With the aging of the population,management of cancer in the elderly aged people represents a priority for health care.However,fewer evidence-based data are available to promote the treatment of these patients.Comprehensive geriatric assessment (CGA) is developed recently as a multi-disciplinary in-depth evaluation to assess life expectancy and risk of morbidity from cancer in elderly patients,which is helpful for physicians to develop a coordinated plan for cancer treatment and to provide appropriate interventions to decrease the risk of morbidity and mortality.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

Objective To explore the effect of operative treatment of hypertensive intracerebral hemorrhage.Methods 386 cases with hypertensive intracerebral hemorrhage were retrospectively analysed,hematoma was removed through big bone flap and small skull window,or drainage and urokinase infusion with small hole puncture.Results 39 cases died(10.1%),according to ADI grade system:Ⅰ 106 cases(27.4%),Ⅱ 136 cases(35.2%),Ⅲ 50 cases(13%),Ⅳ 43 cases(11.1%),Ⅴ 12 cases(3.2%).Conclusion To increase the cure rate and life quality,and obtain a lower mortality,it is a key to do surgical operation such as microsurgery or drainage and urokinase infusion.

Objective To analyze the correlation between fetal right aortic arch and chromosome ab-normality by ultrasound.Methods From January Jan 2009 to Dec 2014,nineteen cases with fetal right aortic arch were enrolled.They were all determined by chromosome karyotype analysis.The correlation of fetal right aortic arch and chromosome abnormalities detected by ultrasound were evaluated.Results Left lock,a “U”shaped vascular structure,were found in 15 cases.One case of fetal aortic arch was surrounded by a “O”shaped package.Three cases of right aortic arch showed fetal left artery catheter and brachiocephalic artery ima-ging branch.Echocardiography mainly for arterial catheter in three vessel trachea view did not show up.Artery catheter,in front of the trachea,did not form the vascular ring.Nineteen cases of right aortic arch were exam-ined by fetal karyotype analysis.Three patients with trisomy 18-karyotype presented ventricular septal defect, single artium,three tricuspid atresia,pulmonary artery stenosis.Four cases with trisomy 18-karyotype presen-ted ventricular septal defect,complete atrioventricular canal,single artium,double outlet right ventricle,pul-monary artery stenosis in atresia.Three cases with trisomy 21 -karyotype showed single ventricle,single atri-um.One case was with tetralogy of Fallot and one case with dextrocardia,aortic stenosis,accompanied by 22q 1 1.2.Conclusion In prenatal ultrasound screening,we should pay attention to three vessels-trachea view on ultrasound image,which can improve the detection rate of right aortic arch.Fetal right aortic arch and triso-my 18-,trisomy 21 -,chromosomal diseases are substantially correlated.Further analysis of chromosome kary-otype is needed to exclude chromosomal lesions,so as to achieve the purpose of prenatal and postnatal care.

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.

Objective To investigate the effects of remifentanil on lipopolysaccharide ( LPS)-induced acute lung injury (ALI) in rabbits.Methods Thirty healthy male New Zealand white rabbits weighing 2.5-3.5 kg were randomly divided into 5 groups ( n = 6 each) : group Ⅰ control (group C) ;group Ⅱ ALI;group Ⅲ, Ⅳ, Ⅴ low, median and high dose RF + LPS (group LR, MR, HR) . The animals were anesthetized with intravenous 3% pentobarbital sodium 30 mg/kg, tracheostomized and mechanically ventilated. The carotid artery and jugular vein were cannulated for MAP and HR monitoring, blood sampling, and fluid and drug administration. LPS 0.5 mg/kg in 10 ml of normal saline (NS) was infused over 30 min in group Ⅱ-Ⅴ. Remifentanil 0.2, 0.4 or 0.8 μg·kg~(-1)·min~(-1) was infused starting from 15 min before LPS administration until the death of the animals. MAP, HR, peak airway pressure (P_(peak) ), PaO_2 and plasma intercellular adhesion molecule 1 (ICAM-1) concentration were measured immediately before LPS infusion (T_0, baseline) and at 1, 2.5 and 5.5 h after the end of LPS infusion. The animals were killed and the lungs were immediately removed for microscopic examination and determination of W/D lung weight ratio. Results MAP, HR and PaO_2 were significantly decreased while W/D ratio and P_(peak) were significantly increased after iv LPS infusion as compared with control group. LPS significantly increased plasma ICAM-1 concentration and damaged the structure of lung tissue. Remifentanil infusion significantly attenuated the LPS-induced changes in a dose-dependent manner. Conclusion RF has protective effect against LPS-induced ALI and inhibition of ICAM-1 expression is involved in the mechanism.

To study the clinical features, diagnosis, and treatment of SCN8 A-related infantile spasm, one 21-month-boy identified a de novo mutation of SCN8 A-related infantile spasm was admitted to West China Second University Hospital, Sichuan University in September 2019 and was enrolled as a research subject.The clinical manifestation and diagnosis process were analyzed by carrying out the retrospective analysis method.This case is the first report on SCN8 A-related infantile spasm in China.This child had hiatal hernia, which has never been reported in SCN8 A gene mutation people.The boy shows marked developmental regression after the onset of seizures at 8-month-old, and a variety of antiepileptic drugs are ineffective.Recently, seizure types have changed into infantile spasm.Levetiracetam was stopped, and provided adrenocorticotropic hormone (ACTH). After treatment, the spasm was relieved.Hiatal hernia may be a phenotype of SCN8 A gene mutation.Sodium channel blockers display high efficacy in SCN8 A-related epilepsy.ACTH therapy for SCN8 A-related infantile spasm is effective.

