Objective To probe the neuroprotective effect of memantine in hippocampal CA1 region of rats with vascular dementia(VD). Methods 36 male Wistar rats were randomly divided into sham-operated group,VD group and memantine group,and each group have 12 rats. Rats of VD were treated with a permanent bilateral common carotid arteries occlusion(2-VO). Then memantine was given by intragastric administration.The behavioral abnormalities were investigated by Y-type maze test.The changes of cell morphology and the expressions of neuronal nitric oxide synthase(nNOS) and cysteine proteinase-3 (Caspase-3) of neuron in hippocampal CA1 region were detected by HE stain and immunohistochemistry respectively.The percentage of neuronal apoptosis by TUNEL. Results Compared with VD group and sham-operated group,the performance records of learning and memory(learning records:63.16±1.75,79.25±2.01,50.83±1.80,F =707.91,P <0.01;memory records:53.17±1.85,69.17±1.70,40.67±1.83,F =762.43,P <0.01),the expressions of nNOS (average gray scale:140.23±2.30,175.87±3.34,105.63±3.52,F =1539.67,P <0.01)and Caspase-3 (average gray scale:132.78±5.36,162.78±5.25,99.54±5.06,F =439.37,P <0.01)and the percentage of neuronal apoptosis (33.75±2.70,56.17±3.56,6.33±3.65,F =672.91,P <0.01)of memantine group were in the middle. Conclusion Memantine can improve spatial memory and attenuate neuronal apoptosis by down-regulation excessive expression of nNOS and Caspase-3 in rats with vascular dementia.

During medical activity,there are theory and realism spring of that the right of emergency treatment is in conflict with the right of informed consent.Simply investigating responsibilities is of no avail to solve the conflicts.To Interpret the real reasons of the conflict through legal and ethical aspects.To avoid and reduce conflict,the effective measures are that perfecting the rules of relevant law,elucidating the rights and obligations of hospital and medical staff;regulating the contents of informed consent form and strengthening medical ethics education.

OBJECTIVE:To investigate the effects of etomidate combined with propofol on painless gastrointestinal endoscopy and cognitive function of elderly patients. METHODS:Totally 90 elderly patients with painless gastrointestinal endoscopy were ran-domly divided into propofol group(30 cases),etomidate group(30 cases)and combination group(30 cases). Propofol group was given Fentanyl injection 1 μg/kg+Propofol injection 1.5 mg/kg;etomidate group was given Fentanyl injection 1 μg/kg+Etomidate injection 0.3 mg/kg;combination group was given Fentanyl injection 1 μg/kg+Propofol injection 1 mg/kg+Etomidate injection 0.15 mg/kg. The levels of SBP,DBP,HR,MAP and SpO2 at different time points,examination time,anesthesia induction time,recov-ery time and recovery time of orientation were observed in 3 groups. NCSE and MMSE score at different time points,the occur-rence of ADR were also observed in 3 groups. RESULTS:During examination,SBP,DBP,MAP and SpO2 of propofol group were significantly lower than before anesthesia,after examination and those of combination group,with statistical significance(P<0.05);but there was no statistical significance in above indexes of propofol group between during examination and before anesthesia (P>0.05). The recovery time and recovery time of orientation in combination group were significantly shorter than propofol group and etomidate group,with statistical significance(P<0.05),but there was no statistical significance in above indexes between etomidate group and propofol group(P>0.05). The proportion of patients'memory ability,computing ability,orientation ability passing examination in combination group were significantly higher than propofol group,with statistical significance(P<0.05). There was no statistical significance in above indexes between combination group and etomidate group,between etomidate group and propofol group(P>0.05). There was no statistical significance in MMSE score of combination group at different time points (P>0.05);MMSE score of propofol group 15,30 min after anesthesia and that of etomidate group 15 min after anesthesia were significantly lower before anesthesia and combination group,with statistical significance(P<0.05). There was no statistical signifi-cance in MMSE score of propofol group 1 h after anesthesia,etomidate group 30 min and 1 h after anesthesia,compared to before anesthesia(P>0.05). The incidence of apnea,hypotension and injection pain in combination group and etomidate group were low-er than propofol group,the motor response,myoclonus,nausea and vomiting in combination group and propofol group were lower than etomidate group,the tachycardia ease in combination group was lower than propofol group,with statistical significance(P<0.05). CONCLUSIONS:Etomidate combined with propofol anesthesia shows good therapeutic efficacy for painless gastrointestinal endoscopy of elderly patient,can reduce cognitive dysfunction and shortens recovery time,but doesn't increase the occurrence of ADR.

