Objective To evaluate the efifcacy and safety of endoscopic submucosal dissection in treatment of prolapse of gastric mucosa.Methods to meet the typical gastric mucosal prolapse of gastric mucosa under endoscopy, the ultrasonic gastroscopy confirmed that the lesion was in the mucosal layer, and the disease was excluded. After PPI continuous treatment for 3 months, no signiifcant improvement in symptoms, in patients with informed consent under the premise of endoscopic mucosal stripping. After 3 months of the operation return visit section for outpatients re-examination of gastroscopy.Results 10 cases of complications of endoscopic submucosal dissection of gastric mucosa prolapse patients had no hemorrhage, perforation after operation, postoperative patients were followed up for 3 months, the symptoms were improved obviously, no antral mucosal prolapse was observed under endoscope.Conclusion Endoscopic submucosal dissection is effective and safe in treatment of gastric mucosal prolapse.

The chemical constituents from green peel of Juglans sigillata were isolated by column chomatographies over silica gel, Sephadex LH-20, and MCI. Four diarylheptanoids were isolated and their structures were characterized as dihydropterocarine(1), 3',4″-epoxy-1-(4'-hydroxy-phenyl)-7-(3″-methoxyl-phenyl)-heptan-3α-ol(2), pterocarine(3), and 1-(4'-hydroxy-phenyl)-7-(3″-methoxy-4″-hydroxyphenyl)-heptan-3α-ol(4). Compound 1 is a new compound, named as dihydropterocarine. Compounds 2-4 were isolated from the plant of J. sigillata for the first time.

Objective To investigate the prognostic value of red cell distribution width (RDW) and relationship between RDW and severity of critical illness patients and prognostic role of RDW.Methods This was a prospective observational and diagnostic test study.From February 2011 to May 2013,196 medical patients in ICU were enrolled to study.Blood samples were taken within 24 hrs after admission to ICU for blood routine test and other chemical routine test,including RDW.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were also calculated.The patients were divided into survival group (n =126) and death group (n =70) based on their hospital outcomes.Differences in RDW levels and APACHE Ⅱ score between survival and death groups were compared with One-way ANOVA.The correlation between RDW and APACHE Ⅱ score were analyzed by Spearman correlation test.Receiver operator curve (ROC) test was used to determine the predictive value of RDW and APACHE Ⅱ for hospital death.Results Both RDW level and APACHE Ⅱ score were significantly higher in death group than those in survival group,whichwere (13.35 ±2.21) vs.(11.34 ±1.32) and (20.43 ±6.41) vs.(13.94 ±6.77) respectively (both P ＜ 0.01).RDW significantly correlated with APACHE Ⅱ score (r =0.309,P ＜0.01).To predict hospital death area under curve (AUC) of ROC curve by RDW and APACHE Ⅱ score were 0.792 (0.725,0.860) and 0.754 (0.686,0.822) respectively.The best cut-off value was determined by Yoden Index were 12.35 for RDW and 17.5 for APACHE Ⅱ score.The Accuracy of prediction was 76.5％ and 70.4％ respectively.In addition,all the 12 paticnts whose RDW level ＞ 15.4 were dead.Conclusion RDW level at admission to ICU correlate well with the severity of critical illness.RDW level has an additional predictive value for the prognosis of critical ill patients.

Objective To investigate the correlation between 28-day prognosis and red cell distribution width (RDW) in sepsis patients.Methods This was a prospective observational study.Two hundred and thirteen sepsis patients were consecutively selected,and the patients were divided into 2 groups according to RDW:normal RDW group (RDW ＜ 0.15,160 cases) and high RDW group (RDW≥0.15,53 cases).The general conditions,acute physiology and chronic health evaluation (APACHE) 1Ⅱ score,sequential organ failure assessment (SOFA),hypersensitive C reactive protein (hs-CRP),procalcitonin (PCT),arterial blood lactic acid,liver function injury,renal function injury and 28-day mortality were compared between 2 groups.The independent risk factors of 28-day prognosis were analyzed by multifactor Logistic regression analysis.Kaplan-Meier survival analysis was used to draw the 28-day survival curve,and the survival rate was compared between 2 groups by log-rank test.Results The 28-day mortality in high RDW group (35.8％,19/53) was significantly higher than that in normal RDW group (17.5％,28/160),and there was statistical difference (P =0.007).RDW ≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.634,95％ CI 1.316-5.273,P =0.006).After adjusted by gender,age and other relative factors,RDW≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.895,95％ CI 1.155-7.252,P =0.023).The 28-day accumulative survival rate in high RDW group was significantly lower than that in normal RDW group (50.5％ vs.63.0％),and there was statistical difference (P =0.014).Conclusion The high RDW in sepsis patients is the independent risk factor of 28-day death,and RDW ≥0.15 shows an important predictive value in the prognosis of sepsis patients.

