The secondary mental disorder is one of the complications of senile cerebrovascular disease, the medication is different from generic mental disorder. This article summarized the medication of elder patients with secondary mental disorder.

Objective To determine the involvement of matrix metalloproteinase-9(MMP-9) in the signal transduction pathway of cigarette smoke-induced airway mucous hypersecretion. Methods The well cultured BEAS-2B airway epithelial cells were incubated with different concentrations of cigarette smoke extract (CSE),also some cells were preincubated with MMP-9 inhibitorⅠbefore CSE or exogenous epidermal growth factor(EGF) was added. The mucin(MUC)5AC mRNA level was analyzed by RT-PCR,MMP-9 and the phosphorylated EGFR(p-EGFR) protein production was assayed by western blot,MUC5AC protein and EGF protein were detected by enzyme-linked immunosorbent assay respectively,and gelatin zymography was used to determine the activity of MMP-9. Results Incubation of BEAS-2B cells with CSE up-regulated MUC5AC gene expression and protein production in a dose dependent manner (P0.05). Conclusion CSE stimulates the activity of MMP-9 and MMP-9 protein,causing the shedding of the EGF and leading to EGFR activation. This activation of EGFR downstream signaling pathway increases MUC5AC gene expression and mucin production.

Object To study the effects of gypenosides on MAO and Na/K ATPase activities in brain tissues of aging mice Methods Models of aging mice were prepared by continuous post orbitol injection of 120 mg/kg D galactose for a month, then the effects of gypenosides on MAO and Na/K ATPase activities in brain tissues were investigated Results It was observed that MAO activity was increased and Na/K ATPase activity was decreased in brain tissues of aging mice models significantly; and these effects were reversible respectively by gypenosides ig of 75 and 150 mg/kg Conclusion The result that gypenosides could invert the changes of MAO and Na/K ATPase activities in brain tissues of aging mice, may provide a further explaination of the anti aging mechanism of gypenosides in molecule enzymology

Objective To discuss the therapy of cholelithiasis complicated with cirrhotic portal hypertension (CPH).Method In this study,clinical data were reviewed on 108 cases with cholelithiasis complicated with hepatic cirrhosis,including 78 cases who underwent surgery.Results Open cholecystectomy,subtotal cholecystectomy,laparoscopic cholecystectomy,open cholecystectomy plus spleectomy,splenectomy plus pericardial devascularization before biliary duct operation,leftlateral hepatectomy with biliary duct operation,and hepatic portal bile duct anaplasty with Roux-en-Y cholangiojejunostomy.10 patients received endoscopic treatment and 20 were treated conservatively.Results 73 patients were cured,with a cure rate of 67.6％; 32 patients were doing well (29.7％);3 patients died (2.8％) of massive hemorrhage and hepatic failure.The operative complications included ascites,jaundice,hemorrhage and hepatic insufficiency.Conclusions Before operation,the conditions of the patient should be accurately evaluated and a correct operative treatment option should be selected.Child C grade patients should be contraindicated for any surgery.

10.3969/j.issn.2095-4344.2013.23.015

Objective To investigate the effect of different degree lipidemia on time-resolved fluoroimmunoassay(TRFIA)for determination of unconjugated estriol(uE3).Methods Mixed serum was prepared by collecting different levels of lipidemia samples which were normal and chylous appearance from male and by mixing with definite value serum of uE3.The levels of uE3 in the sam-ples were measured by TRFIA and the effect of lipidemia on TRFIA for determination of uE3 was evaluated.Results For the ap-pearance of chylous specimens,mild lipidemia increased uE3,mid-or hiper-lipidemia samples reduced uE3 and the effect of both was considerable.Conclusion The chylous lipidemia has variant degree of influence to TRFIA for determination of uE3,then the results effect accuracy of Down′s screening.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P

Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and oxygen metabolism in patients with septic shock.Methods A prospective observational study was carried out in 69 patients with early septic shock within 24 hours.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen (PtcO2) and transcutaneous carbon dioxide (PtcCO2) was monitored and the changes of hemodynamic data,tissue oxygen,microcirculation before and after reaching the criteria of EGDT were recorded.Results Compared with that before treatment,PtcO2,tissue oxygenation index (PtcO2/FiO2) after EGDT was increased [(78.1 ± 30.8) mmHg (1 mmHg =0.133 kPa) vs.(62.8 ± 24.1) mmHg and (141.7 ± 78.3) mmHg vs.(110.8 ± 60.5) mmHg],PtcCO2 and percutaneous arterial carbon dioxide partial pressure difference was decreased[(29.0 ±4.1) mmHg vs.(39.1 ±6.4) mmHg and (1.4 ±0.5) mmHg vs.(1.7 ±0.8) mmHg],there was significant difference(P＜ 0.05).There was no significant difference in PtcO2,PtcO2/FiO2,PtcCO2,central venous blood oxygen saturation,lactic acid,oxygen and oxygen consumption (P ＞ 0.05).Conclusion EGDT can improve local tissue perfusion and microcirculation in patients with septic shock,body tissue perfusion index before and after EGDT may not be able to reflect the local tissue perfusion.

Objective To investigate the anatomical character and clinical application value of external malleolus periosteum bone flap pedicled with facia and external malleolus anterior artery. Methods Applied anatomy was studied with 10 adult corpse specimen after artery perfusion,observed the origin.trackway,and measured the external diameter and major vessel's length of external malleolus anterior artery,observed the composition of external malleolus artery net,and completed the performance in clinic in 10 patients and followed up for 6 months～6 years. Resultes The bone flap had abundant blood-supply,its pedicle was long enough for transfer,little injury to donor,the surgical procedure was easy to manipulate,and was used in clinic to treat talus fracture in 9 cases (fresh 5 and old 4) and old tibia fracture in 1 case,10 cases were involved with satisfactory outcome. Conclusion External malleolus periosteum bone flap pedicled with fascia and external malleolus anterior artery is a good new donor for the patients with fracture of talus or lower tibia,especially ununited case or osteonecrosis.

Objective To study the expression of protein and mRNA of caspase-3 during hepatocyte apoptosis in the mice with fulminant hepatic failure (FHF). Methods Liver damage was induced by tumor necrosis factor-? (TNF-?) in D-galactosamine (GalN) sensitized BALB/c mice. Hepatocyte apoptosis was examined by electric microscopy, in site end labeling (ISEL) and DNA electrophoresis on 1.5% agarose gel. The expression of protein and mRNA of caspase-3 was detected by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). Results After 1.5 h, 3.5 h, 6 h, and 9 h of administration of GalN and TNF-?, rates of hepatocyte apoptosis were found to be 0.0%, 0.3%, 3.15% and 3.19% respectively. The rates of caspase-3 positive hepatocytes were 0.7%, 4.6% , 17.8% and 24.2% respectively. The relative expressive density of caspase-3 mRNA were 0.26%, 0.29%, 0.41% and 0.38% respectively. Conclusions The expression of caspase-3 is up regulated in the TNF-? induced FHF model and may trigger hepatocyte apoptosis and finally lead to FHF.