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Background: Village doctors are primary care physicians at the grass root-level of rural medical and health institutions in China. Their depression can increase medical errors and affect quality of medical care services. This study aims to examine depressive symptoms and their correlates among Chinese village doctors., Methods: A total of 616 village doctors were recruited from Zoucheng County of Shandong province. The Center for Epidemiologic Studies Depression Scale (CES-D), the Duke Social Support Index (DSSI) and the Simplified Coping Style Questionnaire (SCSQ) were used to measure depressive symptoms in the last week, social support and coping styles, respectively. Logistic regression model was conducted to identify the associated factors of depressive symptoms among village doctors., Results: The prevalence rate of depressive symptoms was 27.4% (28.54% for males, 24.69% for females). Logistic regression analysis found that body mass index (BMI), poor physical health, low educational level, and negative coping styles were associated with increased risk of depressive symptoms. Positive coping styles were associated with decreased risk of depressive symptoms in village doctors., Conclusions: Depressive symptoms are prevalent among village doctors in China. They need to adopt more positive coping strategies to respond to negative emotions. More professional and medical trainings may be important to reduce risk of depressive symptoms and improve their quality of healthcare among village doctors in China., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: To study the prevalence of mental disorders among the Chinese youths aged 15 - 34 years, in rural areas and to identify risk factors related to suicide., Methods: A consecutive sampling strategy was used for suicidal cases in 16 randomly selected counties in Hunan, Liaoning, and Shandong provinces. Between 2005 and 2008, a total of 392 suicide cases were recruited with 416 community controls at the same age range, selected from the same areas one family member together with one close friend of each suicidal case were interviewed, using the psychological autopsy (PA) method. The same method with structured instruments was performed on the two informants for each control in the same community. SCID was used for the diagnosis of mental disease., Results: 48.0% of the suicides were diagnosed as having at least one mental disorder episode, in comparison with only 3.8% among the controls. It was found that mental disorder was the most important risk factor for the Chinese young suicide cases in the rural areas., Conclusion: As seen in the Western countries, mental disorder had also been the number one correlate on suicidal cases in China, with the difference as other social and psychological factors might have played relatively more important roles in China.

Objective: To understand the association between gene polymorphism of catechol-O-methyltransferase (COMT) and suicide attempters taking pesticides orally and to provide a scientific base for the prevention of suicidal behavior., Methods: 107 suicide attempters taking pesticides orally were collected from The People's Hospitals in Shandong Province from January 2003 through December 2003. The informations of all the attempters were obtained and 1 ml whole blood from of them were collected. Molecular biological techniques were used to study the gene type of each subject., Results: In the 107 suicide attempters, the ratio of male to female is 1:1.55; 67.3% of them were in age range of 20 - 44 years; 59.8% of them had education level of elementary school or lower. 13 suicide attempters (12.1% of all the attempters) had psychiatric disorders. 84 suicide attempters (78.5% of all the attempters) had affective conflicts with others in the recent year. 30 suicide attempters (28.0% of the suicide attempters) had impulsive behavior. Multivariate logistic regression model analysis showed that suicide impulsion and psychiatric disorders were significantly associated with COMT Val/Val, their OR values were 0.052 (95% CI: 0.006 - 0.437), 2.917 (95% CI: 1.097 - 7.760)., Conclusion: In this population, more attention should be paid to young female people with psychiatric disorders or having affective conflicts with others in the recent year so as to prevent suicide. This study supported that there is heterogeneity in COMT gene in suicide attempters and there is interaction between COMT Val/Val and suicide impulsion and psychiatric disorders.

Objective: To understand the environmental risk factors on attempted suicide, and to study the interaction between factors as gene polymorphism of catechol-O-methyltransferase (COMT) associated to attempted suicide., Methods: Paired case-control study of 205 suicide attempters (89 male, 116 female) and molecular biological techniques were used to study the relation between gene polymorphism of COMT, environmental factors and the rate of attempted suicide. Controls were paired with cases according to the same gender, similar age (no more than 3 years) and in the same district., Results: There were no significant differences in gene types and gene frequency between case and control groups. Multivariate conditional logistic regression model analysis showed that COMT Val/Val 158/108, low education level, cigarette smoking, emotional conflicts, psychologic disorders and depression were risk factors of attempted suicide with OR values as 2.43 (95% CI: 1.10 - 5.40), 5.70 (95% CI: 1.88 - 17.27), 3.54 (95% CI: 1.02 - 12.36), 10.96 (95% CI: 4.74 - 25.34), 6.35 (95% CI: 1.68 - 24.05) and 11.30 (95% CI: 4.58 - 27.89) respectively. There was no first level interaction between any two risk factors., Conclusion: The study supported that low education level, cigarette smoking, affective conflicts, psychiatric disorders, depression were risk factors of attempted suicide and COMT Val/Val 158/108 was suspected to be a susceptible gene type of attempted suicide but needs further study. The study also suggested that 116 bp in gene atlas be possibly correlated to high activity of COMT.

Objective: To explore the relationship between the 7th exon G894T mutation of endothelial nitric oxide synthase (eNOS) gene and overweight in patients with essential hypertension., Methods: Totally, 116 patients with essential hypertension taking no medications and 136 normotensives were selected from a steel workers as study subjects. Polymerase chain reaction and restriction fragment length polymorphism were performed to detect mutation of the 7th exon G894T. Additive model was used to analyze interaction between G894T mutation and overweight on hypertension. Population attributable risk percent (PAR%) for them, etiologic fraction, was applied to their contribution to hypertension., Results: There was a positive interaction between G894T mutation and overweight on essential hypertension, with an index of interaction of 1.99 and attributable interaction percent of 30.76%. Their pure attributable interaction percent was 36.38%. Multiple logistic regression analysis showed that there still was positive interaction between G894T mutation and overweight on essential hypertension, adjusted for age, sex, smoking and alcohol drinking. Index of their attributable interaction was 2.85, with attributable interaction percent of 39.97%, also adjusted for the above-mentioned factors. Their pure attributable interaction percent was 46.49% and PAR% was estimated as about 15% under certain condition., Conclusions: Interaction between mutation of the 7th exon G894T of eNOS gene and overweight played an important role in essential hypertension of the studied population. Control of body weight in the population with both G894T mutation and overweight could markedly decrease their risk of hypertension.

Objective: To analyze the association between G894T (Glu298Asp) mutation at exon 7 in the endothelial nitric oxide synthase gene and essential hypertension., Methods: One hundred and sixteen essential hypertensives without taking hypertensive medication and 136 normotensives screened from health workers in a steel factory were selected as subjects in this study. Polymerase chain reaction (PCR) and Ban II restriction enzyme digestion were performed to detect the G894T mutation., Results: G894T mutation was significantly associated with essential hypertension. The T allele frequency in essential hypertensive group was significantly higher than that in normotensive group (16.0% versus 8.8%, P = 0.019, OR = 1.96, 95% CI: 1.14 - 3.37). The levels of systolic blood pressure and diastolic blood pressure in the G894T mutant genotypes were all significantly elevated in hypertensive, normotensive, and the total subjects (P < 0.05). After adjusting factors as age, sex, smoking, alcohol drinking, body mass index, triglyceride, serum total cholesterol, serum high density lipoprotein cholesterol by analysis of multiple covariance, significant positive effect of the G894T mutant genotypes on blood pressure in the total subjects (P < 0.01) was noticed., Conclusion: This study suggested that the G894T mutation in the endothelial nitric oxide synthase gene might serve as a major risk factor of essential hypertension in this study population.