Objective To observe plasma albumin,total bilirubin and serum inflammatory factors,gonadal hormone levels in men with bipolar disorder,and to provide evidence for the diagnosis of the disease.Methods 48 men with bipolar disorder were selected as disease group,and 42 cases of male physical examination were selected as control group.Plasma albumin,total bilirubin and serum inflammatory factors,gonadal hormone levels of the two groups were detected.Results The levels of serum albumin and total bilirubin of the disease group were (43.4 ± 3.9)g/L and (9.4 ±1.9)μmol/L,which were lower than those of the control group[(49.6 ±3.0)g/L and (11.8 ± 2.1)μmol/L],the differences were statistically significant (t =8.361,5.692,all P <0.05).The levels of serum inflammatory factors IL -1 and IL -4 of the disease group were (4.2 ±2.2)ng/L and (3.3 ±1.8)ng/L,which were higher than those of the control group[(1.3 ±1.0)ng/L and (1.6 ±0.9)ng/L],the differences were statistically significant (t =7.858,5.542,all P <0.05).There were no significant differences in the levels of serum LH,PRL, FSH and PRG between the two groups(all P >0.05).The serum level of E2 of the disease group was (23.2 ± 16.1)pg/mL,which was lower than (35.9 ±18.0)pg/mL of the control group,the serum T level of the disease group was (10.8 ±4.9)ng/mL,which was higher than (4.2 ±1.6)ng/mL of the control group,the differences were statistically significant(t =3.533,8.344,all P <0.05).Conclusion Plasma albumin,total bilirubin and serum IL -1β,IL -4 levels can be used as references for clinical diagnosis of bipolar disorder,and serum E2 and T levels can be used as risk factors for bipolar disorder.

Objective To explore the curative effect of quetiapine combined with paroxetine in the treatment of bipolar depression,and to provide reference for the choice of clinical treatment.Methods According to the digital table,96 patients with bipolar disorder were randomly divided into observation group and control group,48 cases in each group.The control group was treated with quetiapine orally,the observation group was treated with quetiapine combined with paroxetine.After 6 weeks of treatment,the clinical curative effect,the Montgomery Asberg Depression Rating Scale and the Beck pull fan Sen Mania Rating table score before and after treatment were compared between the two groups.At the same time,the adverse reactions of the two groups were compared.Results After 6 weeks of treatment,the total effective rate of the observation group was 70.83％,which was significantly higher than 50.00％ in the control group,the difference was statistically significant(x2 =4.356,P =0.037).After 6 weeks of treatment,the Montgomery Asberg Depression Rating quantity score in the observation group was (14.01 ± 2.95) points,which was significantly lower than (18.07 ± 3.05)points in the control group,the difference was statistically significant (t =5.527,P =0.036).The Baker-pull fan Sen Mania Rating score before and after treatment between the two groups had no statistically significant differences.There were no serious adverse reactions in the two groups.Conclusion Quetiapine combined with paroxetine can effectively inhibit bipolar depressive episodes,avoid manic episodes,has good clinical efficacy and high safety,it is worthy of popularization and application.

Objective To study effects of shuganjieyu capsule of plasma glucose and lipid metabolism and sleep and body weight in patients with depression.Methods 90 patients of depression who received therapy from July 2013 to July 2016 in our hospital were selected.According to random number table, those patients were divided into the observation group ( n =45 ) and the control group ( n =45 ) .The control group was treated with citalopram, while the observation group was treated with shuganjieyu capsule, then glucose and lipid metabolism, sleep, weight and clinical curative effect were compared.Results After treatment, the fasting blood glucose (FBG), postprandial 2h blood glucose (2 hPG), triacylglycerol (TG), total cholesterol (TC) in the observation group were lower than the control group(all P<0.05), the sleep state self rating scale (SRSS) and the Pittsburgh sleep quality index ( PSQI) in the observation group were lower than the control group ( all P <0.05 ) .The body weight and body mass index in the observation group were lower than the control group (all P<0.05).The total effective rate in the observation group 95.56% (43/45)was higher than the control group 77.78% (35/45) (P<0.05); the incidence of adverse reactions in observation group 20.00% (9/45) was lower the control group 46.67% (21/45) ( P <0.05).Conclusion Shuganjieyu capsule is well for depression, which can conducive to maintaining glucose and lipid metabolism, weight stability, and improve sleep quality and clinical symptoms, and high security,it's worthy of application and promotion.

