Objective To compare the effects of propofol and ketamine on long-term memory and the expression of brain N-methylgroup-D-aspartate receptor 2B(NMDAR2B) and Gamma-aminobutyric acid receptor 1(GABAR1) in aged rats, and preliminary investigate the relation between the long-term memory and expression of neurotransmitter receptors in different cerebral areas. Methods The aged male rats were randomly divided into control group,propofol group and ketamine group. Morris water maze training was performed in all the rats of three groups for 5 days. On the 6th day, intraperitoneal injection of 50 mg?mL-1 propofol was administrated in propofol group,80 mg?mL-1 ketamine was intraperitoneally injected in ketamine group,and blank control group was given the same dose of saline.Seven days after the administration,space exploration experiment and navigation experiment test were performed to test the impact on the learning and memory ability of rats. After that, the expression levels of GABAR1 and NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain were detected by immunofluorescence and FISH technique. Results The results of Morris water maze showed there was no significant difference between propofol group (9.49±1.24) s and blank control group (8.82±2.22) s.There was statistically significant difference between ketamine group (12.04±2.67) s and blank control group (P<0.05),with longer latency time and less number of times of passing through target as compared with blank control group.By using immunohistochemistry and FISH technique,the expression of GABAR1 in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly up-regulated in ketamine group as compared with blank control group ( P<0.05) . The expression of NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly down-regulated in ketamine group as compared with blank control group (P<0.05). Conclusion Propofol anesthesia alone had no effect on long-term learning and memory,but ketamine anesthesia can result in long-term learning and memory impairment. The mechanism may be related with down-regulation of the expression of NMDAR2B receptor and up-regulation of GABAR1 not only in CA1 region hippocampus,but also in temporal lobe.

Objective To discuss the clinical application value of ultrasound contrast on evaluating fallopian tube patency.Methods Ultrasound contrast examination was conducted on 84 patients suffering from infertility and the flowing status of contrast agent in the uterine cavity and the fallopian tube and the distribution condition in the pelvic cavity were observed under the real -time ultrasound to judge the patency condition of the fallopian tube.Results After 84 patients receiving ultrasound contrast,38 cases'bilateral fallopian tubes were unobstructed,26 cases'lateral fallopian tube were unobstructed and 20 cases'bilateral fallopian were obstructed.Comparing the result of ultrasound contrast with laparoscopy,the diagnosis accuracy was 89.5%,the specificity 86% and the sensitivity 94%.Conclusion Fallopian tube ultrasound contrast technique can make an accurate and objective evaluation on the fallopian tube patency,it is an effective method to check fallopian tube patency and it is of high clinical application value.

Objective To investigate mortality risk factors in patients with severe cardiorenal syndrome treated with continuous hemofiltration therapy. So we can optimally select patients who may benefit more from this therapy. Methods The clinical data of 68 severe cardiorenal syndrome patients admitted to the ICU of Beijing Shijitan Hospital from May 2012 to May 2015 were retrospectievly analyzed and evaluated. These patients were divided into two groups based on survival or death during hospitalization. Logistic regression analysis was employed to identify independent risk factors for death of patients with severe cardiorenal syndrome during ICU stay. Results There were 36 cases in the death group and 32 cases in the survival group. In the death group, the age,mechanical ventilation rates, vasoactive drug application rates, leukocytes, neutrophils, C-reactive protein,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly higher than those in the survival group,while hemoglobin, serum creatinine, left ventricular ejection fraction, average single amount of dehydration in continuous hemofiltration process were significantly lower than those in the survival group. Logistic regression analysis showed that age, vasoactive drug application rates, APACHEⅡscore and leukocytes were independent risk factors of mortality. Conclusions Cardiac function, mechanical ventilation therapy, average single amount of dehydration in continuous hemofiltration, hemoglobin, C-reactive protein were closely related to the prognosis of severe cardiorenal syndrome patients. The patient′s age,infection, vasoactive drug application, APACHEⅡ score were important risk factors of mortality during hospitalization.

