Objective To investigate the effects of ketamine combined with electroconvulsive shock (ECS) on inflammation and amyloid-beta peptide in hippocampus of depressive rats.Methods Chronic unpredictable mild stress (CUMS) was used to generate animal models of depression.Forty-eight adult male Sprague-Dawley rats were randomly divided into 4 groups (n=12):depression model group (group D),electroconvulsive shock group (group DE),ketamine combined with electroconvulsive shock group (group DKE),and ketamine group (group DK).Rats in group D received sham ECS treatment;rats in group DE received ECS treatment;rats in group DKE were given intraper-itoneal injection of ketamine (100 mg/kg) and then received ECS treatment;rats in group DK were given intraperitoneal injection of ketamine (100 mg/kg) and then received sham ECS treatment.Morris water maze was used to assess the memory abilities of rats.The expression levels of IL-1β and TNF-α were measured by real-time PCR.Enzyme-linked immunosorbent assays were used to detect the levels of soluble Aβ.Results Before the administration of ECS or ketamine treatment,there was no significant difference in the escape latencies and space exploration time between the 4 groups (P>0.05).After the ECS and ketamine treatment,rats of group DKE exhibited a shorter escape latencies and a longer space exploration time,and the expression of IL-1β and TNF-α mRNA were down-regulated while the concentration of Aβ1-40 and Aβ1-42 were increased compared with group DE with significant difference (P<0.05).Conclusion Ketamine can alleviate ECS-induced learning and memory impairments in depressive rats.This cognition-protecting effect of ketamine may be attributed to its suppression of ECS-induced neuroinflammation and decrease of the levels of soluble Aβ in the hippocampus of depressive rats.

Objective To observe the changes of hepatic CT perfusion parameters and their correlation with serum aspartate transaminase( AST),alanine transaminase(ALT) and alkaline phosphatase (ALP) in a rabbit hepalic ischemia reperfusion injury (IRI) model.Methods Hepatic IRI was produced in rabbits by inducing left liver lobe ischemia (60 min) followed by 6 h,12 h and 24 h reperfusion (6 rabbits were used for each reperfusion interval ).Additional 6 rabbits were served as sham-operatedcontrols.All the rabbits were scanned with a dynamic iCT protocol.Blood samples were taken from the superior mesenteric vein to measure the levels of serum amylase (ALT,AST,and ALP) in various groups,and liver samples were taken for histological examinations after scanning.One-way analysis of variance (ANOVA) was used to determine differences between groups.The correlations of CT perfusion parameters with serum levels were analyzed using Pearson correlation coefficient.Results Heterogeneity of CT perfusion patterns appeared in the 6 h groups,which presented as low enhanced area [ ( 25.1 ± 9.3 ) ml · 1min-1 · 100mg-1].In reduced perfusion regions of IRI group,HAP of 12 h IRI group [ ( 19.5 ± 13.6) ml · min-1 · 100 mg-1],24 h IRI group [(8.0+2.7) ml · min-1 · 100 mg-1 ],HPP of 6 h IRI group [(10.8±5.5) ml · min-1 · 100 rng-1],12 h IRI group [(14.4±5.2) ml · min-1 · 100 mg-1],24 h IRI group [(7.8±3.3) ml · min-1 · 100 mg-1] and TLP of 6 h IRI group [(35.9 ±14.0) ml ·min-1 · 100 mg-1 ],12 h IRI group [ (33.9 ± 16.1) ml · min-1 · 100 mg-1 ],24 h IRI group [ (16.0 ±5.5) ml · min- 1 · 100 mg-1 ] were lower than those of sham group [ HAP (21.2 + 10.5 ) ml · min-1100mg-1,HPP(63.5±24.0) ml · min-1 · 100 mg-1,TLP (81.4±24.8) ml · min-1 · 100 mg-1](F=8.376,25.950,16.925,P＜0.01).However,HPI of 6 h IRI group [(65.9±3.9)％],12 h IRIgroup [ (54.2 ± 16.7)％ ],and 24 h IRI group [ (48.9 ± 10.0)％ ] were higher compared to sham group [ ( 24.1 ± 7.5 ) ％ ] ( F =43.664,P ＜ 0.01 ).But,the perfusion parameters in the relatively normal area of IRI groups showed decline compared with sham group.The levels of AST,ALT and ALP in IRI groups were significantly higher than those in the sham group ( P ＜0.05).In poorly enhancing tissues,TLP and HPP of IRI groups were inversely correlated with AST and ALP respectively ( P ＜ 0.01 ),and HPI was closely related to the increase of AST ( r =0.751,P ＜ 0.01 ).Conclusion These results demonstrate CT perfusion is sensitive to detect the hemodynamic changes.Perfusion parameters are closely correlated to the degree of liver injury in the rabbit IRI model.

