Objective To explore the effects of ziprasidone and clozapine on serum cholinesterase (CHE) concentration in schizophrenia patients. Methods 126 schizophrenia patients were randomly divided into the observation group and the control group. The observation group was treated with ziprasidone. The control group received clozapine. The serum CHE concentration was assayed at 7, 14 and 28 days after treatment. Results ① The PANSS scores in both groups were significantly reduced after treatment, while the control group was lower than the observation group (PANSS score for positive symptoms: 15.3±4.7 vs 22.4±4.8, P<0.01; negative symptoms: 14.6±4.5 vs 21.8±5.2, P<0.01; general psychiatric symptoms: 13.3±3.4 vs 19.2±3.9, P<0.01). ② CHE levels were decreased in both groups after treatment. The control group exhibited greater decrease than the observation group. ③ The observation group had lower adverse reaction rate (34.9%) compared to control group (71.4%). Conclusion ziprasidone has weaker inhibitory effect on CHE activity compared to clozapine. This may explain that ziprasidone has lower therapeutic efficacy and better safety profile.

AimTo study the effect of interferon gamma( IFN-γ) and tumor necrosis factor alpha(TNF-α) in the immune pathogenesis of dengue virus infection. Method The serum levels of IFN-γ and TNF-α were measured with emzyme linked immunosorbent assay (ELISA) method in 30 cases of the patients with the dengue virus infection in Guangzhou district. The results were treated with t-test of two sample mean. ResultsThe serum levels of IFN-γ and TNF-α in patients with the dengue virus infection were much higher than healthy controls( P ＜ 0.05、 P ＜ 0.01 ). IFN-γ was detectable on the first day of postinfection. Level of IFN-γ reached their peaks on the second day, then declined . The level of TNF-α had an obvious rise from the second day and reached their peaks on the third day, then declined. ConclusionThe data suggest that the IFN-γ and TNF-α may play an important role in the dengue virus pathogenicity and immunity.

Objective To investigate the effect of early low-glucocorticoid on hemodynamics and prognosis in the patients with septic shock.Methods Sixty patients with septic shock failing in active fluid resuscitation and vasoactive drugs in our hospital from June 2013 to August 2015 were selected and divided into the control group,early-hormone group and late-hormone group.MAP,HR,PO2/FIO2 and serum lactic acid levels were monitored in all selected patients before treatment and at 12,24,48 h after treatment.Apache Ⅱ,SOFA scores were assessed before treatment and on 1,3,7 d after treatment.The ventilation time,ICU stay time,hospital stay time and intravenous use time of vasoactive agents(VDNT) were recorded.Results The Apache Ⅱ scores and SOFA scores on 3,7 d after treatment in the early-hormone group were significantly decreased compared with the late-hormone group and control group (P＜0.05).MAP and HR at 24,48 h after treatment in the early-hormone group were significantly improved compared with the late-hormone group and control group (P＜0.05).The level of serum lactic acid at 12,24 h after treatment in the early-hormone group and late-hormone group were obviously lower than that in the control group,the levels of serum lactic acid at 12,24 h after treatment in the early-hormone group were obviously lower than those in the late-hormone group (P＜ 0.05).PO2/FIO2 at 12 h after treatment in the early-hormone group and late-hormone group were obviously better than that in the control group,and PO2/FIO2 at 12 h after treatment in the early-hormone group was obviously better than that in the late-hormone group(P＜0.05).The ventilation time,ICU stay time,hospital stay time and VDUT in the early-hormone group were significantly shortened compared with the late-hormone group and control group.The ventilation times,ICU stay time and VDUT in the latehormone group were significantly shortened compared with the control group (P＜0.05).Conclusion Early using low-dose glucocorticoid may restore hemodynamics more quickly,protects the organ function and improves the prognosis in the patients with septic shock.

