Background:It is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy,however,this recommendation has been queried recently. Aims:To investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy. Methods:One hundred adult patients undergoing sedative esophagogastroduodenoscopy ( EGD ) were randomly recruited, and another 100 adult patients undergoing conventional EGD were served as controls. All patients had an education level more than 9 years. Cognitive function was assessed by number connection test-A( NCT-A),number cancellation test and digit symbol test( DST)before propofol sedation or the beginning of endoscopic procedure and was reassessed when the discharge criteria were met. If the results obtained were inferior to those before EGD,a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. Results:All patients completed the first and second assessment,and 124 patients had taken the third assessment. When the discharge criteria were met,result of number cancellation test was inferior to that before EGD in sedation group( P =0. 000 ). Furthermore,the results were analyzed by grouping with age,number cancellation test in young patients and NCT-A in elderly patients were inferior to that before EGD,respectively(P=0. 000 and P =0. 025 ). In control group,none of the results were inferior to those before EGD. The results of the third assessment recovered or being superior to the baseline levels. Conclusions:Early postoperative cognitive dysfunction at discharge is common in patients undergoing endoscopy using propofol sedation,but the impairment will recover by a prolonged staying calm before discharge. The optimal time for discharge and resuming driving remains to be further studied.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Esophagus ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Phonation ; Trachea ; surgery

AIM: To elucidate the relationship between the intracellular calcium concentration changes and left ventricular hypertrophy and function in the spontaneously hypertensive rats (SHR). METHODS: Intracellular free calcium concentrations were measured by Fura 2 methodology and left ventricular function quantitated by cardiac catheterization in 20 SHR aged 10, 22, and 34 weeks and 20 age-matched Wistar-kyoto (WKY) rats. RESULTS: (1) The systolic blood pressure(SBP), intracellular calcium concentrations and left ventricular mass / body weight index ( LVM/BW) were significantly higher in all three age groups of SHR than the corresponding groups of WKY; (2) Compared with age-matched WKY groups, the peak left ventricular pressure descending rate(-d p /d t max ) decreased while left ventricular relaxation time constant (?)increased significantly in SHR aged 22 and 34 weeks. The peak left ventricular pressure ascending rate(d p /d t max ) and the left ventricular contractility index were significantly increased only in the 34 weeks SHR; (3) Intracellular calcium concentrations showed a positive correlation with LVM/BW,SBP,-d p /d t max and ?( r =0 47-0 83, P

Objective:To explore the influence of low-iodine diet on the expression of homeobox gene NKX-2.2 in rat cerebrum tissue,and to explain the possible molecular mechanism of cerebrum development retardation caused by low-iodine.Methods:Female Wistar rats were randomly divided into two groups:Low-iodine group and control group,both fed with low-iodine feed,given the deionized water and KIO3 solution respectively,they were drawn from the 16-day pregnancy,new-born and 20th days old low-iodine and normal age offspring after three months,and detect the content of NKX-2.2 mRNA in the cerebrum tissue by Real-time fluorescence quantitative PCR techniques.Results:The thyroid hormone levels of low-iodine group in serum were significantly lower than the control group(P

Objectives:To study the value of fructose-1,6-diphosphate-supplemented parenteral nutrition in elder abdominal surgical patients.Methods:thirty-two patients were randomly allocated into study group and control group,receiving isocaloric(83.6 kJ/kg?d~(-1)) and isonitrogenous(0.2 g/kg?d~(-1)) PN from post-operation day 1 to post-operation day 6.The study group received 10g of FDP every day and did not receive Glycophos.Plasma albumin,pre-albumin and phosphate lever were measured and EKG was examined before surgery and days 1 and 7 after surgery.The level of 3-methylhistidine(3-MH) in urine was measured and nitrogen balances were calculated postoperatively on day 1,3,5 and 7.Results:The blood phosphate levels were normal in two groups before and after surgery.Compared with preoperation,plasma albumin and pre-albumin levels were both decreased in two groups and pre-albumin level was markedly decreased in the control group(P

