Objective To investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD).Methods A total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admis-sion order.The patients in group A (n=25 )received enteral nutritional support after PTCD,and those in group B (n=25 )received total parenteral nutritional support after PTCD.Intra-group and inter-group comparisons were made in terms of jaundice clearance,nutritional indices,and body’s immune function on preoperative day 1 and postoperative day 7;comparison between the two groups was made by t test. Results Among the 50 patients who underwent PTCD,39 (78%)had good drainage,while 1 1 (22%)did not reach the expectation,of which,5 (10%)were in group A and 6 (12%)in group B.In both groups,the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1(P<0.05),but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P>0.05).The immune function of patients in both groups was significantly improved following PTCD and nutrition-al support (P<0.05),but there was no significant difference between the two groups (P>0.05).Although the same scheme of nutritional support was used,there were 1 1 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P<0.05).Conclusion Jaundice clearance is closely re-lated to PTCD in patients with malignant obstructive jaundice,but not markedly associated with the ways of nutritional support.

Objective To examine the clinical effects of intravenous lyophilize recombinant human brain natriuretic peptide (rhBNP) in patients with refractory heart failure caused by coronary artery disease.Methods Seven patients with refractory heart failure caused by coronary artery disease were treated with rhBNP.The rhBNP nea grade,symptoms and signs,24 hours urine output,heart rate,blood pressure and central venous pressure were evaluated at 0,15,30 min and 1,2,4,8,12,24,and 48 h.Serum potassium,sodium,creatinine and plasma BNP before and after treatment were measured.Results After rhBNP therapy,dyspnea grade were improved in 5 patients.Symptoms and signs got better in 6 patients.Systolic blood pressure at 15 min of treatment distolic blood pressure was decreased slightly from (112.00±10.42) mm Hg to (105.14±7.76) mm Hg (P＜0.05) and became (108.71±6.63)mm Hg at 30 rain which was the same with that before treatment.There was no statistical significance in heart beat[ ( 88.57±16.92 ) vs.( 86.00±16.21 ) ] beat/min,serum sodium [ ( 133.57±5,38 ) mmol/Lvs.( 133.57±8.16) mmol/L ],serum potassium [ (3.83±0.37) mmol/L vs.(4.19±0.58 ) mmol/L ],ereatinine [ (93.11±27.90) μmol/L vs ( 123.01±93.01 ) μmol/L ] before and after treatment,and BNP[ ( 1218.43±847.83) vs.(1433.71±676.08)ng/L] before treatment and at24 h treatment,as well as urine output [(2329±1573 ) vs.(2126±1074) ml ] ( P ＞ 0.05 ).Urine output was increased during the treatment,but the usage of diuretic was remarkably decreased.Central venous pressure was gradually decreased from 30 rain to 48 h( P ＜ 0.05 ).Condusion rhBNP can decrease central venous pressure and increase urine output with exerts little side effects on electrolytes and renal function.Therefore rhBNP has positive clinical effects on refractory heart failure which is caused by coronary artery disease.

Light-emitting diodes (LED) can emit lights of different wavelengths, including blue light, yellow light, red light and infrared light. LED has been widely used in dermatology due to its high safety, maneuverability, color purity and low energy. For example, blue light is mostly applied to acne treatment, yellow light is usually used in melasma treatment, red light can be used in treatment of androgenetic alopecia, and infrared light has the function of promoting skin repair. Combination of multi-band lights tends to be applied in clinical practice. For example, the red light and blue light combination, red light and yellow light combination, as well as yellow light and infrared light combination are effective for acne treatment, repair after laser treatment, and skin rejuvenation respectively.