Objective To investigate the different components of Acorus tatarinowii and Polygala tenuifolia(volatile oil, aqueous extract)on the expression of phosphorylated Tau protein at site Ser396 and Tau-5 in the hippocampus of rats with Alzheimer′s disease(AD). Methods Male Sprague Dawley rats were randomly divided into 8 groups:normal control group, model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-, middle-,and high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia. The subacute aging model was established by intraperitoneal injection of D-galactose( D-gal). Rats were given different components of Acorus tatarinowii and Polygala tenuifolia(crude drug dosage,0.6,1.2,1.8 g·kg-1 )in experimental groups,and 0.9% sodium chloride solution in normal control group and model control group,by gavage for 28 days.The levels of phosphorylated Tau protein at site Ser396 and Tau-5 were detected in hippocampal tissues by Western blotting and immunohistochemistry. Results The levels of phosphorylated Tau protein at site Ser396 were significantly enhanced in the model control group,as compared with those in normal control group (P<0.01).The relative expression levels of Tau protein Ser396 were 3.83±0.10,3.35±0.01,3.11±0.01,2.75±0.03,2.93±0.01,2.55± 0.07,and 2.23±0.08 in model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-,middle-,high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia,respectively.Two components of Acorus tatarinowii and Polygala tenuifolia could dephosphorylate Tau protein Ser396 to vary degrees in a dose-dependent manner.The aqueous extract component was slightly better than the volatile oil component,especially in the high-dose group(P<0.01).But Tau-5 did not change significantly after treatment with Acorus tatarinowii and Polygala tenuifolia(P>0.05). Conclusion Acorus tatarinowii and Polygala tenuifolia could promote the dephosphorylation of Ser396 site of Tau protein in the hippocampus of AD rats,with the aqueous extract component having better effects.

Objective:To study the antidepressant effect of Baihe Zhimu decoction (BZD)and its influence in the key factors (CaM,CaMKⅡ,CREB)of CaM signaling pathway in hippocampus of the rats with depression,and to explore the antidepressant effect of BZD. Methods:Fifty rats were divided into control group,model group, fluoxetine group,low and high doses of BDZ groups (n = 10).Expect for control group,all the rats in other groups were made depression models by means of chronic unpredictable mild stress along with isolated raising,for 21 d.Then the rats were fed with NS, fluoxetine (1.8 mg · kg-1 ), and BZD (1.5 and 3.0 g · kg-1 ), respectively;for 28 d.The learning and memory ability,autonomous activities and the fixed time in 5 min of the rats were tested by Morris water amaze,Open-field Test and Forced Swimming Test respectively. The damage and repair status of hippocampal neurons were observed by Nissl staining method;the expression levels of CaM,CaMKⅡ protein,CREB mRNA in hippocampus of the rats were detected by Western blotting and RT-PCR method. Results:Compared with model group,the total time of rats in the platform quadrant of Morris water maze in BZD groups and fluoxetine group,the total distance and the number of crossing platform were increased (P <0.05 or P <0.01),and the time of first crossing platform were shortened (P <0.01);the total scores in open field test were increased (P <0.01),the fixed time with 5 min in the forced swimming test was shortened (P <0.05 or P <0.01).Compared with fluoxetine group,the fixed time within 5 min of the rats in swimming test was shortened (P <0.05).The result of Nissl staining showed that the hippocampal neuron injury in BZD groups and fluoxetine group was improved compared with model group.The molecular test results showed that the CaM and CaMKⅡprotein expression levels in hippocampus of the rats in BZD groups and fluoxetine group were increased compared with model group (P < 0.05 or P < 0.01).Compared with model group,the CREB mRNA expression levels in fluoxetime group and BZD groups were increased (P < 0.05 or P < 0.01).Conclusion:BZD has antidepressant effect and can improve the hippocampal neuron injury of the rats with depression and its mechanism is related to increasing the expression levels of CaM,CaMKⅡ and CREB in hippocampus CAM signaling pathway of the rats.

