objective To observe the clinical efficacy and safety of thought imprint psychotherapy in lower resistant state (TIP) on depression. Methods 60 patients with depression were randomly divided into TIP group and citalporam group. The observation period was 12 weeks. The Hamilton Rating Scale for Depression (HAMD)、 Minnesota Multiphasic Personality Inventory (MMPI) and treatment emergent symptoms scales (TESS) were used to evaluate the efficacy and adverse effects. Results The effective rate was 78.6% and 74.1% in the TIP group and citalporam group respectively. Conclusions TIP is an effective and safe means for the treatment of depression.

Objective To investigate the effects of low-pressure carbon dioxide pneumoperitoneum (CLC) and gasless abdominal distension (GLC) on elderly patients during laparoscopic cholecystectomy. Methods The clinical data,including operation time,hospital stay,surgical complications,and changes of other systems,of 36 elderly patients were analyzed. All the patients were older than 65 years when they received laparoscopic cholecystectomy in our hospital from January 2005 to December 2007. Among the cases,CLC (CO2 pressure:8-10 mm Hg) was used in 24,and GLC was employed in 12. The fourth generation artificial rib lifting apparatus was used for GLC. Results All the procedures were completed by laparoscopy,no patient was converted to open surgery. The operation time of the CLC and GLC groups was (46.2?14.8) min and (52.4?18.6) min respectively (t=-1.087,P=0.285). The vital signs of all the cases were stable during the operation,no carbon dioxide retention or cardiovascular affairs occurred. The hospital stay was (10.5?6.8) d in group CLC and (8.9?5.5) d in group GLC (t=0.706,P=0.485). The patients were followed up for 6 to 42 months,no complications occurred during the period. Conclusions GLC is safe for elderly patients with similar efficacy to that of low-pressure CLC.

BACKGROUND:The treatment of calcaneal fractures using open surgery is likely to cause greater trauma. OBJECTIVE:To explore the clinical effect of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation in repair of Sanders II, III type calcaneal fractures. METHODS:The clinical data of 73 patients with Sanders II, III type calcaneal fractures were retrospectively analyzed and divided into conventional group (n=36) and experimental group (n=37) according to the treatment method. Patients in these two groups were respectively treated with conventional open reduction internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation. RESULTS AND CONCLUSION:Compared with the conventional group, the hospital stays of patients in experimental group were shorter, hospital costs reduced. There were no obvious changes in the foot rating from the American Association of Ankle Injuries, B?hler angle and Gissane angle. The incidence of complications was significantly decreased. These results demonstrate that the treatment of Sanders II, III type calcaneal fractures with conventional open reduction and bone plate internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation can obtain the basic equivalent clinical effect, however, the treatment of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation have more obvious advantages, such as a shorter hospital stays, less hospital costs, and also can effectively control the complications.

Objective To investigate the effect and safety of Compound codeine phosphate syrup with Ambroxol treatment in the stable phase of chronic obstructive pulmonary disease. Methods 100 patients with stable COPD were divided into Compound codeine phosphate syrup with Ambroxolt treatment group (Group A) 50 cases and Compound codeine phosphate syrup treatment group( Group B) 50 cases,drug were given for 3 ～ 7d. The symptom score and efficacy of two groups before treatment and after treatment were compared. Results The symptom score of cough,sputum volume,sputum viscosity ,wheeze,sleep after treatment 8th day were improved significantly ( χ2 = 3. 891 ,χ2 =3. 992, χ2 = 4. 198, χ2 = 3.981, χ2 = 3. 879, allP < 0. 05; Total effective rate of cough, sputum volume, sputum viscosity,wheeze in group A(92. 0% ,94. 0% ,90. 0% ,90. 0% ) higher than that in group B(80.0% ,86.0% ,80. 0%,78.0% ) ( χ2 = 3.991, χ2 = 4. 012, χ2 = 3. 998, χ2 = 3.971, allP < 0. 05); The adverse reactions of A、 B group were 12.0% and 14.0%(χ2 =1.971,P>0.05). Conclusion Compound codeine phosphate syrup with Ambroxol is an effective and safe antitussive in the stable phase of chronic obstructive pulmonary disease.

