Neonatal necrotizing enterocolitis (NEC)is a major cause of morbidity and mortality in premature infants.The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity.Probiotic bacteria prevent or limits disease propagation in NEC.The unique characteristics of developing intestinal epithelia focusing on gut development and colonization as well as the inflammatory propensity of immature epithelia are highlighted in this paper.Additionally, potential mechanisms of beneficial probiotic interaction with immature intestinal epithelia including immunomodulation, upregulation of cytoprotective genes, prevention and regulation of apoptosis and maintenance of barrier function are reviewed.Probiotics may restore or supply essential bacterial strains needed for gut maturation and homeostasis.Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC.

Intestinal tract is the central organ of the body's stress,and it has an important barrier function to prevent the harmful substances,such as bacteria and toxins,from the gut into the body.The main factors of intestinal barrier dysfunction are ischemia and hypoxia and endotoxin damage,and it is essential to explore the protective methods of the intestinal mucosa barrier in the early stage to prevent the organ metabolism disorder induced by intestinal derived endotoxin and bacterial translocation.Glutamine,which can effectively protect the integrity of the intestinal mucosa,maintain the normal intestinal permeability and improve the cell immunity,has been used to intensive adult patients and need further studies in the clinical application of newborns.

Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P<0. 05), while the level of TC, TG, HDL-C and LDL-C had no significant change (P>0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P<0. 05). After the treatment, the level of CRP, IL-6, IL-8 and TNF-α was reduced in the observation group (P<0.05), while the control group had no significant changes in the indices (P>0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.It is very important to correctly select a treating approach for DME.At present,the treating methods of DME include retinal laser photocoagulation,application of the glucocorticoid,intravitreous injection of anti-vascular endothelial growth factor (VEGF) drugs,administration of inhibitor of protein kinase C,vitrectomy and combined treatment etc.However,each method has its advantage and disadvantage.Retinal photocoagulation,vitrectomy,intravitreous injection and drug delivery system implantation are invasive treatment methods,and they can not rescue damaged retinal photoreceptors.Therefore,it is recommended that DME should be early diagnosed and effective treatment.The research status at home and abroad and future development trends of DME treatment were summarized.

Objective To investigate the therapeutic efficacy of refractory glaucoma with compound trabeculectomy.Methods 26 eyes (24 cases ) of refractory glaucoma were treated with compound trabeculectomy.Results Followed up 1 year.There were functional filtering blebs in 20 eyes ;and the IOP was below 21mmHg in 16 eyes without any antiglaucoma drug and in 8 eyes with 1-2 categories of lower IOP drugs after 12 months.The mean IOP at 1 week,1 month,3 months,6months and 12months was (7.9 ± 3.1 ) mm Hg,( 13.5 ± 3.7 ) mm Hg,( 18.2 ±3.8)mm Hg,( 18.1 ±3.5)mm Hg,( 19.1 ±4.8)mm Hg,significantly higher than the IOP preoperatively( 38.2 ±5.6)mm Hg( P ＜0.01 ).Conclusion It was safe and effective of treating refractory glaucoma with compound trabeculectomy.

Iodine is the essential element of the human body. Both of iodine deficiency and iodine excess can produce different biological effects on organisms in various degree . It not only can damage the thyroid gland but also influence the nervous system and oxidize system, even damage hereditary material and immune system. The studies of the different biological effects of iodine deficiency and iodine excess on the cells and organisms can play an important role in unveiling the mechanisms of iodine deficiency disease and iodine excess disease. It also can offer the solution for preventing and curing the relevant disease of iodine.

Objective To investigate the protective effect of coenzyme Q10 (CoQ10) in the liver of preeclampsiapregnant rats and the potential etiology. Methods Fifty pregnant SD rats were equally divided into the normal pregnant (NP) group (n=10) and the preeclampsia (PE) group (n=40) randomly. The PE rats (n=40) were equally divided into four groups randomly,distilled water(DW)group,CoQ10 group, CoQ10 combined magnesium(CM) group and magnesium (Mg) group were established by treating the preeclampsia rats on day 15 to 21 of gestation with different measures. As for all the 50 rats, systolic blood pressure (SBP) of rat tail was detected on day 10, 15 and 21 of gestation respectively, 24 hours proteinuria analysis were detected on day 10, 15 and 21 of gestation respectively, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in blood andsuperoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), caspase-3, Bcl-2 and Bax protein expression in liver tissue were detected by western blot assay on day 21 of gestation. Results (1)SBP and 24 hours proteinuria analysis:there was no statistic difference among all the five groups on day 10 of gestation (P>0.05). Whereas, SBP and 24 hours proteinuria analysis were significantly higher in CoQ10 group, CoQ10 combined CM group, CM group and DW group than that in NP group on day 15, 21 of gestation (P<0.05). And SBP and 24 hours proteinuria analysis were significantly lower in CoQ10 group, CoQ10 combined CM group and CM group than that in DW group on day 21 of gestation (P<0.05). (2) Liver function: among CoQ10 group, CoQ10 combined CM group, CM group, DW group and NP group, serum levels of ALT were respectively(52±7),(34±9),(49±10), (70 ± 19),(30 ± 7)U/L;and serum levels of AST were respectively(169 ± 25),(84 ± 11),(159 ± 20),(281 ± 26)and(78±18)U/L. ALT and AST serum levels were significantly higher in CoQ10 group, CM group and DW group than that in NP group (P<0.05). ALT and AST serum levels were significant lower in CoQ10 combined CM group than those in CoQ10 group, CM group and DW group, respectively (P<0.05). ALT and AST serum levels were significant lower in CoQ10 group and CM group than that in DW group, respectively (P<0.05). (3) SOD, GSH-PX, MDA, caspase-3, Bcl-2 and Bax expression in liver tissue of rats: SOD expression was significant higher in CoQ10 group, CoQ10 combined CM group than thoes in CM group, DW group and NP group(P<0.05);SOD expression was significant lower in CM group, DW grouo than thoes in NP group(P<0.05);and SOD expression was significant higher in CM group than that in DW group(P<0.05). Compared with CoQ10 group, CoQ10 combined CM group, CW group and DW group respectively, the GSH-PX and Bcl-2 protein expressions were significant higher in NP group(P<0.05), while MDA, caspase-3 and Bax protein expressions were significant lower in NP group(P<0.05);compared with CoQ10 group, CoQ10 combined CM group and CW group respectively, the GSH-PX and Bcl-2 protein expressions were significant lower in DW group (P<0.05), while MDA, caspase-3 and Bax protein expressions were significant higher in DW group (P<0.05). Conclusions Oxidative stress and apoptosis levles were upregulated in PE pregnant liver tissues. CoQ10 could effectively protect the liver by improving the liver functions and decreasing the apoptosis of liver cells in PE pregnant rats, and markedly decrease the oxidative stress and apoptosis in the livers. The protective roles of CoQ10 in liver might through its function of anti-oxidative stress and inhibiting cell apoptosis by regulating the balance of Bcl-2/Bax.

