Objective To evaluate the clinical efficacy of hypocaloric enteral nutrition in patients with acute severe traumatic brain injury (TBI).Methods A total of 100 patients with severe TBI [Glasgow Coma Scale (GCS) 3-8 points] were enrolled and randomly divided into hypocaloric enteral nutrition group (hypocaloric group, 41.86-62.79 kJ · kg-1 · d-1) and traditional caloric enteral nutrition group (traditional caloric group, 104.65-125.58 kJ · kg-1 · d-1) ,50 patients per group.The enteral nutrition was given at 24-72 hours postoperatively.The changes of total serum protein (TP), serum-albumin (ALB), plasma hemoglobin (Hb), fasting blood glucose (Glu) and major gastrointestinal tract complications were observed and compared at 7 and 14 days after enteral nutrition support.Results Levels of TP, ALB and Hb were lowered in both groups at 7 and 14 days after nutritional support but showed no statistical difference (P ＞ 0.05).Glu was (6.37 ± 1.02) mmol/L in hypocaloric calorie group, significantly lower than (7.35 ± 1.70) mmol/L in traditional caloric group at day 7 after nutritional support (P ＜ 0.05).At 7 and 14 days after nutrition support, nausea, regurgitation, vomiting and complication incidence showed no significant difference between hypocaloric calorie group and traditional caloric group after nutritional support (P ＞ 0.05), but abdominal distension, diarrhea and stomach retention rate in hypocaloric group were significantly lower than those in traditional caloric group (P ＜ 0.05).Conclusion Hypocaloric enteral nutrition can significantly reduce the stress hyperglycemia, abdominal distention, diarrhea, gastric retention and other gastrointestinal symptoms in patients with acute severe TBI.

China ; Humans ; Pathology, Clinical ; methods ; trends

Objective To analysis the clinical high risk factors for fetal chromosomal abnormalities.Methods Amniocentesis,chromosomal karyotype analysis and other related methods were performed on 4829 pregnant women,who presented sole indication of prenatal diagnosis such as advanced age,high risk factors and fetal ultrasound abnormalities,for analyzing the correlations of those women to the incidence of fetal chromosomal abnormalities.Results The detection rates of abnormal karyotype were 5.0％ (57/1143),1.7％ (40/2367) and 4.3％ (57/1319) in the older women group (age＞35),abnormal maternal serological screening group and abnormal fetal ultrasound finding group,respectively.The detection rats of karyotype abnormality were 6.9％ (23/333) in women with fetal congenital heart diseases,8.5％ (20/234) in those with abnormal amniotic fluid,1.1％ (1/89) in those with fetal ventriculomegaly,1.1％ (10/898) in those with fetal intracardiac hyperechogenicity,5.9％ (2/34) in those with fetal choroid cyst and 5.6％ (1/18) in those with fetal renal pelvis broadening.Conclusion The pregnant women with age＞35,fetal sonographic structural anomalies or two or more soft marker abnormalities should be prenatally diagnosed and doing the genetic counseling combined with the family history.

OBJECTIVETo explore the effects of gastrin on the expression of 1,25(OH)2D3-membrane associated rapid response steroid (1,25D3-MARRS) binding protein in rat intestinal epithelium.

METHODSSD rats received intraperitoneal injections of gastrin, omeprazole or physiological saline. The protein expression of 1,25D3-MARRS binding protein in SD rat intestinal was determined with Western blotting and immunohistochemistry, and its mRNA levels determined by RT-PCR. The serum calcium and phosphate levels in the rats were also detected.

RESULTSImmunohistochemistry showed that 1,25D3-MARRS binding protein was expressed mainly in the nuclei, cytoplasm and membrane of the intestinal epithelial cells. Both the protein and mRNA expression levels of 1,25D3-MARRS binding protein were up-regulated after treatments with gastrin and omeprazole (P<0.05), but the serum calcium and phosphate concentrations showed no obvious increase.

CONCLUSION1,25D3-MARRS binding protein, which is widely expressed with versatile functionalities, is regulated by gastrin and shows high potentials in the study of gastrointestinal diseases.

Animals ; Calcitriol ; metabolism ; Epithelial Cells ; drug effects ; metabolism ; Gastrins ; pharmacology ; Intestines ; cytology ; drug effects ; Male ; Protein Disulfide-Isomerases ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective: To probe into the correlation between chronic liver disease and intestinal barrier function. Methods: 1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients’ intestinal barrier function like diamine oxidase (DAO), D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett’s test, χ ² test of fourfold table, Pearson’s correlation, and binary logistic regression. Results: The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% (379/741) vs. 18.53% (139/750), χ ² = 193.58, P < 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier function in chronic liver disease group showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes (P < 0.05 ). GGT had stimulated DAO (P < 0.05, OR > 1), D-lactate (P < 0.05, OR > 1), lipopolysaccharide (P < 0.05, OR > 1), ALT and AST. Conclusion Chronic liver disease increases with damage to intestinal barrier function.

