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OBJECTIVE@#This study was aimed at investigating the carrier rate of, and molecular variation in, α- and β-globin gene mutations in Hunan Province.@*METHODS@#We recruited 25,946 individuals attending premarital screening from 42 districts and counties in all 14 cities of Hunan Province. Hematological screening was performed, and molecular parameters were assessed.@*RESULTS@#The overall carrier rate of thalassemia was 7.1%, including 4.83% for α-thalassemia, 2.15% for β-thalassemia, and 0.12% for both α- and β-thalassemia. The highest carrier rate of thalassemia was in Yongzhou (14.57%). The most abundant genotype of α-thalassemia and β-thalassemia was -α 3.7/αα (50.23%) and β IVS-II-654/β N (28.23%), respectively. Four α-globin mutations [CD108 (ACC>AAC), CAP +29 (G>C), Hb Agrinio and Hb Cervantes] and six β-globin mutations [CAP +8 (C>T), IVS-II-848 (C>T), -56 (G>C), beta nt-77 (G>C), codon 20/21 (-TGGA) and Hb Knossos] had not previously been identified in China. Furthermore, this study provides the first report of the carrier rates of abnormal hemoglobin variants and α-globin triplication in Hunan Province, which were 0.49% and 1.99%, respectively.@*CONCLUSION@#Our study demonstrates the high complexity and diversity of thalassemia gene mutations in the Hunan population. The results should facilitate genetic counselling and the prevention of severe thalassemia in this region.
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Humanos , Talassemia beta/genética , Talassemia alfa/genética , Hemoglobinopatias/genética , China/epidemiologia , Sequenciamento de Nucleotídeos em Larga EscalaRESUMO
Objective To understand the situation of depression and its related influencing factors among medical staff in Hunan province.Methods Data were collected through random sampling with multi-stage stratified cluster.Wilcoxon rank sum test,Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software.Results This survey was including 16 000 medical personnel with 14 988 valid questionnaires and the effective rate was 93.68%.Results from the single factor analysis showed that factors as:level of the hospital grading,gender,education background,age,occupation,title,departments,the number of continue education,income,working overtime every week,the frequency of night work,the number of patients treated in the emergency room etc.,had statistical significances (P<0.05).Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR=1.58,95% CI:1.30-1.92).The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR=2.19,95%CI:2.05-2.35).The higher the numbers of days with working overtime every week,the frequencies of night work,and the numbers of patients being treated at the emergency room,with more probabilities of the people with depression seen in our study.Conclusion Depression seemed to be common among doctors and nurses.We suggested that the government need to increase the monthly income and to reduce the workload and intensity,lessen the overworking time,etc.
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<p><b>BACKGROUND</b>Coexistent carotid and coronary artery diseases are common and patients with them remain at a high risk for perioperative stroke or myocardial infarction after coronary bypass surgery. The aim of this study was to investigate the effect of combined carotid endarterectomy (CEA) and off-pump coronary artery bypass grafting (CABG) in patients with coexistent carotid and coronary artery diseases.</p><p><b>METHODS</b>Between January 2002 and December 2007, consecutive patients with coexistent carotid and coronary artery diseases underwent one-stage unilateral CEA and off-pump CABG in Heart Institute of Nanjing First Hospital Affiliated to Nanjing Medical University. Perioperative complications were assessed and follow-up was carried out.</p><p><b>RESULTS</b>A total of 51 cases of isolated off-pump CABG and unilateral CEA, including 34 right and 17 left, were performed. The mean blocked time of carotid artery in CEA was (25.5 +/- 7.0) minutes. The mean number of distal grafts per patient was 3.30 +/- 0.45. The mean ventilation time, intensive care unit stay, and postoperative hospital stay was (11.3 +/- 5.4) hours, (2.1 +/- 0.9) days, and (12.5 +/- 6.1) days respectively. None of the patients had stroke or myocardial infarct. There was one perioperative death due to acute cardiac failure, resulting in an operative mortality of 1.96%. Follow-up was completed for 47 patients (92.16%) with a mean follow-up of (39.5 +/- 12.5) months. None of the patients manifested stroke, new angina or newly developed cardiac infarct. No late death occurred.</p><p><b>CONCLUSION</b>Combined CEA and off-pump CABG is a safe and effective procedure in selected patients with coexistent carotid and coronary artery diseases.</p>