Objective To explore the status and impact factors of hospitalized patients with coronary heart disease(CHD) accompanying depression disorders.Methods Adopt HRSD,SDS and general questionnaire for survey tools to evaluate the 300 hospitalized patients with CHD.Using SPSS13.0 software to build database,and the data was analyzed by descriptive statistics analysis and correlation analysis.Result There were 148 people accompanying depression disorders among the hospitalized·patients with CHD(47.30％ ),and 68 people were treated (47.89％).Multivariate logistic regression indicated that the age ( OR =-0.415,P ＜ 0.05,CI =0.443 ～0.984),smoking history( OR =0.384,P ＜ 0.05,CI =1.118 ～ 1.928 ),course of disease ( OR =-0.250,P ＜0.05,CI =0.608 ～ 0.996),myocardial infarction ( OR =0.676,P ＜ 0.05,CI =1.082 ～ 3.576 ),family history ( OR =-0.744,P ＜ 0.05,CI =0.231 ～ 0.978 ) were related to coronary artery disease accompanying depression disorders.Multivariate correlation analysis indicated that anxiety factor and gender were closely related,weight factor and age,educational level,myocardial infarction had closed relationship,cognitive factors were closely associated with the course of disease,day and night changes were in relation to age,block factor and gender,age,education,drinking history,smoking history were related closely,sleep factor and gender,onset form,hypertension relations closed,despair factor have closed relationship with gender,age,educational level,course of disease.Conclusion Age,smoking history,course of disease,myocardial infarction,family history were important risk factors of depression disorders in hospitalized patients with CHD.The HRSD's seven symptoms factors are closely associated with multipling influence factors.

Objective To explore the relative factors of aggressive behaviors in inpatients with schizophrenic.Methods 178 cases of continuously admitted schizophrenic patients were divided into attack group and non aggressive group according to the aggressive behavior of preadmission.Single factor analysis and multi factor regression analysis was applied to two groups in situation(such as age,gender,education level,course of disease,past aggressive behaviors and so on),Brief Psychiatric Rating Scale (BPRS) and Eysenck Personality Questionnaire (EPQ).Results By single factor analysis,attack group had significantly longer course of disease(7.73±6.67) than non aggressive group (5.22 ± 5.47,t =2.631,P＜ 0.01).The score of hostile suspicious factor in BPRS (13.73 ± 3.098) in attack group was significantly higher than that in nonaggressive group(11.47±3.93) (t=4.063,P＜ 0.01),but anxiety factor (7.18± 3.583) was significantly lower than that in nonaggressive group (8.70 ± 3.89) (t=2.679,P＜0.01).The score of E scale of EPQ(11.99±4.340) in attack group was significantly higher than that in nonaggressive group(10.67±4.293) (t=1.990,P＜0.01).Attack group's proportion of patients of previous attacks (71.1％) was significantly higher than that in non aggressive group (16.0％),(x2 =39.082,P＜ 0.01).(2) Logistic analysis showed that hostile suspicious factor in BPRS and past aggressive behaviors entered the regression equation.Condusions Aggressive behavior in schizophrenic patients occurs mainly with psychiatric symptoms and the past history of aggressive behavior.The patients should be treated actively to control the symptoms and prevent the disease recurrence.

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI).Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016.The patients were divided into two groups according to the prolongation of R time at admission,and the basic data and the outcomes were analyzed.Results In basic data,Glasgow coma scale (GCS) [(9.7 ± 4.4) scores vs (12.1 ± 2.2) scores] was lower,and injury severity score (ISS) [(32.4 ± 8.9) scores vs (21.7 ± 10.4) scores],head abbreviated injury scale (AIS) [(5.0 ±0.0) scores vs (4.1 ± 1.5) scores],hemorrhage volume [(6.2 ± 5.5) ml vs (1.1 ± 1.8) ml] and mean arterial pressure[(127.2 ± 28.1) mmHg vs (103.3 ± 17.0) mmHg] were higher in the prolonged R time group.In outcomes,the in-hospital mortality (42.9％ vs 17.2％) and the rate of neurosurgical intervention (71.4％ vs 37.7％) were higher,and the duration of mechanically ventilated [(9.3 ±3.2) d vs (4.1 ± 1.7) d],ICU stay [(10.2 ± 4.4) d vs (5.6 ± 2.1) d] and hospital stay [(22.4 ± 8.1) d vs (8.3 ± 4.7) d] were longer in prolonged R time group.The Logistic regression analysis results showed that GCS ≤8 scores,ISS ＞ 25 scores and R time ＞ 10 min were the possible risk factors of hospital mortality.Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality,and the prediction efficiency of R time need to be explored and validated by more research.

