Objective To analyze the clinical features and its influencing factors of depression pa?tients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression ( PMD group,79 case) and nonpsychotic major depression ( NMD group,268 case) . All patients completed social demographic question?naire ( including gender,age,marital status,educational level,family history,positive family history of psychi?atric disorder,disease onset age,frequency of attack,times of hospitalization,etc.) and Hamilton's depression scale (HAMD?24). Results Positive family history(PMD group 47/79,NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79,NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29),NMD group(1.39±1.31), P<0.01) in the PMD group were signifi?cantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69),NMD total score (43.44±8.51), P<0.01),the factor score of anxiety/somatization(PMD group(11.40±3.28),NMD group (9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77),NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09 ±5.17),NMD group(35.95±9.06), P<0.01),the course of the disease(PMD group(1.58±0.76),NMD group(3.02±2.87), P<0.01),the factor score of day and night change(PMD group(0.76±0.46),NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression anal?ysis showed the major depression with positive family history of mental disorders( β=3.278) ,attack in early age( β=-2.524),seriously cognitive dysfunction in patients( β=3.836) may indicate the psychotic symp? toms( P<0.05).Conclusion PMD patients more positive family history,psychiatric disorder positive family history,likely to be hospitalization,severe symptoms and attack in early age compared with NMD. With posi?tive family history of mental disorders,attack in early age,seriously cognitive dysfunction in patients with ma?jor depression may indicate the psychotic symptoms.

OBJECTIVETo systematically evaluate the effectiveness of integrative medicine (IM) for preventing postoperative recurrence of primary hepatic carcinomas (PHC).

METHODSSuch databases as The Cochrane Library, PubMed, EMbase, China National Knowledge Infrastructure (CNKI), VIP Database, Wan-fang Database were retrieved to collect randomized controlled trials (RCTs) on preventing postoperative recurrence of PHC by IM. The retrieval period started from database establishment to June 2013. Literature screening, data extraction, and quality evaluation were performed by two reviewers strictly according to inclusion criteria. Meta-analysis was conducted using RevMan 5.2 Software.

RESULTSA total of 5 RCTs involving 367 patient cases were included. Results of Meta-analysis showed that the IM group was superior to the Western medicine (WM) group in the 1-, 2-, and 3-year recurrence rates (P < 0.05).

CONCLUSIONIn the prevention of postoperative recurrence of PHC, the effectiveness of IM was more significant, when compared with treatment of Western medicine.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine ; Liver Neoplasms ; prevention & control ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.

Baculovirus has many advantages as vectors for gene transfer. We demonstrated that recombinant baculovirus vectors expressing p35 (Ac-CMV-p35) and eGFP (Ac-CMV-GFP) could be transduced into human kidney 293 cells efficiently. The level of transgene expression was viral dose dependent and high-level expression of the target gene could be achieved under the heterogonous promoter. MTT assay suggested that both Ac-CMV-p35 and Ac-CMV-GFP did not have cytotoxic effect on human embryo kidney 293 cells. Cell growth curve showed the Ac-CMV-p35 and Ac- CMV-GFP transduced and non-transduced cells had similar proliferation rate, so baculovirus-mediated p35expression had no adverse effect on cell proliferation. In addition, baculovirus-mediated p35 gene expression protected human embryo kidney 293 cells against apoptosis induced by various apoptosis inducers such as Actinomycin D, UV or serum-free media. These results suggested that the baculovirus vector mediated p35 gene expression was functional and it could be widely used in molecular research and even gene therapy.

