Objective:To investigate the effect of enteral nutritional support in treating COPD patients with respiratory failure and mechanical ventilation.Methods:40 patients were randomly divided into two groups:high-fat and low-carbohydrate enteral nutritional solution group(HL group) and ordinary enteral nutritional solution group(control group).The volume of expired gas(VE),carbon dioxide production(VCO2),partial pressure of carbon dioxide(PaCO2),respiratory quotient(RQ),serum albumin,immunoglobulin,total lymphocyte count(TLC) were detected.Results:VCO2 and PaCO2 were significantly decreased in HL group compared with control group(P

OBJECTIVE To analyze the characteristics of nosocomial infections,risk factors and prevention measures in patients with chronic severe hepatitis B.METHODS A retrospective review of the medical records of 354 patients with chronic severe hepatitis B admitted between Jan 2006 and Dec 2006 was performed.RESULTS The incidence of nosocomial infection in patients with chronic severe hepatitis B was 16.67% and mainly infection sites consisted of abdominal cavity(40.32%),and upper respiratory tract(22.58%).The most common infection(47.46%) was occurred during the period of hospitalization 15-30 days after and the most commonly pathogens were Gram-negative bacilli(68.75%).The infection risk factors were associated with invasive operation,hypoalbuminemia,endotoxemia,advanced age,antibiotics application and decrease in cell immune function.CONCLUSIONS It is important for the patients with chronic severe hepatitis B to strengthen management on related risk factors in order to prevent nosocomial infection effectively.

A new method has been established for simultaneous determination of anions and cations in fertilizer sample by multimodal liquid chromatography with direct conductivity detection. An Acclaim Trinity P1 column based on nanopolymer silica hybrid technology with multimodal separation functional groups reversed-phase/anion-exchange/cation-exchange was used for the analysis. The chromatographic conditions were optimized and the effect ion of eluent on retention was discussed. Eight ions ( Li+, NH+4 , K+, HCOO-, NO-2 , Cl-, NO-3 and Br-) were separated and determined simultaneously by using 25 mmol/L CH3 COONa solution containing 50% acetonitrile at pH=5. 0 as mobile phase. The flow rate was 0. 50 mL/min and the temperature was 30 ℃. Under the optimum conditions, the linear ranges of the method were in the range of 0 . 5-200 mg/L for all the ions with correlation coefficient of 0 . 9997-0 . 9999 . Whereas the detection limits (S/N=3) were in the range of 0. 16-1. 72 mg/L and the relative standard deviations (RSD, n=9) were in the range of 1 . 3-2 . 5%. The method was applied to the determination of anions and cations in the fertilizer samples with satisfied results and the recoveries were in the range of 95 . 8%-103 . 8%.

Objective:To investigate the relationship between the gene polymorphism cluster of differentiation 14 (CD14)-159C/T (rs2569190),and interleukin-8 (IL-8)-251A/ T (rs4073)and the susceptibility of necrotizing enterocolitis (NEC),to clarify the influencing factors of susceptibility of NEC and to provide genetics theory basis for the research on the pathogenesis of NEC. Methods:Total 28 newborns with NEC and 41 newborns without NEC were selected.The amplification of peripheral blood DNA was conducted by PCR.The genotypic and allelic frequencies of CD14-159C/T and IL-8-251A/T of the patients were detected by Sanger DNA sequencing method. The relationship between them and the susceptibility of NEC was studied.Results:The distribution of genotypic frequencies of CD14-159C/T and IL-8-251A/T was consistent with Hardy-Weinberg equilibrium (P >0.05).There were no significant differences of the allelic and genotypic frequencies of CD14-159C/T,or genotypic frequencies of IL-8-251A/T between two groups (P >0.05).While in NEC group,the T allelic frequency of IL-8-251A/T site was higher than that in control group (χ2 = 4.184, P = 0.041, OR = 2.14, 95% CI: 1.03 - 4.46 ). Conclusion:The polymorphism of CD14-159C/T is irrelevant to the pathogeny of NEC,but T allelic frequency of IL-8-251A/T site might be related to the susceptibility of NEC.So T allele in IL-8-251A/T may be one of the danger factors of NEC.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.

ObjectiveTo investigate the expression of T lymphocytes and activated subsets in patients with HIV/AIDS and early latent syphilis. MethodsT lymphocytes and activated subsets ( HLADR+ CD3 +/CD3 + , HLA-DR+ CD4 +/CD4 + and HLA-DR+ CD8 +/CD8 + ) as well as rapid plasma reagin (RPR) and treponema pallidum particle agglutination (TPPA) test were detected by flow cytometry in 78 patients with HIV/AIDS, 66 patients with HIV/AIDS and early latent syphilis, and 30 healthy subjects. SPSS 13.0 was used for statistical analysis, and t (for normal distribution) or Mann-Whitney U (for skew distribution) tests were performed to compare between the groups. ResultsThe absolute counts of CD4+ T cells in patients with HIV/AIDS and early latent syphilis were significantly higher than those in HIV/AIDS patients ( t = 2. 041 and 2. 223, P ＜ 0.05 ), but no difference in the counts of CD3 + T cells and CD8 + T cells was observed (tcD3 =0. 362 and 0.692, tcD8 =0.043 and 0.617, P＞0.05). HLA-DR+ CD4 +/CD4 +level in AIDS plus syphilis group was much higher than that in HIV plus syphilis group ( t = 2. 647, P ＜ 0. 05 ), but no difference was observed in HLA-DR+ CD3 +/CD3 + and HLA-DR+ CDs +/CDs + ( t = 1. 112 and 0. 093, P ＞ 0.05). ConclusionsImmune function in patients with HIV/AIDS and early latent syphilis may be enhanced temporarily.

