Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on normal intestinal flora,fecal SIgA and infectious complications in patients with hypertensive intracerebral hemorrhage.Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition group (control group,n =26) and early enteral nutrition combined with synbiotics group (study group,n =27).The patients in control group started receiving enteral nutrition (RuiSu) within 24 to 48 hours after injury ; Patients in study group received a enteral nutritional support which as well as control group,but added synbiotics (Golden Bifid) in the first 14 days of enteral nutritional support.Stool specimens were Collected on day 0,day 4,day 8,day 15 of enteral nutrition support for quantitative analysis of normal intestinal flora and detection of stool SIgA through enzyme-linked immunosorbent assay.The difference of two groups in infectious complications were observed.Results On nutritional support day 8 and day 15,escherichia coli (P =0.004,P =0.004) and enterococci (P =0.032,P =0.048) expression were lower in study group than the control group,bifidobacteria (P =0.046,P =0.024) expression were higher in study group than the control group.During the study period lactobacillus,bacteroides and clostridium were no statistically significant between the two groups (P ＞ 0.05).Fecal SIgA expression in study group was higher than control group (P =0.035) on nutritional support dayl5.The incidence of infectious complications in study group was lower than the control group (33.33％ vs.46.15％),but there was no significant difference (P =0.230).Conclusion compared with ordinary enteral nutrition,enteral nutrition combined with synbiotics agents can be effective in improving intestinal flora imbalance and increase intestinal immune function in patients with hypertensive intracerebral hemorrhage.

Objective To discuss the therapeutic effect in the treatment of the acute limb arterial critical ischemia.Methods Collect thirty-nine cases of acute limb arterial critical ischemia in Renji Hospital from Janary 2014 to July 2016.According to the patients' manifestation,these operations were porfermed including thrombectomy,cathetery-directed thrombolysis,mechanical suction bolt,percutaneous angioplasty and stenting.The effect and complications were observed.Results The eighteen patients in 39 cases (46.2％) were dead,including 5 cases without operation,13 operation.The eight cases were amputated during 34 cases of operations.In the 21 out-patients safely,2 cases were not followed up.The time of follow-up was from 3 to 27 months,on average 14.3 months.During the 21 patients,5 cases died from heart cerebrovascular or tumor diseases,3 cases with footdrop,2 cases with toe amputations,3 cases with distal leg and foot anesthesias.Conclusions The patiens with acute limb arteries critical ischemia must be treated as early as,and reinforced the management of multiple organ function,which may improve the diseases' therapeutic effect.

OBJECTIVETo compare the difference in the therapeutic effects on ovulation disorder in polycystic ovary syndrome (PCOS) between the combined therapy of electroacupuncture and clomiphene and the single medication of clomiphene and to explore the effect mechanism.

METHODSA total of 80 patients of PCOS were randomized into an acupuncture plus medication group (40 cases) and a medication group (40 cases). In the medication group, since the 5th day of menstruation or medicine-withdrawal bleeding, clomiphene was prescribed for oral administration, continuously for 5 days. In the acupuncture plus medication group, the medication was the same as the medication group. Additionally, 30 min electroacupuncture (continuous wave, 2 Hz) was applied to Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Dahe (KI 12), Sanyinjiao (SP 6), Zhongji (CV 3), Diji (SP 8), Shenshu (BL 23), Sanjiaoshu (BL 22) and Ciliao (BL 32), etc. The treatment started on the 5th day of menstruation or medicine-withdrawal bleeding, once every two days, 3 times a week. One cycle of menstruation or 1 month was taken as one course. The treatment cycles were 3 months in the two groups. The level of estradiol (E) and progesterone (P) in the serum, the endometrial thickness and morphology, ovulation rate and clinical pregnancy rate, as well as the clinical therapeutic effects were compared after treatment in the two groups.

RESULTSTwo cases were dropped out because the herbal medicine was taken simultaneously in the acupuncture plus medication group. In the medication group, the medication was discontinued in 3 cases due to gastrointestinal adverse reactions. The total effective rate was 86.8% (33/38) in the acupuncture plus medication group, better than 64.9% (24/37) in the medication group (<0.05). The ovulation rate in the acupuncture plus medication group was higher than that in the medication group [(86.8%, 33/38) vs (64.9% 24/37), <0.05]. The pregnancy rate in the acupuncture plus medication group was higher than the medication group in tendency, without significant difference [21.1% (8/38) vs 16.2% (6/37), >0.05]. After treatment, the results of endometrial thickness and morphology (A-type rate) in the acupuncture plus medication group were better than those in the medication group (<0.01, <0.05). After treatment, regarding the levels of E and P in the serum in the window period of implantation, the results in the acupuncture plus medication group were higher remarkably than those in the medication group (both <0.01).

