Summarize all kinds of methodology of scar’s treatment,reflect the condition of research on the treatment of scar,and outlook the prospect of traditional Chinese medicine on scars in the future.

Objective To explore the efficacy of low-dose aripiprazole combining with citalopram on the depression. Methods A total 57 patients with depression were randomly assigned to the study group and the control group. Either group was treated with a fixed dose 20 mg citalopram per day, and the study group was simultaneously titrated to low dose (5～10mg/d) of aripiprazole at initiating dose 2.5 mg per day within two weeks. They were evaluated with Hamilton Depression Scale (HAMD).Clinical Global Impression (CGI-SI) and Treatment Emergent Symptom Scale(TESS) before treatment and at the end of 1st, 2nd, 4th and 6th week after treatment. The study lasted for 6 weeks. Results HAMD total score of either group were 11.54 ± 5.58 and 16.59 ± 6.67 respectively, which had statistically significant difference between two groups(t = 2.961, P<0.05) at the end of the study. CGI-SI score of either group was 2.12 ± 1.47 vs 3.17 ± 1.63 at treatment termination, which also had statistically significant difference (t = 2.439, P<0.05). There were mild side effects rate and no statistically significant difference between two groups (χ~2 =0.625, P>0.05). TESS scores were not statistically significant difference between two groups at each point of measure. Conclusion The results suggest low dose of aripiprazole augmentation of citalopram may be effective and safe in the treatment of depression.

Objective To observe the therapeutic efficacy of endoscopic pancreaticobiliary duct drainage for acute necrotizing pancreatitis. Methods 41 cases of acute necrotizi ng pancreatitis were randomly divided into pancreaticobiliary duct drainage (21 causes) group and control group (20 cases).Results The procedure was successful in all 21 cases. The difference bet ween the two groups was statistically significant including hospital stay 〔(2 8?12) days vs. (37?19) days,P

Objective To explore the clinical effectiveness of the platelet parameter in neonatal hypoxic-ischemic encephalopathy(HIE).Methods From Oct,1999 to May 2001,50 cases of neonatal HIE were final diagnosed,the platelet total(PLT),mean platelet volume(MPV) and platelet distribution width(PDW) were dynamic observed.It was compared with 27 cases of normal term infant.Results ⑴PLT in acute period of HIE was obviously lower than that of the normal term infant(P0 05).⑵The PLT in the HIE was decreased(P

Objective To probe the classification of diabetic retinopathy (DR) and the different grade of diabetic and type of macular edema according to fundus fluorescein angiography (FFA). Methods FFA was performed on 1 058 patients (2 097 eyes) to classify DR and macular edema with the analysis of duration of DM, visual acuity, manifestation of FFA images and results of ophthalmoscopic examination. Results In 2 097 eyes, there were 124 (5. 9%) without DR, 396 (18. 9%) with DR I, 430 (20. 5%) with DR II, 563 (26.8%) with DR III, 262 (12. 5%) with preproliferative diabetic retinopathy ( PPDR), 254 (12.%) with DR IV, 60 (2. 9%) with DR V, and 8 (0. 4%) with DR VI. In 2 097 eyes there were 819 (39. 1%) with macular edema, including 311 (38%) with focal macular edema, 322 (39. 3%) with diffused macular edema, 112 (13. 7%) with cystoid macular edema, 25 (3. 1%) with ischemia macular edema, and 49 (6. 0%) with proliferative macular edema. Conclusion With the analysis of the results of FFA of 2 097 eyes, we classify DR in stage Ⅰ (primary stage Ⅰ and Ⅱ), Ⅱ (primary stage Ⅲ), Ⅲ (preproliferative diabetic retinopathy), Ⅳ,Ⅴ, and Ⅵ; classify macular edema of DR in focal, diffused, cystoid, ischemic, and proliferating ones.

Objective To report immune-reconstruction in two patients with acute radiation sickness due to 60Co radiation accident after stem cell transplantation.Methods Patient “A” and “B” were diagnosed as intestinal form of acute radiation sickness(ARS)and extremely severe degree bone marrow form of ARS,respectively.Peripheral blood stem cell transplantation was successfully performed in these two patients.During their whole disease course,absolute lymphcyte count,neutrophil leukocyte count,T-lymphocyte subsets,natural killer(NK),and immunoglobulin were sequentially determined.Results Immunoglobulin was decreased after irradiation without any recovery tendency after the transplantation.After irradiation,absolute lymphcyte count decreased rapidly,but recovered partially after the transplantation(maintained at 0.5?109/L).Neutrophilic leukocyte count rose rapidly to normal after the transplantation.NK was lowered obviously after irradiation,and it rapidly recovered to normal level after the transplantation,and maintained at a level higher than normal.After irradiation,the proportion of CD4/CD8 showed a transient rise,followed by an abrupt lowering.After the transplantation,it showed a tendency of elevation,but it did not recover to normal.Conclusions The tendency of lowering of immunoglobulin,lymphocyte count,NK cell count,and CD4/CD8 ratio indicate that there is a rapid deterioration of both cellular and humoral immunity after irradiation.Following the homogeneic peripheral blood transplantation,neutrophil count and NK cell count showed a rapid recovery,lymphocyte count and CD4/CD8 ratio also showed a tendency of slow elevation,but there is no sign of recovery of immunoglobulin.The results indicate that there is a faster recovery of cellular immunity.

