Objective:To investigate the prevalence of mild cognitive impairment (MCI) among elderly people aged 60 and over in urban and rural areas of Guizhou Province. Methods:A total of 4535 residents aged 60 and over was selected by random cluster sampling in Giuyang City and Zheng'an County. All participants were interviewed with questionnaires, they also received physical examination for related information, and their cognitive function was assessed by the mini-mental state examination (MMSE). Frisoni's criteria for MCI, the score of MMSE below one standard deviation matching age and education was used to this investigation. Chi-square test and u test were used in data analysis. Results: The total prevalence of MCI among all elderly people aged 60 years and over was 15.4%. Prevalence for urban community was higher than that of rural area (16.3% vs. 13.2%,?2=6.71, P=0.01). Prevalence in female (17.0%) was higher than in male (13.1%)(?2=12.88, P

Objective:To evaluate value of neuronavigator-assisted microsurgery of glioma located in cerebral functional areas.Methods:Patients with glioma located in cerebral functional areas were underwent operation in Xiangya Hospital.Of 64 patients,34 patients were performed neuronavigator-assisted microsurgery,and 30 were underwent routine surgical operation.Results:The neuronavigator-assisted microsurgery group showed high complete resection rate with low neurological deficit and cerebral edema compared with the routine surgical group (P＜0.05).Conclusion:Neuronavigator-assisted microsurgery is effective and characterized by accurate location,personalized operative incision design,and higher rate of tumor resection.

Objective To investigate the relationship between hypertension and cognitive function in community-based elderly people aged 60 and over in Guiyang city.Methods By using multistage sampling technique,general conditions and healthy status were surveyed in 3229 old individuals aged ≥60 years.Blood pressure and the mini-mental state examination(MMSE)were measured.Results Hypertensive subjects had MMSE score 25.7?4.2 lower than that 26.3?3.6 in normotensive subjects(t=3.92,P

Objective To explore the effect of a new prone position for general anesthesia.Methods 50 patients in the group were made a retrospective study:All the 50 patients needed prone position surgeries under general anesthesia.After awake flexible fiberoptic intubation,with the anesthesia of thyrocricoid puncturing the intra-trachea surface,has been taken,patients lied in the prone position according to their own comfort with the guide of medical staff,which was followed by anesthesia induction and the operation.The SBP,DBP,HR and RPP were recor-ded at different point of time after patients entered the operation room.Results 33 cases of 50 patients completed the whole process successfully and the indexes at the time of the intubation had no significant difference with those at basic state(all P >0.05).17 operations suffered discomfort.The SBP,DBP,HR and RPP in these patients were (159.2 ±25.9)mmHg,(97.2 ±11.6)mmHg,(98.2 ±9)beats per minute and (16 028 ±6 725)respectively, which were higher than those at basic state(t =2.698,2.802,5.720,8.905,all P <0.05).After applications of small dose sedative,these patients were successfully tracheal intubated.The SBP,DBP,HR and RPP were (144.0 ± 18.5)mmHg,(83.0 ±10.5)mmHg,(89.3 ±10.0)beats per minute and (12 658 ±5 521)respectively at the time of the second intubation,which had no significant difference with those at basic state(all P >0.05).Conclusion It is technically simple and easy to operate,the way that patients waiting for prone position surgeries lie in the prone position by themselves with awake flexible fiberoptic intubation lightens the workload of medical staff and reduces complications of the intubation,which is optional in clinical situations.

Ob jective To research the gene expression profile of aura-absence migraine patients before and after acupuncture of Shaoyang meridian acupoints or non-acupoints. Methods Twenty aura-absence migraine patients were randomly divided into meridian acupoint group and non-acupoint group, 10 cases in each group. Gene chip technology was used to investigate the differences of two sets of gene expression profiles, and reverse transcription-polymerase chain reaction (RT-PCR) was applied for the analysis of partial genes to verify the accuracy of gene chip detection results. Results Seventy-two differentially expressed genes were obtained in meridian acupoint group, and 110 differentially expressed genes were obtained in non-acupoint group. The function genes of meridian acupoint group involved brain endorphin enzyme, adenosine triphosphate ( ATP) synthase, etc., which were closely related with the curing of aura-absence migraine. Non-acupoint group had extensive and scattered function genes involving apoptosis, DNA repair, etc., which had less correlation with the curing of aura-absence migraine. ATPAF2, PTGS2, TOR3A genes of meridian acupoint group and ACP2, AURKA, ARHGEF11, CASP8 gene of non-acupoint group presented by RT-PCR analysis had verified the reliability of microarray data. Conclusion The therapeutic effect of meridian acupoints acupuncture for aura-absence migraine has achieved through the multi-gene action at the molecular level, but the corresponding target genes for the placebo effect of non-acupoint acupuncture have not been found , which demonstrates the existence of meridian effect.

