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Objective@#To explore the clinical characteristics and related factors of somatization symptoms in outpatients with psychiatric disorders of the cardiology department in general hospital.@*Methods@#Cross-sectional survey method was used in this study. From August 2017 to September 2018, 508 outpatients of our department with suspected mental disorders, who complained of physical discomfort and screened by the "Three Questions" method recommended by the Chinese Expert Consensus on Psychological Prescriptions of Cardiovascular Patients in 2014, were consecutively included. General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Patient Health Questionnaire-15 (PHQ-15) and self-made general demographic questionnaire (including age, sex, marital status, educational level, occupation, duration of disease, clinical diagnosis and the process of medical treatment for the main somatic symptoms in recent one year) were used to investigate these patients, under the assistance of unified training psychological consultants. The detection rate of anxiety and depression, the degree and distribution of somatization symptoms in outpatients with mental disorders were analyzed, and the related factors affecting the occurrence of somatization symptoms were screened by multivariate logistic regression.@*Results@#The selected patients were (51.3±10.1) years old, of which 37.8% (192/508) were males and 62.2% (316/508) were females. The total detection rate of anxiety/depression was 86.8% (441/508), and the detection rate of somatization symptoms was 93.1% (473/508). The number of positive symptom items in PHQ-15 was 8.0±2.7, and the detection rate of anxiety/depression was 78.6% (372/473) in patients with somatization symptoms. There were significant differences in the proportion of women, the average number of outpatient visits and hospitalizations in the past one year, GAD-7 score and PHQ-9 score among the patients with mild, moderate and severe somatization symptoms (all P<0.05). PHQ-15 score was positively correlated with GAD-7 score (r=0.524 5, P<0.001) and PHQ-9 score (r=0.574 9, P<0.001) in patients with somatization symptoms. Stepwise logistic regression analysis showed that total scores of PHQ-9 (OR=8.020, 95%CI 3.470-18.930, P<0.001) and GAD-7 (OR=6.526, 95%CI 2.903-13.045, P<0.001) and female (OR=4.440, 95%CI 1.059-9.073, P=0.011) were related factors of somatizations.@*Conclusions@#The incidence of somatization symptoms is high in patients with psychological disorders in outpatients of cardiology department in general hospital. Anxiety, depression and gender are the main related risk factors of somatization symptoms in this patient cohort. Degree of anxiety and depression increased in proportion to the severity of somatization symptoms. Anxiety, depression and female is related to somatization symptoms.
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Objective To investigate the incidence of insomnia and its influencing factors in the outpatients with cardiovascular diseases in a general hospital.Methods A total of 956 consecutive cases of the outpatients was collected from March 2016 to September in the department of cardiology patients in this general hospital.Insomnia was diagnosed with the 2012 Chinese adult insomnia diagnosis and treatment guidelines.All subjects underwent clinical examination,generalized anxiety scale (GAD-7),patient health questionnaire depression scale (PHQ-9),and self-made demographic sociology information questionnaire.Results A total of 925 patients with completed data was included in the analysis data.The insomnia incidence rate was 51.4％.The insomnia incidence rates were 57.8％ and 37.6％ in the patients with and without cardiovascular diseases.The difference was statistically significant (P ＜ 0.01) between both groups.The insomnia incidence rates in the patients with hypertension,coronary heart disease,arrhythmia,hypertension combined with coronary heart disease and other cardiovascular diseases were 50.8％,56.3％,53.2％,63.0％,and 54.3％,respectively.There were significant differences between the groups (P ＜ 0.05).The incidence of anxiety or depressive symptoms was 44.5％ in all investigators.Insomnia incidence rates were 75.6％ and 32.0％ in the subjects with and without anxiety or depressive symptoms.The difference was statistically significant (P ＜ 0.01) between both groups.Multivariate logistic regression analysis showed that gender,type A personality,family income satisfaction,cardiovascular diseases and anxiety/depression were independent factors to affect the occurrence of insomnia.Conclusions The insomnia incidence rates was high in the outpatients from the department of cardiology of general hospital.The main factors that affect the occurrence of insomnia include psychological,social aspects,and cardiovascular diseases.
