Objective To investigate the cytotoxic effects of differentiated PC12 cells afterinfected by prion protein 106-126 peptide.Methods The PC12 cells were infected by prion protein 106-126peptide after differentiated by nerve growthfactor(NGF).Cell viability andthe morphological changes were observed.The energy metabolize and apoptosis was detected.Results Afterinfected by this peptide,cell viability decreasedfrom(98.1±1.9)% to (69.2±4.7)%,and apoptosis peak Was observed byflow cytometry.Aboutthe process of the cytotoxic effects,afterthe cells affected by PrP106-126,oxidative stress presented and existed continually,and then the intracellular free calcium concentrate increased from (185.74±12.93)nmol/L to (493.00±58.71)nmol/L subsequently,the activity of Ca2+ ATPase decreased from 54.92±4.05 to 34.92±4.86,the mitochondrial membrane potential decreasedto 65%,and also the energy metabolize disorder,the cells presented apoptosisinthe end.The changed Bcl-2/Bax system involvedinthe apoptosis.Conclusions Prion protein106-126 peptide caninduce apoptosisin differentiated PC12 cells and presented cellulartoxicity definitely.It might be a perfect model to study the cellular toxicity of prion protein.Continual oxidative stress could causetheintracellularfree calcium concentrate and disturb the energy metabolize,and the apoptosis might be the end-result.The oxidative stress of might play a startup and important role.

Objective To explore the effect of swallowing training on dysphagia in patients with head and neck neoplasm receiving ra-diotherapy. Methods 60 patients with head and neck neoplasm receiving radiotherapy from March, 2014 to August, 2015 were divided into intervention group (n=30) and control group (n=30) randomly. The control group received routine nursing and relevant health education, while the intervention group received swallowing training from 2 weeks before to 3 months after radiotherapy. They were assessed with Functional Oral Intake Scale and M. D. Anderson Dysphagia Inventory 1 week, 3 months after radiotherapy. Results The scores of Function-al Oral Intake Scale (Z=-3.195, P<0.01), the total score of M. D. Anderson Dysphagia Inventory and the subscores (t>4.385, P<0.01) were better in the intervention group than in the control group 1 week after radiotherapy, as well as 3 months after radiotherapy (Z=-4.436, P<0.01;t>5.361, P<0.01). Conclusion Swallowing training could improve the condition of dysphagia of head and neck neoplasm patients after radiotherapy.

Objective To observe the effect of memantine on NR1 ,NR2A ,NR2B of N‐methyl‐das‐partate receptor and learning or memory ability in vascular dementia (VaD) rats .Methods Thirty adult male SD rats were randomly divided into sham operation group ,VaD model group and me‐mantine treatment group (10 in each group) .A rat VaD model was established by permanent liga‐tion of bilateral common carotid arteries .Rats in memantine treatment group received gastric me‐mantine 10 mg/(kg · d) 1 week after operation while those in model group received normal sa‐line .Five weeks after operation ,their learning or memory ability was tested by Morris water maze test ,expressions of NR1 ,NR2A and NR2B were detected by Western blot .Results The escape latency was significantly longer whereas the percentage of target quadrant and expression levels of NR1 ,NR2A and NR2B were significantly lower in model group than in sham operation group (P=0 .001 ,P=0 .002 ,P<0 .05) .The learning or memory ability and the expression levels of NR1 ,NR2A and NR2B were significantly higher in memantine treatment group than in model group but still lower in memantine treatment group than in sham operation group ( P< 0 .05) . Conclusion Memantine can improve the learning or memory ability of VaD rats by upregulating the expression of NR1 ,NR2A and NR2B in their hippocampus .

