The incidence of malnutrition is high among critically ill children.Thus, nutritional support has a major influence on the prognosis of critically ill children.Appropriate nutritional support can not only correct the poor nutritional status of critically ill children, but also improve the clinical prognosis.Fortunately, there are enteral and parenteral nutrition support available, but both have advantages and disadvantages.How to combine enteral and parenteral nutrition for a better personalized nutrition support plan, has become the major focus of nutritional support.In this regard, the nutrition risk, malnutrition screening and the effect of enteral/parenteral nutrition on the disease severity are summarized in this review.

Objective:To enhance the transfection efficiency and to reduce the toxicity of the polyethyleneimine(PEI),we synthesized PEI derivatives and tested their toxicity and transfection efficiency in different cell lines. Methods:We first developed PEGylated PEI to decrease the toxicity of PEI,and then we conjugated folate on the distal end of the novel PEG-PEI to introduce specificity for special tumor cells.Following we checked the characterization of polymers and tested their toxicity and transfection efficiency in three cell lines with MTT assay,EGFP/fluorescent image,reporter assay and flow cytometry. Results:These copolymers effectively condensed plasmid DNA(pDNA) into nanoparticles with positive surface charge under a sui table N/P ratio.These derivatives reduced the cytotoxicity of PEI 25ku in different cell lines(i.e.,HEK 293T,glioma C6 and hepatoma HepG2 cells).More importantly,compared with PEI 25ku,the transfection efficiency was increased. Reporter assay and flow cytometry showed that FA-PEG-PEI/pDNA complexes exhibited higher transgene activity than that of PEG-PEI/pDNA or PEI/pDNA in folate-receptor(FR) positive(HEK 293T and C6) cells but not FR-negative(HepG2) cells. Conclusion:These results indicated that FA-PEG-PEI might be a promising candidate for gene delivery with the characteristic of good biocompatibility and relatively high gene transfection efficiency.

Catheter Ablation ; Humans ; Thyroid Nodule ; surgery

Objective_To explore the effect and the mechanism of isoflurane on human cardiac myocytes ( HCM) injury induced by anoxia/reoxygenation ( AR) .Methods_HCM cells were divided into control group ( con) , an-oxia/reoxygenation group (AR) and isoflurane (0.5%, 1%, 1.5%and 2%) treatment group (n=6).Cell via-bility, LDH activity, apoptosis and the expression level of Anoxia inducible factor-1α( HIF-1α) were detected using CCK-8 assay, LDH activity assay kit, Annexin V-FITC/PI staining, PCR and western blot, respectively. Results_Compared with the con group, cell viability decreased, LDH activity and apoptosis cells increased in AR group.Isoflurane can significantly relieve the decrease of cell viability, the increase of LDH activity and apoptosis cells, and the down-regulation of the mRNA and protein expression level of HIF-1αinduced by AR ( P<0.05 ) . Compared with AR group, the mRNA and protein expression level of HIF-1αin siRNA transfected group signifi-cantly decreased (P<0.05).2%isoflurane significantly relieve the increase of cell viability, the decrease of LDH activity and apoptotic cells induced by HIF-siRNA in AR injuried HCM cells(P<0.05).Conclusions_Isoflurane can protect HCM cells from AR injury partly through up-regulate the expression of HIF-1α.

Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.

Objective To explore the effects and mechanism of propofol on cognitive function of type 2 diabetic rats.Methods Ten of fifty adult male SD rats were fed with basic diet and allocated to control group.Another forty rats were fed with high sugar and high fat for 8 weeks and composite intraperitoneal injection of 1% streptozotocin (STZ)to establish model and then divided into four groups:diabetes group;low dose,middle dose and high dose of propofol group (diabetic rats were given intraperitoneal injection of 1% propofol 10,30,75 mg·kg-1·d-1 for 5 consecutive days).The cognitive functions were examined by Morris water maze from the first day after intraperitoneal injec-tion with propofol.The hippocampus were isolated for observing histopathologic alterations by HE staining and for the determinations of SOD,MDA,CAT,GSH and GSH-PX by colorimetry. Western blot was used to detect the expression of AGEs and RAGE.Results Compared to the control group,there was an obvious increased escape latent period,decreased the frequency of crossing platform,increased hippocampal neurons damage and MDA,decreased levels of SOD, CAT,GSH and GSH-PX,as well as the protein levels of AGEs and RAGE in diabetes group (P <0.05).There was no significant difference between diabetes group and low dose propofol of group on behavior ability and detection index.However,middle dose and high dose of propofol group showed more serious cognitive dysfunction,aggravated hippocampal neurons cells loss,increased oxidative stress as well as enhanced expression of AGEs and RAGE (P <0.05 ).Conclusion Multiple given sedative or anesthetic doses of propofol can aggravate the cognitive dysfunction and oxidative stress in type 2 diabetic rats,which may be related to increase the expression of AGEs and RAGE in brain tis-sue.

