Objective To determine the effects of the early enteric nutrition (EEN) up to scratch on the outcomes of the critical care patients with different degrees of severity of illness. Method There were 192 critically ill patients eligible for enrollment for study during the past 18 months in our ICU. They were classified by using APACHE Ⅱ scores. The aim of this retrospective analysis of the early enteric nutrition was to see if the enteric nufore, the patients were divided into two groups: up to scratch group and not up to scratch group. According to APACHE Ⅱ scores, the patients of each group were further divided into three sub-groups in terms of scores below 15, between15 and 25, and above 25, respectively. Results There were 62 patients in the group of EEN up to scratch, and 130 patients' EEN did not up to scratch. When the scores of APACHE Ⅱ were below 15, the length of hospital stay (LOS) was significantly shorter in group of EEN up to scratch in comparison with that of EEN not up to scratch (t = 6.453, P = 0.000). When the scores of APACHE Ⅱ were between15 and 25, the LOS in ICU (t = 3.966, P = 0.000), in hospital (t = 8.165,P = 0.000), The cost of medical care (t = 4.812,P= 0.000) and the mortality (x2 = 5.421,P = 0.038) were all significantly less in patients with EEN up to scratch. However, when the scores of APACHE Ⅱ were above 25, only the cost of medical care ( t = 7.364, P = 0.000) was significantly lower in patients of EEN up to scratch than that of EEN not up to scratch. Conclusions The EEN up to scratch can significantly improve the outcomes of critical patients and the clinical value of EEN up to scratch depends on the severity of illness.

Objective:To explore the application effect of optimizing the anti-epileptic drug (AED) administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods:A quasi-experiment study was conducted by convenience sampling. The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group .The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group .The experimental group was implemented the optimized administration procedure after ICU admission. The control group was implemented the routine administration procedure after ICU admission. Some data of the two groups were compared, including baseline data, first administration time after admission, administration step time, AED dose reserve, and seizures at different time periods and so on.Results:Comparative analysis of the time of the first drug administration after admission into the two groups .The administration time of the control group was 31.0 (10.0-69.0) min, which was significantly longer than that of the experimental group, 25.0 (16.0-31.8) min ( χ2 value was -2.760, P<0.05). Comparison and analysis of the time taken for each step of drug administration: The time taken for step 1(Patient admission—medical order confirmation) in the control group was significantly greater than that in the experimental group ( χ2 value was -2.811, P<0.05); step 2 (medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group ( χ2 value was -4.327, P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups ( χ2 value was -1.137, P>0.05). Control group AED reserve ratio 63.6% (28/44), experimental group AED reserve was 100.0% (44/44), and the difference was statistically significant ( χ2 value was 19.556, P<0.05). Epilepsy control in two groups of patients: the total control rate after the first administration of the experimental group was 93.2% (41/44), which was significantly higher than 61.4% (27/44) of the control group ( Z value was -3.445, P<0.001). Conclusion:It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.

Objective To evaluate the combined effects of photodynamic therapy (PDT) with PSD-007 and cytarabine (Ara-c) on human acute promyelocyte leukemia cell HL-60.Methods The experiments were divided into four groups:control group,PDT-only groups (PDT 1-4 groups:the combination of PSD-007 concentrations (5 μg/ml and 7.5 μg/ml) and the energy density of laser (EDL) (1.2 J/cm2 and 2.4 J/cm2),Ara-c-only groups (Ara-c A group:0.3μg/ml,Ara-c B group:1.2μg/ml) and combination groups (the pair-wise combinations of the PDT doses and Ara-c doses above).All combination groups were treated with three treating methods,including P24A (the cells were treated with PDT for 24 h,and then cocultured with Ara-c for another 24 h),A24P (treated with Ara-c for 24 h before PDT,and then cocultured with PDT for 24 h),and PA24 (treated with the Ara-c and PDT for 24 h).CCK-8 method was used to test the cell viability,and the combined effect was analyzed using King formula.The changes of cell cycles were analyzed using flow cytometry.Results In the case of low-dose PDT,the combination groups showed coordinated effect with all three methods,whereas in the case of high-dose PDT,they showed additive or coordinated effect in P24A and A24P,but it showed antagonistic effect in the schedule of PA24.Cell cycles were inhibited to G0/G1 phase by both PDT and Ara-c.Conclusions Coordinated effects could be found when HL-60 cells were treated with the combination of Ara-c and PDT.The effects depended on the dose of Ara-c and PDT and the operation schedules.The effects at low dose were more obvious than that of high dose,and allowing a 24 h period in between the addition of PDT and Ara-c also promoted the effects.