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Objective:To explore the effects of compound Danshen dripping pills (CDDP) and CDDP combined with transplantation of human umbilical cord blood cells (HUMNCs) on the inlfammatory response, oxidative stress, myocardial cell apoptosis and cardiac function, and also to investigate the possible mechanisms of the combined therapy in the acute myocardial infarction (AMI). Methods:Rabbit model of AMI successfully established by ligation of the letf anterior coronary artery (LAD). Forty rabbits were randomly divided into 4 groups (n=10 per group):a control group, injected with 0.5 mL of saline in 24 h atfer AMI and then gavaged with 5 mL of saline daily;a CDDP group, injected with saline 0.5 mL atfer AMI and then gavaged with CDDP (270 mg/d) daily;a transplantation group, injected with 0.5 mL of saline contained 3 × 107 HUCBMCs [labeled with green fluorescent protein (GFP)] and then gavaged with 5 mL of saline daily;a combined group, injected with 0.5 mL of saline contained 3 × 107 HUCBMCs (labeled with GFP) and then gavaged with CDDP (270 mg/d) daily. Cardiac function index such as left ventricular fractional shorting (LVFS) and ejection fraction(LVEF) were measured by echocardiography;the pathological changes were observed by HE staining and the white blood cells in the myocardium were determined by light microscopy. hTe superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in myocardium were detected by nitrotetrazolium blue chloride (NBT) and thiobarbituric acid colorimetric measurement respectively. hTe number of transplanted cells in the myocardium was examined by GFP positive cells counted with lfuorescence microscopy. Results:1) Compared with the control group (at 1 or 4 week), LVEF and LVFS were signiifcant improved in the CDDP group, the transplantation group and the combined groups (all P Conclusion:The intravenous transplantation of HUMNCs combined with the CDDP in the treatment of rabbits with AMI could increase the survival rate of transplanted cells and inhibit the myocardial cell apoptosis, therefore improve the heart function. hTe possible mechanism of the combined treatment may be involved in the inhibition of the inlfammatory response and oxidative stress in the myocardium following AMI.
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Objective To explore the effect of endothelial progenitor cells (EPCs) on the proliferation of co-cultured rat vascular smooth muscle cells(VSMCs). Methods Mononuclear cells were isolated from fresh cord blood by 6% hydroxyethyl starch (HES) and density gradient centrifugation. Isolated mononuclear cells were cultured in EGM-2 medium supplemented with 20% fetal bovine serum (FBS), VEGF,bFGF and other growth factors. Biological features of EPCs were observed at different time points, and EPCs were identified by morphology, fluorescence double-staining and flow cytometry. Indirect immunofluorescence was performed to analyze the expression of α-SM-actin, calponin of VSMCs special antigen. Co-culture system of EPCs and VSMCs was established by transwell permeable support. FBS (20%) was used to stimulate the proliferation of VSMCs. In a VSMCs/EPCs co-culture system, the DNA synthesis ability, total protein level and cell cycle of VSMCs were determined by BrdU marking method,protein quantitation and flow cytometry after co-culture for 6, 12, 24,48 and 72 h. Results After co-culture for 12, 24, 48, and 72 h, the DNA synthesis ability and total protein level of VSMCs significantly decreased compared with the control group(P＜0.05). Flow cytometry showed that the percentage of S phase of VSMCs in VSMCs/EPCs co-cultured group significantly decreased and the percentage of G_1 phase increased markedly compared with the control group(P＜0.05). The maximal inhibitory effect was observed at 48 h. Conclusion Early EPCs could inhibit the proliferation of VSMCs.
