OBJECTIVE: To evaluate the safety and efficacy of Wuling Capsule combined with Deanxit in treating post-stroke depression (PSD). METHODS: One hundred and fourteen patients with PSD were randomly divided into Wuling Capsule-treated group (n=39), Deanxit-treated group (n=37) and Wuling Capsule plus Deanxit-treated group (n=38). Patients in Wuling Capsule-treated group were administered with three Wuling Capsules three times a day, and patients in Deanxit-treated group were administered with Deanxit 10.5 mg twice daily, while patients in the Wuling Capsule plus Deanxit-treated group were administered with both Wuling Capsule and Deanxit. Patients in the three groups were all treated for six weeks. Treatment efficacy was evaluated with Hamilton Depression Scale (HAMD) and the side effects were evaluated with Treatment Emergent Symptom Scale (TESS) before treatment and after 2-, 4-, and 6-week treatment. The blood and urine routine examinations were performed, and the hepatorenal functions and electrocardiogram were examined as well. RESULTS: There was no statistical difference in the total efficacy rate between Wuling Capsule-treated group and Deanxit-treated group (64.1% vs 64.9%, P>0.05), but the total efficacy rate of Wuling Capsule plus Deanxit-treated group was higher than that of the monotherapy (89.5% vs 64.1%, 89.5% vs 64.9%, P<0.05). There were no significant side effects in Wuling Capsule-treated group, while the incidence of side effects was 9% in both groups administered with Deanxit. CONCLUSION: The efficacy of Wuling Capsule plus Deanxit is better than that of the monotherapy in treating PSD.

Objective The aim of this study was to investigate the accuracy and reliability of linear measurements using cone beam computed tomography(CBCT) system and to provide theoretical application of CBCT in oral implantation. Methods Ten experimental models of different toothless mandibles mixed with 10% of barium sulfate were used in this study. All these mandible models were marked with gutta-percha markers to standardize the plane of the transverse cross-sections and path of measurements. The mandible models were imaged using Mayer SS-X9010D CBCT device. Measurements were taken with DCT Viewer software and compared with measurements recorded directly in the mandible models using vernier caliper. A paired sample t-test was performed to compare difference between CBCT measurement and vernier caliper measurement. Less than 0.05 were considered statistically significant. Results The differences of vertical lines between CBCT and vernier caliper were (-0.089 5±0.220 0) mm in anterior teeth area and (-0.083 0±0.190 0) mm in posterior teeth area. The differences of vertical lines between CBCT and vernier caliper were (-0.052 0 ± 0.140 0) mm in anterior teeth area and (-0.084 7 ± 0.320 0) mm in posterior teeth area. The corresponding t values were-1.784,-1.981,-1.621 and-1.684, respectively. All the P values were greater than 0.05. There was no significant difference between CBCT measurement and vernier caliper measurement. Conclusions CBCT is auseful tool to provide good accuracy and precision of linear measurement in dental implants.

Objective:To investigate the efficacy, safety, and overall survival of advanced upper gastric cancer patients who received preoperative chemoradiation therapy. Methods:A total of 62 patients who received preoperative chemotherapy or chemoradiation therapy in the Department of Gastrointestinal Surgery of Beijing Cancer Hospital&Institute were retrospectively observed to determine the efficacy and safety and to perform survival analysis of preoperative chemoradiation therapy. Results:Results of the postoperative pathology showed that the number of patients with T4 and N3 stages was significantly lower in the preoperative chemoradiation therapy group than in the preoperative chemotherapy group (P<0.05). In addition, the differences between the two groups in terms of safety and toxicity were not significant (P≥0.05). Analysis also showed that the differences between the two groups in terms of survival were not significant (P≥0.05). Conclusion:Patients with advanced upper gastric cancer can gain a potential survival advantage from preoperative chemoradiation therapy. Compared with preoperative chemotherapy, preoperative chemoradiation therapy was performed without increased risk of toxicity and insecurity. Preoperative chemoradiation therapy can also improve the local control ratio, especial y the control ratio of lymphatic metastasis. However, the final results of survival analysis depend on long-term follow-up of patients.

