Objective To study the effects of antidepressant treatment on living quality of patients at stable stage of COPD with depression. Methods 43 cases at stable stage of COPD with depression were randomly divided into treatment group( n = 22) and control group( n = 21 ). The control group were given appropriate bronchodilators and disperse phlegm with common;the treatment group were given zoleft(50mg, 1 time/d, 6 weeks and 10 weeks) based on the control group. Lung function, nutritional status and quality of life score before and after inpatient treat-ment were determined. Results There was significant difference on lung function, nutritional status and quality of life score between the treatment group before and after inpatient treatment( P < 0.05 ～ P < 0.01 ). There was no significant difference in the control group (P > 0.05 ). Conclusion Antidepressant treatment on patients at stable stage of COPD with depression is very important for improving the quality of life.

About 50％ to 60％ of the stage Ⅱ-Ⅲ colorectal carcinoma patient suffer from liver metastases.Recently,there is a research hotspot on how to improve the prognosis of the colorectal carcinoma liver metastases (CRLM) patient.It can elucidate the way how the carcinoma cells transfer from the original tumor to the liver,through establishing a CRLM animal model.An ideal CRLM animal model should perfectly mimic the total procedure of the metastases pathway,including the change of the cytology behavior and the development of the tumor biology.Besides,the model should be practical,tumor-predictable and accord with the ethical consideration.Until now,there is not an ideal CRLM animal model can perfectly match those conditions.This review goes through the advantages and disadvantages of different CRLM animal model methods used for research.

Objective To observe the protection effects of sodium ?-aescinate(SA) on the nervous function in the rats with early spinal cord injury(SCI). Methods One hundred and twenty SD rats were randomly divided into four groups(n=30).Rats in the blank control group were performed laminectomy only,while those in the other three groups were injured at the level of Tl1 spinal segment by Allen's weight drop method(10 g ?10 cm) and immediately intraperitoneally given normal saline(5.0 mg/kg)(control group), SA(5.0 mg/kg)(SA group) and methylprednisolone(100 mg/kg)(MP group) once daily,respectively.After 8 h,24 h,96 h,7 d and 14 d,spinal cord function change of posterior limb were determined with Rivlin method.The rats were sacrificed and the injured segments were resected for pathological analysis. Results As time prolonged,the rehabilitation of spinal cord function with various degree could be observed in each group.Function rehabilitation was found among the rats in the control group,SA group and MP group 96 h after injury,and more rehabilitation was gained later in the latter two groups,while that was not the case in the control group.Rats in the SA and MP group gained more significant rehabilitation than those in the control group(P0.05).It was revealed by pathological analysis that no necrotic neurons was found in the blank control group,and the necrotic neurons in the SA group and MP group were significantly less than the control group at the same time points(P

Objective To evaluate the value of 2D ultrasound and elastic strain ratio (SR) in diagnosis of thyroid nodule by fine needle aspiration (FNA).Methods 196 thyroid nodules were analyzed retrospectively with 2D ultrasound,elastography and FNA results,pathology results as the golden standard.A receiver operating characteristic (ROC) curve was used to identify the best cut-off point of SR.The Logistic regression analysis was used to evaluate the variables effectiveness on age,nodule echo,calcification and SR.Tried to discuss how to use SR before or after US-FNA in diagnosis of thyroid nodule.Results The SR of the malignant nodules group was significantly different from the benign nodules group,and the best cut-off point was 0.5 with sensitivity 91.7％,specificity 90.2 ％ and accuracy 90.8 ％.The Logistic analysis results were SR,age,echo,calcification according to the odds ratio.SR can screened nodules without puncture necessary before FNA,and increase the FNA sensitivity,specificity and accuracy after FNA.Conclusions SR has good application value in diagnosis thyroid malignant tumor.SR can reduce unnecessary FNA and make a supplementary diagnosis of FNA.

Objective To assess the effect of three different liver vascular exclusions on prognosis of patients undergoing hemihepatectomy.Methods Clinical data of 216 patients undergoing hemihepatectomy were analyzed retrospectively.Ninety-eight out of 216 patients received Pringle maneuver during hepatectomy in group A,71 patients of selective liver inflow and outflow vascular exclusions in group B,47 patients using liver hanging maneuver combining with selective liver inflow and outflow vascular exclusions were in group C.Results There was no difference in operation time between the three groups ( t =0.72,0.83,and 0.67,P ＞ 0.05 ).The intraoperative blood loss and transfusion in group B and C were less than that in group A (t =3.72,3.83 and 4.11,4.07,P ＜0.05).Serum albumin level on day 1 and day 3 in group B and C were higher than that in group A (t =3.65,3.77,and 3.90,3.74,P ＜0.05 ).Serum total bilirubin level on day 3 and 5 in group B and C were lower than that in group A ( t =4.13,5.01,and 4.09,3.99,P ＜0.05).Serum alanine aminotransferase on day 1,3 and 5 in group B and C were lower than that in group A ( t =5.36,6.14,and 5.70,7.01,and 4.94,3.98,P ＜ 0.05 ).Postoperative complication rate in group A was higher than that in group B and C ( x2 =13.71 and 23.56,P ＜ 0.05 ).The 3-year survival rate of patients with malignant tumor in the three groups were not significantly different (t =2.38,P ＞ 0.05 ).Conclusions Intraoperative blood loss and transfusion and postoperative complication rate can be reduced,and liver injury can be diminished in hemihepatectomy using selective liver inflow and outflow vascular exclusion alone and or in combination with a liver hanging maneuver.

