Objective: To discuss the effect of early enteral nutrition support on immunological function in patients with acute stroke. Methods: Forty-nine stroke patients with dysphagia were randomly allocated into study group (n = 24) and control group (n = 25). They were received enteral nutrition via nasogastric tube and ordinary nasal feeding of liguid diet, respectively within 72 hours after admission. The levels of total lymphocyte count (TLC), immune globulin A (IgA), immune globulin G (IgG), immune globulin M (IgM), complement 3 (C3), and complement 4 (C4) in both groups were detected on day 1, 7 and 21 respectively after admission. The changes of nutritional index and the incidence of infective complications were observed. Results: The levels of TLC [(2.1 ± 0.4) × 109/L], IgA [(2.7 ± 0.5) g/L], IgG [(11.1 ± 2.2) g/L], IgM [(1.7 ± 0.7) g/L], and C3 [(1.2 ± 0.2) g/L] in the study group were significantly higher than the levels of TLC (1.7 ± 0.4 × 109/L, P < 0.05), IgA [(2.0 ± 0.4) g/L, P < 0.01], IgG [(8.9 ± 2.5) g/L, P < 0.01], IgM [(1.3 ± 0.6) g/L, P < 0.05], and C3 [(1.0 ± 0.3) g/L, P < 0.01] in the control group after 21 days. The incidence of infective complications in the study group (29.1%) was significantly lower than that in the control group (60.0%; P < 0.05). The nutritive index of the study group was also significantly better than that in the control group. Conclusion: Early enteral nutrition support may improve the immunological function in patients with acute stroke, and decrease the incidence of infective complications.

Objective: To analysis the key factors of quality control for high frequency surgical unit to provide reference to ensure accurate and standard. Methods:To analysis the details of quality control on protective earth impendence, resistor-capacitor network, test error on definition, structure, magnitude and other aspects. Results:To master the key factors of quality control is important for the promotion of operability of the quality control work and decrease the using risk, and then to improve the quality of medical services ensure the safety of patients and medical staff. Conclusion: To analysis the each key factor is important significance to the quality control for high frequency surgical unit.

Objective:To master the methods of reducing electromagnetic interference by RFID system, and presents the feasible technical advices for hospital’s implementation to ensure the safety of applications of electronic medical devices. Methods:According to analysis the causes of electromagnetic interference by RFID system, the methods of suppressing the electromagnetic interference are put forward for practical application. Results:The clinical engineers could refer to the methods of suppressing the electromagnetic interference and then conduct and use the RFID system, taking account of the management efficiency and the safety of applications of the medical devices. Conclusion:To determine the proper strategy for RFID system application in medical management of hospital may reduce the electromagnetic interference to the electrical devices of hospital and ensure its safety of application.

Objective To study the clinical characteristics of early esophageal varices bleeding after endoscopic varices liga-tion EVL in advanced schistosomiasis patients. Methods The data of 206 advanced schistosomiasis patients who received VEL were collected and studied retrospectively. Results There were 17 cases of early esophageal varices bleeding after EVL in-cluding 1 died case the early hemorrhage rate was 8.25% and the mortality rate was 0.5%. The early bleeding occurred from the 4th to 12th day and 76%occurred from the 7th to 9th day postoperatively. The direct cause of hemorrhagic was ligation ring falling off and the inducements were the improper diet 10 cases 58.8% and increased abdominal pressure 6 cases 35% . All the cases of early esophageal varices bleeding occurred in the patients whose liver function being Child-Pugh C. Conclu-sions The incidence and mortality of EVL early postoperative hemorrhage are both low and mostly occur from the 7th to 9th day postoperatively. We should pay attention to the diet and nursing and the patients with Child-Pugh C liver function are the high risk group.

