Objective To explore the effects of citalopram on interleukin-6 (IL-6) and brain derived neurotrophic factor (BDNF) in serum and cortisol in plasma of patients with depression syndrome.Methods 60 patients with depression in Kangci Hospital of Jiashan were randomly divided into two groups.31 cases in experimental group were treated with citalopram, 29 cases in control group were treated with imipramine.Levels of IL-6 and BDNF in serum and cortisol in plasma were compared pre-and post-treatment between two groups.Results Compared with pre-treatment, the levels of IL-6 and cortisol were lower(P<0.05), the level of BDNF was higher(P<0.05) post-treatment in two groups.Compared with control group, the levels of IL-6 and cortisol were lower(P<0.05), the level of BDNF was higher(P<0.05)in experimental group.Conclusion Citalopram has good curative effect on depression.The mechanism may be related to the decrease of IL-6 and cortisol levels, and the increase of brain derived neurotrophic factor level.

Objective To investigate the protective effect of peroxisome proliferator-activated receptor ?(PPAR?) activator 15-deoxyprostaglandin J2(15d-PGJ2) in rat hepatic ischemia-reperfusion injury and its mechanism.Methods The models of 70% warm ischemia-reperfusion injury were established in SD rats,rats were randomly divided into 4 groups: sham operation group,ischemia-reperfusion group,15d-PGJ2 group and 15d-PGJ2+GW9662 group.After reperfusion,serum AST and ALT levels were determined;the liver tissues were removed for measurement of activity of NF-?B and myeloperoxidase(MPO),TNF-? content and expression of ICAM-1.Results Compared with sham operation group,the serum levels of ALT and AST,and the activities of MPO and NF-?B,TNF-? content and expression of ICAM-1 in ischemia-reperfusion group,15d-PGJ2 group and 15d-PGJ2+GW9662 group were greatly improved(P

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

AIM: To investigate the effect of single immunoglobin IL-1 receptor related protein (SIGIRR) on damage of alveolar epithelial cells in acute lung injury induced by lipopolysaccharide. METHODS: The acute alveolar epithelial cell injury model was constructed by stimulation of A549 cells with LPS. In order to over-express SIGIRR, the A549 cells were transferred with eukaryotic expression vector containing full length SIGIRR cDNA. The transcriptional activity of NF-κB was measured by dual-luciferase reporter assay system. The concentrations of IL-1β, TNF- α and IL-6 were detected by ELISA. The levels of these inflammatory factors between the transfected cells and untransfected cells were compared. RESULTS: The over-expression of SIGIRR inhibited the transcriptional activity of NF-κB. The increases in IL-1β, TNF-α and IL-6 concentrations in alveolar epithelial cells induced by LPS were observed. CONCLUSION: SIGIRR in alveolar epithelial cells inhibits TLR4 signals triggered by LPS and attenuates the inflammatory reactions in alveolar epithelial cells, which plays a protective role against the acute damage of the alveolar epithelial cells.

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To investigate the effect of different doses of dexmedetomidine (DEX) on myocardial ischemia-reperfusion injury (MIRI) in rats.Methods Seventy-five SD male rats weighing between 250 and 300g were divided into sham group,MIRI group,small-dose DEX group,medium-dose DEX group and high-dose group according to the random number table,with 15 rats per group.Threading the left anterior descending coronary artery was done only in sham group,but the MIRI model was produced in the rest groups by ligation of the artery for 30 minutes followed by 120 minutes of reperfusion.Fifteen minutes before the ligation,small-,medium-and high-dose DEX groups were injected 2.5,5 and 10 μg · kg-1 · h-1 of DEX respectively until the end of reperfusion.Instead,an equal volume of normal saline was given in sham and MIRI groups.At the end of reperfusion,five rats in each group were used to determine the myocardial infarct size,and arterial blood samples and myocardial tissues from ten rats in each group were used to measure serum levels of interleukin-1β (IL-β) and serum tumor necrosis factor-α (TNF-α),expression of myocardial nuclear factor kappa B p65 (NF-κB p65) and change of myocardial pathomorphology.Results Myocardial infract size,degree of myocardial pathomorphology structure damage,serum levels of IL-1 β and TNF-αt and expression of myocardial NF-κB p65 in sham group were significantly lower in sham group than other groups (P ＜ 0.05).Above mentioned parameters in small-,medium-and high-dose DEX groups were all significantly decreased compared to MIRI group (P ＜ 0.05),and the decrease was most significant in medium-dose DEX group (P ＜ 0.05).Conclusions DEX can attenuate the MIRI in rats and the possible mechanism is suppressing the release of NF-κB p65,which can reduce serum pro-inflammatory cytokines like TNF-α and IL-1β.And mediumdose DEX exhibits better protective effect.

