Objective To discuss the feasibility and safety of early enteral nutrition (EN) on treatment of severe acute pancreatitis (SAP) and its influence. Methods The advancement about application of early EN on treatment of SAP in recent years were reviewed. Results In patients with SAP, early EN via catheter placed in the jejunum could protect the integrity of intestinal barrier and reduce infectious complications. But no consensus had been reached about the starting time, ingredient and infusion mode yet. Conclusion Early EN may have positive effects on treatment of SAP, but further researches are still needed.

Anti-Bacterial Agents ; adverse effects ; Child, Preschool ; Clindamycin ; adverse effects ; Humans ; Infant ; Male ; Paraplegia ; chemically induced

Objective:To investigate the levels of the specific antibody in the serum of convalescent SARS patients.Methods:The specific antibody in the serum of convalescent SARS patients were detected by indirect ELISA and double antigen sandwich method.Results:The levels of the specific IgG antibody in the serum of convalescent SARS patients is up to the maximum in the fifth week, the levels of the specific IgM is up to the maximum in the third week. The levels of the specific IgG in the serum of convalescent SARS patients is 1-7 times than that of the specific IgM. The positive detection rate of the specific antibody during 5-7 weeks in the serum of convalescent SARS patients is up to 100%.Conclusion:The levels of the specific antibody in the serum of convalescent SARS patients is up to the maximum in the fifth week, and the positive detection rate of the specific antibody is 100%.

Vascular cognitive impairment (VCI) is a main type of syndrome from mild cognitive impairment to dementia,which is caused by cerebrovascular risk factors (eg,hypertension, diabetes,hyperlipemia),obvious (cerebral infarction and hemorrhage) or unobvious cerebrovascular disease (leukoaraiosis and chronic cerebral ischemia).Its incidence is increasing,however,its pathogenesis remains uncertain,and effective therapeutic tools are lacking.Therefore,an increasing attention is being paid to all aspects of studies.This article mainly reviews the recent development in research of neuropsychology,imaging,electrophysiology,biology,and gene.

Objective To assess whether dynamic arterial elastance (Eadyn)can be used to predict the reduction of arterial pressure after decreasing norepinephrine (NE) dosage in patients with septic shock.Methods A prospective observational cohort study was conducted.Thirty-two patients with septic shock and mechanical ventilationwere enrolledfrom January 2014 to December 2015 in ICU of Wuxi People's Hospital of Nanjing Medical University.Hemodynamic parameters were recorded by pulse contour cardiac output(PiCCO) monitoring technology before and after decreasing norepinephrine dosage.Eadyn was defined as the ratio of pulse pressure variation (PPV) to stroke volume variation (SVV).Mean arterial pressure (MAP) variation was calculated after decreasing the dose of NE.Response was defined as a ≥ 15％decrease of MAP.AUC was plotted to assess the value of Eadyn in predicting MAP response.Results A total of 32 patients were enrolled in our study,with 13 responding to NE dose decrease where as the other 19 did not.Eadyn was lower in responders than in nonresponders (0.77 ± 0.13 vs 1.09 ± 0.31,P ＜ 0.05).Baseline Eadyn was positively correlated with systolic blood pressure variation,diastolic blood pressure variation,systemic vascular resistance variation and MAP variation (r =0.621,P =0.000;r =0.735,P =0.000;r =0.756,P =0.000;r =0.568,P =0.000 respectively).However,stoke volume variation,baseline level of systemic vascular resistance and NE baseline dose were not correlated with Eadyn baseline value (r =0.264,P =0.076;r =0.078,P =0.545;r =0.002,P =0.987 respectively).Eadyn ≤ 0.97 predicted a decrease of MAP when decreasing NE dose,with an area under the receiver-operating characteristic curve of 0.85.The sensitivity was 100.0％ and specificity was 73.7％.Conclusions In septic shock patients treated with NE,Eadyn is an index to predict the decrease of arterial pressure in response to NE dose reduction.

AIM:Scopolamine blocks cholinergic transmission and impairs learning and memory in mice．The purpose of this study was to evaluate the memory-improving properties of curcumin on scopolamine-induced memory im-pairment in mice．METHODS：The mice of memory impairment were induced by scopolamine．Step down test and Morris water maze test were used to observe the earning and memory ability in curcumin-treated ice．Biochemical assessments of AChE，MDA，and GSH-Px levels in brains were performed．RESULTS：Oral administration of curcumin ignificantly reduced the numbers of step-down rrors(P<0．05)and prolonged the step-down latency induced by scopolamine(P<0．05)．The escape latency time in mice treated with curcumin Was remarkably educed compared to that in scopolamine group by Morris water maze test(P<0．05)．After the platform was removed，the total time that the mice swam in the tar-get quadrant Was also longer in curcumin group than that in model group(P<0．05)．The data also indicated that curcumin significantly inhibited AChE ctivity(P<0．01)and prevented oxidative stress characterized by the significant reduction in MDA content and the significant increase in GSH-Px activities in the brain(P<0．01)．CONCLUSl0N：Curcumin in-duces cognitive improvement by enhancing the function of cholinergic system and its antioxidant activity．

