OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Sequences analysis revealed Grass carp reovirus (GCRV) s10 was 909 nucleotides coding a 34 kDa protein denoted as VP7, which was determined to be a viral outer capsid protein (OCP). To obtain expressed OCP in vitro, a full length VP7 gene was produced by RT-PCR amplification, and the amplified fragment was cloned into T7 promoted prokaryotic expression vector pRSET. The recombinant plasmid,which was named as pR/GCRV-VP7,was then transformed into E.coli BL21 host cells. The data indicated that the expressed recombinant was in frame with the N-terminal fusion peptide. The over-expressed fusion protein was produced by inducing with IPTG, and its molecular weight was about 37kDa, which was consistent with its predicted size. In addition, the fusion protein was produced in the form of the inclusion body with their yield remaining steady at more than 60% of total bacterial protein. Moreover,the expressed protein was able to bind immunologically to anti-his-tag monoclonal antibody (mouse) and anti-GCRV serum (rabbit). This work provides a research basis for further structure and function studies of GCRV during entry into cells.

Objective To analyse the risk factors for lymph node metastasis of early colorectal cancer and the therapeutic indication for endoscopy.Methods The clinical data of the 269 early colorectal cancer patients who underwent surgical treatments between January 2009 and December 2013 in the West China hospital of Sichuan University were analyzed retrospectively.Pathologic features were compared between different histological types and investigated by univariate and multivariate analysis of their possible risk factors for lymph node metastasis.Results Univariate analysis showed that tumor size (P =0.029),depth of tumor invasion (P =0.006),histological type (P =0.000) and lymphatic involvement (P =0.035) were correlated with lymph node metastasis.Multivariate analysis revealed that tumor size (OR =5.385,95％ CI:1.156-25.075,P =0.032)and histological type (OR =5.145,95％ CI:1.553-17.053,P =0.007) were independent risk factorsfor lymph node metastasis.Comprehensive analysis showed that lymph node metastasis could not be found in patients with tumor invading the mucous layer.However,lymph node metastasis occurred if the tumor invaded the submucous layer.The larger and less differentiated tumor was,the higher occurrence of lymph node matastasis would be (P ＜ 0.05).Conclusion Endoscopic resection is recommended for those with early colorectal cancer localized in the mucous layer and without lymph node metastasis.It is recommended that patients with submucosal carcinomas undergo a preoperative endoscopic ultrasonography or pathological screening for the most appropriate surgical treatment,as the larger and the lower differentiated the tumor is,the higher chance the lymphatic metastasis is.

Objective To investigate the clinical outcomes of percutaneous kyphoplasty (PKP) for treatment of vertebral compression fractures in perimenpausal women.Methods A total of 53 perimenopausal patients (70 vertebrae) undergone PKP for vertebral compression fractures from January 2007 to May 2014 were analyzed retrospectively by case-control study.Thirty-six patients had single vertebral fractures and 17 two-level vertebral fractures.The fracture segments included 5 T11 vertebrae,14 T12 vertebrae,30 L1 vertebrae,12 L2 vertebrae and 9 L3 vertebrae.Ratio of vertebral compression was 10％-30％.According to treatment difference,the patients were divided into PKP group and non-operation group.In PKP group,there were 30 patients with age range of 44-54 years (mean,51.0 years),and the fracture segments included 13 T11 vertebrae,11 T12 vertebrae,17 L1 vertebrae,7 L2 vertebrae,3 L3 vertebrae.In non-operation group,there were 23 patients with age range of 44-54 years (mean,50.5 years),and the fracture segments included 2 T11 vertebrae,3 T12 vertebrae,13 L1 vertebrae,5 L2 vertebrae,6 L3 vertebrae.Visual analogue scale (VAS),Oswesty disability index (ODI),vertebral compression rate,Cobb angle and bone mineral density change were compared preoperatively,2 weeks,6 months and 3 years after operation.Results All patients were followed up for 6-36 months.VAS and ODI were improved compared with preoperative status in two groups at 2 weeks,6 months and 3 years (P ＜ 0.01).VAS and ODI in PKP group were significantly decreased at 2 weeks and 6 months compared with non-operation group (P ＜ 0.01).The Cobb angle and vertebral compression rate in non-operation group were improved at 6 months compared with those in preoperative status (P ＜ 0.05),and a consistent increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group were reduced at 6 months compared with preoperative status (P ＜ 0.05),and an increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group did not increase at 6 months and 3 years,but they had significant increase in non-operation group (P ＜ 0.05).The body mass index in non-operation group decreased at different degrees at 6 months and 3 years,compared with preoperative status (P ＜ 0.05),while the body mass index reduction in PKP group had no statistically significant difference (P ＞ 0.05).The body mass index reduction in PKP group was less than that in non-operation group at 3 years (P ＜0.01).The body mass index reduction in PKP group was slow and had no statistically significant difference compared with preoperative status (P ＞ 0.05).The body mass index reduction in non-operation group was fast and had significant decrease compared with preoperative status (P ＜ 0.05).Conclusion PKP can relieve pain for vertebral compression fractures in perimenopausal women in short term and long term,and PKP can also improve spinal kyphosis and prohibit the decline of bone mineral density.

