Objective It has been demonstrated that para-operative fasting often induce gastrointestinal mucosal atrophy, that, together with the surgically-stress effects, deteriorate the intestinal harrier structure and may further cause gut-origin infection. Parenteral nutrition has been widely employed in the patients undergone surgery or with trauma as a standard nutritional support in many hospitals. It can provide sufficient nutrients, including calories, nitrogen, and minerals for the daily and extra needs during the stress. However, numbers of investigations have proven that long term parenteral nutrition support has no effects on preventing intestinal mucosa atrophy, but indeed, consistently result in down-regulation of mucosal structure. It has been widely accepted in the clinic that enteral nutrition should be chosen as a priority mean, as to parenteral nutrition, to support the patients whenever they can tolerant. However, there are few reports concerning earlier use of enteral nutrition in post-operative patients. The purpose of this study was to evaluate the effects of postoperative earlier enteral nutrition support (24～36 hours) on the patients undergone major surgery. The cases with earlier enteral nutrition feeding during last three years were reviewed and the feeding method, the effectiveness, and the complications of earlier feeding were investigated. In five cases, with two of proximal small intestine fistula, three of pancreas, duodenal injury, the total effectiveness was satisfactory. All patients gained wight and the nutritional states were much improved. The initial disease of the patients with earlier feeding were all cured within the time periods which were significantly shorter than those who had ordinary post-operative feeding. Only one case among five had mild nausea during the feeding, and was settled after anti-nauseas medications. Two cases with proximal small intestine fistula were recovered in four weeks time. We thus conclude that earlier enteral feeding post-operatively is a safe and effective method for those who have major surgery. It benefits bowel barrier function and further improves the recovery after surgery. Besides, earlier enteral feeding is less costly compared to parenteral nutrition, and easy to operate. A more case-based, prospective controlled clinical study should be organized in the future to further evaluate the usefulness of earlier enteral feeding in the patients with surgery.

Glaucoma is a common blinding eye disease mainly characterized by optic nerve damage.Lowing intraocular pressure is still the main managing method of glaucoma up to now.However,although the intraocular pressure is reasonably controlled,optic nerve damage is difficult to recovery and sustainable development in some patients.Therefore,the pathogenesis and prevention and treatment of glaucoma have always been the hot spot of the research of glaucoma in recent years.Even though the big progresses have been made in the experimental research of optical nerve injury and repair,little good evidence has been seen in the clinical management of glaucoma neuroprotection.In recent years,genomics study,stem cells study,molecular biological study,electronic technology application in medical research,especially the rise of big data era laid a good basis for the neuroprotection of glaucoma.Ophthalmologists should focus on new insights into the potential and beyond impact factors in the precise individual therapy of glaucoma neuroprotection.

The relationship between neuronal inflammatory changes and extensive neurodegeneration in patients with multiple sclerosis (MS) remains to be studied.Recent neuroimaging studies have shown that energy depletion due to the impairment of effective oxygen metabolism and oxygen supply defects may be one of the causes of neurodegeneration.In this paper,the pathologic mechanism of MS related to energy failure and associated MRI imaging techniques were reviewed.

Objective To clarify the etiology of pathological nipple discharge.Methods Since 1990,81 patients with pathological niplpie discharge underwent mammary duct incision to identify the lesion.Results 67 patients had intraductal papilloma,5 patients had intraductal papillomatosis,6 patients had duct carcinoma,and 3 patients were not found pathological changes.Conclusions Intraductal papilloma,intraductal papillomatosis,and duct carcinoma might be the exclusive etiology of pathological nipple discharge.

Through intensifying the clinical pathological discussions and clinical pathological dissections,the clinical thinking,iatri- cal responsibility and analytical ability of the medical students have been improved markedly and the abridge function of pathology between basic medicine and clinical medicine has also been reinforced.

Objective To observe the clinical efficacy of percutaneous minimally invasive plate osteosynthesis(MIPPO) in treatment of senile proximal humeral fractures(SPHF).Methods The clinical data of 41 SPHF patients treated by MIPPO were analyzed retrospectively.The effect of surgery was evaluated by Neer scoring system.Results 41 patients were follow-up for 5 to 19 months (mean 11.6 months).Based on the Neer scoring criteria:the turn of excellent,good,fair or poor were 25 cases,12 cases,3 cases,1 case,the excellent rate was 90.2％.Never happened avascular necrosis of the humeral head,plate and screw fracture,nerve injury,fractures unhealed or delay healing and other negative phenomena.Conclusion The application of MIPPO in treatment of SPHF is easy to operate,little nerve damage,good fixed performance,high reliability,which is worthy of clinical application.

ObjectiveTo investigate the psychological state and care measures for patients undergoing pereutaneous coronary intervention (PCI). Methods300 patients treated with PCI from December 2009 to June 2011 in our hospital were chosen as the research object.The factors arousing psychological disorders for PCI patients were taken for comparison.And then the appropriate nursing measures were discussed. ResultsThe most evident negative emotion of PCI patients was depression.The factors arousing negative emotion included the factors of family members and undesirable environment by many people going in and out. ConclusionsEffective measures can avoid the psychological barriers of PCI patients and improve the quality of postoperative recovery for patients.

Objective To investigate the women during pregnancy because of various reason caused by the impact of diabetes on perinatal outcome.Methods The delivery 24-28 weeks pregnant or first diagnosed more than 28 weeks after the gynecology clinic diagnosis with diabetes in 125 singleton pregnant women and newborns were selected as the research object of study.Except giving birth to the same period 95 cases of normal of diabetes single fetus of pregnant women and their newborn for the control group.The complications of pregnancy and gestational age,birth and neonatal intrauterine nutrition status,mode of delivery,neonatal asphyxia,hypoglycemia and jaundice,case analysis,comparison.Results The two groups in the average age,average number of pregnancy pregnancy and intrauterine nutrition(group GDM,PI =2.717,control group 2.469) and the rate of neonatal asphyxia were not statistically significant(P ＞ 0.05).GDM group of 71 cases of cesarean section,natural childbirth in 54 cases,31 cases of control group difference and 64 cases,very significant differences between the two groups (x2 =12.678,P ＜ 0.01),group GDM,the incidence of neonatal jaundice neonatal hypoglycemia respectively 18.4%,24%,and 7.4% in the control group,there was significant difference compared with 12.6% (x2 =4.500,5.577,all P ＜0.05).Conclusion Gestational diabetes is the important reason which caused by adverse perinatal outcome.