Objective: To investigate the peri-operative incidence of depression and anxiety symptoms of coronary artery bypass grafting (CABG). Methods: 73 patients,who underwent scheduled consecutive CABG between July 2005 and May 2006,were assessed with self-rating depression scale( SDS) and self-rating anxiety scale(SAS)before operation and before leaving hospital.Results: 21 patients (28.8%) had depression and/or anxiety symptoms before CABG, including 11 patients with depression, 7 patients with both depression and anxiety and the other 3 patients had anxiety symptoms. 34 patients (46.6%) had depression and/or anxiety symptoms after CABG, including 18 patients who had depression, 13 patients had both depression and anxiety symptoms and the other 3 patients had anxiety symptoms. The SDS score(47.9?10.0)after surgery was significantly higher than that before surgery(43.7?10) ,t=3.55, P=0.001. The SAS score after surgery (41.6?8.5) was significantly higher than that before surgery (39.3?7.4),t=2.20, P=0.031. Patients with bad mood before operation had lower educational levels (8?3/10?3,t=2.18,P=0.032). Four patients had multiple myocardial infarctions, all of them were in the anxiety-depression group postoperatively (4/34 vs 0/39,P=0.043). There was no difference in post-operative length of hospital stay between the two groups.Conclusions: The peri-operative incidence of depression and anxiety of CABG patients was very high and even higher after surgery. Less education is a risk factor for preoperative depression and anxiety states, multiple infarctions is a risk factor of post operative anxiety and depression.

Objective To study absorption characteristic of dioscin from Dioscorea nipponica Makino extract in rat intestine.Methods Single-pass intestinal perfusion (SPIP) model was used for rat in situ and HPLC was used to determine the concentrations of dioscin.The effects of different intestinal segments,drug concentration and P-glycoprotein (P-gp) inhibitor on intestinal absorption were investigated.Results Dioscin could be absorbed in the whole intestine,the absorption rate constant (Ka) and the apparent coefficient (Papp) of dioscin decreased following the sequence of ileum > duodenum =jejunum > colon.Absorption parameters of dioscin had no significant difference at different concentrations (40,80,120 mg·L-1).There were significant differences in Ka and Papp values between P-gp inhibitor group and no P-gp inhibitor group(P<0.05).Conclusion The saturate phenomena was not observed under the test range of drug concentration,and the absorption mechanism may be passive diffusion transport.Dioscin in Dioscorea nipponica Makino extract may be the substrate of P-gp.

Objective To make spinal cor injury model of rabbit in order to investigate the feasibility and accuracy of diffusion tensor imaging in diagnosis of early ASCI. Methods In 30 Chinese rabbits ,24 rabbits were randomly selected as the experimental group and the other 6 as the control group. Allen′s technique were used to make moderateacute spinal cord injury in the experimental group. In the control group ,the operation only exposed the spinal membrane ,wihthout damage on the spinal cord. All rabbits were performed in routine MRI , DTI ,diffusion tensor tractography and post-processing. After the MRI scan ,the rabbit spinal cord was removed to have pathological examination at 1 ,3 ,5 ,7 days. Results The number of inflammatory cells and spinal motor neurons were closely correlated with FA values and ADC values. DTT images showed the spinal cord defects, curling and breaking. Conclusion The parameters of DTI (FA ,ADC) can reflect the pathological changes of acute spinal cord injury in early stage ,and therefore may be used as an routine evaluation method for clinical acute spinal cord injury.

This study aimed to evaluate emerging trends of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) among 290 former blood donor HIV-1 infected patients in Hubei,China,from 2004 to 2006,all of whom had received anti-HIV-1 therapy.The presence of NRTI- and NNRTI-associated mutations were established by sequencing; genotypic and predicted phenotypic drug resistance were evaluated using HIVdb Program version 5.0.1 (http://hivdb.stanford.edu/pages/algs/HIVdb.html).Genotypic drug resistance analysis showed significant increases in percentages of patients carrying HIV-1 strains with M41L,T215Y/F,D67N,K103N,G190A/S,Y181C/F or L210W mutations.Of the variants' predicted phenotypic drug resistance,highly significant increases were detected in percentages of patients carrying HIV-1 with high resistance to zidovudine (AZT) or stavudine (D4T) in NRTIs,and to delavirdine (DLV),efavirenz (EFV) or nevirapine (NVP) in NNRTIs; intermediate resistance to abacavir (ABC),AZT,D4/T,didanosine (DDI) or tenofovir disoproxil fumarate (TDF) in NRTIs,and to etravirine (ETR) in NNRTIs; and low and potential low resistance to lamivudine (3TC),ABC,emtricitabine (FTC) or TDF in NRTIs,and to ETR in NNRTIs.

