BACKGROUND: Many methods involved in measuring energy expenditure of physical action, however, study regarding measurements of upper limber movement energy expenditure are few.OBJECTIVIE: To measure the energy expenditure of limber movement using indirect calorimetry, and to analyze the characteristics of upper limber movement energy expenditure and influencing factors such as age and gender.DESIGN, TIME AND SETTING: The comparison observation was performed at the Jiangsu Institute of Sports Science from January to March 2009.PARTICIPANTS: Totally 108 health adults, including 47 males and 61 females, participated in the study, 65 of them aged 20-39 years, and the remained 43 aged 40-59 years.METHODS: Energy expenditure of 4 upper limb movements were performed, including sitting posture arm swing (60 times/min),elbow flexion (40 times/min), shoulder flexion-extension (60 times/min), and lateral arm raise (30 times/min). At each interval,have a 3-minute rest.MAIN OUTCOME MEASURES: Oxygen expenditure of 4 kinds upper limb movements were measured by MetaMax 3B tester. RESULTS: Rest oxygen expenditure of males were greater than that of females (P < 0.05), greater in 20-39 years old than 40-59 years old (P < 0.05). The greatest oxygen consumption occurred in males with arm swing [(550.9±90.6) mL/min], which was (425.8±75.7) mL/min in females. The lowest oxygen expenditure was elbow bend [male: (440.4±82.7) mL/min, female: (367.0±60.1) mL/min]. Net oxygen expenditure of all 4 kinds of upper limb movements was lower than 250mL/min (1 metabolic equivalent).CONCLUSION: ① The energy expenditure of usual upper limber movements below 1 metabolic equivalent. ② Age and body mass has more effect on resting energy expenditure than the gender. ③ The efficiency of young adults upper limb movements is higher than old adults.

Objective To discuss the practical effect of process reengineering in PICC reengineer-ing management. Methods PICC process was analyzed and the original unreasonable process was reengineered. The number of cases for tube insertion, success rate of paracentesis, incidence rate of compli-cations and patients satisfaction degree with nursing before and after implementing process reengineering were compared nsing χ2 test. Results After the promotion for clinical use of PICC, the numbers of cases for tube insertion, success rate of paracentesis and incidence rate of complication evidently decreased, pa-tients satisfaction degree increased greatly. Conclusions Process reengineering makes the PICC man-agement more standard, safe and highly effective.

Objective To investigate the effects of minimally invasive intracranial hematoma clearance on the perihematomal glutamate(Glu) level,permeability of blood-brain barrier(BBB) and brain edema.Methods Thirty rabbits with body weight of 2.80-3.40 kg were used to established the model of spontaneous intracerebral hemorrhage(ICH) and randomly divided into the minimally invasive group(MI) and control group(MC) after the model was prepared successfully.The MI group underwent minimally invasive procedures for removing intracranial hematoma by stereotactic instrument within 6 h after establishing the ICH model.The brain tissue was extracted on postoperative 1,3,7 d,and the perihematomal brain tissues were taken to detect the Glu level,BBB permeability and water content of brain tissue,which were compared with those in the control group.Results The Glu level,BBB permeability and brain water content on 1,3,7 d in the MI group were lower than those in the MC group,and the differences were statistically significant(P＜0.05).Conclusion The minimally invasive surgery for removing intracranial hematoma is helpful to reduce perihematoma Glu level,BBB permeability and brain water content.

Objective:To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC).Methods:A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN.Results:In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis ( P=0.041, 0.025). Conclusions:Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.