By inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, statins up-regulate the expression and activation of endothelial nitric oxide synthase (eNOS) in brain tissues, increase the levels of serum catalase and plasma nitric oxide, enhance antioxidant capacity, decrease oxygen free radical release, improve immunoreactivities of tight junction (zonula occludens), transmembrane proteins and glial fibrillary acidic protein of astrocyte. Stains may also exert the effects that is completely unrelated with inhibiting HMG-CoA reductase, e.g. binding to leucocyte function-associated antigen-1(LFA-1) L-site, restraining its interactions between LFA-1 and intercellular adhesion molecule-1 (ICAM-1), and playing anti-inflammation and immunoloregulation roles. The above mechanisms contribute to remain the integrity of blood-brain barrier and the activity of astrocyte under the pathological conditions.

Objective To evaluate the efficacy and safety of remifentanil and propefol combined with local anesthesia for cobiation-assisted upper-airway procedure (CAUP). Methods Eighty ASAⅠorⅡpatients aged 25-60 yr body mass index ≤ 35 kg/m2 with sleep apnea hypopnea syndrome scheduled for CAUP were randomly divided into 4 groups (n=20 each): normal saline group (S), propefol group (P), remifentanil group (R) and propoful + remifentanil group (PR). After topical anesthesia with 1% decicaine, the patients in group S, P, R or PR received iv infusion of normal saline 0.15 ml·kg-1·h-1 , propofol 25 μg·kg-1·min-1 , remifentanil 0.05 μg·kg-1·min-1, or propefol + remifentanil at the same rate respectively. Ten minutes later local infiltration anesthesia was performed in operative field with lidocaine containing epinephrine 1:200 000. Ramsay sedation score and verbal rating scale (VRS) were assessed every 5 min. VRS Ⅲwas defined as anesthesia failure in group S. It was also defined as anesthesia failure that Ramsay sedation score > 3 or occurrence of respiratory depression during increment of propofol or remifentanil in patients with VRS Ⅲ in the other 3 groups. BP and HR were recorded before coblation and 5 rain after coblation. Airway obstruction and apnea were also observed. Results Anesthesia achievement ratio was significantly higher in group R and PR (90% and 100% respectively) than in group S and P (40% and 65% respectively) (P<0.05). SP, DP and HR were significantly lower 5 rain after coblation in group R and PR than in group S (P < 0.05). There was no significant difference in incidence of adverse effects between the 4 groups(P>0.05). Conclusion Remifentanil or propofol-remifentanil combined with local anesthesia is safe and effective for CAUP.

Objective:To evaluate mental health status of medical students and to explore its related factors.Methods:877 medical students were tested by Symptom Checklist(SCL-90),Simplified Coping Style Questionnaire(CPS),and the stressful events items;240 of them were tested by Eysenck Personality Questionnaire (EPQ).Results:①Compared with the SCL-90 norm of youth group,medical students had higher scores ( P

Objective To evaluate the efficacy of I-gel laryngeal mask airway (LMA) for airway management in patients undergoing radical mastectomy.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients (Mallampati Ⅰ or Ⅱ),aged 25-64 yr,weighing 45-90 kg,with body mass index ＜ 30 kg/m2,scheduled for elective radical mastectomy under general anesthesia,were randomized into 2 groups (n=60 each): I-gel LMA group (group Ⅰ) and Classic LMA (group C).Anesthesia was induced with iv midazolam 0.04 mg/kg and vecuronium 0.10 mg/kg.I-gel and classic LMAs were inserted in I and C groups,respectively,after induction of anesthesia.The success rate of LMA placement at first attempt,LMA placement time,airway sealing pressure,peak airway pressure,leaks and hypoxemia,and complications (nauseas and vomiting,bucking,aspiration and blood stain on the LMAs,sore throat and hoarseness within 24 h after surgery) were recorded.Correct position of the LMAs was verified by fiberoptic bronchoscopy.Results The success rate of LMA placement were 100 ％ in both groups.The success rate of LMA placement at first attempt and fiberoptic bronchoscope scores were higher,the LMA placement time was significantly shorter,and the incidence of blood stain on the LMAs and sore throat were significantly lower in group Ⅰ than in group C (P ＜ 0.05).A transient increase in airway pressure and leaks occurred in 5 patients in group C,and the airway pressure returned to normal and no leaks developed after treatment.No transient increase in airway pressure and leaks occurred in group Ⅰ.Hypoxemia was not found in both groups.Conclusion The placement of I-gel LMA is easier than that of Classic LMA and the success rate of placement at first attempt is high,with fewer complications.I-gel LMA can be safely and effectively used for airway management in patients undergoing radical mastectomy.

