高原外训军人心理健康、认知因素与急性高山病的相关性

目的:探讨高原外训军人心理健康、认知因素与急性高山病的相关性。方法:采用基本信息问卷、Lake Louise急性高山病评分量表(AMS)、症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对191名急进高原进行高原适应性训练的军人施以团体测验。结果:研究样本SCL-90的躯体化因子显著高于全国正常成人常模(t=5.019,P0.001)。AMS症状阳性组与阴性两组样本在文化程度(t=2.385,P0.05)、社会支持中的倾诉方式(t=2.542,P0.05)、求助方式(t=2.133,P0.05)、对AMS的认知(t=2.423,P0.05)、SCL-90总分(t=-4.936,P0.001)及各因子分均有显著差异。SCL-90总分、对AMS应对策略的认知对预测AMS症状总分有一定的预测作用。结论:高原外训军人心理健康水平、认知因素对AMS有显著的影响,运用合理的心理干预技术,可降低AMS的发生率,增强高原作战部队的战斗力。     

慢性精神分裂症患者血清S100B水平与事件相关电位P300的相关性

目的:探讨慢性精神分裂症患者血清S100B水平与事件相关电位P300(Event-related potential P300,P300)的关系。方法:随机将年龄在18~60岁之间符合ICD-10及CCMD-3诊断标准的慢性精神分裂症患者40例作为研究组,选择40例健康者作为对照组。同时检测血清S100B水平及以P300评定认知功能,并将结果加以分析、比较。结果:与对照组相比,研究组CZ、PZ点的N1、P2、N2、P3潜伏期均明显延长(t=2.24~3.85,P0.05或0.01),研究组CZ、PZ点的N2、P3波幅明显降低(t=3.04~5.26,P0.01);研究组的血清S100B水平高于对照组(t=4.15,P0.01);CZ、PZ点P300潜伏期与血清S100B水平呈正相关(r=0.35~0.48,P0.05或0.01),CZ、PZ点P300波幅与血清S100B水平则呈负相关(r=-0.48~-0.58,P0.01)。结论:慢性精神分裂症患者血清S100B水平高于健康者并且认知功能存在损害,其认知功能损害可能与血清S100B水平有关。     

丁基苯酞对大鼠额叶损伤后学习记忆的影响

目的:研究丁基苯酞对于大鼠额叶损伤后学习记忆功能的影响。方法:选用40只雄性SD大鼠随机分成四组:丁基苯酞组、神经节苷脂组、损伤对照组和假手术组。分组后制作大鼠额叶损伤模型和假手术模型,并予以药物和生理盐水腹腔注射。腹腔注射后进行水迷宫检测、并对大鼠额叶皮层进行SOD(超氧化物歧化酶)、MDA(丙二醛)检测,分析丁基苯酞对额叶损害后大鼠学习记忆功能的影响。结果:与损伤对照组比较,丁基苯酞能够提高额叶损伤后大鼠的水迷宫学习记忆成绩,能够提高损伤区的SOD活性,降低MDA含量,抑制Ach E活性。结论:丁基苯酞能改善大鼠额叶损伤后学习记忆功能,其机制可能与抗氧化和抑制Ach E(乙酰胆碱酯酶)活性有关。     

根除幽门螺旋杆菌治疗与非口源性口臭(湿热中阻型)的相关性分析

目的 探讨胃幽门螺杆菌(Hp)感染与中医证属湿热中阻型口臭的关系.方法 选择非口源性口臭患者53例,进行1℃尿素呼气试验检测Hp感染情况;对Hp感染的口臭患者行三联方案根除Hp.结果 53例口臭患者的Hp阳性者为39例,占73.58％.39例口臭患者予根除Hp治疗,其中34例根除Hp成功,根除率为87.2％,根除Hp者口臭消失者29例,占85.3％.结论 胃Hp感染很可能是非口源性口臭中医证属湿热中阻型的一个重要相关因素.     

