To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini-Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow-up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.
Anxiety ; Atropine ; Cognition ; Cognition Disorders ; Depression ; Depressive Disorder, Major ; Electric Stimulation Therapy ; Electroconvulsive Therapy ; Follow-Up Studies ; Humans

A UPLC method has been developed for simultaneous determination of nine furanocoumarins of Angelica dahurics,and was used for quality evaluation of A. dahurica from different habitats. ACQUITY UPLC BEH C18 chromatographic column was employed,the separation was performed with the mobile phase consisting of acetonitrile and water,and the detection wavelength was set at254 nm. This method was used to simultaneously determine the content of xanthotoxol,oxypeucedaninhydrate,byak-angelicin,psoralen,xanthotoxin,bergapten,oxypeucedanin,imperatorin and isoimperatorin in A. dahurica from different habitats. Then,the further quality assessment of the drug was carried out by similarity evaluation,cluster analysis( CA),principal component analysis( PCA),and orthogonal partial least squares discriminant analysis( OPLS-DA). The content order of measured furanocoumarins from high to low was: oxypeucedanin>imperatorin>isoimperatorin>oxypeucedaninhydrate>bergapten>byak-angelicin>xanthotoxin>xanthotoxol>psoralen,with the mean content 2. 844,1. 277,0. 649 2,0. 216 2,0. 129 8,0. 062 68,0. 052 68,0. 019 30,0. 018 19 mg·g-1,respectively. There were difference between the batches of the drug,and the quality was influenced by smouldering sulphur based on the results of chemical pattern recognition and content determination. Finally,six active ingredients were recognized as the quality makers using OPLS-DA method. The validated UPLC fingerprint combined with chemical pattern recognition method can be used in the quality control and evaluation of A. dahurica.
Angelica ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; standards ; Ecosystem ; Furocoumarins ; analysis ; Quality Control

OBJECTIVE: To compare the clinical effects of closed reduction and internal fixation with limited transtarsal sinus incision in the treatment of Sanders type II calcaneal fractures. METHODS: From June 2015 to February 2018, 60 patients with Sanders type II calcaneal fractures were treated by minimally invasive method. According to the different treatment methods, they were divided into two groups: closed prying reduction and internal fixation with hollow nails(group A) and limited transtarsal sinus incision internal fixation (group B). There were 34 cases in group A, including 22 males and 12 females, aged 21 to 60(38.90±3.25) years old, 14 cases of Sanders type IIA, 14 cases of Sanders type IIB and 6 cases of Sanders type IIC. There were 20 cases in group B, including 14 males and 6 females, aged 20 to 59(39.20±2.96) years old, 8 cases of Sanders type IIA, 9 cases of Sanders type IIB and 3 cases of Sanders type IIC. Calcaneal height, calcaneal width, Gissane angle and Bohler angle were measured before and after operation. The complications, hospitalization time and cost were compared. Functional evaluation was performed by AOFAS score system one year after operation. RESULTS: Fifty-four cases were followed up for 6 to 16(11.40±2.55) months and 6 cases were lost. All the wounds healed in grade A without complications such as skin infection and necrosis. There were 1 case of nerve injury in group A, 2 cases of tendon entrapment, 2 cases of nerve injury in group B, there was no significant difference(>0.05). There was no significant difference in calcaneal width, height, Bohlers angle and Gissane angle between group A and group B (>0.05). There was no significant difference in AOFAS score between group A and group B(89.2±4.7 vs 88.7±4.8, >0.05). The hospitalization expenditure and length of stay in group A were(5 021.25±1 047.19) yuan, (6.31±4.75) d, and those in group B were(13 591.35±1 975.21) yuan, (9.65±3.42) d, respectively, with significant difference(<0.05). CONCLUSIONS Closed reduction and internal fixation is as effective as transtarsal sinus incision reduction and internal fixation for Sanders typeIIfracture. It has the advantages of less trauma and fewer complications. Closed reduction and hollow nail fixation group can significantly shorten hospitalization time, reduce hospitalization costs, and is more economical. It is worth recommending, but attention should be paid to avoid choosing to comminute serious calcaneal fracture.
Adult ; Ankle Injuries ; Calcaneus ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the effects of apple polyphenols on pulmonary vascular remodeling in rats with pulmonary arterial hypertension and its mechanism. METHODS: Rats were randomly divided into 4 groups:control (Con) group, monocrotaline (MCT) group, apple polyphenol (APP) group,monocrotaline + apple polyphenol (MCT+APP) group. In Con group, rats received a subcutaneous injection of physical saline. In APP group, rats received intraperitoneal injection of 20 mg/kg APP, every other day. In MCT group, rats received a single subcutaneous injection of MCT(60 mg/kg). In MCT+APP group, rats received subcutaneous injection of 60 mg/kg MCT followed by an intraperitoneal injection of 20 mg/kg APP every other day. All the disposal lasted 3 weeks. Then the PAH-relevant indicators, such as mean pulmonary artery pressure(mPAP), pulmonary vascular resistance(PVR), right ventricular hypertrophy index (RVHI) ,wall thickness (WT%) and wall area (WA%) were tested. After that, the inflammatory pathway related indicators, such as interleukin1(IL-1),interleukin1(IL-6), tumor necrosis factor α(TNF-α), cyclooxygenase 2(COX-2) and myeloperoxidase(MPO) in pulmonary tissue and free intracellular Ca in pulmonary smooth muscle cell(PASMC), content of eNOS and NO in endothelial cells were determined. RESULTS: Compared with the control group, the levels of mPAP, PVR, RVHI, WA%, WT%, and IL-1, IL-6, TNF-α, COX-2, MPO in tissue and the expression of Ca in PASMC of MCT group were increased significantly, while the contents of eNOS and NO in endothelial cells were decreased significantly (P＜0.05). Compared with the MCT group, the apple polyphenol treatment could improve the above mentioned situation, and the COX-2 and Ca indicators of the apple polyphenol treatment group were decreased significantly (P＜0.05). CONCLUSION MCT can increase COX-2 expression and intracellular Ca in pulmonary artery smooth muscle cells, decrease the contents of eNOS and NO in endothelial cells, while apple polyphenols can significantly inhibit these effects.
Animals ; Calcium ; metabolism ; Cyclooxygenase 2 ; metabolism ; Cytokines ; metabolism ; Malus ; chemistry ; Monocrotaline ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Polyphenols ; pharmacology ; Pulmonary Artery ; drug effects ; pathology ; Random Allocation ; Rats ; Vascular Remodeling ; drug effects

