Objective: To compare the efficacy of paroxetine and amitriptyline in the treatment of primary fibromyalgia syndrome.Methods:46 out- and in-patients with primary fibromyalgia syndrome were randomized to two groups and treated respectively with amitriptyline 25mg~50mg per day and paroxetine 10mg~20mg per day. The Visual analogue scales(VAS) was used to evaluate the efficacy and adverse effects were recorded at baseline, month 1 and month 3.Results:In both groups pain was alleviated with statistical significance after 1 month of treatment. However the efficacy of amitriptyline and paroxetine was not statistically significant at different time points. The occurrence of adverse effects in paroxetine group was less than in amitriptyline group and the difference was statistically significant, especially dry mouth and palpitation.Conclusion:Paroxetine is as effective as amitriptyline in the treatment of primary fibromyalgia syndrome but with a better safety profile.

Objective To explore the clinical value of measuring myoglobin (MYO) for the early diagnosis of ACS and monitoring the effect of thrombolysis. Methods MYO and cTnT, CK、CK-MB were measured. The sensitivity, specificity, positive predicting value and negative predicting value of cTnT and CK-MB at different time points were studied. And the correlation was investigated between the MYO plasma level and the severity of coronary artery lesion according to coronary arteriongraphy. The changes of MYO level with thrombolysis were also observed. Results The concentration of MYO, cTnT, CK, CK-MB in acute myocardial infarction patients were (56?34)?g/L, (0. 05?0. 03 )?g/L,(94?84) U/L,(17?13) U/L respectively, which were higher than that in the healthy controls(P 0. 05). The level of MYO rises to the peak at 5. 26 hours after operating thrombolysis. The peak time was earlier than CK and CK-MB (P

Objective To calculate the social economic burden of mental illness,and to analyze the economic impact of different patients with mental illness in Shandong Province.Methods Direct method was used to calculate the direct economic burden,and human capital method was employed to estimate the indirect economic burden.Results The social economic burden increased from 10.076 billion in 2005 to 31.277 billion in 2013,and the proportion of the social economic burden accounting for GDP of Shandong province was between 0.5 ％ ～ 0.7％.The economic burden caused by women,18-39 years old patients,rural patients and mood disorders was higher than that of men,more than 55 years-old patients,urban patients and other diagnoses,respectively.Conclusions The economic burden brought by mental illness was heavy and increasing during 2005-2013.The economic burden caused by different people was heterogeneous.

Objective To study the relation between the effect of Curcumin on the proliferation and activation of hepatic stellate cells(HSC)and the expression of the peroxisome proliferator-activated receptor?(PPAR?).Methods The rat HSC was isolated from SD rats through in situ perfusion of liver with Pronase E and density-gradient centrifugation with Nycodenz.The subcultured cells were treated with corresponding compound.The inhibition effect on HSC proliferation was determined by MTT colorimetry.The total RNA was extracted by TRizol reagent,and the gene expression level of PPAR? and smooth muscle actin (?-SMA)were determined by semi-quantitative RT-PCR.The total cellular proteins were extracted and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis,and the protein level of ?-SMA was determined by Western blotting.Results The MTT analysis results showed that Curcumin inhibited HSC proliferation between 10 and 50 ?mol/L in a dose-dependent manner.In the Day 1,4,7 of primary HSC and passaged HSC,the expression of PPAR? mRNA decreased with HSC activation extent;Curcumin could up-regulate the expression level of PPAR?.Curcumin suppressed the expression of ?-SMA not only at the gene level but also at the translation level.But all these effects of Curcumin on HSC could be blocked by the PPAR? specific antagonist GW9662.Conclusion The effect of Curcumin on HSC cell proliferation and activation is through the up-regulation of PPAR? signal.

Aim To study the effect of Curcumin on the apoptosis of hepatic stellate cells (HSC), and the correlation between the effect and peroxisome proliferator-activated receptor ?(PPAR?) signal.Methods The HSC was isolated from normal SD rats through in situ perfusion of liver with protease E and density-gradient centrifugation with Nycodenz.The subcultured cells were treated with corresponding compounds. Cell apoptosis was detected by Hoechst 33258 staining. PPAR? subcellular distribution was detected by immunofluorescent staining. Total RNA, total protein and nuclear protein were extracted respectively, target gene and protein levels were determined by semi-quantitative RT-PCR or Western blot.Results There was nearly no apoptosis in activated HSC. Curcumin treatment induced the apoptosis of HSC, enhancing PPAR? nuclear translocation/redistribution.At the transcription and translation level,curcumin upregulated nuclear PPAR? expression, inhibited anti-apoptotic Bcl-2 expression, and promoted pro-apoptotic Bax expression; but all these effects could be reversed by PPAR? antagonist GW9662.Conclusions Curcumin induces HSC apoptosis by enhancing PPAR? expression and nuclear translocation/redistribution.

Objective To study the clinical efficacy of emergency early mechanical ventilation and bron -choalveolar lavage and drug intervention to severe asthma .Methods 140 cases with severe asthma were selected ,the patients were divided into the study group and the control group according to a random number table ,70 cases in each group,the control group were received early mechanical ventilation ,the study group were given bronchoalveolar lavage and interventional therapy on the basis of the control group ,clinical efficacy ,alveolar function ,her condition improved and hospital stay of the two groups were compared .Results The total efficiency of the study group were 92.9%(65/70) significantly higher than 81.4%(57/70) in the control group,the difference was statistically significant (χ2 =12.382,P<0.05);Forced expiratory volume in one second (FEV1),forced vital capacity (FVC) and FEV1/FVC of the study group were significantly better than that of the the control group ,the difference was statistically significant ( t=9.098,10.382,11.204,all P<0.05);Condition improved and hospital stay of the study group were significantly shorter than that of the control group,the difference was statistically significant (t=9.898,12.393,all P<0.05). Conclusion Emergency early mechanical ventilation and bronchoalveolar lavage and drug intervention to severe asthma had better clinical efficacy ,which can significantly improve the clinical symptoms of the patient .

