A possible ?-Galactosidase gene(pwtsA) was discovered from soil metagenomic DNA of Taishan Mountain.PwtsA gene was inserted into the expression vector pET30a and transferred into E.coli BL21(DE3).Recombinant protein PWTSA was expressed as a soluble form at high level through IPTG induction,with a molecular mass of 57 kD analyzed by SDS-PAGE.PWTSA can produce o-nitrophenol from o-nitrophenol-?-D-galactopyranoside(ONPG),and its specific activity was determined as 13.6 U/mg.The enzymatic studies demonstrated that the recombinant protein PWTSA was a thermostable ?-Galactosidase,its optimum temperature and pH were 85?C～95?C and 6.5 respectively.In standard assays,the Km for ONPG was 0.83 mmol/L.

Menarche and menopause are two important physiological periods that denote the beginning and the end of normal reproductive life.Studies have suggested that ages at menarche and menopause are important biological markers,and are also predictors of several chronic diseases.We published one manuscript in J Clin Endocrinol Metab titled Associations between age at menarche and menopause with cardiovascular disease,diabetes,and osteoporosis in Chinese women,which suggested that ages at menarche and menopause are not associated with diabetes,delayed menarche and menopause are associated with decreased risk of cardiovascular disease risk and early menopause with high risk of osteoporosis.

[Summary] Kisspeptin is vital for the neuroendocrine regulation of GnRH secretion. Kisspeptin neurons are now recognized as a central pathway responsible for conveying key homeostatic information to GnRH neurons. A number of metabolic modulators have been proposed as regulators of kisspeptin including leptin, adiponectin, insulin, ghrelin, POMC, and neuropeptide Y. Recent data indicate that kisspeptin may have a direct role in regulating energy balance by its regulation of food intake and glucose homeostasis. Thus, kisspeptin may serve as a new connection between reproductive function and energy metabolism.

Screening Tool of Older Persons' Prescriptions (STOPP criteria) version 1 was first launched by geriatricians from Cork University Hospital (Ireland) in 2008.The criteria played a positive role in identifying potentially inappropriate prescriptions.It could also enhance the supervision of drug abuse and reduce adverse drug reactions in the elderly.Recently,a new version of STOPP was published,with updated,more practical and evidence-based guidance.Here we translated and edited the new version of STOPP,in order to provide a valuable reference for physicians and pharmacists and promote rational drug use in elderly patients.

Objective To study a new endoscopic technique, double-balloon enteroscopy on its efficiency and indication of examining small intestinal diseases. Methods Thirteen patients suspected to suffer from small intestinal disease received double-balloon enteroscopy. By pumping the two balloons to grip the small intestinal walls, the enteroscope can be inserted further without forming redundant loops in the small intestine. Eight patients undergoing these procedures received a combination of sedative drugs and anisodam-ine intravenously. Results Nineteen procedures were performed in 13 patients, among them 8 patients were performed through anus and 11 patients through mouth. The enteroscope reached the 3th - 6th group small intestine through mouth or anus in average 80 minutes for each procedure. Eight positive lesions were detected or diagnosed by the enteroscopy and biopsy. The nausea, mild temporary abdominal pain and liquids effusing from the overtube occurred during examination through the mouth. There were no severe complications such as hemorrhage, perforation occurred. Conclusion The double-balloon enteroscopy is a new safe and controllable endoscopic procedure for those small intestinal disease patients without severe organ dysfunction and intestinal adhesion, and having the adventages of completing the procedure within 2-3 hours, allowing direct visualization of the entire small intestine, taking biopsy specimens to get pathological diagnosis, and is superior to barium enteroclysis.

Objective To investigate the morphological features,biological behavior ,and diagnosis and treatment of gastric hepatoid adenocarcinoma(GHA).MethodsTwenty GHA cases were evaluated. Of the 20 patients,14 underwent radical gastrectomy, 3 total gastrectomy,3 total gastrectomy and wedge excision of the liver metastasis.ResultsHistologically,hyaline globules and venous invasion were common features of GHA.Tumor cells were immunohistochemically positive for alpha fetoprotein(AFP), alpha antitrypsin(AAT), and alpha antichymotrypsin(ACT). Ultrastructurally,tumor cells were arranged toward the lumens with microvilli on the luminal surfaces.There were junctional complexes between the lateral plasma membranes of adjacent tumor cells.Patients were followed up for 1～5 years with 12 deaths, 11 died of metastasis and one died of intraabdominal tumor seeding. The 1, 3 year survival rate was 44%(8/18), and 17%(3/18), respectively. Conclusions GHA deriving from gastric mucosa is characterized both by the histologic structures of hepatoid differentiation and adenocarcinoma.The prognosis is usually poor due to frequent liver metastasis.

Objective To explore the anatomy and the adjacent of the medial malleolus,the operative approach of soluting the tibial nerve in endoscopy and the significance of making use of it in operation. Methods The five cadaver feet were dissected,the tibial nerve and the fiber diaphragm in the middle of me- dial and lateral plantar tunnels in the ten cadaver feet were soluted in endoscopic.Results The operative approach was designed on the basis of the anatomy data (the three-portal approach:The perpendicular bisetor which was the medial malleolus pointed to the medial margin of tendon calcaneus insertion was 4.5cm;The midpoint of the medial malleolus pointed to the calcaneus tubercle;The midpoint of the calcaneus tubercle to the medial margin of the first metatarsophalangeal joint).It was succeed that soluted the tibial nerve and the fiber diaphragm in the middle of medial and lateral plantar tunnels.Conclusion The operative approach on the basis of the anatomy data is design,and testfy the feasibility of exploring curved tunnel in endoscopic.

Adult ; Ear Ossicles ; injuries ; Humans ; Joint Dislocations ; Male ; Wounds and Injuries

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

Objective To observe the effect of remifentanil combined with propofol to induce and sustain controlled hypotension in children during endoscopic sinus surgery(ESS). Methods Forty ASA Ⅰ children undergoing adenoidectomy in ESS were divided into control group and controlled hypotension group by random digits table with 20 cases in each group. No controlled hypotension in control group. Anesthesia was induced with propofol,remifentanil and atracurium, and maintained with continuous infusion of propofol 2 min until the target mean arterial pressure (MAP)(55 - 60 mm Hg, 1 mm Hg = 0.133 kPa) was reached,and MAP was maintained at this level during operation in controlled hypotension group. During 15 min before surgical procedure pharynx nasalis blood flow was measured and recorded with laser Dopper flowmetry continuously. The quality of the surgical field in term of blood loss and dryness was established at 15 min after operation starting. Results Controlled hypotension was induced within (2.5 ± 0.3 ) min, the infusion rate ofMAP and heart rate at 15 min after controlled hypotension and 15 min after operation starting were significantly lower than those at controlled hypotension instantly in controlled hypotension group and control group (P ＜ 0.05 ). The pharynx nasalis blood flow decreased at 15 min after controlled hypotension from baseline [(68.3 ± 8.3 )% vs. (99.8 ± 7.9 )%] (P ＜ 0.05 ). The operation time and the quality of the surgical field in term of blood loss and dryness in controlled hypotension group were better than those in control group [(21 ± 4) min vs. (32 ± 6) min and ( 1.8 ± 0.1 ) scores vs. (3.5 ± 0.5) scores] (P ＜ 0.05 ). The awakeextubate time was within 10 min in two groups, and there were no anesthesia related complications.Conclusion Remifentanil combined with propefol can induce and sustain controlled hypotension,reduce pharynx nasal is blood flow and provide good surgical conditions in children for ESS.