Adult ; Cytokines ; metabolism ; Female ; Gene Expression ; Humans ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Male ; Semaphorins ; genetics ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism ; Thrombocytopenia ; genetics ; metabolism

Objective To investigate the clinical effect and safety of EEG biofeedback therapy combined with mirtazapine in the treatment of depressive disorder.Methods 124 patients with depressive disorder were selected and randomly divided into the observation group and the control group,62 cases in each group.The control group was given mirtazapine treatment,while the observation group was given EEG biofeedback therapy combined with mirtazapine.All the two groups were treated for 8 weeks.Before and 2,4,8 weeks after treatment,the clinical effects in the two groups were evaluated by Hamilton depression scale (HAMD),Montgomerie depression rating scale (MADRS) and the clinical global impression scale (CGI).The side effects scale(TESS) assessment was used to assess the side effects.And the serum norepinephrine (NE),5-hydroxytryptamine (5-HT) and dopamine (DA) levels were measured before and 8 weeks after treatment.Results The total effective rate of the observation group was 87.5％,which was significantly higher than 66.1％ in the control group (x2 =7.213,P ＜ 0.05).In the two groups,2,4,8 weeks after treatment,the HAMD scores were significantly lower than those before treatment (t =9.391,19.349,26.349,5.026,12.610,19.518,all P ＜ 0.05),the M ADRS scores were significantly lower than those before treatment (t =8.646,22.190,33.101,4.986,13.185,25.959,all P ＜ 0.05),and the CGI scores were significantly lower than those before treatment(t =17.471,29.482,42.256,13.136,28.358,35.661,all P ＜ 0.05).In the observation group,after treatment for 2,4,8 weeks,the HAMD scores were significantly lower than those in the control group(t =4.093,4.537,5.655,all P ＜ 0.05),and the MADRS scores were significantly lower than those in the control group (t =3.622,9.740,7.490,all P ＜ 0.05),while the CGI scores were significantly lower than those in the control group(t =8.608,11.024,12.598,all P ＜ 0.05).After treatment,the levels of 5-HT,NE and DA were (148.5 ± 4.9) ng/mL,(60.6 ± 4.2) ng/L and (78.0 ± 4.1) ng/L in the observation group,which were significantly higher than before treatment [(79.8 ± 4.3) ng/mL,(30.3 ± 4.0) ng/L and (43.5 ± 4.0) ng/L,t =82.977,41.134,46.837,all P ＜ 0.05].In the control group after treatment,the levels of 5-HT,NE and DA were (125.4 ± 4.1) ng/mL,(40.2 ± 4.0)ng/L and (50.3 ± 4.3)nig/L,which were significantly higher than those before treatment [(79.2 ± 3.9)ng/mL,(30.5 ±4.1)ng/L and (43.2 ±3.6)ng/L,t =64.287,13.334,9.969,all P ＜0.05],but which those in the observation group increased more significantly (t =28.469,27.695,36.286,all P ＜ 0.05).4 weeks and 8 weeks after treatment,the TESS scores in the observation group were (3.0 ± 1.0) points and (4.3 ± 1.2) points,which in the control group were (2.8 ± 1.2) points and (4.1 ± 1.3) points,there were no significant differences in terms of TESS scores (t =1.150,0.846,all P ＞ 0.05).Conclusion EEG biofeedback therapy combined with mirtazapine in the treatment of depression is better,the adverse reactions is not significantly increased,and it also has higher clinical safety compared with mirtazapine alone.

Objective To elucidate the clinical and pathological features, diagnosis, treatment and prognosis of nodal marginal zone B-cell lymphoma (NMZL). Methods 2 patients, with NMZL who has extremely elevated monoclonal IgM were analyzed and review were included. Results The common pathological diagnosis caused by the association of monoclonal gammopathy with indolent B-cell non-Hodgkin lymphomas was marginal zone lymphoma or B small cell lymphocytic lymphoma/B-cell chronic lymphocytic leukemia. According to our cases and literatures, the main distribution of involved sites in NMZL were lymph nodes, spleen and bone marrow. Sixty percent of the NMZL patients presented with advanced stage with, high risk of IPI. The diagnosis of NMZL was based on pathology of the lymph node. The proliferation and distribution of the differentiation monocytoid cell had a specified significance. Prognosis of early stage ( I or Ⅱ) NMZL were much better than that of advanced stage NMZL even the patients had received chemotherapy.Conclusion NMZL mainly involved lymph nodes, bone marrow and spleen, sporadically associated with the elevated monoclonal IgM. Most of the NMZL patients presented with advanced stage.The prognoses were poor.

Bilateral lung lavage was performed under general anesthesia with muscle relaxation in 3 patients with pulmonary alveolar proteinosis(PAP)aged 43-57 yrs weighing 48-68 kg.Left lung lavage was performed first and the right lung was lavaged one week later.Left radial artery and right internal jugular vein were cannulated for MAP,HR and CVP monitoring.SpO_2 and P_(ET) CO_2 were monitored during lavage.Left-sided Robertshaw double-lumen tube was used for both right and left lung lavage.After proper placement of the double- lumen tube was verified both lungs were ventilated with 100% O_2 for 10 min to wash out N_2.Hyperoxygenated lavage fluid was made by aerating the lactated Ringer's solution with 100% O_2 at 1 L?min~(-1) flow rate for 30 seconds.The tidal aliquot of lavage was 700 ml which was kept in the lung for 50 seconds and then drained.Each lung was lavaged with hyperoxygenated and plain lactated Ringer's solution 10 times each alternatively.While one lung was being lavaged the contralateral lung was mechanically ventilated with 100% O_2.SpO_2,MAP,HR,CVP and P_(ET)CO_2 were recorded immediately before lavage and at 10,20,30,40,50,60,70 and 80 seconds after the lung was filled with lavage fluid.SpO_2 was significantly higher during lavage with hyperoxygenated fluid than with ordinary lactated Ringer's solution,but there was no significant difference in MAP,HR,CVP and P_(ET)CO_2.The PaO_2 of the 3 patients breathing room air was 46-52 mm Hg before lung lavage and increased to(72.3?2.1) mm Hg one week after left lung lavage and to(83.5?4.8)mm Hg 3d after right lung lavage.During the lung lavage,hyperoxygenic significantly improve oxygen supply in patients with pulmonary alveolar proteinosis compared with lactated Ringer's solution.

Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.

Objective To explore the histocompatibility and plasticitity of hydroxyapatite/high-density polyethylene composite (HMPE). Design Experimental study. Participants Forty-five rabbits. Methods Rabbits were randomly devided into HA/PE, HA and PE surgical groups, every group included 15 rabbits. Osteoeetomy of orbital rim and implantation (HA/PE, HA and PE materials were used) were performed on 3 groups of the rabbits. At 1st week, 4th week, 8th week, 12th week and 24th week of postoperation, we took out the samples from the rabbits separately in each group and did histopathologic and electron microscope examinations. Main Outcome Measures Physical signs of the implant combination with the bone. The bone cell appeared in the implants. Results After 12 weeks, the calcium salts deposit like bone plate with some osteoblast inside the HA/PE implants was observed. After 8 weeks, the calci- um salts deposit inside the HA plants was observed. In the PE implants, nothing could be seen but some fibrous connective tissue. Conclusion HMPE is an ideal repair material especially for orbital bone.

This study was aimed to observe the promotion effect of wound healing retention enema for postoperative anal fistula by modifiedWu-Wei Xiao-Du(WWXD) decoction, in order to explore its mechanism. A total of 60 patients who met the inclusion criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Patients in both groups were diagnosed as simple low anal fistula and treated with low anal fistula incision. The retention enema of 30 mL modified WWXD decoction or complexHuang-Bai fluid were given once a day for postoperative dressing changes. Detailed observations and scores were made on wound exudate, color, and itching around the anus. The comparisons were made on carrion off time, new epithelium time, rate of wound-reducing, wound healing time, and the total clinical efficacy 21 days after operation. The results showed that the wound exudate on the 7th and 14th postoperative day was better than that of the control group. There was no significant difference on the 21st day between two groups. The wound color of the treatment group was better than that of the control group on the 7th and 14th postoperative day. The itching around anus of the treatment group was better than that of the control group on the 7th, 14th and 21st postoperative day. The carrion wound off time and new epithelium time of the treatment group were earlier than that of the control group. There was no significant difference on the rate of wound-reducing. There were no significant differences on the total clinical efficacy 21 days after operation as well as the total average healing time of both groups. It was concluded that modified WWXD decoction can shorten the inflammation phase, reduce the wound exudate and itching, promote early carrion fall and as well as the wound healing.

Medical research has entered the era of mega-science.The multidisciplinary collaboration has attracted great attention.besides studies on genes and the environment interaction,multidisciplinary research between natural sciences has received widespread recognition.However muhidisciplinary researches on the interaction between the gene and social factors or behavioral factors on health science deserve more emphasis.This article described development of multidisciplinary research and its features;analyzed importants of conducting multidisciplinary research between natural and social disciplines,and finally provided suggestions on research organization reform in order to promote the multidisciplinary research.

Objective:To investigate the value of indocyanine green retention rate at 15 minutes (ICG R15) on postoperative day 3 combined with standard remnant liver volume (SRLV) in predicting the occurrence of liver dysfunction after hepatectomyin hepatocellular carcinoma (HCC).Methods:The clinical data of 61 HCC patients undergone hepatectomy in Xiangya Hospital of Central South University from January 2015 to February 2016 were collected and analyzed.The patients were divided into 2 groups:a normal liver function group (n=40) and a liver dysfunction group (n=21).Univariate analysis was used to evaluate the risk factors for postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was established,The receiver operating characteristic (ROC) curve was used to examine the regression equation and compare the value difference in predicting postoperative liver dysfunction between single and combined independent risk factors.Results:Postoperative liver dysfunction occurred in 21 of the 61 patients,with an incidence rate at 34.4％.There was no significant difference in the time of operation,time of hepatic portal occlusion,volume of tumor and volume of resected liver between the 2 groups (all P＞0.05),but there were significant differences in the ICG R15 on postoperative day 3,intraoperative blood loss and SRLV between the 2 groups (all P＜0.05).The ICG R15 on postoperative day 3,intraoperative blood loss,SRLV were the risk factors for postoperative liver dysfunction.Logistic regression analysis showed ICG R15 on postoperative day 3 and SRLV were the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was as follows:logit(P)=1.277+0.140×ICG R15 on postoperative day 3-5.125×SRLV.The area under the ROC curve ofICG R15 on postoperative day 3 combined with SRLV was more than that of single ICG R15 and single SRLV.Conclusion:ICG R15 on postoperative day 3 and SRLV are the independent risk factors for postoperative liver dysfunction.The regression equation,which is established by combination of ICG R15 with SRLV,can predict the occurrence of postoperative liver dysfunction.The accuracy of ICG R15 on postoperative day 3 combined with SRLV is better than that of single ICG R15 or single SRLV.