Objective To achieve primary intervention from early on the analysis concerning correlations between BI-RADS classification and the factors that might influence it was conducted. Methods In this paper, the women involved in the 7204 cases of physical examinations in our hospital(over the past 5 years)were chosen as the subjects investigated. The correlations between their breast ultrasounography results and the factors such as age,BMI,triglycerides,total cholesterol,glucose,and uterine status were analyzed. The breast report used the Breast imaging reporting and data system(also known as BI-RADS)of the American Society of Radiology to inter-pret the results. Chi-square test and logistic multivariate analysis of data were analyzed by SPSS 13 statistical soft-ware. Results The age,triglyceride,total cholesterol,HDL and glucose were not the factors influencing BI-RADS classification(P>0.05);BMI(P=0.004)and uterine status(P=0.000)turned out to be the independent factors. Low body weight[odds ratio(OR)= 0.696,95%Confidence interval(CI)= 0.502 ~ 0.966],overweight (OR=0.217,95%CI=0.142~0.333),and obese(OR=0.123,95%CI=0.066~0.231)were negatively correlat-ed with it. Hysterectomy(OR = 19.189,95%CI = 14.055 ~ 26.198),(OR = 4.384,95%CI = 3.499 ~ 5.492), uterine fibroids ,menopausal uterus were found to be the risk factors(OR = 3.283 ,95%CI = 2.374 ~ 4.541). Conclusion For the premenopausal women,being overweight or underweight can help reduce the risk of getting breast diseases. However,those suffering absence of uterus,or uterine fibroids,or in their menopausal period,are supposed to be among the high-risk group of breast cancer for regular screening.

Objective To investigate the effect of Intedeukin-18 (IL-18) on Th1/Th2 balance and its antitumor mechanism in C57BL/6 mice Lewis lung cancer model. Methods 24 C57BL/6 mice were randomly divided into three equal groups: group A(IL-18 injec-tion group, n = 8), group B (Lewis lung cancer model, n = 8) and group C (normal control group, n = 8). The Lewis lung cancer cells were cultured and implanted subcutaneously into the group A and group B. IL-18 and NS were given to group A and B respectively by intrap-eritoneal injection on the 7th day (once every day, 7 times altogether), but group C was not given any treatment. Enzyme-linked immunosor-bent assay (ELISA) was used to detect the Th1/Th2 cytokines. Health status in all the animals was evaluated; the volume and weight ofsubcutaneous tumors were measured. Results The concentration of IFN-γ in group A and C were significantly higher than those in group B (P <0.05), and the concentration of IL-4 in group A and C were significantly lower than those in group B (P<0.05), but there was no significant difference between group A and C (P>0.05). The tumor growth inhibitory rate was 75%. Conclusion IL-18 can effectively induced IFN-γ and inhibit IL-4 production, regulate Th1/Th2 balance in the C57BL/6 mice Lewis lung cancer model, and elicit the antitu-mor immunity of the host, which could obviously inhibit the growth of tumor cells and decelerate the proliferation of tumor cells.

Diarrhea is a common intestinal symptom in macaque.The corresponding intestinal lesions of macaque are mainly described at autopsy but less observed by colonoscopy.The aim of this study was to develop a colonoscopic technique and to obtain endoscopic images of the entire colon in macaques.Eight healthy adult macaques ( 5 males and 3 females) without diarrhea for 2 months, were fed Glauber’ s salt through nasogastric tubes.The colon cleanliness was well matched to the endoscopic observation of macaque colon.The procedure took 10-20 min for each animal.There was no obvious abnormality in the colon of four animals except some slight differences of mucosal structure from that of human beings.Small pieces of erosion and ulcer in the colons were observed in four macaques which presented mild diarrhea for less than 1 day, while a severe stenosis was observed in one of those four macaques.No animal died during and one week after the endoscopic procedure.Colonoscopy may safely performed in macaques.The images taken by colonoscopy may be important to establish diagnosis and treatment of colitis in macaques in time and to evaluate the efficacy of drug intervention as well.This technique is also helpful to provide qualified macaques for scientific researches.

