Objective To investigate the effects of ATP, suramin, ivermectin (IVM) and low pH value on pyramidal cells of rat hippocampus. Methods Pyramidal cells were rapidly dissociated from the hippocampus of 7-day postnatal rats by mechanical and enzymatic methods. Effects of ATP, suramin, IVM and low pH value on P2X receptor of neurons were studied by the technique of whole cell patch clamp. Results The transmembrane current was affected by ATP and suramin. There were different effects of IVM and low pH value on ATP induced current on different neurons. Conclusion There is extensive expression of P2X receptor on hippocampus pyramidal cells of rats. The expression of P2X receptors subunits are different among neurons.

Objective To observe the expression and phosphorylation of N-methyl-D-aspartate (NMDA) receptor NR1 subunit in rat cortex and hippocampus under high altitude hypoxia. Methods The adult SD rats were exposed to hypobaric hypoxia imitating 5 500-meter high altitude for 8 h daily for 3, 7, 14, 21 d. Immunohistochemical staining, Western blotting and co-immunoprecipitation were used to detect the expression and phosphorylation of NR1 in rat cortex and hippocampus. Results Both immunohistochemistry and Western blotting showed NR1 expression in rat cortex and hippocampus was increased under hypoxia in a time-dependent manner. The tyrosine phosphorylation of hypoxia groups was increased, and reached the peak on day 14 after hypoxia, then decreased, still higher than that of control groups till day 21 (P

Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.

Objective To investigate the expression of P2X receptors in CA1 subfield of rat hippocampus and the effect of hypoxia on the expression. Methods We set up the hypoxia animal model of high altitude and observed the expression of P2X receptors by using immunohistochemical staining before and after hypoxia. Results Immunohistochemistry showed that there were several sub-type of P2X receptors expressed in hippocampus CA1 neurons. After long term hypoxia, the expression of these receptors was increased. Conclusion there were abundant of P2X receptors expressed on the hippocampus CA1 neurons. Hypoxia affects the expression P2X receptors.

ObjectiveToevaluatelaparoscopiccholecystectomy(LC)versusopen cholecystectomy (OC) in compensated cirrhotics and model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP)classification in predicting perioperative morbidity.MethodsBetween January 1998 and June 2011,128 cirrhotic patients of symptomatic innocuous gallbladder disease at CPT class A or B liver function were prospectively and randomly divided into LC group (64 patients) and OC group (64 patients ). Data were analyzed by T test, Mann-Whitney U test and Pearson x2 test.ResultsThere was no statistical differences in operation time between the two groups ( t =1.761,P =0.081 ).The intraoperative blood loss ＞ 200 ml occurred in 15 ( 26％ ) LC patients and 35 ( 55％ ) OC patients ( x2 =4.467,P =0.035 ).LC patients had earlier up and about,earlier oral intake,short hospital stay ( t =5.424,t =8.573,t =15.634; P =0.000,respectively) and lower complication rate [ CTP:24％ (14/58) vs 38％ (24/64),x2 =4.582,P =0.032; MELD scores 21％ (12/58) vs 34％ (22/64),x2 =4.238,P =0.040] compared with OC patients.LC patients' VAS- fatigue and VAS-pain scores on first 3 days were lower than OC according to the VAS (visual analogue scale) (Mann-Whitney U =473.0,MannWhitney =6.0,Mann-Whitney =22.5,Mann-Whitney =24.0,Mann-Whitney =46.0; P =0.000,respectively),and the VRS-cosmetic score was higher in LC group than in the OC group according to the VRS ( verbal rating scale) ( Mann-Whitney =145.0,P =0.000).MELD score ＞ 14 predicted higher blood loss and complication rate regardless of LC or OC,while CPT classification did not seem to predict intraoperative bleeding volume and morbidity.ConclusionsLC can be performed safely in cirrhotic patients with CPT class A and B.LC has less,blood loss lower postoperative complication rate,and quicker postoperative recovery.MELD score system is more valuable than CPT classification system in predicting blood loss and postoperative complication rate in cirrhotics undergoing cholecystectomy.

