Objective To investigate the efficacy and effects on cognitive functioning of antipsychotic addition to serotonin reuptake inhibitors in patients with treatment-refractory obsessive-compulsive disorder. Methods 58 therapy-resistant OCD patients were randomly grouped and receipt 8-week quetiapine-augmentation treatment or placebo respectively. At baseline and post-treatment, in order to evaluate symptom, executive functions, attention and memory, all patients were measured with Yale-Brown Obsessive-Compulsive Scale and cognitive functioning test, which included Wisconsin Card Sorting Test, Stroop Color Word Test,Continuous Performance Test and Memory Scale. Results Comparing quetiapine-augmentation group and placebo, there was significant difference of Y-BOCS total score between baseline and post-treatment (baseline:28.5±4.4,26.3±6.5,post-treatment:18.5±6.4,25.7±5.4, respectively,P=0.01). There was no major effects on cognitive functioning, apart from a failure to maintain set on the WCST (baseline:1.2±1.1,1.3±1.4,post-treatment:1.6±1.0,1.5±1.2,respectively,P=0.03).Conclusion It was effective of quetiapine-augmentation treatment on refractory OCD. There was no major effects on cognitive functioning of quetiapine-augmentation treatment.

Inosine 5'-monophosphate dehydrogenase (IMPDH) is a key enzyme of de novo GMP biosynthesis. The expression and activity of IMPDH can be affected by diseases and physiological process. It is the drug target for anticancer, antiviral, antimicrobial and immunosuppressive therapeutics. Not only catalytic action but the other biological functions of IMPDH also play an important role in diseases. The basic functions, mechanism of catalysis, classification of inhibitors, biological functions and the latest advances to IMPDH will be illustrated in this review. It is expected to be helpful to the discovery of new inhibitors and biological functions of IMPDH.

Objective: To explore the clinical effect of two disinfectors on prevention for central line-associated blood stream infection (CLABSI) in hemodialysis. Methods: 168 patients received blood purification through central venous indwelling catheter were divided into control group (82 cases) and observation group (86 cases) as random table. The patients of control group were disinfected by using iodophor disinfectant on central venous catheter and skin around puncture, while the patients of observation group were disinfected by using medical chlorhexidine gluconate (2% chlorhexidine gluconate, 70% isopropanol and 28%injection) on the same positions. In different stages, before and after central venous indwelling catheter and 24 hours after central venous indwelling catheter, the colony count and incidence of CLABSI of patients between two groups were compared. Results: There was no significant difference between the two groups for colony count around puncture before central venous indwelling catheter (t=-1.478, P>0.05). The colony count of observation group was lower than that of control group after 24 hours of disinfection. According to the diagnosis standards of CLABSI, the incidence of CLABSI in observation group was significant lower than that in control group (x2=6.048, P<0.05). Conclusion: The disinfector of chlorhexidine gluconate can decrease the incidence of CLABSI in hemodialysis and its bacteriostatic time is longer than that of iodophor disinfectant. Therefore, this method is worthy for promotion in clinical practice.

BACKGROUND: Sodium alginate-poly-lysine can cause foreign body reaction to induce functional inactivation of the microencapsulated islets following transplantation. Can barium chloride solve this problem?OBJECTIVE: To assess the biocompat ibility of purified sodium alginate-barium chloride microcapsules and the bioactivity of the microencapsulated islets of rats.DESIGN: A randomized controlled experiments based on the experimental animals.SETTING: Department of endocrinology in a university hospital.MATERIALS: This experiment was completed in the Laboratory of Endocrinology and Department of Laboratory Animals, First Affiliated Hospital of Nanjing Medical University during July to December 2002. Specific pathogen-free SD and Wistar rats were provided by Center of Animal Experiment, Nanjing Medical University and Animal Experiment Center of Shanghai respectively.METHODS: Purified and non-purified sodium alginate-barium chloride microcapsules were prepared with one-step method using domestically made equipment. The microcapsule was transplanted intraperitoneally into normal SD rats and its biocompatibility was observed 4 weeks later. The bioactivity of the microencapsulated islets was also observed following transplantation in streptozotocin(STZ)-induced diabetic Wistar rat models.MAIN OUTCOME MEASURES: ① The recovery rate of the transplanted empty microcapsule; ② Results of bioactivity assessment of the insulin from the microencapsulated islets; ③ Histological examination.RESULTS: Four weeks after the transplantation, the recovery rate of the transplanted empty microcapsules in the purified group was higher that that in non-purified group( P > 0.05), and the purified microcapsules retained intact and smooth morphology with out causing fibrosis. The islets encapsulated by purified sodium alginate-barium chloride microcapsules showed good insulin-ecreting function in in vitro culture, without significant difference from non-microencaps ulated islets( P > 0. 05) . The islets transplanted via the microcapsules into diabetic Wistar rat models induced by STZ had a survival time over 6 weeks.CONCLUSION: The purified sodium alginate-barium chloride microcapsules have good bioactivity and tissue compatibility, which might provide a solution for the source of donor diabetic islets in the treatment of type Ⅰ diabetes.