Objective To establish a preoperative nomogram model in predicting microvascular invasion (MVI) and to test its predictive effectiveness in hepatocellular carcinoma (HCC).Methods This retrospective study was conducted on 798 patients with HCC,including 690 males and 108 females,aged (49.8± 10.9) years old who underwent curative hepatectomy in the Guangxi Medical University Affiliated Tumor Hospital between January 2014 and December 2017 were retrospectively analyzed.The patients were divided into the model group (n=579) and the validation group (n=219) according to the periods of the operation time.Independent risk factors of MVI were identified by univariate and multivariate logistic regression analysis in the model group,and a nomogram model was established according to the independent risk factors.The accuracy of the nomogram model in predicting MVI was detected in the two groups by the computer consistency coefficient (C-index) and calibration graph method.The predictive value was evaluated by receiver operating characteristic curve.Results Histopathological diagnosis revealed 278 patients with MVI and no MVI in the 301 patients of HCC out of the 579 patients in the model group.In the validation group,there were 119 patients with MVI and 100 patients with no MVI out of the 219 patients.Total bilirubin ＞15 μmol/L(OR=1.519,95％ CI:1.041 ～ 2.217),alkaline phosphatase ＞60 U/L(OR =1.681,95％CI:1.059～2.670),alpha-fetoprotein ＞200 ng/L (OR=2.192,95％CI:1.531 ～3.134) and tumor maximum diameter (OR =1.120,95％CI:1.057 ～ 1.187) were the independent risk factors of MVI on multivariate analysis.After establishment of the nomogram model using the independent risk factors,the C-indexes were 0.680 and 0.773 respectively in the model group and the validation group.In the calibration graph,the standard curve properly fitted with the predicting calibration curve.The predicted value of MVI obtained was in good agreement with the observed value.The ROC curve analysis nomogram model predicted the low performance of MVI.Conclusion The nomogram model in predicting MVI in patients with HCC was successfully established.The model offered certain guiding significance in the clinical treatment of HCC.

Objective To analyze the therapeutic effect and tolerability of decitabine monotherapy or combined with arsenic trioxide for the treatment of patients with myelodysplastic syndromes (MDS). Methods Clinical characteristics of 32 patients with primary MDS in North Hospital of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2014 to April 2017 were retrospectively analyzed. The clinical data of these patients were collected, and the patients were followed up. Decitabine combined with arsenic trioxide was used in 23 cases, decitabine (20 mg·m-·2d-1) and arsenic trioxide (0.16 mg/kg) were administrated from day 1 to day 5 and was repeated every 4-6 weeks. For the remaining 9 cases, only decitabine was applied, decitabine(20 mg·m-2·d-1) was administrated from day 1 to day 5 and was repeated every 4-6 weeks. The clinicopathological characteristics and the effect of genetic mutations on the efficacy of treatment were investigated. Results Of the 32 patients with primary MDS, 18 were male and 14 were female. The patients were 17-72 years old with a median age of 56 years old. Genetic analysis revealed 10 cases with TP53 mutations, 8 cases with TET2 mutations, 4 cases with U2AF1 mutations, 3 cases with RUNX1 mutations, 3 cases with ASXL1 mutations, 2 cases with NRAS mutations, 2 cases with DNMT3A mutations and 1 case with JAK2 V617 mutation. The follow﹣up time was 2-23 months with a median follow﹣up time of 8 months. A total of 21 cases (65.6%) attained treatment response. Among them, there were 10 cases (31.3%) with complete remission (CR), 5 cases (15.6%) with bone marrow complete remission (MCR), and 6 cases (18.7%) with hematological improvement. There was no significant difference in the efficiency and CR rate between the combination group and the monotherapy group (P＝0.441, P＝0.681). Ten cases were found to have TP53 mutations, of which 7 cases had CR. Multivariate analysis demonstrated that TP53 mutation was an independent risk factor for CR (P＝ 0.037). All patients developed myelosuppression after treatment, of which 16 cases developed pulmonary infection. Conclusions Decitabine combined with arsenic trioxide in the treatment of MDS is effective and well tolerated. The therapeutic effects of decitabine monotherapy or decitabine combined with arsenic trioxide for treatment of patients with TP53 mutations are better than the average levels.