Objective To investigate the effect of psychological intervention combined with venlafaxine and risperidone in the treatment of refractory depression and its influence on the quality of life .Methods 97 patients with refractory depression were selected .According to the random number table , they were divided into the observation group(50 cases) and the control group(47 cases).The control group was given venlafaxine combined with risperidone treatment,the observation group received psychological intervention on basis of the control group .The Hamilton depression scale ( HAMD) of patients in the two groups before treatment ,4,8 and 12 weeks after treatment were recorded .The curative effect after 12 weeks of treatment was evaluated ,the adverse reaction was evaluated by the side effects scale ( TESS ) , and the quality of life ( WHOQOL-100 ) of the two groups before treatment , 12 weeks after treatment were compared .Results The HAMD score of the two groups had no statistically significant difference before treatment(t=0.307,P>0.05).After treatment for 4,8,12 weeks,the HAMD scores of the two groups were significantly lower than before treatment (t=5.743,17.756,27.288,4.595,15.801,23.247,all P<0.05),and the HAMD scores in the observation group after treatment for 8 weeks and 12 weeks were significantly lower than those in the control group(t=0.887,3.717,5.854,all P<0.05).After 12 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group (90.00％ vs.74.47％,χ2 =4.043,P <0.05 ).There was no statistically significant difference in incidence rate of adverse reactions between the two groups (26.00％vs.25.52％,χ2 =0.003,P >0.05).The WHOQOL-100 scores of the two groups had no statistically significant differences before treatment(t=0.597,0.497,0.378,0.923,0.136,all P>0.05).The WHOQOL-100 scores of the two groups after treatment were significantly higher than those before treatment ( t =11.668,8.701, 6.857,7.053,2.247,4.815,4.639,2.999,4.117,2.011,all P<0.05).After treatment,the psychological and physiological independence and social relationship domain scores in the observation group were significantly higher than those in the control group(t=5.618,3.295,4.335,3.603,all P<0.05).Conclusion Psychological interven-tion combined with venlafaxine and risperidone in the treatment of refractory depression can significantly improve the clinical efficacy ,improve the clinical symptoms and the quality of life of patients .

Objective A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province.Methods The cohort involved 89 789 adult residents aged 25-69 years.Upon the entry of this project,each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml.Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay.All the subjects were followed-up every year for vital statistics and death certificate information until 2014.Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95％ confidence interval (95％ CI) for PLC mortality associated with HBsAg status and other risk factors.Results During the 1 299 611 person-years of follow-up,a total of 2 583 PLC cases were identified,including 2 149 men and 434 women.Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100000 person-years,respectively.Among those who died of PLC,73.87％ had been tested HBsAg positive.HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95％CI:14.29-17.85) and 21.63 for women (95％CI:16.16-28.96) respectively.Ageing,cigarette smoking,previous history of hepatitis,and family history of HCC were factors associated with the increased risk for PLC.Conclusion People living in Haimen city had a high risk on PLC.HBV infection appeared the most important risk factor for HCC mortality in this area.

