0 05) , repectively. Of all dementia, AD and VD accounted for 58 48% and 31 58%, respectively. The AD prevalence in female was higher than that in male( P 0 05). The prevalence of total dementia, AD and VD tended to increase with aging( P 0 05). The prevalence of dementia increased one fold every five year of age increasing. The prevalence of dementia and AD in illiterate group was higher than in educated people with elementary school level and above junior high school level ( P

DS ③Combined MMSE with one or more of FOM、RVR 、BD、DS,the validity of diagnosis was improved.Conclusion: Neuropsychological test is useful in diagnosis of AD.The validity is improved when MMSE are combined correctly with other rating scales.

Traumatic brain injury(TBI), also known as intracranial injury or head trauma, specifically refers to the brain tissue damage caused by trauma.Currently the mechanism of TBI and repair therapy after nerve injury become a hotspot in brain research.Duplicating animal models plays a significant role in promoting experimental therapeutics of TBI.This review systematically describes the progress in animal models for TBI including impact brain injury, nonimpact acceleration head injury and blast(explosion)wave-induced neurotrauma, which have been established at home and abroad.Based upon the aforementioned models, some relevant applications in experimental therapeutics are simultaneously enumerated.Hopefully all these information provides scientific guidance for the pharmacodynamic screening of potential neuroprotective drugs.

Objective:To evaluate the short-term effect of robotic pancreaticoduodenectomy (RPD) and laparoscopic pancreaticoduodenectomy (LPD) in the treatment of ampullary and periampullary tumor systematically.Methods:A systematic search of the PubMed, Embase and Cochrane library database using the key words "pancreaticoduodenectomy, duodenopanreatectpmy, whipple, laparoscopic, robotic, Da Vinci" . A systematic search of the Sinomed, Wangfang, VIP and CNKI databases including the key words "胰十二指肠切除" , "腹腔镜" , "机器人" , "达芬奇" . To investigate the differences of the conversion rate of laparotomy, incidence of postoperative complications, and the postoperative hospital stay between the RPD group and the LPD group. The software RevMan5.3 was used in this meta-analysis.Results:A total of 4 retrospective cohort studies and 1 001 patients were included in this meta-analysis, including 451 patients in the RPD group and 550 patients in the LPD group. The results of the meta-analysis showed that there were significant differences between RPD group and LPD group for the conversion rate laparotomy ( OR=0.35, 95% CI: 0.24-0.50, P<0.05). There were no significant differences between RPD group and LPD group for the incidence rate of overall complication( OR=1.23, 95% CI: 0.95-1.58, P>0.05), hemorrhage ( OR=0.71, 95% CI: 0.50-1.00, P>0.05), pancreatic fistula ( OR=1.09, 95% CI: 0.80-1.49, P>0.05), delayed gastric empty ( OR=0.81, 95%CI: 0.57-1.14, P>0.05) and hospital stay after surgery ( WMD=-2.87, 95% CI: -1.44-1.70, P>0.05). Conclusions:RPD is as safe as LPD, with the same complication rate. Therefor it is worthy for further application in medical institutions with relevant conditions.

Objective To investigate the specific application of ergonomics for design of operation field in sanitary train. Methods The use of ergonomics theory, the layout of operation field, personnel operating capacity, environmental comfort and operation security were analyzed, surveyed and discussed. Results The principles and guidelines for design of opera- tion field in sanitary train were proposed in order to make full development the efficiency of "operator-equipment-environ- ment" mode. Conclusion The application of ergonomics for design of operation field in sanitary train can be improved the rationality of the layout of field of operation, environmental comfort and work efficiency.

Objective To investigate the drug resistance of bacteria clinically isolated from Yuyao people's hospital and its relationship with antibiotic consumption, in order to provide basis for rational use of antibiotics in clinic.MethodsA total of 3178 strains of bacteria were detected in our hospital from the third quarter of 2015 to the second quarter of 2016.The drug resistance of bacteria, the consumption of antibacterial agents in each quarter, and their relationships were analyzed.ResultsThe major isolated bacteria was gram-negative bacteria, among which constituent ratio of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa ranked the top 4.Gram-negative bacteria's resistance rates of several antibiotics were positively correlated with the utility rate of quinolones, and also had a different degree of positive correlation with the use of beta lactamase/inhibitor, aminoglycosides and carbapenems.Staphylococcus were the mainly gram positive bacteria, whose resistance rates to penicillin, ciprofloxacin, levofloxacin and erythromycin were positively correlated with the usage of the same type of antibiotics.ConclusionBacterial resistance rates are closely associated with the consumption of antimicrobials.Selecting antibacterial agents reasonably according to the results of drug susceptibility test is important to control the drug resistance of bacterial.

