It's known that ICU patients is in critical condition and might deteriorate rapidly,so it's important for them to get appropriate nutritional support in order to recover.We must make proper nutrition treatment plan for patients according to their different nutritional condition and potential risk.Nutritional risk screening can not only assess the nutritional status of children,is more likely to predict its potential nutritional risk,to guide nutritional support treatment plan,and ultimately improve the prognosis.Looking out for comprehensive,simple,fast,and easy nutritional risk screening tools as soon as possible and appropriate nutrition risk screening is significantly for growth and development as well as prognosis of ICU patients.

Urinary tract obstruction that occurs during early kidney development affects renal morphogenesis,maturation and growth,and in the most severe cases this will ultimately cause renal insufficiency.15％ ～ 20％ of the patients with obstructive nephropathy require early surgical intervention to preserve renal function,another part of those children without significant loss of renal function may be appropriate in conservative treatment because of spontaneous resolution.Current imaging examination for urethral obstruction are uncertainties and invasive,and therefore there is a need for urinary biomarkers that may be used as predictors for renal structural changes and decreasing renal function,and thereby provide the surgeon with more clear indications for surgical intervention.This review will discuss the clinical application value of various types of urinary biomarkers,including transforming growth factor-β1,monocyte chemoattractant protein-l,epidermal growth factor,endothelin-1,to provide important theoretical basis for searching new approaches for diagnosis,prevention and treatment of diseases related to ureteral obstruction and irreversible damage of kidney.

ObjectiveTo observe the turnover of impaired glucose tolerance(IGT)patients intervened with different measures.MethodsIGT 158 patients found by physical examination in the community residents were randomly divided into health education group,Chinese medicine group,and western medicine group,and treated with health education,traditional Chinese medicine and western medicine respectively.The fasting blood glucose,oral glucose after 2hour blood glucose (2hPG),serum lipid,glycosylated hemoglobin index were observed.ResultsThe efficiency of patients with IGT was 48.0％,70.3％ and 75.0％ in health education group,Chinese medicine and western medicine respectively.There was significant difference of therapeutic effect between the western medicine group and health education group (x2=7.96,P＜0.05),and between the traditional Chinese medicine group and health education group (x2=5.46,P＜0.05),while there was no significant difference between the traditional Chinese medicine group and Western medicine group (x2 =2.31,P＞0.05).ConclusionTraditional Chinese medicine and Western Medicine both have good effects on patients with IGT.But due to its good tolerability and few side effect,TCM may be more easily accepted by patients.

Objective To investigate the risk factors and prevention of recurrent laryngeal nerve injury during thyroid operation.Methods The clinical data of 2180 patients with thyroid operation were retrospectively analyzed.The potential relationship of the incidence rate of recurrent laryngeal nerve injury were evaluated,such as age,gender,nature of lesions,thyroid pathology,anesthesiology,operation times,whether or not to reveal recurrent laryngeal nerve.Results The overall incidence rate of recurrent laryngeal nerve injury postoperatively was 2.7％ (59/2180).The incidence rate of recurrent laryngeal nerve injury in patients with thyroid malignant neoplasms,repeated surgery and without reveal recurrent laryngeal nerve were 6.7％ (33/492),5.6％ (15/267),4.4％ (39/891),significantly higher than those in the patients with thyroid benign neoplasms,first time operation and with reveal recurrent laryngeal nerve [1.5％ (26/1688),2.3％ (44/1913),1.6％ (20/1289)] (P ＜ 0.01).In the patients with thyroid dorsal lesion,the incidence rate of recurrent laryngeal nerve injury in the patients without reveal recurrent laryngeal nerve was significantly higher than that in the patients with reveal recurrent laryngeal nerve[13.7％(29/212) vs.2.9％(12/417),P＜0.01].Conclusion Thyroid malignant neoplasms,repeated surgery and without reveal recurrent laryngeal nerve can increase the risk of recurrent laryngeal nerve injury,routine reveal recurrent laryngeal nerve in the patients with thyroid dorsal lesion can decrease the incidence rate of recurrent laryngeal nerve injury.

