Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD) ,and explore the correlation between them.Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116).TABP,Social Support Scale, MMSE, NIHSS,mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80);fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls (NC group).Results (1) The incidence of acute PSD was 31.03％.(2)The constituent ratio of type A behavior(83.33％ vs 57.50％), CH scores, TH +CH scores were significantly higher in PSD group than NPSD group(P＜0.01).Social Support Scale scores,MMSE scores were significantly lower in PSD group than NPSD group(P＜0.01, P＜0.05).NIHSS scores,mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P＜0.01).(3) The levels of serum BDNF,hs-CRP in the PSD group,the NPSD group and the normal control group were respectively (BDNF (617.24(274.98,976.22)) pg/ml, (938.19(615.88,1 714.76)) pg/ml, (4 149.46(1 658.83,7 583.34)) pg/ml);(hs-CRP(6.47(2.66,11.21)) mg/L, 1.77(0.74,6.51) mg/L, (0.86(0.47,1.59)) mg/L).The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group (P＜0.01).(4) The severity of depression was positively correlated with CH,TH+CH scores(r=0.38, P＜0.05;r=0.43, P＜0.01).CH scores were negatively correlated with social support(r=-0.38, P＜0.05),and were positively correlated with hs-CRP levels(r=0.34, P＜0.05).Conclusion In patients with post stroke depression,the BDNF levels decrease and hs-CRP levels increase,but severity of depression and cognitive function are not correlated with BDNF levels.Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support.Hostility and excessive competition are psychosocial risk factors occurring PSD.

OBJECTIVE:To establish the method for determination of astragaloside IV and astragalus polysaccharides in Radix Astragali injection METHODS:Astragaloside Ⅳ was determined by HPLC and astragalus polysaccharides by iodometry RESULTS:The recoveries of astragaloside Ⅳ and astragalus polysaccharides were 97 51% RSD=2 48% and 99 18% (RSD=1 91%) respectively CONCLUSION:This method is accurate,sensitive and repeatable,and can be used for quality control of the preparation

Objective To investigate the incidence of brain injury and analyze the risk factors in very low birth weight infants (VLBWI),in order to explore methods to improve neurodevelopmental outcome.Methods This was a retrospective study in which we reviewed the incidence of brain injury in 326 VLBWI who admitted to our NICU from October 2007 to September 2014.The differences of general characteristics,high-risk perinatal factors,complications of prematurity and respiratory support in brain injury group (n =132) and no brain injury group(n =194) were analyzed,and Logistic regression was used to analyze the related risk factors.Results In 326 VLBWI,premature brain injury was observed in 132 cases(incidence of 40.49％).Hemorrhagic brain injury was observed in 80 cases(incidence of 24.54％,80/326),in whom total 66 cases (20.25％,66/326) with periventricular-intraventricular hemorrhage (PVH-IVH),41 cases with PVH-IVH grade Ⅰ-Ⅱ,25 cases with PVH-IVH grade Ⅲ-ⅣV.Non-hemorrhagic brain injury was observed in 52 cases (incidence of 15.95 ％,52/326),in whom 46 cases with periventdcular leukomalacia (14.11％,46/326).There were no statistically significant differences in general characteristics except gender differences between the two groups.Further analysis of the 28 factors including high-risk perinatal factors,premature complications and respiratory support between the two groups,showed that there were significant differences in 16 factors including asphyxia,chorioamnionitis,antenatal steroid use,neonatal respiratory distress syndrome,hypoxemia,apnea,pulmonary hemorrhage,patent ductus artedosus,hypotension,acidosis,hypocapnia,anemia,hyperglycemia,thrombocytopenia,high frequency ventilation and extrautedne growth retardation.Further binary Logistic regression analysis showed that antenatal steroids use was negatively correlated with brain injury,chorioamnionitis,acidosis,and patent ductus arteriosus were positively correlated with brain damage,the relative risks of premature brain injury was 0.108,7.222,3.045 and 4.565 respectively.Conclusion The mortality rate and the incidence of brain injury in VLBWI are still high.Chorioamnionitis,acidosis and patent ductus arteriosus are closely associated with premature brain damage.Antenatal steroids can prevent premature brain injury.We should pay much attention to these risk factors in the perinatal management of VLBWI,in order to decrease the incidence of premature brain injury.

