Objective To investigate the therapeutic effects of citalopram on alleviating painful symptoms in type 2 diabetes mellitus(DM) patients with complication of painful peripheral neuropathy.Methods Thirty-eight type 2 DM patients with painful peripheral neuropathy were randomly divided into control group(eighteen patients) and treatment group(twenty patients).The diabetes control(including fasting blood glucose) and general health state(including body mass index,liver function,renal function) of patients were recorded.Patients in control group were given conventional drugs(including hypoglycemic drugs,anodyne,neurotrophy drugs,antiplatelet drugs),and those in treatment group received conventional drugs plus antidepressant drugs(citalopram,20mg,q.i.d.for 14 days).Hamilton Depression Rating Scale for Depression(HAMD-17) was used to assess the depressive symptoms,and numeric pain intensity scale(NPIS) was used to assess the pain intensity on baseline and the 1st,7th and 14th day.At the same time,the levels of analgesic agents were recorded.Results On the 7th and 14th day,the HAMD-17 scores in treatment group(22.14?8.92,18.69?9.4) were significantly lowered compared with that in control group(26.81?9.79,25.71?9.92),P

BACKGROUND: Tumor spinal metastasis is often complicated with pain,limitations in movement, paralysis and poor prognosis.OBJECTIVE: To investigate the factors affecting the recovery of the spinal functions in patients with spinal metastatic carcinoma and its therapeutic methods so as to improve the living quality of the patients with a terminal cancer.DESIGN: A case-controlled observation.SETTING: The Department of Tumor and Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College.PARTICIPANTS: We selected 162 patients with spinal metastatic carcinoma with different degrees of paralysis who received treatment at the Department of Oncology and the Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College between March 1992 and June 2001. They participated in this experiment voluntarily.METHODS:①Radiotherapy and chemotherapy; All the patients were given symptomatic treatment with simple radiotherapy or a combined therapy of simple radiotherapy and chemotherapy, in which the dose of chemotherapy was 2 Gy/time,5 times a week,3 weeks in total. A combined method was used for chemotherapy according to the nature of the different primary tumors. The chemotherapy was conducted for 3 therapeutic courses in average ranging from 2 to 6 courses of treatment with 21 days for each course. ② Physical rehabilitation therapy included exercise therapy, massage (twice/day), functional electrical stimulation (once a day),bladder training and toilet training (once or twice every day), 10 days as a therapeutic course, 3 successive therapeutic courses in total. After the treatment, analgesic pain, muscle power of the limbs and the recovery of defecation function were observed.MAIN OUTCOME MEASURES: Pain-alleviating, muscle power of the limbs and the recovery of defecation function after the operation. RESULTS: Totally 162 patients with spinal metastasis carcinoma were recruited, and all the patients entered the stage of result analysis at the end of therapy with no loss in the midway. ① Pain complete alleviating was in 97 cases (59.88%); no alleveclting in 0 case. ② The condition was remarkably improved in 127 cases(78.40%), and it was not improved in 35 cases (21.60%). The improved rate of muscle power of the patients with one focus and 2 adjacent focuses was 92.98%. The improved rate of the patients with multiple foci was 64.59%. The muscle power of the patients with a disease history of less than 2 weeks was improved remarkably, but there was no change in muscle power in patients with a disease history of more than 2 months. CT or MRI showed that spinal cord at the affected segment of the 21 patients suffered severely compression before the treatment, and only 2 cases were improved in muscle power, with no other changes.③The defecation function of 162 patients all became normal.CONCLUSION: Patients with spinal metastatic carcinoma complicated with paralysis have different degrees of relief and amelioration in pain,muscle power of the limbs and defecation function after radiotherapy,chemotherapy and synthetic rehabilitation therapy. Factors affecting the recovery of spinal function mainly included the length of disease course,compressed degree of the spinal cord, the quantity of metastatic focus, the health status of the patients and therapeutic time and the quality of primary rehabilitation and so on. Mental help to the patients should be paid attention to so as to improve the quality of life at the same time.

Objective To investigate the expression of caspase-3 in colon carcinoma,colon adenoma and normal colon mucosa and its clinical significance.Methods The expression of caspase-3 was detected with immunohistochemical EnVision in 60 cases of colon carcinoma,30 cases of colon adenoma and 30 cases of normal colon mucosa.Results The positive expression rates of caspase-3 in colon carcinoma,colon adenoma and normal colorn mucosa were 18.3％(11/60),50.0％(15/30),86.7％(26/30).There was significant difference among three groups(P＜0.01).The expression of caspase-3 was closely related to Dukes clinical stage,differentiation degree,lymph node metastasis and the degree of infiltration(P＜0.01).Conclusion The low expression of caspase-3 may play an important role in the carcinogenesis of colon carcinoma and it is involved in the metastasis and infiltration.

Objective To explore the role of Color Doppler Flowing Imaging(CDFI) in assessing metastatic lymph node for nasopharyngeal carcinoma (NPC). Methods Neck lymph node were detected by CDFI in 206 patients who received the initial course radiotherapy in our hospital. The characteristic of neck node, such as position, figure, number, size, its relation to surrounding soft tissue, the ratio of longitudinal diameter over trnsverses′(L/T) and blood flow resistance index (RI), were recorded detailedly. Fine needle aspiration biopsy was performed on some of patients under the guide of ultrasound. Results The clinical N-stage was changed markedly after CDFI plus biopsy, with up-staging in 25 from N0 to N1 , 6 N0 to N2, 20 N1 to N2, 3 N1 to N3, 4 N2 to N3; and down-staging in 14 from N2 to N1, 7 from N3 to N2. The misdiagnosis rate of node involvement by palpation was 38.3% (79/206). The sizes of lymph node detected by palpation were larger than those by CDFI (P0.6, and the value would reached to 92.9%(182/196) and 95.5%(107/112)when such criteria combined with the diameter and growth behavior of lymph node. Conclusion Color Doppler Flowing Imaging is useful in N-staging for nasopharyngeal carcinoma by providing more reliable evidence.

