Objective To evaluate the effect of percutaneous endoscopic gastrostomy ( PEG) on the nutritional status and complication rate in patients with enteral nutrition support.Methods Sixty five patients receiving PEG from January 2008 to December 2014 were enrolled in the study.The nutritional status was examined and the incidence of complications was documented before and after PEG.Results The serum albumin, body mass index (BMI) and arm muscle circumference were (29.2 ±3.2)g/L, (18.0 ± 1.0)kg/m2, (21.1 ±1.9)cm and (32.9 ±3.0)g/L, (18.8 ±1.6)kg/m2, (23.0 ±3.0)cm before and 1 month after PEG, respectively (t=-6.798, -3.202 and -3.957, all P<0.05).Compared to those before PEG, the serum albumin, BMI and arm muscle circumference at 3 and 6 months after PEG were increased to ( 35.4 ±4.9 ) g/L, ( 19.7 ±1.4 ) kg/m2 , ( 24.9 ±2.2 ) cm ( t =-7.845, -7.202,-10.432, all P<0.05) and (37.9 ±3.7)g/L, (20.7 ±1.6)kg/m2, (26.9 ±3.7)cm (t=-14.046,-10.686, -9.827, all P<0.05), respectively.Compared to those with nasal feeding, the incidence of aspiration pneumonia was decreased from 62% ( 40/65 ) to 18% ( 10/57 ) and the incidence of reflux esophagitis was decreased from 51% (33/65) to 19% (11/57) 6 months after PEG, respectively (χ2 =24.3 and 13.5, all P<0.01).Conclusion PEG can improve nutritional status and reduce the incidence of aspiration pneumonia and reflux esophagitis for patients with enteral nutrition support.

Objective To explore the influence of intraventricular injection of 5, 7-drhydroxytryptamine (5, 7-DHT)in 5-HT1A receptor sensitivity of medial prefrontal cortex pyramidal neurons in the rats,and to clarity the effect of 5-HT1A receptor on the eletronic response of pyramidal neurons.Methods 36 male SD rats were randomly divided into sham operation group (n=21)and 5,7-DHT lesion group (n=15).5,7-DHT was injected intraventricularly in the rats in 5,7-DHT lesion group,and the same dose saline was injected in the rats in sham operation group.The rats in two groups were intravenously injected with different doses(0.5-128.0μg·kg-1 )of 8-CH-DPAT.The firing rate of mPFC pyramidal neurons was recorded with extracellular electrophysioological examination.The rats in two groups were intravenously injected with WAY100635,the sensitivites of the rats to 8-OH-DPAT and WAY100635 in 5, 7-DHT lesion group were observed, and compared with sham operation group.Results The different doses (0.5-128.0μg·L-1 )of 8-OH-DDAT had an excitatory-inhibitory effect on the firing rate of mPFC pyamidal neurons in sham operation group;the neurons were excited when the doses of 8-OH-DPAT were 0.5-38.0μg·kg-1 ,and the firing rates were increased(P<0.05);the neurons were inhibited when the dose of 8-OH-DPAT was 128.0μg·kg-1 ,and the firing rate was decreased.The different doses(0.5-218.0μg·L-1 )of 8-OH-DPAT inhibited the elecctronic response of pyramidal neurons of the rats in 5,7-DHT lesion group in a dose-dependent manner (df=5,F=3.44,P=0.003),and the firing rates were reduced. WAY-100635 (50μg·kg-1 )reversed completely the inhibition of 8-OH-DPAT.Conclusion The sensitivity of 5-HT1A receptor of rat mPFC pyramidal neurons can be decreased by intraventricular injection of 5,7-DHT.

Objective To assess the clinical features of female patients with AMI and their out-comes .Methods Two hundred and eighty-four AMI patients (216 males and 68 females) were in-cluded in this study .Their clinical features ,complications ,PCI and outcomes were comared .The patients were followed up for 3 months ,during which the major adverse cardiac events (MACE) were observed with their mortality and risk factors for MACE assessed .Results The age was ol-der and the heart rate ,TIMI grade ,GRACE score were significantly higher in female patients than in male patients (P<0 .05 ,P<0 .01) .The ratio of female patients who underwent PCI was signif-icantly lower than that of male patients who underwent PCI (30 .9% vs 48 .6% ,P=0 .012) .The in hospital mortality was higher in female patients than in male patients (17 .6% vs 9 .3% ,P=0.077) ,and the incidence of MACE in a 3-month follow-up period was significantly higher in fe-male patients than in male patients (27 .9% vs 15 .7% ,P=0.032) .Multivariate logistic regression analysis showed that age and Killip classification were the independent risk factors for in hospital mortality (OR=1 .078 ,95% CI:1 .035 -1 .123 ,P=0 .000 ;OR= 1 .901 ,95% CI:1 .373 -2 .633 , P=0 .000) and for MACE in a 3-month follow-up period (OR=1 .040 ,95% CI:1 .008 -1 .074 , P=0 .015;OR=1 .543 ,95% CI:1 .170-2 .034 ,P=0 .002) .PCI was a protective factor for MACE in a 3-month follow-up period (OR=0 .090 ,95% CI:0 .026-0 .306 ,P=0 .000) .Conclusion The age of female AMI patients is older and their heart function is poorer with a higher risk of MACE and a less chance for PCI .However ,gender itself is not an independent predictor for in hospital mortality and M ACE in a 3-month follow-up period .

