This article introduces the progress about study of lipid mdeiating action of chitosan. It was found that chitosan could mediate blood lipids and modification of chitosan could improve its lipid mediating activity in animal and human.

Objective To compare the quality of life,nutritional status,and immune function after radical proximal gastrectomy,radical total gastrectomy,or radical distal gastrectomy.Methods Totally 163 patients underwent radical gastrectomy for gastric cancer in our department from Jun 2002 to Jun 2008,among whom 36 cases underwent proximal gastrectomy,and 78 cases underwent total gastrectomy,and 49 cases underwent distal gastrectomy.The indicators for their quality of life,nutritional status,and immune function were compared among these three groups.Results The scores for anxiety was significantly higher in the radical proximal gastrectomy group compared with radical total gastrectomy and radical distal gastrectomy groups 1 year(79.8 ± 4.3 vs 72.2 ± 5.2and 70.6±5.5,P=0.037)and 2 years(80.3 ±4.4 vs 70.2±4.8 and 68.6±5.3,P=0.041)after surgery.The scores for the sense of taste was significantly higher in the radical total gastrectomy group compared with radical proximal gastrectomy and radical distal gastrectomy groups 1 year(82.6 ± 1.3 vs 71.1 ±4.8 and 72.3 ± 3.6,P =0.033)and 2 years(88.1 ± 3.4 vs 65.6 ± 5.2 and 69.6 ± 4.8,P =0.046)after surgery.The scores for body appearance was significantly higher in the radical total gastrectomy group compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years(45.5 ± 2.4 vs 35.6 ± 2.2 and 33.3 ± 2.5,P =0.031),1 year(49.2 ± 1.9 vs 33.2 ±2.8 and 32.7 ±2.3,P =0.039),and 2 years(47.6 ±2.5 vs 32.4 ±4.0 and 30.0 ± 2.2,P =0.025)after surgery.The scores for dysphagia was significantly lower in the radical distal gastrectomy group compared with radical proximal gastrectomy group and radical total gastrectomy group 1 year (26.6±3.0vs38.1±2.2 and 35.1 ±2.3,P=0.043)and 2 years(17.3±2.5 vs 36.3±3.1 and 34.1 ±2.4,P =0.021)after surgery.The scores for stomach pain was significantly higher in the radical proximal gastrectomy group compared with radical total gastrectomy 0.5 years(41.2 ± 3.3 vs 37.1 ± 2.5,P =0.039),1year(38.1±2.2vs35.1±2.2,P=0.023),2 years(36.3±3.1 vs 34.1±2.4,P=0.034)after surgery.Radical distal gastrectomy group were significantly lower than those in radical proximal gastrectomy group and radical total gastrectomy group 0.5 years(38.6 ± 3.7 vs 55.3 ± 4.2 and 42.3 ± 3.9,P =0.034),1 year(35.4 ± 3.4 vs52.3 ±3.9 and 39.3 ±4.2,P=0.040),and 2 years(31.6±3.7 vs 53.3 ±4.2 and 35.5 ±3.7,P=0.011)after surgery.Radical proximal gastrectomy group compared with radical total gastrectomy,0.5 years(55.3 ± 4.2vs 42.3±3.9,P=0.036),1 year(52.3±3.9 vs 39.3±4.2,P=0.042),2 years(53.3±4.2 vs 35.5±3.7,P =0.019)after surgery,the difference has statistically significant.The scores for hiccup was significantly lower in the radical distal gastrectomy group compared with radical proximal gastrectomy group and radical total gastrectomygroup,0.5 years(16.8±3.3 vs 45.6±2.5 and 40.3±2.8,P=0.019),1 year(15.6±3.4 vs 40.7±2.3 and 36.5 ± 3.1,P =0.025),2 years(14.4 ± 2.6 vs 39.3 ± 1.9 and 35.6 ± 3.2,P =0.042)after surgery.Radical proximal gastrectomy group compared with radical total gastrectomy 0.5 years(45.6 ± 2.5 vs 40.3 ± 2.8,P=0.039),1 year(40.7±2.3 vs 36.5±3.1,P=0.019),2 years(39.3±1.9 vs 35.6±3.2,P=0.028)after surgery,the difference has statistically significant.In the restricted diet,the radical distal gastrectomy group had significantly lower scores compared with radical proximal gastrectomy group and radical total gastrectomy group 0.5 years(22.4 ±3.8 vs 38.4 ±2.3 and 42.1 ±3.1,P=0.020),1 year(18.7 ±2.3 vs 35.3 ±3.2 and 36.8 ±3.4,P =0.018),and 2 years(16.5 ± 2.7 vs 33.4 ± 2.7 and 32.4 ± 2.8,P =0.026)after surgery.The level of albumin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(30.6 ± 2.5)vs(34.3 ± 2.6)and(35.4 ±2.5)g/L,P=0.025],1 year[(32.4±2.1)vs(35.3 ±2.2)and(38.9 ±2.0)g/L,P=0.041],2 years [(32.1 ±2.4)vs(36.4 ±2.1)and(42.4 ±2.3)g/L,P=0.016]after surgery.The level of prealbumin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(209.1 ±5.7)vs(218.2 ±5.9)and(225.5 ±7.6)mg/L,P =0.030],1 year[(215.5 ±4.6)vs(223.1±3.7)and(236.1 ±4.4)mg/L,P=0.019],2 years[(216.1 ±3.1)vs(221.5 ± 4.3)and(240.5 ± 5.6)mg/L,P =0.024)]after surgery.The level of transferrin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(153.1 ± 3.2)vs(167.9 ± 2.4)and(170.3 ± 3.8)mg/L,P =0.017],1 year[(157.1 ±3.8)vs(169.4±2.2)and(175.4±3.7)mg/L,P=0.040],2 years[(156.4±2.7)vs(173.1 ± 1.8)and(174.1 ±2.8)mg/L,P =0.031]after surgery.The level of hemoglobin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(109.5 ± 4.6)vs(120.2 ± 2.7)and(122.6 ± 3.9)g/L,P =0.016],1 year[(103.6±2.9)vs(117.5 ±16.6)and(125.2±1.5)g/L,P =0.030],2 years[(105.5 ±1.6)vs(106.6 ± 2.9)and(132.6 ± 2.9)mg/L,P =0.028]after surgery.The level of retinol binding protein in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(32.3 ± 2.1)vs(167.9 ± 2.4)and(37.6 ± 2.8)mg/L,P =0.013],1 year[(33.9 ± 1.6)vs(39.3 ±2.5)and(38.5 ±3.5)mg/L,P=0.009],2 years[(35.3 ±2.7)vs(38.9 ± 1.4)and(39.1 ±2.3)mg/L,P =0.034]after surgery.The weight in different periods was significantly higher in radical distal gastrectomy groups compared with radical proximal gastrectomy and radical total gastrectomy group 0.5 years[(63.4±2.5)vs(60.7 ±3.2)and(59.4±1.1)kg,P=0.017],1 year [(66.1 ±3.7)vs(59.4±2.1)and(56.4±6.1)kg,P=0.028],2 years[(67.4 ±4.1)vs(57.4 ±4.1)and(53.3 ± 2.4)kg,P =0.035]after surgery.The level of CD4 + in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy groups 0.5 years(30.46 ±4.45 vs 33.32 ±5.6 and 34.24 ±2.54,P =0.036),1 year(32.84 ± 3.61 vs 35.30 ±4.27and 35.49±3.01,P=0.025),and 2 years(31.61±4.04 vs36.24±4.71 and 37.74±4.15,P=0.030)after surgery.Also,the radical total gastrectomy group had significantly lower CD8 + than radical proximal gastrectomy and radical distal gastrectomy groups 0.5 year(24.16 ± 5.07 vs 24.12 ± 5.9 and 25.25 ± 3.54,P =0.036),1 year(32.84 ±3.61 vs 35.30 ±4.27 and 35.49 ±3.01,P =0.025),and 2 years(31.61 ±4.04 vs36.24 ±4.71 and 37.74 ±4.15,P =0.030)after surgery.The level of IgM in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 year(1.20 ±0.17 vs 1.36 ±0.22 and 1.41 ±0.27,P =0.026),1 year(1.25 ±0.14 vs 1.38 ±0.19 and 1.40 ± 0.15,P =0.037),and 2 years(1.29 ± 0.17 vs 1.39 ± 0.16 and 1.42 ± 0.13,P =0.017)after surgery.Also,the radical total gastrectomy group had significantly lower IgA than radical proximal gastrectomy and radical distal gastrectomy groups 0.5 year(2.03 ± 0.21 vs 2.47 ± 0.32 and 2.43 ± 0.25,P =0.020),1 year(2.14 ±0.21 vs 2.64 ±0.23 and 2.52 ±0.17,P =0.025),and 2 years(2.25 ±0.19 vs 2.63 ±0.18and 2.74 ± 0.16,P =0.033)after surgery.Conclusion The distal gastrectomy may have better quality of life,nutrititional status,and immune function than the proximal gastrectomy and total gastrectomy,whereas the latter two procedures also have certain advantages.

