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.

Lipoprotein-associated phospholipase A2(Lp-PLA2) can rapidly hydrolize and oxidize the oxidized phosphatidylcholine molecules produced in low density lipoprotein and atherogenic lipoprotein (a),generating the soluble proinflammatory and proapoptotic mediatorslyso-phosphatidylcholine and oxidized free fatty acids.It stimulates aggregation and activation of monocyte-macrophage system and induces apoptosis and damages the removal of dead cells.It plays an important role in the development of lipid necrotic core of atherosclerosis.Lp-PLA2 is not an independent risk marker of coronary artery disease and ischemic stroke,but also plays an important role in the development of atherosclerotic plaques.Selective Lp-PLA2 inhibitor reduces the development of necrotic cores.It may play a role in the stabilization of atherosclerotic plaques.At the same time,it may represent a novel target for the treatment of atherosclerosis.

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

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 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 compare the clinical curative effect between mini laparoscopic cholecystectomy (MLC) and conventional laparoscopic cholecystectomy (LC).Methods Using random number table method to divide the patients into conventional laparoscopic cholecystectomy group (30 cases) and mini laparoscopic cholecystectomy group (27 cases).Compared the operation time,bleeding volume,VAS score,postoperative hospital stay,complications.Results No conversion to laparotomy and serious complications,but each group has 6 cases from the three holes increase to four holes,and 4 cases of MLC group were converted to traditional LC.MLC group and LC group,average operation time (57.5 ± 17) min and (50 ± 15) min (P ＞ 0.05);the average postoperative hospital stay was (2.5 ± 1.4) d and (3.1 ± 1.5) d (P ＞ 0.05);postoperative pain degree of MLC group of 6 h and 12 hrespectively (4.8±2.6) and (3.5±1.1),LC group were (5.5 ±2.7) and (5.0±2.1) points (P＜ 0.05).Conclusion Postoperative pain of MLC is lighter than LC,in appropriate cases,is a safe and effective treatment method.

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 explore the effect of estrogen on striatal neurons damage in rats induced by quinolinic acid (QA).Methods Ovariectomized rats were divided into two groups:non-replacement treatment group (recievied intrastriatal application of QA alone) and replacement treatment group (received both QA and 17-? estradiol). Striatal neurons injury was evaluated using NADPH-diaphorase histochemistry and the rotation number of rats induced by apomorphine was recorded. Activity of SOD and contents of MDA in striatum was measured by xanthine oxidase and thio-barbital method, respectively.Results Compared with non-replacement treatment group, there was a significant increase in the number of NADPH-diaphorase positive neurons ( P