Objective To observe the changes of hospitalization rates of patients with goiter in Lianyungang City in a coastal area with mild iodine deficiency in 2002-2010.Methods Medical reports of patients with goiter from county hospitals were studied at county level with a retrospective method.In accordance with the National Iodized Salt Monitoring Program,nine townships(towns) were taken from each county (district) [total of five counties(districts)]; four villages were selected from each township (town); salt samples were taken from eight households in each village,and salt iodine was determined using direct titration of sodium thiosulfate.Results The hospitalization rate of patient with goiter increased from 1.87/10 million in 2002 to 7.05/10 million in 2009,and then fluctuated to 6.06/10 million in 2010(x2 =281.91,P＜ 0.01).Among them,female's hospitalization rates were significantly higher than that of male 's(The variation range of x2 values were 35.23-116.04,all P ＜ 0.01),and the hospitalization rates of people over the age of 40 years were significantly higher than that of people less than 40 years of age(The variation range of x2 values were 33.04-263.04,all P ＜ 0.01),and the hospitalization rates of people in urban areas were significantly higher than that of people in rural areas (The variation range of x2 values were 18.35-140.00,all P ＜ 0.01).Average salt iodine was 27.61-30.13 mg/kg in 2002-2010.The coverage rate of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,P ＜ 0.01).There was a positive correlation between hospitalization rate of patient with goiter and coverage rate of iodized salt(spearman correlation coefficient was 0.83,P ＜ 0.05).There was a positive correlation between hospitalization rate of patient with goiter and the consumption rate of qualified iodized salt too (spearman correlation coefficient was 0.93,P ＜ 0.05).Conclusions In Lianyungang City,the hospitalization rate of patient with goiter,the coverage rate of iodized salt and the consumption rate of qualified iodized salt all show upward trend in 2002-2010.The relationship among them is worth further study.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Diarrhea ; chemically induced ; Drug Delivery Systems ; methods ; Exanthema ; chemically induced ; Humans ; Leukopenia ; chemically induced ; Lung Diseases, Interstitial ; chemically induced ; Myocardial Infarction ; chemically induced ; Neoplasms ; drug therapy ; Tumor Lysis Syndrome ; etiology

Objective To explore the effect of circadian rhythm disorder on cognitive decline and neurologic impairment after traumatic brain injury (TBI) in rats.Methods Rats were subjected to a weight-drop model of TBI,then the rat models were divided into 2 groups ac-cording to the environmental length of day and night ,namely,the whole day group (12 h light/12 h light) and the control group (12 h light/12 h dark).After 14 days,the Morris water maze test and step-down test were carried out to evaluate the memory of the rats in each group . HE staining and immunohistochemistry ( BrdU, Ki-67) were carried out to evaluate the degree of the neurologic impairment of the rats in each group.And the mRNA expressions of Caspase-3,Caspase-9,Bcl-2 and Bax were evaluated with realtime PCR .Results The memory function of the rats in whole day group was significant lower than control group ;the damage degree of the cells in the hippocampus and the cortical lesion volume in whole day group were significant higher than control group ;the cell proliferation rate and newborn cell survival rate in the whole day group decreased significantly compared with the control group ;the mRNA expression of Bcl-2 in whole day group was signifi-ant lower than control group ,and the mRNA expression of Caspase-3,Caspase-9 and Bax in whole day group was signifiant higher than control group.Conclusion Circadian rhythm disorder can worsen TBI-induced cognitive decline and neurologic impairment .

Objective Through analyzing and summarizing the main pathogens of bacterial infections of children in Sichuan Province and trends of drug resistance in 2013 to provide a reference for the clinical use of antibiotics.Methods The pediatric pathogen were collected by member of Sichuan province in china antimicrobial resistance surveillance system.Results A total of 22 470 clinical bacterial were isolated from the members,in which Staphylococci,Escherichia coli,Streptococcus pneumoniae,Kleb-siella pneumoniae,Hemophilus influenza,Moraxella catarrhalis were the most common Bacteria.The resistance rates of Staphylo-coccus aureus and Coagulase-negative staphylococci to oxacillin were 1 7.7% and 71.1%.4 strains of Staphylococcus aureus and 20 strains of coagulase-negative staphylococci were teicoplanin resistance.Escherichia coli and Klebsiella pneumoniae were clearly re-sistant to the third generation cephalosporins,ampicillin and ampicillin/sulbactam,with the exception of ceftazidime.Carbapenems remained highly active against all the target bacteria.The resistance rate of Streptococcus pneumoniae to Penicillin was 3.9% .All antibiotics excepted cotrimoxazole remained highly active against the haemophilus influenzae.All antibiotics except macrolide anti-biotics remained highly active against the moraxella catarrhalis.Conclusion Penicillin-insensitive Streptococcus pneumoniae,mac-rolides-resistant gram-positive cocci,cephalosporin-resistant Enterobacteriaceae ,Oxacillin-resistance coagulase-negative staphylo-cocci were revealed to be the most serious problems in terms of bacteria resistance for children in Sichuan province.