Objective To investigate the influencing factors of cognitive impairment in patients with lacunar infarction (LI) and to analyze the features of cognitive impairment at different parts in patients with LI.Methods Patients with LI and normal controls were enrolled in the study.Mini-Mental Status Examination (MMSE) was used to evaluate cognitive impairment.California Verbal Learning Test (CVLT),Verbal Fluency Test (VFT),Benton Judgment of Line Orientation Test (BJLOT),Digit Symbol-Coding subtest (DSCT),Paced Auditory Serial Addition Test (PASAT),and Wisconsin Card Sorting Test (WCST)were used to evaluate attention,information processing speed,memory,verbal fluency,and executive function.Results A total of 98 patients with LI and 20 normal controls were enrolled.Of the 98 patients with LI,31 had cognitive impairment and 67 were cognitively normal.The proportions of hypertension,diabetes,multiple LI,and severe white matter lesions,as well as the level of low-density lipoprotein cholesterol in the CI group were significantly higher than those in the normal controls (all P ＜ 0.05).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 5.391,95％ confidence interval [CI] 1.515-19.182; P=0.009),diabetes (OR 4.679,95％ CI 1.428-15.339; P=0.011),multiple LI (OR 6.458,95％ CI 1.797-23.213; P =0.004),and severe white matter lesions (OR 6.724,95％ CI 1.440-27.331; P=0.014) were the independent risk factors for the occurrence of cognitive impairment in patients with LI.Among the 98 patients with LI,56 were pure LI (no white matter lesions),but 5 of them were excluded because they could not complete neuropsychological tests.Finally,51 patients were enrolled and were compared and analyzed with the normal control group.Compared to the normal control group,the number of correct answers of WCST-64 in the corona radiata/semi-oval center group (n =15) reduced significantly,and the number of sustained errors increased significantly (P ＜ 0.05).The scores of verbal fluency,DSCT,PASAT,as well as the number of correct answers and the number of completed categories of WCST-64 decreased significantly in the basal ganglia group (n =20) (all P ＜0.05).The scores of short-term memory and delayed recall,as well as the scores of DSCT and PASAT decreased significantly in the thalamus group (n =16) (all P ＜0.05).Conelusiuns Hypertension,diabetes,multiple LI,and severe white matter lesions are the independent risk factors for occurring cognitive impairment in patients with LI.The corona radiata/semi-oval center infarction is easy to complicate with impaired executive function.Basal ganglia infarction is associated with verbal fluency,information processing speed,attention,and executive function impairment.The cognitive impairment of thalamic infarction is mainly manifested in the memory,attention,and information processing speed.

0 1). (4)75 2% of all the patients in DM group showed one or more abnormalities in MCV or F wave parameters, and electrophysiological abnormalitis correlated with, or precede to clinical findings in 175 of 190 patients (92 1%). Conclusion MCV and F wave parameters are sensitive measures for detection of DPN. Among these parameters, FwPL, F MIPL from all the four nerves are the most sensitive. To improve diagnostic accuracy, all the MCV and F wave parameters recorded should be considered.

OBJECTIVE To compare the air sterilization effect of in operating room used by different air sterilization methods.METHODS Four types sterilization methods were used to operating room air.Then sampling monitoring and evaluation were done.RESULTS The qualification rate of air sterilization were 79.17%,62.79%,79.63%,97.22% in peroxyacetic acid fumigating,simple ultraviolet radiation,peroxyacetic acid fumigating combined with simple ultraviolet radiation,ultraviolet light circulation wind air sterilization machine,respectively.The sterilization effect of ultraviolet light circulation wind was better than the others.CONCLUSIONS Ultraviolet light circulation wind air sterilization machine can be used to air sterilization in non-laminar air flow purify operating room.

Objective To summarize the experience on diagnosis and treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 91 PHPT patients treated in Beijing Jishuitan Hospital from November 1992 to December 2008 were analyzed retrospectively.Results Among 91 PHPT cases,88 were diagnosed as parathyroid adenoma(96.7%),3 were diagnosed as parathyroid carcinoma (3.3%).Serum calcium and PTH levels increased in all cases.Main clinical manifestations were osteodynia and kidney stones.The accuracy rate of preoperative B-ultrasound.CT and ECT~(99m)Tc-MIBI on location was 83.5%(76/91),60.9%(14/23)and 98.6%(69/70)respectively.Parathyroidectomy was performed in all but one cases,in which parathyroid carcinoma was managed by ipsilateral hemithyroidectomy and modified neck dissection.The cure rate of primary operation was 97.8%(89/91).Ninety cases were followed-up from 8 months to 14 years postoperatively,87 cases with parathyroid adenoma achieved complete remission,2 with parathyroid carcinoma suffered from tumor recurrence and 1 died.Conclusion Patients with chronic bone diseases,repeatedly recurrent nephrolithiasis,peptic ulcer disease should be a suspect of PHPT.The routine examinations of serum calcium and phosphorus are to be conducted.UItrasonography and ECT~(99m)Tc-MIBI should be considered as the methods of first choice for preoperative localization.