Objective: To determine the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the long-term outcome of patients with hypertrophic cardiomyopathy (HCM) . Methods: NT-proBNP was measured in 831 consecutive patients with HCM at Fuwai Hospital from October 2009 to December 2013 and patients were followed up clinically for (53.3±15.4) months. Patients were divided into 3 groups according to NT-proBNP values: NT-proBNP<860 pmol/L (n=276) , 860 pmol/L≤NT-proBNP≤1 905 pmol/L (n=278) , NT-proBNP>1 905 pmol/L (n=277) . The related baseline data, laboratory examination and echocardiographic results were compared among groups. The primary endpoints of this study were all-cause mortality and cardiac transplantation. Cox proportional hazards model was used to estimate hazard ratio (HR) . Kaplan-Meier analysis was used to evaluate the survival status of patients among the 3 groups. Results: During a median follow-up of (53.3±15.4) months, all-cause mortality or cardiac transplantation occurred in 37 patients (4.5%) , event rate was 1.4% (4/276) , 4.0% (11/278) and 7.9% (22/277) in patients with NT-proBNP<860 pmol/L, 860 pmol/L≤NT-proBNP≤1 905 pmol/L and NT-proBNP>1 905 pmol/L, respectively. Multivariable Cox regression analysis identified that age (HR 1.066, 95%CI 1.027-1.107) and NT-proBNP (HR 1.026, 95% CI 1.010-1.042) were independent predictors of all-cause mortality or cardiac transplantation. Among the 3 groups, the survival rate of the NT-proBNP<860 pmol/L group was the highest,and that of the NT-proBNP>1 905 pmol/L group was the lowest (P<0.01) . Conclusions The level of NT-proBNP provides clinically relevant information for long-term adverse events risk stratification in patients with HCM.

Objective: This cross-sectional study aimed to address the relationship between the volume of epicardial adipose tissue (EAT) with cardiovascular risk factors and coronary artery calcification(CAC) in the community residents. Methods: Individuals were recruited from the Jidong Community (Tangshan City, Northern China) which mainly comprised employees of the Jidong Co. Ltd. and their family members. From July 2013 to August 2014, 2 647 participants aged ≥40 years were included in this study. The volume of EAT and coronary artery calcification score (CAC score) were determined by a 64-slice CT. Carotid intima-media thickness (CIMT) was measured by a trained sonographer using a high-resolution B-mode topographic ultrasound system. Venous blood samples were analyzed by automated analyzers in the central laboratory. A validated questionnaire specifically designed for this study was used to collect demographic data from all participants by trained doctors. Characteristics of study cohort were compared according to quartiles of EAT volume (n=660, 663, 662, 662, repectively). Results: (1) The mean age of participants was (55.31±7.76) years and 49.94% (n=1 322) were men. The median EAT volume (interquartile) was 129.42 (95.66, 176.51)cm³. (2) Age, BMI, waist circumference and hip circumference, systolic blood pressure, LDL-C, triglycerides, and fasting blood glucose were significantly higher, while HDL-C level was significantly lower in participants with higher EAT volume than participants with lower EAT volume (all P<0.05). Carotid intima-media thicken (CIMT) and higher CAC score were also significantly higher in participants with higher volume of EAT. Furthermore, percentage of diabetes mellitus, hypertension, hyperlipidemia increased in proportion with increasing EAT volume (P<0.05). (3) In the linear regression, significant positive relations were found for age (β=0.019 3, 95%CI 0.017-0.021, P<0.001), waist circumference (β=0.012 7, 95%CI 0.009-0.016, P<0.001), BMI (β=0.022 4, 95%CI 0.013-0.032, P<0.001), LDL-C (β=0.048 4, 95%CI 0.021-0.076, P<0.001), and HDL-C (β=-0.098 1, 95%CI-0.164--0.032, P<0.001) was inversely related to the EAT volume. (4) Logistic regression analysis indicated that EAT volume was an independent risk factor for CAC score>0 (OR=1.233, 95%CI 1.205-1.262, P<0.001) . Conclusions Our findings indicate that EAT volume is strongly correlated to cardiovascular risk factors and coronary calcification and is an independent risk factor of increased coronary calcification in community residents.