Objective To introduce a new computer-aided technique applicable for myocardial contrast echocardiography(MCE)to quantitate automatically calibrated myocardial contrast intensity(CI)and to test the value of color-coded images of calibrated CI in assessing myocardial perfusion.Methods There were two experimental groups of anesthetized rabbits,which underwent 30 min(group I)and 120 min(groupⅡ)coronary occlusion followed by 60 min reperfusion.MCE was performed on all rabbits during occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique.Myocardial calibrated CI of each segment was measured and a color-coded map was produced automatically by software.The risk areas and infarct sizes obtained by myocardial perfusional defect(MPD)and color-coded map were compared with those by fluorescent microsphere and triphenyl-tetrazolium chloride(TTC)staining.Results Compared with non-risk segments,myocardial CI values were significantly decreased in risk segments in group Ⅰ and Ⅱ before calibration (P＜0.01),however,myocardial calibrated CI values were significantly decreased in risk segments in group Ⅱ(P＜0.01)and not different in group Ⅰ after calibration.Calibrated CI in-70 pix was an optimal cutoff point to identify infarcted segments and to yield the sensitivity of 95% and specificity 87%.The correlation between the risk area by MPD and fluorescent staining was 0.84(P=0.003)whereas color-coded map and staining was 0.91 (P＜0.001).The correlation between the infarct size by MPD and TTC was 0.75(P＜0.001),and between color-coded image and TTC was 0.89(P＜0.001).Conclusions MCE with a new computer-aided technique canassess quantitatively myocardial perfusion and identify automatically risk area and infarct region.

Objective To explore the induced effects of colchicine in different concentration and times on Foeniculum vulgare polyploidy.Methods Seed germination rate and mutation rate,morphology of radicle induced mutants,chromosome number,tissue structure,and content and component of essential oil,which induced by colchicine in different concentiation and times were investigaled using the method of soaking seeds.Results The results showed that 0.13% of colchicine concentration and 24 h inducing time had the best induction on F.vulgare polyploidy.Compared to the control,the radicle of mutant was thicker,the chromosome number increased clearly,and the cell number in radicle manifolded distinctly.Among the four main components of essential oil,the contents of Dill apiol in anamorphosis radicle was a little lower than that of the control,but the contents of limonene,(E)-anethole,and camphene in anamorphosis radicle were all remarkably higher than that of the control after induced by colchicine.ConclusionThe content of main essential oil components in fennel mutant induced by colchicine is remarkably enhanced.The study provides the theoretical basis for the breeding of F.vulgare new varieties of high oil content.