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Objective To observe the neurologicaI functional recovery after intravenous transplantation of human umbilical cord blood(HUCB)CD34~+ cells transfected with glial cell-derived neurotrophic factor (GDNF) and green fluorescent protein (GFP) in SD rats with middle cerebral artery occlusion (MCAO).and tO investigate the survival,migration and neural differentiation of the graft cells.Methods (1)CD34~+ cells were isolated from HUCB using centrifuge combined with immune beads and then identified by flow cytometry,and transfected by the recombinant plasmid of GDNF.GFP or GFP plasmid by liposome method.(2) Sixty aduh male SD rats with MCAO were randomly divided into three groups (n=20 in each group):GDNF-GFP-CD34~+ cells group,in which the GDNF-GFP-CD34~+ cells were transplanted intravenously at the 24th h after the establishment ofmodels of MCAO;GFP-CD34~+ cells group:in which the GFP-CD34~+ cells were transplanted intravenously at the Same time;Normal saline group,in which normal saline was injected at the same time.Fifteen SD rats served as sham-operated group.(3) Neurological functional measurements were performed using the modified neurolc'gical severity score.Quantitative histological determinations of infarct volume were performed using standard TTC staining and quantitative image analysis. The GDNF level in the cell culture or the cerebral tissue was measured by ELISA. Meanwhile, the survival and migration of GFP-labeled CD34~+ cells and the expression of astrocytie marker-GFAP and the neuron marker-neuronal nuclei (NeuN) were detected by immunohistochemical and fluorescent staining. Results (1) The GDNF level in the cell culture was significantly higher in GDNF-GFP-CD34~+ cells than in GFP-CD34~+ cells (P<0. 05). (2) No significant difference was found in the modified neurological severity score at the day 7 after transplantation among the three groups with MACO, but at day the 28 after transplantation, the neurological function in GFP-GDNF-CD34~+ group was improved significantly (5.0±1. O) as compared with the GFP-CD34~+ cells (5. 9 + 1.4) or saline groups (7. 0±1.7) (P<0. 05). The cerebral infarct volume in GFP-GDNF-CD34~+ group (142±44mm~3) was significantly decreased as compared with the GFP-CD34~+ group (196±58 mm~3) (P<0. 05) or saline group (233<50 mm~3 ) (P<0. 01 ). The GDNF level in cerebral tissue in GFP-GDNF-CD34~+ group was significantly increased as compared with the GFP-CD34~+ group (P<0. 05) at the 28th day after treatment. At the 28th day after treatment, the NeuN positive cells (6.7±2.0), and GFAP positive ceils (14.1±3.3) in GFP-GDNF-CD34~+ group were significantly increased as compared with the GFP-CD34~+ group (P<0. 05), but there were no positive cells in sham-operationgroup. Conclusion Intravenous transplantation of GDNF gene-modified CD34~+ cells from human umbilical cord blood could improve the neurological function in rats with MCAO. The increased GDNF level in cerebral tissue was one of possible mechanisms responsible for the different improvements.
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OBJECTIVE@#To explore and evaluate the characteristics of spectra wave shapes and parameters of the superior vena cava (SVC) Doppler flow patterns in patients with pulmonary arterial hypertension(PAH) by echocardiography.@*METHODS@#Forty-nine patients with PAH as the PAH group and the paired healthy subjects as the control group were included in this study. Transthoracic echocardiography was used, and the spectra of SVC flow Doppler velocities in the right supraclavicular fossa view were examined and recorded. Peak velocity and velocity time integral (VTI) were measured.@*RESULTS@#The spectra wave shapes of SVC flow velocity in the PAH group were distinguished from those of the control. The peak velocity and VTI of S waves during inspiration and the rate of respiratory changes of peak velocity of SVC flow Doppler velocity in moderate and severe PAH groups were significantly lower than those of the control (P<0.05).The peak velocity and VTI of D waves of SVC flow Doppler velocity in the PAH groups were significantly lower than those of the control (P<0.05). The rate of respiratory changes of peak velocity of D waves in the PAH groups was significantly lower than those of the control (P<0.05). The peak velocity and VTI of AR, and VR waves of SVC flow Doppler velocity in the PAH groups were significantly higher than those of the control (P<0.05). Linear regression analysis revealed a significant correlation between pulmonary arterial systolic pressure(PASP) and the Vexp/Vins ratio (r=0.760, P<0.001).@*CONCLUSION@#The spectra wave shapes of SVC flow velocity in the PAH groups were distinguished from those of the control which may have some diagnostic value for PAH.The peak velocities and VTI of S waves during inspiration, D waves, AR waves and VR waves of SVC flow Doppler in the PAH groups are different from the control. The ratio of Vexp/Vins of S wave may be a non-invasive quantitative index to detect PAH.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Blood Flow Velocity , Case-Control Studies , Echocardiography, Doppler, Color , Methods , Hypertension, Pulmonary , Diagnostic Imaging , Vena Cava, Superior , Diagnostic ImagingABSTRACT
OBJECTIVE@#To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein (hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI).@*METHODS@#Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group (n = 19) which took routine treatment or a tongxinluo group (n = 20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed.@*RESULTS@#NOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P < 0.05), but hs- CRP obviously increased (P < 0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P < 0.05 or P < 0.01), but hs-CRP obviously decreased (P < 0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P < 0.05). NO was negatively correlated with hs-CRP (r = -0.3219, P<0.01).@*CONCLUSION@#Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.
