Objective To investigate the effects of different duration of sevoflurane anesthesia in the neonatal period on the long?term cognitive function and hippocampal synaptic plasticity in rats. Methods Twenty?four pathogen?free healthy Sprague?Dawley rats of both sexes, aged 7 days, weighing 12-16 g, were divided into 3 groups ( n=8 each) using a random number table: control group ( group C) , sevoflu?rane anesthesia for 2 h group ( group S1 ) , and sevoflurane anesthesia for 6 h group ( group S2 ) . Group S1 and group S2 inhaled 2% sevoflurane for 2 and 6 h, respectively. Morris water maze test was performed at 30 days after the end of anesthesia ( postnatal day 37) to assess the cognitive function. After the end of the test, the rats were sacrificed, and hippocampi were isolated for determination of the expression of brain?de?rived neurotrophic factor ( BDNF) , postsynaptic density?95 ( PSD?95) and synapsin 1 in hippocampal tis?sues by Western blot. Results Compared with group C, the escape latency on 4th and 5th days of the test in group S1 and on 2nd-5th days of the test in group S2 was significantly prolonged, and the frequency of crossing the original platform was significantly decreased, and the time of staying at the platform quadrant was significantly shortened in S1 and S2 groups, the expression of BDNF, PSD?95 and synapsin 1 in hipp?ocampal tissues was significantly down?regulated in group S2 (P<0?05), and no significant change was found in the expression of BDNF, PSD?95 and synapsin 1 in hippocampal tissues in group S1 ( P>0?05) . Compared with group S1 , no significant change was found in the escape latency and frequency of crossing
the original platform (P>0?05), the time of staying at the platform quadrant was significantly shortened, and the expression of BDNF, PSD?95 and synapsin 1 in hippocampal tissues was significantly down?regula?ted in group S2 ( P<0?05) . Conclusion Short?time and long?time sevoflurane anesthesia both can induce long?term cognitive dysfunction in the neonatal period, and the severity is aggravated with prolonged anes?thesia; the partial mechanism is related to inhibition of the synaptic plasticity of hippocampal neurons of rats.

Objective To study the salt intake of patients undergoing maintenance hemodialysis and explore their knowledge and behaviour. Methods The patients undergoing maintenance hemodialysis were offered salt spoon and soy sauce cup. Their diaries on home meals for 3 consecutive days were collected to calculate their salt intake. Meanwhile, a one to one interview was done to evaluate the accuracy of patient′s diet diary and the knowledge and behavior of low salt diet and find out related factors of salt intake. Results The average salt intake was (6.49 ± 1.64)g/d. The average composition rate in the low salt diet knowledge in low salt diet behavior was 51.00% and 47.00% respectively. Age and education level were the influencing factors of salt intake. Conclusions The average salt intake is much higher than the standard for the patients undergoing maintenance hemodialysis. Their low salt diet knowledge is in the middle level and their low salt diet behavior is in the middle or lower level. The related factors include age and education among patients undergoing maintenance hemodialysis.

Objective To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE),which is helpful to the differential diagnosis.Methods Outpatients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study.Clinical data were comprehensively collected.Incidence of disease,severity,frequency of esophageal and extraesophageal symptoms,and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.Results Totally 446 subjects were recruited,including 225 patients with NERD and 221patients with RE.The occurrence rates of esophageal symptoms including heartburn [76.0％ (171/225) vs 52.0％ (115/221),P ＜ 0.01] and acid regurgitation [74.7％ (168/225) vs 54.3％ (120/221),P ＜0.05] in NERD group were significantly higher than those in RE patients,with more severe and frequent (P ＜ 0.05).Despite the rates of food regurgitation were similar,NERD patients behaved more severely and frequently (P ＜ 0.05).Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9％ (92/225) vs 27.6％ (61/221),42.2％ (95/225) vs 31.7％ (70/221),all P ＜0.05] were also higher than those in RE group,the degree of which was more severe too (P ＜ 0.05).RE patients claimed a higher proportion of chronic cough.The incidences of overlapping with IBS in two groups were similar.But there were more patients with FD in NERD group [72.0％ (162/225) vs 62.9％ (139/221),P ＜ 0.05] than in RE group.Conclusions The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different,as well as comorbidities such as FD and IBS.These results suggest that NERD and RE are independent diseases.

