Objective:To study the efficacy and safety of mirtazapine and paroxetine in patients with first-episode climacteric depression. Methods:A 8-week double-blind study was conducted with 90 female patients suffered with climacteric first-episode depression. Subjects were randomly assigned to either mirtazapine (n=45) or paroxetine (n=45). All subjects were evaluated with Hamilton Rating Scale for Depression-17 (HAMD-17), Hamilton Rating Scale for Anxiety,and Treatment Emergent Symptom scale (TESS) at baseline, the end of week 1, 4 and 8 after treatment. The study had lasted for 8 weeks.Results:The response rate between two groups (mirtazapine 88.9% vs paroxetine 82.2%) was similar. There were significant differences on the scores of HAMD between the two groups at the end of 1st and 8th week, and HAMA at the 1st week after treatment(21.3?3.5/25.2?2.9,18.2?3.2/21.5?2.4,t=-2.367、-3.514,P=0.042、0.032;7.2?3.5/9.8?2.3,t=-3.258,P=0.035). Mirtazapine had increased food appetite(15.6%), body weight(13.3%), hydropsia(8.9%), dry mouth(6.7%), sleep disorder and nausea(4.4%). Meanwhile paroxetine had dry mouth(22.2%), sleep disorder(20.0%), nausea(17.8%), tremor(15.6%), restlessness/agitation(13.3%) and sexual disturbance(11.1%).Conclusion:Mirtazapine has rapid response, strongly antidepressive effect in female climacteric first-episode patients and less side-effects.

Aim To investigate the effects of tamoxifen on the proliferation and DNA synthesis of cultured human pituitary adenoma cells and make a further investigation of the mechanism of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells. Methods The techniques of MTT colorimetry, 3H-TdR, flow cytometry, PKC activity detection and cAMP/ cGMP levels detection were used to detect or observe the effects of tamoxifen on proliferation, DNA synthesis, cell cycle, PKC activity and cAMP/ cGMP levels of cultured human pituitary adenoma cells, respectively.Results ①Tamoxifen (0.1,1 and 10 ?mol?L -1) inhibited the proliferation and DNA synthesis of cultured human pituitary adenoma cells in a dose-dependent manner.② tamoxifen (1,10 and 20 ?mol?L -1) increased the ratio of G_1 phase of pituitary adenoma cells, and decreased the ratio of S and G_2 phase markedly;②compared with control, PMA, a PKC activator, increased the activity of membrane and total PKC in human pituitary adenoma cells. However, after a 15-min treatment with tamoxifen (10 ?mol?L -1),a significant reduction of the activity of cytoplasm, membrane and total PKC in human pituitary adenoma cells was observed;③tamoxifen (1 and 10 ?mol?L -1) increased the amount of cAMP in the cytoplasm of human pituitary adenoma cells, but had no effect on that of cGMP. Conclusion These data provide an important clue to explore the molecular mechanisms of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells, and suggest that the modulating effect of tamoxifen on the proliferation of pituitary adenoma cells results from interactions of several cellular signaling pathways.

Objective To evaluate the reliability of gas sampling from the distal end of the tracheal tube for partial pressure of end-tidal CO2 (PETCO2) monitoring in neonates.Methods A total of 50 fullterm neonates,scheduled for elective abdominal surgery under general anesthesia,aged 1-28 days,weighing 2.55-4.00 kg,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =25 each) using a random number table:gas samples collected from proximal end of tracheal tube group (group P) and gas samples collected from distal end of tracheal tube group (group D).Epidural catheters of 1 mm in external diameter were used.One end of the catheter was connected to a tube for carbon dioxide sampling,and the other end was inserted into the endotracheal tube and advanced toward the distal hole of the tube.At 15 min of mechanical ventilation,blood samples were collected from the radial artery for record of PETCO2 and for blood gas analysis.Consistency test was performed between PETCO2 and partial pressure of arterial CO2 (PaCO2).Results PET CO2 was significantly lower than PaCO2 in the two groups.There was no significant difference in PaCO2between the two groups.PETCO2 was significantly higher in group D than in group P.Kappa was significantly higher in group D than in group P.Conclusion Gas sampling from the distal end of the tracheal tube is more reliable than gas sampling from the proximal end in monitoring PETCO2 in the neonates.

on,size and the extent structures of atrial septal defect on line.

