Objective To investigate the clinical value of early enteral nutrition (EN) on hospital acquired pneumonia (HAP) in postoperative patients with severe hypertensive cerebral hemorrhage.Methods One hundred and forty postoperative patients with severe hypertensive cerebral hemorrhage were divided into treatment group (70 cases) and controll group (70 cases) by random digits table. The treatment group was given EN from the second day after operation, while the control group was given total parenteral nutrition (TPN). The incidence and duration of HAP,the incidence of superinfection,the percent and duration of mechanical ventilation and the mortality rate of HAP was observed. Results The incidence of HAP, superinfection and using mechanical ventilation in treatment group [30.0% (21/70), 12.9% (9/70),35.7%(25/70)] were significantly lower than those in control group [47.1%(33/70) ,27.1%(19/70) ,47.1%( 33/70 )] (P ＜ 0.05 ). The duration of HAP and using mechanical ventilation in treatment group[(6.4 ± 2.3 ),(6.4 ± 0.5 ) d] were significantly lower than those in control group [( 15.6 ± 2.1 ), ( 11.4 ± 0.3 ) d] (P ＜ 0.01or ＜ 0.05 ). The mortality rate of HAP in treatment group was significantly lower than that in control group [8.6% (6/70) vs. 18.6% (13/70),P ＜0.05]. Conclusion Early EN not only effectively decreases the incidence of HAP and superinfection,but also decreases the incidence of mechanical ventilation, shortens the duration of mechanical ventilation and decreases the mortality rate of HAP.

Objective To investigate the effect of severe eraniocerebral injury patients with hypernatremia.Methods Review and analysis of 356 cases of severe craniocerebral injury and 185 cases of hypernatremia. Analysis on the relationship between hypernatremia and prognosis. Results The 185 eases of severe craniocerebral injury with hypernatremia, the incidence is 52 %. Including 136 death cases, the mortality rate was 73.5 %. Hypernatremia appeared after admission since 1～18 days,the average days for this were 4.1 days. 69 cases appeare hypernatremia in 24 hours,60 cases in 48 hours,16 cases in 72 hours,145 cases of hypematremia appeared after admission within 3 days,about 78%. Blood sodium level was 148～196mmol/L, average was 172mmol/L, duration time was 1～25 days, average was 5.4 days. Conclusion It seems that almost hypernatremia appeared, when severe crartiocerebral was injuried in 3 days. The mortality is very high.

Objective: To explore the effects of growth hormone (GH) added early enteral nutrition(EEN) on nutrition status and complications in postoperative hypertensive intra-cerebral hemorrhage(HICH) patients.Methods: 122 patients with postoperative HICH were randomized into the treat group and control group. The treatment group (61 cases) received enteral nutrition support on the 2nd day after operation, and growth hormone was combined for one week. The control group (61 cases) received total parenteral nutrition(TPN) support. The clinical effect and complications were observed between the two groups. Results: The patientss serum pre-albumin , transferrin ,albumin , and nitrogen balance in the treatment group were significantly better than those in the control group (P

Objective To investigate the choice and efficacy of surgury in treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 278 cases of hypertensive cerebral hemorrhage were retrospectively analyzed. These cases respectively used CT Stereotactic puncture and drainage, minimally invasive craniotomy and Craniotomy hematoma surgical treatment. According to the GCS cores and hematoma volume,they were divided into 3 groups so as to comparatively analyze the efficacy of different surgical methods. Results Hypertensive cerebral hemorrhage CT stereotactic puncture good prognosis group was 74 cases(59.6% ) ,minimally invasive craniotomy group of good prognosis ,48 cases(56.4% ) ,there was no significant difference between the two groups(P＞ 0.05). Craniotomy mortality is 15 cases (21.7% ). Conclusion Three surgical treatment of hypertensive cerebral hemorrhage had their own characteristics:CT stereotactic puncture and drainage characteristics with less trauma,faster recovery,timely and effectively discharge brain compression. It was a simple and effective treatment for hypertensive intracerebral hemorrhage. In many cases, CT sterotactic puncture and drainage could replace invasive hematoma evacuation.

