Depression is a difficult problem because of its unresolved etiology , complex pathogenic factors ,and unknown path-ogenesis in the field of neuroscience .In recent years,the research of the pathogenesis in depression had made important progress at home and abroad .This article elaborates the mainstream hypothesis of depression mechanism to broaden the understanding depression in the fields of neurobiochemical study , neuroendocrine and neural plasticity studies .

Objective To explore the application of the ultraviolet spectrophotometry method in detecting colchicine poisoning serum to provide the basis for clinical diagnosis and treatment of colchicine poisoning.Methods 0.5 mL of serum was taken and added with the extract solution(chloroform∶methanol=95 ∶5)4.0 mL.The sufficient oscillation extraction and high-speed cen-trifugation were performed.Then the organic layer was taken into another test tube for drying by nitrogen.0.2 mL of methanol dis-solved residue was taken and blended.50 μL of the mixed solution was taken for conducting ultraviolet scanning.Results The max-imum absorption peak of serum colchicine was (351 ±1)nm,the concentration within 5.0-40 μg/mL showed linearity,the regres-sion equation wasY =0.050 2X +0.001 3,the correlation coefficient was 0.999 5,the recovery rate was 83.8% -102.8%,the rel-ative standard deviation:3.3% -4.8%.The intra-day and inter-day were 3.22%-4.74% and 3.45%-4.66%,the lowest detec-tion concentration was 1 .0 μg/mL.Conclusion This method is simple to operate,fast in analysis,accurate in the detection result, which provides a simple and accurate detection method for clinical diagnosis of colchicine poisoning.

Objective To examine the relationship between inflammatory response induced by cardiopulmonary bypass and postoperative cognitive dysfunction.Methods Twenty-five patients undergoing elective cardiac valve replacement under cardiopulmonary bypass were randomly divided into two groups:ulinastatin group(group U,n=13) and control group(group C,n=12).In group U,ulinastatin 12 000 U/kg Was given intravenously immediately after induction of anesthesia,6 000 U/kg ulinastatin Was added to the priming solution,and 6000 U/kg ulinastatin was given at 5 min before the aortic decamping.In group C,normal saline was given instead of ulinastatin.Venous blood samples were taken after induction of anesthesia,at the end of CPB,and 24 h after operation for determination of plasma IL-6 concentration and neutrophils NF-kB expression.The cognitive function of the patients was evaluated by Mini-Mental State Examination(MMSE) before and 3 d,7 d after operation.Results The concentraion of IL-6 and neutrophils NF-kB expression were lower in group U than in group C(P<0.05 or 0.01).There wag no significant difference in the incidence of postoperative cognitive dysfunction between group C and U.Conclusion Inflammatory response induced by cardiopulmonary bypass is not related to postoperative cognitive dysfunction.

Objective To understand whether it had differences in bile culture and drug susceptibility test between patients with community-acquired acute cholecystitis and patients with community-acquired acute cholangitis at present.Methods 169 patients with community-acquired acute cholecystitis and the 97 patients with community-acquired acute cholangitis in our department were selected prospectively,in which 16 patients suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis.Bile sample was extracted in operations and delivered to perform aerobic culture and drug sensitivity test.The bile samples coming from cholecyst were divided into group A,while the bile samples coming from bile duct were divided into group B.Results The positive rates of bile culture in group A and group B were separately 24.9% and 64.9%(P<0.05).The result of the sample coming from cholecyst and the result of the sample coming from bile duct were not the same in 4 patients of the 16 patients who suffered from both community-acquired acute cholecystitis and community-acquired acute cholangitis simultaneously.The main bacteria of acute cholecystitis included Escherichia coli(28.0%),Klebsiella pneumonia(24.0%)and Enterococcus faecium(16.0%).The main bacteria of acute cholangitis included Escherichia coli(39.7%),Klebsiella pneumonia(19.2%)and Enterobacter cloacae(12.3%).The antibiotics which were lowly resistant to gram negative bacteria in the two groups(A and B) included amikacin(0%/0%),ertapenem(0%/0%),imipenem(0%/7.0%)and piperacillin/tazobactam(0%/7.0%).The antibiotics which had lower resistant rates to gram positive bacteria in the two groups included tigecycline(0%/0%)and linezolid(0%/0%).The proportions of the multidrug-resistant strains in the two groups were separately 24.0% and 35.6%(P>0.05).Conclusion Some difference exist in the results of bile culture between patients with community-acquired acutecholecystitis and patients with community-acquired acute cholangitis,but the main bacteria of the both two types of biliary tract infection are Escherichia coli and Klebsiella pneumonia.The drug resistance is serious in the both infections,and the most sensitive antibiotics to gram negative bacteria include amikacin,ertapenem,imipenem,piperacillin/tazobactam,and the most sensitive antibiotics to gram positive bacteria include tigecycline,linezolid in the both infections.

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.

Objective To analyze the effect of total parenteral nutrition (TPN) and enteral nutrition (EN) in patients with acute pancreatitis. Methods Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in Medline and China Biological Medicine Disk from Jan 1966 to June 2004. Eight studies were enrolled into the analysis. The detail about the trial design, characters of the subjects, results of the studies were reviewed by two independent authors and analysed by using Revman 4.2 software. Results Compared with TPN, EN was associated with a significantly lower incidence of secondary infections (RR 0.45, 95% CI 0.29-0.68, P=0.0002) and other complications(RR 0.67, 95% CI 0.47-0.96, P=0.03), fewer surgical interventions (RR 0.47, 95%CI 0.24-0.94, P=0.03) and shorter hospitalization. However, there was no significant difference in mortality (RR 0.61, 95%CI 0.32-1.18, P=0.14) between patients with TPN and EN. Conclusion EN could be the preferred nutrition feeding method in patients with acute pancreatitis.

