OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.

Objective To study the recent effect of ovary dislocation during the operation of cervical squa- mous carcinoma with stageⅠon ovary function.Methods 12 cases with cervical squamous carcinoma of stageⅠwere treated with surgery.During the operation bilateral ovaries with blood vessels were dislocated the abdominal cavity over the umbilical line through postperitoneum and fixed on the postperitoneum.12 cases were hysterec- tomized simply as the control.The change of ovary function was observed in one year after the operation.Results The levels of FSH and E_2 were decreased in the dislocating group(P

The low dose hyper-radiosensitivity (HRS) in human lung cancer cell line A549 was investigated, the changes of ATM kinase, cell cycle and apoptosis of cells at different doses of radiation were observed, and the possible mechanisms were discussed. A549 cells in logarithmic growth phase were irradiated with (60)Co gamma-rays at doses of 0-2 Gy. Together with flow cytometry for precise cell sorting, cell survival fraction was measured by means of conventional colony-formation assay. The expression of ATM1981Ser-P protein was examined by Western blot 1 h after radiation. Apoptosis was detected by Hoechst 33258 fluorescent staining, and Annexin V-FITC/PI staining flow cytometry 24 h after radiation. Cell cycle distribution was observed by flow cytometry 6, 12 and 24 h after radiation. The results showed that the expression of ATM1981Ser-P protein was observed at 0.2 Gy, followed by an increase at >0.2 Gy, and reached the peak at 0.5 Gy, with little further increase as the dose exceeded 0.5 Gy. Twenty-four h after radiation, partial cells presented the characteristic morphological changes of apoptosis, and the cell apoptosis curve was coincident with the survival curve. As compared with control group, the cell cycle almost had no changes after exposure to 0.1 and 0.2 Gy radiation (P>0.05). After exposure to 0.3, 0.4 and 0.5 Gy radiation, G(2)/M phase arrest occurred 6 and 12 h after radiation (P<0.05), and the ratio of G(2)/M phase cells was decreased 24 h after radiation (P<0.05). It was concluded that A549 cells displayed the phenomenon of HRS/IRR. The mode of cell death was mainly apoptosis. The activity of ATM and cell cycle change may take an important role in HRS/IRR.
Cell Cycle Proteins/genetics ; Cell Cycle Proteins/metabolism ; Cell Cycle Proteins/physiology ; Cell Line, Tumor ; DNA-Binding Proteins/antagonists & inhibitors ; DNA-Binding Proteins/metabolism ; DNA-Binding Proteins/*physiology ; Dose-Response Relationship, Radiation ; Lung Neoplasms/*pathology ; Protein-Serine-Threonine Kinases/*metabolism ; Radiation Dosage ; Radiation Tolerance/*physiology ; Tumor Suppressor Proteins/metabolism

Objective To study the low dose hyper-radiosensitivity in human lung cancer cell line A549,and its possible mechanisms.Methods Exponentially growing A549 cells were irradiated with 60Co γ-rays at doses of 0-2 Gy.Together with flow cytometry for precise cell sorting,cell survival fraction was measured by mean of conventional colony-formation assay.ATM1981 Ser-P protein expression was examined by Western blot.Apoptosis was identified by Hoechst 33258 fluorescent staining,and Annexin V-FITC and propidium iodide staining flow cytometry.Cell cycle distribution was observed by flow cytometry.Results There was an excessive cell killing per unit dose when the doses were below about 0.3 Gy,and the cells exhibited more resistant response at the doses between 0.3 and 0.5 Gy,the cell survival fraction was decreased as the doses over 0.5 Gy.The expression of ATM1981Ser-P protein was first observed at 0.2 Gy,followed by an increase over 0.2 Gy,and reached the peak at 0.5 Gy(compared with 0.2 Gy group,t=7.96,P＜0.05),with no further increase as the doses at 1.0 and 2.0 Gy(t=0.69,0.55,P＞0.05).24 hours after irradiation,part cells presented the characteristic morpholos4cal change of apoptosis,and the apoptosis curve was coincident with the dose-survival curve.Compared with the control group,the cell cycle had no change post-irradiation to 0.1 and 0.2 Gy.G2/M phase arrest was manifested at 6 and 12 hours post-irradiation to 0.3,0.4 and 0.5 Gy(t=2.87,2.88,4.92 and 3.70,3.12,8.11,P＜0.05),and the ratio of G2/M phase was decreased at 24 hours post-irradiation(t=3.87,4.77,3.01,P＜0.05).Conclusions A549 cells displays the phenomenon of hyper-radiosensitivity(HRS)/induced radioresistance(IRR).The model of cell death induced by low dose irradiation is mainly apoptosis.The activity of ATM and cell cycle change might play an important role in HRS/IRR.

