Depression is one of the diseases with the highest disability rate in the world. A large number of studies have shown that the intake of unsaturated fatty acids can deal with depression while chronic overconsumption of saturated fatty acids is a risk factor for depression. It was suggested that the mechanism of saturated fatty acids inducing depression is related to the following four aspects: regulating the function which links to depression in whole brain and specific brain regions, including the hippocampus, the hypothalamic-pituitary-adrenal axis, the striatum, and the prefrontal cortex; stimulating the secretion of inflammatory factors; affecting the balance and function of metabolic regulatory hormones, including leptin, adiponectin, glucocorticoid, and insulin; inducing the disturbance of intestinal flora. This article reviews the relationship between dietary fatty acids and depression, and the possible mechanisms by which saturated fatty acids induce depression from the four aspects mentioned above.

OBJECTIVE:To investigate the effects of fluvastatin combined with aspirin on the related indicators of patients with diabetic lower extremity arteriosclerosis occlusive desease(LEAOD). METHODS:80 patients with diabetic LEAOD were ran-domly divided into control group(40 cases)and observation group(40 cases). Based on convertional treatment,control group was given Rosuvastatin calcium tablet 5 mg+Aspirin enteric-coated tablet 100 mg every evening;observation group was given Fluvas-tatin sodium capsule 40 mg+Aspirin enteric-coated tablet 100 mg. They were treated for 3 months. Fibrinogen,plasma D-dimer, blood viscosity, cholesterol (TC), triglyceride (TG), glycosylated hemoglobin (HbAlc), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), carotid intima-media thickness, compliance situation of TC, TG, HbAlc,LDL-C and HDL-C,cases of carotid intima thickening,plaque formation,stenosis and occlusion before and after treat-ment were observed,and the incidence of adverse reactions was recorded. RESULTS:After treatment,fibrinogen,plasma D-di-mer,blood viscosity,TC,TG,HbAlc,LDL-C and carotid intima-media thickness in 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group;HDL-C in 2 groups was significantly higher than be-fore,and observation group was significantly higher than control group,with statistical significance (P<0.05). Compliance rates of TC,TG,LDL-C and HDL-C in observation group were significantly higher than control group,proportion of carotid intima thickening and carotid plaque formation were significantly less than control group,with statistical significance (P<0.05),there were no significant differences in the compliance rate of HbA1c,proportion of carotid stenosis and occlusion and the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Fluvastatin combined with aspirin can significantly improve the pa-tients 'blood viscosity,blood lipid,vascular endothelial function in the treatment of diabetic LEAOD,it can reduce the thrombotic disease risk,and does not increase the incidence of adverse reactions.

BACKGROUND: Carotid-femoral pulse wave velocity in hemodialysis patients is influenced by multiple factors.OBJECTIVE: To explore the carotid-femoral pulse wave velocity (PWVcf) changes and related factors in maintenance hemodialysis (MHD) patients.DESIGN, TIME AND SETTING: Non-randomized control experiment was performed at the Third Hospital of Peking University from January to August 2006.PARTICIPANTS: A total of 66 MHD patients were selected from Third Hospital of Peking University.METHODS: General clinical conditions, biochemical indexes, PWVcf and subjective nutritional state were evaluated. MHD patients were divided into two groups according to the state of nutrition evaluated with SGA: non-malnutrition (n=49), malnutrition group (n=17). The PWVcf of two groups was compared, and one-way and multiple regression analyses were performed to explore PWVcf-relatest factors.MAIN OUTCOME MEASURES: PWVcf, blood albumin and parathyroid hormone.RESULTS: PWVcf was significantly positively correlated with age (r= 0.284, P< 0.05), systolic blood pressure (r= 0.468, P<0. 001), and pulse pressure (r=0.451, P< 0.001), while negatively correlated with prealbumin (r=0.318, P< 0. 05),plasma-albumin (r=0.263, P< 0.05), parathyroid hormone (r=0.167, P< 0.05), serum creatinine (r=0.347, P= 0.004)and transferring (r=0.284, P < 0.05) before dialysis. Multiple regression analysis demonstrated that pulse pressure and parathyroid hormone were independently related with PWVcf. The PWVcf was significantly increased in malnutrition group compared with non-malnutrition group (P < 0.05). CONCLUSION: Pulse pressure is the major clinical determinants of arterial stiffness in patients with MHD independent of conventional risk factors for cardiovascular disease; Malnutrition and atherosclerosis are common complications of MHD,showing close relationship. The PWVcf was significantly increased in malnutrition patients.

