Objective To observe the liver function changes in patients after enteral nutrition through nasal jejunal tube.Methods Altogether 74 inpatients requiring enteral nutrition were collected for this study from September 2011 to August 2014 in the Intensive Care Unit of Zhengzhou People's Hospital and divided into 2 groups with random number table:the nasal jejunal tube group (n =36) and the nasogastric tube group (n ＝38),with nasal jejunal tube and nasogastric tube inserted,respectively,for early enteral nutrition.We observed the two groups of patients in terms of liver function indexes on day 7 and day 14 after starting enteral nutrition.Results In the nasal jejunal tube group,31 patients (86.11％) showed abnormality in at least 1 liver function index,while that number was 23 in the nasogastric tube group (60.53％),with significant inter-group difference (x2 =6.136,P =0.013).On day 7 after enteral nutrition,there were no significant differences in alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptidase (γ-GGT) and albumin (ALB) between the two groups [(39.1 ± 8.6) U/L vs.(42.3 ±8.9) U/L,t=-1.475,P=0.145;(36.2±6.8) U/Lvs.(38.0±7.1) U/L,t=-1.237,P=0.220;(61.8±11.5) U/Lvs.(63.1 ±13.2) U/L,t=-0.696,P=0.489;(47.3±8.2) U/Lvs.(50.5±7.5) U/L,t=-1.640,P=0.106;(35.2±6.7) g/Lvs.(36.2±7.4) g/L,t=-0.610,P=0.543];but on day 14,the nasal jejunal tube group had significantly higher levels of ALP,γ-GGT,and ALB compared with the nasogastric tube group [(201.2 ± 15.2) U/L vs.(116.5 ± 13.6) U/L,t =-25.380,P =0.000;(109.4±7.2) U/Lvs.(49.2±6.5) U/L,t=-37.665,P=0.000;(37.2±7.1) g/Lvs.(30.1±6.5) g/L,t =-4.490,P =0.000].On day 7 and day 14,there were no statistically significant differences in totalbilirubin [(4.6±0.9) μmol/L vs.(4.8 ± 1.0) μmol/L,t =-0.905,P=0.368;(4.8±12) μmol/Lvs.(5.2±1.1) μmol/L,t=-1.492,P=0.140],indirect bilirubin [(6.1 ±0.8) μmol/Lvs.(6.3±0.9) μmol/L,t=-1.012,P=0.315;(6.9±0.9) μmol/L vs.(7.3±1.0) μmol/L,t=-1.811,P =0.074],and direct bilirubin [(4.0 ± 0.6) μmol/L vs.(3.9 ± 0.5) μmol/L,t =0.777,P =0.440;(5.1 ±0.8) μmol/L vs.(5.4±0.9) μmol/L,t=-1.517,P=0.134] between the nasogastric tube and the nasal jejunal tube groups.The incidence of pulmonary infection in the nasal jejunal tube group was significantly lower than that in the nasogastric tube group (30.56％ vs.55.26％,x2 =4.598,P =0.032).Conclusion Compared with enteral nutrition through nasogastric tube,enteral nutrition through nasal jejunal tube may be more likely to lead to abnormal liver function.

Objective To analyze the incidence and related risk factors of hyperuricemia after liver transplantation.Methods A total of 286 cases undergoing liver transplantation from 2009 to 2012 in the Armed Police General Hospital , who had normal uric acid before transplantation and had been followed up for more than 1 year, were enrolled in this study.The clinical data, including liver and kidney function , blood glucose, and lipids were collected .The potential risk factors of hyperuricemia were analyzed .Results 53.5% cases ( 153/286)had hyperuricemia after transplantation.Hyperuricemic patients were predominately older (P =0.038). They also had a higher prevalence of increasing creatinine (P=0.000),and hyperlipidemia(P=0.000).Among female cases, hyperuricemic patients had a higher average BMI (P=0.027).Hyperuricemia group had an elevat-ed ratio of blood lipids 60.1%(92/153), higher than normal uric acid group (39.1%,52/133) ( P<0.05). Conclusions Liver transplantation recipients have a higher incidence of hyperuricemia , particularly in elderly and overweight female patients .Our findings suggest that postoperative hyperuricemia may be associated with high serum creatinine, elevated blood lipids.We should strengthen follow-up, take early detection and early treat-ment.

