Objective To evaluate the clinical value of computed tomography (CT) examination in the etiologic diagnosis of small bowel obstruction.Methods From January 2010 to September 2013,a total of 237 patients with small bowel obstruction confirmed by operation were enrolled.The clinical data of all patients were collected.The diagnostic value of color Doppler ultrasound and abdominal CT examination were compared in estimating site of obstruction,etiology of obstruction and strangulation obstruction.Chi square test was performed for count data comparison.Results Among 237 patients with small bowel obstruction,there were 121 patients with data of both color Doppler ultrasound and abdominal CT examination.After operation,it was comfirmed that the accurate diagnosis rates of abdominal CT scan in the site of obstruction,the etiology of obstruction and strangulation obstruction were 75.2 ％ (91/121),66.1％ (80/121) and 87.2％ (41/47),respectively,and which were higher than those of abdominal color ultrasound (44.6％,54/121; 30.6％,37/121 and 42.6％,20/47).The differences were statistically significant (x2 =23.555,30.595 and 20.593,all P＜0.01).Conclusion The accurate diagnosis rates of abdominal CT scan in estimating the site of obstruction,the etiology of obstruction and strangulation obstruction were higher than those of color Doppler ultrasound,especially with obvious advantage in judging the etiology of obstruction.

Objective To investigate the effects of left dorsolateral prefrontal cortex with 10HZ , 80%motor threshold repetitive transcranial magnetic stimulation ( rTMS ) on the cognitive function in unipolar depression. Method Sixty-nine patients with unipolar depression were randomly assigned to either the real rTMS group or the sham rTMS treatment( the control group) ,all patients were given extended releasing venlafaxine. the cognitive function was evaluated using P300 and Repeatable battery for the assessment of neuropsychological status ( RBANS-immediate memory, visuospatial, language, attention, delayed memory, total score), Wisconsin card sorting test ( WCST-Right responses, Completed categories, Total errors , Preservative errors, Nonpreservative errors ). The depression severity was assessed with the 24-item Hamilton Rating Scale for Depression(HAMD-24). All of tests were examined before and after six weeks with thirty times rTMS. Results At the end of six weeks treatments, regarding the WCST,real rTMS group showed better improvement in the right responses than control group(33.23±10.29 vs 27.09 ± 9.82, F= 16. 116 , P= 0. 000), besides right responses, real rTMS group had better performance in the rest items than control group(F=4.862 ～ 17.758, P= 0.031 ～ 0.000) ;concerning the RBANS, real rTMS group was significantly superior to control group in total score( (88.83 ± 16.48 ) vs (78.85 ± 13.51 ), F= 8. 425,P = 0. 005 ), besides total score , the real rTMS group had better performance in some rest factors than control group (F= 10.088 ～20. 801, P=0. 002 ～0.000);real rTMS group showed better improvement in the amplitude of P3than control group( (8.27 ± 2.97 ) μV vs ( 7.37 ± 2.66) μV, F= 5. 838 , P=0.018 ) ;real rTMS group demonstrated better improvement in HAMD-24 than control group( (4.7 ±2.4)vs ( 11.2 ±5.1 ), F= 29.537, P=0. 000).Conclusion rTMS can significantly improve cognitive function and depressive symptoms with unipolar depression.

Objective To analyze the plasma free fatty acid (FFA) composition in patients with T2DM. Methods All subjects were from Zhongnan hospital of Wuhan university, and they were divided into three groups: normal control ( n = 94 ), T2DM ( n = 101 ) and T2DM with hyperlipidemia ( n = 77 ). Fasting blood samples were taken from the participants, and plasma FFA were separated using a modified Doles method with the bromoacetophenone, pre-column-derivative. The quantitation of FFA was performed on were (355.63 ± 100. 35) μmol/L, (421.21 ± 200. 83 ) μ mol/L, ( 473.04 ± 213.40 ) μmol/L in healthy controls, T2DM group and T2DM with hyperlipidemia group, respectively. The significant differences were observed among the 3 groups(x2 = 13.08, P <0.01 ). However, there was no significant difference of UFA concentrations among the 3 groups [(206.29± 61.94) μ mol/L, (218.11 ± 110.28) μmol/L and ( 240.94 ± 116.79 ) μmol/L, x2 = 2.17, P > 0.05]. Compared to normal control [( 355.63 ± 100.35 )μmol/L], the FFA concentration[(421.21 ±200.83) μmol/L] in T2DM has significantly increased (x2 =FFA concentrations were higher in T2DM with hyperlipidemia [(473.04 ±213.40) μmol/L] (x2 =27.93,P <0.01 ). The RSD values for intra- and inter-day precision were less than 5%, and the minimal detection limits ranged from 0.05 μmol/L to 0.35 μmol/L The recoveries of high, intermediate and low-level materials were 96.4% -104.8%. Conclusions The total FFA concentration in T2DM has increased, most of which are saturated FFA. The unsaturated FFA has not significantly increased. They seem to be related to the development of T2DM, and might be a new biomarker for clinical monitoring of metabolic disorder of T2DM.