Aim: To study the effects of berberine( Ber) on the rapidly activating component( Ⅰ_(Kr)), the slowly activating component(Ⅰ_(Ks)) of the delayed rectifier potassium current and the inward rectifier potassium current(Ⅰ_(K1)) in cardiomyopathic guinea pig ventricular myocytes. Methods: After guinea pigs were ip L-thyroxine 0. 5 mg/kg for 10 d, their hearts were cardiomyopathic. Then whole cell patch-clamp recording technique was used to observe the effect of 30 μmol/L Ber on the Ⅰ_(Kr), Ⅰ_(Ks) and Ⅰ_(K1) in cardiomyopathic guinea pig ventricular myocytes. Results: In cardiomyopathic guinea pig ventricular myocytes, Ber 30 μmol/L markedly inhibited Ⅰ_(Kr) and Ⅰ_(Ks) by 22. 8% and 29. 5% at + 10 mV and + 80 mV, respectively. The effect of Ber on Ⅰ_(Ks) was greater than that on Ⅰ_(Kr). Ber 30 μmol/L also inhibited the inward component of Ⅰ_(K1) by 29. 1% at + 120 mV, but the reverse potential of Ⅰ_(K1) was unaffected. Ber( 1-300 μmol/L) was shown to inhibit Ⅰ_(Kr) and Ⅰ_(Ks) in a concentration-dependent manner. Their IC_(50), were 76. 74 μmol/L and 55. 37 μmol/L, respectively. Conclusion: Ber inhibited Ⅰ_(Kr),Ⅰ_(Ks) and Ⅰ_(K1) in cardiomyopathic guinea pig ventricular myocytes, which may be important in understanding the antiarrhythmic effects of this drug.

[Objective]To introduce the technique important points of intramedullary fixation with bone cement add the plate fixation for treated the unstable proximal humeral fractures in elderly patients,and proceed the analysis to the principle of bone cement fix.[Method]Ten cases of the unstable proximal humeral fractures were treated with open reduction,intramedullary fixation with bone cement first,then fix with the plate.Three days after operation functional trainings were began.The radiographic outcome and shoulder joint functions were observed postoperatively at 1 month,3 months,6 months and 12 months.[Result]The results were excellent in 5 cases,good in 4 cases,fair in 1 case according to the JOA function standard.The rate of excellent and good clinical results was 90%.Radiography showed that the fractures dissects to reply in 7 patients,fractures still had 3～5 mm moving in 3 cases.All plates were fixed dependable,with no loosening.All fractures had bone fusion.[Conclusion]The intramedullary fixation with bone cement add fixation with plate for the unstable proximal humeral fractures in the elderly can proceed the functional training of the earlier period,acquire the satisfactory function instauration.

With the development of modern medicine,to see a doctor is no longer a simple process of diagnosis or taking drugs.Human have deeply recognized medical science and health from a simple biomedical model to a social,psychological and biomedical model.On the one hand,people seek help from medical science.On the other hand,people fear that malpractice could occur.It has been in a love-hate mentality for people to seek medical and legal relief.In the new era,physician-patient relationship needs to be recognized again from medical staff,patients and legal angles.The combination of medicine and law is the requirement of development of the times.No matter how strong the law is,and no matter how much we hope the legislation is from strength to strength,moderation is still the virtues of the law.Medical perspective is still required in the examination of medical activity.

Objective To observe the distribution of ER? in the sigmoid colon specimens from the patients with slow transit constipation(STC).Methods The expression of ER? was detected by immunohistochemical staining in formalin-fixed,paraffin-embedded sigmoid colon tissues from 16 cases of STC,and from 8 cases of rectal cancer at Dukes' stage A,2 cases of rectal villous adenoma(10 as control).The positive cells were analyzed by computer assistant image analysis system.Results ER? immunoreactivity was present in normal epithelium and interstitial cells of the sigmoid colon tissues in the two groups,but nucleus-positive in STC group and cytoplasm-positive in control group.In comparison with the control group,the ER? immunoreactivity in STC group was much lower(P

Objective To develope effective TCM antirheumatic drug and provide theoratical basis of establishing TCM effect evaluation system of RA,the effect of modified Guizhishaoyaozhimu Decoction on RA was evaluated by SF-36 questionnaire. Methods Evaluation of 59 cases in a RCT (random control test) study was based on SF-36 questionnaire. Treatment group was given modified Guizhishaoyaozhimu decoction bid,while control group was given MTX 10 mg,one time a week with celecoxib 200 mg,qd. Observation last on 24 weeks and comparing patients’ quality of life was done at the beginning and end point. Results There was significant difference between two groups on improving physical functioning,role-physical,body pain,social function,and role-emotional (P 0.05). Conclusions Modified Guizhishaoyaozhimu decoction has better effect on improve RA patients’ quality of life than MTX.

Rheumatoid arthritis (RA) , an autoimmune disease, become much popular in recent years. In this article, apoptosis of RA fibroblast like synovial cells and influence factors in this process were discussed, and the relating signal transduction pathway of RA fibroblast apoptosis was described.