Objective To explore the influence of erythropoietin (EPO) on infection induced neonatal rat brain injury at different starting time and its related mechanism.Methods Postnatal day 2 (P2) newborn SD rats were randomly divided into 4 groups:control group (group A),lipopolysaccharide (LPS) group (group B),the early EPO group(group C)and the later EPO group(group D).Pups in group A,B and C were injected different drugs intraperitoneally(group A for saline,group B for 0.6 mg/kg of LPS,and group C for 0.6 mg/kg of LPS and 5 000 U/kg of EPO) once a day for consecutive 5 days(P2-P6).LPS in group D were injected 0.6 mg/kg of LPS intraperitoneally once a day for consecutive 5 days(P2 P6),and with 5 000 U/kg of EPO once a day for consecutive 5 days(P7-P1 1).Rats in each group were given different drugs starting at corresponding time by intraperitoneal injection for 5 consecutive days.Every 10 newborn rats in group A and B were selected randomly on P2(6 h after intraperitoneal injection of drugs for the first time),P7 and P12,the brains were divided into the left and the right hemispheres marked by sagittal suture,using enzyme-linked immunosorbent assay method to evaluate the erythropoietin receptor(EPOR) protein level with the right cerebral hemisphere and reverse transcription-polymerase chain reaction (RT-PCR) method was used to investigate EPOR mRNA level of the left cerebral hemisphere.Immunohistochemical method was adopted to evaluate the expression of myelin basic protein(MBP),glial fibrillary acidic protein(GFAP) and EPOR at specified time point,and HE dyeing for the pathological changes of brain damage in different groups.Results HE staining of the group A presented the normal structure in the neonatal rat brain.Reduced numbers of hippocampal pyramidal cells,expansion of the lateral ventricles and periventricular leukomalacia were found in group B.No leukomalacia or lateral ventricles's expansion in EPO administrated groups and it was more obvious in group C.The EPOR protein and mRNA of group B was increased compared with the group A.The EPOR protein and mRNA levels had a tendency to decline with the increase of age.The MBP expression of group B(107.46 ±3.65)was significantly reduced compared with the group A(146.78 ± 3.13) (P ＜ 0.05),and the expression of EPO groups increased in contrast to the group B,moreover,the group C (126.25 ± 4.42) increased more obviously than that of group D(117.35 ± 3.42) (P ＜ 0.05).The GFAP expression of group B(141.46 ± 11.92 at P7 and 149.48 ± 13.59 at P12) increased significantly than group A(120.63 ± 13.32 at P7 and 119.74 ± 12.48 at P12) (P ＜0.05),the EPO group expressed lower than group B at the P12,and the group C (134.59 ± 12.19) decreased than the group D(137.27 ± 13.87) (P ＞ 0.05).Conclusions EPO shows a protective effect on the cerebral white matter injury caused by postpartum infection,it is superior to administer EPO at early time than later time.The mechanism of the protective effect may be connected with the fact that the infection can induce the expression of brain EPOR and the EPOR expression level has a tendency to decline with the increase of age.

Objective To envaluate the accuracy of Photoplethysmograph pulse wave in monitoring stress reaction to harmful stimulation. Methods Patients (n=75) were randomly assigned to three groups according to the dosages of fentanyl that were administrated ( 4, 5 and 6 g/kg were given to F4, F5, F6 group respectively (n=25) in each group. Heart rate (HR), Systemic blood pressure (SBP), Diastolic blood pressure (DBP), SpO2, the skin temperature of finger, perfusion index (PI), epi?nephrine(E) and Norepinephrine (NE) were recorded at following time points:just in operation room (T1), 2 min after induc?tion (T2), at intubation (T3),1 min (T4) and 5 min (T5) after intubation. And the PPGPW was printed and measured at the same time points. Results PPGA and PI were significantly increased while E and NE were significantly decreased in T2 and T5, compared with those baseline at T1 (P < 0.05). At T3, PPGA and PI were significantly decreased while NE markedly in?creased in group F4 and F5 compared to T1. At T3, E in group F4 were remarkably increased h while E in group F5 were of no obvious changed, compared with those at T1(P<0.05). PPGA and PI increased while E and NE decreased in group F6 at T2, T3 ,T4 and T5 compared with those at T1 (P<0.05). In summary, PI was negatively correlated with plasma E and NE while PP?GA was negatively correlated with plasma E and NE .Conclusion PPGA and PI are negatively associated with intensity of stress response. And they can reflect the stress reaction during the induction period of intravenous anesthesia accurately.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia.Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin,cytarabine,granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen.Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%),but there was no statistically significant difference(χ2=2.042,P=0.153).The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%),(χ2=5.811,P=0.016).The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months),the difference was statistically significant(t=2.211,P=0.018).Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective,which is worthy of clinical promotion.

OBJECTIVE:To investigate the anti-inflammatory and analgesic effects of mongolian medicine Cymbaria dahurica extract. METHODS:96 KM mice(or SD rats)were randomly divided into model group(water),positive control group(aspirin, 0.5 g/kg),C. dahurica ethanol extract (70% ethanol) low-dose,medium-dose and high-dose groups (0.325,0.650,1.300 g/kg, calculated by crude drug) and C. dahurica aqueous extract of the residue of alcohol extraction low-dose, medium-dose and high-dose groups(0.325,0.650,1.300 g/kg,calculated by crude drug). They were given relevant medicine intragastrically,once a day,for consecutive 7 d. The xylene-induced ear edema method was used to determine the degree of ear edema,and egg white-in-duced paw edema method was used to determine paw edema after inducing inflammation 1,2,4,6 h;anti-inflammatory activity of C. dahurica extract was investigated. 96 KM mice were grouped and given medicine with same method;the number of writhing within 20 min was determined by acetic acid writhing method. Another 64 KM mice were grouped with same method,with 8 mice in each group;except positive control group was given tramadol hydrochloride(0.5 g/kg)intragastrically,other groups were given relevant medicine with same method. Pain thresholds of mice were determined by hot-plate test before and after medication 30,45, 60,90 min,and analgesic effects of C. dahurica extract were investigated. RESULTS:Compared with model group,C. dahurica extract could obviously restrain the ear edema of mice and paw edema of rats 6 h after egg white-induced inflammation. Except paw edema of rats in C. dahurica aqueous extract of the residue of alcohol extraction high-dose group was decreased slightly,there was statistical significance among other groups (P<0.05 or P<0.01). C. dahurica extract decreased the number of writhing in mice within 20 min,and extended pain thresholds of mice 30,60,90 min after medication (P<0.05). CONCLUSIONS:Both C. dahurica ethanol extract and aqueous extract of the residue of alcohol extraction posses certain anti-inflammatory and analgesic effects.

