Objective To assess whether 5-HTR1A C( - 1019) G and GNβ3 C825T gene polymorphisms are associated with post-stroke depression (PSD) and explore the genetic mechanism of the pathogenesis of post-stroke depression. Methods All 159 patients with first stroke were divided into the PSD group and the control group according to HAMD scores. Their genotypes were determined with polymerase chain reaction and allele-specific restriction enzyme analysis. Results The frequency of 5-HTR1A (-1019) GG genotype(8/53,15. 1% ), G allele (44/106,41.5%)and GNβ3 825T allele(68/106,64. 2% ) were significantly higher in the post-stroke depression group than in the controls (5/106,4.7% ;35/212, 16. 5%; 113/212, 53.3%; ×2 = 23.204, 23. 655, 3. 392, all P ＜ 0. 05 ). Combined genotype analysis showed that individuals with both 5-HTR1A ( - 1019) G and GNβ3 825T allele ( OR =4. 980,95% CI 2. 429-10. 210,P =0. 000) had a higher risk than those with 5-HTR1 A (-1019) G allele ( OR = 3. 589,95% CI 2. 113-6. 096, P = 0. 000) or GNβ3 825T allele ( OR = 0. 638,95% CI 0.395-1. 031 ,P =0. 042) only for post-stroke depression. Conclusion The 5-HTR1A C( - 1019)G and GNβ3 C825T polymorphisms are predisposing genes of post-stroke depression. Our data also suggest a significant interaction between the 5-HTR1A ( - 1019)G allele and GNβ3 825T allele in post-stroke depression.

0 05) Conclusion The results suggested that pregnancy immunological tolerance can be induced efficiently and the ELR can be decreased significantly by oral administration of proper dosage antigens of OVA and TMA2

Objective To summarize the experience of endoscopic thyroidectomy for hyperthyroidism.Methods Endoscopic total or subtotal thyroidectomy was performed through anterior chest wall approach in 7 patients with primary or secondary hyperthyroidism.Results The operation was successfully performed in all the 7 patients.The operation time was 130~260 min(mean,168 min),and the intraoperative blood loss was 10~200 ml(mean,70 ml).No recurrent laryngeal nerve or superior laryngeal nerve injuries,or postoperative hemorrhage,or conversions to open surgery were encountered.The postoperative recovery was uneventful.Short-term follow-up observations demonstrated satisfactory cosmetic results and no recurrence.Hypothyroidism occurred in 2 patients and thyroid functions restored to normal levels in 1 of them 2 months after operation.Conclusions Endoscopic thyroidectomy is a safe and effective procedure for hyperthyroidism.Apart from conventional pre-operative preparation,CT examination is also necessary for identifying the measurements of thyroid glands and determining the proportion and location of residual glands.

Objective To investigate the clinical diagnosis and treatment of pneumocystis carinii pneumonia(PCP) after kidney transplantation. Methods Eight patients who developed PCP between 90 days and 140 days following renal transplantation were enrolled in this study.All of them were male with a mean age of 28 years.The clinical manifestations,accessory examinations and treatment were retrospectively analyzed. Results All the 8 patients fully recovered.With early diagnosis and administration of compound sulfamethoxazole(SMZ),clinical symptoms of 6 patients were rapidly controlled within 5 to 7 days.Because of delayed diagnosis and treatment,the conditions of the other 2 cases were more severe and were controlled within 25 days and 46 days separately. Conclusions Application of percutaneous pneumocentesis biopsy can be useful for correct diagnosis in early stage of PCP and has high positive rate of the pathogen. Most PCP patients can be cured with early use of SMZ.Types and doses of immunosuppressor should be adjusted properly.

