Aim To study Dehydroepiandrosterone (DHEA) and 7-oxo-dehydroepiandrosterone (7-oxo-DHEA) protected hippocampal neurons against neurotoxicity induced by glutamate(Glu). Methods Cell survival rate was analyzed using MTT colorimetry, the change of Ca 2+ levels and the levels of free radical in cultured hippocampal neurons were analyzed by the laser scanning confocal microscope, and cellular GSH level was also analyzed. Results Exposure of cultured rat hippocampal neurons to Glu resulted in accumulation of celluar Ca 2+ and cellular free radical were prevented by DHEA (0.1 ?mol?L -1 )and 7-oxo-DHEA(0.1 ?mol?L -1),and cellular GSH was increased. Conclusion DHEA and 7-oxo-DHEA protected hippocampal neurons against neurotoxicity induced by Glu.

Objective To assess the efficacy of the prophylactic de-escalation use of noninvasive positive pressure ventilation(NPPV) in improvement of oxygenation following extubation after stanford type A aortic dissection.Methods 40 patients recovering from the stanford type A aortic dissection operation in the Center for Cardiac Intensive Care,Beijing Anzhen Hospital between December 2015 and April 2016,and meet the inclusion criterion after extubation,were investigated.The patients were random divided into 2 groups with RandA1.0 software,each group contained 20 patients:NPPV with mask vs.traditional oxygen treatment with mask.NPPV initial 2 h(started from extubation) settings:inspiratory pressure(IPAP) of 14-16 cmH2 O,expiratory pressure (EPAP) of 6-8 cmH2 O,the fraction of inspired oxygen (FiO2) of 0.35-0.55.2-8 h the parameters of setting were decreased:IPAP l0-12 cmH2 O,EPAP 4 cmH2 O.After 8 h the NPPV was finished and the oxygen treatment instead.The oxygen treatment settings:the flux inhalation of oxygen was 6-10 L/min,and FiO2 was adjusted to 0.35-0.55.Make a comparison with the two groups in the clinical effect at 2 h,8 h,24 h,3 days,and to compare their reintubation rate.Results PaO2 and PaO2/FiO2 were higher in the prophylactic NPPV group compared to oxygen treatment group after 2 h [94.7(89.7,100.1) mmHg vs.84.5(78.7,87.1) mmHg,P ＜0.05.(192.7 ±31.2) mmHg vs.(167.0 ± 18.9) mmHg,P＜0.05],8 h[99.1(90.3,132.8) mmHgvs.86.3(82.3,95.6) mmHg,P＜0.05.198.2(180.5,246.2) mmHg vs.172.5(164.7,191.2) mmHg,P ＜0.05],24 h[(100.0 ± 18.9) mmHg vs.(87.3 ±12.9) mmHg,P＜ 0.05.(197.5±36.8) mmHgvs.(170.1 ±29.8) mmHg,P＜0.05] and3 days[98.2(87.4,110.5)mmHg vs.86.8 (79.4,89.6) mmHg,P ＜ 0.05.(193.2 ± 37.1) mmHg vs.(164.4 ± 23.8) mmHg,P ＜ 0.05],and respiratory rate was lower in the NPPV group at the same time.Heart rate and mean arterial pressure were lower in the NPPV group at 24 h and 3 days.At 3 days in the NPPV group PaCO2 was lower,and left ventricular ejection fraction was improved.But the treatment of traditional oxygen leaded to a higher incidence of pulmonary atelectasis,and more longer hospitalization time.Conclusion In the early stage after extubation,prophylactic de-escalation therapy of NPPV for patients following operation of stanford type A aortic dissection,may quickly improve PaO2/FiO2,and increase the function of heart,avoid atelectasis.Furthermore,hospital stay was eventually shortened in NPPV group.

Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.

Objective To improve the diagnostic and therapeutic efficacy for young patients with malignant tumors of pancreas at the early stage, and describe the clinical characteristics of this group of patients. Methods The clinical data of 46 young patients less than forty years old with malignant tumors of pancreas received treatment and follow up, including clinical features, clinicopathological parameters, status of misdiagnosis, CA 19-9, CEA, were retrospectively reviewed. Results The main manifestations of young patients with malignant tumors of pancreas were abdominal bloating (78.26% ), epigastric discomfort (73.91%), weight loss (73.91%), loss of appetite (69.57%), abdominal pain (60.87%). Majority of the tumors were located in pancreatic head. 30 cases (65.22%) had pathological evidence of metastasis, among them 13 cases had multi-organ involvement. Pancreatic exocrine tumor accounted for 72.73% (24/33) of all the tumors, while endocrine tumor accounted for 27.27% (9/33). The positive rates of CA 19-9 and CEA were 73.91% (34/46) and 32.6% (15/46). The misdiagnosis rate of young patients with malignant tumors of pancreas was up to 80.43% (37/46). The main misdiagnoses were acute or chronic gastritis (36.96%). The rate of radical operation for young patients with malignant tumors of pancreas was 23.91%, and the median survival was 12.6 months. Conclusions The symptoms of young patients with malignant pancreatic tumors are non-speciflc and the misdiagnosis rate was high and the prognosis was poor, therefore, the early diagnosis of pancreatic malignant tumors shall be emphasized.

