Objective To explore the discrepancy of anxiety and depression between breast cancer patients and general population,to provide reference for psychological ethical intervention.Methods Breast cancer patients and general population admitted randomly from October.2008 to April.2009 were assessed according to Self-reporting inventory,Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS).Patients with breast cancer were come into the study group(n=100) and general population come into the control group(n=100),and then psychological ethical intervention was provided to each group.Results The Morbidity of anxiety and depression in breast cancer patients is much higher than that in the general population(P

Cyanoacrylate adhesive (CA) is a common clinical medical adhesive. In recent years, CA has been used as a securement device for vascular access devices. This paper reviews the development and properties of CA, the effect of CA on catheter failure rate, skin damages, the number and interval time of dressing change, the satisfaction of nurses and patients as well as economic benefits, which provides references for the clinical practice and scientific research.

Iliac arteriovenous ifstula (AVF) usually manifests in a wide range of symptoms similar to typical deep venous thrombosis (DVT), which often lead to delayed diagnosis or misdiagnosis. We reported a 51-year old woman who was performed lumbar discectomy and showed a progressive abdominal distention, dyspnea, and swollen left leg. She was initially diagnosed as deep vein thrombosis and the ifnal diagnosis was arteriovenous ifstula. hTe ifstula was successfully sealed by an endovascular covered stent. No further recurrence was found atfer a half year’s follow-up. hTis article summarized the experience regarding iliac arteriovenous ifstula misdiagnosed, and discussed the differential diagnosis between arteriovenous ifstula and pulmonary thromboembolism causedby deep vein thrombosis.

Objective To summarize the imaging features of computed tomography (CT)and magnetic resonance imaging (MRI) combined with multi-technology imaging and compare its effects in the preoperative evaluation of malignant perihilar biliary obstruction.Methods The clinical data of 20 patients receiving CT and MRI who were diagnosed with malignant perihilar biliary obstruction by pathological examination at the Wuxi Second People's Hospital between January 2008 and April 2014 were retrospectively analyzed.Patients receiving CT combined with negative-contrast CT cholangiopancreatography (nCTCP) and computed tomography angiography (CTA) were allocated into the CT group,and patients receiving MRI combined with magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance angiography (MRA) were allocated into the MRI group.The images of the 2 groups were analyzed by 2 independent reviewers.The classification of malignant perihilar biliary obstruction,hepatic artery and portal vein invasions and lymph node and organ metastases were evaluated respectively,and then the results of evaluation were compared with the results of surgery and pathological examinations.The comparison between the accuracy of imaging examination in the 2 groups and accuracy of perihilar biliary obstruction classification were analyzed by the chi-square test.The comparison of evaluating accuracy (sensitivity and specificity) among vascular invasion and lymph node and organ metastases were done by the receiver operating characteristic (ROC) curve analysis,and the comparison of its accuracy were done by the z-score test.Results The imagings of bile duct involvement of the 2 groups showed that there were irregular thickening bile duct wall combined with retrograde intrahepatic bile duct dilatation.The symptoms of vascular invasion included the stricture and occlusion of blood vessels or more than half of vascular contact surface with tumor.The symptoms of lymph node metastasis included the enlarging short-axis or round-like circular enhanced lesions.The symptoms of organ involvement included the unclear boundary of lesions or low-density necrotic foci within organ.All the 20 patients underwent the surgical treatment,including 13 patients with hilar cholangiocarcinoma and 7 patients with gallbladder carcinoma.Hepatic artery invasions were detected in 5 patients,portal vein invasions in 10 patients,lymph node metastases in 10 patients and organ metastases in 4 patients.The cases of classification of perihilar biliary obstruction,hepatic artery invasion,portal vein invasion,lymph node metastasis and organ metastasis which were evaluated respectively by reviewer 1 and 2 were 18/18,19/18,18/18,17/16 and 18/19 in the CT group and 17/16,14/13,17/16,15/14 and 19/18 in the MRI group.The imaging of the 2 groups were compared with the evaluating accuracies of classification of malignant hilar biliary obstruction,hepatic artery and portal vein invasions,lymph node and organ metastases in the 2 groups,showing no significant differences (x2=12.593,8.889,z=1.823,1.956,0.462,0.817,0.977,0.751,0.233,1.403,P＞0.05).Conclusion CT and MRI for malignant hilar biliary obstruction had the same imaging features,meanwhile,they can provide an equivalent performance in the classification of malignant hilar biliary obstruction,hepatic artery and portal vein invasions and lymph node and organ metastases.

