Amyloid beta-peptides ( Aβ) is the key pathological feature of Alzheimer’s Disease (AD). Various factors contrib-ute to the accumulations of Aβ in the brains of patients. Among them, blood-brain barrier ( BBB) plays a crucial role in trans-porting Aβ between the brain and the bloodstream while this transfer function is mediated by the receptor of Aβon BBB. The abnormality of Aβ transport and related receptor expression can be detected in the brains of patients with AD, resulting in an un-usual increase in Aβlevels unusually increased . This review e-laborates the structure and function of BBB, the transport of Aβand the expression and transport mechanism of the related recep-tor, as well as summarizes the possible clearance strategy of Aβacross the BBB.

A method of solid phase extraction coupled with ultra performance liquid chromatography-tandem mass spectrometry ( SPE-UPLC/MS/MS) was developed for the determination of 15 phthalate esters. Drinking water samples were concentrated by C18 SPE cartridge. The fifteen phthalate esters were separated on a phenyl column with gradient elution using methanol and water as mobile phases. Multiple reaction monitoring ( MRM) acquisition under positive ion mode was performed. The external matrix standard solutions were used for the quantitative determination. The linear range of Di-n-butyl phthalate was 0. 63-1000 μg/L. The other 14 phthalate esters showed good linearity in the range of 0 . 002-500 μg/L with the correlation coefficients more than 0. 9970. The limits of quantification ( LOQ) were 2. 2-632 ng/L. The spiked recoveries ranged from 81 . 3% to 109%. The relative standard deviations were less than 14%.

[Objective]To discuss the treatment effect of locking compression plate(LCP)for proximal humeral complicated fractures.[Method]A retrospective study was done on 21 cases of proximal humeral fractures treated with LCP from April 2005 to June 2006.There were 13 male and 8 female,with age of 26-71 year(mean 42.3 year).According to Neer classification,15 cases were three-part fractures including 5 cases with anterior dislocation and 6 cases with primary osteoporosis;6 cases were four-part fractures including 3 cases with anterior dislocation and 2 cases with posterior dislocation.Reduction and fixation were done by deltopectoral-gap approach,the operator put the locking plate on 10mm positerior to the intergroove of tuberosity,5mm away from the tip of humeral greater tuberosity.If there were bone defects in the fracture site after reduction,they were treated with allografts,locking screws and unlocking screws were drilled into proximal and distal part of the fracture.Shoulder exercise should be performed passively three days after operation.One week after operation,active shoulder exercise was done,which was gradually intensified two weeks after operation.[Result]Twenty-one cases were followed up for 10-14 months,average 12.5 months,all fractures were union in 12 month.According to Neer shoulder score,the result was excellent in 11 cases,good in 7 and fair in 3,with excellent and good rate of 85%.[Conclusion]The screw of LCP can lock the plate so that the plate can firmly fixate the proximal humeral comminution fractures and osteoporosis bone,so simultaneously reach fracture union and function exercise,but attentions should be paid to the suitable procedure of LCP to avoid a series of problem of locking plate.

Proteio degradation via ubiquitin-proteasome system(UPS) is carried out with a wide variety of signallingpathways,from cell cycle and transcription to development.The mass spectrometry-based proteomics techniques are powerful tools in the research of UPS.The recent advance in the study of UPS by proteomics techniques is briefly reviewed.

Objective To explore the nursing experience of the safe intra-hospital transport of patients with the severe aspiration of the inhalation injury. Method The nursing measures for the intra-hospital transport of 2 cases of smoke pot inhalation injury caused by extracorporeal membrane oxygenation treatment were taken, including disease risk assessment, preparation for transport, organization of a transport team, effective vital signs monitoring during transport, extracorporeal membrane oxygenation (ECMO) pipeline monitoring and nursing and observation and nursing of complications. Result No emergency was found during the transport of patients and both of them were safely transported. Conclusion Such nursing measures as pre-transport assessment and preparation and bettering predictive nursing for the patients with severe inhalation pulmonary injury treated with extracorporeal membrane oxygenation are key to the safety during intra-hospital transport.

Problem-based learning(PBL)plays an improtant role in fostering the ability of problem-solving,creative thinking and active learning of medical undergraduates.Based on the present clinical education resources,how to implement PBL at the largest advantages is the main issue we should concern.

