OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.

Objective To evaluate the efficacy of tolterodine in preventing bladder spasm during the operation to BPH.Methods One hundred and twelve cases of BPH patients were randomized to two groups:56 cases in one group were prescribed tolterodine 4-5 d before operation and 3-4 d after operation (2 mg twice daily),another 56 cases did not take any anti-spasm drugs.The bladder spasm occurring or not,frequency and continuing time of bladder were evaluated and recorded.Results In the controlling group:the non bladder spasm in 12.5% (7/56),mild bladder spasm in 14.3% (8/56),severe bladder spasm in 73.3% (41/56),In the treatment group:non bladder spasm in 87.5% (49/ 56),mild bladder spasm in 8.9% (5/56),severe bladder spasm in 3.6% (2/56).There was signifi-cant difference between the 2 groups (P<0.001).Conclusion Tolterodine could alleviate bladder spasm around the operation to BPH.

Objective To investigate the expression of CRKL in thyroid papillary micro-carcinoma and its clinical significance.Methods 120 patients with thyroid tissue specimens were collected,in which 30 cases of diam-eter >1 cm of papillary thyroid carcinoma,30 cases of thyroid papillary micro-carcinoma,30 cases of nodular goiter, 30 cases for specimen of thyroid disease patients without diabetes.Immunohistochemical(SP)method was used to de-tect samples in CRKL expression.Results In thyroid papillary micro-carcinoma and thyroid papillary cancer group, CRKL expression positive rates were 30.12% and 29.87% respectively,which were higher than that of nodular goiter and normal thyroid group 30.03% and 28.57%(χ2 =52.102,P <0.05);The average absorbance(A)value in thy-roid papillary micro-carcinoma and thyroid papillary carcinoma group which were respectively (0.516 ±0.100)and (0.496 ±0.201),were higher than that in nodular goiter and normal thyroid group (0.246 ±0.050)and (0.117 ±0.015),the difference was statistically significant(F =149.105,P <0.05).Conclusion CRKL is highly expressed in papillary thyroid micro-carcinoma and the clinical detection of CRKL is helpful to determine the surgical plan for papillary thyroid micro-carcinoma.

Objective: To describe the prevalence of food allergy in Asian patients with allergic rhinitis. Study Design: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge. Results: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%). In the children food allergy category, the top three allergens were egg white (54%), milk (31%) and soya bean (13%). The adult group had results of Dermatophagoides pteryonysinus (71%), Dermatophagoides farina (72%), and Blomia tropicalis (59%); the adult food allergy category, the top 3 allergens were egg white (13%), milk (6%) and soya bean (5%). There was a statistically significant difference in the child and adult group for Dust, D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat, gluten and soya bean. In the age specific child groups, there was an increased in egg food allergy levels, with a peak at the age of five-nine years old and decreasing thereafter (p=0.04). In the children group, the mean Total Nasal Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult group was similar, with a mean TNSS of 9.8 (range 5 to 12). Conclusion: The prevalence of food allergy in paediatric patients with allergic rhinitis is fairly high and should be considered when treating these children.

ObjectiveTo study the relation ship between progressive cerebral infarction and thyroid hormone level,and analyze the risk factors of progressive cerebral infarction.MethodsThe thyroid hormone,triglyceride esters and fasting glucose levels of 48 patients with progressive cerebral infarction,138 patients with non-progressive cerebral infarction and 60 healthy subjects as control group were measured.ResultsCompared with the patients with non-progressive cerebral infarction,serum T3 of patients with progressive cerebral infarction was lower( P ＜0.05),and the levels of triglyceride ( TG),C-reactive protein ( CRP),and fasting blood glucose were higher ( all P ＜ 0.01 ).ConclusionPatients with progressive cerebral infarction were in a low level of thyroid hormones,and the increasing levels of TG,CRP,and fasting blood glucose were risk factors for progressive cerebral infarction.

