Objective To compare the differences of cognitive dysfunction and hippocampal atrophy among patients with temporal lobe epilepsy (TLE) and healthy controls and probe into the relativity of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy. Methods Forty-nine TLE cases and 20 healthy individuals were randomly selected. The WAMS-R and WAIS-R scales were adopted to assess the memory and intelligence of all the subjects. Hippocampal volumes were measured by semiautomatic measurement on the head magnetic resonance imaging (MRI). The degree of hippocampal atrophy (DHA) and asymmetry index (AsI) were caculated by adjusting hippocampal volumes and ratio of difference of two lateral hippocampal volumes. Results Compared with the healthy controls, not only did the TLE patients exhibit more memory deficits (83.2±21.0,t=-3.365 ,P=0.001 ), but also more fullscale intelligence (91.0±12.3, t=- 4.291, P=0.000). The bilateral hippocampi of all TLE patients significantly decreased in volume ( P=0.000 ) and increased in AsI ( t=3.975, P=0.000 ). The MQ of TLE patients was significantly negatively related to the duration of the illness ( r=-0.339, P=0.017 ). The bilateral DHA and the hippocampal AsI were negatively related to Z scores (left: r=-0.297, P= 0.038, right: r=-0.305, P=0.033, AsI: r=-0.441, P=0.002), repectively. Conclusions The more the DHA and asymmetry of bilateral hippocampi, the worse the cognitive dysfunction. The quantitative measurements of hippocampal volume could be used as a clinically effective factor for evaluating the decrease of the intelligence of TLE patients.

OBJECTIVE:To virtually screen potential α-glycosidase inhibitor ingredients from C. mori and F. mori,and to pro-vide reference for finding out new typeα-glycosidase inhibitor ingredient. METHODS:Surflex-Dock module of Sybyl-x 2.0 molecu-lar simulation software was used to perform the docking of small molecule compound,which was from the ingredients of C. mori and F. mori as ligand stated in literatures,with α-glycosidase. Total score of affinity scoring function was equal to 7 as the thresh-old value,to judge potential α-glycosidase inhibitor ingredient in C. mori and F. mori. RESULTS:After 70 small molecule com-pounds docked with α-glycosidase, 10 compounds showed binding activity (Total score≥7.00). Among them, moracin M-3′-O-β-D-glucopyranoside,5,7,2′-trihydroxyflavanone-4′-O-β-D-glucoside,mulberroside A,resveratrol-4,3′-di-O-β-D-gluco-pyranoside and 1,4-dideoxy-1,4-imino-(2-O-β-D-glucopyranosyl)-D-arabinitol had higher binding activity with α-glycosidase(Total score>8.00). CONCLUSIONS:Multi-constituents of C. mori and F. Mori show potential α-glycosidase inhibitory activity. The method is a kind of highly targeted,rapid and efficient approach to discover α-glycosidase inhibitor from traditional Chinese medi-cine.

This paper discusses the current prevalence of hospital preparations backward quality standard test methods, quality standards for lack of a serious problem , and analyses the reasons from four aspects , proposed to strengthen the construction of a pharmaceutical ethics; examination and approval departments shall strictly agents registration review technical requirements;rectify and improve the quality of all preparation standards;Introduction and training of strengthen pharmacy personnel , and actively improve the quality standard revision work;hospital in-creasing hardware and software construction , support quality standards revision suggestions for the improvement of work, provide reference standard for quality improvement of hospital preparations .

