Objective To investigate the effect of different pressure CO 2 pneumoperitoneum on early postoperative cognitive function in female patients undergoing gynecological laparoscopic sur-gery.Methods Ninety female patients,aged 40-60 years,ASA physical status Ⅰor Ⅱ,scheduled for elective gynecological laparoscopic surgery,were randomly divided into three groups (n = 30). The pressure of CO 2 pneumoperitoneum were set at 6-8,9-1 1 and 12-14 mm Hg in groups L,M and H,respectively.All of the patients were tested by the neuropsychology and questionnaire review to estimate whether the patient got cognitive decline at 24 h before the operation.The venous blood sam-ples 10 minutes before anesthesia (T1 ),at the end of surgery (T2 ),6 hours after surgery (T3 ),24 hours after surgery (T4 )and 72 hours after surgery (T5 )were collected for determination of serum concentrations of NSE and S100βprotein.The pH,PaCO 2 and PaO 2 were recorded before anesthesia (Ta ),before pneumoperitoneum (Tb ),1 hour after pneumoperitoneum (Tc ),2 hours after pneumo-peritoneum (Td )and 1 hour after stopping pneumoperitoneum (Te ).Results Scores of these tests in three groups were not different and there was no patient with cognitive decline after surgery.Com-pared with group H,the concentration of NSE at T2 and T3 was significantly lower in groups L and M (P <0.05).Compared with group H,the concentration of S100βprotein at T2 was significantly lower in groups L and M (P <0.05).Compared with group L,pH at Tc and Td was significantly decreased in groups M and H (P <0.05).Compared with group L,PaCO 2 was significantly increased at Tc-Te in groups M and H (P <0.05).Conclusion Different pressure of CO 2 pneumoperitoneum has no ob-vious effect on the early cognitive function,but low (6-8 mm Hg)CO 2 pneumoperitoneum can reduce the release of NSE and S100βprotein after operation.

BACKGROUND: Hippocampal neuron presents remarkably injury in cerebral after seizure of epilepsy. Necrosis and apoptosis are two kinds of neural cell injury after epilepsy and play an important role in neural injury of epilepsy. Being endogenous neural protective transmitter, adenosine may inhibit the release of excitatory amino acid, production of oxygenic free radical and action of nitric oxide. Simultaneously, it can improve cerebral blood flow and anti-convulsion. But it has been unknown concerning to the relationship between adenosine and cell apoptosis after epilepsy yet.OBJECTIVE: To observe the effects of 2-CAdo adenosine-receptor excitant on genetic expression of bcl-2, Bax of hippocampal cells in epileptic rats and further probe into the mechanism of adenosine on anti-convulsion and brain protection.DESIGN: Completely randomized controlled experimental research in which the experimental animals were taken as the objects.SETTING: Pediatrics department and general surgical department of one oil field general hospital, and pediatric internal department of a hospital affiliated to one university.MATERIALS: The experiment was performed in Experimental Zoology Departnent and Pathological Teaching & Research Department of Harbin Medical University from October 2002 to March 2003. Totally 104 Wistar rats of either sex were employed, weighing varied from 200 g to 250 g. The animals were randomly divided, named as normal group 8 rats, epileptic group 32 rats, epileptic & 2-CAdo group 32 rats, and epileptic & physiological saline group 32 rats.INTERVENTIONS: The animal epileptic model was set up by intra-abdominal injection of coriamyrtin 15 mg/kg(provided by Pathology Department of Harbin Medical University. Convulsion presented in all of rats, 5 minutes later after injection, lasting for 1 or 2 minutes. In epileptic & 2-CAdo group, 2-CAdo(provided by ICN company), 0.6 mg/kg, was injected from the vein on the tail 1 hour before coriamyrtin injection and 1 hour after convulsion respectively. In epileptic & physiological saline group, the physiological saline of equal dosage was injected from the vein on the tail 1 hour before coriamyrtin injection and 1 hour after convulsion respectively.MAIN OUTCOME MEASURES: Positive cell counts of bcl-2 and Bax genetic expression in hippocampal CA1 area.RESULTS: Twenty-four hours after epilepsy seizure, neural cell bcl-2 expression was increased in hippocampal CA1 area, was remarkably decreased in 48 hours, and the expression was only little amount in 72 hours, but it was increased again in 7 days. Bax expression began increased in 24 hours after epilepsy seizure, was significantly increased in 48 hours, reached the peak in 72 hours, the expression was the minimum in 7 days. In epileptic & 2-CAdo group, bcl-2 expressions at corresponding times were remarkably increased compared with epileptic group and epileptic & physiological saline group( P＜ 0.05), Bax expressions were remarkably decreased compared with epileptic group and epileptic & physiological saline group( P ＜ 0.05), indicating statistical significance.CONCLUSION: 2-CAdo can reduce apoptosis of hippoeampal neural cells after epilepsy seizure and provide a certain protection for neural cells.

