Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS) treatment on the brain derived neurotrophic factor(BDNF) serum levels in depressive patients.Methods Sixty-eight unipolar depressions treated with venlafaxine were randomly assigned to the real rTMS group(n =34)and the sham rTMS group(n =34),which were accepted the real or the shame rTMS treatment on the left dorsolateral prefrontal lobes respectively.The Hamilton Rating Scale for Depression (HAMD) and BDNF serum was assayed before and after 4 weeks' treatment.Results 1) A significant increase of serum BDNF((12.2 ± 1.3) μg/L vs (5.6 ± 0.8) μg/L,t=-9.167,P=0.000;(11.4 ± 1.5)μg/L vs (6.0± 1.0)μg/L,t=-7.421,P=0.000)and a significant decline of HAMD((11.6 ± 1.7) score vs (32.6 ± 2.5) score,t =14.654,P =0.000 ; (4.2 ± 2.8) score vs (31.8 ± 3.2)score,t=12.089,P =0.000) were found after the treatment in the real and the shame group,and the real group changed more significantly than the shame group ((6.7 ± 0.8) μg/L vs (5.1 ± l.2) μg/L,t =2.690,P =0.009 ; (21.0 ± 2.1) score vs (17.6 ± 2.6) score,t =2.693,P =0.000).2) A negative correlation was found between the serum BDNF levels and the HAM D scores before the treatment(r =-0.530,P=0.003; r =-0.490,P =0.004),and a positive correlation between changes of BDNF levels and HAMD scores changes(r =0.439,P =0.006 ; r =0.454,P =0.005).Conclusion The rTMS treatment can increase serum BDNF levels in depressive patients.

Microglia are a type of immune cells and widely distributed in the central nervous system(CNS), accounting for about 5% to 20% of the total number of glial cells. Microglia were first identified by Hortega using the silver carbonate method.It is believed that microglia originate from the mesoderm and invade the brain during the formation of blood vessels in the late embryonic development.Recent research shows that microglia are derived from yolk sac-derived macrophages. As a resident immune cell of the CNS,microglia belong to the monocyte-macrophage cell line and are an important immuno-logical defense against the invasion of pathogens. The resting microglia play a role in monitoring the nervous system to maintain the homeostasis.The activated microglia play a role in phagocytosis of cell debris and have neuroprotective and neurotoxic dual roles under different pathological conditions by secreting different cytokines.

Objective: To prepare nanobowls, establish the method for characterizing nanoparticles, and test drug loading efficiency and release efficiency of nanobowls. Methods: The polystyrene nanoparticles (PSNPs) were prepared by the means of the normal emulsion polymerization. The peanuts nanoparticles (PNPs) were synthesized by the swelling process of PSNPs and the selective crosslinking between 3-(trimethoxysilyl) propyl methacrylate and tetraethylorthosilicate. Finally, the polystyrene was dissolved to obtain nanobowls. Dynamic light scattering (DLS) was used to analyze the size of each kind of nanoparticles. Transmission electron microscope (TEM) was used to observe the morphology of nanoparticles. Nanobowls loaded doxorubicin hydrochloride as a model drug though continuous shaking were used to measure drug loading capacity and release efficiency. Results: PSNPs, coated polystyrene nanoparticles (CPSNPs), PNPs, silica peanuts nanoparticles (Si-PNPs) and nanobowls were synthesized successfully. The size of nanobowls was (126.7±4.9) nm and the Zeta potential was (-30.2±1.1) mV. The final nanoparitcles could be used to load drug easily. The drug loading efficiency and loading capacity reached 51.1% and 9.3%, respectively. Moreover, the nanobowls had the expected sustained release effect. Conclusion: The prepared nanobowls are loaded with drugs successfully, which can release drug slowly and almost completely. The nanobowls can be used for drug release delivery.

OBJECTIVETo summarize the clinical features, diagnostic and therapeutic experiences of colorectal Non-Hodgkin's lymphoma (NHL).

METHODSClinical data of 32 patients with colorectal NHL admitted to our hospital from January 1988 to December 2006 was retrospectively analyzed.

RESULTSThis study included 22 B-cell NHL and 10 T-cell NHL cases. In the B-cell NHL group, the male: female ratio was 14:8 and the median age was 60.5 years. In the T-cell NHL group, the male: female ratio was 5:5 and the median age was 31.0 years. The ileocecal region was most frequently involved in both groups, which accounted for 77.3% and 60.0% of the B and T group respectively. The common clinical manifestations included abdominal pain, weight loss, and abdominal mass. Of the 14 cases of B-cell NHL with definite subtype classifications, 64.3% were of the Diffuse Large B-cell Lymphoma (DLBCL) type. Among the 22 B-cell NHL, 40.9% were with localized diseases (stage I-II1), while all 10 patients in T-cell NHL group were in stage IV with 3 patients complicated with massive GI bleeding and 4 with perforation. All patients of B-cell type received chemotherapy utilizing mainly CHOP after surgical resection. After a median follow-up of 55 months, the disease-free survival was rate 88.2%. Among the T-cell NHL group, 8 out of 10 patients underwent surgery and chemotherapy was given to all those who could tolerate it. Five patients died within 2 months after surgery. It's known that 3 patients were still alive after 23 months.