Objective To compare the diagnostic value of prenatal ultrasound with magnetic resonance imaging(MRI)in the abnormalities of fetal urinary reproductive system,and explore the value of combining prenatal ultrasound and MRI in diagnosis of fetal urinary and reproductive system abnormalities.MethodsTwenty-seven fetal abnormalities in urinary reproductive system detected by prenatal ultrasound received MRI examination within 24 hours after ultrasound,confirmed by autopsy or clinical follow-up.The results of prenatal ultrasound and MRI were analyzed retrospectively.Results Ultrasound,MRI,autopsy or after birth,postpartum follow-up confirmed 27 cases of Genitourinary system anomalies,including 2 cases of hydronephrosis,renal agenesis in 6 cases,14 cases of renal cystic disease,renal fusion in 3 cases,1 case of renal tumors,ovarian cyst in one case of crown .Fetal ultrasound can diagnose the majority of the genitourinary system anomalies (25/27),MRI can diagnose fetal anomalies of 26 cases of genitourinary system.Conclusion Ultrasound could diagnose the majority of fetal abnormalities in urology reproductive system accurately.However,combining ultrasound and MRI could establish more precise estimation in urology reproductive system,such as the level of obstruction of urinary system in hydronephrosis,the pulmonary hypoplasia secondary to urology system abnormalities,and location of cyst in the renal parenchyma or in the renal capsule.

Background Many studies and clinical trials of pharmacologic vitreolysis are already under way to try to improve vitreo-retinal surgery and to liquefy and detach the vitreous from the retina ultimately, including chondroitinase,hyaluronidase,dispase and plasmin. However, there has not been any report on purification of human plasminogen from cord blood plasma and inducing posterior vitreous detachment of the animal eye at present.Objective This study was designed to isolate and purify the production of human plasminogen (Plg) from cord blood plasma with ethanol precipitation and evaluate the efficacy of Plg in inducing posterior vitreous detachment (PVD).Methods Human Plg was Separated and purified from cord blood plasma by ethanol precipitation method. The protein band corresponding to Plg with molecular mass of 92 000 was revealed in SDS-PAGE and confirmed by MALDI-TOF and Mascot database. Anion-exchange chromatography and plasminogen activity assay kit were used to obtain purified Plg with biological activity. Twenty-five fresh pig eyes were enucleated and assigned to 5 groups and 5 eyes for each group. The normal eyes were used as control group. Balanced salt solution(BSS)of 0.1 ml was intravitreally group and standard substance group. All of the eyes were then incubatedfor 60 minutes under the 37 ℃. Retinal histopathology and ultrastructure were examined under the light microscopy, scanning electron microscopy ( SEM ) and transmission electron microscopy (TEM). Results The Plg with potential fibrinolytic activity was successfully extracted and purified from cord blood plasma by ethanol precipitation method. No posterior vitreous detachment (PVD) was seen in normal control group, BSS group and r-SK group following the intravitreal injection under the sem. However,PVD was demonstrated in r-SK+ Plg group and standard substance group under the SEM. The inner limiting membrane ( ILM ) and the retina were well preserved in all of the experimental eyes. No retinal morphology and ultrastructural abnormality were found under the light and SEM and TEM. Conclusion Ethanol precipitation is a feasible way to isolate and purify Plg from human cord blood plasma. Extracted Plg shows potential fibrinolytic intravitreal injection of Plg.

Objective In this study,we aim to investigate and evaluate the application of peer education on the teaching of medical graduate students and to evaluate the teaching effect,in order to provide the basis for subsequent practice reform.Methods 49 graduate students majoring Internal Medicine-Pulmonology were randomly divided into traditional teaching(24) and peer education groups (25).We chose the primary culture technology of rat distal pulmonary arterial smooth muscle cells to be the teaching contents.For the traditional teaching group,we used the mode of class lecture giving and experimental skills learning under the assistance of the teachers; while in the peer education group,students benefited from the combination of class lecture given by the teacher and the seniors fixed teaching in which seniors help younger students.We selected the experimental operating time,cell purity and the practicing time to reach a standard culture as the evaluation indexes by filling a follow up questionnaire.The SPSS 13.0 was applied to the related data forx2 or t test.Results In the traditional teaching group,the average time to reach three times of standard culture was(3.2 ± 0.5) hour,which was(2.3 ± 0.4) hour in the peer education group.The cell purity was 80.1 ± 3.6％ in the traditional teaching group,while(85.4 ± 5.9)％ in the peer education group.The average practicing time was(6.3 ± 1.0) in the traditional teaching group,while(4.9 ± 0.6) in the peer education group.The peer education group master the teaching content better than the traditional teaching group (P=0.00).95.8％(23/24)of the students in the peer-education group considered the teaching contents simple,which was statistically higher(P=0.00) than traditional group (62.5％,15/24).Meanwhile,95.8％ (23/24)of the students in the peer-education group considered the teaching methods easy to accept,which was also statistically higher(P=0.02) than traditional group(70.8％,17/24).The difference was statistically significant (P=0.02).Conclusion The application effect of peer education is good and there is high degree of acceptance among the students.Besides,peer education accords with the medical postgraduate experiment teaching rules,and can cultivate medical graduate students' spirit of cooperation and communication ability in the process of implementation.