Objective To investigate the significance of HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness. Methods Patient “A” from Shandong province suffered from a 60 Co radiation accident with a dose of 20-25Gy, and was diagnosed as intestinal form of acute radiation sickness. On the 3rd day after irradiation, total environmental protection (TEP), antibiotics treatment and emergency HLA zygosity with his elder sister were done, and HLA haploidentical peripheral blood stem cell transplantation was performed with a preconditioning regimen of “CTX+ATG+Flu”. The regimen for protecting from GVHD was “CsA/FK506+MMF+CD25+MSC”. Results WBC began to increase on the 17th day after treatment, and WBC recovered to 5.1?109/L on the 19th day, platelet to over 30?109/L, and RCT to normal. Bone marrow image showed hematopoietic recovery of the three cell lineages. Continuously detection of the implantation ratio of donor's cells by STR-PCR, sexual chromosome analysis and HLA zygosity showed stable complete donor-derived chimera. No GVHD was observed. On the 19th days after treatment, chest X-ray films and CT suggested that a mixed bacterial and fungous infection existed in the patient's lungs. The severest skin damage occurred on the 25th day which occupied 14% of whole body surface. The functions of lung, kidney and heart were damaged sequentially. The patient died of multiple organ failure (MOF) 33 days after admission. Conclusion It is the first time to report a successful HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness in China. A successful transplantation might be a key for prolonging the survival period of such a patient.

Objective To report the diagnosis and treatment of an extremely severe bone marrow form of acute radiation sickness complicated with disseminated Trichosporon Asahii in Jining,Shandong province, China.Methods An extremely severe bone marrow form of acute radiation sickness was transfered to our hospital 3 days after the accident on October 24,2004.The patient was performed allogeneic stem cell transplantion from his brother and soon acquired hematogenesis recovery, however, refractory disseminated Trichosporonosis(mainly lung) then occured in the patient.after the hemato-reconstitusion,and gradually aggravate.Result Strong support treatment and high dosage combination of drug therapy were used to combat fungi ,the accumulative dose of Ampghotec (amphotericin B) was 2965mg, the accumulative dose of itraconazole was 4000mg, and the accumulative dose of Caspofungin(concidas) was 3020mg. The refractory disseminated Trichosporon Asahii was once partially controlled, but the radiation injury and infection were still becoming worse even after many kinds of antiinfection drugs, the patient then died of multiple organ failure on d75 after the accident. Conclution The combination of Ampghotec with Caspofungin and Itraconazole in the treatment of disseminated Trichosporon Asahii was effective, no related toxicity occured, which has not been reported before. However, with continuously injury of radiation, we couldn’t cure the Trichosporonosis thoroughly, and the patient finally died of multiple organs failure related with radiation and infection.According to the clinical treatment of the patient, we also acquired the experience that when we resolve the hematogenesis, to promote the immunologic reconstitution and the tissue damage repair, control the whole body radiation damage and infection will be the key point for this kind of patient to survive.

Objective To observe the changes of serum high-sensitivity C-reactive protein (hs-CRP) in 2 patients diagnosed as acute radiation sickness, and to evaluate its clinical significance. Methods Two victims from Shandong province, China were accidentally received a 60 Co irradiation from a dropped 60 Co source in 2004. They were exposed to more than 20Gy (patient A) and 9Gy (patient B) of X-ray irradiation respectively. The patient A was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS), and patient B was diagnosed as having developed intestinal form of ARS. The two patients successfully got HLA-haploidentical (patient A) and HLA-identical (patient B) peripheral blood stem cell transplantation, and their hematopoiesis recovered, but they cached serious bacterial infection in whole clinical course. Hs-CRP was quantitatively detected by automatically immunoturbidimetric assay. Result The serum level of hs-CRP in the two patients elevated quickly when they suffered from serious bacterial infection, and declined markedly when the infection was controlled effectively. The serum level of hs-CRP also increased slightly when the patients suffered from severe damage on organs or skin function. There existed 3 peak values of hs-CRP level in patient A when kept in the hospital, with a highest value of 188.8mg/L; there existed 4 peak values of hs-CRP level in patient B when kept in the hospital, with the highest value of 377.2mg/L. Conclusion The present results suggested that hs-CRP may be a good indicator to acute radiation sickness complicated with serious bacterial infection, for the hs-CRP levels may fluctuate following the bacterial infection and effectively controlling.

Objective To compare the results of mobilization of peripheral stem cells of two different G-CSF dosage schedules in 30 healthy donors. Methods In one group 15 healthy subjects received 5?g/kg filgrastim once daily subcutaneously (SC), while in the other group another 15 individuals received 2.5?g/kg of filgrastim twice daily SC. Peripheral blood stem cells were collected after five days of filgrastim administration, and flow cytometric immunophenotyping was performed for the first harvest. Results The MNC count was 2.93?10 8/kg donor body weight in the 5?g/kg Qd group compared with 4.42?10 8/kg in the 2.5?g/kg bid group (P0.05). Conclusion Administration of filgrastim twice a day at 2.5?g/kg instead of once a day at 5?g/kg is more efficient in mobilizing stem cells without obvious side effect.