This article reviewed the digestive system characteristics,enteral nutrition style,milk choice,the starting time of enteral nutrition,the velocity of milk volume increased and the ideal growth velocity of very low birth weight infants.The aim was to investigate the effect of the different starting time of enteral nutrition on their digestive function and the growth velocity,in order to find the suitable starting time of enteral nutrition,providing the basis for clinical enteral nutrition program of very low birth weight infant.

The medical ethics professionals which have resourceful ethical knowledge ought to give full play to subjects superiority in the review of the clinical trials involving human subjects. Before ethical review, it is needed to learn the series of international and domestic laws, regulations, and documents, and communicate with peers timely. In the review, they should focus on the necessity and security of the research project, conduct a compre-hensive review combined with the principle of medical ethics, and master the review key point of informed consent, to fulfill their duty of protection of human rights of subjects.

This paper summarizes the nursing experience of 9 very low birth weight infants with catheter-related infections. Among the 132 very low birth weight infants with PICC,9 cases suffered from catheter-related infections. Three cases showed positive results on the germiculture of catheter tip and blood, two cases showed positive result only on the germiculture of blood, and four cases showed negative results on both germiculture of catheter tip and blood. One infant's parent gave up the treatment and eight cases were cured. It is suggested that closely monitoring the signs of infections and taking effective treatment and nursing care as early as possible were the key points of infection control.

Objective To systematically evaluate the effects of the different postoperative exercise programs on the rehabilitation (such as shoulder range of motion,the incidence of the lymphedema and postoperative complications) of breast cancer patients.Methods The relevant randomized controlled trials which were retrieved from January 2008 to October 2013 were searched in the databases of the Pubmed,Embase,Ovid,Cochrane Library,China Biomedical Literature Database (CBM),China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP.Two reviewers independently screened the literature according to the inclusive and exclusive criteria,extracted the data,and assessed the quality.The RevMan 5.2 software was used for Meta-analysis.Results Finally 10 randomized controlled trial involving 1 110 patients were included.The Metaanalysis showed that progressive exercise program compared to usual exercise obviously modified the shoulder anteflexion [MD =33.04 (26.85-39.23) and 28.05 (21.81-34.30)],abduction [MD =31.06 (8.17-53.95) and 31.39(24.96-37.82)],extorsion [MD=18.47(13.44-23.50) and 16.02(8.35-23.68)] 1 month and 3 months after surgery (P＜ 0.05),extension 1 month after surgery,adduction 3 months after surgery.It also decreased the incidence of the lymphedema.Conclusions It gives us some evidence that the progressive exercise program can promote the rehabilitation of the postoperative breast cancer patients.

Objective To investigate the current status analysis the risk factors of medical adhesive related skin injury(MARSI) in neonates in NICU, in order to provide guidance in prevention and nursing of the skin injury. Methods Convenience sampling five NICU in Shenyang, prospective investigate the incidence of MARSI of neonates during the NICU stay, and analysis the incidence , injury type distribution and risk factors. Results The incidence of MARSI in neonates in NICU was 12.8%(53/413);the major injury type of MARSI was epidermal stripping(47.2%,25/53)and skin tear(35.8%,19/53) in mechanical injury;Logistic analysis showed that the independent risk factors of MARSI were the use of stomach tube, dehydrate skin and blue light therapy (χ2=5.953, 9.806 and 7.568, P<0.05). Conclusions MARSI is frequency interrupted in neonates during the NICU stay, correct selection of medical adhesive products, application of suitable paste and remove skills are helpful to reduce the incidence of MARSI in neonates during the NICU stay.

Objective To evalute the feasibility of a double hand allogroft to reconstuct the limbs'function. Methods A brain dead donor was chosen under the test of blood group in ABO and Rh,HLA match,PRA and the mixed leukocyte culture.The level of the transplantated hands was 5 cm proximal to the wrists The procedure of the allotransplantation was similar to that of the autologous replantation.The immunosuppressants were taken two days before the operation,in the operation and after the operation. The circulation,the vital signs and the rejection were under the supervision. Results The progress was satisfactory. No rejection was found postoperation.After 10 weeks the callus in both ends of radius and ulna was obvious.After 5 months sensation recovered.After 7 months the internal fixation(plates and screws) was removed and tenolysis was done. Now the recipient could use engrafted hands to wash face,make the bed,wear clothes,brush teeth,peel oranges,eat with a spoon,tie the shoelace slowly,pick up a telephoneor and use the conroller of Television. Conclusions With the immunosuppressive agents,the double hands allograft can survive.The growth rate of bone and nerve is faster than that of autologous replantation.

