In patients with a functional gut,enteral nutrition is the preferred route of nutrition support.The favorable effects of enteral nutrition include prevention of mucosal atrophy,maintaining of the integrity of gut flora,and improvement of immunocompetence.The guidlines recommend EN be withheld in patients requiring significant hemodynamic support,because of highdose catecholamine agents which could reduce EN tolerance.Splanchnic perfusion is reduced in sepsis shock,yet vasoactive agents have demonstrated both improved and diminished perfusion.Inadequate perfusion increases the risk of experiencing rare but serious adverse events.This study summarizes the tolerability and safety of enteral nutritionin in critically iH patients with hemodynamic instability and provides theoretical basis for the early administration of EN.

Objective To investigate effects of very early hyperbaric oxygen treatment (HBOT) on patients with malignant brain edema after surgical operation for treatment of severe traumatic brain injury (TBI).Methods A total of 146 patients who suffered from malignant brain edema after last surgical operation for severe TBI were enrolled for this study.According to the intervention time of HBOT,they were randomized into a very early group (HBOT within 3 days after operation,n =55),an ordinary group (HBOT at 4 to 10 days after operation,n =65) and a control group (non-HBOT,n =26).Mortality rate of the 3 groups were recorded within 4 weeks after operation,and GCS (Glasgow Coma Scale) score were assessed in 1,2,3 and 4 weeks after operation.Dynamic head CT scan were performed for detecting brain status and for determine the duration of brain edema.Results The mortality of the very early group,the ordinary group and the control group were 10.9％,7.7％ and 11.5％,respectively,and no statistically significant difference was revealed among the groups (P ＞ 0.05).In very early group,the GCS scores of 1,2,3 and 4 weeks after operation were (8.837 ±3.350),(10.755 ± 3.388),(11.633 ± 3.408) and (12.367 ± 3.408),respectively,with significant difference between the time points 1 week and 2,3 and 4 weeks as well as 2 and 4 weeks after surgery (P ＜0.05),but not between 2 and 3 as well as 3 and 4 weeks after surgery (P ＞ 0.05).In ordinary group,the GCS scores at 1,2,3 and 4 weeks after surgery were (8.509 ±3.042),(9.458 ±3.115),(10.186 ±3.203) and (10.627 ±3.439),respectively,with significant difference between 1 week and 2,3 and 4 weeks after operation (P ＜ 0.05).In control group,the GCS scores at 1,2,3 and4 weeks after surgery were (8.042 ±2.881),(8.417 ±2.962),(8.542 ±3.02) and (8.958 ± 3.043),with no statistical difference among different time points (P ＞ 0.05).When compared with the very early group,the GCS sores of the ordinary group and the control group were significantly lower after intervention (P ＜ 0.05),and the GCS of control group was lower than that of the ordinary group (P ＜ 0.05).As for brain edema duration,the very early group was the shortest among the 3 groups (P ＞ 0.05) Conclusion Very early hyperbaric oxygen treatment could improve consciousness state and alleviate malignant brain edema after surgical operation in TBI patients.

Background Vancomycin has been increasingly recommended for the management of endophthalmitis,but few research report has been published about the pharmacokinetics of intravitreal vancomycin up to now.It is necessary to have an exact method to measure the concentration of vancomyein in animal eyes after intravitreal injection.Objective This study was to observe and compare the phamacokinetical process of vancomycin in serum,vitreous and aqueous humor between normal and infected rabbit eyes.Methods Seventy-two healthy adult rabbits were randomly divided into normal group and infected group and 36 rabbits for each.The animal models of endophthalmitis were established by intravitreal inoculation of 2000 CFU/ml staphylococcus aureus in the right eyes of rabbits in the infected group.Once endophthalmitis developed,0.1 ml vancomycin ( 10 g/L) solution was injected into the vitreous of every rabbit.The peripheral blood,vitreous and aqueous humor samples were respectively collected in 4 rabbits for each group at 0.5,2,4,6,12,24,48,72 and 84 hours after injection for detection of vancomycin concentration by high performance liquid chromatography(HPLC-UV).3p97 software was used to create fit parameters of pharmacokinetics.This experiment followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission (Version 1988).Results The accuracy of HPLC fitted the detecting request of biological specimen.The concentration-time data of vancomycin in normal rabbit aqueous humor and vitreous was subject to two-compartment model.The pharmacokinetic parameters were separately as following:Cmax was 50.16 mg/L and 751.42 mg/L,t1/2was 51.04 hours and 53.21 hours.The concentration-time data of vancomycin in infected rabbit aqueous humor and vitreous was subject to one-compartment model.The pharmacokinetic parameters were separately as following:Cmaxwas 24.94 mg/L and 687.66 mg/L,t1/2was 11.42 hours and 12.91 hours.The concentration of vancomycin in serum was much lower and almost undectable.The concentration of vancomycin in vitreous was gradually reduced as the prolong of time after injection in both normal group and infected group,but a obvious decline after increased level was scen in aqueous humor.Compared with normal group,the concentrations of vancomycin in both vitreous and aqueous humor were reduced at various time points(P＜0.05,P＜0.01 ).Conclusions HPLC is simple,highly sensitive and specific for the pharmacokinetic analysis of vancomycon.These results indicate that pharmacokinetic parameters of vancomycin alter in pathological condition,which is helpful for us to establish the better treatment guidelines for endophthalmitis.