12 m/s group,n=70;cfPWV≤12 m/s group,n=49). Carotid atheromatous plaque was assessed by Doppler echocardiograph;blood pressure and hemoglobin A1c were measured. Results After adjustment for body mass index (BMI),sex,stroke and fasting blood glucose,logistic multivariable analysis showed that cfPWV associated with age,systolic blood pressure(SBP),pulse pressure,coronary artery disease,diabetes,carotid atheromatous plaque and hemoglobin A1c. Conclusion Arterial stiffness in elderly patients with essential hypertension was strongly positively associated with age,SBP,pulse pressure,coronary artery disease,diabetes,carotid atheromatous plaque and hemoglobin A1c.

Objective To explore the relationship between cognitive impairment and arterial stiffness in elderly patients. Methods A total of 142 elderly patients were enrolled. Cognitive function was assessed by mini-mental state examination (MMSE) and arterial stiffness was assessed by pulse wave velocity (PWV). A full score on the MMSE was 30, and cognitive impairment was defined as a score less than 24. All subjects underwent the measurement of PWV and MMSE . The subjects were divided into 2 groups: 93 were assigned to the normal cognitive function group (MMSE score 24), and the remainders (n=49) were assigned to the cognitive impairment group (MMSE score 24). Results The PWV was significantly increased in the cognitive impairment group than in the normal cognitive function group [(13.3±2.4) m/s vs. (11.8±2.2) m/s, t=3. 775, P=0. 000]. Logistic regression analysis showed that the PWV was also independently and significantly associated with the MMSE score. Conclusions The increase of arterial stiffness is an important risk factor for impaired cognitive function in elderly patients.

Objective To observe the effects of tacrolimus on blood glucose, insulin, expressions of protein phos-phatase 2A and P-AKT in rats in order to explore the mechanism of hyperglycemic action of tacrolimus. Methods Sixty male SD rats (body weight 89. 83 ±4. 44 g) were randomly divided into tacrolimus group (n =40) and control group (n=20). The rats in the tacrolimus group were administrated with tacrolimus 4 mg/kg daily. The rats in the control group were given the same amount of normal drinking water daily. The rat body weight, fasting blood glucose concentration and blood concentration of tacrolimus were measured monthly. All rats were killed at 5 months after the tacrolimus administra-tion. The serum insulin levels were detected by radioimmunoassay method. The expressions of PP2A and P-AKT in liver tissues were assessed by immunohistochemistry. Results After two months of administration, the blood glucose levels in the tacrolimus group were significantly higher than those in the control group. The HOMA-IR in tacrolimus group was signif- icantly higher than that in the control group P<0. 05 ) . ISI was significantly lower than that in the control group ( P<0. 05). Immunohistochemical examination showed that the expression of PP2A in hepatocytes in the tacrolimus group was increased compared with the control group, while expression of P-AKT in hepatocytes of the tacrolimus group was decreased than that in the control group. Conclusions Tacrolimus can induce necrosis of islet cells, decrease of the amount of islet cells and insulin secretion, decease of sensitivity to insulin, and increase the resistance to insulin, therefore, leading to in-crease the blood glucose level in rats. The expression of PP2A in hepatocytes in the tacrolimus group is increased, while the expression of P-AKT is decreased. Interfering of insulin signal transduction pathways may be involved in the hyperglyce-mic effects of tacrolimus.

