Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.

Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011 and March 2014.The patients (11 males and 3 females) were aged between 22 and 46 years (mean,26.4 years).Nine patients sustained traffic injury,4 fall injury and 1 crash injury.Nine patients were classified as type Ⅱ and 5 type Ⅱ a according to the Levine-Edwards classification.All were completed cervical anteroposterior and lateral X-ray,CT scan,three-dimensional CT reconstruction and MRI examination after adnission.American Spinal Injury Association (ASIA) grade E was noted in all before operation.Clinical posttraumatic neck score,visual analogue scale (VAS) as well as angle deformity and displacement of the axis were recorded before operation and at the latest follow-up.Results All patients were operated successfully.Mean operation time was 61 min(range,45-116 min).There were no injuries of superior laryngeal nerve,hypoglossal nerve,throat wall and vessel during operation.Laryngeal edema,dysphagia,paralysis of tongue,hematoma and wound infection were not observed after operation.Mean period of follow-up was 24.2 months (range,4-32 months).All segments and fracture sites showed solid fusion after 3 months.No cages became subsided or displaced,no discs collapsed,and no malunion occurred at the latest follow-up.Data of preoperation and latest follow-up differed significantly with respect to clinical posttraumatic neck score[(53.1 ±7.2) points vs.(91.1 ±5.0)points],VAS[3.38(2.43,4.33)points vs.0.58(0,1.29) points],axis displacement[(4.0 ± 1.5) mm vs.(1.3 ± 1.2) mm],and angle deformityoftheaxis[(9.2±4.7)° vs.(2.1 ±1.9)°] (P＜O.05 or O.01).Conclusion Anterior cervical surgery with ROI-C implantation for type Ⅱ or type Ⅱa Hangman fracture provides good fusion rate and satisfactory clinical effect.

Objective To investigate the charateristics of pathological changes in hippocampal subregions in rats with epilepsy induced with different doses kainic acid(KA) ,discuss the etiology and pathway of epileptic wave.Methods 30 male Wistar rats were randomly divided into control group,low(0.025 ?g) and high(0.1 ?g) dose KA injection groups with 10 rats each.KA was focally injected into the right amygdala by a glass micropipette connected to an air pressure system to make epilepsy model.The pathological characteristics in hippocampal subregions in rats with epilepsy induced with different doses KA were observed.Results Compared with control group,high dose KA injection mainly caused neuron loss in the CA3 region,while pyramidal and dentate granule cells were evenly distributed with normal shape and size.Low dose KA injection caused severe damage in both CA1 and CA3 regions.Dentate granule cells didn't show any pathological change and neuron loss in low dose injection.Conclusion The pathological changes in hippocampal subregions in rats with epilepsy induced with KA are different with different doses KA,it might be related to the pathway of epileptic wave and the specific properties of hippocampus.

Objective To investigate the expression of connexin CX43 using hybridization techniques after GABA restraining receptor gene was transferred into the supramammillary of hypothalamus in Kainic acid(KA) induced epileptic rats.Methods Twenty-four male Wistar rats were divided into four groups: control group(n=2),surgery group(n=2),KA group(n=10) and GABA restraining receptor gene transferred group(GABA group)(n=10).No treatment was given to the control group.Physiological saline(1 ?L) was injected into right amygdala of rat in surgery group.In KA group,KA(1 ?L,1 ?g) was injected into the amygdala of rat to build epileptic model.In GABA group,the GABA restraining receptor gene(400 nL,40 ng) was transferred into the supramammillary of hypothalamus by HVJ-liposome 48 h before KA was injected into amygdala.The expressions of CX43 mRNA and morphological changes different time(3 h,6 h,24 h,3d,7d) were observed by in situ hybridization in each group.Results In control group and surgery group,the morphological manifestations were normal,and the hippocampus structures were complete.In KA group,swell and degenerative hippocampus neurons were showed and deteriorated with time.In GABA group,the degeneration and necroses of hippocampus neurons were relatively alleviated.The positive expression of CX43 mRNA was few in control group and surgery group.And in KA group it increased with time.In GABA group,the positive expression of CX43 mRNA was fewer than that of KA group at every period.Conclusion The expression of CX43 mRNA in hippocampus can be decreased by transferring GABA receptor gene into hypothalamus.