Objective:To investigate the effect of pirfenidone (PFD) on the proliferation of human glomerular mesangial cells (HMC) stimulated by serum IgA1 in patients with IgA nephropathy (IgAN) and its possible mechanism.Methods:Serum IgA1 of IgAN patients was purified by Jacalin affinity chromatography combined with Sephacryl S-200 gel filtration, and then heated to aggregated form (aIgA1). CCK8 method was used to confirm the concentration and time of PFD. The cells were divided into blank control group, IgA1 (0.5 mg/ml) group and IgA1 (0.5 mg/ml)+PFD (2 mmol/L) group. The CCK8 method was used to detect proliferation of mesangial cells. The cell cycle was detected by flow cytometry, and the proliferation index of mesangial cells was calculated. The expression levels of transforming growth factor β1 (TGF-β1), Smad4, Smad7, fibronectin (FN) and collagen Ⅳ protein and mRNA were detected through Western blotting and real-time PCR.Results:Compared with blank control group, the proliferation of HMC was promoted significantly by aIgA1 ( P<0.05). After PFD treatment, the proliferation of HMC was significantly inhibited ( P<0.01). Compared with the blank control group, the number of G1 phase cells decreased, the number of S phase cells and cell proliferation index increased in IgA1 group (all P<0.05). Compared with IgA1 group, the number of cells in G1 phase increased significantly, the number of cells in S phase and G2/M phase decreased significantly, and the cell proliferation index decreased in IgA1+PFD group (all P<0.05). Western blotting and real-time PCR results showed that compared with the blank control group, the protein and mRNA expressions of collagen Ⅳ, FN and Smad4 in HMC stimulated by aIgA1 were significantly increased, while TGF-β1 protein expression was increased and Smad7 protein expression was decreased (all P<0.05). After PFD treatment, the protein and mRNA expression of collagen Ⅳ, FN and Smad4 in HMC was significantly decreased, while TGF-β1 protein expression was obviously decreased, and Smad7 protein was up-regulated (all P<0.05). There was no significant difference in the mRNA expression of TGF-β1 and Smad7 in each group before and after PFD treatment (all P>0.05). Conclusions:PFD can increase the arrest of HMC in G1 phase, inhibit the proliferation of HMC induced by aIgA1 of IgAN patients, and reduce the production of extracellular matrix. The mechanism may be related to up-regulation of Smad7 expression and down-regulation of TGF-β1/Smad4 pathway.

OBJECTIVE: To explore different doses of sodium(s)-2-(dithiocarboxylato((2R,3R,4R,5R,6R)-2,3,4,5,6-pentahydroxyhexyl) amino)-4-(methylthio) butanoate(GMDTC) for removing cadmium. METHODS: Thirty-five male New Zealand rabbits were randomly divided into blank control group,GMDTC high dose control group,model control group,ethylene diamine tetraacetic acid(EDTA) control group and GMDTC low,medium and high dose groups,five rabbits in each group. The blank control group and GMDTC high dose control group were given 0. 90% normal saline solution intravenously; model control group,EDTA control group and GMDTC low,medium and high dose group were given 2 μmol/kg of cadmium chloride(CdCl_2) and 40 μmol/kg of β-mercaptoethanol mixed solution intravenously,5. 0mL/kg body weight(bw),once a day for five days. On the forty-one day of the experiment(the fist day of GMDTC treatment),the control group and the model control group were injected 0. 90% normal saline solution 250 mL via ear vein,the EDTA control group was given EDTA solution at the dose of 93. 5 mg/kg bw with 250 mL 0. 90% normal saline solution,also via ear vein; the GMDTC high dose control group,and the GMDTC low,medium and high dose groups were given 250 mL GMDTC solution at the concentration of 108.0,12.0,36.0 and 108. 0 mg/kg bw with 0. 90% normal saline by intravenous infusion,once a day,6 times a week for four consecutive weeks. The urine β_2-microglobulin(MG),renal cadmium,blood cadmium,and urinary cadmium before and after the treatment were detected. RESULTS: The body weight of New Zealand rabbits increased with the increasing feed time(P < 0. 01). The levels of β_2-MG before treatment increased in model control group,EDTA control group,GMDTC low,medium and high dose groups than that in the blank control group(P < 0. 01). The levels of renal cadmium after treatment in GMDTC medium and high dose groups decreased compared with those in the blank control group and EDTA control group respectively(P < 0. 05). The blood cadmium after treatment in EDTA control group,GMDTC low,medium and high dose groups were decreased compared with those before treatment in the same group respectively(P < 0. 05),meanwhile decreased than the blood cadmium after treatment in the model control group respectively(P < 0. 05). The blood cadmium after treatment had not a statistically significant difference among the EDTA control group,GMDTC medium and high dose groups(P < 0. 05). At all the time points(1,6,8,13,15,20,22 and 28 days after treatment),the urinary cadmium after treatment in EDTA control group and the three GMDTC dose groups increased compared to the model control group at the same time(P < 0. 05). The urinary cadmium after treatment increased with GMDTC dose increased at the other six time points,expect on 20 and 22 days after treatment(P < 0. 05). The blood cadmium removal rates after treatment were 70. 06%,74. 86% and 78. 05% and the renal cadmium removal rates were 14. 27%,27. 95% and 61. 24% in GMDTC low,medium and high dose groups,respectively. CONCLUSION: The intravenous infusion of GMDTC at the dose of 108. 0 mg/kg bw effectively removed cadmium in cadmium poisoning rabbit. This dose had no obvious toxic effect and was equivalent to human dose of 36. 0mg/kg bw which meets the requirement of new drug property.

