Objective To evaluate efficacy and safety of escitalopram in treating depression .Methods In this randomized , single-blind, citalopram parallel controlled, fixed dosage study, the study group was treated with escitalopram tablet 10mg/d and the control group with citalopram tablet 20mg/d.Observation duration was 6 weeks.Hamilton Rating Scale for Depression ( 17-item HAMD),Clinical Global Impression (CGI) and Hamilton Rating Scale for Anxiety (HAMA) were used to measure the efficacy.Items including Treatment Emergent Symptoms Scale (TESS), lab examination and vital signs for assessment of safety .Results Eighty-eight patients were randomly divided into study group (43 patients) and control group (45 patients).After 6 weeks treatment, a signif-icant greater reduction in HAMD 17 ,CGI-SI and HAMA total score was found for both study group and control group showing significant difference with their baseline ( P <0.01 );but there were no significant difference between two groups ( P >0.05 ) .However , after 1 week treatment , the HAMD17 and CGI-SI score reductions between two groups were significant difference ( P <0.01 ) .The score of HAMA was no significant difference between two groups ( P >0.05 ) .In study group , the positive response rates was 81.4%,and in controls was 80.8%, there was no significant difference between two groups ( P >0.05 ) .There was no significant difference about the incidence of adverse reaction between two groups ( P >0.05 ) .Conclusions Escitalopram is a safe and effective antidepressant as citalopram , however , it has a more rapid reaction than the latter .

Objective To explore the clinical curative effect of irinotecan HCL trihydrate combination with cisplatin in treatment of non.small-cell carcinoma(NSCC)by observing the clinical curative effect,adverse reactions and the improvement of the quality of life post therapy.Methods 120 patients with NSCC were divided into two groups.60 cases in control group were treated with cisplatin and topotecan while ifinotecan HCL tfihydrate combination with cisplatin chemotherapy for 60 case of patients in observation group.The curative effect and Kamtfsky point were observed.Results The effective rate of observation group was 56.7%,which was significantly higher than that of the control group(41.7%),and differences between the two groupswas statistically significant(P＜0.05).Average survival time for treatment group was(9.3±4.2)months that was longer than that of the control group[(7.2±3.2)months](P＜0.05).The result of Kamofsky classification standard after chemotherapy also indicated the same situation(P＜0.05).Conclusion Irinotecan HCL trihydrate combining with cisplatin in treatment of non-small cell lung cancer had a effective therapy result and could reduce the toxicity.as well as improving the quality of life of the patients.

Objective To review the clinical features of small cell neuroendocrine carcinoma of the prostate (SCPCa). Methods The ages of 4 cases were 25-77 years. Four cases had progressive dysuria with 2 cases had chronic urinary retention and 2 had upper urinary tract hydronephrosis. On admission, all cases were palpated a hard prostate mass in digital rectal examination. Serum tPSA were 0. 57-6.36 ng/ml with a ratio f/t PSA 0. 26-0.63. B ultrasound, CT and MRI detected 3.9 cm×3. 9 cm×1.6 cm-11.3 cm×7. 9 cm×9. 5 cm irregular shape mass in prostate. 2 cases had seminal vesicle involved, 2 cases had rectum involved, 2 had unilateral ureter involved, and 1 case had sacrum involved. Pelvic lymphonodes metastasis were seen in 3 cases. Bone scan detected multiple bone metastasis in 3 patients. Results The final diagnoses were accomplished by prostate biopsy. Under light microscope, tumor cells were orbivular-ovate or fusiform shape, small volume, and had little cytoplasm. The margin of tumor cells was not clear. Caryokinesis phase could be found with hyperchromatic chromatin. Immunohistochemistry showed positive ChA staining in 4 eases, positive NSE expression in 2 patients and negative PSA in 4 cases. 3 cases were given cisplatin-based chemotherapy, pelvic radiation, or chemotherapy plus radiotherapy. All patients appeared widespread metastasis quickly and died or lost visit within one year. Conclusions SCPCa is a rare, poor prognosis malignancy with early extensive metastasis. The diagnosis is based on pathology.

