Objective To explore the effects of galantamine on function of learning and memory and cholinergic neurons in cortex and hippocampus in rat models of Alzheimer's disease (AD) so as to further investigate the mechanism of cholinesterase inhibitors in improving the cognitive ability of AD patients. Methods The AD rat models established by injecting amyloid-beta protein (A? 1-40) into the bilateral Meynert nucleus were intervened with galantamine, and their abilities of learning and memory were measured with a behavioral test. Meanwhile, the changes in choline acetyltransferase (ChAT) in the rats were examined with immunohistochemical technique. Results In the AD model rats administered with galantamine, the performances in the test were significantly improved and ChAT immunoreactive positive neurons were increased significantly in hippocampus and cortex fields. Conclusion Galantamine can significantly improve the function of learning and memory of the AD model rats, and enhancing the survival characteristics of cholinergic neurons may be one of the important mechanisms, indicating a new possible mechanism of cholinesterase inhibitors as a remedy for AD.

Objective To investigate the protective effects and mechanism of shenmai injection(SMI) on cardiomyocytes injured by hydrogen peroxide(H 2O 2) or angiotension Ⅱ(AngⅡ). Methods According to the different concentrations of H 2O 2, AngⅡ,SMI,Vitamin C(VitC) added into the cardiomyocytes culture media(CCM), the cultures were divided into 15 groups. Lactate dehydrogenase(LDH ),malondialdehyde(MDA),superoxide dismutase (SOD) of CCM and cardiomyocytes viability(CMV), Na +-K +-ATPase,Ca 2+-ATPase?cardiomyocytes apoptosis rate(CMAR) ,nitrogen oxide(NO), nitrogen oxide synthesis enzyme(NOS),eNOS expression of cardiomyocytes were detected respectively .Results H 2O 2 or AngⅡ could decrease CMV, SOD, Na +-K +-ATPase,Ca 2+-ATPase,NOS,NO,eNOS expression and increase CMAR,LDH and MDA.SMI could lessen the changes of the items mentioned above ,which were caused by H 2O 2 or AngⅡ.The effects of SMI 10 ml/L were stronger than those of SMI 5 ml/L or VitC 50 mg/L.Conclusion SMI has a significant protective effect on cardiomyocyte injured by H 2O 2 or AngⅡ.

According to multicenter randomized controlled trials, laparoscopic radical resection of colon cancer has the same short and long term clinical efficacy as traditional open surgery. In laparoscopic radical resection of right semicolon cancer, it is important to separate the embryonic plane of the root, and to ligate and cut off the central vascular roots. Only by separation along the membrane space can one achieve minimally invasive operation with no bleeding, and ensure the integrity of the excision of the mesangium and avoid damage of internal fascia and other organs. The mesangial distribution of the right semicolon is adjacent to the mesangium of the stomach and is connected to the mesentery of the small intestine. The pancreaticoduodenum locates between the right semicolon mesentery and the retroperitoneal subperitoneal fascia. In particular, the relationship between the anterior and posterior Treitz fascia of the pancreaticoduodenum and the Toldt space is complex, which is closely related to the feasibility of complete mesocolic excision(CME). This article introduces the distribution of intermembranous space and mesangial bed in the right semicolon, presenting the problem in CME surgery. In addition, there are key points in identifying the gap between the membranes based on the author’s experience and we propose a new evaluation criteria for membrane surgical specimens, which has certain guiding significance for radical CME surgery for right semicolon cancer.

Proper evaluation and management of surgical specimens of colorectal cancer,such as standardizing the macroscopic evaluation criteria of colorectal cancer specimens,standard processing procedure of specimens,decision criteria of routine histologic types,the method for determination of the resection specimen infiltration distance and curative degree,are of important clinical significance for surgical quality control,assessment of local lesion infiltration and diffusion,pathological classification and stage,which is able to predict prognosis and guide postoperative treatment.