Objective To evaluate the role of C-type lectin domain family 2,member B (CLEC2B) gene in the pathogenesis of vitiligo.Methods Real time fluorescence-based PCR was performed to detect the expression of CLEC2B mRNA in the peripheral blood and lesional skin of 37 patients with vitiligo as well as in the peripheral blood and normal skin of 40 healthy controls.Data were statistically analyzed by t test and chisquare test.Results Among the 37 patients,23 had progressive vitiligo,14 stable vitiligo,31 vitiligo vulgaris,6 segmental vitiligo.The expression level of CLEC2B mRNA was significantly higher in vitiligo lesions than in the control skin (1.21 ± 0.03 vs.1.00,t =4.432,P ＜ 0.05),but was of no significant difference in peripheral blood between the patients and healthy controls (1.02 ± 0.05 vs.1.00,t =1.435,P ＞ 0.05).Increased expression of CLEC2B mRNA was noted in lesions of vulgaris vitiligo compared with those of segmental vitiligo (1.21 ± 0.03 vs.1.02 ± 0.01,t =5.330,P ＜ 0.05),as well as in lesions of progressive vitiligo compared with those of stable vitiligo (1.25 ± 0.05 vs.1.08 ± 0.03,t =3.046,P ＜ 0.05).No significant difference was observed in the expression of CLEC2B mRNA among lesions of vitiligo with different courses (P ＞ 0.05).Conclusion The differential expression of CLEC2B mRNA may take part in the pathogenesis of vitiligo.

BACKGROUND: The biomechanical property(BP) of the bone is decided by its geometric structure and component material. Merely pursuing increase of the bone mineral density(BMD) might lead to deterioration of bone BP.However at present, some researohes on therapeutic action on osteoporosis emphasize excessively medical influence to BMD, and the change in the holistic BP of the bone in osteoporotic zone and its mechanism still need to investigate deeply.OBJECTIVE: To probe into the action and its mechanism of "the kidney tonifying compound of the Traditional Chinese Medical (TCM) "on BP of cortical bone in ovariectomized osteoporotic model rats.DESIGN: Completely randomized controlled experiment based on experimental animals.SETTING: Laboratory of Biomedical Engineering, Luoyang Hospital and Institute of Traditional Chinese Orthopedics and Traumatology in Henan Province.MATERIALS: The experiment was completed from November 2000 to July 2001 at Research Laboratory of Biomedical Engineering,Luoyang Institute of Traditional Chinese Orthopedics and Traumatology of Henan Province. The healthy Wistar female rats aged 10 months,weighing(350±20) g.METHODS: Fifty Whistar female rats aged 10 months were randomly divided into 5 groups: the normal, model, premarin-treated, xianling gubao-treated and migu capsule-treated with 10 in each group. The normal group was only given sham operation and the other four groups were ovariectomized. The rats after operation were fed normally for ninety days.Since the 91st day after operation,the rats had been given the medicines for 90 days and then killed. The thighbones were taken out,then BMD,femoral geometry sizes and BP were determined.MAIN OUTCOME MEASURES: ① The primary sequel was the comparison of the parameters of femoral BP. ② The secondary sequel was the changes in parameters of femoral geometric structure, area of cortical bone and BMD of every midsectional fomur.RESULTS: Femoral BP worsened significantly,its mechanical intensity reduced,its external diameter diminished,cortical bone area decreased and femoral BMD lowered in osteoporotic model rats. In comparison with the above,in "the kidney tonifying compound ofTCM " groups(migu capsule group and xianling gubao group) femoral BP raised significantly, its mechanical intensity advanced,its external diameter augmented,cortical bone area aggrandized and femoral BMD enhanced.CONCLUSION: "The kidney tonifying compound of TCM" can improve BP of the cortical bone(thighbone) in ovariectomized osteoporosis rats. Its primary mechanism of action is that the TCM compound prescription could enhance"the mechanism of biomechanical response and regulation"(MBRR) of macrostructure of cortical bone,consequently increase femoral external diameter,aggrandize cortical bone area and enhance BMD in ovariectomized rats.

BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation.OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery.METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age,Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type,bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws.