Objective To evaluate the curative effects of venlafaxine in patients with depressive disorder between therapeutic modes of inpatient and outpatient. Methods Seventy-two patients with depressive disorder including 36 inpatients and 36 outpatients were measured respectively with HAMD24 after treatment for 1 week, 2 weeks, 4 weeks and 8 weeks, and then the curative effects were compared between two groups. Results It was found that all patients in the inpatient group completed the observation and two patients in the outpatient group didn’t complete the observation. The HAMD24 score was significantly decreased in the inpatient group than that of the outpatient group from the second week to the end of the eighth week (P<0.05). The total effective rates were 80.6% for inpatient group and 64.7% for outpatient group, no significant difference between them. Conclusion Venlafaxine shows a higher therapeutic value and outcome in the therapeutic mode of inpatient.

Objective To discuss the barriers influencing the application of evidence-based nursing. Methods Nine hundred nurses from August 2013 to February 2014 were selected from five polyclinics in Shenzhen by randomly cluster sampling according to different departments and wards. We carried out the survey with the Chinese version of cognitive of impairment of nursing scientific research scale. Results The sores of 4 dimesions of scientific application of evidence-based nursing from high to low were effectiveness and system of research, resource to evidence-based nursing, quality of research and attitude and ability of nursing staff. The main barriers in applying scientific research payoffs by the nursing staff included the deficient resource and equipment provided by hospitals (68.09%), the jumbled medical development information confused the nurses in selecting related reference (66.75%), failing to put the scientific achievements into practice (66.01%),insufficient time to actualize new ideas (64.15%), and difficulty in obtaining the reference of scientific research (64.04%). Conclusion The barriers to scientrfic application of evidence-based nursing were the deficient resource and time and difficulties to find evidence. The nursing policy makers should adopt efficient measures aimed at the difficulties the nursing staff in applying their research results, thereby popularize the application of research achievements in hospitals.

Objective To establish a thin layer chromatography scanning method for the determination of cinnamaldehyde content in Qianzheng Plaster.Method Cinnamaldehyde was extracted from Qianzheng Plaster by distillation method.Silica G was used as the thin-layer plate;petroleum ether (60～90℃) and acetic ethyl acetate (17 ∶3)served as the mobile phase and the scanning wavelength was 269 nm.Results A good linearity was obtained in the range of 0.81?g～4.05 ?g (r=0.9993).The mean recovery rate was 95.23 %and RSD=1.39 %.Conclusion This method is accurate and sensitive with good reproducibility.

Objective To observe the efficacy of Shuilongjian in treating cerebellar infarction, and compare with the pure western medicine. Methods 67 inpatients with cerebellar infarction enrolled were divided into two groups according to the method of random digits table, 36 cases in the treatment group and 31 cases in the control group. The control group was given 500 mL dextran by venoclysis, once a day. The treatment group was given Shuilongjian as an additional drug. The therapeutic effect was evaluated according to the nerve function and the total capability in dealing with daily activities. Result All the 67 cases of cerebellar infarction were included in the analysis. The effective rate of the treatment group was better than that of control group with 83.3% and 58.1% (P

This article explains four cases of professor REN Ji-xue,including anasarca,serious blepharoptosis,head cold,summer diarrhea,from which we can find the laws of syndrome differentiation by him. In which,the key point of the pathogenesis of anasarca is spleen-qi deficiency, so replenishing qi and invigorating the spleen, warming yang for diuresis are the treatment nethod for anasarca. Sinking of qi due to deficiency of spleen leads to serious blepharoptosis and Invigorating Spleen and Replenishing Qi Decoction is the main prescription. The key pathogenesis of head cold is disharmony of nutrient qi with defensive qi, so regulating ying and wei, dispersing lung qi for resuscitation are the treatment methods, and both inside and outside therapies are in use. Cold-damp invasion of spleen is the main cause of summer diarrhea, so activating qi flowing and warming spleen and stomach, dissipating dampness for stopping diarrhea are used. Professor REN Ji-xue is good at taking different method according to different key point of the pathogenesis, so the efficiency is good. This is one feature of Professor REN in treating miscellaneous diseases.

CyberKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy(SRS/SRT).Compared with conventional SRS/SRT,there are many advantages for CyberKnife in terms of being real-time image-guided,frameless,highly accurate,etc.Recently,it has been used to treat different types of malignant carcinoma including intracranial and extracranial tumors.This article summarized the contemporary progress of CyberKnife in the treatment of intracranial and extracranial tumors.