Objective To determinate the seroprevalence of hepatitis E virus (HEV) exposition among HIV-infected people in Hubei Province so as to provide basic data for effective prevention and control of HIV and hepatitis E virus． Methods A total of 335 serum samples of HIV-infected people were collected from January to June 2017．Serum samples were subjected to anti-HEV IgG andanti-HEV IgM screening. Data were statistically analyzed. Results In 335 HIV-infected people，0.89% (3/335) of serum samples were anti-HEV IgM positive and 41.49% (139/335) of them were anti-HEV IgG positive．The anti-HEV IgG positive rate was not linearly correlated with age ( 2linear=0.756，P=0.385), and there was no significant difference between the age groups (P>0.05). There was no significant difference in anti-HEV IgG positive rate between different gender( 2=0.085，P=0.771)．Anti-HEV IgG positive rate for the crowd with CD4 value ≤ 200 cell/μl was higher than that with CD4 ＞200 cell/μl，but showed no significant difference( 2=1.016，P=0.314)，and CD4 indexes of three positive anti-HEV IgM patients were 222, 446 and 198 in cell/μl．The anti-HEV IgG positive rate in HIV-infected population in eastern Hubei (30.77%, 32/1 041) was statistically different from that in central Hubei (47.92%, 46/96) ( 2=6.169，P=0.013) , and it was also different from that in southeastern Hubei (45.79%， 49/107) ( 2=5.034，P=0.025). Conclusions There were higher HEV infection rate among HIV-infected people in Hubei Province; thus, it is essential to positively carry out double-way screening for these two diseases at the same time, and effective prevention and control of these viruses are required.

Background: Deceleration capacity (DC) is a non-invasive marker for cardiac autonomic dysfunction; however, few studies have shown that the influence factors of cardiac autonomic dysfunction and the correlations between DC and stroke risk in paroxysmal atrial fibrillation (AF). We aimed to explore the influencing factors of abnormal DC and the relationships between DC and stroke risk in patients with paroxysmal AF. Methods: The study included hospitalized paroxysmal AF patients with DC measurements derived from 24-h Holter electrocardiography recordings taken between August 2015 and June 2016. Multivariable regression analysis was performed to evaluate the associations between correlated variables and abnormal DC values. The relationship between DC and ischemic stroke risk scores in patients with paroxysmal AF was analyzed. Results: We studied 259 hospitalized patients with paroxysmal AF (143 [55.2%] male, mean age 66.4 ± 12.0 years); 38 patients of them showed abnormal DC values. In the univariate analysis, age, hypertension, heart failure, and previous stroke/transient ischemic attack (TIA) were significantly associated with abnormal DC values. Among these factors, a history of previous stroke/TIA (odds ratio = 2.861, 95% confidence interval: 1.356–6.039) were independently associated with abnormal DC values in patients with paroxysmal AF. The abnormal DC group showed a higher stroke risk with the score of congestive heart failure, hypertension, age >75 years, diabetes mellitus, previous stroke and TIA (CHADS₂) (2.25 ± 1.48 vs. 1.40 ± 1.34, t = -4.907, P = 0.001) and CHA₂DS₂-vascular disease, age 65–74 years and female category (VASc) (3.76 ± 1.95 vs. 2.71 ± 1.87, t = -4.847, P = 0.001) scores. Correlation analysis showed that DC was negatively correlated with CHADS₂ scores (r = -0.290, P < 0.001) and CHA₂DS₂-VASc scores (r = -0.263, P > 0.001). Conclusions Lower DC is closely associated with previous stroke/TIA, and is also correlated negatively with higher stroke risk scores in patients with paroxysmal AF. It could be a potential indicator of stroke risk in paroxysmal AF patients.

