Neuropeptide Y (NPY) is a pancreatic polypeptide-related peptide, consisting of 36 amino acids. NPY is expressed in the nervous system widely and abundantly, mainly in the hippocampus, regulates the excitability of neurons through its receptors (Y_1, Y_2, Y_5). In recent years the research progress indicated the changes induced by seizures in the level and distribution of NPY, its receptors subtypes and their respective mRNAs in brain. The inhibitory action of NPY on glutamate-mediated neurotransmission and in seizure phenomena, suggests that one of its roles in hippocampal physiology is to modulate neuronal excitability by regu-lating glutamate release.

Objective To analyze the characteristics of military training injury caused by distal femoral fractures that used reverse interlocking intramedullary nail(retrograte nails) and condylar plate to fix,and then compare the clinical treatment effects.Methods Retrospective analysis of clinical information of 30 cases,14 cases were treated with reverse interlocking intramedullary nail(reverse nail group) and 16 cases with condyle plate fixation(condyle plate group),all the cases were followed up for 12～20 months to compare the treatment effect and complications.Results According to Merchan criteria with clinical evaluation of knee function,the rate of good and excellent was 85.7% in the reverse interlocking in-tramedullary nail group,68.7%(P

catechin plus dexamethasone-treated group. Compared with nephrotic group, the renal pathologic score were significantly different among the nephrotic group and the catechin-treated group (6 80?0 84,P

Objective To study the features of pulmonary cryptococcosis and the curative effect of thoracoscopic operation for it. Methods The authors retrospectively analyzed the clinical data of 11 patients with pulmonary cryptococcosis in this hospital between January 1996 and December 2002, consisting of 8 cases of thoracoscopic wedge resection, 2 cases of thoracoscopy-assisted modified posterolateral mini-lobectomy, and 1 case of pulmonary wedge resection. Results Ten patients were preoperatively misdiagnosed. Solitary lesions were found in 8 patients and multiple lesions in both lungs in 3 patients. Complete removal of lesions was achieved in 8 patients and pulmonary biopsy was conducted in 3 patients. Except for 3 cases of wound effusion, there were no other postoperative complications. Follow-up for (38.6?10.8) months (range, 12～72 months) found no pyothorax, bronchopleural fistula, or recurrence of cryptococcosis. Conclusions Pulmonary cryptococcosis usually makes its appearance as a solitary lesion without underlying diseases or symptoms, which is difficult to diagnose preoperatively. Video-assisted thoracoscopic surgery can remove the lesion completely, giving a minimal invasion and rapid recovery.

Objective To investigate the security and validity of transabdominal preperitoneal prosthetic (TAPP) in treatment of incarcerated hernia.Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method:observation group with treatment of laparoscopic reposition and TAPP (56 cases) and control group with treatment of open reduction and tension-free hernioplasty (68 cases).The operative time,hospital stay,bed time,hospital costs,recurrence rate and complication were compared between the 2 groups.Results All patients in observation group were received laparoscopic surgery successfully.The operation time,hospital stay,bed time in observation group were significandy shorter than those in control group [(37.52 ± 7.78) min vs.(44.23 ± 11.32) min,(4.53 ± 0.89) d vs.(6.85 ± 2.03) d,(9.30 ± 2.65) h vs.(12.63 ± 3.97) h],there were statistical differences (P ＜0.05).The hospital costs in observation group was significandy higher than that in control group [(9 324 ± 599) yuan vs.(7 203 ± 507) yuan],there was statistical difference (P ＜ 0.05).There was no statistical difference in complication rate between the 2 groups (P ＞ 0.05).Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group,there was no statistical difference between the 2 groups (P ＞ 0.05).Conclusions TAPP is safe and effective with advantages of mini-invasion,quicker recovery but more hospital costs in treatment of incarcerated hernia.The recurrence rate of TAPP is similar to tension-free hernioplasty.

