Objective To compare the efficacy and safety of mirtazapine and fluoxetine in the treatment of somatoform disorders.Methods 82 patients were randomly divideded into mirtazapine group and fluoxetine group,all the patients were treated for 6 weeks.The efficacy was evaluated with Hamilton depression rating scale and symptom checklist,the side effects were evaluated with treatment emergent symptom scale.Results The total effective rate of the mirtazapine group was 88％.The total effective rate of the fluoxetine group was 80％.There was no difference between the two groups in efficacy (x2 =0.13,P ＞ 0.05).After the first week of treatment,by Symptom checklist,somatization,anxiety and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.97,3.01,3.73,all P ＜ 0.05).After the sixth week of treatment,somatization,interpersonal,depression,anxiety,fear and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.01,2.36,3.25,3.62,2.17,3.84,all P ＜ 0.05).Mirtazapine group had no significant adverse drug reactions.Fluoxetine group had four cases of adverse drug reactions.Conclusion Mirtazapine in the treatment of patients with somatoform disorders has more rapid onset and drug side effects is less than fluoxetine.

Objective Base on the theory of traditional Chinese medicine (TCM), obtained human diagnostic information available for joint syndrome differentiation is integrated based on subjective and objective combined syndrome differentiation, in the form of data expression of TCM four diagnosis, forms multiple information fusion of open platform for TCM diagnosis and treatment, and provides some revelation for promoting the development of depression and treatment technology. Methods Totally 30 depression patients and 30 normal people were selected according to the inclusion criteria. TCM four diagnostic and auxiliary diagnosis instrument was used to collect information of four diagnosis, and the statistical software was used for the analysis on pulse diagnosis, and information features of digitalized tongue and listening diagnosis of patients in depression group and normal group were studied. Results Compared with depression group, pulse frequency, fluency, and heart rate of normal group were a bit higher than depression group, without statistical significance (P>0.05);There was statistical significance among pulse frequency, strength, tightness, and pulse wave velocity between the normal group and depression group (P<0.05). 30 patients had 6 depression syndrome types:heart-gallbladder qi deficiency (8 cases), phlegm-heat attacking internally (6 cases), fire excess from yin deficiency (6 cases), liver depression forming fire (6 cases), intense heart fire (3 cases), and heart-spleen deficiency (3 cases). Conclusion The results of differences in pulse diagram parameters were consistent with the theory of classical TCM pulse theory. The results of differences in pulse wave velocity conform to the modern medical research conclusion. TCM four diagnostic auxiliary diagnosis and treatment technology can realize the dynamic detection of depression patients with four diagnostic information, and establish diagnostic methods for depression based on digitalized four diagnostic auxiliary diagnosis.

Objective To describe the status quo of position rotation in self-injection of insulin, and explore its influencing factors, so as to provide the basis for regulating the rotation of injection. Methods A convenient sample of 176 patients coming from endocrinology in a third grade first-class hospital were surveyed by self-designed self-injection of insulin in patients with site rotation behavior questionnaire survey. Results 176 diabetics of their own insulin injection site rotation score was 12-27 (17.79 ± 2.81) points. The age, knowledge sources, the numbers of injection sites were mainly influence to insulin injection site rotation factor score. Conclusions Diabetics insulin injection site rotation behaviors is not standard, rotation of different parts is worrying. It is necessary to strengthen the education and guidance of the site rotation of the patients.

BACKGROUND: Recently simvastatin has been shown to stimulate osteogenic differentiation and bone formation, but there is no report about the effect of simvastatin on the bone development of young rats.OBJECTIVE: To evaluate the effects of simvastatin on osteogenic relative genes of proximal tibia trabecular bone and osteogenic differentiation of bone marrow stromal cells (BMSCs).METHODS: Twenty 1-week-old Spragua-Dawley young rats were randomly and equally divided into simvastatin and control groups. Rats in the simvastatin group were treated with a subcutaneous injection of simvastatin[5 mg/(kg·d)] for 2 weeks, while rats in the control group were treated with placebo for 2 weeks. The expressions of bone morphogenetic protein-2 (BMP-2), matrix metalloproteinase-13 (MMP-13), and vascular endothelial growth factor (VEGF) of trabecular bone in the tibia were analyzed by mmunohistochemicel staining. BMSCs harvested from the rat femur were osteogenic-differentiation cultured. Alkaline phosphatase (ALP) staining was performed on day 14, real-time PCR analysis was applied to investigate the BMP2, RUNX2,Osterix, MSX2, DLX3, DLX5 mRNA expressions during osteogenic differentiation in vitro on day 21, and von Kossa staining was detected on day 28.RESULTS AND CONCLUSION: ① There was no significant difference in the expressions of BMP-2, MMP-13, and VEGF between simvastatin and control groups. ② The percentages of ALP positive-stained cells were about 30% and there was no significant difference between the two groups (P ＞ 0.05). ③There was no significant difference in the expressions of BMP-2,RUNX2, Osterix, MSX2, DLX3, DLX5 mRNA in osteoganic differentiation-induced BMSCs. ④ von Kossa staining demonstrated that dark brown calcified spots in various sizes were observed, but there was no significant difference in size and density between simvastatin and control groups. A subcutaneous injection of simvastatin[5 mg/(kg·d)] for 2 weeks could not remarkably affect osteogenic relative genes of bone trabecula and osteogenic differentiation of BMSCs.