Objective:To observe the effect of enriched rehabilitation training on cognitive function, plasma mir-146a-5p microRNA precursor levels and inflammatory factors in persons with post-stroke cognitive impairment (PSCI).Methods:Fifty-eight persons with PSCI were randomly divided into an observation group and a control group, each of 29. The observation group was given enriched rehabilitation training, while the control group was provided with conventional cognitive rehabilitation training. The Montreal Cognitive Assessment Scale (MoCA), the Digit Span Test (DST), parts A and B of the Trail Making Test (TMT A-B) and the Modified Barthel Index (MBI) were used to assess the subjects′ cognitive functioning and their ability in the activities of daily living (ADL). Plasma levels of mir-146a-5p, IL-6 and TNF-α were detected before and after the treatment.Results:After treatment, the average MOCA, DST and MBI scores, as well as the average TMT A-B times had improved significantly for both groups. However, the observation group′s averages were significantly better than those of the control group on all three tests. After the treatment, the average plasma expression of miR-146a-5p had increased significantly in both groups, but the increase in the observation group was significantly greater. Plasma IL-6 and TNF-α levels were significantly lower than before the treatment, with the average TNF-α level in the observation group significantly lower than that of the control group.Conclusions:Enriched rehabilitation training can improve the cognition of stroke survivors more effectively than conventional cognitive rehabilitation training. That may be related to the up-regulation of plasma miR-146a-5p and reducing inflammation.

Objective To evaluate the efficacy and safety of glargine combined with repaglinide in the treatment of post-transplantation diabetes mellitus(PTDM).Methods PTDM patients who were treated in our hospital from Jan 1,2010 to Dec 31,2010 were enrolled in this study.They were administrated with glargine combined with repaglinide for 6 months,and their glucose level,hepatic and renal function indicators,and tacrolimus concentration were examined at baseline and 1,3,and 6 months after treatment.Results Totally 44 patients were included and given dietary control.Three cases were not given any hypoglycemic drugs,7 were administrated with glargine only,30 cases received glargine combined with repaglinide therapy,and 4 cases required intensive insulin therapy.All the patients achieved satisfactory glycemic control.The hepatic function,renal function,and serum tacrolimus concentration showed no significant change before and after repaglinide therapy(P ＞ 0.05).Five hypoglycemic events were recorded during the treatment,in which the lowest blood glucose level was 3.7 mmol/L.No severe hypoglycemia happened.Conclusion On the basis of dietary control,glargine combined with repaglinide provides a safe and effective therapy for PTDM.

AIM: To investigate the effect of ambroxol on pulmonary and vascular injury in chronically hypoxic rats. METHODS: 36 male Wistar rats were randomly divided into 3 groups: normal control,chronically intermittent hypoxia(CIH) and ambroxol precaution group(AP).The CIH and AP groups were made into the chronically hypoxic models .The mean pulmonary artery pressure(PAPM) and the levels of plasma superoxide dismutase (SOD) and plasma nitric oxide (NO),lipid peroxide(LPO) were determined. The levels of the lung homogenates SOD, LPO, NO and the changes in pulmonary vascular structure were also examined. RESULTS: The levels of plasma and lung homogenates SOD,NO in CIH group were respectively significantly lower than that of normal control and AP group ( P

ObjectiveTo evaluate the value of Token Test in testing Chinese aphasia and study the mechanism of bilateral hemispheric asymmetry.Methods33 patients with left hemispheric cerebral vascular diseases and 30 patients with right hemispheric cerebral vascular diseases were studied by Token Test and Aphasia Battery of Chinese(ABC). ResultsThe statistical analysis shows that the score of Token Test was significantly correlated with all tests of ABC in both left and right hemispheric damages groups(P<0.01), and that the score of Token Test was significantly negative correlated with infarction areas in left hemispheric damages groups (P<0.01),but incorrelated with infarction areas in right hemispheric damages groups(P>0.05). There is a significant correlation between the score of Token Test and the severity of the aphasia(P<0.01). Conclusions Token Test was closely related with ABC. It can be effective to detect some higher neuropsychological function disorder.