BACKGROUND: lead can facilitate the active oxygen-derived free radicals formation, and make many tissue systems in oxidative stress situation especially during the process of lipid peroxidation in cerebral tissue.OBJECTIVE: To establish the dying lead model by making rat offspring to expose to lead during pregnant and breast-feed period, and observe effect of dying lead on the lipid peroxidation in central nervous system of different developmental stages,DESIGN: Randomized controlled study.SETTING: Liaoning Woman and Children Health Care College and Liaoning Tumor Institute.MATERIALS: The experiment was carried out at the Laboratory of China Medical University from June to August 2003. Totally 150 adult Wistar rats was utilized for the experiments. The ratio between female and male was 2:1. Seven days after feeding respectively, female and male rats were put together with the ratio of 2:1. The day in which the sperms were found in vaginal plug or in vaginal secretion was considered gestational day (GD)0 day. And 100 gestational rats were randomly divided into 4 groups, with solution). The lead-treated animals received solution containing lead acetate from GD 0 day, while the control animals received distilled water 5 mL from GD 0 day too, until 21 days after rat offspring giving birth.METHODS: Tissue sampling at the 21st day after rat offspring giving birth, the blood collected by head cutting of 10 rats in each group was used to determine blood lead level; brain tissue of 15 rats in each group was used to determine brain lead level, and the rest was made to be equal slurry to determine the level of lipid peroxidase (LPO), glutathione (GSH),and the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-PX).and activity of SOD, GSH-PX and CAT of 21-day-old rat offspring among different groups.RESULTS: Data of totally 100 infant rats was entered the final analysis.birth: Lead content of blood and brain of 21-day-old rats offspring in 0.5, 1and 2 g/L lead-treated groups were higher than those in control group observably (P ＜ 0.01), and increased along with increase of the dose of expowas higher than that in control group [(34.56±6.96), (38.76±11.11),(23.33±5.23) mmol/g, P ＜ 0.05-0.01], but activity of SOD in those two groups was lower than that in control group [(423.25±157.70),(426.92±161.53),(542.78±97.69) μkat/g, P ＜ 0.05-0.01].CONCLUSION: Lead, metal toxicant, at moderate and high dosages can induce damage of nervous system during development through accelerating lipid peroxidation of cerebral tissue.

Objective To investigate the influence of social support on the depression and anxiety of standardized training residents.Methods Three hundred and eighteen standardized training residents selected by random sampling method from 4 training bases in Shanghai participated in this survey.ResultsThe average score of PHQ-9 was(7.24±5.20), and 67.30%(n=214)of participants had different degrees of depression;the average score of GAD-7 was(5.57±4.55), and 55.03%(n=175)of participants had different degrees of anxiety.One-way analysis of variances showed that standardized training residents who had work experience, longer training years and less salary satisfaction got higher scores in PHQ-9 and GAD-7.Male physicians had higher scores in GAD-7 than female ones.The scores of PHQ-9 (r=-0.390, P<0.01) and GAD-7 (r=-0.376, P<0.01) were both negatively correlated with social support.Regression analysis showed that training years,salary satisfaction,objective social support and the availability of support were significant for predicting the scores of PHQ-9(adjusted R2=0.242,F=17.893), work experience, salary satisfaction,objective social support and the availability of support were significant for predicting the scores of GAD-7(adjusted R2=0.228,F=14.390).After controlled the demographic variables, social support explained the variation rate of 0.119 to the score of PHQ-9 and 0.126 to the score of GAD-7.Conclusion The depression and anxiety of standardized training residents in this study is in a serious situation.Providing the objective social support and the availability of support as well as improving the salary satisfaction of standardized training residents may relieve the depression and anxiety and enhance their mental health.

Objective To explore the prevalence of self reposed mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital.Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire(CV-MDQ)and the Chinese Version 32 items hypomania check list(CVHCL-32).The positive mania symptoms were elevated with at least seven positive mania items reported by the CVMDQ.The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32.Results The internal consistency(Cronbach alpha)of the CV-MDQ was 0.808(95% CI=0.767～0.845,P<0.01).The internal consistency(Cmnbach alpha) of the CV-HCL-32 was 0.916(95% CI=0.898～0.930,P<0.01).11 patients(10.8%) reported positive mania symptoms by the CV-MDQ.14 patients (13.7%)had been reported positive hypomania symptoms through the CV-HCL-32.The ability of discriminating mania or hypomania between the two scales was significantly different(Kappa=0.227,P<0.05).Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32.the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode(35.0 vs 50.5,z=-2.065,P<0.05),much longer months in total disease course(60.0 vs 22.0,z=-2.102,P<0.05)and present episode (12.0 vs 6.0,z=-2.180,P<0.05),and much higher frequency of relapse(2.5 vs 1.0,z=-2.168,P<0.05),but no significant differences at age,gender and education.No significant differences appeared between CV-MDQ positive and negative group.Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with depressive disorders who are diagnosed by ICD-10 in general hospital.whether CV-HCL-32 is superior to CV-MDQ when screening bipolar Ⅱ disorder is worthly further study.

Objective To summarize the clinical results of posterior fusion plus pedicle screw fixation in treatment of dens fracture combined with recoverable atlantoaxial dislocation. Methods Twenty-seven patients with dens fractures combined with recoverable atlantoaxial dislocation were treated with posterior pedicle screw fixation, reduction and fusion. In this series of patients, skull traction was made to restore the normal atlantoaxial joint before the operation. Results Atlantoaxial alignment or stability were restored, without complication due to instrumentation. A follow-up for 12-48 months (average 24 months) showed osseous union. Conclusion Posterior aflantoaxial pedicle screw and rod fixation provides immediate three-dimensional rigid fixation of aflantoaxial joint and is a more effective technique compared with previously reported techniques.

Myelodysplastic syndrome(MDS)is a malignant clonal disease with high heterogeneity in cytogenetics and molecular genetics,and the risk of progression to acute myeloid leukemia(AML)is extremely high.Transforming growth factor-β(TGF-β)is closely related to the pathogenesis of MDS.It is a key executor of immune homeostasis and immune tolerance,and can inhibit the expansion and function of many components of immune system.TGF-β signaling pathway can regulate hematopoietic cells and immune cells in microenvironment,inhibit their normal biological functions,and thus accelerate the progression of MDS.This study reviews regulatory effects of TGF-β signaling pathway on MDS blood cells,T lymphocytes,natural killer cells and macrophages in recent years,and provides a new perspective for the pathogenesis and treatment of MDS.