A spore is another life cycle form of Bacillus anthracis for resisting starvation.When conditions are favorable for growth, the dormant spore will germinate,go through outgrowth, and are ultimately converted back into a growing cell. As the first step back to vegetative growth, germination could be induced by nutrients and a variety of non-nutrient agents. Nutrient germinants trigger cation release and water absorption by binding to receptors in the spore′s inner membrane.Then the spore′s peptidoglycan cortex is hydrolyzed and the spore core rehydrates, which allows the resumption of spore metabo-lism and macromolecular synthesis.This paper reviews the nutrient germinant receptor and cortex lytic enzymes in the spore germination process of B.anthracis.

AIM:To determine the right ventricular angiotensin converting enzyme2 (ACE2) activity in adult SD rats under normoxia and hypoxia environment,and to detect the relationship between ACE2 and high altitude heart disease initially. METHODS:Adult male Sprague Dawley (SD) rats were raised under hypoxia environment simulated to high altitude (5 000 m,23 h/d),then divided into hypoxia 1 d,15 d and 30 d groups randomly. The control group was set up under normoxia environment. The right ventricular function,ponderal index,pulmonary artery pressure and right ventricular ACE2 activity were determined. The effect of captopril or nitrendpine on cardiac ACE2 activity in hypoxia 30 d group was also observed. RESULTS:The dramatic up-regulation of cardiac ACE2 expression of mRNA and protein and its activity in hypoxia 30 d group was observed,together with obvious increase in right ventricular function,ponderal index and pulmonary artery pressure. Although captopril or nitrendipine depressed pulmonary artery pressure and cardiac function dramatically,no significant alteration of right ventricular ACE2 activity was detected. CONCLUSION:Chronic hypoxic exposure promotes the ACE2 expression and activity in right ventricular,indicating that ACE2 may be correlated to the changes of cardiac architecture and function induced by hypoxia. Up-regulation of ACE2 expression maybe contribute to the increase in right ventricular ACE2 activity,and pulmonary artery hypertension may not be the main reason for the changes of ACE2 activity under hypoxia environment.

[Objective]To discuss the basic principles and methods of surgical protocols in treating multilevel cervical disc herniation.[Method]The surgical protocols patients underwent operation based on patient's changes in radiology.Protocols varied from anterior approach discectomy,partial corpectomy with bone grafting and plate fixing;titanium mesh+plate;titanium mesh+plate in major segment and decompression with trepan+cage in secondary segment;combined anterior and posterior surgical procedure.[Result]Totally 96 cases of cervical spondylosis in different types were observed.After average 32 months of follow-up,an overall excellent and good rate in 90% of the cases was obtained.[Conclusion]To choose the appropriate surgical protocol for different multilevel cervical disc herniaion or degenerative myelopathy patients,every treatment should rely on patient's symptoms and changes in radiology.We must check out which vertebra is major segment or secondary segment,generalized or localized,with or without developmental stenosis of cervical spinal canal.Most patients can achieve satisfied prognosis by anterior approach decompression with bone grafting and plate fixing.Intervertebral bone grafting and plate fixing is preferred to single level degenerative.Anterior decompression with approach discectomy,partial corpectomy with bone grafting and plate fixing is preferred to 2 or 3 level degenerative.Combined anterior and posterior surgical procedure is the best method to treat generalized degenerative or obvious stenosis of cervical spinal canal,and continuous type OPLL.In conclusion,the key to excellent prognosis of cervical spondylosis is choosing the right operation for the right patient.

OBJECTIVE:To establish the method for the determination of pemetrexed disodium in human plasma. METHODS:The plasma sample was determined by HPLC after protein were precipitated with strong acid. The determination was performed on Xterra?RP 18 column with mobile phase consisted of acetonitrile-50 mmol/L sodium dihydrogen phosphate buffer solution(15∶85) at the flow rate of 1.2 ml/min. The detection wavelength was set at 225 nm. RESULTS:The linear range of pemetrexed disodium were 1.0-32.0 mg/L (r=0.999 9,n=5) with recoveries of 86.35%-87.25%. RSDs of inter-day and intra-day were lower than 4.21%(n=5). Minimum detection concentration of plasma was 0.05 mg/L. The patients with high plasma concentration easily suf-fered from arrest of bone marrow. The plasma concentration was(18.56±4.50)mg/L,which could induce ADR;when the plasma concentration was (14.05 ± 6.72) mg/L,no ADR was found. There was statistical significance after t-test (P<0.05). CONCLU-SIONS:The method is simple,quick,accurate,sensitive and suitable for the plasma concentration determination of pemetrexed di-sodium and human pharmacokinetics study.

