Background:Some functional dyspepsia(FD)patients are accompanied by sleep disorder,which severely affects the quality of life. Aims:To explore psychological factors and quality of life of FD patients with sleep disorder. Methods:A total of 240 FD patients from Jan. 2013 to Jan. 2014 at the Second Affiliated Hospital of Xi’an Jiaotong University and the Affiliated Hospital of Yan’an University were enrolled,and were divided into sleep disorder group and non-sleep disorder group according to Pittsburgh sleep quality index. Zung’s self rating anxiety scale,Zung’s self rating depression scale and SF-36 quality of life questionnaire were performed in all the patients. Results:Compared with non-sleep disorder group, the incidence of anxiety(72. 5% vs. 40. 8% )and incidence of depression(65. 0% vs. 37. 5% )were significantly higher in sleep disorder group(P < 0. 05). Score of physical function(86. 65 ± 3. 84 vs. 88. 88 ± 4. 56),vitality(44. 79 ± 18. 13 vs. 54. 63 ± 9. 63),mental health(46. 90 ± 11. 47 vs. 63. 42 ± 17. 60),general health(42. 79 ± 11. 07 vs. 58. 29 ± 14. 99)in sleep disorder group were significantly lower than those in non-sleep disorder group,and no significant differences in physical role function,emotional role function,social role function,and body pain were found between the two groups(P > 0. 05). In patients with sleep disorder,the incidence of mental disorder was significantly different among young age group,middle age group and old age group(50. 0% ,55. 0% ,80. 0% ,respectively)(χ2 = 8. 10,P < 0. 05), and the incidence of mental disorder in male patients was significantly lower than that in female patients(32. 6% vs. 79. 2% ;χ2 = 25. 62,P < 0. 05). Conclusions:FD patients with sleep disorder has its own clinical characteristics. Study on the clinical characteristics of FD patients with sleep disorder could facilitate the effectiveness therapy,and has important significance in improving the quality of life.

Adult ; Aged ; Aged, 80 and over ; Carbon Monoxide Poisoning ; complications ; Female ; Humans ; Interleukins ; blood ; Male ; Middle Aged ; Neurotoxicity Syndromes ; blood ; etiology

Objective To evaluate the effect of Tirofiban on CRP levels in patients with acute myocardial infarction (AMI) after primary emergency percutaneous coronary intervention (PCI). Methods Eighty-four AMI patients admitted on emergency were randomly divided into two groups: (1) early-treated group (n=45), immediately receiving Tirofiban intravenously on admission and (2) late-treated group (n=39), receiving Tirofiban intravenously after coronary angiography was performed. TIMI grading before and after PCI in beth groups were compared, CRP levels before and three days after PCI were estimated. The major adverse cardiovascular events (MACEs) occurred during hospitalization and following-up period of three months were recorded. Results Before PCI, TIMI grade 3 forward flow rate in early-treated group was significantly higher than that in late-treated group, while no significant difference existed between two groups after PCI. Three days after PCI, CRP level in early-treated group was markedly lower than that in late-treated group. During hospitalization, the occurrence of MACEs in early-treated group was lower than that in late-treated group, while no marked difference was found between two groups during the following-up period of three months. Conclusion In treating AMI patients with primary PCI, Tirofiban should be used as early as possible, which is safe and effective for PCI and can also significantly improve forward blood flow in target vessels, decrease the ClIP level and reduce the occurrence of MACEs during hospitalization.

Recently,the relationship between psoriasis and coronary heart disease(CHD)have been casting close attention.It has been demonstrated that the prevalence of CHD in patients with psoriasis is more than one time higher than that of healthy people. Meanwhile,the prevalences of hypertension,diabetes mellitus, hyperlipoidemia and smoking in patients with psoriasis are higher than those of normal people,and some drugs for treatment of psoriasis may induce CHD.Therefore,the relationship between psoriasis and CHD is still unclear.In this paper,two cases of psoriasis complicated with CHD are reported,and the relationship between psoriasis and CHD is explored.

