OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). HAMD after 4 and 8 weeks,HAMA after 8 weeks in control group,HAMD and HAMA after 2,4 and 8 weeks in observation group were significantly lower than before,and it gradually decreased by time pro-longed,observation group was lower than control group,the differences were statistically significant (P<0.05 or P<0.01). And there was no significant difference in the TESS rating in 2 groups before and after treatment(P>0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.

By analyzing the quality requirements for the majors in pharmacy speciality and the shortcomings existing in present practice teaching this article brought up the corresponding improving measures,which include courses and teaching modes innovation,teaching ability improvement and management reinforcement.

BACKGROUND:Subcutaneous effusion often occurs after digital shaping titanium mesh cranioplasty, and affects therapeutic effects.
OBJECTIVE:To explore the causes and corresponding prevention measures of subcutaneous effusion after digital shaping titanium mesh cranioplasty.
METHODS: We retrospectively analyzed the clinical data and treatment methods of 19 cases of subcutaneous effusion after digital shaping titanium mesh cranioplasty, summarized the postoperative complications and explored the effective methods for prevention and treatment of subcutaneous effusion.
RESULTS AND CONCLUSION: After active treatment, five cases of dural breakage, four cases of foreign body stimulation, three cases of getting out of bed early, three cases of early extubation, three cases of long-time operation repair, and one case of excessive use of electric knife were al cured. Dural breakage and foreign body stimulation is considered as the main causes of postoperative effusion. Patients with subcutaneous effusion were given releasing elastic bandage, aspiration, and strict bed rest. After these active treatments, patients were al cured. Subcutaneous effusion may result from single or mixed factors. The above-mentioned causes are only a part. Non-central suspension, incomplete hemostasis, and preoperative excessive colapse of the bone window are al reported to be the reasons for the occurrence of subcutaneous effusion.

Adolescent ; Cyanosis ; complications ; Heart Septal Defects, Atrial ; complications ; Humans ; Male ; Pulmonary Wedge Pressure

Objective To investigate the clinical manifestation,pathological characteristics,neurological imaging,indications,operative approach and microsurgieal technique of surgery for brain stem tumor.Methods 17 cases of brain stem tumor treated by applying microsurgical skills were retrospectively analyzed from Jan.2002 to Dec.2007.Ten cases were operated via the suboccipito-retromastoid approach,among which 5 situated in pons,3 in medulla oblongata and 2 invoved both pens and medulla oblongata;4 cases were performed via the posteromedian-suboccipital approach,among which 2 located in pens,1 in medulla oblongata and 1 involved both midbrain and pens;3 lesions situated in varying sites of mesencephalon were operated by the suboceipito-supratentorial,infratemporal approach and pterional approach respectively.Results In the series of the patients,lesion was totally excised in 6 cases,subtotally in one,without surgical mortality.All patients were followed up for years ranging from 5 months to 4 years.During the follow-up period,seven patients resumed work and normal life;4 patients could perform physical labor;3 patients obtained self care capability;2 patients needed to be taken care of,1 patient died from pneumonia after discharge.Conclusion Fine therapeutic efficacy and low disability rate could be obtained while applying microsurgical techniques to resect brain stem tumors with correct indication,appropriate approach and elaborate microneurosurgical skills.

Objective:To observe the expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance,so as to assess their expression with the metastasis and prognosis of colorectal carcinoma. Methods:Immunohistochemistry was used to detect the expression of chemokine receptor CCR7 and CXCR4 in 110 patients with colon cancer.The relationship between the CCR7 and CXCR4 expression and the clinic pathological characters was statistically analyzed. Results:CCR7 and CXCR4 expression were positively expressed in 59.1% and 45.5%of the patients. The high expression rate of CCR7 and CXCR4 in lymph node metastasis positive cases was 81. 5% and 60.0% respectively,but the without lymph node metastasis positive cases were 26.7% and 24.4% respectively. The positive expression was significantely higher in the patients with lymph node metastasis than those non-lymph node metastasis(P

