0.05 ). Conclusions With low initial FGF addition of N2O does not affect the uptake of desflurane. The low-flow desflurane anesthesia is safe and economical.

The quantitative parameters based on dynamic contrast-enhanced MRI (DCE-MRI)scan,simulate the distribution of contrast inside and outside of the blood vessels through a variety of tracer kinetic models.The DCE-MRI perfusion parameters now are widely applied in clinical management of uterine tumors,to analyze the microcirculation characteristics in tumor and to guide the diagnosis,tumor grading and efficacy evaluation.

Objective To evaluate the long-term efficacy and the influencing factors of biofeedback (BF) treatment in functional constipation (FC).Methods Totally 120 BF treated FC patients were retrospectively followed up.The clinical symptom score,the use of laxatives,the result of colonic transit test and anorectal manometry were compared before BF treatment and during follow-up.The long-term efficacy of biofeedback treatment was evaluated.Thirty-two possible influencing factors of long-term efficacy were selected and univariate and multivariate analysis were conducted.The groups were compared with t test,rank-sum test and x2 test.The influencing factors of long-term efficacy were analyzed with a stepwise multiple regression analysis.Results The median score of clinical symptoms in follow-up period (3) was significantly lower than that before BF treatment (10,Z=-7.900,P＜0.01).The total long-term efficacy rate was 70.6％ (77/109).During follow-up,the rate of laxatives use [39.4 ％ (43/109)] was lower than that before BF treatment [83.5％ (91/109),x2 =44.623,P＜0.01].During follow-up,the 48 hour median colonic emptying rate (30.0％)was higher than that before BF treatment (0,Z=-2.298,P=0.022).During follow-up,the proportion of patients with uncoordinated defecation (51.4％) was lower than that before BF treatment (77.1％,x2 =5.040,P=0.025).The results of univariate and multivariate analysis showed that the long-term efficacy of BF treatment was positively correlated with the compliance for home training and utilization of social support,negatively correlated with the course of disease.Conclusions BF therapy can improve clinical symptoms of FC patients,correct physiological dysfunction and have a satisfactory lon~term efficacy.Compliance for home training,utilization of social support and the course of disease were independent influencing factors.

Objective To compare the effects of biofeedback (BF) training on clinical symptoms , psychological status and quality of life in different subtypes of patients with functional defecation disorders (FDD) .Methods According to Rome Ⅲ criteria ,50 FDD patients were divided into non coordinated defecation (F3a) and the lack of promoting defecation (F3b) two subtypes .The patients of these two subtypes received BF training three times every week ,five to ten times each course ,two to three times training at home were required during and after treatment .The changes ,of clinical symptoms scores ,self‐rating anxiety scale (SAS) ,self‐rating depressive scale (SDS) and the patient assessment of constipation quality of life question naire (PAC‐QOL ) were compared between before and after BF training in the patients of two subtypes .The difference between two subtypes were also analyzed as well .Paired t‐test or Wilcoxon signed‐rank test was performed for comparison between before and after treatment ,and group t‐test or Wilcoxon rank sum test was for comparison between groups .Results Among 50 FDD patients , there were 13 cases of F3a type and 37 cases of F3b type .After BF training ,the clinical symptoms scores of two subtypes patients were both lower than those before BF training (5 .62 ± 3 .91 vs 8 .77 ± 3 .59 , 5 .89 ± 3 .67 vs 9 .35 ± 3 .22 ,t = 3 .264 and 6 .272 ,both P< 0 .01) .There were no statistically significant differences in the scores of clinical symptoms between two subtypes at before and after BF training (t =- 0 .545 and - 0 .230 ,both P > 0 .05) .After BF training ,the SAS scores of two subtypes patients were both lower than those before BF training (30 .85 ± 6 .67 vs 42 .46 ± 8 .37 ,30 .65 ± 7 .51 vs 38 .59 ± 8 .38 , t= 4 .536 and 6 .402 ,both P< 0 .01) ,and the scores of SDS were both lower than those before BF training (42 .85 ± 8 .30 vs 53 .92 ± 7 .98 ,43 .95 ± 12 .17 vs 55 .39 ± 10 .83 ,t = 4 .788 and 6 .830 ,both P< 0 .01) . There were no statistically significant differences in the scores of SAS and SDS between two subtypes at before and after BF training (t= 1 .431 ,0 .084 ,- 0 .447 and - 0 .301 ,all P> 0 .05) .After BF training ,the PAC‐QOL scores of two subtypes [0 .54 (0 .15 ,0 .88) 、0 .98 (0 .51 ,1 .34)] were both lower than those before BF training [2 .08(1 .18 ,2 .34) 、1 .86(1 .34 ,2 .29)] ,Z= - 2 .903 、- 4 .825 ,both P < 0 .01) .There were no statistically significant differences in the PAC‐QOL scores between two subtypes at before and after BF training (Z= 0 .409 ,1 .891 ,both P > 0 .05) .Conclusions BF training is both effective on two subtypes of FDD ,which can improve clinical symptoms ,psychological status and quality of life ,and with There is no difference in efficacy between the two subtypes .

