Feeding intolerance in preterm infants,which is an important issue that the neonatal pediatri-cians have to work out,leads to malnutrition of early preterm infants and growth restriction which have an impact on later behavioral and cognitive outcomes. Feeding intolerance is related to the immature of gastrointestinal function,perinatal asphyxia,infection and other diseases. Minimal enteral feeding,prokinetic agents and supple-mentation of the enteral probiotics,are used generally,but at present there is no guidelines for the prevention and treatment.

Objective To present a solution of the hospital information management access control for more secure information sharing. Methods Several commonly used access control models were compared. Some problems of the RBAC model were analyzed in the hospital information circumstances. Results A solution of space-based data access control was presented on the base of the role-based access control (RBAC) module. Conclusion The space-based data access control method can reduce space consumption and maintain data consistency, which is more suitable for the use of the hospital management information system.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fistula ; surgery ; Humans ; Hyoid Bone ; surgery ; Infection ; Male ; Middle Aged ; Thyroglossal Cyst ; surgery ; Young Adult

Objective To investigate the effect of radix paeoniae rubra (RPR) on expressions of p38MAPK, NF-κB and iNOS in ltpopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its protective mechanism. Methods Forty Wistar rats with ALI were divided randomly into five groups: saline control group (Group A) , LPS group (Group B), RPR for treatment group (Group C), RPR for prevention group (Group D) and SB203580 group (Group E). The effects of RPR on protein content and the ratio of neutrophiles in bronchoalveolar lavage fluid (BALF), contents of malondidehyde (MDA) and serum NO in lung tissue were observed. Arterial blood was collected for blood gas analysis. Expressions of p38MAPK, NF-κB and iNOS in rat lung tissues were detected. Results Compared with Group A, expressions of p38MAPK, NF-κB and iNOS were significantly increased (P <0.01 orP< 0.05) , the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly higher (P<0.01 or P<0.05) in Groups B, C, D and E. There was a significant decrease in the level of arterial bicarbonate and partial pressure of oxygen in Groups B, C, D and E (P<0.01 or P<0.05). Compared with Group B, the expressions of p38MAPK, NF-κB and iNOS were significantly lower, and the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly decreased, while the levels of arterial bicarbonate and partial pressure of oxygen were significantly higher in Groups C, D and E (P<0.05 or P<0.01). Compared with Group B, the lunginjury of Groups C, D and E was significantly alleviated, while there was no statistical difference among Groups C, D and E in the indices of lung injury. Conclusion Protective effect of RPR on LPS-induced ALI is closely related to the inhibited expressions of p38MAPK, NF-κB and iNOS.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

ObjectiveTo discuss influence of Lamaze childbirth method on breast milk secretion during the course of Doula delivery. Methods106 primipara of natural childbirth were divided into the observation group(52 cases) and the control group(54 cases). Lamaze childbirth method of minus pain was applied in the observation group based upon Doula delivery, the control group only received Doula delivery. The initiating time of lactation, lactation volume were observed and the result underwent t test and χ2 test. ResultsThe initiating time of lactation was earlier and the lactation volume was increased in the observa-tion group than those in the control group. ConclusionsApplication of Lamaze childbirth method of mi-nus pain during the course of Doula delivery can promote early postpartum lactation and adequate lac-tation volume.

Anti-Inflammatory Agents ; pharmacology ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology ; Prednisone ; pharmacology

Objective To investigate the significance of testing serum homocysteine for renal transplant patients .Methods 445 renal transplant patients from outpatient follow‐up(renal transplant group) and 100 healthy subjects(control group) were enrolled in the study ,whose serum homocysteine(Hcy) ,Cystatin C(CysC) ,creatinine(Cr) were tested .Then according to the eGFR(refered to the principle of NKF‐K/DOQI) patients of renal transplant group were divided into six subgroups .Serum levels of Hcy and Cr were compared among different groups ,and the relationship between serum Hcy concentration and anti‐rejection drugs were ana‐lyzed .Results In the transplant group ,concentrations of Hcy were obviously higher than that in control group(P<0 .05) .There was no significant difference in Hcy concentrations among renal transplants who had taken different anti‐rejection drugs(P>0 .05) . Concentrations of CysC and Cr were significantly associated with Hcy in renal transplant group(r=0 .481 ,0 .456 ,P<0 .05) .There was significant difference between eGFR≥90 subgroup and control group in CysC concentration(P<0 .05) .Conclusion Concen‐tration of Hcy in renal transplant group was obviously higher than that in control group .With the eGFR decreased ,Hcy increased gradually ,and in transplant group was associated with the concentration of CysC and Cr .There was significant difference between eGFR≥90 subgroup and control group in Hcy and CysC concentrations(P<0 .05) .The different anti‐rejection drugs had no effect on serum Hcy levels .

Objective To evaluate the effect of desflurane on emergency in patients undergoing suspension microlaryngoscopy surgery.Methods Forty adult patients with ASA Ⅰ-Ⅱ who underwent elective microlaryngoscopy surgery were randomly divided into desflurane group (group D,n =20) and sevoflurane group (group S,n =20).Time from end of the surgery to resume of spontaneous breathing,extubation,and discharge from postanesthesia care unit (PACU) were recorded.The extent of cough reflex during extubation and cough episode after extubation were recorded.Perioperative mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0),on suspension laryngoscope instrument (Ttary),the gas concentration reached 1.3 MAC (T1.3mac),1 min after 1.3 MAC (T1.3 1),on arrival at PACU (Tpacu),on extubation (Textu),1 min after extubation (T 1),5 min after extubation (T 5),and on discharge from PACU (Tdis).Results Time from end of the surgery to resume of spontaneous breathing was not significantly different between the two groups.Time to extubation in group D was 4.6 min,which was shorter than it was in group S (P＜0.05).Time to discharge from PACU was 5.0 min in group D,which was shorter than it was in group S (P＜0.05).Incidence of cough was 100％ in group D and 55％ in group S during extubation (P＜0.05).The episode of coughing after extubation was not significantly different between the two groups.Perioperatively,changes of MAP and HR between the two groups were not significantly different (P ＞ 0.05).Conclusions Desflurane for adult patients undergoing suspension microlaryngoscopy surgery was associated with fast emergence.The incidence of cough was higher in group D than it was in group S during extubation,but it continued a short duration.

Objective To investigate the preoperative preparation for pheochromocytoma. Methods The data of 286 cases of pheochromocytoma, who were treated in our hospital from 1980 to 2002,were collected and reviewed on the preoperative preparation.Phenoxybenzamine was given to 207 cases and urapidil to 78 during preoperative period, lasting for 2～9 weeks with a mean of 6 weeks.The remaining 1 underwent emergent surgery without use of ?-adrenergic blockers.In 28% of the cases,?-adrenergic blocker was given for control of heart rate. Results In 254 cases,blood pressure remained stable at the level of 120/80 mm Hg (1 mm Hg=0.133 kPa) or so.No paroxysmal hypertension,palpitation and sweating occurred after use of ?-blockade.The heart rate remained 80～85 times/min.No arrhythmia occurred.Peri-microcirculation was obviously improved.The tumor size (range,3～12 cm in diameter;mean,5.2 cm) was not related to the function and length of preoperative use of the medications.Hypertensive crisis occurred in 32 cases 2 weeks before operation. In most cases (96%), blood pressure fluctuated (reaching up to 280/180 mm Hg) when they experienced anesthesia induction and tumor crush during operation.However,it was easy to control.Postoperative blood pressure remained stable. Conclusions The full preoperative preparation for patients with pheochromocytoma is essential for the safety and success of anesthesia and operation.