Neonatal necrotizing enterocolitis (NEC)is a major cause of morbidity and mortality in premature infants.The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity.Probiotic bacteria prevent or limits disease propagation in NEC.The unique characteristics of developing intestinal epithelia focusing on gut development and colonization as well as the inflammatory propensity of immature epithelia are highlighted in this paper.Additionally, potential mechanisms of beneficial probiotic interaction with immature intestinal epithelia including immunomodulation, upregulation of cytoprotective genes, prevention and regulation of apoptosis and maintenance of barrier function are reviewed.Probiotics may restore or supply essential bacterial strains needed for gut maturation and homeostasis.Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC.

Intestinal tract is the central organ of the body's stress,and it has an important barrier function to prevent the harmful substances,such as bacteria and toxins,from the gut into the body.The main factors of intestinal barrier dysfunction are ischemia and hypoxia and endotoxin damage,and it is essential to explore the protective methods of the intestinal mucosa barrier in the early stage to prevent the organ metabolism disorder induced by intestinal derived endotoxin and bacterial translocation.Glutamine,which can effectively protect the integrity of the intestinal mucosa,maintain the normal intestinal permeability and improve the cell immunity,has been used to intensive adult patients and need further studies in the clinical application of newborns.

Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P<0. 05), while the level of TC, TG, HDL-C and LDL-C had no significant change (P>0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P<0. 05). After the treatment, the level of CRP, IL-6, IL-8 and TNF-α was reduced in the observation group (P<0.05), while the control group had no significant changes in the indices (P>0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.It is very important to correctly select a treating approach for DME.At present,the treating methods of DME include retinal laser photocoagulation,application of the glucocorticoid,intravitreous injection of anti-vascular endothelial growth factor (VEGF) drugs,administration of inhibitor of protein kinase C,vitrectomy and combined treatment etc.However,each method has its advantage and disadvantage.Retinal photocoagulation,vitrectomy,intravitreous injection and drug delivery system implantation are invasive treatment methods,and they can not rescue damaged retinal photoreceptors.Therefore,it is recommended that DME should be early diagnosed and effective treatment.The research status at home and abroad and future development trends of DME treatment were summarized.

Objective To explore the relationship of course experience,course engagement and learning outcomes in medical nursing.Methods Adapted Course Experience Questionnaire and Selfestablished Course Engagement Questionnaire were used to collect data of 142 nursing undergraduates of which 126 were valid.The data were analyzed by regression analysis.Results Course experience had significant impact on course engagement,t=4.621,2.477,4.538,P＜0.01 or 0.05.Course engagement had significant impact on learning outcomes,t=2.439,P＜ 0.05.Course experience had significant impact on learning outcomes,P＜ 0.05.Conclusions It is proposed that the clinical courses should provide students with good experience,increase the deep learning engagement,and reform evaluation methods to improve the students' academic achievement.

Objective To investigate the relationship between levels of homocysteine ( Hcy ) and serum uric acid( UA) and stability of carotid atherosclerotic plaque in young patients with cerebral infarction .Methods 150 cases of cerebral infarction in young patients carried the carotid ultrasonography were divided into the non -plaque group ( n=37),stable plaque group(n=52) and unstable plaque group(n=61) according to the results.The levels of Hcy and UA in the three groups of patients were detected and analyzed statistically .Results The stable plaque group′s Hcy and UA levels were (15.92 ±2.52)μmol/L and (294.85 ±25.52)μmol/L,which were significantly higher than those of the non-plaque group(t=7.33,6.89,all P<0.05);The unstable plaque group′s Hcy and UA levels were (23.17 ±3.82 )μmol/L and ( 388.57 ±26.61 )μmol/L, which were significantly higher than those of the the non-plaque group and stable plaque group(t=9.82,10.02,6.90,7.12,all P<0.05).Conclusion There is a close correlation between the stability of carotid artery plaque and the levels of Hcy and UA .

