Objective Recent studies suggest that the red blood cell distribution width ( RDW) may play a role in the diag-nosis and treatment of cardiovascular disease.The aim of this study was to investigate the correlation of red blood cell distribution width (RDW) with cardiovascular events in patients with Acute ST-segment elevation myocardial infarction (ASTEMI) in order to provide the basis for improving the diagnosis level and therapeutic effect. Methods Retrospective study was made on the clinical data of 189 patients with ASTEMI enrolled in Sichuan Provincial People′s Hospital from January 2013 to March 2014.The survival rates of patients with ASTEMI with different RDW were estimated by Kaplan-Meier and compared by Log-rank test and the prognosis factors were inves-tigated by Cox proportional hazard regression model. Results 97 patients′RDW levels were more than 13.7% and 92 patients′RDW levels were less than or equal to 13.7% in 189 ASTEMI patients. The hs-CRP, BNP, LVEF and HDL-C were significantly different be-tween two groups (P<0.05).The rates of recurrent myocardial in-farction, heart failure, sudden death cardiac in patients with highRDW were higher than that in patients with low RDW (22.7%vs 8.7%, 27.8%vs 10.9%, 15.5%vs 5.4%)(χ2 =6.915, 8.632, 5.019, P<0.05) .There were 60 patients with high RDW who experienced cardiovascular events and the 1-year cardiovascular event-free survival rate was 38.1%, and 20 patients with low RDW cardiovascular events was 79.3% in follow-up period (χ2 =30.959, P<0.001).Multivariate cox regression showed that age>65 (HR=2.43, 95%CI:1.09~5.44) and RDW>13.7%(HR=2.20, 95% CI:1.10~4.43) were risk prognostic factors. Conclusion There is a certain correlation between RDW and cardiovascular e-vents in patients with ASTEMI.The ASTEMI patients with high RDW hold higher risk of cardiovascular events and poorer prognosis.

Objective:To explore the quality of life in patients with primary insomnia.Methods:Comprising 85 patients diagnosed as primary insomnia and 57 healthy controls,the study analyzed and compared the differences in quality of life between the two groups.Results:(1)Compared with healthy controls,the patients with primary in- somnia decreased in quality of life.total score,Physical functions,psychological function and social function in pri- mary insomnia group were significantly lower than those in control group in score of generic quality of life inventory (score:254.9?26.4/287.1?30.4,t=-5.15,P

Objective To investigate the clinical and molecular genetic changes in a Chinese family with oculopha?ryngeal muscular dystrophy(OPMD). Methods We collected the clinical data of the familial members and blood sam?ples from all available 16 familial members, including the proband. The samples were analyzed using modified poly?merase chain reaction amplification and direct sequence analysis. Results Male OPMD patients initially presented with ptosis, followed by pronunciation difficulty, dysphagia and limb weakness whereas female OPMD patients initially pre?sented with swallowing difficulty. Genetic test revealed the abnormal expansions of the GCG trinucleotide repeat from GCG6 to GCG10 in PABPN1 gene in 10 familial members. Conclusions The genetic test and prenatal diagnosis is the key for the prevention treatment of oculopharyngeal muscular dystrophy. The ptosis of eyelid may be the initial symptom for the male patients of oculopharyngeal muscular dystrophy with (GCG)10 mutation.

Objective To evaluate the effectiveness of biofeedback in preventing chronic daily headaches. Methods One hundred patients experiencing daily headaches were randomly divided into a biofeedback group ( n=50) and a drug therapy group (n=50). The patients in the drug therapy groupwere administered a predetermined course of medication. Those in the biofeedback group were given 30 minutes of biofeedback therapy twice a week for 8 weeks, followed by 10 months of intensive therapy once a month. The headache frequency, duration of headache at-tacks, days of using acute pain medication and any other adverse events were recorded 3, 6 and 12 months after the treatment. Results The patients in the biofeedback group had significantly less-frequent headaches, shorter headache attacks and fewer days of using acute pain medications. Conclusion Compared to drug therapy, biofeed-back can prevent chronic daily headachesmore safely and effectively.