Objective To observe the clinical efficacy of needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride.Method Ninety-three patients with early Parkinson's disease were randomized into group A of 32 cases, group B of 30 cases, and group C of 31 cases. Group A was intervened by needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride, group B by rehabilitation and taking levodopaand benserazide hydrochlo-ride, while group C by taking levodopaand benserazide hydrochlo-ride. UPDRSⅢ scores and Berg balance scale (BBS) scores were observed.Result After intervention, UPDRSⅢ scores and BBS scores were significantly changed in all groups (P<0.05). UPDRSⅢ scores of group A were markedly different form that of group B and C (P<0.05). BBS scores of group A and B were markedly different form that of group C (P<0.05).Conclusion Needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride can improve motor function and equilibrium function in the early Parkinson's disease patients.

OBJECTIVE:To investigate the inhibitory effect of Baixuan xiatare tablet on the model mouse with allergic contact dermatitis (ACD). METHODS:60 BALB/c mice were equally randomized into normal control (isometric solvent) group,model (isometric solvent)group,ebastine(positive control,0.003 g/kg)group and the groups of high,middle and low doses of Baixuan xiatare tablet(2.0,1.0 and 0.5 g/kg). The mice were given drugs,ig,once daily for 14 consecutive days. 0.5% 2,4-dinitrofluoro-benzene(DNFB)acetone olive oil solution was applied,for sensitization,on the prepared mouse’s skins one and two days before administration,and 0.2% DNFB acetone olive oil solution on their left ears 16 days thereafter to establish mouse models of ACD. At 48 h after successful establishment of the models,the thickness of the mouse’s left ear margin was measured and the difference value and swelling degree were calculated;flow cytometer was used to determine the levels of T lymphocyte subsets CD4+ and CD8+ in mouse blood and calculate the ratio of CD4+ to CD8+;the levels of interleukin 4(IL-4)and IL-6 in mouse serum were de-termined. RESULTS:Compared with normal control group,those in the model group had higher difference value of ear margin and swelling degree,lower level of CD4+ in blood and ratio of CD4+ to CD8+,and higher content of IL-6 in serum. There was statisti-cally difference (P<0.01). Compared with model group,those in the groups of high,middle and low doses of Baixuan xiatare tablet had lower degree of left ear swelling and higher level of CD4+ in blood;those in the groups of high and middle doses thereof had lower difference value of left ear margin and level of IL-6 in serum;and those in the group of high dose thereof had higher lev-el of CD8+ in blood. There was statistically significance(P<0.01 or P<0.05). CONCLUSIONS:Baixuan xiatare tablet has inhibi-tory effect to some degree on the mouse model with ACD by a mechanism which may be related to the balance of subsets CD4+and CD8+in blood and the reduction of IL-6 in serum.