Objective To analyze the impact of tripterygium glycosides (TG) on the expression of CXCR3 and CCR4 gene in peripheral blood mononuclear cells from experimental autoimmune thyroiditis (EAT) rats, and to explore the possible mechanism for regulation of Th1/Th2 balance by TG. Methods EAT was induced in 20 rats, which were randomly divided into two groups, i.e., control group and TG group, to receive intragastric physiological saline and TG suspension (5.5 mg/kg) daily, respectively. The rats were killed 4weeks later, and total RNA was extracted from the peripheral blood mononuclear cells of rats and used for cRNA synthesis. The gene expressions of CXCR3 and CCR4 were detected with a Th1-Th2-Th3 microarray gene chip and realtime RT-PCR. Results Compared with the control group, there was a significant decrease in the mRNA expression of CXCR3 (0.52 ± 0.10 vs. 1.05 ± 0.17, P < 0.01 ) and CXCR3/CCR4 ratio (0.39 ± 0.22 vs. 1.04 ± 0.12, P< 0.01) in the TG group, together with an increase in the mRNA expression of CCR4 (1.56 ±0.13 vs. 1.02 ± 0.09, P < 0.01 ). Conclusions TG could regulate the number of Th1 and Th2 cells as well as their cytokine expression ratio likely by reducing CXCR3 and enhancing CCR4 expression, so as to modulate the Th1/Th2 balance in EAT rats.

Venous thromboembolism,including deep vein thrombosis and pulmonary embolism,is one of the common complications after stroke,and it also significantly increases the mortality in patients with stroke.Because of limb paralysis,prolonged bed rest,and specific hypercoagulable state,the patients with stroke become the high risk population of thrombosis.The preventive measures manly including physical and drug prevention.Clinical studies have confirmed that anticoagulation therapy for the prevention of venous thromboembolism is effective in patients with ischemic stroke.However,for patients with spontaneous intracerebral hemorrhage,whether anticoagulant drugs can be used and how to use them have not yet reached consensus,mainly on account of the risks of rebleeding or hematora enlargement.This article reviews the related literatures in recent years and summarizes the advances in research on the prevention and treatment of venous thrombosis in patients with intracerebral hemorrhage.

OBJECTIVE: To explore the effects of Liangxue Huayu therapy (LXHYT), a traditional Chinese herbal therapy for cooling blood and dissipating blood stasis, on rat model of experimental autoimmune thyroiditis (EAT) and its impact on tumor necrosis factor-alpha and interleukin-10 mRNA expressions in peripheral blood mononuclear cells. METHODS: Forty Wistar rats were randomly divided into five groups: normal control group, untreated EAT group, cyclosporine A (CyA)-treated group, Tripterygium glycosides-treated group and Liangxue Huayu Recipe (LXHYR)-treated group. The interventions were given by gavage to the rats in different groups once a day. All rats were sacrificed after 4-week treatment, and the level of serum thyroglobulin antibodies (TgAb) and the changes of histological grade of thyroid specimen were assessed by blind evaluation. Expressions of tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) mRNAs in peripheral blood mononuclear cells were assessed by real-time reverse transcription polymerase chain reaction method. RESULTS: There was a significant increase in the serum TgAb level and severe inflammatory infiltration in the untreated group. Expression of TNF-alpha mRNA in peripheral blood mononuclear cells was increased, while the expression of IL-10 mRNA was decreased in the untreated group (P<0.01). Compared with the untreated group, CyA, Tripterygium glycosides and LXHYF could decrease the serum TgAb level (P<0.05), but the three interventions showed no significant improvement in thyroid inflammation (P>0.05). TNF-alpha mRNA expression was decreased, while IL-10 mRNA expression was increased as compared with the untreated group (P<0.05). CONCLUSION: LXHYT can decrease the serum TgAb level and recover the balance of Th1/Th2. This may provide an experimental basis for further research of assessing the antipsoriatic effect of Chinese herbal drugs with a rat model of EAT as an alternative model of psoriasis in vivo.

