Objective To investigate the effect of α-lipoic acid on cerebral injury induced by cardiopulmonary bypass (CPB) in dogs. Methods Twelve adult healthy mengrel dogs of both sexes weighing 13.5-17.5 kg were randomly divided into control group (group C) and α-lopoic acid group (group L) (n = 6each). In group L α-lipoic acid 50 mg/kg was injected iv immediately before CPB. The animals were anesthetized with intraperitoneal 2.5% pentobarbital 25 mg/kg, intubated and mechanically ventilated. PaCO2 was maintained at 35-40 mm Hg. Femoral artery and vein were cannulated and Swan-Ganz catheter was inserted into pulmonary artery for MAP, CVP and CO monitoring and blood sampling. Blood samples were obtained immediately before aortic cross-clamping (T0, baseline), at 30 and 60 min after aortic cross-clamping (T1,2) and 30 and 60 min after aortic unclamping (T3,4) for measurement of plasma concentrations of TNF-α, S100β protein and neuron-specific enolase (NSE). Results In group C CPB significantly increased plasma TNF-α, S100β protein and NSE concentrations as compared with the baseline values at T0. Pretreatment with α-lipoic acid significantly attenuated CPB-induced increase in plasma TNF-α, S100β protein and NSE concentrations in group L. Plasma S100β protein and NSE levels were positively correlated with plasma TNF-α level. Conclusion Pretreatment with α-lipoic acid is effective in attenuating CPB-induced inflammatory response and cerebral injury.

Objective To explore the relationship between S100β, neuron-specific enolase (NSE) and postoperative cognitive dysfunction(POCD) in the elderly. Methods Cognitive function was evaluated using a battery of nine neuro-psychological tests before operation,at one week after operation. The old people were divided into POCD group(n=121) and normal group(n=439). Their S100β and NSE levels in all group were detected by enzyme linked immunesorbent assay(ELISA) before anesthesia,at the end of surgery and 6h,24h after opera-tion. Meanwhile relativity between S100βand NSE levels and factors of postoperative cognitive dysfunction were an-alyzed. Results S100βand NSE levels increased significantly at the end of surgery in both groups, but the levels in normal group were significantly lower than those in POCD group at the same stage(P<0.05). S100β and NSE levels were obviously relative to POCD. Conclusion S100β and NSE levels have close correlation with POCD in the elderly.

Objective To observe the effects of hyperventilation on jugular bulb pressure and optic nerve sheath diameter during RALRP. Methods Twenty patients undergoing elective RALRP were enrolled in this study. After hyperventilation of General anesthesia,we monitored and recorded changes of Heart rate(HR),mean arterial pressure (MAP),end-tidal carbon dioxide (ETCO2),arterial oxygen tension (PaO2),arterial carbon dioxide tension(PaCO2),peak airway pressure(PIP),JBP and ONSD in 5 minutes after intubation(T0),Trendelenberg posture in 15 minutes (T1),the established pneumoperitoneum in 30,60,90 minutes (T2,T3,T4) and termination of pneumoperitoneum in 15 minutes in supine position(T5)respectively. Results Compared with T0, JBP increased at T1 ~ T5(P < 0.05). ETCO2 and PaCO2 of T1 ~ T5 were lower than those of T0(P < 0.05)during hyperventilation. After establishment of Trendelenburg posture and pneumoperitoneum,PIP values increased at T1~T4 than that at T0 (P < 0.05),However,ONSD increased from T3 to T5 compared with T1 to T2 (P < 0.05). Conclusion Through over-ventilation,pneumoperitoneum and Trendelenburg posture,JBP and PIP can increase, and ONSD becomes wider evendually.

Objective To evaluate the effect of α-lipoic acid on the cognitive function after cardiopulmonary bypass (CPB) in diabetic rats.Methods Health adult male Sprague-Dawley rats,weighing 400-500 g,aged 16-22 weeks,were used in this study.Diabetes mellitus was induced by intraperitoneal streptozocin 60 mg/kg and confirmed by blood glucose≥ 16.7 mmol/L.Thirty-two diabetic rats were randomly divided into 2 groups (n =16 each):diabetes mellitus group (group D) and α-lipoi cacid group (group L).In group L,α-lipoic acid 30 mg/kg was intraperitoneally injected once a day for 7 consecutive days starting from 6th week after induction of diabetes mellitus.While the equal volume of normal saline was given instead in group D.The two groups underwent CPB after the last administration.Before induction of diabetes mellitus,on 5th week after induction of diabetes mellitus,before CPB,at the end of CPB,and on 3 and 5 days after termination of CPB,10 rats were chosen from each group and venous blood samples were collected for determination of plasma TNF-α and IL-10 concentrations.Ten rats in each group were chosen for detection of cognitive function before induction of diabetes mellitus,before CPB and 5 days after termination of CPB.The rats were then sacrificed and hippocampi were isolated for measurement of NF-κB activity.Results Compare with group D,the plasma TNF-α concentration,times of electric shock and activity of NF-κB in hippocampal tissues were significantly decreased and the plasma IL-10 concentration was increased in group L (P ＜ 0.05 or 0.01).Conclusion α-lipoic acid can improve the cognitive function after CPB in diabetic rats and inhibition of activation of NF-κB in hippocampal neurons is involved in the mechanism.

