ObjectiveTo investigate the therapeutic efficacy of paroxetine and influence on inflammatory markers in elderly acute myocardial infarction (AMI) patients with anxiety and depression.Methods 136 patients with AMI graded bythe hospital depression and anxiety score were divided into three class:(1)patients with anxiety ( n =54) ; (2)Patients with depression ( n =39) ; (3)Patients with anxiety and depression ( n =43 ).136 patients were randomly divided into paroxetine group (paroxetine 10-20 mg/d)and conventional group (conventional drugs based on guidelines).After 28 days treatment,HAD scores,serum level of inflammatory markers (Hs-CRP,MPO,and cTnI ) were compared between two groups.Results (1)HAD scores (HADa and HADd)of paroxetine group were decreased significantly after 28 days treatment (P ＜ 0.01 ) ;while there were no remarkable improvements in conventional group.With paroxetine treatment HAD scores of anxiety,depression,anxiety and depression( 10.52 ± 2.74,10.83 ±3.25,9.49 ± 2.57,9.99 ± 2.38) were much lower than those of conventional group(P ＜ 0.05 ).(2)Serum Hs-CRP,MPO and cTnI of paroxetine group in patients with anxiety were much lower than those of conventional group (P ＜ 0.05 ).Serum Hs-CRP,MPO and cTnI of paroxetine group in patients with depression were much lower than those of conventional group (P ＜ 0.05 ).Serum Hs-CRP,MPO and cTnI of paroxetine group in patients with anxiety and depression were much lower than those of Conventional group (P＜ 0.05 ).ConclusionParoxetine has remarkable treatment effect in elderly AMI patients with anxiety and depression,and paroxetine call significantly decreased serum levels of inflammatory markers.

At present,China's description of macrosomia diagnosis is single,Only in the quality evaluation of 4 000 or higher,and BMI,body index can better response body quality development.Macrosomia is related with many factors,and its mechanism remains unknown.Therefore,this article summarized the research status in those aspects of hormones,cell,gene,motherhood diabetes,pregnancy weight,gestational age,and the related factors of macrosomia in order to improve the knowledge of these aspects.

Ever since 1980’s, outcome-based learning (OBL) has been applied to the reform in education as a systematic method in the whole world. It’s based on the expected learning outcomes and emphasized on study from the aspect of students, and its target is to let the students transform what they have learnt into practice. Therefore, it’s widely rewarded in the undergraduate medical education. As a basic theoretical course in acupuncture-moxibustion and an essential component in traditional Chinese medicine, Meridians and Acupoints is a compulsory course for overseas students in studying traditional Chinese medicine. The authors induced OBL into the study of this course and correspondingly conducted exploratory reform in the education of evaluation, by taking practice as the expected outcome and reversely designing teaching and evaluation.

Parkinsons disease(PD) is characterized by a selective lo ss of dopaminergic neurons in the substantia nigra pars compacta. The etiology of PD is still not full y understood. Molecular pathways such as oxidative stress, mitochondrial dysfunc tion and impairment in the ubiquitinproteasomal system, are involved in the proc ess of the dopaminergic neuronal cell death and the progress of PD. The explorat ion and elucidation of these molecular pathways will provide new potential targe ts for the drug therapy of PD.

The authors adopted an auto control experimental research on 18 male adult dogs with 36 sides of femoral heads and necks which were divided into two groups. They were separately made models of old fracture of femoral neck and avascular necrosis of famoral head. Two wecks later, The free fibula with microvascular an astomosis was tranplanted. All experimental dogs were examined with X-ray, pathohitology, electron microscopy, 99~mTc-MDP scanning and tetracycling labeling after operation.The experiment showed that the free fibular graft with mierovascular anastomosis could provided a new system of vascula supply to the injured femoral head. The hard free fibula and the metallic internal fixation were inserted in femoral head and neck. After the Operation, in the fracture area the fibula formed a bone-bridge which not only diminished the stress force but also prevented rotation displacement of the bone fracture The periosteum of the transplanted fibula also took part in the repair course of avascular nerosis of femoral head.

Objective To develop a method for the direct determination of eight life elements (Ca, Mg, K, Al, P, Cu, Zn, Fe ) in serum by ICP-AES. Methods The serum samples were determined by ICP-AES after diluted in 0.1% Triton X-100. Results The RSD of the method were 2.36%-9.46% and the recovery rates were 87.3%-116.5%. Conclusion This method was quick, simple and accuracy, which is suitable for direct determination of life elements in serum samples at one time.