Meisoindigo is an indigo natural derivative commonly used in anti-cancer therapy. In the clinical application, it was also found to have good therapeutic effect on psoriasis. In order to further understand its mechanism of action, human normal keratinocyte cell line HaCaT and RAW 264.7 were used to identify if meisoindigo could affect the inflammatory factors such as NO and other important cytokines which were highly involved in psoriasis. Our results indicated that meisoindigo decreased the production of NO in LPS-stimulated RAW 264.7 cells and reduced the expression of cytokines in LPS-stimulated HaCaT cells. And TLR4-TAK-NF-kappaB was a possible pathway mainly involved in the attenuation of iNOS and pro-inflammatory cytokine production by meisoindigo, which may take part in the therapeutic effect of meisoindigo on psoriasis.

The good cooperation between the operating room nurses and anesthesiologists is benefitial to improving working efficiency and can make the patients uneventful during operating period.As an anesthesiologist,the author taught the basic anesthesia knowledge such as the commonly used anesthesia methods,the prevention and treatment of complications and gave advice to the nurses of the nursing trainning group.The cooperations before anesthesia,during anesthesia,after anesthesia were analyzed and the significance of nursing cooperation with anesthesiologist was discussed.

Objective To evaluate the value of multislice spiral computed tomography angiography (MSCTA) in differential diagnosis between epithelial ovarian carcinoma (EOC) and borderline epithelial ovarian tumor (BOT).Methods The MSCTA images of 39 EOC patients and 23 BOT patients confirmed by surgical pathology were reviewed retrospectively.Main characteristics of tumor vessels were analyzed: the number of feeding arteries, the existence of dilated draining veins, whether the tumor vessels were tortuous, whether the distribution of tumor vessels were disturbed, and whether there were accompanying microaneurysms or arteriovenous malformations (AVMs).Results Two or more feeding arteries of the EOCs and BOTs were 89.7% (35/39) and 8.7% (2/23), respectively.Dilated draining veins were observed in 87.2% (34/39) of the EOCs and 4.3% (1/23) of the BOTs.The tortuosity of tumor vessels was observed in 97.4% (38/39) of the EOCs and 13.0% (3/23) of the BOTs.79.5% (31/39) of the EOCs and 8.7% (2/23) of the BOTs were complicated by microaneurysms, and 74.4% (29/39) of the EOCs and 4.3% (1/23) of the BOTs were complicated by AVMs.The characteristics of tumor vessels were significantly different between the two groups (P<0.01), with relatively high sensitivity and specificity.Conclusion MSCTA can better show the distribution, number and pattern of tumor vessels and is of great value in differential diagnosis between EOC and BOT.

Objective To observe the change of the balance between regulatory T (Treg) cells and T helper 17(Th17) cells in peripheral blood of the patients with serofast syphilis .Methods From January 2010 to September 2012 ,28 patients with serofast syphilis in our department were selected into the observation group and 30 normal persons were selected into control group .Flow cytometry was used to measure the expression of Treg cells ,Th17 cells ,specific transcription factors Foxp3 and ROR-γ in the pe-ripheral blood .The comparative analysis was carried out .Results The proportion of Treg cells in the peripheral blood of the obser-vation group was (34 .02% ± 12 .31% ) ,which was higher than (21 .86% ± 8 .24% ) in the control group(P<0 .05) ,and the pro-portion of Th17 cells in the peripheral blood of the observation group was (3 .08% ± 2 .17% ) ,which was lower than (9 .13% ± 1 .96% ) in the control group(P<0 .01);the expression level of Foxp3 of CD4+ T cells was (2946 .35 ± 995 .63) in the observation group ,which was higher than (2468 .74 ± 869 .63) in the control group(P< 0 .05),and the expression level of ROR-γwas (1438 .29 ± 659 .31) ,which was lower than(1831 .25 ± 426 .37) in the control group(P<0 .05) .All above differences had signifi-cantly statistical significance .Conclusion The Treg/Th17 cell balance is abnormal in peripheral blood of the patients with serofast syphilis .This cellular immunity suppression of human body may be the reason leading to serofast syphilis .