Objective To investigate the effects of mirtazapine ccombined with psychological treatment on depression of patients with epilepsy.Methods 102 patients with epilepsy and complicated with depression were divided into the control group and trial group with 51 cases in each group.The control group received conventional mirtazapine and the trial group received mirtazapine combined with psychological therapy.The course was six weeks.The follow-up was performed six months after treatment and all patients were evaluated with Hamilton Depression Scale(HAMD)and Clinical Global Impression(CGI-SI).The side effects were evaluated with Treatment Emergent Symptom Scale(TESS).Results After the treatment of six weeks,the HAMD and CGI-SI scores of patients of the two groups significantly increased(P<0.05)and the scores of the trial group increased more significantly than that of the cintrol group(P<0.05)six months later.Conclusion The effect of mirtazapine combined with psychological therapy on depression of patients with epilepsy is obvious.

Objective To observe the value of transvaginal color Doppler ultrasound (TVCDU) in the diagnosis of endo-metrial lesions.Methods All 246 patients suspected of endometrial diseases underwent TVCDU and transabdominal ultra-sonography.Ultrasonographic characteristics,especially the uterine endometrial thickness and blood flow distribution were observed,and the results were compared with surgery and pathological results.Results A total of 242 patients were pathologically diagnosed as endometrial diseases.TVCDU diagnosed 232 cases,with the diagnostic accordance rate of 95.87%.Transabdominal ultrasonography diagnosed 182 cases,with the diagnostic accordance rate of 75.21%.TVCDU was superior to transabdominal color Doppler examination (P<0.05).Conclusion TVCDU has high diagnosis accordance rate and can be used as routine examination of endometrial diseases.

AIM: To investigate the protective effect of crude Paecilomyces tenuipes polysaccharides(cPtPs) and Paecilomyces tenuipes polysaccharides(PtPs) in a rat model of acute hepatic necrosis induced by carbon tetrachloride(CCl4).METHODS: Wistar rats were divided into four groups(control group,CCl4 group,cPtPs+CCl4 group and PtPs +CCl4 group),the four groups were given intragastrically with normal saline,cPtPs and PtPs for 15 d,respectively.In the last two days,these groups except control group were injected peritoneally with CCl4.Serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL) and indirect bilirubin(IBIL) were detected by automatic biochemistry analyzer.Pathological changes of hepatic tissue were assessed by hematoxylin-eosine(HE) staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA) in liver homogenate were analyzed using xanthinoxidase and thio-barbituric acid,respectively.The concentration of Ca2+ in hepatocyte mitochondria was determined by colorimetric method.The expression of ?-smooth muscle actin(?-SMA) was examined in hepatic tissue by immunohistochemical method.RESULTS: Compared with control group,serum levels of ALT,AST,TBIL,DBIL and IBIL in CCl4 group increased significantly,denaturation and necrosis implicated to the whole hepatic lobules.Compared with CCl4 group,serum levels of ALT,AST,TBIL,DBIL and IBIL in PtPs +CCl4 group decreased significantly,denaturation and necrosis located in the third region of hepatic lobules,the level of SOD increased and MDA decreased(P

Objective To investigate the physicochemical properties,structural characters and antitumor activity of a polysaccharide PTPS-1 from Paecilomyces tenuipes.Methods PTPS-1 was obtained by DEAE-cellulose and Sephadex G-100 chromatography column.The methods of HPLC,GC,IR,and NMR were used to investigate the molecular weight,monosaccharide composition,and structural characters of PTPS-1.The CCK-8 kit was used to determine the proliferation of PTPS-1 on murine splenocyte and the supernatant of the murine macrophage with PTPS-1-stimulated on Sp2/0 cells.Results PTPS-1,whose molecular weight was 1.84?104 and purity was 98.977%,contained mannose(Man) and galactogen(Gal) as monosaccharide constitute in molar ratio of 1.3∶1.It consisted of a backbone of ?-(1→6),?-(1→2),and ?-(1→3) linkage,whose branches were made by Gal-(1→3) linkage.PTPS-1 significantly stimulated the murine splenocyte proliferation and the supernatant of macrophage inhibited the growth of Sp2/0 cells in vitro.Conclusion PTPS-1 is a polysaccharide from P.tenuipes with immunomodulatory and antitumor activity.

