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 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.

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.

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 observe the effect of MG-132 on NF-κB signal path of cartilage and synovium in a rat model of knee osteoarthritis.Methods The rat models of knee osteoarthritis were established by performing anterior cruciate ligament amputation and partial medial meniscectomy.Totally 144 adult SD rats were randomly divided into 4 groups:MG-132 group,100 ml 0.007 g/L MG-132 solution was injected in to the knee joints of rat model 24 h after surgery; DMSO group,100 ml 0.1％ DMSO solution was injected 24 h after surgery; sham surgery group,merely the knee capsulotomy was performed and no solution was injected;control group,100 ml 0.007 g/L MG-132 solution was injected into the knee joints.The cartilage and synovium specimens were obtained at 2,4,12 weeks postoperatively.Pathomorphological observation was taken.The levels of NF-κB p65,I-κB,TNF-α and IL-1β at mRNA were detected by real-time PCR,and the activityof 20S proteasome was measured by fluorospectrophotometry.Resnlts The Mankin score of MG-132 groupwas lower than that of DMSO group.The Mankin scores of sham surgery and control groups were lower thanthose of MG-132 and DMSO groups with significant difference.The mRNA levels of NF-κB p65,IL-1 β,TNF-α of cartilage and synovium in MG-132 group were lower than those of DMSO group with significant differenceexcept for NF-κB p65 of synovium at 2 weeks and IL-1β of cartilage at 12 weeks.The mRNA levels of I-κB of cartilage at 2 weeks and I-κB of synovium at 4 weeks in MG-132 group were higher than those in DMSO group with statistical significance.Conclusion MG-132,the proteasome inhibitor,could postpone the progress of osteoarthritis through alleviating synovial inflammation and defending the articular cartilage.

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 investigate the effect of progressive neurological deterioration ( PND) of cerebral watershed infarction on early prognosis. Methods The consecutive patients with cerebral watershed infarction admitted in the Department of Neurology,Jinling Hospital,Nanjing University School of Medicine and their cerebral watershed infarctions confirmed by the imaging examination from March 2009 to March 2014 were enrolled. The clinical features, laboratory indicators and imaging features of internal watershed infarction,cortical-type watershed infarction,and mixed watershed infarction were identified and analyzed. The National Institutes of Health Stroke Scale was used to score neurological deficit. The modified Rankin scale ( mRS) was used to score the prognosis of patients. Single factor analysis was used to compare the differences between the groups. At the same time,the correlation between PND and poor prognosis of cerebral watershed infarction at day 90 was analyzed by multivariable Logistic regression analysis. Results A total of 89 patients with cerebral watershed infarction were enrolled,including 43 cortical-type watershed infarctions,36 internal watershed infarctions, and 10 mixed watershed infarctions. Single factor analysis indicated that the incidences of PND of internal watershed infarction and mixed watershed infarction were significantly higher than the cortical-type watershed infarction (36. 1% [n=13],50. 0% [n=5], and 16. 3% [n=7],respectively;P=0. 018). At day 90,28 patients had poor prognosis,and mRS was (3.4±1. 0) scores at day 90. There was significant difference in the types of infarction between the patients with poor prognosis and patients with good prognosis (P<0. 05). In patients with poor prognosis, most of them were internal watershed infarctions,accounting for 50. 0% (14/28),while in patients with good prognosis,most of them were cortical-type watershed infarctions(57. 4% [35/61]). The incidence of PND in patients with poor prognosis was significantly higher than that in patients with good prognosis (57.1% [16/28] vs. 14. 8% [9/61];P<0. 05). The result of multivariate Logistic regression analysis showed that after adjustment for confounding factor, PND was independently associated with the poor prognosis of cerebral watershed infarction at day 90 (OR 6. 969,95%CI 2. 451-19. 869;P<0. 01). Conclusion Compared with the cortical-type watershed infarction, the patients with internal watershed infarction is more prone to have PND, and PND is independently correlate with the poor prognosis at day 90.