OBJECTIVEThis study was undertaken to observe the change in the local level of angiotensin II (Ang II) and the expression of its corresponding receptors AT1 and AT2 during wound healing, and explore the possible role of Ang II in wound healing .

METHODSA model of full-thickness cutaneous wound was developed on the back of C57/BL6 mice. Specimens were taken from the wound of each mouse on the day 0, 1, 3, 5, 7, 9, 11, 13 and 15 after wounding. The change in the generation of Ang II in wounded tissue during the healing process was detected with ELISA. The proliferation and the apoptosis of cells were detected by bromodeoxyuridine (Brdu) and terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labeling (TUNEL) method in wounded skin during the healing process, respectively. The cellular localization and the mRNA level change of Ang II receptors in wounded tissue during healing were detected with immunostaining and RT-PCR.

RESULTSAng II produced in wounded skin was increased in the first 7 days to reach the peak, and then gradually decreased during wound healing. BrdU labeling index was increased gradually in the first 7 days to reach the peak, and then gradually decreased during wound healing. The number of TUNEL-positive cells was increased slowly in the first 7 days after wounding. The increase in the number of TUNEL-positive cells was more markedly after epithelization of the wound. In normal mice, AT1 and AT2 receptor were found positively expressed in the whole epidermal layer, while positive expression was only found in the endothelial cells of the capillary vessels within the dermal layer, and positive expression was also found in appendages of the skin, i. e. hair follicle, sweat gland and sebaceous gland respectively. Positive staining signal of both AT1 and AT2 receptors were increased in the first 7 days to reach the peak, then gradually decreased. Expression of AT2R was increased again following the epithelization of wound. The result of RT-PCR showed that the expression of both AT1 and AT2 receptors was detectable, and AT1 receptor was increased in the first 7 days to the peak, and then gradually decreased during wound healing, while AT2 receptor expression reached its peak value on day 7, then gradually decreased, and increased again following the epithelization of wound.

CONCLUSIONSThese results indicate that Ang II participate in wound repair and related to remolding in the late stage of wound healing through the change in production of angiotensin II and expression of AT1 and AT2 receptors. AT1 receptor might be closely associated with cell proliferation, while AT2 receptor might play a role in cell apoptosis and remolding during wound healing.

Angiotensin II ; genetics ; metabolism ; Animals ; Apoptosis ; Cell Proliferation ; Male ; Mice ; Mice, Inbred C57BL ; RNA, Messenger ; genetics ; Receptors, Angiotensin ; genetics ; metabolism ; Skin ; injuries ; metabolism ; pathology ; Wound Healing ; physiology

OBJECTIVETo study the status of and the factors contributing to Internet addiction among middle school students in Guangzhou.

METHODSCluster sampling method was used to recruit an urban middle school, a rural junior middle school and a rural senior high school to conduct the survey with the stressful life event questionnaire, the trait-oriented coping styles questionnaire and the Internet Addiction Test.

RESULTSThe majority of respondents were classified as normal users of the Internet (n=1392, 89.2%), with 158 (10.2%) moderately and 10 (0.6%) severely addicted to the Internet. Fifty-eight students had never used the Internet. There were significant differences in gender, the father's education, the 4 dimensions of the stressful life event questionnaire and the coping styles between students with and without Internet addiction. Binary logistic analysis showed that the factors contributing to Internet addiction included passive coping styles, male gender and stressful life event experienced in family and interpersonal communication.

CONCLUSIONSThe incidence of Internet addiction is high among middle school students in Guangzhou. Male students with stressful life events in family and interpersonal communication, poor education on the part of the father, and frequent use of negative coping styles are more likely to develop Internet addiction.

Adolescent ; Behavior, Addictive ; epidemiology ; China ; epidemiology ; Female ; Humans ; Internet ; Male ; Prevalence ; Students ; psychology ; Surveys and Questionnaires

OBJECTIVETo identify polymorphisms of the serotonin transporter(5-HTT) gene and to find out whether there was relationship between any such polymorphisms and sleep apnea syndrome (SAS).