Objective To determine whether thyroid hormone (TH) level could also be an independent and incremental predictor of adverse events in patients with hypertrophic cardiomyopathy (HCM).Methods A total of 982 consecutive patients with HCM at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013 were included in the present study,and followed up till the end of December 2016.The patients were divided into three groups according to the levels of free triiodothyronine (FT3):the group 1 (FT3≤4.28 pmol/L,n=335),the group 2 (FT3＞4.28-＜4.79 pmol/L,n=310),and the group 3 (FT34.79-6.30 pmol/L,n=337).Results After a follow-up period of (53.8 ± 14.1) months,39 patients (4.0％) either suffered death with all causes or received a cardiac transplantation (7.8％,2.9％ and 1.2％ of the patients in the group 1,group 2 and group 3,respectively).A multivariable Cox regression analysis revealed that FT3≤4.28 pmol/L was associated with a significantly higher risk of all-cause mortality or cardiac transplantation (HR 8.83,95％ CI 1.115-69.905,P=0.039) in HCM patients.Conclusions Low levels of FT3 is a risk factor of adverse events for patients with HCM,indicting a role of FT3 as a marker for assessing the risk of long-term adverse events in these patients.

ObjectiveTo investigate the effect and mechanism of Shenling Baizhusan on the treatment of oligoasthenospermia with hyperuricemia （HUA）. MethodThirty-two male Kunming （KM） mice were randomly divided into blank group （n=6）， model group （n=6）， high-dose Shenling Baizhusan group （n=7）， low-dose Shenling Baizhusan group （n=7）， and febuxostat group （n=6）. Except for the blank group， all other groups received intraperitoneal injection of potassium oxazinate suspension （600 mg·kg^-1） for 7 days. After modeling， the high-dose Shenling Baizhusan group and the low-dose Shenling Baizhusan group were orally administered with 20.14 g·kg^-1 and 10.07 g·kg^-1 of Shenling Baizhusan， respectively. The Febuxostat group was orally administered with 0.25 g·kg^-1 of Febuxostat， while the blank group and model group were orally administered with the same volume of physiological saline. Oral administration was performed once a day for 14 consecutive days， after which samples were collected. Biochemical methods were used to measure serum uric acid （UA）， superoxide dismutase （SOD） and malondialdehyde （MDA） in testicular tissue. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes in testicular tissue and evaluate the spermatogenesis function. Automated sperm analyzer was used to measure sperm density and motility. Single-cell gel electrophoresis （SCGE） was used to assess sperm DNA integrity. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （TUNEL） was used to detect testicular cell apoptosis rate. Western blot analysis was performed to measure the protein expression levels of Kelch-like ECH-associated protein 1 （Keap1）， nuclear factor E₂-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and Caspase-3 in testicular tissue. Real-time polymerase chain reaction （PCR） was conducted to evaluate the mRNA expression levels of Keap1， Nrf2， and HO-1 in testicular tissue. ResultCompared with the blank group， the model group showed elevated serum UA level （P<0.01）， decreased testicular spermatogenesis function， sperm density， and motility （P<0.01）， and increased sperm trailing rate and testicular cell apoptosis rate （P<0.01）. Compared with the model group， the high-dose Shenling Baizhusan group showed significant improvements in the above-mentioned indicators （P<0.05， P<0.01）. Additionally， the expression levels of Keap1， Bax， and Caspase-3 in testicular tissue were reduced， while the expression levels of Nrf2， HO-1， and Bcl-2 increased （P<0.05， P<0.01）. The mRNA level of Keap1 decreased （P<0.05， P<0.01）， while the mRNA levels of Nrf2 and HO-1 increased （P<0.05， P<0.01）. ConclusionShenling Baizhusan can significantly improve HUA oligoasthenospermia， and its mechanism may be related to the Nrf2/antioxidant response element （ARE） signaling pathway.

In order to improve the wearing comfort and bearing effectiveness of the exoskeleton, based on the prototype and working mechanism analysis of a relaxation wearable system for knee exoskeleton robot, the static optimization synthesis and its method are studied. Firstly, based on the construction of the virtual prototype model of the system, a comprehensive wearable comfort evaluation index considering the factors such as stress, deformation and the proportion of stress nodes was constructed. Secondly, based on the static simulation and evaluation index of system virtual prototype, multi-objective genetic optimization and local optimization synthesis of armor layer topology were carried out. Finally, the model reconstruction simulation data confirmed that the system had good wearing comfort. Our study provides a theoretical basis for the bearing performance and prototype construction of the subsequent wearable system.
Humans ; Exoskeleton Device ; Computer Simulation ; Emotions ; Knee Joint