Objective To explore the relationships among posttraumatic growth (PTG),social support,and coping style in women with infertility.Methods 182 women with infertility were recruited in one public hospital department of assisted reproduction technology.Measures included Posttraumatic Growth Inventory (PTGI),Perceived Social Support Scale (PSSS),and Simplified Coping Style Questionnaire (SCQ).Results ① The PTG score of women with infertility was 42.55 ± 16.83,lower than the average level.② Compared with the lower PTG group,the higher PTG group scored significantly higher in social support,positive coping,and negative coping (t =3.867,P＜ 0.01 ; t =8.452,P＜ 0.01 ; t =2.817,P＜ 0.01).③ There were significantly positive correlations among PTG,social support and positive coping (r =0.295-0.515,P ＜ 0.01).④ Positive coping served as a total mediator in the relationship between social support and PTG.Conclusion There are closely correlations among PTG,social support,and positive coping style.Positive coping style significantly mediate the relationship between social support and PTG.

OBJECTIVETo analyse clinical feasibility of two electrophoresis procedures of seminal plasma proteins, agarose gel electrophoresis and SDS-agarose gel electrophoresis.

METHODSSixty-nine semen samples were examined and classified into three groups: the asthenozoospermia (n = 22), the asthenoteratozoospermia (n = 19), and the relative normal group (n = 28) with normal routine and special test results, according to WHO routine and special test criterion. Then, the seminal plasma protenis were separated by two different electrophoresis, with SDS-agarose and agarose support medium, the buffer pH 7.0 and 9.2 respectively. The agarose gel electrophoresis was done under various sample loading time, motion power and staining modules. The completed gels were scanned and compared the each other statistically.

RESULTSSeminal plasma proteins can be separated into 4 strips by SDS-agarose gel electrophoresis with acid crystal violet, and the strips were diffusion and with dark background. However, 6 clear strips named A, B, C, D, E, and F can be obtained by agarose gel electrophoresis with 6 min. After samples were loaded and stained by amidoblack, there showed appropriate spaces among strips, and it was very easy to scan the drying gel by a densitometer. Using agarose gel electrophoresis, the statistical difference in strip C and E was shown between the asthenozoospermia and the relative normal group, and between the asthenozoospermia and the asthenoteratozoospermia, however, not between the relative normal and the asthenoteratozoospermia group. Moreover, the samples in the relative normal group with normal routine and special test results were in different electrophoresis maps.

CONCLUSIONAgarose gel electrophoresis of seminal plasma proteins with buffer pH 9.2, 6 min. sample loading and amidoblack stain was a simple, fast and fit technique for clinic.

Adult ; Electrophoresis, Agar Gel ; methods ; Electrophoresis, Polyacrylamide Gel ; methods ; Humans ; Male ; Proteins ; analysis ; Semen ; chemistry ; Staining and Labeling

OBJECTIVETo analyse protein alterations in the seminal plasma of non-obstructive azoospermia patients.

METHODSSemen samples were collected from 11 healthy fertile and 6 azoospermia male volunteers respectively and tested by SELDI-TOF-MS with CM10 protein chip to get protein spectra maps, which were automatically treated with the special softwares of Ciphergen Inc.

RESULTSThe mean peak heights of 28 proteins expressed in the seminal plasma of the azoospermia patients were statistically different from those of the healthy fertile males (P < 0.05 ), of which 24 were of lower contents than in the normal controls, 4 with remarkably significant difference, M/Z 7 196.058, 7 630.573, 7 547.610 and 7 709.833 (P < 0.01).