Objective To explore the significance of serum levels of interleukin(IL)-33,21,17, 6,the positive rates of anti-cardiolipin antibody(ACA)-IgG,ACA-IgM and anti endothelial cell antibody (AECA)-IgM in diagnosis of Kawasaki disease and prediction of coronary artery lesions. Methods Seventy children with Kawasaki disease were selected as Kawasaki disease group,and the children were divided into abnormal ultrasonic group(11 cases)and normal ultrasonic group(59 cases)according to the result of cardiac ultrasound. Fifty children with upper respiratory tract infection or bronchitis were selected as control group.The serum levels of IL-33,21,17,6 and positive rates of ACA-IgG,ACA-IgM, AECA-IgM were detected.Results The serum levels of IL-33,21,17 and 6 in Kawasaki disease acute stage were significantly higher than those in control group:(127.43 ± 10.87)ng/L vs.(69.67 ± 6.38)ng/L, (130.43 ± 11.22) ng/L vs. (87.56 ± 7.76) ng/L, (1 243.38 ± 612.08) ng/L vs. (397.26 ± 182.16) ng/L, (438.35 ± 101.78)ng/L vs.(213.74 ± 104.52)ng/L;the positive rates of ACA-IgG,ACA-IgM and AECA-IgM were significantly higher than those in control group: 37.1%(26/70)vs.8.0%(4/50),32.9%(23/70) vs.6.0%(3/50)and 34.3%(24/70)vs.8.0%(4/50),and there were statistical differences(P<0.01).The acute stage serum levels of IL-33, 21, 17 and 6 in abnormal ultrasonic group were significantly higher than those in normal ultrasonic group:(135.92 ± 11.56)ng/L vs.(123.48 ± 10.14)ng/L,(138.29 ± 11.86) ng/L vs.(128.08 ± 10.94)ng/L,(2 042.47 ± 968.43)ng/L vs.(1 096.59 ± 502.82)ng/L,(495.58 ± 103.04) ng/L vs. (402.67 ± 98.26) ng/L; the positive rates of ACA-IgG, ACA-IgM and AECA-IgM were significantly higher than those in normal ultrasonic group:7/11 vs.32.2%(19/59),8/11 vs.25.4%(15/59) and 7/11 vs. 28.8% (17/59), and there were statistical differences (P < 0.01 or <0.05). In Kawasaki disease, the acute stage serum levels of IL-33, 21, 17 and 6 were significantly higher than those in subacute stage:(127.43 ± 10.87)ng/L vs.(94.48 ± 8.56)ng/L,(130.43 ± 11.22)ng/L vs.(91.78 ± 8.03) ng/L, (1 243.38 ± 612.08) ng/L vs. (527.12 ± 236.94) ng/L and (438.35 ± 101.78) ng/L vs. (308.41 ± 144.09)ng/L,and there were statistical differences(P<0.01).Conclusions IL-33,21,17,6 and ACA-IgG, ACA-IgM, AECA-IgM participates in the process of Kawasaki disease vasculitis and coronary artery damage,which can assist the early diagnosis of Kawasaki disease and predict the coronary artery lesions.

Objective ToexploretheCTcharacteristicsofinvasivepulmonaryadenocarcinomapresentingaspuregroundglass nodule(pGGN)withthin-sliceCT,andtodifferentiateinfiltratingadenocarcinoma(IA)fromnon-IA.Methods 271patientswith pGGNconfirmedbysurgicalpathologywereenrolledinthisstudyforretrospectiveanalysis.Patientsweredividedinto4groups:18 atypicaladenomatoushyperplasias(AAH),114adenocarcinomasinsitu(AIS),82minimallyinvasiveadenocarcinomas(MIA)and 57IA.Allthepatientsunderwentthin-sliceCTscansin1weekbeforesurgery.ThemaximumdiameterandaverageCTvaluewere measured,andtheimagingcharacteristicsofallpGGN,includingpleuralinelentationandvacuolesignwererecorded.Results The maximumdiameter,averageCTvalue,age,vacuolesignandsmokinghistory weresignificantlydifferent (P<0.05)betweenIA groupandnon-IAgroup.Nosignificantstatisticaldifferenceswereobservedingenderandpleuralindentation.Thediagnosticefficacy ofthemaximumdiameterandaverageCTvalueweregoodandtheROCcurveswere0.876and0.802respectively.Conclusion Itis helpfultodifferentiateIAgroupfromnon-IAgroupusingthemaximumdiameter,theaverageCTvalue,age,vacuolesignandsmoking history.ThemaximumdiameterandaverageCTvalueofIAgrouparesignificantlyhigherthannon-IAgroup.