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Aged , Female , Humans , Male , Middle Aged , Acute Coronary Syndrome , Blood , Therapeutics , Angioplasty, Balloon, Coronary , Methods , C-Reactive Protein , Metabolism , Drugs, Chinese Herbal , Therapeutic Uses , Endothelium, Vascular , PhytotherapyABSTRACT
Objective To determine the plasma urolensin Ⅱ(UⅡ) levels in various types of coronary heart disease and to clarify how the plasma UⅡ levels correlate with the clinical presentation, extent and severity of coronary artery atherosclerosis (CAD). Methods: One hundred and three aged patients undergoing elective diagnostic coronary angiography for proven or clinical suspected coronary heart disease were enrolled in this study. The extent and severity of coronary artery disease were evaluated by vessel score and Gensini score, respectively. Plasma UⅡ levels were measured by radioimmunoassay. Results: The plasma UⅡ levels in the patients with modest to severe coronary stenosis (3.03±0.34 pg/ml, 1.83±0.67 pg/ml) were significantly lower than that in subjects with normal coronary artery (4.80±1.11 pg/ml, P＜0.001). The plasma UⅡ levels in patients with coronary heart disease were also significantly lower than that in patients with insignificant coronary stenosis (P ＜ 0.001). Compared to patients with stable angina pectoris, plasma UⅡ levels in patients with acute coronary syndrome were significantly decreased (1.89±0.51 pg/ml vs 2.42±0.77 pg/ml, P＜ 0.001). Plasma UⅡ levels were found to be negatively correlated with the severity of coronary artery stenosis (r = -0.488, P＜0.001), as well as the vessel score (r = -0.408, P＜0.05) in the patients with CAD. Conclusion: Significant inverse correlations exist between the plasma UⅡ levels, and the extent and severity of coronary artery stenosis. These findings suggest that plasma UⅡ contribute to the development and progression of coronary artery stenosis, and may be a novel marker to predict clinical types, as well as the extent and severity of coronary artery disease in the patients.
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0.05).The cerebral infarcted area in SHR were significantly greater than that in SD rats [(42.6?5.6)% vs(29.5?6.7)%,P
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Objective To study the influences of psycho-social factors in the treatment of the aged patients with hypertension. Methods Aged in-patients with hypertension were divided into two groups according to their improvement: 148 reached the standard and 62 did not reach the standard. Their psycho-social factors were assessed by self-rating depression scale(SDS), self-rating anxiety scale(SAS), life events scale (LES) and social support scale. Results (1)The percentages of depression (7.4% vs 32.2%, P
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<p><b>OBJECTIVE</b>To investigate the different effects of an angiotensin II type 1 (AT(1)) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardial fibrosis, and angiotensin II (Ang II) in the left ventricle of spontaneously hypertensive rats (SHRs).</p><p><b>METHODS</b>SHRs of 16-week-old were randomly divided into 3 groups: SHR-L (treated with losartan, 30 mg.kg(-1) x d(-1)), SHR-F (treated with fosinopril, 10 mg x kg(-1) x d(-1)), and SHR-C (treated with placebo). Each group consisted of 10 rats. Five rats, randomly selected from each group, were killed at the 8th and 16th week after treatment. Cardiomyocyte apoptosis, collagen volume fraction (CVF), perivascular collagen area (PVCA) and Ang II concentrations of plasma and myocardium were examined.