Objectives:To investigate the effects of early enteral feeding(EEF) after hemorrhagic shock(HS) on gut structure and function,hormones for stress and metabolism and nutritional conditions. Methods:Seventy two Wistar rats were randomly divided into sham shock group(SS),HS group(HS) and post HS EEF gorup(HSE).HSE group was fed with ENSURE and HS group was fed with normal saline.EEF was started within 1 hour after resuscitation.The body weight,liver weight,musculus gastrocnemius weight,nitrogen content in liver and musculus gastrocnemius,total plasma protein level,albumin level,MDA(malondialdehyde) and Na + K + ATPase activity in stomach and jejunum mucosa, the change of liver function, the levels of glucagon,cortisol and insulin,and the pathological changes in stomach, small intestine and liver were investigated at 2,6,24,48 h after resuscitation. Results:When compared with HS group,the weight of body,liver and musculus gastrocnemius,the nitrogen content in liver and musculus gastrocnemius,the levels of total plasma protein and albumin and the liver function were significantly better in the HSE group.MDA content was less and Na + K + ATPase activity was higher in HSE group than those in HS group.The glucagon and cortisol levels were significantly lower and the insulin level was significantly higher in HSE group than those in HS group.The pathological changes in the stomach,intestine and liver in HSE group got an obvious improvement. Conclusions:After HS,EEF is helpful to maintain visceral organ function,reduce the stress and hypermetabolic response and improve the nutritional conditions.

We studied the effects of the selective thromboxane synthetase inhibitor, dazoxiben (UK-37 248), on the reperfusion arrhythmias induced by ischemia-reperfusion in rats. The results indicated that the administration of dazoxiben (2.5 mg/kg i.v.) 15 min prior to coronary occlusion significantly decreased the incidence of ventricular fibrillation induced by 5 inin ischemia and reperfusion from 11/13 in control to 4/13 in drug-treated (P

Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake,and study the effects of rehabilitation treatment for stumps.Methods Fifty-two cases with stump limbs post-amputation were evaluated,including stump skin status,stump shape,stump length,stump swelling,range of motion (ROM)of joint and strength of stump,and were treated with physical therapy,stump moulding and kinesiotherapy.Results The incidences of stump ulcer,stump swelling,conical stump,short stump and limitation of ROM of joint in all 52 cases were 76%,73%,34%,40%and 42%respectively.After rehabilitation treatment stump ulcers healed,stump swelling eliminated;stump shape,ROM of joint and muscle strength improved obviously.All poor stumps could be fit with the prosthetic limb and get good function.Conclusion The incidences of poor stump limb post·amputation after earthquake were high.Rehabilitation treatment can improve the stump condition.Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb tO the stump.

Objective To identify the relationship of pelvic floor muscle surface electromyography (sEMG) variables and the items ofthe International Bowel Function Basic Spinal Cord Injury (SCI) Data Set in patients with SCI. Methods 180 SCI patients were divided intoGroup A, B, C and D according to the International Standards for Neurological Classification of Spinal Cord Injury (American Spinal InjuryAssociation, ASIA). Testi was performed on 180 SCI subjects utilizing sEMG equipment, an inserted anal sensor electrode, and the Glazerprotocol. Questionnaire of the items in the International Bowel Function Basic SCI Data Set were conducted. Results The values of pelvicmuscle sEMG variables were significantly correlated with awareness of the need to defecate, major defecation method, average time requiredfor defecation, frequency of fecal incontinence, need to wear pad or plug (P<0.05), as well as the impairment scale of ASIA (P<0.01).Conclusion Glazer pelvic floor muscle sEMG protocol and questionnaire of the International Bowel Function Basic SCI Data Set are usefulcomplementary methods for the choice of hydrotherapy types in patients with SCI.