Objective:To investigate the effect of atorvastatin on the blood lipid and uric acid levels of elderly patients with coronary heart disease complicated with diabetes mellitus.Methods:116 patients with coronary heart disease and diabetes were randomly divided into the control group and the experimental group,58 cases in each group.Both groups of patients were given blood glucose control,blood pressure and other symptomatic treatment.The control group was treated with Aspirin Enteric-coated Tablets 0.3～0.6 g/times,3 times/d,oral,clopidogrel tablets,2 tablets each time,1 time/d,oral,nitroglycerin,0.25～0.5 g/time,3 times/d,with service;the experimental group was given atorvastatin on the basis of control group,10～20 mg/time,1 time/d,treatment for 4 weeks.During the treatment,the dosage was timely adjusted according to the conditions of patients.The serum low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),triglyceride (TG),total cholesterol (TC),uric acid (UA),glycosylated hemoglobin (HbA1c) levels before and after treatment and the clinical treatment efficiency were observed and compared between two groups.Results:Compared with before treatment,the serum LDL-C,TG,TC,UA,HbA1c levels were decreased ahter treatment in both groups of patients,the HDL-C level was increased (P＜0.05);compared with the control group,the serum LDL-C,TG,TC,UA,HbA1c levels were lower,HDL-C level was higher in the experimental group (P＜0.05);compared with the control group,the effective rate of clinical treatment of the experimental group were higher (P＜0.05).Conclusion:Atorvastatin could effectively reduce the blood glucose,blood lipid,uric acid levels of elderly patients with coronary heart disease complicated with diabetes.

Objective To explore the effect of the three level storehouse system on ward drug management.Methods The three level storehouse system was established in our hospital,which includes drug demanding quantity of ward,delivering quantity of the drug storehouse,and management supervision of pharmacy.Result After implementing three level storehouse system, the incidence of medicine expiry,improper storage,drug reception,confused marking ,improper placement and incorrect drug administration were decreased(P<0.05).Conclusion The three level storehouse system could improve the quality of hospital drug management as well as ensure clinical medication safety.

Dilated cardiomyopathy (DCM) is the most frequent pattern of non-ischemic cardiomyopathy with poor prognosis and high mortality.Studies in recent years found that non-coding small RNA molecules (miRNA) were closely related to the clinical course of DCM.The present article made a review on the expression pattern of miRNA and development of DCM study.

