OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Objective:To compare the pharmacoeconomics value of domestic olanzapine with imported olanzapine in the treatment of schizophrenia to provide reference for the rational drug use in clinics. Methods:Two hundred patients with schizophrenia were ran-domly divided into group A ( treated with domestic olanzapine ) and group B ( treated with imported olanzapine ) with 100 cases in each. The treatment course was 8 weeks. The patient’ s condition, adverse reactions, social function, quality of life and daily activity in the two groups were evaluated. Meanwhile, cost-efficacy analysis was performed. Results:The scores of PANSS, SDSS, SQLS and ADL after the treatment were all significantly lower than those before the treatment in both groups (P<0. 01). However, there was no significant difference between the two groups (P>0. 05). In the 2nd and 4th weekend after the treatment, the scores of TESS in group A were all significantly higher than those in group B (P<0. 01). The effectiveness of the two groups was similar. The cost in group A was significantly lower than that in group B(P<0. 01). The efficacy-cost ratio in group A was higher than that in group B(P<0. 01). Conclusion:The domestic olanzapine is as effective and safe as imported olanzapine in the treatment of schizophrenia with lower treat-ment cost. Therefore, the pharmacoeconomics value of domestic olanzapine is much better.

Objective:To search for potential protein biomarkers of papillary thyroid carcinoma (PTC) and thyroid borderline lesion. Dif-ferentially expressed proteins between the two were analyzed and identified. Methods:A total of 118 cases of thyroid resection sam-ples were obtained from patients who underwent surgery at the First People's Hospital of Yunnan Province from April 2013 to Febru-ary 2015. Experimental groups included 43 PTCs (40 classic and 3 follicular variants) and 33 thyroid borderline lesions (with equivocal PTC type nuclear features and papillary structure, but without metastasis, and lacking capsular or vascular invasion;8 cases with atypi-cal adenoma), respectively. The control group included 42 normal thyroid tissues adjacent to carcinoma. The total protein extracts from frozen thyroid samples of 10 cases in each group were profiled with 2D electrophoresis. The differential protein spots were then revealed by PDQUEST 7.3 software and identified by matrix-assisted laser desorption ionization time-of-fight/time-of-fight mass spec-trometry and Swiss-Prot database search. Six differentially expressed proteins of these spots were further validated using 118 samples through immunohistochemistry. Results:A set of 24 differentially expressed spots significant in discriminating between the sample groups were found, and 18 proteins were identified. Immunohistochemistry revealed the following six proteins located in the cyto-plasm:keratin, type II cytoskeletal 8 (CK8);keratin, type I cytoskeletal 18 (CK18);60 kDa heat shock protein (HSP60);actin, cytoplasmic 2 (γ-actin);14-3-3 protein beta/alpha (14-3-3β/α);and 14-3-3 protein epsilon (14-3-3ε). All six proteins were overexpressed in PTC compared with normal tissues (P<0.001). Meanwhile, CK8, CK18, HSP60, andγ-actin were overexpressed in PTC compared with bor-derline lesions (P<0.01). Except for CK8, the five other proteins were overexpressed in borderline lesions compared with normal tis-sues (P<0.001). Conclusion:Proteomic analysis is useful in searching for new biomarkers of PTC and thyroid borderline lesion. The ex-pression patterns of these differentially expressed proteins can be further validated using immunohistochemistry. The newly identified protein biomarkers can positively contribute to early PTC diagnosis.

Objective To investigate the effect of up-regulating miR-34c-5p on cloning formation and migration of nasopharyngeal carcinoma cell line HONE-1 in vitro. Methods Expression levels of miR-34c-5p in nasopharyngeal cell line NP69 and nasopharyngeal carcinoma cell line HONE-1 were investigated by real time quantitative PCR;Cloning Forma?tion Test and Transwell Migration Assay were used to explore the effect of up-regulating miR-34c-5p on proliferation and migration of nasopharyngeal carcinoma cell line HONE-1. Results The expression of miR-34c-5p in nasopharyngeal car?cinoma cell line HONE-1 was lower than that in normal nasopharyngeal cell line NP69. Up-regulating miR-34c-5p signifi?cantly suppressed the cloning formation and migration capacity, compared to those of NP69 cell line and HONE-1 with nor?mal level of miR-34c-5p(P<0.05). Conclusion Down-regulating miR-34c-5p involve in proliferation and migration of nasopharyngeal carcinoma and may be a used as a new therapeutic target for nasopharyngeal carcinoma.