To understand the morphologic features of primary signet-ring cell carcinoma of the breast. MethodsFour cases of primary signet-ring cell carcinoma of the breast were studied by means of HE and AB/PAS stains. ResultsIn four cases,signet-ring cells accounted for more then 20% of the neoplastic cells. These cells were appeared as classical signet-ring form in HE staining and showed intracytoplasmic mucin by AB/PAS staining. On the basis of histological pattern, these cases were divided into four types: intraductal, lobular, infiltrating ductal, and infiltrating lobular. ConclusionPrimary signet-ring cell carcinoma of the breast is a specific variant of breast carcinoma.

PTEN is a tumor suppressor with double specific phosphatase activity,and PTEN brings into its lipid and protein phosphatase activity through PIP3, FAK, MAPK pathway. PTEN also induces apoptosis, inhibits cell growth, and regulates cell migration and adhesiveness. PTEN expression is lower in gastric carcinoma. It may be valuable to evaluate that the abnormal expression of suppressor gene PTEN participates in the malignant conversion process of the gastric mucosa cell, and the expression levels of the PTEN protein can be used to evaluate the pathologic biology behavior of gastric carcinoma.

Endocardial myocardial biopsy is the gold standard in the diagnosis of viral myocarditis.However,the limitations of sampling to the low sensitivity,and invasive inspection methods limit its clinical application.The traditional diagnostic tool electrocardiography,laboratory values and echocardiography are lack of specificity.Thus,a non-invasive diagnostic approach with high sensitivity is in need.Cardiovascular magnetic resonance(CMR) can evaluate the function of the heart parameters,such as left ventricular function and regional wall motion,and various CMR imagings including T2-weighted imaging,and early- and late-contrast enhanced T1-weighted imaging can evaluate the hyperemia,oedema and necrosis of myocardial inflammation histological character.CMR provides a scientific basis for the diagnosis of viral myocarditis in clinical.

Enteral nutrition therapy is the first choice of clinical nutrition therapy method in children with disease.We should make full use of the gastrointestinal function and total nutritional therapy.The key is based on gastrointestinal function choose enteral nutrition infusion way,infusion pattern and prevention and treatment of refeeding syndrome.As following is introduction about a few problems.

Objective To compare the efficacy and side effects of paliperidone-ER and risperidone in treating schizophrenia.Methods 60 patients of schizophrenia were treated with paliperidone-ER( n = 30) or risperidone (n =30) randomly,for 8 weeks. The efficacy was assessed with the positive and negative symptoms scale( PANSS), and the safety was assessed with treatment emergent symptoms scale before treatment and at the ends of week 1,2,4and 8 treatments,respectively. Results The PANSS scores of two groups were significantly decreased after the patients received the drug treatment. Paliperidone-ER group showed lower negative symptom score at week 4 and 8 than risperidone group. The efficacy of study group was significantly higher than that of control group. Conclusion Paliperidone-ER was effective and safe antipsychotic drug with significant improvement compared with risperidone in negative symptoms.

Objective To study the cause of placental abruption and relationship of outcomes of different clinical types of placental abruption.Methods 35 patients with placental abruption hospitalized were retrospectively analyzed. Results The incidence of placental abruption was 0. 3％. The rate of type Ⅰ was 60. 0％ (21cases) ,type Ⅱ 31.4％ ( 11 cases) and type Ⅲ 8. 6％ ( 3 cases). The gestational hypertension was the main cause of placental abruption. The rate of antepartum ultrasonic diagnostic was 40. 0％. The cesarean section rate was 71.4％. The incidence of postpartum hemorrhage, uteroplacental apoplexy and shock, DIC and partial hysterectomy on uterus were 22. 8％ (8 cases) ,8.6％ (3 cases) and 8.6％ (3 cases) ,respectively. The mortality rate of perinatal newborn was 14. 3％ (5 cases). Conclusion The gestational hypertension was the main cause of placental abruption. There was close relationship between the degree of placental abruption and different pregnant outcomes of women.