Host innate and adaptive immune responses are essential for the clearance of hepatitis B virus (HBV). Patients with chronic HBV infection have defects in innate and specific immune responses against HBV, which cannot effectively eliminate the virus and may result in persistent virus replication and liver inflammation. In addition to direct inhibition of HBV, treatment strategies targeting host immunity, such as stimulating or restoring antiviral immunity, are also important methods to achieve functional cure in patients with chronic hepatitis B. The liver is the target organ for HBV infection, and therefore, the research on the impact of HBV infection on intrahepatic immune microenvironment has become a hotspot for the research and development of new drugs that regulate the antiviral immune response against HBV in the liver. This article reviews the recent research advances in innate immune response associated with HBV infection and the new strategies to activate intrahepatic innate immune response and achieve the cure of hepatitis B.

Women′s health is the cornerstone of national health. During the 70 years since the founding of New China, under the leadership of the Communist Party of China, a legal system and related policies including more than 100 laws and regulations have been established to fully protect women′s rights and health, and women′s rights and health throughout their life cycle have been effectively protected. The health status of Chinese women has been significantly improved, the form and accessibility of women′s health care services have been continuously improved, and the building of women′s health care teams has been continuously strengthened. All of these achievements demonstrate the original intention of the Communist Party of China to put people′s health first and action of forging ahead.

Objective To analyse the effect of mobilization and collection's time of peripheral blood stem cells(PBSC) from 8 cases of healthy donors. Methods The 10 donors were studied by self-control design.The number of aphereses was two times every donors. Healthy donors received rhG-CSF according to two different PBSC collection starting time: group 1:PBSC collection was starts 2 hours(2 h) after the fourth day or the fifth day of rhG-CSF. group 2:PBSC collection was starts 4 hours(4 h) after the fourth day or the fifth day of rhG-CSF.(The first dose of rhG-CSF was given on day 1, considering day 0 as the day before starting mobilization). In this study we have compared with two groups of apheresis product. Results The MNC count was significantly higher for donors 4 h collection (groups 2) then 2 h. ( groups 1)(P

Allotransplantation of peripheral blood-derived hemopoietic stem cells is the best therapy for acute leukemia. With increases of only-child families, sibling donors are decreasing. Moreover, the probability is low and time consuming is long to search a matched hemopoietic stem cell donor from the Chinese Marrow Donor Program. Haploidentical stem cell transplantation would bring a hope for donor resource. However, difficult transplantation and high incidence of graft versus host disease are two risks. Based on modified regimen and cyclosporine A+short-term amethopterin, mycophenolic acid, interleukin-11, anti-lymphocyte immunoglobulin and hemopoietic stem cells mobilized by recombinant human granulocyte colony-stimulating factor can prevent graft versus host disease. This therapy succeeded in two cases with no severe graft versus host disease.

OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.

Objective:To evaluate the relationship between declined preoperative left ventricular diastolic function and postoperative increased extravascular lung water (EVLW) in the patients undergoing transurethral resection of the prostate (TURP).Methods:A total of 116 patients, aged 55-90 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, with body mass index of ≤30 kg/m 2, undergoing elective TURP under general anesthesia, without increased EVLW before surgery, were included in the study.Lung ultrasound examination was performed and lung ultrasound scores were assessed before leaving PACU.Increased EVLW was defined as lung ultrasound score ≥20.The occurrence of increased EVLW after operation was recorded, and patients were divided into increased EVLW group and non-increased EVLW group according to whether increased EVLW occurred.Multivariate logistic regression analysis was used to identify the risk factors for postoperative increased EVLW. Results:The results of multivariate logistic regression analysis showed that declined preoperative left ventricular diastolic function was an independent risk factor for postoperative increased EVLW ( P<0.05). Conclusions:Declined preoperative left ventricular diastolic function is an independent risk factor for postoperative increased EVLW in the patients undergoing TURP.