Objective To explore the differences of curative effect and short-term prognosis to severe traumatic brain injury patients with three different early postoperative nutritional supports.Methods A retrospective study was performed on 60 severe traumatic brain injury patients received in Neurosurgical Intensive Care Unit of Northern Jiangsu People's Hospital from July 2014 to July 2016.A total of 60 cases were randomly divided into the early enteral nutrition support therapy group,the early parenteral nutrition group,and the early compound nutrition group.The clinical indicators such as basic clinical characteristics before treatment,the nutrition data in two weeks,the length of stay in the Neurosurgical Intensive Care Unit,complications and GCS scores between the three groups were observed and analyzed.Results The indicators of early compound nutrition group were fasting blood-glucose (5.74 ± 0.64) mmol/L,prealbumin(203.80 ± 10.45) mg/L,total serum protein(61.99 ± 1.34) g/L,blood hemoglobin (114.53 ± 2.69) g/L,C-reactive protein(0.37 ± 0.06) mg/dl.The length of stay in Neurosurgical Intensive Care Unit was (11.6 ± 0.42) days in the compound nutrition group while those in the early enteral nutrition group was (13.20 ±0.42) days and those in the early parenteral nutrition group was(14.65 ± 0.42) days.The postoperative complications of the compound nutrition group were significantly lower than other two groups.The GCS scores of early compound nutrition group was(11.40 ± 1.60),which was the best in three groups.The differences were statistically significant (P ＜ 0.05).Conclusions Early compound nutrition support has an exact curative effect on postoperative severe traumatic brain injury patients in Neurosurgical Intensive Care Unit.It can obviously improve the nutrition status of patients with less complications,shorter length of stay in Neurosurgical Intensive Care Unit,higher safety and lower degree of coma,worth clinical promotion.

Bridged-Ring Compounds ; poisoning ; Child ; Child, Preschool ; Electroencephalography ; Female ; Hemoperfusion ; Humans ; Male ; Prognosis ; Treatment Outcome

Objective To investigate the value of bispectral index and intracranial pressure monitoring in evaluation of postoperative consciousness and short-term prognosis in patients with severe traumatic brain injury.Methods A simple random sampling method was used in 30 cases of brain trauma coma patients in the People's Hospital of Northern Jiangsu Province from January 2014 to December 2014.Glasgow coma scale (GCS) were evaluated at intervals of 8 hours,GCS were recorded for 3 days after surgery,The bispectral index value and intracranial pressure value are recorded at the same time.According to GCS,the patients were divided into two groups,group A (3≤GCS≤5) and group B(5 ＜ GCS≤8).The 21-days natural survival rate was counted.The Kaplan-Meier Method and Log-rank test were used to analyze the relationship between Bispectral index and intracranial pressure.Results The bispectral index value of group A was 45.3 ± 3.8,the intracranial pressure value of group A was (18.6 ± 2.8) mmHg,The bispectral index value of group B was 32.2 ± 8.2,the intracranial pressure value of group B was (33.4 ±4.6) mmHg.The 21-days survival rate of group A was 55％,and 21-days survival rate of group B was 30％.The Spearman rank correlation method was used to analyze the values.Bispectral index value was positively correlated with coma degree after operation in patients with severe traumatic brain injury,and was negatively correlated with intracranial pressure value (r =0.532,P ＜ 0.05;r =0.521,P ＜ 0.05).The more severer the patient's craniocerebral injury.,the more severer the condition,the higher the intracranial pressure,the lower the bispectral index value,the worse the prognosis is.Conclusion Combined monitoring of bispectral index and intracranial pressure has high application value in evaluating the coma degree and prognosis of patients with severe craniocerebral injury after operation.

