Objective To explore the effects of repetitive transcranial magnetic stimulation ( rTMS ) on cognitive function in patients with mild cognitive impairmen ( MCI).Methods Fifty patients with MCI were randomly divided into rTMS treatment group ( rTMS group ) and piracetam treatment group ( control group ) , 25 patients in each group .The stimulated point of rTMS treatment were in the bilateral prefrontal area , for one time a day, continuous treatment for 6 d as a courses in rTMS group patients .Two courses of treatment was interval of 3 weeks, a total of 4 courses.The patients of control group were treated with piracetam 0.8 g, 3 times a day, for taking 16 weeks.Before and after treatment, the event-related potentials P300 and Montreal Cognitive Assessment (MoCA) scale examination were taken in two group respectively .Results Compared with before treatment , the P300 latency significant was significantly shortened and amplitude increased , scores of MoCA scale and delay memory were significantly increased (P<0.05-0.01) after treatment in the rTMS group.Compared with the control group, the difference of those had statistical significance ( all P<0.05 ) .The difference of those had no statistical significance before and after treatment in control group .Conclusion rTMS treatment can improve memory and cognitive in patients with MCI .It can delay the progress of dementia to some extent .

AIM: To determine the median effective dose(ED50) of spinal anesthesia 0.75% ropivacaine for cesarean section. METHODS: Thirty-two ASAⅠ-Ⅱ parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. The initial dose of was 12.8 mg of 0.75% ropivacaine, and the dosing intervals were 98.4% of the preceding dosage. Doses for subsequent parturients were determined by the response of the previous parturient. Successful anesthesia was defined as a loss of sensation to an acupuncture stimulus at the T7 level, full motor blockade within 10 minutes after administration of the local anesthetic, analgesia of incision and the satisfaction of skelaxin evaluated by one operator. ED50 and its 95% confidence interval (CI) was determined with use of Dixon method. RESULTS: Five parturients were rejected out the study because of doubtful anesthsia. According to the rest twenty-seven parturients' data, the ED50 of intrathecal 0.75% ropivacaine was 11.97 mg (95% confidence interval [CI], 11.75-12.19 mg). CONCLUSION: The ED50 of spinal 0.75% ropivacaine for cesarean delivery under the conditions of this study were 11.97 mg.

Objective To evaluate sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia.Methods Seventy ASA Ⅰ children were randomly divided into two groups,35 children in every group.Children in group S were appliedsevoflurane inhalation[the minimum alveolar concentration(MAC)of sevoflurane was 1.0-1.5],children in group PK were applied ketamine inhalation and total venous anesthesia of propofol[80μg/(kg·min)]with ketamine[20μg/(kg·min)].Compared the time of anesthesia induction,tracheal catheter extubation,anesthesia recovery between the two groups.The mean arterial pressure(MAP),heart rate,pulse oxygen saturation(SpO_2)during anesthesia were compared.During 2 days after operation,the adverse effects such as nausea and vomit,lower grade of sleep quality were also compared.Results Compared with group PK,the time of anesthesia induction,tracheal catheter extubation and anesthesia recovery in group S were shorter (P<0.05),the incidence of emergence agitation in group S was higher(20.0%,7/35 vs 2.9%,1/35)(P<0.05).But nausea(17.1%,6/35),vomit(31.4%,11/35)and lower grade of sleep quality(54.3%,19/35)were higher in group PK than those in groups(all 2.9%,1/35)at 1 day after operation(P<0.05).The incidence of lower grade of sleep quality at2 days after operation in group PK(14.3%,5/35)was higher than that in group S(0)(P<0.05).Cardiovascular effects of children,such as MAP and heart rate during the period of tracheal catheter extubation in group S was higher than that in group PK.Conclusion Sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia still has some disadvantages,the anesthesia technology is selected by anesthesia method and medicine combination.

