Objective To explore the effect of antidepressant adjuvant treatment for chronic prostatitis (CP),and to find an effective treatment for the clinical therapy of CP.Methods 88 patients with CP were randomly divided into two groups,the control group 41 patients were treated with the antibacterials moxifloxacin,the treatment group 47 patients were treated with the moxiiloxacin treatment and paroxetine adjuvant therapy.The clinical symptoms,life quality (QOL) and Zung depression scale score of the two groups were evaluated and compared.Results After four weeks of treatment,voiding difficulty endless,urinary urgency,perineal discomfort symptoms of the treatment group were improved significantly compared with the control group (x2 =23.563,18.348,15.874,all P ＜ 0.05).After four weeks of treatment,QOL,Zung depression scale scores the treatment group were more significant decline than before treatment and the control group after treatment (t =0.554,0.615,0.382,0.336,all P ＜ 0.05).Conclusion Antidepressant adjuvant therapy improves the psychiatric symptoms of CP patients,which can effectively improve the clinical efficacy of antibiotic therapy of CP.

BACKGROUND: The main pathological change of intervertebral disc herniation is that nucleus pulposus protrudes from ruptured annulus fibrosus, thus we can hypothesize that it is possible to prevent disc herniation prior to its protrusion by coagulating it as a whole.OBJECTIVE: To observe the coagulation effects of intervertebral disc nucleus pulposus by alum solution.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed between September 2002 and April 2003 at Department of Animal Experiment, Peking University First Hospital, Beijing China.MATERIALS: Twenty-six healthy adult hybrid dogs, 9 for in vitro experiment and 17 for in vivo experiment, weighing 16-21kg, with no restrictions on male and female, were obtained from Department of Animal Experiment, Peking University First Hospital, Beijing, China.METHODS: Twenty canine in vitro intervertebral discs obtained from 5 dogs were randomly divided into 4 groups, with 5 discs in each group, and were put into 2.5%, 5%, 10% alum solutions and 0.9% physiological saline, respectively. Effects of disc coagulation were observed after immersing for 1 day and 10 days, respectively. Another 16 in vitro intervertebral discs obtained from 4 dogs, composed of L2/3, L3/4, L4/5, L5/6, were also injected with the above 4 experimental solutions, 0.15ml, respectively. Sixty-eight in vivo intervertebral discs were obtained from 17 dogs and divided into 4 groups: blank control group, physiological saline group, 10% alum solution+one puncture point group, and 10% alum solution+two puncture points group, 17 discs in each group. Harvesting time: 3 days, 2 weeks, 1 month and 3 months postoperation.MAIN OUTCOME MEASURES: Effects of alum solutions on the coagulation of the intervertebral discs and related histological changes were observed and an alum solution of suitable concentration was preliminarily selected. General observation, light microscopic observation and scanning electron microscopic observation were made of the nucleus pulposuses.RESULTS: In the in vitro and in vivo experiments, it was found that physiological saline did not produce the effect of coagulation on the nucleus pulposus, while immersion in the alum solution induced nucleus pulposus coagulation in the in vitro intervertebral discs. Also, as the concentration of the alum solution increased, the volume of the coagulated nucleus pulposus gradually decreased. After alum solution was injected into the in vitro intervertebral discs, no nucleus pulposus coagulation appeared. When the 10% alum solution was injected into the in vivo intervertebral discs, nucleus pulposus coagulation occurred, with the strongest coagulation effect reached at 1 month postoperation. This was manifested in the agglutination reaction centered around the puncture point. When there were 2 puncture points, 2 coagulated lumps might appear. There was an increase in the mesenchymal component of the coagulated nucleus pulposus. Histochemical and scanning electron microscopic examinations confirmed the proliferation of large numbers of collagen fibers in the mesenchyme.CONCLUSION: Alum can promote nucleus pulposus to coagulate around the injection point. This may be related to the increase of collagens and the fibrosis resulting from stimulation of the nucleus pulposus by alum solution.

Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

Objective To select health individual and test serum total bilirubin and direct bilimbin in order to provide a reference range for the establishment of appropriate reference interval in this region.Methods From October to December in 2009,314 of physical examination population of Beijing Hospital were selected by questionnaire and laboratory test excluding liver and gallbladder diseases or metabolic diseases.Roche and Prodia reagents were used to test TBIL and DBIL,respectively.Reference interval was calculated by sex group and compared with the existing reference interval.Results The level of TBIL had a significant difference between different genders(P ＜ 0.01).The level of TBIL had a significant difference between two kinds of reagents(P ＜ 0.01).Using Roche reagent,the reference interval of TBIL was 7.1 ～ 27.2 μmol/L for man,and 4.8 ～ 20.9 μmol/L for woman,and the reference interval of DBIL was 1.4 ～6.8 μmol/L for man,and 0.9 ～5.7 μmol/L for woman.Using Prodia reagent,the reference interval of TBIL was 9.5 ～ 35.7 μmol/L for man,and 6.8 ～ 28.9 μmol/L for woman,and the reference interval of DBIL was 1.3 ～ 7.0 μmol/L for man,and 1.0 ～ 6.6 μmol/L for woman.Conclusions The level of TBIL and DBIL in physical examination population was higher than the existing reference interval.It is necessary to modify the existing reference interval and establish reasonable reference interval for different regions and gender,respectively.

The health check-up results of 11 514 subjects in 2011 at Beijing Hospital were retrospectively analyzed,including the results of 13C urea breath test for detection of Helicobacter pylori (Hp) and HbA1c test.The results showed that the prevalence rate of Hp infection was significantly higher in females (31.77％) than that of males (29.36％) (x2 =7.355,P ＜0.05) ; the highest prevalence was found in 35-60 y age group (31.17％).Hp positive rates in subjects with body mass index (BMI) ≥28kg/m2 and central obesity were 31.55％ and 30.44％,respectively; there were no significant differences from those with normal weight and non central obesity.Subjects with positive Hp infection had higher levels of HbA1 c,compared to those with negative Hp infection (t =-2.276,P =0.01).In subjects with BMI ≥24 kg/m2 and central obesity,HbA1c level was higher in Hp positive subjects than that in Hp negative ones (P ＜0.05).Diabetes mellitus was positively associated with Hp infection (OR 1.282; 95％ CI 0.941-1.799),particularly in obese patients (OR 1.459 ; 95 ％ CI 1.070-2.071).The results indicate that Hp may be involved in the impairment of glucose regulation,particularly in those with higher body mass index.

Objective To evaluate the treatment of obstructive jaundice caused by bile duct strictures after hepatic transcatheter arterial chemoembolization in hepatic tumor patients. Methods A retrospective review (Jun 1994 - Mar 2010) of databases at two institutions (Zhejiang Provincial People's Hospital and Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine) identified 15patients with obstructive jaundice caused by liver bile duct stricture after transcatheter arterial chemoembolization. There were 7 cases of primary liver cancer, 5 patients of liver hemangioma, 3 cases of metastatic liver cancer including 2 cases of colonic cancer and one of pancreatic cancer. Obstructive jaundice appeared in a period of 5 months to 16 months after TACE. The median time was 9 months. Results The obstructive jaundice was relieved by surgically constructed hepatobiliary drainage or PTC+stenting treatment in 13 cases and PTCD in 2 cases. All patients of hepatic hemangioma were doing well after treatment. Two cases of primary liver cancer patients with obstructive jaundice after TACE were followed up for 2 years with no recurrence of hepatic carcinoma and bile duct obstruction. The other 8 patients were followed up from 3months to 18 months until to their death from primary disease progress. Conclusions Surgery and or PTCD plus stent can effectively relieve the obstructive jaundice caused by TACE in benign or malignant liver tumors.