BACKGROUNDThe pathophysiology of poststroke depression (PSD) remains elusive because of its proposed multifactorial nature. Accumulating evidence suggests that brain-derived neurotrophic factor (BDNF) plays a key role in the pathophysiology of depression and PSD. And the cerebellar dysfunction may be important in the etiology of depression; it is not clear whether it also has a major effect on the risk of PSD. This study aimed to explore the expression of BDNF and high-affinity receptors tyrosine kinase B (TrkB) in the cerebellum of rats with PSD.

METHODSThe rat models with focal cerebral ischemic were made using a thread embolization method. PSD rat models were established with comprehensive separate breeding and unpredicted chronic mild stress (UCMS) on this basis. A normal control group, depression group, and a stroke group were used to compare with the PSD group. Thirteen rats were used in each group. Immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) for detecting the expression of BDNF and TrkB protein and mRNA in the cerebellum were used at the 29 th day following the UCMS.

RESULTSCompared with the normal control group and the stroke group, the number of BDNF immunoreactive (IR) positive neurons was less in the PSD group (P < 0.05). Furthermore, the number of TrkB IR positive cells was significantly less in the PSD group than that in the normal control group (P < 0.05). The gene expression of BDNF and TrkB in the cerebellum of PSD rats also decreased compared to the normal control group (P < 0.05).

CONCLUSIONSThese findings suggested a possible association between expression of BDNF and TrkB in the cerebellum and the pathogenesis of PSD.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Cerebellum ; metabolism ; Depression ; etiology ; metabolism ; Female ; Protein-Tyrosine Kinases ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stroke ; complications

OBJECTIVE：To establish a meth od for the simultaneous determination of 7 active components in Mori Australis Cortex and Mori Cortex from different sources in Chongqing area ，so as to provide reference for improving the quality control standards of Mori Australis Cortex and Mori Cortex and comparing the equivalence of their quality. METHODS ：HPLC method was used to determine the contents of neochlorogenic acid ，mulberroside A ，chlorogenic acid ，astragalin，kaempferol，morusin and isoquercetin in 58 batches of Mori Australis Cortex and Mori Cortex. The chromatographic column was Diamonsil C 18 with mobile phase consisted of 0.1％ formic acid solution-acetonitrile （gradient elution ） at the flow rate of 1.0 mL/min. The detection wavelength was 280 nm，column temperature was 30 ℃，and the injection volume was 10 μL. Using SPSS 22.0 software， independent sample t-test，principal component analysis and cluster analysis were used to analyze the content difference of the above-mentioned 7 active components in Mori Australis Cortex and Mori Cortex. RESULTS ：There was a good linear relationship between the peak area and the concentration of the above 7 active components （r≥0.999 0）. The RSDs of precision ，stability（24 h），repeatability，durability and recovery were less than 3％. The average contents of neochlorogenic acid ，mulberroside A ， chlorogenic acid ， astragalin， kaempferol， morusin and 023-58576130。E-mail：1025473978@qq.com isoquercetin in Mori Australis Cortex were 0.304，22.462， 1.730，1.308，1.593，2.842 and 0.657 mg/g，respectively. Those of Mori Cortex were 0.305，22.995，2.486，2.438， 2.916，4.158 and 1.264 mg/g，respectively. The results of independent sample t-test showed that only the content of kaempferol in the above 7 active components of Mori Australis Cortex and Mori Cortex had significant difference （P＜0.05）. The results of principal component analysis and cluster analysis showed that there was no significant difference in the contents of above 7 active components between Mori Australis Cortex and Mori Cortex. CONCLUSIONS：The established HPLC method is simple ，sensitive and accurate ，which can provide a reference for improving the quality control standard of Mori Australis Cortex and Mori Cortex. Mori Australis Cortex and Mori Cortex have certain quality equivalence in main active components ，and the Mori Australis Cortex from M. australis and M. cathayana can be used as a substitute for the Mori Cortex.