BACKGROUND:The self-locking ROI-CTM interbody fusion has zero profile design which can significantly reduce the impact on the esophagus and pharynx, and also simplify the operation procedure. However, there is no report whether it has satisfactory outcomes in the treatment of Hangman fractures.
OBJECTIVE: To compare the clinical effects of ROI-CTM or titanium plate internal fixation on postoperative cervical stability and fusion rate in the treatment of Hangman fractures.
METHODS:Twenty-one cases of Hangman fractures were included, including 13 males and 8 females, aged 25-62 years old. Fifteen cases were treated with titanium plate internal fixation, and the other five cases were treated with ROI-CTM fusion device. Cervical anteroposterior and lateral radiographs, lateral flexion extension radiographs and CT scanning were carried out before, 3 days and 3 months after repair to assess angular displacement, horizontal displacement and fusion rate; visual analog scale score and Bazaz dysphagia score were determined.
RESULTS AND CONCLUSION:At 3 days after operation, the ROI-CTM group was significantly better than the titanium plate group in visual analog scale scores and Bazaz dysphagia grade (P < 0.05), and there were no significant differences in angular displacement and horizontal displacement (P > 0.05). However, at 3 months after operation, there was no significant difference between the two groups in visual analog scale score, Bazaz dysphagia grade, angular displacement and horizontal displacement and fusion rate (P > 0.05). Postoperative complete reduction rate of spondylolisthesis was higher in the ROI-CTM group than the titanium plate group (P < 0.05). In each group, the angular displacement and horizontal displacement were significantly reduced at 3 day and 3 months after operation (P < 0.05), but there was no significant difference at 3 days and 3 months after operation (P > 0.05). No rejection reaction, internal fixation fracture and loosening occurred in the two groups. These findings indicate that the self-locking ROI-CTM fusion for treatment of Hangman fractures are characterized as higher reduction rate of spondylolisthesis, less dysphagia, and less neck pain.

Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.

Objective To compare the health related quality of life (HRQoL) of ileal conduit versus orthotopic ileal neobladder using the FACT-BL scale.Methods One hundred and thirty patients underwent radical cystectomy and urinary diversion for invasive bladder cancer from Jan 2006 to Dec 2010 at our hospital.According to different urinary diversions,patients were divided into ileal conduit (IC) and orthotopic ileal neobladder (NB).HRQoL was assessed using FACT-BL.The following scores calculated from the FACT-BL questionnaire and list:physical well-being ( PWB ),social/family well-being ( SWB ),emotional well-being(EWB),functional well-being( FWB),overall bladder-special subscale and total FACT-BL were included.A high FACT score indicated a high level of HRQoL.The medical records of each patient were then reviewed.Clinical parameters including age,sex,type of diversion and pathological status were recorded and analyzed.Results A total of 94 questionnaires were collected,of these patients 50 had an IC and 44 had an NB.Among the respondents,the age at surgery was significantly younger in NB group than IC group (P =0.014 ).While the percent of males,follow-up years and pathological stage T3 or greater revealed no significant difference.The NB group got significantly higher scores in PWB,SWB,EWB and FACT-BL than the IC group.Which indicated that the HRQoL was higher in patients following orthotopic ileal neobladder.Conclusions The HRQoL was better in patients who followed orthotopic ileal neobladder than those who followed ileal conduit.This may indicate that orthotopic ileal neobladder should be considered first when making a decision about which urinary diversion should be used.

