There are difficulties in the treatment of Alzheimer's disease (AD) in medical community. Since the surgery of cervical deep lymphatic vessel/lymphatic node-vein anastomosis (LVA/LnVA) has made clinical improvement in patients with AD, it offers a surgical option to treat AD. Especially improvements in cognitive impairment. However the mechanism in treatment of AD is not yet made clear. This article preliminarily explores the mechanism in improvement of some symptoms in patients with AD through cervical deep LVA/LnVA on the basis of morphological characteristics of the cribriform plate-cervical lymphatic pathway.

There are difficulties in the treatment of Alzheimer's disease (AD) in medical community. Since the surgery of cervical deep lymphatic vessel/lymphatic node-vein anastomosis (LVA/LnVA) has made clinical improvement in patients with AD, it offers a surgical option to treat AD. Especially improvements in cognitive impairment. However the mechanism in treatment of AD is not yet made clear. This article preliminarily explores the mechanism in improvement of some symptoms in patients with AD through cervical deep LVA/LnVA on the basis of morphological characteristics of the cribriform plate-cervical lymphatic pathway.

Objective:To investigate the effects of subanesthetic concentration of sevoflurane on the plasticity of dendritic spines in the prefrontal cortex neurons of juvenile rats.Methods:Thirty-six clean-grade male Sprague-Dawley rats, aged 24 days, weighing 50-60 g, were divided into control group (group C) and sevoflurane anesthesia group (group S) using a random number table method, with 18 rats in each group.Group S inhaled 1.2% sevoflurane and 50% oxygen (flow rate 1 L/min) for 3 h, while group C inhaled 50% oxygen (flow rate 1 L/min) for 3 h. Open-field test and Morris water maze test were performed at 3 days after anesthesia.Animals were sacrificed, and brain samples were then taken for determination of the number of apoptotic neurons in layer Ⅱ-Ⅲ of the prefrontal cortex, density of dendritic spines, and expression of postsynaptic density protein 95 and gephyrin by TUNEL staining, Golgi staining or Western blot.Results:Compared with group C, no significant change was found in total distance or time of staying at the central region in the open-field test or the average swimming velocity, escape latency or the number of apoptotic neurons in the Morris water maze test ( P>0.05), and the density of dendritic spines was significantly increased, and the expression of postsynaptic density protein 95 and gephyrin was up-regulated in group S ( P<0.05). Conclusion:Subanesthetic concentration of sevoflurane can enhance the plasticity of dendritic spines in the prefrontal cortex neurons of juvenile rats.

Objective:To investigate clinicobiological characteristics and treatment principles of diffuse calcified variant of papillary thyroid carcinoma.Methods:Twenty one patients with diffuse calcified thyroid glands admitted to the Department of Head and Neck Surgery of Tianjin Medical University Cancer Hospital from Jan 2011 to Dec 2015 were enrolled in the study group. One humdred and five patients with papillary thyroid carcinoma (PTC) confirmed by postoperative pathology (non-diffuse calcified thyroid nodules) during the corresponding period were included into the control group. The clinicobiological characteristics of different cases were analyzed by collecting the following information: gender, age, ultrasonic features, thyroid function, pathological type, lymph node metastasis, BRAF V600E mutation and follow-up.Results:No significant difference was found between the study group and the control group in gender, age or the number of patients complicated with Hashimoto′s thyroiditis; while there were significant differences in bilateral involvement of central lymph node metastasis, lateral neck lymph node metastasis and positive rate of BRAF V600E mutant protein expression in postoperative specimens ( P<0.01). As found by postoperative follow-up, there was no significant difference in the rate of neck lymph node recurrence between the two groups. Conclusions:Diffuse calcified variant of papillary thyroid carcinoma is a new subtype of PTC with unique clinicobiological characteristics, and more active clinical treatment programme should be adopted for the diffuse calcified thyroid carcinoma.

OBJECTIVETo determine whether quercetin inhibits oxidized low-density lipoprotein (Ox-LDL)-induced osteogenic differentiation and calcification of vascular smooth muscle cells (VSMCs) and understand the underlying mechanism.

METHODSThe calcification of human VSMCs following Ox-LDL treatment was assessed using alizarin red staining and by detecting ALP activity. The mRNA expressions of the bone-related genes including Msx2, BMP2 and Osterix, and the contractile proteins including SMA and SM22a were analyzed using qPCR. The effects of quercetin were investigated on OxLDL-induced VSMC calcification and changes in ALP activity, expressions of Msx2, BMP2, Osterix, SMA and SM22a, ROS levels and SOD activity. The effect of Toll like receptor 4 (TLR4) silencing mediated by siRNA transfection on cell calcification, ALP activity, gene expressions and ROS levels were investigated.

