Objective To study the value of plasma D-dimer ＜ 500 μg/L level in diagnosis of pulmonary thromboembolism occurred in patients.Methods The clinical data of the patients with pulmonary embolism confirmed by imaging examination with plasma D-dimer levels ＜ 500 μg/L admitted from January 1st 2008 to June 30th 2011 were analyzed retrospectively.Results Totally,there were ten pulmonary embolism patients with plasma D-dimer levels ＜ 500 μg/L.The 10 eligible patients were assessed for the possibility of pulmonary embolism by using the Wells score (i.e.Wells clinical pretest probability prediction model).Of them,0 cases was evaluated as low clinical pretest probability (grade ＜2),7 cases as moderate clinical pretest probability (grade 2 ～6) and 3 cases as high clinical pretest probability (grade ＞ 6).Conclusions Pulmonary thromboembolism was easily misdiagnosed for lacking specific clinical manifestations and the missed diagnosis in patients caused high mortality,so it was difficult to exclude acute pulmonary embolism simply depending on the D-dimer levels ＜ 500 μg/L.Therefore,in case of plasma D-dimer levels less than 500 μ g/L,the possibility of pulmonary embolism cannot be ruled out in patients with moderate or high Wells clinical pretest probability.

Objective To explore the effects and safety of citalopram combined with low-dose risperidone on refractory depression. Methods All of 54 patients with the refractory depression were ran-domly divided into two groups: augmented treatment group (taken citalopram 20 mg/d, risperidone 0.5-2.0mg/d) and mono-thempy group (taken citalopram alone 20 mg/d). The treatment lasted for 6 weeks. They were estimated with Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and treatment emergent symptom scale (TESS) at baseline and every two weeks subsequently. Results In the augment-ed treatment group, total effective rate was 60.7% and recovery and excellence rate was 50.0%, while that was 26.9% and 15.4% in mono-therapy group (P< 0.05). The adverse effect of two groups was minor. Conclu-sion Rispefidone may be a useful and safe adjunct to citalopram in treatment of refractory depression.

The cause of dilated cardiomyopthy (DCM) has not been elucidated yet .The poor prognosis and lack of specific and effective treatment became a serious health problem .Therefore to establish animal models of DCM to study the pathogenesis and treatment is necessary and urgent .At present the molding method of DCM mainly includes drug induction, immunological induction and molecular biology , etc.This article reviews the mature and commonly used establishing methods and mechanism of DCM models .

Esophageal Achalasia ; surgery ; Esophagus ; pathology ; surgery ; Humans ; Surgical Procedures, Operative ; methods ; trends

Cardia ; Esophageal Neoplasms ; surgery ; Humans ; Neoplasm Recurrence, Local ; surgery ; Reoperation ; Stomach Neoplasms ; surgery

0.05),But induced distraction had lower positive (t=3.060,P=0.014) and negative priming effects (t=3.527,P=0.006) for positive faces than induced rumination.(2) In induced rumination task,depressed individuals had lower positive (F=21.56,P=0.000) and negative priming effects (F=34.17,P=0.000) to negative faces than normal controls.(3) In induced distraction task,depressed patients had lower positive (F=51.97,P=0.000) and negative priming effects (F=10.21,P=0.000) to positive faces than controls.And it had lower positive priming effects (F=4.07,P=0.014) and negative priming effects (F=9.70,P=0.000) to negative faces than normal controls.Conclusion Induced rumination has no influence on inhibition of distraction in depressed individuals.Induced distraction decreases the distracter inhibition and increases the excessive facilitation for positive faces stimuli.