Objective To investigate the effect of early early enteral nutrition combined with parenteral nutrition support on postoperative gastrointestinal function,nutritional status and liver function of patients with obstructive jaundice.Methods Sixty-two patients with obstructive jaundice of hepatobiliary who were treated in the General Surgery Department of the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2014 were randomly divided into the control group and the observation group,31 cases in each group.The control group were treated with simple parenteral nutrition,and were injected by central venous catheter at the first day after operation,with the injection tiem of 12-15 h and continuous infusion of 7 d or more.The observation group were received enteral nutrition combined with parenteral nutrition,parenteral nutrition was given first,and the preparation method of the nutrient solution was identical with that of the control group;and then slowly dropped 250 ml physiological saline into the jejunum nutrition tube at the second day,dropped into the enteral nutrition liquid at the third day with the initial dose of 300 to 500 ml per day,slowly dropped in the speed of 20-30 ml/h.Results The first exhaust time,first defecation time and hospitalization time in the observation group were (41.37±6.85) h,(46.85±7.13) h and (12.79±3.76) d,significantly shorter than those in the control group ((57.21 ± 9.23) h,(61.43 ± 10.62) h and (16.94 ± 4.33) d;t =7.67,6.35,4.03;P＜O.05),daily hospitalization expenses was (1637.65± 138.24)yuan,significantly less than that in the control group((2121.42±112.38)yuan;t=15.12;P＜0.05).The serum albumin berofe and after the operation in the control group and observation group were (28.73±3.24) g/L and (29.21±3.31) g/L,(36.85±4.05) g/L and (47.21±4.13) g/L,respectively.The serum pre albumin berofe and after the operation in the control group and observation group were (162.81±31.27) g/L and (163.14±30.56) g/L,(248.95±58.62) g/L and(324.24±61.34) g/L,respectively.There was no difference before operation between the two groups (P＞0.05),while the serum protein levels were significantly increased in observation group than the control group (P＜0.01).There were no difference in ALT,total bilirubin and direct bilirubin levels between the two groups before operation (P ＞ 0.05),after treatment,the levels of ALT,total bilirubin and direct bilirubin in the observation group were significantly higher than those in the control group(P＜0.01).The patients in the two groups recovered well,and no serious adverse reactions occurred.Conclusion Early enteral and parenteral nutrition support in patients with obstructive jaundice has better effect and safety in the clinical treatment.

Objective To observe the prognostic effects of the patients with intracranial saccular aneurysm (Hunt-Hess grade Ⅳ- Ⅴ)first treated conservatively for 12 hours and then with surgical treatment and endovascular treatment. Methods The clinical data of 32 patients with intracranial saccular aneurysm (grade Ⅳ,n = 24 and gradeⅤ,n = 8)Hunt-Hess grade Ⅳ-Ⅴadmitted from January 2012 to January 2014 were analyzed retrospectively. Sixteen of them were treated conservatively for 12 hours in hospital,and then they were treated with surgery or embolization (postpone surgery group)and 16 underwent emergency surgery or embolization (immediate surgery group). The neurological prognosis of the patients was evaluated at 1,3 and 6 months before and after treatment. Results There was no significant difference in Glasgow outcome scores between the postpone surgery group and immediate surgery group at 1 month after treatment (3. 7 ± 1. 4,3. 8 ± 1. 2;t = 1. 372,P > 0. 05);there was no significant difference in Rankin prognostic scores at 3 months after treatment (3. 7 ± 1. 7,3. 6 ± 1. 5;t = 1. 361,P > 0. 05);But there was significant difference in prognostic scores at 6 months after treatment between the two groups (3. 5 ± 1. 5, 4. 2 ± 1. 8;t = 2. 234,P < 0. 05). Conclusion Patients with high grade cystic aneurysmal subarachnoid hemorrhage can be treated with conservative treatment. After 12 hours,endovascular embolization or surgical treatment may be performed. The prognosis at 6 months is better than emergent direct surgery or embolization.