Objective To investigate the relationship between apparent diffusion coefficient (ADC)value of rectal adenocarcinoma on DWI and its pathological grading.Methods The ADC values of 46 rectal adenocarcinomas were measured and compared with their histopathological grades.Results The 46 rectal adenocarcinomas included well differentiated adenocarcinomas in 14,moderate-ly differentiated ones in 20,and poorly differentiated ones in 12.The ADC values of well,moderately and poorly differentiated ade-nocarcinomas were (1.125±0.103)×10 -3 mm2/s,(1.030±0.098)×10 -3 mm2/s and (0.922±0.091)×10 -3 mm2/s,respective-ly,exhibiting a statistical difference (χ2 =1 7.35 1,P =0.000).Mann-Whitney U test showed that difference in ADC value between different histopathological grades was statistically significant.Conclusion ADC value of rectal adenocarcinoma can be used as a bio-marker for cell grading to guide treatment decision and prognosis assessment.

Objective To investigate the clinical characteristics of twice-weekly hemodialysis patients.Methods Data were collected from Shanghai Renal Registry.A total of 1288 patients undergoing regular hemodialysis (HD) with dialysis adequacy index and other biochemical parameters in Shanghai in January 2007 were enrolled into the cohort study with 2 years follow-up.Clinical characteristics and outcome of twice-weekly HD patients were analyzed as compared with thrice-weekly HD patients.Results Compared with patients on thrice-weekly HD,the twice-weekly HD patients were significantly younger and had significantly shorter HD vintage,smaller body surface area,longer HD session time,higher single-pool Kt/V (spKt/V) and serum albumin but lower weekly Kt/V (P＜0.05).There was no statistical difference in ultrafiltration volume between two groups.Kaplan-Meier survival analysis indicated that both groups had similar two-year survival.Multivariate Cox regression analysis showed that age,body mass index,serum albumin and weekly Kt/V were predictors of patient mortality.Conclusion It is acceptable for some hemodialys patients with twice-weekly HD,and close monitor of dialysis adequacy and volume status is necessary for this therapy model.

Objective To explore the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis.Methods Retrospectively analysed the clinical data of 472 patients with decompensated hepatitis B cirrhosis,and compared with 681 healthy control volunteers.All the informations such as gender,age,family history of liver disease,hepatitis B virus infection,hepatic function classification,complications of portal hypertension and the distribution of ABO blood group were observed.Results The highest incidence of decompensated hepatitis B cirrhosis was found in A blood group.There was no significant difference in the distribution of ABO blood group for patients with different age (P ＞ 0.05).Significant correlations were observed between AB blood group and family history of hepatitis B patients,expansion of the portal veines ＞ 1.5 cm,esophageal varices,cirrhosis complications,hepatic function classification (P ＜ 0.01).C ystatin C expression was increased with hepatic function classification (P ＜ 0.05).Conclusions The risk of liver cirrhosis is increased in patients with A blood group.Compare with other blood group,patients with AB blood group has a serious progression.The level of nitrogen,creatinine,cystatin C in decompensated cirrhosis are significantly higher than healthy controls.The level of cystatin C expression is increased with hepatic function classification.Cystatin C may be a potential marker in the classification of hepatic function.

Objective To investigate the long-term prognosis and possible risk factors of acute kidney injury(AKI)following cardiac surgeries. Methods Clinical data of 941 patients undergoing open heart surgery from January 2004 to June 2007 were retrospectively analyzed.Survival and renal function of above patients were informed through telephone or clinic follow-up till February 2010.Long-term survival was analyzed using risk-adjusted Cox proportional hazards regression model. Results Of the 941 patients after cardiac surgery,275(29.2%)developed AKI and 666(70.8%)did not.Survival was worse in patients with AKI(67.8%vs 85.6%,P<0.01)and was proportional to its severity (AKIN 1,2 and 3 stages:70.7%,62.3%and 58.6%,P<0.01).Although 90.5% of patients had complete renal recovery after AKI at discharge of hospital,they still had an increased risk for death during follow-up compared with patients without AKI (69.6% vs 85.6%,P<0.01).In the Cox proportional hazards regression model,age(HR=2.238),anemia (HR=1.625),prolonged operation time (HR=1.153),AKI severity (HR=1.473)were independent risk factors for long-term prognosis after cardiac surgery.At the end of the follow-up,patients with AKI had statistically higher Scr than non-AKI patients(107.6 μmol/L vs 83.0 μmol/L,P=0.014),and among those AKI patients,34.0%progressed into CKD 3-5 stages,34.8%developed double serum creatinine. Conclusions AKI is a risk factor for the long-term prognosis of cardiac surgery.Patients with complete renal recovery after AKI still has an increased risk for death and poor renal function compared with patients without AKI.