AIM:To study the effect of mistletoe lectins on cell proliferation and apoptosis in HT-29 human colon cancer cell.METHODS:The effect of mistletoe lectins on cell viability in HT-29 cell was evaluated by MTT assay.Cell apoptosis was observed by DNA ladder analysis and Tunel.RESULTS:Mistletoe lectins(eg.,1-4 mg/L) inhibited cell growth in a dose and time dependent way in HT-29 cells.HT-29 cells apoptosis can be induced when exposed to mistletoe lectins(eg.,1-4 mg/L).CONCLUSION:Mistletoe lectins can inhibits proliferation and induces apoptosis in HT-29 cells in vitro.

Objective To evaluate the value of plasma soluble urokinase plasminogen activator receptor (suPAR) and serum pmcalcitonin (PCT) to investigate their assessment of disease severity and prognosis in patients with sepsis.Methods The levels of plasma suPAR and serum PCT were monitored in 77 patients with sepsis.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score were recorded.According to the disease severity and their prognosis,the value of plasma suPAR,serum PCT,APACHE Ⅱ and SOFA score on predict the disease severity and prognosis of septic patients were compared.Results The levels of plasma suPAR in septic patients [(7.9 ±6.5) ng/mL] were lower than severe sepsis patients [(8.4 ±4.5) ng/mL] and septic shock patients [(13.9 ± 8.0) ng/mL],allP ＜ 0.05.The levels of serum PCT in septic patients (6.3 ± 3.5) ng/mLwere lower than severe sepsis patients [(23.7 ± 3.9) ng/mL] and septic shock patients [(25.7 ±4.3) ng/mL],allP ＜0.05.But there was no significant difference in the levels of serum PCT between the severe sepsis group and the septic shock group.Receiver operator characteristic curve (ROC)of the level of plasma suPAR could distinguish survivors from non-survivors in septic patients,maximal area under curve (AUC) of plasma suPAR was 0.803.The best cut-off value of plasma suPAR to distinguish survivors from non-survivors was 9.905 ng/mL.And the AUC of serum PCT was 0.61 (P ＞ 0.05) ; the AUCofAPACHEⅡ score was 0.832 (P＜0.05); the AUC of SOFA score was 0.767 (P＜0.05).Conclusion Monitoring of the levels of plasma suPAR and the APACHE Ⅱ score can help to assess the severity and the prognosis of sepsis in the early stage.

Objective To investigate the Toll like receptor-4 (TLR4) expression on pancreatic islet beta-cell of septic rat and its effects on glucose regulation.Methods SD male septic rats were made with LPS intra-abdominal injection in a dose of 5 mg/kg body weight and it repeated once 3 h later.Rats were randomly (random number) divided into four groups randomly (n =5 in each):normal control group,LPS group,LPS antibody group and PLS with LPS antibody group.The expression and protein level of TLR4 were measured by RT-PCR,Western-blot and immunochemistry analysis respectively.IVGTT (intra-venous glucose tolerant test) was used to measure the glucose and insulin levels 6 hours after LPS administration and as well as in control group,and then their AUC were calculated.Results The TLR4 protein and mRNA expressed on pancreatic islet beta-cell of normal rat were significantly up-regulated 6 hours after LPS administration,while its up-regulation could be inhibited when LPS antibody was used in advance (P ＜ 0.01).Rat blood glucose levels were higher at 10,30,60 and 120 min in LPS group and insulin levels were lower at 30,60,120 min compared with normal control (P ＜ 0.01).LPS antibody improved the insulin secretion and then blood glucose level distinctly decreased during 30-120 min period after LPS challenge proved by IVGTT test.Conclusions TLR4 expression up-regulated on pancreatic islet beta-cell of septic rat and LPS-TLR4 system might be a mechanism of stress hyperglycemia genesis.

Objective To explore the clinical value of diffusion weighted imaging (DWI) in the diagnosis of breast disease ,and compared with ultrasound and mammography .Methods The clinical data of 28 patients who were pathologically confirmed with breast cancer were retrospectively reviewed .The diagnostic accuracy of DWI ,mammogra-phy and ultrasound , the surface diffusion coefficients ( ADC value ) were statistically analyzed .Results ( 1 ) DWI scan:the diagnostic accuracy of malignant tumor was 90.9%(20/22),the ADC value of malignant tumor was (0.955 ±0.199) ×10 -3mm2/s;the diagnostic accuracy of benign lesions was 83.3%(5/6),the average ADC value of benign lesions was (1.660 ±0.339) ×10 -3 mm2/s,there were statistically significant differences ( t=2.371,P<0.05).(2)Mammography:the diagnostic accuracy of malignant tumor was 81.8%(18/22),the diagnostic accuracy of benign lesions was 33.3%(2/6).(3) Ultrasound:the diagnostic accuracy of malignant tumor was 86.4%(19/22),the diagnostic accuracy of benign lesions was 50.0%(3/6).The diagnostic accuracy of malignant tumor had no significant difference among three techniques (χ2 =0.752,P>0.05),but for the diagnostic accuracy of benign lesions,DWI was better than ultrasound and mammography ,the difference was statistically significant (χ2 =6.146, P<0.05).Conclusion For the diagnosis of malignant breast tumors and benign lesions ,DWI is better than ultra-sound and mammography ,which has high clinical application value .