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ObjectiveTo explore the anhedonia level and its relationship with cognitive function in patients with first-episode psychosis， and to analyze the influencing factors of cognitive function. MethodsA total of 143 first-episode psychiatric patients who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） in the Affiliated Brain Hospital of Guangzhou Medical University from December 2016 to March 2019 were selected. Positive and Negative Syndrome Scale （PANSS） was used to evaluate the patient’s psychiatric symptoms， in which N2 （emotional withdrawal） and N4 （passive/apathetic social withdrawal） were used to assess the anhedonia level， and patients whose （N2+N4） scores beyond 4 were classified into anhedonia group， and those with （N2+N4） scores less than or equal to 4 were classified into non-anhedonia group. Hamilton Depression Scale-24 item （HAMD-24） was used to measure the depressive symptoms， and the MATRICS Consensus Cognitive Battery （MCCB） was used to detect cognitive function. Then the clinical symptoms and cognitive function of two groups were compared， and the influencing factors of cognitive function were screened by multiple linear regression analysis. ResultsThe negative symptom score， general pathological symptom score and total score of PANSS in anhedonia group were significantly higher than those of non-anhedonia group， with statistical difference （P<0.05）. The score of working memory in adolescent subgroup， the scores of information processing speed， attention/alertness and vocabulary learning in adult subgroup of anhedonia group were lower than those of non-anhedonia group， with statistical difference （P<0.05）. Multiple linear regression analysis showed that the anhedonia score and the duration of untreated psychosis were the influencing factors of working memory in adolescent subgroup （P<0.05）. ConclusionPatients with high levels of anhedonia suffer more severe mental symptoms and cognitive impairment， moreover， anhedonia is one of the influencing factors of working memory in adolescents.
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Objective:To investigate the distribution of uric acid in different occupation, age and gender groups, and changes of prevalence of hyperuricemia (HUA) and its influencing factors in healthy adults who receiving physical examination in Nanjing.Methods:The study was conducted in 107 478 subjects who received physical examination from 2012 to 2016. The prevalence of HUA in different genders and different years was compared. Subjects were divided into non-HUA and HUA groups according to serum uric acid. The differences in metabolic indicators and ages between two groups were analyzed. Uric acid levels among different occupations were evaluated. A multivariate logistic regression analysis was used to estimate the odds ratios ( OR) of HUA. Results:The total HUA prevalence was 14.9%, in which the prevalence of HUA in men was significantly higher than that in women [20.5%(15217/74339)vs .2.5%(818/33139), P<0.01]. The prevalence of HUA in men sustained at a high level, while that in women trended to decrease during the five years. The prevalence of HUA increased with age in women (1.0%, 0.7%, 0.9%, 2.7%, 3.8% and 9.6% in subjects within 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 age groups, respectively, Pfor trend<0.01). The percentages of hypertension, hyperlipidemia and diabetes, and body mass index (BMI) in both men and women were significantly higher in HUA group than those in non-HUA group ( P≤0.01). Among all occupations, subjects in health care had the lowest levels of uric acid (298±91 μmol/L) and prevalence of HUA (10.4%), while, those in public security had the highest levels of uric acid [(342±82) μmol/L] and prevalence (16.5%). Multiple logistic regression analyses revealed that males, high triacylglycerol, high cholesterol, obesity and certain occupation were significantly associated with HUA. Conclusions:The prevalence of HUA in men is significantly higher than that in women. It increased with ages in women. Subjects in health occupations had the lowest levels of uric acid and HUA prevalence, while, those in public security had the highest levels among the six occupations. Obesity, hyperlipidemia, hypertension, occupations and males are positively associated with HUA.
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The management of drug clinical trial institutions from the risk management point of view is investigated. According to the technology of risk assessment in risk management, taking the project audit as an example, basing on the basic procedures of risk identification, risk assessment and risk control, making 8 risk factors into the table of risk management for project approval of clinical trial in order to initially establish a risk management of drug clinical trial institutions. In this way, the management quality of project for drug clinical trials will be probably improved, so that the risk incidence rate will be effectively reduced in the later phase of clinical trial.
