Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.

Objective Meta-analysis was used to evaluate the effect of the solution-focused brief therapy on im-proving the anxiety and depression status of patients with HIV/AIDS.Methods Computer search of PubMed,Embase,Web of Science,Cochrane Library,CINAHL,PsycINFO,Chinese Biomedical Literature Database,China Na-tional Knowledge Infrastructure,Wanfang Database,CQVIP were conducted,and the search time frame was from the establishment of databases until April 9,2023.There were 2 investigators who independently screened the literature according to inclusion and exclusion criteria,extracted data and performed quality evaluation,and performed Meta-analysis using RevMan 5.4 software.Results A total of 11 publications were included,including 9 randomized controlled trials and 2 quasi-experimental studies,with a total of 1 219 patients with HIV/AIDS.Meta-analysis re-sults showed that solution-focused brief therapy reduced anxiety scores(SMD=-1.89;95%CI:-2.79～-0.99,P＜0.001),depression scores(SMD=-2.45;95%CI:-3.51～-1.39,P＜0.001).Subgroup analysis showed that improved anxiety(SMD=-4.16;95%CI:-7.97～-0.35,P＜0.001),depression(SMD=-5.69;95%CI:-11.20～-0.19,P＜0.001)in pregnant HIV/AIDS patients was significantly better than that in ordinary patients.Conclusion Solution-focused brief therapy is effective in improving anxiety and depression levels in patients with HIV/AIDS,and the application of this model in pregnant patients with HIV/AIDS has a more significant improvement effect,but high-quality,multicenter,large-sample clinical trial studies are needed to further confirm this conclusion in the future.

Adult ; Humans ; Cardiovascular Diseases ; East Asian People ; Hypertension ; Prevalence ; Risk Factors ; Ethnicity

Objective To investigate the effect of dexmedetomidine pretreatment on hippocampal endoplasmic reticulum stress-induced cell apoptosis after asphyxial cardiac arrest-resuscitation in rats. Methods A total of 60 pathogen-free male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-300 g, were divided into 3 groups (n= 20 each) by using a random number table: control group (C group), as-phyxial cardiac arrest-resuscitation group ( CA group) and dexmedetomidine pretreatment group ( Dex group). The anaesthetized rats were intubated with a 16G tracheal catheter which was connected to a rodent ventilator for mechanical ventilation. Cardiac arrest was induced by clamping the tracheal tube at the end of the exhalation until systolic blood pressure decreased to 25 mmHg lasting for 5 min, and then resuscitation was started. At 5 min before cardiac arrest, dexmedetomidine 4. 0 μg∕kg was intravenously injected in group Dex, and the equal volume of normal saline was given instead in C and CA groups. Rats were sacri-ficed at 6 h after successful resuscitation, brain tissues were removed for determination of wet to dry weight ratio ( W∕D ratio), and hippocampal tissues were obtained for examination of the pathological changes (with a light microscope) and ultrastructure (with an electron microscope) and for determination of cell ap-optosis (by TUNEL), expression of CCAAT∕enhancer-binding protein homologous protein (CHOP) and ac-tivated transcription factors (ATF4) and X-4 box binding protein 1 (XBP1) mRNA (by real-time polymer-ase chain reaction) and expression of CHOP, Bcl-2, Bax and caspase-3 (by Western blot). The apoptosis rate was calculated. Results Compared with group C, W∕D ratio of brain tissues was significantly in-creased, the apoptosis rate of hippocampal tissues was decreased, the expression of XBP-1, ATF4 and CHOP mRNA was up-regulated, the expression of CHOP, Bax and caspase-3 was up-regulated, and the expression of Bcl-2 was down-regulated in CA and Dex groups (P<0. 05). Compared with group CA, W∕D ratio of brain tissues was significantly decreased, the apoptosis rate of hippocampal tissues was decreased, the expression of XBP-1, ATF4 and CHOP mRNA was down-regulated, the expression of CHOP, Bax and caspase-3 was down-regulated, the expression of Bcl-2 was up-regulated (P<0. 05), and the pathological changes were significantly attenuated in group Dex. Conclusion The mechanism by which dexmedetomi-dine pretreatment mitigates brain injury after asphyxial cardiac arrest-resuscitation may be related to inhibi-ting cell apoptosis induced by endoplasmic reticulum stress in rats.

