The significance of identification of mild cognitive impairment (MCI) is to intervene as soon as possible and delay or even prevent its progression to dementia.However,due to the limitations of diagnostic methods and standards,the diagnosis of in patients with MCI is more difficult.In recent years,as an emerging functional neuroimaging technique,resting-state functional magnetic resonance imaging (rsfMRI) has developed rapidly.It has been widely used in the studies of MCI.It may be provide objective biomarkers for the diagnosis of MCI.This article reviews the advances in research on rs-fMRI in MCI.

Objective To study the relationship between the clinical imaging manifestations and the judgement of benign and malignant of solitary pulmonary nodules (SPN) .Methods A retrospective analysis of 146 patients with SPN which confirmed by pathological diagnosis .According to SPN diameter all SPN were divided into three groups ,the number of SPN which diameter smal-ler than 0 .8 cm were 16 case ,> 0 .8 - 1 .5 cm were 41 cases ,> 1 .5 - 3 .0 cm were 89 cases .Collect patients′ age ,sex ,smoking his-tory ,clinical symptoms and imaging data ,and analyze its relationship with pathological results .Results All the 146 patients were pathological diagnosis ,benign in 52 cases (35 .6% ) ,malignant in 94 cases (64 .4% ) .As the diameter increases ,the malignant rate increased .There was statistical significance in benign and malignant lesions with smoking history and clinical symptoms (P< 0 . 05) .Whether SPN boundary is clear ,have lobulation ,burr ,pleural indentation syndrome and vessel convergence in benign and ma-lignant lesions were statistically significant (P< 0 .05) .Conclusion The feature size and imaging performance of SPN has important reference value for the judgement of benign and malignant .The positive intervention to SPN have great significance on improve sur -vival rate of lung cancer .

Objective To evaluate the effect of ketamine on the expression of tryptophan hydroxylase 2 (TPH2) in the median raphe nuclei of mentally depressed mice.Methods Thirty-six healthy SPF male C57BL/6J mice,aged 8-12 weeks,weighing 20-26 g,were divided into 3 groups (n=12 each) using a random number table:control group (C group),depression group (D group) and depression plus ketamine group (D+K group).Mental depression was induced by forcing the animals to swim in a narrow cylinder from which they can not escape.Ketamine 15 mg/kg was intraperitoneally injected once a day for 7 consecutive days starting from 1 day after successful establishment of the model in group D+K.The equal volume of normal saline was given instead of ketamine in C and D groups_ Forced swimming test was performed again at 30 min after the last administration,and the immobility time was recorded.Open field test was also performed at 30 min after the last administration,and the total horizontal distance and the number of standing on the back legs were recorded.The mice were sacrificed after the end of the behavioral testing,and the hippocampi and median raphe nuclei were isolated.High-performance liquid chromatography-electrochemical detection assay was used to measure the content of 5-hydroxytryptamine (5-HT) in hippocampi.The expression of TPH2 protein and mRNA in the median raphe nuclei was detected using Western blot and real-time polymerase chain reaction,respectively.Results Compared with group C,the immobility time was significantly prolonged,the total horizontal distance was shortened,the number of standing on the back legs and content of 5-HT in hippocampi were deceased,and the expression of TPH2 protein and mRNA in the median raphe nuclei was down-regulated in group D,and the total horizontal distance was significantly shortened,the number of standing on the back legs was decreased (P＜0.05),and no significant change was found in the immobility time,content of 5-HT in hippocampi or expression of TPH2 protein and mRNA in the median raphe nuclei in group D +K (P＞0.05).Compared with group D,the immobility time was significantly shortened,the content of 5-HT in hippocampus was increased,the expression of TPH2 protein and mRNA in the median raphe nuclei was up-regulated (P＜0.05),and no significant change was found in the total horizontal distance or the number of standing on the back legs in group D+K (P＞0.05).Conclusion The mechanism by which ketamine produces anti-depressant effect may be related to up-regulation of TPH2 expression in the median raphe nuclei and increase in the synthesis of 5-HT in hippocampi of mice.

Chemotherapy is one of the traditional tumors treatment solutions.Chemotherapy has the feature of tissue non-specificity,which can cause side effects on normal cells while inhibiting tumor cell growth.Magnetic targeting drug delivery system (MTDDS) employs biocompatible and stable magnetic nanoparticles (MNP) as drug carries to transport and accumulate anticancer drugs to the specific tumor tissues under the guidance of external magnetic field.This technology not only improves the efficiency of drug delivery and antitumor activity,but also reduces the drug dosage and side effects.The properties of drug-loaded MNPs and the applied external magnetic field are the main factors that affecting the MNPs targeting to the tumor tissues.The effectiveness of the targeted delivery of the drug-loaded magnetic nanoparticles mainly depends on the form and strength of the magnetic field at the target site.That is,whether there is sufficient strength to attract and retain NMPs,and to promote antitumor drug release at the tumor region.In this paper,the research progress of static magnetic field targeting drug delivery system in tumor diagnosis and therapy was summarized,which can provide some basic information for the relative scientific researches.

