Objective: To explore a treatment method for vascular dementia. Methods: Sixty patients were randomly allocated into two groups. The observation group was treated with long-term needle-retaining method of scalp acupuncture and the control group was treated by medications. Evaluation was made respectively before and after the treatment by means of Hasegawa dementia scale (HDS), neurological function deficit (NFD) score and main symptom (MS) score. Results: There were statistically significant differences in HDS, NFD score and MS score in both groups (PO.01) before and after the treatment. There were statistically significant differences in HDS, NFD score and MS score between the two groups (P<0.05) before and after the treatment. The total effective rate was 86.8% in the observation group and 80.0% in the control group. There was a statistically significant difference in the effects between the two groups (P<0.05). Conclusion: This long-term needle-retaining method of scalp acupuncture is precisely effective for vascular dementia.

Objective To explore the dosimetric difference between different radiotherapy technologies in the treatment of early peripheral stage non?small ?cell lung cancer ( NSCLC ) . Methods Four?dimensional computed tomography scans and delineation of target volumes and organs at risk ( OARs) were performed in 5 patients pathologically diagnosed with stage T1/T2 peripheral NSCLC who were admitted from 2014 to 2015. Target volumes contained gross tumor volume (GTV), internal target volume (ITV), and planning target volume (PTV). ITV was contoured on the maximum intensity projection images. PTV was defined as ITV plus a 5 mm margin. OARs contained the heart, lung, esophagus, and spinal cord. The Monaco 5. 0 treatment planning system was used to design three plans. The three?dimensional conformal radiotherapy (3DCRT) plan had 11 fields in the diseased lung covering the PTV plus a 0. 2 cm margin. The sliding window intensity?modulated radiotherapy ( SW?IMRT ) plan had 9 fields in the same areas as the 3DCRT plan. The volumetric modulated arc therapy ( VMAT) plan had the gantry rotating 180° around the diseased lung. The evaluation criteria referred to the RTOG 0618 trial. Comparison was made by paired t test. Results The SW?IMRT plan had a significantly better homogeneity index than the 3DCRT plan ( 1. 03 vs. 1. 24,P= 0. 017 ) . Compared with the VMAT plan, the mean monitor units in the 3DCRT plan was significantly reduced by 24. 5%( P=0. 022) . The V30 and V40 of the 3DCRT plan were significantly reduced by 29. 4% and 28. 4%, respectively, compared with the SW?IMRT plan ( P=0. 003,0. 006) and 56. 7%and 59. 7%, respectively, compared with the VMAT plan ( P=0. 041,0. 019) . Conclusions 3DCRT may be an appropriate radiotherapy method for early stage NSCLC.

AIM:To observe the protective effect of nicorandil on myocardial ischemia reperfusion injury in patients undergoing valve replacement.METHODS:Sixty patients undergoing valve repalacement were randomly divided into 3 groups:control(Ⅰ)group,nicorandil delayed precondictioning(Ⅱ)group and nicorandil preconditioning(Ⅲ)group.20 mg nicorandil was given i.v.24 h before operation in group Ⅱ,whereas in group Ⅲ,20 mg nicorandil was given i.v.after induction of anesthesia.Blood samples were taken from coronary venous for determination of cTnI,TNF-?,IL-6 levels at aortic clamping(T0),15 min(T1),30 min(T2),60 min(T3),90 min(T4)after aortic declamping.Right atria myocardium tissue were taken at T0 and T2 to observe the histopathological changes with electron microscopy.RESULTS:The levels of cTnI,TNF-?and IL-6 in group Ⅱand Ⅲ were significantly lower than those in group I.Myocardium injury was obviously lighter in groupⅡand Ⅲ than that in group Ⅰ,whereas the levels of cTnI,TNF-?,IL-6 and myocardium injury were lower in group Ⅱ than those in group Ⅲ.CONCLUSION:Nicorandil is effcetive in decreasing myocardial ischemia repefusion injury in patients undergoing valve replacement,The protective effect of nicorandil delayed preconditioning is more obvious than precondictioning.