Objective To investigate the clinical value of serum homocysteine (Hcy),Cystatin C (CysC) detection in coronary heart disease prevention,diagnosis and treatment.Methods A total of 200 cases of coronary heart disease patients including 50 cases of acute myocardiac infarction (AMI) (AMI group),85 cases of unstable angina pectoris (UAP)(UAP group.) and 65 cases of stable angina pectoris (SAP) (SAP group) were selected,and 120 cases of healthy controls were selected as control group.The serum levels of Hcy and CysC were detected and compared.Results The serum levels of Hcy and CysC in AMI group,UAP group and SAP group were significandy higher than those in control group[Hcy:(22.35 ± 8.18),(16.54±7.56),(14.52±6.38) μmol/Lvs.(9.35±3.23) μmol/L; CysC:(1.32±0.27),(1.88± 0.66),(1.19 ± 0.46) mg/L vs.(0.80 ± 0.33) mg/L],and there were significant differences between two groups (P＜ 0.01).The serum level of Hcy in AMI group was higher than that in UAP group and SAP group [(22.35 ± 8.18) μ mol/L vs.(16.54 ± 7.56),(14.52 ± 6.38) μ mol/L],and there was significant difference (P ＜ 0.01).Conclusions The relationship between Hcy,CysC level and coronary heart disease is close,and Hcy levels increase with increasing degree of coronary heart disease.Detection of Hcy and CysC has some clinical value on prevention,diagnosis,treatment of coronary heart disease.

Objective To evaluate the magnetic resonance imaging (MRI) monitoring for osteonecrosis of the knee joints in recovered patients with severe acute respiratory syndrome (SARS) after the administration of glucocorticoids and its characteristics. Methods One hundred and ninety-eight knee joints in 99 recovered SARS patients after administration of glucocorticoids,22 males and 77 females,were examined by MRI and interpreted independently by four senior radiologists for determining osteonecosis. Results Osteonecrosis were found in 56 knee joints (28%,56/198) in 31 of 99 patients (31%,31/99),25 with bilateral lesions (81%,25/31) and six unilateral ones (19%,6/31). The lesions were symmetric (100%,25/25) in all the patients with bilateral osteonecosis,involving weight-bearing zone in 27,non-weight-bearing zone in 29 and subchondral zone in 47 knee joints (84%,47/56). The anterior zone of the medial femoral condyle was involved in 14 (8%) lesions,the posterior zone of the medial femoral condyle in 27 (16%) ,the anterior zone of the lateral femoral condyle in 29 (17%),the posterior of the lateral condyle in 44 (27%),the metaphysis of femur in 18 (11%),the anterior zone of the medial tibial plateau in three (2%),the posterior zone of the medial tibial plateaus in 13 (8%),the anterior zone of the lateral tibial plateaus in two (1%),the posterior zone of the lateral tibial plateau in seven (4%),the metaphsis of the tibia in nine (5%),and no lesion was found in the patella. Conclusions MRI can preferably be used to reveal changes of ischemia and necrosis in the knee joints. So,MRI for the knee joints should be earlier performed in the patients with glucocorticoids for diagnosis and therapy for them.

ObjectiveTo investigate the risk factors and morbidity of carotid atherosclerosis (CA) and unstable plague in patients with sleep apnea-related hypertension (SA-RH).MethodsA total of 603 SA-RH subjects screened by polysomnography according to apnea hypopnea index (AHI) were recruited and divided into 3 groups:mild (AHI 5-15 ),moderate (AHI 15-30) and severe (AHI ≥ 30) group,with hypertensive patients with AHI less than 5 served as control.CA was determined by doppler ultrasound as formation of plaque and/or intima-media thickness more than 0.9 mm.Unstable atheroma plaque (UAP) was defined as low echo plaque and/or admixing echo plaque.Results Gender,age,BMI and blood pressure were not matched among groups.The prevalence of CA increased in moderate and severe SA-RH than that in control ( P ＜ 0.01 ) with no significant difference for UAP among groups.Factor analysis was performed to extracted common factors that may influence CA and UAP,such as factor 1-6,represent obstructive sleep apnea (OSA),dyslipidemia (TC,LDL),BMI,blood pressure,age and duration of disease and dyslipidemia (TG,HDL) respectively.Logistic analysis show that OSA and dyslipidemia (TC,LDL) increased the risk of CA,with OR 1.36(95％ CI 1.15-1.59),1.31 (95％ CI 1.12-1.54)respectively,and dyslipidemia (TC,LDL) increased the risk of UAP,with OR 1.30 (95％ CI 1.06-1.58).ConclusionsIn SA-RH populations,higher prevalence of CA may be associated with severity of OSA independently,meanwhile the formation of UAP may be mainly associated with dyslipidemia.