Objective To assess the psychometric potential of the Montreal Cognitive Assessment Scale-Beijing (MoCA-BJ) as a screening instrument for mild cognitive impairment (MCI) in older adults in Wuhan communities of central China. Methods MoCA-BJ and Mini-Mental State Examination (MMSE) were adopted to assess the MCI of 381 older adults from 13 communities in Wuhan in 2015. Confirmatory factor analysis was conducted to evaluate the construct validity of MoCA-BJ, and the relationship between all aspects of cognitive function and MoCA different dimensions. Results MoCA-BJ had acceptable reliability (w=0.76), and MoCA-BJ and MMSE estimation results were highly correlated (r=0.73, P＜0.01). By comparing three measurement models through confirmatory factor analysis, we found that the MoCA-BJ scale had two factors (F1: visual space executive function, F2: memory-based other cognitive functions) in model 3, fit degree of which was higher than model 1 by one factor, and there was a statistically significant difference in the number of factors between model 1 and model 3 (χ2dif=8.73,P＜0.01). Conclusions The MoCA-BJ has two underlying factors that respectively represent two highly correlated but distinct factors, cognition and visual-spatial. Uninformative items should be revised with culturally sensitive items and the cut-off point for mild impairment should also be altered.

Objective To investigate G protein-coupled estrogen receptor(GPER)mediated neuroprotective effect and mechanism in an ischemic stroke model. Methods Bilateral ovariectomy (OVX)was used to establish a castrated model of adult SPF grade female SD rats. Enzyme-linked immunosorbent assay was used to detect serum estrogen level at 4 weeks after procedure.Middle cerebral artery occlusion(MCAO)was use to prepare a stroke model.The rats were randomly divided into sham operation(n=6),MCAO(n=7),MCAO+estrogen(MCAO+E2,n=8),MCAO+agonist(MCAO+G1,n=8)and MCAO +antagonist G15(MCAO +G15,n =7)groups. The neurological severity score (NSS),2,3,5-triphenyltetrazolium chloride(TTC)staining were used to measure the volume of cerebral infarction in order to assess the effects of different interventions.Western blot was used to detect the protein expression of hypoxia inducible factor-1α(HIF-1α),c-Jun N-terminal kinase(JNK),and Caspase-3 in the ischemic penumbra. Results (1)Estrogen level:after OVX,The level of serum estrogen in rats was significantly lower than that before castration(20 ± 9 ng/L vs. 73 ± 21 ng/L,P <0. 01).(2)NSS score:the NSS score of MCAO in each group was significant higher than that in the sham operation group (P<0.01);The NSS score of the MCAO+G1 group was significantly lower than that of the MCAO group and the MCAO+G15 group(6.0 ±1.8 vs.11.9 ±2.0 and 10.0 ±2.1).The difference was statistically significant (all P<0.05).(3)Cerebral infarct volume:there was significant difference in infarcted volume between the sham operation group and all other groups(all P<0.01);Compared with the MCAO group and the MCAO+G15 group,the infarct volume of the MCAO+E2 group and MCAO+G1 group was significantly reduced(19.8 ± 4.0%,14.0 ± 2.9%)vs.29.7 ± 5.8% and 27.6 ± 3.6%).The difference was statistically significant (all P<0.05).(4)Results of Western blot:the relative optical density values of HIF-1α,JNK,and Caspase-3 of the MCAO group were higher than those of the MCAO + G1 group(all P <0.01). Conclusions GPER mediates the neuroprotective effect of estrogen in the ischemic stroke model.This protective effect is associated with the regulation of the expression levels of HIF-1α,JNK,and Caspase-3.

