Objective To study the efficiency,safety,and its impact on the functional rehabilitation of the selective 5-serotonin reuptake inhibitor(SSRI) drugs paroxetine in treatment patients with poststroke depression and anxiety.Methods The acute stroke patients at our Neurology department and old-age cadres department were selected,in which have 88 cases of poststroke patients with depression and anxiety,which were divided into paroxetine group and the control group.Paroxetine group was given Seroxat 20 ng,1 time/d + conventional treatment of cerebrovascular disease.The control group was gaven conventional treatment of cerebrovascular disease only.After 4 weeks,6 weeks of treatment,we assessed Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale(HAMA),neurological deficit and the state of living ability were assessed.Results There were significant differences in improvenent of depression and anxiety,neurological deficit and the capacity of the state of life between the Paroxetine group and the control group the control group of 4 weeks treatment compared with before treatment(all P＜0.05);Compared with before treatment,the control group of 6 weeks treatment compared with before treatment(all P＜0.05);Paroxetine group of 4 weeks treatment compared with before treatment(all P＜0.05);Paroxetine group of 6 weeks treatment compared with before treatment(all P＜0.05),and Paroxetine group control is obvious Improved(all P＜0.05).Conclusion Using Paroxetine to treat poststroke patients with depression and anxiety,not only could significantly improve symptoms of depression and anxiety,but also speed up the rehabilitation of limb function,efficacy reliable,and had no significant adverse reactions.So,it was an ideal medcine for poststroke patients with depression and anxiety.

Objective NKT cells are very important as a kind of non-specific immune cells. Much attention in antitumor significance has been received in the study of its effect on malignant diseases. The aim of this study was to detect the expression of NKT cells and its CD+8 NKT subsets in peripheral blood of esophageal patients and normal person, and to analyze the changes in the expression of NKG2D and NKG2A receptorsand its clinical pathological factors. Methods By flow cytometric analysis, 53 patients with esophageal carcinoma and 39 normal controls were analysed for peripheral blood of NKT cells and CD+8 NKT subsets, and the expression of NKT cells NKG2A and expression of NKG2D receptor. The clinical pathological factors were collected for the comparative analysis. Results Compared with the normal control group, the expression of NKT cells in peripheral blood of esophageal patients increased [(4.32±0.73) %, (5.97±1.29) %] (t =3.562, P <0.01), and the expression level of its surface receptor NKG2D reduced [(17.56±5.92) %, (15.12±1.56) %] (t =3.892, P <0.05), but the express levels of NKG2A [(4.02±1.41) %, (5.99±4.59) %] in creased (r = 4.015, P <0.05), those expression change with the development of the esophageal cancer. Conclusion The increased expression of NKT cells and CD+8 NKT subsets in the peripheral blood of patients with esophageal carcinoma refletcs that the immune feedback of patients' antineoplastic effect is strengthened. The decresed expression of the active receptor NKG2D and the increased expression of the inhibitory receptor NKG2A on NKT cells might be one of mechanisms leading to the reduction of NKT cell activity and immune escape of patients with esophageal carcinoma. The changes of surface receptors of NKT cells may be associated with the development of the esophageal cancer.

Aim To study the single nucleotide poly-morphism ( SNPs ) of AMP-activated protein kinase ( AMPK) ?2 subunit gene PRKAA2 ( rs2051040 and rs17848595) and its relationship with metformin response. Methods A total of 32 patients with type 2 diabetes( T2DM) were enrolled. All patients were required to take metformin for 1 week. The serum levels of FPG,TG,TC,LDL-C,HDL-C were assayed before and after therapy. The gene polymorphism of PRKAA2 was analyzed by PCR-DGGE,the effects of metformin were compared between patients with different phenotypes. Results FPG,TG,TC,LDL-C were significantly improved after therapy in wild genotype carriers( P 0. 05) . Conclusion The results of this study suggest that PRKAA2 polymorphism may be associated with metformin treatment effects in T2DM patients.

