OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). HAMD after 4 and 8 weeks,HAMA after 8 weeks in control group,HAMD and HAMA after 2,4 and 8 weeks in observation group were significantly lower than before,and it gradually decreased by time pro-longed,observation group was lower than control group,the differences were statistically significant (P<0.05 or P<0.01). And there was no significant difference in the TESS rating in 2 groups before and after treatment(P>0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.

Objective: To investigate the protective effect of shenduqing Granules on chronic renal insufficiency in rats. Methods: The rat model of chronic renal insufficiency was made by feeding 0.75% adenine forage. The blood biochemical indexes, ion concentration in serum of rat was measured and the pathological changes of rat kidney were observed. Results: Shenduqing Granules obviously increased thymus index (TI). The weight of rat kidney in the treatment group was lighter than that of the model group. The kidney histomorphological study showed that Shenduqing Granules obvionsly reduce the pathological changes. The drug crystals were also reduced. Conclusion: Shenduqing Granules has the potential protection against chronic renal insufficiency in rats.

Aim Toinvestigatetheroleofbrain-de-rived neurotrophic factor(BDNF)-tyrosine receptor ki-nase B (trkB ) signaling pathway in the therapeutic effects of ketamine on diabetic neuropathic pain.Meth-ods Forty-eightWistarrats,aged3months,weighing 200~250 g,were equally randomized into 4 groups(n=12 ):control group (C group ), saline group (S group),ketamine group (K group)and ketamine +ANA-12 group (KA group ).Rats in S,K and KA groups were intraperitoneally injected with a single of streptozotocin(STZ)65 mg·kg-1 to construct diabetic neuropathic pain model.After twenty-eight days,rats in S,K and KA groups were intraperitoneally injected with saline, ketamine 10 mg·kg-1 and ketamine 10 mg·kg-1 +ANA-12 0. 5 mg·kg-1 for consecutive 7 days, respectively. On the 8th day, mechanical withdrawal threshold(MWT)of rats was measured.Af-ter that,the rats were immediately sacrificed,and dor-sal ganglion of lumbar spine and prefrontal cortex (PFC)were harvested for measuring BDNF,p-trkB/trkB,synaptophysin and spine density by Western blot andglogistaining.Results ComparedwithCgroup, rats in S group significantly decreased MWT,BDNF, p-trkB/trkB,synaptophysin and spine density in dorsal ganglion and PFC (P <0. 05 ).Compared with S group,rats in K group showed a significant increase of MWT,BDNF,p-trkB/trkB,synaptophysin and spine density in the all observed regions(P<0. 05 ).On the contrary,rats in KA group showed a significant de-crease of MWT and BDNF,p-trkB/trkB,synaptophys-in and spine density as compared with K group in all regions(P<0. 05 ).Furthermore,BDNF was positive-ly correlated with spine density in all regions (P <0.05).Conclusion BDNF-trkBsignalingpathway mediates ketamine-induced therapeutic effects in dia-betic neuropathic pain.

Objective:To observe the expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance,so as to assess their expression with the metastasis and prognosis of colorectal carcinoma. Methods:Immunohistochemistry was used to detect the expression of chemokine receptor CCR7 and CXCR4 in 110 patients with colon cancer.The relationship between the CCR7 and CXCR4 expression and the clinic pathological characters was statistically analyzed. Results:CCR7 and CXCR4 expression were positively expressed in 59.1% and 45.5%of the patients. The high expression rate of CCR7 and CXCR4 in lymph node metastasis positive cases was 81. 5% and 60.0% respectively,but the without lymph node metastasis positive cases were 26.7% and 24.4% respectively. The positive expression was significantely higher in the patients with lymph node metastasis than those non-lymph node metastasis(P

OBJECTIVETo investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.

METHODSFrom June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females, with an average age of 41 years (ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases, by falling down from high place in 8 cases. Based on the Tile classification, there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time, intraoperative blood loss, complications, functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws, cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.

RESULTSAnatomical reduction achieved in 7 cases, satisfactory reduction 11 cases, and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks (mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards, 12 patients obtained an excellent results, 6 good and 1 fair.

CONCLUSIONPercutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma, less blood loss, fewer rates of complications, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but it needs adequate preoperative preparation and high requirements for the surgeon.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography ; Young Adult

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective:To investigate the expression of MACC1 in Klatskin tumor and the relationship between the clinicopathological features and prognosis and the expression of MACC1.Methods:Immunohistochemistry staining was employed to assess the expression of MACC1 protein in Klatskin tumor tissues and matched adjacent non-tumor bile duct tissues.Quantitative real-time PCR was performed to examine MACC1 mRNA expression in Klatskin tumor tissues and the adjacent non-tumor bile duct tissues and normal bile duct tissues.The correlation between MACC1 expression and the clinicopathological features and prognosis was analyzed.Results:The positive rate of MACC1 in Klatskin tumor tissues was significantly higher than that in matched adjacent non-tumor bile duct tissues(P＜0.05).MACC1 mRNA expression in carcinoma tissues was significantly higher than that in the non-tumor bile duct tissues and normal bile duct tissues(P＜0.05).MACC1 expression in Klatskin tumor tissues was related to tumor size,recurrence and lymphatic metastasis(P＜0.05).Survival analysis indicated that the 1-year,3-year,5-year survival rate were with significantly differences between the two groups (P＜0.05).Conclusion:MACC1 expression was significantly higher in Klatskin tumor and it was related to the tumor size,recurrence and lymphatic metastasis.It would affect the prognosis of patients.