Objective To compare clinical effect of unipolar versus bipolar radiofrequency ablation in treating atrial fibrillation (AF) in elderly patients and discuss the correlated risk factors.Methods From October 2008 to December 2013,a total of 50 elderly patients with organic heart disease and AF underwent radiofrequency ablation surgery.All patients were divided into 2 groups of unipolar (group A,n=20) and bipolar (group B,n=30 patients) radiofrequency ablations.The variations of electrocardiogram (ECG) and ultrasonic cardiogram (UCG) in patients were collected and the complications and the NYHA class of the patients were recorded at 3,6 and 12 months after surgery.The total 43 elderly patients were divided into sinus group and non-sinus group according to their ECG at 12 months after surgery.Results The recovery rates of sinus rhythm at 3,6 and 12 months after surgery were 73.7％(14/19),66.7％(12/18) and 61.1％ (11/18)respectively in group A and 82.8％(24/29),85.2％(23/27)and 88.0％(22/25) respectively in group B.Two groups of the recovery rate of sinus rhythm had a statistically significant difference between the two groups (P＜0.05) at 12 months after surgery.The complication rate in group A was higher than in group B [55.0％ (11 cases) vs.26.7％ (8 cases),P＜0.05].Preoperative history of AF and left atrial diameter were the influencing factors for the sinus rhythm recovery rates (P＜0.05).Conclusions Bipolar radiofrequency ablation for AF is safe and has less complications and high success rate of restoring sinus rhythm.The patients with long preoperative history of AF and left atrium distension have a low success rate of restoring sinus rhythm with a high recurrence rate.

ObjectiveTo investigate the relevant factors influencing the incidence and mortality of post cardiac arrest syndrome (PCAS), and to provide the basis of improvement of resuscitation rate.Methods A single center retrospective study of cardiopulmonary resuscitation (CPR) according to Utstein model was conducted. A clinical case report form was designed to collect clinical data. The clinical data of patients whose spontaneous circulation was restored (ROSC)> 24 hours in intensive care unit (ICU) of the First Hospital of Jilin University from January 2008 to June 2014 were collected and analyzed. The relevant risk factors of the incidence and mortality rate of PCAS were screened and analyzed by multivariate logistic regression analysis.Results① Successful CPR was achieved in 93 patients, of whom 83 patients were shown to have systemic inflammatory response syndrome (SIRS), and 75 patients suffered from PCAS (80.65%). Among them 49 died, and 18 patients who did not suffer from PCAS survived.② The age, gender, history of previous chronic disease, site of occurrence of cardiac arrest, type of rhythm when cardiac arrest occurred, and dosage of adrenaline showed no significant influence on the incidence of PCAS. The incidence of PCAS was elevated when defibrillation was done more than 3 times (χ2= 10.806,P= 0.001), SIRS occurred after ROSC (χ2= 46.687,P< 0.001), interval between collapse and first defibrillation over 5 minutes (χ2 = 6.429,P = 0.011), interval between collapse and CPR longer than 5 minutes (χ2 = 4.638,P = 0.031), interval between collapse and administration of first resuscitation medication> 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P< 0.001). Bivariate correlation showed that interval between collapse and CPR, interval between collapse and administration of first resuscitation medications, and ROSC time were all correlated (r1 = 0.677,r2 = 0.481,r3 = 0.617, allP< 0.001).③ There were no significant relations between the prognosis of PCAS patients and times of defibrillation, the amount of adrenaline used, and interval between collapse and first defibrillation. The mortality rate of PCAS was relatively elevated when interval between collapse and CRP was longer than 5 minutes (χ2 = 10.792,P = 0.001), interval between collapse and administration of first resuscitation medications was longer than 5 minutes (χ2 = 13.841,P< 0.001), ROSC time> 10 minutes (χ2 = 36.451,P< 0.001), the number of dysfunction organ≥ 4 (χ2 = 28.287,P< 0.001), arterial blood lactate levels> 2 mmol/L (χ2 = 28.926, P< 0.001), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score> 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

Objective To investigate the clinical efficacy of Nazi method of midnight-midday ebb flow plus warm needling moxibustion in treating transient ischemic attack (TIA). Methods Sixty patients with transient ischemic attack were randomly allocated to treatment and control groups, 30 cases each. The control group received routine medication and the treatment group, Nazi method of midnight-midday ebb flow plus warm needling moxibustion in addition. The main clinical symptoms were observed by TCD monitoring of microembolic signals in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results After treatment, the positive rate of microembolus monitoring was 3.3%in the treatment group and 20.0%in the control group;there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the traditional Chinese medical syndrome score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the traditional Chinese medical syndrome score between the treatment and control groups (P<0.05). The total efficacy rate was 96.7% in the treatment group and 80.0% in the control group;there was a statistically significant difference between the two groups (P<0.05). At six months after treatment, the rate of disappearance of TIA, the rate of recurrence of TIA and the rate of occurrence of cerebral infarction were 90.0%, 6.7%and 3.3%, respectively, in the treatment group and 60.0%, 20.0%and 20.0%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusions Nazi method of midnight-midday ebb flow plus warm needling moxibustion can decrease the positive rate of microemboli and shorten transient ischemic attack to prevent cerebral infarction in patients with transient ischemic attack.