Objective　To analyze the clinicopathologic characteristics and treatment of primary and secondary bladder mucosa lymphoma.　Methods　From June 1996 to September 2011,8 cases of bladder mucosa lymphoma patients including primary bladder mucosa lymphoma patients (2 males and 3 females)and secondary bladder mucosa lymphoma patients ( 1 male and 2 females) were treated in our institute.The patient's mean age was 68 years (ranged from 57 to 78 years),and the other 3 secondary bladder mucosa lymphoma patient's mean age was 61 years (ranged from 41 to 81 years).7 of 8 patients accepted transurethral resection of bladder tumor combined with CHOP chemotherapy and radiotherapy,and 1 patient abandoned treatment.CHOP chemotherapy and radiotherapy were performed at 2 weeks post-operatively.Secondary bladder mucosa lymphoma patients accepted 3-dimensional conformal 6000 cGy radiotherapy.Urinary CT examination showed that there were round or oval irregular tumors in the wall of urinary bladder,whose diameters were 1 to 4 cm.Tumor edges were glossy and tumor density were uniform.In addition,the bladder wall with tumor was uneven.In contrasted CT,the tumors appeared obviously enhanced.7 cases had cauliflower-like tumors found by cystoscope,and there were necrosis-calcification area in the center of tumors.1case appeared multiple tumors,which consisted of one big tumor and three smaller ones.　Results　There were 5 cases of primary bladder mucosa lymphoma, including 3 bladder mucosa associated lymphoma (MAL) cases and 2 diffuse large B cell lymphoma cases.There were 3 secondary bladder mucosa lymphoma cases including 2 diffuse large B cell lymphoma cases and 1 generalized follicular cystic central lymphoma case,which belongs to the tuberous sclerosis Hodgkin lymphoma.Immunohistochemical analysis showed that CD20,CD21,CD43 staining were positive in low grade MAL (3 cases).However,CD3,CD20,CD31 staining were positivein high grade MAL (5 cases). All patients were followed up 3 to 44 months.3 cases of secondary malignant lymphoma patients died after diagnosed after 3 to 13 months.5 cases of primary malignant lymphoma patients were all survived. 1 case recurred 14 months after surgery and accepted TURBT and CHOP chemotherapy again.Pathologic diagnosis showed the transformation from peripheral zone of bladder mucosa associated lymphoma to diffuse large B cell lymphoma.The patient was free of recurrence.　Conclusions　MAL and diffuse large B cell lymphoma are the most common type of bladder mucosa lymphoma.Primary and secondary diffuse large B cell lymphoma have similarities in histological analysis,but the former prognosis is better than the latter's. Transurethral resection of bladder tumor combined with chemotherapy and radiotherapy can prevent the relapse of MAL in short term and long term with good tolerance,and can be used as ideal treatment of MALT.

Objective To explore the mechanism of spontaneous seizures in adaptor protein complex type 3B knockout mice(AP3M2KO mice).Methods AP3M2KO mice were generated.Seizures and electroencephalogram(EEG)were monitored using video camera and telemetry system.Glutamate and GABA releases were determined using in vivo microdialysis method.Results AP3M2KO mice began to suffer from spontaneous seizures 8 weeks after the birth,but did not show any other behavior abnormality.The onset of ictal discharge over the temporal region was synchronized with seizures.There were no significant differences in basal glutamate and GABA releases in hippocampus between AP3M2KO((0.35±0.08)pmol/20μl and(2.94±1.69)fmol/20μl,respectively)and wild-type mice.However,the 50 mmol/L K+-evoked GABA release was impaired in AP3M2KO mice((63.5±11.8)fmol/20μl vs(209.2±63.7)fmol/20 μl,t=4.405,P＜0.05),whereas no significant difference was found in K+-evoked glutamate release.Conclusions AP3M2KO mice suffer from epileptic seizures similar to the clinical features of human epilepsy.The impairment of inhibitory GABAergic transmission iS involved in the mechanism of spontaneous seizures in AP3M2KO mice.

DNAzymes, screened through in vitro selection, were artificial nucleic acids with catalytic function . They could cleave specific substrates in the presence of cofactors with unique characteristics, such as high catalytic activity, high specificity for cofactors, excellent stability, and easy to synthesize and modify. The combination of DNAzymes with nanomaterials could retain the DNAzyme activity and realize the functional integration of recognition and signal transduction, promoting rapid development of biosensors. In the current paper, we mainly reviewed the recent progress in DNAzyme-nanomaterial based biosensors, and the nanomaterials included gold nanoparticles, graphene, quantum dots, magnetic nanomaterials, and so on.