Objective To evaluate the diagnostic value and limits of 64-slice spiral coronary artery imaging,by com- parison with selective coronary angiography,in detection of coronary heart disease.Methods Fourty-two patients sus- pected CAD were performed 64-slice spiral CT coronary imaging and selective coronary artery angiography in two weeks, comparative analysis of results were progressed consequently.Results The sensitivity,specificity and positive and nega- tive predictive value to identify≥50% stenosis branches was 90.5%,96.6%,85.9% and 97.8%,respectively.The sen- sitivity,specificity and positive and negative predictive value to identify≥75% stenosis branches was 93.5%,98.9%, 87.9% and99.4%,respectively.Conclusion As a noinvasive quantitative assessment of coronary artery stenoses exami- nation,64-slice spiral CT is a valuable method to detect and diagnose the disease of coronary artery,but its clinical use maybe presently be limited due to image quality in a number of cases.

Objective To explore the application of subdermal vascular network skin graft in severed finger reunion with small area skin defects.Methods Modified subdermal vascular network,which was inversion thin and middle thick,was used to repair defect of severed finger reunion without exposure of blood vessel.There were 10 patients and 14 fingers,including 7 patients and 10 fingers injured in the dorsal sid with 5 fingers' extensor tendon exposed,and 3 patients and 4 fingers injured in the palmar side with 2 patients' flexor tendon exposed.The defect area was ranged from 1.0 cm × 0.8 cm to 3.0 cm × 1.5 cm.Results In 6 larger subdermal vascular network,skin's edge became blue and blister appeared in the middle.The others was good with skin texture and aspect.Conclusions Modified subdermal vascular network skin graft is safe and effective choose to solve severed finger reunion with smnall area skin defects.

Objective To study the relationship of serum visfatin level and coronary heart disease (CHD). Methods Eighty eight hospitalized patients were enrolled into the study and divided into CHD group(n = 62) and non-CHD control group(n = 26) according to the angiography results; the CHD group was further divided into single-, double-, multi-vessel affected groups. The serum level of visfatin was measured by ELISA,the lesion severity of coronary arteries was assessed by Gensini coronary scoring system, and the correlation between serum visfatin level and coronary lesion severity was evaluated statistically. Results The level of serum visfatin was significantly higher in CHD group than the control group([ 10. 77 ± 2. 63 ] μg/L vs. [ 7. 13 ± 2. 06 ]μg/L,P ＜ 0. 05). The visfatin level increased along with the the number of stenosis vessels(P ＜ 0. 05). The sermn visfatin levels of no stenosis, single-, double-, multi-vessel groups were(7. 13 ± 2. 06) μg/L,(9. 30±2. 19) μg/L,(10. 81 ± 2. 12) μg/L,(12. 79 ± 2. 20) μg/L respectively. A significant positive correlation was found between coronary lesion severity score and serum visfatin level(r = 0. 483, P ＜ 0. 01). Conclusion The visfatin may be directly related to the initiation and development of coronary diseases. The higher level of serum visfatin was, the more severe coronary artery disease would be.