Objective To analyze the clinical features of adult patients with acute intestinal obstruction secondary to Meckel's diverticulum and the experience in management of the disease.Methods The clinical data and pathological features of 9 patients with acute intestinal obstruction secondary to Meckel' s diverticulum were retrospectively analyzed. Results All patients were diagnosed with acute intestinal obstruction secondary to Meckel's diverticulum via abdominal cavity exploration and underwent surgical treatment. Before surgical treatment, 1 out of 9 patients was correctly diagnosed as acute intestinal obstruction secondary to Meckel's diverticulum, and the other 8patients were diagnosed as acute intestinal obstruction. Diverticulum was resected in 5 cases and the rest 4 cases received partial excision of small intestine including the diverticulum. Pathological examination showed that all patients had inflammatory changes in diverticulum. Some patients were complicated with mucosal erosion, small ulcers, bleeding or perforation. Forty-four percent (4/9) of diverticula contained ectopic tissue. All patients were cured. Conclusion Meckel's diverticulum is a rare cause of acute intestinal obstruction and preoperative diagnosis is difficult. Diverticulum,howere,is likelihood to develop strangulation or contains ectopic tissue, so that the surgical treatment should be performed early.

Objective To explore methods to develop a hospital quality of care index system of county level hospitals based on the homepage of inpatient medical records and examine the validity of this system. Methods By means of literature review, homepage data and panel discussion, along with theories and statistical methods, indexes were identified. The dimensions and indices of the index system were pinpointed. Confirmatory factor analysis and normalization methods were combined to calculate the weights and scores of such indices. Scores were adjusted by Charlson comorbidity index ( CCI) with multi-regression method. The hospitals were ranked by adjusted scores in each dimension. The validity was evaluated by comparing the application results to universally acknowledged standards, such as hospital level and economic level of the geographic areas. Results An index system with 6 dimensions and 25 indices was developed, and the application results proved valid to some extent. The adjustment of CCI also proved effective. The 6 dimensions were correlated yet their directions were not consistent. Conclusions The methods and data used to develop the system have demonstrated strong operability and availability. The application results can reflect medical care quality in different aspects making it applicable among homogeneous hospitals. It is meaningful to assess dimensions respectively.

Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17％,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.

Objective To observe the growth of human adipose stem cells (hADSCs) co-culture with expanded polytetrafluoroethylenee (ePTFE) scaffold in vivo.Methods hADSCs were isolated from healthy human liposuction fat.The hADSCs were seeded onto the ePTFE scaffold as Group A,while the ePTFE scaffold without hADSCs as Group B,and the two groups were randomly implanted under the back skin of 10 SD rats.The transplant compound in two groups was harvested at 4 weeks after implantation.Wet weight of transplanted compound was measured.After HE and immunofluorescence CD31 staining,blood vessel density and fibrous proliferation were observed and evaluated.Results Primary cultured hADSCs were spindle-shaped cells.The histological study found that after cultured in vivo,hADSCs could grow in the space of the ePTFE scaffold,several cells were found at the edge of the scaffolds and parts of cells had grown into the inside even the whole layer of the scaffolds.The wet weight of transplanted compound in group A (511.62±32.82) mg was significantly higher than that in group B (363.56±34.74) mg,(P＜0.05).Histological and immunofluorescence analysis showed the blood vessel density was (29.50±2.63)/HPL in group A,(12.00±2.26)/HPL in group B.Compared with group B,group A had significantly higher blood vessel density and lower fibrosis counts (P＜0.05).Conclusions hADSCs have a good biocompatibility with ePTFE scaffold.ePTFE scaffold has no negative effect on the proliferation of hADSCs.

MicroRNA-375 (miR-375) is closely related to the development of cancer,such as liver cancer,gastric cancer,pancreatic cancer,endometrial cancer,esophageal cancer,non-small cell lung cancer,etc.The mainly tumor pathogenesis related miR-375 includes that miR-375 is combined with specific target genes,can degrade mRNA or inhibit protein translation in the transcriptional level,and plays antitumor effect of inhibition of cell proliferation,promoting cell apoptosis and inhibiting the invasion and metastasis.miR-375 is expected to be a new target for cancer therapy,which may become an important biomarker for the diagnosis,treatment and prognosis of cancer.

Platelet count (PC) and plasma prothrombin time (PPT) of sixty- six patients with cyanotic congenital heart disease (cyanotic CHD) were determined, and linear relationship analysis was made between PC, PPT and hemoglobin (HB), Hemotocrit saturation of blood (SaO2). Blood viscosity (BV) and hemotocrit (HT) were also examined. It was discovered that there was a significant positive linear relationship between SaO2 and PC, HB and PPT, and a significant negative linear relationship between PC and HB, BV, HT, respectively. There was a significant difference of PC in cyanotic-CHD (n = 66) as compared with noncyanotic-CHD (t=13.9508, P