Objective: To investigate the treatment effect of rational enteral nutrition in hyperglycemia after severe brain injury.Methods: 60 patients were randomly divided into control group and study group.The control group was given homogenized diet and the study group was given low carbohydrate formula.Blood glucose,ALB,K+,Na+,Cl-,TG,TC were measured before and after therapy.Results: After the nutrition treatment,patients biochemical indices of fasting blood-glucose,blood sugar 2 hours after meal in study group were significantly lower than control group(P

Objective To explore the value of bone marrow megakaryocyte counts in predicting clinical response of thrombocytopenia (TP) in systemic lupus erythematosus (SLE) patients. Methods Thirty-one patients of SLE with severe TP (platelet ≤50×109/L) from Peking Union Medical College Hospital during 2007 to 2014 with appreciable bone marrow aspiration results were retrospectively analyzed. Their therapeutic responses were stratified and the correlation with clinical and laboratory findings including the megakaryocyte counts in bone marrow were evaluated with logistic multivariate regression. Results Totally fifteen patients obtained complete response (CR), eight patients obtained partial response (PR) and eight no response (NR). Megakaryocyte counts in bone marrow were (101±26)/slide, (156±48)/slide and (34±15)/slide respectively with statistically significant difference (χ2=6.632, P=0.036). Those NR patients had less megakaryocytes in their bone marrow compared with those with clinical response (CR+PR) (Z=-2.438, P=0.015). By ROC curve method, we found 20/slide might be a good cutoff of megakaryocyte counts in bone marrow for determining the therapeutic response of immunotherapy with a sensitivity of 91% and a specificity of 63% and a AUC (area under the curve) of 0.793. Those with 20/slide or less megakaryocytes in bone marrows only had a clinical effective response rate of 29% verse a response rate of 88% in those with more megakaryocytes in bone marrow. Conclusion Megakaryocyte counts in bone marrow may provide predictive value for therapeutic response of severe TP in SLE patients. Those patients with equal or less than 20/slide megakaryocytes in their bone marrow tend to have poor therapeutic response.

Objective To evaluate effect of comprehensive health intervention on serum lipids in obese children.Methods Totally 67 obese children (obesity group) who were treated in Baoan People's Hospital re-ceived one-year comprehensive health interventions. Another 65 normal-body-weighted children were recruited as control group.The changes of body height,weight,BMI,blood pressure (BP),and serum lipids were recorded before and after interventions.Results Compared with the control group,the weight,BMI,BP,TG,and LDL-C in the obesity group significantly decreased (P<0.05 or P<0.01).The BMI,BP,and TG in the obesity group were significantly improved after intervention (P<0.05 or P<0.01).HDL-C was significantly higher than the pre-intervention level (P<0.05),while was significantly lower than that in the control group (P

Objective: To compare the effect of enteral and parenteral nutrition on critically ill patients. Methods: 48 patients with critically ill in ICU were randomly divided into EN group and PN group.The nutritional index and the complication were compared between groups. Results: The levels of Hb,TP and ALB were significantly increased after EN,and the rates of complications in PN group were higher in PN group than that in EN group. Conclusion: Compared to parenteral nutritional support,enteral nutritional support can improve the nutritional condition and have less complications in critically ill patients.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

Objective To detect of clostridium perfringens by qPCR in mouse models and a clinical case in order to offer early diagnosis.Methods 40 Kunming mice were randomly grouped and intramuscular injected clostridium perfringens type A in leg 0.1 ml(3.5 × 109cfu/ml or 3.5 × 108cfu/ml or 3.5× 107cfu/ml,diluted with saline),while control group was injected with 9% sodium chloride 0.1ml.The mouse models and a clinical case were detected by qPCR.Results The death rate of 3.5 × 109,3.5 × 108,3.5 × 107cfu/ml and the blank group were 90%,70%,10% and 0% after intramuscular injection for 72 h spectively.The mean Ct values among these groups were 21.21 ±2.69,28.45 ±2.74,32.49 ±2.87 and 0.00 ± 0.00(P ＜ 0.05).The Ct values of the patient were 30.67 and 30.44.Conclusions Cclostridium perfringens could be successful identified with qPCR in mouse models when the mice still did not show any symptoms.

