Objective To investigate the clinical effects of fluoxetine combined with small doses of aripiprazole in treatment of post -stroke depression and the influence on the recovery of neurological function. Methods 74 patients with post stroke depression were randomly divided into the two groups,all patients were given routine comprehensive treatment,the control group treated with fluoxetine,while the observation group was treated with fluoxetine combined with small doses of aripiprazole,clinical curative effect,neurological deficits and activities of daily living of the two groups were compared.Results The total effective rate of the observation group was 94.59%,which was significantly higher than 78.38% of the control group (χ2 =9.78,P<0.05);NIHSS scores of the observation group at the end of 4 week and 8 week of treatment were (10.85 ±1.22)and (6.03 ±0.78),which significantly reduced than that of the control group(t=6.18,6.62,all P<0.05 );Barthel index of the observation at the end of 4 weeks and 8 weeks of treatment were (49.56 ±4.68)and (67.43 ±4.75),which significantly increased than that of the control group(t=6.63,7.00,all P<0.05);The incidence of adverse reactions of the two groups had no signif-icantly different(χ2 =2.38,P>0.05).Conclusion Fluoxetine combined with small dose of aripiprazole has an ex-act effect in the treatment of post stroke depression,with high security.

Objective To observe the protective effect of N-acetyl-cysteine (NAC) on the injury of irradiation-in-duced bone marrow mononuclear cells (BMMNCs), and explore the possible mechanism. Methods There were 3 groups in the study:control group, irradiation group (doses of irradiation were 1 Gy and 4 Gy) and irradiation with NAC group (NAC was cocultured with BMMNCs half hour before irradiation). The 2×106/mL BMMNCs and the RPMI-1640 medium or 2×10-5 mol/L NAC were added into the 2 mL EP tubes according to the different requirement of groups. The tubes were then cul-tured in the 37℃CO2 incubator for 30 min and irradiated with 1 Gy and 4 Gy. The viability of BMMNCs was measured by bioluminescence. The level of reactive oxygen species (ROS) was measured by DCFH-DA, and the ability of colony-forming units was detected by CFU-GM. Results After 4 Gy irradiation exposure, the cell viability of BMMNCs was significantly lower in irradiation group (284 296.7±16 541.2) than that of control group (848 586.7±61 404.4). After 1 Gy irradiation expo-sure, the level of ROS was higher in irradiation group (6 750.0±103.5) than that of control group (5 710.7±56.2). The number of colony-forming units per 105 cells after irradiation exposure was (626.7±51.3), which was significantly lower than that of control group (986.7±100.7). Compared to irradiation group, the cell viability of BMMNCs increased to (352 770.0±23 466.1) in irradiation with NAC group. The level of ROS decreased to (5 430.0±61.0), and the number of colony-forming units per 105 cells increased to (773.3 ± 49.3). Conclusion NAC has protective effect on irradiation-induced injury in BMMNCs, which may be related with the decreased level of ROS. NAC can play the role of positive control for the following work.

Objective To observe the injury effect of ionizing radiation on bone marrow derived c-kit+ cells.Methods Via-bility of c-kit+ cells was measured by bioluminescence;the level of c-kit+ cells reactive oxygen species was measured by DCFH-DA, the ability of colony-forming units was reflected by CFU-GM;proliferation and apoptosis of c-kit+ cells were measured by flow cy-tometry;the variation of pathway was detected by arrays of gene chip.Results Compared to control group(0 Gy).It had a decrease of c-kit+ cells′cell viability and the ability of colony-forming units after the cells receipt irradiation with the dose of 1 Gy and 4 Gy;and the level of cell reactive oxygen species,ratio of apoptosis cells increased.After 1 Gy irradiation exposure,the ratio of prolifera-tion(S/G2/M phase)cells increased compared to control group.However,when the c-kit+ cells were receipt 4 Gy irradiation expo-sure,the ratio of proliferation(S/G2/M phase)cells decreased.After 4 Gy irradiation exposure,the up-regulate genes contained Srxn1,Psmb5,Cdkn1a,Smc1b,Bcl2l1,Lrdd and so on;the down-regulate genes contained Mpo,Mtf1,Chek1,Rcc1 Ebag9,Ciapin1 and so on.Conclusion There was injury effect of ionizing radiation on c-kit+ cells,and it could induce variation of many pathways.