Objective To discuss the clinical features,management,pregnancy outcome and prognosis of obstetric mirror syndrome.Methods The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management,pregnancy outcome and prognosis.Results ( 1 ) Etiology:12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis,2 cases with fetal complicated congenital cardiac anomalies,and 1 case of unknown etiology.(2)Gestational age at diagnosis and at delivery:gestational age at diagnosis ranged from 28 to 36 weeks [ mean (31.5 ±4.7) weeks],and gestational age at delivery ranged from 28+3 to 38 weeks [ mean (32.9 ±2.9)weeks].There were no significant differences between the gestational age at diagnosis and at delivery in consistented with severe preeclampsia group and mild preeclampsia group [ (31.8 ± 2.3 ) weeks vs.(30.9 ± 7.2) weeks,(32.5 ± 2.3 ) weeks vs.(33.5 ± 3.9 ) weeks,P ＞ 0.05 ].( 3 ) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome:maternal extremity edema in 12 cases,headache and visual disturbance in 1 case,proteinuria in 11 cases,elevated blood pressure in 5 cases,elevated uric acid in 9 cases,hypoproteinemia in 12 cases,elevated creatinine in 3 case,elevated liver enzyme in 1 case,thrombocytopenia in 2 cases.The major complications included 1 case of HELLP syndrome,acute pulmonary edema,placental abruption,amnionic fluid embolism,DIC respectively,3 cases of acute kidney failure and 6 cases of postpartum hemorrhage.(4) Sonographic findings:① Hydrops fetalis:fetal ultrasound revealed pleural fluid,fetal ascites,skin edema,scalp edema,encephalocolele enlargement, hydropericardium and increased cardio-chest ratio.②Placenta megaly:the placental pathological examination revealed edematous and large in 12 cases.Placental thickness was beyond 4 cm in all cases [ (6.3 ± 1.9) cm ].③Hydramnios:hydramnios could be found in 11 cases [ amniotic fluid index ( 19.7 ± 3.1 ) cm ]. (5) Postnatal conditions:all blood pressure and laboratory findings including urine protein normalized within 5 to 7 days after delivery. (6) Pregnancy outcome:all 12 patients survived,however the perinatal mortality rate was 100％.Two of 12 cases with mirror syndrome underwent cesarean section,and 10 were vaginal delivery,of which 1 need uterine artery embolisom due to postpartum hemorrhage.Conclusions Obstetric mirror syndrome seems to simulate preeclampsia although there are distinguishing features,such as hemodilution,placental edema,and polyhydramnios.When the specific cause of obstetric mirror syndrome can not be identified and corrected,the decision for delivery should be made as soon as possibly.

Objective To study effect of pentanuclear copper complexes of imino acetic acid two aromatic derivatives on oxidative cutting DNA. Methods Synthesized complexes later, protonation constants and the stability constants of the complexes were determined by potentiometric titration method, the cutting DNA was studied by agarose gelelectrophoresis.Results Under physiological conditions, complexes H4L1, H4L2, between H6L3 and Cu2 +coordination capability was stronger; three carboxylic multi copper complexes in Cu2 + concentration cutting efficiency were higher than the corresponding mononuclear copper complexes, synergistic effect exists between Cu2 + Center; H6L3 complexes of the three DNA cut the highest efficiency, complex H4L1 was followed, complex H4L2 cutting efficiency was the lowest.Conclusion Change the complex chelating ligands has great influence on the properties of complex, which provides a theoretical basis for the design and synthesis of copper nucleases reasonable.

Objective To compare the degree of inflammatory response and changes in pulmonary function in patients undergoing coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) Methods Elective CABG was performed in twenty-two patients with CPB (n = 11) or off-pump (n = 11). The patients were premedicated with oral midazolam 7.5 mg and intramuscular morphine 10 mg. Anesthesia was induced with fentanyl 5-10 ?g?kg-1 , midazolam 0.05 mg?kg-1 , etomidate 0.15 mg?kg-1 and rocuronium 0.6 mg?kg-1 and maintained with intermittent i.v. boluses of fentanyl and rocuronium. All patients had pulmonary artery catheter and arterial line placed. ECG, SpO2, PET CO2 , body temperature and urine output were monitored. In CPB group aprotinin was given. The patients were transferred to ICU after operation and mechanically ventilated. Extubation was performed when standard extubation criteria were met. The length of ICU stay and hospitalization were recorded. CI, PVRI, SVRI, PA-aO2 , PaO2/FiO2 and QS/QT were measured and calculated before and at the end of operation and 4, 12, 24, 36 h after operation. Blood samples were taken from radial artery and pulmonary artery (mixed venous blood) before and at the end of operation and 4, 12, 36 h after operation for determination of plasma levels of IL-6, IL-8 and neutrophil elastance, the numbers of WBC and neutrophil, the numbers of WBC and neutrophil segregated in the lungs (the number of WBC/neutrophil in mixed venous blood - the number of WBC/neutrophil in arterial blood) .Results The two groups were comparable with respect to age, sex, duration of anesthesia and surgery and the number of grafts. CI was significantly increased while SVRI significantly decreased after operation as compared to the baseline values before operation. There was no significant difference in CI and SVRI after operation between the two groups. The postoperative PVRI and PA-a O2 were significantly lower while postoperative PaO2/FiO2 was significantly higher in the off-pump group than in the CPB group ( P