The study aims to investigate the effect of the ratio of long axis to short axis (RLS) of upright polypropylene infusion bag on discharging process and to search the best RLS. Aiming at five different RLS (1. 5 : 1, 2 : 1, 3 : 1, 4 : 1 and 5 : 1, respectively) with the volume of 100 mL, 250 mL and 500 mL, respectively, based on finite element method, analyzing the variation of stress distribution, emptying rate, drugging space and steadiness coefficient, etc. For the bags of the same volume, emptying rate increased with increasing of RLS, but the steadiness coefficient decreased with increasing of RLS. The specific increasing amplitude of emptying rate and decreasing range of steadiness coefficient were as follows: 20% and 49% for 100 mL infusion bag, 9% and 51% for 250 mL infusion bag, and 11% and 46% for 500 mL infusion bag, respectibvely, when RLS increased from 1. 5 : 1 to 5 : 1. Comparatively speaking, the increasing amplitude of the emptying rate is remarkably less than the decreasing range of the steadiness coefficient. By comprehensive consideration of both emptying rate and steadiness coefficient, lower RLS is recommended for upright polypropylene infusion bag.
Drug Delivery Systems ; instrumentation ; Finite Element Analysis ; Polypropylenes

Objective To understand the status of depression and quality of life in the patients with advanced gastric cancer , and to explore their relationship .Methods The depression self rating scale (SDS) and the Chinese Scale of World Health Organiza‐tion Quality of Life Scale‐Brief Form Questionnaire (WHOQOL‐BREF) were adopted to conduct the questionnaire investigation on 131 patients with advanced gastric cancer ,then the results were compared with those of the health population .Results Among 131 patients with advanced gastric cancer ,the prevalence rate of depression was 47 .33% ,and the average SDS score was 45 .99 ± 15 .47 ,which were higher than those of the health population .The scores of quality of life were 61 .61 ± 12 .66 for the physiologic health domain ,59 .54 ± 12 .49 for the mental health domain ,64 .95 ± 14 .16 for the social relation domain and 52 .93 ± 14 .07 for the surrounding environment domain .There was a significant correlation between the depression score with the four domains scores of life quality ,in which the correlation with the mental health domain was strongest (r= -0 .636 ,r2 =0 .405) .Conclusion High depression level and poor quality of life exist in the patients with advanced gastric cancer ,and there is a correlation between them , in which the correlation between depression with the mental health domain is strongest .

Objective To investigate the mechanism of an inhibitor of NADPH oxidases,diphenylene iodonium (DPI),in preventing radiation-induced lung injury.Methods Totally 48 adult SD male rats were randomly classified into 4 groups:control group (C),radiation group (R),radiation plus DPI group (R + D) and DPI group (D).The radiation induced pulmonary injury model was preformed by using 6 MV X-rays to deliver 8 Gy per day for 5 consecutive days with 40 Gy in total to the thorax of each animal.Rats in R + D group were subcutaneously administered with 0.02％ DPI (1 mg/kg) at 1 h prior to radiation while rats in D group received the same dose of DPI without radiation.DPI was given from 3 d before radiation to 30 d after the first radiation.Rats in C and D groups received the same dose of saline.Animals were sacrificed at 1 month and 6 months after radiation,respectively.The lungs were removed and processed for HE and Masson staining,hydroxyproline content measurement,and TGF-β1 immunohistochemical detection.Results At 1 month post-radiation,rats in R group showed typical alveolitis,the level of hydroxyproline was (0.69 ± 0.05) μg/mg,and the positive area of TGF-β1 expression was (39.97 ± 0.90) ％,while the level of hydroxyproline in R + D group was (0.55 ± 0.03) μg/mg and the positive area of TGF-β1 expression was(33.83 ± 1.55) ％,rats in R + D group showed less severe alveolitis compared with R group(t =5.32,5.93,P ＜0.05).At 6 months post-radiation,rats in R group showed typical lung fibrosis with hydroxyproline level of (1.04 ±-0.02) μg/mg and TGF-β1 expression of (37.80 ± 0.85) ％,whereas the hydroxyproline level in R + D group was (0.85 ± 0.02) μg/ mg,the TGF-β1 expression was(23.93 ± 1.16)％,rats in R + D group showed moderate lung fibrosis(t =15.77,16.68,P ＜ 0.05),rats in C and D group had no noticeable changes.Conclusions Diphenylene iodonium could prevent radiation-induced lung injury by reducing the level of hydroxyproline and the expression of TGF-β1.

Objective To analyze psychological status of the donors and the recipients before and after the relative kidney transplantation.Method Symptom checklist 90 (SCL-90) were performed for 147 renal transplant recipients and donors preoperative and postoperative.Statistical analysis were performed to analyze the scores between the recipients,donors and normal standards.Results Over 90％ recipients were of obvious anxiety preoperative.The scores of most factors of recipients were significantly higher than those of donors.The scores of somatization,interpersonal sensitivity,depression,anxiety,hostility,phobia and paranoia between two groups has statistical significance(P＜0.05).Part of recipients retest SCL-90 3 month after operation,the data showed that the scores of somatization,interpersonal sensitivity,depression,anxiety,hostility were obviously declined after operation(P＜0.05).And the test also showed that most of the donors were willing to help preoperative.Conclusion Preoperative psychological test was useful in preoperational psychological intervention for transplantation recipients.It can increase the safety of the recipients during perioperative period.