Autophagy is a metabolic pathway that widely presents in eukaryotic cells through the lysosomal mechanism to degrade its components. Autophagy regulates cell death not only by activating classic autophagosomal-lysosomal pathway, but also by influencing the occurrence and development of apoptosis and necrosis. Currently, the effect of autophagy in neuronal injury after acute cerebral ischemia/hypoxia and its specific mechanisms remain unclear. Studies have demonstrated that the autophagy after ischemia/hypoxia has a neuroprotective effect, such as maintaining neuronal homeostasis and reducing neuronal death; but other studies have also suggested that autophagy may aggravate neuronal injury after ischemia/hypoxia by activating multiple pathways, and even induce neuronal death.

Objective To investigate the effects of cataract surgery with transparent corneal incision in different directions,and discuss the application of dual channel visual quality analysis system in the evaluation of visual quality before and after cataract surgery.Methods Sixty-four patients (64 eyes) with cataract phacoemulsification combined with intraocuiar lens (IOL) implantation were enrolled in our hospital from January to May in 2016,and randomly divided into 2 groups:Group A with corneal incision in the temporal side of the eyes,group B with upper corneal incision.All the cases were examined with standard logarithmic optical acuity and dual-channel optical quality analysis system.The visual acuity,MTF cutoff,Strehl ratio (SR),objective scattering index (OSI) and contrast ratio were compared between the two groups.The OQAS values were 100％,20％ and 9％.Results (1) The visual acuity and corrected visual acuity of all patients increased gradually from postoperative 1 day to 1 week (P ＜0.05),and the visual acuity gradually stabilized after 1 week.The uncorrected visual acuity and corrected visual acuity at postoperative 1 day and 1 week in group A were significantly higher than those in group B at the same time point(P ＜ 0.05).There was no significant difference in uncorrected visual acuity and corrected visual acuity between the two groups at postoperative 1 month and 3 months (P ＞ 0.05).(2) At postoperative 1 day and 1 week,the OSI values of two groups were higher than those before operation,and all the time points were statistically significant (all P ＜ 0.05).The OSI values of group A at postoperative 1 day(2.81 ±0.89) and 1 week(1.98 ±0.73) were significantly lower than those of group B at 1 day(3.46 ± 1.17) and 1 week(2.61 ± 1.20) (all P ＜ 0.05).There was no significant difference in OSI between postoperative 1 month and 3 months (all P ＞ 0.05).The OV9％ values of the two groups were increased at postoperative 1 day,1 week,1 month and 3 months,and all the time points were statistically significant(all P＜0.05).The value of OV9％ in group A at postoperative 1 day(0.29 ±0.09),1 week(0.33 ±0.12),1 month (0.37 ± 0.14) and 3 months (0.42 ± 0.17) were significantly higher than those in group B at 1 day (0.24 ± 0.10),1 week (0.27 ± 0.09),1 month (0.31 ± 0.09) and 3 months (0.34 ± 0.14),which was statistically significant (all P ＜ 0.05).The MTF,SR,OV100％ and OV20％ values of all the patients were not statistically significant (all P ＞ 0.05).Conclusion In the operation of cataract with the temporal and transparent corneal incision,the postoperative intraocular scattering is small,early visual recovery is fast and the visual quality is high.The long-term effect needs further study.Dual channel visual quality analysis system can further quantify the visual quality parameters,has certain advantage in visual quality assessment.

[Objective]To discuss the difference of mechanical stability in using different fixation methods in treating radius and ulna fracture,in order to provide a theoretical basis for clinical applications.[Method]In the experiment,15 pieces of fresh radius and ulna were used to produce middle-part transverse fracture models(A3.2)which were fixed by three different methods(double plate fixation group,double-intramedullary nail fixation group,ulnar intramedullary nailing + radial plate group).Through biomechanical tests,axial stiffness,bending stiffness,torsional stiffness and the equivalent stiffness were compared.[Result]There were no difference between double-plate group and ulnar intramedullary nailing + radial plate group,the stability in these two groups were higher than that in double-intramedullary nail fixation group.[Conclusion]Ulnar intramedullary nailing + radial plate has a good biomechanical property,it can provide firm fixation and with less trauma.So it is a good fixation.

This study was aimed to analyze the clinical features of paroxysmal kinesigenic dyskinesia (PKD) and extend the understanding of this disease. From August, 2008 to October, 2010, 9 patients were diagnosed with PKD in the Department of Neurology of the First Affiliated Hospital of Zhejiang University, China. The data involving clinical demographic characteristics, somatosensory evoked potentials, results of electromyography, video electroencephalography (EEG), brain magnetic resonance imaging (MRI) and computerized tomography (CT) were collected. All PKD patients exhibited unilateral or bilateral recurrent episodic dyskinetic attacks triggered by sudden voluntary movements. The duration of the attacks ranged from several seconds to one minute. The attack frequency ranged from approximately once in several months to more than 10 times in a day. Patients suffered from no conscious disorders during the attack, and no neurological signs were found during the period between attacks. No abnormal somatosensory evoked potentials were found. Routine EEG, video EEG monitoring or brain imaging showed normal findings. Classical treatment for anti-epilepsy, including carbamazepine and topiramate, was administered to the patients and proved to be effective. It was concluded that PKD is characteristically triggered by sudden voluntary movement; no abnormal electroneurophysiological findings are observed in PKD, and antiepileptic drugs are effective in treating the disorder.

