Objective To evaluate the effect of sevoflurane on cognitive function of mice with Alzheimer's disease.Methods Twenty male mice carrying mnutations in amyloid precusor protein (APP) and presenilin 1 genes,weighing 30-40 g,aged 7 months,were divided into either sevoflurane group (group Sev) or control group (group C),with 20 mice in each group.Mice inhaled 3％ sevoflurane for 4 h in group Sev,and mice inhaled 30％ oxygen for 4 h in group C.At 1 month after inhaling sevoflurane or oxygen,the mice underwent continuous multiple-trail inhibitory avoidance training.The mice were then sacrificed and hippocampi were isolated for determination of the number of Aβ plaques (by immunohistochemistry) and expression of APP and Tau (S396) phosphorylation (by Western blot).Results Compared with group C,the memory lateucy was significantly shortened,the number of Aβ plaques was increased,the phosphorylation of Tau (S396) was increased,and the expression of APP was up-regulated in group Sev (P＜0.05).Conclusion Sevoflurane can decrease the cognitive function of mice with Alzheimer's disease.

Objective To investigate the protective effect of protocatechuic acid(PCA)on the PC12 cell model of Alzheimer’s disease(AD)and to explore its mechanism . Methods Amyloid beta peptide 1-42(Aβ1-42)fiber polymers were identified by immunofluorescence. After PC12 cells were stimulated with the Aβ1-42 fiber polymers, the cellular morphology was observed at different time points of hour 0, 3, 6, 9, 12, 24 , and the cellular viability was tested by methyl thiazolyl tetrazolium(MTT)assay to monitor the modeling condition. The effect of PCA on PC12 cells was detected after PC12 cells were pretreated with the different contentions of PCA. Autophagy-related marker Beclin1 protein level was detected by Western blotting method to investigate the protective mechanism of PCA. Results Aggregated white Aβ1-42 mass was stable at hour 12 and 24, and showed no significant difference between the two time points, the cell damage rate being 40%. Therefore, we defined culturing time being 12 and 24 hours as the modeling condition of AD model. The cell viability was increased with 200-800 μmol/L of PCA after culturing for 24 hours(P<0.01) , and the Western blotting results showed that the Beclin1 protein expression was up-regulated by PCA. Conclusion PCA prevents PC12 cells from Aβ1-42-induced toxicity, the mechanism being related with the increase of cellular autophagy.

Objective To evaluate the efficacy of oxycodone for patient-controlled intravenous analgesia (PCIA) after hip arthroplasty in elderly patients.Methods Sixty patients of both sexes,aged 65-85yr,weighing 42-89 kg,of American Society of Anesthesiologists physical status Ⅰ or]Ⅱ,scheduled for elective unilateral hip arthroplasty under general anesthesia,were divided into 2 groups (n =30 each) using a random number table:morphine group (group M) and oxycodone group (group O).Parecoxib sodium 40 mg was injected intravenously at 30 min before induction of anesthesia,followed by induction and maintenance of anesthesia.PCIA pump was connected at the beginning of skin closure.PCIA solution contained morphine 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group M and oxycodone 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group O.The PCA pump was set up with a background infusion at 2 ml/h,a 0.5 ml bolus dose and a 15 min lockout interval in both groups.Visual analogue scale score was maintained ≤ 3,and postoperative analgesia lasted until 48 h after operation.When analogue scale score ≥ 4,pethidine 50 mg/kg was injected muscularly as rescue analgesic.The requirement for rescue analgesic and occurrence of adverse effects were recorded.Results Ten percent patients required rescue analgesics in group M,and no patients required rescue analgesics in group O.Compared with group M,the requirement for rescue analgesics and incidence of nausea,vomiting and pruritus were significantly decreased in group O (P＜0.05).Conclusion Oxycodone provides reliable efficacy for PCIA after hip arthroplasty in elderly patients with fewer adverse effects,indicating that oxycodone produces good analgesic efficacy for severe somatalgia.

Objective:To compare the dosimetric difference between knowledge-based planning (KBP) volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) models for predicting the dose distribution during IMRT, aiming to investigate the feasibility of VMAT model to predict the IMRT plans.Methods:Fifty prostate cancer patients who had completed radiotherapy were selected. Manual planning was performed on each selected patient to generate the corresponding IMRT and VMAT plans. The IMRT and VMAT manual plans of the 40 randomly-selected patients were adopted to generate the KBP VMAT and IMRT models. The remaining 10 patients were utilized to predict IMRT plans. VMAT library-derived IMRT model (V-IMRT) and IMRT library-derived IMRT model (I-IMRT) were generated. Dosimetric parameters related to organ-at-risks (OARs) and planning target volume (PTV) were statistically compared among the manual IMRT (mIMRT), V-IMRT and I-IMRT plans.Results:Compared with the mIMRT plan, I-IMRT could significantly better control D max of the PTV ( P=0.039), whereas V-IMRT and I-IMRT plans could better protect the bladder and bilateral femoral heads (both P<0.05). V-IMRT plan could better protect the D max of bilateral femoral heads and the D 15% of the right femoral head (both P<0.05), whereas no significant difference was observed in other OARs and PTV (all P>0.05). Conclusions:Compared with the manual plans, KBP IMRT plan has significant advantages in protecting the OARs. KBP VMAT and IMRT models are both feasible in clinical practice, which yield equivalent accuracy for predicting IMRT plan.