METHODSFor two polymorphisms of 5-HTT target DNA gene was amplified using polymerase chain reaction (PCR) and 6% non-denaturing polyacrylamide gels electrophoresis. The frequencies of the different forms of the genotypes and alleles of 5-HTT gene were analyzed in 104 patients with SAS and 150 healthy controls.

RESULTSThe frequencies of the S or L alleles and the S/S, S/L or L/L genotypes in promoter region of 5-HTT gene in SAS group were not significantly different to those in healthy controls (P > 0.05). However, the frequencies of 10/10, 12/10 genotypes of 5-HTT-VNTR in SAS patients were significantly higher than those in healthy control subjects (P < 0.05). Moreover, the frequency of the allele 10 of 5-HTT-VNTR in SAS patients was significantly higher than that in healthy controls (P<0.01).

CONCLUSIONThe allele 10 of 5-HTT-VNTR might be a susceptible factor in the pathogenesis of SAS.

Adult ; Aged ; Alleles ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Male ; Middle Aged ; Minisatellite Repeats ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Sleep Apnea Syndromes ; genetics ; Young Adult

OBJECTIVETo summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment for adult refractory cardiogenic shock.

METHODSFrom January 2003 to January 2011, patients with refractory cardiogenic shock required veno-arterial ECMO by failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury, advanced malignancies and multiple organ failure were excluded. Patients were divided into weaned group (n = 31) and not weaned group (n = 23) according to the ECMO weaning.

RESULTSThe duration of ECMO was 24.16 (14.12, 56.75) hours. Twenty-two out of 31 patients in the weaned group survived and were discharged, 9 patients died after successfully weaned from ECMO (5 due to multisystem organ failure, 2 due to reoccurred cardiogenic shock, 1 due to infectious shock and 1 due to disseminated or diffuse intravascular coagulation). Pre-ECMO mean arterial pressure, ejection fraction, the duration of ECMO were significantly higher while pre-ECMO blood lactate [(8.64 ± 3.17) vs. (14.44 ± 2.52) , P < 0.01], the duration of ROSC [ (16.70 ± 5.29) vs. (35.64 ± 5.89), P < 0.01] and multisystem organ failure [0 vs. 17.4% (4/23) , P < 0.05] were lower in weaned group than in not wean group.

CONCLUSIONSECMO is an effective mechanical assistant therapy strategy for adult refractory cardiogenic shock patients. Timely applying this strategy on suitable patients is crucial for the success of ECMO. Cardiac function and reversibility of heart failure are key factors determine the fate of weaned or not weaned ECMO in adult refractory cardiogenic shock patients.

Adult ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shock, Cardiogenic ; therapy

OBJECTIVETo observe the distribution difference of magnetic resonance imaging (MRI) signals in osteonecrosis of the femoral head (ONFH) patients of different TCM syndrome types.

METHODSRecruited 29 ONFH patients were assigned to the tendon and vessel stagnation group (14 cases) and the Gan-Shen deficiency group (15 cases) according to TCM syndrome typing. The distribution difference of their MRI signals of MRIT1WI, T2WI + fs, T1 and T2 combined signal were compared.

RESULTSThere was statistical difference in T1W1 signal distribution between the two TCM syndrome types (P = 0.04). There was no statistical difference in T2WI + fs or T1 and T2 combined signal between the two TCM syndrome types (P = 0.42, P = 0.15). MRI signals in the tendon and vessel stagnation group were mainly manifested as fat-like signals,while they were mainly manifested as mixed signals in the Gan-Shen deficiency group.

CONCLUSIONDistribution difference of MRI signals exists between ONFH patients of different TCM syndrome types.

Adult ; Aged ; Diagnosis, Differential ; Female ; Femur Head Necrosis ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Medicine, Chinese Traditional ; Middle Aged

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.