Choledochojejunostomy is a common surgical method for the treatment of organ diseases such as hepatobiliary, gastrointestinal and pancreatic diseases, but there are many complications related to the operation. Benign biliary-enteric anastomosis stricture (BBES) is the most common long-term complication after operation, which seriously affects the quality of life of patients. At present, bile duct reconstruction and endoscopic treatment are the main methods to deal with BBES, but there are some limitations. The new interventional therapy has the advantages of small trauma, good repeatability, high success rate and few complications. It has been applied in many medical centers. The main treatment methods include percutaneous transhepatic biliary balloon dilatation, percutaneous temporary stent placement, percutaneous transhepatic choledochoscopy, magnetic compression anastomosis and intrabiliary ablation. Up to now, there is no uniform standard for the choice of interventional therapy for BBES at home and abroad, so it is of great clinical significance to establish a standardized interventional therapy strategy.

Objective:To observe and analyze the clinical characteristics and correlation between the eye and nervous system in children with infantile gangliosideosis.Methods:From November 2018 to January 2021, 3 children with infantile ganglion lipidosis diagnosed by genetic examination in the Department of Ophthalmology and Neurology, Beijing Children's Hospital of Capital Medical University, and through China National Knowledge Infrastructure and Wanfang database and The National Library of Medicine of the United States (PubMed) were searched, and 53 cases of Chinese infantile gangliosideosis diagnosed by gene, enzyme activity or pathological examination were selected and a total of 56 cases were included in the study. The searching time was from the establishment of the database to February 2021, and the search keywords are"gangliosideosis", "cherry-spot" macula and "Chinese". The demographic characteristics of 56 cases of children and other system manifestations were analyzed such as eyes, nervous system, skin, bones. According to the presence or absence of cherry-spot (CS) on the fundus examination, the children were divided into a fundus CS group (group A) and a fundus without CS group (group B), with 20 and 27 cases, respectively. The age of onset, gender, different types and neurological manifestations of the two groups of children were compared and analyzed. The non-parametric rank sum test was used for age comparison between groups; the χ2 test or Fisher's exact test were used for the comparison of gender, disease type and incidence between groups. Results:Among the 56 children, 27 were males and 29 were females; the median age of onset was 7.0 months. There were 33 and 23 cases of GM1 and GM2, respectively. Among 44 children with visual function examination records, 41 cases (93.2%, 41/44) were unable to follow the visual object. Of 47 children who underwent ocular fundus examination, 20 cases (42.6%, 20/47) had CS on the fundus. The main manifestations of the nervous system are neuromotor development regression or retardation (100%, 56/56), convulsions (58.1%, 25/43), and "startle" phenomena (89.7%, 26/29). Among 42 patients with brain magnetic resonance imaging examination records, 39 cases (92.9%) were abnormal. The incidence of "startle" and seizures in group A was higher than that in group B, and the difference was statistically significant ( χ2=5.815, 6.182, P=0.021, 0.013). Conclusios:Chinese infantile gangliosideosis is more common in GM1 type. Ocular visual impairment is the visual object as the main manifestation, the incidence of fundus CS is 42.6%, and the symptoms of neurological damage in children with CS are more severe.