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Objective To investigate the intervention effect of 1,25(OH)2D3 on serum level of parathyroid hormone,bone metabolic markers and muscle strength in the community elderly with low bone mass.Methods A total of 132 residents aged 60 years and over from Shanghai communities diagnosed as osteopenia or osteoporosis were enrolled and treated with 0.5 μg/d calcitriol for 3 months.Serum levels of parameters in blood biochemistry and bone metabolic markers were determined by Cobas Diagnosis System of Roche before and after treatment,and the handgrip strength of both left and right hands were measured at the same time.Results The average age of 132 patients was(66.1 ± 6.3) years,4 cases (all female) terminated their medication in advance,and 128 patients completed the treatment for three months.The baseline serum levels of 25 (OH)D and PTH were 19.6 ± 7.9 μg/L and 41.0 μg/L respectively.According to the median value of serum PTH before treatment,patients were divided into the two groups:the high PTH group and the low PTH group.Compared with the low PTH group,the serum levels of 25OHD and serum calcium were decreased in the high PTH group[(17.1 ± 7.0) μg/L vs.(22.1 ± 8.2) μg/L,2.4 mmol/L vs.2.5 mmol/L,P＜0.05].After 3 months of intervention,serum levels of creatinine,urine calcium and left handgrip were significantly elevated[(68.2 ± 13.8) μmol/L vs.(65.2 ± 13.4) μmol/L,(5.9 ± 2.8)mmol/24 h vs.(4.4 ± 2.0) mmol/24 h,23.8 kg vs.21.0 kg,all P ＜0.05],while serum levels of PTH,eGFR,phosphorus were significantly decreased[35.5 ng/L vs.42.0 ng/L,(87.0 ± 17.0) ml/min vs.(93.1±17.9) ml/min,1.2 mmol/L vs.1.3 mmol/L,all P＜0.05).There was a significant negative correlation between serum 25(OH)D and PTH before treatment(r=-0.312,P＜0.05),but the negative correlation between them was no longer significant after 3 months of treatment (r =0.042,P ＞ 0.05).A multivariate logistic regression analysis revealed that the increment of left handgrip strength greater than 25％ (OR =0.138,95％ CI:-0.002-8.383),the increment of serum calcium levels(OR =2.578,95％CI:1.0345-8.693)and age(OR =0.103,95％CI:0.035-0.345) were significantly correlated with the decrement of serum PTH levels greater than 30 ％ after three months of treatment.Conclusions Vitamin D diminution or deficiency is common in the elderly.The shortterm treatment of calcitriol can obviously reduce serum PTH,inhibit bone absorption and increase muscle strength.The effect of calcitriol on serum PTH is closely related to promoting calcium absorption and improving handgrip strength.
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Objective To investigate the prevalence and risk factors of vertebral fractures in the elderlys in Shanghai community. Methods Stratified sampling was performed according to the age distribution of the population in 3 urban and 2 suburban communities in Shanghai, and a total of 2 929 old people aged over 65 years were enrolled. The thoracic and lumbar radiographs and questionnaires were obtained in all the participants. The diagnosis of vertebral fractures were evaluated using Genant′s semi-quantitative method, and the prevalence of vertebral fracture was calculated. Logistic regression was used to analyze the risk factors of vertebral fracture. Results ( 1) The prevalence of vertebral fractures in community-dwelling elderly was 14.4%totally,and 20.1%in individuals above 80 years old,which was significantly higher than the others (P<0.05). The prevalence of vertebral fractures in females was significantly higher than that in males (18.5%vs 12.4%, P<0.05). (2) The most common vertebral fracture sites were T12 and L1. Grade 1 vertebral fracture was most common in our cohort. The proportions of grade 2 and grade 3 were significant higher in females than that in males (30.6% vs 17.0%, P<0.05). (3) Gender and sex had an interaction effect on the prevalence of vertebral fractures. Prevalence of vertebral fractures increased steadily with age in both genders, although the gradient was steeper for women (P<0.001). (4) Logistic regression analysis showed that: female, age, parental hip fracture history, previous fracture history, and alcohol consumption were risk factors of vertebral fractures in community elderly. Smoking, long-term use of glucocorticoid, various diseases associated with secondary osteoporosis had no significant correlation with vertebral fracture. Conclusion The vertebral fractures were more common and serious in women than in men in community elderly. Age was significantly correlated with the presence of vertebral fracture in women than that in men. Female, age, parental hip fracture history, previous fracture history, and alcohol consumption were risk factors of vertebral fractures in community elderlys.
