Objective To explore the relationship between behavioral psychological symptoms in Alzheimer' s dementia(AD) patients and region-specific alterations in cerebral blood flow. Methods 60 patients with AD randomly selected from a psychiatric outpatient department and 30 randomly selected healthy elderly community controls were administered the Mini-Mental State Exam (MMSE). All subjects underwent a perfusion CT scan to assess blood perfusion in brain regions of interest. The AD subjects were administered the behavioral patholigy in alzheimer' s disease(BEHAVE-AD) Rating Scale classified as mild, moderate or severe based on the results of the Clinical Dementia Rating scale. Results The most incidence was conduct disorder and the next was delusion.The score was 81.7% and 58.3% in turn. The conduct disorder score was higher in the severe demented group than in the mildly and moderate demented group(P＜0. 05). The delusion score was higher in the moderate demented group than that in the mildly demented group(P＜0.05). The time to peak(TTP)scores in the four groups of subjects were significantly different in the bilateral hippocampal formation, anteroinferior subiculum and entorhinal area. The TTP score was significantly higher in the moderately demented group than that in the mildly demented group and the control group(P＜0. 05 ). Correlation analysis identified a positive correlation between conduct disorder, delusions and TTP in cerebral heteroplasia cortex (P ＜ 0. 05 ), also identified a negative correlation between mood disorder and TTP(P＜0. 05 ). Conclusion The conduct disorder,delusions and mood disorder in AD are associated with the chronicity ischemia of cerebral heteroplasia cortex leading to neural conduction disorders.

Objective To explore the clinical and ultrasonographic characteristics leading to non-diagnostic results after ultrasound-guided fine-needle aspiration ( US-FNA) in patients with thyroid nodules . Methods One thousand and thirty-four thyroid nodules of 1009 patients who underwent US-FNA from June 2013 to September 2015 in Fudan University Shanghai Cancer Center were included in this study . The ultrasonographic characteristics , cytological and histological diagnosis were collectecl . Univariate and multivariate logistic methods were applied to analyze the factors bringing about non-diagnostic results . Results Of the 1034 nodules ,174 ( 16 .8％ ) had non-diagnostic results and 860 ( 83 .2％ ) had diagnostic results . Age ,echogenicity ,anteroposterior/transverse diameter ratio ( AT ) ,calcification ,margin and depth were associated with nondiagnostic results . Age ≥45 years ,the largest diameter ≤10 mm ,AT <1 ,located at the middle 1/3 and dorsal 1/3 in the cross section of nodules , macrocalcification were proved as independent influencing factors for non-diagnostic results of FNA . Conclusions Age≥45 years ,the largest diameter ≤10 mm ,AT < 1 ,located at the middle 1/3 and dorsal 1/3 in the cross section of nodules , macrocalcification are independent influencing factors of non-diagnostic results . As a result ,for nodules with the characteristics above it may recommend follow up instead of FNA . During follow-up ,it may recommend surgery if the nodule has progressed .

Objective To evaluate the effects of different dosages of rocuronium on abdominal wound closure under general anesthesia.Methods Ninety ASA class I or II patients scheduled for elective abdominal surgery under general anesthesia were randomized into three groups with 30 cases each.Each group received rocuronium 1 time of ED95 (0.3 mg/kg),0.5 time of ED95 (0.15 mg/kg),0.2 time of ED95 (0.06 mg/kg) respectively when closing the abdominal wall.TOF recovered to 25%, 75%, 90%, time of eye-opening on command, time of head-lift for more than 5 seconds,extubation time, the rate of upper airways obstruction after extubation and the satisfaction score for the muscle relaxation to general surgeons were recorded.Results TOF values had no significantly different among the three groups before abdominal wound closure (P＞0.05).Compared with group A and group B,time of TOF in group C was significangtly increased after administration of rocuronium (P＜0.05) . Time of TOF recovery to 25%, 75%, 90%in group C were significangtly decreased (P＜0.01).Compared with group A and group B, time of eye-opening on command ,head-lift for more than 5 seconds and extubation time were significantly shorter in group C.There were 8,4,0 patients undwent upper airways obstruction among each group respectively after extubation (P＜0.05).The satisfaction score for muscle relaxation among three groups had no significant difference.Conclusion An additional administration of 0.2 time of ED95 (0.06 mg/kg) rocuronium before abdominal wound closure in abdominal surgery can achieve satisfactory muscle relaxation for surgeons.

