Objective To explore mechanisms of sustained and transient effects in encoding processes of emotional memory by examining activation of amygdala via functional MRI and to provide evidence for understanding the underlying neural mechanism related to emotional memory disorders further. Methods Twenty two subjects (aged from 20 to 24 years old) participated in the study and mixed blocked/event-related design was adopted. Sixty negatively emotional pictures and sixty neutral scene pictures were used. Functional MRI scanning was performed while subjects were doing encoding tasks. Behavioral data were acquired during retrieval. Correlation analyses of functional MRI data and simples paired t -test of behavioral performance were performed with SPM2 and SPSS13.0 statistical software,respectively. Results Significant differences of behavioral performance ( t= 2.791,P= 0.01 ) was found between emotional (3.15 ± 0.14) and neutral (2.25 ± 0.08 ) pictures. A whole-brain voxelwise correlation analysis between functional MRI and emotional enhancement effect indicated that the transient effect of emotional enhancement of memory involved the left amygdala, left hippocampus and left lateral orbitofrontal cortex, while the sustained effect involved the right amygdala, right hippocampus, right inferior frontal gyrus, right medial and lateral orbitofrontal cortex. Region of interest analysis demonstrated that the sustained effect was related to the right amygdala (r= 0.50, P = 0.019 ), which was different from transient effect ( Z = 1.655, P = 0.049 ),while the transient effect was correlated with the left amygdala (r=0.65, P=0.001 ) ,which was different from sustained effect( Z= 2.512, P=0.006). Conclusion Different neural mechanisms are involved in sustained and transient effects of emotional memory encoding. The right amygdala is responsible for sustained effect and the left amygdala is responsible for transient effect ,respectively. The results confirm and extend the model of the left-transient/right-sustained effect.

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To investigate the expression of calpains and calpastatin in diaphragm of a rat model of chronic obstructive pulmonary disease(COPD). Methods Fotry male Wistar rats were randomly divided into the control group and the COPD group. Rats in the COPD group were copied by expo -sing to cigarettes smoking and dripping lipopolysaccharide into trachea. Pathological changes of lung and diaphragm were deteted. Immunohis-tochemistry and RT-PCR were performed to determine protein and mRNA expression of calapins and calpastatin. Results Diaphragmatic atrophy was observed in rats in the COPD group instead of the control group. The protein and mRNA expression of calpains in diaphrag-m of COPD group were Increased than those in the control group(P < 0.05). On the contrary ,the expression of calpastatin was significantly reduced in rats in the COPD group(t =-9.38 and-2.97;P < 0.001 ,P = 0.005). Conclusions An imbalance in the expression of calpains/calpastatin in diaphragm was observed in COPD rats ,and this imbalance may be responsible for diaphragm atrophy.

Objective To study the relationship between neurodevelopment and early nutritional status of very low birth weight(VLBW)infants in NICU.Methods VLBW infants admitted to NICU of our hospital from January 2013 to December 2014 and received regular follow-up management at our high-risk infant outpatient clinic were retrospectively studied. All infantsˊdevelopmental quotient ( DQ) were evaluated at 3 months of corrected gestational age ( cGA) . DQ ≥130 was defined as excellent, 115-129 above medium, 85-114 medium, 70 -84 below medium and ≤69 abnormal. According to their DQ scores, infants were assigned into two groups, normal neurodevelopment group ( DQ≥85 ) and abnormal neurodevelopment group ( DQ<85 ) . Nutritional status during hospitalization between the two groups were compared.Results A total of 125 VLBW infants were recruited.At three months of cGA, 2 cases ( 1. 6℅) had excellent DQ score; 3 ( 2. 4℅) above medium; 63 ( 50. 4℅) medium;57 (45. 6℅) below medium. 68 cases (54. 4℅) in the normal development group and 57 (45. 6℅) in the abnormal group. The total energy intake, the proportion of enteral energy supply on 4 d, 7 d, 14 d after birth and amino acid supply on 4 d, 7 d were significantly higher in the normal neurodevelopment group than the abnormal group (P<0. 05). Comparing with the abnormal group, weight loss of VLBW infants in the normal neurodevelopment group was less; the time needed to reach birth weight and exclusive enteral nutrition in the normal neurodevelopment group was shorter. The differences were statistically significant between the two groups(P<0.05).Conclusions VLBW infantsˊearly nutritional status may influence their neurodevelopmental outcome.

To investigate the clinical features and principles of diagnosis and treatment of early postoperative inflammatory ileus (EPII). The clinical data of 69 patients with EPII treated in this hospital were retrospectively reviewed. EPII mostly occurred in 3-11d after abdominal surgery, and the average time was 5d. Sixty two cases were cured in a mean period of (22±13)d through combination therapy including gastroenteral decompression, somatostatin, dexamethasone and total parenteral nutrition (TPN). Seven cases were cured by operation. EPII is a special type of early intestinal obstruction which often occurs in two weeks after abdominal operation. Its typical symptoms are abdominal distension; conservative therapy is effective for most cases and reoperation is usually contradicted.