Objective:To evaluate the clinical efficacy of Tianma Gouteng Decoction combined with amlodipine besylate tabletsin treating patients with hypertension of liver-yang hyperactivity complicated with left ventricular hypertrophy (LVH).Methods:A total of 80 patients with hypertension of liver-yang hyperactivity complicated with LVH, who met the inclusion criteria and were treated in the hospital between June 2019 and January 2021, were divided into two groups, with 40 in each group according to the random number table method. The control group was treated with amlodipine besylate tablets orally, and the observation group was treated with granules of Tianma Gouteng Decoction on the basis of the control group. Both groups were treated for 2 months. Before and after treatment, the TCM syndromes were scored and the office blood pressure was measured with sphygmomanometer, and color Doppler ultrasonic diagnostic apparatus was adopted to detect the interventricular septum thickness (IVST), left ventricular posterior wall thickness (PWT), left ventricular end diastolic diameter (LVDd) and left ventricular mass index (LVMI), and the levels of homocysteine (Hcy) and Cystatin C (Cys-C) were determined by ELISA and the level of uric acid (UA) was determined by fully automatic biochemical analyzer. The clinical efficacy was evaluated.Results:The total effective rate was 95.0% (38/40) in the observation group and that of the control group was 77.5% (31/40) ( χ2=5.17, P=0.023). After treatment, the scores of dizziness, headache, insomnia and dreaminess and vexation and forgetfulness and total score of the observation group were significantly lower than those in the control group ( t=10.06, 14.47, 15.47, 8.74, 14.50, all Ps<0.001), and the systolic blood pressure and diastolic blood pressure were significantly lower than those in the control group ( t=6.30, 8.79, P<0.001). The IVST [(9.36±1.32) mm vs. (11.23±1.07) mm, t=6.96], PWT [(8.89±1.14)mm vs. (10.03±1.02)mm, t=4.71], LVDd[(40.36±4.29) mm vs. (47.62±4.19) mm, t=7.66] and LVMI [(112.39±22.29) g/m 2vs. (148.26± 21.39) g/m 2, t=7.34] were significantly lower compared to the control group ( P<0.01). The levels of Hcy[(12.87±3.11) μmol/L vs. (19.85±3.67) μmol/L, t=9.18], UA [(276.29±19.56) μmol/L vs. (338.52±17.07) μmol/L, t=16.65] and Cys-C [(0.86±0.15) mg/L vs. (1.10±0.17) mg/L, t=6.70] were significantly lower than those in the control group ( P<0.01). Conclusion:The Tianma Gouteng Decoction can improve the clinical symptoms, control the blood pressure, relieve the left ventricular hypertrophy and improve the renal function of patients with hypertension of liver-yang hyperactivity complicated with LVH.

Objective To explore the effect of non-nutritive sucking combined with massage on digestive function in premature infants .Methods Ninety six premature infants from January 2012 to December 2012 were randomly divided into the control group and the observation group , each with 48 cases.The control group received the routine feeding and nursing , and the observation group received the non-nutritive sucking combined with massage on the basis of the control group .The cases of gastric residue , vomiting and abdominal distension, the waiting time of meconium and the time of intestinal nutrition heat up to 418.4 kJ/(kg· d) were compared between two groups .Results The incidence rates of gastric residue , vomiting and abdominal distension were respectively 12.5% (6/48), 10.4% (5/48) and 8.3% (4/48) in the observation group, which were lower than 31.2%(15/48), 27.1% (13/48), 22.9% (11/48) in the control group, and the differences were statistically significant (χ2 =4.94,4.38,3.87, respectively;P<0.05).The waiting time of meconium and the time of intestinal nutrition heat up to 418.4 kJ/(kg· d) were respectively (5.6 ±0.7) d, (18.6 ±2.8) d in the observation group, which were shorter than (7.7 ±1.6) d, (21.9 ±2.1) d in the control group, and the differences were statistically significant (t =8.333,6.532, respectively;P<0.01). Conclusions The non-nutritive sucking combined with massage can promote the process of digestive function development and maturation in premature infants .

