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 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.

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.

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.

Objective To investigate the effectiveness of Uromentor virtual reality simulator in flexible ureteroscopy training for catechumen.Methods Fifty-one catechumen were selected.After 1 hour training of basic operation in Uromentor virtual reality simulator, all trainees performed special-purpose exercise ( kidney inspection with flexible ureteroscopy ) for 3 hours. Using right kidney inspection, a preliminary assessment for each trainee was made before the special-purpose exercise and data such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and global rating scale ( GRS ) were recorded.The same assessment was performed once again after the special-purpose exercise ( secondary assessment ) , and data were recorded and compared to the preliminary assessment. Results Each trainee made a significant improvement in flexible ureteroscopic skill after the special-purpose training.The parameters such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and GRS of all trainees in preliminary assessment were 14.63 ±1.01 min, 8.62 ± 2.67, 51.05%±20.79%and 10.31 ±2.53, respectively;while in secondary assessment, parameters were 7.71 ±1.13 min, 1.67 ±1.23, 98.04% ±5.42% and 29.14 ±3.01, respectively.The differences between the preliminary assessment and the secondary assessment of each parameter were significant ( P<0.01).Conclusions The Uromentor virtual reality simulator can improve the trainee′s skills of flexible ureteroscopy.It is a good instrument of the flexible ureteroscopic training for catechumen.

Objective: To observe the impact of electroacupuncture on the pain threshold and the content of excitatory amino acids in the spinal cord of the rats with neuropathic pain to discuss the mechanism of electroacupuncture in treating neuropathic pain. Methods: The rats were randomly divided into a control group (n=10), a sham surgery group (n=10) and a surgery group (n=30) to take spared nerve injury (SNI) surgery of sciatic nerve. The successful SNI model rats in the surgery group were randomly divided into a model group (n=10), an electroacupuncture group (n=10) and a sham electroacupuncture group (n=10). The mechanical pain threshold (MPT) and heat pain threshold (HPT) were measured on the preoperative day, postoperative day 7, postoperative day 9 and the day after the sixth acupuncture treatment. The electroacupuncture was carried out at Huantiao (GB 30) and Weizhong (BL 40) starting from the postoperative day 10 to reflect the impact on the mechanical pain threshold and heat pain threshold. The pre-column deriverization and HPLC fluorescence detection as well as microdialysis method were adopted to test the content of EAAs in spinal cord of rats. Results: The SNI surgery decreased the mechanical pain threshold of rats significantly. The glutamate (Glu) and aspartic acid (Asp) in the microdialysis solution of rats in the model group were higher than in the control group and sham surgery group at the same time point (P<0.05). The contents of Glu and Asp in the microdialysis solution of rats in the electroacupuncture group and sham electroacupuncture group decreased significantly (P<0.05), comparing with model group at the same time point (except the Glu of the sham electroacupuncture group at the second time point). The electroacupuncture reduced the mechanical allodynia markedly. Conclusion: The mechanism of electroacupuncture treating neuropathic pain may relate with the decrease of excitatory amino acids in spinal cord.

In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.

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 .

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.