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Objective To analyze risk factors for the perioperative complications and death following hip fracture in the elderly. Methods The present study included 1352 elderly patients (≥65 years) who had received hip fracture surgery from January 2010 to June 2015 in Huadong hospital affiliated to Fudan University. Their clinical data were analyzed to determine risk factors for perioperative complications and death. Results Factors significantly affecting the perioperative complications included gender, preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ), respiratory system disease and blood transfusion. Factors significantly affecting the death included preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ) and blood transfusion. Multivariate Logistic regression analysis revealed that the independent risk factors for perioperative complications included gender (B=-0.686, P=0.019), preoperative serum albumin (B=-0.808, P=0.006), cardiac functional grade (≥Ⅲ, B=1.181, P=0.004), blood transfusion (B=0.890, P=0.004) and respiratory system disease (B=3.118, P=0.000);while the independent risk factors for death included preoperative serum albumin (B=-2.516, P=0.000) and blood transfusion (B=1.396, P=0.010). Conclusions In elderly patients undergoing hip fracture surgery, the independent risk factors for perioperative complications included gender, preoperative serum albumin, cardiac functional grade, blood transfusion and respiratory system disease, while the independent risk factors for death included preoperative serum albumin and blood transfusion. Perioperative risk assessment and prevention are the keys of better prognosis.
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Objective@#To investigate the distribution and resistance of pathogens isolated from blood cultures in patients with hematological malignancies after chemotherapy in Union Hospital of Fujian Medical University so as to understand the real situation of blood stream infection (BSI) and provide the basis for rational use of antibiotics in clinic.@*Methods@#The data of 657 strains isolated from blood culture specimens of patients with hematological malignancies from January 2013 to December 2016 were collected analyzed.@*Results@#A total of 657 cases of blood culture positive bacterial strains were included in the study, involving 410 cases (62.4%) with single Gram-negative bacteria (G- bacteria) , 163 cases (24.8%) with single Gram-positive bacteria (G+ bacteria) , 50 cases (7.6%) with single fungi. The most common 5 isolates in blood culture were Klebsiella pneumoniae (17.5%) , Escherichia coli (17.2%) , Coagulase negative staphylococci (CNS) (14.9%) , Pseudomonas aeruginosa (14.2%) and Staphylococcus aureus (3.5%) . The extended-spectrum beta-lactamase (ESBL) production rates of Klebsiella pneumoniae and Escherichia coli were 25.2% and 55.8%, respectively. ESBL producing strains were almost more resistant than non-ESBL producing strains. The resistance rates of Enterobacteriaceae to carbapenems, piperacillin/tazobactam and tigecycline were lower than 14.0%. The resistance rates of Pseudomonas aeruginosa to a variety of drugs were lower than 12.0%. Tigecycline-resistant Acinetobacter baumannii bacteria were not detected, and the resistance rates of Acinetobacter baumannii to cefixime and cefotaxime were 7.1%. Methicillin-resistant strains in CNS (MRCNS) and in Staphylococcus aureus (MRSA) accounted for 84.7% and 43.5%, respectively. Vancomycin, linezolid and tigecycline-resistant G+ bacteria were not detected.@*Conclusion@#The pathogens isolated from blood culture were widely distributed. Most of them were G- bacteria, and the resistance to antibiotics was quite common. Furhermore, vancomycin, linezolid and tigecycline can be chosen empirically to treat patiens who ar suspected to have G+ bacterial BSI.
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Objective To explore the value of combined detection of parathyroid hormone(PTH),β2-microglobulin(β2-MG)and high sensitivity C-reactive protein(hs-CRP)in differentiating diagnosis of acute and chronic renal failure. Meth?ods Patients diagnosed with renal failure was divided into acute renal failure patients group (n=64) and chronic renal fail?ure group (n=74) . Other patients with non-renal failure kidney disease (NRF group, n=80) and healthy adult (control group, n=80) were also selected. Levels of PTH,β2-MG, hs-CRP , PTH+β2-MG, PTH+hs-CRP,β2-MG+hs-CRP and PTH+β2-MG+ hs-CRP were compared between these four groups to choose the optimal combination for differential diagnosis. Re?sults Hs-CRP in ARF group was significantly higher than that in control group and CRF group. Levels of PTH andβ2-MG were significantly lower in ARF group than that in CRF groups but not in control group (P < 0.01). hs-CRP andβ2-MG in the ARF group were moderately higher (68.7%) and severely higher (81.2%) while PTH was mild higher (25%) in ARF group than those in control group, On the other hand, hs-CRP andβ2-MG in the ARF group were moderately higher (56.8%) and severely higher (98.6%) while PTH was mild higher (39.2%) in ARF group than those in control group. Combina?tion of hs-CRP withβ2-MG could increase total case rate (TCR) and Youden index (YI) of ARF;while combination of PTH andβ2-MG could improve the TCR and YI of CRF. Conclusion Combined detection of PTH,β2-MG and hs-CRP is use?ful in differential diagnosis of ARF and CRF.