Objective To study the relationship between level of plasma glucose and cognitive function in patients with Parkinson's disease.Methods Two hundred PD patients were assessed cognitive function using Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),Wechsler Intelligence Scale and Wechsler Memory Scale.The patients were divided into cognitive normal group (n=91) and cognitive impairment group (n=109).One hundred twenty-six normal subjects were enrolled as control group (n=126).The levels of fasting plasma glucose (FPG),postprandial plasma glucose (2hPPG),glycosylated hemoglobin (HbAlc) and the prevalence of diabetes mellitus were compared among the groups.The effect of blood glucose level on the cognitive function of PD patients was analyzed by Binary Logistic Regression.Results The levels of FPG,HbAlc and the prevalence of diabetes mellitus [5.19 (0.72),5.7％ (0.5％),14％] were significantly higher than those in the normal control group [4.85(0.79),5.6％ (0.5％),6％] (P＜0.05).The levels of FPG in PD patients with cognitive impairment [5.21 (1.32)] was significantly higher than that in PD patients with cognitive normal group [4.81 (0.95)] (P＜0.05).Although 2hPPG and HbAlc increased slightly in PD patients with cognitive impairment,the difference did not reach an significant level (P＞0.05).Binary Logistic Regression analysis showed that FPG(OR:1.764;95％ CI:0.06-3.244;P=0.068) was not associated with the impaired cognitive function in PD patients.Conclusion The present study has not revealed an association between the incidence of cognitive impairment in patients with PD and plasma glucose level although high plasma glucose may be a high risk factor for PD patients.

OBJECTIVE: To investigate the efficacy and safety of Yisui Shengxue Granule (YSSXG), a compound traditional Chinese herbal medicine, in treating beta-thalassemia. METHODS: A randomized single-blinded trial was designed. Sixty patients with beta-thalassemia were divided into two groups: 30 patients in YSSXG-treated group and 30 in placebo parallel-control group. The patients in the two groups were assigned to receive either YSSXG or placebo for three months. The patients' symptoms and their blood indexes such as hemoglobin (Hb), red blood cell (RBC), reticulocytes (Ret) and fetal hemoglobin (HBF) were examined before and after the treatment. Meanwhile, the liver and spleen were examined with B-mode ultrasound. RESULTS: In the YSSXG-treated group, the blood indexes (Hb, RBC, Ret and HBF) and the symptoms of the patients were improved after three-month treatment, with statistical significance compared to those before treatment (P<0.01); hepatauxe and splenomegaly were also relieved (P<0.05) and no adverse reactions were monitored. In the placebo parallel-control group, no significant improvement of the blood indexes and symptoms, as well as the hepatauxe and splenomegaly had been found (P>0.05). CONCLUSION: YSSXG demonstrates obvious clinical efficacy and no adverse reactions in treating beta-thalassemia.

Objective To analyze and review clinical characteristics of brucellosis and improve awareness of brucellosis and level of diagnosis.Methods Totally 72 in-patients treated for brucellosis from March 2012 to June 2015 in Affiliated Hospital of Jining Medical University were retrospectively analyzed for epidemiology,clinical feature,laboratory data,treatment and prognosis.Results A total of 72 cases were confirmed and included.Thirty seven patients (51.39％) had definitely contact history with raw meat or progeny and 3 (4.17％) with brucellosis patients.The common clinical presentations included persistent fever (100.00 ％,72/72),followed by headache (87.50％,63/72),chills (48.61％,35/72),muscle-joint pain (47.22％,34/72) and cough (43.06％,31/72).The laboratory test showed there were 14 patients (19.44％,14/72) with decreased leukopenia,49 patients (68.06％,49/72) with elevated C-reactive protein and 46 patients (63.89％,46/72) with elevated procalcitonin.Abnormal liver function showed elevated alanine aminotransferase (69.44％,50/72),aspartate aminotransferase (66.67％,48/72) and alkaline phosphatase (61.11％,44/72) with proportions.The mainly abnormal imaging features showed hepatomegaly,splenomegaly,lymphadenopathy,pulmonary infiltrating and nodules.Sixty-five patients (90.28％) had positive blood culture and 13 cases (18.06％) had positive marrow culture.Seventy-two patients were cured after active medical treatment and no recurrence after 1 year of follow-up.Conclusions Brucellosis is a invasive infectious disease with many systemic involvements,whose clinical symptoms are not typical.For those patients with long-term fever of unknown origin and poor effect anti-infection treatment,especially complicated with multi-system damage hepatomegaly,splenomegaly,lymphadenopathy,brucellosis should be suspected and be treated early.