Objective To study the influence of low-iodine diet on the expression of homeobox gene Nkx-6.1 and Nkx-6.2 in rat cerebrum tissue, and to explore the possible molecular mechanism of cerebrum development retardation caused by low-iodine. Methods Twenty female Wistar rats were randomly equally divided into two groups: low-iodine group and control group, both fed with low-iodine diet as low as 13.66 μg/kg determinated by spectrophotometry in Tianjin Institute of Endocrinology and the former with deionized water, the later 200 μg/L potassium iodate. Thyroid hormone level was detected using chemiluminescence immunoassay 3 months later and they were mated with male rats normally fed. Rats of 16-day pregnancy, new-born and 20th days old were detected the content of Nkx-6.1 and Nkx-6.2 mRNA in the cerebrum tissue by real-time fluorescence quantitative PCR 0.61), (3.28±0.80)pmol/L] were lower than the control group[(1.04±0.06), (39.42±14.68)nmol/L, (4.83±0.33), day pregnancy, new-born and 20th days old of control group was (1.90±0.23)×10-3,(1.86±0.40)×10-4, (1.11± 0.27)×10-4(F=827.58, P<0.01), Nkx-6.1 mRNA expression level gradually decreased along with aging(all P<0.05). The intra-group difference was significant (F=297.25, P<0.01) and the Nkxr.1 mRNA expression level during 16 days of pregnancy was the highest(P<0.01). It was higher in the control group than in the low-iodine group during 16 days of pregnancy (t=10.14, P<0.01) as well as in the low-iodine group than in the in 16-day pregnancy, new-born and 20th days old of control group was respectively(1.03±0.19)×10-2, (1.33± 0.10)×10-3, (8.79±0,87)×10-3, and that of low-iodine group was (0.31±0.03)×10-2, (1.53±0.13)×10-3, (7.51±0.86)×10-2. The intra-group difference was significant(F=1293.02,1065.83, all P<0.01). Nkx-6.2 expression level during 20th days old was the highest(P<0.01) and that of newborn was the lowest(P<0.01). The Nkx6.2 mRNA expression level in control group were higher than the low-iodine group during 16-day pregnancy and 20th days old(t=14.35, 4.05, all P<0.01). It was higher in the low-iodine group than in the control group during newboru(t=4.78, P<0.01). Conclusions The difference in the expression of Nkx-6.1 and Nkx-62 is highly related to the brain development retardation caused by low-iodine.

Objective To investigate the efficacy and safety of multi-band mucosectomy (MBM) for the treatment of high-grade intraepithelial neoplasia.Methods The clinical data of 24 patients with high-grade esophageal intraepithelial neoplasia who were admitted to the Henan Honliv Hospital from April 2011 to October 2012 were retrospectively analyzed.All the 24 patients received MBM,and the operation time,resection of the lesion and complications were observed.All the patients were followed up with gastroscopy at postoperative 1,3,6,12 months.The follow-up was ended in April 2013.Results A total of 26 lesions in 24 patients were resected successfully by MBM (2 patients received MBM twice).The mean operation time was 42 minutes.The mean length of the lesions was 3.1 cm (range,0.8-6.0 cm),and it occupied 3/4 of the circumference of the esophagus to the maximum.The mean number of the band used was 4 (range,1-6).During the operation,bleeding was occurred in 4 patients,and they were cured by hot biopsy forceps.No perforation of the esophagus was detected.The results of post-MBM pathological examination showed that 22 patients were with severe atypical hyperplasia,and 2 were with carcinoma in situ.During the follow-up of 6-24 months,22 patients were cured,and esophageal stricture occurred in 1 patient at post-MBM 1 month,and the symptoms were successfully relieved by endoscopic balloon dilatation.Neoplasia recurrence was observed in 1 patient (2 lesions were resected twice) at post-MBM 3 months,and he received surgical treatment.Histopathological diagnosis showed that he had esophageal squamous cell carcinoma.No stricture or neoplasia was detected by gastroscopy at postoperative month 12.Conclusions MBM is a relatively safe and effective endoscopic technique for the treatment of high-grade esophageal intraepithelial neoplasia.The resection range should not be blindly extended.For patients whose lesions are beyond 3/4 of the circumference of the esophagus in width or with multiple lesions which can not be resected by MBM at one time,MBM should be applied cautiously to avoid esophageal stricture and recurrence.