Objective To study the clinical significance of using MSCT(16 multi slice spiral CT,MSCT)to evaluate the patency of coronary arterial stent,and to explore the factors contributing to the image quality.Methods 32 patients with coronary arterial stent im- plantation received MSCT.The shape and position of the stent and the situation of restenosis were checked with several methods.Of the 32 patients,the results in 7 cases were further verified by X-ray coronary artery angiography.The image qualities were classified in three grades.The influence factors contributing to imaging quality were analyzed.Results The rate of good image quality for MSCT coronary artery angiography was 87.5%(28/32).The rate of good image quality for the patients with heart rate less than 60 was 94.7%,for those with heart rate of 61-70 was 88.9%,and for those with heart rate over 70 was 50.0%,there existed significant differences(X~2=16.354, P

Rho/ROCK pathway is a ubiquitous singling pathway in organisms,and is involved in many biological processes. In the brain of Alzheimer′s patients,the activities of Rho and Rho associated coiled coil forming protein kinase(ROCK)are up-regulat?ed,which is accompanied by the elevation of Aβ42 level,and the abnormal change of the morphology and function of neuronal process?es,suggesting that the occurrence and development of Alzheimer′s disease(AD)is associafed with the overexpression and excessive activation of Rho or ROCK. Rho/ROCK2 pathway is considered a target pathway for the prevention and treatment of AD,and Rho or ROCK2 also becomes an important target for AD drug development. Numerous studies have revealed that suppressing the expression or decreasing the activity of Rho or ROCK2 can reduce Aβ42-induced neurotoxicity,protect neurons,and slow down the occurrence and de?velopment of AD. Therefore,specific inhibition of ROCK2 has an important significance for the repair of central nervous system dam?age and the treatment of AD. This article reviews several effects of Rho/ROCK2 pathway on the development of AD.

AIM To investigate the effect of tamoxifen on the proliferation of the anterior pituitary cell of rats and its mechanism. METHODS Primary culture of the anterior pituitary cell of rats and 3H TdR incorporation method were applied. The changes of cell morphology were observed directly by electric microscope. RESULTS Tamoxifen could inhibit the proliferation of the anterior pituitary cell of rats. The inhibitory effect of tamoxifen (0 1 ?mol?L -1 ) could be reversed by estrogen.The classical apoptotic changes appeared in the cells after tamoxifen incubation for 48 h. CONCLUSION Tamoxifen can inhibit the proliferation of the anterior pituitary cell of rats and resultin the cell apoptosis.

Rheumatoid arthritis (RA) is a systemic autoimmune disease with unknown etiology.The main feature of RA is chronic,symmetrical and invasive arthritis.RA may present with severe joint deformity and functional loss,which has higher disability and fatality rates.At present,no effective measures can reverse bone damage associated with RA clinically.Therefore,early diagnosis of RA is critical to improve prognosis.In recent years,imaging increasingly plays an important role in the early diagnosis of RA.This article reviews recent advances in imaging methods for early diagnosis of RA.

Objective To investigate the clinical and pathological characteristics,surgical treatment strategy and prognosis of primary malignant neoplasms of the appendix.Methods The clinical data of 74 patients with primary malignant neoplasms of the appendix in our hospital from January 1982 to December 2012 were retrospectively studied.Results Among the 74 cases of primary malignant neoplasms of the appendix,carcinoids were the most common accounting for approximately 70％,adenocarcinoma accounting for 22％ and lymphoma accounting for 8％.The prognosis of primary malignant neoplasms of the appendix is rather poor,nainly because of patients' later presentetion.The overall 1,3,5-year survival rate is respectively 95％,74％,60％,the prognosis of carcinoid is good,while that of adenocarcinoma is poor.Conclusions The incidence of primary malignant neoplasms of the appendix is relatively low.It is difficult to diagnose preoperatively,and the diagnosis relies mainly on rapid intraoperative frozen section and postoperative pathology.