Objective To evaluate the clinical value and toxicities of docetaxel plus capecitabine in the first-line treatment of metastatic breast cancer (MBC),and compare the outcomes among different molecular subtypes.Methods A total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1,2012 and December 31,2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed,and 104 cases were available for evaluation.The clinicopathological characteristics,clinical value and toxicities of these patients were evaluated.Results The patients were divided into 3 molecular subtypes,among 104 patients,85 patients in Luminal subtype,14 patients in triple negative breast cancer (TNBC) subtype,and 5 patients in human epidermal growth factor receptor-2 (HER-2) over expression subtype.The treatment achieved objective responses (OR) in 55 patients (52.9％),and the disease control rate (DCR) was 88.5％,including complete response (CR) in 4 patients,partial response (PR) in 51 patients,stable disease (SD) in 37 patients,and progressive disease (PD) in 12 patients.In Luminal subtype,4 patients achieved CR,43 PR,33 SD,and 5 PD.In TNBC subtype,6 patients achieved PR,3 SD,5 PD.In the HER-2 over expression subtype,2 patients achieved PR,1 SD,2 PD.There was no significant difference in the short-term therapeutic effect among 3 molecular subtypes (x2 =4.429,P =0.106).As a result,the progression-free survival (PFS) of the 104 patients was 1.5-121.0 months,and the median PFS was 10.0 months.The median PFS was 11.0 months in Luminal subtype,4.0 months in TNBC subtype and 10.3 months in HER-2 over expression subtype,with a significant difference (x2 =7.510,P =0.006).The most common adverse events were hand-foot syndrome (HFS),nausea or vomiting,neutropenia,anaemia,diarrhea and so on.The incidence of grade 2/3 HFS was 44.2％ (46/104),and the grade 3/4 neutropenia was 39.4％ (41/104).Conclusion The first-line treatment of MBC using docetaxel plus capecitabine is effective,and the toxicities can be tolerable,especially in the Luminal subtype.

Objective To evaluate the effect of oral compound carbohydrate drinks before operation on the postoperative recovery of gastrointestinal function in the patients undergoing gynecological laparoscopic operation.Methods Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective gynecological laparoscopic operation under general anesthesia,were divided into 3 groups (n =30 each) using a random number table method:routine fasting and water deprivation group (group C),preoperative intravenous infusion of glucose group (group Ⅴ),and oral compound carbohydrate drinks group (group O).In group Ⅴ,5％ glucose solution 8 ml/kg was intravenously injected over 30 min starting from 3 h before operation.In group O,compound carbohydrate drinks 355 ml was given orally within 30 min starting from 3 h before operation.The occurrence of reflux or aspiration,recovery time of bowel sounds and time of passing flatus/defecating time were recorded.The occurrence of nausea,vomiting and bloating was recorded within 48 h after operation.The levels of plasma motilin (MTL) and serum gastrin (GAS) were determined using radioimmunoassay at 6 h before and after operation.The area of gastric antrum was measured before anesthesia induction.Anxiety was assessed using Self-rating Anxiety Scale (SAS) at 1 h before operation and 4 and 24 h after operation.Results No patients developed reflux or aspiration.Compared with group C,the recovery time of bowel sounds and time of passing flatus/defecating time were significantly shortened,the incidence of nausea,vomiting and bloating was decreased,the levels of plasma MTL and serum GAS were increased at 6 h after operation,and SAS scores were decreased at 4 and 24 h after operation in group O,and SAS scores were significantly decreased at 1 h before operation (P＜0.05),and no significant changes were observed in the other indexes in group Ⅴ (P＞0.05).Compared with group Ⅴ,the recovery time of bowel sounds and time of passing flatus/defecating time were significantly shortened,the incidence of nausea,vomiting and bloating was decreased,the levels of plasma MTL and serum GAS were increased at 6 h after operation,and SAS scores were decreased at 1 h before operation and 4 and 24 h after operation in group O (P＜0.05).Conclusion Oral compound carbohydrate drinks 355 ml at 3 h before operation can promote the postoperative recovery of gastrointestinal function without increasing the risk of reflux or aspiration in the patients undergoing gynecological laparoscopic operation.

Objective To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC) patients.Methods Fifty-eight NPC patients with radiation-induced temporal lobe necrosis (TLN) were recruited in the study.Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT) and occurrence of plaque formation.Flow velocities of bilateral middle cerebral arteries (MCAs),internal carotid arteries (ICAs) and basal artery (BA) were estimated through Transcranial Color Doppler (TCD).The result were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals,to study the relationship between IMT,occurrence of plaque and ventricular diastolic dysfunction.Results Significant differences in IMT,occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after and healthy individuals (t =18.624,8.221,P ＜0.05;x2 =17.886,P ＜0.05;t =14.367,10.112,P ＜0.05).IMT had positive correlation with post radiation interval (r =0.368,P =0.049).IMT or incidence of plaques may be related to dose of radiotherapy,course of treatment and T stage (x2 =-17.635,12.006,-3.125,P ＜ 0.05).Compared with result from patients without radiation-induced TLN,the mean IMT was significantly thicker in patients with TLN (t =10.208,P ＜ 0.05).Plaques were more common in patients with TLN than patients without TLN (x2 =13.118,P ＜0.05).In addition,flow velocities of MCAs and ICAs in patients with TLN were much faster (t =5.011,5.035,P ＜ 0.05).Among patients with unilateral TLN,flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (t =18.362,P ＜ 0.05).Conclusions Thickening of IMT,occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy,especially in those with TLN,compared with healthy individuals.