Objective To investigate rickettsiae infection from host animals and vector arthropods in some areas of Yunnan Province. Methods Rat clip and cage traps were used to capture mice. Chiggers from body surface of mice and ticks from body surface of farm cattle were collected. DNAs were extracted from mice spleens, chiggers and ticks. Rickettsiae groEL segment were amplified by nested-polymerase chain reaction (nPCR), sequenced to analyze the homology with other known sequences. Results A total of 410 samples were collected for rickettsiae groEL segment detection with nPCR and 19 samples (4.63%) showed positive for rickettsiae groEL segment . Among them, 2.68%(11/410)were positive for Orientia tsutsugamsushi (Ot) groEL segment, and 1.22%(5/410)were positive for spotted fever group rickettsia (SFGR) groEL segment, and 0.49%(2/410)were positive for rickettsia mooseri (Rm) groEL segment, and 0.24%(1/410)were positive for rickettsia endosymbiont(Re) groEL segment. When analyzed the homology with other known sequences, 11Ot strains with 93.6%-100% similarities among them in this study shared the highest similarity with other Ot strains from GenBank respectively, reached up to 96.1%-100%; The groEL segments of 5 SFGR strains with 92.1%-99.5% similarities among them in this study shared highest similarity with other SFGR strains from other GenBank respectively, reached up to 98.9%-100%; In this study groEL segments of 2 Rm strains all showed 100% similarity with Wilmington strain (GenBank No:AE017197); One groEL segment of Re showed 98.9% similarity with Re strain (GenBank No:EU435143). Conclusion There were kinds of rickettsiaes infection in host animals and vector arthropods in Yunnan Province, so the monitoring and prevention of the Rickettsiosis should be strengthened.

Objective To investigate the application of venous superdrainage technique based anterolateral thigh flap based on oblique branch for the soft tissue defect of proximal shank.Methods Between October,2012 and March,2017,11 cases of the soft tissue defect in proximal shank were treated.There were 8 males and 3 females with a mean age of 43 (range,26-59) years.Causes of injury:7 cases of traffic injury,3 cases of bruise,1 case of machine wound;The defect sizes ranged from 10 cm×5 cm to 13 cm×10 cm,with fracture or plate exposure.Accord ing to the size of the defect,the distally based anterolateral thigh flap was designed to repair the defect.The flap sizes ranged from 14 cm×6 cm to 16 cm×8 cm.The oblique branch and their accompanying vein with great saphenous vein was anastomosed to construct the venous superdrainage,and the donor site suture directly.Three cases followed-up by WeChat,and 8 cases by return visit.Results Distally based anterolateral thigh flaps were derived from oblique branches,and no arteriovenous crisis occurred postoperatively.Eleven flaps healed well after operation.There were no distal end blood supply disorder.Followed-up for 6-12 months,the flaps survived well.The texture was closed to the surrounding skin,and no ulcer exposed.There were no serious complications in donor site.And the thighs were linear scars.Conclusion The distally based anterolateral thigh flap based on oblique branch have a long vascular pedicle.The venous superdrainage technique can effectively avoid venous crisis,and improve the survival quality of the flap and the survival rate.

Objective:To investigate the effect of different arbuscular mycorrhizal （AM） fungi combinations on the rhizospheric environment of Paris polyphylla var. yunnanensis. Method:The different combinations of 12 arbuscular mycorrhizal （AM） fungi species were inoculated to the seedlings P. polyphylla var. yunnanensis planted in the sterilized soil under the condition of room temperature to investigate their infection abilities and effects on the root activity，soil nutrient contents，enzyme activities and microbial community structure of P. polyphylla var. yunnanensis rhizospheric environment. Result:The inoculation of exogenous AM fungi can regulate the spore densities and infection rate of P. polyphylla var. yunnanensis rhizosphere AM to improve the root activity， the exogenous AM fungi can also regulate the nutrient contents in the rhizosphere soil，increase the contents of total glomalin and easily extracted glomalin，increase the abilities of P. polyphylla var. yunnanensis to absorb the available N，P and K，and increase the enzyme activities in the rhizosphere soil， improve the microbial community structure， and improve the rhizospheric environment of P. polyphylla var. yunnanensis by increasing the bacteria/fungi and bacteria/actinomycetes quantity ratios and reducing the fungi/actinomycetes quantity ratio. Conclusion:Different AM fungal treatment groups had certain effects on the physicochemical properties and microbial community structure of the rhizosphere soil of P.polyphylla var. yunnanensis，which provided a technical basis for the cultivation of P. polyphylla var. yunnanensis.