Objective To observe the different radiosensitivity induced by different doses of 137Csγ-ray irradiation between hematopoietic stem and progenitor cells. Methods Seventy-two C57BL/6 mice were randomly divided into control group and irradiated groups (2, 4 and 6 Csγ-ray irradiation, n=18 for each group). Mice of control group received sham irradiation, and the rest accepted 2, 4 and 6 Gy137Csγtotal body irradiation, respectively. After 14-day, 35-day and 56-day irradiation, the peripheral blood samples were collected by balls enucleation. The number of bone marrow nuclear cells, hematopoietic stem and progenitor cells were counted. Results The peripheral blood of irradiated mice showed significant changes in the number of white blood cells (WBC), red blood cells (RBC), platelets (PLT) and hemoglobin (HGB) in a dose-response relationship. Compared with the control group, the numbers of BMNCs and hematopoietic progenitor cells (HPCs) were significantly lower in irradiated group. At 35 d and 56 d after 6 Gy irradiation the numbers of BMNCs and HPCs were significantly lower than those of control group (P<0.05). There were no significant differences in numbers of BMNCs and HPCs between irradiated groups (2 and 4 Gy) and control group. The number of bone marrow hematopoietic stem cells (HSCs) was significantly lower in irradiated group than that in control group after 14-d and 56-d irradiation (P<0.05). Conclusion 137Csγ-ray irradiation has some damage in mouse hematopoietic system. The damage caused by radiation is persistent to hematopoietic stem cells.

Objective To investigate the protective effect of sesamol on radiation injury mouse bone marrow c-kit+cell,and further explore its possible mechanism.Methods Mouse bone marrow c-kit+cells were collected by immunomagnetic cell sorting method.There were 2 groups in the study:single dosing group and radiation plus drug group(doses of irradiation included 1 Gy and 4 Gy),and 10 -8 ~10 -3 mol/L sesamol were co-cultured with mouse bone marrow c-kit+cell half hour before irradiation exposure,cells were then cultured for 18 hours under the conventional culture conditions (37℃ and 5% CO2 ).The viability of mouse bone marrow c-kit+cells were measured by bioluminescence.The ability of colony-forming units were detected by CFU-GM and apoptotic rate of c-kit+cells were detected by Annexin V/PI antiapoptotic assay. Results Compared with control group,after 1 Gy and 4 Gy irradiated,cell viability of mouse bone marrow c-kit+cells were decreased 59.52% and 79.35%,respectively(P<0.05),the number of colony-forming were decreased 40.38% and 87.69%,respectively(P<0.05 ).Cell viability of c-kit+cells and the number of colonies formed were significantly increased with sesamol concentration between 10 -8 ~10 -6 mol/L,but not improve apoptosis rate.Conclusion Sesamol has protective effect on irradiation-induced injury in mouse bone marrow c-kit+cells,the mechanism of which may be related to the ability of hematopoietic progenitor cells proliferation.

Objective To observe the effect of sesamol on the hematopoietic system in mice exposed to 4 Gy irradiation. Method Twenty C 57 BL/6 mice were randomly divided into control group, sesamol group, irradiated group and irradiated+sesamol group (n=5). Mice of control and sesamol group received sham irradiation, and the rest exposed to 4 Gy total body irradiation, dose rate 1.01 Gy/min. Mice in sesamol group and irradiated+sesamol group received a dose of 10 mg/kg sesamol administered by gavage every day for 7 days after irradiation exposure. Mice of other two groups were treated with vehicle solution. After 4 Gy irradiation 7 day, the peripheral bloods were collected. The levels of colony forming units-granulocyte-macrophage (CFU-GM) were detected. Results Compared to irradiation group, the level of WBC、cell count of BMNCs and CFU-GM significantly decreased in the irradiated mice, decreased in the irradiated mice (P<0.05). Compared to irradiation group, cell count of BMNCs and CFU-GM in the irradiated+sesamol group increased significantly (P<0.05). Conclusion Sesamol has a certain impact on the radiation-induced changes in hematopoietic system. The mechanism need to be further explored.

Antineoplastic Agents/therapeutic use* ; Gastrointestinal Stromal Tumors/drug therapy* ; Humans ; Liver ; Liver Neoplasms/drug therapy* ; Lung ; Naphthyridines/therapeutic use* ; Urea/analogs & derivatives*

Objective To evaluate the perioperative period safety of improved transurethral plasma kinetic enucleation of prostate (TUPKEP) in high-risk benign prostatic hyperplasia (BPH) patients with coronary heart disease (CHD).Methods One hundred and twenty-eight BPH patients were selected,24 patients had CHD (with CHD group),among whom 10 patients were given transurethral vapor-resection of prostate (TUVP),and 14 patients were given improved TUPKEP; 104 patients didn't have CHD,among whom 22 patients were given TUVP,and 82 patients were given improved TUPKEP.The serum endothelin (ET)-1 was measured by specific radioimmunoassay at preoperative 2 h and postoperative 1,2,6 d,and complication was observed.Results All the patients were cured by operation,and left hospital smoothly.There were no statistical differences in the preoperative 2 h serum ET-1 in with CHD group and without CHD group (including all TUVP patients and improved TUPKEP patients) (P ＞ 0.05).The postoperative 1 and 2 d serum ET-1 levels of TUVP patients were significantly higher than those of improved TUPKEP patients,in with CHD group:(114.09 ± 15.33) ng/L vs.(94.77 ± 12.14) ng/L and (99.67 ± 9.87) ng/L vs.(88.21 ± 9.55) ng/L; in without CHD group:(70.21 ± 12.44) ng/L vs.(53.67 ± 9.02) ng/L and (61.18 ± 9.52) ng/L vs.(48.54 ± 9.15) ng/L,and there were statistical differences (P ＜ 0.05).There were no statistical differences in postoperative 6 d serum ET-1 in TUVP patients and improved TURKEP patients (P ＞ 0.05).In with CHD group,5 patients had ischemic ST-T change in the early postoperative period,and 3 patients had angina pectoris.They all were promptly treated,and the events were controlled.Serious complications did not present such as acute myocardial infarction (AMI),acute heart failure and sudden cardiac death,etc.Conclusions The postoperative BPH patients have vascular endothelial injury catholically,especially the high-risk patients with CHD.Furthermore,it might be one of the causes of the postoperative adverse cardiovascular events.Compared with TUVP,improved TUPKEP has a minor impact on vascular endothelial function,and it can reduce the postoperative adverse cardiovascular events in the BPH patients with CHD.Improved TUPKEP is a relatively safer surgical method for high-risk BPH with CHD.