Objective To explore the preventive effect of Fluconazole on invasive fungous infections in premature infants.Methods Two hundred and thirty-four cases of preterm infants hospitalized in Jiangmen Central Hospital from Feb.2008 to Oct.2013 were analyzed by retrospective study.The subjects were divided into 3 groups based on whether Fluconazole was used and it was used orally or intravenously for the prevention of invasive fungous infections in premature infants.The Fluconazole prophylaxis was not given to group A,whereas oral Fluconazole prophylaxis [6 mg/(kg · times),every other day] and intravenous Fluconazole prophylaxis [3 mg/ (kg · times),once every 3 days] were applied in group B and group C.The incidence of invasive fungous infections and the clinical effects of Fluconazole on the 3 groups were evaluated and compared.Results The number of cases analyzed in the study were 53,115 and 66 cases in group A,group B and group C,respectively.There were no significant differences between the 3 groups in terms of gender,gestational age,birth weights,length of hospitalization,intravenous nutrition,and number of peripherally inserted central catheter,antibiotics and invasive mechanical ventilation use days (all P ＞ 0.05).The incidences of invasive fungal infections were 11.32％ (6/53 cases),6.96％ (8/115 cases) and 0 in group A,group B and group C,respectively.The prophylaxis effects between the 3 groups were significantly different (x2 =7.078,P =0.029).Group A and group B were not significantly different (x2 =0.905,P =0.342),but group C was better than group A and group B,and the differences were significant (P =0.007,0.028).Conclusions Prevention of invasive fungous infections by intravenous Fluconazole has good curative effects,and which can be used as the first choice.

Objective To investigate the clinical features of neuromyelitis optica (NMO) and NMO spectrum disorders (NMOSD) with primary Sj(o)gren' s syndrome (pSS).Methods Eleven inpatients diagnosed as NMO secondary to pSS in Peking Union Medical College Hospital were retrospectively analyzed.Results Eleven patients of pSS with NMO were enrolled in this study,including 10 females and 1 male.The mean age was(35 ± 15)years old.The course of disease ranged from one month to 16 years,with a median of 10 months.The interval between optic nerve and spinal cord involvement was 3 months to 2 years.Eight patients had NMOSD as initial presentations of pSS.Eight patients had history of optic neuropathy.The most frequently involved spinal segment was cervical cord (10 cases) shown by magnetic resonance.Serum NMO-IgG antibodies were tested in 7 patients and 6 of them were positive.Conclusion NMOSD may present as an important and initial clinical manifestation of pSS,which suggesting the involvement of central nervous system.Autoimmune antibodies,NMO-IgG and imaging were supposed to be done for further evaluation of prognosis and therapy regimens.

Objective To perform the sample survey on the recognition degree of abdominal compartment syndrome (ACS) among domestic pediatric healthcare providers (PHCP) Methods Three hundred self‐designed questionnaires were distributed to the participants at the twelfth Chinese Medical Association Congress of Pediatric Critical Care Medicine in November 2011 .Results A total of 194 effective questionnaires were reclaimed with the recovery rate of 64 .7% .28 .9% (56/194)of respondents did not heard of ACS .49 .5% (96/194)of them heard of ACS ,but did not contact ACS .Only 21 .6% (42/194)of respondents were well fa‐miliar with ACS .Among the medical staffs who were aware of ACS (familiar or just heard of ) ,only 7 .2% (10/138)knew the real definition of ACS .83 .3% (35/42) of respondents who were familiar with ACS used the intravesical route to measure the intra -ab‐dominal pressure(IAP) .However ,only 57 .1% (20/35)of respondents knew the correct saline volume for measuring IAP .Conclusion The recognition degree of ACS is low among domestic PHCP .It is necessary to strengthen the ACS related education among do‐mestic PHCP for increasing the awareness of ACS and promoting its treatment .