Objective:To investigate the exression of miR-34a on lung cancer and normal lung tissues,and the effect and mechanism of miR-34a in lung cancer cell invasion and migration.Methods: qPCR was used to detect the expression of miR-34a on lung cancer.miR-34a-mimic and miR-34a-inhibitor were used to overexpress and knockdown miR-34a.qPCR was used to detect the effectiveness.Western blot was used to detect the expression of Snail after induced with miR-34a-mimic and miR-34a-inhibitor.Luciferase reporter gene was used to detect interaction between miR-34a and Snail.Transwell invasion assay was used to detect invasion ability after induced with miR-34a-mimic and miR-34a-inhibitor.Scratch assay was used to detect migration ability after induced with miR-34a-mimic and miR-34a-inhibitor.The expression of E-cadherin,Vimentin and Twist were detected by Western blot.Results: miR-34a expression was significantly reduced in lung cancer.With the stage of lung cancer progression,the expression of miR-34a reduced.With the differentiation of lung cancer progression,the expression of miR-34a decreased.Decreasing of miR-34a was associated with lung cancer lymph node metastasis.miR-34a-mimic and miR-34a-inhibitor could overexpress and knockdown miR-34a.miR-34a could regulate expression of Snail.Snail was the direct target of miR-34a;miR-34a could regulate the invasion ability of human lung carcinoma H1650 cells;miR-34a could regulate the migration of human lung carcinoma H1650 cells;miR-34a could regulate the expression of E-cadherin,Vimentin and Twist.Conclusion: miR-34a plays the role of tumor suppressor factor in lung cancer.miR-34a can regulate the invasion and migration ability of lung carcinoma H1650 cells by Snail induced EMT.

Objective:To investigate the inhibitory effect of perillyl alcohol (PA) on the proliferation and invasion of tung cancer cell A549,and the influence of PA on tumor angiogenesis was studied.Methods:Different concentrations of PA and erlotinib were added into lung cancer cell A549,the inhibiting effect of drug group on lung cancer cell A549 was found by MTT assay.The inhibiting effect of PA on lung cancer cell A549 invasion was measured by Transwell assay.ROS changes of PA on lung cancer cell A549 was detected by fluorescent.Influence of PA on Caspase-3 activity of lung cancer cell A549 was measured by spectrophotometry,VEGF,HIF-1 α,COX-2 expression in lung cancer cell A549 was measured by Western blot,and the NF-κB activity of lung cancer cell A549 was measured by EMSA.Results:Compared with blank control group,cell growth inhibition rate of PA and erlotinib on lung cancer cell A549 was increasing with the increased concentrations (10,50,100 μ,g/ml),the difference was statistically significant (P＜ 0.05),the invasion ability of lung cancer cell A549 was decreased continuously,the difference was statistically significant (P＜0.05).The ROS level of lung cancer cell A549 had no obvious change with the increasing density of erlotinib,but obviously increased with the increasing concentrations of PA (10,50,100 μg/ml).With the increasing concentrations of PA,the expression of COX-2,VEGF and HIF-1α were continuously decreased.EMSA assay showed that NF-κB was continuously decreased with the increasing concentrations of PA.Conclusion:The antitumor mechanism of PA on lung cancer cell A549 might be related to increase the expression level of ROS and reduce the expression of activity of NF-κB,COX-2,VEGF and HIF-1α with angiogenesis signaling pathway.

Objective To evaluate the role of P2X7 receptors in release of glutamate (Glu) and γ-aminobutyric acid (GABA) during oxygen-glucose deprivation (OGD) in rat hippocampus and neuronal synaptosome.Methods Healthy male SD rats weighing 150-200 g were decapitated. Their hippocampi were isolated and cut into slices 400 μm thick or made into neuronal synaptosomes. The hippocampal slices and neuronal synaptosomes were incubated in artificial cerebro-spinal fluid (aCSF) at 35℃ for 30 min and divided into 3 groups ( n = 32 or 24 each): control group (group C); group OGD and group OGD + BBG (brilliant blue G, a specific P2X7 receptor antagonist). OGD was induced by incubating the slices and synaptosomes in glucose-free aCSF aerated with 95% N2-5% CO2. In group OGD + BBG the slices and synaptosomes were incubated in O2-glucose deprived aCSF containing BBG 1 μmol/L 2 ml. Release of Glu and GABA from hippocampal slices and synaptosomes was determined by HPLC at 0, 20, 40, 60 min of OGD (T1-4). Hippocampal slices were examined with microscope.Results ( 1 ) The release of Glu and GABA from hippocampal slices and synaptosomes were significantly increased after OGD ( P ＜ 0.05). (2) Glu released from hippocampal slices was significantly decreased at T3-4 and Glu released from synaptosomes increased at T2-4 in group OGD + BBG as compared with group OGD ( P ＜ 0.05). (3)GABA released from hippocampal slices was significantly decreased at T4 in group OGD + BBG as compared with group OGD ( P ＜ 0.05). There was no significant difference in GABA released from synaptosomes between group OGD and OGD + BBG (P ＞ 0.05). (4) Microscopic examination showed that OGD induced significant histopathological damage to hippocampal slices which was attenuated by BBG treatment. Conclusion P2X7 receptors mediates the release of Glu and GABA during OGD in rat hippocampus and the P2X7 receptors in glial cells plays a leading role.