Objective: To investigate the strong expression (S+) of P53 and BCL2 proteins in MYC/BCL2 double-expression DLBCL (DEL) and whether they can be used for the prognostic evaluation and stratified diagnosis of DELs. Methods: Tissue microarray were made by filed FFPE blocks of 174 DLBCL cases. The translocation of MYC, BCL2 and BCL6 genes were detected by FISH, and the proteins were detected by IHC. Data of clinicopathologic features and follow up of patients were collected and OS (overall survival) and PFS (progression free survival) were analyzed by statistics. Results: Eight double-hit lymphomas (DHLs) were identified in all cases, and 45 DELs were selected from 166 remaining cases, which have no significant difference in OS and PFS compared with non-DEL cases (P=0.668 and P=0.790) . Of 42 DEL-cases with follow up data, 24 cases with P53+ or/and BCL2 (S+) are significantly shorter OS and PFS than others (P=0.003 and P=0.000) , in which the cases with P53+/BCL2 (S+) co-expression were the worst prognosis, and P53/BCL2 co-weaker positive DEL cases even have superior OS and PFS than those non-DELs. Although statistics showed that the cases of P53+ or/and BCL2 (S+) have a lower OS and PFS in total cases (P=0.063 and P=0.024) , it is not the case when the DEL-cases take out from total cases, that is the cases with P53+ or/and BCL2 (S+) are as similar OS and PFS as others in non-DEL group (P=0.590 and P=0.550) . Conclusion The strong expression of P53 and BCL2 proteins can be used as indicators of stratified diagnosis and poor prognosis of DEL.

Objective Reports are rarely seen on the treatment of blood blister-like aneurysm(BBA)of the internal carotid artery with the overlapping low-profile visualized intraluminal support device(LVIS)stent. This study was to investigate the effects of overlapping versus non-overlapping LVIS stent-assisted coiling in the treatment of BBA. Methods We retrospectively analyzed the clinical data about 15 cases of BBA of the internal carotid artery treated in our hospital from February 2015 to February 2017,11 by o-verlapping and the other 4 by non-overlapping LVIS stent-assisted coiling. Using Raymond-Roy Occlusion Classification(RROC),we evaluated the effects of treatment immediately and at 1 week after operation. We followed up the patients from April 2015 to October 2017 and analyzed the results of follow-up digital subtraction angiogra-phy(DSA)and modified Rankin Scale scores(mRS)of the patients. Results RROC showed 10 cases of grade Ⅰ and 1 case of grade Ⅲocclusion in the overlapping group and 3 cases of gradeⅠand 1 case of gradeⅡin the non-overlapping group right after operation. In com-parison,there were 11 cases of gradeⅠin the overlapping group and 2 cases of grade Ⅰ and 2 cases of grade Ⅱ in the non-overlapping group at 1 week postoperatively.DSA at the end of the follow-up exhibited 9 cases of gradeⅠand 1 case of gradeⅡin the overlapping group and 1 case of grade Ⅰ,2 cases of grade Ⅱ and 1 case of gradeⅢin the non-overlapping group. Satisfactory prognosis was ob-served in all the 15 cases,with mRS=0 in 9 cases and mRS = 1 in 2 cases in the overlapping group and with mRS=0 in 3 cases in mRS=1 in 1 case in the non-overlapping group. Conclusion Overlapping LVIS stent-assisted coiling is safe and effective for treat-ment of BBA of the internal carotid artery.

Objective Distal anterior cerebral artery aneurysm(DACAA)is rare and difficult to be treated. The aim of this study was to investigate the clinical effect of stent-assisted coiling in the treatment of DACAA. Methods We retrospectively analyzed the clinical data about 15 patients with 15 DACAAs treated by stent-assisted coiling,with all the aneurysms occluded and the parent ar-teries preserved,including 4 ruptured and 11 unruptured aneurysm,8 in the A2 and 7 in the A3 segment. The follow-up ranged from 6 to 33 months,during which we evaluated the prognosis of the patients by radiological and clinical examinations. Results There were no operation-related complications in any of the cases. One patient died of subarachnoid hemorrhage-induced cerebral vasospasm. Fol-low-up angiogram revealed complete occlusion of the aneurysms in 9 cases. The last follow-up Glasgow Outcome Scale score was 5 in all the 14 survived patients. No rupture,rebleeding or fresh neurologic deficits was observed in any of the patients. Conclusion Stent-assisted coiling is safe and effective,with a low short-term recurrence rate,in the treatment of distal anterior cerebral artery aneurysm.