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 study the effects of Shuanghuanglian on pharmacokinetics of theophylline in healthy sub?jects.METHODS:The serum concentration of theophylline was determined by HPLC and analyzed by3p97pharmacokinetic program.RESULTS:The main pharmacokinetic parameters of single theophylline and that in combined use with Shuanghuan?glian were as follows:T max were(1.66?0.56)and(1.59?0.78)h,C max were(6.23?1.31)and(6.10?0.94)?g/ml,T 1/2 were(5.76?1.11)and(6.09?1.63)h,CL were(47.72?5.12)and(50.98?10.85)ml/(kg?h),Vd were(369.18?40.15)and(430.37?48.33)ml/kg,AUC 0～∞ were(84.56?14.43)and(89.27?26.35)?g/(h?ml),respectively.CONCLUSION:The Vd of theophylline were increased(P

To study the expression of transforming growth factor β1 (TGFβ1) and platelet-derived growth factor (PDGF) in alveolar type Ⅱ cells and their significance in the process of pulmonary fibrosis. MethodsCultivation of alveolar type Ⅱ cells were mode from normal adult rat and of silicotic animal model of rat was established. In situ hybridization and irnmunohistochemieal staining were applied to detect the gene expression of TGFβ1 and PDGF-B in the alveolar type Ⅱ cells of primary culture and silicotic tissue. Results(1) In situ hybridization and immunohistochemical staining showed the positive expression of TGFβi, PDGF-B rnRNAs and their relevant proteins in cultured alveolar type Ⅱ cells. (2) The positive expression of TGFβ1, PDGF-B rnRNAs and their proteins were prominent in the proliferative alveolar type Ⅱ cells of experimental group of silicotic models. Weak expression of TGFβ1 mRNA were found only in a part of normal alveolar type Ⅱ cells of control group. ConclusionThe proliferative alveolar type Ⅱ cells express TGFβ1 and PDGF-B, which may play an important role in silicotic fibrcsis.

Objective To evaluate the safety of helical tomotherapy (HT) for hepatocellular carcinoma confined to the liver,and to investigate the efficacy of HT by comparison with three-dimensional conformal radiotherapy (3DCRT).Methods In June 2011,hypofractionated HT was performed in 35 patients with unresectable hepatocellular carcinoma confined to the liver who had no distant metastasis or tumor thrombosis.The dose in each fraction increased from 2.4 Gy to 5.0 Gy with a median dose of 3.2 Gy.The median dose for the total treatment was 50.0 Gy.Within the same period,45 patients received conventionally fractionated 3DCRT with a median dose of 54.0 Gy.The adverse reactions,clinical outcomes,and survival time were compared between the two groups.The survival rate was calculated with Kaplan-Meier method,and log-rank test was used to estimate statistical significance of survival differences.Multivariate analysis of survival was carried out with Cox' s regression model.Results There were no significant differences in adversc reactions between the two groups.The objective response rate was significantly higher in the HT group than in the 3DCRT group (60％ vs.33％,P=0.024).There was no significant difference in the disease control rate between the two groups (94％ vs.89％,P=0.459).The HT group showed significantly higher 1-,2-,and 3-year overall survival rates than the 3DCRT group (97％ vs.80％,P=0.025;81％ vs.55％,P =0.008;67％ vs.50％,P =0.048).The multivariate analysis indicated that tumor smaller than 8 cm,transarterial chemoembolization before radiotherapy,and HT were associated with improved survival (P=0.005;P =0.000;P=0.002).Conclusions HT shows an advantage in precise treatment of hepatocellular carcinoma confined to the liver.With acceptable toxicity,hypofractionated HT shortens the treatment duration and improves the survival in patients.

OBJECTIVE:To prepare ofloxacin hollow suppository(OHS) and to observe its in vitro dissolubility.METHODS:OHS was prepared with PEG 6000,PEG 400 and Carbopol-940 as wase material and wax as retardant.The content of ofloxacin in OHS was determined with the first order derivative UV-spectrophotometry.RESULTS:The wax,as a retardant,could retard the release of drug.The in vitro dissolution of OHS revealed the first order dissolution pattern:K0～1=27.81/h,indicating a speedy effect,K2～6=5.94/h,indicating sustained-release effect.CONCLUSION:This preparation is feasible in technology and controllabe in quality.The preparation of OHS extends the kinds of dose-form of ofloxacin

