Objective:To explore the utility of psychiatric service of clients having online counseling for anxiety or depression. Methods:The anxiety group was consisted of clients (n=107) who were positive in the Self-rating Anxiety Scale (SAS) online, similarly the depression group was consisted of clients (n=102) with positive results in Self-rating Depression Scale (SDS) online screening. Both groups were investigated with the questionnaires include issues related to the clinical features, diagnostic categories and treatment vs professional advice on clients. Results:In the anxiety group (male 69/female 38), the average age was 28+8, 88(82.2%) with more than 15 years education. In the depression group (male 57 vs. female 45), the average age was 29+8, 81(79.4%) with more than 15 years education. None was illiterate. For the age, sex, education and occupation, there was no significant difference between the two groups. 81(79.4%) clients in the anxiety group and 89(87.2%) clients in the depression group were advised to visit psychiatrists or psychologists. A few were advised to counseling online only and there was no significant difference between the two groups. The main diagnoses were mood disorders, neurosis and psychogenic disorders. Actually, 29(27.1%) in the anxiety group were treated with anxiolitics, 31(30.2%) in the depression group were treated with antidepressants at local clinics. Conclusion:Most of the clients should visit psychiatrists or psychologists, and a few may have their psychological counseling online only. Health education and psychological counseling online may be helpful to improve the rate of diagnosis and treatment of mental disorders in local clinics.

Objective:To study the scavenging activity of macroporous resin isolate of gynostemma pentaphyllum on free radical DPPH. Methods:The extract of gynostemma pentaphyllum via water boiling and precipitation with ethanol was separated by macro-porous resin respectively eluted by water, 40% ethanol and 80% ethanol to obtain the corresponding isolates. The antioxidant activity of the three isolates was determined by free radical DPPH systematic method, and the results were compared with that of gallic acid and ascorbic acid. Results: The 50% inhibitory concentration on free radical DPPH of the three isolates was 0. 081 2, 0. 028 7 and 0. 541 0 g·L-1 ,respectively. The 40% ethanol isolate had the highest saponins concentration. Conclusion:The macroporous resin i-solate with different solvent all shows antioxidant activity and the 40% ethanol isolate has the strongest effect, suggesting saponins may be the active substances for the lipid-lowering, hypoglycemic and free radical scavenging activities.

Objective To investigate the efficacy of ventilation with selective lobar collapse for thoracic surgery in elderly patients with chronic obstructive pulmonary disease (COPD).Methods Thirty ASA Ⅱ or Ⅲ patients with COPD,aged 65-80 yr,with a body mass index of 16-28 kg/m2,undergoing radical resection of esophagus cancer,were randomly divided into 2 groups (n=15 each):one-lung ventilation (OLV) group and ventilation with selective lobar collapse group (group SLC).In group OLV,OLV was performed,while in group SLC,the balloon of the blocker was placed at 0.5 cm below the opening of the upper lobe bronchus and the lower lobe was collapsed when chest was open.The patients were mechanically ventilated (VT =7-8 ml/kg,RR =14-16 bpm,I∶E=1∶1.5-2.0,FiO2 =100％).Peak pressure (Ppeak),plateau pressure (Pplat),airway resistance (Raw),and dynamic lung compliance (Cd) were measured at 10 min of two-lung ventilation in supine position (T0),at 5,45 and 90 min of OLV or selective lobar collapse (T1-3) and at 10 min of two-lung ventilation in lateral position after the end of operation (T4).Arterial blood samples were obtained at To,T3 and T4 for blood gas analysis.Oxygenation index (OI),alveolar-arterial oxygen gradiant (P(A-a)O2),and respiratory index (RI) were calculated.Results Ppeak,Pplat and Raw were significantly lower at T2-4,while Cd was significantly greater at T1-4,OI was significantly higher at T3,4,and P(A-a)O2 and RI were significantly lower at T3,4 in group SLC than in group OLV.Conclusion The thoracic operation can be completed safely using ventilation with selective lobar collapse and OLV,however,ventilation with selective lobar collapse can improve oxygenation and provides better ventilatory efficacy than OLV in elderly patients with COPD.