Objective To investigate the serum superoxide dismutase( SOD) ,malondialdehyde ( MDA) , and nitric oxide( NO) level in generalized anxiety disorder ( GAD) patients for exploring the importance of oxida?tive stress in etiology of GAD. Methods 42 cases of first episode patients with GAD ( GAD group) and 42 cases of health ( control group) matched with age and gender were included . Serum levels of SOD,MDA ,and NO were tested to analyze for a control study.Results GAD patients had significantly higher levels of SOD,MAD and NO than health controls ((858.09±137.32)×102 U/L vs (745.40±119.19) ×102 U/L;(10.92±3.42)mmol/L vs (7.52±2.32)mmol/L;(74.32±12.34) μmol/L vs(65.22±14.29) μmol/L), t=4.036,5.368,3.297;P=0.000, 0.000,0.003) . A positive relationship between SOD and total score of Hamilton Anxiety Scale( HAMA ) ,psychotic anxiety factor of HAMA,or somatic anxiety factor of HAMA was found in GAD group ( r=0.331,0.370,0.318;P=0.029,0.016,0.040).The level of MAD correlated with total score or psychotic anxiety factor of HAMA( r=0.311, 0.320;P=0.042,0.039).Conclusion It is suggested that the dysfunction of oxidative stress may play a role in pathogenesis of generalized anxiety disorder.

Objective To study the liver fat content (LFC) in schizophrenia patients during olanzapine or aripipra?zol treatment, and to explore the relation between LFC and insulin resistance (IR). Methods Schizophrenia patients were randomly administered with olanzapine (10~25 mg/d, n=57) or aripiprazole (15~30 mg/d, n=47) for eight weeks. All sub?jects underwent sonographic quantification of LFC and homeostasis model assessment of insulin resistance index (HOMA-IR) once 0, 4, 8 weeks of treatment. Results Compared with baseline, the levels of HOMA-IR significantly in?creased after a 4-week and an 8-week of olanzapine treatment, and so did the LFC after an 8-week of olanzapine treat?ment (P<0.05). The levels of LFC (P>0.05) or HOMA-IR (P>0.05) did not significantly changed at week 4 and 8 in ar?ipiprazol group. The increment of LFC, HOMA-IR at week 8 was significantly higher in olanzapine group than that in ar?ipiprazol group (P<0.05). The change of LFC after 8-weeks olanzapine treatment was positively correlated with the change of HOMA-IR (r=0.298, P=0.036). Conclusion Olanzapine treatment increases whereas aripiprazol has little ef?fect on liver fat and insulin resistance in schizophrenia.

ObjectiveTo explore the relationship between brain iron deposition and pathogenesis of tardive dyskinesia (TD) in schizophrenia.MethodsThe corrected phase (CP) of basal ganglia was measured in schizophrenia with TD( n=18) and without TD( n =18 ) using susceptibility weighted imaging MRI.Abnormal Involuntary Movement Scale (AIMS) was applied for clinical assessment of TD.ResultsAfter adjusting for age,sexual,and antipsychotic dosage,the mean CP of substantia nigra (SN) and caudate nucleus (CN) were significantly lower in schizophrenia patients with TD ( ( - 0.194 ± 0.040 ) rad,( - 0.089 ± 0.023 ) rad) than those without TD ( ( - 0.163 ± 0.033 ) rad,( - 0.076 ± 0.013 ) rad ; P =0.022,0.023 ).Lower mean CP in CN correlated with higher severity score of AIMS in TD patients ( r =- 0.468,P =0.034).Logistic regression analysis showed that the lower CP vaule in SN (β=-72.12,P=0.029) and CN(β=- 156.43,P=0.037),aging (β=0.379,P=0.042)were associated with the onset of TD.ConclusionThe results imply that the excess iron accumulation in basal ganglia may be associated with pathogenesis of TD in schizophrenia.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS) treatment on the brain derived neurotrophic factor(BDNF) serum levels in depressive patients.Methods Sixty-eight unipolar depressions treated with venlafaxine were randomly assigned to the real rTMS group(n =34)and the sham rTMS group(n =34),which were accepted the real or the shame rTMS treatment on the left dorsolateral prefrontal lobes respectively.The Hamilton Rating Scale for Depression (HAMD) and BDNF serum was assayed before and after 4 weeks' treatment.Results 1) A significant increase of serum BDNF((12.2 ± 1.3) μg/L vs (5.6 ± 0.8) μg/L,t=-9.167,P=0.000;(11.4 ± 1.5)μg/L vs (6.0± 1.0)μg/L,t=-7.421,P=0.000)and a significant decline of HAMD((11.6 ± 1.7) score vs (32.6 ± 2.5) score,t =14.654,P =0.000 ; (4.2 ± 2.8) score vs (31.8 ± 3.2)score,t=12.089,P =0.000) were found after the treatment in the real and the shame group,and the real group changed more significantly than the shame group ((6.7 ± 0.8) μg/L vs (5.1 ± l.2) μg/L,t =2.690,P =0.009 ; (21.0 ± 2.1) score vs (17.6 ± 2.6) score,t =2.693,P =0.000).2) A negative correlation was found between the serum BDNF levels and the HAM D scores before the treatment(r =-0.530,P=0.003; r =-0.490,P =0.004),and a positive correlation between changes of BDNF levels and HAMD scores changes(r =0.439,P =0.006 ; r =0.454,P =0.005).Conclusion The rTMS treatment can increase serum BDNF levels in depressive patients.