Objective To investigate MR findings and dynamic changes of the brain after gas explosion,and to evaluate the relationship between MR findings and post-traumatic stress disorder (PTSD).Methods Forty-nine survivors of a gas explosion (group A) were examined with brain MRI within 1 to 3 days,and serial MR follow-up examinations were also performed.Forty miners not under the ground that day were assigned as group B,and 40 staff working on the ground as group C.The signal intensity values of hippocampus and globus pallidus on T2WI were measured in the three groups and F test was performed by using SPSS 13.0.The relationship between signal intensity values of hippocampus/globns pallidus and PTSD was explored,and the relationship between ADC values of hippocampus and PTSD was also investigated.Results In group A,slight low signal on T1WI and high signal on T2WI were detected on initial MRI in hippocampus (33 cases),globus pallidus (12 cases),cortex (10 cases),and midbrain (2 cases),respectively.On follow-up MRI at 2 months,lesions in hippocampus disappeared (25 cases) or remained slight high signal on T2WI (8 cases),lesions in globus pallidus disappeared (3 cases,5 sides) or showed shrinkage and encephalomalacia (9 cases),cortical lesions resulted in encephalomalacia in 2 cases and returned normal in the others,and lesions in the midbrain showed encephalomatacia.For comparison of T2 signal intensity values in hippocampus and globus pallidus,there was significant difference between group A and group B(P <0.01),and also between group A and group C(P <0.01),but no difference was detected between group B and group C (P>0.05).In group A,the T2 signal intensities of PTSD and non-PTSD were 455±37 and 462±53 in the left hippocarnpus,and 458±36 and 460±43 in the right hippoeampus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 438±29 and 424±37 in the left hippocampns,and 442±31 and 430±32 in the right hippocampus at 2 months.The T2 signal intensities of PTSD and non-PTSD were 361 ±35 and 366±63 in the left globus pallidus,and 363 ±41 and 375±62 in the right globus pallidus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 341±24 and 337±39 in the left globns pallidus,340±26 and 332±35 in the tight glohus pallidns at 2 months.There was no difference of T2 signal intensity values in hippocampus and globus pallidus between PTSD and non-PTSD( t=0.350,0.826,0.503,0.907,P>0.05).In group A,ADC values of PTSD and nun-PTSD were (8.1±1.1)×10-4 and(8.1 ±0.9)×10-4mm2/s in the left hippocampus,and (8.2±1.0)×10-4 and(8.2±0.8)×10-4mm2/s in the tight hippocampus on 1 to 3 days,ADC values were (8.8±0.7)×10-4 and (9.0±1.0)×10-4mm2/s in the left hippocampus,and (8.5±0.9)×10-4 and (9.3±1.1)×10-4mm2/s in the tight hippocampus at 2 months.ADC values in hippocampns showed no difference between PTSD and non-PTSD(t=0.016,0.081,P>0.05)on initial MRI,but showed significant difference between PTSD and non-PTSD in tight hippocampus (t=7.407,P < 0.05) on follow-up MRI at 2 months,while no difference in left hippocampus (t =0.333,P>0.05) was observed at 2 months.Conclusion Hippocampns and globus pallidus are the most vulnerable structures in gas explosion.The occurrence of PTSD may be related to the injury of fight hippocampus,but not related to the injury of globns pallidus.

Objective To investigate the compliance status of secondary prevention in patients with coronary artery disease (CAD) following revascularization.MethodsA total of 512 patients with CAD who received procedures for coronary revascularization were enrolled in the study from January 2009 to October 2010,including 472 cases of percutaneous coronary intervention stenting,25 cases of coronary artery bypass grafting and 15 cases of stenting plus bypass.The demographic information,prophylactic drug therapies, lifestylechangesandmodifiableriskfactorsweresurveyedwithquestionnaires,anthroposomatologicalmeasurementsandlaboratorytestsinpatients3monthsaftercoronary revascularization.ResultsThe proportion of patients on statins,aspirin,β-blockers,angiotensin-converting enzymeinhibitors/angiotensinreceptorblockers(ACEIs/ARBs)andinfluenzavaccinationwere 81.4％ (417/512),93.9％ ( 481/512 ),82.0％ ( 420/512 ),76.2％ ( 390/512 ) and 3.7％ ( 19/512 ) respectively.Based on the criteria recommended by the American Heart Association/American College of Cardiology (AHA/ACC)Guidelines for Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2006 Update, the percentages of achieving therapeutic targets of modifiable risk factor management were as follows:glycosylated hemoglobin (90.2％,462/512 ),total cholesterol ( 68.6％,351/512 ),triglycerides ( 58.8％,301/512 ),high-density lipoprotein cholesterol ( 91.6％,469/512 ),low-density lipoprotein cholesterol ( 44.5 ％,228/512 ),systolic pressure ( 75.2 ％,385/512 ) and diastolic pressure (90.4％,463/512 ) respectively.And the proportions of improved lifestyle were as follows:smoking cessation/non-smoking 81.4％ (417/512),diet control 78.5％ ( 402/512 ),achieving weight targets 61.7％ (316/512)and regular exercise 58.2％ (298/512).ConclusionsThere is a relatively high percentage of standardized antiplatelet therapy and continuous statins medication in patients with coronary artery disease following revascularization. However,many significant modifiable risk factors have not been controlled optimally and lifestyle of patients needs further improvement. There is still a considerable scope for further improvement of secondary prevention in this group of patients.

