Objective To investigate the effects of amino acid receptor antagonists in the treatment of vascular dementia after cerebral apoplexy in elder in the function of study and memory.Methods 68 elder patients(≥65 years older) with vascular dementia caused by stroke from August 2014 to December 2015 in tongde hospital of zhejiang province were selected and randomly divided into study group and control group , 34 cases in each group.The control group received the convention treatment and combined with compound haishe capsule three pills each time , three times/day,the study group received convention treatment and combined with memantine three weeks before 5-15 mg/day,fourth week 20 mg/day,two groups were treated for six months.Cerebrospinal fluid,hematological and clinical indexes were compared before and after treatment.Results Compared with before treatment, levels of SS and AVP of cerebrospinal fluid in two groups after treatment increased,levels of MMSE and HDS-R increased,scores of ADL decreased, levels of P300 in latency decreased and levels of P300 in amplitude increased,levels of VEGF and BDNF increased,the differences were statistically significant (P<0.05).Compared with the control group,levels of SS and AVP in cerebrospinal fluid in the study group were higher,levels of MMSE and HDS-R were higher,scores of ADL were lower,levels of P300 in latency were lower and levels of P300 in amplitude were higher,and levels of VEGF and BDNF were higher,the differences were statistically significant (P<0.05).Conclusion Amino acid receptor antagonists can increase the ability of learning and memory in patients with senile vascular dementia after stroke, and it can improve the cerebrospinal fluid and blood indexes.

Objective: To explore the clinical significance of combination preoperative carbohydrate loading and postoperative enteral nutrition in patients with gastric cancer during perioperative period. Methods: 70 patients were randomly divided into group A(preoperative fasting + postoperative EN,n = 23),group B(preoperative carbohydrate loading + postoperative TPN,n = 23) and group C(preoperative carbohydrate loading + postoperative EN,n = 20).After operation,insulin sensitivity,nutritional status,immune function and clinical outcome were compared among three groups. Results: Compared with the other two groups in insulin sensitivity,nutritional status,immune function and clinical outcome,the group C was better and different(P

Objective To analyze the clinical features of 6 patients with imported schistosomiasis mansoni,including the epidemic history,clinical manifestations,laboratory tests and therapeutic effect,so as to provide references for improving the levels of diagnosis and treatment of physicians. Methods The clinical data of 6 patients with imported schistosomiasis mansoni from January 2009 to July 2016 were collected and analyzed. Results All the 6 imported patients with schistosomiasis mansoni had a clear history of cercarial infested water exposure. The main manifestations were continuous fever and eosinophilia. Three (50%)patients were accompanied with diarrhea. Anti-Schistosoma japonicum IgG antibody were cross positive in 2(33.3%)pa-tients,while live eggs of S. mansoni were explored in intestinal mucosa specimens of all the patients. CD3+CD8+T cell ratio was decreased significantly but B cell ratio was elevated in all the patients,and the main immunoglobulin of the patients was IgG. Hydroperitoneum and splenomegaly signs were discovered by abdominal ultrasonography in 16.6%(1/6)of the patients. Multi-ple liver nodules and wall thickening of rectum and sigmoid colon were revealed by pelvic MR scan in 16.6%(1/6)of the pa-tients. Colitis was found in all the patients,and 66.6%(4/6)of the patients were combined with multiple colonic ulcers by the electronic colonoscopy examination. Chronic inflammation and eosinophil infiltration were found in all the patients by rectum pa-thology. All 6 patients were cured with chemotherapy named praziquantel. Conclusion Comprehensive analysis of clinical data including epidemiological history,specific manifestations,laboratory tests and intestinal mucosa pathology may be benefit of the management of schistosomiasis mansoni.

Objective To investigate the histological changes of the right ventricular remodeling in Xinjiang Mar-mota baibacina which are adapted to high-altitude hypoxia .Methods Hematoxylin and eosin and Masson staining was used to examine the pathological changes and degree of fibrosis , and immunohistochemical technique was used to detect connexin 43 ( CX43) expression in the right ventricular myocardium .Results In the right ventricular myocardium , cardio-myocyte hypertrophy and increased amount of collagen fibers were observed .The right ventricular hypertrophy index and weight index of Marmota baibacina were significantly higher , and expression of CX43 was significantly reduced than that of normal rats ( P<0.05 for both ) .Conclusions High-altitude hypoxia induces right ventricular remodeling in Xinjiang Marmota baibacina.It can be used as an ideal animal model for studies on the mechanisms of hypoxia adaptation on high -altitude plateau .

