Objective To study the relationship between QT interval and the compements of antipsychotic-induced metabolic syndrome in schizophrenic patients. Methods Totally 460 schizophrenic patients(240 men and 220 women)aged 19～60 from the study cohort of the schizophrenic patients in treatment with antipsychotant were recruited in the study for epidemiologic examinations,involving anthropometry and measurements of blood pressure,fasting ang 2hr plasma levels of glucose and insulin and serum levels of lipid.A standard 12-lead ECG was recorded and the corrected QT (QTc)was calculated accordingly by Bazett formula.HOMA-IR index was calculated for estimating individual insulin resistance.Metabolic syndrome(MS)was diagnosed according to the definition issued by the International Diabetes Federation(IDF)in 2005.Results The prolonged QT interval was found in 124 of the 460 cases(27.0%),and the rates of prolonged QT interval being 21.7% and 32.7% in men and women respectively (χ2=7.13,P<0.01).The prevalences of MS,IR,central obesity,IFG,higher serum level of triglyceride(TG)and lower serum level of high-density lipoprotein cholesterol(HDL-C) were 39.3%,38.7%,35.4%,34.1%,31.3%,29.8% and 27.0% in schizophrenic patients population respectively.The prolonged QT interval was significantly associated with MS,IR,IFG,higher serum level of triglyceride(TG)and central obesity respectively(χ2=4.95～13.63,P<0.05).Conclusion The prolonged QT interval was significantly correlated with antipsychotic-induced metabolic syndrome(MS) and components of abnormal metabolism.

Objective To investigate the correlation between family environment,cognitive disposition,self-esteem and adolescent social phobia.Methods 110 adolescents with social phobia and 142 healthy control subjects were selected.They were surveyed by Family Environment Scale of Chinese version (FES-CV),cognitive appraisal orientation test (CAOT),and Self-Esteem Scale (SES).Moreover,the adolescents with social phobia were administered with Social Avoidance and Distress Scale (SAD).Results When compared with the controls,the score of adolescent social phobia group showed significantly lower score in total and optimistic factor of CAOT,cohesion,expressiveness,achievement,activerecreational orientation,organization and self-esteem; but higher in conflict factor.The analysis of the results showed that SAD was significantly and negatively correlated with the score of total and optimistic factor of CAOT,cohesion,expressiveness and SES,while was significantly and positively correlated with the score of conflict factor.The seriousness of the condition was significantly negatively related to the score of optimistic factor,cohesion,expressiveness and SES,while the onset age was significantly positively related to them.The clinical course was significantly negatively related to the cohesion,expressiveness and self-esteem,while was significantly positively related to the score of conflict.Conclusions Negative cognitive disposition,lower cohesion,less expressiveness,higher conflict and lower self-esteem are the major factors that could affect the onset of adolescent social phobia.The more negative the cognitive disposition is,the lower the cohesion,the expressiveness and the self-esteem are,the earlier the onset age and the more serious the illness is.The longer clinical course is in ration to lower cohesion,less expressiveness,higher conflict and lower self-esteem.

Objective: To observe the inlfuence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome (ACS) with impaired glucose tolerance (IGT).
Methods: A total of 316 patients with ACS and IGT were randomly divided into 2 groups: Treatment group, the patients received simvastatin 20 mg/day with ezetimibe 10 mg/day,n=160 and Control group, the patients received simvastatin 20 mg/day,n=156. All patients were treated for 24 months. Blood levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed at 6, 12 and 24 months of medication; fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication.
Results:①In Treatment group, at 6 months of medication, blood levels of TC (mmol/L) and LDL-C (mmol/L) were (3.5 ± 0.5) and (2.1 ± 0.4) which were both lower than baseline levels (5.2±1.2) and (3.5±0.5),P<0.05; at 12 and 24 months, TC and LDL-C were (3.1 ± 1.0), (1.8 ± 0.6) and (3.0 ± 0.6), (1.8 ± 0.5), TC and LDL-C were consistently decreased, all P<0.05. In Control group, at 6 months of medication, TC and LDL-C were (4.0 ± 0.5) and (2.4 ± 0.5) which were both lower than baseline levels (5.3 ± 0.8) and (3.1 ± 0.4),P<0.05; at 12 and 24 months, TC and LDL-C were (3.8 ± 0.6), (2.3 ± 0.6) and (3.7 ± 0.5), (2.1 ± 0.7), allP<0.05. TC and LDL-C levels in Treatment group were lower than Control group at 6, 12 and 24 months of medication, allP<0.05.②In Treatment group, FBG (mmol/L) levels at 12 and 24 months were similar to 6 days,P>0.05; HbA1c at 12 and 24 months were similar to baseline,P>0.05; 2hPG (mmol/L) level at 24 months was higher than 6 days (9.5 ± 1.1) vs (8.7 ± 1.0),P<0.05; there were 26 patients with new onset diabetes at 24 months after medication. In Control group, 2hPG level at 24 months was higher than 6 days (9.6 ± 0.8) vs (8.7±0.7); there were 25 patients with new onset diabetes at 24 months after medication. The levels of FBG, 2hPG, HbA1c and the number of patients with new onset diabetes were similar between 2 groups, allP>0.05.
Conclusion: Ezetimibe combining simvastatin may better reduce blood lipids, while it had no real effect on blood glucose metabolism in patients with ACS and IGT.