Objective To investigate the susceptibility profile of clinical isolates collected from hospitals across China.Methods Twenty-six general hospitals and four children's hospitals were involved in this program.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2016 breakpoints.Results A total of 153 059 clinical isolates were collected from Junuary to December 2016,of which gram-negative organisms and gram-positive cocci accounted for 71.6％ and 28.4％,respectively.The overall prevalence of methicillin-resistant strains was 38.4％ in S.aureus (MRSA) and 77.6％ in coagulase negative staphylococcus (MRCNS),respectively.The resistance rates of methicillin-resistant strains to most of other antimicrobial agents were much higher than those of methicillin-susceptible strains.However,92.3％ of the MRSA strains were still sensitive to trimethoprim-sulfamethoxazole,while 86.5％ of the MRCNS strains were susceptible to rifampin.No staphylococcal strains were found resistant to vancomycin or teicoplanin.The resistance rates of E.faecalis strains to most drugs tested (except chloramphenicol) were much lower than those of E.faecium.A few strains of both species were resistant to vancomycin.Vancomycin resistant E.faecalis and E.faecium strains were mainly VanA,VanB or VanM type based on their phenotype or genotype.Regarding the non-meningitis S.pneumoniae strains,the prevalence of PSSP or PISP strains isolated from children was higher than that isolated in 2015,but the prevalence of PRSP strains decreased.However,the prevalence of PISP and PRSP strains isolated from adults was lower than that isolated in 2015.The prevalence of ESBLs-producing strains was 45.2％ in E.coli,25.2％ in Klebsiella spp.(K.pneumoniae and K.oxytoca) and 16.5％ in Proteus mirabilis isolates on average.ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBLs-producing strains in terms of antibiotic resistance rate.The strains of Enterobacteriaceae were still highly susceptible to carbapenems.Overall,less than 10％ of these strains were resistant to carbapenems.About 68.6％ and 71.4％ ofAcinetobacter spp.(A.baumannii accounts for 90.6％) strains were resistant to imipenem and meropenem,respectively.The prevalence of extensively-drug resistant strains in P.aeruginosa was higher than that in 2015.Conclusions Bacterial resistance to commonly used antibiotics is still on the rise.It is necessary to strengthen hospital infection control and management of clinical use of antimicrobial agents,and maintain good practice in surveillance of bacterial resistance.

Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011.Methods Fifteen repre-sentative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi-nation.Results were analyzed according to CLSI 2011 break-points.Results Majority (93.3%) of the 1 889 clinical strains of S.maltophilia were isolated from inpatients.On-ly 6.7% of the isolates were from outpatients.About 62.9% of these S .maltophilia strains were isolated from old patients whose age was 60 years or older.Only 8.2% of the strains were from the patients younger than 18 years old.Sputum and re-spiratory tract secretion were the most common specimen source,accounting for 82.6%.Another 4.2% isolates were from blood,abdominal fluid and other sterile body fluids.The percentage of the S .maltophilia strain resistant to trimethoprim-sul-famethoxazole,levofloxacin and minocycline was 16.6%,10.0% and 1.8%,respectively.The strains resistant to cefopera-zone-sulbactam accounted for 19.0%.About 37.1% of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole,significantly higher than the strains from urine or wound specimens (P < 0.01).Conclusions S.maltophilia strains are mainly isolated from inpatients.The most common source is sputum and other respiratory speci-mens.Most of the patients with S.maltophilia isolate are 60 years of age or older.The S.maltophilia strains are constitu-tively resistant to several antibacterial agents,but showed relatively lower resistance to trimethoprim-sulfamethoxazole,levo-floxacin and minocycline.Cefoperazone-sulbactam is still active against these strains.The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.