Objective To study the effect of smoking on resting energy expenditure ( REE ) and the relationships among REE, smoking , inflammation and oxidative stress in patients with diabetic kidney disease. Methods A case control study of 31 smokers and 40 non-smokers with early stage of diabetic kidney disease( stage Ⅲ ) were performed to evaluate the chronic effect of smoking on REE. REE/fat free mass( FFM ), biomarkers of oxidative stress malondialdehyde ( MDA ), superoxide dismutase ( SOD ) and inflammation high-sensitivity C-reactive protein (hs-CRP), adiponectin, TNFα were also measured in these subjects. Data were analyzed by Pearson correlation analysis. Results Compared with non-smokers, REE/FFM in smokers group was significantly increased by 15.96% ( P =0.001 ). Pearson analysis showed that smoking was significantly correlated with REE/FFM ( t = 0.395, P = 0.001 ). There were significantly different between smokers and non-smokers in MDA, SOD and hs-CRP ( P＜0.05 ). But no difference between two groups in adiponectin and TNFα ( P ＞ 0.05 ). No significant relationships between REE/FFM and MDA, SOD, hs-CRP, adiponectin, TNFα was found ( P ＞ 0.05 ). Conclusion Chronic smoking can lead to increased REE, arouse oxidative stress and inflammatory in patients with early stage of diabetic kidney disease. However, there is no relationship between increased REE due to smoking and oxidative stress and inflammatory.

Objective To investigate the effect of remote ischemic preconditioning (RIPC) combined with dexmedetomidine on lung injury during perioperative period and postoperative pulmonary complications in elderly patients with thoracotomy and pulmonary dysfunction.Methods Sixty ASA Ⅱ or Ⅲ patients aged 65-76 years [mean (70.4±6.3) years],weighing 50-75 kg,with moderate and severe pulmonary dysfunction,who were scheduled for elective radical operation for esophageal cancer,were randomly divided into 3 groups (n=20,each) by using a random number table:the control group (group C),RIPC group (group OR) and RIPC plus dexmedetomidine group (group ORD).At 10 min after endotracheal intubation,group ORD was induced by three cycles of 5 min of lower extremity ischemia followed by 5 min of reperfusion,at the same time a loading dose of dexmedetomidine 0.5 μig / kg was infused iv over 15 min,and then was infused at a rate of 0.5 μg · kg-1 · h-1 until the end of operation.Group OR was induced by three cycles of 5 min of lower extremity ischemia followed by 5min of reperfusion without dexmedetomidine.Group C received only the equal volume of normal saline.Blood samples were obtained from radial artery immediately before anesthesia induction (T0),before one lung ventilation (T1),at 1 h after one lung ventilation (T2),the end of surgery (T3) and 24 h after operation (T4).Blood gas analysis was done at T1,T2,and T3.Plasma superoxide dismutase (SOD) activity and concentration of malonyldialdehyde (MDA),matrix metallo-proteinase-9 (MMP-9),interleukin-6(IL-6) and white blood cell (WBC) and neutrophil granulocyte (PMN) counts were measured at T0,T2,T3 and T4.The complications including pulmonary infection and atelectasis were recorded at 1,3 and 7 days after operation.Results At T2-3,PaO2 was higher in groups of OR and ORD than in group C Group ORD had higher PaO2 than did group OR [(265±15) mmHg,(305±23) mmHg vs.(231±17) mmHg,(273±21)mmHg,(312±24) mmHg vs.(242±18) mmHg,F=34.791 and 31.813,P＜0.01].At T2-3,RI was lower in groups of OR and ORD than in group C,and group ORD had lower RI than did group OR [(1.48±0.16),(1.14 ±0.14) vs.(1.86±0.18);(1.35±0.13),(0.96±0.09) vs.(1.73±0.15),F=119.260 and 164.855,P＜0.01].At T3-4,SOD activity was higher in group OR and ORD than in group C,and group ORD had higher SOD activity than did group OR [(83.6 ± 7.8) U/mg prot,(97.6± 9.5) U/mgprot vs.(70.5±7.4) U/mgprot;(73.5 ± 6.3) U/mgprot,(87.7 ± 8.9) U/mgprot vs.(61.6 ± 5.4) U/ mgprot,F=94.540 and 90.839,P＜0.01].At T3-4.plasma concentration of MDA,MMP-9,WBC and PMN counts were lower in group OR and ORD than in group C,and the above indices were lower in group ORD than in group OR [(7.5 ± 1.4) nmol/mgprot,(5.8 ± 1.0) nmol/mgprot vs.(9.5 ±1.5) nmol/mgprot;(8.2± 1.5) nmol/mgprot,(6.5 ± 1.0) nmol/mgprot vs.(10.1 ±1.6) nmol/mgprot;(205±23) μg/L,(173±21) μg/L vs.(237±26) μg/L,(179±16) μg/L,(158±12) μg/L vs.(203± 20) μg/L;(8.0±0.5) ×109/L,(7.2±0.6) × 109/L vs.(9.2±0.8)×109/L;(9.4±0.7) ×109/L,(8.2±0.6)×109/Lvs.(11.2±0.8) ×109/L;(7.4±0.7) ×109/L,(6.5±0.5) ×109/Lvs.(8.3 ±0.8) ×109/L,(7.8±0.8) ×109/L,(6.7±0.6) ×109/L vs.(9.2±0.9) ×109/L,F=98.872,52.723;198.307,47.622,20.319,36.935,18.197,35.036,respectively,all P＜0.01].At T2-4,IL-6 level was lower in groups of OR and ORD than in group C,and group ORD had lower IL-6 level than did group OR [(105±14) ng/L,(86±12) ng/L vs.(127±18) ng/L;(125±19) ng/L,(101±16) ng/ L vs.(156±22) ng/L;(110±16) ng/L,(89±12) ng/L vs.(132±20) ng/L,F=85.449,139.848,124.129,respectively,P＜0.01].The incidences of postoperative pulmonary infection and atelectasis were lower in group OR and ORD than group C,and group ORD had lower incidences of postoperative pulmonary infection and atelectasis than did group OR (x2 =6.303 and 14.545,P ＜ 0.05).Conclusions RIPC combined with dexmedetomidine can improve pulmonary function in elderly patients with thoracotomy and pulmonary dysfunction,may relieve the inflammatory reaction and oxidation reaction during perioperative period and finally help to improve the prognosis of patients.

