Objective To investigate the status of fatigue and depression and their influencing factors in patients with acute coronary syndrome, and analyse the correlation of fatigue, depression and self-management behavior. Methods 113 patients were investigated by using Fatigue Symptom Inventory (FSI), Patient Health Questionnaire-9 (PHQ-9), Coronary artery disease Self-management Scale (CSMS). Results The score of fatigue was (4.59±1.93)points, while depression scored (5.05±1.48)points and self-management behavior scored (57.29 ±8.29)points; the score of fatigue, depression of female patients were higher than that of male patients, which had statistical difference(t=2.535-5.894, P<0.05);Regression analysis showed that gender, time of illness, number of other chronic diseases were major factors affecting fatigue while gender and treatment method were major factors affecting depression; there were negative ralationships between self-management and fatigue, self-management and depression (r=-0.855-0.682). Conclusions Fatigue, depression are common in patients with acute coronary syndrome, and can affect their self-management behavior, and the female patients are more susceptible to fatigue and depression.

The technique of double-layered plate was developed for screening the library of mutant endoglucanase III from Trichoderma reesei generated by the method of directed evolution.The enzyme activity was determined according to the velocity of the formation of halos on the plates.Several mutants with higher activity than the wild type at low temperature or alkaline pH were obtained by using this strategy under different screening conditions.Further results of spectrophotometric determination of the activities of these mutants were consistent with the results of plate screening.The establishment of such strategy will broaden the applications of the directed evolution methods for improving the existing proteins to obtain useful enzymes with new properties for industrial applications.

ObjectiveTo evaluate the clinical effects of guiding apparatus assisted individual posterior cervical pedicle screw fixation technique.MethodsThe study enrolled 24 patients treated with posterior cervical decompressive single open-door laminoplasty and transpedicular screw-rod fixation from January 2008 to December 2010.The point of screw penetration and screw path direction were confirmed by measuring the transverse nail angle (TNA) and sagittal nail angle (SNA) of nail channel on the pre-operative CT plain scan of cervical pedicle and sagittal two-dimensional imaging of transpedicular axis.According to the results of CT measurement,individual cervical pedicle screw was implanted with the assistance of self-made guiding apparatus and then fixed after decompression.Transverse screw angle ( TSA ) and sagittal screw angle ( SSA ) were determined on the CT scan of cervical pedicle and sagittal two-dimensional imaging of transpedicular axis one week postoperatively in order to analyze the accuracy of placement of pedicle screws.Periodical anteroposterior and lateral X-ray radiographs of cervical vertebra were taken postoperatively to detect the stabilization of internal fixation.ResultsA total of 223 pedicle screws were inserted successfully into the C3 ～ C7,of which 220 crews were inserted accurately but three had slight inclination according to the postoperative CT,with placement accuracy of 98.7％.The comparison between inclination angle of inserted screws and that of preoperative transpedicular axis showed insignificant statistical difference ( P ＞ 0.05 ).All the patients were followed up for 6-34 months ( mean,18.5 months),which showed no neurovascular complications related to screws perforation out of pedicle cortex or no screw loosening,prolapse or breakage.ConclusionPosterior cervical pedicle screw insertionperformed according to the individual CT measurement is easy and safe and has a high accuracy rate under the assistance of self-made guiding apparatus.

Blood stasis theory (BST) is widely used in the department of Chinese medical dermatology. Skin lesion we often see and modern medical examination results can be used as evidence for diagnosing BST and indications for using it. Better efficacy could also be obtained by using BST in treating wind evil or heat evil induced skin disease, and itching, hemorrhagic and stubborn dermatoses as well.
Humans ; Medicine, Chinese Traditional ; Pruritus ; Skin Diseases ; therapy

ObjectiveTo summarize and review the clinical characteristics of congenital pulmonary lymphangiectasia with fetal bilateral pleural effusions.MethodsThe clinical data of a newborn diagnosed as congenital pulmonary lymphangiec-tasia with bilateral pleural effusions in Obstetrics and Gynecology Hospital, was summarized. The clinical, radiographic features, treatment and prognosis of this case are discussed in the context of the literature review.ResultsThe premature infants present-ed with rapid progression bilateral pleural effusions, respiratory distress, chylothorax, hypoalbuminemia and persistent pulmo-nary hypertension at birth. The pulmonary surfactant was given and mechanical ventilation was used for respiratory support. NO was inhaled, high-frequency mechanical ventilation was applied and albumin was repeatedly administered. After treatment for 3 months in the NICU, the patient was discharged. After 10 days, the patient was administered to the PICU with severe pneumo-nia, chronic lung disease, mechanical ventilation and anti-infection treatments were applied for 2 months. After living for six months, the baby died.ConclusionsCongenital pulmonary lymphangiectasia is extremely rare and prenatal diagnosis was dif-ifcult. The disease should be considered in patients presented with progressive dyspnea, interstitial emphysema after birth. Lung tissue biopsy and radioisotope scanning should be performed in time to get diagnosis.