OBJECTIVETo observe the effect of inhibition of serine/threonine kinase15 (STK15) gene expression on apoptosis induction in gastric cancer cell line-MKN45 and discuss the role of STK15 in viability of gastric cancer cells.

METHODSThe STK15 expression was inhibited by chemically synthesized siRNA. The STK15 mRNA and protein level were respectively measured by real-time quantitative PCR and western blotting,the change of cell cycle distribution and apoptosis rate were detected by flow-cytometry, cell morphological change was observed by Hoechst staining,and pro-caspase 3 level was also detected by western blot.

RESULTSAfter treatment by siRNA targeting STK15 after 48 h, STK15 mRNA and protein level decreased obviously. More MKN45 cells accumulated at G(2)/M phase (P< 0.05). The apoptosis rate of STK15 siRNA treated MKN45 cells was higher than that of control cells(P< 0.05) with the pro-caspase 3 level decreased.

CONCLUSIONSInhibition of STK15 gene expression may induce apoptosis in MKN45 cells through the pathway of caspase3. STK15 gene play a key role in proliferation and viability of MKN45 cells.

Apoptosis ; Aurora Kinase A ; Aurora Kinases ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Humans ; Protein-Serine-Threonine Kinases ; genetics ; RNA, Small Interfering ; Stomach Neoplasms

OBJECTIVETo investigate the role of STK15 in regulating mitosis of gastric cancer cells (MKN45) by gene silencing through RNA interference mechanism.

METHODSRNA interference technique was used to inhibit STK15 expression in MKN45 cells. The expression levels of STK15 mRNA and protein were measured by real-time quantitative RT-PCR and Western blot respectively and cell morphological changes were investigated by reverse microscopy. In addition, cell cycle distribution and cellular proliferation were determined by flow-cytometry and MTT assay respectively. Finally, the mitotic phenotype of MKN45 cells was studied by immunofluorescence staining and confocal microscopy.

RESULTSSilencing of STK15 gene by RNA interference was confirmed by marked decrease of STK15 mRNA and protein levels in the treated MKN45 cells. This silencing correlated with rounding of the cells, decreasing of DNA content in G(2) phase (P < 0.05) and a lowered proliferation index (P < 0.05), along with alterations of mitotic phenotype of MKN45 (P < 0.05).

CONCLUSIONSTK15 gene may play a key role in regulating cellular mitosis and its inhibition by RNA interference leading to mitosis arrest in MKN45 cells.

Adenocarcinoma ; metabolism ; pathology ; Aurora Kinase A ; Aurora Kinases ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; DNA, Neoplasm ; metabolism ; Gene Silencing ; Humans ; Mitosis ; drug effects ; Protein-Serine-Threonine Kinases ; biosynthesis ; genetics ; RNA Interference ; RNA, Messenger ; biosynthesis ; genetics ; RNA, Small Interfering ; pharmacology ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo observe the effect of polo-like kinase 1 (PLK1) gene depletion on mitosis phenotype and elucidate its vital role in gastric cancer cell line (MKN45) mitosis.

METHODSThe PLK1 expression in MKN45 cells was blocked by RNA interference (RNAi), the expression level of PLK1 mRNA and protein were measured by real-time quantitative PCR and Western blot, respectively. The morphological change of microtubules and mitosis phenotype in MKN45 cells were observed by immunofluorescence staining and laser confocal microscopy, the morphological changes of cells were observed by reverse microscopy, the variation of cell cycle distribution was detected by flow-cytometry.