Objective To identify the prognostic factors for patients with intrahepatic cholangiocarcinoma.Methods The clinical data of 99 patients with intrahepatic cholangiocarcinoma who received surgical treatment at the Cancer Hospital of Tianjin Medical University from January 2000 to January 2010 were analyzed retrospectively.Lymph nodes at the hepatic portal and group 12,13 and 8 lymph nodes were resected.The range of hepatectomy was decided according to the size,location,number of tumor and the hepatic function.Patients were followed up every month within the first 6 months after operation,every 3 months at 6 months later,and they were followed up every half year at 2 years later.Patients who were suspected as with tumor recurrence or progression were followed up every month.All the patients were followed up till death or March of 2013.The survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results Forty patients received hemi-hepatectomy,27 received extended hemi-hepatectomy,20 received segmentectomy,and 12 received hemi-hepatectomy + wedge resection.All the patients were followed up and the median time of follow-up was 33 months (range 21.1-44.9 months).The 1-,3-,5-year recurrence-free survival rates and total survival rates of the 99 patients were 64.6％,29.2％,22.7％ and 78.8％,46.4％ and 30.3％,respectively.The results of univariate analysis showed that hepatitis B or C virus infection,preoperative CA19-9 level,TNM staging,lymph node metastasis,microvascular invasion,number of nodules and Ro resection were risk factors influencing the recurrence-free survival time (Log-rank value =5.048,5.982,20.128,13.148,29.632,32.488,50.574,P ＜0.05).The peroperative CA19-9 level,TNM staging,lymph node metastasis,microvascular invasion,number of nodules and R0 resection were risk factors influencing the total survival rate (Log-rank value =4.302,17.267,11.756,23.840,36.411,47.126,P ＜0.05).There were significant differences in the recurrence-free survival time and total survival time between patients in different TNM stages (20 patients in stage Ⅰ,44 in stage Ⅱ,8 in stage Ⅲ and 27 in stage Ⅳ) (Log-rank value =20.128,17.267,P ＜0.05).There were significant difference in the recurrence-free survival time between patients in stage Ⅰ and Ⅲ,patients in stage Ⅰ and Ⅳ,and between patients in stage Ⅱ and Ⅳ (Log-rank value =10.807,19.368,6.347,P ＜ 0.05).There were significant difference in the total survival time between patients in stage Ⅰ and Ⅱ,patients in stage Ⅰ and Ⅲ,patients in stage Ⅰ and Ⅳ and between patients in stage Ⅱ and Ⅳ (Log-rank value =6.119,4.015,16.282,4.929,P＜0.05).There was no significant difference in the survival time between patients in other TNM stages (P ＞ 0.05).The results of multivariate analysis showed that TNM stage Ⅲ and Ⅳ,microvascular invasion,multiple nodules and R0 resection were independent risk factors influencing the recurrence-free survival time (RR =1.413,3.073,2.737,3.916,95％ confidence interval:1.119-1.784,1.837-5.140,1.338-4.207,1.849-8.291,P＜0.05) ; lymph node metastasis,microvascular invasion,multiple tumors and R0 resection were the independent risk factors influencing the total survival time (RR =2.025,2.948,0.327,3.494,95％ confidence interval:1.215-3.374,1.774-4.900,0.183-0.583,1.670-7.310,P ＜ 0.05).Conclusions TNM stage Ⅲ and Ⅳ,lymph node metastasis,microvascular invasion,multiple nodules,non-R0 resection shorten the recurrence-free survival time and total survival time of patients who received surgical resection for intrahepatic cholangiocarcinoma,and they are the main factors influencing the prognosis.R0 resection could improve the survival of patients with intrahepatic cholangiocarcinoma.