ObjectiveTo observe the changes of serum homocysteine acid ( Hcy),interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP)and elucidate the clinical significance in patients with acute stroke. MethodsA total of 126 acute stroke patients were enrolled in the investigation. Based on the MESS,patients were divided into different groups according the severity and prognosis, and 108 physically healthy subjects were selected as controls. The concentration of serum Hcy, IL-6, and hs-CRP were determined in all cases after being attacked at day 3,day 14 and day 28 respectively. Results①The levels of Hcy, IL-6, hs-CRP in patients with acute stroke were significantly higher than controls ( (58.24 ±9.86) μmol/L vs. ( 17.12 ±4.23) μ mol/L, (59.64 ±13.82) ng/L vs. (18.46 ±4.62) ng/L,(19.78 ±6.12) mg/L vs. (2.28 ±0.82) mg/L,all P＜0. 01 ). ②The levels of Hcy,IL-6, hs-CRP in patients with mild, moderate and severe acute stroke were significantly higher than controls (P ＜ 0.01 ) at 3 day after the onset; and the Hcy, IL-6, hs-CRP were also significantly lower in mild cases with acute stroke compared with moderate and severe cases (P ＜ 0. 01 ). At day 14 ,the moderate and severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild cases and controls (P ＜ 0.01 ). At day 28 the severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild and moderate cases and controls (P ＜ 0.01 ) ③At day 28, the levels of Hcy, IL-6, hs-CRP in basically recovered and remarkably improved cases were significantly lower than unrecovered cases [ ( 16.12 ± 4.74) μmol/L, ( 1 8.42 ± 5.02) μ mol/L vs. ( 48.69 ± 7.89)μmol/L; ( 19.52 ± 5.67 ) ng/L, ( 20. 74 ± 6. 13 ) ng/L vs. ( 51.26 ± 11.66 ) ng/L, ( 3.21 ± 1.36) mg/L,(3.24 ± 2.51 ) mg/L vs. ( 8.86 ± 1.32 ) mg/L respectively, all P ＜ 0. 01 ]. ConclusionsThe levels of serum Hcy, IL-6, hs-CRP are significant biomarkers to evaluate the severity and prognosis of acute stroke.

Objective To study the physical characteristics of the OPEN stereotactic body radiotherapy system for the clinical application. Methods The 0. 125cc ioniztion chamber, 160 mm polystyrene sphere model,Gafchromic EBT2 films and IBA film analysis software were used to evaluated the focus position tolerance,dose rate,repeatability,linear relation,penumbra and composite error of the OPEN stereotactic body gamma knife. We used the DTA method to verify the accuracy of dose distribution between the plans and measured value. Resualts The focus error was 0. 36 mm,max dose rate tolerance 3%,linear relation error 2%,repeatability error 0. 3%,composited error 2. 5 mm. There was 90% pass rate when the distance away from test point was less than 2 mm and the dose error was set less than 5 % . Conclusions Parts of the test resualts were similar to the head gamma knife national protocal of OPEN stereotatic body gamma knife. The deliver dose distribution can meet the clinic need.

Objective To investigate the effects of chondroitinase ABC injection on motor and acetylcholinestarase (AchE) expressed inthe motor end-plate of gastrocnemius in adult rats with spinal cord injury. Methods The spinal cords in T10 of 40 male Wistar rats (10 weeksold) were exposed and the right sites were semi-transected. The left sites were considered as the control (group A), the transected sites wereas the injured group (group B) and chondroitinase ABC-treated group (group C). The rats were assessed with Basso, Beattie & Bresnahan(BBB) score for ethological test, and sacrificed 3 d, 7 d, 14 d and 28 d after operation. The AchE expressed in gastrocnemius was detectedwith zymochemistry staining. Results BBB score in group C was significant higher than that in group B 14~28 d after operation, while theAchE activity in group B and C was lower than that in group A (P<0.05), and lower in group B than in group C (P<0.05). Conclusion ChondroitinaseABC injection can enhance AchE activity and promote the locomotor recovery after spinal cord injury in adult rats.