Objective:To explore the application of real-time transrectal ultrasound (TRUS) during seminal vesiculoscopy in infertile men with azoospermia or oligoasthenospermia.Methods:We retrospectively analyzed the clinical data of 25 cases of azoospermia or oligoasthenospermia due to ejaculate ducts obstruction who were treated with real-time transrectal ultrasound-guided seminal vesiculoscopy between September 2011 and December 2015. Patients’ age was(29.4±4.5) years. All patients accepted semen analysis, serum sex hormone, MRI, TRUS and then diagnosed as obstructive azoospermia, and 13 cases had intractable obstructive azoospermia or oligoasthenospermia after the failure of simple seminal vesiculoscopy(the path to the ejaculatory duct and seminal vesicle couldn’t be found). All patients were treated with seminal vesiculoscopy under real-time guidance with TRUS. We assessed the success rate of surgery, surgical time and complications.Results:The scope was successfully inserted into the seminal vesicle in 21 of the 25 cases (success rate, 84%). The median operative time was 75(31, 148) min. None of the patients developed severe complications. Among 4 failure cases (4/25, 16%), 1 was due to abnormal congenital development. In 2 cases, a clear outlet of the dual ejaculatory duct could not be found after it was inserted into the prostatic utricle. One case was considered as a Müllerian tubular cyst, and the seminal vesicle scope was used to assess the cystic side wall. The 21 patients were followed up for 3 to 6 months, semen volume 2.0(0-5.2)ml, total sperm 28(0-832) ×10 6/ejaculate, sperm density 5.6(0-110.3)×10 6/ml, mobility rate of sperm 5.4%(0-63.6%), and the differences were significant as compared to that before the surgery [semen volume 0.4(0-2.8)ml, total sperm 0(0-342)×10 6/ejaculate, sperm density 0(0-90.7)×10 6/ml, mobility rate of sperm 0(0-24.1%), all P<0.05]. Among the 17 patients who underwent follow-up of 5 to 9 years, 3 patients was conceived naturally and 9 patients’ postoperative sperm quality has improved and pregnancy in vitro fertilization by extracting sperm from semen. Conclusions:Intraoperative real-time transrectal ultrasound guidance can improved the success rate of seminal vesiculoscopy and promoted operative safety.

Objective To assess the differences in carotid artery stiffness properties and endothelium-independent dilation (EID)between elderly and young patients,and evaluate the echotracking (ET)system for vascular stiffness at different ages.Methods A total of 79 outpatients with multiple cardiovascular risks were recruited.Clinical data including medical history,height,weight,blood pressure,fasting blood glucose and blood lipid were collected.We evaluated the arterial stiffness parameters of carotid artery and EID using an ultrasonic ET system in 46 elderly subjects,compared with 33 sex-matched non-elderly subjects.The impaired EID function was defined as brachial artery nitroglycerin mediated dilation (NMD)below 4％.Results All stiffness parameters including pressure-strain elasticity modulus stiffness index β (Ep),pulse wave velocity β (PWVβ)and augmentation index (AI)were significantly increased in elderly group compared with the non-elderly group [(138.9±64.7)kPa vs.(100.6±30.8)kPa,(10.9±4.7)vs.(8.2±2.3),and (6.9±1.4)m/s vs.(6.1±0.9)m/s,P＜0.05 respectively],while the exception of arterial compliance (AC)was reduced (0.9±0.3)mm2/kPa vs.(1.0±0.5)mm2/kPa(P＜0.05).The incidence of impaired EID in elderly group was higher than in non-elderly group [56.5％ (26 cases) vs.33.3％ (11 cases),P＜0.05].ET parameters including Ep,stiffness index β,PWVβ,AC and AI were related to age (r=-0.44,-0.45,-0.40,-0.40,0.34,all P＜0.01)； Ep,stiffness index β,PWVβ and AC were also related to impaired EDI (r=-0.38,-0.40,-0.34,-0.29,all P＜0.01).Conclusions Arterial stiffness properties and EID measured by ET system was more serious in elderly with multiple cardiovascular risks than in non-elderly subjects.As a convenient and accurate assessment of stiffness parameters,ET system is optimal option for measuring arterial stiffness and EID in elderly people.

Objective To develop a method of loop-mediated isothermal amplification(LAMP) to Staphyloccocus aureus rapidly, specifically, sensitively and simply suited for the primary health agency. Methods According to conserved nucleotide of Staphyloccocus aureus and principle of LAMP, we designed a set of LAMP primers and set up an LAMP reaction system. We evaluated the specificity, sensitivity and re-peatability of the method. In addition,we evaluated the linearity between initial template copies 1g value and reaction time (the time when the fluorescent value is 1×10~4). Results The optimal assay showed that it was no cross-reaction with other closely related members of pathogens, and was 10 times more sensitive than PCR. The coefficient of variance between tests was less than 5% ,and the kinetics curves showed a good line-arity between initial template copies lg value and reaction time(r~2=0. 9501). The detection activity could be finished within 1 h with the sensitivity of LAMP was 100% and the specificity was 94.4%, and the accuracy was 96.6%. Conclusion These findings demonstrated that the LAMP had the potential clinical application for detection and differentiation of Staphyloccocus aureus in the public health agency for its sensitive, specific and simple feature.