Objective To observe the expression changes of 5-hydroxytryptamine (5-HT),brainderived neurotrophic factor (BDNF) in rats with chronic manganism.Methods Sixty healthy male Sprague-Dawley rats were randomly divided into control group (n =15) and experimental group (n =45).The experimental group was divided into three subgroups:low-dose group (n =15),middle-dose group (n =15),high-dose group (n =15).The rats in control group were given intraperitoneal injection of normal saline while the rats in low-dose group,middle-dose group,high-dose group were given intraperitoneal injection of 5 mg/kg,15 mg/kg and 25 mg/kg manganese chloride tetrahydrate,respectively for 5 days oncea week and lasted for 12 weeks.The depressive behavior changes of rats were observed by sucrose preference test and open field test.The concentrations of manganese in the striatum of rats were detected by inductively coupled plasma-atomic emission spectrometry.The expression of 5-HT in frontal cortex,hippocampus of rats was determined by high performance liquid chromatography.The expression of BDNF in frontal cortex,hippocampus of rats was examined by Western blotting.The expression of BDNF mRNA was detected using real-time fluorescence quantitative polymerase chain reaction.Results The chronic manganese poisoning rats presented depression-like behavior based on the sucrose preference test and open field test,which was more distinct in high-dose rats.As compared with the control group (frontal cortex (459.65 ± 16.81) ng/g,hippocampus (323.92 ± 17.41) ng/g;tissue wet weight),the expressions of 5-HT were significantly decreased in frontal cortex ((423.45 ± 17.19) ng/g,(376.89 ± 18.87) ng/g,(280.17 ± 25.46) ng/g),hippocampus ((265.71 ± 17.89) ng/g,(214.35 ±23.63) ng/g,(172.67 ± 18.24) ng/g) of the experimental group (F =132.68,69.66,both P ＜ 0.05).As compared with the control group (frontal cortex 0.962 ±0.111,hippocampus 0.873 ± 0.101;the expressions of BDNF were significantly decreased in frontal cortex (0.855 ± 0.106,0.649 ± 0.112,0.506 ± 0.121) and hippocampus (0.731 ± 0.092,0.626 ±0.104,0.544 ± 0.113) with the increasing concentration of MnCl2 which showed dose dependence (F =13.26,18.54,both P ＜ 0.05).As compared with the control group (frontal cortex 0.000 87 ± 0.000 07,hippocampus 0.000 82 ± 0.000 09),the expressions of BDNF mRNA were decreased significantly in frontal cortex (0.000 71 ± 0.000 06,0.000 48 ± 0.000 03,0.000 36 ± 0.000 03) and hippocampus (0.000 57 ± 0.000 05,0.000 49 ± 0.000 04,0.000 38 ± 0.000 05) in the treated group with the increasing concentration of manganese (F =18.46,12.76,both P ＜ 0.05).Conclusion Rats with chronic manganese poisoning could present depression-like behavior and the expression of 5-HT and BDNF is decreased in the frontal cortex and hippocampus with the increased accumulation of manganese.

Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P＜0.001),and the prevalence of nutritional risk also increased gradually (21.43％ vs.37.50％ vs.71.43％,x2 =29.700,P ＜0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P＜0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P＜0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P＜0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P ＜ 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P ＜ 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.

Objective Recent studies have found that Roux-en-Y gastric bypass( RYGB) can inhibit the levels of blood glucose in type 2 diabetes,but its mechanism still remains unknown. In present study,we observed the effect of RYGB on insulin and GLP-1of type 2 diabetes mice. Methods The 12-week-old male SD rats were divided into four groups:group A ( no surgery,normal diet) ,Group B ( no surgery,DM diet+STZ injection) ,group C ( gastric bypass surgery+normal diet) ,group D ( gastric bypass surgery+DM diet+STZ injection) . One week after surgery rehabilitation,the diabetes model was built by STZ ( revulsant of the classical diabetes model) and high-fat-control diet. After four months,the changes of blood glucose,OGTT,body weight,food intake,water intake in each group were examined. Furthermore,the patho-logical changes of insulin and pancreatic were detected by HE staining. Meanwhile,the liver PEPCK gene and protein expression were detec-ted by using RT-PCR and Western blot. Results Four groups of rats all have significant changes in diet and weight. HE staining suggests the disseminated hyperemia and edema in pancreas and showed that islet has been severe damaged. Compared with no treatment normal diet,nor-mal rat+DM diet+STZ injection,has a markedly elevated blood glucose level 3 days later,insulin,OGTT,GLP,and ITT all have remarkable changes in different time periods,with a statistically significance (P<0. 05). Compared with the normal rat+DM diet+STZ injection group, RYGB + DM diet+ STZ injection group showed that these indicators of pancreas pathological changes significantly,glucose,insulin,OGTT, GLP,ITT all have significantly drop,as well as the gene and protein expression of PEPCK (P<0. 05). Conclusion RYGB can exert influ-ence on the change of insulin,OGTT,GLP,ITT and PEPCK in islets of type 2 diabetes rats,which may play a positive role in the further clini-cal applications.