The principle of total mesorectal excision (TME) standardizes the resection range and surgical dissection plane in radical rectal cancer surgery, reduces the local recurrence rate and improves the long-term survival. TME is the "gold standard" in radical rectal cancer surgery. However, with the progress of laparoscopic surgical instruments and techniques in recent years, further understanding of pelvic membrane anatomy and autonomic nervous system has been gained, which makes the surgical plane of TME more accurate and the autonomic nervous system better preserved. According to anatomical discovery and histological confirmation, there is a fascia between the mesorectal fascia and pelvic parietal fascia, called pre-hypogastric nerve sheath, in which autonomic nervous system courses, including the superior hypogastric plexus, left and right hypogastric nerves, pelvic plexus and the neurovascular bundles, from the abdominal to the pelvic cavity behind the mesorectal fascia. It fuses with the end of the mesorectum at the superior border of musculi puborectalis, and goes around the mesorectum to join with Denonvillier fascia. On the basis of anatomical studies and empirical anatomical observations, we put forward the concept of network preservation of the autonomic nervous system: the main trunk as well as the nerve branches of the pelvic autonomic nervous system and accompanying blood vessels should be preserved to ensure the integrity of the nerve reflex arc. The concept allows the radical resection of rectal cancer to follow the principle of TME, and meanwhile, protect patient's urination function and sexual function to the greatest extent, improving the quality of life of patients after surgery.
Autonomic Nervous System ; Humans ; Neoplasm Recurrence, Local ; Pelvis ; Quality of Life ; Rectal Neoplasms/surgery* ; Rectum

【Objective】 Heart Model(HM) is a new method of 3D automatic left ventricular quantitative technique. This experiment is designed to test the feasibility and reproducibility of HM in evaluating left ventricular volume and ejection fraction of patients with pacemaker. 【Methods】 Echocardiography was performed in 50 patients with pacemaker. All of the two-dimensional and three-dimensional images were collected. Biplane Simpson method, HM method and traditional 3D-manual method were used to measure left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV) and left ventricular ejection fraction(LVEF), respectively. The measurement results and post-processing time of the three methods were compared. At the same time, the repeatability of HM method within and between groups was evaluated. 【Results】 The differences among Simpson, HM and 3D-manual in the measures of LVEDV and LVEF were statistically significant(P<0.05). LVEDV and LVESV measured by HM were larger than those measured by 3D-manual(P<0.05), while LVEF had no statistical significance(P>0.05). HM and 3D-manual measurements had a very high correlation and consistency. Compared with Simpson and 3D-manual, HM method had the least post-processing time, and the repeatability was good within and between groups. 【Conclusion】 HM method for automatic evaluation of left ventricular volume and ejection fraction is rapid, feasible and highly reproducible.

Administration, Oral ; Anticoagulants/adverse effects* ; Atrial Fibrillation/drug therapy* ; Humans ; Stroke ; Vascular Calcification/drug therapy* ; Warfarin

To study the effect of nicorandil pretreatment on ketone body metabolism and Acetyl-CoA acetyltransferase (ACAT1) activity in hypoxia/reoxygenation (H/R)-induced cardiomyocytes. In our study, we applied H9c2 cardiomyocytes cell line to evaluate the cardioprotective effects of nicorandil. We detected mitochondrial viability, cellular apoptosis, reactive oxygen species (ROS) production and calcium overloading in H9c2 cells that exposed to H/R-induced cytotoxicity. Then we evaluated whether nicorandil possibly regulated ketone body, mainly β-hydroxybutyrate (BHB) and acetoacetate (ACAC), metabolism by regulating ACAT1 and Succinyl-CoA:3-keto-acid coenzyme A transferase 1 (OXCT1) protein and gene expressions. Nicorandil protected H9c2 cardiomyocytes against H/R-induced cytotoxicity dose-dependently by mitochondria-mediated anti-apoptosis pathway. Nicorandil significantly decreased cellular apoptotic rate and enhanced the ratio of Bcl-2/Bax expressions. Further, nicorandil decreased the production of ROS and alleviated calcium overloading in H/R-induced H9c2 cells. In crucial, nicorandil upregulated ACAT1 and OXCT1 protein expressions and either of their gene expressions, contributing to increased production of cellular BHB and ACAC. Nicorandil alleviated cardiomyocytes H/R-induced cytotoxicity through upregulating ACAT1/OXCT1 activity and ketone body metabolism, which might be a potential mechanism for emerging study of nicorandil and other K(ATP) channel openers.
Acetyl-CoA C-Acetyltransferase ; Apoptosis ; Calcium ; Cell Line ; Coenzyme A ; Gene Expression ; Metabolism* ; Myocytes, Cardiac ; Nicorandil* ; Reactive Oxygen Species ; Transferases

