In the paper, the optimal self-scaling strategy to the modified symmetric rank one (HSR1) update, which satisfies the modified quasi-Newton equation, is derived to improve the condition number of the updates. The scaling factors are derived from minimizing the estimate of upper bounds on the condition number of the updating matrix. Theoretical analysis, and numerical experiments and comparisons show that introducing the optimal scaling factor into the modified symmetric rank one update preserves the positive definiteness of updates, and greatly improves the stability and numerical performance of the modified symmetric rank one algorithm.

OBJECTIVE:To study the effect of natural emulsifier acacia senegal on in vivo and in vitro performance of chloro-genic acid self-microemulsion. METHODS:Chlorogenic acid self-microemulsion containing acacia senegal(new chlorogenic acid self-microemulsion)was prepared by using acacia senegal to gradually replace polysorbate 80 in chlorogenic acid self-microemul-sion containing nonionic emulsifier (traditional chlorogenic acid self-microemulsion). The appearance,morphology,particle size,conductivity,pH value,stability,in vitro release and intestinal absorption kinetics of the 2 kinds self-microemulsions were evaluated. RESULTS:50％of polysorbate 80 was replaced by acacia senegal in new chlorogenic acid self-microemulsion. The tradi-tional and new chlorogenic acid self-microemulsions had clear appearance,and approximately spherical drops. Particle sizes were (24.53 ± 3.03),(35.51 ± 5.91) nm;dectrical conductivities were (195.6 ± 0.3),(189.5 ± 0.4)μs/cm;and pH were 3.87 ± 0.02, 4.08 ± 0.03 (n=3),respectively. Compared with traditional chlorogenic acid self-microemulsion,the absorption rate constant,ef-fective permeability coefficient and absorption amount of the new one in duodenum,jejunum,ileum were increased a little (P>0.05);the above indexes in colon were obviously decreased (P<0.05). CONCLUSIONS:The new chlorogenic acid self-micro-emulsion can maintain the performance of traditional one,and increase absorption of chlorogenic acid in small intestine.

BACKGROUND:The existed artificial anal sphincter cannot sense whether there are intestinal contents in the bowel and the state of intestinal contents, and the previous studies on the intestinal content signal did not included the different parts of colon and the signals of different intestinal content status.
OBJECTIVE:To compare the differences of ultrasound signals of different intestinal content status in different parts of New Zealand rabbits detected with transmission-type ultrasonic signal detection system.
METHODS:Twenty healthy New Zealand rabbits were used;the rabbits were divided into groups according to distal part of proximal colon, distal colon and distal rectum. Five positions of solid stool particles were selected randomly as the detection point in each group. The voltage signals of stool were measured under solid, fluid, gaseous, and deflation status of the lumen.
RESULTS AND CONCLUSION:In rectum, there were no significant differences in voltage signals between solid and gaseous conditions, while there were significant differences between fluid and deflation conditions (P=0.000). Multiple comparison showed there were significant differences between four conditions in distal part of proximal colon and distal colon (P=0). There were significant differences in voltage singles between rectum, distal colon and proximal colon under solid and fluid conditions (P=0). Multiple comparison showed there were significant differences in any part of large bowel for solid and fluid status (P=0). There were no significant differences in voltage singles between rectum, distal colon and proximal colon under gaseous and deflation conditions. There was interactive effect of intestinal contents between three parts of large bowel under the four conditions (P=0.000). Transmission-type ultrasonic detection system can distinguish artificial intestinal contents sensory nerves of various intestinal contents. And the application of ultrasonic detection system to detect the intestinal contents under different conditions can provide a new effective method for the research on artificial intestinal content sensory nerves.

Objective To investigate the role of T-type calcium channel in lidocaine-induced neuronal cytotoxicity . Methods SH-SYSY cell line was a gift from cell biology laboratory of our medical university. The cells were cultured in DMEM liquid culture medium at 37℃ in incubator filled with 5% CO2 , and randomly divided into 4 groups ( n = 66 each) : control group (group C)and M, L and ML groups were exposed to 5 μmol/L mibefradil (a T-type calcium channel blocker), 10 mmol/L lidocaine and 5 μmoL/L mibefradil + 10 mmol/L lidocaine for 24 h. Cell morphology was examined by electronic microscopy at 24 h of drug exposure. Cell viability (by MTT) and neuronal apoptosis (by flow cytometry) were detected immediately before and at 1, 6, 12 and 24 h of exposure to mibefradil or/and lidocaine.Results In C and M groups, the cells demonstrated dendritic protrusions, enlarged nerve processes and dense lattice. After being exposed to lidocaine for 24 h, the dendritic protrusions disappeared,the cells decreased in size, shrinked and became round; the cell viability was significantly decreased while the neuronal apoptosis increased. The lidocaine-induced changes were significantly attenuated by co-incubation with mibefradil. ConclusionT-type calcium channel is involved in lidocaine-induced neuronal cytotoxicity.