Humans ; Pancreaticoduodenectomy ; Pathology, Clinical ; Perioperative Period ; Postoperative Period ; Preoperative Period

Objective To explore the association between interleukin 28B (IL-28B),equilibrative nucleoside transporters 1 (ENT1) gene polymorphisms and spontaneous clearance of HCV in HIV/HCV co-infectors in Hunan province.Methods Genotypes of IL-28B and ENT1 (rs12980275,rs12979860,rs8099917 and rs760370) were analyzed in 107 HIV/HCV co-infectors in Hunan province and the distributions of gene polymorphisms were compared between chronic hepatitis and spontaneous clearance groups.Results The major genotypes in rs12980275,rs12979860 and rs8099917 of IL-28B were AA,CC and TT in HIV/HCV co-infectors,which accounted for 84.1％ of each.The three single nucleotide polymorphisms were highly linkage disequilibrium (r2＞0.94) and the differences of genotype distribution were statistically significant between chronic hepatitis and the spontaneous clearance groups (P＜0.05).Infectors which carrying the major genotypes were more susceptible to spontaneous clearance of HCV.Differences of the genotype distributions in rs760370 of ENT1 were not statistically significant between the two groups.Conclusion Genotypes AA,CC and TT of IL-28B were related to spontaneous clearance of HCV in HIV/HCV co-infectors.

Objective To detect the transcription factors of copper ion (Cu,2+) metabolism and oxidative stress by Candida albicans knocked down different transcription factors.Methods Spot assay, growth curve were used.Results The sensitivity to Cu,2+ in Cup2Δ/Δ was increasing and the growth of Cup2Δ/Δ was inhibited in 5 mmol /L Cu,2+ medium.The results showed that Cup2Δ/Δ also increased the sensitivity to H2O2, interestingly, Cu,2+and H2O2 played a synergistic antifungal effect.The tolerance of Cup2Δ/Δ and SN250 to H2O2 induced oxidative stress was increased after BCS chelating Cu,2+.In the fluconazole, miconazole and ketoconazole susceptibility experiments, Cup2Δ/Δ did not show susceptibility to azole drugs.Conclusion Knockout transcription factor Cup2, which could increase the sensitivity to Cu,2+ and H2O2in Candida albicans.Transcription factor Cup2 might be involved in the regulation and control of Candida albicansmetabolism on Cu,2+ and oxidative stress induced by H2O2, but not involved in the regulation and control of drug resistance to azole drugs.

Objective:To investigate risk factors for vascular cognitive impairment(VCI)in elderly patients 12-18 months after the onset of acute partial anterior circulation infarction(PACI), and to establish a diagnostic and predictive model.Methods:This was a prospective study. Demographic characteristics, vascular risk factors and laboratory data of 148 patients with acute PACI were collected, and patients were followed up for 12-18 months.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate patients' cognitive function.Logistic stepwise regression was used to screen risk factors for VCI.We established a diagnostic and predictive model.The area under the receiver operating(ROC)curve(AUC)was used to evaluate the efficiency of the model.Results:A total of 126 subjects completed the 12-18 month follow-up.Multivariate logistic regression analysis found that high homocysteine(Hcy)( OR=1.082, 95% CI: 1.002-1.167), high glycated hemoglobin(HbA1c)( OR=1.653, 95% CI: 1.052-2.598), high National Institutes of Health Stroke Scale(NIHSS)score( OR=1.291, 95% CI: 1.098-1.518), high hypersensitive C-reactive protein(hs-CRP)( OR=1.026, 95% CI: 1.005-1.047)and low education level( OR=2.485, 95% CI: 1.231-5.018)were independent risk factors for VCI in patients 12-18 months after PACI( P<0.05). The AUC of the diagnostic and predictive model was 0.828(95% CI: 0.755-0.902). Conclusions:High Hcy, NIHSS score, hs-CRP and low education level are independent risk factors for VCI in patients 12-18 months after PACI.The diagnostic and predictive model can help to screen patients at high-risk for VCI, so that timely clinical recognition, diagnosis and treatment can be made after acute PACI.