Objective To compare the phage based splitting assay and BACTEC 460 in the rapid detection of Mycobacterium tuberculosis ( M. tuberculosis ). Methods 30 clinical isolates of M. tuberculosis, 10 strains of non M. tuberculosis, 7 strains of non mycobacterium and 60 sputum specimens of pulmonary tuberculosis patients were detected with phage based splitting assay and BACTEC 460 system. Results All the strains of M. tuberculosis clinical isolates detected with phage based splitting assay were positive, while all of the non M. tuberculosis and non mycobacterium strains were negative. 41 sputum specimens with BACTEC 460 culture positive and 19 sputum specimens with BACTEC 460 negative were detected with phage based splitting assay, the number of positive specimens was 34 (82.9%) and 5 (26.3%) respectively.Conclusions The phage based splitting assay can detect the M. tuberculosis easily and quickly in two days with high sensitivity and specificity.

OBJECTIVETo study the changes in the expression of divalent metal transporter 1 (DMT1) and ferroportin 1 (FP1) in the substantia nigra (SN) of rats with manganese-induced parkinsonism.

METHODSEighty Sprague-Dawley rats were randomly divided into four groups. Rats in the control group were injected intraperitoneally with saline solution. Rats in the low-dose, medium-dose, and high-dose groups were injected intraperitoneally with 5, 15, and 20 mg/kg MnC12 solution, respectively, for 16 weeks. Three behavioral tests were performed at the 16th week. The concentration of Mn2+ in the SN was determined by inductively coupled plasma-atomic emission spectrometry (ICP-AES), and the positive expression of tyrosine hydroxylase (TH) was measured by immunohistochemical staining to determine whether rats with manganese-induced parkinsonism were successfully produced. The expression of DMT1 and FP1 in SN was measured by immunohistochemical staining and fluorescent quantitative polymerase chain reaction.

RESULTSRats with manganese-induced parkinsonism were successfully produced using the above method. Compared with that in the control group, the concentrations of Mn2+ in the SN of rats exposed to 5, 15, and 20 mg/kg Mn2+ were significantly higher (1.72?0.33 vs 0.56 ± 0.20 µg/g, P<0.01; 2.92±0.77 vs 0.56±0.20 µg/g, P<0.01; 5.65±1.60 vs 0.56±0.20 µg/g, P<0.01). The mean ODs of TH-positive cells in the SN of rats exposed to 5, 15, and 20 mg/kg Mn+ were significantly lower than that in the control group (0.054±0.008 vs 0.109±0.019, P<0.01; 0.016±0.004 vs 0.109±0.019, P<0.01; 0.003±0.001 vs 0.109±0.019, P<0.01). Compared with that in the control group, the mean optical densities (ODs) of DMT1-positive cells in the SN of rats exposed to 15, and 20 mg/kg Mn2+ were significantly higher (0.062±0.004 vs 0.015±0.007, P<0.01; 0.116±0.064 vs 0.015±0.007, P<0.01). The mean ODs of FP1-positive cells in the SN of rats exposed to 5, 15, and 20 mg/kg Mn2+ were significantly lower than that in the control group (0.092±0.011 vs 0.306±0.081, P<0.01; 0.048±0.008 vs 0.306±0.081, P<0.01; 0.008±0.002 vs 0.306±0.081, P< 0.01). Rats exposed to 15 and 20 mg/kg Mn2+ had significantly higher expression of DMT1 mRNA in the SN than those in the control group (0.052±0.0126 vs 0.001±0.0004, P<0.05; 0.124±0.0299 vs 0.001±0.0004, P<0.05). However, rats exposed to 5, 15, and 20 mg/kg Mn2 had significantly lower expression of FP1 mRNA in the SN than those in the control group (0.059±0.0076 vs 0.162±0.0463, P<0.05; 0.033±0.0094 vs 0.162±0.0463, P< 0.05; 0.002±0.0007 vs 0.162±0.0463, P<0.05).

CONCLUSIONThe increased expression of DMT1 and reduced expression of FP1 may be involved in the processes of Mn2+ accumulation in the SN and dopaminergic neuron loss in rats with manganese-induced parkinsonism.

Animals ; Cation Transport Proteins ; metabolism ; Disease Models, Animal ; Manganese ; adverse effects ; Parkinsonian Disorders ; chemically induced ; metabolism ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Substantia Nigra ; metabolism ; physiopathology