Objective:To investigate the optimal dose of dexmedetomidine combined with propofol for anesthesia in patients undergoing modified electroconvulsive therapy (MECT).Methods:One hundred and sixty patients of both sexes, aged 20-60 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective MECT, were allocated into 4 groups ( n=40 each) by a random number table method: different doses of dexmedetomidine combined with propofol group (D 1, D 2 and D 3 groups) and routine anesthesia group (group C). Dexmedetomidine 0.2, 0.4 and 0.6 μg/kg were intravenously injected in D 1, D 2 and D 3 groups, respectively, the equal volume of normal saline was given instead in group C, and propofol 1.0 mg/kg and succinylcholine 0.5 mg/kg were intravenously injected in turn 10 min later.Venous blood samples were collected before giving dexmedetomidine (T 0) and at 1 min after the end of MECT (T 1) for determination of the plasma epinephrine (E) and norepinephrine (NE) concentrations.Propofol consumption, occurrence of cardiovascular events, duration of epilespsy and energy suppression index were recorded. Results:Compared with group C, the plasma E and NE concentrations were significantly decreased at T 4, and the propofol consumption was reduced in D 1, D 2 and D 3 groups ( P<0.05). Compared with group D 2, the plasma E and NE concentrations were significantly increased at T 1 in group D 1 and decreased at T 1 in group D 3 ( P<0.05). The incidence of adverse cardiovascular events was significantly increased in group D 3 than in the other 3 groups ( P<0.05). There was no significant difference in duration of epilespsy or energy suppfession index among the 4 groups( P>0.05). Conclusion:The optimal dose of dexmedetomidine combined with propofol 1.0 mg/kg is 0.4 μg/kg when used for anesthesia in the patients undergoing MECT.

Objective:To determine whether postoperative concurrent chemoradiotherapy (CCRT) improves the survival outcomes of cervical cancer patients with pelvic and/or para-aortic lymph node metastasis after radical surgery.Methods:Clinical data of 188 cervical cancer patients presenting with pelvic and/or para-aortic lymph node metastasis after radical surgery between February 2008 and November 2011 were retrospectively analyzed. The incidence of pelvic and/or para-aortic lymph node metastasis was confirmed by postoperative pathology. The clinical efficacy of CCRT was evaluated.Results:Recurrence/metastasis occurred in 46 patients. In the radiotherapy alone group, 4(57.1%) patients had recurrence/metastasis in the posterior peritoneum subgroup, 5(55.6%) in the iliac subgroup and 11(28.2%) in the pelvic non-iliac subgroup, respectively. In the CCRT group, there were 5(62.5%) cases of recurrence/metastasis in the posterior peritoneum subgroup, 5(25%) in the iliac subgroup and 16(15.2%) in the pelvic non-iliac subgroup, respectively. Compared with the radiotherapy alone, CCRT could significantly improve the 5-year overall survival (OS) rate of patients with pelvic without iliac lymph node metastasis or iliac lymph node metastasis (pelvic without iliac: 88.6% vs.76.9%, P=0.003; iliac: 80.0% vs.44.4%, P=0.041), whereas failed to improve the 5-year OS of patients with para-aortic lymph node metastasis (50.0% vs.42.9%, P=0.973). The location of lymph node metastasis and CCRT were the independent prognostic factors for OS (para-aortic vs. pelvic without iliac: hazard ratio[HR]=4.259, 95% CI=1.700-10.671, P=0.002; iliac vs. pelvic without iliac: HR=2.985, 95% CI=1.290-6.907, P=0.011; concurrent chemotherapy vs. radiotherapy alone: HR=0.439, 95% CI=0.218-0.885, P=0.021). Conclusions:CCRT can improve the survival of patients with pelvic lymph node metastasis, but it fails to enhance the survival rate of patients with para-aortic lymph node metastasis.

