Objective: To investigate the peri-operative incidence of depression and anxiety symptoms of coronary artery bypass grafting (CABG). Methods: 73 patients,who underwent scheduled consecutive CABG between July 2005 and May 2006,were assessed with self-rating depression scale( SDS) and self-rating anxiety scale(SAS)before operation and before leaving hospital.Results: 21 patients (28.8%) had depression and/or anxiety symptoms before CABG, including 11 patients with depression, 7 patients with both depression and anxiety and the other 3 patients had anxiety symptoms. 34 patients (46.6%) had depression and/or anxiety symptoms after CABG, including 18 patients who had depression, 13 patients had both depression and anxiety symptoms and the other 3 patients had anxiety symptoms. The SDS score(47.9?10.0)after surgery was significantly higher than that before surgery(43.7?10) ,t=3.55, P=0.001. The SAS score after surgery (41.6?8.5) was significantly higher than that before surgery (39.3?7.4),t=2.20, P=0.031. Patients with bad mood before operation had lower educational levels (8?3/10?3,t=2.18,P=0.032). Four patients had multiple myocardial infarctions, all of them were in the anxiety-depression group postoperatively (4/34 vs 0/39,P=0.043). There was no difference in post-operative length of hospital stay between the two groups.Conclusions: The peri-operative incidence of depression and anxiety of CABG patients was very high and even higher after surgery. Less education is a risk factor for preoperative depression and anxiety states, multiple infarctions is a risk factor of post operative anxiety and depression.

Objective To evaluate the incidence of asymptomatic carotid stenosis (ACS) in patients with peripheral arterial occlusive disease (PAOD) who was admitted for revascularization.Methods 229 PAOD patients were evaluated by carotid ultrasound preoperatively and divided into severe ACS group (ACS ≥ 70％) and non severe ACS group (ACS ＜ 70％).The clinical characteristics and associated risk factors of the two groups were analyzed.Results The incidence of severe ACS was 19.7％,age,blood pressure,total cholesterol and fibrinogen levels in severe ACS group were significantly higher than those in non-severe ACS group (P ＜ 0.05),the more severe the symptoms of PAOD are,the higher is the incidence of severe ACS.Age,hypertension and hypercholesterolemia were all predictors of severe ACS.Conclusions The severity of PAOD is positively correlated with the incidence of severe ACS.Age,hypertension and hypercholesterolemia are independent risk factors for severe ACS.

Objective To explore the clinical value of the duplex ultrasonography (duplex US) for evaluating the re-stenosis after peripheral arterial bypass grafting. Methods Eighty prosthetic grafts of sixty-three patients with femoral-pop-liteal arterial bypass grafting were follow-up regularly by duplex US. They were divided into non significant stenosis group (n=56), the significant stenosis group (n=15) and occlusion group (n=9) according to the tube diameter and arterial blood flow-ing parameters, which changed postoperatively. The diagnostic results were compared and analyzed between duplex US and digital subtraction angiography (DSA). The peak flow velocity of middle grafts (MG) to 40 cm/s was defined to evaluate risk of graft occlusion. Results The diagnostic coincidence rate of duplex US and DSA for grafts stenosis classification was 90%. The diagnostic sensitivity of duplex US to grafts stenosis was 91.7%, and the specificity was 92.9%. The positive pre-dictive value was 84.6%for grafts stenosis, and the negative predictive value was 96.3%, the false positive rate was 16.7%, and the false negative rate was 8.3%. The grafts occlusion rate was higher in MG<40 cm/s group than that of MG≥40 cm/s group. Conclusion There was a good consistency with Duplex US and DSA for the diagnosis of peripheral artery bypass graft restenosis. Duplex US showed characteristics of non-invasive, simple and easily accepted by patients.