ObjectiveTo explore the treatment desicions of Contusion and laceration of the brain at temporal lobe and frontal lobe with small hematoma and base pond changes. MethodsAccording to three grades of consciousnee,areas of brain contusion or quantity of hematoma,and changes of base pond,it divided 274 patients into different types,then analyzed treatments and retrospect to them. Results33 cases of Type Ⅰ:33 cases had operated immediatelly and 3 cases had died;44 cases of Type Ⅱ:17 cases had delayed operations and 1 case had died;27 cases without operations.Type Ⅲ: 15 cases without operations. ConclusionThese "three-3" method of grade could be regarded as the quantification index of treatment desicions before deterioration.

Objective To explore the the rapeutic efficacies of different surgical methods for hypertensive intracerebral hemorrhage so as to find out their indications. Methods Admittedin to 218 eases of hypertensive intracerebral hemorrhage since, which treated by tereotaetie aspiration or eraniotomy through small bone window or eraniotomy through bone flap was divided into three subgroups according to GCS scores and hematoma volume indications and trerapeutic outcomes of these three surgical methods were analyzed comparatively. Results Satisfactory prognosis was found in 64(60.4%) patients of brain hematoma puncture drainage. Satisfactory prognosis was found in 35(54.7%) patients of small windowing skull. No significant was occurred between the two groups (P＞0.05). The mortality rate decreased obviously in the bone-flap eraniotomy group with greathematoma volume (29.2%). Conclusions Puncture drainagc has small wound and instauration quickly. And valid for time to relief encephalothlipsis. In most circumstances, puncture drainage can replace the small hole craniotomy. Bone flap craniotomy can lower a great deal of apoplexy death rate.

Objective:To investigate the effects of Buzhong Yiqi Decoction on the expressions of multidrug resistance-related protein (MRP), lung resistance-related protein (LRP), and P-glycoprotein (P-gp) in transplantation tumor of A549 tumor-bearing nude mice.Methods:A549 cells were cultured to establish xenograft models of tumor-bearing nude mice. According to the random number table method, they were divided into blank control group, cisplatin group, cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin + Buzhong Yiqi Decoction high-dosage group. After 25 days of corresponding drug intervention, the mRNA expressions of MRP, LRP and P-gp in transplantation tumors were detected by Real-Time PCR, and Western blot was used to detect the expressions of MRP, LRP and P-gp proteins in xenograft tissues in each group.Results:Compared with blank control group, the mRNA and protein expressions of MRP, LRP and P-gp in cisplatin group were significantly down-regulated ( P<0.05). Compared with cisplatin group, the mRNA and protein expressions of MRP, LRP and P-gp in the cisplatin + Buzhong Yiqi Decoction low-dosage group, cisplatin + Buzhong Yiqi Decoction medium-dosage group, cisplatin+Buzhong Yiqi Decoction high-dosage group decreased ( P<0.05). Conclusion:Buzhong Yiqi Decoction can inhibit the expressions of MRP, LRP and P-gp in transplantation tumor of A549 tumor-bearing nude mice and without dosage dependence.