Objective To analyze the results of postoperative conventional radiotherapy supplemen- ted by stereotactic radiotherapy for glioma and with analysis of prognostic factors.Methods From Dec. 1998 to Dee.2004,143 patients with brain glioma were postoperatively treated with conventional radiotherapy supplemented by stereotactic radiotherapy.Steretactic radiotherapy of 5-7 Gy/fraction,to totally 5-7 fractions were added as boost to the GTV following the conventional radiotherapy.The conventional radiotherapy,ai- ming at the peri-tumoral subclinical micro-loci,was about 50 Gy.Results The KPS grades were 81?9, 71?9 in patients 3-6 month after treatment in contrast to that prior to operation (t=5.98,P＜0.01 ).CR 39 patients (27.3%) ,PR 70 patients(49.0% ) ,NC 25 patients(17.5%),PD 9 patients(6.3%),with an effi- ciency rate of 76%.The 1-,3-,and 5-year survival rate was 56.6%,36.0% and 21.7%,respectively. Prognostic factor analysis showed that patients with low grade glioma had better survival time.Age,tumor site and dose,etc were unrelated to prognosis.Conclusion Stereotactic radiotherapy supplementing conven- tional radiotherapy is effective for postoperative brain glioma,which method not only shows excellence in physical dose distribution but strictly in accordance with the principle of radiobiology also.

Objective To analyze the characteristics of auditory verbal memory impairment in mild Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI).Methods Auditory verbal memory test was performed in 72 patients with MCI,45 patients with mild AD,and 62 normal controls.Results Significant intergroup differences were found in total former five free recall and learning scores,The MCI subjects( 16.4?5.5,2.6?1.7)performed significantly more poorly than the normal control subjects(NC) (30.2?5.6,3.4?1.9),and mild AD categories (9.8?4.1,2.0?1.2) showed lower results than the MCI subjects(t=2.26,P

Objective To observe the clinical characteristics and prognosis in children with high take -off coronary artery.Methods The clinical characteristics,laboratory examinations and prognosis were retrospectively ana-lyzed in 49 children with high take -off coronary artery who had been admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from April 2009 to December 201 2.Results Among 49 medical records of children with high take -off coronary artery,34 cases were male and 1 5 cases were female,with a mean age of (9.28 ±4.42)years old,and the youngest patient was 1 3 months old,and the oldest patient was 1 7 years and 2 months old.The 64 -section multidetector CT angiography of all patients showed one or both coronary arteries originated from 1 .0 cm higher than the junction area of sinus and aorta,including 38 high take -off of the left coronary artery,7 high take -off of the right coronary artery and 4 high take -off of both coronary arteries.The chief complaints of the patients included chest pain (22 cases,44.90%),chest tightness(1 3 cases,26.53%),declining of exercise tolerance(7 cases,1 4.29%),fatigue (5 cases,1 0.20%),palpitation(3 cases,6.21 %),syncope(1 case,2.04%).Electrocardiogram(ECG)of those pa-tients showed ST -T changes,atrioventricular block,sinus tachycardia,pathological Q -wave,proiosystole and bundle branch block.Ultrasonic cardiogram(UCG)indicated 1 4 patients with the enlarged left ventricle,including 2 patients with ejection fraction lower than 60%.After 1 0 days hospitalization,the anesis of chest pain and chest tightness were significantly different statistically(P <0.05),but there was no significant difference in ECG and UCG.Thirty -nine out of 49 children were followed for 1 year.After 3 months,6 patients with ST -T problem showed normal ST -T segment. After 6 months,1 0 patients with ST -T problem showed normal ST -T segment.After 1 year,1 7 patients with ST -T problem showed normal ST -T segment.Conclusions High take -off coronary artery is a rare malformation of the coronary artery,which can cause myocardial ischemic,leading to multiple clinical manifestations and may result in ECG changes and the left ventricle enlargement.High take -off coronary artery can be confused with myocarditis and myocar-dial lesion clinically.Patients receiving systemic treatment may have their symptoms released,but ECG and UCG may not relieve in a short term.Patients with high take -off coronary artery need long -term observation.

Objective To evalute and compare the efficacy and safety of epinephrine-saline submu-cosal injection of different concentrations on endoscopic submucosal dissection (ESD),and to discuss the best concentration of submucosal injection.Methods A total of 128 patients who underwent ESD were ran-domly assigned to submucosal normal saline injection group (group A,n =32),0.001% epinephrine-saline injection group (group B,n =32),0.002% epinephrine-saline injection group (group C,n =32),and 0.004% epinephrine-saline injection group (group D,n =32).The incidence of bleeding during and after ESD were counted,the blood preasure and heart rate of preoperative and intraoperative,the amount of sub-mucosal injection,the time of operation were observed.Results ESD was successfully performed on all pa-tients.There were no difference in highest blood preasure and fastest heart rate between preoperative and in-traoperative results of each group.No perforation or intraoperative acute massive bleeding occurred.Intraop-erative acute minimal bleeding during ESD occurred in 9 patients in group A and 3 in group B,2 in group C and 2 in group D (P <0.05),but there were no differences among group B,C and D.The amount of submu-cosal injection of group A was(39.5 ±10.8)ml,which was more than that of group B(29.4 ±9.4)ml,group C(27.3 ±8.2)ml and group D(20.4 ±11.8)ml with significant difference.There were no differences a-mong group B,C and D,but there was less in group D than group B.The operation time of group A was(82.3 ±24.78 minutes),which was longer than that of group B (60.7 ±25.35minutes),group C (54.7 ± 31.72minutes)and group D(59.2 ±28.49 minutes),but there was no difference among B,C and D group. Conclusion Epinephrine-saline submucosal injection assiting ESD is safe and effective and reduces the op-eration time and bleeding than normal saline.The increase of the epinephrine-saline concentrations has not been found to be more beneficial.