Complex clinical situation requires healthcare providers to be able to perceive, un-derstand and predict the situation changes correctly, namely they need situation awareness. Good clin-ical situational awareness can help clinical decision-making and cooperation, which is critical to im-proving the quality of healthcare. Therefore this review aims to summarize the meaning, applications, status and influence factors, measurements and training of clinical situation awareness, to provide evidence for training and improving clinical situation awareness.

Objective To examine the expression of heparin binding-epidermal growth factor-like growth factor (HB-EGF) in paclitaxel-resistant ovarian cancer and elucidate the relationship between HB-EGF and the resistance of ovarian cancer to paclitaxel. Methods The human ovarian carcinoma cell line A2780 and the paclitaxel-resistant human ovarian carcinoma cell line A2780/Taxol were cultured in vitro. Western blot was used to dectect the expression of HB-EGF protein in A2780 and A2780/Taxol groups. The A2780 cells were treated with cross-reacting material 197 (CRM197 and A2780 + CRM197 group) or dimethyl sulphoxide (DMSO;A2780 group), while the A2780/Taxol cells were treated with CRM197 (A2780/Taxol+CRM197 group) or DMSO (A2780/Taxol group). The effects of CRM197 on growth and proliferation was tested by methyl thiazolyl tetrazolium( MTT) and the results were showed as absorbance (A).The effects of CRM197 on cell cycles was tested by flow cytometry, while the effects of CRM197 on apoptosis was examined by caspase-3 activity assay and the results were showed as p-nitroaniline(pNa). In animal experiment, four groups of cells were inoculated to BALB/c nude mouse subcutaneously to observe tumor formation ability following CRM197 treatment. Immunohistochemistry was used to determine the expression of HB-EGF protein in A2780 and A2780/Taxol group. Results The expression level of HB-EGF protein in A2780/Taxol group (2.11±0.41) was significantly higher than that of A2780 group (0.75±0.20;P<0.01). The inhibition effect of CRM197 on the cell growth of A2780+CRM197 and A2780/Taxol+CRM197 group was accompanied by the acceleration of CRM197 concentration(P<0.01). When CRM197≥1 μg/ml, the inhibition effect of CRM197 on the cell growth of A2780/Taxol+CRM197 group was significantly higher than that in A2780/Taxol group(P<0.05). In cell cycle experiment, CRM197 induced the cell-cycle arrest at the G0/G1 phase in A2780+CRM197 cells[(67 ± 4)%] compared with A2780 cells[(54 ± 6)%;P<0.01], while CRM197 significantly induced the cell-cycle arrest at the G0/G1 phase in A2780/Taxol+CRM197 cells [(72± 4)%] compared with A2780/Taxol cells [(24±8)%;P<0.01]. CRM197 treatment in A2780+CRM197 group [(40 ± 6)μmol/L] led to the acceleration of the caspase-3 activity when compared to A2780 group [(6 ± 6)μmol/L;P<0.01], while CRM197 treatment in A2780/Taxol+CRM197 group [(66 ± 12)μmol/L] led to significant acceleration of the caspase-3 activity when compared to A2780 group [(9 ± 6)μmol/L;P<0.01]. In experiments in vivo, the expression scores of HB-EGF protein in A2780/Taxol tumors(10.8 ± 3.3) were higher than that in A2780 tumors (5.0±2.2;P<0.01). The tumor size and tumor weight of the A2780/Taxol+CRM197 group were both higher than those of the A2780+CRM197 group [(546 ± 85) mm3 vs (1 355 ± 119) mm3,(0.56 ± 0.09) g vs (1.31 ± 0.27) g; all P<0.01]. The CRM197 inhibition rate of the A2780+CRM197 and A2780/Taxol + CRM197 group were 43% and 68% respectively, showed that CRM197 significantly suppressed the growth of A2780/Taxol xenografts in vivo(P<0.01). Conclusions HB-EGF is over-expressed in paclitaxel-resistant ovarian cancer and may be contributes to drug resistance. Inhibition of HB-EGF expression potently enhances apoptosis and inhibit the growth of paclitaxel-resistant ovarian cancer, shedding light on the HB-EGF-targeted therapy options for chemoresistant ovarian cancer patients.