Blood brain barrier is the main obstacle for drug delivery to the brain.To overcome the limited access of drugs to the brain,three methods have been developed at present:neurosurgical-based strategies,chemistry-based strategies to increase the lipid solubility of the drug,and biology-based strategies of endogenous BBB transporters-mediated drug delivery.PTD transport system to delivery drug across BBB is an emerging technology,which conveniently and efficiently deliver various molecules into spinal cord and brain via blood,intraperitoneally etc.PTD transport system offers a new approach to central nervous system disease with quick,convenient and safe charcteristics.

Objective To investigate the correlation between Presenilin 1 gene methylation (PSEN1) and sporadic Alzheimer's disease (SAD).Methods Massarray method was used to perform an analysis of DNA methylation in the promoters of PSEN1 gene in lymphocytes from 35 SAD patients,33 mild cognitive impaired (MCI)patients and 22 age-and gender-matched controls.Reporter gene plasmid of PSEN1 was built by genetic recombination methods,and then transiently transfected into the SH-SY5Y and HeLa cells.After that,cells were treated with several agents including serum deprivation,Aβ25-35,5-aza-2'-deoxycytidine (5-aza Cdr) and S-adenosyl-Lmethionine (SAM).A dual-luciferase reporter assay system was used to calculate the relative luciferase activity (RLA).Results Some CpG sites of PSEN1 (Cytosines at-173,95 and +76) showed hypomethylation patterns in SAD cases as compared with MCI and control group (P＜0.01).A dual-luciferase reporter assay showing significant differences in PSEN1 transcription activities were found in both cell lines under SAM treatment [SY5Y,SAM:(6.40±0.81),control:(9.13±1.67),P=0.000; Hela,SAM:(2.06±0.34),control:(2.99±0.59),P=0.000].Conclusions DNA hypomethylation of PSEN1 gene promoter is significantly associated with SAD susceptibility.PSEN1 may change the gene transcription level by methylation,further affecting the activity of amyloid protein-like γ-secretase,leading to the onset of AD.

Objective To study the clinical features of traumatic mitral regurgitation and its surgical treatment methods and outcomes. Methods Clinical data of 16 patients with traumatic mitral regurgitation surgically treated from December 2000 to November 2008 were retrospectively analyzed. The cardiac thoracic ratio was 0.55 ±0.07 and the left ventricular ejection fraction (LVEF) was (51.2% ±23.2)%. According to the New York Heart Association (NYHA) functional classification, 10 patients were at grade Ⅰ - Ⅱ before operation. The surgical procedures consisted of mitral valvuloplasty in 14 patients and mitral replacement in two, when correction of other cardiac injuries was made at the same time.Of all, 14 patients obtained follow-up for (35.2 ± 25.7 ) months. Results The interval between trauma and appearance of mitral regurgitation was (23.3 ±50.90) months. Of 13 patients with echocardiography during follow-up, there were four patients with normal tricuspid hemodynamics, seven with trace tricuspid regurgitation and two with mild regurgitation. The value of LVEF was (66.8 ± 9.0)% at followup, significantly higher than preoperation (P ＜ 0. 05 ). There were 13 patients at grade Ⅰ - Ⅱ of NYHA,with a significant increase compared with preoperation ( P ＜ 0. 01 ). Conclusions Mitral regurgitation may emerge either immediately or several years after trauma. Traumatic mitral regurgitation patients can get satisfactory outcomes when comprehensive mitral valvuloplasty or mitral replacement is performed promptly.

Core human resource serves as the principal capital of carrier of knowledge and skills of a hospital,which is the most decisive factor of a hospital' s competitiveness and adaptability for its initiative and creativity.Their stability and development plays a key role in hospital development.This study analyzed the characteristics and capacity demand of such human resource,and proposed that their management should differ from the rest,recommending reforms in their job description,development and training,performance appraisal,remuneration design and incentive mechanism.

Objective To investigate the relationship between the levels of serum glial fibrillary acidic protein (GFAP) ,ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) ,CT findings and outcome in patients with severe traumatic brain injury .Methods En-zyme linked immunosorbent assay (ELISA) was conducted to detect the serum level of GFAP and UCH-L1 in 62 patients with se-vere traumatic brain injury at the time of 12 h and 36 h after the trauma .CT scans of the brain were obtained within 12 h of injury . Outcome was assessed by glasgow outcome scale (GOS) at 6th month .The relationship between GFAP ,UCH-1 ,CT findings and outcome were analyzed .56 healthy persons were selected as control group .Results The concentrations of serum GFAP and UCH-L1 of patients were significantly higher than those of the control group (P< 0 .05) ;GFAP levels were higher in patients with mass lesions than in those with diffuse injury while UCH-L1 levels were higher in patients with diffuse injury (P< 0 .05) ;the levels of GFAP and UCH-L1 of patients with unfavourable outcome(GOS 1 - 3 scores) were significantly higher than those of patients with favourable outcome(GOS 4 - 5 scores) ,and the concentrations of biomarkers were significantly negatively correlated with outcome . Conclusion Serum levels of GFAP and UCH-L1 are good predictors for severity and outcome in severe traumatic brain injury (TBI) .The levels of GFAP and UCH-L1 could reflect different injury pathways which were different in patients with mass lesions and diffuse injury remarkbly .GFAP and UCH-L1 could provide better characterization of subjects for specific types of cellular dam -age than that obtained with CT alone .