Objective:This study aimed to analyze and summarize the clinicopathologic characteristics and treatment protocols of large cell lung carcinoma (LCLC). Methods:Clinicopathologic data of 83 cases with LCLC confirmed by pathology in 2012 were retrospectively reviewed. Results:Exactly 83 cases of LCLC accounted for 5.4%of lung cancer in 2012. Sixty-three cases were male and twenty were female. The average age was 60.4 years old. The average maximum diameter of the tumor was 4.6 cm. The common manifestations in imageology were peripheral type. Only four cases were correctly diagnosed by sputum exfoliocytology, biopsy of bronchofibroscope, and paracentesis before surgery. Sixty-three cases (76%) underwent surgical resection, and pulmonary lobectomy was mainly selected. Postoperative pathology diagnosis indicated that 39 cases were classic large cell carcinoma, 31 were large cell neu-roendocrine carcinoma, 2 were combined large cell neuroendocrine carcinoma, 8 were basaloid carcinoma, 2 were clear cell carcinoma, and 1 was lymphoepithelioma-like carcinoma. Each subtype of LCLC had respective characteristics of pathomorphology and immuno-histochemistry. Lymph node metastasis occurred in 62 cases (75%). Conclusion:The incidence rate of LCLC, which is a highly aggres-sive malignancy, is low. The clinical manifestation and imageology characteristics of LCLC do not have specificity, and its final diagno-sis depends on pathology diagnosis. Operation is the main treatment method. Improving the diagnosis rate of LCLC and further subdi-viding the pathological subtypes are important for a normalized comprehensive treatment of LCLC.

The detection of R-wave of ECG is essential to the analysis of the heart rate variability (HRV). In this paper, an R-wave detection method using wavelet transform(WT) is presented in line with the principle of discrete wavelet transform(DWT) and multi-resolution technique (MRT). We made use of the special properties of dbl wavelet in time-domain, decomposed the original ECG signals into 3-level detailed signals on different frequency bands by using DWT with Mallat algorithm, and got appropriate threshold values in different high frequency bands to distinguish R-wave. It is concluded that the algorithm had significant effects on it, which is verified by MIT/BIH (Massachusetts Institute of Technology/Boston's Beth Israel Hospital) ECG Database. The results show that R-wave could be detected accurately and localized precisely by this method, even when the patient was seriously sick or the signal was disturbed by noise. Consequently the method has a quite high locating precision (its error is not more than two sampled points and about 85 percent of the points of R-wave in ECG signal are localized precisely) and the correct detection rate of R-wave is 99.8% by using wavelet transform, so this method is quite feasible.
Algorithms ; Electrocardiography ; Heart Rate ; physiology ; Humans ; Signal Processing, Computer-Assisted

In this paper a filtering method for EECG (Exercise ECG) signal is proposed which is based on wavelet transform (WT) and Stein's unbiased risk estimate (SURE). This algorithm was used to decompose original EECG signals into detail signals on different frequency bands by using WT and get different thresholds with SURE. According to EECG signal features and by using the above thresholds, the method amended several detail signals so that the main interferences in EECG signal can be removed efficiently. The authors also put forward two indexes to estimate the validity of such algorithms. Our experimental results demonstrate that this is an efficient de-noising method for EECG.
Algorithms ; Echocardiography, Stress ; Electrocardiography ; methods ; Exercise Test ; methods ; Humans ; Signal Processing, Computer-Assisted