Objective Through the detections of the heterozygote frequencies tests of fetal specific genes PLAC4 and COL6A2 mRNA alleles in plasma of pregnant women, to explore its possibility of application in the noninvasive prenatal screenings of trisomy-21. Methods A toltal of 500 cases (males and females 250 cases respectively)of Han ethnic groups with Henan Provice of China who were subject to the physical checkup clinic of the Third Affiliated Hospital,Zhengzhou University from June to December, 2013 were selected as the healthy physical checkup group, and such techniques as DNA sequencing and PCR-restriction fragment length polymorphism (RFLP) were adopted to the determinations of the heterozygote frequencies of the single nucleotide polymorphism(SNP)of the PLAC4 and COL6A2 genes in the maternal peripheral blood in the healthy physical checkup group, and the differential comparisons of the determination results of the SNP heterozygote frequencies and the corresponding heterozygote frequencies in the National Center for Biotechnology Information (NCBI) database;30 cases of healthy pregnant women who spontaneously underwent pregnancy checkups at the maternity clinic were randomly selected as the healthy pregnancy group, and real-time fluorescence quantitative reverse transcription-PCR technique was adopted for determining the expression levels of PLAC4 and COL6A2 mRNA in the peripheral blood of pregnant women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks;40 cases of the same phase were selected for acting as the specimens for the karyotype analyses of the amniotic fluid cells, among which 20 cases were trisomy-21, and the 20 cases of the negative control group, and reverse transcription-multiplex ligation dependent probe amplification (RT-MLPA) technique was adopted for screening the fetal trisomy-21. Results (1) The allele heterozygote frequencies of the SNP of the healthy physical checkup group:determinations of the genotypes and hybrid rates of the 10 SNP sites of the PLAC4 and COL6A2 genes indicated that those with higher heterozygote frequencies were respectively rs7717, rs559, rs1044598, rs59066201 and rs1042917, with population coverage of 98%. Among them, the allele hybrid rates of rs59066201 were never seen in the NCBI database;in the respective comparisons of the allele hybrid rates of rs8130833, rs9977003 and rs7844 with the hybrid rates of the NCBI database, the variations had statistical significance (P<0.05). (2) The expression levels of PLAC4 and COL6A2 mRNA of the different pregnancy weeks of the healthy pregnancy group: the levels of PLAC4 mRNA in the peripheral blood of women of 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks of pregnancy were respectively 7.22 ± 1.05, 8.02±1.41,9.51±1.69,11.33±2.11 and 13.31±2.58, with their expression levels rising along with the increase of the pregnancy weeks; among them, the comparison of pregnancy 8 weeks and pregnancy 10 weeks, the variations had no statistical significance (P>0.05);in the mutual comparisons among the expression levels of the various pregnancy weeks, the variations had statistical significance (P<0.05). The expression levels of COL6A2 mRNA in 8 weeks, 10 weeks, 12 weeks, 14 weeks and 16 weeks were respectively 8.95 ± 1.28, 11.19 ± 1.36,15.00 ± 1.58,16.87 ± 1.72 and 18.96 ± 2.79, with their expression levels rising along with the increase of the pregnancy weeks, and in the mutual comparisons between the expression levels of the various pregnancy weeks, the variations all had statistical significance (P<0.05). (3) Prenatal screenings of trisomy-21 in the validation group of the trisome:a total of 5 sites of rs7717, rs559, rs1044598, rs59066201 and rs1042917 were selected from the allele heterozygote frequencies of SNP sites were selected from the subjects of the healthy physical checkup group, and 10 cases of trisomy-21 specimens and 10 cases of negative CTR specimens were accurately determined, with the sensitivity reached 80%(17/20), and the specificity reached 90%(18/20). One case of the trisomy-21 and two negative cases were both homozygotes, and among the trisomy-21 specimens of two cases, only one SNP was a heterozygote, and it was impossible to conduct screenings on these 5 cases, with the screening accuracy reaching 100%(35/35). Conclusions Fetal specific genes PLAC4 and COL6A2 mRNA are expressed in the peripheral blood of pregnant women in different gestational age;its expression level increases with the increase of gestational age. Among them, five SNP including rs7717, rs559, rs1044598, rs59066201 and rs1042917 show highest heterogeneity rate, which is different from the corresponding heterogeneity rate in NCBI database. RT-MLPA technology is a rapid, effective, noninvasive and low cost method of prenatal screening 21 trisomy.