Objective To explore the clinical efficacy of fluoxetine hydrochloride capsules and escitalopram oxalate tablets in the treatment of first-episode depression disorder.Methods Eighty patients with first-episode depression disorder who were hospitalized in the 14th district of Integrated Traditional Chinese and Western Medicine of Xiamen Xianyue Hospital from February to November 2023 were selected,and divided into fluoxetine hydrochloride capsules group(n=40)and escitalopram oxalate tablets group(n=40)according to random number method;Conducted the Hamilton depression scale(HAMD)estimates before treatment and four weeks after treatment,to analyze and compare the clinical efficacy of two groups.Results After four weeks of treatment,the HAMD scores of all patients significantly decreased compared to before treatment in this group(P＜0.01);There was no statistically significant difference between two groups(P＞0.05).There was no statistically significant difference in the total effective rate between two groups(P＞0.05).Conclusion Escitalopram oxalate tablets and fluoxetine hydrochloride capsules were both effective in treatment of the first-episode depression disorder patients,and the total effective rates of them were similar.

Objective To investigate the application of liver three-dimensional (3D) visualized reconstruction technique in hepatectomy for children with complicated hepatoblastoma. Methods A retrospective analysis was performed for the clinical data of 30 children with hepatoblastoma who underwent hepatectomy for radical resection in PLA Rocket Force Characteristic Medical Center from January 2018 to October 2020, and according to whether liver 3D visualization with IQQA-Liver system was performed before surgery, the children were divided into 3D reconstruction group with 15 children and control group with 15 children. The two groups were compared in terms of perioperative parameters, short-term prognosis, and follow-up conditions. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Fisher's exact test was used for comparison of categorical data between two groups. Results Compared with the control group, the 3D reconstruction group had a significantly higher mean age (55.7±10.2 years vs 28.2±2.7 years, P < 0.05) and a significantly higher number of patients with POSTTEXT stage III/VI hepatoblastoma (12 vs 5, P < 0.05) or involvement of the hepatic vein or the inferior vena cava (11 vs 3, P < 0.05). All children completed the surgery successfully, and there were no significant differences between the two groups in blood loss, time of operation, number of times and duration of hepatic portal occlusion, and number of children receiving segmental hepatectomy or partial hepatectomy (all P > 0.05). The median follow-up after surgery was 9.5 months. In the 3D reconstruction group, 2 children experienced recurrence and were diagnosed at 10 and 12 months, respectively, after surgery, and they were treated with chemotherapy at the moment; in the control group, 4 children experienced recurrence, which was higher than that in the 3D reconstruction group ( P =0.651), and among these 4 children, 2 had recurrence at 7 months after surgery, received liver transplantation, and survived up to now, and the other 2 children died shortly after recurrence. Conclusion 3D visualized reconstruction technique helps to perform hepatectomy for children with complicated hepatoblastoma more safely and accurately, especially extended hepatectomy for patients with stage POST TEXT III/IV hepatoblastoma, thereby avoiding liver transplantation.

Dysregulation of the gut microbiota/gut hormone axis contributes to the pathogenesis of irritable bowel syndrome (IBS). Melatonin plays a beneficial role in gut motility and immunity. However, altered expression of local mucosal melatonin in IBS and its relationship with the gut microbiota remain unclear. Therefore, we aimed to detect the colonic melatonin levels and microbiota profiles in patients with diarrhea-predominant IBS (IBS-D) and explore their relationship in germ-free (GF) rats and BON-1 cel s. Thirty-two IBS-D patients and twenty-eight healthy controls (HCs) were recruited. Fecal specimens from IBS-D patients and HCs were separately transplanted into GF rats by gavage. The levels of colon mucosal melatonin were assessed by immunohistochemical methods, and fecal microbiota communities were ana-lyzed using 16S rDNA sequencing. The effect of butyrate on melatonin synthesis in BON-1 cel s was eval-uated by ELISA. Melatonin levels were significantly increased and negatively correlated with visceral hypersensitivity in IBS-D patients. GF rats inoculated with fecal microbiota from IBS-D patients had high colonic melatonin levels. Butyrate-producing Clostridium cluster XIVa species, such as Roseburia species and Lachnospira species, were positively related to colonic mucosal melatonin expression. Butyrate signif-icantly increased melatonin secretion in BON-1 cel s. Increased melatonin expression may be an adaptive protective mechanism in the development of IBS-D. Moreover, some Clostridium cluster XIVa species could increase melatonin expression via butyrate production. Modulation of the gut hormone/gut micro-biota axis offers a promising target of interest for IBS in the future.