Objective:To optimize the clarification process of total flavonoids extract from Geum aleppicum with ZTC1+1-Ⅱtype clarifying agent. Methods:With the solid removal rate, retention rate of the total flavonoids and clearance rate of protein as the indi-ces, single factor tests were adopted to study the effects of extract concentration, amount of clarifying agent, reaction temperature and reaction time on the clarification results. Results:The optimal clarification process was as follows:the extract concentration was 0. 5 g ·ml-1 , the amount of clarifying agent was 4% component B and 2% component A, the reaction temperature was at 60℃, and the soaking time was 60 min. The retention rate of total flavonoids was 91. 32%, the clearance rate of protein was 35. 82%, and the solid removal rate was 8. 1%. Conclusion:ZTC1+1-Ⅱ type clarifying agent has good effect on the clarification of total flavonoids extract from Geum aleppicum with promising feasibility and stability.

Objective:To analyze and optimize the extraction technology of Geum aleppicum by Box-Behnken design and response surface methodology. Methods:With the content of total flavonoids as the index, the effects of three factors including the solvent-solid ratio, ethanol concentration and extraction time on the content of total flavonoids were studied by single factor experiment, and the ex-traction technology was optimized by Box-Behnken design and response surface methodology. Results: The optimal extraction condi-tions of Geum aleppicum were as follows:the solvent-solid ratio was 4. 2, the ethanol concentration was 50% and the extraction time was 80 min. Under the above conditions, the average yield was 12. 590 0 mg·g-1 . Conclusion: Optimizing extraction technology of the total flavonoids in Geum aleppicum by Box-Behnken design and response surface methodology is reasonable, and the mathematical mod-el is consistent with the experimental data, which has good predictability.

Objective: To establish the quality standards for Jifukang Oral Solution. Methods: Fructus Corni, Fructus Ligustri Lucidi, Herba Epimedii were identified by TLC, and the content of astragalin A was determined by TLC scanning. Results: The Fructus Corni, Fructus ligustri licidi, Herba Epimedii could be identified by TLC. Astragalin A showed a good linear relationship at a range of 1.065～5.325?g,r=0.9991. The average recovery was 95.1%, and RSD was 2.0%. Conclusion: The methods are accurate and can be used for the quality control of Jifukang Oral Solution.

Objective To establish an indicator system for performance assessment of women and children health care institutions,and provide basis for performance management of such institutions.Methods In this study,literature searching,expert discussion,Delphi method,coefficient of variation method,correlation analysis,principal components analysis,factor analysis and cluster analysis were used to establish the indicator system.In addition,expert scoring and CRITIC methods were called into play to calculate the weight coefficient of each index,and to test the validity and reliability of such an indicator system.Results Thanks to the framework of this indicator system,we set up six class 1 indicators,including heahhcare quality,healthcare efficiency,quality and efficiency of public health service,social efficiency,economic benefit,and development potential.Conclusions Scientific studies can help us build a scientific and practical general performance assessment indicator system applicable to women and children care hospitals at all levels.

Objective To investigate the prevalence and risk factors of adult chronic kidney disease (CKD) in the Xishuangbanna district of Yunnan province with a big population of minorities. Methods Residents aged 20 years and older in the area of Xishuangbannan were randomly selected by using a stratified, multi-stage sampling method. All the residents were tested for morning spot urine of albumin tO creatinine ratio (ACR) (abnormal≥ 30 mg/g); morning spot urine dipstick of hematufia (abnormal 1+ or greater) was confirmed by urine microscopy (abnormal ＞ 3 red blood cells/HP); and modified simplified MDRD equation for Chinese adult was applied to characteristics, health characteristics (e.g. hyperglycemia, hyperlipidemia and hypertension) and indicators of kidney damage were also examined. Results Eligible data of 5566 subjects were included in the study. The prevalence of albuminuria was 8.06%, hematuria was 4.01% and reduced eGFR was 2.89%. Apart from the repetition among microalbuminuria, hematuria and reduced eGFR, approximately 12.53% subjects had at least one indicator of kidney damage. The prevalence of CKD in stratified subgroups with age, gender, nations and CKD risk factors was coincidence with the Logistic regression results. Age increase, hypertension, byperlipidemia and fasting plasma glucose increase were independently associated with albuminuria; age increase, hypertension were independently associated with reduced renal function; age increase was independently associated with hematouria. Conclusions The prevalence of adult chronic kidney disease is 12.53% in the Xishuangbanna district of Yunnan province. Independent risk factors associated with kidney damage are age, hyperglycemia, hyperlipidemia and hypertension.