Objective To investigate the effect of ethanol on level of the main hippocampal subtype of muscarinic receptor(M1)in mice,and evalu?ate whether the content change on this receptor could be linked with alterations in cognition,so as to further reveal the mechanism of brain damage in?duced by ethanol. Methods Sixty female mice were randomly divided into four groups. The model mice were induced by intragastric administration of ethanol at dose of 8%,16%,and 32%respectively of 0.2 mL/10 g for 8 weeks according to the protocol,and control group were treated with intra?gastric administration of distilled water. The capability of learning and memory were examined by Morris water maze,and ELISA method was used to measure the M1 receptor content in hippocampus in each group of mice. Results Compared with first day,the mean escape latency period on the fifth day was significantly shortened in each group. There was no significant difference between ethanol and control group for the mean escape latency period on the fifth day. Compared with the control group,the active time in the target quadrant was significantly shortened in 16%and 32%ethanol group. M1 receptor content in hippocampus formation was significantly decreased in all the ethanol group mice. The ethanol concentration was nega?tive correlated with the M1 receptor content. Conclusion Chronic alcoholism can induce the memory impairment in mice,which might be associat?ed with the low level of M1 receptor subtype in hippocampus of mice.

Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) on survival of adult from acute respiratory distress syndrome (ARDS). Method We searched Pubmed, Embase, Cochrane Library, Web of Science databases to find relevant literatues on ECMO in treatment of ARDS, which are reported from January 1966 to June 2010. Meta analyses was performed. Results Three papers about randomized controlled trial (RCT) of evaluating ECMO in patients with severe ARDS were enrolled for analyses. Meta-analysis of the three randomized controlled trials revealed ECMO did not decrease the mortality of ARDS patients. However, the cumulative meta-analysis of randomized trials showed ECMO had a protective effect on patients with ARDS. The most recent observational studies suggested that ECMO significantly decreased the mortality of ARDS caused by H1 N1 viral pneumonia. Conclusions There is no evidence to prove the benefit of ECMO in patients with ARDS. However, ECMO should be considered to use in early stage of ARDS as a last rescue resort for potentially reversible severe acute respiratory failure. Further investigation of large sample of high quality RCTs is needed.

Objective To investigate the effects of elasticity resistance (Ers) in respiratory system on oxygenation in patients with acute lung injury (ALI) after recruitment maneuvers (RM). Method Meta-analysis of data about the effects of recruitment maneuvers on oxygenation in ALI patients with different elasticity resistances in respiratory system carried out with pooling of study-oriented data stored in Pubmed, Embase, Web of Science databases from January 1999 to June 2010. Results A total of 281 articles were taken, and 20 of them included a sample size of 395 ALI patients. In patients treated with RM in different degrees of respiratory system elasticity resistance ( ≥33.3 cmH2O/L and ＜33.3 cmH2O/L), the effect of RM was better in patients with the high respiratory system elasticity resistance than that with the low one [(51.97 + 8.89) mmHg vs. (35.13 ± 10.33 ) mmHg], P ＜ 0. 01 ), but the high respiratory system elasticity resistance was potentially to lower blood pressure [(4. 33 ± 1.32 ) mmHg vs. (0.22 ± 1.03 ) mmHg],P ＜ 0.01 ). Conclusions This study suggests RM could improve oxygenation of ALI patients with high respiratory system elasticity resistance, and caution must be made to avoid hypotension during RM.