ObjectiveTo analyze the relationship between expressions of Indoleamine 2,3-dioxygenase (IDO) and B7-H1 with clinico-pathological features and their prognostic significance in pancreatic cancer (PC).Method95 patients who underwent radical pancreaticoduodenectomy for PC were studied.The IDO and B7-H1 expressions in tissue specimens were determined by immunohistochemistry.ResultsIDO and B7-H1 expressions were higher in pancreatic carcinoma tissues than in normal pancreatic tissues (P＜0.05).IDO and B7-H1 expressions positively and significantly correlated with pathological grades and tumour-node-metastasis (TNM) stages (P＜0.05).They were prognostic of poor cancer-specific survival.After adjusting by the Cox proportional hazards regression models (P＜0.05),only a combined IDO/B7-H1 expression served as an independent prognostic marker.ConclusionsIDO and B7-H1 were expressed in PC,and they were important markers for malignant progression of PC.A combined IDO/B7-H1 expression served as an independent prognostic marker for PC.

Objective: To evaluate the efficacy and safety of ultrafiltration in patients with heart failure. Methods: One hundred and thirty four cases of patients with heart failure, who hospitalized in our hospital from June 2010 to June 2016 were enrolled in this study. Random serial number was generated using SPSS 22.0 software, patients were then randomly divided into control group and ultrafiltration group with the proportion of 1∶1 (67 cases in each group). Patients in the control group received standard therapy. Patients in the ultrafiltration group received ultrafiltration therapy for 8 hours. Curative effect was evaluated after 8 hours treatment in the control group and after 12 hours in the ultrafiltration group. Following parameters were compared between the two groups: body weight, dyspnea score and 6 minutes walking distance as well as blood pressure, heart rate, Na⁺ , K⁺ , Cl^-, pH, HCO₃^-, Hb, PLT, Cr, BUN levels. Results: (1)Two patients died during run-in process and eventually 132 cases were chosen for final analysis (65 cases in control group and 67 cases in the ultrafiltration group). Gender, age, type of heart failure, dyspnea score, body weight at baseline were similar between the two groups. (2)Post therapy, patients′ body weight decreased obviously, while dyspnea score and 6 minutes walking distance increased significantly in the ultrafiltration group compared to baseline(all P<0.05), and the improvement was significantly greater compared to control group(all P<0.05). (3)The safety index comparison of two groups: blood pressure, heart rate, Na⁺ , K⁺ , Cl^-, pH, HCO₃^-, Hb, PLT, Cr, and BUN were similar between the two groups at baseline and post therapy. Conclusion Ultrafiltration therapy is safe and effective to treat patients with heart failure.

Objective To evaluate the efficacy and safety of a new ultrafiltration device for treating refractory heart failure patients.Methods A total of 52 patients (37 male,age 29-85 (33 ± 44) years)with refractory heart failure were treated using a new ultrafiltration device (FQ-16).Body weight,dyspnea score,oxygen saturation (SatO2),left ventricular ejection fraction (LVEF),BUN,creatinine,electrolytes and blood gas analysis were assessed before and after the treatment.Hypotension event and other main adverse events were recorded.Results Ultrafiltration duration ranged between 8-22 hours.Total ultrafiltration volume was (4 489 ± 1 548) ml.Compared with baseline,patients' body weight decreased from (75.3 ± 8.74) kg to (69.8 ± 8.39) kg (P ＜ 0.01),dyspnea score improved from 2.47 ± 1.55 to 12.87±3.61 (P＜0.01) and SatO2 increased from 91.0 ±6.01 to 96.4 ±2.52 (P ＜0.01) and LVEF increased from (30.0 ± 4.1) ％ to (36.0 ± 4.3) ％ (P ＜ 0.01) after ultrafiltration.Blood creatinine,BUN,electrolytes and blood gas analysis values were similar at baseline and post ultrafiltration.No hypotension event and other main adverse events occurred during the ultrafiltration treatment.Conclusions The novel ultrafiltration device adequately relieved hypervolemia and dyspnea in patients with refractory heart failure and the treatment process is safe in this patient cohort.

Acute pancreatitis (AP) is a common and potentially threatening disease of the pancreas, and some patients eventually develop to severe acute pancreatitis (SAP). Symptomatic support therapies such as rehydration therapy and anti-infection are still the main treatments. Lacking specific therapies is the main reason for the high mortality of AP patients, especially those with SAP. Premature trypsinogen activation is the most important pathologic cellular event in the pathogenesis of AP. The release of trypsin can cause self-digestion inside and outside of acinar cells, especially the release of cathepsin B can also cause a caspase-unrelated regulatory cell death (RCD) known as necroptosis, which is closely related to the development and prognosis of AP. Therefore, it is necessary to further study the mechanism of necroptosis in the occurrence and development of AP. This article reviews the mechanism of necroptosis and the research progress related to AP, in an attempt to provide a new understanding of the pathogenesis and treatment of AP, and promote the better target drug development.