Objective: To compare the curative effect of postoperative concurrent chemoradiotherapy (CCRT) and radiation therapy (RT) alone on early-stage cervical cancer patients with intermediate-risk factors. Methods: Clinical data of patients with early stage (ⅠB-ⅡA) cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy in Zhejiang Cancer Hospital between January 2008 and December 2011 were retrospectively analyzed. Cervical squamous cell carcinoma patients with more than two intermediate-risk factors, including lymphatic vascular infiltration, depth of cervical stromal infiltration >1/2 cm or tumor size >4 cm, were screened. Among them, 80 patients were divided into the RT group, 137 patients were divided into the CCRT group. The survivals of these patients were analyzed. Results: At the end of the follow-up period, a total of 22 patients were dead, one patient was alive with neoplasm. There were 23 patients who occurred recurrence/ metastasis, 14 of them were in the RT group and 9 were in the CCRT group. The 5-year progression free survival (PFS) and 5-year overall survival (OS) rate of the entire cohort were 89.9% and 89.8%, respectively. The 5-year PFS rate of RT group was 82.4%, the 5-year PFS rate of CCRT group was 94.1%, and the difference between the two groups was statistically significant (P=0.013). The 5-year OS rate of RT group was 85.1%, the 5-year OS rate of CCRT group was 92.7%, and the difference between the two groups was statistically significant (P=0.049). Univariate analysis showed that therapeutic modality was associated with the 5-year DFS and OS of early-stage cervical cancer patients with intermediate-risk factors (P<0.05). The results of multivariate analysis showed that therapeutic modality was an independent prognostic factor of favorable PFS (RR=3.741, 95% CI: 1.506-9.289, P=0.004) and OS (RR=2.754, 95%CI=1.143-6.637, P=0.024). Neither of the two groups occurred severe anemia. However, the incidence of mild and moderate anemia in the CCRT group was higher than that of RT group (P<0.001). The incidence of leukocytopenia severer than grade Ⅲ in the CCRT group was significantly higher than that of RT group (P<0.001). However, the patients could recover quickly with the treatment of granulocyte colony-stimulating factor. Conclusion Postoperative CCRT improves the survival of early stage cervical cancer patients with two or more intermediate-risk factors.

Objective: To explore the perioperative clinical treatment of thyroid cancer patients with heart disease. Methods: A retrospective analysis was conducted on 39 thyroid cancer patients with heart disease admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital,Capital Medical University from April 2014 to February 2018,including 25 males and 14 females, the age ranged from 59 to 75 years,with an average age of 67.3±6.2 years. Perioperative clinical monitoring indicators included cardiac ultrasound left ventricular ejection fraction (LVEF), degree of vascular stenosis revealed by coronary CT, hypersensitive troponin I (TNI), b-type natriuretic peptide (BNP), fibrinogen degradation products,and coagulation indexes. This panel of patients comprised 26 cases with 50% ≤ LVEF<60%,10 cases with 40% ≤ LVEF<50%, 3 cases with 36% ≤ LVEF<40%, 27 cases with 0≤BNP<100 ng/L, 7 cases with 100≤BNP<400 ng/L, and 5 cases with 400≤BNP<700 ng/L. Coronary CT showed no coronary artery stenosis>75%. The vascular graft was patent and the coronary artery after stenting was unobstructed. For 3 patients with LVEF<40% and 5 patients with BNP>400 ng/L,cardiotonic,diuretic,and nutritional myocardial therapy were used for 1 week. SPSS 17.0 software was used to analyze the data. Results: All 39 patients successfully completed the operation under general anesthesia,including 32 cases of total thyroidectomy,7 cases of glandular lobe and isthmic resection,and 40 cases of lateral neck dissection. One patient developed heart failure three days after surgery and was discharged after two weeks of treatment. No other cardiac related events,cerebrovascular and pulmonary thrombosis occurred during the perioperative period. The anesthesia preparation time was significant different between the group with 0≤BNP<100 ng/L and 50%≤LVEF<60% and the group with 0≤BNP<100 ng/L and 36%≤LVEF<50%. Conclusions Multi-indicators were utilized to adequately assess cardiac function before surgery. According to the results of cardiac ultrasound and coronary CT examination, the corresponding treatment should be conducted to improve the cardiac function. After the perioperative risk assessment and management of thyroid cancer patients with heart disease,standardized thyroid cancer surgery can be performed safely.