Objective To discuss the effect of early combined therapy of sertraline and psychotherapy on the rehabilitation of the patients with post-stroke depression (PSD)and observe its effect on plasma and platelet serotonin(5-HT). Methods All of 130 patients with PSD were divided into sertraline treatment group (65 cases) and routine treatment group (65 eases). Every patient was given routine treatment according to treatment guideline of cerebrovascular disease after admission. The sertraline treatment group received twelve-week sertraline treatment and psychotherapy, while the routine treatment group only received psychotherapy. Patients were evaluated by HAmilton rating scale for depression (HRSD) and serf-rating depression scale (SDS) before treatment and at the ends of the 4th and 8th week treatment, respectively. Meanwhile, the levels of plasma and playlet 5-HT of every patient were measured by the enzyme immunoassay methods. Results The scores of HRSD and SDS were lower in sertraline treatment group than those in routine tretment group at the ends of the 4th and 8th week. The rate of decrease of HRSD and SDS in sertraline treatment group was higher than that in routine treatment group at the end of the 8th week (Pall<0.01).The levels of platelet 5-HT in sertraline treatment group was lower at the ends of the 4th and 8th week than those before, treatment (P< 0.01).No significant change in plasma 5- HT level could be observed before and after treatment in two groups(P> 0.05). Conclusions Early treatment by sertraline can release the symptom of PSD and promote rehabilitation of PSD patients. The sertraline treatment can reduce the level of platelet 5- HT in PSD patients. However, the effect of plasma 5-HT value is not clear.

Objective To validate cystatin (Cys C)-based equations for evaluation of residual renal function (RRF) in patients on continuous ambulatory peritoneal dialysis (CAPD).Methods Fifty patients on CAPD from our department were enrolled in the study.Eight patients with residual urine volume ≤ 100 ml/d and 42 patients with residual urine volume ＞ 100 ml/d were enrolled into anuria group and non-anuric group respectively.The clinical and laboratory status of each group were compared and equations (Hoek' s,Yang' s and abbreviated MDRD equations) were validated in the non -anuric group by comparing with the arithmetic average of residual renal creatinine clearance rate and residual renal urea clearance rate which was considered as the golden standard for RRF.Results (1) Anuric group had significantly higher serum Cys C than the non-anuric group [(7.73±1.13) mg/L vs (6.46± 1.15) mg/L,t =2.39,P =0.02)].(2) RRF estimated by each equation was correlated well with measured RRF (r =0.56,0.56 and 0.39,all P ＜ 0.05).(3) Yang' s equation [0.10 ml· min1· (1.73 m2)-1]was least biased,followed by Hoek' s equation [-0.73 ml· min-1 · (1.73 m2) 1] and abbreviated MDRD equation [3.15 ml· min-1 · (1.73 m2)-1].(4) The precision of Yang' s equation was equivalent to that of Hoek' s equation and both of them were better than abbreviated MDRD equation [6.2 and 6.1 vs 8.4 ml· min-1 · (1.73 m2)-1].(5) 50％ accuracy according to Yang' s equation and Hoek' s equation revealed an elevated results in comparison to that according to abbreviated MDRD equation (59.5％ and 54.8％ vs 23.8％,respectively,all P ＜ 0.01).Conclusions Serum Cys C-based prediction equations are better than the abbreviated MDRD equation in bias,precision and 50％ accuracy.For patients undergoing CAPD,the use of Cys C-based equation to estimate RRF may be a clinically acceptable alternative.