Objective To evaluate the efficacy objectively and systematically between endoscopic and microscopic surgery for transsphenoidal pituitary adenoma by a Meta-analysis.Methods A systematic literature search of Medline,the Cochrane Library,the Web of Science and the Google Scholar were performed to recruit studies between January,1990 and May,2015 that compared endoscopic and microscopic approaches in the treatment of pituitary adenomas.A Meta-analysis(R-3.1.3) was conducted to estimate the effect of different operative procedures.Results A total of 22 studies including 3 randomized or quasi-randomized controlled trails and 19 case-control studies met the inclusion criteria.Among 1421 patients studied,733 of them were treated with endoscopic and 688 were treated with microscopic surgery.The rate of gross tumor removal was higher in patients who underwent endoscopic surgery (71％) than those who underwent microscopic surgery (56％)(P ＜ 0.05).The rate of remission of hypersecretion was also higher in patients who underwent endoscopic surgery(60％) than those who underwent microscopic surgery(54％),but the difference was not significantly(P ＞ 0.05).Conclusion The present study indicates that the endoscopic transsphenoidal approach is more effective than microscopic surgery in the treatment of pituitary adenomas.

Objective To investigate the expression of Notch4 protein and to analyze its correlation with the clinical parameters and the microvessel dentisty in renal cell carcinoma. Methods The expression of Notch4 was examined in 60 cases of renal cell carcinoma and the para-carcinoma tissue by SP immunohistochemical stain-ing ,and CD34 detection was used for counting microvessel density. Statistical analysis was performed to reveal the correlation with clinicopathological parameters ,microvessel density and prognosis. Results The positive rate of Notch4 protein expression was 75%(45/60)in para-carcinoma tissue,and was 43.3%(26/60)in renal cell car-cinoma,with significant difference on tumor grade and Lymph node metastasis(P<0.05). The microvessel densi-ty in Notch4 positive tissues was significant lower than that in the negative samples(P<0.05). The survival time of patients with Notch4 positive expression was significantly longer than that of patients with Notch4 negative expres-sion(P<0.05). Conclusion Notch4 protein plays an important role in the development of renal cell carcinoma. Notch4 expression might both attenuate the malignant biological characteristics and suppress the angiogenesis dur-ing tumor development.

Objective To evaluate the effects of interferon therapy after curative surgical intervention on improving prognosis of patients with hepatitis C-related hepatocellular carcinoma (HCC).Methods We searched randomized clinical trials from 1990 to 2015 on interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC from the Cochrane Library,the Cochrane Database of Systematic Reviews,MEDLINE and Embase.A Meta-analysis was carried out using Revman 5.Results There were 7 studies included in this research.The results showed that interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC reduced the recurrence rate of HCC at 3 years (RR =0.84,95％ CI 0.73 ～0.97,P ＜0.05).The therapy could not improve the 3-year survival rate in these patients (RR =1.04,95％ CI 0.90 ～ 1.21,P ＞ 0.05).Stratified subgroup analyses showed interferon therapy after liver resection reduced the recurrence rate (RR =0.62,95 ％ CI 0.39 ～ 1.00,P =0.05).For patients with tumors less than 3 cm,interferon therapy reduced the recurrence rate (RR =0.82,95％ CI 0.69 ～ 0.98,P ＜ 0.05).Conclusion Interferon therapy after curative surgical intervention improved prognosis in patients with hepatitis C-related HCC.

Objective To investigate the effects of ischemic preconditioning (IP) on the expression of extracellular signal-regulated protein kinase (ERK) and c-jun N-terminal kinase (JNK) in hippocampus in a gerbil model of ischemia-reperfusion (I/R) injury and the role of ERK and JNK in the mechanism of ischemic cerebral preconditioning. Methods Gerbils of both sexes weighing 50-70kg were randomly divided into 4 groups : ( Ⅰ ) sham operation group; ( Ⅱ ) IP group; (Ⅲ) I/R group and ( Ⅳ ) IP + I/R group. Cerebral ischemia was produced by occlusion of bilateral common carotid arteries and confirmed by isoelectricity on EEG. In sham operation group bilateral common carotid arteries were exposed but not occluded. In IP and I/R groups the animals were subjected to 3 min (IP group) or 5 min (I/R group) cerebral ischemia respectively. In IP + I/R group the animals first underwent 3 min cerebral ischemia followed by 24h reperfusion and then were again subjected to 5 min cerebral ischemia. Open field test was performed to evaluate the behavioral deficit 1,3,5 and 7 days after ischemia. The animals were sacrificed at 15 min, 2, 4, 6h and 1, 3, 5, 7 days after ischemia. The brains were immediately removed for detection of apoptosis (TUNEL) and expression of p-ERK and JNK (immuno-histochemistry) in hippocampal CA1 and CA3 regions and microscopic examination. Results Compared with I/R group the behavioral deficit was significantly decreased and the number of living pyramidal neurons was significantly increased and apoptotic neurons significantly decreased in IP + I/R group. No p-ERK expression was detected in CA1 region in all of the 4 groups but in CA3 region the p-ERK expression was significantly higher in group IP + I/R than in group I/R. The p-JNK expression increased gradually during reperfusion in both CA1 and CA3 regions and was still detectable 7 days after ischemia and was significantly lower in CA1 region in group IP + I/R than in group I/R.Conclusion IP protects hippocampal neurons from I/R injury by inhibiting the expression of p-JNK in CA1 region and enhancing the activity of p-ERK in CA3 region