Kinetically Trapped Block Copolymer Nano‐Objects with Cylinder to Sphere Shape Transition Properties

Here, the cylinder to sphere transition property is reported in kinetically trapped block copolymer (BCP) nano‐objects made from polystyrene‐block‐poly(N‐isopropylacrylamide) (PS‐b‐PNIPAM) in ethanol. The PS‐b‐PNIPAM BCPs are found to self‐assemble into hexagonally packed cylindrical morphology in bulk. When dispersing the bulk microphase‐separated BCP materials in selective solvent, nanocylinders stabilized by kinetically trapped PS cores were obtained. However, when the kinetic barrier is removed by external energy input, a morphology transition from cylinder to sphere occurred. The transition procedure could be accelerated by applying higher external energy, which could be realized by using higher temperatures as well as treating with ultrasonic. Additionally, lowering the kinetic barrier by using polymers with a shorter PS block also accelerates the morphology transition process.

     

Postoperative survival for patients with thymoma complicating myasthenia gravis—preliminary retrospective results of the ChART database

Background

It is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.

Methods

The Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, patients were followed and their survival status were analyzed.

Results

There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5- and 10-year overall survival (OS) rates were both higher in MG group (93% vs. 88%; 83% vs. 81%, P=0.034) respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was 3/4 (P=0.003). Among patients with advanced stage thymoma (stage 3, 4a, 4b), the constituent ratios of 3, 4a, 4b were similar between MG and non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classification, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were significant factors, and multivariate analysis showed WHO classification, Masaoka stage, and resectability were strong independent prognostic indicators.

Conclusions

Although MG is not an independent prognostic factor, the survival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.     

The role of postoperative radiotherapy for stage I/II/III thymic tumor—results of the ChART retrospective database

Background

Postoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I to III thymic tumors.

Methods

The Chinese Alliance for Research in Thymomas (ChART) was searched for patients with stage I to III thymic tumors who underwent surgical resection without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.

Result

From the ChART database, 1,546 stage I to III patients were identified. Among these patients, 649 (41.98%) received PORT. PORT was associated with gender, histological type (World Health Organization, WHO), thymectomy extent, resection status, Masaoka-Koga stage and adjuvant chemotherapy. The 5-year and 10-year overall survival (OS) rates and disease-free survival (DFS) rates for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001, P<0.001) respectively. In univariate analysis, age, histological type (WHO), Masaoka-Koga stage, completeness of resection, and PORT were associated with OS. Multivariable analysis showed that histological type (WHO) (P=0.001), Masaoka-Koga stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univariate analysis, gender, myasthenia gravis, histological subtype, Masaoka-Koga stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariate analysis showed that histological subtype (P<0.001), Masaoka-Koga stage (P=0.005) and completeness of resection (P=0.006) were independent prognostic factors for DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001, P<0.001, respectively).

Conclusions

The current retrospective study indicates that PORT after incomplete resection could improve OS and DFS for patients with stage I to III thymic tumors. However for those after complete resection, PORT does not seem to have any survival benefit on the whole.     

Influence of relative hypoparathyroidism on the responsiveness to recombinant human erythropoietin in hemodialysis patients

BACKGROUND/AIM: It has been shown in a few studies examining small patient groups that high levels of intact parathyroid hormone (iPTH) were associated with a less efficient response to recombinant human erythropoietin (rHuEPO). However, the responsiveness to rHuEPO in hemodialysis (HD) patients with relative hypoparathyroidism remains undetermined. This study examines the responsiveness to rHuEPO in HD patients with relative hypoparathyroidism. METHODS: We retrospectively studied 19 nondiabetic patients (mean age 44.3 +/- 8.2 years, age range 29.4-55.6 years) treated with HD for chronic glomerulonephritis. Of the 19 patients, 8 (group A) had iPTH levels <100 pg/ml for the preceding 6 months without administration of 1,25-(OH)(2)-vitamin D(3). Eleven patients had iPTH levels >100 pg/ml (group B). Hematocrit (Hct) and rHuEPO doses were recorded for statistical analysis. RESULTS: In patients of groups A and B, the rHuEPO dose (U/kg/week) was 55.21 +/- 16.23 vs. 84.08 +/- 24.56 (p = 0.01); Hct (%) 33.29 +/- 1.72 vs. 31.43 +/- 2.98 (p = 0.67), and rHuEPO resistance index (weekly rHuEPO dose/Hct) 81.38 +/- 16.64 vs. 155.63 +/- 42.22 (p < 0.001). Furthermore, weekly rHuEPO dose and rHuEPO resistance index correlated positively with serum iPTH levels (R = 0.765, p < 0.001; R = 0.764, p < 0.001), whereas the Hct correlated negatively with serum iPTH levels (R = -0.400, p = 0.045). The alkaline phosphatase level (IU/l) was lower (50.46 +/- 12.87 vs. 69.61 +/- 20.68, p = 0.17) in group A. CONCLUSION: Our observations suggest that the lower the iPTH levels of chronic HD patients, even with relative hypoparathyroidism, the better the responsiveness to rHuEPO.     

