Objective: To observe the clinical efficacy of tuina in treating depression.Method: Eighty depression cases that conformed to the inclusive criteria were randomized into tuina and Deanxit group, with 40 cases in each group. Tuina manipulations were adopted for cases in the tuina group, 30 min for each treatment. While 2 Deanxit tablets were adopted for cases in the Deanxit group, twice a day. The clinical efficacy of the two groups was evaluated by using Hamilton Rating Scale for Depression (HAMD) before treatment and the 2nd, 4th and 6thweeks after. In addition, the Treatment Emergent Symptom Scale (TESS) was adopted to evaluate the adverse reactions in the two groups. Result: Both tuina and Deanxit can help to relieve the symptoms of depression patients. The effective rate of tuina and Deanxit were 72.5% and 70.0% respectively. However, there were no adverse reactions in tuina group, while 12.5% of adverse reaction rate occurred in the Deanxit group. Conclusion: Tuina can definitely benefit patients with depression and cause no adverse reactions.

AIM: To observe the effects of aspirin and prostaglandin E_2 (PGE_2) on the cell viability and cell cycle in SW1990 human pancreatic carcinoma cell lines, and to investigate the mechanisms of aspirin-induced growth inhibition and cell cycle arrest. METHODS: After incubated with aspirin or PGE_2 and their combination, the viability of SW1990 cells was measured by MTT assay. The levels of intracellular PGE_2 were determined by ELISA. The effects of aspirin or PGE_2 on cell cycle were investigated by flow cytometry (FCM). The expression of p21~ Wafl/cipl and p27~ Kipl/pic2 (the cyclin-dependent kinase inhibitors) were analyzed by Western blotting. RESULTS: Aspirin could inhibit the growth of cells and level of intracellular PGE_2 in a dose-dependent manner. Aspirin enhanced the expression of p21~ Wafl/cipl and p27~ Kipl/pic2 and induced cell cycle arrest at G_0/G_1 phase. PGE_2 increased the cell viability of SW1990 cells. However, it couldn't antagonize the changes of cell viability and cell cycle that induced by aspirin. CONCLUSIONS: The inhibitory effects of aspirin on growth and cell cycle of pancreatic carcinoma cells might not be mediated by a COX-dependent pathway completely. Cell cycle arrest induced by aspirin might be associated with up-regulation of p21~ Wafl/cipl and p27~ Kipl/pic2 .

Objectives To prospectively investigate the diagnostic accuracy,image quality and radiation doses of prospectively ECG-triggered high-pitch spiral acquisition computed tomography coronary angiography (CTCA) using Flash dual-source CT for the diagnosis of significant coronary stenoses.Methods Seventy-three patients underwent both CTCA and CCA.CTCA was performed using a Flash dual-source CT system with data acquisition at a high-pitch of 3.4.CCA served as the standard of reference.Radiation dose values were calculated using the dose-length product.Results There were 925 vessel segments in 73 patients.(1)Diagnostic accuracy: the sensitivity,specificity and positive and negative predictive values were 93.2％ (164/176),96.4％ (722/749),85.9％ (164/191),98.4％ (722/734) for segment assessment and 98.4％ ( 123/125 ),87.4％ ( 83/95 ),91.1％ ( 123/135 ),97.6％ ( 83/85 ) for vessel assessment and 100％ (44/44),89.7％ ( 26/29 ),93.6％ ( 44/47 ),100％ ( 26/26 ) for patient assessment.( 2 ) Image quality: there were 2 coronary segments of right coronary artery and one segment of left circumflex artery with non-diagnostic image quality.There was no non-diagnostic image quality in left anterior descending artery.(3) Radiation dose: the effective radiation dose was ( 1.14 ± 0.10) mSv.Conclusions CTCA using the prospectively ECG-triggered high-pitch spiral mode of the Flash dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low dose.