RESULTSAfter RNAi targeting PLK1, PLK1 mRNA and protein level decreased obviously, the cell microtubules became obscure and lost cohesiveness, the mitosis phenotype also varied substantially (P < 0.05), more gastric cancer cells became rounded and showed G(2) phase cell DNA content (P < 0.05).

CONCLUSIONPLK1 gene plays a key role in mitosis and its inhibition can lead to mitosis arrest in MKN45 cells.

Adenocarcinoma ; enzymology ; metabolism ; pathology ; Cell Cycle Proteins ; biosynthesis ; genetics ; Cell Line, Tumor ; G2 Phase ; drug effects ; Humans ; Mitosis ; drug effects ; Protein-Serine-Threonine Kinases ; biosynthesis ; genetics ; Proto-Oncogene Proteins ; biosynthesis ; genetics ; RNA Interference ; RNA, Messenger ; biosynthesis ; genetics ; RNA, Small Interfering ; genetics ; pharmacology ; Stomach Neoplasms ; enzymology ; metabolism ; pathology ; Transfection

OBJECTIVETo observe the effect of polo like kinase 1 (plk1) gene depletion on the growth of gastric cancer cell line-MKN45 cells in vitro and vivo and discuss the feasibility and effectiveness of arranging plk1 as gene therapeutic target for gastric cancer.

METHODSThe plk1 expression of MKN45 cells was inhibited by RNA interference (RNAi). The plk1 mRNA and protein level were measured by real-time quantitative PCR and western blotting, and the change of cell cycle distribution and apoptosis rate were detected by flow-cytometry, and the MKN45 cells proliferation was measured by MTT method. MKN45 cells treated with plk1 siRNA were transplanted subcutaneously in nude mice and their tumorgenesis ability were observed, the plk1 protein levels of the samples from nude mice in different groups were compared.

RESULTSAfter treatment with plk1 siRNA, plk1 mRNA and protein level decreased obviously in certain time, more MKN45 cells accumulated at G(2)/M (P < 0.05). Apoptosis rate of MKN45 cells treated with plk1 siRNA was higher than that of control cells at 48 h and 72 h (P < 0.05), and MKN45 cells proliferated slowly than control groups (P < 0.05), while the tumorgenesis ability obviously decreased, but the plk1 protein levels of the samples from nude mice in different groups were not different.

CONCLUSIONSsiRNA targeting plk1 can inhibit the proliferation of MKN45 cells in vitro and vivo. Plk1 may be a novel therapeutic target for gastric cancer.

Animals ; Apoptosis ; drug effects ; Cell Cycle Proteins ; drug effects ; genetics ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Male ; Mice ; Mice, Nude ; Protein-Serine-Threonine Kinases ; drug effects ; genetics ; Proto-Oncogene Proteins ; drug effects ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; pharmacology ; Stomach Neoplasms ; drug therapy ; enzymology ; pathology ; Transfection

OBJECTIVETo evaluate the efficacy of early superselective angiography and embolization in the diagnosis and treatment of massive bleeding after gastrectomy.

METHODSThe clinical data of 28 patients with massive bleeding after surgery from 1980 to 2001 were retrospectively analysed. All patients underwent emergency angiography and 27 of them were treated by transcatheter embolization.

RESULTSBleeding was controlled in 26 of the 28 patients (93%), recurrent bleeding occurred in 1, an recognized bleeding in 1, and abdominal pain in 1. There was no death.

CONCLUSIONSTransarterial embolization for massive bleeding after gastrectomy is safe and effective. It is suggested that early emergency angiography should be considered in all patients with massive gastrointestinal bleeding after gastrectomy.