Objective:To study the application of HL-60 monocyte activation test in the pyrogen detection of vaccines. Methods:HL-60 cells were incubated with the standard pyrogen(endotoxin,zymosan and lipoteichoic acid)solution and the sample solution at different concentrations,and then IL-6 level was detected using ELISA kit. According to the concentration of standard pyrogen solution and the level of IL-6,the standard curve and linear relationship were obtained. Based on the IL-6 value from the sample solution,the pyrogen content of the sample was calculated. The standard pyrogen solution at middle concentration of the standard curve was used as the interference sample,and the interference assay was performed referring to the bacterial endotoxin test in Chinese pharmacopoeia. The pyrogen recovery rate and the content were detected using HL-60 / IL-6 assay in seven kinds of vaccines such as influenza vaccine(Split Virion),inactivated;hepatitis A(live)vaccine,freeze-dried;rabies vaccine(Vero Cell)for human use,freeze-dried;lyophilized human measles and rubella combined vaccine,live;measles and mumps combined vaccine, live; haemorrhagic fever with renal syndrome bivalent vaccine, inactived; group A and C meningococcal polysaccharide vaccine. Results:① The linear relationship between the pyrogen concentration and the IL-6 level was good,and R2 value was 0. 996,0. 993 and 0. 997,respectively. ② The recovery rate of pyrogen in the above vaccines ranged from 50% to 200% . ③ The endotoxin concentration of 10 batches of group A and C meningococcal polysaccharide vaccine was detected using HL-60 / IL-6 assay,and the average value of 6 batches from factory A was 134. 73 EU·ml-1 ,and that of 4 batches from factory B was 40. 75 EU·ml -1 . The pyrogen in the other vaccines was all negative. Conclusion:The HL-60 / IL-6 assay is suitable for the pyrogen detection of the seven kinds of vaccines.

Objective To evaluate the diagnostic accuracy of contrast-enhanced harmonic EUS (CH-EUS)for pancreatic cancer.Methods Patients with pancreatic occupying lesion underwent CH-EUS with ultrasonic contrast medium Sonovue.Pathological diagnoses by EUS-FNA or surgery and the follow-up results were made as the final diagnosis to evaluate the accuracy of CH-EUS for pancreatic cancer.Character-istics of CH-EUS in different pancreatic tumors were analysed.Results A total of 76 patients were en-rolled,with an average age of 53. 1 ±14. 2.Thirty-five were finally diagnosed as having pancreatic cancer, 21 local mass-type pancreatitis,10 pancreatic neuroendocrine tumor,6 cystadenoma,4 intraductal papillary mucinous neoplasm.Tumor diameter was 3. 4 ±1. 4 cm and there were 18 less than 2 cm.The sensitivity and specificity,positive and negative predictive value of CH-EUS for pancreatic cancer was 97. 1%, 92. 9%,91. 7% and 97. 5% respectively.The sensitivity was 100% combined with FNA.Conclusion CH-EUS is safe,convenient for pancreatic cancer with high accuracy and can be used as an additional diag-nostic method to EUS-FNA.

Osteoporotic fractures represent the most severe complications of osteoporosis,characterized by insidious onset,high mortality and disability rates,and a steadily increasing incidence,imposing a significant socioeconomic burden.Western medicine has advantages in diagnosis and surgical interventions,while traditional Chinese medicine excels in holistic manage-ment and the restoration of bodily equilibrium.The integration of both traditional Chinese medicine(TCM)and western medicine emerges as an effective therapeutic strategy for osteoporotic fractures.In order to propagate the concept of integrated diagnosis and treatment,foster the advancement of integrated medical techniques for osteoporotic fractures,and establish standardized and nor-mative protocols for disease prevention,diagnosis,and treatment,a consensus expert group,led by Geriatric Branch of Chinese Geriatrics Society,the Young Osteoporosis Group of Orthopedics Branch of Chinese Medical Association,Osteoporosis Group of Orthopedics Branch of Chinese Physician Association,and Osteoporosis Professional Committee of the Shanghai Society of Inte-grated Traditional Chinese and Western Medicine,was established.This group engaged in deliberations and formulated the"Ex-pert Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Osteoporotic Fractures"elu-cidating the concept of integrated medicine and offering recommendations in the domains of prevention,diagnosis,and treatment,with the aspiration of ameliorating the prognosis of osteoporotic fractures and enhancing the quality of life for these patients.