AIM To observe the effects of Huangdi Anxiao Capsules (Puerariae lobatae Radix,Eriobotryae Folium,Notoginseng Radix et Rhizoma,etc.) on blood glucose and insulin resistance in GK rats with type 2 diabetes mellitus (T2DM) and its possible mechanism of action.METHODS GK rats with T2DM included in the experiment were randomly divided into model group,rosiglitazone (1.44 mg/kg) group,Shenqi Jiangtang Granules (1.08 g/kg) group,Huangdi Anxiao Capsules high,medium and low (12,6,3 g/kg) group and normal control group of Wistar rats.After six weeks of consecutive administration,fasting blood glucose (FBG),serum insulin (FINS),fasting plasma glucose (FPG),and insulin resistance index (HOMA-IR) were measured in all groups.Serum biochemical indexes of (TG,TC,HDL-C,LDL-C),glycosylated hemoglobin (HbA1c),glucagon-like peptide (GLP-1) and insulin-like growth factor (IGF-1) were measured.The pancreatic tissue was obtained by routine paraffin embedding and HE staining to observe the pathological changes.RESULTS Compared with the normal group,FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1c of the model group were significantly higher (P ＜0.01),and GLP-1 and IGF-1 expressions were markedly decreased (P ＜ 0.01).Compared with the model group,the levels of FBG,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C and HbA1 c in Huangdi Anxiao Capsules high-,medium-and low-dose group were significantly decreased (P ＜ 0.05,P ＜0.01);GLP-1 and IGF-1 expressions were markedly increased (P ＜0.05,P ＜0.01),compared with the model group,the structure changes of pancreatic tissue in Huangdi Anxiao Capsules high-,medium-and low-dose groups largely reduced.CONCLUSION Huangdi Anxiao Capsules can reduce GK rats fasting blood glucose,insulin resistance,and its mechanism may be related to promoting the emergence and proliferation of pancreatic islet cells,improving the function of islet beta cells,and increasing insulin secretion.

Objective To evaluate the anesthetic effect of ultrasound guided thoracic paraverte-bral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy. Methods Eighty patients (38 male and 42 female ) undergoing selected thoracoscopic sympathectomy,aged from 16 to 28 years,in ASA physical status Ⅰ or Ⅱ,were equally divided into study group and control group,40 patients in each,according to random number table.Fifteen mi-nutes before paravertebral blockade,while study group received loading dose (0.5 μg/kg)of dexme-detomidine (4 μg/ml)intravenously within 10 min and received continuous intravenous pumping (0.3-0.5 μg·kg-1·h-1 )throughout the operation,control group received isovolumetric normal saline in the same pattern.Patients'heart rate (HR),respiratory rate (RR),mean arterial pressure (MAP),SpO 2 ,observer's assessment of alertness/sedation (OAA/S)scale and adverse reactions were recorded in several time points,namely timing of entrance (T0 ),timing of paravertebral block-ade (T1 ),timing of skin incision (T2 ),timing of sympathectomy (T3 )and the end (T4 ),respective-ly.Results Compared to the control group,while MAP and HR in the study group were obviously decreased through T1-T4 (P <0.05),RR was obvious increased in T2 and T3 (P <0.05)and OAA/S scale was obviously lowered in the study group (P <0.05 ).The study group and the control group had one case and two cases of adverse reaction,respectively,with no significant difference between the two groups.Conclusion The application of ultrasound guided thoracic paravertebral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy is safe and effective.