Objective To investigate the the operative time of two stage soft ureteroscope lithotripsy for hemorrhagic embolism after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 1 patient with massive hemorrhage after PCNL who treated with superselective renal artery embolization and ureteral soft lens were analyzed.Results The patient with postoperative bleeding after PCNL was treated with superselective renal artery branch embolization,after 30d embolization,the holmium laser lithotripsy under the soft ureteroscope for ureteral calculi was performed,and the renal pelvis mucosa smooth,no bleeding and scar formation were intraoperative visible.After operation,the stone was removed basically,and the double J tube was removed 2 weeks after operation.The patient had no special discomfort and the renal function was normal.Conclusion Postoperative 14-30d is a relatively safe time to perform flexible ureteroscopic lithotripsy for super selective renal artery embolization in the treatment of patient with massive hemorrhage after PCNL.

OBJECTIVE To obser ve the efficacy and safety of rimazo lom for painless gastroscopy sedation in outpatients. METHODS Totally 84 patients who underwent painless gastroscopy were collected from the outpatient department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to June in 2021. By random number table method combined with envelope allocation concealment method ，they were randomly divided into observation group and control group ，with 42 cases in each group. The patients in the observation group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+Rimazole toluenesulfonate for injection 0.2 mg/kg. Patients in the control group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+ Propofol emulsion injection 2 mg/kg. Gastroscopy was performed after the patient ’s consciousness disappeared. The sedative efficiency，sedative onset time ，recovery time and the occurrence of adverse drug reaction were observed in 2 groups. The heart rate（HR），mean arterial pressure （MAP），pulse oxygen saturation （SpO2），modified observer ’s assessment of alertness/sedation （MOAA/S）score and Narcotrend score were recorded in 2 groups after entering the room （T0），after anesthesia induction （T1）， when gastroscope entered the throat （T2），at the end of gastroscope withdrawal （T3），5 min after gastroscopy （T4）. RESULTS There was no significant difference in the effective rate of sedation （100％），the incidence of respiratory depression ， nausea and vomiting between the two groups （P＞0.05）. The qq.com onset time of sedation in the observation group was longer than control group ，and the recovery time and the incidence ofhypotension，hypotension to be tre ated，injection pain and bradycardia in observation group were significantly shorter or lower than control group （P＜0.05）. At T 0，there was no significant difference in HR ，MAP，SpO2，MOAA/S score or Narcotrend score between two groups （P＞0.05）. From T 1 to T 4，the HR of control group was significantly lower than that of the same group at T 0，and significantly lower than observation group at the same time（P＜0.05）. From T 1 to T 3，the MAP of two groups were significantly lower than the same group at T 0（P＜0.05），but there were no significant differences between two groups and between T 4 and T 0（P＞0.05）. There was no significant difference in SpO 2 at different time points between two groups and HR at different time points in observation group （P＞0.05）. From T 1 to T 3，MOAA/S score and Narcotrend score of two groups were significantly lower than the same group at T 0，while the MOAA/S score and Narcotrend score at T 1 and T 3 and Narcotrend score at T 3 of observation group were significantly higher than control group at the same time （P＜0.05），and the Narcotrend score of observation group at T 2 was significantly lower than control group at the same time（P＜0.05）；at T 4，there were no significant differences in MOAA/S score and Narcotrend score between two groups （P＞ 0.05）. CONCLUSIONS Remazolam shows good sedative effect and safety for painless gastroscopy.

OBJECTIVE To analyze the odor composition changes of two kinds of traditional Chinese medicine sachet （children type and adults type） with different placement time by using ultra-fast gasphase electronic nose technology. METHODS The change rule of sachet components at different storage times was analyzed by gas chromatography. At the same time， the qualitative results were obtained by combining electronic nose with Arochembase database. Discriminant factor analysis was used to analyze the overall odor composition differences of the two sachet samples. RESULTS A total of 10 odor compositions were identified in children-type sachet， including α-pinene and β-pinene as the functional index compositions； five odor compositions of children-type sachet disappeared after 0.25 days， and most of them disappeared after 7 days； the cumulative contribution rate of discriminant factor analysis was 99.225%. A total of 8 odor compositions were identified in adult-type sachets， including α-pinene and α-phellandrene as the functional index compositions； four odor components disappeared after the adult-type sachet was placed for 0.25 days； after 15 days of placement， the peak 6-8 disappeared， and the intensity of peak 5 decreased by 34.3% compared with 0 day of placement； the cumulative contribution rate of discriminant factor analysis was 91.965%. CONCLUSIONS With the extension of storage time， the smell and composition of the two traditional Chinese medicine sachets are decreasing. It is recommended that the use time of children-type sachet is 7 days， and that of adult-type sachet is 15 days.