Objective to investigate the outcome and EP treatment outcome of small‐cell lung cancer (SCLC) patients with different hyponatraemia .Methods This retrospective study analyzed the relationship between the serum sodium ,serum osmolality , urine sodium ,urine osmolality and survival time of 51 patients .Moreover ,we analyzed the survival time and chemotherapy outcome of SCLC patients in hypovolaemic and euvolaemic hyponatraemia .Results The data indicated that the serum sodium and osmolality correlated with the survival time positively ,and the pearson correlation coefficient are 0 .48 [95% CI:(0 .23 to 0 .67)]and 0 .61 [95% CI:(0 .40 to 0 .76)] ,respectively .urine sodium and osmolality correlated with survival time negatively ,and the pearson corre‐lation coefficient are -0 .6 [95% CI:(-0 .75 to -0 .38)] and‐0 .31 [95% CI:(-0 .54 to -0 .04)] ,respectively .Etoposide plus cisplatin treatment showed less effectiveness to the SCLC patients in euvolaemic hyponatraemia (29 .17% VS .66 .7% ,P<0 .05) , and the survival time of SCLC patients in euvolaemic hyponatraemia is shorter (33 .3% VS .92 .6% ,P<0 .05) .Conclusion Euvol‐aemic hyponatraemia could be a risk factor for poor outcome in SCLC .

Objective To compare the clinical outcomes of bone transport technique versus induced membrane technique for treatment of infected bone nonunion.Methods A retrospective study was made on 46 cases of infected bone nonunion admitted from April 2011 to December 2014.They were 33 males and 13 females,aged from 12 to 68 years (mean,45.3 years),involving 40 tibial and 6 femoral fractures.Bone transport technique was used in 37 cases while 9 cases were treated with induced membrane technique.Fracture union and complications were recorded.The function of the affected limb was evaluated at the final follow-up using Johner-Wruhs criteria.Results The 46 cases were followed up for 9 to 18 months (mean,14 months).In the bone transport group,bone union was achieved after a mean duration of 6.5 months (range,from 4 to 11 months) without complications like wound infection or neurovascular lesions.In the induced membrane group,bone union was achieved after a mean duration of 5.8 months (range,from 4 to 11 months) and there was one case of re-infection.According to the Johner-Wruhs score system,34 cases were rated as excellent,9 as good and 3 as fair,with a total excellent and good rate of 93.5％.Bone transport technique led to 28 excellent,4 good and one fair cases in the patients with tibial nonunion,and one excellent,2 good and one fair cases in the patients with femoral nonunion.Induced membrane technique led to 3 excellent,3 good and one fair cases in the patients with tibial nonunion,and 2 excellent cases in the patients with femoral nonunion.Conclusions Both bone transport technique and induced membrane technique are effective for infected bone nonunion.Bone transport technique may be preferred for tibial infected nonunion while induced membrane technique preferred for femoral infected nonunion.

AIM and METHODS: To investigate the effect of electrical stimulation of ventlal septal area (VSA) on discharge of pyrogen - treated thermosensitive neurons in preoptic anterior hypothalamus (POAH) region, the discharging rate of thermosensitive neurons in the POAH region of 32 New Zealand white rabbits were recorded by using extracellular microelectrode techinque. RESULTS: (1) Intraceretroventricularly (i c v) injection of interleukin - 1?(IL - 1?) caused decrease of discharging rate of warm - sensitive neurons and increased in discharging rate of cold - sensitive neurons in POAH regions. (2) These effects could be reversed by electrical stimulation of VSA. CONCLUSION: VSA may play a central role of negative regulation in thermoregulation of pyrogen - treated animal.

BACKGROUND:Nowadays, the internal fixation materials for the clinical treatment of unstable femoral intertrochanteric fractures are broadly divided into two categories:intramedul ary fixation system and
extramedul ary fixation system. However, the effects of the treatments usual y lack of macro evaluation.
OBJECTIVE:To compare the effect of intramedul ary fixation system and extramedul ary internal fixation system in the treatment of unstable femoral intertrochanteric fractures.
METHODS:217 patients with unstable femoral intertrochanteric fracture (Evans typing: Ⅲ type to Ⅴ type and R type) were treated by using intramedul ary fixation system and extramedul ary internal fixation system:18
cases were treated with dynamic condylar screw, 67 cases were treated with dynamic hip screw, 43 cases were treated with reconstruction nail, 72 cases were treated with proximal femoral anti-rotation blade nail, and 17 cases were treated with new generation of antegrade interlocking intramedul ary nail. The operative time, length of
incision, blood loss, time in bed, fracture healing time, complications and Harris hip score were analyzed and compared.
RESULTS AND CONCLUSION:In the aspects of operative time, blood loss, time in bed, complications and
Harris hip score, the intramedul ary fixation system was superior to extramedul ary internal fixation system. But there were significant differences in the aspects of length of incision and fracture healing time between two
methods. The results showed that the treatment of unstable femoral intertrochanteric fractures by using
intramedul ary fixation system was better than the extramedul ary internal fixation system, as the intramedul ary fixation system could effectively shorten the operative time and reduce blood loss. This stable and reliable fixation enables patients to take early postoperative functional exercise, and could significantly shorten the time in bed and reduce the incidence of complications and it is conducive to postoperative hip function recovery.
Therefore, intramedul ary fixation system is an ideal method for the treatment of unstable femoral intertrochanteric fractures.