BACKGROUND:A large number of experiments have confirmed that bone marrow mesenchymal stem cells can differentiate into hepatocytes under the induction of cytokines and specific micro-environment, and have been widely used in clinical alternative treatment for terminal liver disease, but the optimal inducing conditions are unclear.
OBJECTIVE:To explore the possibility and validity of differentiation of rat bone marrow mesenchymal stem cells into hepatocytes with a culture system containing salidroside and cholestatic rat serum in vitro.
METHODS:Bone marrow mesenchymal stem cells were isolated by plastic adherence from the whole bone marrow of health rats, and cellphenotypes were identified using the flow assay;cholestatic serum was prepared by common bile duct ligation. Passage 3 bone marrow mesenchymal stem cells were randomly divided into three groups for in vitro induction by the different culture systems:blank control group:basic medium plus 5%cholestatic serum;salidroside group:basic medium plus 5%cholestatic serum plus 30 μmol/L salidroside;positive control group:basic medium plus 5%cholestatic serum plus 20 μg/L hepatocyte growth factor. Changes of cellmorphology during culture time were observed in each group, reverse transcription-PCR assay and western blot assay were used to expression of hepatocyte-specific proteins.
RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cells highly expressed CD90, CD105, but did not express CD45, CD14, CD34, and CD79a. Polygonal and binucleate cells appeared in the three groups during the procedure of induction. The mRNA and protein expression of alpha-fetoprotein and albumin emerged in the three groups on the 7th day;in the same period, the lowest expression ratio was in the blank control group (P<0.05), while there was no significant difference between the salidroside and positive control groups (P>0.05). Combination of salidroside and cholestatic serum can effectively induce bone marrow mesenchymal stem cells differentiating into hepatocytes.

Modern pharmacological studies have shown that Cistanche deserticola (C. deserticola) has a protective effect on the liver, but its active fraction and mechanism are not clear. In order to identify the effective fraction of C. deserticola Y. C. Ma, an acute alcoholic liver injury model in mice was established with 56-proof Erguotou and different fractional extracts of C. deserticola Y. C. Ma (total glycosides, polysaccharides, and oligosaccharides) were administered. After 14 days of oral administration, liver pathology and lipid deposition were measured and the expression of nuclear factor E2-related factor (Nrf-2), kelch-like ECH-associated protein-1 (Keap-1), and plasmalemma vesicle-associated protein-1 (PV1) were measured by immunofluorescence. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), endotoxin (ET), diamine oxidase (DAO), and D-lactic acid (D-LA) in serum, and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) in liver were measured by ELISA. All animal experiments were carried out with approval of the Experimental Animal Welfare Ethics Committee of the Peking University Health Science Center. The results show that the total glycosides of C. deserticola Y. C. Ma (400 mg·kg^-1) could decrease liver pathology, decrease serum endotoxin, diamine oxidase, and D-lactic acid, and reduce hepatic lipid deposition. Total glycosides also promoted Nrf-2 transfer into the nucleus and decreased the expression of Keap-1 and PV1. In summary, the total glycosides of C. deserticola Y. C. Ma had a protective effect in acute alcoholic liver injury and the mechanism may be related to the activation of the Nrf-2/Keap-1 pathway, improvement of intestinal wall integrity, and inhibition of the transport of harmful substances into the liver.

Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .

Objective To discuss the methods and clinical effects of phased treatment of ankylosing spondylitis (AS) combined with severe hip flexion contracture.Methods The study enrolled 8 cases (12 hips) of AS combined with severe hip flexion contracture hospitalized from September 2011 to November 2012.Phased treatments included lateral hip arthrolysis,articular capsulectomy,stripping of the reflected head of rectus femoris,femoral neck osteotomy,traction and stage Ⅱ biotype total hip arthroplasty (THA).Preoperative and postoperative Harris score,hip range of motion,and complication of femoral nerve injury were detected.Results Period of follow-up was 6-12 months (mean 10 months).One case developed heterotopic ossification,which affected postoperative hip activity and received resection one year later.One case sustained fissure fracture of calcar femorale during implantation of the prosthetic femoral stem,but no special handling was provided.Of all cases,active flexion and extension of the hip were both 0° before operation,but increased to (96.25 ± 4.33) ° and (24.17 ± 4.69)° respectively after operation ; mean Harris score was improved from (26.67 ± 2.39) points preoperatively to (90.92 ± 5.66) points postoperatively (P ＜ 0.01).Besides,no femoral nerve injury was observed.Conclusion Phased treatment of AS combined with severe hip flexion contracture restores hip function and minimizes femoral nerve injury following THA.