OBJECTIVE:To investigate the effects of alanyl-glutamine dipeptide-intensified early enteral nutrition (EN) sup-port on nutritional indexes,immune indexes,renal indexes and complications of sepsis patients. METHODS:A total of 112 cases of sepsis admitted into our hospital during May 2013-Jan. 2015 were selected and divided into observation group and control group according to random number table,with 56 cases in each group. Both groups received routine antibiotic therapy and early EN support(48 h)with nitrogen supplement 0.2 g/kg,calories 25 kcal/kg and nonprotein calories 19-21 kcal/kg each day. Observation group was additionally given Alanyl-glutamine for injection 0.5 g/kg with 0.9% sodium chloride injection 100 mL,continuous pump within 24 h,for 4 d. The levels of nutritional indexes (ALB,PAB,Hb),immune indexes (CRP,IgG,IgA and IgM), APACHEⅡ scores,SOFA scores,liver and renal function indexes (the levels of ALT,AST,Cr and BUN) were compared be-tween 2 groups before and after treatment. The prognosis and the occurrence of complication were also observed in 2 groups. RE-SULTS:Before treatment,there was no statistical significance in the levels of ALB,PAB,Hb,CRP,IgG,IgA,IgM,ALT, AST,Cr,BUN and APACHEⅡ scores,SOFA scores between 2 groups(P>0.05). After treatment,the levels of ALB and PAB in observation group were increased significantly compared to before treatment,and the observation groups was significantly higher than control group,with statistical significance(P<0.05). APACHEⅡ score and SOFA score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statis-tical significance(P<0.05). CRP of 2 groups were decreased significantly while IgG were increased significantly;the observa-tion group was significantly better than the control group,with statistical significance (P<0.05). Cr and BUN levels of 2 groups were decreased significantly compared to before treatment,and the level of Cr in observation group was significantly con-trol group,with statistical significance (P<0.05). The time of ICU stay,ventilator supporting time and antibiotics application time in observation group were significantly shorter than control group,and the incidence of diarrhea and gastric retention were significantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Alanyl-glutamine dipeptide-in-tensified early EN support can significantly improve immune function and liver and renal function of sepsis patients and reduce the occurrence of complications.

To distinguish the degrees of frostbite in early stage after freezing-thawing injuries is a most impor- tant yet difficult task. In order to seek the indicators of severity of injuries, we observed the relationship between the degrees of cold injuries and serum creatine phosphokinase (SCPK) levels. Results showed that after freezing the rabbit paws to 0℃, SCPK level began to rise. Freezing in the range of 0℃ to-25℃, SCPK levels rose inversely with the lowering of tissue temperature. The elevation of SCPK activity usually appeared 1 hr after freezing, reaching thepeak at 12 hours, and it began decline at 24 hours,returning to normal level at 72 hours after freezing.

Objective To observe the effect of eradication of helicobacter pylori (Hp) combined with comprehensive rehabilitation treat-ment on patients with non-alcoholic fatty liver disease (NAFLD). Methods From December, 2015 to April, 2016, 219 patients diagnosed as NAFLD with Hp infection were enrolled, in which 119 patients (observation group) were treated with anti Hp quadruple therapy. They were tested with 13C urea breath test one month after drug withdrawal. The other 100 patients were as control group. The severity of NAFLD was observed with abdominal ultrasound after six months. Results After treatment, Hp was eradicated in 107 cases (90.68%) in the observation group, one dropped out for pulmonary infection. After six months, the severity of NAFLD improved better in the patients eradicated Hp in the observation group than in the control group (χ2=8.397, P<0.05). Conclusion Eradication of Hp combined with comprehensive rehabilita-tion treatment can improve the severity of NAFLD.