Objective:To investigate whether octyl ester derivative of ginsenoside Rh2(Rh2-O)can induce immunogenic cell death of Huh-7 hepatocellular carcinoma cells and possible mechanism.Methods:Huh-7 cells were cultured in vitro,and divided into control group,Rh2-O group,positive control group(mitoxantrone treatment).Viability and apoptosis of cells were detected by CCK-8 and flow cytometry,respectively.Concentrations of high mobility family protein 1(HMGB1)and adenosine triphosphate(ATP)in supernatant were detected by ELISA and chemiluminescence assay,respectively.Membrane eversion of calreticulin(CRT)was detected by immunofluorescence assay.ROS level in cells was detected by fluorescence probe DCFH-DA,and expressions of proteins associated with endoplasmic reticulum stress signaling pathway were detected by Western blot.Results:Rh2-O treatment significantly reduced cell viability,promoted apoptosis,induced secretion of HMGB1,ATP,membrane eversion of CRT,increased accumulation of ROS in cells,and enhanced expressions of endoplasmic reticulum stress-related proteins PERK,eIF2α,p-eIF2α(all P<0.05).After addition of endoplasmic reticulum stress inhibitor 4-phenylbutyric acid(4-PBA),membrane eversion of CRT induced by Rh2-O was significantly inhibited(P<0.05).Conclusion:Rh2-O can induce immunogenic cell death in hepatocellular carcinoma cells,whose mechanism may be associated with activation of endoplasmic reticulum stress and promotion of CRT membrane eversion.

Pheretima,also called"earthworms",is a well-known animal-derived traditional Chinese medicine that is extensively used in over 50 Chinese patent medicines(CPMs)in Chinese Pharmacopoeia(2020 edi-tion).However,its zoological origin is unclear,both in the herbal market and CPMs.In this study,a strategy for integrating in-house annotated protein databases constructed from close evolutionary relationship-sourced RNA sequencing data from public archival resources and various sequencing al-gorithms(restricted search,open search,and de novo)was developed to characterize the phenotype of natural peptides of three major commercial species of Pheretima,including Pheretima aspergillum(PA),Pheretima vulgaris(PV),and Metaphire magna(MM).We identified 10,477 natural peptides in the PA,7,451 in PV,and 5,896 in MM samples.Five specific signature peptides were screened and then validated using synthetic peptides;these demonstrated robust specificity for the authentication of PA,PV,and MM.Finally,all marker peptides were successfully applied to identify the zoological origins of Brain Heart capsules and Xiaohuoluo pills,revealing the inconsistent Pheretima species used in these CPMs.In conclusion,our integrated strategy could be used for the in-depth characterization of natural peptides of other animal-derived traditional Chinese medicines,especially non-model species with poorly annotated protein databases.

Objective: To investigate whether a deep learning-based model using unenhanced computed tomography (CT) at baseline could predict the malignancy of pulmonary nodules. Methods: A deep learning model was trained and applied for the discrimination of pulmonary nodule in Dr. Wise Lung Analyzer. This study retrospectively recruited 130 consecutive participants with pulmonary nodules detected on CT who undergoing biopsy or surgery from May 2009 to June 2017 in Jinling hospital. A total of 136 pulmonary nodules were included in this study, including 86 malignant nodules and 50 benign ones. All patients underwent CT scans 2 times at least, the first scan was defined as baseline and the last scan before the pathological results was defined as final scan. The ROC curve of deep learning model was plotted and the AUCs were calculated. Delong test was used to examine the difference of AUCs baseline and final scan. The nodules were further divided into subsolid nodule group (pure ground-glass nodule and part solid nodule) (n=87) and solid nodule group (n=49). The difference of AUCs at baseline and final scans was evaluated intra two groups. Results: The AUCs of the deep learning model at final and baseline scans were 0.876 and 0.819, respectively. There was no significant difference between them (P=0.075). The result indicated that the model could predict the consequences of pulmonary nodules well at baseline. In small nodules (longest diameter ≤10mm), the AUC at final scan (0.847) was better than it at baseline scan (0.734), but there was no significant difference between them (P=0.058). In solid nodule group, The AUC at final scan (0.932) was better than it at baseline scan (0.835), but there was no significant difference between them (P=0.066). In subsolid nodule group, the deep learning model exhibited consistent performance at final scan (AUC, 0.759) with the baseline scan (AUC, 0.728, P=0.580). Conclusions The deep learning model could predict the malignancy of pulmonary nodules including small ones at baseline, and the model exhibited consistent performance between baseline and final scans in subsolid nodules.