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.

ObjectiveTo investigate the application and effect of problem-based learning ( Problem-based learning,PBL ) pedagogy in theoretical teaching of pediatric nursing.MethodsThe two nursing classes in the same grade were selected respectively as a control group of 62 people and research group of 62 people.Traditional pedagogy was taken in control group to give lessons for theory pediatric nursing,while PBL pedagogy was taken in research group to give lessons ftr theory pediatric nursing.At the end of the semester,students' scores in theory exam,practice exam and case care were analyzed by using t tests.ResultsThe results of the two groups of students were compared,with t value 4.96 of the theoretical results,t value 5.312 of the experimental results,t value 8.06 of the case study,and P ＜0.05 in three items,suggesting statistically significant difference.ConclusionsPBL pedagogy can raise nursing students' learning interest in the theory of pediatric nursing,and improve teaching effect on theory of pediatric nursing.

Objective To investigate the role of protein O-linked N-acetyl-glucosamine (O-GlcNAc) modification in glutamine-induced improvement in the vascular hyporeactivity in rats with septic shock.Methods Thirty-two adult male Sprague-Dawley rats,aged 2-3 months,weighing 250-300 g,were randomly divided into 4 groups (n =8 each):sham operation group (S group); septic shock group (C group); glutamine group (G group) ; alloxan group (A group).Septic shock was induced by cecal ligation and puncture (CLP).In G and A groups,glutamine 0.75 g/kg was infused intravenously over 30 min at 1 h before CLP,and in addition alloxan 90 mg/kg was infused intraperitoneally in A group.Phenylephrine (PE) 0.5,1.0,2.0,and 2.5 μg/kg was injected intravenously at 20 min intervals at 6 h after CLP and the percentage increase in mean arterial pressure (MAP) was calculated.The thoracic aorta rings were isolated to perform the isolated vascular tension experiment.The concentration-response curve of PE was obtained in tension experiments,and the PE maximum efficacy (Emas) and median effective dose ( EC50 ) were calculated.The expression of O-GlcNAc modification and iNOS content in the thoracic aorta were detected in all groups.Blood samples were taken to determine the serum concentration of NO.Results Compared with S group,the percentage increase in MAP and Emax were significantly decreased,while the EC50,serum concentration of NO,and expression of O-GlcNAc modification and iNOS content in thoracic aorta were significantly increased in C,G and A groups ( P ＜ 0.05).Compared with C group,the expression of O-GlcNAc modification in the thoracic aorta was significantly increased,and EC50 was significantly decreased in G group,and the percentage increase in MAP and Emax were significantly increased,while the serum concentration of NO,and content of iNOS in the thoracic aorta were significantly decreased in G and A groups ( P ＜ 0.05).Compared with G group,the EC50,serum concentration of NO,and content of iNOS in the thoracic aorta were significantly increased,while the percentage increase in MAP,Emax and expression of O-GlcNAc modification in the thoracic aorta were significantly decreased ( P ＜ 0.05 ).Conclusion Glutamine improves the vascular hyporeactivity through increasing the level of protein O-GlcNAc modification in rats with septic shock.

Objective To explore the diagnostic and differential diagnostic value of spiral CT in traumatic wet lung.Methods CT features of traumatic wet lung in 60 cases were retrospectively analyzed and summarized. Results CT features of wet lung included 4 types:(1)the interstitial type in 10 cases,appeared as thicknees and blurring of the shadow of pulmonary blood vessels;(2)the disseminated consolidation type in 15 cases appeared as scattered mottling or small patch foci with slight high density in pulmonary parenchyma;(3)the mist type in 20 cases appeared as slight high density with ground-glass like cloudy shadow;(4)the type of segmental consolidation in 15 cases appeared as high dense foci with large patch in segmental distribution.Conclusion Spiral CT can well detect the site, type, extent of traumatic wet lung and other injury. It is the most optimal means at present for traumatic wet lung.

OBJECTIVE To get knowledge of the drugs resistance change of Pseudomonas aeruginosa in intensive care unit ICU, so as to offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS Antimicrobial susceptibility tests of Staphylococcus aureus(SAU) were performed from 2001 to 2006. RESULTS The most frequent isolates were P. aeruginosa, Klebsiella pneumonia and Acinetobacter baumannii in 2001-2004. S. aureus were more than A. baumannii in 2006 and became the majore isolated bacteria in the sputum of the ICU patients. The incidence of drug resistance increased yearly(0, 25.0%, 29.4%, 74.4%, 87.7%, 92.7%, respectively) in S. aureus, and it was susceptibte to vancomycin. CONCLUSIONS It was showed that P. aeruginosa, K. pneumonia, A. baumannii and S. aureus were the major pathogens in the ICU, showing high drug resistance. Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.