Objective To investigate the antimicrobial resistance of clinical strains of K lebsiella spp .isolated from 15 hospitals in China CHINET during 2012 .Methods Kirby-Bauer method and automatic microbiology analysis system were employed to study the antimicrobial resistance . WHONET 5 .6 software was applied for data analysis according to Clinical and Laboratory Standards Institute (CLSI) 2012 breakpoints .Results A total of 9 621 clinical K lebsiella isolates were analyzed ,including 8 772 strains of K . pneumoniae and 804 strains of K . oxytoca . About 54 .9% (5 285/9 621) of the K lebsiella strains were isolated from sputum ,and 16 .3% (1 564/9 621) were isolated from pediatric patients .Antimicrobial susceptibility testing showed that about 8 .9% ,10 .8% and 12 .9% of the strains were resistant to imipenem ,meropenem and ertapenem ,respectively .About 14 .1% and 17 .0% of the strains were resistant to piperacillin-tazobactam and cefoperazone-sulbactam , respectively . Carbapenem-resistant K lebsiella strains were identified from all the 15 hospitals ,including 945 strains of K .pneumoniae and 45 strains of K .oxytoca ,which were resistant to either imipenem ,meropenem or ertapenem .Conclusions The Klebsiella isolates collected from 15 hospitals in China during 2012 are relatively sensitive to carbapenems ,cefoperazone-sulbactam and piperacillin-tazobactam .The prevalence of carbapenem-resistant strains is still increasing in China ,about 10 .3% in 2012 ,and relatively higher in Eastern China .More efforts should be made to control the superbug .

Objective To investigate the antimicrobial resistance in the A cinetobacter baumannii strains in different parts of China during 2012 .Methods A total of 8 739 clinical isolates of Acinetobacter were collected from 13 general hospitals and two children’s hospitals ,of which most were A . baumannii (89 .6% , 7 827/8 739 ) . Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to the unified protocol . The susceptibility testing data were analyzed by WHONET 5 .6 software according to CLSI 2013 breakpoints .Results Majority (85 .4% ) of the Acinetobacter strains were isolated from inpatients .The remaining 14 .6% were from outpatients and emergency room patients .Of the 7 827 strains of A .baumannii , 10 .9% ,35 .2% ,35 .7% and 43 .4% were resistant to tigecycline ,minocycline ,cefoperazone-sulbactam and amikacin , respectively .The percentage of A .baumannii resistant to imipenem and meropenem was 63 .5% and 68 .2% ,respectively . The antimicrobial resistant pattern varied in different hospitals . The resistance of A . baumannii varied between different clinical departments .A number of pandrug resistant (PDR) (20 .0% ,1 567/7 827) and multidrug-resistant (MDR) (45 .0% , 3 521/7 827 ) A . baumannii were identified . Conclusions A . baumannii is the most popular pathogenic bacteria among Acinetobacter .The antibiotic resistance of A .baumannii is still increasing .Cefoperazone-sulbactam and minocycline has good in vitro antibacterial activity against A .baumannii .The antibiotic resistance of A .baumannii varies greatly with hospital and department .

Objective To investigate the distribution and antibiotic resistance of clinical Enterobacter isolates .Methods A total of 3 031 clinical strains of Enterobacter were collected from 15 hospitals from January 1 through December 31 , 2012 . Antimicrobial susceptibility testing was performed with Kirby-Bauer or minimum inhibitory concentration method .The results were analyzed according to CLSI 2012 breakpoints .Results Enterobacter cloacae and Enterobacter aerogenes accounted for 73 .0% (2 212/3 031) and 23 .9% (725/3 031) of all the Enterobacter strains .The isolates of other Enterobacter species accounted for 3 .1% (94/3 031 ) . The main source of the isolates was respiratory tract specimen , accounting for 53 .2% (1 612/3 031) .Most (> 89% ) of the Enterobacter strains were resistant to cefazolin and cefoxitin . Generally ,54 .4% ,47 .5% and 34 .3% of the strains were resistant to cefuroxime ,cefotaxime and cefazidime ,respectively . About 6 .6% to 26 .3% of the strains were resistant to amikacin ,gentamicin ,piperacillin-tazobactam ,cefepime ,cefoperazone-sulbactam ,ciprofloxacin and trimethoprim-sulfamethoxazole .Imipenem ,meropenem and ertapenem showed the highest activity , to which only 3 .5% ,3 .7% and 10 .3% of the strains were resistant ,respectively .About 8 .9% (269/3 031) of the strains were resistant to at least imipenem ,meropenem or ertapenem .Four Enterobacter strains were extensive-drug resistant (XDR) .Conclusions The prevalence of antibiotic resistance in Enterobacter isolates decreased slightly in 2012 compared to the data in 2011 ,but the situation is still very serious .We should continue to take effective measures to control the resistant strains .