BACKGROUND: Auditory steady-state responses (ASSR) is an objective method of hearing examination in clinic in recent years. ASSR has the frequency specificity as compared with previous auditory brainstem responses (ABR).OBJECTIVE: To investigate the accuracy of ASSR in objective hearing assessment.DESIGN: A case-control observation.SETTING: Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: The subjects in the normal hearing group were the 21 undergraduates (42 ears) were enrolled, they all had not any symptoms of ear disease, without history of noise exposure and disease of vestibule system, and they were normal in otoscopy. The outpatients and inpatients with neurosensory deafness were selected from the Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University. All the children cases worn hearing aids, and had the speech ability, and cooperated in the examination. The main types included 6 ears of sudden deafness,8 ears of presbycusis, and 20 ears of neurosensory deafness due to other unknown causes. Central lesions were excluded by MR examination, and all the patients agreed with the enrollment. The results of pure-tone audiometry were all flat or descending audiogram. According to the severity of hearing damage, the patients were divided into mild deafness group (13ears), moderate deafness group (9 ears) and moderate-to-severe deafness group (12 ears).METHODS: ① The pure-tone audiometry was performed at the frequencies of 0.125-8 000 Hz in a sound insulation room. The auditory threshold grades of the subjects with normal hearing all accorded with the standards of GB-7583-87 expected value distribution. The average value of air-conduction auditory thresholds of pure-tone audiometry at the frequencies of 0.5, 1, 2 and 4 kHz was calculated. ② ASSR measurement was performed with the synchronous stimulation pattern in a sound and electromagnetic shielding room, including 8 points for both ears of the same stimulation intensity and the carrier frequency tones of 0.5, 1, 2 and 4 kHz respectively.③ ABR examination was performed by click sounds with sparse waves in a sound and electromagnetic shielding room, and insert earphones were used.The threshold results were judged according to the minimal stimulation sound intensity of the distinguishable Ⅴ wave. ③ The results of pure-tone audiometry were compared with those of ABR examination, and the results of ASSR measurement in different hearing groups were processed with analysis of variance, multi-classification discrimination based Bayes standard and q test.MAIN OUTCOME MEASURES: The thresholds of pure-tone audiometry, ASSR measurement and ABR examination, and the correct rate analyzed by the multi-classification discrimination based Bayes standard were mainly observed.RESULTS: The indexes of the 42 ears in the normal hearing group, 13, 9 and 12 ears in the mild, moderate and moderate-to-severe deafness groups were all involved in the analysis of results. ① The ABR values were accorded with the actual hearing levels, and the closest to the ASSR thresholds at 1-2 kHz; ASSR reflected induction rates at different frequencies were gradually decreased with the aggravation of hearing damage, and that at each frequency varied with the changes of hearing level, the induction rates of ASSR responses were all 100% for the subjects with normal hearing and patients with mild deafness, but those for the patients with moderate and moderate-to-severe deafness were decreased (0.5 kHz: 77.8%,92.8%; 4 kHz: 88.9%, 85.7%). At different frequencies, the ASSR thresholds in the moderate-to-severe deafness group were significantly higher than those in the normal hearing group (P ＜ 0.05). The ASSR thresholds at 0.5 and 4 kHz in the moderate-to-severe deafness group were significantly higher than those in the mild deafness group (P ＜ 0.05). The ASSR threshold at 2 kHz in the mild deafness group was significantly higher than that in the normal hearing group (P ＜ 0.05). The ASSR thresholds at 4 kHz in the everedeafness group were significantly higher than those in the normal hearing group and mild deafness group. ② The incorrect discriminations of actual pure-tone audiometry were analyzed with the interactive clustering discriminant analysis of ASSR measurement and actual pure-tone audiometry, and the results showed that the correct rate of discrimination was 100% in the normal hearing group; Only 1 of the 12 cases in the mild deafness group was incorrectly judged, and the correct rate was 92%; Only 1 of the 19 cases in the moderate deafness group was incorrectly judged, and the correct rate was 89%; the correct rate in the moderateto-severe deafness group was 83%.CONCLUSION: The results of ASSR measurement can detect the incorrect discrimination of objective hearing condition by taking the results of pure-tone audiometry as the standards. ASSR has an acceptable accuracy for deafness higher than mild level in estimating objective hearing, and it has a better prospect of application in practice.

The paper is to report the pharmacokinetics of furosemide in rats living at plain area and high altitude. After intragastric administration of furosemide (2.87 mg x kg(-1)), serial blood samples (0.5 mL) were collected by retro-orbital puncture at 0, 20 min, 40 min, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 h, samples were determined by LC-MS/MS, and plasma concentration-time data were analyzed by DAS 2.0 software to get the related pharmacokinetic parameters. The main pharmacokinetic parameters: area under curve (AUC), mean residence time (MRT), the biological half-life (t1/2) and the peak concentration (C(max)) of furosemide, were significantly increased at high altitude, the time to reach peak concentration (t(max)) and clearance (CL) was significantly decreased. This study found significant changes on the pharmacokinetics of furosemide under the special environment of high altitude. This finding may provide some references for clinical rational application of furosemide at high altitude.

Objective To study the applied value of multi-slice spiral CT(MSCT)in pulmonary lesions.Methods 68 cases with massive hemoptysis caused by lung tumor or other reasons underwent 16-slice spiral CT scan including plain and contrast-enhanced scan.Volume reconstruction(VR),multiplanar reconstruction(MPR),maximum intensity projection(MIP)and curved planar reconstruction(CPR)were performed using original images.The origin,number and shape of vessels feeding lesions were observed.Results Among 68 cases(two failed),the blood supply of pulmonary lesions was from bronchial artery in 60 cases,from the intercostals artery in 8 cases,from the internal thoracic artery in 5 cases,from the left subclavian artery in 6 cases,from the right inferoir phrenic artery in 5 cases,from the celiac trunk artery in 3 case and from the right renal artery in 1 case.The blood supply was from single artery in 50 cases,double arteriae in 10 cases and three arteriae in 6 cases.The supply arteriae were vascular plexus in 55 cases,meandering in 8 cases,net in 2 cases and aneurysm formation in one cases.Conclusion MSCT can clearly display the vessels feeding pulmonary lesions.