Objective To explore the effect of bone marrow mesenchymal stem cells (MSCs) on LPS-stimulated BV2 microglia in inflammatory reaction. Methods Mouse MSCs were isolated and purified by adherence screening. The routinely cultured BV2 microglia in vitro were divided into PBS control group (group A),PBS plus MSCs treatment group(group B),LPS stimulation group(group C) and LPS plus MSCs group(group D).MSCs and BV2 microglia were cultured in the transwell co-culture system for 24 hours. We observed BV2 microglia morphological changes under the microscope,detected the concentrations of NO by Griess reaction,and the level of IL-1β,TNF-αby ELISA. Results MSCs can improve the morphology of activated microglia. The concentrations of TNF-a, IL-1βand N0 in culture supernatants were increased significantly (P < 0.05) after microglia activation, however, at the present of MSCs,the concentration of these inflammatory factors declined dramaticly (P<0.05). Conclusions MSCs can significantly inhibit the activation of microglia. It may play a neuroprotective effect by reducing the inflammation of microglia. MSCs showing anti-inflammatory effects through non-direct contact with nicroglial, suggesting that MSCs outside the brain may also inhibit the activation of microglia.

Objective To discuss and analyze the clinical relationships between the gene polymorphism of vitamin D receptor and adiponectin with the susceptibility of non-alcohol fatty liver disease(NAFLD).Methods One hundred and two cases of NAFLD were selected as the observation group,and other 100 healthy volunteers were selected as the control group.The gene polymorphism of vitamin D receptor and adiponectin in the two groups was detected,then the genotype distribution and allele frequencies of vitamin D receptor and adiponectin were compared between the two groups,then their relationship with the susceptibility of NAFLD was analyzed.Results The genotype distribution situation of vitamin D receptor BsmI site,adiponectin 45 and 276 sites had statistically significant difference between the observation group and control group(P＜0.05).The B allele frequency of BsmI site of vitamin D receptor in the observation group was far lower than that in the control group,and the allele frequencies of 45-T and 276-G of vitamin D receptor in the former were far higher than those in the latter,and the differences between the two groups were statistically significant(P＜0.05).The multivariate unconditional Logistic regression analysis showed that vitamin D receptor:bb genotype,adiponectin 45 locus:TT genotype and ALT,TG,complicating hypertension history and HOMA-IR all were the independent risk factors in NAFLD patients.Conclusion The genotype distribution of different sites of vitamin D receptor and adiponectin has obvious abnormality in the patients with NAFLD,and both are closely related with the NAFLD susceptibility.

Objective To evaluate the detection competence of HbA2 and HbF in Guangxi medical laboratories.Methods The external quality assessment(EQA) of HbA2 and HbF was conducted twice a year and five samples was detected each time during 2012 to 2016.The laboratories participated in EQA completed the samples' detection and submitted the detection results at specified time according to the requirements of EQA.The distribution of each detection system,the qualification rate of each laboratory,the variation degrees of each detection system and each detection method,and the variations of results for different levels of quality control(QC) materials during 5 years were analyzed based on the returned results.Results The application of high performance liquid chromatography (HPLC) and capillary electrophoresis(CE) increased year by year and their usage rates in 2016 reached up to 46.1％ (82/178) and 18.0％ (32/178),respectively.The qualification rates of HbA2 and HbF increased from 51.5％ (34/66) and 60.6％ (40/66) in 2012 to 93.3％ (166/178) and 92.1％ (164/178) in 2016,respectively.The average coefficient of variation(CV) of each detection system decreased year by year.There were good CVs for the results of high,medium and low levels of HbA2 QC materials detected by the Bio-Rad Variant Ⅱ and Sebia CAPILLARYS 2 systems,and they were less than 6.0％.HPLC and CE could quantitatively detect the HbA2 and HbF levels,and their total detection competence was superior to that of agarose gel electrophoresis.Conclusion EQA can assess the abihty of one laboratory detecting HbA2 and HbF,and quantitatively analyze the levels of HbA2 and HbF,which may provide the quality assurance and data support for the screening and prevention of thalassemia.