Cerebrovascular disease,Alzheimer's disease,Parkinson's disease and other chronic encephalopathy has become a worldwide public health problem.Cognitive impairment,including mild cognitive impairment to dementia,is closely related to chronic encephalopathy,especially cerebrovascular diseases.Early detection,early diagnosis,early treatment of cognitive impairment has become the focus of the research,in order to reduce the development of dementia,improve the quality of life and reduce the burden of disease.This article elaborates the research progress of cognitive impairment from the aspects of pathological mechanisms,risk factors,clinical diagnosis and strategy prevention and control,and the arguments of domestic experts.

Objective:To evaluate the performance of biomarkers in aneuploidy screening in the first trimester-pregnancy associated plasma protein A(PAPP-A) combined with Fetal Medicine Foundation (FMF)'s competing risk model in screening preeclampsia among our population.Methods:This study was based on a prospective cohort of singleton pregnant women who underwent aneuploidy screening in the first trimester in Nanjing Drum Tower Hospital from January 2017 to September 2020. Mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and PAPP-A were converted into multiples of median (MoM) using the algorithm disclosed on the website of the FMF (fetalmedicine.org). The predictive outcomes of maternal factors alone or in combination with MAP, UtA-PI, and PAPP-A (alone or in combination) were calculated. Chi-square test, Fisher's exact test or rank sum test were used for comparison among groups and Bonferroni method for pairwise comparisons. Receiver operating characteristic (ROC) curve was used to evaluate the screening efficiency and to calculate the sensitivities of predicting preeclampsia, term and preterm preeclampsia at false-positive rates of 5% and 10%. The predictive performance of this model was further compared to the screening strategy that was recommended in Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy: a clinical practice guideline in China (2020). Results:Among the 5 144 singleton pregnancy women who were recruited in the cohort, 4 919 cases were included and analyzed in this study. A total of 223 cases were diagnosed as preeclampsia (4.5%), including 55 preterm (1.1%) and 168 term preeclampsia (3.4%). The median of MoM values of MAP, UtA-PI, and PAPP-A in the non-preeclampsia group were around 1.0±0.1. Statistical significance was observed in the difference of MAP, UtA-PI, and PAPP-A Mom between women with preterm preeclampsia and those without preeclampsia [1.061 (0.999-1.150) vs 0.985 (0.935-4.043), 1.115 (0.873-1.432) vs 1.039 (0.864-1.236), 0.820 (0.493-1.066) vs 1.078 (0.756-1.508)], which was also seen in the difference of MAP and PAPP-A Mom between women with term preeclampsia and those without preeclampsia [1.065 (1.002-1.133) vs 0.985 (0.935-4.043), 1.007 (0.624-1.393) vs 1.078 (0.756-1.508)] (all P<0.025). The combination screening with maternal factors+MAP+UtA-PI+PAPP-A was noted for the best efficiency. In predicting preeclampsia preterm and term preeclampsia at the false-positive rate of 10%, the sensitivity of the model was 53.0%, 76.4% and 44.6% respectively. Using the screening method recommended in Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy: a clinical practice guideline in China(2020), the proportion of people at high risk of preeclampsia was 5.9% (290/4 919), and the sensitivity for predicting preterm preeclampsia was 25.5% (14/55), which was significantly lower than the combination screening with maternal factors+MAP+UtA-PI+PAPP-A [65.5% (36/55)] when using the same proportion of high-risk population. Conclusion:The preeclampsia screening model based on aneuploidy screening biomarkers in the first trimester--PAPP-A in combination with materral factors, MAP, UtA-PI, can effectively screen preterm preeclampsia in the local population without increasing the laboratory costs.