This article introduced the biological characteristics of N-methyl-D-aspartate (NMDA), and reviewed the relationship be-tween NMDA receptor and neurological disease, including cerebral trauma, cerebral ischemia, epilepsy, neuropathic pain, depression and Al-zheimer disease.

Objective:To investigate the expression of 5-HT 2A receptor in the prefrontal cortex of traumatic brain injuryinduced coma rats after median nerve electrical stimulation.Method:A total of 72 SD rats (weighing 250-300g) were randomly divided into 4 groups:a stimulationgroup,an antagonist group,a sham-stimulation group and a control group.This traumatic brain injury model was established by a weight-drop head injury,and we evaluated the change of behavior through the six classical levels of consciousness.The animals were sacrificed and their brain tissues were removed at 6,12,and 24 hours after injury.5-HT 2A protein expression was examined by immunohistochemistry.Result:Thirteen rats exhibited righting reflex in the stimulation group.In the antagonist group,9 rats exhibited righting reflex.5 rats in the sham-stimulation group had the same response.The mean rank of consciousness degree were degree 9.50 in the control group,degree 52.75 in the sham-stimulation group,degree 37.61 in the stimulation group,degree 46.14 in the antagonist group.Comparison among groups presented an increasing consciousness degree:control group＜stimulation group＜antagonist group＜sham-stimulation group(P＜0.01).Resuits from immunohistochemistry showed that significant differences in the 5-HT 2A expression among the four groups (sham-stimulation＜control＜antagonist＜stimulation))(P＜0.05),and a within-group comparison showed that the 5-HT 2A expression level was as follows:6 hours＜24 hours ＜12 hours(P＜0.05).Conclusion:Median nerve electrical stimulation might modulate wakefulness by promoting the 5-HT 2A expression via orexin-A in the prefrontal cortex of rats with traumatic brain injury-induced coma.

Objective To investigate the expression of H1 protein in the prefrontal cortex of comatose rats which have suffered traumatic brain injury (TBI) after electrical stimulation of the median nerve (MNS).Methods Seventy-two Sprague-Dawley rats (weighing 250 to 300 g) were randomly divided into a stimulated group (MNS+ TBI),an antagonist group (MNS+TBI+OXR1 antagonist),a model group (TBI) and a control group,with 18 rats in each group.Traumatic brain injury was modeled in all of the rats except those of the control group.After the modeling,the stimulated group was given MNS,the antagonist group was provided with MNS and an OXR1 injection,and the model group was given MNS with a current intensity of 0.One hour after the experiment,the consciousness of each rat was evaluated using a double-blind method.Animals were sacrificed at 6,12 and 24 hours after the intervention and brain tissue was removed.H1 protein expression was examined using immunohistochemistry.Results One hour after the experiment,significant differences were observed in the consciousness of the 4 groups,with the 18 rats of the control group on consciousness level one.Thirteen rats in the stimulated group exhibited a righting reflex,compared with 9 in the antagonist group and 5 in the model group.Immunohistochemistry showed that H1 expression was strongest in the stimulated group,followed by the antagonist,control and model groups.The H1 expression was highest at 24 hours after the experiment,followed by that at 6 h and 12 h,but those differences were not statistically significant.Conclusion Median nerve electrical stimulation might modulate wakefulness after traumatic brain injury by promoting H1 expression via orexin-A in the prefrontal contex.

Objective To investigate the wake-promoting action of median nerve electrical stimulation(MNES) in coma rats induced by traumatic brain injury(TBI) and its influence on the expression of α1-adrenergic receptor(α1 R) in the prefrontal contex (PFC).Methods Seventy-two healthy Sprague Dawley(SD) rats were randomly divided into the control group,sham-stimulated group(TBI),stimulated group (TBI+ MNES) and antagonist group(TBI+ OX1R antagonist +MNES).The control group had no any treatment.The TBI coma rat models were prepared in the other 3 groups.The sham stimulated group had no treatment.The antagonist group was injected with orexin receptor-l(OX1R) antagonist SB334867 into lateral ventricle,and both the antagonist group and stimulated group received MNES treatment.Then the behavior changes of rats in each group were observed and the α1 R expression level in PFC was detected by using the immunohistochemistry technique.Results Thirteen rats in the stimulated group and 8 rats in the antagonist group revived,while only 4 rats in the TBI group.The α1R levels from low to high were the blank control group,sham-stimulated group,antagonist group and stimulated group,showing the increasing trend,and the difference was statistically significant(P＜0.05).Conclusion MNES can improve the rat consciousness level after TBI coma,and its mechanism may be related with up-regulating the α1 R expression level in PFC area,moreover Orexin-A participates in this regulation process.

