OBJECTIVE: To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA), to investigate whether there is a difference in the prevalence of depression and anxiety between PsA and rheumatoid arthritis (RA) patients and to identify associated risk factors for depression and anxiety in PsA patients. METHODS: PsA and RA patients who visited Department of Rheumatology and Clinical Immunology in Peking University First Hospital from May 2018 to Sep 2019 were recruited. Self-rating anxiety scale and self-rating depression scale were surveyed and compared between PsA and RA patients. Demographics and clinical features including age, gender, disease duration, disease activity score, psoriasis area and severity index (PASI), and medical application were collected. Power Doppler and grey-scale ultrasound of joints, tenosynovitis and enthesis were performed. Multivariate Logistic regression was used to identify the factors associated with mood disorders and the odds ratio of depression and anxiety between the PsA and RA patients. RESULTS: Among the 114 enrolled PsA patients, 37 (32.5%) had mood disorders, in which 36 (31.6%) with depression and 15 (13.2%) with anxiety. Compared with 201 RA patients, PsA patients showed greater odds for depression [adjusted OR (95%CI): 2.7 (1.1-6.4)]. Depression was more often observed in the PsA than in the RA patients (31.6% vs. 18.9%, P=0.011). The similar trend for anxiety was also observed, although the difference was insignificant (13.2% vs. 8.5%, P=0.185). Age (OR=0.95, P=0.008), psoriasis duration (OR=0.94, P=0.018), pain visual analogue scale (OR=1.47, P=0.011), PASI score (OR=1.07, P=0.007) and presence of ultrasound enthesitis (OR=4.13, P=0.009) were identified as factors associated with depression in the PsA patients. PASI score (OR=1.07, P=0.001) was identified as associated factor for anxiety in the PsA patients. CONCLUSION The prevalence of depression and anxiety is elevated in PsA patients. Depression is significantly more prevalent in PsA patients than in RA patients. Younger age, shorter psoriasis duration, worse pain and presence of ultrasound enthesitis are associated with depression, while severe psoriasis rash is associated with both depression and anxiety in PsA patients.
Anxiety/etiology* ; Arthritis, Psoriatic/epidemiology* ; Depression/etiology* ; Enthesopathy ; Humans ; Prevalence

OBJECTIVETo study the effects of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion.

METHODCerebral ischemia model in gerbils was produced by ligating bilateral common carotid artery. The dynamic expressin of GFAP were determined by immunochemistry after cerebyal ischemia for 15 min followed by reperfusion for 24 hours and 48 hours.

RESULTGFAP positive reactions reached a peak after cerebral ischemia for 15 min followed by reperfusion for 24 hours. Bu Yang Huan Wu Decoction decreased the expression. GFAP positive reactions decreased after cerebral ischemia for 15 min followed by reperfusion for 48 hours, Bu Yang Huan Wu Decoction increased the expression.

CONCLUSIONThe regulation of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion may be related to repairing process after cerebral ischemia.

Animals ; Astrocytes ; drug effects ; Brain Ischemia ; complications ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Hippocampus ; metabolism ; Male ; Plants, Medicinal ; chemistry ; Reperfusion Injury ; etiology ; metabolism ; pathology

OBJECTIVETo compare the clinical effectiveness of blind intubation through the Cookgas intubating laryngeal airway(CILA) or Fastrach intubating laryngeal mask airway(FT-LMA) for anticipated difficult tracheal intubation.

METHODSEighty-six patients with anticipated difficult tracheal intubation who were undergoing elective plastic surgery under general anesthesia were randomly allocated into CILA group(n=43) and FT-LMA group(n=43) . After general anesthesia being induced and CILA or FT-LMA being inserted, the patients were treated with blind intubation through CILA or FT-LMA. In each case, the number and the time of intubating laryngeal airway(ILA) insertion and blind intubation attempts and ILA removal were recorded. The view of glottis under fiberoptic bronchoscope(FOB) via CILA or FT-LMA was recorded. In addition, noninvasive blood pressure and heart rate were recorded before and after intravenous anesthetic induction, at ILA insertion, at intubation, at ILA removal and every minute thereafter for 5 minutes.