Through the experiments of producing spherical steel-bullet (4.763mm in caliber and 0,44gm in weight) wound on the hind legs of 17 dogs, the authors re- ported that there was a definite linear relationship between the reactions of the serum creatine kinase and the amount of kintic energy from the high speed of the bullets absorbed by the tissues and also with the weight of dead tissue removed around the bullet-path, Within the first 6 hours after injury, the activity of SCK increased with the rise of the biologic effect values of the amount of the kinetic energy absorbed and the weight of the dead tissue removed.

The biological mineralization,which widely occurs in the nature.is a biological mineralization process.The remarkable characteristic of biological mineralization is that organic substances play template function for the inorganic materials formation.The resulted inorganic materials have definite shape.size and texture;it is well-known that biominerals are distinguished by a complexity of form well-suited to their functions.The formation of inorganic materials with special structure and properties is controlled by organic templates through biomimetic synthesis.Polymer iS one of the most applicable organic templates which control the nucleation,growth,and alignment of inorganic particles to produce Organic,inorganic hybrids with multistep architecture,special morphology and good properties in mild conditions. The progress of polymer application in biomimetic syntIlesis is reviewed.Problems and a perspective in this research field are alSO discussed

Objective To investigate the effect of decoction of Fructus Gardeniae in decreasing blood sugar level in normal mice and diabetes mellitus mice (DM). Methods DM mice models were induced by glucose, adrenalin, desamethasone and alloxan respectively. After treatment, the influence of Fructus Gardeniae on blood sugar level in normal mice and DM mice was observed. Results Fructus Gardeniae decreased the blood sugar level significantly in DM mice and slightly in normal mice. Conclusion Fructus Gardeniae is effective in decreasing blood sugar level in both normal mice and several DM mice.

Objective: To summarize the characteristics of arrhythmia with the relevant factors affecting its prognosis in patients of apical hypertrophic cardiomyopathy (AHCM). Methods: A total 283 AHCM patients with echocardiography or cardiac magnetic resonance (CMR) conifrmed diagnosis in our hospital from 2005-01 to 2012-08 were summarized. The patients were divided into 2 groups: With arrhythmia group, n=103 and Without arrhythmia group,n=180. The endpoint event was followed-up by clinical and telephone visits in both groups and the relevant risk factors affecting AHCM prognosis were investigated by Cox regression analysis. Results: There were 269 patients ifnished the follow-up investigation, 98 in With arrhythmia group, 171 in Without arrhythmia group, and the death rate was 4.08% vs 1.17%, the occurrence of endpoint event was 18.37% vs 5.58%respectively. Cox regression analysis indicated that age (HR=23.051, 95% CI 1.08-1.068,P<0.005), left atrial diameter (HR=4.113, 95%CI 1.002-1.119,P=0.043) and NT-proBNP (HR= 18.653, 95% CI 3.433-26.650,P<0.005) were the independent risk factors affecting prognosis in AHCM patients. Conclusion: Arrhythmia is one of the common presentations of AHCM, it does not have much impact on survival, while it may cause ventricular ifbrillation and increase the occurrence of cardiovascular events.