OBJECTIVETo analyze clinical features and genetic mutations in a Chinese family affected with autosomal dominant caveolinopathies.

METHODSClinical data of the proband and her family members were collected. Genomic DNA was extracted from peripheral blood samples with a standard procedure. Next generation sequencing was carried out for the proband, and direct sequencing was employed to detect potential mutation of the CAV gene.

RESULTSThe proband presented with slowly progressing distal muscle weakness and atrophy, especially distal upper limbs and muscular soreness during early childhood, with her CK level moderately elevated and EMG showing myogenic and neurogenic injuries. Her sisters presented mild symptoms with hand muscle atrophy and fasciculation after exercise. A heterozygous missense mutation c.80G>A (p.Arg27Gln), which was reported as being pathogenic, was identified in the CAV3 gene in the proband and her sisters.

CONCLUSIONA heterozygous c.80G>A (p.Arg27Gln) mutation in the CAV3 gene probably underlies the autosomal dominant caveolinopathies in this Chinese family.

Objective To assess the effectiveness of a novel mobile health patient management system involving doctors, nurses, and patients ( TRIO mode) on glycemic control and self-monitoring of blood glucose (SMBG) compliance among the type 2 diabetes mellitus ( T2DM) patients using basal insulin standardization treatment in China. Methods From April 2014 to April 2015, 416 hospitals in 110 cities of 30 provinces, municipalities, and autonomous regions across China were selected to participate in the program. A Online-to-Offline ( O2O) integrated mobile health patients management system with mobile terminals for the doctors, nurses, and patients was applied in the program for patient education, follow-up, and data collection. For all the newly recruited patients, the baseline information was collected and a first-day patient education program were provided by a designated nurse. In the 12-week follow-up period, data of basal insulin doses and fasting plasma glucose ( FPG) values were collected from the patients by text messages or tracking phone call by the nurse. The patients also received timely standardized patients health education and glycemic control guidance by participating in thepatient education forum anddoctors' hotline in order to help them achieve the glycemic control goals. Results A total of 102 524 patients using basal insulin treatment were eligible and enrolled in the program. 64 420 patients completed the 12 weeks follow-up and provided at least one FPG value at all five follow-ups. In total, 62. 6% (40 334 / 64 420) of the patients reached the FPG control target(FPG≤7. 0 mmol/ L) at the end of follow-up period. The weekly average FPG for patients with complete SMBG data decreased from 10. 58 mmol/ L to 6. 91 mmol/ L while the FPG control rates increased from 13. 4% to 69. 2% . The weekly average FPG for the patients provided incomplete SMBG data decreased from 10. 54 mmol/ L to 7. 13 mmol/ L while the FPG control rates increased from 13. 6% to 62. 2% . The FPG control rates for the patients provided complete SMBG were 1. 74 times higher than those patients provided incomplete SMBG. Based on a GEE model, the average decline of the FPG and the increase of the FPG control rates were significantly better for patients who provided complete SMBG as compared to the patients with incomplete SMBG data. The results of the multivariate logistic regression analysis showed that factors such as receiving the first-day education, participating in the follow-up patient education forum, and the doctors' hotline were significantly associated with the improvement of the SMBG compliance, the treatment adherence, and the FPG control rates. The SMBG compliance and the treatment adherence for patients who completed first-day education were 1. 68 times and 1. 22 times higher, respectively. For the patients who participated in follow-up education activities, their SMBG compliance and treatment adherence were 3. 17 times and 3. 36 times higher, respectively. Conclusion The innovativeTRIOmobile health patient management mode was feasible and effective for better managing the type 2 diabetes patients initiated on basal insulin treatment in China. Active participation in the first-day education program and the follow-up patient education activities can effectively improve the SMBG compliance and the treatment adherence, and therefore play an important role in helping patient achieving FPG control in a faster manner.

OBJECTIVE:To evaluate the clinical efficacy of somatostatin and protease inhibitors in the prevention of post-ERCP pancreatitis(PEP)and hyperamylasemia(PEHA). METHODS:Retrieved from databases as Cochrane Library, PubMed,Embase,RCTs about therapeutic efficacy of somatostatin and protease inhibitors in the prevention of PEP were included. EndNote X8 software was used to eliminate duplicate documents,and the quality of included studies was evaluated according to Cochrane System Evaluator Manual version 5.3.3. Bayesian network Meta-analysis was conducted by MCMC method with R 3.4.3 software Gemtc 0.8 program package. Risk of bias was evaluated by using Rev Man 5.3 software,and risk of publication was evaluated by using Stata 14.0 software draws funnel map. RESULTS:A total of 33 RCTs were included,involving 10 576 patients,somatostatin,gabexate,ulinastatin,nafamostat. Network Meta-analysis showed that in the prevention of PEP,the order of curative effect was as follows:somatostatin(intravenous bolus)>nafamostat>ulinastatin>somatostatin(high-dose intravenous drip)>gabexate,somatostatin(low-dose intravenous drip)was ineffective. In the prevention of PEHA,the order of probability being somatostatin(high-dose intravenous drip)>somatostatin(intravenous bolus)>ulinastatin. Only nafamostat was effective in preventing PEP in high-risk patients. CONCLUSIONS:Compared with somatostatin(low-dose intravenous drip)and gabexate,somatostatin(intravenous bolus)and somatostatin(high-dose intravenous drip),ulinastatin,nafamostat can more effectively prevent PEP. Nafamostat cannot prevent PEHA,but can prevent PEP in high risk patients.

