Female ; Humans ; Middle Aged ; Recurrent Laryngeal Nerve ; abnormalities ; diagnostic imaging ; Tomography, X-Ray Computed

The tight junction of intestinal epithelium plays an important role in maintaining the function of intestinal barrier and regulating the cell differentiation. The intestinal epithelial cells interact with neighboring cells and the extracellular matrix and then affect the epithelial barrier as well as the proliferation, polarization, and apoptosis of cells. As an important cell junction, the tight junction of intestinal epithelium participates in a series of signal transduction pathways including the classic cyclic adenosine monophosphate-protein kinase A-cyclic adenosine monophosphate response element-binding, inositol trisphosphate, Ras-mitogen-activated protein kinase, phosphatidylinositol 3-kinase, and in some special pathways including zonula occludents protein 1-associated Y-box factor,cyclin related protein, phosphorylation, and methylation. Furthermore, regulations of gene and protein expression of the tight junction are also complex, while disorders of such regulations may lead to clinical diseases, such as disruption of the intestinal barrier, refractory infection, and even cancers. This article reviews the research advances in gene expressions, related signal transduction, and self-regulation in the tight junction of intestinal epithelium.

Establishment of depressive animal model is the premise for evaluating the effect and mechanism of traditional Chinese medicine on depression. Many traditional Chinese medicines for depressive treatment in a mouse model of experimental studies have demonstrated a sound antidepressant effect, indicating that traditional Chinese medicine treats depression effectively. Therefore, more and more attentions have been paid in recent years. My article made a summary on depressive animal models of experiment study.

An investigation was made on reforrs of connty public hospitals in Yulin region,Shaanxi province.With theories of public administration,the authors probed into the government investment behavior in county-level public hospitals reform,hospital operation mechanism,and govemmem regulation,as well as multi-sector involvement in healthcare services Proposals made in the paper advocate constructing a responsible and limited service-based government in the county-level public hospitals reform.

Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

With the change of diet and lifestyle,the development of medical concepts and techniques,the spectrum of disease has changed dramatically. The standardization of gastrointestinal surgery will be the key to further improvement.Endoscopic ultrasonography,computed tomography,magnetic resonance imaging, positron emission tomography-computed tomography and laparoscopy are helpful for preoperative staging of gastrointestinal carcinoma.The standards of operation,such as D2 lymph node dissection for gastric cancer and total mesenteric excision for rectal cancer,are also very important.Creating standards for multi-disciplinary treatment of gastrointestinal diseases will be important factors for improving outcomes.

ObjectiveTo explore help-seeking behavior and treatment towards people with mental illness,so as to provide evidence for intervention measures.Methods 1988 mental disorders in outpatient were selected with a self-developed questionnaire randomly,and regression analysis was carried out.ResultsUnstable marriages and the lack of mental health knowledge were risk factors for actively professional help-seeking contact after first onset of a mental disorder.Median delays of seeking help and treatment in depression,schizophrenia,anxiety disorders and somatoform disorders were 113.5 days,34.0 days,86.5 days,309.0 days and 6.0 months,3.0 months,3.0 months,5.5 months orderly.There were notable difference for primary treatment contact between the four mental disorders ( x2 =46.317,P =0.029 ).No-professional recognition ratio was 17.8％.The ratio of correctly diagnosed and rationally cured with drugs ratio was 10.5％.89.5％ of outpatients had not been given rational drugs then they sought to psychiatry.ConclusionThe delay of help-seeking and treatment in mental illnesses are serious,so it should be taken effective measures to promote the popularization of mental health knowledge and train no-professional doctors in order to improve the behavior of seeking help and provide the ratio of recognition and treatment.

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Objective To investigate the methods for the detection of serum samples with low-concentration HBsAg and its clin-ical value.Methods Serum samples with HBsAg weak positive were measured by ELISA or using Roch cobas e601 were collected from the clinical laboratory.The samples with low-concentration HBsAg were confirmed by neutralization assay by using Lizhu ELISA reagent Kit or Roch cobas e601 analyzer.at the same time,ALT/AST concentrations and HBV DNA copies were also deter-mined.Results Among 53 samples that showed weak positive reaction by using Kehua reagent kit,37 samples were positive in neu-tralization test,while the other 16 samples were negative.Among 18 samples that showed weak positive reaction tested by using Roch cobas e601 analyzer,13 samples showed positive in neutralization test,and the other 5 samples showed negative.Conclusion The results of HBsAg test varies in different detection System.The clinical significance of samples with low-concentration HBsAg needs further study.

Objective:To explore the anti-fatigue effect of Tibet maca in mice. Methods: The mice were respectively given the powder or the alcohol extract of Tibet maca. The lactic acid concentration in blood, serum lactate dehydrogenase ( LDH) , the time of weight loading swimming and serum urea ammonia level after the exercise in the mice were detected, and the anti-fatigue effect of the powder and the alcohol extract of Tibet maca was compared. Results: After the 30-day feeding, the serum LDH activity of the mice taking the powder or alcohol extract of Tibet maca was obviously higher than that of the mice in the control group(P<0. 05), the time of weight loading swimming was significantly longer than that in the control group (P<0. 05), and the blood lactic acid concentration after the exercise was obviously lower than that in the control group (P<0. 05). Conclusion: Tibet maca can improve the time of weight loading swimming of mice, and reduce the level of serum urea ammonia after exercise and blood lactic acid concentration, sug-gesting the powder and alcohol extract of Tibet maca have obvious anti-fatigue effect.