Objective To explore the effect of puncture the left or right branch of portal vein on the incidence of postoperative hepatic encephalopathy in transjugular intrahepatic portosystemic shunt (TIPS). Methods A literature search was conducted through investigating PubMed, Cochrane Library, CNKI digital library and Wanfang databases. Randomized controlled trials and cohort studies related to the effect of puncture the left or right branch of portal vein on the incidence of postoperative hepatic encephalopathy in TIPS were included in this review. According to the methods for Cochrane systematic review, the data were extracted, the quality of the literatures was evaluated, statistical analysis was conducted and the data were analyzed with RevMan 5.0. Results One randomized controlled trial and four cohort studies, including 552 patients with liver cirrhosis received TIPS, were finally included in this review. Random-effects model meta-analysis showed that puncture of the left branch of portal vein in TIPS caused lower incidence of postoperative hepatic encephalopathy than puncture of the right branch of portal vein (RR=0.51, 95%CI was 0.39 to 0.66, P<0.01). Conclusion Puncture of the left branch of portal vein in TIPS can significantly reduce the incidence of postoperative hepatic encephalopathy in comparison with puncture of the right branch of portal vein.

Objective:To investigate the clinical efficacy and prognosis of transjugular intrahepatic portosystemic shunt (TIPS) and drug combined with endoscopic treatment in patients with liver cirrhosis and esophagogastric variceal bleeding (EGVB).Methods:From January 2012 to December 2013, at the First Affiliated Hospital of Xi′an Jiaotong University, the data of 147 patients with liver cirrhosis and EGVB undergoing TIPS or drug combined with endoscopic treatment were retrospectively collected, with 87 cases in TIPS treatment group and 60 in drug combined with endoscopic treatment group.The 5 years follow-up data were analyzed, and the overall survival rates, rebleeding-free survival rates and hepatic encephalopathy-free survival rates at 6 weeks, 1 year, 2 years and 5 years after treatment of two groups were compared. Independent sample t test, Mann-Whitney U test, chi-square test, Fisher exact test, Z test, log-rank test and trend test were used for statistical analysis. Results:There were no significant differences in age, gender, etiology, Child-Pugh classification, initial liver function, coagulation function, liver ascites, previous history of hepatic encephalopathy, blood pressure and preoperative blood transfusion history between the TIPS treatment group and combination of drugs and endoscopy treatment group (all P>0.05). Forty-one patients died within 5 years, of which 20 (48.8%) died of rebleeding and 6 (14.6%) died of hepatic encephalopathy. There were no significant differences in 6-week, 1-year and 2-year overall survival rates between the TIPS group and drug combined with endoscopic treatment group (all P>0.05), however the 5-year overall survival rate of the TIPS treatment group was higher than that of the drug combined with endoscopic treatment group (78.4% vs. 63.2%), and the difference was statistically significant ( Z=2.06, P=0.048). The 6-week, 1-year, 2-year, 5-year rebleeding-free survival rates of the TIPS group were 97.7%, 96.5%, 88.9% and 70.9%, respectively, which were all higher than those of the drug combined with endoscopic treatment group (86.7%, 53.3%, 43.3% and 27.1%), and the differences were statistically significant ( Z=2.35, 6.39, 6.26 and 4.80, all P<0.05). There were no significant differences in hepatic encephalopathy-free survival rates at 6 weeks, 1 year and 2 years after treatment between the TIPS group and drug combined with endoscopic treatment group (all P>0.05), however the 5-year hepatic encephalopathy-free survival rate of the TIPS treatment group was lower than that of the drug combined with endoscopic treatment group (67.7% vs. 86.7%), and the difference was statistically significant ( Z=2.28, P=0.030). The lower the Child-Pugh classification, the higher the cumulative 5-year survival rate ( χ2=6.75, P<0.01). There was no statistically significant difference in the 5-year overall survival rate in patients with the same Child-Pugh classification between the TIPS group and the drug combined with endoscopic treatment group (all P>0.05). Conclusions:The efficacy of TIPS is better than that of the drug combined with endoscopic treatment in treating EGVB. Even the long-term risk of hepatic encephalopathy of TIPS is higher, the short-term, middle-term and long-term rebleeding rate are decreased. Patients with Child-Pugh grade C do not need to avoid TIPS when choosing the treatment, the earlier the TIPS used, the better survival benefit will be obtained.