OBJECTIVETo investigate the value of technetium-99m methoxyisobutylisonitrile ((99)Tc(m)-MIBI) imaging in predicting the efficacy of neoadjuvant chemotherapy (NCT) and prognosis in patients with operable breast cancer.

METHODSSixty five patients with breast cancer underwent (99)Tc(m)-MIBI scintimammography before NCT, and static planar images were taken at 10 min and 180 min after scintimammography. The clearance rate was calculated in each patient, correlation between the clearance rate and efficacy of NCT, and the disease free survival rate were analyzed.

RESULTSThe mean clearance rate of 65 patients was (17.4 ± 6.8)%. The efficacy of NCT was 86.2% (CR 4 cases, PR 52 cases, SD 8 cases, and PD 1 case), and the mean clearance rate of patients with good response or poor response of chemotherapy were (15.5 ± 5.0)% and (29.2 ± 3.2)%, respectively. There was a significant difference between the two groups. The average disease free survival rate in the group with low clearance rate was (75.8%, P = 0.046), significantly higher than that in the group with high clearance rate (53.1%).

CONCLUSIONScintimammography of (99)Tc(m)-MIBI may be used to evaluate the efficacy and prognosis of NCT for patients with operable breast cancer.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; diagnostic imaging ; drug therapy ; Carcinoma, Ductal, Breast ; diagnostic imaging ; drug therapy ; Carcinoma, Lobular ; diagnostic imaging ; drug therapy ; Chemotherapy, Adjuvant ; Cyclophosphamide ; therapeutic use ; Disease-Free Survival ; Epirubicin ; therapeutic use ; Etoposide ; therapeutic use ; Female ; Fluorouracil ; therapeutic use ; Follow-Up Studies ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Predictive Value of Tests ; Radionuclide Imaging ; Radiopharmaceuticals ; Remission Induction ; Taxoids ; therapeutic use ; Technetium Tc 99m Sestamibi

Objective To study the diagnosis and treatment of primary adenosquamous carcinoma (ASC) of liver.Methods The clinical and histopathological data of 2 patients with ASC were analyzed retrospectively.The cases were confirmed by surgery and histopathological examination.Results The tumors were located in the left liver in these 2 patients.Both patients presented with abdominal pain and they underwent surgical resection.On gross pathological examination,the tumors were irregular in shape with unclear boundaries.Microscopically,the tumor cells were arranged in a nesting pattern with a tubular structure,which was an adenosquamous carcinoma structure.One patient survived 4 months after surgery and the other patient died of intrahepatic tumour recurrence 7 months after surgery.Conclusions The diagnosis of primary hepatic ASC relied on histopathological examination.Surgical resection was safe and feasible.

Objective To compare the curative effect of high ligation+exfoliation and subfascial endoscopic perforator surgery(SEPS)for superficial varicose veins in calf+invagination spot-striping surgery in great venous varicosity.Methods Study group(42 patients)accepted SEPS+invagination spot-striping surgery and control group (42 patients)accepted traditional surgeries.Operation duration,bleeding volume in operation,the time of beginning movement away from bed after operation,hospitalization duration,the degree of pain,the scar,the recrudescence af- ter operation and the instance of the ulcer heals of two groups were compared.Results Operation duration,bleeding volume in operation,the time of begin movement away from bed after operation and hospitalization durations of study group were significantly lower than those of control group(P0.05).All of the patients in study group recovered without severe syndromes such as venous thrombosis,skin necrosis,lower limb functional disorder etc.They had no recrudesce after 4～16 months and were satisfied with the curative effect.Con- elusions The clinical curative effect of SEPS+invagination spot-striping surgery in great venous varicosity is superi- or to that of traditional operation and it has the advantages such as minor wound,few scars,light pains,short hospi- talization duration,without recrudescence,the ulcer heals quickly and so on.