The blood-brain barrier (BBB) exerts its central nervous system (CNS) protective function as it hinders the delivery of diagnostic and therapeutic agents to the brain. With the development of nanotechnology during the last thirty years, the nanocarriers for delivering drugs make it possible to transport drugs across the BBB. The brain-targeted drug delivery system usually consists of two parts: nanocarriers and brain-targeted strategies. In this review, several kinds of nanocarriers are introduced for brain-targeted drug delivery. We focus on several possible strategies for brain-targeting and comment on their advantages and disadvantages in application.

The mechanisms underlying early neurological deterioration (END) after ischemic stroke are not clear.There are no reliable predictive factors and effective preventive measures for END.The glutamatemediated excitotoxicity plays a very important role in the cascade reaction of ischemic events.High level of glutamate in plasma is one of the important predictors for END.Studies have shown that the polymorphism in the promoter of the excitatory amino acid transporter-2 gene is a potential cause for individual susceptibility to END.Some therapeutic strategies of interrupting the glutamatergic pathways may be as the strategies of intervention END.

Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, which leads to hemodynamics disorder, prolongs hospitalization and increases mortality. The underlying mechanisms behind POAF are associated with cardiomyocyte injury, sympathetic activation and inflammation. The prediction of POAF is based on correlated index from pre-, intra-and post-surgery. POAF can be treated by rhythm and heart rate control as well as and antithrombotic therapy.

Objective To measure the curvatures of the distolingual root canals of permanent mandibular first molars by cone-beam computed tomography (CBCT). Methods The CBCT was used to collect 230 cases of mandibular first molar distalingual root from 513 patients. The images were created by 3-D reconstruction based on the BECT data. Images were analyzed by NNT image analysis software. Each tooth was captured in clinical (CV) and proximal view (PV) image, and measured by the Schneider method. Results The average curvature of the distallingual canal was (13.27 ± 8.57)° in CV, and (30.96 ± 11.63)° in PV. Most of the distallingual root in the buccolingual view was mild bending or moderate bending , and the proximal view was severe bending. The distal lingual root bending was the most common in the crown third of the root , next in the apical third of the root, in the middle third of the root. Conclusion CBCT is an effective tool for the detection of additional distolingual roots and is a valuable aid for dentists in root canal treatment.

Objective To evaluate the value of CT-guided self-made positioning puncture device in radiofrequency ablation of liver tumors. Methods A total of 78 tumor foci from 64 patients with primary hepatocellular carcinoma treated with radiofrequency ablation from January 2010 to November 2014 were analyzed. Among them, 13 tumor diameters were 3.5-5.0 cm and 65 < 3.5 cm. The location and puncture of tumor lesion were performed by CT-guided positioning device, and the effect of puncture and lesion was evaluated by using tumor precise radiotherapy planning system. Radiofrequency ablation of tumor lesion was performed by tumor radiofrequency treatment system. Results The puncture error of all tumors in the space was 1-4 mm, the average puncture error was 2.9 mm, the complete ablation rate of tumor lesions was 93.59%(73/78), and there was no serious complication in the course of treatment. After treatment, the alpha-fetoprotein and liver function were significantly improved, and the differences were statistically significant (both P<0.05). At 1 month after surgery, CT found that no tumor and ablation was enhanced, at 3 months after surgery, CT showed that the arterial phase of all the tumor lesions did not strengthen, all of them were low-density lesions, no ablation recurred. The recurrence rates of 1, 2, 3, and 4 years after treatment were 17.9 %, 29.9 %, 45.9 % and 55.0 %. Conclusion CT-guided radiofrequency ablation with self-made puncture device is effective in the diagnosis of primary liver cancer, ablation is complete and safe.

The specific forms and contents of narrative nursing clinical practice were analyzed. On the basis of a brief review of the concept and origin of narrative nursing and the significance of it, this paper focuses on the field, methods, forms and evaluation methods of clinical practice of narrative nursing. The study found that through the literature review, the value of narrative medicine has been fully affirmed, but how to implement theory to a real clinical nursing practice environment has not yet been reported more. Therefore, exploring the narrative nursing in the clinical workplace, rich forms, contents and methods of clinical practice can provide new methods and new ideas for nursing humanistic care and clinical practice, and has certain social significance, academic significance, individual significance and application prospect.

Objective To investigate the clinical effect and safety of linagliptin combined with insulin aspart 50 in the treatment of hepatogenous diabetes (HD).Methods A total of 57 patients with HD who visited The People's Hospital of Liaoning Province from October 2014 to February 2016 were enrolled and randomly divided into insulin aspart 50 group (group A,28 patients) and linagliptin combined with insulin aspart 50 group (group B,29 patients).The two groups were compared in terms of blood glucose,insulin,C-peptide,glucose disposition index (DI),glycosylated hemoglobin A1c (HbA1c),glucagon,and daily insulin dose at baseline and after 12 weeks of treatment.The adverse events including hypoglycemia were observed.The paired t-test was used for comparison of continuous data within one group,and the independent-samples t test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups.Results After 12 weeks of treatment,both groups had significant reductions in blood glucose at four time points (t =5.357-21.380,all P ＜ 0.05) and significant increases in the insulin level at 30,60,and 120 minutes (t =2.222-6.491,all P ＜0.05).Compared with group A,group B had significantly lower levels of HbA1c and glucagon,daily insulin dose,and blood glucose and insulin levels at 30,60,and 120 minutes (t =3.136-15.096,all P ＜ 0.05),as well as significantly higher DI and levels of C-peptide at four time points (t =2.994-10.813,all P ＜ 0.05).Group A had a significantly higher incidence rate of hypoglycemia than group B (28.6％ vs 3.4％,x2 =5.005,P ＜ 0.05).Conclusion Linagliptin combined with insulin aspart 50 can effectively control blood glucose in patients with HD and has good safety.

AlM:To analyze and explore the clinical efficacy of strengthening lateral tarsal strip and advancing lower eyelid retractor for the treatment of degenerative entropion with eyelid relaxation
METHODS: Reviewed from January 2011 to January 2013, 21 cases (33 eyes) of degenerative entropion eyelid relaxation were treated with operation of strengthening lateral tarsal strip and advancing lower eyelid retractor ( fornix conjunctival incision ) , the follow-up was 12-24mo, curative effect was observed.
RESULTS: All the patients were cured completely, have no recurrence or overcorrection phenomenon. The cure rate of operation was 100%, there was no complication.
CONCLUSlON: Operation of strengthening lateral tarsal strip and advancing lower eyelid retractor is a safe, reliable, efficient operation to the treatment of degenerative entropion with mode of eyelid relaxation.

At present,radiofrequency ablation (RFA),as a minimally-invasive and effective therapeutic means,is widely employed for the treatment of hepatic tumors.This technique is especially suitable for the patients with liver tumor who are unwilling to accept surgery or who cannot undergo surgery.In the past 20 years,great development and progress have been achieved in RFA technology.As a main therapeutic tool,the property of the radiofrequency electrode needle has great influence on the curative effect.This paper aims to make a comprehensive summary about the radiofrequency electrode needles that are currently used in clinical practice or are still in the research and development stage,focusing on the following special radiofrequency electrode needles,including multiple-point expandable electrode needle,perfusion electrode needle,internal cooling electrode needle and bipolar electrode needle.The properties and distinguishing features of these radiofrequency electrode needles will be discussed,and their advantages and disadvantages will be compared.In order to improve the curative effect of RFA for hepatic tumors,further research is suggested.