Objective To discuss the effectiveness of the second surgical procedure of adjacent segment degeneration after the first spinal fusion.Method 35 patients who had been performed spinal fusion in our hospital or had symptoms recurred or aggravated after 12 ～ 114 (42 ±35) months of the prior surgery were enrolled in this study.A second surgery was performed and intraoperative the intradiscal pressure of adjacent segments of degeneration and normal segments was measured.The VAS score systems were compared among prior surgery,3 months later and 2 years after the second surgery.Result The intradiscal pressure of adjacent segments after the cervical vertebra and lumbar vertebra fusion were [ (15 ± 4.6)cmH2O,(23 ±5.2)cmH2O],much higher than normal segments [ (3 ±2.3)cmH2O,(8 ±4.1)cmH2O](P ＜0.01).The VAS score systems of 3 months later and 2 years after the second surgery were [ (2.9 ±0.7),(2.0 ± 0.6) ],which were dramatically lower than the prior (7.8 ± 1.2) (P ＜ 0.01).In 12 ～ 46(31 ± 12) months of follow-up after the second procedure,X-ray and MRI showed that fusion segments reached nearly bone fusion,well decompressed and without nerve compression or other complications.Conclusion If recurrence of symptoms after spinal fusion were caused by adjacent segment degeneration,reoperation would guarantee good clinical outcome.

Objective To analyze the characteristics of bone scintigraphy in 117 cases with primary hyperparathyroidism (PHPT).Methods Of these 117 cases (50 males and 67 females),there were 116 parathyroid adenomas and 1 parathyroid cancer.Mean age was 61.1(12-86) years old.All had ~(99)Tc~m-methylene diphosphonate (MDP) bone scintigraphy.The bone images could be classified into 4 categories.Category Ⅰ:normal;category Ⅱ:localized abnormal,which could be subcategorized as Ⅱ A with skull and mandible involvement,and Ⅱ B with Ⅱ A characteristics plus metabolic derangement;category Ⅲ:systemic,whole-body incmased tracer uptake;category Ⅳ:systemic plus localized metabolic derangement.Data were analyzed statistically with X~2 and t-test (isolated samples).Results According to the scintigraphic findings,there were 47 cases(40.17%)of category Ⅰ,35 cases(29.91%) category Ⅱ (21/35cases Ⅱ A and 14/35 cases Ⅱ B),30 cases (25.64%) category Ⅲ,and 5 cases (4.27%) category Ⅳ.Combining categories Ⅱ、Ⅲ and Ⅳ together,there were 70 abnormal cases.These patients had history of abnormal bone images such as bone fracture (39 cases,55.71%),calculus (8 cases,11.43%),bone fracture plus calculus(7 cases,10.00%),osteoporosis (51 cases,72.86%) or ostalgia(26 cases,37.14%);however,in the 47 cases of category Ⅰ,only 1 (2.13%),0,0,10(21.28%)and 10 cases (21.28%),respectively,were found.Therefore.these case history characteristics were statistically significant (X~2=11.152,P=0.01).The tumor size,parathyroid hormone (PTH),blood calcium,blood phosphorus in the patients of abnormal PHPT categories Ⅱ to Ⅲ were(14.52±13.72)cm~3,(731.67±618.40)ng/L,(3.05±0.29) mmol/L and (0.71±0.14) mmol/L,respectively.with statistically significant difference compared to category Ⅰ:(0.78±1.33) cm~3,(112.04±62.98)ng/L,(2.56±0.42) mmol/L and (1.03±0.36)mmol/L(t=-5.724,-5.741,-7.274 and -6.451;all P＜0.01).Conclusions (1)Bone scintigraphy was normal in 40% of PHPT patients.(2)The bone images of PHPT could be classified into 4 categories and each could reflect the duration and severity of the disease status on bone.(3)The bone imaging characteristic could be useful for differential diagnostic purposes.