Parathyroid carcinoma is a rare sporadic disease.Clinical manifestations include hypercalcemia,increased urinary calcium and urinary calculus,osteoporosis,and pathologic fracture.While this patient complained of pollakiuria,urgency,and painful urination,thus might lead to misdiagnosis or missing of diagnosis of parathyroid carcinoma.This article is herewith presented to call attention to discovery,diagnosis,and treatment of parathyroid carcinoma.

Objective To explore the possibility of the inner vertical outer spiral complex tubular urethra scaffold vascularization in repairing long segment of urethral defect.Methods From August 2014 to October 2015,27 clean male New Zealand white rabbits were divided into 3 groups,S1 group was transfected recombinant vascular endothelial growth factor(VEGF) gene lentiviral vector group.S2 group was vascular pedicle transfer tube group.C group was simple stent group.A 3.0 cm inner vertical outer spiral complex scaffold was constructed by using the small intestine acellular matrix (SIS) and polylactic acid copolymer (PLGA) modified by type Ⅰ collagen surface,and adipose-derived mesenchymal stem cells (ADSC) and smooth muscle cells after transformation from New Zealand white rabbits.In S1 group,the seed cells were transfected by recombinant vascular endothelial growth factor (VEGF) gene lentivirus,which express VEGF protein.The complex scaffold was used to repair 3.0 cm rabbit urethral defect In S2 group,the untransfected cells were seeded into the scaffold and embedded in the skin near the groin artery 3 weeks for repairing urethral defect with vascular pedicle transfer tube.In group C,the unseeded scaffold was used to repair the urethral defect alone.Postoperative observation and urethrography were followed 4,8 and 24 weeks after implantation.The HE staining,fluorescence tracing,immunohistochemical and scanning electron microscopy were evaluated at the same phase.Results In S1 group,there were one urinary fistula and one urethral stricture-related death,respectively.The urethra was smooth and patent,histological examination showed active hyperplasia of urethral capillary.In S2 group,there were one urinary fistula and two urethral stricture-related deaths,respectively.The urethral was rough,local thinning or dilated.Fat accumulation and mucosal contraction were found in the urethral submucosal,respctively.In C group,there were one urinary fistula,three hypospadias,and three urethral stricture-related deaths.The thickness of the urethra was uneven and stricture bending.The urethral mucosa was poorly repaired and the scar was narrow.HE and CD31 staining showed that S1 and S2 groups were active in the proliferation of urethral capillaries,and the angiogenesis was abundant.VEGF staining showed that the cytoplasm of endothelial cell layer,smooth muscle layer of vascular wall and the urothelial epithelial cell layer were fully expressed at 24 weeks,especially in epithelial cell layer.CKpan staining showed that the epithelium of S1 and S2 group developed to stratified epithelium,and the morphology of urethra was similar to normal urethra at 24 weeks.The urethral epithelial in C group of grew poor as single-level,irregular arrangement,24 weeks is still a lack of effective stratified epithelium.HE and oα-SMA staining showed that the smooth muscle and actin gradually increased in group S1 and S2,α-SMA staining in group C was scarce and increased at 24 weeks.PLGA was encapsulated by the surrounding tissue and the structure of electrospinning was clear after 4 weeks,absorbed and degraded after 8 weeks and absorbed after 24 weeks.Conclusions The inner vertical outer spiral comnplex tubular urethra scaffold maybe a reasonable method in repairing long segment urethral defects,and the methods of tubular urethra scaffold vascularization by transfected VEGF gene recombinant lentiviral vector and vascular flap deserve more research.