Pancreatic neuroendoerine tumors (PNET) is a complicated and heterogeneous group of neoplasia,and the incidence of PNET is growing rapidly recently.The current study on PNET lags behind what is known of other pancreatic tumors.Therefore,understanding of the molecular pathology is important for improving the early diagnosis,treatment and prognosis.With the development of molecular biology,there are already several potential targets proved to have application role in treatment of PNET.Here,the authors present the current knowledge about the molecular alterations of PNET.

Objective:To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).Methods:A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively,and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery.The patients undergone cardiac catheterization intervention therapy were guided under the digital substraction angiography (DSA) and were monitored by transthoracic echocardiography (TTE) in the whole interventional process,and the efficacy was evaluated with TTE.The occlusion of transthoracic small incision surgery was guided under the transesophageal echocardiography (TEE),which was used to monitor the position of occluder and evaluate the efficacy immediately.Results:Two kinds of intervention in the occlusion by domestic occluder had achieved satisfactory results in patients with ASD.There was no statistically difference in the longest size of ASD between the 2 intervention methods,while there were statistically differences in the ratio between ASD longest diameter and atrial septal length,and the size of the occlusion,and the disparity between the size of the occluder and ASD longest diameter (D value),respectively (all P＜0.05).When the size of arithmetic mean of the ASD was ＜30 mm,the success rate of the 2 methods was both 100％.When the size of arithmetic mean of the ASD was ≥ 30 mm,the success rate was 100％ in the transthoracic small incision surgery and 50％ in the cardiac catheterization intervention therapy.Conclusion:Domestic occluder is safe.Compared with the imported one,its cost is lower.When the size of the defects is same,the occlusion is smaller in the transthoracic small incision surgery compared with that in the cardiac catheterization intervention therapy.When the size of arithmetic mean of the ASD is ≥ 30 mm,the success rate of the transthoracic small incision surgery is higher compared with the cardiac catheterization intervention therapy.When the cardiac catheterization intervention therapy fails,the transthoracic small incision surgery may be a better choice.

Objective To compare scene simulation teaching method with traditional methods on training in cardiopulmonary resuscitation (CPR) for the practice students. Methods A convenience sample of 62 nursing students in the emergency department of our hospital in 2014 were recruited as the observation group,and 75 practice students in 2013 were recruited as the control group. The observation group used the scene simulation teaching method for students and the control group used the traditional methods. The students′theoretical knowledge, operation skill of CPR and total score of core capability were compared between two groups. Results The theoretical knowledge, operation skill of CPR and total score of core capability in the observation group were (85.23±6.36), (86.90±4.85), (217.98±6.06), significantly higher than those of the control group, which were (75.36±7.77), (82.38±8.84), (209.33±8.91), t= 8.02, 3.60 and 6.50, P<0.01. Conclusions The scene simulation teaching method is an effective form of emergency department training in CPR, help to improve students practice ability and the ability of emergency cardiopulmonary resuscitation.

Objective To compare the difference of early optic nerve damage and visual field defect between primary open angle glaucoma(POAG)and primary angle-closure glaucoma(PACG).Design Prospective case series.Participants 30 eyes of 23 patients with early POAG and 30 eyes of 22 patients with early PACG were recruited.Methods Routine ophthalmologic exams,visual field (Humphrey Field Analysis 24-2),scanning laser polarimetry GDx ECC(Full Exam)were performed.Different types of RNFLD and GDx ECC parameters were compared between the two groups through X square-test and independent samples t-test,respectively.Both the intra-group globe visual indices and retinal sensitivity loss of each illumination target were compared with independent samples t-test. Main Outcome Measure GDx ECC parameters,types of RNFLD,visual indices and retinal sensitivity loss of each illumination target. Results Significant differences in all GDx ECC parameters of the two groups were found except Superior Average and Symmetry.In GDx ECC reports,diffuse RNFLD in POAG and PACG were 40% and 10%,respectively(P＜0.05),while localized RNFLD were 53% and 63%,respectively.The differences of PSD and CPSD between groups were significant.More localized retinal sensitivity loss in the superiotemporal visual field in PACG were found.Conclusion The diffuse RNFL damage of early POAG is more than that of PACG. Differences between POAG and PACG in retinal sensitivity loss of the superiotemporal visual field are found,which are consistent with the RNFL damages.The pattern of RNFL damage and the visual field defects are different both functionally and structurally,which may give insight into the different etiologies of POAG and PACG.

