Our study showed that the concentration of plasma ammonia in patients with hepatic encephalopathy was increased significantly than that in patients with decompensated liver cirrhosis, primary hepatocellular carcinoma and fulminant hepatitis. The concentration of serum free tryptophan and "free/total" tryptophan ratio in patients with hepatic encepha-lopathy were significantly increased as compared with patients of other three groups. The concentration of serum serotonin was not significantly increased and that of serum 5-hy- droxyindolacetic acid was significantly increased in comparison with normal controls. In addition, the concentrations of serum free tryptophan and serum "free/total" ratio were closely positive correlated with the degree of hepatic encephalopathy, the concentrations of. plasma ammonia and serum free tryptophan and serum "free/total" ratio were higher in patients with hepatic coma than that of patients regainning consciousness, but the difference was not statistically significant. The role of plasma ammonia and serum tryptophan in pathogenesis of hepatic encephalopathy was discussed

Objective To investigate the ultrasonographic manifestations of the wrestler's ear.Methods Fifteen healthy volunteers and 12 wrestlers and judokas underwent sonography on ears of both sides. Results The appearance of the wrestlei's ear was the thick auricle,wrestlers hydrocele,increasing of color Doppler signals and conchal cartilage injury. There was significant difference between the average auricular thickness of athletes[(0.95±0.41)cm]and that of volunteers[(0.41±0.07)cm,t=7.06,P＜0.(11].Conclusions The ultrasonographic appearance of the wrestler's ear is characteristic.It is significant of ultrasonography to be used in the evaluation of diagnosis and therapy.

Objective To study the potential effects of angiopoietin 1(Ang1) via adenovirus mediated gene transfer on ischemic heart disease in rabbits. Methods Forty-five male New Zealand white rabbits underwent high positioned double-ligation of the anterior descending left coronary artery, and were divided into three groups: Ang1 group (n=15) received direct myocardium injection of Ang1 recombinant adenovirus; DMEM group (n=15) and LacZ group (n=15) received only DMEM and LacZ recombinant adenovirus as controls respectively. The myocardial infarcted size was evaluated by N-BT macroscopic standing and the degree of angiogenesis was assessed by use of immunohistochemical analysis. The echocardiographic changes were measured on before operation and the 7 th, 14 th, and 28 th postoperative days. Results Animals in three groups had no significant difference in the percentage of infarction size of left ventricle at the 7 th, 14 th day and capillary density at the 7 th day. Animals in Ang1 group showed less infarcted size than DMEM group or LacZ group at the 28 th day and higher capillary density at the 14 th and the 28 th day. The results from echocardiographic measurements showed that animals in all three groups had no significant difference in the left ventricular systolic function before operation and at the 7 th , 14 th day, but the left ventricular systolic function in Ang1 group was better than that in DMEM group or LacZ group at the the 28 th day(P

Objective To investigate associations of UC with the polymorphisms of TRAIL receptors.Methods From January 2008 to December 2012, 380 consecutive UC patients [215 males and 165 females, the average age was (42.63 ±14.61) years] as well as 539 sex-and age-matched healthy individuals [290 males and 249 females, the average age was (41.29 ±15.86) years] were recruited from four large scale comprehensive hospitals in Wenzhou city.Five single nucleotide polymorphisms of DR4 (rs20575, rs13278062), DR5(rs1047266), DcR2(rs1133782) and OPG (rs3102735) were detected by a SNaPshot technique.Distributions of mutant alleles and genotypes for targeted polymorphisms in TRAIL receptors were analyzed by Chi-square test or Fisher′s exact test. By means of unconditional Logistic regression analysis, it evaluated associations between the polymorphisms and the risk of UC attack as well as the clinical features of UC patients.Furthermore, an unconditional Logistic multiple regression analysis was employed to investigate the independent risk factors of UC and their multiplicative interaction effects on UC.Results The frequencies of mutant allele (G) and genotype (CG+GG) of DR4(rs20575) were higher in UC patients than those in the controls (3.55%vs 1.95%,χ2 =4.512, P=0.034;6.58%vs 3.71%,χ2=3.938, P=0.047, respectively).However, the frequeucies of mutant allele ( A) and genotype ( GA+AA) of DcR2(rs1133782) were decreased in UC patients compared to the controls(6.18%vs 9.09%,χ2=5.183, P=0.023; 11.32% vs 17.44%, χ2 =6.589, P=0.010, respectively).The frequencies of mutant allele (T) and homozygote (TT) of OPG(rs3102735) were significantly higher in UC patients than in the controls (86.32% vs 81.54%, χ2 =7.385, P=0.007;75.26% vs 66.98%, χ2 =7.346, P=0.007, respectively) .Furthermore, the genotype (GG) of DcR2 (rs1133782) was found to be the independent risk factor for UC attack (OR=4.937, 95%CI:2.320-10.504, P<0.001).Moreover, the (GG) of DcR2(rs1133782) and (CC) of DR4(rs20575) had an interactive effect on UC (OR=0.322, 95%CI:0.164-0.633, P=0.001).The same conclusion was drawn for the ( GG) of DR4( rs20575) and (TT) of OPG(rs3102735) (OR=1.580, 95%CI:1.165-2.144, P=0.003).Conclusions The genetic polymorphisms of DR4 ( rs20575 ) , DcR2 ( rs1133782 ) and OPG ( rs3102735 ) were associated with UC. The mutation of DcR2(rs1133782) might play a protective role in UC.Moreover, the DcR2(rs1133782) and DR4(rs20575) gene had a collaborative effect on UC.So did the DR4(rs20575) and OPG(rs3102735) genes.