Objective To investigate the pathogenic bacterial distribution and drug resistance situation of multi‐drug resistant bacterial strain mixed infection among postoperative traumatic patients in Zaoyang area to provide a reference for clinical treatment . Methods A total of 71 traumatic cases of multi‐drug resistant bacterial strain mixed nosocomial infection were selected and per‐formed the bacterial culture and drug resistance analysis according to the samples taking from different infection sites .The the re‐sults were statistically analyzed .Results Among 71 cases of multi‐drug resistant strains mixed infection ,205 multi‐drug resistant strains of bacteria were isolated .Among them ,119 (58 .05% ) strains were Gram‐negative bacteria ,Gram‐positive bacteria was in 83 strians(40 .49% ) and fungus was in 3 strains(1 .46% ) .The resistance of Escherichia coli ,Klebsiella pneumoniae ,Enterobacter and Serratia to more than 10 kinds of antibacterial drugs was more than 50% ,which to ampicillin ,cephalothin ,cefuroxime ,azlocillin ,ce‐fotaxime cefuroxime ,azlocillin ,cefotaxime and cefoperazone was more than 80% ,while which to imipenem and amikacin was only 5 .88% and 28 .57% respectively .The resistance rates of Gram‐positive bacteria represented by Staphylococcus aureus ,Staphylococ‐cus epidermidis ,Staphylococcus haemolyticus and Streptococcus pneumoniae to penicillin G ,oxacillin and ampicillin generally reached 98 .80% ,97 .59% ,and 95 .18% respectively .No Gram‐positive bacteria was resistant to vancomycin ,in addition the resist‐ance to rifampin and chloramphenicol also was only 32 .53% and 34 .94% respectively .Conclusion In early stage of infection ,it is unable to determine the types of pathogenic bacteria and difficult to select sensitive antibacterial drugs ,under this occasion ,the com‐bination of imipenem and vancomycin is a good choice .

Objective To investigate the relationships among distal contractile integral (DCI), ineffective esophageal motility (IEM)and gastroesophageal reflux through high resolution manometry (HRM)in patients with gastroesophageal reflux disease (GERD).Methods A total of 69 patients with GERD were enrolled.All patients received HRM and 24 hour pH and impedance monitoring examination. Pearson correlation analysis was performed to analyze the correlation between DCI,number of invalid swallowing and DeMeester score.All the patients were divided into three groups according to the number of invalid swallowing in 10 times of 5 mL liquid swallowing test.Patients with 5 to 10 invalid swallowing was in IEM group (n=21),one to four was in abnormal motility group (n=19),and zero was in normal motility group (n=29).The t test was performed for comparison of average DCI,average DCI of residual effective swallowing,DeMeester score,acid reflux time,bolus exposure time and proximal reflux times
among the three groups.Results Among the 69 patients with GERD,there was negative correlation between DCI and DeMeester score (r=-0.363,P =0.003)in 10 times of 5 mL liquid swallowing test;the number of invalid swallowing was positively correlated with DeMeester score (r=0.374,P =0.002). The mean DCI in 10 times of 5 mL liquid swallowing of normal motility group,abnormal motility group and IEM group was (1 458.96±545 .10),(986.48 ±577.50)and (288.50 ±167.25 )mmHg·s·cm, respectively,and that of IEM group was lower than normal motility group and abnormal motility group (t =-11 .42 and -2.12,both P <0.05).The average DCI of residual effective swallowing of normal motility group,abnormal motility group and IEM group was (1 458.96 ± 545 .10 ),(1 187.90 ± 669.40)and (450.78 ±350.73 )mmHg ·s ·cm,respectively,and that of IEM group was also lower than normal motility group and abnormal motility group (t = -8.05 and -5 .27,both P <0.01 ).The DeMeester score of IEM group (15 .42±8.79)was higher than that of normal motility group (6.34±3.45),and the difference was statistically significant (t=2.43,P <0.05).The acid reflux time and bolus exposure time of IEM group were (54.93 ± 37.07 )min and (0.64 ±0.49 )%,respectively,which were longer than abnormal motility group ((37.37±22.66)min,(0.52 ±0.24)%)and normal motility group ((21 .22 ± 13.98)min,(0.39 ±0.14)%),and the differences were statistically significant (t =2.36,2.17,2.60 and 2.54,all P <0.05).The total number of reflux of IEM group and abnormal motility group were 67.10± 32.94 and 57.26±38.90,which were both more than that of normal motility group (44.61 ±23.84),and the differences were statistically significant (t =2.48 and 2.17,both P <0.05 ).Conclusions DCI and the number of invalid swallowing can predict reflux condition of GERD patients in a certain degree.The contraction strength of esophageal body was the weakest and esophageal clearance was the worst in IEM group.

Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle factors were collected.First,single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed.Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group (all P >0.05).The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group.According to decision tree model analysis,body mass index (BMI),water intake per day and constipation family history were finally enrolled.The incidence of FC was higher in patients with BMI < 23.56 kg/m2 (except 18.74 to < 19.83 kg/m2 )(79.75 %).The incidence of FC was higher in patients with BMI from 18.74 to <19.83 kg/m2 and water intake <1 L
(66.67%).The incidence of FC was highest in patients with BMI≥23.56 kg/m2 and family history of constipation (70.00%).The total prediction accuracy of this model was 64.6% (42/65 )and area under curve (AUC)value was 0.688.Conclusions FC and IBS-C are related with many lifestyle factors.Low BMI and less water intake per day are influence factors of FC,while higher BMI and family history of constipation are influence factors of IBS-C.

