OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.

Objective:To investigate the hepatitis C virus (HCV) infection in hemodialysis patients.Methods:One hundred and fifty hemodialysis patients were tested for HCV-RNA using a reverse transcription-polymerase chain reaction (RT-PCR) assay and for anti-HCV IgG using an enzyme-linked mmunosorbent assay (ELISA).Result:The positive rate of anti-HCV IgG was 24%.The positive rate of HCV-RNA was 26.7%;the total positive rate of HCV markers was 35.3%.Conclusion:HCV infection rate in hemodialysis patients is higher than that of general population.The first-class risk factors for HCV infection is transfusion of blood,while the cross using of dialyzer and dialysis pipe-line is also one of the risk factors.

Diverticulum ; diagnosis ; diagnostic imaging ; Heart Defects, Congenital ; diagnosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective: To observe the clinical efficacy of combined electroacupuncture and nerve growth factor (NGF) injection at acupoints in the treatment of common fibular nerve paralysis and provide evidences for integrative Chinese & western medicine against diabetic peripheral neuropathy (DPN). Methods: Forty subjects were randomized into two groups and NGF injection; and control group was given herbal suffocation, oral Dibazol and compound vitamin B and Mecobalamin Injection. The clinical symptoms and nerve conduction velocity were observed and compared. Results: The cure rate was higher in treatment group than in control group (P<0.05); after treatment, the nerve conduction velocity was improved in both groups (P<0.01), with a significant improvement in treatment group than in control group (P<0.01). Conclusion: Combined electro-acupuncture and NGF injection at acupoints is quite effective in the treatment of common fibular nerve paralysis.

Objective:To analysis the effects of alprostadil and yishen huashi particles on blood glucose,blood lipid,renal function and urinary podocyte proteins of patients with diabetic nephropathy.Methods:98 patients with diabetic nephropathy were selected and randomly divided into the control group and the experimental group with 49 cases in each group.The patients in the control group were treated with alprostadil,while the patients in the experimental group were treated with yishenhuashui particles on the basis of the control group.Then the curative effect,the levels of glycosylated hemoglobin (HbAlc),blood glucose (FPG),2 h postprandial blood glucose (2h PG),triglycerides (TG),total cholesterol (TC),high-density lipoprotein (HDL-C),low density lipoprotein (LDL-C),blood urea nitrogen (BUN),creatinine (Cr),β2 microglobulin (β2-MG),bladder inhibition (Cys-C) and urinary podocyte proteins (PCX) in the two groups were observed and compared between the two groups before and after the treatment.Results:The total effective rate of experimental group was higher than control group (P＜0.05).After treatment,there was no statistically significant difference about the HbA1c,FPG and 2 HPG between the two groups (P＞0.05).After the treatment,the levels ofTG,TC,LDL-C,BUN,Cr,β2 MG,Cys C,PCX and urinary nephrin/urine Cr of the experimental group were lower than those of the control group (P＜0.05).The HDL-C of experimental group was higher than that of the control group (P＜0.05).Conclusion:The curative is effect of alprostadil and yishen huashi particles in treatment diabetic nephropathy patients,can conducive to the improvement of blood glucose,blood lipid,renal function,reduce the concentration of urinary podocyte related proteins.

Objective To study the chemical constituents of Dioscorea zingiberensis.Methods The fresh rhizome of D.zingiberensis was extracted three times,3 h once with EtOH-H2O at 80 ℃.The EtOH was evaporated under reduced pressure to give a residue which was suspended in water and then was exacted with petroleum ether,ethyl acetate,and n-butanol fraction.The water fraction was isolated by the reversed-phase ODS column chromatography.The chemical structures were elucidated by means of 1H-NMR,13C-NMR,135DEPT,HMQC,and HMBC spectroscopic analyses.Results Three steroidal saponins were isolated from the fresh rhizome of D.zingiberensis.The compounds were identified as:diosgenin-3-O-?-D-glucopyranosyl(1→3)-?-D-glucopyranosyl(1→4)-[?-L-rhamnopyranosyl(1→2)]-?-D-glucopyranoside(Ⅰ),(25R)-26-O-?-D-glucopyranosyl-furost-5-en-3?,22?-diol-3-O-?-D-glucopyranosyl(1→3)-?-D-glucopyranosyl(1→4)-[?-L-rhamnopyranosyl(1→2)]-?-D-glucopyranoside(Ⅱ),and(25R)-26-O-?-D-glucopyranosyl-furost-5-en-3?,22?-diol-7-carbonyl-3-O-?-D-glucopyranosyl(1→3)-?-D-glucopyranosyl(1→4)-[?-L-rhamnopyranosyl(1→2)]-?-D-glucopyranoside(Ⅲ).Conclusion Compound Ⅲ is a novel compound named as zingiberenin H.

Objective To investigate correlation between post-stroke depression (PSD) and multiple factors during onset of acute cerebral infarction. Methods Depression was measured with Hamilton Depression Rating Scales (HAMD) in 58 patients with acute cerebral infarction, and their neurological function were evaluated by neurological function defect (NFD) score. Their immunoglobulin G (IgG) index was calculated and level of nitric oxide (NO) in cerebrospinal fluid (CSF) was measured. Lesion and nature of cerebral infarction in 58 patients with acute stroke were located by CT. All the data were statistically analyzed with student-t test and ? 2 test, as well as linear regression model. Results Seventeen of 58 patients of stroke appeared PSD with an occurrence rate of 29.3%. Occurrence rate of PSD was significantly higher in patients with cerebral infarction than in those with cerebral hemorrhage  2=4.86, P