Objective To analyze the preoperative related factors of early weaning of infants with congenital heart disease after operation. Methods From January ,2014 to January ,2017 in Pediatric Cardiology CICU , infants with congenital heart disease were selected as research objects. The clinical data were retrospectively collect ed and the relationship between preoperative influencing factors and postoperative early weaning were analyzed. Early weaning meant mechanical ventilation time was shorter than 24 h and late weaning meant longer than 24 h. Results Single factor analysis showed that early weaning success rate was related to preoperative cardiac function grade 1,NNIS grade 0~1,ASA grade 1,no lung infection and no or mild pulmonary hypertension(average P<0.05). Non conditional logistic regression analysis showed that preoperative heart function grade 1 was an indepen-dent influencing factor,with OR value(95%CI)of 3.9(1.9~7.7). Conclusions In infants with congenital heart disease,preoperative heart function grade 1,NNIS grade 0 ~ 1 ,ASA grade 1,no lung infection and no or mild pulmonary hypertension benefit early withdrawing of ventilator and preoperative cardiac function grade 1 is an inde-pendent factor for early weaning.

ObjectiveTo investigate the individualized treatment for traumatic liver rupture. MethodsClinical data of 58 patients with traumatic liver rupture diagnosed and treated in the CAPF Sichuan Provincial Corps Hospital between April 2011 and December 2013 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 58 patients, 31 were males and 27 were females with the age ranging from 2 to 76 years old and the median of 44 years old. According to the American Association for the Surgery of Trauma (AAST) grading for liver injury, 33 patients were with GradeⅡ liver injury, 16 with GradeⅢ liver injury and 9 with GradeⅣ liver injury. After admission, all patients underwent routine abdominal examination and abdominocentesis for the closed liver rupture. In addition, blood routine, coagulation function, hepatic and renal function, abdominal ultrasound and computer tomography (CT) were also examined emergently to know about the location, size and depth of liver rupture, blood loss, underlying diseases and combined injuries. The individualized treatments, including non-surgical treatment and surgical treatment were performed according to the AAST grading criteria for liver injury and the comprehensive conditions of patients.ResultsNon-surgical treatment was given to 24 patients in which 9 cases were found having obviously increased ascites by ultrasound and CT examination 3-7 d after treatment. Laparoscopic exploration was then performed on the 9 patients. During the operation, 5 were found with mild bleeding and the bleeding was stopped successfully with electrotome, cavitron ultrasonic surgical aspirator or titanium clip. And the rupture bleeding of the other 4 cases were found stopped. Two patients received CT scan 2-3 weeks after treatment and were found with encapsulated effusion near the right liver lobe and 1 case with effusion in hepatic and renal recesses. All these 3 patients underwent CT-guided puncture drainage and were cured. A total of 34 patients underwent emergency exploratory laparotomy. Among these patients, 25 underwent debridement of devitalized liver tissues and wound suture, 6 underwent regular segmental hepatectomy or hepatic lobectomy, 2 underwent hepatic artery branch ligation and wound suture, and 1 underwent greater omentum iflling and suture. After the treatment, 1 patient developed perihepatic abscess and was cured after puncture drainage. All 58 patients recovered and were discharged. Forty-ifve patients were followed up for 1-6 months. No recurrence of bleeding, bile leakage, infection, hepatic insufifciency and other complications were observed.ConclusionsIndividualized treatment can be applied for traumatic liver rupture. Patients with small and shallow liver rupture may receive non-surgical treatment under a close observation and patient with unstable vital signs and progressive bleeding at the liver rupture may receive surgical treatment. Both treatments can achieve good curative effects.

Objective To investigate the methods and effects of Ebola preventive skill training being given to Sierra Leonean health-care workers by the first batch of Chinese military medical aid team to Sierra Leone. Methods A total of 47 nursing staffs and 40 cleaners of Sierra Leone were given Ebola preventive skill training respectively by Chinese Military Medical Aid Team. The duration lasted 10 days. The training included knowledge education related to Ebola virus disease, psychological counseling and preventive knowledge and skill training. After the training, each trainee was required to be appraised by corresponding criteria. Before the training, the self-designed questionnaire had been used to investigate current status of preventive knowledge and skill. Results Of all the Sierra Leonean health-care workers, 74. 41% had no knowledge about Ebola virus disease;85. 06% had no knowledge about prevention and control of infectious diseases; and 88. 50% had not taken any training about preventive skill training, especially the cleaners, who had lower educational attainments. All the 87 Sierra Leonean health-care workers took the training and examination, and then 47 nurses (100%) and 37 cleaners (92. 50%) passed the examination with the average scores of (91. 18 ± 5.37) and (91. 18 ± 5. 37), respectively. After being trained again, the other 3 cleaners passed the examination. The Chinese military medical aid team supervised, examined and instructed the work of Sierra Leonean health-care workers. The local health-care workers worked with a stable mood and a sound health status during a period of two months. None quitted his job and no Ebola virus infection occurred in those health-care workers. Conclusions Owing to good communication and proper and efficient methods, the preventive skill training for Sierra Leonean health-care workers achieves good effects, which is conducive to promote medical care services, and provides a reference for other medical aid team to Africa as well.