Objective To investigate the clinical characteristics of posterior malleolar ankle fracture, and the selection of the surgical approach. Methods From January 2013 to September 2015, 83 cases of posterior malleolar fractures were retrospectively analyzed. Haraguchi typing was performed based on the three-dimensional CT. There were 54 cases with HaraguchiⅠtype, 16 cases with HaraguchiⅡtype, and 13 cases with HaraguchiⅢtype. The patients who were HaraguchiⅠand Haraguchi Ⅲtypes accepted the operation with posterolateral approach. The patients who were HaraguchiⅡtype and combined medial malleolus fracture accepted the operation with medial approach. The HaraguchiⅡpatients who were not combined medial malleolus fracture were used the medial paraachilles approach. Images of the ankle joint were filmed 2 weeks, 4 weeks, 12 weeks, 6 months and 12 months after the surgery. The healing time, complications and corresponding record outcome were determined by X-ray and clinical examination. At the last follow-up, ankle function and quality of life of patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and SF-36. Results Eighty-three patients were follow-up for 6-24 (mean 15.4± 6.2) months. The fractures healed on X-ray. The average X-ray healing time was from 12 to 24 (mean 18.6±4.2) weeks. AOFAS score was 71 to 100 (mean 88.4±8.4) points. Sixty-seven cases were excellent, 14 cases were good, 2 cases were moderate, and good rate was 97.59%. SF-36 physiological score was 31.6-69.2 points(mean 48.4 ± 4.8 points);SF-36 psychological score 28.6-64.5 points(mean 45.8 ± 3.5 points). Chronic ankle pain was complained by one patient. He was diagnosed traumatic arthritis, oral non-steroidal drugs was used to relief his ankle pain. One patient wound infected, and healed after treatment. No instrument failure and fracture displacement were found. Conclusion According to fracture morphology and clinical features after posterior malleolar ankle fracture, different surgical approaches are selected, which will be satisfied with the outcome.

Objective To explore the influence of G4 cyberknife treatment of large hepatocellular car-cinoma on liver function,and to evaluate its treatment safety.Methods Sixty-three large liver cancer patients treated with routine G4 cyberknife treatment were retrospectively analyzed,and then statistical analysis of the difference in liver function before and after treatment was conducted.Results After G4 cyberknife treatment of 1 2 months,the levels of ALT,ALP,TBIL,PA were respectively 23.00 U /L,1 1 1 .00 U /L,1 3.70 μmol/L, (81 .87 ±1 3.94)%.Compared with the levels before treatment [28.00 U /L,32.00 U /L,1 1 .30 μmol/L, (86.07 ±1 4.07)%],there were no signi-ficant differences found (Z =-1 .677,P =0.094;Z =-0.504, P =0.61 4;Z =-1 .945,P =0.053;t =1 .271 ,P =0.21 3).The level of ambumin was (34.84 ±4.75)g/L at 1 2 months after treatment,which decreased and the difference compared with the level before treatment [(37.45 ±4.1 4)g/L]was significant (t =3.357,P =0.002).The Child-Pugh grade was 5.80 ±1 .1 7 respectively at the time points of 1 2 months after treatment,and no significant difference was found compared with the Child-Pugh grade before treatment (5.48 ±0.81 ,t =-1 .668,P =0.1 06).Conclusion G4 cyberknife treatment does not cause liver injury.It is safe and reliable in large liver cancer treatment.So,it is worth widely clinical popularizing.

Objective To invesigate the influence of breathing motion on intensity-modulated radiotherapy (IMRT) of chest wall after radical mastectomy,and explore clinical value of accurately determined target volume.Methods A total of 17 radical mastectomy patients underwent 3DCT simulation scans sequentially followed by 4DCT simulation scans during free breathing.The targets and normal organs was determined based on CT images respectively.Three sets of radiotherapy plan were designed for each patient:plan 3D,plan 4D and plan 3D-A.The Plan 3D and plan 4D was designed based on 3D and 4D targets respectively.Plan 3D was copied to 4D target with the same isocenter coordinates.The dose distribution was calculated separately to evaluate the dose-volume histograms parameters for PTV,ipsilateral lung and heart,respectively.Two planning parameters was compared with paired t-test or Wilcoxon sign-rank test.Results The average volume of PTV4D was (10.35 ± 4.80) ％ larger than PTV3D (P =0.000).Compared with plan 3D,the V100,V95,V90,D95,D90,Dmin of plan 3D-A were reduced,that were (0.78 -18.0)％ (P=0.000),(0.01-3.90)％ (P=0.000),(0-2.12)％ (P=0.000),(13-222) cGy (P=0.000),(1-118) cGy (P=0.000),(6-1 910) cGy (P=0.000).However,the V20,V10,V5,Dmean of the ipsilateral lung and V30 of heart were same between 3D plan and 4D plan (P =0.288,0.407,0.435,0.758,0.575).Conclusions The respiratory motion may reduce the target dose and its coverage in chest wall treatments,so 4DCT plan could accurately define target volume without increasing the exposure dose of normal tissues.