CONCLUSIONThe combined intervention of electroacupuncture and clomiphene achieves the definite effects of ovulation and pregnancy promotion in PCOS. It remarkably increases the levels of E and P in the serum, the endometrial thickness and A-type rate. The therapeutic effects of the combined intervention are remarkably better than those of the simple application of clomiphene. This combined intervention is safe and tolerable for the adverse reactions. The effect mechanisms may be related to the improvements of estrogen, progestin and endometrial receptivity.

Acupuncture Therapy ; Clomiphene ; therapeutic use ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Infertility, Female ; therapy ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Pregnancy Rate

OBJECTIVE: To study the killing effect of suicide gene CDglyTK combined with GCV or 5-FC on the human laryngeal carcinoma Hep-2 cell line in vitro. METHOD: Constructed plasmid pcDNA3.1 (-) CMV. CDglyTK was verified by enzyme digestion of Xho I /Hind III and automatic sequence analysis, then it was introduced into Hep-2 cells by electroporation to yield cells expressing CDglyTK stably after selecting with G418(400 ng/L) for 14 da. The expression of CDglyTK mRNA in transfected Hep-2 cells was tested by RT-PCR. Compared with Hep-2 cells transferred with pcDNA3.1(-), in vitro chemosensitivity of CDglyTK-expressing Hep-2 cells to 5-FC, GCV or 5-FC + GCV was detected by MTT assay. RESULT: The recombinant plasmid contained full-length coding region sequence of CD and TK gene. A anticipated 707 bp fragment was amplified from total RNA of CDglyTK-expressing Hep-2 cells by RT-PCR and a fusion protein of 59 000 was detected in cell extract from transfected Hep-2 cells. In vitro study growth of CDglyTK-positive Hep-2 cells were inhibited by 5-FC, GCV or 5-FC + GCV respectively, and the antitumour effect of 5-FC + GCV is superior to 5-FC or GCV. CONCLUSION CDglyTK may be a candidate for treating human laryngeal cancer.
Cell Line, Tumor ; Cytosine Deaminase ; genetics ; Genes, Transgenic, Suicide ; genetics ; Genetic Therapy ; Genetic Vectors ; Humans ; Laryngeal Neoplasms ; genetics ; Plasmids ; Recombinant Fusion Proteins ; genetics ; Thymidine Kinase ; genetics

Objective:To explore the application effect of swallowing-feeding safety management of food flow test on improving postoperative swallowing function recovery of patients with laryngeal neoplasms.Methods:By the convenient sampling method, patients with laryngeal neoplasms who underwent open surgeries in Department of Otolaryngology Head and Neck Surgery in a Class Ⅲ Grade A hospital in Changsha from January to November 2019 were selected as research objects. A total of 33 patients who were admitted to hospital from January to May 2019 were set as the control group while 36 patients who were admitted from June to November 2019 were set as the experimental group. The control group was given regular diet guidance such as food type guidance, eating position and posture guidance, eating environment management, oral nursing and other routine eating guidance. The experimental group adopted a swallowing-feeding evaluation based on routine nursing and used the food flow test method to guide individualized eating plans based on the assessment results. The incidence of irritating cough during eating and days of gastric tube indwelling were compared between two groups. Functional Oral Intake Scale (FOIS) and Visual Analogue Scale (VAS) subjective score of eating sensation were used to compare intervention effects.Results:Difference in the incidence of irritating cough in patients with laryngeal neoplasms between two groups was statistically significant ( P<0.05) . The number of days of gastric tube indwelling in the experimental group was less than that in the control group, and the FOIS and VAS scores were higher than those in the control group, the differences between the two groups were statistically significant ( P<0.05) . Conclusions:Swallowing-feeding safety management of food flow test can provide accurate feeding guidance for patients with laryngeal neoplasms, which can improve the safety of eating, promote the recovery of swallowing function, reduce the retention time of the gastric tube and improve the subjective experience of eating.