Objective To explore microsurgical treatment of tuberculum sellae meningiomas.Methods A retrospective analysis was made on 35 cases of tuberculum sellae meningiomas operated from January 2005 to July 2013 in neurosurgery department of Sun Yat-sen Memorial Hospital,surgical approach,removal rate,surgical effect and complications were analysed.Results All patients were accepted microsurgical treatment,twenty cases were operated via subfrontal approach,four cases via anterior interhemispheric approach,ten cases via pterional approach,one case via combined subfrontal and pterional approach.According to Simpson grade,grade Ⅱ,rection was achieved in 26 cases,grade Ⅲ in 4 cases and grade Ⅳ in 5 cases.The total rection rate was 85.7％.There were 28 cases with merger ision loss and visual field defects preoperate,twenty cases were improved after operation,five cases with no change,three cases aggravated.The visual improved rate was achieved 71.4％,there was no surgical mortality case.Conclusion The surround tissue of tuberculum sellae meningiomas is very import ant,microsurgical rection is the main treatment.The choice of surgical approach should according to tumor size,growth pattern,degree of impaired vision and surgeon experience.Family with microanatomy and skillfull microsurgical techique can make sure operation succes.

Objective To investigate the biological function of miR-622 in human gastric cancer cell lines of SGC-7901 and NCI-N87 cells and its role in gastric carcinogenesis.Methods We analyzed the expression of miR-622 in those human gastric cancer cell lines by quantitative real-time polymerase chain reaction.Tumorigenesis,migration and invasion ability of miR-622 overexpression was assessed in vitro with miR-622 precursor and inhibitor in in SGC-7901 and NCI-N87 cells.Results The expression level of miR-622 in SGC 7901 was 1.29 ± 0.57,and it was 10.96 ± 1.02 in NCI-N87 cells.The soft agar colony formation rate was 76％ in SGC-7901 after transfecting miR-331-3p precursor,the ability of scratch healing was ( 11 ±7) μm,and the ability of transwell invasion was (731 ±3),compared with that in control group,the differences were statistically significant ( P ＜ 0.05 ).Conclusions Over-expression of miR-622 promotes tumorigenesis,migration,and invasion in gastric cancer cells in vitro.

Objective To evaluate the harmful effects of olanzapine and quetiapine therapeusis on swallowing ability in patients with Alzheimer'disease (AD).Methods AD inpatients with behavioral and psychological symptoms were randomly divided into two groups,treated with olanzapine (n=42) or quetiapine (n=38) for 6 weeks.The patients were assessed with Kubota's water swallowing test and arterial oxygen saturation(SaO2) monitoring pre and pro treatment.Results After treatment,a significant higher score of water swallowing test (t =2.682,2.040;both P＜ 0.05)in either of two groups,and a significant raised degrade of SaO2 only in olanzapine group(t=4.313,P＜0.01)but not in quetiapine group (P＞0.05)were observed.There was a significant higher degrade of SaO2 in olanzapine group than that in quetiapine group (t=2.155,P＜0.05)at 6 weekend of the study.Before pharmacon,about 29％ (23/80) AD subjects were diagnosed as dysphagia.After pharmacon,more emerging dysphagia patients were surveyed in olanzapine group compared with that in quetiapine group(9/31 vs 2/26,x2=4.135,P＜0.05).No significant change (both P＞0.05) in scores of mini-mental state examination(MMSE) and a significant reduced score(t=3.019,2.867;both P＜0.01)of behavioral pathology in Alzheimer'disease rating scale (BEHAVE-AD) were found in both two groups at the end of study.There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment(both P＞0.05).Conclusion Either olanzapine or quetiapine therapeutics might do some harmful effects on swallowing function in patients with AD,especially the former.