CONCLUSIONThe seminal plasma proteins of the azoospermia patients were significantly different from those of the healthy fertile males, with decreased contents of most of the different proteins, which might be significantly correlated with the development of azoospermia.

Adult ; Azoospermia ; metabolism ; Humans ; Male ; Proteins ; analysis ; Proteomics ; methods ; Semen ; chemistry ; cytology ; Spectrometry, Mass, Electrospray Ionization ; Sperm Count ; Sperm Motility

OBJECTIVETo study the preparation of phenols gastric floating tablet.

METHODThe tablets which were prepared using Eudragit IV, HPMC(K4M), MCC101 and Octadecanol as excipients were evaluated by vitro floatation and releasing performance. The pressure of preparationg was also study to select the optimal preparation.

RESULTThe tablets were successfully prepared in which the drug, Eudragit IV, Octadecanol were 31% respectively,and MCC101 was 7%. And 3-4 kg was found to be the eligible pressure.

CONCLUSIONThe study was found to be effective in the process of phenols gastric floating tablet.

Drug Carriers ; Excipients ; chemistry ; Gastrointestinal Agents ; chemistry ; Phenols ; chemistry ; Polymethacrylic Acids ; chemistry ; Tablets ; Technology, Pharmaceutical ; methods

A novel drug delivery system combining oral fast dissolving film with sodium deoxycholate/phospholipid mixed micelles was prepared to increase the absorption of cucurbitacin B that is a poor aqueous solubility substance. Encapsulation efficiency, particle size, zeta potential, polydispersity coefficient, investigated the morphology, disintegration time of oral fast dissolving film and the pharmacodynamic properties of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles before and after solidified in mice were evaluated and compared. The oral fast dissolving film prepared in this study showed a homogeneous pale yellow and could completely disintegrated in the 30 s. It could meet the requirements of rapidly disintegrating fully. The encapsulation efficiency, particle size, zeta potential, polydispersity coefficient of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles loaded in oral fast dissolving film were (43.36 +/- 2.12)%, (108.82 +/- 5.2) nm, (-34.18 +/- 1.07) mV, 0.088 +/- 0.012, respectively. The encapsulation efficiency, particle size, zeta potential, polydispersity coefficient of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles in solution were (41.26 +/- 2.22)%, (181.82 +/- 4.48) nm, (-30.67 +/- 0.81) mV, 0.092 +/- 0.012, respectively. The difference of pharmacodynamics among film of cucurbitacin B-loaded micelles, cucurbitacin B-loaded micelles and free cucurbitacin B in vivo was compared. Solubility of cucurbitacin B loaded in sodium deoxycholate/phospholipid-mixed micelles has also been greatly improved. The tumor inhibition rate of cucurbitacin B loaded in sodium deoxycholate/phospholipid-mixed micelles was significantly improved and did not change significantly before and after solidified. These showed that the sodium deoxycholate/phospholipid-mixed micelles could enhance the antitumor activities of cucurbitacin B and the stability of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles was improved significantly after solidified by oral fast dissolving film technology without pharmacodynamic properties changed significantly.
Animals ; Antineoplastic Agents ; administration & dosage ; chemistry ; Cell Line, Tumor ; Deoxycholic Acid ; chemistry ; Drug Carriers ; chemistry ; Humans ; Male ; Mice ; Neoplasms ; drug therapy ; Phospholipids ; chemistry ; Solubility ; Triterpenes ; administration & dosage ; chemistry

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objective To analyze the investigation results of an acute respiratory infection outbreak caused by adenovirus and provide scientific information for the prevention and control of congener public health emergencies .Methods A case‐control study was performed with grades and gender as matching factor ,all cases and selected controls were investigated with the same question‐naire .Results A totul of 47 cases were diagnosed in the outbreak ,no death ,the attack rate was 8 .88% ;the main clinical symptom was fever and 27 .7% of the cases became pneumonia .The case‐control study analysis demonstrated that with close contact to cases or not(χ2 =7 .96 ,P<0 .05) ,contact time (χ2 =7 .95 ,P<0 .05) ,hand washing habits (χ2 =25 .92 ,P<0 .05) and with or without the habit of cleaning snivel by hand directly (χ2 =22 .78 ,P<0 .05) were statistically different between cases and controls .Conclu‐sion long‐time contact to cases maybe the main risk factor for the adenovirus infection ,especially the contact manner were sharing the same desk or playing together .A good health habit of washing hands often and no cleaning snivel by hand directly were impor‐tant protective factors .Thus ,strengthening the training of health habit and awareness is the important preventive measure for re‐spiratory infectious diseases .