CONCLUSIONSThe ileocecal region is the most frequently involved site of the colorectal NHL. The histology is usually B-cell type with a majority being DLBCL. Currently R-CHOP chemotherapy after the surgical resection is the principal treatment modality. Patients of B-cell type have a better prognosis while the prognosis of T-cell NHL is poor. Therefore more aggressive diagnostic and therapeutic approaches are recommended for T-cell NHL patients. The prospective of organ preservation treatment for colorectal NHL is still in need of further investigations.

Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; therapy ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; therapy ; Male ; Middle Aged ; Retrospective Studies

Objective: To investigate the mechanisms of electroacupuncture (EA) at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) in intervening diabetic gastroparesis (DGP) based on calcium-activated chloride channel. Methods: Forty Sprague-Dawley rats were randomly divided into four groups, including a normal control group (group A), a model group (group B), an EA group (group C) and a metoclopramide group (group D), with 10 rats in each group. A single intraperitoneal injection of 2％ streptozotocin (STZ) combined with 8-week high-glucose high-fat diet was used to establish a DGP rat model. After intervention, gastrointestinal propulsive rate was observed; the expression level of transmembrane protein 16A (TMEM16A) was examined by immunohistochemistry; the Ca2+ concentration in interstitial cells of Cajal (ICCs) was detected by immunofluorescence; and whole-cell patch-clamp technique was applied to detect the current intensity of calcium-activated chloride channel (ICaCC) in ICCs in gastric antrum. Results: After modeling, the blood glucose levels in group B, group C and group D were significantly increased compared with group A (all P<0.01); after intervention, compared with group B, the blood glucose levels in group C and group D were significantly decreased (P<0.05, P<0.01); the intra-group comparison of blood glucose level between after modeling and after intervention found significant difference only in group C (P<0.01). The gastrointestinal propulsive rates in group B, group C and group D were significantly different from that in group A (P<0.01 or P<0.05); the gastrointestinal propulsive rates were markedly higher in group C and group D than in group B (P<0.01, P<0.01). The expressions of TMEM16A in group B and group C were decreased compared with group A (P<0.01, P<0.05); the expressions of TMEM16A in group C and group D were increased compared with group B (P<0.01, P<0.05). The fluorescence intensity of Ca2+ was significantly lower in group B than in group A (P<0.01); the fluorescence intensity of Ca2+ was significantly higher in group C and group D than in group B (P<0.01, P<0.05). ICaCC in ICCs in group B was significantly decreased compared with group A; ICaCC in group C and group D were increased compared with group B. Conclusion: EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6) can significantly improve gastrointestinal motility in DGP rats by up-regulating the ICaCC in ICCs.

This study was aimed to investigate the effects of the introplasmic interferon-γ level in circulating T cell of patients with aplastic anemia (AA) and its clinical significance. The interferon-γ level before and after immuno-suppressive therapy was monitored by flow cytometry. The results indicated that the higher interferon-γ level was detected in 28 out of 50 AA patients, detected rate was 56%. The effective rate of immunosuppressive therapy for AA patients with higher interferon-γ level was up to 85.7% (24/28). The decrease of interferon-γ level in these patients positively correlated with hemogram recovery to normal level and obviously earlier than hematologic remission. It is concluded that the immunosuppressive therapy shows better efficacy for AA patients with high interferon-γ level, moreover the change of interferon-γ level is earlier than hematologic change, that is important for predicting the therapeutic efficacy and relapse of disease.
Adolescent ; Adult ; Aged ; Anemia, Aplastic ; drug therapy ; metabolism ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Immunosuppressive Agents ; therapeutic use ; Interferon-gamma ; metabolism ; Male ; Middle Aged ; T-Lymphocytes ; metabolism ; Young Adult

OBJECTIVETo evaluate the clinical effect of titanium mesh in anterior cervical subtotal subcorpectomy with locking plate for treatment of cervical spondylotic myelopathy.

METHODSThirty-eight patients with cervical spondylotic myelopathy were treated with anterior cervical subtotal corpectomy using titanium mesh and locking plate. The JOA score of the patients were assessed before and after the operation, and the pre- and postoperative lateral cervical radiographs were taken to observe the instability of the titanium mesh, dynamic plates and changes of the cervical curvature.