Objective To discuss diagnosis and anterior surgical treatment of hyperextensian cervical spine injury combined with intervertebral disk injury. Methods A retrospective study was done on clinical data of 27 patients who suffered from hyperextension cervical spine injury combined with intervertebral disk injury to analyze their age distribution, clinical symptomes, X-ray and MRi manifesta-tions and perioperative intervertebral disk injury. All patients were treated with discectomy, strut bone grafting within vertebral bodies and internal fixation with titanium plate. The clinical outcomes were evalu-ated by using Frankel scale and ASIA motor score (AMS). Results Both MRI and X-ray detected following abnormal pathological changes in all patients: rupture of anterior longitudinal ligament, horizon-tal tear of disk, intervertebral disk hernia, compression and edema of spinal cord. The follow-up lasted for 9-32 months (average 17.5 months), which showed that all patients got improvement for 1-3 scales except that one patient with Frankel A had no improvement in neurological function. Compared with AMS on admission, both AMS at two months after surgery and at final follow-up was increased significantly, with recovery rate of AMS for 44.9% and 68.1%, respectively. There found no hardware related compli-cations such as implant loosening, defluxion or breakage. Bone fusion was found in all fixation segments. Conclusions MRI and X-ray are important examination means for hyperextension cervical spine injury combined with intervertebral disk injury. On a specified diagnosis, anterior surgical treatment should be done early and can get satisfactory recovery of spinal cord function.

Objective To evaluate the clinical effect of the cannulated screw fixation in treatment of the dens fracture under locational guidance. Methods The study involved 27 patients treated with the cannulated screw fixation under locational guidance from January 2005 to January 2009.There were 19 patients with type II fracture and eight with type light m fracture.The lateral and open mouth position X-ray examination of the cervical ventebrae was done to observe the fracture healing. Results The operation lasted for a range of 40 minutes to 1.3 hour (average 1.0 hour),which showed no any complications.The patients were followed up for average 6.5 months(3-12 months),which showed sound fracture healing in 26 patients but nonhealing in one. Conclusion The cannulated screw fixation for treatment of the dens fracture under locational guidance is characterized by easy operation,minor trauma and satisfactory outcome.

Objective To establish a model for the calculation of biologically effective dose (BED) and EQD2 (Equivalent dose in 2 Gy fractions) in radioactive seed implantation brachytherapy.Methods The BED formula for EBRT(external beam radiotherapy) and for continuous low dose-rate irradiation established under the L-Q model were introduced.The EDQ2 formula for the continuous low dose-rate irradiation (radioactive seed implantation) was established according to the definition of EQD2 and the formula of BED.The α/β values of common tissues and the Tr 1/2 values reported in the literature were summarized.The EDQ2 formula were further simplified by using the actual values.The empirical formula of EDQ2 for early reaction tissues and late reaction tissues were proposed,named as Wang-Peng empirical formula.EDQ2≈ (10/12) D (Wang-Peng Formula 1) was fit for early response tissue,and EDQ2≈ D/2 (Wang-Peng Formula 2) for late reaction tissues.Further examples on the clinical applications of the proposed formula were given,including primary lung cancer,supraclavicular lymph node metastasis of esophageal cancer and celic lymph node metastasis of cervical carcinoma.Results According to the Wang-Peng empirical formula,the EDQ2 of the late reaction tissue adjacent to the tumor was only about half that of the tumor tissue,so the radioactive seed implantation brachytherapy naturally protected the late reaction tissue by the biological equivalent dose.The actual calculation,showed that the empirical formula of early reaction tissue was more accurate,but the empirical formula of late reaction orgtissue was less inaccurate and could only be roughly estimated.Conclusions The BED calculation formula introduced here and the set of EQD2 calculation formula and Wang-Peng empirical formula established here were theoretically feasible and could be used for the conversion and superposition between the physical dose of radioactive seed implantation brachytherapy and the external irradiation dose.But it should be careful to apply the formula,pay attention to the default conditions,and carefully interpret the calculated results.

Objective To analyze the complete genome sequence of Guangxi HEV isolate swGX32 and to compare it with other HEV isolates. Methods The overlapping fragments of HEV isolate swGX32 were amplified with reverse-transcription nested polymerase chain reaction (RT-nPCR),and the 5′ and 3′ ends of viral genome were amplified with rapid amplification of cDNA ends (RACE). The PCR products were cloned and sequenced. The sequence and phylogenetic analysis of swGX32 was performed. Results The genome of swGX32 consisted of 7240 nt excluding the polyA tail, with 4 nt overlapping between ORF1 and ORF2. ORF3 is contained in the sequence of ORF2. The complete genome sequence of swGX32 shared identity of 73%-74%, 73%, 74%-75%,83%-94% with HEV genotype 1,2,3 and 4, respectively. Among all these HEV reference sequences, swGX32 showed the highest identity with the human isolate JKO-ChiSai98C (94%). Phylogenetic tree showed that swGX32 belonged to genotype 4 and clustered with JKO-ChiSai98C in the branch of HEV subtype 4a. Conclusion The swine HEV isolate swGX32 is closely related to human strain JKO-ChiSai98C genetically and phylogenetically, which further provides molecular biology evidence of hepatitis E as a zoonosis.

Objective To study effects of Rupixiao granules on contraction of uterus of mice in vitro. Methods Mouse model with isolated uterine contraction was established. The mice pretreated with estradiol benzoate were sacrificed and then the uteri were taken out. The normal contractions were recorded by the biological function system. Effects of 10, 20, 30, 40, 50, 60 mg.mL-1 Rupixiao granules on spontaneous and oxytocin-induced (5 U.L-1) uterine contractions were recorded,inhibition of Rupixiao granules on mean constriction amplitude,constriction frequency and contraction activity of pitocin-pretreated uterus was observed and the inhibition rates were calculated. Results Compared with the baselines, the amplitude, frequency, activity of spontaneous uterine contraction were significantly down-regulated by Rupixiao solution at a range of 10-60 mg.mL-1 ,as well as it could inhibit oxytocin-induced spasmodic contraction of isolated uterus at 10-50 mg . mL-1 ( P<0. 01 ) . Conclusion The Rupixiao granules inhibits spontaneous contraction of isolated mouse uteri and oxytocin-induced spasm of uterine smooth muscle in vitro.