OBJECTIVE:To observe therapeutic efficacy and side effect of perospirone in the treatment of elderly depression. METHODS:64 elderly patients with depression were randomly divided into paroxetine combined with perospirone group (drug combination group) and paroxetine group (single drug group) with 32 patients in each group. Both groups were given paroxetine 20-40 mg/d,and drug combination group was additionally given perospirone 4-8 mg/d. HAMD and CGI-SI were adopted to evalu-ate therapeutic efficacy after 8 weeks treatment,and side effect was evaluated with TESS scale;those were compared between 2 groups. RESULTS:After 8 weeks treatment,the effective rate of drug combination group and single drug group were 75.0% and 50.0%;there was statistical significance(P<0.05). There was statistically significant difference in HAMD and CGI-SI scores be-tween two groups(P<0.05). There was no statistically significant difference in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Small-dose of perospirone can improve therapeutic efficacy of paroxetine in the treatment of elderly depression with less side effect and good safety.

Objective To carry out a systematic study on the chemical constituents in the fruits of Momordica grosvenori. Methods To isolate pure compounds by using repeated column chromatography,while the structure of a new compound was determined by detailed spectral analysis. Results Four cucurbitane triterpenoid glycosides, mogroside Ⅱ E (Ⅰ), mogroside Ⅲ (Ⅱ), grosmomoside Ⅰ (Ⅲ), and mogroside Ⅴ (Ⅳ) were isolated from the 50% ethanolic extract of the fruits of M. grosvenori. Conclusion Grosmomoside Ⅰ is a new compound identified as mogrol-3-O-β-D-glucopyranoside-24-O-{[β-D-glucopyranosyl (2-1 ) ]- [β-D-glucopyranosyl (6-1 ) ]-β-D-galactopyranoside } and the other three compounds are known compounds.

Objective To carry out a systematic study on the chemical constituents in the fruits of Momordica grosvenori. Methods To isolate pure compounds by using repeated column chromatography, while the structure of a new compound was determined by detailed spectral analysis. Results Four cucurbitane triterpenoid glycosides, mogroside Ⅱ_E(Ⅰ), mogroside Ⅲ(Ⅱ), grosmomoside Ⅰ (Ⅲ), and mogroside Ⅴ (Ⅳ) were isolated from the 50% ethanolic extract of the fruits of M. grosvenori. Conclusion Grosmomoside Ⅰ is a new compound identified as mogrol-3-O-?-D-glucopyranoside-24-O-{[?-D-glucopyranosyl(2-1)]-[?-D-glucopyranosyl (6-1)]-?-D-galactopyranoside} and the other three compounds are known compounds.

Objective To study anti-inflammatory, analgesic and immunomodulatory effect of total flavone in culture of Saussurea medusa Maxim and the wild one. Methods Different pain, inflammatory and immune models were made to investigate the anti-inflammatory, analgesic and immunomodulatory effect of total flavone in culture of Saussurea medusa Maxim and the wild one such as paw edema in mice, ear edema in rats and so on. Results There are obvious analgesic effect in pain caused by heat in total flavone in culture of Saussurea medusa Maxim and the wild one, and they have obvious restraining effect on paw edema in mice and ear edema in rats as well as on the function of transformation of lymphocyte T and B in rats. Moreover, there is no obvious difference between total flavone in culture of Saussurea medusa Maxim and the total flavone of the wild one. Conclusion Total flavone in culture ofSaussurea medusa Maxim and the wild one possess anti-inflammatory, analgesic and immunomodulatory effect, and there is no obvious difference between them.

Objective To study the chemical constituents in the fruits of Momordica grosvenori. Methods Isolation and purification of the constituents were carried out on column chromatography. Their structures were identified by NMR and MS spectral analyses. Results Ten compounds were isolated and elucidated as kaempferol (Ⅰ), kaempferol 7-O-?-L-rhamnopyranoside (Ⅱ), kaempferitrin (Ⅲ), mogroside ⅡE (Ⅳ), mogroside Ⅲ (Ⅴ), kaempferol 3-O-?-L-rhamnopyranoside-7-O-[?-D-glucopyranosyl (1-2)-?-L-rhamnopyranoside] (Ⅵ), mogroside ⅣA (Ⅶ), grosmomoside Ⅰ (Ⅷ), mogroside Ⅴ (Ⅸ), and mogroside ⅡA1 (Ⅹ). Conclusion Compounds Ⅶ and Ⅹ are new natural products, and Ⅰ is isolated from the fruits of M. grosvenori for the first time.