ObjectiveTo induce human peripheral blood mononuclear cells differentiate into hepatocyte-like cells by hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in vitro and determine whether PKH26 could be used to serve as an effective tracer for the cells,and observe the ability of transplanted hepatocyte-like cells differentiate into hepatic cells in nude mice.MethodsGroup A and B were set up respectively.In Group A,mononuclear cells were cultivated without hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in cell culture.They were used as negative control group.In Group B,mononuclear cells were cultured with the administration of both HGF and FGF-4 to induce the differentiation into liver hepatocyte-like cells.The changes in cell morphology were observed and the expressions of AFP and CK 19 were detected by immunocytochemical staining in two groups at different times after induction.The hepatocyte-like cells differentiated from human peripheral blood mononuclear cells labeled by the fluorescent dye PKH26 injected into caudal vein in nude mice is experimental group.The nude mice injected with equal amount of normal saline in control group.The migration of the labeled cells into the liver are observed by the fluorescence microscope in the hepatic tissue sections of nude mice and the expressions of ALB were detected by immunocytochemical staining two weeks after the cells transplantation.ResultsCells in group B have a strong proliferative activity.It becomes large and oval,grows in colonies following induction.Cells in group A that showed spherical shape when peripheral blood mononuclear cells were just isolated are gradually becoming inconformity in morphology,spindle or fibroid,and a few cells are round:cells developed apoptosis and cracked following incubation.The expressions of AFP and CK19 were positive after induction in group B as detected by immunocytochemicat staining.Inversely,the expressions of AFP and CK19 were negative in group A after incubation.The experimental group showed numerous PKH26 labeled cells in the hepatic tissue sections of nude mice.But the control group did not show PKH26 labeled cells.The expressions of ALB were positive in the experimental group as detected by immunocytochemical staining after two weeks of the cells transplantation.ConclusionHuman peripheral blood mononuclear cells have the potential to differentiate into hepatocyte-like cells under the induction of HGF and FGF-4.Additionally,PKH26 is an effective tracer in hepatocyte-like cell transplantation.The hepatocyte-like cells settled in hepatic tissue begin to differentiate into mature hepatocyte after two weeks of the cells transplantation.It plays hepatic cells function and expresses alhnmin.

Objective To investigate the clinical value of the test injection at popliteal arteries on 64-slice CTA in lower extremity peripheral arterial occlusive disease (PAOD). Methods Twenty-eight patients with PAOD referred for 64-slice CTA were enrolled consecutively in the study. Test injection was performed at bilateral popliteal arteries (the level of knee joints) and the clinic value of the peak value and the time to peak was analyzed. The relationship between the time to peak and the peak value was evaluated with Pearson test. The time to peak was used for programming of the CT angiographic acquisitions with fast scanning mode. The quality of visualization of each arterial segment was determined independently by two radiologists. Results Fifty-four (96%, 54/56) time-attenuation curves were obtained in 28 patients. The wide interindividual variation in the peak value and the time to peak was observed in 52 curves of 26 patients with range of 60-178 HU,21-46 s and an average of (135±28) HU,(31±6) s, respectively. The difference in the peak value and the time to peak between bilateral popliteal arteries was also observed with range of 10-80 HU and an average of (32±18) HU in 19 patients,with range of 1-12 s and an average of (5±3) s in 21 patients. There was negative relationship between the peak value and the time to peak (r=-0.526, P<0.01). The CTA images were of good (598 segments) or medium quality (12 segments) in 99% segments (610/616). Conclusions The test injection at popliteal arteries was useful for 64-slice CTA in the patients with PAOD, as it could accurately specify the delay time of CT angiographic acquisitions.

Objective To summarize the clinical efficacy of interventional treatment for lower extremity arteriosclerosis obliterans and its complications.Methods We analyzed sixty-nine patients with lower extremities arteriosclerosis obliterans undergoing interventional treatment from October 2011 to January 2013.During the same period,three patients were referred to us who suffered from the complications of interventional treatment.In these patients,eight were TASC ⅡA type,twenty-one were TASC Ⅱ B,twenty TASC Ⅱ C,and twenty-two TASC Ⅱ D lesions.All patients received CTA or DSA.Seventy patients were treated by interventional treatment,and two who had fractured stent underwent external iliacsuperficial femoral artery bypass grafting using artificial grafts.Results The technique success rate was 100％.The symptoms disappeared after surgery.During interventional treatment,one iliac artery ruptured,one patient suffered from arterial perforation and three patients suffered from distal embolization.Sixty-eight patients were followed-up for 9 ± 4 months.Conclusions Endovascular treatment has good early clinical efficacy.In order to reduce the incidence of complications,indication of interventional treatment should be controlled strictly and manipulation should be careful.

Objective To understand the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Methods Taking a survey among the pre-hospital emergency physicians(80 people)and nurses(248 people)by Questionnaire of ethics conflicts during pre-hospital emergeney service,to investigate the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Resulls (8.046±6.990)%of the patients who needed treatments refused to be treated completely,and(14.544±10.558)%of them refused partially.(14.451±14.747)% of the patients who needed ambulance transport refused to be delivered.In the patients who refused treatments and transportation.payment problem accounted for(23.52±19.79)%,(22.22±20.84)%of them did not believe they needed.(5.77±4.47)%of them wished to die,(19.44.4±18.65)%of them were hard to be idenfified.Other reasons accounted for(30.08±25.78)%.(20.31.4±16.66)% of the patients refused the ambulance crews' judge for some state.(29.66.4±24.02)%of the patients who got the pre-hospital emergency service were not necessary to call an ambulance.(22.1 l±19.52)%of the patients' demand conflicted with pre-hospital emergency services network management system.Conclusions There exists some conflicts between the pre-hospital patients and ambulance crews' determinations.