Objective:To investigate the predictive value of the ischemic stroke predictive risk score (iScore) and serum homocysteine (Hcy) for early neurological deterioration (END) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to the Affiliated Hospital of Jining Medical University from July 2018 to June 2020 were enrolled retrospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 d after admission increased by ≥2 from the baseline. Multivariate logistic regression analysis was used to determine the independent correlations of iScore and serum Hcy level with END, and then the receiver operating characteristics (ROC) curve was used to evaluate the individual and combined predictive values of iScore and serum Hcy for END. Results:A total of 398 patients with acute ischemic stroke were enrolled, including 241 (60.6%) males, aged 65.02±12.17 years. The baseline NIHSS score was 12.15±5.67 and iScore was 124.58±37.51, and 103 patients (25.9%) developed END. Univariate analysis showed that there were significant differences in atrial fibrillation, fasting blood glucose, serum Hcy, stroke etiology type (large artery atherosclerosis and small artery occlusion), baseline NIHSS score and iScore between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for age, atrial fibrillation, fasting blood glucose, and stroke etiology type, the iScore (odds ratio [ OR] 1.016, 95% confidence interval [ CI] 1.009-1.040; P=0.004), serum Hcy ( OR 1.191, 95% CI 1.075-1.588; P<0.001) and baseline NIHSS score ( OR 1.289, 95% CI 1.101-1.613; P=0.023) had significant independent correlation with END. ROC curve analysis showed that the area under the curve of iScore combined with serum Hcy for predicting END was 0.859 (95% CI 0.820-0.898; P<0.001), which was significantly higher than that of iScore or serum Hcy alone ( P<0.001). The sensitivity and specificity of combined prediction were 81.55% and 85.76%, respectively. Conclusion:The iScore combined with serum Hcy has higher predictive value for END in patients with acute ischemic stroke.

Objective:To analyze the clinical characteristics and treatment of tricuspid valve prolapse caused by chordal rupture complicated with persistent pulmonary hypertension in neonates.Methods:The clinical data of a male neonate with tricuspid valve prolapse complicated with persistent pulmonary hypertension admitted to the Neonatal Intensive Care Unit of Children′s Hospital of Hebei Province in November 2018 was analyzed retrospectively. Related literature up to September 2020 was searched with the strategy of "(neonate OR newborn) AND (tricuspid valve prolapse) AND (rupture OR necrosis) AND (papillary muscle OR chordae tendineae) AND (pulmonary hypertension)" in Wanfang, CNKI and PubMed database in Chinese and English. The characteristics of the disease were summarized.Results:A male full-term neonate was admitted due to presenting severe cyanosis for 9 hours. He was born by caesarean section and presented severe cyanosis and dyspnea at 10 min of ages, unresponsive to the positive airway pressure resuscitation. After 9 hours of mechanical ventilation, there was no improvement. Thus he was transferred to Children′s Hospital of Hebei Province. On admission, the initial blood gas analysis showed an arterial partial pressure of oxygen of 22.5 mmHg (1 mmHg=0.133 kPa). The echocardiography revealed prolapsed anterior leaflet of tricuspid valve, severe tricuspid regurgitation (TR) and pulmonary artery hypertension, and right to left shunt via a patent foramen ovale. The arterial duct was closed. The chest X-ray was normal. The boy was treated with nitric oxide, milrinone, and continued mechanical ventilation initially. Addition of prostacyclin analog (treprostinil) on day 3 led to significant improvement of pulmonary blood flow, oxygenation, and stabilization, so that the extracorporeal membrane oxygenation therapy was avoided. At 11 months after birth, the boy underwent cardiac surgery. At surgery, the rupture of chordal tendineae in anterior leaflet of tricuspid valve was found. Tricuspid annuloplasty, valvuloplasty and repair of patent foramen ovale were successfully performed. The follow-up echocardiogram at postoperative 3 months showed only mild tricuspid insufficiency. The boy was well at last follow-up at 22 months of age with normal cognitive skill development. According to literature, 20 cases of papillary muscle or chordae tendineae rupture in neonates had been reported in 12 English papers. Among the total 21 neonates, there were 12 male infants and only one premature infant with gestational age of 33 weeks. They presented with profound cyanosis soon after birth. All of them received endotracheal intubation and mechanical ventilation. Other treatments included inhalation of nitric oxide, intravenous milrinone, vasoactive drugs, diuretics and prostacyclin, etc. Extracorporeal membrane oxygenation (ECMO) was used in 6 infants as a bridge to surgical treatment. Two cases reported earlier death of cardiopulmonary failure without operation and the rest 19 survived after surgery. The followed surgery or autopsy revealed that all of them had tricuspid valve prolapse, rupture of papillary muscle or chordae tendineae.Conclusions:The severe TR resulting from rupture of papillary muscle or chordate tendineae in neonates is rare and could cause severe hypoxemia. Early recognition, adequate cardiopulmonary support to stabilize the hemodynamic status and timely surgery can significantly reduce the mortality.