Objective To evaluate Alberta stroke programme early CT score on diffusion-weighted imaging (DWI-ASPECTS)and clot burden score on MR angiography (MRA-CBS)in predicting hemorrhagic transformation(HT) in acute anterior circulation cerebral infarction after thrombolysis in diffusion-weighted imaging Alberta stroke program.Methods A total of 37 consecutive patients with acute anterior circulation cerebral infarction were treated with thrombolysis.The clinical information , score of DWI-ASPECTS before thrombolysis , score of MRA-CBS before thrombolysis and images of enhanced gradient echo T 2*-weighted angiographywithin ( ESWAN) 24 hours before and after thrombolysis were all collected.The interval between onset and the two MRI scans were recorded respectively.We identified HT according to the images of ESWAN scanned after thrombolysis , and divided patients into 2 groups:with HT(14 cases) and without HT (23 cases).Differences of clinical data and imaging indicators between the two groups were compared by using Fisher′s exact test and Wilcoxon rank sum test.Logistic regression analysis was performed by taking HT as the dependent variable , and the scores of NIHSS , DWI-ASPECTS and MRA-CBS at admission were taken as independent variables.The variables which were statistically significant in logistic regression analysis were enrolled in receiver operating characteristic analysis.Results In HT group, the scores of NIHSS, DWI-ASPECTS and MRA-CBS were 15.00 ±5.30, 6.00(4.75,7.00) and 7.00(0.75,8.50) respectively.In the other group without HT, these scores were 7.00 ±4.80, 9.00(8.00,10.00)and 10.00(6.00,10.00) respectively.Compared with patients without HT , patients with HT had a higher baseline NIHSS score ( Z=-3.72,P<0.01), a lower DWI-ASPECTS (Z=-4.13,P<0.01) and a lower MRA-CBS (Z=-2.00, P<0.05).Logistic regression analysis showed that the scores of DWI-ASPECTS ( OR 0.42,95%CI 0.21-0.87,P <0.05 ) and NIHSS ( OR 1.22, 95%CI 1.00-1.48, P <0.05 ) at baseline predicted HT development independently.Receiver operating characteristic analysis showed that the optimal cut -off point of DWI-ASPECTS to predict the development of HT was≤7.Its sensitivity, specificity and area under ROC curve were 92.9%, 78.3% and 0.902 respectively ( P<0.01 ).Conclusions ASPECTS on DWI is of great value in predicting HT after thrombolysis in acute cerebral infarction.CBS on MRA can provide additional information for predicting HT.

Objective To compare the applied value of BK virus DNA load detection in urine and plasma for diagnosis BK virus nephropathy (BKVN) in renal transplantation recipients.Method In 88 renal transplantation recipients receiving renal allograft from February 2011 to January 2012 in our institute,BK virus DNA load in urine and plasma was detected by using real-time PCR,and renal biopsy was performed on the recipients with gradual deterioration of the graft function or the loads of BKV replication being very high.The diagnosis of BKVN was confirmed by using immunohistochemistry.Results Of 88 recipients,there were 35 cases (39.8％) of viruria,18 cases (20.5％) of viremia and 5 cases (5.7％) of BKVN.The median BKV DNA load in both urine and plasma in BKVN recipients was significantly higher than in non-BKVN recipients (P＜0.05).The viruria sensitivity and specificity for BKVN were 100％ and 57.3％ (P =0.03),and the viremia sensitivity and specificity for BKVN was 100％ and 82.9％ (P =0.0002),respectively.We regraded viral load ≧ 105 copies/mL in plasma or ≥107 copies/mL in urine as the best discriminant cut-off value to predict the disease and to identify patients at risk of developing BKVAN.The positive cut-off value of urine's positive predictive value (PPV+) was 26.3％ and negative predictive vaule (PPV-) was 95.7％,and the positive cut-off value of plasma's positive predictive value (PPV +) was 83.3％ and negative predictive vaule (PPV-) was 98.8％.Conclusion The viral load ≥105 copies/mL in plasma can be used as the best discriminant cut-off value to predict the disease and to identify patients at risk of developing BKVAN,but the cut-off value of urine should be only used for screening BKV infection.