Objective To explore the microneurosurgical technique and prevention of postoper-ative complications for the fourth ventricle tumors in adults. Methods We retrospectively analyzed the clinical data of 68 patients with the fourth ventricle tumors between August 2005 and August 2007 in Xiangya Hospital after microsurgical operation. Tumors were excised by inferior vermis cere-bellar approach or cerebellomedullary fissure approach. The extent of tumor removal should take into consideration the possible injury of brain stem respiratory center, especially tumors adherent to the brain stem. Cerebral aqueduct obstructions were removed in all patients, suspending dura on the neck muscles during closing skull to eliminate scalp hydrops. Results There were 58 total tumor excisions and 10 subtotal tumor excisions. No patient died and no suboccipital hydrops took place before dis-charge in this study. Postoperative symptomatic hydrocephalus was found in 10 patients, but it was cured by ventricle-abdomen shunt. Hemorrhage in tumor lumen happened in 4 patients, who received second microsurgery. Drugs were given to 8 patients with intracranial pneumatocele, 10 with intracra-nial infection, and 18 with upper gastrointestinal hemorrhage. Five patients out of the 16 tracheoto-mies recovered well by mechanical ventilation. Conclusion Protecting the life center of brain stem and dredging the aqueduct outlet completely were the key to surgical success. Therapeutic effect could be improved by adept microneurosurgical techniques after operation. The prognosis of patients may be improved by preventing complications actively and combined therapy after the operation.

Objective: To investigate the different efficacy of Yinchenhao Decoction (YCHD), a compound traditional Chinese herbal medicine, for liver cirrhosis induced by dimethylnitrosamine (DMN) or carbon tetrachloride (CCl(4)) in rats. Methods: To induce liver fibrosis, 0.5% DMN solution (2mL/kg body weight, i.p.) was given three consecutive days a week to male Wistar rats for 4 weeks. Cirrhotic rats were randomly divided into DMN group, YCHD group, Xiaochaihu decoction group by the end of the fourth week to accomplish a 2-week recipe treatment course. In CCl(4)-induced liver fibrosis model, 50% CCl(4)-olive solution was injected subcutaneously to rats at a dose of 2 mL/kg body weight twice a week to duplicate rat cirrhosis model. After 8 weeks, rats were divided into CCl(4) group, CCl(4) plus YCHD group and Xiaochaihu decoction group. For the YCHD group, YCHD was administered intragastrically once a day for 4 weeks. For DMN or CCl(4) model, by the end of 6 or 12 weeks respectively, rats were sacrificed for sampling to detect liver function, hepatic histological changes, hydroxyproline (Hyp) content and apoptosis-related gene expressions. Results: In DMN liver fibrosis model, hepatic fibrosis was obvious at week 2 and cirrhosis was evident at week 4 in DMN-treated rats. Compared to 6-week DMN group, hepatic pathological changes and liver function were improved significantly and content of Hyp decreased remarkably in YCHD group. In CCl(4)-induced liver fibrosis model, hepatic fibrosis was obvious at 8 weeks and cirrhosis was evident at 12 weeks in CCl(4)-treated rats. Compared to 12-week CCl(4) group, hepatic pathological changes and liver function were not obviously improvement in YCHD group. The results of gene chip showed that YCHD significantly decreased Fas, Bax and caspase-3 gene expressions, and increased Bcl-xL gene expression in the liver of DMN model. However, in the model induced by CCl(4), YCHD did not inhibit hepatocyte apoptosis induced by CCl(4), but increased tyrosine kinase receptor gene expression by 4.8 times. Conclusion: YCHD exerts more significant therapeutic effects on DMN-induced than CCl(4)-induced cirrhosis in rats in Hyp content and pathological change in liver tissue.