Objective To investigate the prevalence of thyroid nodules(TN)among centenarians in Hainan province and explore the association between thyroid nodules and major chronic diseases.Methods A mixed cross-sectional study of questionnaire survey,medical examination including ultrasonography and laboratory examination were conducted in elderly who resided in Hainan province and aged 100 and over,the subjects who have signed consent and complete data in both basic information and medical examination were included in this study.Eight hundred and four centenarians were finally enrolled and data of them was analyzed to investigate the prevalence of thyroid nodules and to explore its association with common chronic diseases by comparing the prevalence of chronic conditions between groups with and without thyroid nodules.Results The overall prevalence of TN was 73.5%(591、804)and the prevalence of TN was significantly higher in female when comparing with male[75.1%(505、672)vs 65.2%(86、132)](P <0.001).No significant correlation was found between the prevalence of TN and major chronic diseases (P>0.05),however,the factors associated with dyslipidemia and anemia such as TC[(4.6±1.2)mmol、L vs(4.3±1.5)mmol、L],LDL-C[(2.8±0.8)mmol、L vs(2.7±0.8)mmol、L],and Hb[(110.6±22.5)g、L vs(105.5±31.7)g、L]were significant higher in TN group than those in Non-TN group(P <0.05). Conclusions The thyroid nodule is common in centenarian population and its prevalence was higher in female than male.The associations between TN and biomarkers of dyslipidemia and anemia are found in the present study.

Objective To understand the molecular epidemiological characteristics of Norovirus outbreaks and the genome evolution of Norovirus epidemic strains in Hainan Province from 2020 to 2022.Methods The information and samples have been collected from the norovirus outbreaks from 2020 to 2022.Norovirus was detected by using the real-time PCR in these samples,then the detected sequences were amplified the analyzed.The Norovirus se-quences of 8 strains had been amplified and analyzed.Results From 2020 to 2022,39 gastroenteritis outbreaks were reported,and 25 outbreaks caused by Norovirus which mainly occurred in childcare institutions and schools(20/25,80％).The Norovirus outbreaks were mainly concentrated in counties around Haikou(northeast),which including Ding'an(5 cases),Wenchang(4 cases),Chengmai(4 cases),and Lingao(3 cases);following by western regions which included Baisha(2 cases),Ledong(2 cases),and Dongfang(3 cases).1 case was in Wanning in the southeast.Among individuals aged 2-17,the positive proportion of Norovirus in males was higher than that in females.Among individuals aged over 55,the proportion of Norovirus positive in females was higher than that in males.The gender of positive samples among individuals aged 18-40 was related to their profession.According to RT-PCR typing and sequencing,GⅡ group Norovirus were classified in13 outbreaks.There were 4 genotypes detected.GⅡ.2[P1 6]was the main epidemic strain with 60％(9/13),and the other three genotypes were GⅡ.4 Sydney[P31](15.4％,2/13)GⅡ.4 Sydney[P16](7.7％,1/13)and GⅡ.3[P12](7.7％,1/13).Further genic analysis of 8 Norovirus strains showed that all of them were still in the same branch as the previ-ous strain,and all exhibited a certain amount of amino acid variation.Conclusion Norovirus is the main pathogen of gastroenteritis outbreaks in Hainan province,and the main epidemic strain is GⅡ.2[P16].It is necessary to continue to strengthen the monitoring that provides scientific evidence for the prevention and control of norovirus out-breaks in Hainan region.