Objective To investigate the effect of dexmedetomidine on excitatory aminoacid (EAA)and inhibition of amino acid(IAA)in cerebro-spinal fluid(CSF)of patients undergoing in-tracranial tumor surgery,and to explore the cerebral protective mechanism of dexmedetomidine in neurosurgery.Methods Sixty patients aged 18-64 years old,ASA Ⅰ or Ⅱ,weighing 50-90 kg un-dergoing elective intracranial tumor surgery were randomly divided into dexmedetomidine group (group D)and control group(group C).Dexmedetomidine 1 μg/kg was infused before anesthesia in-duction for more than 10 minutes and pumped continously with 0.2-0.7 μg·kg-1·h-1 in group D, while in group C midazolam 0.03-0.05 mg/kg was injected followed by intermittent administration of 0.03-0.05 mg/kg.BIS value was maintained between 40-50.MAP and HR was recorded at the time points before induction(T0 ),dura mater incision(T1 ),tumor resection(T2 ),at the end of the surgery (T3 ).And we collected CSF at T0 ,T3 ,6 hours after the surgery(T4 ),12 hours after the surgery (T5 ),24 hours after the surgery(T6 ),then the concentrations of EAA and IAA were determined with high-performance liquid chromatography (HPLC)at T0 ,T3 ,T4 ,T5 and T6 .Results The MAP and HR in group D at T1-T3 were much lower than that in T0 and in group C(P <0.05).Compared with T0 ,the Glu and Asp in CSF significantly increased in group C at T3-T6 and were much higher than those in group D (P < 0.05 ),GABA was significantly decreased and much lower than group D(P <0.05).Compared with T0 ,the Glu and Asp in group D at T3-T5 were increased and GABA was decreased, but without statistic significance. At T6 , the values recovered to the level at T0 . Conclusion Dexmedetomidine can be used to maintain hemodynamic stability in intracranial tumor surgery,and may play a role in cerebral protection through inhibiting expression of Glu and Asp (EAA).

ObjectiveTo evaluate the association between alveolar dead space fraction and the prognosis of patients with acute respiratory syndrome in the early phase ( ＜ 3 days).MethodsTwentythree patients with ARDS were enrolled in this study.The VD/VT was measured by the single breath test of CO2 (SBT-CO2).The age,heart rate,mean arterial pressure,APACHE Ⅱ,Murray lung injury score,functional residual capacity ( FRC ),PaO2/FiO2,tidal volume,airway plateau pressure ( Pplat ),static pulmonary compliance (Cst),28-day mortality were recorded.ResultsThe alveolar dead-space fraction was markedly elevated (0.59 ±0.06) and the mean FRC was markedly decreased (1643 ±409) ml in the early phase of ARDS.The mortality of 28 days was 52.2％.The mean dead-space fraction was significantly higher in non-survived patients than that in survival [(0.64 ± 0.08 ) vs.(0.53 ±0.04 )].VD/VT was correlated significantly with Murray lung injury score ( r=0.464,P =0.026).The area under the ROC curve for dead space fraction was 0.867,with sensitivity of 83％,and specificity of 82％.Conclusions Increased alveolar dead-space fraction of patients in the early phases of ARDS is associated with greater risk of death.

Breast cancer is the second malignant tumor of female reproductive system.With the development of modern medical imaging technology,conventional ultrasound and mammography are the most popular methods in breast examination and cancer screening.While CT,MRI and nuclear medicine diagnosis act as the additional methods of breast cancer diagnosis.In addition,CEUS and biopsy might be used in diagnosis of lesion lacking imaging characteristics.The imaging methods in diagnosis of breast lesions were reviewed in this paper.

