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 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 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 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.

Objective To summarize the characteristics of ecthyma gangrenosum and explore its significance in early diagnosis of pseudomonas aeruginosa sepsis in children.Methods We retrospectively reviewed the medical records of 11 children with ecthyma gangrenosum who were hospitalized at Guangzhou women and children's medical center between May 2008 and Apr 2011.Results Eight cases were male and 7 were less than twelve months,the oldest was 2 years old,all of them were diagnosed as Pseudomonas aeruginosa spesis.Two patients had a single lesion,and the others had multiple lesions.Ecthyma gangrenosum located on the trunks in 7 cases,on anogenital areas in 5 cases,on extremities in 5 cases and on faces in 3.The lesions appeared on day 2 to day 10.On average,they developed on day 5.Seven patients developed ecthyma gangrenosum before admission,the course of the illness before admission was 6 days.Fever and multiple organ dysfunction occurred in all the patients and their cultures grew pseudomonas aeruginosa,blood cultures were positive in 8 cases,the others were isolated psudomonas aeruginosa from tissue of the lesion,discharge,ascites,pleural effusion,respectively.The time of ecthyma gangrenosum appeared was earlier than the time of the culture results reported.All of the patients were started empiric antibiotics therapy on admission,the initial antibiotic regimen was appropriate in 9 patients,8 needed surgical intervention,4 were treated with continuous blood purification.Ten patients survived and 2 died,the hospital stay was from 1 to 63 days,the average was 30.Conclusion Ecthyma gangrenosum is a known cutaneous manifestation of pseudomonas aeruginosa sepsis,which is helpful for early diagnosis and treatment,and then the outcome will be improved.

Objective To evaluate the clinical application of spiral CT pulmonary angiography(SCTPA) in the diagnosis of pulmonary embolism(PE) and its limitation.Methods 52 cases of PE were analyzed.SCTPA were performed in all cases with slice thickness 3 mm,pitch 1.5~2.0,scanning time 0.8 s,reconstruction thickness 1mm.The reconstructions of SCTPA included MIP,MPR and SSD.Results 2898 pulmonary arteries in 52 cases were observed.The direct manifestations of PE were showed in 927 pulmonary arteries(32.0%) by SCTPA,in which superior segmental and inferior segmental of pulmonary arteries were involved respectively.The indirect manifestations of PE were showed by plain scan in 113 cases.Conclusion SCTPA is a high effective and noninvasive method in the diagnosis of PE especially for the PE of superior segmental.

Objective:To discusse the clinical features of sarcomatoid hepatocellular carcinoma to improve the understanding of diagnosis and treatment for sarcomatoid hepatocellular carcinoma. Methods:Data including clinical features and follow-up from 8 pa-tients admitted in Tianjin Medical University Cancer Institute and Hospital from January 2009 to April 2014 were retrospectively ana-lyzed. Results: The average age of all patients was 56.6 years old, and the male-to-female ratio was 3:1. Preoperative CT or MRI showed specific characteristics but it was difficult to confirm diagnosis. Pathological and immunohistochemical examination revealed an expressed epithelial-like phenotype. All 8 patients had advanced local tumor invasion and high lymph node metastasis rates. These patients received surgery, and the median survival time was 10.8 months (3 months to 35 months). Conclusion:Diagnosis of sarcoma-toid hepatocellular carcinoma mainly depended on postoperative pathological examination. Immunohistochemistry was beneficial for sarcomatoid hepatocellular carcinoma diagnosis and differential diagnosis. Surgical treatment prolonged survival time, but the overall prognosis remained poor.