ObjectiveTo compare the efficacy of intravenous infusion of dexmedetomidine and midazolam for premedication in children.MethodsNinety-two ASA Ⅰ or Ⅱ children (46 cases aged 1-3 yr and 46 cases aged 4-6 yr) scheduled for elective general or urologic surgeries,were enrolled in this study.The children were randomly divided into 2 groups (n =46 each):midazolam group (group M) and dexmedetomidine group (group D).The children accompanied by their parents were admitted to the anesthesia preparation room at about 20 min before induction of anesthesia,and midazolam 0.1 mg/kg òr dexmedetomidine 1 μg/kg was infused intravenously over 10 min.Anesthesia was induced with proporol-rocuroniume-remifentanil,and maintained with sevoflurane-remifentanil-rocuroniume.Modified Yale Preoperative Anxiety Scale (mYPAS) score,sedation score,HR,mean arterial pressure (MAP),respiratory rate (RR) and SpO2 were recorded before premedication (T1),before separation from their parents (T2) and when entering the operating room (T3).The incidence of sleep (a sedation score of 4) was recorded at T2,3.The end-tidal concentration of sevoflurane,infusion rate of remifentanil,laryngeal air way removal time,emergence time,duration of stay at the recovery room,incidence of delirium during recovery period,the percentage of patients requiring rescue analgesic,and adverse effects were also retorded.ResultsCompared to that at T1,the mYPAS score was significantly decreased at T2,3,and the sedation score was significantly increased at T2,3 in both groups ( P ＜ 0.05),HR at T2 and MAP at T2,3 were significantly decreased in group D,and HR at T3 was significantly increased in group M ( P ＜ 0.05 ).Compared to group M,the sedation scores and the incidence of sleep were significantly increased at T2,3,and the HR was significantly decreased at T2 in group D ( P ＜ 0.05).There was no significant difference in the mYPAS score,RR,MAP,SpO2,end-tidal concentration of sevoflurane,infusion rate of remifentanil,laryngeal air way removal time,emergence time,duration of stay at the recovery room,incidence of delirium during recovery period,the percentage of patients requiting rescue analgesic,and incidence of adverse effects between D and M groups ( P ＞ 0.05).ConclusionThe sedative efficacy of iv dexmedetomidine is superior to that of iv midazolam when infused for premedication in children,but it exerts much influence on hemodynamics,and the changes in hemodynamics should be noted.

Objective To compare the effects of different stent configurations on shunt failure,hepatic encephalopathy,and hepatic myelopathy after transjugular intrahepatic portosystemic shunt (TIPS).Methods From March 2014 to June 2015,the clinical data of 73 hospitalized,patients who met the inclusion and exclusion criteria,and underwent TIPS for upper gastrointestinal hemorrhage caused by cirrhotic portal hypertension were retrospectively analyzed.According to the stent configuration during operation,patients were divided into simple coated stent group (hepatic vein,portal vein and hepatic parenchyma coated stent,23 cases),simulated Viatorr stent group (hepatic vein and hepatic parenchyma coated stent plus portal vein bare stent,27 cases) and combined stent group (hepatic vein and portal vein hare stent plus hepatic parenchyma coated stent,23 cases).Patients were followed up for one year,the incidences of shunt failure,hepatic encephalopathy and hepatic myelopathy within one year after TIPS of three groups were compared.Chi-square test,Fisher exact probability method and variance analysis were performed for comparison among groups.Cox regression analysis was used for difference analysis in imbalance of variables and incidence of outcome events among the three groups.Results The portal vein pressure gradient of simple coated stent group,simulated Viatorr stent group and combined stent group decreased from (22.15±4.52),(23.01±5.48) and (21.13±4.49) mmHg (1 mmHg=0.133 kPa) to (9.15±2.94),(11.20±3.27) and (8.75+4.06) mmHg after operation,respectively.Before and after operation,the differences in portal venous pressure gradient were statistically significant of three groups (t=10.488,7.188 and 7.850,all P＜0.05).The shunt failure rates of simple coated stent group,simulated Viatorr stent group and combined stent group were 13.0％ (3/23),18.5％ (5/27) and 30.4％ (7/23),respectively.The results of Cox regression analysis indicated that there was no statistically significant difference in shunt failure rates among different stent configurations after TIPS (P=0.339).The incidences of hepatic encephalopathy of simple coated stent group,simulated Viatorr stent group and combined stent group postoperative were 69.6％ (16/23),33.3％ (9/27) and 30.4％ (7/23),respectively,the difference was not statistically significant among the three groups (P＞ 0.05).The results of Cox regression analysis showed that the relative ratio values (95％ confidence interval) of incidence of postoperative hepatic encephalopathy of simple coated stent group compared with simulated Viatorr stent group and combined stent group were 2.901 (1.279 to 6.584) and 2.735 (1.123 to 6.658),and the differences were statistically significant (both P＜0.05).The incidences of hepatic myelopathy of simple coated stent group,simulated Viatorr stent group and combined stent group were 8.7％ (2/23),3.7％ (1/27) and 4.3％ (1/23),respectively,and there was no statistically significant difference in the incidence of hepatic myelopathy among three groups after operation (P＞0.05).During one-year follow-up,among 73 patients,two patients died,one in simple coated stent group and the other in combined stent group.The one-year survival rate after TIPS was 97.3％.Conclusions One year after operation,the incidences of shunt failure are similar between simple coated stent group,simulated Viatorr stent group and combined stent group.One year after operation,the incidence of hepatic encephalopathy is similar between simulated Viatorr stent group and combined stent group which are both lower than that of simple coated stent.The incidence of hepatic myelopathy is low,and its association with TIPS remains to be further investigated.