AIM: To study the absorption performance and purification process of total flavones from Bushen Recipe(Radix polygoni multiflori;Herba epimedii;Rhizoma drynariae;etc) with macroporous resin. METHODS: The contents of total flavones,icariin,tetrahydroxystilbene and naringin were worked as indexes,the adsorptive capacity of D101,DA201 and DM301 resins were investigated,and the static adsorption curve,dynamic leakage curve and elution curve were used for the selection of macroporous resin. RESULTS: The elution parameters of selected DM301 consisted of the 0.25 BV/h feed rate solution ratio of 4 BV water to elute resin and 4 BV 70% alcohol to be collected as elution solvent,and the elution rate of 2.4 BV/h was established. CONCLUSION: Macroporous resin method is a better candidate method for purifying flavones in Bushen Recipe.

Objective:To examine whether the use of moderate hypothermic circulatory arrest in a pig model provides comparable vital organ protection outcomes to the use of deep hypothermic circulatory arrest.Methods:Thirteen pigs were randomly assigned to 30 minutes of hypothermic circulatory arrest without cerebral perfusion at 15℃(n=5), 25℃(n=5) and a control group(n=3). The changes in standard laboratory tests and capacity for protection against apoptosis in different vital organs were monitored with different temperatures of hypothermic circulatory arrest management in pig model to determine which temperature was optimal for hypothermic circulatory arrest.Results:There were no significant differences in the capacity for protection against apoptosis in vital organs between 2 groups( P>0.05, respectively). Compared with the moderate hypothermic circulatory arrest group, the deep hypothermic circulatory arrest group had no significant advantages in terms of the biologic parameters of any other organs( P>0.05). Conclusion:Compared with deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest is a moderate technique that has similar advantages with regard to the levels of biomarkers of injury and capacity for protection against apoptosis in vital organs.

Objective: To explore the therapeutic effects of edaravone, oxiracetam combined with Shuxuetong on cerebral hematoma and improvement of neurological function in patients with cerebral hemorrhage. Methods: A total of 96 patients with cerebral hemorrhage were randomly divided into observation group and control group by the random number table method, with 48 cases in each group.The observation group received intravenous drip of edaravone (4.0g added into 0.9% sodium chloride injection to 250mL, intravenous drip, 1 time/d), oxiracetam(30mg added into 0.9% sodium chloride injection to 100mL solution, 30min intravenous drip, 2 times/d), and Shuxuetong injection(4mL added into 0.9% sodium chloride injection to 250mL, intravenous drip, 1 time/d) on the basis of routine treatment, and the control group was treated with routine treatment for cerebral hemorrhage.The efficacy and safety in the two groups after treatment of 21 days were observed. Results: After treatment, the neurological deficit score and cerebral hematoma volume of the two groups were improved(all P<0.05), but the improvements of the observation group was significantly better than those of the control group[(4.44±3.20)points vs.(10.53±2.86)points, (21.83±3.85)points vs.(26.71±3.49)points, (7.83±5.31)mL vs.(13.74±6.16)mL, t=9.818, 6.506, 5.035, all P<0.01]. The total effective rate of the observation group was higher than that of the control group(87.5% vs.52.1%, χ²=14.740, P<0.05). No drug-related adverse reactions occurred in two groups. Conclusion The application of oxiracetam and edaravone combined with Shuxuetong injection in patients with cerebral hemorrhage can effectively improve the brain edema and nerve defect, it has a positive significance to promote the patients' recovery after cerebral hemorrhage, and it is worthy of clinical application.

Objective To investigate the clinical features and the management of primary pigmented nodular adrenocortical disease PPNAD) and to evaluate its relationship with Carney complex. Methods One case of PPNAD reported. The patient was a 52 years oldmale. He was hospitalized because of hypertension for one year. The patient had a Cushing's face with elevated plasma and urine cortisone levels which could not be suppressed by both low dose and high dose dexamethasone tests. Ultrasonography howed normal bilateral adrenal glands. CT scan found a 1.6 cm × 2.0 cm mass in the left adrenal gland and normal on tralateral adrenal gland. Results The patient had accepted left laparoscopic adrenalectomy. The pathological examination onfirmed the diagnosis of PPNAD. Micro scopic study showed that there were black-gray spots in the center of the specimen. Hyperplasia was found in all the three adrenal zones. Lipofuscin was observed in the cytoplasm of reticular zone cells. The patient's blood pressure had returned to normal level after the surgery. Conclusions PPNAD is a rare type of ypercortisolism. As there is no specific feature in clinical manifestation and radiological examination of this disease, it is very easy to make a misdiagnosis in clinical practice. PPNAD itself can be the comorbidity of Carney complex, careful differentiation is needed.