RESULTSCILA or FT-LMA was inserted successfully in all 86 patients. The rate of the first successful insertion was not significantly different between two groups(P>0.05) . In CILA group, the first intubation attempt succeeded in 35 patients;5 and 2 cases were intubated blindly at the second and the third attempt, one patient failed who was intubated successfully by FOB via CILA. In FT-LMA group, 32 patients were intubated successfully at the first attempt, 4 at the second attempt, 3 at the third attempt, and 4 cases failed, three of them were intubated smoothly with FOB through FT-LMA, one failed patient was intubated by FOB. The time of FT-LMA insertion(34.2∓13.9) s was significantly longer when compared with CILA(22.4∓18.9) s (P<0.05) . However, the time of blind intubation through CILA and FT-LMA [(46.0∓26.7) s vs.(51.8∓41.1) s]and the time of ILA removal[(39.3∓11.9) s vs.(35.3∓10.4) s] were not significantly different between groups(P>0.05) . Hemodynamic changes during blind intubation in the two groups showed no significant differences(P>0.05) .

CONCLUSIONSBlind intubation via CILA or FT-LMA is safe and effective for anticipated difficult tracheal intubation. Nevertheless, CILA is easier to be inserted, with relatively higher success rate of blind intubation.

Adolescent ; Adult ; Anesthesia, General ; Bronchoscopy ; Humans ; Intubation, Intratracheal ; instrumentation ; Laryngeal Masks ; Middle Aged ; Young Adult

OBJECTIVETo construct a replication-defective adenovirus containing TK gene and investigate the killing effects of TK gene against human liver cancer cells SMMC-7721.

METHODSThe recombinant adenovirus ADV-TK was constructed using homologous recombination in the cells. SMMC-7721 cells transfected with recombined adenovirus were exposed to GCV, and the cell viability was measured by MTT assays.

RESULTSThe recombinant adenovirus containing TK gene was successfully constructed. Transfection by the recombinant adenovirus ADV-TK and GCV exposure significantly suppressed the growth of SMMC-7721 cells.

CONCLUSIONA replication-defective adenovirus containing TK gene has been successfully constructed, and in combination with GCV, the recombinant adenovirus produces significant killing effect against SMMC-7721 cells in vitro.

Adenoviridae ; genetics ; Cell Line, Tumor ; Genetic Therapy ; Genetic Vectors ; Humans ; Liver Neoplasms ; therapy ; Thymidine Kinase ; genetics

Objective To study the anatomical classification and surgical management of communicating tumors invading the anterior or middle skull base. Methods According to the location and growth direction of the tumors, the communicating tumors invading the anterior or middle skull base in 29 patients were classified into 4 types, namely fronto-naso-orbital tumors in 16 cases, middle-lateral cranial base tumors in 8 cases, central-medial skull base tumors in 4 cases and petrous bone-jugular foramen tumor in 1 case. Based on this classification, extended transbasal approach (13 cases), supraorbital-pterional approach (9 cases), fronto-temporal approach (3 cases), ffontotemporal-orbitozygomatic approach (3 cases) and transpetrol approach (1 case) were adopted for tumor resection and skull base defect reconstruction. In the transbasal approach group, the surgery was performed also through transnasal endoscopic approaches. Results Twenty-four patients underwent total tumor resection and 5 had subtotal tumor resection. No operative death or serious complications (e.g. intracranial infection, cerebrospinal fluid leakage or meningoencephalocele) occurred after the operations. Conclusion Classification of the communicating tumors invading the anterior or middle skull base according to their location and growth direction facilitates planning of the surgical approaches for tumor resection and skull base defect reconstruction.

OBJECTIVETo observe the effectiveness of conscious sedation with midazolam, propofol and sufentanil for patients in plastic surgery.

METHODS81 patients, scheduled for plastic surgery, were randomly selected to receive conscious sedation with midazolam 0.05 mg x kg(-1) and sufentanil 0.1 microg x kg(-1) intravenously, following by a continuous infusion of midazolam-propofol-sufentanil combination (midazolam 5 mg + propofol 200 mg + sufentanil 10 microg, a total of 23 ml). The initial infusion rate was 0.2 ml x kg(-1) x h(-1), and was adjusted (in 20% of initial infusion rate increment) to maintain OAA/S score as 11 during the operation. The patients' vital signs, discomfort and level of sedation were evaluated at 5 to 10 min intervals until the end of the surgery. The complications (i. e. anoxemia, apnea, restlessness, nausea and vomiting), anesthesia duration and drug consumption were recorded. The drug infusion was discontinued at 5 - 10 min before the end of the surgical procedure. On the first postoperative day, patients were asked to rate their satisfaction with the anesthetic management and whether they would choose to receive the same anesthetic technique if necessary in the future.