Objective To investigate the efficiency,decision of intra-operative puncture route,treatment of perioperative complications and discuss the other relative problems of the treament for lumbar disc herniation with percutaneous transforaminal endoscopic discectomy.Methods To excise the nucleus pulpesus under percutaneous transforaminal endoscopic discectomy,use the Macnab standard,visual analogue scale and infrared thermal imaging to estimate the efficiency.Results Among followed-up of 208 patients,182 patients were excellent and good outcome,23 patients favorable,2 patients fair,0 patient poor.The leg and back VAS was a significant improvement 1 week post-operation compared with pre-operation (P ＜ 0.05),but no statistical difference among 3 months,6 months,12 months and 1 week post-operation (P ＞ 0.05).The infrared thermal imaging point out that the legs skin temperature of D-value was a significant improvement post-operation compared with pre-operation (P ＜ 0.05).Conclusions The method excised the nucleus pulpesus,and provided the spine maximum protection about the stability and flexibility.Intra-operative puncture route of individuation design can reduce the complications of intervertebral foramen perioperative,and the key to improve the effectiveness.

In recent years, the rapid development of stem cell transforming technology and regeneration pose great re?search value. With maturation of transformation induction, other cell lineages were shown to be able to transform into neu?rons. In addition, astrocytes are widely distributed in the gray and white matter of the central nervous system, whose exces?sive proliferation contribute to glial fibrillary scar formation, which is the key obstacle in recovery of neurological function. Therefore, the study of transforming astrocytes into neurons draw attention from many scientists. Astrocytes transformation not only prevent the formation of glial scar, but also generate new neurons. This article summarized relevant studies that re?port function of astrocytes and its transformation into neurons.

Objective To investigate the effect of 3‐dimensonal conformal radiotherapy (3D‐CRT ) combined with dendritic cell‐cytokine induced kill (DC‐CIK) cell in the treatment of recurrent small cell lung carcinoma (SCLC) in high altitude regions ,and its influence on VEGF and NSE .Methods Eighty‐five patients with recurrent SCLC in the tumor radiotherapy department of the Qinghai Provincial Fifth People′s Hospital from May 2012 to April 2014 were selected and divided into the control group(41 cases) and observation group(44 cases) according to the random number table .The two groups were respectively treated by 3D‐CRT treat‐ment and 3D‐CRT combined with DC‐CIK treatment cell .The curative effect ,incidence rate of adverse reactions ,levels of VEGF and NSE ,changes of liver and renal function indexes in the two groups were compared before and after treatment .Results The ef‐fective rate and sickness control rate of the observation group were 65 .9% and 79 .5% respectively ,which were higher than those in the control group ,and the differences were statistically significant (P<0 .05) .The levels of serum EGF and NSE ,and pain score at 4 ,8 weeks after treatment were decreased ,the differences were statistically significant (P<0 .05) .The levels of VEGF and NSE , and pain score at 8 weeks after treatment in the observation group were lower than those in the control group ,the differences were statistically significant(P<0 .05) .The incidence rate of adverse reactions in the two groups had no statistically significant differ‐ences after treatment(P>0 .05) .The levels of liver and renal function indexes had no statistically significant differences between before and after treatment(P>0 .05) .Conclusion 3D‐CRT combined with DC‐CIK cell in the treatment of recurrent SCLC in high altitude regions has more obvious curative effect ,moreover has no obvious influence on radiotherapeutic adverse reactions ,and liver and renal functions .

To observe the effects pf propofol combined with fentanyl on metabolic rate of energy cxpen diture in anesthesia. Method: Thirty-one elective neurosurgical adult patients, ASA class Ⅰ-Ⅱ, received tolal intravenous anesthesia with propofol combined with fentanyh Oxygen consumption (VO_2), carbon dioxide production (VCO_2), respiratory quotient(RQ), metabolic rate(MR)were measured. Resuh: VO_2 and MR increased when patients' posture changed or there existed strong operative stimulation. VO_2 and MR during post induction were 91.09% and 91.29% of the level before anesthesia respectively(P