Objective To investigate the clinical outcome before and immediately after implementation of fast track surgery protocol on patients with gastric cancer.Methods One hundred and thirty patients with gastric cancer in our hospital underwent an elective,uncomplicated,open gastric surgery before (Traditional care group,n =65) and immediately after implementing fast track surgery (Fast track surgery group,n =65).Postoperative food and fluid intake,mobilization,length of hospital stay,and clinical outcome were recorded and analysed,and a interview-based assessment was performed on days 14 and 30 postoperatively.Results Patients implemented fast track surgery were associated with a significantly earlier resumption of mobilization and oral fluids and normal diet,shorter duration of intravenous infusion compared with traditional care patients 0.3 (0-1) d vs 3.3 (2-4) d,0.2(0-1) d vs 3.5(3-4) d,3.3(3-4) d vs 5.6(5-6) d,3.4(3-4) d vs 5.2(5-6) d; P=0.000,respectively.Postoperative hospital stay was also shorter in fast track surgery group 6.6 (6-8) d vs 8.6 (8-9) d ; P =0.000.Instrumental activities of daily living decreased in both groups on day 14,but significantly more in the traditional care group,despite having a higher preoperative instrumental activities of daily living level compared with the fast track surgery group 5.0 (3-6) vs 3.0 (3-5),4.0 (3-6) vs 3.0 (3-5) ; P =0.000,respectively.Preoperative fatigue score was not different between two groups,but the fatigue score was significantly increased on day 14,and returned to normal value on day 30 in the traditional care group 2.0 (1-5) vs 3.0 (1-5),2.0(1-5) vs 2.0(1-6) ; P =0.005,P =0.065.Total length of sleep on day 14 was increased significantly in the traditional care group,but not changed in the fast track surgery group compared with preoperative value 9.0 (6-11) vs 8.0(5-10) h,8.0(5-11) vs 8.0(6-10) h; P=0.000,P=0.327.Conclusions A fast track surgery protocol can lessen postoperative stress reactions and enhance recovery for patients with gastric cancer undergoing an elective,uncomplicated,open resection.

Objective To explore 18F-FDG PET-CT in the detection of malignant tumors of the gastrointestinal tract.Methods 39 patients with gastrointestinal tumors who was diagnosed with operation,pathological examination,clinical and imaging follow-up undertake the whole-body 18F-FDG PET-CT.Results The sensitivity and specificity were both 100.0 ％ for primary malignant tumors.Gastric metastases sensitivity,specificity and accuracy were 80.0 ％ (4/5),90.9 ％ (10/11),87.5 ％ (14/16),and the colorectal metastases sensitivity,specificity,accuracy of diagnostic results were 88.9 ％ (8/9),92.9 ％ (13/14),91.3 ％ (21/23).The gastric cancer lymph node metastasis sensitivity,specificity and accuracy were 50.0 ％ (3/6),90.0 ％ (9/10),75.0 ％ (12/16),in the diagnosis of colorectal local lymph node metastasis the sensitivity,specificity and accuracy were 71.4 ％ (5/7),93.8 ％ (15/16),87.0 ％ (20/23).Conclusion The 18F-FDG PET-CT imaging for gastrointestinal malignant tumor diagnosis and residual lesions recurrence or lesions metastases of detection is of important value and better than traditional examination methods.

Objective To characterize the clinical manifestations and to evaluate the value of the electrophysio-logical examination in patients with peripheral nerves injuries caused by neurobrucellosis. Methods Electrophysiology examination was conducted in 32 patients with peripheral nerve injuries caused by neurobrucellosis and 32 normal controls who had equivalent age and gender. The results were further statistically analyzed. Results There were sig-nificant difference between patients and healthy control group in distal motor latency (DML), compound motor active potentials (CMAP) amplitude, motor nerve conduction velocity (MCV), sensory nerve action potential latency(SL),senso-ry nerve action potential (SNAP) amplitude and sensory nerve conduction velocity (SCV) ( P﹤0.05). Electrophysiology examination revealed peripheral nerve damage of limbs involving, both sensory nerve and motor nerves, of which sen-sory and motor nerve injuries accounted for 55.47% and 16.80%, respectively. Median and sural nerve injuries were most frequently affected in upper (64) and lower limbs (16). Motor and sensory nerve conduction velocity was delayed in 43 nerves (16.80%) of 256 examined motor nerves and in 142 nerves (55.47%) of 256 examined sensory nerves. The damage of the sensory nerves was more severe than those of the motor nerves and damage of nerves in the upper limbs was more severe than those in the lower limbs. Conclusion Electrophysiologoical examination provides objective basis for the diagnosis of peripheral nerve injuries in neurobrucellosis.

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

Objective To explore the value of image fusion guided contrast-enhanced ultrasonography (CEUS) in detecting liver nodules with abnormal blood supply missed by ultrasonography (US) and CEUS.Methods In 35 patients with HBV cirrhosis,forty-two liver nodules with abnormal blood supply which were missed by US and CEUS but detected by contrast-enhanced CT/MRI were analyzed retrospectively.Image fusion guided CEUS was performed after ultrasound and contrast enhanced CT/MRI images were fused.The fusion time,technical success rate,nodule detection rate and diagnosis accuracy rate were analyzed.Results Image fusion was underwent successfully in all 35 patients,the technical success rate was 100％.Average fusion time was (4.1-± 1.8)min(1-17 min).Forty liver nodules with abnormal blood supply were detected by image fusion guided CEUS,and the detection rate was 95.2％ (40/42).One nodule located at the top of right liver was missed because of the influence of lung gas,the other one was invisible due to its deep position.The diagnosis accuracy rate of image fusion guided CEUS was 97.5 ％ (39/40),and two nodules misdiagnosed by contrast-enhanced CT were diagnosed correctly by image fusion guided CEUS.Conclusions Image fusion guided CEUS had a high detection rate and diagnosis accuracy rate for liver nodules with abnormal blood supply missed by US and CEUS.It can improve the clinical diagnosis and guide interventional procedures.