Ketamine, a nons-elective N -methyl-D-aspartate (NMDA ) receptor antagonist , is widely used as a general anesthetic in clinical practice. Recent studies have shown that ketamine can produce rapid , effective, and long-lasting antidepressant effects , and the strength of synaptic plasticity induced by inhibitory interneurons , excitatory transmitters , AMPA receptors , and postsynaptic signal pathways may be involved in this procedure .The antidepressant effects of ketamine and the underlying mechanisms are concisely intro -duced in this paper .

Objective To investigate the clinical values of serum histidine decarboxylase(HDC),intestinal fatty acid binding protein(I-FABP),and diamine oxidase(DAO)for diagnosing intestinal mucosal injury (IMI)in patients with intestinal obstruction.Methods The expression levels of serum HDC,I-FABP,and DAO in 28 patients with strangulated intestinal obstruction,19 patients with simple intestinal obstruction,17 patients with acute simple appendicitis,and 20 healthy control were determined by enzyme-linked immunosorbent assay (ELISA)before clinical treatment,and then the areaa under receiver operating characteristic curves(AUC)of these diagnostic indicators were compared.In addition,the incidences of systemic inflammatory response syndrome (SIRS)and infectious complications were closely observed.The difference of the expressions of HDC,I-FABP,and DAO and their relationship with SIRS and infectious complications were compared among these patients and controls.Results The expression levels of serum HDC, I-FABP, and DAO were the highest in patients with strangulated intestinal obstruction (all P < 0.001), and the expression levels of these three indicators were significantly higher in patients with simple intestinal obstruction than in those with acute simple appendicitis or healthy controls (all P<0.05).The AUC of HDC (0.913) was significantly larger than that of I-FABP (0.877, P =0.000) and DAO (0.873, P = 0.000).When the cut-off value of HDC ≥31.00 ng/ml, the sensitivity, specificity, false negative rate, and false positive rate of HDC were 74.5% , 94.6% , 25.5% , and 5.4% , respectively,which were all better than those of I-FABP and DAO.There were significant differences of the incidence of SIRS ( P = 0.046) and abdominal infection (P = 0.027) among patients with strangulated intestinal obstruction, patients with simple intestinal obstruction, and patients with acute simple appendicitis, while lung infection showed no such significant difference (P = 0.728).The expression level of serum HDC was significantly higher in patients with strangulated intestinal obstruction who were also suffered from SIRS ( P = 0.000) or abdominal infection ( P =0.002) than that of uninfected patients.Meanwhile, the expression levels of serum I-FABP and DAO were significantly higher in the SIRS patients with strangulated intestinal obstruction than that of uninfected patients ( P = 0.027, P=0.017, respectively).The expression levels of HDC, I-FABP, and DAO were significantly correlated with the incideces of SIRS and abdominal infection ( all P < 0.05 ) , among which the level of HDC and the incidence of SIRS had the highest correlation (R = 0.608, P = 0.001).Conclusion HDC can be an effective indicator for diagnosing IMI in patients with intestinal obstruction.

Objective To summarize the clinical experience of intracranial wide-necked aneurysms using intracranial stent technique or balloon-assisted technique. Methods Thirty-three ruptured intracranial wide-necked aneurysms were treated by stent-assisted or balloon-assisted technique combined with the use of Microplex coils. The lesions included 8 anterior communicating artery aneurysms, 19 posterior communicating artery aneurysms, 3 middle cerebral artery aneurysms and 3 basilar artery aneurysms. Results Of 19 patients treated with stent-assisted technique and Microplex coils, complete occlusion of the aneurysm was achieved in 13, over 90% occlusion in 4 and (70-90) % occlusion in 2. Among another 14 patients treated with balloon-assisted technique and Microplex coils, complete occlusion of the aneurysm was achieved in 9, over 90% occlusion in 3 and (70-90) % occlusion in 2. Conclusion For the treatment of intracranial wide-necked aneurysms, both the stent-assisted and balloon-assisted techniques are safe and effective. In treating intracranial wide-necked aneurysm, the selection of proper technique should be based on the patient's individual condition.

OBJECTIVETo observe the lower gastrointestinal mesenchymal tumors CT virtual endoscopy and pathology, and to explore its possible mechanism.

METHODSSelect 80 patients suspected colon gastroenterology treat in the hospital gastroenterology department, randomly divided into experimental group and control group, 40 cases in experimental group were given CT virtual endoscopy and pathological check, the control group received conventional colonoscopy and pathological check, and all the results compared with the pathological results.

RESULTSCompared with the pathological test results, consistent rate with the experimental group reached 94.73%, the same rate was 92.85% in control group. The difference was not statistically significant (P > 0.05).

CONCLUSIONSCT virtual endoscopy can quickly image and draw detailed information, and can improve the sensitivity and specificity of cancer diagnosis greatly. Clinically, CT virtual endoscopy have the same function as colonoscopy, can replace colonoscopy, can be important complement of electronic colonoscopy by those who cannot tolerate electronic colonoscopy or have contraindications. Its value is worth taking a step forward in-depth study.

Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; Endoscopy, Gastrointestinal ; methods ; Female ; Humans ; Male ; Mesenchymoma ; diagnostic imaging ; pathology ; Middle Aged ; Tomography, X-Ray Computed

Intestinal ischemia is a severe and life-threatening acute abdomen. Although its incidence is low,early diagnosis remains relatively difficult. The efficiencies of conventional laboratory biochemical tests are low. In recent years, many new markers for the early diagnosis of intestinal ischemia have been developed. In this article,we summarize their diagnostic efficiencies and relevant factors.

Epidemiologic evidence suggests that diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm formation. Diabetes mellitus may affect the physiological characteristics of the aorta and reduce the prevalence, incidence and expansion rate of abdominal aortic aneurysm. But the impact of diabetes mellitus on the rupture, operative complication and clinical outcome of abdominal aortic aneurysm is unclear. Randomized controlled trials are needed before conclusions can be drawn on the link between development and expansion of abdominal aortic aneurysm and medicines for diabetes. This review aims to analyze updated evidence of the association between diabetes mellitus and abdominal aortic aneurysm.

0.05). CONCLUSION: Only partial of the breast cancer tissues were seen of expression changes in ER, PR, C-erbB-2 and p53 after neoadjuvant chemotherapy, but on the whole, the neoadjuvant chemotherapy has no significant influence on the expressions of ER, PR, C-erbB-2 and P53.

Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; Humans ; Mastoid

This paper analyzed the current status of clinical research at Peking University, which was compared with that of a number of international and domestic universities. Suggestions were put forward in accordance with the current domestic problems in clinical research.

Intestinal immunologic barrier plays an important role in preventing the bacterium and endotoxin.Lymphocyte homing to the intestine is one of the normal intestinal immunologic functions,and has the theoretical significance and clinical value for the balance of intestinal immunologic barrier.The basic and clinical researches of lymphocyte homing to the intestine are reviewed.