Objective To explore the evaluation value of serum Ghrelin and pleural effusion in patients with acute pancreatitis . Methods Eighty patients with acute pancreatitis treated in our hospital from February 2011 to February 2014 were divided into mild case group (31 patients) and severe case group (49 patients) according to the severity of the disease .Venous blood samples were collected at time point including :admission ,48h after admission and after discharge at empty stomach in the morning ,and CRP level ,WBC ,PCT level of patients were checked .The concentration of serum Ghrelin of patients were mensurated by enzyme linked immunosorbent assay and pleural effusion were diagnosed by sternum .Results Compared with the patients in the mild case group , serum Ghrelin ,CRP level ,APACHE score ,CT score and Ranson score were higher in the severe case group and the hospital day of patients in the severe case group was longer(P<0 .01) .The area under the curve of CRP level ,pleural effusion ,Ghrelin ,Ghrelin combined with pleural effusion of ROC were 0 .708 3 ,0 .749 6 ,0 .852 4 and 0 .910 8 .Ghrelin combined with pleural effusion has the best evaluation effect on the patients with acute pancreatitis .The sensibility ,specificity ,accuracy of CRP were 93 .6% ,69 .4% and 73 .7% ;the sensibility ,specificity ,accuracy of pleural effusion were 75 .2% ,88 .7% and 76 .8% ;the sensibility ,specificity ,accuracy of Ghrelin were 86 .9% ,88 .2% and 85 .3% ;the sensibility ,specificity ,accuracy of Ghrelin combined with pleural effusion were 90 .1% ,92 .6% and 91 .4% .Conclusion Serum Ghrelin and pleural effusion have high sensibility ,specificity and accuracy in pa‐tients with acute pancreatitis and has high clinical value .

Objective This study was designed to investigate influence of resveratrol on serum lipid and antioxidant enzyme lev‐els in atherosclerotic rabbit model ,and to explore its influence on NF‐κB and MAPKs signal pathway .Methods Rabbits were as‐signed to five groups :control (group A) ,high fat diet group (group B) ,resveratrol group (group C ,D and E) .The contents of lip‐ids level (TC ,TG ,LDL‐C ,HDL‐C) and antioxidant enzyme (GSH ,GSH‐PX ,GST ,γ‐GCS ,CAT ,SOD ,MDA) levels in the serum were measured respectively and the difference was studied .Phosphorylation levels of MAPKs cascades ,NF‐κB were measured by Western blot .Results Compared with group A ,group B had elevated levels of blood lipids ,antioxidant enzymes were on the de‐cline ,the MDA content increased ,MAPKs and the NF‐κB protein phosphorylation enhanced .C ,D ,E group can reduce levels of blood lipids ,increases HDL‐C ,improve antioxidant enzyme activity and reduce MDA content ,inhibit MAPKs ,NF‐κB protein phos‐phorylation .Conclusion Resveratrol could reduce the atherosclerotic rabbit blood lipid levels ,increase antioxidant enzyme activity , reduce the MDA level and this effect is likely to inhibit NF‐κB and MAPKs signaling pathway activation .

Cognitive impairment includes several clinical processes from mild cognitive impairment to dementia, and now it has been a serious public health problem, as there is no effective treatment, it has caused a heavy economic and psychological burden on the family and society, therefore, it seems important to find effective intervention means.Vitamin D is an essential nutrient element for the human body, more and more evidences show that it also participates in many extraskeletal biological reactions, such as nervous system regulatory processes, in addition to calcium and phosphorus metabolism.Several researches have revealed that Vitamin D deficiency is associated with impaired cognition, the mechanisms mediating this link are poorly understood, what's more, for further clinical application, we need to solve the problems like choosing the suitable populations and drug dosage, therefore, this article summarizes and analyzes the effects of serum Vitamin D levels on the cognitive function of different populations, the research progress of Vitamin D intervention research and its possible mechanism of action, hoping to provide references for the clinical application of Vitamin D in the treatment of cognitive impairment.The results show that Vitamin D deficiency is related to the decline of cognitive function in different populations, and Vitamin D can improve cognitive function through reducing Aβ toxicity, anti-inflammatory and anti-oxidative stress and other mechanisms, its supplementation is expected to be an important measure of treating cognitive impairment, in the future, large-scale longitudinal cohort studies are needed to determine the optimal dosage and duration of treatment.