</p><p><b>RESULTS</b>Compared with the controls at the 8th and 16th week, systolic blood pressures were similarly decreased in both treatment groups. Left ventricular weight and left ventricular mass indexes were significantly lower in both treatment groups. However, the latter parameter at the 16th week was reduced to a less extent in the fosinopril group than that in the losartan group. Compared with the controls, cardiomycyte apoptotic index was significantly reduced at the 8th week only in the fosinopril group, and at the 16th week in both treatment groups. The index of the fosinopril group was lower than that of the losartan group at the latter endpoint examined. Compared with the controls, the left ventricular collagen volume fraction and perivascular collagen area at the 8th and 16th weeks were significantly reduced in the SHRs treated with either fosinopril or losartan. However, the collagen volume fraction at the latter endpoint in the fosinopril group was lower than that in the losartan group. Compared with the controls at endpoints, plasma and myocardium Ang II levels were significantly increased in the losartan group. However, plasma Ang II concentrations were not altered, and myocardium Ang II concentrations at the 8th and 16th weeks were significantly reduced in the fosinopril group.</p><p><b>CONCLUSIONS</b>Both losartan and fosinopril could effectively inhibit cardiomyocyte apoptosis and myocardial fibrosis and reverse heart hypertrophy. Fosinopril may be more effective in these cardioprotective effects, suggesting that the effects of both drugs are related to the inhibition of myocardium renin-angiotension-aldsterone system.</p>
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Animals , Rats , Angiotensin II , Antihypertensive Agents , Therapeutic Uses , Apoptosis , Blood Pressure , Fibrosis , Fosinopril , Therapeutic Uses , Hypertension , Drug Therapy , Hypertrophy, Left Ventricular , Drug Therapy , Losartan , Therapeutic Uses , Myocardium , Chemistry , Pathology , Rats, Inbred SHRABSTRACT
Objective: To investigate effects of lorsartan, fosinopril on myocardial fibrosis, angiotensin Ⅱ and cardiac remolding in the spontaneously hypertensive rats (SHR). Methods: 16-week-old SHRs were divided randomly into 3 groups: SHR-L (treated with lorsartan), SHR-F (treated with fosinopril) and SHR-C (untreated), each group consisting of 10 rats. After 8 weeks' and 16 weeks' therapeutic period, collagen volume fraction (CVF), perivascular circuferential area (PVCA), plasma and myocardium angiotensin Ⅱ concentrations were examined by pathological examination with computed processing and radioimmunoassay respectively. Results: (1) Compared with SHR-C after 8 weeks' and 16 weeks' therapeutic period, the systolic blood pressure (SBP) was decreased similarly in both treatment groups. Heart and left ventricular weights, heart weight and eft ventricular mass indexes were lower significantly in both treatment groups than in SHR-C. Left ventricular mass index was reduced to a lower extent in SHR-F group than in SHR-L group after 16 weeks. (2) Compared with SHR-C, CVF, PVCA after 8 weeks and 16 weeks were reduced significantly in SHR-F and SHR-L. Meanwhile, CVF after 16 weeks in SHR-F than in SHR-L. (3) Compared with SHR-C after both therapeutic periods, plasma and myocardium angiotensin Ⅱ concentrations were increased Significantly in SHR-L, but plasma angiotensin Ⅱ concentrations were not altered significantly in SHR-F. However, myocardium angiotensin Ⅱ concentrations were reduced significantly in SHR-F after 8 weeks and 16 weeks in SHR-F. Conclusion: Lorsartan, fosinopril inhibit myocardial fibrosis and reverse heart hypertrophy. Fosinopril may be more effective in these above effects than Lorsartan. The mechanism of the both drug's cardioprotective effects was related to inhibition of myocardium rennin-angiotension-aldsteron system.
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Objective: To study the quality of life of chronic elderly patients Method: 150 chronic patients aged 60 or above were assessed with SCL-90 (symptom checklist-90), SDSS (social deficit screening scale), ADL (activity of daily living) and QOL (quality of life), their demographic data were also collected Results: Men's social function was poorer than women's, but their quality of life had no significant difference to women's The quality of life in our sample differed with different age, educational degree, family conditions, occupations and incomes Conclusion: Life quality of chronic old patients is related to their demographic characters