Objective To investigate the clinical and pathological prognostic factors in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Methods The clinical and pathological factors of patients with carcinoma of ampulla of Vater who were operated from February 1994 to February 2009 at the Urumqi General Hospital of Lanzhou Military Region were retrospectively analyzed.The survival curves of these patients were also analyzed.Results The post-operative 1-,3-,5-year survival rates were 90％,63％,55％ respectively.The diameter of the majority of tumor (58.3％) was less than 2.0 cm.Of all the patients with carcinoma of ampulla of Vater,48.7％ were in T1 stage,41.7％ had high grade differentiation,73.0％ had no lymphatic metastasis.Univariate analysis showed that gender,age,tumor diameter,biopsy or not,the type of operation,the value of pre-operative serum bilirubin and the value of serum CA19-9 were not related to survival.The gross type of tumor (P =0.018),histological type (P =0.000),grade of differentiation (P =0.003),depth of infiltration (P =0.003),lymphatic metastasis (P =0.014) and TNM stage (P =0.031) were significant impact factors of survival.Multivariate analysis showed histological type and depth of infiltration were independent prognostic factors of surviva1 (P =0.002,P =0.005).Conclusion Grossly ulcerated carcinoma,mucinous adenocarcinoma on histology,low degree of differentiation,T2/T3 stage,lymphatic metastasis and clinical stage of Ⅱb were all significantly associated with poor prognosis in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Histological type and the depth of infiltration were the most important risk factors of survival.

The choice of medicines is a key point in the treatment of hypertension.There are hundreds of antihypertensive drugs in China,including Traditional Chinese Medicines(TCM),chemical medicines and all kinds of compound preparation.But the rates of treatment and control of hypertension in China are very low,the situation of hypertension management in China is critical.In this article we compared the differences in the drug treatment among Chinese,American and European guidelines for the management of hypertension,and discussed the principles of choosing antihypertensive drugs.Chinese,American and European guidelines all mention that the specific drug classes may differ in some effect or in special groups of patients,so certain compelling indication requires certain antihypertensive drug classes.Three guidelines also emphasize the benefits obtained from the combination therapy and recommend the long-acting drugs or preparations with 24 h efficacy.The main differences among the three guidelines is whether to recommend the firstline drugs.Thiazide-type diuretics are recommended by American guideline(JNC7) in drug treatment for most patients with uncomplicated hypertension.But the European and Chinese guidelines do not recommend the first-line drugs,and the major classes of antihypertensive agents are suitable for the initiation and maintenance of therapy.Traditional Chinese medicines are invaluable resource of China,all kinds of antihypertensive TCM are widely used in the clinical,but owing to the deficiency of the high-quality evidence for TCM,the part of TCM is not included in the 2004 Chinese guideline for the management of hypertension.The choice of antihypertensive drugs is determined by its efficacy and safety.When safety and efficacy are equal,the lowest cost drug should be preferred.For the majority of patients without a compelling indication for another class of drug,a low dose of thiazides diuretic should be considered as the first choice in China.2004 Chinese guideline for the management of hypertension is based on many scientific evidences,and its publication is very important for the prevention and cure of hypertension in China.Nowadays,we must strengthen the dissemination and implementation of guideline,promote the rational use of antihypertensive drugs and improve the control rate of hypertensive in China.

Objective To explore the accuracy and the clinical significance about the diagnosis treatment to allergy rhinitis with bioresonanztherapie.Methods 22 cases who were confirmed as house dust mite,extremely sensitive to duse diagnosed by BICOM were randomly collected and examined by allergic-skin test,which were compared with the control group.Results 22 examples by BICOM bioresonanztherapie,for to the house dust mite and the dust highly sensitive patient,allergy test sets piercing experiment was the strong masculine genders.Conclusion Bioresonanztherapie is really feasible at accuracy and practicability to test allergic rhinitis.

Interleukin-12 can induce the production of INF-?, up-regulate the inhibitive factor of angiogenesis such as IP-10, MIG, TIMP, TNF-?, down-regulate the induced factor of angiogenesis such as VEGF, bFGF, MMP, inhibit the angiogenesis of tumor together and accelerate the regression of tumor. Interleukin-12 can inhibit the angiogenesis of tumor, which is independent of the immune system.