Is circumferential pulmonary vein isolation preferable to stepwise segmental pulmonary vein isolation for patients with paroxysmal atrial fibrillation?

BACKGROUND: Stepwise segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) have been developed to treat patients with atrial fibrillation (AF), but the preferable approach for paroxysmal AF (PAF) has not been established. METHODS AND RESULTS: One hundred and ten patients with symptomatic PAF were randomized into a stepwise SPVI group (n=55) or CPVI group (n=55). Systemic SPVI combined with left atrial linear ablation tailored by inducibility of AF was performed in the stepwise SPVI group. Circumferential linear ablation around the left and right-sided pulmonary veins (PVs) guided by 3-dimensional electroanatomic mapping was performed in the CPVI group. The endpoints of ablation are non-induciblity of AF in the stepwise SPVI group and continuity of circular lesions combined with PV isolation in the CPVI group. After the initial procedures, atrial tachyarrhythmis (ATa) recurred within the first 3 months in 23 of the 55 patients (41.8%) who underwent stepwise SPVI and in 20 of the 55 patients (36.4%) who had CPVI (p=0.69). Repeat procedures were performed in 7 patients from the stepwise SPVI group and 5 from the CPVI group (p=0.76). During the 3-9 months after the last procedure, 46 patients (83.6%) from the CPVI group and 43 (78.2%) from the stepwise SPVI group did not have symptomatic ATa while not taking anti-arrhythmic drugs (p=0.63). Severe subcutaneous hematoma or PV stenosis occurred in 3 patients. CONCLUSIONS: The efficacy of stepwise SPVI is comparable to that of CPVI for patients with PAF.     

Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease.

BACKGROUND: Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) is associated with myocardial scar in patients with coronary artery disease (CAD). OBJECTIVE: We postulated that fQRS is a predictor of cardiac events and mortality in patients who have known CAD or who are being evaluated for CAD. METHODS: The cardiac events (myocardial infarction, need for revascularization, or cardiac death) and all-cause mortality were retrospectively reviewed in 998 patients (mean age 65.5 +/- 11.9 years, male 967) who underwent nuclear stress test. The fQRS on a 12-lead ECG included various RSR' patterns (> or =1 R' prime or notching of S wave or R wave) without typical bundle branch block in 2 contiguous leads corresponding to a major coronary artery territory. RESULTS: All-cause mortality (93 [34.1%] vs 188 [25.9%]) and cardiac event rate (135 [49.5%] vs 200 [27.6%]) were higher in the fQRS group compared with the non-fQRS group during a mean follow-up of 57 +/- 23 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events (P <.001) and all-cause mortality (P = .02). Multivariate Cox regression analysis revealed that significant fQRS was an independent significant predictor for cardiac events but not for all-cause mortality. The Kaplan-Meier survival analysis showed no significant difference between fQRS and Q waves groups for cardiac events (P = .48) and all-cause mortality (P = .08). CONCLUSION: The fQRS is an independent predictor of cardiac events in patients with CAD. It is associated with significantly lower event-free survival for a cardiac event on long-term follow-up.