Objective To objectively and systematically evaluate the prognostic significance of nestin in glioma patients with Meta-analysis.Methods A systematic literature search of PubMed/Medline,Web of Science,Cochrane Library and Google scholar was performed to recruit studies between January 1990 and May 2015 that evaluated the correlation of nestin with overall survival (OS) and progression-free survival (PFS) in glioma patients.A Meta-analysis (R-3.1.3) was conducted to analyze the prognostic significance of nestin in glioma patients.Results A total of 8 studies with the total number of 1313 patients met inclusion criteria.The analysis demonstrated negative associations between nestin high expression and both poor OS (hazard ratio [HR]=1.64,95％ confidence interval [CI] =1.27-2.12,P=0.0001) and PFS (HR=1.54,95％CI=1.04-2.28,P=0.0301).WHO grading was the main source of heterogeneity of OS data (P=0.0015),and the lower the WHO grade,the more significant the influence in OS.The sample capacity was the main source of heterogeneity of PSF data (P=0.008),and the larger the sample capacity,the more significant the influence in PFS.Conclusion The nestin expression can be used for accurately assessing the survival of glioma patients,thus,nestin could be recommended as a useful survival biomarker in clinical practice.

A quantitative analytical method based on HPLC coupled with the charged aerosol detector (CAD) for quantitative analysis of multi-components with a single marker (QAMS) was established for simultaneous determinations of astragaloside Ⅰ, astragaloside Ⅱ, astragaloside Ⅳ, calycosin-7-O-β-D-glucoside, formononetin and 7,2'-dihydroxy-3',4'-dimethoxyisoflavan in Astragalus membranaceus. The separation was performed on an Agilent SB-C18 (150 mm×4.6 mm, 3.5 μm), with gradient elution using the mobile phase consisting of 0.05% formic acid solution and 0.05% formic acid acetonitrile at the flow rate of 1.0 mL·min^-1. The column temperature was 35 ℃, and the injection volume was 20 μL. For CAD, the drift tube temperature was at 50 ℃. The contents of six components in A. membranaceus were determined by both external standard method (ESM) and QAMS, and then were compared. The results showed that chromatographic peaks were separated well and the linear ranges of astragaloside Ⅰ, astragaloside Ⅱ, astragaloside Ⅳ, calycosin-7-glucoside, formononetin and 7,2'-dihydroxy-3',4'-dimethoxyisoflavan were 0.113-2.250 mg·mL^-1, 0.012-0.240 mg·mL^-1, 0.004-0.080 mg·mL^-1, 0.065-1.300 mg·mL^-1, 0.005-0.100 mg·mL^-1 and 0.007-0.150 mg·mL^-1, respectively. The content ranges of astragaloside Ⅰ, astragaloside Ⅱ, astragaloside Ⅳ, calycosin-7-glucoside, formononetin and 7,2'-dihydroxy-3',4'-dimethoxyisoflavan were 0.306-0.922 mg·g^-1, 0.053-0.183 mg·g^-1, 0.015-0.092 mg·g^-1, 0.069-0.823 mg·g^-1, 0-0.098 mg·g^-1 and 0.020-0.107 mg·g^-1 in 20 batches of A. membranaceus, respectively. Using astragaloside Ⅱ as an internal reference, the relative correlation factors of astragaloside Ⅰ, astragaloside Ⅳ, calycosin-7-O-β-D-glucoside, formononetin, and 7,2'-dihydroxy-3',4'-dimethoxyisoflavan were calculated as 0.561, 0.835, 0.299, 0.796, and 0.799, respectively. The results were compared with those obtained by the external standard method to verify the feasibility, rationality and repeatability of QAMS method, and there was no significant difference in assay results between the two methods. In conclusion, the QAMS method is accurate and feasible, and could be used to determine the contents such as astragaloside Ⅰ, astragaloside Ⅱ, astragaloside Ⅳ, calycosin-7-glucoside, formononetin and 7,2'-dihydroxy-3',4'-dimethoxyisoflavan, and it can be used for quality control of A. membranaceus.