Objective To investigate effects of β-thalassemia on 8 HbA1c measurement systems including Capillary electrophoresis and application of HbA2 values of samples with β-thalassemia from Capillary 2 Flex Piercing HbA1c measurement systems.Methods 338 samples without β-thalassemia ( include 80 α-thalassemia with --SEA/ααgenotype) and 225 samples with β-thalassemia were collected in Peking University Shenzhen hospital from January 2014 to August 2014.Samples withβ-thalassemia are all heterozygotes with normal α-globin and abnormal β-globin, and without combining other haemoglobinopathies.76 normal samples and 76 samples with β-thalassemia were selected from above all samples, HbA1c values of which were given by capillary electrophoresis ( Capillary Flex 2 Piercing), enzymatic ( Norudia N HbA1c ), immune transmission turbidity ( oneHbA1c FS ), chemiluminescent immunoassay (ARCHITECT HbA1c Reagent Kit), boronate affinity HPLC (Trinity Ultra2)and ion exchange HPLC (HA8160, VariantⅡTurbo and Variant Ⅱ BioRad 2.0), respectively.HbA1c values given by the eight systems were compared.338 samples without β-thalassemia and 225 samples with β-thalassemia were measured by using Capillarys 2 Flex Piercing HbA1c system and capillary electrophoresis hemoglobin system, the cut-off values of HbA2 from Capillary 2 Flex Piercing HbA1c measurement system for β-thalassemia was
assessed by using ROC curve.Data statistics were done by using SPSS 19.0.Results The HbA1c values of normal samples were well correlated with the comparative system.The correlation coefficients for the 7 systems are all greater than 0.98.For samples withβ-thalassemia, the correlation coefficients are all greater than 0.98 except for Variant Ⅱ Turbo.The bias between normal samples and samples with β-thalassemia have no significant difference except for VariantⅡTurbo.HbA2 values from Capillary 2 Flex Piercing HbA1c measurement and capillary electrophoresis hemoglobin system were well correlated. The correlation coefficient is 0.993.When cut-off value of HbA2 from Capillary 2 Flex Piercing HbA1c measurement system for β-thalassemia is 3.38, sensitivity is 98.3%, specificity is 100% .Conclusions Samples withβ-thalassemia have no significant effects on HbA1c measurement syetems except for Variant Ⅱ Turbo.The Capillary 2 Flex Piercing HbA1c measurement syetem has the advantage of screeningβthalassemia by HbA2 while measuring HbA1c.

Objective To probe into effective surgical methods to reduce post-operational recurrence rate of nodular goiter.Methods One hundred and fifty-seven patients with nodular goiter who were admitted and had operations in our hospitals between Jan,2007 and June,2011 were assigned to one of the following 4 groups:total thyroidectomy(TT),nearly total thyroidectomy (NTT),subtotal thyroidectomy (STT),removal of lesion only or partial thyroidectomy (also termed as local removal,LR).Postsurgical recurrences and complications were compared among these groups.Results The recurrences were statistically analysed.There was a highly significant difference between TF and STT、TT and LR、NTT and LR; no difference was observed between TT and NTT,STT and STT + E,STT and LR.A statistical analysis was also carried out on the postsurgical compications in these patients.highly significant differnce was found between TT and STT,TT and NTT,TT and LR.There was a significant diffrence between STT and NTT.There was no difference between STT and LR,NTT and LR.Conclusion TT,STT,NTT are all effective operations for nodular goiter and should be advocated.Satisfactory efficacy may be obtained with oral thyroxine or euthyrox for postsurgical lifetime.However,LR or partial thyroidectomy should be adopted cautiously.

Objective To stuay CT findings of adrenal gland trauma(AGT).Methods The CT images of adrenal gland trauma which were found in 1712 patients who had emergency abdominal CT examinations for assessment of blunt force trauma were analyzed restrospectively.Results Among 1712 cases.we identified 29 patients(1.7%)with adrenal gland traumatic lesions.A total of 32 lesions were found.Twenty-six lesions were unilateral(23 right-sided,3 left-sided),and 3 cases were bilateral(6 lesions).Main CT findings were as followed:(1)Adrenal hematomas appeared as discrete round or oval masses expanding the adrenal gland in 22 patients with 25 lesions.The lesions were hyperdense or of homogeneous density in plain scan and did not enhance in three-phase contrast-enhanced dynamic scan.The splayed adrenal limbs around hematoma were enhanced significantly as eurvilinear structures.(2)Mild to moderate uniform swelling of gland was shown in 4 cases.(3)Diffuse irregular hemorrhage obliterating the gland was shown in 3 cases.Contrast extravasation was shown in 1 case,which was active bleeding from the broken adrenal gland proven by operation.Associated CT findings included strand-like hemorrhage of the periadrenal fat and posterior pararenal hemorrhage mimicking thickened diaphragmatic crus.The concurrent injuries of ipsilateral thorax or/and abdomen were found in 25 patients.Conclusion The AGT has typical CT findings.Familiarity with characteristic CT findings of adrenal trauma is essential for the radiologist to avoid misdiagnosis.