Objective: To establish an HPLC method for the determination of codonoposide in Codonopsis lanceolata Benth. et Hook.F..Methods:The HPLC analysis was performed on a Kromasil C18column (250 mm×4.6 mm,5 μm). The mobile phase was 0. 1% phosphoric acid-acetonitrile (70∶ 30) and the flow rate was 1. 0 ml·min-1 . The detection wavelength was 203 nm and the column temperature was 30℃. Results:Codonoposide in Codonopsis lanceolata Benth. et Hook. F. had a good separation from the oth-er components, and a good linear relationship was obtained within the range of 1. 09-17. 41 μg( r=0. 999 9). The average recovery was 98. 46%(RSD=1. 64%, n=6). Conclusion: The method is practicable with promising repeatability, which can be applied in the content determination of codonoposide in Codonopsis lanceolata Benth. et Hook. F. .

Objective To observe the effects of hyperbaric oxygen (HBO) on learning and memory ability and on the level of myelin basic protein (MBP) in the brain tissue of rats with delayed neurological sequelae (DNS) after acute carbon monoxide poisoning (COP).Methods Forty-eight male SD rats had their cognitive performance assessed with the Morris water maze.After basic training with the Morris water maze and screening,the rats were randomly divided intoanormalcontrol (NC) group (n=11),a COP group (n=17) and an HBO group (n=17).Pure CO gas was injected intraperitoneally to establish acute COP in the latter two groups.The NC group received a similar injection of air.The HBO group was given HBO therapy.The rats in each group were tested for changes in their learning and memory abilities using the Morris water maze.On the 21 st day after the treatment,paraffin tissue sections of the rats' brains were subjected to immunohistochemical (IHC) examination and Western blotting (WB) was used to detect any expression of MBP in the brain tissue.Results After 21 days,morbidity among the COP group was 64.3％,while it was 26.7％ in the HBO group,a significant difference.The average maze escape latency in the COP group was significantly longer than in the HBO group.IHC staining and Western blotting showed that MBP in the hippocampal tissue of the COP group was significantly lower than that in the HBO group.In gray scale comparisons of the rats' brain tissue,that from the NC group was significantly better than that from the COP and HBO groups,but that from the HBO group was significantly better than that from the COP group.Conclusion HBO can effectively reduce DNS after acute COP,mitigate the severity of DNS,reduce demyelination of brain tissue and thus play an important role in protecting brain cells.

Objective To investigate the effect of silencing Notch1 gene by RNA interference on the proliferation,apoptosis and Akt/mTOR signaling pathway in clear renal cell carcinoma.Methods The optimal segment targeting Notch1 gene was designed and transfected into 786-O cells by Lipofectamine TM2000.The Notch1 mRNA and protein were detected by RT-PCR and Western blot.The proliferation rate of 786-O cells was evaluated by MTT and the variation of apoptosis was measured by TUNEL.The protein expression level of apoptosis-related protein Bcl-2,caspase-3,caspase-9,and signaling pathway protein Akt,p-Akt,p-mTOR,p-P70S6K were detected by Western blott.Results Notchl mRNA and protein was markedly suppressed by the siRNA targeting Notch1.Treated with 0,40,60,80,100 and 120 nmol/L of Notch1 siRNA for 24 hours,cell proliferation rates were (98.51 ± 1.33) ％,(87.34 ± 2.26) ％,(64.72 ± 3.24)％,(57.68 ±3.32)％,(31.91 ± 1.85)％ and (19.27 ±2.73)％,and the difference was statistically significant (P ＜ 0.01).Treated with 0,40,80,and 120 nmol/L of Notchl siRNA for 24 hours,apoptosis rates were (7.6 ± 3.8) ％,(21.5 ± 4.8) ％,(32.3 ± 3.5) ％,and (46.3 ± 4.7％),the difference was statistically significant (P ＜ 0.05).Decreased expression of Akt signaling pathway proteins p-Akt,p-mTOR,p-70S6K and apoptosis-related protein Bcl-2,procaspase-3 was detected,but no change in the total protein of Akt.Conclusions Depletion of Notch1 gene could inhibit cell growth and induce apoptosis in 786-O cell line.It inhibits Akt/mTOR signaling pathway by dephosphorylated.