Objective To observe the clinical efficacy and safety of acetylcysteine effervescent tablets in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS).Methods One hundred patients with OSAHS were divided into control group and treatment group with 50 cases per group.Control group was given the conventional treatment with low flow oxygen absorption,functional exercise and diet.Treatment group was given acetylcysteine effervescent tablet 600 mg,qd,oral,on the basis of control group.Two groups were treated for 12 weeks.The clinical efficacy,serum endothelin-1 (ET-1),nitric oxide (NO),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 90.00％ (45 cases/50 cases) and 74.00％ (37 cases/50 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:ET-1 were (39.24 ±5.50) and (46.28 ±0.12)ng · L-1,NO were (56.25 ±7.05) and (48.88 ±5.60)μmol · L-1,IL-6 were (41.48 ±4.91) and (65.77 ±9.10)ng · L-1,TNF-α were (28.37 ±3.42) and (42.32 ± 6.21) ng · L-1,the differences were statistically significant (all P ＜ 0.05).There were no adverse drug reactions occurred between two groups.Conclusion Acetylcysteine effervescent tablet has a definitive clinical efficacy and safety in the treatment of OSAHS,which can adjust the levels of ET-1,NO,IL-6 and TNF-α.

ObjectiveTo evaluate the accuracy of contrast-enhanced harmonic EUS (CEH-EUS) by using a second-generation contrast medium in differential diagnosis of pancreatic occupying lesions.MethodsPatients with suspected pancreatic neoplasms or chronic pancreatitis were enrolled and underwent CEH-EUS by using ultrasonic contrast medium Sonovue.Cytological and/or histological diagnoses were made by EUS-FNA and the final follow-up results.Characteristics of enhancement of the target areas,such as enhancement sequence,time features,pattern grade and venous elution degree were investigated.ResultsA total of 23 patients were enrolled,in which 13 were diagnosed with FNA as having pancreatic cancer,7 with chronic pancreatitis,2 with intraductal papillary mucinous neoplasms and 1 with microcystic serous cystadenoma.The accuracy of CEH-EUS was 95.65％,which was significantly higher than that of conventional EUS (78.2％).Enhancement of pancreatic cancer by CEH-EUS was later than or simultaneous with the nearby tissues,with heterogeneous low enhancement or fulfillment defect areas,and early subsidence without obvious peak.Enhancement of benign pancreatic diseases was simultaneous with the surrounding tissues,with homogenous fulfillment and simultaneous subsidence.ConclusionCEH-EUS is safe,convenient and accurate in diagnosis of pancreatic occupying lesions and can be used as an additional diagnostic method to EUSFNA.

Humans ; Liver Function Tests ; methods ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

BACKGROUNDVitrification is a prospective technology in ovarian tissue cryopreservation, but it is still in an initial stage. This study was conducted to investigate a modified vitrification protocol for human ovarian tissue, which can be used as an alternative to preserve fertility for young women with cancer who have to undergo cytotoxic therapy and sterilization.

METHODSOvarian tissue samples were collected from 15 patients and randomly allocated to groups of fresh, vitrification, and conventional slow freezing. A modified carrierless vitrification method was applied. The proportion of morphologically intact follicles in fresh ovarian tissues was compared with that in warmed/thawed tissues. The initial growth of the follicles and the concentrations of estradiol and progesterone were detected to determine the viability and endocrine function of the cryopreserved tissues.

RESULTSThe proportion of morphologically intact primordial follicles in the fresh group (97.6%) was significantly higher than that in the other two groups (vitrification group 80.3% and slow-freezing group 72.6%, P < 0.001). In both the vitrification and slow-freezing groups, estradiol and progesterone were secreted continuously during 2-week culture in vitro, the proportion of primary follicles were both significantly increased compared to the fresh group. No statistically significant differences existed between the two groups after cryopreservation in the proportion of both primordial and primary follicles, and the concentrations of estradiol and progesterone (P > 0.05).

CONCLUSIONThe modified vitrification method for cryopreservation of human ovarian tissues is effective, simple, and inexpensive.

Adult ; Cryopreservation ; methods ; Estradiol ; biosynthesis ; Female ; Humans ; Ovary ; cytology ; metabolism ; Progesterone ; biosynthesis ; Tissue Culture Techniques