Objective To evaluate the effect of remffentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing open heart surgery under CPB.Methods Thirty patients (ASA grade Ⅱ or Ⅲ, NYHA class Ⅰ or Ⅱ ) of both sexes aged 18-45 yr undergoing repair: of ventricular septal defect and/or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each): control group (group C)and remifentanil postconditioning group (group R). Anesthesia was induced with midazolam, sufcntanil, propofol and rocuronium. The patients received 5 min infusion of remifentanil at 4 μg · kg- 1 · min - 1 8 min before aortic unclamping in group R, while the patients received equal volume of normal saline in group C. Blood samples were obtained from the right internal jugular vein for determination of plasma concentrations of cardiac troponin-I (cTnI)and MDA and activities of CK-MB and SOD before induction of anesthesia (baseline) and at4, 8, 24 and48 h after aortic unclamping. Results The plasma concentrations of cTnI and MDA and activity of CK-MB were significantly lower, while the plasma SOD activity was significantly higher at 4 and 8 h after aortic unclmping, and the plasma concentration of MDA was significantly lower at 24 h after aortic unclamping in group R than in group C ( P ＜ 0.05 ). Conclusion Remifentanil postconditioning can attenuate myocardial I/R injury in patients undergoing open heart surgery under CPB through inhibiting lipid peroxidation.

Objective To evaluate the effect of emulsified isoflurane preconditioning on myocardial iachemia-reperfusion (I/R) injury in rabbits.Methods Thixty-two male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups(n=8 each):group Ⅰ I/R;group Ⅱ isoflurane preconditioning (group Ⅰ);group Ⅲ emulsified isoflurane preconditioning (group EI) and group Ⅳ intralipid (group INT).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 180 min of reperfusion.After 30 min of post-preparation equilibration.the animal inhaled 3%isoflurane for 30 min followed by 15 min washout in group Ⅰ(group Ⅱ);8% emulsified isoflurane 8-10 ml was injected iv at 1 ml/s followed by continuous infusion at 6-8 ml·kg-1·h-1,maintaining end-tidal isoflurane concentration at 1.28% for 30 min in group EI (groupⅢ);30% intralipid 9 ml was injected iv at 1 ml/s fullowed by continuous infusion at 7 ml·kg-1·h-1 for 30 min in group INT (group IV).HR and BP were monitored and recorded at 30 min of post-preparatory equilibration(T0),before ischemia(T1),at the beginning of ischemia(T2),at 30 min ofischemia(T3),60,120 and 180 min of reperfnsion(T4,5,6).HR-SP product (RPP) was calculated.Infarct size (IS) was determined by TIC staining.Blood samples were taken from carotid artery at T6 for determination of serum CK and LDH activities and IL-6 and IL-10 concentrations.Results HR,MAP and RPP were decreasing during T2-6, but there was no significant difference in HR, MAP and RPP among the 4 groups.The infarct size was signigicantly smaller, serum CK and LDH activities and IL-6 concentration were significantly lower while serum IL-10 concentration was significantly higher in group I and EI than in group I/R and INT.Conclusion Emulsified isoflurane preconditioning can attenuate myocardial I/R injury by inhibiting inflammatory response.

Obgective To observe the effect of Milrinone combined with Esmolol in the treatment of severe hand-foot-and-mouth disease (HFMD) so as to improve the prognosis.Methods Eighty-two cases of children with critically severe HFMD,who were hospitalized in the Intensive Care Unit of Xuzhou Children's Hospital,were enrolled in the study from may of 2013 to June of 2014,and were randomly divided into a control group and an observation group.The control group was given intravenous Milrinone,and the observation group was given Milrinone combined with Esmolol.The heart rate (HR),systolic blood pressure (SBP),cardiac output (CO),left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP),norepinephrine (NE) were detected on admission and checked again 1 hour and 48 hours again after treatment.The changes in the above indicators were compared before and after therapy to evaluate the clinical curative effect.Results (1) There was no significant difference in the HR,SBP,CO,LVEF,BNP and NE between the 2 groups before treatment(all P ＞ 0.05).(2) The HR,SBP,CO and LVEF of 2 groups were significantly improved after 1 hour treatment compared with those before treatment (all P ＜ 0.05),and the BNP and NE of the control group were not obviously improved compared with those before therapy (all P ＞ 0.05),but the significant changes were seen in the observation group (all P ＜ 0.05).Forty-eight hours after the treatment,all the observed indicators in 2 groups were significantly improved compared with those before treatment(all P ＜ 0.01).(3)Compared with control group,the HR,SBP,CO,LVEF and BNP of the observation group were significantly improved after 1 hour treatment (t =2.08,2.12,-2.11,-2.37,2.07,all P ＜ 0.05),but the NE of the observation group had no obvious improvement (t =0.83,P ＞ 0.05).All the observed indicators of the observation group were significantly improved compared with the control group after 48 hours treatment(t =3.76,2.48,-2.70,-2.27,5.37,2.74,all P ＜ 0.05).Conclusions Milrinone combined with Esmolol can significantly improve the cardiac function and the vital signs of the children with critically severe HFMD,which can be recommended clinically.