Objective To evaluate the efficacy and effective time of low dosage of olanzapine combined with fluoxetine in treatment of major depression. Methods A total of 53 patients who suffered from major depression diagnosed according to CCMD-3 and the score of Hamilton rating scale for depression (HAMD) over 28, were randomly divided into 2 groups: alprazolam group (0.4 mg alprazolam, 2/d and 20 mg fluoxetine, 1/d), olanzapine group (2.5 mg olanzapine, 1/d, and 20 mg fluoxetine, 1/d). The treatment period lasted six weeks and the subjects were evaluated by using HAMD and HAMA at week 1, 2, 4, 6. The effective time was estimated by decreasing rate of the scale of HAMD and the amelioration of sleep disturbance and anxiety/somatization in HAMD were observed before and during the treatment. Results The therapeutic effects in olanzapine group at week 1 were observed with the apparent rate of 67%. The scores of HAMD and HAMA in olanzapine group were obviously lower than those in alprazolam group at each time point. The sleep disturbance and anxiety/somatization of the patients in olanzapine group improved significantly as compared with those in alprazolam group. Conclusion Fluoxetine combined with olanzapine is a fast and effective method to treat major depression.

BACKGROUND: According to Eysenck's theory of personality, trait level belongs tolow-grade personality, which can better reflect characteristics of individual habitual behavior reaction.OBJECTIVE: To explore the correspondent relationship between generalized anxiety patient and internal personality trait through adopting Cattell's 16 Personality Factor Questionnaire (16PFQ) and Zung's Self-rating Anxiety Scale (SAS) to test generalized anxiety patients.DESIGN: A transectional sampling survey and data was compared with that of health adult norms.SETTING: Counseling clinic of out-patient in the Southwest Hospital of the Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 100 patients with generalized anxiety disorders who visited the clinical counseling clinic of out-patient in the Southwest Hospital, Third Military Medical University of Chinese PLA for the first time from August 2003 to March 2004 were included, including 40 men and 60 women.METHODS: Catell's 16PFQ was tested with Psychometric Toolbox Standard Edition V2.3 developed by the Insight Group of Peking University.The patients filled out the forms independently after the method being explained clearly by professional staff members. These 16 personality factors included warmth (reserved vs. warm; Factor A), reasoning (concrete vs.abstract; Factor B), emotional stability (reactive vs. emotionally stable;Factor C), dominance (deferential vs. dominant; Factor E), liveliness (serious vs. lively; Factor F), rule-consciousness (expedient vs. rule-conscious;Factor G), social boldness (shy vs. socially bold; Factor H), sensitivity (utilitarian vs. sensitive; Factor I), vigilance (trusting vs. vigilant; Factor L),abstractedness (grounded vs. abstracted; Factor M), privateness (forthright vs. private; Factor N), apprehension (self-assured vs. apprehensive; Factor O), openness to change (traditional vs. open to change; Factor Q1), self-reliance (group-oriented vs. self-reliant; Factor Q2), perfectionism (tolerates disorder vs. perfectionistic; Factor Q3), tension (relaxed vs. tense; Factor Q4). Standard score of each observed index was measured automatically by computer measuring system. The standard score in Zung's SAS was (65.31±7.90).MAIN OUTCOME MEASURES: Comparison of standard scores in Cattell's 16PF between anxiety group and health adult norms.tell's 16PFQ for patients with generalized anxiety disorders: Scores in A,I, L, M, O, Q4 factor of anxiety patients were higher than that of health adult norms (6.19±1.69, 5.49±1.75;6.63±1.46, 5.53±1.84;5.84±1.52,5.47 ± 1.78; 6.22 ± 1.54,5.42 ± 1.61; 8.32 ±1.54,5.48 ±1.81; 8.10 ±1.27,5.60±1.99,(t=-2.03 to -13.15, P＜ 0.05-0.01)) while scores in B, C, E, F, G H,Q1, Q2, Q3 were significantly lower (5.22±1.46, 5.93±1.97;3.48±1.68,5.51±1.75;4.86±1.60, 5.53±1.83;5.01±2.22, 5.50±1.89;4.42±1.60,5.54 ±1.66 ;4.58±1.66, 5.56±1.84 ;4.64±1.29, 5.50±1.72 ;4.73±1.80, 5.50±1.72;and F had a significantly negative correlation with scores in Zung's SAS (r=-0.273,P ＜ 0.01 ;r=-0.217,P ＜ 0.05;r=-0.217,P ＜ 0.05) while factor Q4 had a significantly positive correlation(r=0.248 ,P ＜ 0.05).CONCLUSION: The development of anxiety with high scores in C, E, F and Q4 correlates with self-personality trait. These 4 personality traits may be susceptible factors in the development of anxiety disorder and may also affect its severity.

