Objective:To explore the clinical therapeutic efficacy and the best way of nutritional support and period in patients with severe head injury.Methods:128 patients with severe head injury were divided into internal nutrition group(ENG) and parenteral nutrition group(PNG)at random.Treated by emergent operations and 48 hours later,all the patients received the rationed nitrogen and calorie,containing nutritional support via different pathway.At the same time,we had been monitoring the nutrional indexes,the metabolic indexes,the complications of nutritional support and calculating the nutritional costs during the whole treatment.Results:The nutritional indexes were effectively maintained in both ENG and PNG,but the metabolic indexes,the complications of nutritional support and the nutritional cost of the PNG rose more obviously than those of ENG.Conclusion:Early postoperative EN and PN nutritional support could improve the nutritional status of the patient.EN had much benefit,including comprehensive nutrition,safety,convenience and low costs.It should be the first pathway for mutritional support.

Objective To analysisthe evaluation clinical effects and complications of retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap for the re-pair of the leg and foot skin defect effect. Methods In January 2010 to January 2015,patients with leg and foot skin defect effect in our hospital administrated withperoneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle skin flap were retrospectively analyzed.Flap survival,necrosis rate, the function of the skin flap and complications were analyzed. Results The one stage flap survival rate of peroneal artery group(84.6%)is higher than the posterior tibial artery group(57.69%),the difference was statistically sig-nificant(P < 0.05). There were no significant difference between the flap function index(pain,activity limita-tion,wearing shoes,functional recovery satisfaction)score and posterior tibial artery group(P>0.05). The occur-rence of hyperplastic scar,itching,pigmentation,skin graft,numbness,skin graft abnormal pain complication rates inperoneal artery group were significantly lower than the posterior tibial artery ,and the difference was statisti-cally significance(P < 0.05). Conclusion Retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap can effectively repair skin and soft tissue defect ,retrograde peroneal artery perforators shows with higher survival rate and less complication.

Chemotherapy resist is the problem for clinic,and some researches find that chemotherapy with anthracycline and oxaliplatin not only induces the tumor cell apoptosis,but also the celt immunogenic cell death (ICD) by inducing the tumor cell apoptosis and releasing three kinds of signals:exposure of calreticulin on the cell surface to stimulate the dendritic cell (DC) to engulf,and the secretion of adenosine triphosphate to recruit DC to enter into tumor bed,and the release of the high mobility group B1 to promote DC to steadily bind with dying tumor cell to induce specific T cell antitumor immune response.It is with great meaning to promote the chemotherapy protocol by studying the ICD induced by chemotherapy.

Objective To investigate the therapeutic effect of paclitaxel plus oxaliplatin chemotherapy to the transplanted non-small cell lung cancer of nude mice and the effect to the apoptosis protein expression of PDCD5 and XIAP with mice model.Methods A tumor-bearing mice were randomly divided into blank group, normal saline group, oxaliplatin group, paclitaxel group, paclitaxel plus oxaliplatin group.The gene expression of PDCD5 and XIAP was assayed by real-time quantitative PCR(q-PCR).The apoptosis related PDCD5 and XIAP protein were detected by Western blot.Finally, the tumor weight of each group was measured for statistical analysis.ResultsThe mRNA expression of PDCD5 was highest and the gene expression of XIAP was lowest in paclitaxel plus oxaliplatin group(P<0.01).The expression of PDCD5 protein was highest and the expression of XIAP protein was lowest in paclitaxel plus oxaliplatin group (P<0.01).Finally, compare the tumor weight of each group, paclitaxel plus oxaliplatin group has the least mass(P<0.01).Conclusions Paclitaxel plus oxaliplatin group chemotherapy significantly increases PDCD5 expression and reduce XIAP expression.Meanwhile, paclitaxel plus oxaliplatin chemotherapy can significantly reduce the tumor weight of happened non-small cell lung cancer.

By furthering microbiology experiment reform,enforcing "high starting point,high efficiency,high quality"teaching,adjusting teaching contents,reforming teaching methods,establishing and promoting testing system,a new microbiology experiment curriculum system is to be established with the basic knowledge and skills as basic contents and cultivating creative ability as central contents.This will motivate the students' interests for microbiology experiment,which helps them to improve their ability of thinking independently and creatively as well as their practicing ability.

Based on the standard strain-Vibrio parahaemolyticus BJ1.1997, temperature (7?C～43?C) and salinity (0.5%～9.5% NaCl) which affected its growth status was studied with uniform design. The results showed that Logistic equation was optimal in primary models, the second was Gompertz equation, the last was Linear equation, so growth parameters can calculated from Logistic equation. The secondary model was developed by square root models, its r value was 0.9863, the lowest growth temperature was 9.0506?C and the highest growth salinity was 5.93% [the corresponding lowest growth water activity (Aw min) was 0.9227]. Through F test, residual analysis and evaluation by bias factor and accuracy factor, the model can exactly describe the relationship between the growth rate and combined effect of temperature and salinity (water activity).

