OBJECTIVE:To investigate the clinical utilization and the tendency of antidepressant drugs in Beijing area.METHODS:Using the analytical method of the defined daily dose(DDD)recommended by WHO,the application of antidepressant drugs in Beijing from 2005 to 2007 was analyzed statistically.RESULTS:The consumptive sum and DDDs of antidepressants increased significantly year by year,with SSRIs representing more than 88% of all the antidepressant drugs in terms of the consumptive sum,leading the first 3 places in terms of consumption sum and DDDs were fluoxetine,paroxetine and citalopram.The market share of traditional tricyclics and tetracyclines showed a slight reduction,but there were still a stable population of these drugs.CONCLUSION:SSRIs such as fluoxetine have been dominated the antidepressants market in Beijing area.

Objective To investigate the distribution of pathogenic bacteria in children with chronic rhinosinusitis (CRS) and their susceptibility to commonly used antibacterial drugs .Methods 95 cases of CRS complicating adenoidal hypertrophy were per-formed adenoidectomy .The secretion of maxillary sinus ostium and posterior ethmoid sinus ostium was collected during endoscopic adenoidectomy by the disinfected cotton swab for conducting the bacterial culture and the drug sensitivity test .Results 89 speci-mens showed the bacterial growth ,the positive rate of bacterial culture in all culture specimens was 93 .7% ,86 strains of aerobic bacteria ,28 strains of anaerobic bacteria .Among 95 patients ,81 cases of aerobic infection ,52 cases of anaerobic infection ,44 cases of mixed infection .The drugs susceptibility test in vitro displayed that amoxicillin and clavulanate potassium had the higher antibacte-rial activity to aerobic bacteria and metronidazole had the higher antibacterial activity to anaerobic bacteria .Conclusion Children CRS is dominated by the aerobic bacterial infection .The bacterial infection plays a larger role in children CRS .Antibacterial drugs have better effect for treating CRS .

Objective:To study the perioral soft tissue characteristics of the subjects with ClassⅡDivisionⅠand various vertical pat-terns. Methods:Lateral cephalograms of 90 adults ( half men, half women) were divided into 3 groups based on GoGn-SN angle:low angle, normal angle and high angle(n=30). The perioral soft tissues were measured and compared for the determination of the vertical skeletal variables influencing soft tissue characteristics. Results: The subjects with low angle showed significantly smaller values than those with high angle for basic lower lip thickness and lower lip length(P<0. 05). Most measurements of soft tissue thickness were greater in men than in women in all groups, especially for basic upper lip thickness and upper lower lip thickness(P<0. 05). Conclu-sion:Orthodontists need to pay more attention to the differences of perioral soft tissue in the subjects with various vertical patters to ob-tain balance of the facial harmony in orthodontic treatment.

Objective:To evaluate the biocompatibility Abstract of a liquid of propolis. Methods:According to the relative Chinese national standards,the cytotoxicity of the propolis abstract was investigated by in vitro cell culture,agar diffusion test and the oral mucous membrane irritation response test in rabbits. Results:In the in vitro tests the propolis abstract showed grade 0 cytotoxicity. In the in vivo test the abstract did not result in any pathological change in oral mucous membrane.Conclusion:The propolis abstract is biocompatible.

Objective To investigate the relationship between absent end-diastolic velocity of fetal umbilical artery (AEDV) and perinatal outcome. Methods The color Doppler ultrasound result of maximum flow velocity waveforms at the cardiac level (aorta, pulmonary artery) and the peripheral level (fetal umbilical artery, middle cerebral artery) in 27 cases with Umbilical artery AEDV were analyzed. Fetal heart rate monitoring was performed and perinatal outcome was followed up. Results All of the 27 cases presented with remarkable pulmonary artery contraction. The result of velocity time integral (VTI)?fetal heart rate (FHR) and right cardiac output declined significantly. Among 22 cases with continuous monitoring, 10 cases showed reduced PI of middle cerebral artery (MCA) without changes of left cardiac output; 12 cases had biphasic changes of the MCA PI which consisted of decrease followed by increase and showed significant reduction of VTI?FHR of aorta and left car-(diac) output. The interval between the first detection of AEDV and the presentation of abnormal FHR patterns was 2 to 7 days. Conclusions Umbilical artery AEDV usually precedes the presentation of abnormal FHR under fetal hypoxia. Delivery before decompensation may improve the perinatal morbidity and mortality.

Objective To observe the effect of laser irradiation on the level of histamine (Hm) , 5- hydroxytryptamine(5-HT), interleukin-1 (IL-1), tumor necrosis factor α (TNF-α) in serum and β- endorphin (β- EP) in brain tissue in rat model of rheumatoid arthritis. Methods A total of 60 Wistar rats were randomly divided into four groups:a normal group, a model group (RA without treatment), a laser + drug treatment group (RA treated by laser and drug) and a drug treatment group (RA treated by drug alone). All the groups, except the normal one, were injected with complete Freund's adjuvant to make animal model of adjuvant arthritis. All the animals were then treated accordingly. The level of Hm, 5-HT, IL-1 and TNFα in serum and β-EP in brain tissue were measured. Results Laser downregulated the content of Hm, 5-HT, IL-1 and TNFα in serum and increased the content of β-EP in brain tissue. Conclusion Laser irradiation is an effective modality for treating the animal model of rheumatoid arthritis.

