BACKGROUND: Most of patients with depression suffer from cardiovascular or cerebrovascular diseases. This kind of depression is conceptualized as vascular depression. Specific 5-hydroxytryptamine (5-HT) uptake inhibitors are proved to have a definite therapeutic effect on depression, but their influence on vascular depression need to be confirmed.OBJECTIVE: To compare the therapeutic effects and side effects between fluoxetine hydrochloride and clomipramine in patients with vascular depression.DESIGN: Randomized controlled investigation.SETTING: It was conducted at the Cardiological Department of the First Hospital Affiliated to Xinxiang Medical College.PARTICIPANTS: From January 2003 to December 2004, inpatients and outpatients at the Cardiology Department of the First Hospital Affiliated to Xinxiang Medical College were selected. Inclusion criteria: ① a diagnosis of depression according to the diagnostic criteria of the Chinese Classification of Mental Disorder (CCMD); ② a diagnosis of vascular depression according to the clinical definition suggested by Alexopoulos et al[1], which is,before the onset of depression, cardiovascular diseases or cerebrovascular diseases have been evidenced already;③ with an age less than 70 years old; ④ and getting informed consents from the patients and their relatives.Exclusion criteria: ① having a history of drug allergy;② having consciousness disorders and obvious dementia symptoms; ③ having severe impairment in cardiac function, hepatic function or renal function; ④ having severe mental disorders, ⑤ and having trauma, tumor, inflammation or demyelination in brain, and a history of depression. Sixty eligible patients were selected and divided into the experimental group and the control group, 30 patients in each group.METHODS:With promoting-blood-circulation-to-remove-blood-stasis medication, patients in experimental group took oral fluoxetine hydrochloride (20 mg/day) while patients in control group took oral clomipramine (starting with a dose of 25 mg/time and then adding to 50-250 mg/day, tid, according to the state of illness and the patients' tolerance), the duration of the medication in each group was 12 weeks. Before treatment and at posttreatment week 4, 6 and 12, the therapeutic effects on depression were assessed using Hamilton Depression (HAMD) Rating Scale respectively, and pre-treatment and post-treatment adverse reactions and side effects were recorded as well. Descriptive data were shown as percentage, comparison between groups was performed using Chi-square test, and measurement data was compared with t Test.MAIN OUTCOME MEASURES:Primary outcomes included ① Comparison of pre- and post-treatment HAMD scores between the two groups.groups.② Comparison of post-treatment therapeutic effects between the two groups.Secondary outcomes included: adverse events and side effects.RESULTS: In each group, 30 patients completed the medication and entered the statistical analysis procedure.① Comparison of HAMD scores between the two groups: In experimental group, the HAMD scores at posttreatment week 6 and 12 were lower than the pre-treatment scores (12.40±4.30, 7.80±4.36 and 21.30±2.64; P ＜ 0.01), and lower than those in control group (at post-treatment week 6: 13.20±4.90; at post-treatment week 12: 7.90±4.20; t=3.98, 5.02, P ＜ 0.01). ②Comparison of improvement in depression between the two groups: In experimental group, the effective rate at post-treatment week 6 and 12 were higher than those in control group (week 6: 93％ and 87％; week 12: 97％ and 93％, P ＞ 0.05). ③Comparison of adverse events and side effects between the two groups: In experimental group, there were 8 patients had adverse events and side effects, 2 of them might be linked to the medication, with manifestation of nausea and thirsty. In control group, the number was 13, 10 of them might be linked to the medication, with manifestation of thirsty, constipation,voiding dysfunction, dizziness and excitation. The occurrence rate of side effects was lower in therapeutic group than in control group (27% and 43%, P ＜ 0.01).CONCLUSION: The therapeutic effect of fluoxetine hydrochloride was close to that of clomipramine. And the patients' tolerance to fluoxetine hydrochloride is better than their tolerance to clomipramine.