Objective:To retrospectively analyze the survival outcomes of the surgical management of primary small cell carcino-ma of the esophagus. Methods:The medical records were reviewed for patients diagnosed with esophageal carcinoma and underwent esophagectomy from January 2000 to December 2009 at the Department of Thoracic Surgery of the Henan Cancer Hospital. We fo-cused on the clinical data of patients with small cell carcinoma of the esophagus. The Kaplan-Meier approach with log-rank test was used for survival analysis. Results:A total of 5,062 patients underwent esophagectomy with curative intent at the Department of Thorac-ic Surgery of the Henan Cancer Hospital;among which, 57 (1.1%) were diagnosed with small cell carcinoma of esophagus. The most common surgical approach was trans-left thoracic incision esophagectomy. Cervical esophagogastrostomy was performed for all pa-tients. The most common chemotherapy regimen was EP. The overall 5-year survival rate was 12.5%, and the median survival time was 45 months. Among the various stages, the 5-year survival rate and survival time were 25% and 50 months for Stage I, 5.9% and 43 months for Stage II, and 4.3%and 43 months for StageⅢ. Subgroup analysis showed that cases treated with surgery alone had poorer overall median survival time compared with those cases that underwent surgery plus chemotherapy (23.2 months vs. 60.7 months, re-spectively;P<0.01). Even for Stage I patients, thesurgery plus chemotherapysubgroup was associated with a significantly longer me-dian survival time than the surgery alone subgroup (81.9 months vs. 22.3 months, P<0.01). Conclusion:For patients with primary small cell carcinoma of the esophagus, surgery alone cannot provide the optimal prognosis. Surgery combined with systemic chemother-apy can improve the survival time.

Objective To investigate the phototoxicity effects of the nanocompound of upconversion nanoparticles (UCNPs) on rat astrocytes in vitro.Methods The spinal astrocytes cells were cultured successfully in vitro and then incubated with the UCNPs-MC540 of various concentrations and exposured 980 nm infrared laser irradiation of different energy densities.The cell survival rates of each group were detected by MTT assay.The cellular morphology was observed via transmission electron microscope after photodynamic therapy.Results UCNPs-MC540 of different concentrations without laser irradiation or laser of different energy had no significant effects on cell survival rates.when cells incubated with 100 μg/ml UCNPs-MC540 for 12 h underwent laser irradiation of different energy,the cellular survival rates significantly decreased with the increased energy densities.when the cells incubated with UCNPs-MC540 of various concentrations for 12 h underwent laser irradiation of 2 000 J/cm2,the cellular survival rates significantly decreased with the increased concentrations.Compared with controls,the TEM show the apoptosis sign in the cells incubated with 200 μg/ml UCNPs-MC540 after laser irradiation of 2 000 J/cm2.Conclusion The UCNPs-MC540 mediated photodynamic therapy have effective killing effect on astrocytes by the mechanism of induction the apoptosis.