Objective To compare the postoperative follow-up indexes of femoral popliteal artery bypass grafts and evaluate the sensitivity of vessel function test methods for the early detection of grafts restenosis.Methods 84 cases were followed-up after femoral popliteal graft bypass,using ankle brachial index (ABI),ABI decrease amplitude,and Duplex ultrasound to detect peak systolic velocity (PSV) and peak systolic velocity ratio (PSVR).All patients were divided into mild stenosis group (0-49％),moderate stenosis group (50％-74％) and severe stenosis group (75％-99％).Results ABI was 0.88 ±0.12,0.81 ± 0.10 and 0.52 ± 0.13;ABI decrease amplitude was 0.13 ± 0.06,0.12 ± 0.06 and 0.36±0.06;PSV(m/s) was 0.89 ±0.23,0.91 ±0.31 and 1.70 ±0.85,respectively.There was remarkable difference for ABI,ABI decrease amplitude and PSV between severe stenosis and mild to moderate stenosis group (P ＜0.05).PSVR was 1.00 ±0.08,2.14 ±0.31 and 3.58 ±0.31 respectively,in the three groups (P ＜ 0.05).Conclusion PSVR was more sensitive to detect grafts restenosis early than ABI,ABI decrease amplitude and PSV.

Objective To analyze the epidemiologic features of visceral leishmaniasis in different age groups in China from 2005 to 2012,and to provide a scientific basis for prevention and treatment of the disease.Methods The visceral leishmaniasis cases were obtained from China disease epidemic monitoring information system from 2005 to 2012.All the cases were divided into subgroups by demographic characteristics:infant (＜1 year old),childcare (≥1 and ＜4 years old),child (≥4 and ＜15 years old),adult (≥15 and ＜65 years old) and senior adult (above 65 years old).The epidemiologic features,such as gender,season of disease onset and area distribution of visceral leishmaniasis were analyzed.Results The total reported visceral leishmaniasis from 2005 to 2012 were 2 979,among which cases in infant,childcare,child,adult and senior adult were 24.9％,21.7％,20.0％,32.4％ and 1.0％,respectively.Infant cases were most reported in April; childcare cases in December which began to increase since September; child cases in October and adult and senior adult in March.The reported cases were mainly from Xinjiang,Gansu and Sichuan areas.However,age characteristics differed among regions,which were mainly infants,both childcare and children,and adults,respectively in this three areas.The duration from onset to diagnosis was shortest in infant group (11 d) and longer in adult group (15 d).Conclusions The number of visceral leishmaniasis cases in different age groups peaks in different months.Regional distribution is not even.Cases are most concentrated in Xinjiang,Gansu and Sichuan areas.Infants predominate in Xinjiang,childcare and children in Gansu and adults in Sichuan.

Objective To evaluate the influence and significance of Pingyangmycin chemotherapy on the c-myc and Ras-P21 protein expression in penile cancer .Methods A total of 100 penile squamous cell carci-noma cases was retrospectively studied and divided into two groups .Data were obtained from 1995 to 2005 .In the chemotherapy group ,50 cases of patients were selected to perform preoperative chemotherapy before surgery .The patients were treated by Pingyangmycin .After 7 times of medication ,partial excision of penis plus improved ingui-nal lymph node dissection was performed .In the control group ,50 cases of patients were selected for partial exci-sion of penis plus improved inguinal lymph node dissection directly without any pre -operative chemotherapy .All pathology specimens were detected of c -myc and Ras-P21 protein expression by immunohistochemical staining assay.Theχ2 test was used for the statistical analysis .Results In chemotherapy group,the positive expression rates of c-myc and Ras-P21 were 30%,27%,respectively.However,in control group,the positive expression rate of c-myc,Ras-P21 were 52%,48%,respectively.By theχ2 test,the expressive differences of c -myc,Ras-P21 positive expression rate between chemotherapy group and control group were all significant (P<0.05). Conclusion The protein expressions of c -myc and Ras-P21 is significantly decreased in the tissue of Pingy-angmycin chemotherapy of penile cancer .