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ObjectiveTo develop doxorubicine-loaded nanomicelles based on a type of novel starshaped 4-arm PLGA-PEG-NH2 amphiphilic block copolymers.Methods 4s-(PLGA-PEG-NH2) synthesized by 4s-PLGA and (H2N-PEG-NH2) according to N,N'-dicyclohexylcarbodiimide(DCC) condensation reaction was demonstrated by 1H NMR spectroscopy and gel permeation chromatography(GPC); DOX-loaded 4s-(PLGA-PEG-NH2) nanomicelles were self-assembled by doxorubicin(DOX) and 4s-(PLGA-PEG-NH2) via emulsion-solvent evaporation method and characterized in terms of morphology,particle size and size distribution,drug loading,encapsulation efficacy,cell uptake and cytotoxicity studies.Results4s-(PLGA-PEG-NH2) were capable of selfassembling intocore-shell nanomicelles structure and encapsulating DOX into their hydrophobic cores.The mean size of DOX-loaded 4s-(PLGA-PEG-NH2) was nanometer size; drug loading and encapsulation efficacy were around 7.5％ and 75.2％,respectively.Mean surface charge of the micelles was around -17.6 mV.In vitro cell uptake and cytotoxicity studies indicated that comparing to the DOX-loaded linear-(PLGA-PEG-PLGA)nanomicelles,DOX-loaded 4s-(PLGA-PEG-NH2) nanomicelles showed better performance in uptaking by HeLa cells and higher cytotoxicity to cancer cells.Conclusion4s-(PLGA-PEG-NH2) amphiphilic block copolymers can be successfully used in encapsulating DOX,self-assemblingcore-shell nanomicelles in aqueous solvent.Therefore,4s-(PLGA-PEG-NH2) copolymers can be considered as a promising drug carrier in effectively carrying hydrophobic drug,improving the efficacy while reducing the side effect.
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Objective: To observe the effect of Baihe Zhimu Decoction on serum sex hormone and uterus index of ovariectomized rats with kidney-yin deficiency. Methods: 3-month years old femal SD rats which were ovariectomized were divided randomLy into 6 groups: ovariectomized, Baihe Zhimu DecoctionⅠ, Baihe Zhimu DecoctionⅡ, Baihe Zhimu Decoction Ⅲ, Baihe Zhimu Decoction Ⅳ, then the normal group was set. The rats were induced to kidney-yin deficiency by using etraiodothyronine, then ig Baihe Zhimu Decoction for 4 weeks. The levels of sex hormone E2, FSH, LH in serum were detected and the indexes of uterus were caculated to observe the effect of Baihe Zhimu Decoction on sexual hormone and sexual organ in ovariectomized rats with kidney-yin deficiency. Results: Compared with normal group, the index of uterus and E2 level declined, and the level of FSH and LH increased (P
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Objective To observe the effect of Aitongping on c-fos gene expression and substance P(SP) content in spinal dorsal horn of rats with formalin-induced pain.Methods Fifty SD rats were randomized into 5 groups: blank control group,model group,tramadol group(0.06g/kg),high-and low-dose Aitongping groups(36 and 18g/kg respectively).Rats model of pain was induced by subcutaneous injection of formalin into the plantar surface of the left hind paw of rats.The fos gene expression and SP content were observed in superficial lamella of spinal dorsal horn of spinal section from the lumbar vertebrae L3 to L5 by immunohistochemical method.Results The number of neurons with fos gene expression positive and the optical density(D value) of reactants with SP expression positive were increased in the model group(P