Objective To investigate the efficacy and safety spinal ropivacaine and fentanyl-epidural anes-thesia for the first stage of preclinical of childbirth.Methods 78 cases of full-term maternal were divided into the three groups randomly by using digital representation,each group had 26 cases.A group did not implement analgesia, B group was given analgesia in the first stage of incubation(ropivacaine and fentanyl epidural anesthesia),C group was given labor analgesia on the first line of the active phase.The labor time,mode of delivery,Apgar score,pain VAS score and the occurrence of adverse reactions of three groups were observed.Results The VAS pain scores of B group were (5.01 ±0.61)points,(2.30 ±0.32) points and (1.65 ±0.21) points after 5,10,30min of analgesia, which were significantly lower than those of before(t=6.59,9.62,10.73,all P<0.05) and A group(t=6.76, 9.80,11.02,all P<0.05);The VAS pain scores of C group were (4.92 ±0.57)points,(2.34 ±0.30)points and (1.61 ±0.23)points after 5,10,30min of analgesia,which were significantly lower than those of before(t=9.72, 9.55,10.91,all P<0.05) and A group( t=6.88,9.73,11.30,all P<0.05);The VAS pain scores of B group and C group showed no significant difference(t=2.22,2.08,1.99,all P>0.05) at each time point;The first stage of labor of B group and C group were (327.43 ±31.02)min and (335.62 ±30.18)min,respectively,which were significantly decreased compared with A group(t=7.21,6.90,all P<0.05);The natural birth rate of B group and C group was 80.77%and 84.62%,respectively,which were significantly higher than 57.69%of A group(χ2 =8.43, 8.81,all P<0.05);There was no significantly different among three groups in the incidence of adverse reactions (χ2 =2.23,2.23,all P>0.05).Conclusion Ropivacaine and fentanyl in epidural anesthesia had a preferable effect for the first stage of preclinical and active period of childbirth which can effectively reduce maternal labor pain and improve the natural birth rate and has a fewer adverse reactions.

n clinic.

OBJECTIVE: To explore the effect and clinical significance of serum S100β and NSE on moderate and severe obstructive sleep apnea syndrome (OSAHS) after the continuous positive airway pressure (CPAP). METHOD: A total of 60 cases with obstructive sleep apnea were choosed with PSG in our hospital in June 2009 to June 2009. According to apnea hypoventilation index and at night the lowest oxygen saturation, divided into severe group (n=60) and moderate group (n=60), selecting 60 cases of healthy physical examination for a control over the same period. According to the length of the course of the disease in patients with each group can be divided into <5 years group, 5-10 years and > 10 years group, severe and moderate groups were recruited to undergo an CPAP treatment,both before and after treatment for 3 months, the lowest oxygen saturation, average blood oxygen saturation and apnea hypoventilation index were determined in moderate and severe groups with PSG, at the same time, serum S100β and NSE were determined with immune enzyme-linked adsorption testing before and after patients in different course of treatment and control group. RESULT: Compared with pretherapy of severe and moderate groups, the lowest oxygen saturation, average blood oxygen saturation and apnea hypoventilation index were ower after treatment (P<0. 05), serum S100β and NSE in severe and moderate groups before and after treatment were significantly higher than control group (P<0. 05), and two groups > 10 years before and after treatment in patients with serum according to beta and NSE levels higher than 5-10 patients, 5-10 patients before and after treatment according to beta and NSE serum levels higher than <5 years group of patients, the relation between the two groups of patients before and after treatment according to beta and NSE serum levels with the extension of history time increased. Before the treatment serum according to beta and NSE in patients with severe group were higher than moderate group before treatment (P< 0.05). Relation between the two groups after treatment according to beta and serum NSE was significantly decreased the (P<0. 05), the relation between the two groups after treatment according to beta and serum NSE, there was no statistically significant difference (p>0. 05), the relation between two groups according to beta, NSE serum are positively correlated with AHI (P < 0. 01). CONCLUTION CPAP significantly reduced serum S100β and NSE levels in patients with OSAHS, both may be important index which evaluated nervous system protection of CPAP in patients with OSAHS.
Continuous Positive Airway Pressure ; Humans ; Phosphopyruvate Hydratase ; blood ; S100 Calcium Binding Protein beta Subunit ; blood ; Sleep Apnea, Obstructive ; blood ; therapy

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

Objective To investigate the effect of intravenous infusion of hyper-oxygenated solution (HOS) on small intestinal ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty-four rabbits of both sexes,weighing 2.5-3.2 kg,were randomly divided into 3 groups ( n =8 each):sham operation group (group S),I/R group,and HOS group.Small intestinal I/R was produced by clamping the superior mesenteric artery (SMA) for 1 h followed by 2 h of reperfusion in I/R and HOS groups,while the SMA was only clamped in group S.HOS was infused intravenously at a rate of 20 ml· kg-1 ·h -1 via the auricular vein starting from the time immediately after clamping the SMA in group HOS and the equal volume of normal saline was infused instead of HOS in group I/R.Blood samples were obtained from the inferior vena cava at 2 h of reperfusion to detect the concentration of serum lactic acid.The animals were then sacrificed and the small intestine was removed for determination of the malondialdehyde (MDA) content,and activities of superoxide dismutase (SOD),catalase (CAT) and glutathione peroxidase (GSH-Px) in intestinal tissues and for microscopic examination.The pathological changes of the intestinal epithelia were observed and the damage.to the mucous membrane was scored.The internal organs were removed and bacterial translocation from gut to the internal organs was observed.Results Compared with group S,the level of MDA and lactic acid,and rate of bacterial translocation were significantly increased,and the activities of SOD,CAT and GSH-Px were significantly decreased in groups I/R and HOS ( P ＜ 0.05).Compared with group I/R,the level of MDA and lactic acid,rate of bacterial translocation,and activities of SOD,CAT and GSH-Px were significantly decreased in group HOS ( P ＜ 0.05).Conclusion Intravenous infusion of HOS can reduce small intestinal I/R injury in rabbits.