RESULTSThe OAA/S score decreased from 20.0 +/- 0 to 11.9 +/- 2.6 after midazolam and sufentanil IV (P < 0.05), and was maintained as 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score returned to 16.0 +/- 2.2, which was also lower significantly compared with baseline value (P < 0.05). The induction of sedation produced a significant decrease in SBP and DBP (P < 0.05) and no significant changes in heart rate (P > 0.05). At the end of the procedure, SBP, DBP and HR returned to the baseline value. The anoxemia happened in 11 cases, apnea in 5 cases and restlessness in 2. No nausea and vomiting occurred. The anesthesia duration and consumption of midazolam, propofol and sufentanil were (101.1 +/- 42.5) min, (8.4 +/- 3.7) mg, (189.1 +/- 88.7) mg and (18.2 +/- 5.6) microg respectively. In an interview on the first postoperative day, 96% (78/ 81) of the patients were satisfied with their anesthesia and were willing to receive the same anesthetic technique if necessary in the future.

CONCLUSIONConscious sedation with midazolam, propofol and sufentanil is an effective anesthetic technique for patients in plastic surgery.

Adolescent ; Adult ; Conscious Sedation ; methods ; Female ; Humans ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage ; Sufentanil ; administration & dosage ; Surgery, Plastic ; Young Adult

OBJECTIVETo study the role of a pathologic niche inducing mouse embryonic stem cells (ESC) to express hepatic cell functions in vitro.

METHODSEmbryoid bodies were developed from 5 to 7 day hanging-drop culture of mouse ESC, and their dissociated cells were planted in three differential systems: nothing added; with 20 ng/ml hepatocyte growth factor (HGF); and 5% rat cholestatic serum plus 20 ng/ml HGF added. Their differentiation was observed with inverted microscopes daily, and their hepatic functions were analyzed against their synthesis of glycogen, triglycerides, albumin, and urea nitrogen, and by their staining of indocyanine green (ICG) and fluorescein diacetate (FDA).

RESULTSESC spontaneous differentiation was hardly being controlled to form three germ layers. HGF prompted the ESC to develop further into visceral endoderm and mesoderm (myocardium), but both of them only expressed a low level of hepatocyte-specific metabolic functions. With cholestatic serum added into the HGF-induced system, differentiated cells grew into similar angular cells, and had a higher level synthesis of glycogen, triglycerides, albumin and urea nitrogen with positive ICG and FDA staining.

CONCLUSIONSSpontaneous or HGF-induced ESC differentiation has only limited hepatic functions expressed. A pathologic niche in vitro induces ESC to develop into hepatic lineages, with a higher level of hepatic metabolic functions.

Animals ; Cell Differentiation ; physiology ; Cells, Cultured ; Cholestasis ; blood ; Culture Media ; pharmacology ; Embryo, Mammalian ; Hepatocytes ; cytology ; Mice ; Serum ; Stem Cells ; cytology

BACKGROUNDSome larger scale, randomized studies have demonstrated the superiority of drug-eluting stents (DES) over bare metal stents (BMS) for the treatment of acute myocardial infarction (AMI). This study aimed to investigate the impact of DES, in comparison with BMS, on the 2-year clinical outcomes in patients with ST-elevation myocardial infarction (STEMI).

METHODSFrom January 2002 to December 2008, a total of 1301 consecutive STEMI patients treated with coronary stenting in Shenyang Northern Hospital were prospectively registered. Patients received BMS (n = 868) or DES (n = 435) implantation in the infarction related artery according to physician's discretion. A propensity score analysis was performed and two well matched subgroups were selected (BMS, n = 288; DES, n = 288) to evaluate the 2-year clinical outcomes. The primary outcome was the occurrence of major adverse cardiac events (MACE), which was defined as a composite of all-cause death, myocardial infarction (MI), or target vessel revascularization (TVR).

RESULTSSurvival salvage analysis showed that 2-year cumulative hazards were not significantly different between the two groups with respect to TVR (2.8% vs. 3.1%, log-rank P = 0.780), stent thrombosis (1.7% vs. 4.2%, log-rank P = 0.079) and MACE (8% vs. 10.8%, log-rank P = 0.236). Multivariate analysis showed that DES was an independent protective factor of MI (HR: 0.211, 95%CI: 0.049 to 0.908) and stent thrombosis (HR: 0.327, 95%CI: 0.107 to 0.994).