Objective: This study aims to investigate the willingness and influencing factors of COVID-19 vaccination among Chinese middle school students, and to provide a reference for promoting the implementation of COVID-19 vaccination among middle school students. Methods: An online survey was conducted among middle school students in Beijing, Anqing of Anhui Province, Xi an of Shaanxi Province and Shenzhen of Guangdong Province, and 9 153 participants were enrolled in the present study. Single factor analysis and multinomial Logistic regression was used to determine the related factors of COVID-19 vaccination willingness. Results: The prevalence of vaccine acceptance, vaccine hesitancy and vaccine refusal among middle school students were 60.05%, 31.59% and 8.36%, respectively. The results of Chi square analysis showed there were significant difference of COVID-19 vaccination willingness among sex, school residence, grade, region, vaccination willingness of surrounding classmates, vaccination willingness of others, fear of SARS-CoV-2 and risk of SARS-CoV-2 infection( χ 2=8.43-1 059.43, P <0.05). Multinomial Logistic regression analysis presented that, compared to "vaccine acceptance" group, those girls, non resident in school, living in Beijing or Anqing, disagree or uncertain with influenced by peers, disagree or uncertain with influenced by others, uncertain with fear of SARS-CoV-2, disagree or uncertain with having risk of SARS-CoV-2 infection were more likely to show vaccine hesitancy( OR =1.22,1.21,1.49,1.69,1.75,2.54,1.41,2.32,3.32,1.99,2.38, P <0.05). And those non boarding in school, living in Beijing or Xi an, disagree or uncertainty influenced by peers, disagree or uncertainty influenced by others, disagree with fear of SARS- CoV- 2, disagree or uncertainty in having risk of SARS-CoV-2 infection were more likely to show vaccine refusal ( OR =1.27, 2.29 ,1.46,3.88,2.37,2.31,1.47,2.14,4.24,1.47, P <0.05). Conclusion The willingness of COVID-19 vaccination among middle school students in four cities is low, and targeted interventions should be advocated to form herd immunity.

Objective: To explore the longitudinal association between organophosphate esters (OPEs) exposure and blood pressure in children, so as to provide a reference for identifying the effects of OPEs exposure on child health. Methods: A total of 404 children from the Beijing Child Growth and Health Cohort (PROC) were enrolled using a case cohort study design, baseline physical examination, urine collection, questionnaires survey were administered in 2018 and follow up surveys in 2019-2020 and 2023. Participants were divided into case group ( n =140) and control group ( n =264) according to the observation of new onset of high blood pressure during the follow up period. High performance liquid chromatography tandem mass spectrometry was used to detect diethyl phosphate (DEP)，bis (2-chloroethyl) phosphate (BCEP)，bis (1-chloro-2-propyl) phosphate, (BCIPP), diphenyl phosphate(DPHP), dibutyl phosphate (DnBP), bis (1,3-dichloro-2-propyl) phosphate(BDCIPP), bis(2-butoxyethyl) phosphate(BBOEP), bis (2-butoxyethyl) 2-hydroxyethyl phosphate (BBOEHEP), 4-hydroxyphenyl diphenyl phosphate (4-OH-TPHP). Generalized linear mixed models and Quantile g computation models were developed to analyze the longitudinal associations between OPEs individual/mixed exposure and blood pressure in children. Results: The detection range of 9 OPEs metabolites,including DEP, BCEP, BCIPP, DPHP, DnBP, BDCIPP, BBOEP, BBOEHEP and 4-OH-TPHP at three time points (baseline, first follow up and second follow up) were 27.7%-92.1%, 24.0%-99.3% and 39.2%-90.9% respectively. Without adjustment for covariates such as gender, age, body mass index, Tanner stage, parental education, and monthly household income, and family history of hypertension, the increase of BDCIPP concentration and mixed exposure of OPEs may reduce children s systolic blood pressure( β= -0.85，-2.40，95%CI=-1.69--0.01，-3.30--1.50，P <0.05). After adjusting for the covariates, the longitudinal association of individual OPEs or mixed exposure with pediatric BP was not statistically significant ( P >0.05). Conclusion Children are commonly exposed to OPEs, and although no significant longitudinal associations are observed between exposure to OPEs and blood pressure among school aged children in Beijing, it is recommended that child exposure should be minimized whenever possible.