Objective To compare the transfection rate and safety between SonoVue + ultrasound and liposome mediated gene transfection to retinal pigment epithelium (RPE) in vitro, and to approach the feasibility of SonoVue and ultrasound enhancing liposome mediated gene transfection to RPE in vitro. Methods RPE were cultured in 24 well dishes with green fluorescent protein plasmid of 2 μg/well. All the cells were divided into 5 groups: control group, ultrasound irradiance group, SonoVue + ultrasound irradiance group(2 W/cm2 and 3 W/cm2),liposome group and liposome + SonoVue + ultrasound irradiance group. There were 10 wells in every group. Gene transfection results were observed under inversion fluorescent microscope. Seventy-two hours later, gene transfer was guantified under flow cytometry. The apoptosis rates of RPE were determined with Annexin Ⅴ-FITC and PI staining by flow cytometry. Results The transfection rate of ultrasound exposure group was (1.06 ± 0.13)%. The transfection rate of SonoVue + ultrasound group was (15.81 ± 1.70)% and (20.86 ± 2.63)%. The transfection rate of liposome group was (30.06 ± 3.49)% ,and the differences between above mentioned sets were significant(P<0.05). The transfection rate of liposome + SonoVue + ultrasound was (44.51 ± 1.28) %,and the differences between above mentioned two sets were significant (P<0.05). Conclusions The transfection rate of liposome is higher than that of SonoVue + ultrasound group. SonoVue and ultrasound can obviously enhance liposome mediated EGFP gene transfection to RPE in vitro.

Objective To investigate the effects of total anthraquinone in rheum on aquaporin 2 and aquaporin 4 expression in rat kidney and explore its diuresis mechanism.Methods Thirty-two SD rats were randomly divided into control group,low dose group,medium dose group and high dose group.Total anthraquinone in rheum was administered to rats at different doses.Urinary volume of 24 h,Na+ concentration and osmolality were detected.Rats were sacrificed 5 days later.Blood samples were taken from the abdominal aorta to detect blood biochemical indicators. Kidneys of rats were removed to detect AQP2, AQP4 expression through immunohistochemistry,Western blot,and RT-PCR. Results Compared with control group,there were significantly increased 24 h urine output of rats in medium and high dose group[(16.21±1.96),(18.16±1.8) ml vs(13.85±1.25)ml,P＜0.05].24 h urine output in low-dose group did not change significantly.AQP2 protein and mRNA expression were significantly decreased in rats'kidneys of medium and high dose group (P＜0.01),The AQP4 protein and mRNA expression was significantly down-regulated in high dose group (P＜0.01).In medium does group,the AQP4 protein expression was down-regulated (P＜0.01),without significant decrease in the mRNA expression.Protein and mRNA expression of AQP2 and AQP4 did not significantly change in low dose group.Conclusion Total anthraquinone in rheum can reduce the expression level of AQP2 and AQP4 in rat kidney,which is probably one mechanism of diuresis caused by rheum.

ObjectiveTo investigate whether the eight- year program students retain the skills from the endoscopy simulator gastroscopy training.Methods4 trainees accepted virtual reality simulator gastroscopy training and performed a standardized VR gastroscopy scenario at the end of training,and after a median 12 months without practice ( retention ).The intensified training was done by trainees based on the differences between the training end and the retention for a median 12 months and the number of intensified training times was found.ResultsThe significant differences existed in the overinsufflation and opeirational force and time.The score at the training end was better than after retention.Through the average 5.5 times intensified trainings the original levels could be reached.ConclusionThrough Endoscopy Simulator the key skills could be retained well and through a litde training the original levels could also be reached.

ObjectiveTo observe effects of the nonunion of stale humeral shaft fracture treated by using the interlocking medullary nail.Methods21cases with the stale fracture of humeral shaft were treated with the interlocking medullary nail. The effect over post operation 1 year was evaluated.ResultsAll cases were recovery after treated by the interlocking medullary nail. Conclusions It shows that the effect of treating the fracture of humeral shaft with the interlocking medullary nail is very satisfactory.