Objective: To confirm the effectiveness of fluoxetine in treatment of depression associated with apparent life events Method: Sixty-two depressive patients who had a total score of the Life Event Scale of more than 30 were treated with fluoxetine for 6 weeks, diazepam was added if necessary CGI, HAMD and HAMA were used to assess the result Result: At the endpoint, the total score of HAMD decreased from 23?4 at baseline to 10?6, the total score of HAMA was also decreased significantly (23?5 to 10?6) At the meantime, the HAMD sleep factor and CGI severity score were also decreased significantly All above measurements showed improvement at the first week of treatment The adverse effects were mild, with lose of appetite, dry mouth and nausea as the most frequently seen, which had no influence on treatment process Conclusion: Fluoxetine plus diazepam is effective in depressive patients with apparent life events with quick response and mild adverse effects

Objective To explore the effects of high intensity focused ultrasound (HIFU) on cell multiplication and apoptosis at exposure coverage and marginal zone and the expression of vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen and apoptosis of subcutaneous neurogliocytoma in nude mice. Methods Eighteen nude mice bearing subcutaneous human neurogliocytoma were consecutively ablated in 20s by an extracorporeal HIFU with 9.7MHz transducer (the focal length of 4.5mm and focal intensity 2500W/cm2). The 18 nude mice were randomly di?vided into 7 d group,14 d group and 30 d group according to sacrifice date. Immunohistochemical method, TdT-mediat?ed dUTP nick end labeling method were used to examine the expression of vascular endothelial growth factor and prolifer?ating cell nuclear antigen and apoptosis at exposure coverage, marginal zone and normal zone, respectively. Results The expression of VEGF and proliferating cell nuclear antigen were evident at exposure coverage, marginal zone and normal zone in 7, 14 and 30 days after ablation. The expression of proliferating cell nuclear antigen and apoptosis were absent at exposure coverage in 7,14 and 30 days after ablation. The percentage of VEGF expression was lower in marginal zone than in normal zone (23.79%± 3.11% vs. 46.16%± 2.43%) in 7 d after ablation (F=110.03,P<0.05). The percentage of VEGF expression was also lower (10.94%±3.95%) in exposure coverage than in normal zone (46.16%±2.43%) in 7 d af?ter ablation (F=272.80,P<0.05). The percentage of VEGF expression was lower in marginal zone than in normal zone (17.17%±2.89%vs. 43.47%±3.77%) in 14 d after ablation (F=152.05,P<0.05). The percentage of VEGF expression was lower in marginal zone than in normal zone (9.27%± 2.08%vs. 44.58%± 3.34%) in 30 d after ablation (F=274.1,P<0.05 2). The proliferating cell nuclear antigen labeling index(PCNA LI) was lower in marginal zone than in normal zone ((33.04%±4.31%vs. 65.15%±3.85%) in 7 d after ablation (F=242.46, P<0.05). The PCNA LI was lower in marginal zone than in normal zone (21.05%± 1.96%vs. 62.99%± 3.34%) in 14 d after ablation (F=413.52, P<0.05). The PCNA LI was lower in marginal zone than in normal zone (6.36%± 0.51% vs. 62.07%± 18.07%) in 30 d after ablation, (F=729.59, P<0.05) .The apoptotic index (AI) was higher in marginal zone than in normal zone (26.10%±4.54%vs. 1.43%±0.35%) in 7 d after ablation, (F=216.22, P<0.05). The apoptotic index(AI) was higher in marginal zone than in normal zone (65.70%± 1.14% vs. 1.82%± 0.31%) in 14d after ablation (F=1448.64, P<0.05). The apoptotic index (AI) was higher in marginal zone than in normal zone (82.02%± 3.98% vs. 2.52%± 0.29%) in 30d after ablation (F=2244.33, P<0.05). Conclusion The present study demonstrates that an extracorporeal HIFU with 9.7MHz transducer (the focal length of 4.5mm and fo?cal intensity 2500W/cm2) can completely ablate neurogliocytoma at exposure coverage and inhibit the proliferation of neurogliocytoma at marginal zone. Thus, HIFU may be a new and selective treatment for neurogliocytoma.

