Post-stroke depression (PSD) is a common complication of stroke. Its patogenesis is complex, mainly including the mechanisms of neurobiotogy and social psychology. So far, there has been no uniform conclusion both at home and abroad. Now it is considered that PSD is the results of comprehensive effect of various neurobiology and social psychology, and its onset is in accordance with the bio-psycho-social medical model.

Objective To investigate the effect of escitalopram on the levels of serum proinflammatory cytokine interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),and IL-18 in a rat model of poststroke depression (PSD).Methods Twenty-four male Sprague-Dawley rats were randomly allocated into sham operation,middle cerebral artery occlusion (MCAO),PSD and escitalopram groups (n =6 in each group).A model of MCAO was induced by the intraluminal suture method,and on this basis,a PSD model was induced by combining with chronic unpredictable mild stress (CUMS) plus lonely upbringing.The rats of both the sham operation group and the MCAO group were neither CUMS nor lonely upbringing,and in the PSD group they were both CUMS and lonely upbringing.The escitalopram group was given escitalopram intervention (10 mg/kg · d,intraperitoneal injection for 3 weeks) at the beginning of CUMS and lonely upbringing.At baseline and on day 7,14 and 21 after CUMS,sucrose solution consumption and wilderness trials were used to assess depression-like behavior.Enzyme-linked immunosorbent assay was used to detect the levels of serum proinflammatory cytokines IL-6,TNF-α and IL-18 on day 21 after CUMS.Results On day 21 after CUMS,the scores of weight,sucrose solution consumption,vertical test and the distance of horizontal activities were all significantly decreased and shortened compared to those of the sham operation group and the MCAO group (all P＜0.01).The weight,sucrose solution consumption,and the distance of horizontal activities of the escitalopram group were significantly increased compared to those of the PSD group (P ＜0.05 or P ＜0.01).On day 22 after CUMS,the serum IL-18 level of the PSD group was increased significantly compared to that of the sham operation group and the MCAO group (P ＜ 0.05 or P ＜ 0.01).The serum IL-18 level of the escitalopram group was decreased significantly compared to that of the PSD group (P ＜0.05).However,there were no significant differences in the levels of IL-6 and TNF-α among all the groups.Correlation analysis showed that on day 22 after CUMS,the serum IL-18 level and sucrose solution consumption (r =-0.415,P =0.044),the distance of horizontal activities in the wilderness trials (r =-0.508,P =0.011) showed a significant negative correlation,however,they did not have significant correlation with the vertical score (r =-0.390,P=0.059) and the body weight (r=-0.216,P=0.311).Conclusions The serum IL-18 level is increased significantly in the PSD rat models.Escitalopram can significantly decrease the serum IL-18 level and improve depression-like behavior of the PSD rats,suggesting that IL-18 may play a role in the pathogenesis of PSD.

Serum KL-6 is a category of glycoprotein coded by the epithelium of sticky protein 1(MUC1) gene,which has already been regarded as an indicator of interstitial lung diseases,and later found highly expressed in part of malignant tumor patients.In recent years,studies has found that serum KL-6 is associated with the incidence of radioactive pneumonia,and monitoring serum KL-6 can predict the occurrence of radioactive pneumonia as well assess the severity and prognosis of disease.

Objective To evaluate the anatomic relationships between the portals and radial nerve of three different operations of antrolateral approach elbow arthroscopy.Methods The dissections were pedormed in 10 formalin soaked adult cadaver elbows.The distances from the three different antrolateral portals to the radial nerve in extension and flexion 90° position were measured.The portal A was located at 3 cm distal and 1 cm anterior to the lateral epicondyle;the portal B was located at 2 cm distal and 2 cm anterior to the lateral epicondyle;the portal C,1 cm distal and 1 cm anterior to the lateral epicondyle.Results The nearest distances from the anterolateral portal A,B,and C to the radial nerve in extension position were (2.30 ± 0.95) mm,(3.00 ± 1.56) mm,and (3.60 ± 1.65) mm,with significant differences (F =11.097,P =0.001).Statistical difference in distances from the anterolateral portal to the radial nerve between portal A and C was found (P =0.006).No statistically significant difference was seen between A and B or B and C (PA-B =0.134,PB-c =0.072).The distances from the anterolateral portal A,B,and C to the radial nerve in flexion 90° position were (4.40 ± 2.01) mm,(6.10 ± 1.79) mm,and (7.90 ± 1.85) mm,with significant differences (F =54.775,P =0.000).There were statistically significant difference among the three approaches (PA-B =0.000,PA-c =0.000,PB-c =0.002).The distances increased when the position changed from extension to flexion 90° for portal A (t =-5.161,P =0.001),portal B (t=-8.188,P=0.000),and portal C (t =-10.167,P =0.000).Conclusion The anterolateral portal 1 cm distal and 1 cm anterior to the lateral epicondyle is the safest apporach.