Objective To evaluate the influences of statin treatment on MR vessel wall imagingobserved characteristics of atherosclerotic plaque in the thoracic aorta of the elderly.Methods Elderly subjects (≥ 60 years) without any serious cerebro-cardiovascular diseases were recruited.Thoracic aorta was imaged on MR scanner for all the subjects.The plaque burden was calculated quantitatively,the composition of plaque in thoracic aorta was evaluated qualitatively,and the contributions of statin treatment to these characteristics were also compared by image interpretation personals.The thoracic aorta was divided into three segments (AAO:ascending aorta;AOA:aortic arch,and DOA:descending aorta)on the imaging.Results Totally 55 recruited subjects had atherosclerotic plaque in thoracic aorta,with 24 subjects receiving statin treatment,and 50 ％ (12/24) male,aged 73.8±6.3 years.The level of LDL C[(2.4±0.7)mmol/L vs.(3.1±0.8)mmol/L(P＜ 0.01)]and total cholesterol[(4.4±0.6)mmol/L vs.(5.1 ±1.0)mmol/L(P＜0.01)]were significantly lower in statin group than in non-statin group.The lumen area,wall area,and total vessel area in all three segments of thoracic aorta were significantly smaller in statin group(all P＜0.05)than in nonstatin group.The average wall thickness in segment of AOA[(2.7±0.3)mm vs.(2.8±0.4)mm(P＜0.01)]and DAO[(2.5±0.4)mm vs.(2.6±0.5)mm(P＜0.01)]were smaller in statin group than in non-statin group.The incidence rate of intraplaque hemorrhage / mural thrombus [6 cases (25.0％) vs.8 cases(25.8 ％)]in thoracic aorta was a little lower in statin group than in non-statin group,with no significant difference(P＞0.05).Conclusions Statin treatment decreases LDL-C level,reduces the burden of atherosclerotic plaque in thoracic aorta,and maintains the atherosclerotic plaque stability.

Objective To contribute the patient-centered nursing mode and discuss its influence on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients. Methods A total of 108 emergency surgery patients admitted to Xiangyang No.1 People's Hospital Affiliated of Hubei University of Medicine from January 2014 to January 2017 were enrolled as research subjects, and they were divided into an observation group and a control group according to difference in nursing modes, 54 cases in each group. During the peri-operational period, the patients in control group were given routine nursing mode, while in the observation group, the patients received patient-centered nursing mode. The blood pressure, heart rate and levels of various kinds of hormone (insulin, cortisol, epinephrine) and interleukin-6 (IL-6) before and after intervention were measured; the Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the psychological stress changes; after operation, the rate of using analgesics, incidence of postoperative infection, Visual analogue scale (VAS), anus exhaust time, off-bed activity time and sleep quality scale scores were recorded to evaluate the quality of patients' postoperative rehabilitation. Results The diastolic blood pressure, systolic blood pressure, heart rate and levels of insulin, cortisol and IL-6 in two groups before operation and 2 hours after operation were significantly higher than those on admission, while the levels of epinephrine were lower than the level on admission, the degrees of increase or decrease of the observation group were slower than those of the control group, and the changes were more significant at 2 hours after operation [diastolic blood pressure (mmHg, 1 mmHg = 0.133 kPa) was 120.58±13.09 vs. 135.35±15.44, systolic blood pressure (mmHg) was 74.69±10.97 vs. 80.50±11.34, heart rate (bpm) was 83.47±11.64 vs. 92.59±12.00, insulin (mmol/L) was 12.58±1.62 vs. 15.96±1.46, cortisol (μg/L) was 128.72±20.53 vs. 140.47±21.58, epinephrine (ng/L) was 38.96±7.24 vs. 35.25±8.01, IL-6 (ng/L) was 157.64±27.06 vs.183.45±29.37, all P ＜ 0.05]. After interference, the HAMA and HAMD scores of the two groups were significantly lower than those before intervention, and the degree of decrease in the observation group was more obvious (HAMA score: 11.58±2.16 vs. 16.74±2.80, HAMD score: 9.42±2.03 vs. 13.38±2.71, both P ＜ 0.05); the rate of using analgetic [25.93% (14/54) vs. 57.41% (31/54)], incidence of postoperative infection [3.70% (2/54) vs. 16.67% (9/54)], VAS scores (4.63±1.21 vs. 6.87±1.74), anus exhaust time (days: 1.53±0.33 vs. 1.86±0.26), off-bed activity time (days: 1.57±0.19 vs. 1.72±0.24) and sleep quality scale scores (5.84±2.07 vs. 9.33±2.39) in observation group were significantly less than those in control group (all P ＜ 0.05). Conclusion The contribution and application of patient-centered nursing mode in treating emmergency surgery patients during peri-operational period is helpful to ameliorate the patients' degree of physiological and psychological stress reactions, and this mode has important significance in promoting the quality of patients' postoperative rehabilitation.