ve In order to improve the reliability of somatosensory evoked potentials (SSEP) monitoring during anesthesia, we compared the effects of three commonly used volatile anesthetics on SSEP to choose suitable volatile anesthetic and determine the appropriate end-expiratory concentrations which have least effects on SSEP monitoring. Methods Sixty ASA I - II patients undergoing elective intracranial surgery were randomly divided into three groups: group A received enflurane; group B isoflurane and group C desflurane. The demographic data including age, body weight, height and sex were not significantly different between the three groups. In addition to SSEP, ECG, BP, SpO2, PET CO2 and end-tidal concentration of inhalation anesthetic were monitored. The SSEP electrodes were placed on N13 on the neck and N20 on the scalp. Before experiment the patient was asked to lie quietly for 10 min, then the patient started breathing 100% O2 and fresh-gas-flow (FGF) was set at 5 L/min. Median nerve on one side was stimulated and SSEP waves from cortex and cervical spinal cord were recorded as baseline tracing before anesthesia. The concentration of inhalation anesthetic was gradually increased from 0 to 0.3, 0.5, 0.75, 1.0 and 1.5 MAC. Each concentration was maintained for 15 min and SSEP waves were recorded. During experiment if the patient developed respiratory depression, oral airway was inserted and assisted ventilation was performed to maintain PETCO2 at 35-45minHg. If the patient developed hypotension, fluid was infused at an increased rate and vasopressor was given if necessary to maintain normal BP (baseline ? 20 % ) . Results The three volatile anesthetics did not change N13 latency and amplitude. Increasing concentrations of enflurane, isoflurane and desflurane were associated with graded reduction in N20 amplitude and increase in N20 latency and N13-N20 interpeak latency. Conclusions The results suggest (1) cortical SSEPs are moresensitive to the volatile anesthetics than subcortical SSEPs, (2) end-tidal concentration of enflurane less than 0.75 MAC is compatible with effective SSEP monitoring, whereas the end-tidal concentration of isoflurane or desflurane compatible with effective SSEP monitoring was less than 1.0 MAC. Enflurane has greater effect on SSEP than isoflurane and desflurane.

Objective To evaluate the current methods for psychiatry clinical internship and needs for innovation from the perspectives of medical undergradutes.Methods Independent interview on patients and their relatives as well as social psychological interview were conducted for five-year psychiatry majors in clinical internship (n =72).Self-made questionnaire was used to investigate the teaching feedback concerning the practice effect and teaching method tendency.Data were analyzed by t test and P ＜ 0.05 signifies statistically significant differences.Results Medical students considered the clinical internship as the main source of psychiatry knowledge (rising from 29.4 ％ (20/69) to 36.2％ (25/69),t =4.67,P ＜0.01).Respective interviewing with patients and their families and then doing focus-group discussion was the most acceptable method for medical undergraduates:82.6％(57/69) of medical undergraduates thought this method helped expose defects of clinical skills and prejudice against psychiatry; 54.3％ (37/69) of medical undergraduates thought this method was more beneficial to acquire psychiatry knowledge.The second acceptable method was the demonstration of a typical case by teacher:27.3％ (19/69) thought this method helped expose defects of clinical skills and prejudice against psychiatry; 27.2％ (19/69) thought this method was more beneficial to acquire psychiatry knowledge.62.0％ (43/69) of medical undergraduates ranked the characteristics of the symptomatology and core symptoms differentiation as the first place.49.0％ (34/69) considered the training of interviewing skills with patients as the second important in the clinical training.91.3％ (63/69) expected to see more kinds of mental disorders.65.2 ％ (45/69) expected to learn more about the interviewing skills.Conclusions It is necessary to pay more attention to the method of doing respective interviewing with patients and their families and then making focus-group discussion.Meanwhile training of interviewing skills in the clinical internship of psychiatry should be enhanced.

Objective To investigate the effects of Tongxinluo on C reactive protein(CRP)and clinical prognosis in patients after coronary stenting. Methods From January 2003 to December 2004, 132 patients in our department diagnosed as coronary artery disease(including acute myocardial infarction, unstable angina pectoris and stable angina pectoris)were divided into two groups: Tongxinluo group and control group. The control group received routine treatment, while Tongxinluo group based on routine treatment was administrated with Tongxinluo capsule in combination for 6 months. Results CRP level was much lower in Tongxinluo group together with apparent decrease of the major adverse cardiac event(MACE)rate in 6 months' follow-up than those of the control group, but showing no difference in coronary arterial restenosis between the two groups at 6 months after coronary stenting. Conclusion Tongxinluo has favorable effects to decrease the CRP level and improve clinical efficiency together with prognosis for patients after coronary stenting.