Objective To investigate the pharmacokinetic profiles of baicalin and wogonoside in diabe-tic rats in vivo,which are two major constituents in Huanglian-Jiedu Decoction(HJD).Methods The diabetic rats were induced by ip administration of streptozotocin(STZ).After the establishment of the method and the set-up of diabetic rats,the pharmacokinetic profiles of baicalin and wogonoside were investigated.Diabetic and normal rats were ig HJD extract,and then the blood samples were collected at the given time points.Contents of baicalin and wogonoside in diabetic and normal rat plasma were assayed by HPLC-UV method.The pharmacokinetic parameters(except Cmax and tmax) were analyzed by noncompartmental method.The area under the serum concentration-time curve(AUC0-t) was calculated using trapezoidal rule to the last point.Moreover,the presystemic metabolism of baicalin was investigated and compared to explore the pharmacokinetic difference by fermentation of baicalin in feces suspensions of normal and diabetic rats,respectively.Results The pharmacokinetic parameters of baicalin in normal and diabe-tic rats were:(4.50?1.92) and(7.5?1.0) h for tmax 2;(2.83?0.25) and(9.54?2.87) ?g/mL for Cmax1,(2.56?0.63) and(6.58?1.15) ?g/mL for Cmax2;(37.58?7.57) and(92.75?24.62) ?g?h/mL for AUC(0～24),(6.6?2.4) and(12.64?3.35) h for t1/2,respectively.And the pharmacokinetic parameters of wogonoside in normal and diabetic rats were:(5.5?1.0) and(8.00?1.63) h for tmax 2;(1.36?0.17) and(6.16?1.40) ?g/mL for Cmax1;(1.58?0.17) and(4.11?0.76) ?g/mL for Cmax2;(27.02?3.72) and(58.16?16.43) ?g?h/mL for AUC(0～24);(9.72?2.24) and(7.89?1.63) h for t1/2,respectively.The results indicated that Cmax1,Cmax2,AUC(0～24) of baicalin and wogonoside were significantly enhanced and t1/2 of baicalin was remarkably extended when compared with the normal rats.And the results also revealed that baicalin contained in HJD hydrolyzed more rapidly when incubated in the feces suspension of diabetic rats than in that of normal rats.Conclusion The results indicate that the pharmacokinetic difference of baicalin between diabetic and normal rats may result from the presystemic metabolism of baicalin.

Objective To explore the diagnostic value of the quantitative detection of serum miRNA-193a in pulmonary adenocarcinoma.Methods 40 pulmonary adenocarcinoma patients and 40 healthy people were recruited to receive quantitative detection of serum miRNA-193a and CEA.And then the relationship between the concentration of miRNA-193a and CEA was analyze by spearman correlation analysis.12 of the 40 patients underwent operation and the different levels of miRNA-193a expression among pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues was detected by qRT-PCR.The different miRNA-193a levels were compared among groups of by t-test.The diagnostic performance of miRNA-193a was evaluated with receiver operating characteristic curves(ROC) and the area under the curve (AUC) and its 95%CI were calculated.Results The relative expressions of miRNA-193a in pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues were 1.07±0.16;0.80±0.10;0.11±0.07.miRNA-193a expression in pulmonary adenocarcinoma tissues was significantly lower than that in other two groups(P<0.05).The expression of serum miRNA-193a in pulmonary adenocarcinoma group was significantly lower than that in healthy group(P<0.05).There was no correlation between miRNA-193a and CEA(r=0.079,P=0.618).The detection of miRNA-193a yielded a ROC AUC of 0.829(0.741-0.917) in discriminating pulmonary adenocarcinoma from healthy group.Conclusion The relative expression of miRNA-193a in pulmonary adenocarcinoma was significantly lower than that in healthy controls no matter in tissue or serum,serum miRNA-193a may prove to be a non-invasive biomarker for the auxiliary diagnosis of pulmonary adenocarcinoma.

Objective:To observe the efficacy and safety of Feilike mixture and Xuanfei Zhisou mixture in the treatment of children acute tracheobronchitis bronchitis. Methods:Totally 110 cases of children with infantile bronchitis were randomly divided into Feilike group(37 cases),Xuanfei Zhisou group(37 cases)and the control group(36 cases). The control groups was treated with the conventional therapy including amoxicillin clavulanic acid potassium dispersible tablets with oral administration and hydrochloric acid ammonium bromide injection with atomization inhalation. Feilike group was treated with Feilike mixture additionally,and Xuanfei Zhisou group was treated with Xuanfei Zhisou mixture additionally. The treatment course was 7 d. Fever,cough and rale disappearance time were observed,and the efficacy and adverse reactions were also compared. Results:The total effective rate of Feilike group and Xuanfei Zhisou group was 94. 6% and 91. 9% ,respectively,both were higher than that of the control group(P < 0. 05),while there was no significant difference between the two groups(P > 0. 05). The disappearance time of cough and rale in Feilike group and Xuanfei Zhisou group was shorter than that in the control group(P <0. 05),and the time was shorter in Xuanfei Zhisou group when compared with that in Feilike group(P < 0. 05). No obvious adverse reaction was shown in the three groups. Conclusion:Feilike mixture and Xuanfei Zhisou mixture both show notable curative effect in the treatment of children acute tracheobronchitis bronchitis with good safety.

