[Current status of depression among workers in a petrochemical enterprise in Liaoning Province, China and related influencing factors]

Objective: To investigate the influencing factors for depression among workers in a petrochemical enterprise and the association of occupational stress and occupational environment with depression, and to provide a scientific basis for the improvement of mental health and the prevention and treatment of depression among workers in petrochemical enterprises. Methods: A cross-sectional study was performed in March 2018, and cluster sampling was used to select 1888 workers from a petrochemical enterprise in Liaoning Province, China for a questionnaire survey. A total of 1888 questionnaires were collected, among which there were 1521 usable questionnaires, with an effective recovery rate of 80.56%. The general status of the workers in this petrochemical enterprise was investigated, and Center for Epidemiologic Studies Depression Scale (CES-D) , Effort-Reward Imbalance (ERI) , and Perceived Work Environment (PWE) were used to evaluate depression, occupational stress, and occupational environment. Constituent ratio was used to describe the distribution of different demographic features, work conditions, and lifestyles among the workers in this petrochemical enterprise. One-way analysis of variance and the t-test were used to compare the scores of depressive tendency between the workers with different features. Pearson correlation analysis was used to investigate the correlation of occupational stress and occupational environment with depression. Multivariate hierarchical regression analysis was used to investigate the influencing factors for depression. Results: The score of depression tendency was 18.94±9.21 in the workers in this petrochemical enterprise, and the incidence rate of depression symptoms was 59.8% (909/1521) . The workers who were aged <35 years, lived alone or in widowhood, or had an income of ≤4000 yuan tended to have a high score of depression tendency. And ordinary workers, oil-refining workers, workers with night shift and non-fixed shift, and workers with a lack of physical exercise and low sleep quality tended to have a high score of depression tendency (P<0.05) . The dimensions of extrinsic and intrinsic efforts of occupational stress and severity of occupational environment were positively correlated with depression (r=0.254, 0.242, 0.274, P<0.01) . And the dimension of reward was negatively correlated with depression (r=-0.348, P<0.01) . The multivariate hierarchical regression analysis showed that occupational stress and occupational environment had a marked predictive effects on depression, with an explained variance of 18.4% and 12.1%, respectively. Conclusion: There is a high level of depression tendency among workers in petrochemical enterprises, and demographic features, work conditions, lifestyle, occupational stressors, and occupational environment factors are influencing factors for depression.

Paired box 6 (PAX6) regulates glucose metabolism via proinsulin processing mediated by prohormone convertase 1/3 (PC1/3)

AIMS/HYPOTHESIS

Human patients with aniridia caused by heterozygous PAX6 mutations display abnormal glucose metabolism, but the underlying molecular mechanism is largely unknown. Disturbed islet architecture has been proposed as the reason why mice with complete inactivation of paired box 6 (PAX6) in the pancreas develop diabetes. This is not, however, the case in human aniridia patients with heterozygous PAX6 deficiency and no apparent defects in pancreatic development. We investigated the molecular mechanism underlying the development of abnormal glucose metabolism in these patients.

METHODS

A human aniridia pedigree with a PAX6 R240Stop mutation was examined for abnormal glucose metabolism using an OGTT. The underlying mechanism was further investigated using Pax6 R266Stop mutant small-eye mice, which also have abnormal glucose metabolism similar to that in PAX6 R240Stop mutation human aniridia patients.

RESULTS

Paired box 6 (PAX6) deficiency, both in aniridia patients with a heterozygous PAX6 R240Stop mutation and in mice with a heterozygous Pax6 R266Stop mutation, causes defective proinsulin processing and abnormal glucose metabolism. PAX6 can bind to the promoter and directly upregulate production of prohormone convertase (PC)1/3, an enzyme essential for conversion of proinsulin to insulin. Pax6 mutations lead to PC1/3 deficiency, resulting in defective proinsulin processing and abnormal glucose metabolism.

CONCLUSIONS/INTERPRETATION

This study indicates a novel function for PAX6 in the regulation of proinsulin processing and glucose metabolism via modulation of PC1/3 production. It also provides an insight into the abnormal glucose metabolism caused by heterozygous PAX6 mutations in humans and mice.

Acute myocardial infarction in elderly Chinese. A clinical analysis of 631 cases and comparison with 389 younger cases

The purpose of this study was to define the clinical features of acute myocardial infarction in a group of elderly Chinese. The presenting symptoms, complications and mortality of acute myocardial infarction were compared in 631 patients (430 men and 201 women) aged 60 and over and 389 patients (333 men and 56 women) whose ages were under 60 years. The incidence of painless myocardial infarction was 17.6% in the elderly versus 5.9% in the younger group. Typical chest pain was present in 63.1% of the elderly and 84.3% of the younger Chinese. However, the incidence of other nonspecific presenting symptoms was higher in the elderly group. Likewise, the major complications in the elderly group were more severe than those in the younger group. For example, the incidences of cardiogenic shock, heart failure, arrhythmia, pulmonary infection and cardiac rupture in the older group were 19.8, 24.2, 77.2, 22.0 and 4.4%, versus 15.1, 19.5, 48.1, 9.5 and 1.1% in the younger group, respectively. The immediate (4 week) mortality rate of the older group was 21.9% (over 80 years 51.5%), but was only 11.0% in the younger group. Although the incidences of hypertension and pulmonary disease were significantly greater in the elderly group, these diseases alone did not account for the higher mortality rate in the elderly.