TLR4 signaling pathway plays an important role in regulation of the innate immune response and the adaptive immune response.Studies have shown that TLR4 signaling pathway is closely associated with the immune inflammatory process in major depressive disorder,but the underlying mechanisms are not clear.The pathophysiological process of depression involves multiple molecule mechanisms and signal pathways.The change of TLR4 signaling pathways exists in the peripheral circulation system or the central nervous system of depressive patients and depression animal models.The activation of TLR4 signaling pathways is associated with stress-inflammation-depression approach and leaky gut hypothesis,however,the relationship of peripheral and central TLR4 signaling pathways is not clear yet.TLR4 signaling pathway may be potential targets for the anti-inflammatory treatment of depression.

Objective To explore the influence of CYP1A2 and CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug duloxetine on depression patients in southern region of Fujian.Methods 82 patients with depression were selected from southern region of FuJian, China,and all participates received duloxetine for two weeks.Blood concentrations of duloxetine were detected by HPLC-MS,and CYP1A2 and CYP2D6 genotypes were determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of duloxetine were evaluated by Hamilton depression scale (HAMD) and treatment emergent symptom scale (TESS) respectively.Results Subjects were divided into GG,GA and AA three groups based on CYP1A2 * 1C genotyping.There was no significant difference in blood concentrations of duloxetine, dose-corrected blood concentrations, the reduction rate of HAMD and the reduction rate of TESS among the three groups.Results were the same with CYP1A2 * 1F,which were divided into CC, CA and AA three groups.Subjects was divided into CC, CT,TT three groups based on CYP2D6 * 10 locus genotyping.Blood concentrations of duloxetine were (13.89±3.22) ng · ml-1 , (16.08±4.24) ng · ml-1 , (17.25±4.62) ng · ml-1 respectively and there was significant difference(F=3.21, P＜0.05).CC group was significantly lower than TT group(P＜0.05) , and CT group was lower than TT group but without significant difference (P＞0.05).Dose-corrected blood concentrations were (304.84± 103.76), (368.13± 143.49), (444.50± 195.58) respectively and there was significant difference(F=4.19, P＜0.05), and CC group was significantly lower than TT group (P＜0.05).The reduction rate of HAMD were 0.42±0.11,0.46±0.11,0.52±0.09 respectively and there was significant difference (F =6.29, P＜0.05), and CC and CT group was significantly lower than TT group(P＜0.05).The reduction rate of TESS were 1.14±0.66,1.48±0.69, 1.69±0.69 respectively and there was significant difference(F=3.38, P＜0.05).CC group was significantly lower than TT group(P＜0.05).Conclusion Among the 3 loci studied,only CYP2D6 * 10 locus within CYP2D6 gene can affect blood concentration,efficacy and adverse effects of duloxetine,which indicate that CYP2D6 gene polymorphism may contribute to therapeutic efficacy of duloxetine on depression in southern region of Fujian.

Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.

In order to overcome the shortcomings of traditional X-ray inspection taking passive protection mode, this paper combines the automatic control technology, puts forward a kind of active protection X-ray equipment. The device of automatic detection of patients receiving X-ray irradiation part, intelligent adjustment in patients and shooting device between automatic tracking radiation protection device height. The device has the advantages of automatic adjustment, anti-radiation device, reduce the height of non-irradiated area X-ray radiation and improve the work efficiency. Testing by the professional organization, the device can decrease more than 90% of X-ray dose for patients with non-irradiated area.
Humans ; Radiation Dosage ; Radiation Protection ; instrumentation ; methods ; X-Rays

Objective To study the variation of blood concentration of tetramine in human body with acute tetramine intoxication treated with three different protocols and the levels in human body after discharge from the hos-pital. Methods The blood concentration of tetramine was determined by gas chromatography-mass spectrometry (GC-MS). All 101 patients of acute tetramine intoxication were divided into 3 groups (routine comprehensive treat-ment group,hemoperfusion group,blood transfusion group) according to their blood concentration of tetramine and clinical symptoms. The patients were followed up to monitor the tetramine levels in a year. Results The level of tet-famine in blood was decreased from 33.0(1.7～115.0)μg/L to 18.0(0.3～47.6)μg/L in routine comprehensive treatment group. The total decrement was 45.5 %. The level was decreased from 108.0 (54.0～290.0)μg/L to 26.0 μg/L in hemoperfusion group. The total decrement was 75.9%. The decrement was 20.0%～45.0% after each he-moperfusion. The level was slightly high after 24 h of hemoperfusion. The total decrement in blood transfusion group was 33.5%～60.0%. The level was <0.3μg/L in all 25 out-patients 1 year after their intoxication. Conclusion Routine comprehensive treatment,hemoperfusion,blood transfusion are effective in the treatment of acute tetramine intoxication. The degradation of tetramine in human body is slow.