Objective To assess the value of corrected TIMI frame count(CTFC) in patients with acute myocardial infarction(AMI) underwent primary percutaneous coronary intervention(PCI) and the change of CTFC before and after adenosine interference. Methods CTFC was defined as the number of cineframes from coronary filling with radiographic reagent to visualization of distal coronary landmark in the infarct-related artery. Normal antegrade flow was 0.05), and CTFC of the patients with slow antegrade flow, who underwent PCI, was not significantly different before and after administering adenosine. LVEF of the patients with normal antegrade flow was significantly higher than that of the patients with slow antegrade flow(P=0.001). MACE of the patients with slow blood flow were obviously higher than that of the patients with natural blood flow(P

Objective To investigate the relationship between tumor necrosis factor-alpha(TNF-?), endothelin(ET) and Interleukin-6(IL-6) plasma level of coronary heart disease(CHD) patients and the type of the coronary plaque morphology.Methods Peripheral blood samples were taken from 230 CAG confirmed CHD patients and the same number of CAG normal patients.Serum TNF-?,ET and IL-6 values were measured through enzyme-labeled immunosorbent assay(ELISA) technique in the 2 groups and their relationship between coronary plaque morphology were assesed.Results The mean levels of serum TNF-?,ET and IL-6 in the CHD group were higher than those of the normal group(P

Objective To observe the change of C-reactive protein (CRP), Interleukin-6(IL-6) plasma levels before and after percutaneous coronary intervention(PCI) in angina pectoris patients to evaluate the relationships between the severity of coronary lesions, CRP and IL-6. Methods 36 patients diagnosed as angina pectoris by coronary angiography received PCI and 15 healthy subjects served as the control. Peripheral blood samples were taken before and after PCI, the serum levels of CRP and IL-6 were measured by ELISA. The relationships between serum CRP,IL-6 and the severity of coronary lesions were analyzed. Results The mean levels of serum CRP and IL-6 in the patients were higher than those in the control(P

AIM: To observe the ameliorative effect of Puerarin Injection on blood hyperviscosity in acute blood-stasis model rats. METHODS: The acute blood-stasis model rats were made by injected adrenaline repeatedly and soaked in ice water. The markers of whole blood viscosity and plasm viscosity in the rats were measured with Auto-Viscometer. RESULTS: The whole blood viscosity and plasm viscosity was significantly raised in the acute blood-stasis model rats and Puerarin Injection had ameliorative effects on them. CONCLUSION: Puerarin Injection can ameliorate the blood-high-viscosity in rats of blood-stasis model.

OBJECTIVE:To study the intervention mechanism of puerarin on expressions of HSP70 and Fas proteinum in rats with acute cerebral ischemia injury.METHODS:12 rats with acute cerebral ischemia injury were randomly divided into ischemia control group(saline) and puerarin treated control group,with 6 in each group,each rat under took own control by ischemia side(exp.group) and non-ischemia side(control group);And rats with acute cerebral ischemia injury were randomly divided into control group (saline,ischemia side),puerarin treated control group and normal group (non-ischemia side),with 6 in each group.And then the expressions of HSP70 and Fas proteinum is determined by HE staining and immunochistochemistry SP.RESULTS: The expression of HSP70 was negative or weakly positive in ischemia control group and puerarin treated control group, while that in ischemia experiment group and puerarin treated experiment group was significantly increased(P0.05);The numbers of dead cells in control group and puerarin group were found to be significantly larger than that in normal group(P

Objective: To investigate the mechanisms of curative effect of Tongxinluo capsule(通心络胶囊) on patients with coronary artery disease and angina pectoris.Methods: One hundred and twelve cases in accord with the diagnostic criteria of coronary heart disease of World Health Organization(WHO) were(randomly) divided into two groups: treatment group(n=60) and control group(n=52).The patients in both groups were treated with routine therapy including ?receptor retardant and ester of nitric acid etc.(Additionally),the treatment group was treated with Tongxinluo capsules,2 capsules each time and 2 times(per day) for 2 months consecutively.The clinical manifestations before and after treatment,the changes of(electrocardiogram)(ECG),microcirculation of nail bed and hemorrheology were observed in all the patients in both groups.Results: The total clinical effective rate and the rate of total improvement in ECG changes were 86.67% and 80.00% respectively after treatment in the treatment group,and compared with the control group(78.85% and 69.23%) the differences were significant(both P

ObjectiveTo observe the effects of sodium ozagrel on nail microcirculation and hemorrheology in patients with myocardial infarction (MI).Methods128 MI cases were randomly divided into the treatment group (group A, n=68) and control group (group B, n=60). On the base routine treatment, patients of group A were treated with sodium ozagrel (80～160 mg/d) and those of group B were treated with glucose-insulin-potassium solution (250～500 ml/d). The changes of nail microcirculation and hemorrheology were measured in pre-treatment and post-treatment.ResultsThe nail microcirculation and hemorrheology in group A were significantly better than group B (P<0.01).ConclusionSodium ozagrel can markedly improve nail microcirculation and hemorrheology in patients with MI.