Aim To investigate the role of p38 mitogen-activated protein kinases(MAPKs) in genistein-induced osteoblastic differentiation of mouse bone marrow-derived mesenchymal stem cells(BMSCs).Methods Mouse BMSCs cultured in phenol red-free ?-MEM containing 10% V/V FBS,were added ?-glycerophosphate and ascorbic acid for inducing osteoblastic differentiation,and treated with 0.01~1 ?mol?L~(-1) genistein and/or SB203580 and PD98059.The temporal sequence of osteoblastic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity(ALP) and calcium deposition.The MAPK phosphorylation level was detected by Western-blot.Results Genistein(0.01~1 ?mol?L~(-1)) showed a dose-dependent effect on osteoblastic differentiation as evidenced by increased alkaline phosphatase(ALP) activity and calcium deposition in mouse BMSCs cultures.Genistein(1 ?mol?L~(-1))-induced osteoblastic differentiation of BMSCs was diminished by p38 MAPK inhibitor but not the p44/42 MAPK inhibitor.The effects of Genistein were associated with rapid and sustained activation of p38 MAPK in the BMSCs cultures,which was blocked by SB203580(1 ?mol?L~(-1)).In contrast,Genistein treatment resulted in inactivation of p42/44MAPK,which was further attenuated by PD98059(25 ?mol?L~(-1)).Conclusion p38 MAPK plays an important role in genistein-induced osteoblastic differentiation of mouse BMSCs cultures.