Objective To explore the reliability of handgrip strength test for evaluating mobility in patients with stable chronic obstructive pulmonary disease.Methods Sixty-one COPD patients in stable stage were measured for handgrip strength and 6-minute walking test(6MWT).The receiver operating characteristic curve(ROC) was calculated to determine the best cutoff points of handgrip strength.Results Handgrip strength was (33.72-±7.47) kgf,6MWD was (437.06±97.96) m,handgrip strength was moderately correlated with 6MWD (r=0.404,P=0.001).6MWD≥350 m was used to classify two groups,and there was significant difference between two groups(P＜0.05).Area under the curv e was 0.722,and the best cutoff points was 32.8 kgf.Conclusion Handgrip strength test can be a useful tool to quickly identify mobility in patients with stable COPD.

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

To analyze the predictors and prognosis for super-response to cardiac resynchronization therapy (CRT) in patients with different etiology. Methods: A total of 181 patients received CRT in our hospital from 2012-01 to 2016-01 were enrolled. The patients were divided into 3 groups: Non-response group, n=63, Response group, n=62 and Super-response group, n=56. The patients were followed-up at 6 months after CRT. Results: There were 30.9% (56/181) patients having super-response. Compared with the other 2 groups, Super-response group had more patients with NYHA II-III and less NYHA IV, the patients were with the smaller LAD, LVESD, LVEDD andless patients had CRT-D implantation. The baseline cardiac function was obviously improved at 6 months after CRT in all 3 groups. The basic LVEDD, LVESD, CRT-D implantation, non-ischemic cardiomyopathy (NICM) and NYHA IV were the independent predictors for super-response occurrence. In addition, compared with ischemic cardiomyopathy (ICM), NICM patients had the higher ratio for super-response occurrence (37.6% vs 7.5%), P<0.001. Survival analysis indicated that NICM patients had the lower risk of all cause mortality (HR=0.31, 95% CI 0.14-0.80), cardiac death (HR=0.27, 95% CI 0.09-0.48) and combined endpoints (HR=0.36, 95% CI 0.27-0.78). Conclusion: At baseline condition, the patients with less degree of left ventricular reconstruction, CRT-D implantation, NICM and NYHA IV had more chance to suffer from super-response after CRT. NICM patients had the better response and prognosis to CRT.

Objective To probe a simple, safe, and minimally invnsive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embelize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Suporselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embelizing leaking arteries with the advantages of preserving the fallopian tubes.

Objective To explore the function and mechanism of estrogen receptor α (ERα) in bladder cancer cell proliferation and aggressivity.Methods The ERα expression bladder cancer cell line T24ERα model was established.The cell growth was detected by MTT assay,apoptosis by flow cytometry,cell invasion by matrigel transwell.Western blot was used to check signals by ERα regulation in bladder cancer cells related to the proliferation and metastatic ability.Results Compared to the control group,the cell inhibition rates of experimental group in 96 h and 144 h were 18.85％ and 37.21％,respectively.The difference was significant compared with the control group (P ＜ 0.05).The apoptosis rates of the experimental group and control group were (18.93 ±1.41)％ and (9.91 ±1.08)％ (P＜0.05).The experimental group through matrix adhesive cell proportion was (10.00 ± 2.00)％,significantly lower than that of the control group (26.00 ± 3.61) ％ (P ＜ 0.05).Western blot showed integrin-β1,p-FAK,p-Src and Scr expression were reduced compared to control group (P ＜ 0.05).Conclusion ERα could inhibit bladder cancer cell growth and metastasis through down-regulating integrin-β1-FAK/Src signal pathway,while promote the apoptosis of bladder cancer cells.

Objective To explore the expression of early growth response gene-1 (EGR-1) in T cells that were positive for Tax protein of human T-cell leukemia virus type 1 (HTLV-1) and its possible reg-ulatory mechanism .Methods A series of expression structures carrying the regulatory elements of EGR-1 in different length and luciferase reporter genes were constructed .TaxP cells were transfected with the con-structs containing reporter genes and cultured with 5μmol/L of NF-κB inhibitor BAY 11-7082 or equal vol-ume of DMSO.After cultured for 24 hours the cells were collected to test the luciferase activity .BAY 11-7082 or equal volume of DMSO was added into the supernatant of TaxP cell culture to test the expression of EGR-1 protein by Western blot after 24 hours of culture .Tax and its mutants M22 and M47 were transfected into 293 T cells respectively to test the expression of EGR-1 protein by Western blot after 24 hours of culture . Results The expression structures carrying the regulatory elements of EGR-1 in different length and their mutants followed by luciferase reporter genes were successfully constructed .The luciferase activity in the cells transfected with the constructs containing the elements E 1 and E2 were higher than that transfected with E3, DelE and MutE, but the reporter gene expressions were decreased with the interference of BAY 11-7082 (P<0.01).However, there were no significant changes with the luciferase activity in the cells transfected by elements E3, DelE and MutE.Western blot analysis indicated that the expression of EGR-1 protein was significantly decreased with the interference of BAY 10-7082 .The expression of EGR-1 protein in M22 mu-tants-transfected 293 T cells were decreased significantly in comparison with those by wild type tax-and M47-transfected cells .Conclusion NF-κB was the key nuclear factor in regulating the expression of EGR-1 pro-tein in Tax-positive T cells .