Objective To investigate the safety and efficacy of selective laser trabeculoplasty(SLT)in primary open-angle glaucoma(POAG).Design Retrospective case series.Participants 47 cases(62 eyes)of POAG patients.Methods 62 eyes of 47 patients with primary open-angle glaucoma were treated with frequency doubled Nd:YAG laser SLT(Selecta Duet).A total of approximately 50 non-overlapping spots were placed over 180 degrees of the trabecular meshwork with energy levels ranging from 0.5 to 1.4 mJ per pulse.After surgery,patients were maintained with the drug regimen identical to that before treatment.The average follow-up was 12 months.Main Outcome Measures Intraocular pressure(IOP)and complications.Results After 1 year,the average reduction in IOP from the baseline was 5.2 mmHg.The IOP of 72.5% eyes were controlled well.Slight inflammation of anterior chamber occurred in all the cases 1 hour later after SLT and disappered 3 days later automatically.Conclusions SLT is an effective and safe method to lower IOP in primary open-angle glaucoma in the one year follow up.

Objective To explore the possible role of miR-146a in the pathogenesis of diabetic peripheral neuropathy( DPN) by investigating the correlation of miR-146a level in the peripheral blood mononuclear cells (PBMCs)with tumor necrosis factor α(TNF-α), interleukin-6(IL-6), and C reactive protein(CRP). Methods The expression levels of miR-146a in the PBMCs were measured using realtime PCR in 81 patients and 34 healthy individuals. The correlation of miR-146a expression with clinical parameters was analyzed. Results Compared to those in the healthy individuals and patients without DPN, miR-146a level was significantly decreased in diabetic patients with DPN while TNF-α, CRP, IL-6, HbA1C, systolic blood pressure, and homeostasis model assessment of insulin resistance index(HOMA-IR) were significantly increased(all P<0.05). Duration of diabetes, blood uric acid, serum creatinine, and urinary albumin to creatinine ratio in diabetics with DPN were higher compared with diabetics without DPN(all P<0. 05). The expression level of miR-146a was negatively correlated with diabetes duration, HOMA-IR, HbA1C, TNF-α, and IL-6. Multiple linear regression showed that HOMA-IR, HbA1C, TNF-α, and IL-6 were independent factors of miR-146a. Conclusion miR-146a may be involved in the development of DPN through inflammation, glucose metabolism, and insulin resistance.

Objective To understand the current status of advanced schistosomiasis patients, so as to provide the reference for improving the medical care of them in Shanggao County. Methods The data of advanced patients in Shanggao County were collected from the Information Management System for the Advanced Schistosomiasis Chemotherapy and Assistance in Jiangxi Province and a field survey including the epidemiological investigation physical examinations and B ultrasound examinations was performed in 2014. All the data were analyzed statistically and compared with those in 2010. Results Among the 128 ad?vanced schistosomiasis patients the male female ratio was 2.46 1 the average age was 68.02±6.19 years and the patients old?er than 65 years contributed to 64.84%for the all. The proportions of clinically types of ascites splenomegaly multiple granulo?ma in the colon dwarf general and haemorrhage were 57.81% 12.50% 2.34% 0 26.57% and 0.78% respectively. The ultrasound examinations revealed the average diameter of the main trunk of portal vein was 12.70 ± 1.91mm in 2014 which was significantly broader than that of 12.05 ± 0.34mm in 2010 P < 0.01 . Conclusions The advanced schistosomiasis patents in Shanggao County decreases with years and shows an aging trend. Some advanced schistosomiasis patients are worse therefore the chemotherapy and salvation work still should be strengthened.

Objective To investigate the association between serum uric acid (SUA ) level and diabetic peripheral neuropathy (DPN ) in middle‐aged and elderly population. Methods A total of 207 middle‐aged and elderly patients with T2DM were enrolled in this study. All the subjects were divided into two groups:T2DM only group and DPN group. The DPN group was further divided into three subgroups (mild ,moderate and severe group) according to TCSS score. Pearson correlation analysis was used to evaluate each index ,and binary logistic regression was used for statistical analysis of risk factors for DPN.Results SBP ,UACR ,BUN ,Scr ,TC ,LDL‐C and SUA were significantly higher in DPN group than in T2DM group. SUA were significantly increased together with the increase of the severity of DPN [(279.66 ± 56.53)vs(308.93 ± 52.96)vs(330.24 ± 48.79) μmol/L](P<0.05). Conclusion SUA level is an risk factor for the development of DPN in the middle‐aged and elders with T2DM. SUA is positively correlated with the severity of DPN.