Objective To study the effects of 3,5-diiodotyrosine (DIT) and potassium iodide (KI) on myocardial ATPase activity in hyperthyroidism Wistar rats induced by thyroid tablets.Methods Seventy-two Wistar rats were divided into 8 groups according to body weight by the random number table method (9 rats in each group),respectively,which were control group,hyperthyroidism model group,low,medium and high doses groups (both DIT and KI contents were 25.0,166.7,500.1 μg/kg).Physiological saline was intragastrically administrated to the control group;the hyperthyroidism model group was given thyroid tablet suspension (200.0 mg/kg);DIT and KI groups were given thyroid tablet suspension with corresponding doses of iodine simultaneously.The medicine was given once a day for a mouth,all the rats were sacrificed and heart tissue was collected.The colorimetric method was used to examine the activity of ATPases (Na+-K+-ATPase,Mg2+-ATPase,Ca2+-ATPase).Results The activities of Na+-K+-ATPase,Mg2+-ATPase,Ca2+-ATPase were significantly different statistically between groups (F =2.99,3.03,6.18,all P ＜ 0.01).Compared with the control group [(4.01 ± 0.22),(4.28 ± 0.28),(4.46 ± 0.35) μmol/mg·h],the activities of ATPases (Na+-K+-ATPase,Mg2+-ATPase,Ca2+-ATPase included) were reduced significantly in hyperthyroidism model group [(3.60 ± 0.25),(3.42 ± 0.31),(3.85 ± 0.17)μ mol/mg·h,all P ＜ 0.01];the activities of Mg2+-ATPase in DIT medium dose group [(3.89 ± 0.35)μmol/mg ·h],Ca2+-ATPase in DIT medium and high doses groups [(4.12 ± 0.20),(4.09 ± 0.21)μ mol/mg·h] were reduced significantly (all P ＜ 0.05);the activities of Na+-K+-ATPases,Ca2+-ATPase were decreased significantly in three KI groups [(3.64 ± 0.32),(3.60 ± 0.32),(3.53 ± 0.33),(3.93 ± 0.22),(3.90 ± 0.23),(3.85 ± 0.26)μmol/mg·h],Mg2+-ATPase in KI high dose group [(3.65 ± 0.49)μmol/mg·h] was decreased significantly (P ＜ 0.05or ＜ 0.01).Compared with the hyperthyroidism model group,the activities of ATPase were increased in most of the DIT groups [Mg2+-ATPase in low,medium doses groups:(4.06 ± 0.51),(3.89 ± 0.35)μmol/mg·h;Ca2+-ATPase in low,medium,high doses groups (4.15 ± 0.26),(4.12 ± 0.20),(4.09 ± 0.21)μmol/mg·h,all P ＜ 0.05].Conclusion Supplementation of thyroid tablets in the process of hyperthyroidism formation in Wistar rats will reduce myocardial damage by DTT compared with the same dose of KI.

Objective To explore the correlation between miR-25 and FBXO33 in renal cell carcinoma (RCC),and to analyze the relationship with apoptosis and prognosis of renal cell carcinoma.Methods The 511 RCC chip results,from 1998 to 2013,were downloaded from the Cancer Genome Atlas (TCGA)database,and were analyzed for the correlation between miR-25 and FBXO33 by Pearson test.The expression of fluorescein were detected with the FBXO33 3’UTR wild-type,mu-tant and blank control luciferase reporter gene treated by miR-25.The viability of cells transient translated by the miR-25 mimic,siRNA and the controls were detected by CCK8 method.The apoptosis of cells transient translated by the miR-25 mimic,siRNA and the controls were detected by flow cytometry.58 cases with follow-up data were screened from TCGA by expression of FBXO33 negative correlation miR-25.The survival was analyzed between low expression of miR-25 combined with FBXO33 high expression group (n=34)with high expression of miR-25 combined with FBXO33 low expression group (n=24),using Log-rank test and Gehan-Breslow-Wilcoxon test.Results FBXO33 was negatively correlated with miR-25 in RCC tissue (r=-0.161 1,Pearson test).Compared with the control group,miR-25 could reduce the RLU of wild type group to 80.2%±2.6%,the difference was statistically significant (t=6.539,P=0.006).The RLU of mutation group was 103.5%±8.4% compared with that of blank control group,the difference was not statistically significant (t=0.041 3,P=0.968 4),compared with the blank group in 72h for the cell varibility,miR-25 siRNA group were elevated by 32.7%± 3.5%,the difference was statistically significant (P<0.05).The miR-25 mimic group were reduced by 23.3%±1.7%,the difference was statistically significant (P<0.05),and compared with the control group,the early apoptosis rate was de-creased in mimic-miR-25-3p group (8.83 ± 0.09 vs 12.83 ± 0.14),while the difference was statistically significant (t=42.17,P=0.005).The late apoptosis rate was slightly escalated (0.41±0.10 vs 0.33±0.15),while the difference was not statistically significant (t=0.75,P=0.639).Compared with the control group,the early apoptosis rate was increased in siR-NA-miR-25-3p group (19.05 ± 1.64 vs 13.68 ± 0.78),while the difference was statistically significant (t=5.12,P=0.006).But the late apoptosis rate was reduced (0.56±0.10 vs 0.62±0.08),while the difference was not statistically sig-nificant (t=0.83,P=0.376).The survival rate was higher in patients with low expression of miR-25 combined with high expression of FBXO33 (n=34)than that of miR-25 high expression combined with low expression of FBXO33 (n=24),the difference was statistically significant (Log-rank test P=0.025 2,Gehan-Breslow-Wilcoxon test P=0.004 9).Conclusion MiR-25 can inhibite FBXO33 in renal cell carcinoma,improve the cell activity,inhibit apoptosis and reduce the prognosis.