Objective To compare the efficacy and safety of E1B gene-deleted adenovirus (H101)and ethanol in treating advanced pancreatic carcinomas by intratumoral injection combined with intravenous gemcitabine.Methods We constructed an orthotopic nude mouse model of pancreatic carcinoma through cancer cell injection into pancreas.A total of 54 nude mice were randomly allocated to 6 groups to accept H101,ethanol or saline (control) intratumoral injection,combined with or without intravenous gemcitabiein.The animals were sacrificed 4 weeks after the treatment and the pancreatic tumors were collected to determine the size,existence of metastasis,distribution of virus by indirect immunofluorescence and apoptosis in tumor by TUNEL and electron microscope.Results All mice completed the scheduled treatment,while 3 died in 48 hours after ethanol injection resulting in a mortality of 16.7％ (3/18).On the contrary,no mice died in the adenovirus injcction group.The average tumor size in group of H101 intratumoral injection combined with intravenous gemcitabie was significant smaller than that in group of saline injection with or without systemic gemcitabie (P =0.008,0.040,respectively).Similar differences were observed between ethanol intratumoral injection and control groups (P =0.012,0.041).Meanwhile,the H101 was absent in all the other organs except the pancreas,which meant that the selectivity of the H101 was tremcndous.The virus combine gemcitabie group had higher apoptosis rate in tumor (83.2 ± 35.7) ％,determined by TUNEL.Conclusion E1B gene-deleted adenovirus intratumral injection in combination with intravenous gemcitabine treating pancreatic carcinomas is efficient and safe,in spite of its lower effectiveness than ethanol.

Objective To compare the effects of dual-wavelength spectrophotometry and HPLC on the content of trimethoprim(TMP)in Compound Dihydroartemisinin Tablets.Methods HPLC was performed in a column of C 18 with acetonitrile and 0.75% diethylamine(15∶85,adjusting pH to 2.5 by phosphoric acid)as the mobile phase and the detecting wavelength was at 271nm.The detecting wavelength was also at 271nm with reference wavelength at 366nm in dual-wavelength spectrophotomerty.Results Within 20.0～100.0 ?g/mL,TMP has a good linearity(r=0.999 94)by HPLC,and the average recovery was 100.9% with RSD being0.24%(n=5).By dual-wavelength spectrophotometry,a good linearity(r=0.999 95)of TMP was within 5.0～25.0 ?g/mL,and the average recovery was 100.0% with RSD being 0.45%(n=5).Conclusion Both dual-wavelength spectrophotometry and HPLC can be used to determine the content of TMP in Compound Dihydroartemisinin Tablets,but the former can detect the content of TMP directly without the disturbance of piperaquine phosphate and is simple,rapid and accurate.

Objective To detect the mutations of GJB2 and GJB6 genes in the first Chinese case of keratitis, ichthyosis and deafness (KID) syndrome. Methods Genomic DNA was extracted from the patient with KID syndrome and his family members. All encoding exons and adjacent splice sites of the GJB2 and GJB6 genes were amplified by PCR. Mutation scanning was carried out by direct bidirectional DNA sequencing. Results No mutation was found in GJB6. A G148A mutation was found at exon2 of GJB2 in the patient, which caused a change from aspartic acid to asparagine at codon 50(D50N). Conclusion This case of KID syndrome may be caused by the mutation in GJB2.

Objective To report one case with congenital ichthyosiform eruption, neurosensory deafness and vascularizing keratitis. Methods The overall clinical and laboratory examinations were conducted to confirm the diagnosis of keratitis, ichthyosis and deafness (KID) syndrome. Results The case presented with the typical hypotrichosis features of the eye lashes and eyebrows, alopecia of the scalp, and ophtalmological lesions. The keratotic plaques over the face, nose, ears, and the extremities were characterstic, and the skin of the trunk was leather-like, dry and hyperkeratotic. Dysplasia of cerebellum, and cystic enlargement of the fourth ventricle of cerebrum, and Dandy Walker syndrome were observed on MRI scanning. Treatment with oral acitretin for 3 weeks cleared the hyperkeratotic ichthyotic lesions on her posterior scalp and also improved other lesions on the extremities and the trunk. Conclusion Acitretin seems to be promising in the treatment of keratotic skin lesions in KID syndrome.