Spinal cord injury can lead to neurogenic bowel dysfunction. With the research of the enteric nervous system, slow transit constipation had a better understanding of the pathogenesis. This article reviewed gastrointestinal motility after spinal cord injury and motilin, substance P, and vasoactive intestinal peptide.

China ; Evidence-Based Practice ; HIV Infections ; prevention & control ; Humans

In the thyroid surgery,parathyroid and laryngeal recurrent nerve injury is the most common complications.With the deepening understanding of the laryngeal recurrent nerve anatomy and surgical skills,laryngeal recurrent nerve injury incidence decline,and the prevention of complications of thyroid operation has turned to protect the parathyroid gland from laryngeal recurrent nerve protection.The technique of carbon nanoparticles labeled lymph nodes can effectively protect the parathyroid gland in thyroid surgery.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Objective To summarize the analytical results of radioactivity in the food and drinking water nationwide following the Fukushima nuclear accident,and to evaluate its possible contamination to the public health in China.Methods According to the national standard methods and IAEA,FDA correlative references,the scheme was established on sampling and measurements in food and drinking water after the breakout of the accident.The quality control was requested on the sampling,analyses and data report.Results Trace artificial radioactive isotope of 131I was measured in spinach samples on 2 April 2011 in Beijing. Subsequently 131I was found in 10 kinds of growing leaves vegetables (open field)nationwide.The maximum detectable activity of 131I in vegetables was about 3.1 Bq/kg.Since 3 May 2011,the concentration of 131I has been below the detection limits.No artificial radionulide was detectable in all of milk,drinking water and marine products samples during March to December,2011.Conclusions The food and drinking water measurements in China following the Fukushima nuclear accident denoted that the minor amounts of 131I in vegetables might result in very low absorbed dose and induce no impact on human health.The maximum detectable activity of 131I in vegetables was close to that reported in European countries,and much less than that measured in China immediately after the Chernobyl accident in 1986.

Objective To observe the effects of 7,8-dihydroxyflavone (7,8-DHF) on hypoxia induced endoplasmic reticulum stress (ERS) in human proximal tubular epithelial cells (HK-2).Methods The mRNA level of ERS associated biomarkers was evaluated by RT-PCR assay in cell hypoxia damaged model.And HK-2 cells were pretreated with different concentrations of 7,8-DHF through CCK-8 assay;meanwhile CCAAT/enhancer-binding protein homologous protein (CHOP),Cyr61,Akt and p-Akt were determined by western blotting assay.Moreover,HK-2 cells were pretreated by LY294002,a kind of PI3K/Akt inhibitor,to inhibit the PI3K/Akt signaling,and its effects on protein level induced by 7,8-DHF was detected.HK-2 cells was then over-expressed Cyr61 and exposed to hypoxia Apoptosis rate and CHOP expression were determined.Results Compared to hypoxia group (P ＜ 0.01),Hypoxia for 12h was effective in inducing ERS (P ＜ 0.01),while pretreatment with 7,8-DHF (100 μmol/L) increased cell proliferation significantly.The protein expressions of Cyr61 and p-Akt in H+7,8-DHF group were higher,but the level of CHOP was decreased (P ＜ 0.05).With LY294002 pretreated,the expression of Cyr61,p-Akt was down-regulated (all P ＜ 0.05) while the expression of CHOP was up-regulated (P ＜ 0.05).In comparison to empty plasmid group,when cells were transfected with over-expression of Cyr61 plasmid and exposed to hypoxia,the number of apoptotic tubular cells was decreased (P ＜ 0.01).And over-expression of Cyr61 significantly reducedCHOP expression compared with the empty plasmid group (P ＜ 0.01).Conclusion Pretreatment of 7,8-DHF could protect cells from hypoxia injury and inhibit ERS,which may involve the Akt-Cyr61 signaling pathway.

Objective To study the anatomic characteristics of Zuckerkandl's tubercle (ZT) and its clinical relevance as an anatomic landmark of the recurrent laryngeal nerve (RLN) in thyroid surgery.Methods This study involved 147 (106 with benign thyroid diseases and 41 with malignancies) patients who underwent thyroidectomy.ZT was measured and classified based on the Pelizzo classification.The relationship between ZT and the RLN and the relationship between the RLN and the inferior thyroid artery were recognized and classified.Results 233 (107 left and 126 right) thyroid gland lobes were dissected and ZT was identified in most patients (left in 93.5％ and right in 96.0％).The distribution of ZT according to grade was as follows:Grade 0,left 16.0％ and right 13.2％ ; Grade Ⅰ,left 32.0％ and right 27.3％ ; Grade Ⅱ,left 46.0％ and right 44.6％ ; Grade Ⅲ,left 6.0％ and right 14.9％.There was no significant difference on classification between the left-sided and right-sided ZTs.In terms of the relationship between the ZT and the RLN,it was classified as follows:Type A,left 92.9％ and right 93.3％ ; Type B:left 0 and right 0; Type C:left 7.1％ and right 6.7％.Similarly,there was no significant difference between the left sided and the right sided.The ZT grade was correlated with the course of the RLN:the higher the ZT grade was (that is,the greater the size of the ZT),the more often was the course of RLN behind the back of the ZT; the lower the ZT grade (that is,the smaller the size of the ZT),the more often was the course of RLN running by the lateral of the ZT.Considering the incidence of being dangerous type of RLN,the right sided (19.0％) was higher than the left sided (8.3％).The relationship between the ZT and the RLN does not relate to RLN course across the inferior thyroid artery.Conclusions As an important anatomic landmark,the ZT is essential for locating and dissecting the RLN during thyroid surgery,and its classification is a guide to RLN dissection and preservation.

Objective To provide a clinical anatomic basis for the bi-pedicled gastrocnemius myocuta- neous flap which is to be used to repair defects of the Achilles tendon and posterior skin of the ankle.Methods In anatomic study,out of 30 cadaver specimens,bi-pedicled V-Y gastrocnemius myoeutaneous flaps were harvested to measure the downward sliding lengths of the flap when the knee was at flexion of different degrees.In clinic,12 patients with the Achilles tendon and posterior ankle skin defects were repaired with the bi-pedicled gastrocnemius myocutaneous flaps.The areas of composite defects ranged from 10 cm?6 cm to 6 cm?4 cm.They were followed up for four months to 12 years.Results The maximal sliding length of the flap reached (9.2?0.9)cm when the knee was at flexion of 90?.All the clinical flaps survived and ambulation of the patients recovered.The dorsiflexion and plantarflexion of the ankles reached 11.0??1.4?and 35.0??4.6?respectively.Conclusion This flap is suitable for one-stage repair of composite Achilles tendon defects.

Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P < 0.05). There was no statistically significant difference between the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, (P > 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.

The significantly high prevalences of cholelithiasis in patients with spinal cord injury (SCI) are related to impaired sympathetic innervations to the gallbladder. Sonography before and after the ingestion of a standard fatty meal is usually applied in evaluation of gallbladder function. This paper reviewed the innervations of gallbladder, sonography application in evaluation of gallbladder function and the relationship between SCI and cholelithiasis.