Objective To analyze the clinical features of obstructive sleep apnea-hypopnea syndrome(OSAHS)with initial diagnosis of aorta dissection(AD)and therefore to improve its diagnosis.Methods The clinical data of 6 cases of AD with OSAHS were retrospectively analyzed.Results There were six male cases of obesity whose average body mass index(BMI)was 32.72±3.57,with an average age of(43.83±2.14)and the leading symptoms were daytime hypersomnolence,nocturnal wake by suffocation and habitual snoring.ESS was(13.83±2.14),apnea hypopnea index(AHI)was≥62/h[on averaga of(73.35±9.16)/h],the lowest pulse oxygen saturation(LSpO2%)was(58.67±10.95)%,time of oxygen saturation level lower than 90%(min)[T90(min)]was(244.20±144.74)min,the percent of the total time with oxygen saturation level lower than 90%(TS90%)was 54.48±30.18.They had more than two years history of hypertension.Conclusion Severe OSAHS affects the prognosis of AD.Early diagnosis and timely treatment can delay the progress of AD and lower death rate,with an important significance in improving the prognosis of AD.

objective To observe whether the killing effect on HCC SMMC-7721 cell of the antihepatocellular carcinoma scFv reconstructed by pharmacy was enhanced or not.Methods Prokarycytic expression vector containing PET32a-RC-RNase was induced to express by IPTG.The inclusion body purified and Western-blotting was used.PC.CHOL and CHS was added in chloroform.Dry membrane was formed after chloroform was removed.RC-RNase protein solution was added to dissolute the membrane.Then pass the solution over a Sephadex G-50 column after ultrasound and filtrated to detect the encapsulation efficiency of the liposome.The solution reacted in EDC.SSNHS and MES for 30 minutes.Then add hdscFv to the solution in 4 ℃ over night.MTT method was used to detect the killing effect on HCC cell of immunoliposome RC-RNase,immunotoxin RC-RNase and liposome RC-RNase in vitro.Resuits The killing effect on HCC cell of immunoliposome RC-RNase is the best.but that of Iiposome RC-RNase is the worst.The respective JC50 are:3.28μg/ml,22.44μg/ml and 98.26μg/ml.Conclusion The anti-hepatocellular carcinoma scFv relomtructed by pharmacy can promote the killing effect on HCC cell and may have potential in the treatment of hepatocarcinoma.

Objective To investigate the effects of total intravenous anesthesia (TIVA) and combined intravenous and inhalation anesthesia on blood glucose and cortisol in spinal neurosurgery.Methods Forty-four spinal neurosurgery patients were divided into propofol combined with remifentanil group (PR group) and sevoflurane combined with remifentanil group (SR group ), 22 cases in each group,they were induced with propofol, sufentanil and rocuronium. Anesthesia was maintained with sevoflurane in SR group while propofol in PR group. Depth of anesthesia adaption according to bispectral index (BIS)(45 -55). Blood glucose, cortisol, haemodynamics were observed at different time points. Results The mean arterial pressure(MAP) was higher after induction in PR group than that in SR group(P ＜ 0.05 ). Sixty minutes after induction, MAP was lower than that before induction in PR group (P ＜ 0.05 ). Heart rate ( HR )in both SR group and PR group were lower at 60 and 120 minutes after induction than those before induction (P ＜ 0.05). HR was lower at 5 minutes after induction in PR group than that in SR group (P ＜ 0.05). No significant difference was showed in blood glucose and cortisol between the two groups (P ＞ 0.05 ). Cortisol level was significantly lower at 120 minutes after induction than that before induction [(40.6 ± 18.3) μg/L vs. ( 129.7 ± 36.7 ) μg/L, P ＜ 0.05 ] and at 24 hours postoperative [ (93.6 ± 19.8 ) μg/L ] recovered to the level before induction in PR group. Cortisol level was significantly higher before induction than 120 minutes after induction [ ( 130.5 ± 32.1 ) μg/L vs. (51.6 ± 16.8 ) μg/L, P ＜ 0.05 ] and 24 hours postoperative was (75.9 ± 18.2) μg/L in SR group. Conclusions Two anesthetic regimens are compatible during spinal neurosurgery, with no apparent fluctuations of perioperative blood glucose. However, longer cortisol inhibition is probably happened when using sevoflurane.