Objective To explore the operation indication feasibility,operation technique and clinical effect of complex tibial plateau fractures with semilateral position through combined approaches.Methods From April 2011 to June 2013,data of 25 patients with complex tibial plateau fractures who were treated by open reduction and interal fixation with semilateral position through anterior lateral incision and an inverse L shaped incision were retrospectively analyzed.There were 15 males and 10 females,with an average age of 49.7 years old (range,30 to 70 years old).21 cases were traffic accident injuris and 4 cases were hurt by falling injuries from bicycle.All of the fracture patterns were three pillars of closed fracture of type Ⅵ according to Schatzker classification.The time at surgery was 5-21 days (mean,9.5 days) after injuries.The posterior condylar and medial condylar fractures were dealt with inverse L shaped incision,and fixated with anatomical locking plate and T shaped plate.The lateral condyle fractures were dealt with anterior lateral incision,and fixated with anatomical locking plate.Results Operating time was 150-250 min with an average time of 197.6 min.Intraoperative blood loss was 150-300 ml with an average of 232 ml.25 patients were followed-up,and the average duration of follow-up was 17.8 months (range,12-24 months).Fracture healing time was 16-24 weeks with an average of 19 weeks.At the time of the latest follow-up,X-ray showed all the knee joint had smooth surface,and there was no obvious varus or valgus deformity.One year later,the flexion of the knees achieved 115.2° (range,100°-130°),and the straighten reached 0°.The mean Rasmussen's score of all the patients were 14-18 (average,16.6),and there were excellent in 11 cases and good in 14.Bassed on the KSS score,the mean score was 88.6 (range,66-96) one year after operation.The excellent and good rate was 96％ (24/25).2 patients had fat liquefaction of anterolateral incision wound dehiscence,local skin necrosis,and they got good outcomes after debridement dressing and secondary suture.Conclusion Multi plate fixation is more effective and safty treatment for complex tibial plateau fractures which can be operated completely through fixed half lateral position,and the knee joint is allowed to do early functional exercise,achieving good clinical efficacy and good knee function.

Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the Xiehe pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( ＜ stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P ＜0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P ＞0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions Xiehe pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

Objective To screen down regulated genes and find down regulated novel genes in gastric cancer. Methods Genes mRNA expression were detected between gastric cancer and normal gastric mucous membrane of five patients using cDNA microarray. Genes mRNA expression signals on hybridization membranes were analysized with computer software. Down regulated genes in gastric cancer were screened. cDNA suppression subtraction library was established by counterpart normal gastric mucous membrane mRNA(Tester) subtracting gastric cancer tissues mRNA(Driver) of five patients. After identification of the subtraction library, positive clones choosen randomly were sequenced , and down regulated novel genes in gastric cancer were screened. Some of the genes were identified by RT PCR.Results Down regulated genes in gastric cancer consist of 60 genes including tumor suppressing genes, apoptosis related genes, DNA replication and transcript or translate related genes, cell cycle related genes, cell migration related genes, etc. Two unknown gene fragments in gastric cancer were cloned. Conclusions Sixty down regulated genes in gastric cancer are confirmed. They are involved in gastric tumorigenicity and metastasis. cDNA subtraction library of gastric cancer was constructed successfully. Two down regulated novel gene fragments in gastric cancer was found.

Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.