Objective To investigate and compare the median effect-site concentration(Ce50)of sufentanil combined with propofol or ciprofol blunting cardiovascular responses to tracheal intubation in eld-erly patients.Methods Sixty-six elderly patients were selected for extracranial-intracranial cerebral revas-cularization for general anesthesia with tracheal intubation,32 males and 34 females,aged ≥ 65 years,BMI 20-30 kg/m2.Patients were randomly divided into two groups:1.5 mg/kg propofol group(group P)and 0.3 mg/kg ciprofol group(group C),33 patients in each group.Sufentanil was target controlled infused with the initial dose of 0.30 μg/kg,then propofol 1.5 mg/kg or ciprofol 0.30 mg/kg injected slowly after reaching the effect-site concentration.After the lose of consciousness and BIS score less than or equal to six-ty,rocuronium 0.60 mg/kg was administrated,and underwent endotracheal intubation after the TOF value monitored by muscle relaxation drops to zero.Dixon's up and down sequential method was used to determined the target concentration of sufentanil.A positive response was defined as a 20％increase in HR or SBP exceeding the baseline within 2 minutes after tracheal intubation,otherwise,it was considered a neg-ative response.According to the Dixon's sequential method,the ratio of adjacent dosed was 1.2 and if the patient had a positive response,the dose of next patient was moved up one gradient,otherwise,the dose would be reduced.The trail was terminated when the seventh crossover point was observed.When a positive response turned to a negative response,it was called a crossover point.HR,SBP,DBP and BIS were recor-ded before induction of anesthesia(T0),before tracheal intubation(T1),1 minutes after tracheal intubation(T2),3 minutes after tracheal intubation(T3)and 5 minutes after tracheal intubation(T4).Dixon-Mood's half effective quantity sequential calculation formula was used to calculate the Ce50 and 95％confidence interval(CI).Results Compared with group P,SBP was significantly increased at T1,BIS was significantly decreased at T2-T4 in group C(P＜0.05).The Ce50 and 95％CI of sufentanil inhibiting cardiovascular response to tracheal intubation were 0.253 ng/ml(95％CI 0.215-0.297 ng/ml)in group P and 0.241 ng/ml(95％CI 0.209-0.279 ng/ml)in group C.There was no significant difference in Ce50 between the two groups.Conclusion When combined with propofol 1.5 mg/kg during anesthesia induction,the Ce50 of sufentanil inhibiting cardiovascular response to tracheal intubation in elderly patients was 0.253 ng/ml(95％CI 0.215-0.297 ng/ml).While combined with cirprofol 0.30 mg/kg,Ce50 of sufentanil was 0.241 ng/ml(95％CI 0.209-0.279 ng/ml).

Objective To explore the effects of Kaixin Jieyu Pill(KJP)on peroxisome proliferator-activated receptor alpha(PPARα),serum and hippocampal tissue fibroblast growth factor 21(FGF21)and hippocampal tissue fibroblast growth factor receptor 1(FGFR1)in rats with depression model.Methods A rat chronic stress model was prepared using the chronic unpredictable mild stimulus method(CUMS)to observe behavioral changes in depression.Hippocampal FGF21,FGFR1 and liver PPARα protein and mRNA expression levels were measured in hippocampal tissues by western blot and real-time fluorescence quantification(RT-qPCT).Results The expression levels of PPARα,FGF21 and FGFR1's protein and their mRNA were dramatically decreased in the CUMS model rats compared with the normal group(P<0.001).KJP could modify the depressive-like behaviors of rats(P<0.001),upregulate the protein expression level of PPARα,FGF21,and FGFR1(P<0.05,P<0.01,P<0.01);markedly modify the mRNA expression levels of PPARα,FGF21,and FGFR1(P<0.001,P<0.01,P<0.01).Conclusion PPARα/FGF21/FGFR1 pathway may participate in the pathogenesis of depression;upregulation of PPARα/FGF21/FGFR1 pathway may be related to the antidepressant mechanism of KJP.

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

In the current international situation, there is the possibility of nuclear war and nuclear terrorism. The nuclear and radiological emergency in the event of an accident should be enhanced. The World Health Organization (WHO) issued a publication on January 27, 2023, updating the list of drugs recommended for stockpiling in response to radiation and nuclear emergencies, which was the first update since 2007. The list of recommended drug stocks in the publication includes drugs to prevent or reduce the effects of radiation, as well as drugs used to treat injuries after exposure. Based on the list of drugs, this article reviews the emergency response to nuclear and radiological accidents, the general situation of emergency drug stockpiles, drug reserves in some countries, and current considerations, with a view to providing references for emergency medical rescue in nuclear and radiological accidents in China.