BACKGROUND:The main component of cartilage, type Ⅱ col agen gene expression in chondrocyte is positively correlated with SOX9 concentration in a dose-dependent manner.
OBJECTIVE:To observe the variation of SOX9 and type Ⅱ col agen mRNA content at different periods in the differentiation process (osteogenic, chondrogenic, adipogenic induction) of mesenchymal stem cel s, and to explore the correlation of SOX9 expression and type Ⅱ col agen.
METHODS:Bone marrow mesenchymal stem cel s were isolated from 4-week-old Kunming mice, and cultured in vitro to passage 3. The cel phenotype was identified with flow cytometry. Cel s were divided into three groups and subjected to three kinds of induction conditions favorable for adipogenic, chondrogenic and osteogenic differentiation, and each group was observed at three time points. In addition, the non-induced cel s were used as a control group. The total RNA of cel s was extracted at 3, 7, 14 days after induction, and SOX9 and type Ⅱ col agen mRNA was quantified with reverse transcription-polymerase chain reaction. The induced cel s were stained by immunofluorescence to observe the differentiation and perform statistical analysis.
RESULTS AND CONCLUSION:Passage 3 bone marrow mesenchymal stem cel s grew wel , and cel phenotype was confirmed as stem cel s by flow cytometry. The staining results showed that, the cel s differentiated into chondrocytes, adipocytes and osteoblasts. The SOX9 mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in osteogenic differentiation group, and the lowest in adipogenic differentiation group. Type Ⅱ col agen mRNA levels in the induced cel s were the highest in chondrogenic differentiation group, then in adipogenic differentiation group, and the lowest in osteogenic differentiation group. SOX9 expression in chondrogenic differentiation group increased at 3 and 7 days, and then decreased at 14 days. While type Ⅱ col agen expression increased at 3, 7, 14 days. SOX9 mRNA levels increased as the osteogenic differentiation, while type Ⅱ col agen expression gradual y decreased. There was no significant difference in the SOX9 mRNA expression between adipogenic differentiation group and control group (P>0.05), while type Ⅱ col agen expression was not regularly changed. Experimental findings suggest that, critical effect of SOX9 in chondrogenic differentiation is better than that in osteogenic and adipogenic differentiation. SOX9 is associated with type Ⅱcol agen, which may alter along with the SOX9 in the early chondrogenic differentiation;SOX9 may play a fine-tuning role in the process of chondrogenic and osteogenic differentiation.

Objective To explore the effects of exclusive enteral nutrition (EEN) on the mucosal healing under endoscopy in adults with active Crohn's disease (CD).Methods From August 2011 to August 2012,adults with active CD met the inclusion criteria were prospectively enrolled and treated with EEN for four weeks.CD activity index(CDAI) score,C-reactive protein (CRP) were evaluated once enrolled and by the end of the second and fourth week.Colonoscopy or small intestinal endoscopy examination was conducted once enrolled and by the end of fourth week,and CD simplified endoscopic score (SES-CD) was also caculated.Wilcoxon test was applied to compare the efficacy.Results Eight patients met inclusion criteria and finished the study.Seven cases achieved clinical remission.Compared with those before treatment,both CDAI score and CRP level decreased significantly after treatment (both Z=2.52,both P=0.012).After treatment,two patients achieved mucosal healing and the mucosa of six cases improved.The mucosa healing rate and improvement rate of terminal ileum was higher than that of colon (3/8 vs 1/6; 5/8 vs 3/6).Compared with those before treatment,SES-CD total score and SES-CD score of ileum decreased significantly after treatment (Z=2.23,2.07; P=0.026,0.038).There was no significant difference in SES-CD score of colon before and after treatment (P =0.102).Conclusions EEN could induce clinical remission in adults with active CD,and promote the healing of mucosal ulcer under endoscopy.The healing rate of colon was lower than that of small intestine.

OBJECTIVETo establish a method of determining the residual epoxyethane in medical instruments.

METHODAn HP-5 capillary column (30 m x 0.32 mm x 0.25 microm), an FID detecter and an oven were used in the determination. The oven temperature was kept at 120 degrees C for 8 minutes, the example inlet temperature was kept at 200 degrees C, while the detecter temperature was kept at 250 degrees C.

RESULTThe method has a linear range between 5.1920-51.920 microg, (r = 0.997, n = 6). The average rate of recovery of the injecter is 103.3%. The average rate of recovery of the infusion devices is 81.04%.

CONCLUSIONThe method has been proved to be convenient, sensitive and accurate. It is suitable for the determination of residual organic solvents in medical instruments.