Objective To evaluate the effect of sevoflurane postconditioning on the expression of Pim-1 kinase during myocardial ischemia-reperfusion (I/R) in rats.Methods Male Sprague-Dawley rats,weighing 250-300 g,were used in this study.After the animals were anesthetized,their hearts were immediately removed and retrogradely perfused with an oxygenated K-H solution at 37 ℃ in a Langendorff apparatus.Thirty-six isolated rat hearts were assigned into 3 groups (n=12 each) using a random number table:control group (group C),group I/R and sevoflurane postconditioning group (group SP).The hearts were subjected to ischemia for 30 min followed by 120 min of reperfusion to establish the model of myocardial I/R injury.In group SP,the hearts were perfused with K-H solution saturated with 3％ sevoflurane for 15 min starting from the beginning of reperfusion.Heart rate (HR),left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and the maximum rate of increase and decrease of left ventricular pressure (±dp/dtmax)were recorded at the end of equilibration and 30,60,90and 120 min of reperfusion.Myocardial tissues were obtained at T2 for determination of the expression of Pim-1 kinase,Bcl-2 and cytochrome c (Cyt c) in cytoplasm and mitochondria by Western blot.The hearts were selected at T4 for determination of myocardial infarct size (by TTC staining) and for examination of mitochondrial ultrastructure (with transmission electron microscope).Results Compared with group C,HR,LVDP and ±dp/dtmax were significantly decreased,and LVEDP was increased at T1-4,the myocardial infarct size was enlarged,the expression of Pim-1 and Bcl-2 in cytoplasm and mitochondria was down-regulated,the expression of Cyt c in cytoplasm was up-regulated,and the expression of Cyt c in mitochondria was down-regulated in group I/R (P＜0.05).Compared with group I/R,HR,LVDP and ±dp/ dtmax were significantly increased,and LVEDP was decreased at T1-4,the myocardial infarct size was decreased,the expression of Pim-1 kinase and Bcl-2 in cytoplasm and mitochondria was up-regulated,the expression of Cyt c in cytoplasm was down-regulated,and the expression of Cyt c in mitochondria was upregulated in group SP (P＜0.05).The damage to mitochondria was significantly attenuated in group SP as compared with group I/R,and was aggravated as compared with group C.Conclusion The mechanism by which sevoflurane postconditioning attenuates myocardial I/R may be related to up-regulation of Pim-1 kinase expression in rats.

Objective To investigate the effect of sevoflurane postconditioning on mitochondrial connexin 43 (Cx43) during myocardial ischemia-reperfusion (I/R) in isolated rat hearts and the role of mitochondrial ATP-sensitive potassium (mito-KATP) channels in it.Methods Forty-five adult male SpragueDawley rats,weighing 200-250 g,were used in the study.Their hearts were excised and retrogradely perfused with K-H solution in a Langendorff apparatus.The 45 isolated hearts were assigned into 5 groups (n =9 each) using a random number table:control group (group C),I/R group,sevoflurane postconditioning group (group Sev),and sevoflurane postconditioning plus 5-hydroxydecanoate (5-HD,a specific mitoKATp channel blocker) group (group Sev+5-HD) and I/R plus 5-HD group (group I/R+5-HD).The hearts were subjected to 20 main of global ischemia followed by 90 min of reperfusion to establish the model of myocardial I/R injury.From the beginning of reperfusion,the hearts were perfused with K-H solution saturated with 3％ sevoflurane for 15 min in group Sev,with K-H solution saturated with 3％ sevoflurane and containing 100 μ mol/L 5-HD in group Sev+5-HD,and with K-H solution containing 100 μ mol/L 5-HD in group 5-HD.The heart rate (HR),left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and the maximum rate of increase and decrease of ventricular pressure (±dp/dtmax) were recorded at the end of equilibration (T1) and 30 and 60 min of reperfusion (T2,3).At 90 min of reperfusion,the myocardial infarct size was measured by TTC staining,and the expression of total Cx43 (tCx43)and phosphorylated Cx43 (p-Cx43) in mitochondria was determined by Western blot analysis.The percentage of myocardial infarct size and p-Cx43/tCx43 ratio were calculated.Results Compared with group C,the HR,LVDP and ±dp/dtmax were significantly decreased,and the LVEDP was increased at T2,3,and the percentage of myocardial infarct size was increased in the other 4 groups,the expression of mitochondrial tCx43 and p-Cx43 was significantly down-regulated in I/R,Sev+5-HD and 5-HD groups (P＜0.05),and no significant change was found in the expression of mitochondrial tCx43 and p-Cx43 in group Sev (P＞0.05).Compared with group I/R,the HR,LVDP and ±dp/dtmax were significantly increased,and the LVEDP was decreased at T2,3,the percentage of myocardial infarct size was decreased,and the expression of mitochondrial tCx43 and p-Cx43 was up-regulated in group Sev (P＜0.05),and no significant change was found in the parameters mentioned above in Sev+5-HD and 5-HD groups (P＞0.05).Compared with group Sev,the HR,LVDP and ±dp/dt were significantly decreased,and the LVEDP was increased at T2,3,the percentage of myocardial infarct size was increased,and the expression of mitochondrial tCx43 and p-Cx43 was down-regulated in group Sev+5-HD (P＜0.05).There was no significant change in the pCx43/tCx43 ratio between the five groups (P＞0.05).Conclusion The mechanism by which sevoflurane postconditioning attenuates myocardial I/R injury may be related to induction of mito-KATP channel opening and up-regulation of the expression of mitochondrial Cx43 in cardiomyocytes of rats.