Objective To compare skin barrier function among patients with facial acne,subacute eczema,melasma and solar dermatitis.Methods Three hundred patients,including 80 patients with facial acne,60 subacute facial eczema,80 facial melasma and 60 facial solar dermatitis,as well as 60 healthy controls were recruited in this study.Skin sebum content and transepidermal water loss (TEWL) were measured by a sebmeter and Tewameter TM 210 (Courage and Khazaka,Germany),respectively.Stratum comeum hydration was measured with a Scalar Moisture Checker (Scalar Corporation,Japan).Statistical analysis was carried out using analysis of variance and t test.Results Compared with the healthy controls,patients with facial acne showed increased skin sebum content and TEWL value but decreased stratum corneum hydration (all P ＜ 0.01),and patients with subacute eczema,solar dermatitis and melasma displayed lower sebum content and stratum corneum hydration but higher TEWL value (all P ＜ 0.01).Skin sebum content was significantly higher in patients with facial acne than in patients with subacute eczema,solar dermatitis and melasma ((184.65 ± 83.07) vs.(21.86 ± 18.94),(25.10 ±14.22) and (36.05 ± 32.84) μg/cm2,all P ＜ 0.01),but was similar between the patients with subacute eczema,solar dermatitis and melasma (P ＞ 0.05).In terms of stratum corneum hydration,patients with subacute eczema and solar dermatitis were statistically lower than those with acne and melasma (18.66％ ± 7.85％ and 20.91％ ± 8.05％ vs.24.32％ ± 8.16％ and 28.02％ ± 4.67％,all P ＜ 0.01),patients with facial subacute eczema were similar to those with solar dermatitis (P ＞ 0.05),and patients with facial acne were statistically lower than those with melasma (P ＜0.01).TEWL value was significantly higher in patients with melasma than in patients with acne,solar dermatitis and subacute eczema ((13.80 ± 4.t 3) vs.(20.86 ± 8.78),(22.85 ± 9.84) and (22.48 ± 10.37) μg/m2 h,all P ＜ 0.01),but similar between patients with acne,solar dermatitis and subacute eczema (P ＞ 0.05).Conclusions Skin barrier function is somewhat impaired in patients with facial acne,subacute eczema,melasma and solar dermatitis.Therefore,to recover skin barrier function may facilitate the treatment of these diseases.

ObjectiveTo summary clinical character of de novo hepatitis B virus infection after liver transplantation,and explore the strategy of prevention and treatment.MethodsThe clinical data of recipients undergoing liver transplantation and the recipients who developed de novo hepatitis B virus infection after liver transplantation between Jan. 2000 to Dec. 2010 were retrospectively analyzed.Results365 patients who underwent liver transplantation were negative for serum HBsAg before liver transplantation.Among them,11patients were diagnosed as having de novo hepatitis B virus infection after liver transplantation,with the morbidity being 3.0 ％(11/365).Most recipients did not have any clinical presentation.They were just found HBsAg positive during the follow-up period.The liver functions were normal.All 11patients received anti-virus therapy after they were found having positive HBsAg and replicated HBV-DNA.One patient whose primary disease was hepatitis C combined with primary hepatic carcinoma was treated with pegylated interferon,thereafter,he was found having YMDD-mutation of HBV-DNA,and he was treated with entecavir.The rest 10 patients received anti-virus treatment with nucleoside analog.The 10 recipients were injected with hepatitis B immunoglobin during operation.After anti-HBV therapy,one patient died from acute liver failure because of inefficient treatment,and one patient died from tumor recurrence.The remaining nine patients survived:HBeAg of one patient became negative,and HBV-DNA replications of the four patients became negative (＜1×105 copies/L).The liver function of the patients who survived was normal.ConclusionFor recipients who were HBsAg negative before liver transplantation,when they received liver transplantation,,they should be given strict screening of blood product for transfusion.The liver transplantation patient who is HBsAg negative in serum before liver transplantation,and whose donor is HBcAb positive in serum and/or HBV-DNA positive in serum,should be treated with HBIG and/or nucleoside analog during operation or after operation,as we said above is a ideal strategy to prevent de novo hepatitis B virus infection after liver transplantation.The prognosis of de novo hepatitis B virus infection after liver transplantation is mild.

Objective To observe the efficacy and safety of high-dose amiodarone administered by continuously intravenous infusion for cardioversion of paroxysmal atrial fibrillation.Methods From 2008 to 2010,109 patients suffered from paroxysmal atrial fibrillation were treated with high-dose arniodarone (125 mg/h) administered by continuously intravenous infusion.Before cardioversion,patients were treated with low molecular weight heparin anticoagulant therapy,Laboratory tests on FT3,FT4,TSH,serum ions,etc,and coloured Doppler ultrasound imaging of heart,and ECG and blood pressure monitoring were carried out.Amiodarone hydrochloride injectio of 150 mg was mixed with sodium chloride 50 mL homogeneously,and then infused continuously by micro-pump in a rate of 41 mL/h until resume of sinus rhythm or infusion was kept up to 24 h.After successful cardioversion,as appropriate,the intravenous amiodarone was maintained in a rate of 0.5-1.0 mg/min for 6-12 h joined with oral amiodarone dosing,and the total dose was limited up to 3000 mg.Results A cohort of 104 (95.4％) patients had the restoration of sinus rhythm after cardioversion.The mean dose of amiodarone for cardioversion was (774.52 t 700.53) mg,and time required for cardioversion was (6.3 ± 5.55) hours.Conclusions The patients with paroxysmal atrial fibrillation are given high-dose amiodarone (125 mg/h) continuously intravenous infusion therapy and have high cardioversion success rate,less complications and side effects,as well as other advantages at the basic hospital.The method above has broad application prospects.