Objective To evaluate the effects of surgical treatment of acute deep vein thrombosis (DV T) of lower extremity. Methods Thirty-six patients with a cute DVT of lower extremity were treated by thrombectomy with thrombolytic,a nticoagulant and compression on the affected lower extremity during and after op eration. Results No death and serious complications happened i n this series. Thirty-one patients were followed-up for 2 to 20 months with a n average of 9 months. Symptoms disappeared totally in 23 patients , 8 patien ts had slight edema in the lower extremities. Conclusions Com bination of thrombectomy the thrombolytic and anticoagulant agent,and comp ression of the affected lower extremity is a safe and effective method in the t reatment of acute DVT of lower extremity.

Objective: To explore the effect of autophagy on process of high phosphate salt induced vascular smooth muscle cell (VSMC) calciifcation in experimental rats. Methods: Rats’ model of VSMC calciifcation was induced by phosphate incubation. VSMC were divided into 3 groups:①Control group,②Calciifcation group which included 3 subgroups as 4-day subgroup, the cells were cultured by 3.2 mmol/L phosphate for 4 days, 6-day subgroup and 8-day subgroup,③Calciifcation+ 3-MA (autophagy inhibitor) group, in which the 8-day cells were cultured with 5mmol/L 3-MA. Calcium nodule formation and calcium deposition in VSMC were measured by Alizarin red staining and o-cresolphthaleincomplexone method, protein expressions of Runx2, α-SMA and LC3 II were examined by Western blot analysis, autophagosome formation in VSMC was measured by transmission electron microscope and the localization and expression of Runx2 and LC3 II in VSMC were observed by immunolfuorescent microscope. Results: Compared with Control group, the cells at 8-day subgroup showed more calcium nodules, higher calcium deposition, increased protein expressions of Runx2, LC3 II, more autophagosome and decreased α-SMA expression, allP<0.05. Compared with 8-day subgroup, the cells in Calcification+3-MA group presented increased calcium deposition, decreased lfuorescence distribution of LC3 II and more cells with positive Runx2 protein expression, all P<0.05. Conclusion: Autophagy has the protective effect on process of phosphate induced VSMC calciifcation in experimental rats.

Objective To study the management of vascular injury.Methods Retrospective analysis was made on the clinical data of 59 cases of vascular injury,including 55 cases of vascular injury in neck and(extremity) and 4 cases of portal vein and vena cava injury.Among them,21 cases had femoral artery injury with infection and 4 cases had vascular injury due to intervention therapy.All patients with vascular wound of extremity or neck had undergone hemostasis by compression and antishock treament before hospital admission.All cases of femoral artery injury with infection underwent hemostasis by arterial ligation and incision and(drainage) of abscess.Vascular anastomosis was performed in 11 cases,vascular grafting in 12 cases,and(vascular) repair in 14 cases.Results There were 2 deaths.5 cases had amputation(including a case of(femoral) embolism due to intervention trerapy).Postoperative intermittent claudication,decreased skin(temperature) and other signs of ischemia occurred in 21 cases of femoral artery injury with infection,but none developed limb gangrene. The other cases were discharged in good health.Conclusions In the treatment of vascular injury,wound hemostasis and antishock treatment should be done first to save the patient′s life and the management of the vascular injury depends on the situation,with the aim to try by all means to save the extremity.Vascular reconstruction is the main method for treatment of vassular injury.Vascular ligation can be done in cases of femoral artery injury with infection.

Objective To summarize the experience in the diagnosis and treatment of hepatic trauma. Methods The clinical data of 260 patients with hepatic trauma admitted from January 1988 to December 2007 were retrospectively reviewed with regard to degree of trauma, treatment methods, therapeutical effects, complications and SO on. Results One hundred and fifty-three eases were treated by operative management,1 07 cases by nonoperative management.236 cases were cured,24 cases died,and the case fatality rate was 10.2%.There were no death among 139 patients with hepatic trauma grades Ⅰ～Ⅱ,22 death among 119 grades Ⅲ～Ⅴ patients, all death of 2 in grade VI, which demonstrated the correlation between death and hepatic trauma grade was statistically significant. Complications appeared in 82 eases, mainly including Secondary hemorrhage, abdominal infection and so on. Conclusions Nonoperative management is suitable for hepatic trauma with stable hemodynamics. Operative management is rapidly selected when the hemodynamics aren't stable. The cooperation of many specialities can enlarge the application of nonoperative management and decrease complications.