Hematogenous metastasis is common in lung cancer, and except for small cell lung cancer and melanoma, tumors with extensive metastasis seldom involve the prostate. The treatment of lung adenocarcinoma with prostate metastasis relies mainly on systemic chemotherapy with rigorous treatment of the primary lesions and metastatic palliative radiotherapy. Comprehensive treatment integrating traditional Chinese medicine may improve the quality of life of the patients.
Adenocarcinoma ; pathology ; Aged ; Humans ; Lung Neoplasms ; pathology ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; secondary

Objective:To discuss the essentials of anesthesia management and treatment strategies for emergency transcatheter aortic valve replacement (TAVR), and to provide standardized recommendations for the development of emergency TAVR technology in China.Methods:This study retrospectively analyzed the relevant data of patients undergoing emergency TAVR surgery in the Second Affiliated Hospital of Zhejiang University School of Medicine from March 2019 to February 2021, including baseline patient characteristics, perioperative echocardiography data, prognosis and 30-day follow-up. Post-operative data were compared with pre-operative data using paired-sample test.Results:Thirteen patients, aged (75.62±9.63) years, underwent emergency TAVR surgery, and 6 of them were male. Eleven patients were New York Heart Association class Ⅳ. The preoperative Society of Thoracic Surgeons score was (20.31±15.15)%. The trans-aortic valve differential pressure was significantly reduced after surgery [(68.92±30.66)mmHg vs. (2.70±2.36)mmHg, P<0.01]. Two patients died within 30 days after surgery, one patient developed a new third degree atrioventricular block, one patient had a stroke, and 4 patients developed pulmonary infection. Conclusions:Emergency TAVR surgery is a feasible and effective rescue strategy for patients with aortic stenosis in critical condition. The establishment of anesthesia standard operation procedure process for TAVR surgery helps ensure homogenized medical behavior and good teamwork.

Objective To explore the clinical feature,treatment and prognosis of incidental prostate cancer(IPC) after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).Methods From January 2009 to April 2017,24 cases undergoing TURP for benign prostatic hyperplasia and being diagnosed with prostate cancer(T1a-T1b) was retrospectivey analysed,who aged from 62 to 84 years (mean 71.8 years).Digital rectal examination (DRE) showed prostate medium texture,smooth surface,and no nodules.Ultrasound presented no low echo nodules in the prostate.Prostate volumes were 19.2-93.4 ml,with median of 40.1 ml.PSA were 1.81-9.11 ng/ml,with median of 4.12 ng/ml.The patients with PSA between 6-10 ng/ml accepted prostate biopsy,and pathological results were negative.Results The The pathology of TURP specimens in 24 cases were diagnosed prostate cancer (21 cases of T1a,3 cases of T1b).According to the new WHO/ISUP classification group,there were 18 cases of hierarchical group 1,3 cases of hierarchical group 2,1 case of hierarchical group 3,2 cases in hierarchical group 4.All patients were treated with hormonal therapy,and 7 cases (5 cases of hierarchical group 1,and 2 cases of hierarchical group 2) underwent laparoscopic radical prostatectomy (LRP) after 3 months of hormonal therapy.The specimens of prostatectomy were examined by whole-mount serial,showing 3 cases of prostate cancer (T1a) with negative margin,and 4 cases of benign prostate cells.They were followed up for 5-82 months with median of 43.5 months.No biological progression or tumor progression was found,and,1 case died of colon cancer after 26 months of follow-up.The patients' age and Gleason score of stage T1b were higher than that of stage T1a.Prostate volume and preoperative PSA had no statistically significant difference between the two stages.Conclusions The patients' age and Gleason score of stage T1b were higher than that of stage T1b.The proportion of residual tumor following TURP was high.The prognosis of incidental prostate cancer was good by hormonal therapy or radical prostatectomy.

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.