Objective To investigate the value of modified pancreatoduodenectomy in the treatment of ampullary carcinoma by comparing the efficacy of pancreatoduodenectomy with preservation of ascending portion of duodenum and that of Whipple procedure. Methods The clinical data of 133 patients with ampullary carcinoma who had been admitted to the Qilu Hospital from 1990 to 2006 were retrospectively analyzed. Of the 133 patients, 88 received Whipple procedure (group A) and 45 received pancreatoduedenectomy with preservation of ascending portion of duodenum (group B). The preoperative condition of the patients and short- and long-term efficacy of the 2 procedures were compared by Fisher exact probability, t test, chi-square test, Kaplan-Meier survival curve and Log-rank test, and the differences between the efficacy of the 2 procedures were compared. Results The operation time, time of gastrointestinal function recovery, hospital stay and ratio of patients with blood transfusion were (366±111) minutes, (7.4±1.4) days, (24±9) days and 76% (67/88) in group A, and (325±32)minutes, (4.3±1.4)days, (31±14)days, 42% (19/45) in group B, with significant difference between the 2 groups (t = 2.34, 2.08, 1.98 ; χ2 = 14.99, P < 0.05). The medium survival time of patients in groups A and B were (19.0±1.5)months and (16.9±1.7) months, with no significant difference between the 2 groups (χ2 = 0.46, P > 0.05). There was no significant difference in the occurrence of postoperative complications between the 2 groups (P > 0.05). Conclusions Pancreateduodenectomy with preservation of ascending portion of duodenum can be applied for patients with ampullary carcinoma.

OBJECTIVE:To compare the inhibition effect of Compound danshen tablets on platelet activation and that of Danshen tablets in patients with coronary atherosclerosis.METHODS:90 patients with coronary atherosclerosis were randomized into compound danshen tablet group,danshen tablet group and control group with treatment course of 2 months.30 cases were included into normal group.Radioimmunoassay and realtime RT-PCR were applied to detect mRNA expression of PTGIS,cAMP,TXA2 and PGI2 in plasma respectively and compared with control group.RESULTS:As compared with normal group,the mRNA expression of cAMP,PGI2,PTGIS were decreased markedly while expression of TXA2 was increased remarkably.In compound danshen tablets group and danshen tablets group the mRNA expression of cAMP,PGI2 and PTGIS were increased while the expression of TXA2 was decreased.The increase and decrease of mRNA expression in compound danshen tablets group was higher than that in danshen tablet group.CONCLUSION:Both of Compound danshen tablets and Danshen tablets could inhibit platelet activation and prevent acute coronary syndrome.The effect of Compound danshen tablets on inhibiting platelet activation is better than that of Danshen tablets.

Objective To explore the influence of intubation-surfactant-extubation (InSurE)therapy combined with bilevel positive airway pressure (BiPAP)in the use time of mechanical ventilation,and to clarify the value of BiPAP in the treatment of respiratory distress syndrome in the preterm infants.Methods Toral 95 preterm infants with respiratory distress syndrome were treated with InSurE therapy during January 2011 to October 2014. Among them,the preterm infants before January 2013 were selected as control group who were treated with InSurE and nasal continuous positive airway pressure (nCPAP).After January 2013, 60 preterm infants were treated with BiPAP,as BiPAP group.The rates of InSurE failure,the need for mechanical ventilation (MV)on the 7th day after InSurE failure, total non-invasive ventilation time, total mechanical ventilation time, atmospheric oxygen therapy time and incidence of clinical complications were compared between two groups.Results ① There were no significant differences in the clinical data of the preterm infants between two groups, such as gender and age.② Although there was no significant difference in the failure rate of InSurE,but the rate of repeated mechanical ventilation during 1 week in BiPAP group was lower than that in control group (P <0.01).③ The Rank sum test result showed that the total time of non invasive ventilation in BiPAP group was longer than that in control group (P <0.01).The total time of invasive mechanical ventilation and oxygen therapy in BiPAP group was lower than that in control group (P < 0.05).④ The incidence of retinopathy of prematurity (ROP)and bronchopulmonary dysplasia (BPD)in BiPAP group was lower than that in control group.Conclusion BiPAP can significantly reduce the use of invasive mechanical ventilation after the failure of InSurE,thereby decreases the oxygen toxicity and barotrauma hazards.