OBJECTIVE:To analyze the non-irrational prescriptions in pharmacy intravenous admixture services to ensure patient's medication safety.METHODS:We examined the prescriptions in pharmacy intravenous admixture services from Sep.2006 to Feb.2007 and analyzed the non-irrational ones regarding incompatibility,improper choice of infusion carriers,improper medication frequency,and the incompatibility of Chinese medicines etc.RESULTS:The non-irrational prescriptions totaled 126 cases,of which,46 associated with incompatibility,38 with improper choice of infusion carriers,25 with improper medication frequency and 17 with incompatibility of Chinese medicines.Most of the irrational drug use behaviors were corrected by informing the clinic these medication errors.CONCLUSION:Examining prescriptions in pharmacy intravenous admixture services can improve the safety and effectiveness of patient's use of intravenous drugs.

Objective To investigate the effects of different tidal volume mechanical ventilation on pulmonary function and inflammatory factors in gynecologic laparoscopic surgery.Methods 45 patients undergoing gynecological laparoscopic surgery without lung disease,ASA Ⅰ-Ⅱ,aged 20-45 years old,weight 45-65 kg,operation time 2-3 hours,were randomly divided into A,B,C three groups,15 cases in each group.Mechanical ventilation with different tidal volume of the three groups,A group,B group and C group were 8mL/kg,9mL/kg,10mL/kg.Blood gas analysis was performed before anesthesia (T0),30 minutes (T1),(T2),PA-aDO2 (60 minutes) (T3),and 120 min (T4),respectively,and the peak airway pressure and mean pressure were recorded.IL-6,TNF-α and IL-10 levels in plasma by radial artery blood sampling were simnultaneously determined.Results Comnpared with A group,the concentrations of Ppeak and Pmean were increased in B group at T1-T4 (t =5.13,4.78,6.54,5.32 and t =7.54,4.88,5.37,4.95;all P ＜ 0.05),the concentration of Ppeak and Pmean in C group at T1-T4 increased (t =7.76,8.87,7.23,8.99 and t =6.42,7.38,7.62,9.86;all P ＜ 0.05).Compared with B group,the concentrations of Ppeak and Pmean were increased in C group at T1-T4 (t =4.76,5.87,4.23,3.99 and t =4.76,3.99,6.06,4.52;all P ＜ 0.05).Compared with A group,the A-aDO2 values of B group and C group were increased at T1,T2,T3 and T4 (t =5.32,5.48,4.88,5.69 and t =7.85,7.32,8.45,6.67;all P ＜ 0.05).Compared with B group at the same time point,the A-aDO2 value of C group increased at four times of T1-T4 (t =5.62,4.38,6.94,4.22,P ＜0.05).Compared with group A,the concentration of A-aDO2 in C group was higher than that in B group at the same time point (t =4.45,4.87,5.32,4.79 and t =7.68,7.59,7.44,8.38;all P ＜ 0.05).The levels of IL-6 and TNF-α in C group were significantly higher than those in the control group (t =4.78,5.56,7.62,8.03 and t =3.98,4.52,5.46,6.23;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations AT T2-T4 in A group had no statistically significant differences (all P ＞ 0.05).Compared with B group,the levels of IL-6 and TNF-α in C group were significantly higher (t =4.58,4.99,6.53,4.77 and t =5.62,7.89,6.43,4.52;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations at T2-T4 in A group had no statistically significant differences (all P ＞0.05).There was no significant difference in IL-10 concentration among the thrce groups.Conclusion Laparoscopic surgery according to the end tidal carbon dioxide partial pressure (PetCO2) ventilation frequency,8 mL/kg tidal volume mechanical ventilation has no effect on the IL-6,TNF-alpha,IL-10 and other inflammatory factors,mechanical ventilation tidal volume is more appropriate.

Objective To explore the inner feelings of gestational diabetes at their primary use of the real-time blood glucose monitoring. Method Using the qualitative method, 10 gestational diabetic patients monitored their blood glucose using the real-time blood glucose monitoring for the first time and then were interviewed, the acquired results treated with phenomenological analysis. Result The inner feelings of the 10 patients were summarized including 5 themes:worry about the safety of the fetus, fear on alarming at monitoring, different views on four times input of finger blood glucose values, worry about inaccuracy in blood glucose monitoring data, changes in mental conditions and diets. Conclusion Health care workers should provide the gestational diabetic patients with targeted care strategies based on presence of psychological status and knowledge needs so as to improve their compliance, reduce the psychological burden of patients and control their blood glucose level.