Objective:To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods:A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014, and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method, the patients were divided into 3 groups: the resistance training group (RT group, 82 cases), the aerobic training group (AT group, 83 cases) and control group (83 cases). Participants in the RT group and the AT group underwent a total of 24 months of exercise training. Changes in indicators (blood glucose,blood lipid, etc.) at baseline and the end of 12 and 24 months among the groups were compared.Results:After intervention, glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure and homeostasis model 2 insulin resistance index (HOMA2-IR) in the RT and AT groups tended to decrease, and the steady state model 2 β cell function index (HOMA2-β) tended to increase. At the end of 24 months, HbA1c [5.80 (5.43, 6.20) %, 5.70 (5.50, 6.00)% vs. 6.20 (5.70, 6.60) %, all P≤ 0.01], LDL-C [3.07 (2.69, 3.58) mmol/L, 2.97 (2.62, 3.95) mmol/L vs. 3.21(2.54, 3.78) mmol/L, all P<0.05] and HOMA2-IR [0.96 (0.82, 1.47), 1.20 (0.99, 1.43) vs. 1.34 (1.09, 1.51), all P<0.05] were significantly decreased in the RT and AT groups than in the control group. In addition, HOMA2-β [84.50 (60.55, 107.33), 93.00 (78.60, 119.75) vs. 53.40 (37.70, 80.40), all P = 0.001] was significantly increased in the AT and RT groups compared with that in the control group. There were no significant differences in triglyceride (TG) and high-density lipoproteincholesterol (HDL-C) levels between the training groups and the control group (all P>0.05). After adjusting for age, sex and blood pressure, the cardiovascular risk of prediabetes was significantly reduced in RT ( P =0.017) and AT groups ( P =0.018). The Cox regression analyses showed that both the resistance training (HR=0.419, 95 %CI =0.415-0.942, P=0.037) and the aerobic training ( HR=0.310, 95 %CI=0.447-0.866, P=0.026) were protective factors for cardiovascular disease in prediabetic patients after adjustment of age, sex, statins, body mass index and waist-to-hip ratio, which reduced the risks of cardiovascular disease in prediabetic patients by 58.1% and 69.0%, respectively. Conclusions:Two years of aerobic and resistance training interventions have obvious advantages on glycemic and insulin resistance control in prediabetes patients. The resistance training can reduce the risk of cardiovascular disease, and it is, thus, recommended for prediabetic patients without obvious exercise contraindications.

Liver transplantation is the only effective method to treat various end-stage liver diseases. The shortage of standard donor liver is the main factor limiting the development of liver transplantation, whereas the application of marginal donor liver has significantly expanded the source of donor liver. New technologies, such as extracorporeal membrane oxygenation (ECMO), mechanical perfusion and hypothermia, can significantly improve the quality of marginal donor liver, which has good development prospects in organ function maintenance. This article reviews the common types of marginal donor liver and the application of related novel technologies in the maintenance of marginal donor liver function.

Objective To analyze the clinical and pathological features of chronic hepatitis B (CHB) patients with hepatic steatosis.Methods Clinical and pathological data of 841 patients with CHB who underwent liver biopsy in Zhejiang Provincial People’s Hospital during September 2015 to September 2018 were retrospectively reviewed.One hundred and thirty five gender and age-matched pairs of steatosis and non-steatosis patients entered the analysis.Multivariable Logistic regression and rank sum test were used to analyze the clinical features and risk factors of hepatic steatosis in CHB patients .Spearman correlation test was used to analyze the correlation between hepatic steatosis and HBV DNA , hepatic inflammation and fibrosis status.Results Logistic regression analysis showed that overweight ／obesity ( χ2 ＝3.947, OR ＝1.436, 95%CI 1.005-2.051, P＜0.05) and hyperlipidemia (χ2 ＝4.277,OR＝1.803,95%CI 1.031-3.151, P＜0.05) were the risk factors for hepatic steatosis in CHB patients.There was no correlation of hepatic steatosis with serum HBeAg and HBV DNA levels (Z＝-1.762,r＝-0.011, both P＞0.05). However, hepatic steatosis was negatively correlated with inflammatory grade and fibrosis grade of the liver (r＝-0.146 and -0.192, both P＜0.05).Conclusions Overweight／obesity and hyperlipidemia are associated with steatosis in CHB patients.Hepatic steatosis may not aggravate the degree of liver inflammation and fibrosis in CHB patients.