CONCLUSIONDES was associated with similar 2-year clinical outcomes to those of BMS for the treatment of STEMI in daily practice.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; therapy ; Prospective Studies ; Stents ; adverse effects ; Thrombosis ; etiology ; Treatment Outcome

OBJECTIVETo compare the hemodynamic responses to orotracheal intubation via Upsher-scope (USSP) or Macintosh direct laryngoscope (MDLS) under general anesthesia.

METHODSFifty patients with ASA grade I-II and undergoing the elective plastic surgery and requiring orotracheal intubation were randomly allocated to either the USSP (U group) (n=25) or MDLS (M group) (n=25). After standard intravenous anesthetic induction, orotracheal intubation was performed using a USSP or a MDLS. Noninvasive systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded before and after anesthetic induction, at intubation and every minute thereafter for 5 minutes. The time spent in tracheal intubation was recorded. The mean blood pressure (MBP) and rate-pressure product (RPP) were calculated.

RESULTSThe intubation time was not significantly different between these two groups (P > 0.05). After anesthetic induction, SBP, DBP, MAP, and RPP in these two groups decreased significantly as compared with preinduction values. The orotracheal intubation caused significant increases in SBP, DBP, MAP, and RPP in these two groups in comparision with postinduction values (P < 0.05), but these hemodynamic changes lasted only 1 to 2 minutes and then decreased gradually to the postinduction level. The blood pressure changes caused by orotracheal intubation did not exceed the preinduction values (P > 0.05). As compared to, the maximal HR values in these two groups during observation (from the beginning of intravenous anesthetic induction to 5 min after intubation) were significantly higher than their preinduction values (P < 0.05). The maximal RPP values in M group during observation were significantly higher than their preinduction values (P < 0.05), but no such significant difference was observed in U group (P > 0.05). The hemodynamic data at each time point during the observation had no significant differences between these two groups. (P > 0.05).

CONCLUSIONSOrotracheal intubation using the USSP and MDLS may result in similar hemodynamic responses. The standard general anaesthesia can effectively inhibit the pressor, but not the tachycardiac responses caused by orotracheal intubation via USSP or MDLS. USSP is not superior than MDLS in palliating the adverse cardiovascular stress responses to orotracheal intubation.

Adult ; Anesthesia, General ; Female ; Hemodynamics ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngoscopes ; Male ; Reconstructive Surgical Procedures

BACKGROUNDTo investigate the incidence and risk factors of retinopathy of prematurity (ROP) in two Neonatal Intensive Care Units in North and South of China, respectively.

METHODSWe studied data concerning 472 infants with gestational age (GA) ≤ 34 weeks or birth weight (BW) ≤ 2000 g who were admitted to the Zhujiang Hospital of Southern Medical University and the Fourth Hospital of Shijiazhuang between January 1, 2011 and December 31, 2011. Clinical information about perinatal neonates was collected and was confirmed by reviewing medical charts. The incidence and severity of ROP were assessed in the screened population. Main outcome measures are the incidence and severity of ROP. The relationship of clinical risk factors and the development of ROP were analyzed.

RESULTSThe overall incidence of ROP was 12.7%, and the overall incidence of type 1 ROP was 2.3%; 9.4% of infants in Zhujiang Hospital had ROP compared to 15.0% infants in the Fourth Hospital of Shijiazhuang developed ROP, and the difference is statistically significant. ROP was significantly associated with GA (odds ratio [OR]: 0.77 [0.62-0.95], P = 0.015), BW (OR: 0.998 [0.996-0.999], P = 0.008), maternal supplemental oxygen administration before and during delivery (OR: 4.27 [1.21-15.10], P = 0.024) and preeclampsia (OR: 6.07 [1.73-21.36] P = 0.005). The risk factors for ROP are different in two hospitals. In Zhujiang Hospital, BW is the independent risk factors for ROP while GA, BW and preeclampsia in the Fourth Hospital in Shijiazhuang Conclusions: Retinopathy of prematurity incidence is different based on area. Incidence of ROP is still high in China. More efforts need to prevent ROP.

China ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; statistics & numerical data ; Male ; Retinopathy of Prematurity ; epidemiology ; Risk Factors