Objetcive To analyze the contrast-enhanced ultrasound (CEUS)features in clear cell renal cell carcinoma (CCRCC) of different size and to discuss the diagnostic value of CEUS in CCRCCs. Methods The contrast-enhanced and conventional US features of 80 CCRCCs confirmed pathologically were retrospectively analyzed. Samples were divided into three groups by diameters: small CCRCCs (≤30 mm), medium CCRCCs(＞30 mm) and large CCRCCs(＞50 mm). The tumoral vascularity, lesion homogeneity and presence of an anechoic rim were observed on conventional US. The enhancement of echogenicity, homogeneity and pseudocapsule were evaluated on CEUS. Results Among the 80 renal masses, 32 were small CCRCCs, 28 were medium CCRCCs while the large CCRCCs were 20. On conventional US, 18.8%(6/32) of small CCRCCs, 71.4%(20/28) of medium CCRCCs and 95%(19/20) of large CCRCCs demonstrated as heterogeneous and the differences were highly statistically significant, whereas there were no differences in the tumoral vascularity and the presence of pseudocapsule sign among the three groups. On CEUS, 28.1%(9/32) of small CCRCCs, 85.7%(24/28) of medium CCRCCs and 100%(20/20) of large CCRCCs showed a homogeneous enhancement. The incidence of pseudocapsule sign in medium tumors was higher than small and large groups(71.4%,50% and 25%,respectively). There were statistically significant differences among the three groups in the enhanced homogeneity and the presence of pseudocapsule sign. However, all the three groups revealed mainly isoechoic and hyperechoic and there were no differences among them. Compared with conventional US, CEUS depicted significantly the increased tumoral vascularity (51.3% vs. 87.5%) and pseudocapsule sign(22.5% vs. 51.3%). Eight lesions demonstrated heterogeneous contrast enhancement on CEUS while homogeneous on conventional US, but there were no differences in lesion homogeneity between conventional US and CEUS findings. Conclusions Different sizes of CCRCC showed distinct CEUS features in the enhanced homogeneity and the presence of pseudocapsule sign. CEUS is more effective on improving the sonographic characteristics of tumoral visualization and may provide important information of US findings for the diagnosis of renal cell carcinoma.

Objective To understand the drug-resistance of MRSA patients in neurosurgery intensive care unit,raise the prevention of MRSA and provide doctors the basis for controlling it. Methods The 5 year(20012005) MRSA patients were tested by Kirby-Bauer in neurosurgery intensive care unit of a third-tier general hospital in Shanghai. Statistic and analysis the drug-resistance of the patients. Results The rates of 121 MRSA drug-resistance to penicillin G,erythromycin, ciprofloxacin, amikacin and the cephalosporins are 92.3 % to 100 %, totally senaitire to teicoplanin and vancomycin and lower drug-resistance to rifampin,netilmicin and fosfomycin, but it rapidly raised from 10.0 % (2001 ) to 95.2 % (2005) to sulfamethoxazole. Conclusion It is time to take care of the drug-resistance of MRSA. Prevention and use antibiotics properly are the important ways to decrease the hospital infection and to improve the quality of recovered.

Four qi theory is an important part of property theory of traditional Chinese medicine. Current researches mainly focus on two aspects of cold and heat properties, which are not only important elements of treating diseases, but also are factors of causing adverse reaction. In this article, through the study on the toxicity mechanism of cold and hot properties, authors put forward to the control measures of toxic and side effects of traditional Chinese medicine with cold and hot properties, and pointed out that the importance of controlling toxicity of traditional Chinese medicine with cold and hot properties lies in the modernization and internationalization of traditional Chinese medicine.

Objective To investigate the effects of changing the arteriovenous pressure difference on the survival area of reverse island flap in New Zealand white rabbits models.Methods The saphenous artery and saphenous vein of New Zealand rabbits were selected to design experimental models of reverse island flap.Experi mental rabbits were randomly divided into 4 groups:group A:control group (reserved pedicle integrity of superficial veins);group B:part anastomosis of saphenous artery group (the distal saphenous artery of the flap was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group C:part anastomosis of vein group (distal superficial veins was cut,then trimmed its original diameter to half and done end-to-end anastomosis);group D:ligated superficial veins group (pedicle superficial veins was ligated).After surgery,the flaps were measured by general observation.Blood distribution at different times of the flaps was detected by radionuclide scans.Survival area of the flap was measured to compare the survival rate of flap.Distribution of blood vessels and the state of blood cells were observed by Histological examination.Results The flap survival rate was (82.27-± 11.71)％ in group B,showing significant differences when compared with that group A (47.70-± 11.18)％,group C (47.70 ± 11.18)％ and group D (47.70 ± 11.18)％ (P ＜ 0.05).Radionuclide scans showed that the radioactive material in group B could be seen clearly,the radioactive material in groups A,C and D were a transient existence.Ten days postoperatively,histological observation showed that group B had more capillary regeneration and blood cells remain compared with other groups.Conclusion Increase the blood supply can increase the survival area of the reverse island flap,and simply promote the venous drainage can not effectively improve the survival rate of the flap.