BACKGROUND:Tranditional Chinese medicine,which possesses anti-oxidation properties,can promote directional differentiation of mouse bone marrow mesenchymal stem cells(BMMSCs)into nerve cells.Salidrosides,as the effective constituent of Rhodiola,have strong anti-oxidation function.OBJECTIVE:To investigate the molecule mechanism of salidrosides induced differentiation of mouse BMMSCs into nerve cells.METHODS:When in vitro cultured BMMSCs reached 80% confluency,the cells were assigned into 3 groups.Cells in the control group were cultured by complete culture medium;those in the induction and positive control groups were cultured by complete culture medium adding 20 mg/L salidrosides or 0.1 mg/L nerve growth factors(NGF).The related gene and protein of nerve cells were detected using RT-PCR and Western blot method at 12 hours after culture.After that,the cells in the induction group were divided into 3 groups,the blocking agents EGTA(Ca~(2+) chelator),Nifedipine(L-type Ca~(2+) channel blocker)and LY294002(IP3 receptor blocking pharmacon)were applied to block the cellular Ca2* signal pathway respectively for 12 hours.RT-PCR and Western blot methods were used to study the signal transduction of the salidrosides.RESULTS AND CONCLUSION:①The expression of neuron specific enolase(NSE),B-Tubulin III,Nurri mRNA could be found ir the induction and positive control groups,instead of the control group;The expression abundance of the positive control group was smaller than that of the induction group.The expression abundance of GFAP mRNA was very low in each group,but the c-fos mRNA was expressed abundantly in the induction group.②Compared with the positive control group,the induction group could promote the NSE expression obviously,which was no expressed in the blank control group.?The expression of NSE and Nurri were conspicuously down-regulated when the Ecto Ca~(2+) and L-type Ca~(2+) channel and IP3 receptor were blocked respectively.Salidrosides can induce the differentiation BMMSCs into nerve cells. Ca~(2+) signaling and IP3 dependent Ca~(2+) signaling pathway play an important role in transduction salidrosides signal in BMMSCs differentiation.

Objective To summarized the experience of simultaneous aortic operation and coroanry artery bypass graft (CABG).Methods Ninety seven patients who underwent combined aortic operation and CABG were reviewed from January 2009 to December 2011.All patients are divided into four groups according to etiology,63 aortic aneurysm,other 25 aortic dissection,7 coarctation of aorta or occlusion of main branch,and the other two aortic ulcer.Mean age of all patients is(57.6 ±9.5) years.The rate of preoperational diagnosis of coronary disease (CAD) were respectively 93.7％ (59/63),40.0％(10/25),100.0％,100.0％.The patients made the preoperative diagnosis of CAD were performed selective simultaneous CABG with aortic procedures.The others without diagnosis of CAD had to receive urgent CABG during the aortic procedures.Results The aortic procedures with simultaneous urgent CABG had signilicant higher mortality than with selective CABG,16.7％,3.8％,Fisher's exact test P =0.078.Conclusion Selective simultaneous CABG with aortic procedures is safely.In aortic surgery,patients with risk factors of CAD should undergo preoperative coronary artery angiography or spiral computed tomography.

Objective To identify the risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients.Methods 210 Stanford type A aortic dissection(TAAD) patients underwent Sun's procedure in Beijing Aortic Disease Center during July 2014 to March 2015.14 patients had spinal cord injury after surgery.Clinical data and computed tomography angiography(CTA) imaging of aorta were retrospectively analyzed and multi-logistic regression analysis was performed to identify risk factors for spinal cord injury post operation.Results 14 out of 210(6.7％) patients had transient or permanent spinal cord injury after surgery.Univariate analysis showed only false lumen derived intercostal arteries at eighth thoracic vertebral level (T8) to first lumbar vertebral level (L1) was significantly associated with post-surgery spinal cord injury (P =0.000).Multi-logistic regression analysis showed that false lumen derived intercostal arteries (P =0.000) and age (P =0.016) were significantly associated with postoperative spinal cord injury.Conclusion Major intercostal arteries derived from false lumen and rapid thrombogenesis in false lumen are the major risk factors for postoperative spinal cord injury in Stanford type A aortic dissection patients.

Objective To identify the risk factors for acute kidney injury (AKI) in overweight patients who underwent surgery for the treatment of acute type A aortic dissection(TAAD).Methods A retrospective study including 108 consecutive overweight patients(body mass index(BMI) ≥24) between January 2010 and May 2013 in Beijing Anzhen Hospital was performed with Sun's procedure of total aortic arch replacement and frozen elephant trunk implantation.AKI was as defined according to Acute Kidney Injury Network (AKIN) criteria based on serum creatinine(sCr) or urine output.Results The mean age of the patients was(43.69 ± 9.66) years.During the postoperative period seventy-two patients(66.7％) developed AKI.The overall postoperative mortality rate was 7.4％,8.3％ in AKI group and 5.6％ in non-AKI group.There is no statistically significant difference between the two groups(P =0.32).A logistic regression analysis was performed to find out the independent risk factors for AKI:elevated preoperative sCr level and postoperative drainage volume.Renal replacement therapy(RRT) was performed in fifteen patients (13.9 ％).Conclusion A higher incidence of AKI (66.7 ％) in overweight patients following acute TAAD was identified.The logistic regression model found out elevated preoperative sCr level and 72 hour drainage volume as the two independent risk factors for AKI in overweight patients.More attention should be paid to prevent AKI in overweight patients following TAAD.