Objective To evaluate the efficacy and safety of two-dose basiliximab vs two-dose daclizumab for prevention of acute rejection in renal transplantation. Methods A total of 58 renal transplant recipients were randomized into 2 groups:basiliximab group ( n =30) and daclizumab group ( n =28).All the cases received the triple therapy of cyclosporine,mycophenolate mofetil and prednisolone (CsA+MMF+Pred).The 3 medications were administered as follows.For CsA,initial dose of 6 mg/kg per day was downtitrated to 4～5 mg/kg per day at 3 months,then to 3～4 mg/kg per day at 6 months.For MMF,initial dose of 0.5 g,3 times per day was downtitrated to 0.5 g,twice per day at 1 month.For Pred,initial dose of 30 mg per day was downtitrated to 20 mg per day at 3 weeks,then to 10～15 mg per day at 6 months.Basiliximab group received two-dose basiliximab (20 mg intravenous infusion) 2 hours before operation and 4 days after transplantation.Daclizumab group received two-dose daclizumab (50 mg) 1 day before operation and 14 days after transplantation.Postoperatively,acute rejection was monitored for 6 months,and adverse events and person/allograft survival were observed for 6～12 months.CD25 + cell count was tested using Beckman Coulter flow cytometer before operation and postoperatively once a week for 2 months. Results During 6-month follow-up, the number of acute rejection episodes were 5 in daclizumab group and none in basiliximab group ( P

OBJECTIVE To analyzed the conditions and tendency of surgical site infection(SSI) occurring in orthopedics patients at 11 hospitals in Beijing from 2002 to 2005.METHODS By sorting the case history database in the computer,the needed case and relative information were first selected.The conditions and tendency that SSI occurring were described.RESULTS The ratio of SSI in orthopedics was 0.14%,from which 0.09% were in type Ⅰ section,0.65% in type Ⅱ section and 1.78% in type Ⅲ section.CONCLUSIONS This paper shows that the different types of surgical section induce different SSI rate.

OBJECTIVE To investigate the incidence,symtoms and prognosis of hospital infection by Mucor after liver transplantation.METHODS The clinical data of all the patients with complicated hospital infection orthotopic by Mucor after orthotopic liver transplantation were analyzed restrospectively.RESULTS There were 9 cases with complicated hospital infection by Mucor from in 750 liver transplant recipients.Seven cases developed superficial incisional infection with delayed healing and rapid increased secretion on the surface of incisions.All of them recovered after antifungal therapy.Two cases had pulmonary Mucor infection combined with bacteria and died of multi-organ failure.CONCLUSIONS The incidence of hospital infection by Mucor in liver transplant recipients is about 1%.The most common symtoms are superficial incisional infection and the patients recover well.However,the cases with complicated pulmonary Mucor infection are difficult to treat and have a poor prognosis.

Objective To summarize the experience on diagnosis and treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 91 PHPT patients treated in Beijing Jishuitan Hospital from November 1992 to December 2008 were analyzed retrospectively.Results Among 91 PHPT cases,88 were diagnosed as parathyroid adenoma(96.7%),3 were diagnosed as parathyroid carcinoma (3.3%).Serum calcium and PTH levels increased in all cases.Main clinical manifestations were osteodynia and kidney stones.The accuracy rate of preoperative B-ultrasound.CT and ECT~(99m)Tc-MIBI on location was 83.5%(76/91),60.9%(14/23)and 98.6%(69/70)respectively.Parathyroidectomy was performed in all but one cases,in which parathyroid carcinoma was managed by ipsilateral hemithyroidectomy and modified neck dissection.The cure rate of primary operation was 97.8%(89/91).Ninety cases were followed-up from 8 months to 14 years postoperatively,87 cases with parathyroid adenoma achieved complete remission,2 with parathyroid carcinoma suffered from tumor recurrence and 1 died.Conclusion Patients with chronic bone diseases,repeatedly recurrent nephrolithiasis,peptic ulcer disease should be a suspect of PHPT.The routine examinations of serum calcium and phosphorus are to be conducted.UItrasonography and ECT~(99m)Tc-MIBI should be considered as the methods of first choice for preoperative localization.

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.

The ongoing health reform is bringing reforms of public hospitals under spotlight in China, attracting growing attention onto its progress and roadblocks. Probing into the "three steps" of public hospital system reform in Wuxi, this article analyzed such a reform in the city. It described the measures and initial outcomes gained in such fields as the hospital trusteeship reform, the separation of hospital regulation from its administration, and the hospital board system. Citing the case of Wuxi No. 2 People's hospital as an example, the authors introduced the innovative efforts made in hospital internal mechanism, management innovation, medical service model, hospital connotation construction, and talents cultivation.