Objective To study the effect of tumor necrosis factor(TNF) and endothelin(ET) on the formation of murine hyperdynamic circulatory syndrome(HCS).Methods Circulation stable HCS model was produced in rats by partial portal vein ligation.Portal blood TNF and ET was determined pre and post injection of anti rat TNF and hemodynamics was monitored simultaneously.Results TNF level did not change 0 5 hour after partial portal vein ligation,but it increased significantly at 24 hour and maintained at this high level thereafter. ET was on a small increment at different time after partial portal vein ligation.The TNF level decreased significantly to the level in controls and ET remained unchanged after injection of anti rat TNF,while HCS was partially ameliorated. Conclusion [WT5”BZ] TNF may be related with the start and maintenance of HCS,and there is no causality between ET and the development of HCS.

Objective To understand the characteristics of complications occurred after endoscopic thyroidectomy and its prevention and treatment.Methods Retrospective analysis on the clinical effects and complications of 105 cases of endoscopic thyroidectomy.ResultsThe average operative time was 85 minutes in the 105 cases.Five cases were transferred to open operation because of bleeding and 11 cases transferred for the intraoperative pathology of papillary carcinoma.After operation,subcutaneous ecchymosis occurred in 5 patients,subcutaneous emphysema in 10 cases,neck and anterior chest skin tautness and discomfort in 7 cases,parathyroid injury in 2 cases.No superior laryngeal nerve or recurrent laryngeal nerve injury was found in the 105 cases.ConclusionUnder strict control on operation indications,proficient and meticulous endoscope operative skills,familiarization with the anatomical structure of thyroid,and timely and proper treatment on postoperative complications can reduce and prevent the occurrence of complications.

Objective To investigate the effects of nerve growth factor (NGF) on the expression of 67-kDa laminin receptor (67LR) in human bile duct carcinoma QBC939 cells, and study the possible mechanism of perineural invasion and metastasis of bile duct carcinoma. Methods ( 1 ) The expression of a high-affinity receptor for NGF, TrkA, was detected by immunofluorescence staining. ( 2 ) QBC393 cells were pretreated by β-NGF at different concentrations ( 1, 10, 100,200 μg/L), and then the mRNA and protein expressions of 67LR were examined by Real-Time PCR and Western blot assay. QBC939 cells were divided into control group and β-NGF (1, 10, 100,200 μg/L) groups. (3) The ideal concentration of β-NGF was selected according to the results of previous tests, and then the mRNA and protein expressions of 67LR were re-examined by adding specific TrkA inhibitor K252a at different concentrations ( 100,200,300 nmol/L). QBC939 cells were divided into control group, β-NGF 100 μg/L group and K252a ( 100,200,300 nmol/L) groups. All data were analyzed by one-way analysis of variance or LSD-test. Results (1) A strong expression of TrkA was detected in the membrane of QBC939 cells. (2) The mRNA and protein expressions of 67LR in QBC939 cells were 0.35 ± 0.06 and 0. 32 ± 0.05 in the control group, 0.38 ±0.14 and 0.50 ±0.09 in the β-NGF 1 μg/L group, 0.62 ±0.14 and 0. 69 ±0. 13 in β-NGF 10 μg/L group, 0.90 ± 0.08 and 0.93 ± 0.07 in the β-NGF 100 μg/L group, and 0. 70 ± 0. 10 and 0. 76 ±0.07 in the β-NGF 200 μg/L group, there were significant differences among the five groups (F = 22. 4, 14. 6,P ＜0.05). The mRNA and protein expressions of 67LR in the β-NGF 100 μg/L group were significantly higher than those in the control group ( t = 19. 0, 21.0, P ＜ 0. 05 ). (3) The mRNA and protein expressions of 67LR in the QBC939 cells were 0.35 ±0.10 and 0.41 ±0.10 in the control group, 0. 88 ±0. 14 and 0.84 ±0.10 in the β-NGF 100 μg/L group, 0.80±0.08 and 0.76 ±0.04 in the K252a 100 nmol/L group, 0.67 ±0.12 and 0.61 ± 0.09 in the K252a 200 nmol/L group, and 0. 43 ± 0.07 and 0. 50 ± 0. 12 in the K252a 300 nmol/L group, there were significant differences among the five groups ( F = 14. 1, 8. 9, P ＜ 0.05 ). There were no significant differences in the mRNA and protein expressions of 67LR between the K252a 300 nmol/L group and the control group (t =1.02, 0. 85, P＞0.05). Conclusion In bile duct carcinoma cells, NGF enhances the expression of 67LR by combining with TrkA, which might be the mechanism of NGF mediating perineural invasion of bile duct carcinoma.