Objective:To investigate whether pORF5 plasmid protein of Chlamydia trachomatis(Ct) induces 1L-1βand 1L-18 production in THP-1 cells,and its potential molecular mechanism.Methods:pORF5 plasmid protein was used to stimulate THP-1 cells at different concentrations(0,3,6,12,24,36 μg/ml),then the inflammatory cytokines IL-18 and IL-1βwere detected by ELISA at the time of 0,8,16,24,36 h;The mRNA expression of NALP3 inflammasome were detected by Realtime-PCR,and Caspase-1 activity was determined by Western blot analysis.THP-1 cells were transfected with siRNA targeting NALP3 and ASC gene for 24 h or pretreated with Caspase-1 inhibitor(Z-YVAD-FMK) for 30 min,and subsequently stimulated with pORF5(24 μg/ml) for 24 h,then secretion of IL-1βand IL-18 were analyzed by ELISA.Results: The pORF5 plasmid protein induced THP-1 cells to secrete IL-1βand IL-18 by dose-and time-dependent manners,production of IL-1βand IL-18 reached their peaks(491 pg/ml and 186 pg/ml) at concentration of 24 μg/ml,and the peak amount of IL-1βand IL-18 occurred at 24 h and 16 h post-stimulation respectively.pORF5 plasmid protein in-creased mRNA expression of NALP3 inflammasome and activated Caspase-1 in THP-1 cells.NALP3 siRNA,ASC siRNA and Z-YVAD-FMK reduced pORF5-induced IL-1βand IL-18 production when compared with control groups(P<0.05).Conclusion:pORF5 plasmid protein could induce THP-1 cells to produce IL-1βand IL-18 through NALP3 inflammasome activation,which may play an important role in the pathogenesis in Ct infection.

OBJECTIVE: To investigate the significance of tumor necrosis factor-alpha (TNF-α) and plasma endothelium (ET) in pathophysiologic process of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with type 2 diabetes mellitus (T2DM). METHOD: All observed subjects were divided into 4 groups. A number of 80 patients with OSAHS, 65 cases of OSAHS with T2DM patients, 20 patients with T2DM, and 32 cases of healthy control group were observed in this study. The serum levels of TNF-α and ET were detected by double antibody sandwich ELISA, the content of TNF-α and ET were compared between OSAHS group and OSAHS + T2DM group. It were also compared before and after treatment of CPAP or surgery. RESULT: TNF-α level is higher in OSAHS+T2DM group than that in the OSAHS group, T2DM group and the control group (P < 0.05); TNF-α level in OSAHS group and the T2DM group are higher than that in the control group (P < 0.05), but there was no difference in TNF-α level between the OSAHS group and the T2DM group. There was also no difference in ET level of the four groups. There were significant differences of TNF-α before and after treatment of CPAP or surgery in OSAHS group and OSAHS+T2DM group (P < 0.05). But there was no significant differences of ET before and after treatment of CPAP or surgery in the OSAHS+T2DM group (P > 0.05). CONCLUSION TNF-α may be involved in the development of OSAHS and T2DM, while ET may have little effect on the occurrence and development of OSAHS and T2DM.
Antibodies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Endothelins ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Sleep Apnea, Obstructive ; blood ; complications ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: To explore the changes of serum interleukin-6 (IL-6) level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS associated type 2 diabetes mellitus (T2DM) and their significance. METHOD: All observed subjects were divided into 3 groups: 20 cases of normal subjects, 35 cases of simple OSAHS patients, 48 cases of OSAHS associated T2DM patients, IL-6 concentrations of serum were measured by the enzyme-linked immunosorbent. RESULT: IL-6 level was higher in the group of OSAHS with T2DM than the group of OSAHS and the healthy control group (P < 0.05); IL-6 level was higher in the simple OSAHS group than the healthy controls. CONCLUSION IL-6 and other inflammatory factors may involved pathological physiological process in OSAHS patients sugar metabolic abnormalities; and is associated with the development of OSAHS associated with type 2 diabetes.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Interleukin-6 ; blood ; Sleep Apnea, Obstructive ; blood ; complications