Objective To explore the necessity and function of the sustentaculum tali screw placement for the treatment of Sanders type Ⅱ calcaneal fracture.Methods The data of Dicom that CT scan with bone was input into Mimics 12.0 software and Ansys 13.0 software for construction of calcaneus three-dimensional finite element model.Then,this model was imported into Solidworks 2010 software.Type Ⅱ calcaneal fracture model was established according to Sanders type cutting of calcaneus.Geometric parameters of AO calcaneal plate and screws were imported to the Solidworks 2010 software.Two internal fixation simulations were established based on the calcaneal model.In one model,the steel was placed on the outside with bone and the cancellous' bone screws were infiltrated respectively into the vertical bone since two screw holes which under the articular surface behind the steel plate,two screw holes which rear of the steel plate,a screw hole of the below calcaneus,two screw holes which in front of steel plate.In another model,a cortical bone screw was infiltrated into the sustentaculum tali through the bottom screw hole of articular surface of the steel plate.The two internal fixation models were loaded under the same condition,and non linear finite element analysis was carried out.The stress distribution in the two internal fixation models was calculated respectively.Results The maximum principal stress focused on the cortical bone of sustentaculum tali in both of the models under the same condition of loading.Bone joint displacement,maximum principal stress of calcaneal and internal fixation system in the model with sustentaculum screw fixation were smaller than that in the model without sustentaculum screw fixation.The stress in the model with sustentaculum screw fixation was more dispersed.Conclusion The placement of sustentaculum tali screw is essential for fixation of type Ⅱ calcaneal fracture to achieve the biomechanical stability and can be used in clinical.

Objective To establish a fluorescence quantitative Taqman-PCR method for rapid and accurate detection of mouse poxvirus.Methods After sequence alignment and comparison, ERPV_027 gene was selected as the primer and probe design gene.Furthermore, the specificity, sensitivity, stability and reproducibility of these primers and probes were detected.Results The detection limitation of this method was 68 copies/μL.Data showed that this method has high specificity, which specifically amplifies mouse poxvirus, with no amplification signal of mouse hepatitis virus, Sendai virus, Salmonella and some other viruses and bacteria.This method also showed good stability and reproducibility. Conclusions This study has successfully established a fluorescence quantitative Taqman-PCR method for detection of mouse poxvirus, with high specificity, sensitivity, good stability and reproducibility, and a broad application potential.

Objective To study the clinical characteristics and to summarize our experience in the diagnosis and treatment of ectopic splenic autotransplantation (ESAP) many years after splenic rupture and splenectomy.Methods The clinical data of 15 patients with ESAP who were treated in the People's Hospital of Zhengzhou from January 1998 to January 2013 were retrospectively analyzed.Results Of the 15 patients,2 patients presented with intestinal obstruction due to the ectopic splenic tissues and required partial resection of small intestine.In 5 patients,the ectopic splenic tissues were in the greater omentum which required resection of part or the whole of the greater omentum.In 4 patients,the ectopic splenic tissues were in the mesentery which required partial or total resection of the tissues.The ectopic tissues were in the pelvis in 3 patients and resection of the left fallopian tube was carried out in 2 patients and resection of the pelvic tissues in 1 patient.In 1 patient the diagnosis was made under laparoscopic biopsy,thus avoiding open surgery.Three patients had multiple implanted sites for these ectopic splenic tissues.Conclusions ESAP is an uncommon disease and it has no clinical characteristics.It is easy to confuse the condition with metastatic deposits.A diagnosis could be made only by combining the history with magnetic resonance imaging,or 99mTc study of red blood cells,or laparoscopic exploration and biopsy.