Objective Comparative study of gastric tube implantation at different times in patients with invasive mechanical ventilation. Methods Random sampling was used to divide 160 patients who were incubated with mechanical ventilation at the hospital into two groups,There were 80 patients in each group. Two groups of patients were routinely placed gastric tube by a stationary nurse.The observation group was treated with ordinary silica gel stomach tube at early stage(immediately)after trachea cannula, the control group still used the ordinary silica gel stomach tube after the trachea cannula late (24 hours later).The one-time successful rate,the total successful rate,the operation time and the result of the two Methods were observed in the two groups. Results The observation group Placing stomach tube one-time successful rate and the total successful rate was 75% (60/80), 97.5% (78/80), significantly higher than the control group 27.5%(22/80),72.5%(58/80),the difference was statistically significant(χ2=36.12, 19.61,P<0.01).The operation time of gastric tube in observation group was(1.49 ± 0.45)min,which was significantly lower than that of control group(3.07 ± 0.32)min,the difference was statistically significant (t=25.48,P<0.01).The observation group only heard gurgling not pumped to the gastric juice of 10 cases (12.50%), only smoke into the gastric juice does not hear the gurgling in 0 cases, both in 70 cases (87.50%),both in 0 cases,the control group were 37 cases(46.25%),0 cases,40 cases(50.00%),3 cases (3.75%). There were significant differences between the 2 groups in determining the success of gastric tube placement,and the difference was statistically significant(χ2=39.36,P<0.01). Conclusions After the trachea cannula,the ordinary silica gel gastric tube was placed in the early stage(immediately),which improved the successful rate of gastric tube placement in the mechanical ventilation patients, Shortened the operation time,improved the work efficiency and alleviated the patient's pain.

Objective To establish a UPLC-MS/MS method for simultaneous determination of 19 chemical drugs in Traditional Chinese Medicines and health products for treating rhinitis. Methods Separation was performed on Waters ACQU-ITY UPLC BEH-C18column(2.1 mm×100 mm,1.7 μm) with 0.1% formic acid acetonitrile solution and 0.1% formic acid aque-ous solution as the mobile phase by gradient elution.The flow rate was 0.3 mL·min-1.The column temperature was set at 35 ℃. The detection was performed by the positive ion electrospray ionization (ESI+) under multiple reactions monitoring (MRM) mode. Results The linear relationships of 19 chemical drugs were good in respective ranges with correlation coefficients higher than 0.995.The average recoveries of the low,medium,and high level were in the range of 84.9%-111.1%,and the RSDs were less than 5.2%.The limits of detection (LOD) and the limits of quantitation (LOQ) were in the range of 0.03-0.78 ng·mL-1 and 0.13-1.82 ng·mL-1,respectively. Conclusion The method is convenient,rapid,accurate,and sensitive,which can be used for the determination of chemical drugs added illegally in traditional Chinese medicines and health products for treating rhini-tis.

Lumbar spinal stenosis is a common clinical syndrome in orthopedics,frequently oc-curring in the elderly,and can affect the physical and mental health as well as daily life of patients.Surgery is the primary treatment measure for lumbar spinal stenosis,among which laminoplasty has re-ceived widespread attention in recent years.This article reviewed the current application status and research progress of laminoplasty for lumbar spinal stenosis in the elderly,aiming to provide reference for technical research and clinical practice in this field.

Lumbar spinal stenosis is a common clinical syndrome in orthopedics,frequently oc-curring in the elderly,and can affect the physical and mental health as well as daily life of patients.Surgery is the primary treatment measure for lumbar spinal stenosis,among which laminoplasty has re-ceived widespread attention in recent years.This article reviewed the current application status and research progress of laminoplasty for lumbar spinal stenosis in the elderly,aiming to provide reference for technical research and clinical practice in this field.

Hepato-pancreato-biliary diseases (HPBD) are often complicated. The diagnosis and treatment of HPBD involve many disciplines. The malignant degree of hepatobiliary pancreatic system is high, and the prognosis of patients is poor. The multidisciplinary team (MDT) brings specialists from different disciplines together to make a comprehensive and individualized treatment for patients. MDT is emerging in HPBD in recent years. MDT helps improve the accuracy of diagnosis and prognosis. However, there are still some controversies and obstacles in the application of MDT for patients with HPBD. We reviewed the development, current status and experience of MDT in the field of HPBD, analyze the current controversy and obstacles, and providing reference for its future application.

[Abstract] Objective: To observe the effects of shikonin on the proliferation, apoptosis and cell cycle of human esophageal carcinoma TE-1 cells, and to explore its mechanism. Methods: TE-1 cells were treated with different concentrations of shikonin (0, 1, 5, 10 µmol/L). MTT assay was used to detect cell proliferation at different time points (24, 48 and 72 h). After treatment with shikonin for 48 h, cell apoptosis in TE-1 cells of each group was observed with Hoechst 33258 fluorescence staining. Flow cytometry was used to detect apoptosis and cell cycle. The changes in expression of TRAP1/Akt/mTOR signaling pathway related proteins were detected by Western blotting. Results: Shikonin inhibited the proliferation of TE-1 cells in a time-dose-dependent manner (P<0.05 or P<0.01). Compared with the control group, shikonin significantly promoted the apoptosis of TE-1 cells (P<0.01), induced the G0/G1 phase block of TE-1 cells (P<0.05 or P<0.01), and reduced the expression levels of TRAP1, p-Akt and p-MTOR (P<0.05 or P<0.01). The above effects were all dose-dependent. Conclusion: Shikonin can significantly inhibit the proliferation of TE-1 cells in vitro, induce G0/G1 phase arrest and promote apoptosis, which may be closely related to the inhibition of TRAP1/Akt/mTOR signaling pathway.