Objective To study the clinical experience of extracorporeal circulation management in modified total arch replacement combined with stented elephant trunk.Methods Fifty-eight patients with Stanford A aortic dissection underwent modified total arch replacement combined with stented elephant trunk.With the modified surgical technique,the technology of extracorporeal circulation was also modified with bilateral antegrade cerebral perfusion,the management of the temperature and blood protection.Results All patients were operated successfully.The operative time was 248-485 (396 ± 67) min,extracorporeal circulation time was 175-260 (181 ± 33) min,cross clamp time was 64-104 (85 ± 12) min,stop circulation time was 22-48 (32 ± 5) min,and selective cerebral perfusion time was 26-54 (39 ± 7) min.The ventilator assisted breathing time was 5.0-35.5 (23.0 ± 4.5) h,and ICU monitoring time was 24-140 (88 ± 12) h.Postoperative complications included transient neurologic deficit in 3 cases (5.2％,3/58),renal dysfunction in 5 case (8.6％,5/58),and pulmonary infection in 4 cases (6.9％,4/58).Conclusion To modified total arch replacement combined with stented elephant trunk,the modified management of extracorporeal circulation with bilateral antegrade cerebral perfusion,the management of temperature and blood protection,has a low prevalence of morbidity and mortality.

Objective To summarise the clinical experience on the treatment of aortic dissection with stent-graft. Methods From June 2005 to November 2008, 117 patients with aortic dissection underwent surgery with stented elephant trunk (CRONUS stent-graft)which was implanted through the aortic arch under deep hypothermic circulatory arrest, including Stanford A in 50 patients who underwent Bentall operation and total arch grafting with stented elephant trunk operation in 28, Wheat operation and total arch grafting with stented elephant trunk operation in 8, ascending aorta and total arch replacement with stented elephant trunk operation in 14 and Stanford B in 67 patients who all underwent stented elephant trunk operation. Results The location of the entry was in the ascending aorta in 35 patients, the aortic arch in 4, the proximal descending aorta in 78. Cardiopulmonary bypass time was ( 159 ±31 ) min, average cross clamp time was (95 ±23) min, and average selected cerebral perfusion and lowerbody arrest time was (27 ±8) min. The in-hospital mortality was 2.6% (3/117). One patient died of the hemorrhage shock, one died of multi-organ failure postoperatively and the third died of infective endocarditis. The complications included transient neurologic deficit in 11(9.4%), cerebrovascular accident in 6 (5. 1%, cerebral embolism in 2 and cerebral hemorrhage in 4, of which 5 cases were discharged from hospital. One case died of multiorgan failure 18 days after discharge owing to his family' s giving up treatment), hemorrhage of anastomose which was treated by reoperation in 5,hoarseness in 2, renal failure in 1. One case died of the cerebral hemorrhage after 4 months due to inappropriate anticoagulation during following up. Conclusion The treatment of the aortic dissection with stent-graft which was implanted into the descending aorta through aorta arch is safe, effective and feasible, which will be helpful to vascular reconstruction by accurately close subintimal rip and can streamline surgery with minimally invasive and less complications.

Objective To investigate the impacts of c.388A ＞ G polymorphism of the solute carrier organic anion transporter 1B1 (SLCO1B1) gene on lipid-lowering and anti-atherosclerosis effects of atorvastatin in Chinese patients with ischemic stroke.Methods The patients with ischemic stroke whose baseline low-density lipoprotein cholesterol (LDL-C) ＞ 1.8 mmol/L were enrolled prospectively.They received atorvastatin (20 mg/d) for 12 months.The lipid and bilateral carotid intima-media thickness (CIMT) were measured respectively before and after treatment.The CIMT differences between SLCO1B1 c.388A＞G genotype groups were compared.Results A total of 71 patients with ischemic stroke were enrolled,including 5 AA genotype,31 AG genotype,and 35 GG genotype.The A allele frequency was 28.9％ and the G allele frequency was 71.1％.After treatment,the total cholesterol (TC),triglyceride (TG),and LDL-C in all patients were significantly lower than those before treatment,and high-density lipoprotein cholesterol (HDL-C) was significantly increase (all P＜0.001),but CIMT did not have significant change (P=0.475).The proportion of patients whose LDL-C ＜ 1.8 mmol/L or LDL-C decreased ≥50％ in the GG genotype group was significantly higher than the AG + AA genotypes group (74.29％ vs.44.44％;x2 =6.540,P =0.011).Conclusions SLCO1B1 gene c.388A ＞ G polymorphism could influence the lipidlowering effect of atorvastatin,lipid-lowering effect in the GG genotype group was better than that in the AG+ AA genotype group.SLCO1B1 gene c.388A ＞ G polymorphism did not have effect on the antiatherosclerosis effect of atorvastatin,but it might be associated with too short follow-up time.

BACKGROUND: Hedgehog signaling pathway is shown to contribute to the osteogenesis of bone marrow mesenchymal stem cells, and to play an important role in regulating the expression of RANKL in osteoblasts. Nowadays, the definite signal transduction pathway has been revealed gradually.OBJECTIVE: To review the research progress of RANKL in osteoblasts that regulated by hedgehog signaling pathway.METHODS: A computer-based online search in CNKI, Google Scholar and PubMed databases was performed with the key words of Hedgehog, osteoblast, BMSCs, PTHrP, CREB, NFAT, RANKL in English and Chinese, respectively.Literatures related to the expression of RANKL in osteoblasts that regulated by the Hedgehog signaling pathway were included initially and 37 eligible articles were extensively summarized for review.RESULTS AND CONCLUSION: The Hedgehog signaling pathway plays an advanced role in the osteogenic differentiation of bone marrow mesenchymal stem cells, and also upregulates intracellular parathyroid hormone related protein, which activates its downstream signaling molecules cAMP response element binding protein and nuclear factor of activated T cells ulteriorly, to promote the expression of RANKL in osteoblasts and increase the differentiation and formation from osteoclast precursor cells to mature osteoclasts.