Objective To investigate the relationship between hepatitis B surface antigen (HBsAg) levels and liver pathology at different phases of natural history in chronic hepatitis B (CHB) patients, and to establish a non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Methods A total of 145 CHB patients were enrolled and underwent liver biopsy from January 2013 to January 2015, among which 73 patients were hepatitis B e antigen (HBeAg) positive.HBsAg levels and HBV DNA levels were compared between patients at different phases of natural history and between patients with different HBeAg statuses.Logistic analysis was used to analyze the risk factors associated with fibrosis in HBeAg-positive patients, and to evaluate the predictive value of non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Analysis of variance was used for statistical analysis, and t test analysis was used for the comparison between two independent samples.Results The serum HBsAg levels at the immunologic tolerance phase, immunologic clearance phase, low copy phase and reactivation phase of CHB patients were (4.29±0.69), (3.56±0.61), (3.22±0.64), and (3.54±0.50) lg IU/mL, respectively (F=16.72, P<0.01), and the HBV DNA levels were (8.48±0.58), (6.69±1.44), (3.80±0.59), and (6.21±1.06) lg IU/mL, respectively (F=76.73, P<0.01).In HBeAg-positive CHB patients with liver inflammation stage (G)≤G1, G2, G3 and G4, the serum HBsAg levels were (4.44±0.65), (4.00±0.72), (3.74±0.62), and (3.28±0.50) lg IU/mL, respectively (F=9.198, P<0.01).In HBeAg-positive CHB patients with liver fibrosis stage (S)≤S1, S2, S3, and S4, the serum HBsAg levels were (4.55±0.54), (4.04±0.89), (3.59±0.63), and (3.34±0.50) lg IU/mL, respectively (F=10.66, P<0.01).Logistic analysis showed that age (OR=1.091, 95%CI: 1.013-1.175) and HBsAg level (OR=0.190, 95%CI: 0.066-0.542) were independent factors for predicting fibrosis stage.The area under receiver operating characteristic curve of the non-invasive fibrosis model based on age and HBsAg level was 0.849, which was higher than aspartate aminotransferase to platelet ratio index (0.749) and fibrosis index based on the 4 factors (0.763).Conclusions The serum HBsAg levels are significantly different among the different phases of natural history in CHB patients.The serum HBsAg levels decline with the progression of liver fibrosis in HBeAg-positive CHB patients.The non-invasive diagnostic model that based on HBsAg quantification could be used to evaluate the stage of liver fibrosis.

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.

Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA<7) and anxiety symptoms group (HAMA>14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.

Objective To evaluate the effect of penehyclidine hydrochloride on the damage to the non-ventilated lung in the pediatric patients undergoing one-lung ventilation (OLV).Methods One hundred and twenty pediatric patients of both sexes,aged 2-6 yr,with body mass index of 17-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or lⅡ and New York Heart Association class Ⅰ or Ⅱ,undergoing elective lobectomy performed via video-assisted thoracoscope,were randomly divided into 2 groups (n=60 each) using a random number table:control group (group C) and penehyclidine hydrochloride group (group P).At 10 rmin before anesthesia induction,penehyclidine hydrochloride 0.05 mg/kg was injected intravenously in group P,and the equal volume of normal saline was given in group C.At 5 min after drug intervention (T0),immediately after onset of OLV (T1),at 60 min of OLV (T2),immediately after the end of OLV (T3),at the end of surgery (T4),and at 24 h after surgery (T5),venous blood samples were collected for determination of serum tumor necrosis factor-alpha (TNF-o),interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay.The specimens of normal lung tissues around the lung lobe to be resected were obtained at T1 and T3 for determination of the injured alveolus count (with a light microscope) and cell apoptosis (using TUNEL) and for examination of the ultrastructure of epithelial cells (with a transmission electron microscope).The injured alveolus rate (IAR) and apoptosis index (AI) were calculated.Results Compared to the value at T0,the IAR and AI were significantly increased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly increased at T2-5 (P＜0.05),and the pathological changes were obvious in the two groups.Compared to group C,the IAR and AI were significantly decreased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly decreased at T2-5 (P＜0.05),and the pathological changes were significantly reduced in group P.Conclusion Penehyclidine hydrochloride can attenuate the damage to the non-ventilated lung in the pediatric patients undergoing OLV,and the mechanism is probably related to inhibition of systemic inflammatory responses and cell apoptosis in lung tissues.