Objective:To investigate the current nutrition support status of hospitalized small for gestational age infants born late preterm in hospitals of Beijing, and analyze the influencing factors.Methods:Clinical data of late preterm infants from 25 medical units in Beijing between October 2015 and October 2017 was collected and analyzed. Infants were assigned into two groups according to the relationship between their gestational age and birth body weight as small for gestational age(SGA) group and not small for gestational age(non-SGA) group, to compare their nutritional status and explore the related influential factors.Results:Totally, 1 347 late preterm infants were enrolled, including 730 males and 617 females, 151 in SGA group and 1 196 in non-SGA group. The data showed that the rate of exclusive breast-feeding was higher (5.3% vs 4.5%, P<0.01), and the increasing of milk volume was slower [11.0 vs 12.1 ml/(kg·d), P=0.003] in SGA group. More parenteral nutrition was used (77.5% vs 53.1%, P<0.01), and the duration of parenteral nutrition was longer (5.0 vs 2.0 days, P<0.01) in SGA group. The birth weight(1 940 vs 2 490 g, P<0.01), the lowest body weight(1 890 vs 2 400 g, P<0.01) and the discharged body weight(2 135 vs 2 530 g, P<0.01)were lower in SGA group. The SGA group showed lower body weight loss(3.1% vs 8.0%, P=0.015), slower weight growth(13.3 vs 33.0 g/d, P<0.01), and longer length of hospital stay (11.0 vs 8.0 days, P<0.01). In SGA group, the milk volume at discharge [145.6 vs 122.2 ml/(kg·d), P<0.01] and the caloric of enteral feeding at discharge [443.9 vs 384.1 kJ/(kg·d), P<0.01] were higher, the rate of infants who regained their birth weight during hospitalization(78.8% vs 57.9%, P<0.01) was higher, and the rate of ones who achieve full enteral feeding (31.8% vs 16.6%, P<0.01) was higher. A Cox regression analysis in which we set infants can achieve full enteral feeding as goal showed that independent factors associated with full enteral feeding at discharge in SGA group included the increasing of enteral feeding, the duration of parenteral nutrition, whether the length of hospital stay longer than 7 days or not whether exclusive breastfeeding and whether the mothers of enrolled infants were diagnosed gestational diabetes mellitus or placental abruption during pregnancy ( P<0.05). Conclusions:Infants in SGA group show slower increasing of milk volume and lower caloric amount of enteral feeding. More parenteral nutrition is used, and the duration of parenteral nutrition is longer in SGA group. Due to the longer length of hospital stay in SGA group, the milk volume and the caloric of enteral feeding at discharge are higher, more infants regain their birth weight during hospitalization, and more infants achieve full enteral feeding at discharge. Despite of higher portion of parenteral nutrition, infants in SGA group show slower weight growth and lower body weight at discharge.

Objective:To investigate the effects of long non-coding RNA (lncRNA) Gm13568 on the activation of A1 astrocytes and the progress of experimental autoimmune encephalomyelitis (EAE) in mice.Methods:A recombinant lentiviral vector (LV-Inhibit-Gm13568) carrying astrocyte-specific promoter of glial fibrillary acidic protein (GFAP) was established to inhibit the function of endogenous Gm13568. A control vector (LV-ctrl) was established as well. The recombinant vectors were packaged. C57BL/6 mice were injected with 1×10 7 transforming units of viral suspension via the tail vein and 7 d after the injection, myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55) was used to establish the mouse model of EAE. Four groups, PBS group, EAE group, LV-ctrl+ EAE group and LV-Inhibit-Gm13568+ EAE group, were included in this study. Clinical signs of the mice were monitored daily in a double-blinded manner. The mice were sacrificed 23 d after the EAE model was established and the spinal cord tissues were collected. The expression of Serping 1, C3, Srgn and H2-T23 at mRNA level was detected by real-time PCR. Changes in the expression of IL-6, TNF-α, macrophage chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) were measured. Western blot was used to investigate the expression of GFAP and Notch1 in spinal cord tissues and the phosphorylation of signal transduction and transcription activator 3 (STAT3). The expression of Notch1 intracellular domain (NICD) and GFAP in spinal cord tissues was detected by immunofluorescence. Furthermore, the infiltration of inflammatory cells and the demyelination of spinal cord were observed using HE and Luxol fast blue (LFB) staining methods. Results:Compared with PBS group, A1 astrocytes were activated and Notch1 expression was significantly up-regulated in EAE group and LV-ctrl+ EAE group. The clinical score of mice in LV-Inhibit-Gm13568+ EAE group was decreased from an average score of 3.5 to less than 1 on 23 d after antigen induction and the clinical symptoms were alleviated as compared with the mice in LV-ctrl+ EAE group. Meanwhile, the activation of A1 astrocytes was down-regulated, and the production of inflammatory cytokines and chemokines was also reduced. The expression of Notch1, GFAP and NICD at protein level and the phosphorylation of STAT3 were significantly reduced. Moreover, the infiltration of inflammatory cells and demyelination of spinal cord tissues were alleviated significantly.Conclusions:LncRNA Gm13568 might regulate the activation of A1 astrocytes via the Notch1/STAT3 pathway, thus affecting the production of inflammatory cytokines and chemokines and participating in the process of EAE.