Objective:To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.Methods:A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms ( r=0.394, P<0.01), anxiety ( r=0.640, P<0.01), depression ( r=0.533, P<0.01) and metacognition ( r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212. Conclusion:Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.

Objective:To find out a specific group of patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) who can benefit from endometrial microstimulation (EM) and how to maximize the effect. Methods:A retrospective case-control study on 1916 cycles from women who underwent EM in Center for Reproductive Medicine, Shandong University between 2006 to 2018. Their baseline characteristics and cycle parameters were analyzed as well as the differences in EM procedures. Results:There were 1435 cycles from women ≤35 years old (867 succeeded in implantation and 568 failed) and 481 cycles from women >35 years old (179 succeeded in implantation and 302 failed). Among women ≤35 years old, compared with those who failed to implant, those who succeeded had thicker endometrium [(1.07±0.20) cm vs. (1.02±0.20) cm, OR=5.01, P<0.001] and a larger proportion of A/A- endometrial type (91.3% vs. 85.3%, OR=1.88, P=0.01) observed on trigger day. As for patients >35 years old, women who succeeded in implantation had thicker endometrium than those who failed in implantation [(1.05±0.19) cm vs. (0.96±0.22) cm, OR=8.73, P<0.001]. In addition, EM in luteal phase resulted in a significantly higher implantation rate in the >35 years old group compared with that when EM in follicular phase (42.9% vs. 32.7%, P=0.02). Conclusion:As for patients who were suggested to do the EM therapy, those ≤ 35 years old with better endometrium condition (thicker and A/A- endometrial type) or women >35 years old with thicker endometrium may benefit from EM, and EM in luteal phase increases implantation rates among >35-year-old patients compared with that when EM in follicular phase.

Objective:To find out a specific group of patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) who can benefit from endometrial microstimulation (EM) and how to maximize the effect. Methods:A retrospective case-control study on 1916 cycles from women who underwent EM in Center for Reproductive Medicine, Shandong University between 2006 to 2018. Their baseline characteristics and cycle parameters were analyzed as well as the differences in EM procedures. Results:There were 1435 cycles from women ≤35 years old (867 succeeded in implantation and 568 failed) and 481 cycles from women >35 years old (179 succeeded in implantation and 302 failed). Among women ≤35 years old, compared with those who failed to implant, those who succeeded had thicker endometrium [(1.07±0.20) cm vs. (1.02±0.20) cm, OR=5.01, P<0.001] and a larger proportion of A/A- endometrial type (91.3% vs. 85.3%, OR=1.88, P=0.01) observed on trigger day. As for patients >35 years old, women who succeeded in implantation had thicker endometrium than those who failed in implantation [(1.05±0.19) cm vs. (0.96±0.22) cm, OR=8.73, P<0.001]. In addition, EM in luteal phase resulted in a significantly higher implantation rate in the >35 years old group compared with that when EM in follicular phase (42.9% vs. 32.7%, P=0.02). Conclusion:As for patients who were suggested to do the EM therapy, those ≤ 35 years old with better endometrium condition (thicker and A/A- endometrial type) or women >35 years old with thicker endometrium may benefit from EM, and EM in luteal phase increases implantation rates among >35-year-old patients compared with that when EM in follicular phase.

Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 (CYP3A4) and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius (eg,simvastatin),these two commonly used drugs should be avoided in hypothyroid patient.

Objective To investigate the effects of ciyelosporine-A(CsA).a calcinenrin(CAN)inhibitor,on electrophysiological propertiesof atria in canine tachycardia-induced model of AF.Methods Eighteen healthy adult mongrel canines weighing 17.0 to 23.2 kg(rangedfrom 2 to 4 years old)were randomized to 3 groups,Sham group(no pacemaker was implanted),atrial tachypacing group(ATP group)each group at baseline and after 8 weeks' tachypacing.Measurements included atrial effective refractory period(AERP),conductionvelocity(CV),wave length(WE),atrial fibrillation load and rate-adaptability. Results After 8 weeks' atrial tachypacing,ATP andCsA groups showed significant longer duration of the P wave,shorter AERP,decreased adaptation of AERE slower CV,shorter Wland longer AF duration compared to the shamg roup (all P＜0.05).AERP of the CsA group was longer than that of ATP group (P＜0.05),but there were no differences in rate-adaptability,CV,incidence of induced AF and AF duration between CsA group and ATP group.Conclusions Our results suggest that calcineurin pathway intervention by CsA have a positive effect on tachycardia-inducedelectrical remodeling of atria,but can not prevent or reverse AF.

Background and objective To assess the predictive value of C-reactive protein(CRP) for major adverse cardiac events and the association between CRP level and the coronary lesion morphology and extent in patients with coronary heart disease (CHD).Methods CRP was measured on admission in 177 consecutive elderly (age≥60 years) patients with CHD who underwent coronary angiography. Patients were divided into high CRP group (CRP≥3mg/L) and normal CRP group (CRP ＜3mg/L). The association between CRP levels and the coronary lesion features, including severity of stenosis (mild, moderate, severe), extent of lesion (diffused or nondiffused), eccentricity of the plaque (eccentric or non-eccentric) were analyzed. Patients were followed up for a mean of 8 months for the occurrences of major adverse cardiac events (MACE). Results Compared with patients in normal CRP group, patients in high CRP group were more frequently to have unstable angina, multi-vessel, diffuse, eccentric lesions, positive remodeling, and non-smooth plaques (P＜0.01). Kaplan-Meier analysis showed patients in high CRP group had a significantly lower MACE-free survival rate than patients in normal CRP group (Log-rank = 12.0, P＜0.01); Cox regression analysis indicated CRP level as an independent predictor for the occurrence of MACE (OR=3.16, P＜0.05) Conclusions High CRP level is associated with more extend, severe and eccentric coronary lesions and is an independent predictor for MACE in elderly patients with CHD.

Adult ; Balloon Occlusion ; instrumentation ; Ductus Arteriosus, Patent ; complications ; therapy ; Equipment Design ; Female ; Humans ; Hypertension, Pulmonary ; complications