ObjectiveTo analyzing the psychological status of hospitalized patients of internal medicine and its impact factors.Methods Hospitalized patients of internal medicine underwent a survey by using Chinese Health Questionnaire (CHQ-12),Social Support Scale and Disease-Cognition Scale.Those with a score of ＞4 received further investigation of Symptom Check-List 90 (SCL-90).Correlation analysis was performed between all factors of SCL-90 and social support or disease-cognition scale score.Results There was no significant difference of psychological status between males and females ( P ＞0.05 ).All SCL90 factors were negatively correlated with social support,of which obsessive,paranoid,and phobic presented stronger negative correlations with social support and objective support (P ＜ 0.05 ).Furthermore,all factors were negatively correlated with disease-cognition scale score.A significantly negative correlation between phobic factor and disease-cognition scale score was identified ( P ＜ 0.05 ).Improvement was found in 26.2％ patients after intervention.Conclusion Patients tend to show unhealthy emotion when they are under the stress of hospitalization.Hospitalization support system may need to be improved and patients' cognition of disease should be increased.

Objective To explore the clinical efficacy of artificial liver technique - double plasma molecular adsorption(DPMAS) combined with continuous renal replacement therapy(CRRT) in the treatment of multiple organ dysfunction syndrome(MODS) patients with liver failure. Methods From April 2014 to October 2016, in the Qinghai Provincial People's Hospital emergency ICU hospitalized MODS combined with liver failure patients were enrolled in this study. On the basis of comprehensive medical treatment, these patients were randomly(random number) divided into CRRT control group(23 cases) and DPMAS + CRRT treatment group(22 cases). Blood biochemical, coagulation index, inflammatory factor and severity score of two groups were comparied before and 72 h after treatment. Results The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood amine(NH3), creatinine(CREA), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), heart rate(HR),APACHE Ⅱ score and SOFA score in CRRT control group were statistically different before and after treatment (P<0.01). However, there was no significant difference in the levels of total bilirubin(TBIL), direct bilirubin(DBIL), bile acid(TBA), prothrombin activity(PTA) and international standardized ratio(INR) (P> 0.05); In the DPMAS + CRRT treatment group, the levels of ALT, AST, NH3, CREA, IL-6, TNF-α, HR, APACHEⅡand SOFA scores were significantly different before and after treatment (P<0.01), as well as the levels of DBIL, TBA, PTA, INR(P<0.01). There was significant differences in ALT, AST, TBIL, DBIL, TBA PTA, INR, IL-6, TNF-α, APACHE Ⅱ and SOFA scores between the two groups (P<0.05), while the levels of CREA, NH3, MAP, HR of these two groups had no significant difference (P>0.05). Conclusions Because of the combination of double plasma adsorption, besides the advantages of CRRT, DPMAS+CRRT can remove bilirubin and bile acid which can not be removed by CRRT, also improve coagulation function. The clearance efficiency of inflammatory factors is also higher, and the severity score is reduced more significantly.

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR₂) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR₂ rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR₂. All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR₂ compared with non-KIT D816 group (23.1% vs 57.1%, χ²=7.559, P=0.006), and patients with longer CR₁ duration achieved significantly higher CR₂ than those with CR₁ duration less than 12 months (74.1% vs 31.9%, χ²=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR₁ duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.

Objective To explore the gender heterogeneity of depression and thyroid hormone and homocysteine levels in infertile patients.Methods Totally 250 patients with infertility were selected in Tangshan Maternal and Child Health Care Hospital affiliated to North China University of Science and Technology from December 2015 to April 2017.The Self-Rating Depression Scale(SDS) was used to evaluated the patients's depression.The patients with infertility and depression were divided into infertility and depression group,and the patients with infertility but without depression were infertile and non-depressed group,patients with infertility and depression were divided into male infertility and depression group and female infertility group with depression,and the levels of thyroid hormone and homocysteine were measured respectively.Results ①The thyroid stimulating hormone and homocysteine levels in infertility patients with depression were significantly higher than those without depression ((2.045± 1.253) uIU/ml,(2.412± 1.236) uIU/ml,t=-2.287,P=0.023;(15.411 ±9.143) mmol/L,(19.129± 13.087) mmol/L,t=-2.467,P=0.014).②There was no statistically significant difference in the degree of depression between male and female infertility patients (x2=0.483,P=0.785).③ The levels of triodothyronine,thyroxine and homocysteine in male infertility patients with depression were significantly higher than those in female patients ((1.926±0.648)nmol/L,(1.712 ±0.416) nmol/L,t=2.457,P=0.015;(117.86± 19.311) nmol/L,(110.185± 18.999) nmol/L,t=2.434,P=0.016;(15.575±4.139) mmol/L,(12.277±3.921) mmol/L,t=4.982,P＜0.01),and the TSH was lower than that in the female group((2.496± 1.329) uIU/ml,(3.057± 1.583) uIU/ml,t=-2.303,P=0.023).④The TSH and Hcy levels of male and female infertility patients were significantly positively correlated with SDS indexes,and had a significant positive predictive power to SDS score.Conclusion The levels of thyroid hormone and homocysteine are different in gender in infertile patients with depression,and the thyroid hormone and homocysteine are related to the depression.so we should pay attention to the depression symptoms of infertility patients and the changes of their biological levels,especially the gender heterogeneity.