ObjectiveTo understand the pathological and physiological roles of Presenilin 1 (PS1) in Alzheimer's disease (AD) recurrence, and the interaction between PSI and carhoxyl terminus of Hsc70 interacting protein (CHIP). MethodsThe yeast two-hybrid system was applied to identify a novel PS1 interacting protein as CHIP. After pGBKT7-PS1-C203 bait plasmid and full fragement CHIP of pACT2-CHIP expression vector were constructed, the interaction between PSI and CHIP was tested by β-galactosidase assay, pGBKT7-PS1-C203 was co-transfected with pACT2-CHIP into 293T cells and the interaction between PS1 and CHIP was tested by co-immunoprecipitation and Western blot. ResultsSpecificity of the interaction between PS1 and CHIP was identified by β-galactosidase assay and co- immunoprecipitation. ConclusionsCHIP is able to modulate chaperone functions and the pathway of protein ubiquitination/degradation. CHIP may regulate a proper assembly of the γ-secretase complex through its interaction with PSI, which is helpful to elucidate the mechanism of AD pathology.

The study was to investigate whether the application of checklist during ward rounds could improve the prognosis of critical ill patients.The results suggested that the checklist used during ward rounds could not improve the inhospital mortality of critically ill patients, but it increased the proportion of deep vein thrombosis prophylaxis, and shortened prophylaxis treatment of gastric stress ulcer.

BACKGROUND/AIMS: Most recent studies using high-resolution manometry were based on supine liquid swallows. This study was to evaluate the differences in esophageal motility for liquid and solid swallows in the upright and supine positions, and to determine the percentages of motility abnormalities in different states. METHODS: Twenty-four asymptomatic volunteers and 26 patients with gastroesophageal reflux disease underwent high-resolution manometry using a 36-channel manometry catheter. The peristalses of 10 water and 10 steamed bread swallows were recorded in both supine and upright positions. Integrated relaxation pressure, contractile front velocity, distal latency (DL) and the distal contractile integral (DCI) were investigated and comparisons between postures and boluses were analyzed. Abnormal peristalsis of patients was assessed applying the corresponding normative values. RESULTS: In total, 829 swallows from healthy volunteers and 959 swallows from patients were included. (1) The upright position provided lower integrated relaxation pressure, shorter DL and weaker DCI than the supine position. (2) In the comparison of liquid swallows, the mean for contractile front velocity was obviously reduced while DL and DCI were increased in solid swallows. (3) The supine position detected more hypotensive peristalsis than the upright position. The upright position provided more rapid and premature contraction than the supine position but there was no statistically significant difference. CONCLUSIONS: Supine solid swallows occur with more hypotensive peristalsis. Analysis should be based on normative values from the corresponding posture and bolus.
Bread ; Catheters ; Esophageal Motility Disorders ; Gastroesophageal Reflux ; Humans ; Manometry* ; Peristalsis ; Posture ; Relaxation ; Supine Position ; Swallows* ; Water

Objective Pancreatic enzymes may spread into the injured intestine, bloodstream,and cause the cascade of inflammatory reactions. Our objective was to explore trypsin expression in serum and vital organs in septic rats. Methods Trypsin levels in serum, heart, lung and jejunum were tested and compared between Escherichia coli endotoxin injected rats(SS), SS treated with a protease inhibitor (ulinastatin) and control group(SHAM). The correlations between serum trypsin, intestinal proteins and inflammation indices were assessed.Two components of mucosal barrier, i.e. mucin-2 and E-cadherin,were measured to evaluate the intestinal mucosal barrier function. The levels of tumor necrosis factor alpha (TNFα), interleukin-6(IL-6) and neutrophil elastase(NE) were measured to determine the inflammation indices.Results Compared to SHAM group, trypsin levels in serum[(73.71±9.14) ng/ml vs. (12.12±2.36) ng/ml],heart[(51.60±15.06) ng/ml vs. (6.39±3.53) ng/ml],lung [(54.73±5.57) ng/ml vs. (5.24±3.08) ng/ml] and jejunum(1.19 ± 0.48 vs. 0.40 ± 0.12) were significantly higher in SS group (all P<0.05). The level of serum trypsin had negative correlation with mucin-2 and E-cadherin, and positive correlation with TNFα, IL-6 and NE (all P<0.05). In rats treated with ulinastatin, trypsin levels were significantly decreased compared with those in SS group including in serum [(65.79±4.88)ng/ml]], heart [(26.33±12.03)ng/ml], lung [(28.73±14.46) ng/ml] and jejunum (0.80±0.20) (all P<0.05).Serum TNFα[ (247.34±16.97)ng/L vs. (178.78±40.81)ng/L] revealed similar changes in ulinastatin and SS group, whereas mucin-2(0.58 ± 0.14 vs. 0.89 ± 0.17)and E-cadherin(0.11 ± 0.04 vs. 0.23 ± 0.06)were both significantly elevated after administration of ulinastatin (both P<0.05). Conclusion Serum and tissue trypsin is elevated in septic rats. Protease inhibitor ulinastatin protects intestinal function by reducing inflammatory reaction.