Objecive To explore the effect of interleukin-10(IL10) on tumor necrosis factor-?(TNF?)- induced expression of intercellular adhesion molecule 1 (ICAM-1 )and related transcription pathway in human renal tubular cells. Methods Human renal proximal tubular cell line HK-2 cell was used as target cell. ICAM-1 was measured by cell ELISA and Northern blot in protein and mBNA levels. Activities of transcriptional factors nuclear factor GB(NFkB) and activator protein 1 (AP-1) were determined by electrophoresis mobility shift assay. Results TNF?-induced ICAM-l expression in HK-2 cells was increased in both protein and mNRA levels(P

Objective To explore the prognostic value of ventricular wall motion score (WMS) and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction (AMI) combined with heart failure (HF) in the recent 12 months Methods We selected hospitalized AMI patients in our department from Jan. 2014 to Nov. 2014. Cardiac ultrasound was performed to detect WMS and LVEF within 48 hours and during the 6?month follow?up period and the occurrence of HF was recorded. Results Totally 127 AMI patients were recruited, including 20 cases combined with HF. The WMS was higher in HF group than those in non?HF group (23.55 ± 3.73 vs 20.11 ± 3.13, P<0.01), while the LVEF in HF group was lower than those in non?HF group (48.77 ± 8.08 vs 56.99 ± 5.17, P<0.01). Multiple logistic regression analysis revealed that WMS and LVEF were both independent predictors of HF in the recent 12 months (P < 0.05). The prediction effect of WMS ROC curve area was 0.81 (P < 0.01) , and LVEF 0.76 (P < 0.05). WMS and LVEF combined assessment area under ROC curve was 0.82 (P < 0.01). Conclusion WMS and LVEF are independent predictors of HF in patients with AMI in the recent 12 months and the combined application of WMS and LVEF can significantly improve the prediction effect.

In order to estimate the relationship between iron and the Alzheimer's disease, the behavioral and pathological changes were observed by Morris water maze and immunohistochemical staining respectively after injecting FeC13 into brain ventricle of rats. The apoptosis was tested by flow cytometry and the electron microscopy was used to observe ultrastructural changes. There were significant differences in escape latency of time and distance between normal animals and iron treated rats. Percentage and fluorescence intension (FI) of AnnexinV FITC loaded cells undergoing apoptosis were higher in iron treated rats compared with normal animals. Fawn-coloured products of β amyloid protein were interspersedly distributed in extensive areas of cerebral cortex and hippocampus. Under electron microscope, vacuolate degeneration of neuronal processes with mitochondria degeneration and accumulation of microtubule near vacuolar nucleus were observed in iron treated rats. These results suggest that a local higher concentration of iron in brain may induce Alzheimer-like impairment of intelligence and pathological changes.

ObjectiveTo evaluate the efficacy of intravenous and intra-arterial thrombolysis with urokinase for acute cerebral infarction.Methods Fifty patients with acute cerebral infarction occurred within 6 hours were divided into two groups by random digits table method with 25 cases each:intravenous and intra-arterial thrombolysis group and intravenous thrombolysis group.The patients in intravenous and intra-arterial thrombolysis group were given 200 000 U urokinase by intravenous infusion for 30 minutes immediately after being hospitalized,and arterial thrombolysis was prepared at the same time.With cerebrovascular angiography,the thrombolytic therapy was carried out in the target vessel blocking points through micro-catheter.Urokinase dissolved in 0.9％ sodium chloride was infused at the rate of 10 000 U per minute,the total volume would not be more than 1 000 000 U.The patients in intravenous thrombolysis group were given 1 000 000 U urokinase in 100 ml 0.9％ sodium chloride by intravenous infusion within 60 minutes.The clinical efficacy after thrombolysis was assessed according to the National Institutes of Health stroke scale (NIHSS) score,the quality of life was judged by Barthel index (BI) score and the prognosis was evaluated by modified Rankin scale (mRS) score of 90 days after thrombolysis.ResultsThere was no significant difference between two groups before thrombolysis according to the NIHSS score (P ＞ 0.05).After thrombolysis,NIHSS scores in two groups showed a downward trend,but they were obviously lower in intravenous and intra-arterial thrombolysis group after 24 h,7 d and 14 d than those in intravenous thrombolysis group [(8.97±4.56) scores vs.(11.01±3.65) scores,(6.88±2.31) scores vs.(8.34±3.05) scores,( 4.06±3.02 ) scores vs.( 6.73±2.15 ) scores ] ( P ＜ 0.05 or ＜ 0.01 ).BI scores before thrombolysis between two groups had no significant difference(P ＞0.05),while BI score of 90 days after thrombolysis in intravenous and intra-arterial thrombolysis group [(79.55±19.64) scores] was higher than that in intravenous thrombolysis group [(69.31±21.35) scores](P=0.0162).The rate of mRS score 0-2 (good efficscy) in intravenous and intra-arterial thrombolysis group [72.0％(18/25) ] was obviously higher than that in intravenous thrombolysis group [ 52.0％ ( 13/25 ) ] (P =0.0198 ).ConclusionsIt is significantly effective to treat acute cerebral infarction by superselective intravenous and intra-arterial thrombolysis.Therefore,it is supposed to be an optimal option for treating acute cerebral infarction in the future.