Objective To establish a rat model of nonalcoholic fatty liver disease (NAFLD) using high-fat diet,and to dynamically observe the influence of the changes in gut microbiota on the development and progression of NAFLD in rats during and after modeling.Methods Sprague-Dawley rats were given high-fat diet to establish the model of NAFLD,and these rats were randomly divided into high-fat group,antibiotic pretreatment group,antibiotic treatment group,restricted diet group,and control group.The rats were sacrificed in different feeding periods,and 16sRNA fluorescent quantitative PCR was used to analyze the changes in ileocecal microbiota in rats.The liver pathological scores were determined,and enzymatic colorimetry was used to measure blood lipid level in serum and liver homogenate.The sample mean t-test was used for comparison between groups.Results Compared with the high-fat group,the restricted diet group showed the most significant improvements in quality of life and biochemical parameters.In the restricted diet group,the number of probiotics (Bifidobacterium and Lactobacillus) at the end of the ileum gradually increased and tended to increase over the time of intervention,and the most significant difference between this group and the high-fat group occurred at the 10th week (Bifidobacterium:0.91±0.23 vs 0.28±0.12,P ＜ 0.05;Lactobacillus:0.78±0.04 vs 0.21±0.03,P ＜ 0.05),while the number of enterococci decreased.There were no significant differences in enteric bacilli between groups (all P ＞ 0.05).At the 10th week,the liver pathological scores in the control group,antibiotic treatment group,and restricted diet group were 1.13±1.74,4.86±0.86,and 2.94±1.91,respectively,significantly lower than 7.09±2.03 in the high fat group (all P ＜ 0.05).Conclusion Diet structure change and antibiotic intervention can adjust gut microecology,alleviate the lesions of NAFLD,and thus provide new strategies for the prevention and treatment of NAFLD from the perspective of microecology.

Objective:To investigate the status quo of knowledge, belief and practice level of nurses on venous access device in three Class Ⅲ Grade A hospitals in Shandong Province and to analyze the influencing factors.Methods:Using the convenient sampling method, a total of 396 nurses from three ClassⅢ Grade A hospitals in Shandong Province were selected as the research objects from June to August 2020. The survey was conducted using the general information questionnaire, Nurses' Knowledge, Belief and Practice Scale on Venous Access Device, Nursing Work Environment Scale and Chinese Registered Nurses Ability Evaluation Scale. Univariate and multivariate analysis were used to analyze the influencing factors of knowledge, belief and practice of nurses on venous access devices. In this study, a total of 396 questionnaires were sent out and 385 were effectively received, with a valid recovery rate of 97.2%.Results:The total scores of Nurses' Knowledge, Belief and Practice Scale on Venous Access Device, Nursing Work Environment Scale and Chinese Registered Nurses Ability Evaluation Scale for 385 nurses in three Class Ⅲ Grade A hospitals were respectively (124.37±16.89) , (98.72±11.32) and (132.04±19.84) . The results of hierarchical regression analysis showed that after controlling for general data, the working environment and the core competence of nurses were important factors that affected the knowledge, belief and practice of nurses on venous access devices, which could explain 40.8% of the total variation of nurses' knowledge, belief and practice on venous access devices.Conclusions:In this study, the knowledge, belief and practice level of nurses on venous access devices in three ClassⅢ Grade A hospitals in Shandong Province is at a medium level, which is affected by a variety of factors. Nursing managers should pay attention to the improvement of nurses' core competence and working environment, so as to enhance their knowledge, belief and practice level of venous access devices and reduce the incidence of complications of venous access devices.

OBJECTIVETo optimize the methods for genetic detection and prenatal diagnosis of Duchenne muscular dystrophy (DMD).

METHODSDenaturing high-performance liquid chromatography (DHPLC), multiplex PCR (mPCR), sequencing and other molecular techniques were used in combination for molecular diagnosis of 8 cases diagnosed as DMD.

RESULTSAmong the 8 cases, 4 have carried large deletions, 3 have point mutations, among which 6 were of de novo type. Prenatal diagnosis were offered for 5 families, the results showed that none of the fetuses had carried large deletions or point mutations. The pregnancies had continued and healthy babies were born.

CONCLUSIONCombined use of short tandem repeat, DHPLC, mPCR and sequencing can improve the detection of DMD gene mutations. By establishing and optimizing genetic and prenatal diagnostic methods, accurate genetic counseling can be provided for families affected with DMD.

Adult ; Base Sequence ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; Humans ; Molecular Sequence Data ; Muscular Dystrophy, Duchenne ; diagnosis ; embryology ; genetics ; Pedigree ; Point Mutation ; Pregnancy ; Prenatal Diagnosis ; Sequence Deletion ; Young Adult