Objective To evaluate the different effects of gastric banding (GB) and sleeve gastrectomy (SG) on diet-induced obese rat model.Methods The obese rat model was established via the diet-induced method,and then underwent SG,GB,or sham-operation (SO) procedures.The different effects of SG,GB,and SO on these rats were evaluated at the 14th,28th and 56th day after operation.Results After 7 weeks' feeding,31rats in high-diet group reached the modeling standard.The model success rate was 88.6％ (31/35).GB and SG group showed significantly less cumulative food intake than SO group ( P ＜ 0.01).There was no significant difference between GB and SG group in cumulative food intake ( P ＞ 0.05 ).The average weight of rats in GB and SG group was (609.1±6.0) g and (591.6 ±4.3) g respectively at the 56th day after operation while it was (649.8 ± 10.0) g for SO group.The difference had statistical significance ( P ＜ 0.01).SG group showed better improvement effects on TC,TG,FFA,LDL-c and HDL-c than GB group (P ＜0.05).The postoperative ghrelin level in GB and SG group all decreased constantly and it decreased slower in GB group than in SG group.At the 56th day after operation,the ghrelin level in GB and SG group reduced from (1151.0 ± 144.2) pg/ml and (1148.2±127.2) pg,/ml to (992.0+121.9) pg/ml (P＜0.05) and (761.0+125.3) pg/ml (P＜0.01) respectively.The leptin level in GB and SG group all showed decreasing tendency.However,the leptin level of the 2 groups presented significant difference at the 56th day after operation.Conclusions There is no significant difference between GB and SG group in postoperative cumulative food intake.However,SG has better effects on controlling weight gain and improving blood lipids than GB.The different effects of GB and SG on the level of ghrelin and leptin in rats may account for the different curative effects.

Postherpetic neuralgia (PHN ) is one of the most frequent complications of herpes zoster, with the feature of intractable chronic pain. The higher incidence of PHN has been found in elder people and the people with low immunity. Because its pathogenesy is not clear, the clinical treatment appears to be very difficult, and all kinds of the treatments just relieve pain. Neurotropin combined with nerve block is one of the new therapies recently, which is deserved to be used in clinic and to be generalized.

Objective: To study the roles of nuclear factor (NF-kB) and intercellular adhesion molecule 1 (ICAM-1) in cerebral ischemic preconditioning induced brain ischemic tolerance. Methods: A total of 100 clean rats were randomly allocated into 4 groups: control, ischemic, preconditioning, and ischemic preconditioning groups. Both focal and ischemic preconditioning models were induced. The neuroethological score, infarct volume ratio and expression of NF-kB and ICAM-1 in the ischemic region at the corresponding time points were observed. Results: Circled digit one The neurological deficit score in the ischemic group was higher than that in the ischemic preconditioning group. The cerebral infarction volume ratio was higher than that in the ischemic preconditioning group (28.6 ± 3.2% vs. 16.2 ± 3.8%, t = 2.668 [P < 0.05]), and there were significant differences (P < 0.05). Circled digit two The number of NF-KB positive cells in the ischemic preconditioning group were lower than those in the ischemic group at the same time points, but they were higher than those in the preconditioning group, and there were significant differences (P < 0.05). The peak time of the number of NF-KB positive cells in the ischemic preconditioning group was delayed for 48 hours. Circled digit three The numbers of ICAM-1 positive cells in the ischemic preconditioning group were less than those in the ischemic group at the same time points, but they were higher than those in the preconditioning group, and there were significant differences (P < 0.05). Conclusion: Ischemic preconditioning decreases the expression of NF-KB and ICAM-1 after ischemia. The inhibition of inflammatory reaction may be one of the mechanisms of the ischemic tolerance induced by ischemic preconditioning.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; Male ; Middle Aged ; Young Adult