Objective:To investigate the relationship between sarcopenia and chronic heart failure(CHF)in the elderly.Methods:In the retrospective study 365 patients aged≥65 years were randomly divided into the CHF group(n=168)and the non-CHF group(n=188). Skeletal muscle mass(ASM) body mass and skeletal muscle mass index(SMI)were measured and compared between the two groups. The correlation between sarcopenia and CHF in the elderly was analyzed.Results:ASM was(15.46±3.02)kg and SMI was(5.12±0.76)kg/m 2in the CHF group which were significantly lower than those in the non-CHF group[(19.87±2.45)kg and(7.23±0.79)kg/m 2 respectively each P<0.01]. The proportion of subjects with sarcopenia in the CHF group was higher than that in the non-CHF group [26.19%(44 cases) vs. 6.38%(12 cases), P<0.01]. Multivariate Logistic regression analysis showed that age( OR=1.87, 95% CI: 1.132 to 2.285 P<0.05) CHF( OR=23.89, 95% CI: 5.394 to 98.842, P<0.01) gender( OR=20.43, 95% CI: 4.294 to 78.324, P<0.01) and body mass index( OR=23.43, 95% CI: 5.328 to 100.786, P<0.01)were risk factors for sarcopenia in elderly patients. Conclusions:CHF is associated with an increased incidence of sarcopenia in elderly patients.

Objective:To evaluate the impacts of resistance training(RT)and aerobic training(AT)for 24 months on the risk of type 2 diabetes in patients with pre-diabetes.Methods:Two hundred forty-eight pre-diabetic patients were enrolled in this multi-center randomized controlled trial. All patients were randomly divided into 3 groups: RT( n=82), AT( n=83), and control( n=83)groups. The participants in RT and AT groups undertook moderate RT or AT 3 times a week(150 minutes/week)under supervision in 3 research centers for 24 months. Elastic bands were used in each session of RT, with intensity of 60% 1RM(maximum weight that muscle can lift at once). Patients in AT group performed aerobic dance at 60%-70% of maximum heart rate. Assessments for each subject were made at baseline and by the end of 6, 12 and 24 months. Primary outcomes were changes in the risk of type 2 diabetes. Secondary outcomes included changes in blood glucose, blood lipids, and blood pressure. Results:There were 217, 206, and 173 subjects who completed the follow-up of 6, 12, and 24 months, respectively. The mean ages of RT, AT, and control groups at baseline were(59.91±5.92), (60.93±5.71), and(60.73±5.83)years. Compared to control group, both RT and AT groups revealed a significant reduction in HbA 1C( P<0.05), and a significant increase in homeostasis model assessment for β-cell function index(HOMA2-β, P<0.01)by the end of 12 and 24 months. Adjusted for age, gender, statin use, lipid profile, blood pressure, and body mass index, COX regression analysis showed that RT and AT reduced the risk of type 2 diabetes by 55.6%( P=0.012)and 59.8%( P=0.010). Conclusions:This study demonstrates that 24-month moderate RT and AT have comparable effects on reducing insulin resistance, improving β-cell function, blood glucose and lipid, and reducing the risk of type 2 diabetes.

OBJECTIVE To investigate the improve-ment functions of flavonoid compounds on temozolomide(TMZ)-,aging-or AD model-induced dysregulation of hip-pocampal NSC lineage progression,retardancy of den-dritic spine maturation in new-born neurons,as well as impairment of hippocampal-related learning and memory.METHODS We applied 30-week-old neural stem cell(NSC)specific promoter Nestin-GFP and NestinCreERT2:Rosa26-LSL-tdTomato transgenic mice and 16-week-old AD model 5XFAD transgenic mice,together with hippo-campal microinjection(ih),endogenous fluorescence trac-ing and immunofluorescent staining.RESULTS Both fla-vonoid compound A and its functional derivative flavo-noid compound B dose-dependently improved TMZ-,aging-or AD-induced defects of hippocampal NSC lin-eage progression and the maturation of dendritic spines of newborn neurons,thereby improving hippocampus related learning and memory.CONCLUSION This paper provides a new idea and treatment strategy for the devel-opment of new flavonoids that can promote neurogene-sis for neurodegenerative diseases and aging.