BACKGROUND:A variety of factors contribute to biliary injury that is difficult to be repaired. Stent implantation is extensively used for bile duct injury, but either scaffolds made by metal or plastics can lead to certain adverse reactions. OBJECTIVE:To explore the biological characteristics of a novel biodegradable scaffold and its repair effects on bile duct injury. METHODS:The biological characteristics of the novel biodegradable scaffold were detected by fresh bile, and its degradation was observed at different time points. Thirty Bama mini pigs were included and were randomly divided into observation group (n=15) and control group (n=15). After bile duct injury models were prepared, the control group was subjected to the bile duct interrupted suture, while the observation group was subjected to the novel biodegradable scaffold combined with omentum majus. The biological properties of the scaffolds were observed. Hepatic enzymes and serum total bilirubin levels were detected, as wel as hematoxylin-eosin staining, Masson staining and immunohistochemistry detection ofα-smooth muscle actin were performed. RESULTS AND CONCLUSION:Before and 1, 3 and 6 months after surgery, hepatic enzymes and total bilirubin of two groups were detected, and neither intra-group nor intergroup comparisons had significant differences (P>0.05). Hematoxylin-eosin staining and Masson staining revealed that inflammatory reactions and fiber hyperplasia at the anastomotic site in the observation group were lighter than those in the control group at different time points after surgery. Theα-smooth muscle actin-positive scores in both two groups were in a rise at 1 and 3 months after surgery, and peaked at the 3rd month, and then began to decline. Moreover, theα-smooth muscle actin-positive scores in the observation group were significantly lower than those in the control group at 3 and 6 months after surgery (P<0.05). These results show that the novel biodegradable scaffold has good biological characteristics and can obtain ideal repair effects in the bile duct injury.

OBJECTIVE:To observe the clinical outcome of lipid microspheres prostaglandin E 1 (Lipo-PGE 1 )injection in combination with diammonium glycyrrhizinate injection plus combined therapy in the treatment of chronic severe hepati-tis.METHODS:68patents with severe hepatitis B were assigned to receive lipid Lipo-PGE 1 injection in combination with di-ammonium glycyrrhizinate injection(treatment group)besides the necessary combined therapy as in the control group for4weeks,the clinical outcome and biochemical indicators were compared between2groups.RESULTS:As compared with the control group,the treatment group had a significantly alleviated clinical symptoms after treatment for2weeks and4weeks(P

Objective To evaluate the efficacy of systemic glucocorticoids and intravenous immunoglobulin (IVIG)for the treatment of toxic epidermal necrolysis (TEN). Methods Clinical data on TEN inpatients treated with systemic glucocorticoids alone or in combination with IVIG were collected from the Department of Dermatology, First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2012. Therapeutic outcomes were evaluated in these patients. Statistical analysis was carried out by using a multiple linear regression analysis, binary logistic regression analysis and Cox regression analysis with the SPSS 16.0 software. Results A total of 48 inpatients with TEN were included in this study. Multiple linear regression analysis showed that the maximum daily dose of glucocorticoids for disease control was decreased gradually over years (β=-0.461, P=0.004). However, binary logistic regression analysis revealed no obvious changes in the frequency of administration of IVIG over years. Cox regression analysis showed that both hospitalization duration (RR=0.351, 95.0%CI:0.150-0.825)and the time required for the control of skin lesions (RR=0.492, 95.0%CI:0.245-0.986)decreased with the increase in the frequency of IVIG administration. In addition, with the increase in the maximum daily dose of glucocorticoids for disease control, the time required for the control of skin lesions was also shortened (RR=0.997, 95.0%CI:0.994 -1.000), while no obvious changes were observed in hospitalization duration. Conclusions IVIG shows superiority in controlling lesions, reducing complications and improving the prognosis of TEN. Compared with systemic glucocorticoids, IVIG shows better therapeutic efficacy and less adverse effects, and may be preferentially selected.