Objectives To learn the incidence and the related factors of pregnancy complicated syphilis and provide basis for policy making. Methods A cross sectional study was carried out for all pregnant women who were checked up in 29 hospitals of Shanghai and delivered between 20th, Sep. to 20 th, Dec. in 1999. Basic condition, marital and obstetric history, lab test, treatment, pregnancy outcomes and lab test on neonate were investigated. Results There were 39 cases of pregnancy complicated syphilis among 12 324 pregnant women, with an incidence of 3.16‰. All cases were in early stage. Among them, 35 cases were latent syphilis, which accounted for 89.7%; 3 cases (7.7%) were primary syphilis; 1 case (2.6%) was secondary syphilis. The average age of the patients was (27?5) years old. The related factors included: couple's education, occupation, the lab index of syphilis at premarital medical examination, the number of sexual partners of pregnant women and residential area. Only 64.1% of partuients received treatment and 48.7% of infants received serological test. Conclusions the incidence of pregnancy complicated syphilis was relatively high and most cases were latent syphilis which were widely dispersal and had adverse sequelae on fetus and neonates; The treatment and followup were not standardized. So it is in urgent need to advocate the standardized treatment and followup for pregnancy complicated syphilis. It's also important to educate among the doctors, nurses in gynecologic & obstetric department and women at their reproductive age on the knowledge about prevention and treatment on syphilis.

Objective To analyze the clinical risk factors of the occurrence of severe proliferative vitreoretinopathy (PVR) after scleral reattachment surgery. Methods A total of 4 031 eyes of 4 031 consecutive patients with reghmatogenous retinal detachment (RRD) and PVR (grade C1 or less), on whom the scleral buckling was performed, were retrospectively studied. Twenty-two clinical characteristics of the patients (including the ocular tension, condition of lens and vitreous, characteristics of retinal detachment, whether or not with choroidal detachment, et al) were recorded. In 4 031 patients, 2 660 were followed up for more than 3 months, and 72 (in PVR group) of the 2 660 patients underwent the second surgery (vitreoretinal surgery) because of the occurrence of postoperative severe PVR; in the other 2 588patients, 72 (72 eyes) with retinal reattachment for more than 3 months were selected randomly as the control. The data were analyzed in SPSS (10.0) software. Results Logistic regression analysis revealed that the significant risk factors for PVR were incomplete posterior vitreous detachment (P2 DD,P

Objective To observe the clinical efficacy of naloxone plus aminophylline in the treatment of children with acute respiratory failure.Methods 72 patients with acute respiratory failure were randomly divided into the study group and the control group.36 cases in the study group were given naloxone plus aminophylline therapy, 36 cases of the control group received conventional therapy.And the clinical efficacy was compared.Results The total effective rate of the study group was 91.67%,which was significantly higher than 66.67% of the control group (χ2 =6.82,P <0.05).In the comparison of the effect of improving blood indicators,arterial blood pressure of the study group was (67.51 ±4.11)mmHg,which was significantly higher than (61.03 ±4.08)mmHg in the control group (t =2.64,P <0.05).The oxygen saturation of the study group was (93.55 ±8.05)%,which was significantly higher than (79.62 ±10.22)% of the control group (t =2.29,P <0.05).The arterial carbon dioxide partial pres-sure of the study group was (69.03 ±5.71)mmHg,which was also higher than (61.52 ±4.09)mmHg of the control group (t =2.22,P <0.05).The incidence rate of adverse reactions of study group was 2.78%,which was lower than 22.22% in the control group (χ2 =6.22,P <0.05).Conclusion Naloxone plus aminophy -lline used in children with acute respiratory failure obtain the desired therapeutic effect,not only can effectively improve blood indicators of children,and without significant adverse reactions,drug safety is high,it is worthy of promoting.

Objective To investigate the effect of Yishen-Daotan decoction on TCM syndrome elements of infertility caused by kidney deficiency and phlegm stagnant type polycystic ovary syndrome.Methods 60 patients of kidney deficiency and phlegm stagnant type polycystic ovarian syndrome infertilities were administrated with modified Yishen-Daotan decoction for 3 months and the changes of TCM syndrome elements,menstrual cycle and serum sex hormone were compared before and after the treatment.Results ① TCM syndrome elements had a statistical changes after the treatment compared with those before the treatment(t=62.79,P＜0.01).②menstrual cycle showed statistical difference after the treatment compared with that before the treatment,(x2=21.64,P＜0.01).③Serum FSH,E2 were increased,while LH,LH/FSH and T were decreased after the treatment,showing a significant difference compared with those before the treatment (t=2.67,P＜0.05).④The total effective rate was 91.67％ and pregnancy rate was 30％.Conclusion Yishen-Daotan decoction significantly improve clinical symptoms in patients with kidney deficiency and phlegm stagnant type PCOS infertility.