BACKGROUND: Major depression is a subtype of depression. Application of thymoleptics alone has bad effect. It has shown from relevant studies abroad that application of fluoxetine combined with atypical antipsychotic drugs maybe an effective treating strategy.OBJECTIVE: To observe the curative effects of fluoxetine combined with olanzapine and the time of its taking effect.DESIGN: Comparative study of open clinical test with completely random sampling for the first visit outpatients SETTING: A psychological consulting clinic in a hospital of a Military Medical College of Chinese PLA.PARTICIPANTS: Totally 140 patients visiting psychological counseling outpatient clinic in the hospital were collected from January 2004 to August 2004. Inclusion criteria: According to the diagnostic criterion of depression of CCMD-3, patients with total scores of 17 items in Hamilton depression rating scale≥28and age ≥18 years old .EXclusion criteria;①slight to middle edgree of depression(Hamt≤27);②secondary depression;③convalesscent period of schizophrenia and other affective disorder caused by psychosis;④severe of unstable body diseases ,including diseases of liver,kidney,cardiae vessel,respiration,gastro-intestine,endocrine,nervous system,innune system or hematological system,cet.⑤drug or alcohol addict;⑥women in pregnancy and lactation. Totally 110 patients accorded with the inclusive criteria. Among them, there were 40 males and 70 females with the course of disease for 4 months to 5 years, aged 18 to 63 with the average (37 ± 12) years old. They all took part in the trial voluntarily. According to the date of admittance, they were divided into odd-numbered date alprazolam group in which there were 55 patients with 21 males and 34 females and double date olanzapine group in which there were 55 patients with 19 males and 36 females.METHODS: The patients were divided into 2 groups according to the date of admittance. Odd-numbered date group was alprazolam group. 0.4 mg alprazolam was given every noon and before sleep and 20 mg fluoxetine was given at a draught after breakfast every day. Even-numbered date group was olanzapine group. 2.5 mg olanzapine was given before sleep every day and 20mg fluoxetine was given at a draught after breakfast every day. The course of treatment was 6 weeks. HAMD and HAMA scores of taken were evaluated respectively before and at the end of 1st, 2nd, 4th and 6th week. Reducing score rate was used to decide effective time. Lost rate was presented as percentage. And improvement of sleep factor and somatization factor in HAMD were observed before therapy and at every observing time period after therapy.MAIN OUTCOME MEASURES: Terminus index: Comparison of HAMD,HAMA score in the two groups before therapy and at the 1st, 2nd, 4th and 6th weekend after therapy. Scores of sleep factor and anxiety somatization factor of HAMD at every observing time period in the two groups. Substitution index: lost rate in the two groups. Reducing score rate at every observing time period in the two groups.RESULTS: Lost rate in olanzapine group was significantly lower than that in alprazolam group ( P ＜ 0.05) and the effect was taken at 1 week after therapy(excellence rate 67% ) . But, scores of HAMD and HAMA at every observing time period in olanzapine group were significant lower than those in alprazolam group( P ＜ 0.01) and sleep factor and somatization factor at every observing time period improved more significantly than those of alprazolam group( P ＜ 0. 01).CONCLUSION: Small amount of olanzapine combined with fluoxetine used to treat major depression of the patients can improve sleep and anxiety body symptoms rapidly and then elevate their living quality significantly.

Objective: To observe the clinical value of three dimensional conformal radiation therapy (3D-CRT) followed by radical surgery and discuss the best radiation technique for cervical cancer patients after radical hysterectomy. Methods: From February of 2003 to June of 2006, 155 stage I-IIIa cervical cancer patients received postoperative radiotherapy in our department after radical surgery. They were randomly divided into two groups. There were 81 patients in 3D-CRT group and 74 patients in traditional radiation group. According to FIGO staging, there were 45 cases in stage I, 77 in stage II a, 31 in stage II b, and 2 in stage III a. Pathological examination confirmed that 148 cases had squamous carcinoma and 7 cases had adenocarcinoma. The target volume included supravaginal portion, the cervical stump, paracervical tissue, common iliac, internal and external iliac, obturator, and sacral lymph nodes, and the pelvic lymphatic drainage area. For 3D-CRT group we designed four-field or two-field rotating irradiation in the left-right and the anterior-posterior direction. For traditional radiation group we designed two-field irradiation, anterior-posterior, at opposed lateral directions. The radiation dose ranged from 48-50 Gy. Stage II b patients with a cervical stump recurrence received postoperative boost irradiation by 8-10 Gy. Results: There were no significant difference in 0.5-year, 1-year, 1.5-year, and 2-year local control rate between 3D-CRT group and traditional radiation group (P > 0.05). The occurrence of early and late complications was significantly lower in 3D-CRT group than that in traditional radiation group (P < 0.05). There was significant difference in gastrointestinal reaction and urinary system reaction between the two groups (P <0.05). In postoperative radiotherapy, 3D-CRT was superior compared with traditional two-field radiation at opposed lateral directions. Conclusion: 3D-CRT is superior compared with traditional two-dimensional radiation. Four-field rotating radiation in 3D-CRT induces focused and even dose distribution and causes less side effects and complications. The side-field and cervical stump-targeted boost irradiation are apparent advantages of 3D-CRT.

