caused by cat-scratch disease (CSD) of the elbow, and to improve the diagnosis and differentiation of CSD by sonologist.Methods:According to the inclusion and exclusion criteria, we retrospectively collected the patients who visited Changsha Third Hospital from March 2015 to October 2021 due to elbow mass, and divided them into CSD group and non CSD group according to the pathological source. We compared and analyzed the ultrasonic manifestations inside and around the mass in the two groups, and summarized the ultrasonic image characteristics of CSD.Results:In 90 cases of elbow mass, there were 14 cases in CSD group and 76 cases in non CSD group. There were 8 cases of cat scratch history and 2 cases of bite history in CSD group. The incubation period ranged from 4 days to 3 months. There were 4 cases of denied cat scratch and bite history or close contact history. Eight patients were treated with antibiotics, and 6 patients did not receive any treatment. 14 patients with CSD were followed up after 1-3 months. There was statistically significant difference between CSD group and non CSD group in tumor location (χ 2=14.507, P<0.05), the masses in CSD group were all located in the medial elbow; The specificity of internal ultrasound in CSD lymphadenitis was not high, but the ultrasonic changes outside the mass had certain characteristics, such as lymphadenitis and localized superficial phlebitis. There was also a statistical difference between CSD group and non CSD group in the ultrasonic changes outside the mass (χ 2=34.070, P<0.05). Conclusions:CSD lymphadenitis usually occurs in the medial epitrochlear region of the elbow. Ultrasound can be highly suggestive when there is a relevant epidemiological history and typical intra and extra-nodal sonographic changes, thus reducing the unnecessary invasive manipulation of the elbow mass.

Objective:To systematically evaluate the prevalence of depressive symptoms and its influencing factors in breast cancer patients during chemotherapy in China.Methods:The databases such as CNKI, Wanfang Data, VIP, PubMed, Web of Science and Embase were searched with retrieval terms of breast cancer, breast tumor, chemotherapy, depressive symptom, mental health, melancholia, Chinese, etc for the literature related to the prevalence of depressive symptoms in breast cancer patients during chemotherapy in China. Relevant literature from the establishment of the databases to August 2022 were retrieved. Two researchers screened the literature independently, extracted data and evaluated the risk of bias in the included studies, and prevalence of depressive symptoms and its influencing factors in breast cancer patients during chemotherapy in China were systematically evaluated by using RevMan 5.3 and Stata 14.1 software.Results:A total of 18 studies were included, including 2 678 subjects. Meta-analysis results showed that the prevalence of depressive symptom in breast cancer patients in China was 51.60% (95% CI: 44.10%-55.10%). The results of subgroup analysis showed that age ( OR=2.55, 95% CI: 1.26-5.14), educational level ( OR=2.01, 95% CI: 1.01-3.98), marital status ( OR=0.50, 95% CI: 0.29-0.86), occupational status ( OR=3.29, 95% CI: 1.04-10.46), clinical staging ( OR=0.32, 95% CI: 0.22-0.46) and frequency of chemotherapy ( OR=0.39, 95% CI: 0.17-0.86) were the influencing factors of depressive symptoms in breast cancer patients during chemotherapy in China (all P<0.05). Conclusions:The prevalence of depressive symptoms in breast cancer patients during chemotherapy in China is high. Breast cancer patients undergoing chemotherapy who are under 50 years old, having a high school education or lower, are not married, currently employed, and in clinical stage 3-4 and receiving more than 4 chemotherapy cycles are more likely to experience depressive symptoms.

Hepatitis B is a major public health problem in China. Nucleoside/nucleotide analogues and interferon(IFN) can effectively inhibit the replication of hepatitis B virus, but the treatment effect is still not so effective because cccDNA cannot be completely removed. IFNλ is a newly discovered family of cytokines that induces antiviral, antiproliferative and antitumor effects by activating the Jak-STAT pathway. Recent studies have found that IFNλ is also of great significance in hepatitis B as a therapeutic agent and immunological indicator. IFNλ can effectively inhibit the replication of hepatitis B virus, while the gene polymorphisms of IFNλ are closely related to prognosis and susceptibility to hepatitis B; and IFNλ also shows a certain anti-tumor activity in hepatitis B-related hepatocellular carcinoma. IFNλ is expected to be used as a clinical adjuvant treatment for patients with hepatitis B. This article describes the current research progress on IFNλ in hepatitis B.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.