Objective To investigate the effects of perioperative parecoxib sodium on serum surfactant protein A and inflammatory response in elderly patients undergoing video-assisted thoracoscopic pneumonectomy,Methods Sixty-two ASA Ⅰ or Ⅱ elderly patients,aged 65-78 years,weighing 51-79 kg,scheduled for elective video-assisted thoracoscopic pneumonectomy under general anesthesia,were randomly divided into 3 groups:0.3 mg/kg parecoxib sodium group (group P1,n=21),0.6 mg/kg parecoxib sodium group (group P2,n =21) and control group (group C,n =20).The patients were given intravenous parecoxib sodium of 0.3 mg/kg immediately before induction of anesthesia and at 12 h after operation in group P1,and also parecoxib sodium of 0.6mg/kg immediately before induction of anesthesia and at 12 h after operation in group P2,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein before the induction of anesthesia(T0),after operation(T1),12 h after operation(T2) and 24 h after operation(T3).The concentration of serum surfactant protein A (SP-A),TNF-α,IL-6 and IL-8 were determined by ELASA.The incidence of pulmonary complications at 72 h after operation were also recorded.Results Compared with T0,the concentration of serum SP-A,TNF-α,IL-6 and IL-8 increased significantly in all groups at T1-T3 (P＜0.05).Compared with C group,the concentration of serum SP-A,TNF-α,IL-6 and IL-8 in groups P1 and P2 decreased significantly at T1-T3 (P＜0.05),there were no significant differences between groups P1 and P2.The incidence of postoperative pulmonary complications had no statistically significant differences between the three groups.Conclusion Parecoxib sodium can significantly reduce the concentration of serum SP-A and alleviate the inflammatory response in elderly patients undergoing video-assisted thoracoscopic pneumonectomy.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway in propofol-induced reduction of lung ischemia-reperfusion (I/R) injury in aged rats.Methods Thirty-two clean healthy male Sprague-Dawley rats,aged 18-22 months,weighing 450-600,were divided into 4 groups (n =8 each) using a random number table:sham operation group (group S),I/R group (group I/R),I/R plus propofol group (group I/R+P) and all-trans retinoic acid (ARTA) plus I/R plus propofol group (group ARTA+I/R+P).Lung I/R was induced by occlusion of the right hilum of lung for 60 min followed by 120 min of reperfusion in anesthetized rats.In group ATRA+I/R+P,Nrf2/ARE signaling pathway blocker ARTA 6 mg/kg was intraperitoneally injected once a day for 3 consecutive days,and the model of lung I/R injury was established at 2 h after the last administration.In group I/R+P and group ARTA+I/R+P,while the model of lung I/R injury was established,propofol 30 mg · kg-1 · h-1 was infused via the caudal vein until 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion and then the lungs were removed for examination of the pathological changes which were scored and for measurement of wet/dry weight ratio (W/D ratio),superoxide dismutase (SOD) activity (by xanthine oxidase method),malondialdehyde (MDA) content (using thiobarbituric acid method) and expression of Nrf2 and heme oxygenase-1 (HO-1) protein (by Western blot).Results Compared with group S,the pathological scores,W/D ratio and MDA content were significantly increased,and the activity of SOD was decreased in I/R and ATRA+I/R+P groups,and the expression of Nrf-2 and HO-1 was significantly up-regulated in I/R,I/R+P and ATRA+I/R+P groups (P＜0.05).Compared with group I/R,the pathological scores,W/D ratio and MDA content were significantly decreased,the activity of SOD was increased,and the expression of Nrf-2 and HO-1 was up-regulated in group I/R+P (P＜0.05),and no significant change was found in the indexes mentioned above in group ARTA+I/R+P (P＞0.05).Compared with group I/R+P,the pathological scores,W/D ratio and MDA content were significantly increased,the activity of SOD was decreased,and the expression of Nrf-2 and HO-1 was down-regulated in group ARTA+ I/R+P (P＜0.05).Conclusion Nrf2/ARE signaling pathway activation is involved in propofol-induced reduction of lung I/R injury in aged rats.

Oncoplastic breast surgery (OBS) using omentum has been developed in the past 20 years. This study reviewed related clinical researches at home and abroad. It summarized the surgical indications, criteria of cosmetic evaluation for omentum mammary tumor, the methods of harvesting omentum and the selection of tissue flaps. Meanwhile, postoperative complications, tumor safety, advantages and disadvantages of different methods were evaluated.