Objective To investigate the changes and clinical significances of the chemokines of interferon-?-inducible protein-10(IP-10),monocyte chemoattractant protein-1(MCP-1) and growth-related oncogene-?(Gro-?) involved in pathagenesis of Kawasaki disease(KD) and HenochSchonlein purpura(HSP).Methods The chemokines production of IP-10,MCP-1 and Gro-? were assayed by ELISA in 15 patients with KD,12 patients with HSP and 10 healthy children.Results The plasma levels of IP-10 and MCP-1 were markedly elevated in KD group [(394.2?176.4)and(420.5?163.4)ng?L-1]compared with HSP group[(94.8?66.4)and(109.2?76.6)ng?L-1] and the control group [(76.4?46.5)and(87.7?47.8)ng?L-1](all P0.05),as well as Gro-? between the three groups.Conclusion Monocyte may enhance the immune damage in KD pathogenesis,and the levels of IP-10,MCP-1 may be important indexes for KD.Neutrophil may be not involved in pathogenesis of HSP and KD.

Objective To investigate the effect of total glucosides of paeony ( TGP ) on the expression of Toll-like receptor 9 (TLR9) in peripheral blood B lymphocytes of the patients with systemic lupus erythematosus (SLE). Methods Sixty SLE patients and thirty healthy volunteers were enrolled, peripheral blood mononuclear cells ( PBMC) were isolated from blood samples and divided into 4 groups, which were incubated with CpG-ODN(final concentration was 1 μmol·L-1), CpG-ODN+TGP ( TPG final concentration was 1í10-4 mol·L-1 ) ,TGP and RPMI medium ( as the blank control group) for 48 hours, respectively. FLA ( Flow cytometry analysis) was used to detect the expression of TLR9 on peripheral blood B lymphocytes after incubated. Results ①In the health people, TLR9 expression in the group of CpG-ODN was(9. 10±2. 12) %, which was higher than the blank control group(4. 96±2. 11) % (P<0. 01).②In the SLE patients, the TLR9 expression in the group of CpG-ODN was(14. 86±3. 42)% , which was significantly higher than the blank control group(9. 20±3. 43) %(P<0. 01). The TLR9 expression in the group of CpG-ODN+TGP was (11. 95±3. 63)%, which was lower than that in the group of CpG-ODN (P<0. 05). The TLR9 expression in the group of CpG-ODN with lightly active degree SLE patients was (10. 74±3. 17)%, which was higher than the blank control group(5. 19±2. 05) % (P<0. 01). For SLE from the moderately to vigorously active degree, the expression of TLR9 in the group of CpG-ODN(16. 51±1. 72) % was higher than the blank control group(10. 80±2. 37) %(P<0. 01), but that in the group of CpG-ODN+TGP (13. 59±2. 58) % was lower than the group of CpG-ODN (P<0. 01). Conclusion Our data indicate that TGP antagonize upregulation effect of CpG-ODN on the expression of TLR9 in peripheral blood B lymphocytes.