Dermoid cysts in the floor of the mouth with tongue fistula are unusual lesions. This study reported a case of dermoid cyst in the floor of the mouth with tongue fistula, analyzed the causes of such formation, and discussed the appropriate diagnosis and treatment methods by reviewing relevant literature.
Dermoid Cyst ; complications ; diagnosis ; therapy ; Fistula ; complications ; Humans ; Mouth Floor ; Mouth Neoplasms ; complications ; diagnosis ; therapy ; Tongue

Objective To determine the factors contributing to the development of deep vein thrombosis (DVT) in the lower extremity in patients after hip or knee arthroplasty and hip fracture internal fixation.Methods One hundred and forty-seven consecutive patients receiving hip or knee arthroplasty and hip fracture internal fixation from 2004 to 2005 were included in this study. Their age ranged from 33 to 92 years. Duplex color ultrasonic inspection was performed on veins of the bilateral lower extremities before operation and 2 weeks after operation for detection of DVT. The patients were divided into a DVT group and a DVT-free group based on the development of DVT after operation. Detailed perioperative clinical information about the patients, surgery and anesthesia was collected.Results Lower extremity DVT was found in 42.2% of the patients after operation, while the incidence of proximal DVT was 2.7%. Compared with the DVT-free group, the usage rate and dosage of ephedrine increased significantly, the duration of anesthesia was significantly longer, and the white blood cell count (WBC) on the 1st postoperative day and the highest WBC count were significantly higher in the DVT group(P＜0.05). Logistic regression analysis indicated that the above factors were closely related to DVT.Conclusion Duration of anesthesia ＞ 3 h, ephedrine administration and a marked increase in WBC count after operation are the risk factors for DVT in the lower extremities in patients after hip or knee arthroplasty and hip fracture internal fixation.

AIM: To investigate the apoptosis of a vascular smooth muscle cell line A10 caused by mild K+ depolarization. METHODS: Apoptosis was evaluated by nuclear staining, DNA fragmentation gel electrophoresis and propidium iodide-stained flow cytometry. Mitochondrial transmembrane potential (Δψm) was measured by flow cytometry. RESULTS: K+ depolarization caused dose correlated A10 cells apoptosis; nifedipine, BAPTA/AM, ryanodine inhibited the cytotoxic effect of K+ completely.The combination use of nifedipine and cyclosporin A made it clear that mitochondria was involved in the apoptosis of A10 cells,and Δψm measurement further confirmed this speculation; A10 apoptosis caused by K+ depolarization was not influenced by heparin or Zn2+,a effective capacitative calcium entry(CCE) blocker. CONCLUSION: Ca2+ entry through voltage-dependent ca channels increases intracytoplasm Ca2+, then triggers further Ca2+ release from endoplasmic reticulum via ryanodine receptor, and the microdomains of elevated intracytoplasm Ca2+ are sensed by adjacent mitochondria, which ultimately lead to cell apoptosis.

Objective:To investigate the rationality of off-label use of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient. Methods:Based on the related literatures, the application rationality of tacrolimus combined with Wuzhi capsules in a membranous nephropathy patient was analyzed. Results:The combination of tacrolimus and Wuzhi capsules against membranous nephropathy was an off -label drug use, however, it showed certain clinical rationality and economic efficiency. Conclusion:Off-label drug use commonly exists in clinics. Clinical pharmacists should provide evidence support for off-label drug use through searching and analyzing clinical evidences and closely monitoring therapeutic outcome.