Objective To discuss the value of Visfatin in severity evaluation in patients with severe pneumonia via observation on the variations of the plasma level of Visfatin. Method Seventy subjects including 40 patients with severe pneumonia ( group A) and 30 patients with non-severe pneumonia (group B) admitted to the ICU of emergency department and general wards from June 2009 to June 2010, were enrolled in this prospective study, and another 30 healthy individuals from physical examinees were included as subjects in control group (group C). Patients with severe diseases of heart, brain and kidney, cancers, autoimmune disease, or under special treatment in latest one month were excluded. For the subjects of all three groups, the plasma levels of Visfatin, IL-6, IL-8 and TNF-α were measured by using ELISA, while the level of CRP was assayed by using immunoturbidimetry, and the routine blood test was performed as well. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ) were carried out in patients with pneumonia. Comparisons between groups were made by t-tests, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson correlation coefficient or Spearman rank correlation test. Results The plasma level of Visfatin in patients with severe pneumonia (group A) was significantly higher than that in patients with non-severe pneumonia (group B) and in the control subjects (group C) (P < 0. 01) , and the level of Visfatin in pneumonia ( group B) and in control group (group C) , and that in group B was significantly higher than that in the controls (group C) (P <0. 01). In group A, the plasma level of Visfatin was positively correlated with CRP, TNF-α, APACHE Ⅱ and PMN% (rha =0. 653, r = 0.554, r = 0.558, r= 0.484, P <0. 05), while negatively correlated with PaO2 and PaO2/FiO2 ( rha = -0.422, r= -0.543, P <0. 05). Conclusions Visfatin may be involved in the systemic inflammation response in severe pneumonia as a pro-inflammatory cytokine which is valuable in assessing the severity of pneumonia.

Objective To determine the level of adiponectin (APN) in serum and induced sputum of patients with chronic obstructive pulmonary disease both during acute exacerbation (AECOPD) and silent stage, and investigate APN' s role as a marker of inflammation in the pathogenesis of COPD. Method From October 2008 to October 2009,30 male AECOPD patients in the emergency department, 30 male silent COPD patients in the department of respiratory diseases and 30 healthy nonsmoking male volunteers were included. All subjects' serum and induced sputum were collected, and they were all of normal weight(BMI range of 18.5～ 24.9 kg/m2). Patients were excluded if they suffered from severe bronchial asthma, bronchiectasis or autoimmune disease. The number of cells in induced sputum was counted and the cell type was classified. The concentrations of APN, IL-8, IL-6 and TNF-α in both serum and sputum were measured by using ELISA, and their pulmonary function was tested. The different groups were compared among them by using the t -tests, ANOVA analysis or nonparametric analysis, the relation between variables was assessed by using the Pearson or Spearman correlation test. Results The concentrations of APN in both serum and induced sputum of AECOPD patients were significantly higher than those in the silent COPD patients and the control subjects ( P ＜ 0.01 ). The concentrations of APN in the silent COPD patients were significantly higher than those in the control subjects ( P ＜ 0. 01 ). There were significant relationships between the concentrations of APN in serum and induced sputum and the levels of IL-8 and TNF-α in AECOPD patients ( r = 0.739, 0. 734,0.852 and 0. 857, respectively, P ＜ 0. 05) and in silent COPD patients ( r = 0.751,0.659, 0.707 and 0.867, respectively, P ＜0.05). There was significant relation betweenship between APN and neutrophil in induced sputum of AECOPD patients (r = 0.439, P ＜ 0.05). Conclusions APN was involved in the process of systemic and airway inflammation of COPD, and it was related with IL-8 and TNF-α. APN can be used as a new inflammation marker for COPD.

Objective To investigate the value of panel fluorescence in situ hybridization (panel FISH)for detection of genomic aberrations in chronic lymphocytic leukemia(CLL). Methods Five types of fluorescein-labelled DNA probes including five sequence specific probes D13S25 for 13q14. 3, RB1, p53, ATM (11 q23)and centromeric probe for chromosome (CSP12) were used to perform fluorescence in situ hybridization assays in 17 patients with CLL. Its results were compared with that obtain by conventional cytogenetic (CC)examination. Results In 17 patients with CLL, CC examination showed that only one case (1/17) was found to have chromosomal abnormality that was simultaneous trisomies 3,8 and 18, whereas panel FISH assay showed that 10 cases (10/17) were found to have genomic aberrations including deletion of D13S25 in 4 cases,deletion of ATM in 2 cases,deletion of p53 in 1 case,deletion of D13S25 combined RB1 in 1 case and 1 case with a variety of abnormalities. Conclusions Panel FISH is a useful method for detection of genomic aberration in CLL If it is combined with CC,it can obviously enhance the detection rate of chromosomal abnormalities in CLL.