〔Abstract〕 Based on elaborating the application of WeChat public platform in various industries, the paper overviews the function and characteristics of WeChat public platform, taking Shanxi Provincial Peoplel's Hospital as an example, it introduces the application of We-Chat public platform in outpatient and inpatient departments, points out that WeChat service could be carried out in hospital in the futrue.

Objective:To explore the relationship between social support and negative emotion in parents of children with congenital heart disease before the operation.
Methods:Social support rating scale (SSRS), self-rating anxiety scale (SAS), and Center for epidemiological survey-depression scale (CES-D) were used to assess the association between social support and anxiety and depression in 226 parents.
Results:The mean SSRS score was signiifcantly lower than the normal. There was signiifcant difference in social support of parents in monthly family earning and knowledge about surgery. Parents with monthly family income≤1000 yuan had lower scores than the other groups. Parents who knew nothing about the surgery approach had lower scores. Social support was significantly correlated to negative emotion (anxiety and depression). Social support could predict anxiety and depression.
Conclusion:Social support is widely and significantly correlated to negative emotion in parents of children with congenital heart disease before the surgery.

Objective To observe the change of serum smooth muscle myosin heavy chain (smMHC) level in the patients with aortic dissection (AD),and evaluate the effect of smMHC in the early diagnosis and prognosis of AD.Methods Forty-two patients with AD were selected as AD group,30 healthy subjects were selected as control group.Blood samples were collected at four time periods (within 3 h of onset,6 h,12 h,24 h),and serum smMHC level were measured by enzyme-linked immunosorbent assay.Results Serum smMHC level of AD group,which collected (within 3 h of onset,6 h,12 h) were significantly higher than that of control group [(88.6 ±21.7),(59.4 ± 18.7),(41.3 ± 10.7) ng/L vs.(17.2 ± 8.3) ng/L,P ＜ 0.01].There was no significant difference between the serum smMHC level of AD group and control group at 24 h after onset [(18.9 ±9.5) ng/L vs.(17.2 ±8.3) ng/L,P ＞ 0.05].Serum smMHC level of Stanford A type group (25 cases) was higher than that of Stanford B type group (17 cases) within 3 h of onset [(95.4 ± 17.8) ng/L vs.(78.5 ± 18.3) ng/L,P＜0.01],and there was no significant difference bewteen the two groups which collected at 6,12 h and 24 h after onset (P ＞ 0.05).Preoperative serum smMHC level was significantly higher than that after intracavitary isolation operation [(58.6 ± 15.9) ng/L vs.(30.1 ± 12.5) ng/L,P ＜ 0.01].Serum smMHC level decreased rapidly after the operation,and there was no significant difference between the two grougs when 12 h after operation [(18.7 ± 8.9) ng/L vs.(17.2 ± 8.3) ng/L,P ＞ 0.05].The serum smMHC level of the deaths (7 cases),which collected within 3 h of onset,6 h,12 h,was significantly higher than that of the survivors (35 cases) [(101.2 ± 20.7) ng/L vs.(86.1 ± 18.9) ng/L,(65.2 ± 16.7) ng/L vs.(58.2 ± 14.2) ng/L,(50.4 ± 10.8) ng/L vs.(39.5 ± 8.3) ng/L,P ＜ 0.05],and there was no significant difference at 24 h after onset (P ＞ 0.05).Detecting serum smMHC level within 3 h of onset,the area under the receiver operating characteristic curve was 0.913,with 51.7 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 88.1％ (37/42) and 96.7％ (29/30).When detecting at 6 h after onset,the area under the curve was 0.865,with 38.5 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 90.4％(38/42) and 90.0％ (27/30).Conclusions The level of serum smMHC in patients with AD increase rapidly after onset,and detecting serum smMHC level within 6 h of onset have important clinical significance in early diagnosis and prognosis of AD.