Objective To compare the curative effects and safety of mirtazapine and fluoxetine in treatment of elderly depressive patients with insomnia.Methods 92 cases of elderly depressive patients with insomnia were randomly divided into two groups: the mirtazapine treatment group and the fluoxetine treatment group. The period of treatment was six weeks. The antidepressant effect was assessed with the drop rate of Hamilton Depression Scale (HAMD),the effect of improving sleep was assessed with HAMD sleep disturbance factor and the Pittsburgh Sleep Index (PSQI), and the administration of security was assessed with vice Treatment Emergent Symptom Scale (TESS).Results After treatment, the effective rate of the mirtazapine group was 90.9% (40/44), that of the fluoxetine group was 84.1% (37/44). In the end of 1st, 2nd, and 4th weeks after treatment, the difference between the two groups were significant (P<0.001). At the end of 6th week, the difference was not significant (P>0.05) in HAMD; the difference was significant in HAMD sleep disturbance factor and PSQI score (P<0.05).Conclusion The clinical effects of mirtazapine in treatment of depression are similar to that of fluoxetine, but mirtazapine takes effects fast, can improve the symptoms of insomnia, has higher safety and better compliance, and is more appropriate for the depressive elderly patients with insomnia than fluoxetine.

Objective To investigate the curative effect of short segment of unilateral laminectomy decompression of intervertebral bone graft fusion with pedicle screw fixation in treatment of lumbar spine instability.Methods 100 cases with lumbar instability were randomly divided into the study group and control group with 50 cases in each group,the study group was treated with short segment of unilateral laminectomy decompression of intervertebral bone graft fusion with pedicle screw fixation for treatment,while the control group was treated with conventional methods of treatment.The intraoperative,postoperative situation and clinical efficacy of the two groups were observed and compared.Results The operation time,intraoperative bleeding,drainage,hospital stay and cost of hospitalization of the study group were (121.31 ± 13.73) min,(151.24 ± 24.65) mL,(35.34 ± 6.79) mL,(12.03 ± 3.22) d and (22 012.23 ± 3 018.67)yuan respectively,which were significantly lower than those of the control group[(161.32 ± 11.60) min,(201.32 ± 25.46) mL,(102.35 ± 11.87) mL,(19.42 ± 4.31) d and (26 278.65 ± 3 216.53) yuan] (t =9.829,10.829,7.984,10.983,9.593,all P ＜0.05).The excellent and good rate of the study group was 92％,which was significantly higher than 70％ of the control group (x2 =13.927,all P ＜ 0.05).Conclusion Short segment of unilateral laminectomy decompression of intervertebral bone graft fusion has a high curative effect in the treatment of lumbar instability,with short operation time and hospitalization time,less blood loss and postoperative drainage volume,low medical cost,which is a good operation scheme.

Objective To explore the long-term effects of physical exercise on learning,memory and the expression of plasticity-related gene-1 (PRG-1) in the cerebral cortex of rats with penicillin-induced developmental seizures.Methods Twenty-four 21-day Sprague-Dawley rats were randomly divided into a control group (CONT1),an exercised control group (CONT2),a seizure group (EXP1) and a seizure plus exercises group (EXP2),each of 6 using a random number table.Penicillin was injected intraperitoneally to the rats in the EXP1 and EXP2 groups to induce seizures,while those in the CONT1 and CONT2 groups received saline injections.Morris water-maze tests were performed to evaluate spatial learning and memory capacity.The rats in the CONT2 and EXP2 groups were administered an aerobic exercise program 30 min per day for 6 consecutive days.The other groups were maintained on the treadmill for the same time but without exercising.Real-time polymerase chain reactions were used to quantify the expression of PRG-1 mRNA in the cerebral cortex.Results There was a decreasing trend in marginal searching and increasing taxis and linear searching in all four groups.Ridit analysis showed that in the watermaze tests on days 2 and 4 the average scores of the control groups were significantly higher than those of the EXP1 and EXP2 groups.However,significant increases in the average scores were observed in the maze tests of the EXP1 group after day 2 and with the EXP2 group from day 4 on.The average scores of the control group were significantly lower than those of the other 3 groups.In the first maze test,the average memory scores of the two seizure groups were significantly lower than those of the controls.In the second maze test,however,only the EXP1 group's average score was significantly worse than those of the other groups.That of the EXP2 group had improved significantly,and was not significantly different from that of the CONT2 group.The expression of PRG-1 was much higher in the CONT2,EXP1 and EXP2 groups than in the CONT1 group.The average expression of PRG-1 in the EXP2 group was not significantly different from that in the EXP1 group.Conclusions Physical exercise can significantly relieve the cognitive deficits induced by long-term seizures,which may be associated with the regulation of PRG-1 expression in the cerebral cortex.