Objective:To explore the clinical effect of combining kinesio taping with filtered infrared-A irradiation in the treatment of scapulohumeral periarthritis.Methods:Eighty-six patients with scapulohumeral periarthritis were randomly divided into a control group ( n=43) and an observation group ( n=43). Both groups received 20 minutes of irradiation with water-filtered infrared-A per day for 14 days, while the observation group was also given kinesio taping after the irradiation on 6 days of each week for the two weeks. Before and after the 2 weeks of treatment, both groups were evaluated for pain, their active and passive range of motion (AROM and PROM) of the shoulder, as well as the range of motion (ROM) of the shoulder joint, and their Constant-Murley score (CMS). The subjects also evaluated the functioning of their own shoulders using a visual analogue scale (VAS). Results:After the treatment, the average VAS scores of both groups were significantly higher than before the treatment, but the observation group′s average was significantly higher than that of the control group. There was significant improvement in the average AROM and PROM in both groups, but in the observation group the average AROM in anteflexion, rear protraction, abduction and extorsion and the average PROM in anteflexion and abduction were significantly better than the control group′s averages. The average total CMS scores of both groups had also improved significantly, but with significantly greater improvement in the observation group leading to a significant difference between the two groups after the intervention.Conclusions:Supplementing water-filtered infrared-A irradiation with kinesio taping is very effective in relieving pain, as well as improving ROM and life quality for persons with scapulohumeral periarthritis.

Aim To observe the effects of flavonoids,including galangin(G),kaempferol(K),apigenin(A),morin(M),quercetin(Q) and myricetin(MY),on myocardial apoptosis induced by H2O2,and explore the possible mechanism.Methods Primary cultured cardiocytes of neonatal rat were randomly divided into normal group,model group,and flavonoids group.Fluorescent staining,electrophoresis and Western-blot were employed to observe the cardiocyte apoptosis and proteins expression.Results Exposure to 100 ?mol?L-1 H2O2 for 16 h resulted in myocardial apoptosis significantly(P

Objective To explore the relationship between the aerocyst continual inflation and clocked deflation and ventilator-associated pneumonia. Methods 60 ICU hospitalized adult patients treated with tracheotomy or trachea canalization for above 24 hours were randomly divided into the tzadi-tional group and the experimental group with 30 patients in each group. After trachea canalization success-fully according to the nursing standard, the experimental group was treated with aerocyst continual inflation, the traditional group gased the ventilator and recorded the time, deflating the gas every 4 hours and inflating again after 5 minutes. The inflation time, nurse management and MOV(minimal occlusive volume)of the two groups were the same. The chest X-rays examination and deep sputum bacilli culture were implemented 12 hours after admission, before pulling out the ventilator and transferring out of ICU to evaluate the inci-dence of ventilator-associated pneumonia according to the infection diagnosis standard. Results The rate of ventilator-associated pneumonia in the experimental group was obviously lower than that of the tradition-al group. Conclusions The rate of ventilator-associated pneumonia reduces obviously in the ICU trachea canalization patients with aerocyst continual inflation.

ObjectiveTo observe the effects of parenteral nutrition (PN) containing ω-3 polyunsaturated fatty acids (ω-3PUFAs) on postoperative systemic inflammatory response syndrome (SIRS) in patients with obstructive jaundice. MethodsTotally 40 patients with obstructive jaundice who underwent hepatobiliary surgery in the Affiliated Hospital of Binzhou Medical College from June 2008 to October 2009 were enrolled in this study and randomly divided into the conventional PN group and PUFAs group with 20 cases in each group. The conventional PN group was provided with medium-chain/long-chain triglycerides lipid emulsion, while the PUFAs group was provided with medium-chain/long-chain triglycerides lipid emulsion supplemented with ω-3PUFAs. The two groups received PN support with equal nitrogen content and calories for 9 days. The non-protein caloric value given was 117.15 kJ/(kg · d) with 0.2 g/(kg · d) of nitrogen. Interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-c) in serum were measured on the day before operation and on the postoperative day 1,3, 5, 7, and 9. Meanwhile, the incidences of SIRS and multiple organ dysfunction syndrome (MODS) were analyzed. ResultsThe levels of IL-6, CRP, and TNF-α on the postoperative day 3, 5, 7, and 9 were significantly lower in the PUFAs group than those in the conventional PN group ( all P ＜ 0.05). The duration of SIRS in the PUFAs group [(3.85 ±2.36) days] was significantly shorter than that in the conventional PN group [(5.31 ±1.47 ) days, P =0.0230]. The incidence of MODS was significantly lower in the PUFAs group ( 10％ ) than that in the conventional PN group (25％, P =0.0076). Conclusionsω-3PUFAs-supplemented PN improves the functions of liver and pancreas and alleviates acute inflammatory response in patients with obstructive jaundice.