Objective To discuss the pathogenesis and clinical characteristics of acute relapsing pancreatitis .Methods The clini-cal data and relevant data of 274 acute pancreatitis cases from January 2010 to and December 2012 were analyzed ,of which one group of 231 cases were first onset and the other group of 43 cases were relapsing .Results The probability of relapse of acute pan-creatitis were highest from 1 month to half a year after first onset (20 cases ,accounting for 46 .51% );biliary factors were the major causes of first onset and relapse cases ,where the relapsing group was higher than first onset group ,with statistical significance (P<0 .05);the relapsing group had more severe symptoms of hyperlipidemia than the first onset group ,with significant difference (P<0 .05) ,The relative risk (OR value) of relevant factors were higher than biliary factors ;improper diet ,alcohol and other factors of the relapsing group were lower than the first onset group ,without statistical significance (P> 0 .05);there was no significant difference between the occurrence rate of severe pancreatitis and the occurrence rate of surgeries and deaths .Conclusion Biliary diseases and hyperlipidemia are closely related with the relapse of acute pancreatitis .

Objective To explore the diagnosis and treatment of unsuspected gallbladder cancer (UGC)related with laparoscopic cholecystectomy(LC).Methods From January 1995 to Dece m ber 2008,4520 cases of LC were performed,UGC waS discovered in 15 cases.Clinical data of the 15 cases were analyzed retrospectively.Results Among the 15 cases of UGC,7 were discovered intraoperatively,and 8 were diagnosed postoperatively.Postoperative pathological examination showed Nevin stage I in 4 cases,stage Ⅱin 7 cases,stage Ⅲ in 3 cases,stage Ⅳ in 1 case.LC was carried out in the patients of Nevin stage I.Radical resection of gallbladder cancer was performed on the patients at stage Ⅱ and stage Ⅲ.One patient at stage Ⅳ received extended radical resection.The patients were followed up from 6 months to 5 years,during the period 3 cases were died and 12 cases were still alive,the 5-year survival rate wag 80.0%.Conclusions Most of LC-related UGC cases are early cancer.Frozen section examination should be performed for high-risk groups and suspicious persons,which contributes to the discovery of UGC.LC can achieve the radical purpose of Nevin stage I patients,Nevin stage Ⅱ-Ⅳ requires open radical operation.

Objective To investigate a mechanism protected radiation-induce injure for radiated guinea pigs'nasal mucosa treated with intranasal corticosteroids (fluticasone nasal cavity spray). Methods 50 health guinea pigs were divided into 2 groups randomly: the irradiated group (control group) with 25 guinea pigs and the administration group after irradiation (test group)with 25 guinea pigs. The nasal part of all guinea pigs were performed irradiation by the 6 MV X-ray with single 5 Gy, one time each week for three weeks. The guinea pigs of test group received intranasai eorticosteroids with one time every day and one spray each side nasal cavity on the second day after three weeks irradiation. Five guinea pigs in each group were saeritieed randomly at 1 week, 1 month, 2 months, 3 months and 4 months after irradiation, and the histopathologie changes were observed under optical microscope and electron microscope. At the same time, blood were drawn from the heart and the concentration of IL-1, IL-6 and TNF-α in serum were measured by ELISA. Results The early nasal mucosa inllammatory reaction of the test group was less than the control group. The coverage rate of cilia of the test group was much than that of the control group (72.9% vs 50.2%) at four months after irradiation. The atrophy of submucosal glandular organ was lessened and they displayed some extent secretory function. The concentration of IL-1 in serum was increased very much in the test group compared with the control group after irradiation and kept higher level in the first two months. After two months, it began to decrease;on four months, it still kept equivalency level with the control group. The concentration of IL-6 and TNF-α in serum were reduced all the while. Conclusions The intranasal eortieosteroids with fluticasene nasal cavity spray can reduce radiation-induced injury of guinea pigs' nasal mucosa. The concentration change of IL-I, IL-6 and TNF-α in serum may be one of mechanism protected radiation-induce injure of guinea pigs' nasal mueosa.

Terapeutic options used to repair tendon and ligament injury consist of autografis,allografts and synthetic prostheses.Tendon and ligament of tissue engineering have their unique advantages as alternative therapy.Choosing the proper scaffold materials is important for successfully constructing tissue engineering tendon and ligament,so in this review we focus on natural and artificial scaffold materials used in tissue engineering of tendon and ligament in recent years.