RESULTSThe patients were followed up for 12-18 months. Radiographic cervical fusion was achieved in 12-16 months (36 cases) or 18 months (2 cases) postoperatively. The degree of Jordosis was improved and the height of the anterior spinal column and physical curvature were effectively maintained after the operation. The titanium mesh and locking plate showed no signs of loosening and the JOA scores was significantly improved after the operation (P<0.05).

CONCLUSIONTitanium mesh in anterior cervical subtotal corpectomy with locking plate allows effective treatment of cervical spondylotic myelopathy, but the indications of this procedure must be carefully evaluated. The long-term effect of this approach still needs verification by further follow-up data.

Aged ; Bone Plates ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Spinal Cord Compression ; etiology ; surgery ; Spinal Fusion ; methods ; Spondylosis ; complications ; surgery ; Surgical Mesh ; Titanium

OBJECTIVETo improve the quality of medical instrument clinical trial in China.

METHODSA systematic analysis on current situation of medical instrument clinical trial in China is conducted to find a way out of problems.

RESULTS & CONCLUSIONSThere is a low level of medical instrument clinical trial now in China. There are still many shortcomings in law and regulations of medical instrument clinical trial. The sponsors and s do not know medical instrument clinical trial well, the measures of quality related to medical instrument clinical trial must be improved.

China ; Clinical Trials as Topic ; standards ; Equipment and Supplies ; Humans

OBJECTIVEAn unhealthy food consumption habit attributes to one of the etiology of gastro-esophageal reflux. The purpose of this article was to study the influence of food intake before going to bed on the nighttime gastro-esophageal reflux.

METHODSThirty-eight children with upper gastrointestinal symptoms were divided into two groups on the basis of taking (Group A, n=16) or not taking (Group B, n=22) food (non-stimulating) within 2 hrs before going to bed. All of them underwent 24 hr esophageal pH monitoring. The times of reflux episode, the longest duration of reflux, the times of reflux duration > 5 min, and the percentage of time of pH < 4 were compared between the two groups.

RESULTSThere were no significant differences in the parameters of pH monitoring between Groups A and B, with the times of reflux episode of 32 (21.5-43.5) vs 24 (15-37.3) , the longest duration of reflux of 6.6 (2.4-29.8) min vs 4.5 (2.5-13.2) min, the times of reflux episode longer than 5 min of 1.5 (0-3) vs 0 (0-3), and the percentage of time of pH < 4 of 4.3 (2.1-15.0)% vs 4.1 (2.0-7.2)% .

CONCLUSIONSNon-stimulating food intake before going to bed did not adversely affect the nighttime gastro-esophageal reflux.

Adolescent ; Child ; Esophageal pH Monitoring ; Feeding Behavior ; Female ; Gastroesophageal Reflux ; etiology ; Humans ; Male ; Time Factors

BACKGROUNDBronchial carcinoids are rare malignant neuroendocrine neoplasms. Some issues regarding surgical treatment of bronchial carcinoids remain controversial, including the role of bronchoplastic surgery and necessity of systematic lymphadenectomy.

METHODSThis retrospective study involved 131 consecutive patients surgically treated for carcinoid tumors at Shanghai Chest Hospital between March 1990 and August 2010.

RESULTSEighty-nine (67.9%) of the patients were male, and the mean age was 46 years, ranging from 17 to 81 years. Preoperative fiberoptic bronchoscopy was performed in all patients. Endoscopic biopsy was performed in 100 patients with central tumors, and 70 (70%) patients were diagnosed as bronchial carcinoid. The resections performed consisted of 31 pneumonectomie, 32 lobectomies, 26 bilobectomies, 34 sleeve lobectomies, six bronchoplastic procedures without lung resection, and two segmentectomies. During a median of 87 months follow-up, there were nine recurrences including three local recurrences and 6 distant recurrences. No bronchial recurrences were observed. The 3-, 5- and 10-year overall survival rates of pneumonectom and bronchoplastic surgery (including sleeve lobectomy and bronchoplastic procedure without lung resection) were 93.2%, 81.0% and 69.4%, 97.5%, 91.9% and 70.0%, respectively. Multivariate Cox regression indicated that histology and nodal status were significant independent prognostic factors.

CONCLUSIONSBronchoplastic surgery should be considered whenever possible for central carcinoids. Systematic lymphadenectomy is recommended for bronchial carcinoid patients. Histology and nodal status were significant independent prognostic factors of overall survival of patients with bronchial carcinoid.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoid Tumor ; mortality ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome