Objectives:To explore the antiepileptic cellular mechanism of chronic vagus nerve stimulation (VNS).　 Methods: The rats were kindled by intraperitoneal injection of pentylenetetrazol (PTZ) (45mg/kg weight), and chronic VNS was applied to the kindled-rats. The effects of glutamate (Glu) on the intracellular free calcium (［Ca2+］i) of cortical and hippocampal neurons of normal, PTZ-kindled and VNS-treated rats were examined with fluorescence spectrophotometry respectively. The behavioral changes of all rats were observed. 　Results: The neuronal ［Ca2+］i of the VNS-treated rats were significantly lower than that of the PTZ-kindled rats. VNS could significantly inhibit the augmentation of neuronal ［Ca2+］i induced by Glu. Behavioral changes demonstrated that VNS could significantly reduce the severity and prolong the latency of seizures of PTZ-kindled rats. 　Conclusions: VNS could significantly inhibit the kindling effect of PTZ and reduce the excitability of neurons induced by Glu. VNS might exerted the antiepileptic effects by influencing the activation of neural receptors.

Objective:To evaluate the shaping effects of multi-taper ProTaper combined with nickel-titanium(Ni-Ti) K file in simulated S-shaped canals. Methods:Thirty simulated S-shaped resinous canals were randomly divided into three groups and prepared with hand ProTaper, hand Ni-Ti K file, hand ProTaper combined with Ni-Ti K file respectively. The shaping effects were assessed by the amount of material removed from the inner and outer wall of canal as well as the width of canal after instrumentation. Results: The shaping files of ProTaper removed the least material in amount of materials from the same apical dimension. The finishing files of ProTaper removed the most amount of material at the inner side of curvature and outer side of apex. ProTaper combined with Ni-Ti K file removed the least material at the above parts and the widths of canals prepared were gradually decreased from the orifice to the apex. Conclusion:ProTaper combined with Ni-Ti K file exhibited good shaping effects in simulated S-shaped canals.

Objective To study the iodine nutritional status and the thyroid function of pregnant women during different periods,and provide scientific basis for iodine supplementation.Methods Totally 728 pregnant women who visited the obstetric outpatient of Nanjing Drum Tower Hospital for routine prenatal care from December 2014 to August 2016 were recruited in this study,and at the same time 182 non-pregnant women were recruited as control group.The thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured by Roche 601.The urinary iodine level was measured by SR-I-100 kit.Results The median urinary iodine of 728 pregnant women was 168.24 g/L,and the median urinary iodine of those women in the T1,T2 and T3 period were 186.31,162.65 and 148.76 g/L,respectively.The TSH at T1 period was lower than T2 and T3 period (t=3.429,3.135,P＜0.05).The FT4 at T1 period was higher than T2 and T3 period (t=5.251,5.965,P＜ 0.05).The prevalence rate of thyroid disease in normal urinary iodine group was lower than that in low urinary iodine group and high urinary iodine group (x2 =4.139,4.131,P＜0.05).Conclusion There was no iodine deficiency among those pregnant women groups,but only 34.75 ％ individuals reached the appropriate iodine nutritional level,and the ratio of iodine insufficient increased with the extension of pregnancy.The whole prevalence rate of thyroid disease in abnormal urinary iodine pregnant women was obviously higher than that in normal.It is necessary to improve the pregnant women's knowledge of iodine nutrition,moreover it is suggested that urinary iodine monitoring and thyroid function should be conducted in pregnant women.

Objective To explore the molecular mechanisms of carbapenem-resistant Klebsiella pneumoniae.Methods Carba NP confirmatory test were used to detect carbapenemases.Carbapenemase genes,ESBL genes and plasmid-mediated AmpC genes were amplified by polymerase chain reaction (PCR).The genetic correlation analysis was carried out by using multiple sequence type (MLST).Results 42 out of the 50 carbapenem-resistant Klebsiella pneumoniae strains were KPC-2-positive strains,1 strain was positive for NDM-1,the other 7 strains were not detected for any carbapenemase genes.The percentages of KPC-2-positive Klebsiella pneumoniae with the bla CTX-M,bla SHV,bla TEM,bla DHA were 21.5 ％,42.9 ％,69.1％ and 4.8％ respectively.The results of MLST showed that 37 out of 42 KPC-2 positive strains were ST11.Conclusion The production of KPC-2 is the main mechanism of Klebsiella pneumoniae resistance to carbapenem and there is an outbreak of ST11 KPC-2 Klebsiella pneumoniae in this hospital.

Objective To investigate the clinical value of urinaryα1-acid glycoprotein (AAG)in the early diagnosis of diabetic nephropathy(DN).Methods 266 cases of diabetic patients in Drum Tower Hospital Affiliated to Medical School of Nanjing University from May 2013 to October 2014 were recruited,and patients were divided into four groups based on the urine al-bumin/creatinine (ACR)levels,as follows:non-diabetic nephropathy group (Non-DN)152 cases,low urinary albumin/cre-atinine group (LUA)49 cases,high urinary albumin/creatinine group (HUA)32 cases,and very high urinary albumin/cre-atinine group (VHUA)33 cases.63 cases of healthy subjects (NC group)and 66 cases of fracture patients (stress group) were recruited as control group.The urinary AAG and other biochemical indicators were measured for all subjects.Results The level of urinary AAG in DN group was significantly higher than that in stress group,Non-DN group and NC group (t=7.951,7.985,8.021,P <0.05),and gradually increased from LUA,HUA to VHUA group (P <0.05).The urinary AAG level was positively correlated with UA,Cr,CRP and ACR (r=0.169,0.286,0.373,0.606,P <0.01).Stepwise logistic re-gression analysis showed that the urinary AAG was the independent risk factor of DN (P <0.05).Conclusion The level of urinary AAG has good application value in the early diagnosis and monitoring progression of DN.

In the last decade, along with the development of taxonomy research in marine-derived actinobacteria, more and more halogenated natural products were discovered from marine actinobacteria. Most of them showed good biological activity and unique structure compared to those from land. The special halogenation mechanism in some compounds' biosynthesis has drawn great attention. So in this review, we focus on the halogenated natural products from marine actinobacteria and their halogenation mechanisms.

Objective To establish the molecular weight distribution of Ganlong capsule by HPSEC the content of the peptide determined by Lowry and Methods The superdex peptide 10/300 GL (10 mm ×300 mm) column was used.The pH=6.0 and phosphate buffer of 0.05 mol/L was used as the mobile phase, containing 0.1 mol/L NaCl.The flow rate was set at 0.7 mL/min;The column temperature was 25℃;The detection wavelength was 214 nm.Results The content of the peptide ranged from 0.08 mg to 0.4 mg ( r =0.9996 ) .The RSDs of measurement precision of molecular weight and content were 0.08% and 0%(n=6), respectively.The RSDs of the repeatability were 1.3% and 1.1%(n=6);The regression equation of standard material was logMr =5.1455 -0.0871tR, r =0.9983,the relative molecular weight ranged from 2.68 ×102 Da ~5.73 ×103 Da(r =0.9983). Conclusion on The method is simple and rapid for determining the peptide content and the molecular weight distribution of Ganlong capsule.It can be used quality control method for Ganlong capsule.

Objective:To discuss the surgical outcome of pediatric intractable temporal epilepsy. Methods:This observation included 34 pediatric patients with intractable temporal epilepsy who were admitted to our hospital from 1990 to 2001.CT or MRI,EEG and neuropsychological examinations were taken to determine the situations of the patients.They all underwent improved anterior temporal lobectomy. Results:The patients have been followed up for 2-13 years.According to Engel's classification,the achieved outcomes were seizure-free in 22(65 %) patients,apparently improved in 3(9 %) patients,improved in 3(9 %) patients,no effect in 2(6 %) patients,and lost of follow-up in 4(12 %) patients,respectively. Conclusion:Surgical treatment to pediatric intractable temporal epilepsy is safe and effective.The most common pathological causes for pediatric epilepsy are tumor and hippocampus sclerosis.Early surgery of pediatric temporal epilepsy could improve the life qualities of patients.

Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73％ vs 7％,x2=29.75,P＜0.01),lower cervical vertebra pain (9％ vs 40％,x2=6.813,P=0.009),cervical activity limitation (68％ vs 14％,x2=19.023,P＜0.01),upper cervical vertebra pressing pain (100％ vs 7％,22=52.297,P＜0.01),lower cervical vertebra pressing pain (9％ vs 60％,x 2=15.056,P＜0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73％) by MRI scan,while 3 cases (14％) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.

Objective To explore the possible mechanism by which thioredoxin-interacting protein (TXNIP) par?ticipated in early brain injury (EBI) of subarachnoid hemorrhage (SAH) via examination of the expression of TXNIP and its downstream apoptotic factors before and after intervention. Methods Subarachnoid Hemorrhage (SAH) was performed by endovascular perforation. Total 97 adult male SD rats were randomly divided into 6 groups:sham-operation (17), SAH (32), control siRNA (12), TXNIP siRNA (12), resveratrol control (12) and resveratrol injection (12). Western blot was used to examine the expression of TXNIP, p-ASK-1, Caspase-3 before and after intervention. Laser scanning confocal microscopy (LSCM) was used to detect the expression of TXNIP in neurons. The co-localization of TXNIP with apoptotic cells was examined by using fluorescent TUNEL. Mortality, behavior score and cerebral edema were also evaluated. Re?sults Mortality, behavior scores and brain edema were improved after TXNIP siRNA and resveratrol injection(P<0.05). LSCM showed that TXNIP was widely expressed in brain and mainly located in cytoplasm of neurons in SAH rats. Fluo?rescent TUNEL revealed the co-localization of TXNIP with apoptotic cells. The expression level of TXNIP was signifi?cantly higher in SAH group than in sham operation (P<0.05, n=3). The expression level of TXNIP gradually increased at 12h and still remained at high level at 72h (P<0.05). This increase was simultaneously accompanied by the increase in downstream apoptosis factors, p-ASK-1 and Caspase-3. Inhibition of TXNIP by siRNA or resveratrol significantly re?duced the expression of TXNIP, p-ASK-1 and Caspase-3 (P<0.05, n=3). Conclusion TXNIP gradually increases in ear?ly period after SAH and aggravates brain damage through activation of ASK-1 apoptosis signaling pathway, whereas inhi?bition of TXNIP may attenuate EBI through reduction of p-ASK-1 and Caspase-3 after SAH.