Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

Objective This study was designed to evaluate the effect of obesity on late survival after aortic valve replacement(AVR) in patients with implantation of small aortic prosthesis(size≤21).Methods From January 1998 through December 2008,307 patients in a single center in china underwent primary AVR with smaller prosthesis survive the 30 days of surgery.Patients were defined as normal if body mass index (BM1) ＜ 24.0 kg/m2,as overweight if BMI 24.0-27.9 kg/m2,and as obesity if BMI≥28.0 kg/m2.Data of New York Heart Association(NYHA) Functional class,effective orifice area index (EOAI),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF) were got at the 3rd month(M),6th M,1 st year(Y),3rd Y,5th Y,8th Y after operation respectively.Results At multivariable analysis,obesity was independent factor of later mortality [hazard ratio (HR):1.62 ; P =0.01].Obesity group and overweight group had poor survival (P ＜0.001)and higher proportion of NYHA Function Ⅲ/Ⅳ (P ＜ 0.01) in long-term compared to normal group.EOAI were lower and LVMI were higher in obesity group and overweight group,but LVEF have no significant difference.Conclusion Obesity is associated with increased late mortality after AVR in patients with implantation of small aortic prosthesis.Obesity and overweight may also affect the NYHA function in long term.EOAI should be improved where possible as it may reduce late mortality and improve life quality in such patients.

Objective To investigate the effects of on-pump and off-pump coronary artery bypass grafting on plasma adrenomedullin (ADM) and endothelin-1 (ET-1) levels before and after operation in elderly patients. Methods Elderly patients aged 60 years and over with coronary artery bypass grafting were enrolled in the study and divided into off-pump group and on-pump group, each group had 20 cases. Blood samples were collected before surgery, immediately after operation and 6,24 hours, 3 days after operation. The plasma levels of ADM and ET-1 were dectecded by radio immunoassay. Results The levels of ADM and ET-1 were significantly increased immediately after operation in 2 groups of on-and off-pump. The levels of ET-1 in on-pump group and off-pump group were (67.59±10.18) ng/L and (58.73±9.64) ng/L respectively. The levels of ADM in on-and off-groups were (284.90±36.24) ng/L and (243.25±25.70) ng/L. This showed that in on-pump group, the plasma levels of ADM and ET-1 increased more significantly(P＜0.05). The plasma levels of ADM and ET-1 began to decline at 6 hours after operation, and continued to 24 hours after operation. On 3 days after operation, the plasma levels of ADM and ET-1 in off-pump group returned to the preoperative level, but they were still maintained at a high level in on-pump group.Conclusions For elderly patients, both on-pump and off-pump coronary artery bypass grafting can cause endothelial dysfunction, increasing plasma levels of ET-1 and ADM. But compared with the on-pump coronary artery bypass grafting, the off-pump coronary artery bypass grafting has less influence.

OBJECTIVE:To investigate the distribution and drug resistance of High-level Aminoglycoside Resistance Enterococcus spp (HLAR) in hospital infection. METHODS:The clinical specimens collected from 2004 to 2007 in our hospital were isolated by routine method. Identification of the bacteria and Antimicrobial susceptibility test were performed using automatic microbiology analysis system. RESULTS:Of the total 292 strains of Enterococcus which induced HLAR in hospital infection,Enterococcus faecalis (E.faecalis) represented 49.3% (144/292) and Enterococcus faecium (E.faecium) 41.4% (121/292). 27.4% (80/292) were from intensive care unit,17.5% (51/292) the department of nephrology and 8.9% (26/292) the neurosurgery department. The urinary system infection represented 29.8% (87/292) in hospital infection. The antimicrobial resistance of E.faecium was significantly higher than that of E.faecalis against quinolones and ?-lactamase antibiotics,but the antimicrobial resistance of E. faecalis was higher than that of E,faecium(P

OBJECTIVETo explore the role of collagen degradation and scar morphology and structure in the formation of hypertrophic scar.

METHODSSDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis) plus collagen substrate electrophoresis, amino acid analysis and compound staining were employed to observe the collagenase activity within hypertrophic scar, collagen degradation and the tissue morphology of the scar.

RESULTSThere exhibited deranged collagen fibres within hypertrophic scar, and large amounts of acid mucopolysaccharide closely surrounded the collagen fibres. All these led to an obvious decrease in collagenase activity and reduction of collagen degradation.

CONCLUSIONThe decrease of collagen degradation and the formation of hypertrophic scar might be closely related to the decrease in collagenase activity and the inhibiting activity of acid mucopolysaccharide on collagenase.

Adolescent ; Adult ; Child ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Collagen ; metabolism ; Collagenases ; metabolism ; Female ; Humans ; Male