Objective To discuss the characteristics of extended-spectrum beta-lactamases(ESBLs)-producing Shigella and the relation between them and drug-resistance plasmid. Methods The suspicious ESBLs-producing isolates were screened by K-B disc diffusion method, and the ESBLs-producing strains were confirmed by confirmatory test recommended by the National Committee for Clinical Laboratory Standards. Furthermore, the partial blageneof these isolates were detected by PCR using universal primers for TEM, SHV, CTX-M-1 group, CTX-M-2 group and CTX-M-9 group, respectively. The entire blaCTX-M-9 and blaTEM were amplified by PCR using the primers outside the open reading frame (ORF) of these β-1actamases and products were directly sequenced. The conjugation experiment was performed to determine whether the resistance was transferable. Minimal inhibitory concentration (MIC) was detected with double agar dilution method. Results Of the 275 isolates, 12 strains were identified as ESBLs producers. Among them, 8 strains were CTX-M-14 carriers and 4 strains were CTX-M-3 carriers. All ESBLs-producing isolates are positive for plasmid conjugative transfer test. The transconjugants are only resistance to betalactams. Conclusions High resistance to beta-laetams in Shigella is caused by production of ESBLs in the local area. The ESBLs-produeing isolates can transfer the drug resistance through lateral transfer of plasmid.

Objective To investigate and analyze TCM syndrome characteristics, impact factors and internal relationship among the factors of mental fatigue of university students. A preliminary understanding of mental fatigue situation of university students and prevent diseases was acquired in advance. Methods 100 students were randomly selected in Beijing University of Chinese Medicine, of whom 40 were undergraduate students and 60 were post-graduate students. Mental fatigue questionnaire was used to investigate mental fatigue situation for students, and TCM constitution scale was applied to collect TCM syndromes. A body energy survey was also conducted. Results In undergraduate and post-graduate students, the mental fatigue rate was relatively higher, both of them were over 50%of the total numbers, 57.5%(23/40)、61.7%(37/60) respectively. For the fatigue levels distribution in these two groups, the ratios of slight mental fatigue (undergraduate:52.5%;post-graduate:56.67%) were both higher than those of severe mental fatigue (undergraduate:5%;post-graduate:5%). In the undergraduate group, the top three biased constitutions among mental fatigue students were yang deficiency (7 out of 23:30.43%), qi deficiency (3 out of 23:13.04%) and dampness-heat (3 out of 23:13.04%). In the post-graduate group, the top three biased constitutions were yang deficiency (11 out of 37:29.73%), qi deficiency (6 out of 37: 16.22%) and dampness-heat (5 out of 37: 13.51%). Conclusion It is easier for university students with biased constitution to suffer from mental fatigue, mostly with yang deficiency, qi deficiency and dampness-heat constitution.

Objective To analyze the distribution of class 1,2 and 3 integrons and their gene cassettes,and to explore its relationship with drug resistance in Shigella.Methods Antimicrobial susceptibility was detected by minimal inhibitory concentration (MIC) method.All the genes of integrons and gene cassettes were amplified by polymerase chain reaction (PCR).The amplicons were identified by amplified fragment length polymorphism (AFLP) and sequencing.Results Fifty seven multi-drug resistant strains were identified from a total of 62 Shigella strains (91.9％).Among multi drug resistant strains,52 strains carried integrons of class 1 (91.2 ％) and 55 strains carried integrons of class 2 (96.5％).Only 2 strains carried class 1 integrons alone,5 strains carried class 2 integrons alone and 50 strains had both class 1 and class 2 integrons.Class 3 integrons were not detected.The gene cassettes of typical class 1 integrons,dfrV and dfrA17-aadA5,were detected in 6 strains and 2 strains,respectively.Atypical class 1 integrons with gene cassettes blaOxA30 aadA1 were detected in 44 strains.The typical and atypical class 1 integrons coexisted in 6 Shigella flexneri strains.Gene cassettes for class 2 integrons were dfrA1 sat1-aadA1.Conclusions The multi-drug resistant Shigella strains are widely distributed in Ji'nan,and the atypical class 1 integrons and class 2 integrons are common in these strains.Coexistence of the two integrons is observed in some of the strains.