Objective The goal of the study was to assess the lethal effect of cytotoxic lymphocyte against A549 cells induced by dendritic cells (DC) pulsed with A549 lysate and transfected with GM-CSF recombinant adenovirus. Methods The cytotoxic lymphocyte against A549 cells were induced by culturing with DCs, which pulsed with A549 antigens and transfected with GM-CSF recombinant adenovirus. The of effector/target ratio, the killing rates of N-DC group, A-DC group and G-A-DC group were (1.9±0.7) %,effector/target ratio, the killing rates of N-DC group, A-DC group and G-A-DC group were (5.3±0.2) %, (40.5±7.7) % and (72.5±4.7) %, respectively. We found that the killing rate of G-A-DC group was the highest by statistics. Conclusion The cytotoxic lymphocyte against A549 cells can be induced by DCs pulsed with A549 lysate ,and the lethal effect of CTLs can be enhanced when DCs were infected with GM-CSF recombinant adenovirus.

Objective To observe the influence of local-anaesthetic combined with dezocine on brachial plexus block and postoperative analgesia.Methods 60 patients scheduled for unilateral upper limb operation were randomly divided into two groups of C group and D group with 30 cases in each group.The brachial plexus block was performed under ultrasound guiding.Two groups received a bolus injection of local anesthetic 30ml,but the local bolus injection of D group consisted of Dezocine 10mg.The tine of sensory blocked producing effect,anesthesia effect,sensory blocked duration were observed.Two hours after sensory nerve recovered,the scores of VAS pain and Ramsay Sedation were recorded.Adverse reactions of perioperation were also observed(nausea,vomiting,dizzy,respiratory,urine retention,pruritus).Results The sensory blocked duration in D group was(7.1±1.1)h,which was significantly longer than that of C group[(4.5±0.8)h](t=10.47,P＜0.01);Two hours after sensory nerve recovered,the score of VAS pain in D group was(1.7±0.7)points,and significantly lower than that of C group[(3.9±1.0)points](t=9.87,P＜0.01).Both two groups had no adverse reactions.Conclusion Addition dezocine 10mg to local anesthetic solutions for interscalene brachial plexus block,it could prolong the sensory block duration,provide satisfactory postoperative analgesia,have no adverse reactions.

Objective To investigate the changes and clinical significance of calcitonin gene related peptide (CGRP) and interleu-kin 1α(IL-1α) before and after warm acupuncture therapy in the patients with lumbar disc herniation (LDH ) .Methods Serum CGRP and IL-1αcontents were detected before and after the warm acupuncture therapy in 60 cases of lumbar disc herniation and 15 healthy control cases by ELISA method for conducting the statistical analysis .The changes of the McGill pain scores and serum CGRP and IL-1αconcentrations before and after the warm acupuncture therapy were observed .Results The McGill pain scores af-ter the warm acupuncture therapy in the LDH patients were significantly decreased ,the difference was statistically significant (P<0 .01) ,and serum CGRP and IL-1α concentrations were significantly decreased ,the difference was statistically significant (P<0 .01) .Conclusion CGRP and IL-1αcan be used as the observation index of the effects for the warm acupuncture therapy in trea-ting LDH ,which can provide the basis for the conservative treatment of LDH .