Objective To investigate and improve the methods of nasal feeding to reduce the occurrence of complication such as diarrhea and vomiting.Methods We separated 140 patients with heavy craniocerebral injury into the control group (50 patients) and the experimental group (90 patients) according to different nasal feeding methods. For the control group traditional method was used. For the experimental group infusion pump was used to control infusion rate. The incidence of complication was compared between two groups. And within experimental group, the same nutrient solutions in respect of type and volume were infused during 10 hours, 16 hours, and 18 hours respectively. The relationship between infusion rate and the occurrence of complication was observed, analyzed and compared to seek for the most suitable enteral nutrition route which incurred the least complication.Results The incidence of diarrhea and vomiting in the experimental group was lower than that of the control group. And there were no significant differences in the occurrence of complication by using infusion pump at three different infusion rates within the experimental group. Conclusions The application of infusion pump in nasal feeding can reduce the incidence of complication and infusing nutrient solution at a slow rate was not necessary.

Objective To determine the relative factors of the onset of repeated ectopic pregnancy. Methods The clinical data of the first time ectopic pregnancy of 28 cases with repeated ectopic pregnancy were analysed, and compared with those of 56 cases of non-repeated ectopic pregnancy onsetting at the same period. The factors measured included: age at onset of disease, age at first coitus, gravidity, parity, methods of contraception, duration of amenorrhea,duration of vaginal bleeding, serum ?-human chorionic gonadotropin level, volume of intraperitoneal bleeding, types of ectopic pregnancy, methods of therapy and inflammation evidence of fallopian tube. Logistic regression analysis was performed to determine the relative factors for onset of repeated pregnancy. Results The risk factors and its odds ratio (OR) from the multivariate analysis were as follow: anastomosis of the tube(62.74, P=0.043), positive evidence of inflammation of the tube (54.85, P=0.000), no contraception (11.29, P=0.002), contraception by condom occasionally (4.75, P=0.046); the protective factors and its OR were as follow: therapy being salpingectomy and sterilization of the opposite tube(0.06, P=0.049), oral contraception (0.10, P=0.050) and pharmacotherapy (0.33, P=0.002). Conclusions The risk factors of onset of repeated ectopic pregnancy include: anastomosis of the tube, positive evidence of inflammation of the tube, no contraception and contraception by condom occasionally; the protective factors include: therapy being salpingectomy and sterilization of the opposite tube, oral contraception and pharmacotherapy.

Vehicle driver fatigue is an important factor in traffic accidents.This paper introduced three kinds of detecting techniques,namely driver's physical signals and individual characteristics,vehicle parameters,and five detecting devices.But there still are limitations of the mentioned detecting techniques and devices in the paper.The problems and developing trend are briefly analyzed.

[Objective] To summarize the therapeutic and nursing care of vacuum sealing drainage to treat skin avulsion injury. [Methods]We used the method of vacuum sealing drainage combined with split thickness skin graft and pre-and post-operation nursing care to treatment of 21 patients suffering with skin avulsion injury, and compared therapeutic effect with routine therapy group. [Result]Skin graft survival rate in VSD group was higher than in routine therapy group. The dressing change, wound healing time, hospitalization time in VSD group were lower in routine therapy group. [Conclusion] The method of vacuum sealing drainage is good in treatment of intervention skin avulsion injury.

Through analyzing the teaching effect,collected disagreements and suggestions by questionnaire,combining our teaching rules,we proposed efficient innovative methods and suggestions in probation of obstertrics-gynecology.

ObjectiveTo analyze the clinical characteristics of Behcet's disease with intracardiac thrombus.MethodsThe data of 8 patients diagnosed as Behcet's disease with intracardiac thrombus in Peking Union Medical College Hospital from January,1990 to January,2011 were studied retrospectively.ResultsBehcet's disease with intracardiac thrombus was found in 8 patients (5 men and 3 women) with a median age of 28.5 years.Most of them were young men.Thrombus was mostly found in the right side of the heart.Most of the patients had pulmonary thromboembolism with negative anticardiolipid antibody and basically normal C-reactive protein and erythrocyte sedimentation rate.ConclusionIntracardiac thrombus associated with Behcet's disease most commonly occurs in young men and usually involves the right side of the heart.

Objective To evaluate the cardioprotective effect of trimetazidine in elderly patients with myocardial ischemia and chronic heart failure of coronary artery disease. Methods Eighty nine patients with angiographically proven coronary artery disease were randomized to therapy group (n=45) and controlled group (n=44). The patients in therapy group were given both the routine treatment and trimetazidine 20 mg, 3 times daily, for 6 months. The patients in controlled group were given only the routine treatment. Results After the therapy, the episode of angina pectoris every week was fewer and weekly consumption of nitroglycerin tablets was less in patients of therapy group than those in controlled group: (3.0?1.7 )episodes/w vs (3.9?2.1 )episodes/w,P0.05). Work load were increased 〔(10.2? 2.2) vs( 9.3 ?1.7)METs, P