Objective:To investigate the effects of Resolvin D1 (RvD1) on the inflammatory response and the expression of Nod-like receptor protein 3(NLRP3) inflammasomes in mice with acute lung injury.Methods:The 30 male BALB/c mice weighing 25-30 g were divided into 3 groups(each group with 10 mice). Mice in the normal control group were given normal saline by tail vein injection.Mice in the lipopolysaccharide (LPS) group were given the same volume of LPS (10 mg/kg) via tail vein injection.Mice in the RvD1 group were injected with RvD1 (5 μg/kg) through the tail vein 30 minutes prior to LPS administration.Mice were humanely sacrificed after 6 hours.Histopatholo-gical changes of lung tissue, the levels of pro-inflammatory cytokines interleukin(IL)-18 and IL-1β, and the expression of NLRP3 inflammasomes in lung tissue were measured.Results:After LPS administration, the lung of mice showed pathological damage.The levels of pro-inflammatory factors IL-18 and IL-1β as well as the expression of NLRP3, apoptosis-associated speck-like protein containing a card(ASC)and Caspase-1 in the LPS group were significantly higher than those in the normal control group (all P<0.05). After pretreatment with RvD1, the pathological damage of lung tissue was alleviated.The levels of pro-inflammatory factors IL-18 and IL-1β as well as the expression of NLRP3, ASC and Caspase-1 in the RvD1 group were significantly lower than those in the LPS group (all P<0.05). Conclusions:RvD1 can attenuate the pulmonary inflammation in acute lung injury and inhibit the release of pro-inflammatory factors, which is possibly related to the suppression of NLRP3.

Objective:To compare the clinical outcomes between modified percutaneous kyphoplasty (PKP) and conventional PKP in the treatment of Kümmell disease.Methods:A retrospective cohort study was conducted of the 57 patients with single level kummell disease who had undergone PKP between January 2015 and December 2017 at Department of Spinal Surgery, Jiangmen Hospital Affiliated to Sun Yat-sen Uni-versity.Of them, 36 received modified PKP and 21 conventional PKP.In the modified PKP group, there were 24 males and 12 females with an age of 73.9 years±9.4 years and a course of disease of 2.2 months±1.5 months; the disease was located at a thorocic vertebra in 20 cases and at a lumbar vertebra in 16.In the conventional PKP group, there were 15 males and 6 females with an age of 72.6 years±11.9 years and a course of disease of 1.8 months±1.1 months; the disease was located at a thorocic vertebra in 10 cases and at a lumbar vertebra in 11.The 2 groups were compared in terms of operation time, bone cement volume, cement leakage, visual analogue scale (VAS), Oswestry disability index (ODI), anterior and middle heights and cobb angle of injured vertebra at postoperative 3 days, 1 and 3 months, and final follow-up.Results:There were no significant differences in the general clinical data between the 2 groups, showing compatibility between groups ( P>0.05).All the operations were accomplished uneventfully with no such serious complications as spinal cord nerve injury, wound infection, pulmonary embolism, bone cement poisoning reaction or death. There was no significant difference between the 2 groups in operation time or bone cement volume ( P>0.05).The rate of cement leakage in the modified PKP group [33.3%(9/27)] was significantly lower than that [52.4%(11/21)] in the conventional PKP group ( P<0.05).There were no significant differences be-tween the 2 groups in VAS, ODI, anterior or middle height of injured vertebra or cobb angle at postoperative 3 days or one month ( P>0.05), but the postoperative values were improved compared to the preoperative ones.At postoperative 3 months and final follow-up, the modified PKP group was significantly better in all the indexes than the conventional PKP group ( P<0.05). Conclusion:Compared with conventional PKP, the modified PKP may lead to better outcomes for Kümmell disease.