Objective To investigate the prevalence rate and the related risk factors of posttraumatic stress disorder ( PTSD) in the rescue paratroopers 1.5 year after Wenchuan earthquake. Methods A total of 183 rescue paratroopers who participated in disaster rescue after Wenchuan earthquake were investigated with the questionnaires composed by General state of health questionnaire, PTSD Checklist-Civilian Version ( PCL-C), Symptom Checklist-90 ( SCL-90), Self-Rating Depression Scale ( SDS) and Eysenck Personality Questionnaire (EPQ). Results Six rescue paratroopers had total PCL-C score ≥ 38 points, with the prevalence rate of PTSD for 3.28%. Total PCL-C score was positively correlated with total SCL-90 score, N score of EPQ and total SDS score (P ＜ 0. 01), but negatively correlated with E score of EPQ. Total PCL-C score showed statistical difference between injury group and uninjury group, family loss group and family integrity group, contacting corpses group and none contacting corpses group (P＜0.05 or ＜0.01). Regression analysis showed the length of military service, nervousness, family loss by earthquake, suffering injuries or contacting corpses during relief operations were the risk factors for PTSD. Conclusion The prevalence rate of PTSD in the rescue paratroopers is higher than that in normal troops (0.49% ) 1.5 year after Wenchuan earthquake, indicating that further attention should be paid to the rescue paratroopers in later period after earthquake.

Objective:To explore the correlation between hypersomnia and anhedonia in patients with major depressive disorder.Methods:From November 2018 to May 2019, patients hospitalized with major depressive disorder who met the ICD-10 diagnostic criteria were selected.According to the Epworth Sleepiness Scale (ESS), 46 patients were divided into daytime sleepiness group with ESS ≥ 7, and 171 patients were divided into non-sleepiness group with ESS < 7.The Chinese Revised Social Anhedonia Scale (RSAS) and the Chinese Revised Physical Anhedonia Scale (RPAS) were used to evaluate the patients' anhedonia symptoms.Two-way ANOVA and Pearson correlation analysis were used for data processing.Results:(1)There was no interaction between the hypersomnia and gender on the score of physical anhedonia ( F=0.274, P=0.601). The main effect analysis showed that there was significant difference in the influence of gender on physical anhedonia ( F=10.948, P<0.05). (2)There was interaction between the hypersomnia and age on the score of physical anhedonia ( F=4.396, P=0.013). Further simple effect analysis showed that the score of physical anhedonia in 40-49 age(21.54±12.37) was lower than that in 50-64 age(34.13±12.53) in daytime sleepiness group( P<0.05). (3) There was interaction between hypersomnia and sitting and lying on the score of social anhedonia ( F=4.247, P=0.041). Further simple effect analysis showed that the score of social anhedonia in patients with sitting and lying time less than 2 hours (13.71±5.18) was lower than that in patients with sitting and lying time more than 2 hours (19.75±6.39) in daytime sleepiness group( P<0.05). (4)Pearson correlation analysis showed that the total sleepiness score of depression patients was positively correlated with the social anhedonia score ( r=0.206, P<0.01). After adjusting for gender, age and sitting and lying time, the total sleepiness score was still positively correlated with the social anhedonia score( r=0.225, P<0.01). Conclusion:Hypersomnia may be associated with anhedonia in patients with major depressive disorder.

Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.

Objective To investigate the correlation of K-ras gene mutations and activation of Hedgehog signaling pathway in pancreatic cancer cell lines.Methods Real-time PCR was used to detect K-ras gene mutations at codon 12 and 13 in pancreatic cancer cell lines of SW1990,PaTu8988,CFPAC-1,PANC1,AsPC-1,Capanc-2,BxPC-3 and the mRNA expression of Glil,Smo in these cell lines.Results The K-ras mutation of PANC1,CFPAC-1,AsPC-1,PaTu8988 was at codon 12,while SW1990 was at codon 13,BxPC-3,Capanc-2 were wild type.The expressions of Glil mRNA of AsPC-1,CFPAC-1,PANC1,PaTu8988,SW1990,BxPC-3,Capanc-2 were 7.84 ± 8.92,1.82 ± 3.45,1.00± 0.00,0.07 ± 0.10,0.88 ± 1.48,0.52 ± 0.98,0.15 ± 0.19,and the expressions of Smo mRNA were 144.00 ± 58.33,3.48 ±3.77,1.00 ±0.00,81.68 ±28.26,0.72 ±0.87,0.34 ±0.60,0.02 ±0.03.Glil,Smo mRNA expressions of cells with wild tpye K-ras were significantly lower than those with mutant type,and wild type BxPC-3's Glil,Smo mRNA expressions were significantly lower than that of mutant AxPC-1 (P ＜ 0.05).Conclusions Activation of Hedgehog signaling pathway may be related to K-ras gene mutations.