Objective To investigate the long-term effects of midazolam and penehyclidine hydrochloride on learning and memory function of mice.Methods According stratified random block design ,80 KM mice were divided into 4 groups: midazolam 1mg/kg(group M,n=20), penehyclidine hydrochloride 0.2mg/kg(group P,n=20),midazolam 1mg/kg + penehyclidine hydrochloride 0.2mg/kg(group M+P,n=20) and control group(group NS,n=20);20 mice in each group were divided randomly into testing memory acquisition(n=10) and memory consolidation(n=10) further.For behavioral testing a step-through passive avoidance test was used,in order to evaluate the effects of the agents administruted on the memory acquisition before fraining and on the memory consolidafion immediately after fraining.The step-through latencies and the numbers of errors 1,2,3,4,5,6 and 7 day after the training were recorded.Results Administration of midazolam impaired memory acquisition and consolidation when administrated alone or in combination with penehyclidine hydrochloride, and this effect persisted for 3 days . Administration of midazolam combinated with penehyclidine hydrochloride did not worsen the effect on memory acquisition,but worsen the effect on memory consolidation obviously. Furthermore, administration of midazolam combinated with penehyclidine hydrochloride impaired memory function persisting longer than that of administration of midazolam alone.Conclusions Administration of midazolam and penehyclidine hydrochloride as premedication was advantageous for prevention of awareness during operation, nevertheless was attributed to one of the causations of POCD.

From May 2012 to May 2013, 60 chronic male smokers received an intravenous infusion of dexmedetomidine 1 μg/kg (Group D, n=30) or an equal volume of normal saline (Group C, n=30) before anesthesia induction.At time of dexmedetomidine or normal saline dosing , after induction of anesthesia, 1 and 3 min after intubation, the heart rates and rate-pressure products were significantly lower in Group D than Group C ( P<0.05 ).Thus the dosing of dexmedetomidine before anesthesia induction could suppress the cardiovascular responses of endotracheal intubation in chronic smokers and avoid increasing myocardial oxygen consumption so as to protect heart functions.

Aim To investigate the effects of midazolam and penehyclidine hydrochloride on learning and memory function of mice.Methods According to stratified random block design,80 KM mice were divided into 4 groups:midazolam 1 mg?kg-1(group M,n=20),penehyclidine hydrochloride 0.2 mg?kg-1(group P,n=20),midazolam 1 mg?kg-1+penehyclidine hydrochloride 0.2 mg?kg-1(group M+P,n=20)and control group(group NS,n=20),and 20 mice in every group were divided randomly into exper-iments of testing memory acquisition(n=10)and memory consolidation(n=10)further.To evaluate the behavioral alteration with these agents,a step-through passive avoidance test was used.Mice were administrated agents before training section for testing memory acquisition,and administrated agents immediately after training section for testing memory consolidation.The step-through latencies and the number of errors on 1,2,3,4,5,6 and 7 day after the training were recorded.Results Midazolam impaired memory acquisition and consolidation when administrated alone or in combination with penehyclidine hydrochloride.Administration of midazolam combinated with penehyclidine hydrochloride did not worsen the effect on memory acquisition,but worsen the effect on memory consolidation obviously.Furthermore,administration of midazolam combinated with penehyclidine hydrochloride impaired memory function persisting longer than that of administration of midazolam alone.Conclusion Administration of midazolam and penehyclidine hydrochloride would result in inhibiting learning and memory function of mice.

Objective The author seeked the suitable tidal volume in order to decrease mechanical ventilation-induced lung injury during closed circuit anesthesia in infants.Methodes 50 infants who practiced selective orthopedics operation randomly divided into traditional mode(12~15ml/kg,groupT,n=25)and low tidal volumes(7~8ml/kg,groupL,n=25).The bronchoalveolar lavage fluid of intants were collected immediately after tracheal intubation(T1)and before tracheal extubation,respectively.Interleukin-6 and interleukin-8 in the bronchoalveolar lavage fluid were determined by enhancement solid-phase enzyme immunoassay action(EASIA),TNF-? in the bronchoalveolar lavage fluid were determined by euzymelinked immunosorbent assay(EIA).The numbers of polymorphonuclear neutrophils in the bronchoalveolar lavage fluid of intants were examined.The infants' SpO2,arterial blood pressure and PetCO2 were monitored continuously.Arterial blood gas was analysised.The time of analepsia and complications of lung were observed after operation.Results PaCO2、PetCO2 in groupL were higher than that in groupT,pH in groupL lower than that in groupT at 30 min,60 min,120 min after mechanical ventilation and before extubation,respectively.The contents of PMN,TNF-?,IL-6 and IL-8 in BALF collected at T2 more than that at T1 in groupT.The contents of PMN,TNF-?,IL-6 and IL-8 in BALF in groupL less than that in groupT at T2(P