OBJECTIVETo assess the suitability of origin habitats of Notopterygium incisum, and provide theoretical basis of screening suitable areas for its large-scale cultivation.

METHODDetailed field survey of N. incisum, spatial databases, and GIS technology were used for the habitats suitability assessment.

RESULTMore than 142 073 km2 in 118 counties of Sichuan, Tibetan, Qinghai and Gansu are the most suitable habitats for N. incisum in which more than 47% of the area is located in sichuan, and more than of 377 000 km2 in 266 counties are relative suitable for N. incisum in Sichuan, Tibetan, Qinghai, Gansu, Yunnan, Xinjiang, etc and 32% of the area is located in Sichuan.

CONCLUSIONAlmost all the most suitable habitats are appropriate for germplasm conservation, wild population protection and regeneration due to the shortage of arable land, fragmentation of these alpine and subalpine ecosystems and sensitiveness of the environment changes. Therefore, large-scale cultivation of N. incisum could be developed in those relative suitable areas abundant in arable lands and labors, especially in moutainous regions with high elevation in the west of Sichuan province, and Qinghai Tibet plateau in the northwest of Sichuan, Southeast of Qinghai and Gansu province.

Objective To study the mutation of FLCN gene in Chinese patients with sporadic and familial primary spontaneous pneumothorax. Methods A complete genetic analysis of FLCN by use of SSCP-PCR was performed in 102 unrelated Chinese patients with isolated PSP. Results Three novel mutations (c. 924_926del, c. 1611_1631del and c. 1740C.T) and a previously reported mutation (c. 1733insC) were identified in five familial and five sporadic PSP patients. Of the 21 family members of patients with PSP including 3 previous considered as sporadic, 4 ( 19% ) had history of at least one episode of PSP and 9 (43% ) were FLCN mutant carriers without PSP. Seven of the nine (78% ) mutant carriers had pulmonary cysts detected by high-resolution computed tomography ( HRCT) . Although c. 924_926del and c. 1611 _1631 del were found in eight patients from the same geographic district, haplotype analysis demonstrated that they did not share the same affected haplotype,thus excluding common ancestry. Conclusion This study first demonstrates that FLCN mutation contributes to not only familial but also apparently sporadic' patients with isolated PSP. It suggests that mutation analysis and HRCT scan may be recommended for first-degree family members of PSP patients with FLCN mutations, irrespective of their family history status of PSP.

Objective To explore the feasibility of repairing the skin and soft tissue defect at finger palm side with the reversed free thenar mini-perforator flaps.Methods From October,2010 to October,2016,7 patients were treated with reversed free thenar mini-perforator flap to repair skin and soft tissue defects at finger palm side,including 5 males and 2 females,which the age were between of 17 and 56 (average,35 years old).Cause of injury:1 case of abrasive wear,1 case of machine twist injury,and 5 cases of heavy injury.All cases with varying degrees of phalanx and tendon exposed.The wound size was from 1.3 cm × 2.0 cm to 2.2 cm × 5.0 cm.According to the origin of the artery in the thenar area,3 kinds of reversed free thenar mini-perforator flaps were designed to repair the defective wound.In the middle of the large fish,the width less than 2.5 cm perforating flap was designed,so that the area can be directly sutured.Results All 7 flaps survived.The flap size was from 1.5 cm × 2.4 cm to 2.5 cm × 5.5 cm.All patients were followed-up from 3 months to 17 months (average,9 months).The appearance and skin texture of flaps was close to the normal finger palm side of the skin,with a clear fingerprint.Two-point discrimination was between 9 mm and 15 mm.The sensory recovery to S3 in 3 cases,S4 in 4 cases.Linear scars were left in the donor areas,with no discomfort.Conclusion This technique has the advantages of good appearance,such as good appearance and small damage to the donor area.However,the surgeon is required the super microscopic techniques.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

As an important complementary form of decoction pieces of traditional Chinese medicine（TCM）， TCM dispensing granules has the advantages of being free of decoction， easy to take， easy to carry and easy to be dispensed， which greatly improves the capacity of emergency services of TCM and is more in line with the needs of modern society. With the end of the pilot project of TCM dispensing granules， the market has been fully liberalized， the competition has been intensified， and it is in the transition period of switching between the new standard and the old one， and there are some problems such as the shortage of varieties， the change of specifications and the difference of quality， and the production enterprises are facing new opportunities and challenges. Based on this， the authors intend to systematically sort out the policies and regulations， enterprise layout and standard formulation since the pilot of TCM dispensing granules. In view of the problems in the post-pilot stage and from the perspective of survival and development of enterprises， it is suggested that enterprises should establish a quality control system for the whole industry chain of TCM dispensing granules to reduce process costs and increase enterprise competitiveness， further increase the investment in scientific research， overcome the key technical problems of difficult varieties， actively and orderly promote the research of national standards， in order to ensure the integrity of clinical formula varieties， and establish and improve the efficacy evaluation mechanism of TCM dispensing granules， build a consistency evaluation system between TCM dispensing granules and decoction pieces. Government departments should strengthen the guidance， fully mobilize the enthusiasm of scientific research institutions， enterprises and hospitals， and explore the establishment of "government-industry-study-research-application" mode to promote the development of TCM dispensing granule industry.

Tyrosine-decahydrofluorene derivatives feature a fused [6.5.6] tricarbocyclic core and a 13-membered