Objective: To explore the clinical value of plasma copeptin level on major adverse cardiovascular event (MACE) occurrence in patients with acute ST-segment elevation myocardial infarction (STEMI) during hospitalization.
Methods: Our research included 2 groups:STEMI group, n=80 and Control group, n=80 patients with stable coronary artery disease (CAD). All patients were treated in our hospital from 2012-06 to 2014-06. Plasma level of copeptin was detected by ELISA, other relevant examinations were conducted to study the MACE occurrence in STEMI patients.
Results: Plasma copeptin level in STEMI group (523.26 ± 142.69) pg/ml was higher than that in Control group (345.25 ± 89.36) pg/ml, P<0.05. In STEMI group, there were 28/80 (35%) patients suffered from MACE, compared with non-MACE patients, they had increased plasma copeptin, cardiac muscle protein I (cTnI), kinase isoenzyme (CK-MB) and left ventricular ejection fraction (LVEF), P<0.05. Multivariate regression analysis indicated that plasma copeptin, cTnI and LVEF were the independent risk factors for MACE occurrence. According to occurred area under the curve, compared with cTnI and CK-MB, plasma copeptin level had the higher predictive value to judge the ROC, positive/negative possibility, sensitivity and speciifcity for MACE occurrence in STEAMI patients, P<0.05.
Conclusion: Plasma copeptin level could effectively predict MACE occurrence in patients with acute STEMI during
hospitalization, it may predict their prognosis at certain point.

Objective To collect the data of present basic constructive situation of intensive care units (ICUs) in second and tertiary grade hospitals in Xinjiang Uygur Autonomous Region and to provide a data base beneficial to the construction of ICUs in the whole region.Methods The information including basic situation of ICUs in a total of 49 second and tertiary grade hospitals as samples in Xinjiang Uygur Autonomous Region were investigated by questionnaire survey from December 2012 to April 2013. The contents of questionnaire chiefly included the basic situations of hospitals, ICU constructions, ICU human resources and allocation of equipments.Results Forty-nine questionnaires were sent out, and all of them gave answers, the recovery rate being 100%. In the whole region of Xinjiang, there were 49 second and tertiary grade hospitals with establishment of 66 various types of ICUs. ① Medical unit basic situation: the second grade A hospitals accounted for 59.2%, and the tertiary grade A hospitals, 34.7%. There was a larger proportion of local hospitals (67.3%); most of the hospitals had beds over 500 (57.14%), the designed hospital bed number was 41 403, and 35 442 beds were open up for service (85.60%). ② The ICU basic construction situation: the construction of ICUs concentrated mainly after the year 2000, from 2000 to 2010, a total of 37 units, and from 2010 to 2012, 12 units were constructed; when they opened to the public, the beds were relatively few, and the ICUs containing less than 10 beds occupied 79.00%. In the 66 ICUs surveyed, there were 43 general ICUs, accounting the largest proportion, followed by 7 emergency ICUs, and the least were 1 neurosurgery and 1 cardiac surgery ICU. In the 66 ICUs, all together 765 beds were prepared, but actually 808 beds were opening up to public; most of ICUs had 5 - 20 beds, accounting for 71% in all the ICUs. At present, in the whole Xinjiang region, the rate of beds in ICUs in various grades of hospitals opening to the outside for use accounted for more than 80% of which 56% ICUs were almost turning round fully. ③ ICU human resources situation: totally, there were 484 doctors in ICUs in the whole region, the ratio of full-time doctor to nurses was 1:3.50, the ratio for bed to physician 1:0.55 and the ratio for bed to nurse 1:0.92. The title of doctor was primarily resident, and the various title gradient levels were good. Most doctors graduated from a regular medical college, and the doctors having obtained a master degree were few. The physician professional backgrounds were mainly critical disease medicine, emergency medicine and respiratory medicine, the professional relevance being good; the chief way of ICU physicians to engage in advanced study of their professional training was in China, and generally they joined professional continuing education programs poorly, mostly joining once a year or non at all. The physicians who obtained the identification of Chinese critical care medicine specialist accounted only for 23.56%. ④ ICU equipment allocation situation: according to the requirements of ICU construction guidelines, the equipments must be allocated including bedside monitors (703 units), ventilators (516 units) and infusion pumps (702 units), occupying the highest proportion. In the optional equipments, there were enteral nutritional pump (89 stations), blood glucose monitoring device (57 units) and anti-decubitus mattresses (54 units), the proportion being the largest, bispectral index monitor (2 units), extracorporeal membrane oxygenation (ECMO, 1 table) and gastric mucosal carbon dioxide tension pHi meter (0 unit), the proportion being the least or non at all.Conclusions In the whole Xinjiang region, the construction of ICUs is still at the developing stage, and needs to further strengthen the standardized construction. The human resources, equipments, etc. are not distributed in balance, and it is necessary to move forward the adjustment to benefit the development of ICUs in the whole region.