Objective To investigate the effect of preoperative percutaneous dilatational trache-otomy (PDT)in oral and maxillofacial surgery anesthesia versus traditional surgical tracheotomy (ST).Methods General data,vital signs,operation time,anesthetics,the amount of bleeding and complications during the procedure were analyzed after reviewing the clinical data of 124 cases under-going radical correction of oral and maxillofacial tumor plus flap transferring and repairing and trache-otomy during May 2013 to May 201 5.Results A total of 124 cases were divided into two groups:PDT group (group P,n =41)and ST group (group S,n =83).There was no significant difference of general data between the two groups.The incision length and operation time were significantly shorter and the amount of bleeding was remarkably lower in group P than those in group S (P <0.05),while the incidence of complications was not significantly different between the two groups.Conclusion PDT has more advantages over traditional ST and is a better airway approach in oral and maxillofacial surgery.

Objective:To observe the clinical application of flexible endoscope assisted by general versus pillow-under-shoulder supine position in nasotracheal intubation of the patients with difficult airway, and to explore the influence of intubation position in the intubation effect.Methods: A total of 168 patients with difficult airway who underwent nasotracheal intubation and oromaxillofacial surgery under general anesthesia were randomly divided into general supine position (control group) and pillow-under-shoulder supine position (experimental group) with 84 cases in each group.The first-time and the total success rate of intubation, the intubation time, and the rate of direct glottis exposure of the patients in two groups were recorded.The mean arterial pressure(MAP), heart rate (HR), and complications of intubation of the patients in two groups before induction, before tracheal intubation, during intubation, 1 and 5 min after intubation, were also recorded.Results:The first-time success rate of intubation in experimental group (94.0 %, 79/84) was significantly higher than that in control group (71.4%, 60/84) (P<0.01);the total success rate of intubation (98.8%, 83/84) had no difference compared with control group (97.6 %, 82/84) (P>0.05);the intubation time (57 s±12 s) was significantly shorter than that in control group (146 s±29 s) (P<0.01);the rate of direct glottis exposure (47.6%, 40/84) when the flexible endoscope passed through the posterior nasal apertures was obviously higher than that in control group (15.5 %, 13/84) (P<0.01).The values of MAP and HR of the patients in two groups before and during intubation were decreased significantly compared with the baselines (P<0.01), and came back to the baselines 1 and 5 min after intubation (P>0.05).There were no significant differences in the MAP and HR between different time points (P>0.05).The incidence rates of complications including pharyngalgia, hoarseness and epistaxis had no differences between two groups (P>0.05).Conclusion: Flexible endoscope assisted by pillow-under-shoulder in nasotracheal intubation has a higher intubation success rate, shorter intubation time and it is a superior procedure for the patients with difficult airway.

Objective To study the distribution and expression of Semaphorins-3A protein in brain of postnatal rats.Methods Semaphorins-3A positive cells were observed by immunohistochemistry in the cerebral cortex,hippocampus,dentate gyms and entorhinal cortex in postnatal 0d,7d,14d,21 d and 28d of Sprague Dawley rats.Results Semaphorins-3A positive cells widely distributed in the granule cell layer ( Ⅱ ),external pyramidal cell layer ( Ⅲ ),internal granular cell layer ( Ⅳ ),pyramidal cell layer ( Ⅴ ) and layer of polymorphous cells ( Ⅵ ),in addition to the molecular layer ( Ⅰ ) of the parietal,occipital,frontal,temporal,insular,cingulate cortex,piriform cortex and entorhinal cortex with postnatal 0d,7d,14d,21d and 28d rats.The amount of semaphorins-3A positive cells(IOD) in the entorhinal cortex was 84916.23 ± 3266.34 in P0d,77711.41 ± 2634.26 in P7d,74124.25 ± 3989.09 in P14d,65887.63 ± 3406.57 in P21d and 57705.96 ± 3136.35 in P28d,meanwhile the region of semaphorins-3A positive cells narrowed in the part level with Ⅱ -Ⅵ levels of cortex.Similarly semaphorins-3A positive cells distributed mainly in granule cell layer of dentate gyrus,CA1,CA3 region and only a few of semaphorins-3A positive cells scattered in the multi-line layer in hippocampus.The expression level of semaphorins-3Awas significant difference among postnatal 0d,7d,14d,21d and 28d rats (P＜0.01).Conclusion Semaphorins-3A positive cells widely distribute in the various cortex and hippocampus in developing rat brain,and the region of semaphorins-3A is reduced with age growth of rats.