Objective To detect the role of AP-1 or ETS-1 transcription factor binding sites (TFBS) in activity of DC-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN) pro-moter. Methods Genomic DNA was extracted from peripheral blood. Complete DC-SIGN promoter and those without AP-1 or ETS-1 TFBS were amplified by PCR using designed primers. The PCR products were digested with MLu Ⅰ and Bgl Ⅱ and then ligated into MLu Ⅰ and Bgl Ⅱ digested pGL-3/Basic and pGL-3/En-hancer vectors. Transfection in Hacat and 293 cells was accomplished with Trans Fast liposome. Activity of luciferase was detected after 48 h. Results The DC-SIGN promoters without AP-1 or ETS-1 TFBS and the recombined pGL-3 vectors were correctly constructed. The activity of DC-SIGN promoters without AP-1 was reduced 20% (293) and 10% (Hacat), which was 40%-50% with enhancer. The activity of DC-SIGN pro-moters without ETS-1 was nearly vanished, no matter with or without enhancer. Conclusion ETS-1 TFBS, not AP-1 TFBS, plays an important role in activity of DC-SIGN promoter.

Objective To compare the effect of repairing large perimembranous ventricular septal defect (VSD) with a new continuous stitching and two classical methods. Methods From January 2005 to January 2008,321 cases with VSD were operated. All the cases were divided into 3 groups according to operational way, with discontinuous stitching in group A (70 cases), continuous stitching in group B(116 cases),new continuous stitching in group C (135 cases). All the patients were total corrected with hypothermic cardiopulmonary bypass. Results Group C had the shortest cardiopulmonary bypass and aortic cross-clamp times [(48 ± 36) min and (26 ± 18) min]among the three groups (P < 0.05). Group C had not residual shunt and incidence rate was lowest among the three groups (P < 0.05). Temporary second degree auriculo-ventricular bolck (AVB) was found in the early stage and no third degree AVB among the three groups. Tricuspid regurgitation was higher in group A,but there was no significant difference between group B and group C. Follow-up was completed in a duration of 1-3 years and all the cases had a good health after discharged. Conclusions The new continuous stitching method has short eardiopulmonary bypass and aortic cross-clamp times. It has fewer residual shunt than other two classical methods and has no evidence of higher AVB occurrence.

Objective:To investigate the relation among platelet activation marker(GPⅡb/Ⅲa,CD62p) and amounts of fibrinogen (FG) and of D-dimer (DD) in elderly patients with chronic cor pulmonale exacerbation.Methods:Subjects were divided into four groups (42 elderly patients with chronic cor pulmonale exacerbation,42 elderly patients with chronic cor pulmonale remission stage,30cases of healthy elderly controls and 30 cases of healthy non-elderly controls).Positive rates of GPⅡb/Ⅲa and CD62p were measured with tricolor flow cytometry.We also determined FG and DD in patients with chronic cor pulmonale and in normal controls.Results:Compared with those of chronic cor pulmonale remission stage group,healthy elderly group and healthy non-elderly group,the levels of GPⅡb/Ⅲa,CD62p,FG and DD increased significantly in elderly patients with chronic cor pulmonale exacerbation (all P<0.001).There was a positive correlation between the amount of GPⅡb/Ⅲa or CD62p and the amount of FG and DD in elderly patients with chronic cor pulmonale exacerbation.Conclusion:There is increased coagulation and platelet activity in elderly patients with chronic cor pulmonale exacerbation,and there is a significant correlation between platelet activity and hypercoagulability.

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.

Objective To investigate the distribution and sequence conservation of Hap adhensin encoding gene (hap) in clinical isolates of nontypeable Haemophilus influenzae (NTHi), to screen out and identify the predominant T-and B-cell (T-B) combined antigenic epitopes on Hap protein and to analyze their immunogenicity.Methods Sequence conservation of hap genes in NTHi strains and T-B combined antigenic epitopes were predicted using bioinformatic softwares.PCR was used to amplify the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap gene (hap-5′-156 and hap-3′-855) and the amplified products were sequenced.Phage display systems of seven T-B combined antigenic epitopes located on the 55 aa segment at N-terminal and the 285 aa segment at C-terminal of Hap protein (Hap-N52 and Hap-C285) were constructed.Western blot assay and ELISA were performed to detect the antigenicity and immunoreactivity of different T-B combined epitopes displayed by recombinant phage PⅢ protein (rPⅢ).Results Hap protein encoded by the hap gene in NTHi was located on membrane surface.Sequences of the 156 bp segment at 5′-end and the 855 bp segment at 3′-end of hap genes extracted from different NTHi strains were relatively conservative, but many mutations were found in sequences at the middle regions of these hap genes.All of the 56 NTHi strains carried hap-5′-156 and hap-3′-855 segments and shared 92.3％-100％ identities in nucleotide and amino acid sequences of these segements.Hap-N5-24 in the Hap-N52 segment as well as Hap-C4-27, Hap-C28-47, Hap-C114-129, Hap-C150-173, Hap-C200-227 and Hap-C241-267 in the Hap-C285 segment was predicted as the T-B combined antigenic epitope with a higher score and less mutations.Results of Western blot assay and ELISA confirmed that the rPⅢ-displayed Hap-C4-27 and Hap-C150-173 epitopes presented clear hybridization bands with NTHi antisera, and 96.9％ (63/65) and 92.3％ (60/65) of serum samples from children with NTHi infection were positive for antibodies against Hap-C4-27 and Hap-C150-173 epitopes, respectively.Conclusion The gene of hap is widely distributed in clinical isolates of NTHi.Moreover, sequences of the 156 pb segment at 5′-end and the 855 bp segment at 3′-end of hap gene are conservative.Hap-C4-27 and Hap-C150-173 are the predominant T-B combined antigenic epitopes on Hap protein, suggesting that they can be used as epitope candidates for developing multiple antigenic peptide vaccines against NTHi.