Adult ; Aged ; Aged, 80 and over ; Angiography ; methods ; Embolization, Therapeutic ; methods ; Female ; Follow-Up Studies ; Gastrectomy ; adverse effects ; Gastrointestinal Hemorrhage ; diagnostic imaging ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage ; diagnostic imaging ; etiology ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the early diagnosis on iatrogenic injuries in distal part of common bile duct and the prevention of severe retroperitoneal infection.

METHODSFrom 1990 to 2004, 17 patients with bile duct injures in the distal part of common biliary tract were admitted. And the clinical data of the 17 cases were retrospectively analyzed.

RESULTSOf the 17 cases, the injuries of 15 cases were caused by the operation, and the injuries of the other 2 cases were caused in the process of removing the stone by endoscopic retrograde cholangiopancreatography (ERCP). The injuries of 14 cases were found during the operation, but the other one was not found in time. Before the operation, 16 cases were examined by B-type ultrasonography, 2 by MRCP and 6 by intraoperative choledocho-endoscope after the biliary tract exploration. Ten cases underwent perforating suture repair and T-tube drainage; 2 with Odd's sphincter incision and shaping; 2 with choledochojejunostomy; 1 with duodenum wall and bile duct repair and drainage. When the bile duct injured, the major findings during operation were bile duct explorer located out of the duodenum wall and bile duct, two or more than cleft in the distal part of common biliary tract found by choledocho-endoscopic examination, retroperitoneal edema and liquid accumulation found by irrigating water through T-tube, and/or retroperitoneal tissues stained blue by irrigating methylthioninium chloride through T-tube. The clinical manifestations after injuries were abdominal distention, abdominal pain, pain in the waist and back, fever and shock, et al. Thirteen cases were cured. And the syndromes included 1 case with intestinal fistula, 1 with incisional infection, 4 dead (3 died from infectious shock; 1 from bleeding in gastrectomy).

CONCLUSIONSThe postoperative clinical manifestations for iatrogenic injuries in the distal part of common biliary tract lack specificity, CT examinations are necessary to doubtful patients. Early diagnosis and timely management can obtain better results, and can effectively lower severe retroperitoneal infection. The perfect preoperative imaging examinations and intraoperative choledocho-endoscopic examinations before the biliary tract exploration maybe reduce iatrogenic injuries in the distal part of common biliary tract.

Adult ; Aged ; Common Bile Duct ; injuries ; surgery ; Female ; Humans ; Iatrogenic Disease ; prevention & control ; Intraoperative Complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Peritonitis ; prevention & control ; Radiography ; Retrospective Studies

OBJECTIVETo summarize the reoperation experiences in treatment of massive rebleeding after subtotal gastrectomy for bleeding gastroduodenal ulcer.

METHODSFrom 1980 to 2002, clinical data of 26 cases with massive rebleeding after subtotal gastrectomy for bleeding gastrorenal ulcer were analyzed retrospectively.

RESULTSPreoperative gastroscopy was performed in 6 cases, intraoperative gastroscopy in 11, and preoperative superselective angiography in 2 cases. Eleven cases with left ulcer or post- bulb ulcer bleeding underwent resection of the left ulcer or longitudinal incision of the duodenal descending part and direct hemostasis. Thirteen cases with anastomotic stoma bleeding underwent local suture hemostasis or resection of the stoma plus Billroth II or Roux- en- Y gastrojejunostomy. Two cases with gastric bleeding received reexcision of the stomach remnant. Twenty- four cases (92.3% ) were cured and 2 cases (7.7% ) died of gastric bleeding.

CONCLUSIONPreoperative superselective angiography and intraoperative gastroscopy are beneficial to clarify the bleeding position and causes for massive rebleeding after gastrectomy. It is very important to select proper operative method to prevent postoperative rebleeding.

Adult ; Aged ; Aged, 80 and over ; Angiography ; Female ; Gastrectomy ; adverse effects ; Gastrointestinal Hemorrhage ; surgery ; Humans ; Male ; Middle Aged ; Peptic Ulcer ; surgery ; Postoperative Hemorrhage ; surgery ; Retrospective Studies