Objective To explore the therapeutic effect of lipid emulsion on acute organophosphorus poisoning and its consequence of acute lung injury. Methods A total of 48 sealant - grade Sprague-Dawley (SD) rats were randomly divided into four groups A,B,C,D,namely saline control group,lipid emulsion control group,the conventional therapy group and lipid emulsion administration group. After dichlorvos (DDVP) 11 mg/kg was given by intra-peritoneal injection,if there was no loss of DDVP during the injection process,the model of poisoning was considered to be made successfully.Then the rat models in four groups were respectively treated:with normal saline (5 ml/kg) intravenous injection in group A,lipid emulsion (5ml/kg) intravenous injection in group B,atropine (5 mg/kg) and pralidoxime chloride (40 mg/kg) intramuscular injection in group C,and combined use of lipid emulsion (5 ml/kg) with atropine and pralidoxime chloride in group D after administration of DDVP by intra-peritoneal injection.The activity of cholinesterase (CHE) in blood was detected before and 0.5 h,2 h and 4 h after DDVP poisoning. The clinical manifestations,the survival of rats,the wet weight of rat' s lung and the pathological changes of the lung tissue were observed within following 24 h. The rates of survival and symptoms of rats were compared between paired groups by using the x2 test,and the mean values of biomarkers were compared paired groups by using t test. Results In groups A and B,the intensity of muscular fasciculation and salivation were more severe and appeared sooner after DDVP exposure in comparison with groups C and D leading to lower survival rates in group A and B. Compared with group C,the rate of 24 h survival was higher and the intensity of muscular fasciculation was weaker in group D ( P ＜ 0.05 ).In group A and group B,the 24-hour survival rates were 1/12 and 2/12,respectively ( P ＜ 0.05 ).The levels of CHE in blood significantly decreased after DDVP poisoning ( P ＜ 0.05 ).There was no significant difference in activity of CHE between group B and group A,and in groups C and D,the levels of CHE in blood were not significantly higher than that in the group B 0.5 h after DDVP poisoning ( P ＜ O.05 ).In groups C and D,the activity of CHE in blood was significantly higher compared with group A and B,and that in group D was higher compared with C,and that in group B was higher compared with A 2 and 4 hours after DDVP poisoning ( P ＜ 0.05 ).In groups C and D,the wet weight of rat lung was significantly lighter compared with groups A and B,and that in group D was lighter compared with C,and that in group B was lighter compared with A 24 h after DDVP poisoning P ＜ 0.05 ).The electron microscopic findings showed the combined use of lipid emulsion with atropine and pralidoxime chloride obviously lessened the lung histopathologic changes after DDVP poisoning.Conclusions The lipid emulsion combined with atropine and pralidoxime chloride can be beneficial to controlling the toxic symptoms,reduce the death rate,accelerate the resume of the activity of CHE in blood,and relieve the lung injury induced by acute organophosphorus poisoning.

Objective To discuss the effect of Montelukast (Mont) on MDA,SOD,W/D,TNF-α,IL-10 and NF-κBp65 in lung tissue of Wistar rats poisoned by paraquat (PQ) and also to observe the pathological changes of the lung tissue.Methods A total of 104 Wistar rats were divided into 3 groups in random (random number),namely PQ group (n =40),Mont group (n =40) and control group (n =24).PQ (20 mg/kg) was administered by intra-peritoneal route to rats of PQ group and Mont group and narcotics were used for 2 hours.Mont in dose of 50 mg/kg was administered intra-gastrically to rats of Mont group per day and saline instead were administered to PQ group and control group per day until they were sacrificed for experiment.Of both PQ group and Mont group,10 rats were sacrificed at each interval of 1,3,5 and 7 days respectively after modeling,whereas 6 rats of control group were sacrificed at each interval.The levels of MDA and SOD in lung tissue and W/D of lung tissue,the levels of serum TNF-α and IL-10 and the level of NF-κBp65 in lung tissue were determined.Further,the specimen of lung tissue was prepared for electron microscopy observation.Results The level of MDA in lung tissue of PQ group was (8.19 ± 0.53) nmol/mg prot,which was significantly higher than that of control group on the 7th day.The level of SOD in lung tissue of PQ group was (128.76 ± 10.18) U/mg prot,which was significantly lower than that of control group.In PQ group,the W/D of lung tissue (6.62 ±0.42),level of serum TNF-α (156.16 ± 11.13) pg/ml,level of IL-10 (43.63 ±4.44) pg/ml and level of NF-κBp65 in lung tissue (0.23 ±0.02) were significantly higher than those in control group (P ＜0.01).In Mont group on the 7th day,the level of serum TNF-α (129.99 ±13.13) pg/ml,level of serum IL-10 (34.28 ± 3.80) pg/ml and level of NF-κBp65 in lung tissue (0.20 ±0.02) were significantly lower than those in PQ group (P ＜ 0.01).In the PQ group,pathological changes of lung tissue under the light and electron microscopes were acute diffused lung injury manifested itself in hemorrhage,effusion and infiltration of inflammatory cells inside the alveolar space,and the necrosis and defluxion of Ⅰ type and Ⅱ type epithelia cells.The pathological changes in Mont group were localized with infiltration of scanty inflammatory cells,and Ⅰ type epithelia cells were intact and there was no obvious necrosis of Ⅱ type epithelia cells.Conclusions Mont has protective effects on acute lung injury caused by PQ poisoning in rats.

Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute kidney injury (AKI).Methods A total of 260 healthy male Sprague-Dawley rats (250-300 g) were randomly divided into 6 groups:normal control group,sham group,CLP model group,the large dose rHuEPO (5000 U/kg)group,the middle dose rHuEPO (1000 U/kg) group,and the small dose rHuEPO (500 U/kg) group.The rat models of sepsis were established by CLP.In treatment groups,rats were treated with rHuEPO through caudalis injection after CLP surgery.Each group was divided into 2-,6-,12-,24-,36-hour subgroups with 10 rats.Rats were sacrificed and the tissue samples including kidney and blood samples were collected.The kidney function,plasma cytokines [interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α)],kidney injury moleclue 1 (KIM-1) and inducible nitric oxide synthase (iNOS)were measured.Cytokines were determined by ELISA method.The expression of nuclear factor-kappaB (NF-κB) protein in kidneys were detected by immnunohistochemistry method.Pathological changes of kidney tissues were observed by light and transmission electron microscopy for cytokine content and apoptosis.Results Compared with CLP model group,renal function,the levels of TNF-α,IL-6,KIM-1 and iNOS in serum,the expression of NF-κB,significantly decresed in large dose rHuEPO group (all P ＜ 0.05).rHuEPO also lessened the histological changes in large dose group.rHuEPO did not lessen the histological changes in others.Conclusion rHuEPO can inhibit the levels of TNF-α,IL-6 and iNOS in serum,thus modify the inflammatory response and provide protective effects against acute kidney injury induced by sepsis.

Objectives To compare total laparoscopic gastrectomy with intracorporeal hand-sewn Gl reconstruction and laparoscopy-assisted gastrectomy for gastric cancer. Methods Between July 2009 and July 2010, 21 patients of gastric cancer underwent total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn reconstruction and 28 did laparoscopy-assisted D2 radical gastrectomy in Xijing Hospital of Digestive Diseases. All patients were operated on by an experienced surgeon. Patient demographics, TNM stage, location of tumor, the intraoperative and postoperative details of the two groups were compared. Results In the 21 patients undergoing total laparoscopic gastrectomy, there were 15 of distal gastrectomy and 6 of total gastrectomy, compared with 21 and 7 in laparoscopy-assisted group. In total laparoscopic group, intracorporeal hand-sewn technique was used for gastro-jejunal and jejuno-jejunal (J-J)anastomosis, and 25 mm circular stapler was used for esophago-jejunal anastomosis. The operation time was significant longer in total laparoscopic group than in laparoscopy-assisted group of (279 ± 65 ) min vs.(232 ±40) min (P ＜ 0.05 ). No significant difference was observed between the two groups in proximal margin [(5.7 ± 1.5 )cm vs. (5.1 ± 1.4) cm, P ＞ 0.05] and distal margin [( 3.1 ± 0.9 )cm vs. ( 2.9 ±0.9) cm,P ＞0.05]. The iv narcotic use in laparoscopy-assisted group was 1.8 d but it was not used in total laparoscopic group. The first passing flatus was on day 3 in total laparoscopic group compared with 4.8 d in laparoscopy-assisted group. Both groups had 2 postoperative early complications, one intra-abdominal infection and one lung infection in total laparoscopic group compared with one wound infection and one lung infection in laparoscopy-assisted group. There was no anastomosis-related complications after 4 months of follow-up. Conclusions The operation time and postoperative early complication was acceptable for selected patients treated by total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn GI tract reconstruction in hands of experienced laparoscopic surgeon.