Objective To investigate the application value of identification of the scalp surface locations of cerebral ischemia lesions before direct revascularization for moyamoya disease and to design surgical approaches according to this by using the fusion of single photon emission computed tomography ( SPECT) cerebral perfusion imaging with CT imaging. Methods The clinical data of 13 adult patients with ischemic-type moyamoya disease underwent superficial temporal artery-middle cerebral artery bypass surgery were analyzed retrospectively. SPECT cerebral perfusion imaging was fused with CT imaging of the same machine before procedure. The lesions of ischemia were located on the cortical surface. The surgical approaches were designed at the center of the ischemic lesions. The patients were followed up for 6 to 12 months after procedure. The improvement of clinical symptoms and cerebral perfusion of the patients were observed after operation. Results One patient had perioperative cerebral hyperperfusion syndrome,and the others did not have any perioperative complications. At one-month follow-up, the improvement of symptoms in 4 patients were excellent,in 5 were good,in 4 were fair,and none was poor. At 6 to 12 month follow-up,the improvement of symptoms in 9 patients were excellent,in 4 were good,and none was poor. The postoperative visual SPECT cerebral perfusion imaging analysis suggested that the cerebral perfusion was improved significantly as compared with before procedure in all patients. Quantitative analysis:There was significant difference in target ischemic lesions between preoperative Fb and postoperative Fb ([2. 13±1. 06]% vs. [4. 13±2. 09]%;P<0. 05). There was significant difference between preoperative Fb and Fe ([2. 46±1. 97]% vs. [2. 13±1. 06]%;P<0. 05). The postoperative BFCR was [67. 57±3. 78]%( >50%) , which indicated that the efficacy of the procedure was remarkable. The superficial temporal arteries fed to brain of the patients were observed after procedure by using the head CT angiography. The postoperative head MRI reexamination showed no new infarcts occurred at 6 months. Conclusion Combine SPECT cerebral perfusion imaging with CT imaging to design surgical approach for superficial temporal artery-middle cerebral artery bypass surgery may improve the efficacy and reduce the risks of operation.

Objective To explore the relationship between health?related quality of life and resili?ence of patients with inflammatory bowel disease( IBD) ,and provide a new entry point to improve the quality of life. Methods The general information questionnaire,the Chinese version of inflammatory bowel disease questionnaire ( IBDQ) and the Chinese version of Connor?Davidson mental resilience scale ( CD?RISC) were used to investigate 102 patients with IBD. Results The average scores of IBDQ and CD?RISC of IBD pa?tients were (157.6±31.7) and (62.5±15.0). Except for the correlation between the score of optimistic di?mension and the social function dimension,the total score and the scores of other dimensions of IBDQ were significantly correlated with the total score and the scores of dimensions of CD?RISC( r=0.200?0.490, P<0.05). Multiple regression analysis showed that tenacity,residence,moderate and severe disease severity,and disease duration with more than 10 years could significantly predict the level of health?related quality of life (β=0.319,0.268,-0.218,-0.373,-0.260, P<0.05) . Conclusion The health?related quality of life of IBD patients has a strong relationship with resilience. Health care workers can help improve health?related quality of life of the patients through fostering resilience.

Objective To assess the psychometric properties of the Chinese Heartburn Version of Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) in patients with gastroesophageal reflux disease.Methods 130 patients with symptoms of heartburn completed the Chinese version of QOLRAD,the Short-Form-36 (SF-36).30 of them received proton pump inhibitors (PPI) for 8 weeks,which was used to test responsiveness of the Chinese heartburn version of QOLRAD.Results The Chinese version of QOLRAD had acceptable internal consistency.The overall Cronbach's alpha was 0.89 and the internal consistency of dimensions ranged from 0.70～0.90.Content validity index (CVI) was 0.82.Confirmation factor analysis revealed a 5 factor solutions accounting for 62.02％ and most of items in their dimensions had acceptable loads (＞0.4).There was acceptable concurrent validity with correlations between the Chinese heartburn version of QOLRAD and Short Form-36 health survey ranging from 0.172～0.613.As to responsiveness,after therapy of PPI for 8 weeks,except the dimension of sleep disturbance,scores for dimensions of vitality,food/drink problems,physical/social functioning,emotional distress had significant changes.Conclusions The Chinese version of QOLRAD has a good reliability,validity and responsiveness to therapy,which can be used to assess the quality of life in patients with gastroesophageal reflux disease.