Objective To investigate the effect of ambroxol administered before surgery on contents of PMN,TNF-?,IL-6 and IL-8 in bronchoalveolar lavage fluid after closed circuit anesthesia in infants.Methods 40 infants who practiced selective orthopedics or abdominal operations were randomly divided into ambroxol group (group A) and control group (group B). Two days before operation,infants in group A and group B were administed ambroxol 0.3 mg/kg or 0.9 normal saline 10 ml through intravenous injection three times per day,respectively .The last single dose was administered before anesthesia induction.The bronchoalveolar lavage fluid of intants were collected immediately after tracheal intubation(T1) and before tracheal extubation(T2),respectively.Interleukin-6 and interleukin-8 in the bronchoalveolar lavage fluid were determined by enhancement solid-phase enzyme immunoassay action(EASIA),and TNF-? in the bronchoalveolar lavage fluid by euzymelinked immunosorbent assay (EIA).The numbers of polymorphonuclear neutrophils in the bronchoalveolar lavage fluid were examined. The contents of PMN,TNF-?,IL-6 and IL-8 in two groups were compared .The time of analepsia and complications of respiratory tract were observed after operation.Results Compared with group A, the contents of PMN,TNF-?,IL-6 and IL-8 in BALF collected at T2 were significant higher in group B (P

Objective To study the possibility of using heterogeneous antiserum in single radial immunodiffusion (SRID) for quantitative detection of HA in H7N9 influenza vaccine product when H7N9-specific antiserum is not available in order to establish a testing method for the detection of H 7N9 antigen in any urgent situation.Methods Antisera specific for H7N1, H7N2, H7N3 and H7N7 were obtained from NIBSC and used for SRID assay .Amino acid sequences of hemagglutinins were comparatively analyzed be-tween H7N9 virus and other viruses used to prepare heterogeneous antiserum .The titers of antisera against H7N9 and their homogenous antigens were detected by double immunodiffusion method .Based on the results of homology analysis and cross-reaction, a suitable antiserum was selected and its applicability was further validated by the SRID assay using H7N9 antigen.Results Influenza A virus subtype H7N3 that used for preparation of 07/278 antiserum showed the highest HA homology with H7N9 (97.14%).The titer of 07/278 antiserum against H7N9 antigen was 1 ∶8 as detected by double immunodiffusion assay .The H7N9 anti-gen and the 07/278 antiserum could form a clear precipitation line in SRID assay .The detection of H7N9 antigen in the range of 10 to 40μg/ml showed a good linearity in the standard curve .Conclusion The 07/278 antiserum from NIBSC can be used as an alternative reagent for the quantitative detection of hemaggluti -nin in H7N9 influenza virus vaccine .

Objective:Recent studies have shown that in contrast to decrease in distal gastric adenocarcinoma (DGA), incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased noticeably in numerous counties. However, the reasons remain unclear. This study evaluated the possible differences in the expression of KLF4, SP1, and Cyclin D1 in AEG and DGA, and explored the potential carcinogenesis of AEG. Methods:Immunohistochemistry was performed on paraffin-embedded tissues to evaluate the pu-tative differences in the expressions of KLF4, SP1, and Cyclin D1 at protein level between AEG (n=58) and DGA (n=47). The patholog-ical significance of these markers between the two groups was also compared and analyzed. Results:The percentage of positive KLF4 expression was significantly lower in DGA than in AEG (P<0.05). Lower KLF4 expression was found both in well-or moderately dif-ferentiated cases and in poorly differentiated cases with DGA compared with their AEG counterparts (P<0.05). However, positive stain-ing for SP1 was significantly higher in DGA (P<0.05). No significant difference was found in the expression of Cyclin D1 between the two groups. Further analysis showed that in DGA, the positive expression of KLF4, SP1, and Cyclin D1 were significantly correlated with lymph node metastasis. In AEG, only Cyclin D1 expression was correlated with lymph node metastasis (P<0.05). No correlation was found among the expression of KLF4, SP1, and Cyclin D1 in AEG. In DGA, KLF4 was inversely correlated with SP1 and Cyclin D1 (r=-0.334 and r=-0.341, respectively, P<0.05), and SP1 was positively correlated with Cyclin D1 expression (r=0.340, P<0.05).Conclusion:Different expression patterns and clinicopathological significance of KLF4, SP1, and Cyclin D1 were observed between AEG and DGA, suggesting the putative difference in the carcinogenesis and progression of AEG and DGA.