Objective To compare the inhibition effect of budesonide suspension and dexamethasone on the rats′ pneumonic anaphylacticitis and serum IL-5,and study the effect mechanism in treatment of asthma with glucocorticoids on systemic administration and with budesonide suspension.Methods Twenty-six health wistar rats were randomly divided into normal group,asthmatic group,budesonide suspension group and dexamethasone group.Asthma models were sensitized with egg albumin.Before sensitized,budesonide suspension group were administered inhalation of budesonide suspension,and dexamethasone group were administered abdominal injection of dexamethasone.The level of IL-5 was measured with enzyme linked immunosorbent assay(ELISA) reagent box,lung was eviscera-(ted after collecting) blood,pathological slice was made.Results The rats′ pathological changes of lung and bronchus were significant between asthma group and other groups,while there were no significant difference between budesonide suspension group and dexamethasone group,but both of two groups showed slight difference with normal group.Compared with normal group,the level of serum IL-5 in asthma group raised obviously,and there was significant difference(P0.05).Conclusions The treatment of inhalation of budesonide suspension can inhibit rats′ pneumonic anaphylacticitis,ameliorate rat anaphylactic asthma symptom.

Objective To investigate the protective effect and mechanism of warm ischemic preconditioning of on liver cold ischemic-reperfusion injury of donor liver in rats. Methods Male Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, the cold ischemia period and anhepatic phase was 120 min and 16～20 min respectively. Rats were randomly divided into 3 groups: sham-operation group, liver transplantation group, and ischemic pre-conditioning(IP) group. IP was performed with 5-min ischemia followed by 5-min reperfusion. Results After operation, the serum levels of ALT and superoxide were significantly higher in the groups of liver transplantation and IP group than in the sham-operation group(P

Objective To investigate the safety and efficacy of carotid angioplasty and stenting(CAS)for the treatment of carotid stenosis with filter cerebral protection devices(CPD).Methods The filter CPD was used in treating carotid artery stenosis by angioplasty and stenting in 19 cases.Cerebral thromboembolic events were noted and the filter devices were observed.All patients were followed-up for short-term.Results The placement of filter CPD and CAS were successfully administered in all patients.Tissue debris could be found in 8 out of 19 with naked eyes in the CPD.There was no death or symptomatic cerebral thromboembolic events during theropy procedure.Short-term follow-up showed excellent results.Conclusion CAS under the filter CPD is a safe and effective method in treating carotid stenosis.The effect of long-term follow-up needs to be further observed and the materials need to be further improved.

AIM To investigate the effects of ethyl acetate extract from Huangqi Injection (HQIEACE) on leucopenia mice.METHODS An experimental mouse model of leucopenia was induced by cyclophosphamide.NMR based metabolomic profiling technique coupled with multivariate statistical method was used for performing metabolomic analysis.RESULTS HQIEACE could elevate the levels of white blood cell,monocytes,neutrophils and lymphocyte in modeled mice.The levels of ten potential endogenous metabolites (lipid,leucine,3-D-hydroxybutyrate,lactate,alanine,pyruvate,creatine,scyllo-inositol,betaine and glucose) were reversed.CONCLUSION The metabolic pathways related to the pharmacological effects of HQIEACE on leucopenia are probably involved in body energy metabolism,amino acid metabolism,oxidative stress and choline metabolism.

Objective To investigate the role of vitamin D receptor (VDR) in the protection of bufalin on podocyte injury induced by adriamycin (ADR).Methods (1) In vitro:the toxic effect of different concentrations of bufalin (10-9,10-8,10-7,104 mol/L) on podocyte was evaluated by lactate dehydrogenase (LDH) test;Annexin V-FITC and RT-PCR were utilized for podocyte apoptosis and VDR mRNA level respectively.Western blotting was used to analyze the protein expression of VDR and nephrin.SiRNA intervene was also applied to evaluate the role of VDR in bufalin's protective effect on podocyte injury induced by ADR.(2) In vitro:24 SD rats were randomly divided into three groups:control group,ADR group and ADR+bufalin group.TUNEL assay was applied to detect the apoptosis of podocytes in the kidney.Immunofluorescence and transmission electron microscope (TEM) were applied to analyze the expression of VDR and the ultrastructure of the glomerulus.Results Bufalin concentration lower than 10-7 mol/L had no toxicity on normal podocyte.Bufalin reduced the urinary protein excretion (P ＜ 0.05),alleviated the removal of podocyte foot processes and attenuated the changes in nephrin expression in the glomerulus of the adriamycin (ADR) rats (P ＜ 0.05).Bufalin notably inhibited the down-regulation of VDR in protein levels on the glomerulus of the ADR rats.Additionally,bufalin inhibited the down-regulation of VDR in both mRNA levels and protein levels (P ＜ 0.05),nephrin protein expression (P＜ 0.05),and apoptosis induced by ADR in cultured podocytes.Additionally,VDR specific siRNA intervene abolished the protective effect of bufalin in ADR-induced podocyte injury.Conclusion Bufalin can alleviate ADR-induced podocyte injury via enhancing VDR expression.

Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.