Objective To explore the relationship of course experience,course engagement and learning outcomes in medical nursing.Methods Adapted Course Experience Questionnaire and Selfestablished Course Engagement Questionnaire were used to collect data of 142 nursing undergraduates of which 126 were valid.The data were analyzed by regression analysis.Results Course experience had significant impact on course engagement,t=4.621,2.477,4.538,P＜0.01 or 0.05.Course engagement had significant impact on learning outcomes,t=2.439,P＜ 0.05.Course experience had significant impact on learning outcomes,P＜ 0.05.Conclusions It is proposed that the clinical courses should provide students with good experience,increase the deep learning engagement,and reform evaluation methods to improve the students' academic achievement.

To prepare simvastatin nanostructured lipid carriers ( simvastatin-NLCs) . Methods:The simvastatin-NLCs were prepared by melt-emulsion ultrasonication and low temperature-solidification methods. Using the particle size, polydispersion in-dex, encapsulation efficiency and drug loading as the idices, the ratio of solid to liquid, lipid concentration, ratio of surfactant to cosur-factant, emulsifier concentration and drug concentration were optimized. The optimized simvastatin-NLCs were characterized for the en-capsulation efficiency, particle size, zeta potential and morphology. In vitro drug release behavior and stability of NLCs were also stud-ied. Results:The optimized simvastatin-NLCs formula was as follows:the concentration of simvastatin, cetyl palmitate, Miglyol? 812, soy lecithin and solutol HS15? was 0. 5%, 1. 5%, 4. 5%, 2. 5% and 1. 5%, respectively. The particle size and zeta potential of NLCs was (102. 2 ± 42. 1) nm and ( -33. 1 ± 4. 1) mV, respectively. The simvastatin-NLCs were found to be small and spherical with smooth surface under a transmission electron microscope. The in vitro release profile indicated that the accumulated release of sim-vastatin reached up to (59. 1 ± 4. 8) % in 24 h. The stability studies showed that simvastatin-NLCs were stable in 3 months after stored at 5℃. Conclusion:The formula of simvastatin-NLCs prepared by melt-emulsion ultrasonication and low temperature-solidifica-tion method is feasible.

Objective To investigate the clinical and pathological prognostic factors in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Methods The clinical and pathological factors of patients with carcinoma of ampulla of Vater who were operated from February 1994 to February 2009 at the Urumqi General Hospital of Lanzhou Military Region were retrospectively analyzed.The survival curves of these patients were also analyzed.Results The post-operative 1-,3-,5-year survival rates were 90％,63％,55％ respectively.The diameter of the majority of tumor (58.3％) was less than 2.0 cm.Of all the patients with carcinoma of ampulla of Vater,48.7％ were in T1 stage,41.7％ had high grade differentiation,73.0％ had no lymphatic metastasis.Univariate analysis showed that gender,age,tumor diameter,biopsy or not,the type of operation,the value of pre-operative serum bilirubin and the value of serum CA19-9 were not related to survival.The gross type of tumor (P =0.018),histological type (P =0.000),grade of differentiation (P =0.003),depth of infiltration (P =0.003),lymphatic metastasis (P =0.014) and TNM stage (P =0.031) were significant impact factors of survival.Multivariate analysis showed histological type and depth of infiltration were independent prognostic factors of surviva1 (P =0.002,P =0.005).Conclusion Grossly ulcerated carcinoma,mucinous adenocarcinoma on histology,low degree of differentiation,T2/T3 stage,lymphatic metastasis and clinical stage of Ⅱb were all significantly associated with poor prognosis in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Histological type and the depth of infiltration were the most important risk factors of survival.