In order to explore the causes and nursing care of gastroesophageal reflux in patients with ceryical vertebra frac-ture and paraplegia,the clinical data of 79 patients were retrospectively analyzed. Among which,31 patients suffered from gas-troesophngeal reflux. The main causes of gastroesephageal reflux were improper body position,gastrointestinal dysfunction,con-sciousness disorders,lnappropriate nasngastric feeding,drng adverse reaction,inappropriate feeding time,lack of knowledge in nurse aids and family members. It is suggested to take proper body position,assess gastrointestinal functions,implement naso-gastric feeding correctly,observe patient carefully to detect gastroesophageal reflux as early as possible,as well as provide health education for the nurse aids and family members to prevent gastroesophageal reflux and complications.

Peptides are a particular molecule class with inherent attributes of some small-molecule drugs and macromolecular biologics, thereby inspiring continuous searches for peptides with therapeutic and/or agrochemical potentials. However, the success rate is decreasing, presumably because many interesting but less-abundant peptides are so scarce or labile that they are likely 'overlooked' during the characterization effort. Here, we present the biochemical characterization and druggability improvement of an unprecedented minor fungal RiPP (ribosomally synthesized and post-translationally modified peptide), named acalitide, by taking the relevant advantages of metabolomics approach and disulfide-bridged substructure which is more frequently imprinted in the marketed peptide drug molecules. Acalitide is biosynthetically unique in the macrotricyclization via two disulfide bridges and a protease (AcaB)-catalyzed lactamization of AcaA, an unprecedented precursor peptide. Such a biosynthetic logic was successfully re-edited for its sample supply renewal to facilitate the identification of the in vitro and in vivo antiparkinsonian efficacy of acalitide which was further confirmed safe and rendered brain-targetable by the liposome encapsulation strategy. Taken together, the work updates the mining strategy and biosynthetic complexity of RiPPs to unravel an antiparkinsonian drug candidate valuable for combating Parkinson's disease that is globally prevailing in an alarming manner.