Objective:To investigate the effect of epidermal growth factor receptor tyrosine kinase inhibitor on the radiosensitivity of human non-small cell lung cancer cells and its possible mechanism.Methods:Human non-small cell lung cancer cells H1299 were cultured in vitro. CCK-8 was used to detect the toxic effects of erlotinib on H1299 cells, IC 50 and IC 20 were calculated, and IC 20 was utilized as the drug concentration for subsequent experiments. The colony formation assay was performed to identifiy the effect of X-ray combined with erlotinib on H1299 cells, the radiosensitivity parameters were calculated, and the cell survival curves were delineated. Flow cytometry was conducted to detect the cell cycle distribution and apoptosis. Western blot analysis was used to detect the expression of EGFR/PI3K/AKT pathway and apoptosis-related proteins. Results:Erlotinib exerted inhibitory effect upon the proliferation of H1299 cells, IC 50 was calculated as 27.3 μmol/L, and 3.3 μmol/L for IC 20. X-ray combined with IC 20 concentration of erlotinib could reduce the cloning ability of H1299, increased the proportion of G 0/G 1 phase and G 2/M phase, decreased the proportion of S phase, aggravated cell apoptosis, down-regulated the expression of pEGFR and pAKT proteins, and up-regulated the expression of apoptosis-related proteins including Active Caspase 3 and Cleaved PARP. Conclusions:Erlotinib exerts a radiosensitizing effect on H1299. The possible mechanism is that erlotinib combined with radiation can suppress the EGFR/PI3K/AKT pathway, reduce the ability of repairing cell damage, change cell growth cycle and induce cell apoptosis.

Esophagogastric variceal bleeding (EGVB) is one of the main complications of decompensated portal hypertension, especially in patients with liver cirrhosis, and it often has a high mortality rate. Medication combined with endoscopy is the main prevention and treatment method for EGVB, while transjugular intrahepatic portosystemic shunt (TIPS) combined with variceal embolization can also be selected for some high-risk patients, and individualized diagnosis and treatment of portal hypertension based on hepatic venous pressure gradient should become the latest consensus and the main strategy. This article mainly reviews endoscopic therapy and TIPS for the prevention and treatment of EGVB patients with decompensated portal hypertension in terms of selection of indications, incidence rate of complications, and respective advantages and disadvantages.