Objective To explore the intrinsic relationship between circadian clock and cell cycle in osteoarthritis(OA)chondrocytes,especially the regulation of cell cycle-related genes by the clock gene Bmal1.Methods The chondroid ATDC5 cells induced by insulin-transfering-selenium(ITS)were divided into control group,OA group and LV-Bmal1 group.The cell viability of each group was detected by CCK8 method.The expression of Bmal1,Per1,Wee1,Cdk1,Ccnb1 and Mmp13 mRNA in each group was detected by RT-qPCR.The expression of BMAL1,PER1,WEE1,CDK1,CCNB1 and MMP13 protein in each group was detected by Western blot.The effects of Bmal1 on different stages of cell cycle and apoptosis was analyzed by flow cytometry.The regulation of Bmal1 on Per1,Wee1,Cdk1,Ccnb1 and Mmp13 and their roles in OA were analyzed.Results Compared with the normal group,the cell viability of the OA group was increased,the relative mRNA expression of Bmal1 and Wee1 in the OA group decreased,and the relative mRNA expression of Per1,Cdk1,Ccnb1 and Mmp13 increased signif-icantly.The cell viability of LV-Bmal1 group decreased,the relative expression of Bmal1 and Wee1 mRNA in-creased,and the relative expression of Per1,Cdk1,Ccnb1 and Mmp13 mRNA decreased(P＜0.05).Correlation analysis showed that Bmal1 was positively correlated with Wee1 and they were negatively correlated with Per1,Cdk1,Ccnb1 or Mmp13.The results of Western blot showed that protein expression in different groups were con-sistent with the trend of PCR.The results of cell cycle and apoptosis showed that compared with the normal group,the S phase and G2/M phase of the OA group were shortened,the proportion of cells decreased significantly,and the proportion of early and late apoptosis increased.The S phase and G2/M phase of the LV-Bmal1 group were prolonged,the proportion of cells was increased,and the proportion of early and late apoptosis was decreased.Conclusions Circadian clock gene Bmal1 in inflammatory chondrocytes might regulate the expression of cell cycle-related genes.

Objective To establish a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs with high repeatability and stability. Methods Twelve Bama miniature pigs were randomly divided into the donor group (n=6) and recipient group (n=6). Pigs underwent non-venous bypass orthotopic liver transplantation. The time of anhepatic phase during operation was shortened, blood pressure during anhepatic phase was stably maintained, and management of anesthesia and body fluid during operation were strengthened. The operation time, anhepatic phase and survival status of the recipients were observed and recorded. The intraoperative heart rate, mean arterial pressure (MAP) and changes in arterial blood gas analysis were monitored. The perioperative liver function was evaluated. Results Among 6 Bama miniature pigs, 1 died from transplantation failure intraoperatively. The operation time of the remaining 5 pigs was (247±27) min and the time of anhepatic phase was (46±4) min. Three animals survived for more than 2 weeks. Compared with the preanhepatic phase, the heart rate of the animals was significantly faster, MAP was considerably reduced to (46±6) mmHg, blood pH value, base excess (BE) and HCO₃^- level were all significantly decreased and serum level of K⁺ was significantly elevated during the anhepatic phase (all P < 0.05). In the neohepatic phase, MAP of Bama miniature pigs was significantly increased, heart rate was dramatically slower.Blood pH value, BE, HCO₃^- level were significantly increased and serum level of K⁺ was significantly declined (all P < 0.05). During abdominal closure, MAP, blood gas indexes and serum level of K⁺ were almost recovered to those in the preanhepatic phase. Compared with preoperative levels, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)were significantly increased after operation (all P < 0.05), the change in AST was the most obvious, and it gradually decreased at postoperative 2 d. The level of γ-gutamyl transferase(GGT) did not significantly elevated. The level of total bilirubin (TB) was evidently elevated at postoperative 5 d. Compared with the preoperative levels, the levels of total protein (TP) and albumin (ALB) were significantly decreased after operation (both P < 0.05), and began to gradually increase at postoperative 1 d. Conclusions The non-venous bypass orthotopic liver transplantation model of Bama miniature pig is convenient, with highly reproducible and survival rate, which can be utilized as a standardized liver transplantation model.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.