Objective: To learn the status and influencing factors of development among infants at ages of 0 to 36 months in Xiaoshan District, Hangzhou City, so as to provide the reference for promoting healthy development of infants. Methods: Infants at ages of 0-36 months who underwent physical examination in Child Health Clinic of Xiaoshan District Community Health Service Center were selected in 2022. General data of infants and their mothers were collected through questionnaires, and the development status of infants was screened by Age and Stages Questionnaire (third edition). Factors affecting the development status were identified using a multivariable logistic regression model. Results: A total of 2 519 infants were investigated, including 1 339 males (53.16%) and 1 180 females (46.84%). There were 608 infants with abnormal development of at least one functional area of communication (CM), gross motor (GM), fine motor (FM), problems solving (CG) and personal-social (PS). The abnormal rate was 24.14%, and the abnormal rates of the above functional areas were 9.77%, 6.59%, 7.98%, 6.39% and 9.33%, respectively. Multivariable logistic regression analysis showed that gender (male, OR=1.563, 95%CI: 1.191-2.052), mother's childbearing age (≥35 years, OR=1.411, 95%CI: 1.001-1.988), mother's educational level (lower than junior college, OR=1.460, 95%CI: 1.116-1.912) were factors affecting abnormal development of CM; preterm birth (OR=2.323, 95%CI: 1.315-4.103) was factors affecting abnormal development of GM; gender (male, OR=1.654, 95%CI: 1.225-2.232) was factors affecting abnormal development of FM; gender (male, OR=1.511, 95%CI: 1.086-2.102) and mode of delivery (cesarean section, OR=1.460, 95%CI: 1.060-2.010) were factors affecting abnormal development of CG; gender (male, OR=1.340, 95%CI: 1.019-1.763) and birth weight (low birth weight, OR=1.985, 95%CI: 1.149-3.432) were factors affecting abnormal development of PS. Conclusions The rate of abnormal development among infants at ages of 0 to 36 months in Xiaoshan District is 24.14%. Gender, preterm birth, mode of delivery, birth weight, mother's childbearing age and mother's educational level could affect the development status of infants.

Objective To investigate the value of multi-phase contrast enhanced MR in the diagnosis and differential diagnosis of thyroid nodules. Methods From September 2015 to January 2018,176 patients with 257 thyroid nodules(109 malignant and 148 benign)preoperatively evaluated by multi-phase contrast enhanced MR were included in the present study.The final diagnoses for all cases were proved by the final pathological reports in our hospital.The diagnostic value of multi-phase contrast enhanced MR in thyroid nodules was analyzed retrospectively. Results The outflow ring sign can be regarded as a specific sign of papillary thyroid carcinoma (χ2＝125.03,P＝0.000)and the diagnostic sensitivity,specificity,positive predictive value and negative predictive value were 66.06%,98.65%,97.30%and 79.78%,respectively.The obvious enhancement was more common in benign thyroid nodules (χ2＝33.45,P＝0.000)and it can be regarded as a specific sign of adenoma and adenomatoid nodule(χ2＝74.7 5 ,P＝0.000 ).Conclusion The multi-phase contrast enhanced MR has important clinical application value in the diagnosis and differential diagnosis of thyroid nodules.The outflow ring sign can be regarded as a specific sign of papillary thyroid carcinoma,and the obvious enhancement was an important feature of benign nodules,especially of adenoma and adenomatoid nodules.

Objective:To compare the different optimized anesthesia strategies in pediatric patients undergoing hypospadias surgery.Methods:Ninety pediatric patients with distal hypospadias undergoing Duckett operation, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, aged 1-6 yr, weighing 10-25 kg, were divided into 3 groups ( n=30 each) using a random number table method: caudal block combined with general anesthesia group (group CG), neurostimulator-guided pudendal nerve block combined with general anesthesia group (group PG) and ultrasound-guided dorsal penile nerve block combined with general anesthesia group (group DPG). Anesthesia was induced with propofol-fentanyl, patients were ventilated through the laryngeal mask and maintained spontaneous breathing, and anesthesia was maintained with sevoflurane.The corresponding regional block was performed in each group, and block was performed with 0.25% ropivacaine 1, 0.25 and 0.15 ml/kg in CG, PG and DPG groups, respectively.The consumption of ropivacaine, occurrence of insufficient analgesia during operation, emergence time, duration of post-anesthesia care unit stay, time of the first requirement for analgesics, requirement for analgesics within 24 h after operation, occurrence of postoperative agitation, nausea and vomiting and lower extremity motor block, and patients′ satisfaction score at 24 h after operation were recorded. Results:Compared with group CG, the consumption of ropivacaine was significantly reduced, the time of the first requirement for analgesics was prolonged, the postoperative requirement for analgesics was decreased, duration of post-anesthesia care unit stay was shortened, the incidence of lower extremity motor block was decreased, and patients′ satisfaction score was increased in group PG and group DPG, and the incidence of nausea and vomiting was decreased in group DPG ( P<0.05). Compared with group PG, the consumption of ropivacaine was significantly reduced, and the time of the first requirement for analgesics was shortened in group DPG ( P<0.05). There was no significant difference in the incidence of insufficient analgesia during operation (3% in group DPG) and incidence of postoperative agitation among the three groups ( P>0.05). Conclusion:Ultrasound-guided dorsal penile nerve block combined with general anesthesia provides significant efficacy with a higher safety, and the efficacy is better than that of caudal block combined with general anesthesia and neurostimulator-guided pudendal nerve block general anesthesia when used for pediatric patients undergoing hypospadias surgery.