BACKGROUND:Bone marrow mesenchymal stem cell (BMSCs) transplantation has been reported to promote the repair of uterine injury;Shenghuazhixue decoction functions to promote blood circulation and remove blood stasis, and dysmenorrhea. OBJECTIVE:To investigate the effect of BMSCs transplantation combined withShenghuazhixue decoction on subinvolution of uterus effect and the underlying mechanism. METHODS:The model of subinvolution of uterus was established in 40 femaleSprague-Dawley rats, followed by randomly divided into four groups: control,Shenghuazhixue decoction, BMSCs, and combination groups. The control group received no treatment; at the 1st day after modeling, 1×107/L BMSCs (1 mL) were injected into the rat myometrium in the BMSCs and combination groups before laparotomy; the rats in theShenghuazhixue decoction group received no treatment after incision of uterus, and then rinsed using normal saline before closing the abdomen; theShenghuazhixue decoction and combination groups were given 8 mL/(kg?d)Shenghuazhixue detectionvia gavage at the 1st day after modeling, once daily, for consecutive 7 days. Afterwards, the relevant indexes were detected. RESULTS AND CONCLUSION:Compared with the control group, the body weight, uterine wet weight and uterine index in the combined group were significantly decreased after treatment (P < 0.05). The body weight and uterine wet weight showed significant differences betweenShenghuazhixue decoction and control groups (P < 0.05). Compared with the control group, the expression levels of intrerleukin-1 and tumor necrosis factor-α were significantly decreased, and the serum level of thromboxane B2 was significantly increased in theShenghuazhixue decoction group after treatment (P < 0.05). After treatment, the expression levels of intrerleukin-1 and tumor necrosis factor-α were significantly decreased, and the level of vascular endothelial growth factor was significantly increased in the BMSCs group compared with the control group (P < 0.05). Compared with the control group, there was significant decease in the expression levels of intrerleukin-1 and tumor necrosis factor-α, and significant increase in serum level of thromboxane B2 and vascular endothelial growth factor in the combination group (P < 0.01). These results suggest that BMSCs transplantation combined withShenghuazhixue detection can reduce postpartum body weight, uterine wet weight and index of uterus, and promote uterine involution in female rats, which may be through decreasing the levels of intrerleukin-1 and tumor necrosis factor-α as well as increasing the levels of thromboxane B2 and vascular endothelial growth factor.

Objective To investigate the expression level of Annexin Ⅱ in bronchial lung cancer tissue,alveolar lavage fluid(BALF) and pleural effusion and its value in the diagnosis of lung cancer.Methods From January 2014 to March 2016 in Jingzhou Infectious Disease Hospital,80 cases of patients with pleural effusion of lung cancer (Lung Cancer Group),40 patients with benign pleural effusion (benign group) were chose.The expression level of Annexin of two groups of patients with pleural effusion,BALF were detected and compared.Sixty specimens of department of pathology past (after lung cancer surgery cancer) and 30 cases of previously collected normal lung tissues (normal lung tissue) were collected,differential expression by immunohistochemical staining were compared between the two groups of Annexin Ⅱ protein.Results The positive expression of Annexin Ⅱ in lung cancer was 61.67％ (37/60),higher than that in normal lung tissue of 23.33％ (7/30),the difference was statistically significant(P＜0.001).The positive expression of Annexin Ⅱ in lung cancer patients was significantly correlated with rate of lymph node metastasis and clinical stage of lung cancer(P =0.039,0.029).Group of patients with pleural effusion,BALF expression of Annexin Ⅱ the level was higher than that in benign group(P＜0.001).When the critical value of Annexin in pleural effusion of lung cancer diagnosis was 10.94 μg/L,the sensitivity of diagnosis of lung cancer was 83.47％,the specificity was 80.66％,AUC value was 0.837.The critical value when BALF Annexin Ⅱ in the diagnosis of lung cancer was 52.08 μg/L,the sensitivity of diagnosis of lung cancer was 86.19％,the specificity was 89.22％,the AUC value was 0.898.Conclusion The expression level of Annexin Ⅱ in the BALF and pleural effusion of patients with bronchial lung cancer and lung cancer is increased,and it has a certain clinical value for the differential diagnosis of lung cancer.

Objective To explore the clinical significance of DSA and MRA detection in cerebrovascular desease of patients with diabetes mellitus.Methods 142 diabetic patients were selected in the study. The vascular structure was detected by digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) . Results There was 1123 (56.5%) branches of artery atherosclerotic stenosis in a total of 1988 detecting artery and there was no significant difference between the DSA and MRA (χ2=0.36、0.47、0.53,P>0.05) . The results showed that the DSA and MRA methods had no significant difference on display average count in detecting bilateral ACA,MCA,PCA 284 vessels (t=0.27、0.56、0.89,P>0.05) . There were 656 arteries stenosis in checking the Willis ring vascular by DSA evaluation of the Willis ring and the sensitivity and specificity by MRA were more than 90%. Conclusion MRA and DSA can be applied in diagnosis of in cerebrovascular disease of patients with diabetes mellitus.The noninvasive advantages of MRA are worth to be concerned by clinician.