OBJECTIVETo study the different effect of needling at different meridian points (MP) on different cerebral functional regions by using positron emission tomography and cerebral function tracer 18F-fluorodeoxy glucose to observe the effect of electro-acupuncture (EA) stimulation at Yin MP or Yang MP on local cerebral glucose metabolism in 30 healthy volunteers.

METHODSThe thirty subjects were randomly divided into 2 groups, the 12 subjects in the Yang MP group treated by needling at Hegu (LI4), Quchi (LI11), Zusanli (St36) and Shangjuxu (St37), the 18 subjects in the Yin MP group treated by needling at Neiguan (Pc6), Chize (Lu5), Sanyinjiao (Sp6) and Yinlingquan (Sp9). All the needling was conducted at one side of body.

RESULTSAfter needling at Yang MP, the cerebral glucose metabolism was elevated in bilateral cross region of frontal lobe and temporal lobe, parietal lobe, thalamus and basal ganglia, and in contralateral cerebellum and hippocampus. After needling at Yin MP, the cerebral glucose metabolism was lowered in bilateral cross region of frontal and temporal lobe, contralateral temporal lobe, cerebellum and thalamus, and was elevated in homolateral hippocampus and caudate nucleus.

CONCLUSIONUnder physiological condition, the regulatory effects of acupuncture on central nervous system would be different when needling at different MP.

Acupuncture Points ; Adult ; Brain ; metabolism ; Electroacupuncture ; Female ; Glucose ; metabolism ; Humans ; Male ; Meridians ; Middle Aged ; Random Allocation ; Tomography, Emission-Computed

Objective To study the effects of Yizhichan moxibustion on chronic fatigue syndrome (CFS) athletes.Methods 143 patients of CFS were blind randomly devided into3 groups, which were moxibustion of Yizhichan (56 cases) group, general moxibustion group (42 cases), and normal group (45 cases).The normal group was treated by passive massage for relaxation, the moxibustion of Yizhichan group was treated by specific acupoints application of moxibustion of Yizhichan in addition to passive massage;and the general moxibustion groupwas treated by general moxibustion in addition to passive massage.All sample were treated once a day for 6 days in a week.3 weeks was a period of treatment, and the total time of treatment was 15 weeks.Results After treatment, the sleep quality (1.73 ± 0.73, 1.54 ± 0.85 vs.0.83 ± 0.52, F=14.130), time for sleep (1.57 ± 0.60, 1.35 ± 0.60 vs.1.03 ± 0.54, F=5.386), sleep time (1.78 ± 0.71, 1.77 ± 0.61 vs.0.67 ± 0.65, F=19.811), daytime dysfunction (0.78 ± 0.83, 1.64 ± 0.83 vs.1.03 ± 0.83, F=4.798) in the control group, moxibustion of Yizhichan group and a general moxibustion group were statistically significant(P＜0.05).The total effective rate of the moxibustion of Yizhichan group was better than the control group and the general moxibustion group (83.8％, 42.2％ vs.63.6％;x2=13.973, P=0.001).Conclusion Specific acupoints moxibustion of Yizhichan is a beneficial exploration of moxibustion methods of traditional Chinese medicine, and can improve CFS athletes level of physical health, attention and sleep quality.

Objective To investigate the efficacy and feasibility of combination of leflunomide and clopi-dogrel in the treatment of IgA nephropathy. Methods 84 patients with primary IgA nephropathy were randomly divided into four groups: Control group (group 1) received valsartan; test group (group 2) received valsartan +clopidogrel; group 3 received valsartan + leflunomide; group 4 received valsartan + clopidogrel + leflunomide. The level of 24 h urinary protein,serum creatinine, glomerular filtration rate and therapeutic efficacy, adverse reactions were detected and recorded during the 48 weeks follow-up. Results The 24 h urinary protein of 84 patients showed a downward trend during the course of treatment , but there were statistical differences between groups since 8 weeks after treatment (P < 0.05). The level of urine protein in group 3 and group 4 decreased significantly to 61.48% and 67.23% respectively in 48 weeks after treatment. At the end of the follow up , the serum creatinine levels in group 1 and group 2 significantly increased while the glomerular filtration rate de-creased obviously (P < 0.05). Conclusion The combination of leflunomide with clopidogrel could reduce the level of urinary proteins and slow renal function deterioration in the treatment of IgA nephropathy with less ad-verse reactions. This study provides a new idea for treatment of IgA nephropathy.