Objective: To investigate the features of plaques of saphenous venous graft (SVG) with virtual histology intravascular ultrasound (VH-IVUS) in patients underwent coronary artery bypass graft surgery. Methods: From March 2016 to March 2018, a total of 45 patients ((64.4±7.9) years old, 88.9% male (40 cases)) with ischemic symptoms after coronary artery bypass graft surgery and with coronary artery angiography evidenced SVG stenosis greater than or equal to 50%, who received percutaneous coronary intervention in Tianjin chest hospital were continuously included in this study, and the clinical data were retrospectively analyzed. VH-IVUS was performed before PCI to analyze plaque composition. The patients were divided into no smoking group (21 cases) and smoking group (24 cases), no diabetes group (30 cases) and diabetes group (15 cases), normal very low density lipoprotein cholesterin (VLDL-C) group (24 cases) and elevated VLDL-C group (21 cases), stable angina pectoris group (5 cases) and acute coronary syndrome group (40 cases), plaque burden (PB) < 70% group (11 cases) and PB ≥ 70% group (34 cases), without thin-cap fibroatheroma group (35 cases) and thin-cap fibroatheroma group (10 cases), and plaque features were compared between different groups. Results: The graft age was (8.9±3.7) years.The stenosis degree of SVG lesions was 90 (90, 98) %. The minimum lumen diameter was 1.6 (1.5, 1.8) mm. The vessel cross-sectional area was (12.1±4.0) mm². The plaque area was 8.6 (5.7,12.0) mm². The minimum lumen area was 2.5 (2.1,3.3) mm². The plaque burden was (75.3±8.3)%. The fibrotic tissue (FI) ratio was (65.1±10.1)%, fibrofatty plaque (FF) ratio was 13.8 (5.4,25.3) %, necrotic core tissue (NC) ratio was 12.0 (5.4,24.0)%, and dense calcium tissue (DC) ratio was1.0 (0.2,3.8)% in SVG lesions. There were no significant differences in SVG plaque area, FI area,FF area,NC area,and DC area between no smoking group and smoking group, no diabetes group and diabetes group, and normal VLDL-C group and elevated VLDL-C group. SVG plaque volume was significantly higher in acute coronary syndrome group than in stable angina pectoris group (262.2 (148.5,401.2) mm³ vs. 93.1 (50.6,155.9) mm³,P=0.006), and plaque area (10.1 (6.6,13.3) mm² vs. 5.0 (3.6,6.9) mm², P<0.001), FI area(4.8 (3.2,6.8) mm² vs. 2.8 (1.9,3.0) mm², P<0.001),and FF area (1.15 (0.60, 2.07) mm² vs. 0.30 (0.10,0.90) mm², P=0.009) were significantly larger in PB ≥ 70% group than in PB < 70% group.The NC area (1.75(0.40,2.78) mm² vs. 0.60 (0.20,1.30) mm², P=0.030) and DC area (0.35 (0.10,0.50) mm² vs. 0.00 (0.00,0.10) mm², P=0.006) were significantly larger in thin-cap fibroatheroma group than that in without thin-cap fibroatheroma group. Spearman correlation analysis showed that the plaque area of SVG lesion was positively correlated with FF area (r=0.64, P<0.001) and NC area (r=0.43, P=0.003). PB was positively correlated with FF area (r=0.50, P<0.001) and NC area (r=0.33, P=0.028). Graft age was positively correlated with FF area (r=0.30, P=0.047). Conclusions The main components of SVG plaque are fibrotic tissue, conversely, calcified tissue is rare in patients with SVG stenosis after coronary artery bypass graft surgery. Fibrofatty tissue is increased in the plaque in patients with PB ≥ 70%. The necrotic component is also increased in patients with thin-cap fibroatheroma. The fibrofatty component increases and the plaque tends to be unstable in proportion with increaing age of the graft in this patient cohort.