Objective To investigate the clinical efficacy and indication of surgical treatment of L5S1 tuberculosis us?ing a medial edge of rectus abdominal muscle and retroperitoneal approach. Methods From Jan. 2010 to Nov. 2014, totally 18 cases of L5S1 tuberculosis were surgically cured by debridement, fusion and internal fixation via a medial edge of rectus ab?dominal muscle and retroperitoneal approach. There were 10 males and 8 females, with an average age of 35.6±10.1 years (21 to 55). The mean course of disease was 5.3±2.2 months. The primary destruction lesions were located at L5S1, and one patient of whom L4 was also involved, three cases S2 involved, and one S3 involved. Abscess pre sacrum was noticed in all cases. Six patients were combined with abscess in vertebral canal. Neural deficiency was detected in 3 patients, all grading as Frankel D. Dubousset's lumbosacral angle was 104°-126°, mean 114.6°±6.0°. Formal anti?tuberculosis medicine treatment was given for at least 2-3 weeks. All patients were treated using a medial edge of rectus abdominal muscle and retroperitoneal approach. Af?ter debridement, a tri?cortical iliac bone was used for structural inter?vertebrae fusion. The iliac bone was fixed to the sacrum by one cortical screw. Operation time, volume of blood loss, and surgery complications, including wound infection, looseness and shift of internal fixation, sinus occurrence, vascular injury, retrograde ejaculation in male patients were evaluated. The X?ray and 3D CT of lumbosacral spine, together with ESR and CRP were used to evaluate the control of tuberculosis during fol?low?up. The Dubousset's lumbosacral angle, visual analogue score, and the Frankel grade were compared between preoperative and postoperative. The bone graft fusion were also observed. Results The operation time was 147±16 min in average. The mean blood lose was 275 ± 77 ml. No vascular or neurological injury was noticed. There was also no retrograde ejaculation happened in this group. All patients were followed up from 18 to 28 months. Dubousset's lumbosacral angle was 122.4°±3.8° post?operatively and 121.4°±3.7° at the final follow?up. There was a significant difference between the lumbosacral angles pre and post operation, whereas no statistical difference between the post operation and the final follow?up. Bone fusion was noticed in all cases. All pa? tients have intact neurological function at the final follow?up. No screw breakage or graft bone migration occurred. VAS was 5.6± 1.09 pre?operation and 0.83±0.71 at the 3rd month's follow?up, and there was a significant difference between them. Conclusion Surgical treatment of L5S1 tuberculosis by debridement, fusion and internal fixation via a medial edge of rectus abdominal muscle and retroperitoneal approach is an effective method in terms of minimal trauma, low rate of modality, good ability in restore and maintenance of lumbosacral junction alignment and high fusion rate.

Objective To study the clinical characteristics,treatment and prognosis of neonatal VACTERL association.Method The clinical data of newborns diagnosed with VACTERL association from January 2010 to December 2015 were collected and retrospectively analyzed.Result A total of 33 patients diagnosed with VACTERL association were included,including 23 males and 10 females.Among them,17 cases were term infants,15 cases premature infants and 1 case of overdue birth,with an admission age of 1 to 24 days.The most common deformities were cardiac anomalies (C) in 27 cases (81.8％),followed by anal atresia/anorectal malformation (A) in 25 cases (75.8％),renal deformity (R) in 24 cases (72.7％),limb abnormalities (L) in 20 cases (60.6％),Tracheoesophageal fistula (TEF) in 8 cases (24.2％) and vertebral abnormalities (V) in 3 cases (9.1％).11 cases (33.3％) had other deformities.Among these 33 patients,24 cases had 3 types of malformations and 9 cases had 4 types of malformations.The most common combination was ACR (n =8).20 patients had no abnormalites on chromosome karyotype test including 2 patients had normal gene microarray results.16 patients received surgical treatment during neonatal period and 13 of them recovered and discharged.Among the other 17 cases received no surgery,only 1 patient improved and discharged.A telephone follow-up was proceeded in 14 discharged cases at 1 year old.Among them,13 cases had good prognosis,however,the remaining one was dead.Conclusion VACTERL association is a rare non-random combination of multiple malformations.The early discovery and appropriately treatment after diagnosis will improve the prognosis and prevent death.Doctors should reinforce the ability to detect various types of deformities and examine the chromosome and gene properly.

Communicable Disease Control ; Communicable Diseases ; Disease Notification ; Humans ; Population Surveillance ; methods

Electronics ; organization & administration ; Health Promotion ; Humans ; Occupational Health Services