RESULTSOx-LDL treatment promoted VSMC calcification and up-regulated TLR4 expression. Quercetin treatment significantly attenuated Ox-LDL-induced VSMC calcification, reduced ALP activity, down-regulated the expression levels of Msx2, BMP2 and Osterix, and up-regulated the expressions of vascular smooth muscle contractile proteins SMA and SM22a. In addition, Quercetin treatment markedly increased SOD activity, reduced ROS levels and TLR4 expression in VSMCs. Silencing TLR4 expression using TLR4 siRNA also significantly decreased calcification of the VSMCs.

CONCLUSIONSQuercetin inhibits Ox-LDL-induced VSMC calcification in VSMCs possibly by targeting the ROS/TLR4 signaling pathway.

Objective To explore the clinico-pathological characteristics and treatment of thyroid carcinoma in patients under 14 years old.Method The clinical and pathological data of 61 children 14 years old or younger treated for differentiated thyroid carcinoma (DTC) from Jan 2005 to Dec 2014 were retrospectively analyzed.Results There were 26 males and 35 females with the sex ratio of 1 ∶ 1.35.All the 61 patients underwent surgery including lobectomy for ipsilateral foci in 11 cases and total or near total thyroidectomy for bilateral or multi-foci in 50 cases.5 patients had not lymph node metastasis.56 patients had central compartment metastasis and 47 patients had lateral cervical lymph node metastasis.9 patients had distant metastasis and the affected organ was lung.Pathology for all the 61 patients was thyroid papillary carcinoma,35 patients were of highly invasive subtype.The median follow-up time was 3 years and 6 months (30-116 months) with a total survival rate of 100％ while 4 patients suffered from recurrence.Conclusions For below 14 years old DTC patients,the prognosis is better than in adults.The rate of bilateral lesions or multiple foci in ipsilateral lobe and central compartment lymph node or lateral neck lymph node metastasis was higher than in adults.Furthermore,highly invasively pathological subtype is more common in younger patients.

OBJECTIVETo study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery.

METHODSSixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2×10(5) U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1×10(5) U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP.

RESULTSIn both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5.

CONCLUSIONUlinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.

Aged ; Aged, 80 and over ; Cardiotonic Agents ; pharmacology ; Creatine Kinase, MB Form ; metabolism ; Digestive System Surgical Procedures ; Female ; Glycoproteins ; pharmacology ; Humans ; Intraoperative Period ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; metabolism ; Stroke Volume

Objective To research the effect ofparecoxib on hippocampal nerve cell apoptosis and expressions of B cell lymphoma/lewkmia-2 (Bcl-2),Bcl-2 associated X protein (Bax) and caspase-3 of epilepsy rats.Methods Thirty SD male rats were randomly divided into three groups (n=10):control group,parecoxib treatment group and epilepsy group.The rats in the parecoxib treatment group and epilepsy group were injected with 4 mg/kg of parecoxib and same volume of saline,respectively,and 3 d after that,they both were injected intraperitoneally with 3 mmol/kg of lithium chloride,and then,20 h after that,they were injected intraperitoneally with 30 mg/kg ofhydrochloride pilocarpine; while rats in the control group were only injected intraperitoneally with the same volume of saline.The behavior changes of rats in the three groups were observed.After 7 d,terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) was used to evaluate the neuronal apoptosis and Western blotting was employed to evaluate the expressions of Bcl-2,Bax and caspase-3 in the hippocarnpus of all groups.Results All epilepsy rats were very irritable; spontaneous seizures (SRS) times of precoxib treatment group were significantly reduced as compared with those of epilepsy group (P＜0.05).As compared with those in the control group,the Bcl-2,Bax and caspase-3 expressions and Bcl-2/Bax ratio in the epilepsy group were increased with statistically significant differences (P＜0.05); As compared with those in the epilepsy group,the Bcl-2,Bax and caspase-3 expressions and Bcl-2/Bax ratio in the precoxib treatment group were decreased with statistically significant differences (P＜0.05).As compared with that in the control group,the number of TUNEL positive cells in hippocampus of rats in the precoxib treatment group and epilepsy group were significantly increased (P＜0.05); as compared with that in the epilepsy group,the number of TUNEL positive cells in the hippocampus of precoxib treatment group was statistically reduced (P＜0.05).Conclusion Parecoxib can reduce the apoptosis of hippocampus neurons through inhibiting the protein expressions of Bax and caspase-3 to affect the Bcl-2 protein expression,whose mechanism may be related to the pathways of Bcl-2/Bax and Caspase-3 proteins.

Objective To study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery. Methods Sixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2 × 105 U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1 × 105 U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP. Results In both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5. Conclusion Ulinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.

Objective To study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing major gastrointestinal surgery. Methods Sixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group received 2 × 105 U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent continuous infusion at the rate of 1 × 105 U until the completion of surgery, and those in the control group received the same amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction (LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP. Results In both groups, MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5. Conclusion Ulinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal surgery.