Objective To investigate the changes of CA125 between primary cytoreductive surgery and interval debulking surgery for prediction the rate of optimal interval cytoreductive surgery and prediction the recurrence and the prognosis in patients with epithelial ovarian cancer.Methods A total of 39 cases with suboptimal primary cytoreductive surgery admitted from Jan.1996 to Jan.2009 were retrospectively analyzed.The median age of patients was 56 years( range:41 -68 years).Based on the changes in CA125level between primary cytoreductive surgery and interval debulking surgery,all cases were divided into four groups,group A (CA125 reduced to normal after primary cytoreductive surgery,n=6),group B (CA125reduced to normal after 1 - 2 cycles of chemotherapy,n =11 ),group C ( CA125 reduced to normal after 3 -4 cycles of chemotherapy,n =14),and group D ( CA125 did not reduced to normal after the chemotherapy,n =8 ), and all received platinum-based chemotherapy.The response to chemotherapy evaluated by pathological examination versus CA125 level,and recurrence and prognoses were also analyzed.Results ( 1 )The rate of optimal interval cytoreductive surgery in group A,B,C and D were 6/6,8/11,9/14 and 2/8respectively,in which there were statistically different between group A or B and group D (P ＜0.05).(2)The clinical benefit rates evaluated by the pathological examination in group A,B,C and D were 4/6,4/11,5/14 and 0,respectively and there were statistically different between group A and group D (P =0.030).( 3 ) There was significant difference in the recurrence rate between group A and group D (3/6 vs.8/8,P =0.024),while there were not significant differences between group B or C and group D ( all P ＞ 0.05 ).The rate of drug-resistant recurrence in group A,B,C and D were 1/6,3/11,5/14 and 7/8,respectively,in which there were significant differences between group A,B or C and group D ( all P ＜ 0.05 ). ( 4 ) The median progression-free survival (PFS) for patients in group A,B,C and D were 32,10,18 and 3 months,respectively,in which there were significant differences in the PFS between group A,B or C and group D (P =0.012,P =0.003,P =0.032 ).The median overall survival (OS) were 44,45,44 and 16 months,respectively.There were significant differences in the OS between group A,B or C and group D ( P =0.022,P =0.004,P =0.000 ).Conclusion The change of CA125 between primary cytoreductive surgery and interval debulking surgery may be predict the recurrence type and the prognosis in patients with epithelial ovarian cancer.

Objective To analyze the clinical features and the application of bronchoscopy in diagnosis and treatment of children with bronchiectasis.Methods All cases with bronchiectasis were collected from in-patient department of the Children's Hospital Affiliated to Nanjing Medical University from December 2011 to November 2015.Clinical manifestations,results of bronchoscopy examination were retrospectively analyzed.Results Of the 33 children,32 cases (97.0％) had chronic cough and sputum.Lung infection was the main cause (50％,16/33 cases).High resolution CT showed signet ring sign and/or double-track sign in lungs,and bronchiectatic lesions were most commonly found in the lower lobes (60.6％).Eighteen cases underwent bronchoscope ciliary biopsy,and the number of cilia decrease was found in 2 cases,and cilia ultrastructure abnormalities were found in 6 cases,with 2 cases diagnosed as Kartagener syndrome.The treatment included the following:treatment of the underlying disease,aggressive treatment of infections,promotion of mucociliary clearance,and bronchoscopy.The symptoms of the most patients were relieved through the symptomatic treatment.Follow-ups after discharge,showed that 15 cases had a slight cough without obvious sputum,11 cases with recurrent lung infections,regular bronchoscope lavage treatment;4 cases underwent surgical lung resection and recovered well postoperative,and 2 cases died.Conclusion The bronchoscopy should be performed early in the children with bronchiectasis,which can clearly detect pathogens and causes,so as to undertake lavage treatment to improve clinical symptoms.

OBJECTIVETo investigate the differences in the condylar position of subjects with skeletal class I and skeletal class II. To provide a basis of diagnosis and treatment.

METHODSGroup A was composed of 50 subjects with skeletal class I (27 males and 26 females; age range = 18 years to 30 years; mean age=26 years). Group B comprised 50 subjects with skeletal class II (24 males and 26 females; age range = 18 years to 28 years; mean age=25 years). The condylar position and the shapes of the condyle and the glenoid fossa were linearly measured on the sagittal and coronal sections by cone-beam computed tomography (CBCT). Data were analyzed by SPSS 19.0.

RESULTSNo statistically significant differences were found in the measurements of the condylar position between the sides of each group on the sagittal plane and the coronal plane (P > 0.05). There were significant differences on the anterior space and the posterior space between group A and B (P < 0.05). The A/P joint space ratio of group A was larger than that of group B (P < 0.05).

CONCLUSIONThe subjects of skeletal class I show an anterior condyle position. The subjects of skeletal class II show a posterior condyle position.

Adolescent ; Adult ; Cone-Beam Computed Tomography ; Face ; Female ; Humans ; Male ; Mandibular Condyle ; Temporomandibular Joint ; Young Adult