Objective To evaluate the effects of dexmedetomidine pretreatment on extracellular sig?nal?regulated kinase ( ERK) pathway during acute lung injury in a rat model of liver transplantation. Meth?ods Sixty male Sprague?Dawley rats, weighing 235-250 g, were divided into 4 groups ( n=15 each) u?sing a random number table: sham operation group (group S), liver transplantation group (group LT), low?dose dexmedetomidine pretreatment group ( group LD ) and high?dose dexmedetomidine pretreatment group ( group HD) . In LT, LD and HD groups, the model of orthotopic liver transplantation was estab?lished, and the operation time was about 4 h. Dexmedetomidine 2?5 and 5?0μg·kg-1 ·h-1 were intrave?nously infused for 1 h starting from 1 h prior to clipping the hepatic artery and portal vein in LD and HD groups, respectively. The rats were sacrificed after the end of operation, and the lungs were removed for determination of wet to dry weight ratio ( W∕D ratio) , cell apoptosis and expression of ERK mRNA, ERK, phosphorylated ERK ( p?ERK) , Bcl?2 and Bax in lung tissues and for examination of the pathological chan?ges ( with light microscope) and ultrastructure of lung tissues ( with transmission electron microscope) . The
injured alveolus rate ( IAR) , apoptosis index ( AI) and ratio of Bcl?2 to Bax expression ( Bcl?2∕Bax ratio) were calculated. Results Compared to group S, the W∕D ratio, IAR, AI, expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK, Bcl?2 and Bax and Bcl?2∕Bax ratio were significantly increased in LT, LD and HD groups ( P<0?05) . Compared to group LT, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the expression of Bax was significantly down?regulated in LD and HD groups (P<0?05). Compared to group LD, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the ex?pression of Bax was significantly down?regulated in group HD ( P<0?05) . The pathological changes of lung tissues were significantly attenuated in LD and HD groups as compared with group LT, and in group HD as compared with group LD. Conclusion The mechanism by which dexmedetomidine pretreatment mitigates cell apoptosis during acute lung injury is related to activation of ERK pathway in a rat model of liver trans?plantation.

Objective To investigate the clinical features of pulmonary infection in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).Methods A total of 666 hospitalized patients with HBV-ACLF in Department of Liver Disease of Fuzhou Infectious Diseases Hospital were retrospectively analyzed.Data of demographic and clinical parameters (sex,age,presence of liver cirrhosis and diabetes),complications (spontaneous bacterial peritonitis,hepatorenal syndrome,hepatic encephalopathy,and upper gastrointestinal hemorrhage),and baseline biochemical parameters were collected from the medical records database.Univariate and multivariate regression analyses were performed to determine the independent risk factors of pulmonary infection in patients with ACLF.Distributions of the pathogenic bacteria were further analyzed.Student t test was used for the means consistent with normal distribution,while non-parametric statistics were used for the data consistent with abnormal distribution.Mann-Whitney U test was used for the data between two groups.Chi square test and Fisher exact probability method were used for comparing the count data.Results A total of 125 out of 666 patients with ACLF developed pulmonary infection.The incidence of pulmonary infection was 18.76 ％ (125/666)..Most patients were infected with fungi (54.84％).The incidence rate of pulmonary infection in patients with liver failure over 60 years (41.18％) was significantly higher than that in patients under 60 years (16.91％;x2 =19.136,P＜0.01).The incidence of cirrhosis or diabetes in the 125 patients with pulmonary infection was higher than patients with no pulmonary infection.The difference between the two groups was statistically significant (P＜0.01).Levels of albumin,cholesterol,alphafetoprotein,white blood cell count,hemoglobin,plasma thromboplastin antecedent,international normalized ratio (INR),and serum sodium were all significantly different between the two groups (all P＜ 0.05).The incidence of spontaneous bacterial peritonitis,hepatorenal syndrome,and hepatic encephalopathy in patients with pulmonary infection were significantly higher than those without pulmonary infection (P＜0.01).Spontaneous bacterial peritonitis,age,albumin,hemoglobin and serum sodium were important factors in the development of the pulmonary infection.And albumin,hemoglobin and serum sodium were protective factors.Conclusions Pulmonary infection,as one of the common and serious complications,significantly affects the prognosis of liver failure patients.Prediction of pulmonary infection in the early stage is essential.Patients with elder age,spontaneous bacterial peritonitis,low albumin level,low serum sodium level and low hemoglobin level should be timely monitored to prevent the development of pulmonary infection.