OBJECTIVE To summarize the clinical features of the acquired immunodeficiency syndrome-related Kaposi's sarcoma(AIDS-KS) in head and neck. METHODS The clinical data of 20 inpatients with AIDS-KS in head and neck from June 2009 to September 2016 in Beijing Ditan Hospital were retrospectively analyzed. RESULTS All 20 patients were male, median age 38.50±10.98. One case was Manchu, 1 case was of Uygur, and others were Han nationality. There were 7 cases with homosexuality history, 2 cases with blood transfusion history, and 1 case with prostitution history. Mass in head and face was the first symptom in 10 cases. The head and neck skin and mucosa were involved, including 2 cases with nasal mucosa involvement, 4 cases with auricle skin involvement, 8 cases with oral mucosal involvement, 3 cases with facial skin involvement, 1 case with neck skin involvement, 1 case with eyelid conjunctiva involvement. Four cases had disseminated lesions. When diagnosed, the CD4+T lymphocyte were 52.55±47.87/mm3. The CD4+T were less than 200/mm3 in all of the patients, including CD4+T＜50/mm3 in 15 cases(75％). After treatment with highly active antiretroviral therapy combined with or without chemotherapy, 12 cases were discharged. Eight cases died due to respiratory failure or septic shock or other reasons. CONCLUSION Kaposi's sarcoma of the head and neck might be the first visit of AIDS patients. Some of the patients get partial remission after highly active antiretroviral therapy and the overall prognosis is poor.

Objective To investigate the expression and clinical significance of CD155 in oral squamous cell carci-noma(OSCC)tissues,as well as its impact on migration,proliferation and invasion.Methods Immunohisto-chemistry(IHC)was used to analyze the expression of CD155 in OSCC tissues and its correlation with clinicopath-ological features and prognosis.The transcription levels of CD155 were assessed by Western blot and RT-qPCR.Cell experiments were conducted to evaluate the effects of CD155 on OSCC cells following transfection with CD155 siRNA.Results CD155 was predominantly expressed on the cell membrane in OSCC tissues,with higher expres-sion levels compared to normal tissues(x2=50.750,P＜0.000 1).High CD155 expression was associated withⅢ+Ⅳ disease stages(x2=25.488,P=0.001),poor differentiation(x2=6.299,P=0.012),T3+T4 depth of invasion(x2=23.820,P=0.001)and lymph node metastasis(x2=7.830,P=0.005)in OSCC patients;survival analysis revealed a correlation between high CD155 expression and shorter patient survival(P＜0.05).COX regression analysis identified lymph node metastasis as an independent factor affecting the survival of OSCC patients(P＜0.05).Both CD155 protein expression and mRNA transcription levels were significantly upregulated in OSCC cells(P＜0.05).Transfection with siRNA-CD155 in OSCC cells resulted in significantly reduced prolif-eration,migration and invasion abilities compared to the control group(P＜0.05).Conclusion CD 155 is highly expressed in OSCC tissues and is associated with poor patient prognosis.Modulating CD155 expression can influ-ence the biological functions of OSCC cells,leading to and inhibition of proliferation,migration,and invasion.