Objective To study and compare the clinical and MR imaging characteristics of common intracranial ring enhanced lesions.Methods MR imaging studies of 65 intracranial ring enhanced lesions were reviewed retrospectively. The lesions included 17 glioblastomas, 17 metastasises, 12 brain abscesses, 8 acoustic neurinomas, 7 craniopharyngiomas, 3 neurocysticercosises, 1 malignant lymphoma. All cases were confirmed by surgery and pathology. Results The ring enhancement of tumors presented heterogenous thickness of thick walls and irregular forms. Among them, the highly malignant tumors appeared very obviously heterogeneous thickness of the walls, especially the inner walls were uneven and coarse. While the ring enhancement of the non-tumor lesions usually were of homogeneous thickness of the walls, regular shapes and smooth inner walls. Conclusion The different patterns of intracranial ring enhanced lesions on MR can supply important diagnostic information. Combining the patients' history, age, location and the information of magnetic resonance imaging, we may make correct diagnosis.

The article reviews the current status of elder abuse from the perspective of epidemiology, characteristics of abuse, risk factors and nursing assessment and management, presenting the idea that nurses are playing a major role in the prevention,detection and resolution of elder abuse. It also introduces that nurse can screen out the situation of elder abuse timely by applying the proper assessment tool flexible and respond to the occurrence of elder abuse as well as avoid the elder abuse again by comprehensive application of nursing knowledge and management skills. Some advices about future research and mismanagement in elder abuse being given.

OBJECTIVE:To provide reference for improving the clopidogrel rational use in cerebral infarction secondary preven-tion. METHODS:Medical cases of 471 patients with acute cerebral infarction in neurology department in a hospital from 2013 to 2014 were retrospective surveyed to collect the utilization rate of clopidogrel and the combination of clopidogrel with proton pump inhibitors(PPIs)and aspirin,and the rationality was analyzed. RESULTS:The utilization rate of clopidogrel in cerebral infarction secondary prevention was 93.84%;the combination rate with PPIs was 52.49%,of which,51.72% had no drug selection or com-bined treatment basis;the combination rate with aspirin was 40.72%,cardiogenic cerebral infarction accounted for only 3.9%, non-cardiogenic cerebral infarction accounted for 96.1%,and recurrence of cerebral infarction in high-risk patients accounted for 31.11%. CONCLUSIONS:Clopidogrel in patients with cerebral infarction secondary prevention is widely used in the hospital,has high combination rate with PPIs and aspirin and low guide compliance rate. Clopidogrel should be enhanced pharmacy services, comply with evidence based medicine and improve the rationality of medication.

Objective To do a hygienic assessment for the preservation time of barreled drinking water. Methods 40 kinds of barreled drinking water samples, all passed the water quality test, were collected from the market in summer and autumn respectively. Each sample was put into a sterile bottle and then taken into the laboratory in 2 hours to detect the microorganism indicators in 0 day, 5 days, 10 days, 15 days and 20 days periodically. Results The qualified rate of microorganism indexes reached 100% in 10 days. As for total bacteria count, 97.5% exceeded the hygiene standard limit,the detected rate of fungi and yeast were 17.5% and 12.5% in 15 days, and 100% exceeded the standard limit,the detected rate of fungi and yeast were 30.0% and 22.5% in 20 days in summer. The qualified rate of microorganism indexes reached 100% in 20 days in autumn. Conclusion Barreled drinking water is safe for drinking in 10 days in summer and in 20 days in autumn.

Objective To study the interaction between ?_1-antichymotrypsin (ACT) and amyloid peptide A?_~1-42 in vitro, and the effects of their complex on expression of transcription factors PPAR? and NF?B in human neuroblastoma (Kelly) cells. Methods A?_~1-42 and ACT were mixed at a 10∶1 molar ratio at room temperature, the complex formed in 2 hours and 24 hours were expressed as A?_~1-42 /ACT (2 hours), A?_~1-42 /ACT (24 hours), respectively. The complexes were studied by using agrose electrophoresis, and their effects on PPAR? and NF?B expressions were assessed by electrophoresis mobility shift assay (EMSA). Results At conditions used, ACT interacted with A?_~1-42 in vitro, the complexes formed and functioned differently according to their interaction period. Compared with unstimulated control cells, A?_~1-42 /ACT (2 hours) strongly increased PPAR? and NF?B expressions by Kelly cells by 158% (P