High-speed counter-current chromatographic ( HSCCC ) method was successfully used to separate and purify prim-O-glucosylcimifugin and 5-0-methylvisammioside from Saposhnikovia divaricata(Thicz. ) Schis-chk. ,a traditional Chinese herb,with a solvent system composed of ethyl acetate-n-butanol-water(2:7:9,V/V). The lower phase of the system was used as the mobile phase at the flow rate of 2.0 mL/min,and the upper phase was used as the stationary phase. The separation produced a total 13.9 mg prim-O-glucosylcimifugin and 25.0 mg 5-0-methylvisammioside with the purity of 98. 1% and 99.2% determined by high performance liquid chromatography (HPLC) from 316 mg of crude sample from S. divaricata. The structures of isolated compounds were identified by ESI-MS,~1H NMR and ~(13)C NMR.

Objective To investigate the clinical manifestation and management of acute cholangitis severe type (ACST) with different typos of obstruction. Methods From January 1997 to December 2006, 164 consecutive patients with ACST had been admitted to Chengdu First People's Hospital. All patients were divided into extrahepatic type group (n=122), intrahepatic type group (n=18) and mixed type group (n=24) accord-ing to the types of obstruction. Clinical manifestation and therapeutic outcome of the 3 groups were analyzed using chi-square test, continuity correction test or Fisher exact test. Results There was no significant difference in clinical manifestation between patients with extrahepatic type and those with mixed type (P>0.05). The incidence of jaundice and abdominal pain in patients with intrahepatic type is significantly lower than those with extrahepatic type (P<0.05). The incidences of distention in consciousness and response to initial medical treat-ment were higher than those with extrahepatic type (P<0.05). The total mortality rate was 9.8% (16/164). Of all patients, 123 received open surgery. There was no significant difference in morbidity and mortality in patients with intrahepatic type and mixed type (χ~2=0.172,0.789; 1.769, 1.948, P>0.05). In emergency operation, the incidence of biliary high pressure and postoperative vital sign improvement rates were significant higher in patients with extrahepatic type than the other 2 types (P<0.05). The morbidity and mortality of patients who received emergency operation were higher than non-emergency operation (P<0.05). Conclusions The clinical manifestation of ACST is different between intrahepatic obstructive type and the other 2 types. There is no signi-ficant difference in morbidity and mortality among the 3 types of obstruction. The morbidity and mortality are high in patients who received emergency operation. Proper management of surgical timing is helpful in decreasing the morbidity and motality of ACST.

Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.

Objective: To investigate the effects of psycholog ical factors on treatment and outcome of patients with high altitude pulmonary e dema(HAPE). Methods: In the present study, one hundred and fifty -two patients with HAPE were tested by hospital anxiety and depression scale. Results: The results showed that there were 61 patients (40.13%) with anxiety and 29 patients (19.08%) with depression. The important factors on mental state of patients were preventive education, the first time suffering HA PE, characters of patients, degree of the disease and the medical fee, the less w ere age, sex, occupation and education of patients. Duration of rales of lung an d course of illness were significantly prolonged in HAPE patients with mental di sorders compared to the patients without mental disorder. Conclusion:The study suggests that anxiety and depression might aggravate the state of HAPE.

Objective To evaluate the bonding condition of hydroxyapatite (HA)/zirconia ( ZrO2 ) composite and bone interface and the ability of HA/ZrO2 in repair of bone defects.Methods Bone defect models were established in the lumbar vertebral body of 24 Beagle dogs and were implanted with HA/ZrO2 gradient composite (Group A ),HA/ZrO2 unilayer composite (Group B ),pure ZrO2 (Group C) and pure HA (Group D) successively.Dogs were sacrificed and lumbar vertebral specimens were harvested 6,12,16 weeks postoperatively and before the sacrifice at postoperative 6 and 12 weeks,the dogs were intramuscularly administered of quadracycline for fluorescence labeling.The interface bonding and repair of bone defects were observed through X-ray films,histomorphology and biomechanical test.Results The X-ray films displayed that the Group A achieved more formation of osteotylus and better repair of bone defects with the extension of the implantation period,followed by the Groups B and D and that the Group C had relatively worse results.Histomorphology study showed that the fluorescence labeling was enhanced gradually from 6 to 12 weeks in the Group A,with its growth from the edge of the implanted material to the inner part and its tight adhesion to the material,indicating active osteogenesis and massive bone formation.While the fluorescence labeling of the Groups B,C and D centered in the edge of implanted materials without presence in the material inner part.The mineralization rate of the four materials at 6 and 12 weeks had significant differences ( P ＜ 0.05).Synostosis rates at 6,12 and 16 weeks were the highest in the Group A,with the rate of up to (90.26 ±3.82) ％ at 16 weeks (P ＜0.05 ).Biomechanical test showed the maximum shear strengths at 6,12,16 weeks in the Group A were (2.64±0.16) MPa,(2.95 ±0.19) MPa and (3.45 ±0.23) MPa respectively (P＜0.05).Conclusion HA/ZrO2gradient biocomposite bonds well with the bone and possesses good repair ability for bone defects and hence is an ideal novel material for bone defect reconstruction.