Objective To evaluate development of gastro-esophageal reflux (GER) during laparoscopic surgery in lateral jack-knife position under general anesthesia through comparing with reverse Trendelenburg/ Trendelenburg position in the patients lying supine.Methods Ninety patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were randomly divided into 3 groups (n =30 each):lateral jack-knife position group (group L),Trendelenburg position group (group T) and reverse Trendelenburg position group (group Tre).Anesthesia was induced with midazolam,sufentanil,propofol and cisatracurium besylate and maintained with propofol and remifentanil given by target-controlled infusion.A pH-sensitive probe was inserted through nose into the lower esophagus and pH value was continuously recorded until 1 min after extubation.GER was defined as pH value ≤ 4 lasting for ≥ 1 min in the lower esophagus during surgery.The development of GER during surgery and the lowest pH value in the lower esophagus when GER developed were recorded.Results Compared with group Tre,the incidence of GER (27％) and total number of times GER had occurred were significantly increased in group L,and no significant changes were found in the indices mentioned above in L and T groups.When GER developed,the lowest pH value in the lower esophagus was 2.1 ± 1.3,2.6 ± 1.2 and 3.5 in L,T and Tre groups,respectively.Conclusion The incidence of GER is 27 ％ during laparoscopic surgery when the patients are in lateral jack-knife position and it is higher than that obtained with reverse Trendelenburg position in the patients lying supine.

Objective To evaluate the role of silent information regulator 1 (SIRT1) in ischemic preconditioning (IPC)-induced alleviation of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Forty-eight male Sprague-Dawley rats,aged 12 weeks,weighing 200-250 g,were randomly divided into 4 groups (n =12 each):sham operation group (S group),I/R group,IPC group and IPC + SIRT1 inhibitor ex527 group (IPC + ex527 group).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.IPC was induced by 3 episodes of 5 min occlusion of left anterior descending branch at 5 min intervals before myocardial ischemia.SIRT1 inhibitor ex527 1 μg/kg was injected intravenously 15 min before myocardial ischemia and at 1 min before reperfusion.Blood samples were collected before myocardial ischemia and at 120 min of reperfusion for measurement of serum TNF-α and IL-6 concentrations by ELISA.The rats were then sacrificed and myocardial specimens were obtained for determination of myocardial lactic dehydrogenase (LDH) and creatine kinase MB (CK-MB) activities,SIRT1 expression and acetylation of NF-κB p65.Results Compared with S group,the serum TNF-α and IL-6 concentrations at 120 min of reperfusion,and myocardial LDH and CK-MB activities and acetylation of NF-κB p65 were significantly increased,and SIRT1 expression was down-regulated in I/R and IPC + ex527 groups (P ＜ 0.05).Compared with I/R group,the serum TNF-α and IL6 concentrations at 120 min of reperfusion,and myocardial LDH and CK-MB activities and acetylation of NF-κB p65 were significantly decreased,SIRT1 expression was up-upregulated in group IPC (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group IPC + ex527 (P ＞ 0.05).Compared with IPC group,the serum TNF-α and IL-6 concentrations at 120 min of reperfusion,and myocardial LDH and CK-MB activities and acetylation of NF-κB p65 were significantly increased,and SIRT1 expression was down-regulated in group IPC + ex527 (P ＜ 0.05).Conclusion SIRT1 is involved in IPC-induced alleviation of myocardial I/R injury in rats.

Objective To investigate the effects of hydrogen gas on the myocardial injury in rats with endotoxemia.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 4 groups (n =12 each ):control group (group C ),hydrogen gas control group (group HC ),endotoxemia group (group E) and hydrogen gas + endotoxemia group (group LH).Endotoxemia was induced by intraperitoneal lipopolysaccharide (LPS) 20 mg/kg in groups E and LH,while the equal volume of normal saline was given in groups C and HC.After LPS administration,the rats were exposed to the air containing 2％ hydrogen gas for 6 h in groups HC and LH,and the rats were exposed to the air for 6 h in groups C and E.Blood samples were taken from the abdominal aorta after 6 h inhalation of hydrogen gas to determine the serum level of cTnI.The hearts were then removed to determine the content of TNF-α and IL-6 and expression of phosphorylated nuclear factor κB ( NF-κB) inhibitory protein (p-IκB-α) and p38 mitogen-activated protein kinase (p-p38MAPK) in the myocardial tissues.Results Compared with group C,no significant change was found in the levels of cTnI,TNF-α and IL-6 and expression of p-IκB-α and p-p38MAPK in group HC ( P ＞ 0.05),and the levels of cTnI,TNF-α and IL-6 were significantly increased and the expression of p-IκB-α and p-p38MAPK was up-regulated in groups E and LH ( P ＜ 0.05).Compared with group E,the levels of cTnI,TNF-α and IL-6 were significantly decreased and the expression of p-IκB-α and p-p38MAPK was down-regulated in group LH ( P ＜ 0.05).Conclusion Hydrogen gas can reduce the myocardial injury in rats with endotoxemia,and inhibition of the p38MAPK and NF-κB pro-inflammatory pathway and reduction of the inflammatory response of myocardial tissues are involved in the mechanism.