Feeding intolerance in preterm infants,which is an important issue that the neonatal pediatri-cians have to work out,leads to malnutrition of early preterm infants and growth restriction which have an impact on later behavioral and cognitive outcomes. Feeding intolerance is related to the immature of gastrointestinal function,perinatal asphyxia,infection and other diseases. Minimal enteral feeding,prokinetic agents and supple-mentation of the enteral probiotics,are used generally,but at present there is no guidelines for the prevention and treatment.

Objective To present a solution of the hospital information management access control for more secure information sharing. Methods Several commonly used access control models were compared. Some problems of the RBAC model were analyzed in the hospital information circumstances. Results A solution of space-based data access control was presented on the base of the role-based access control (RBAC) module. Conclusion The space-based data access control method can reduce space consumption and maintain data consistency, which is more suitable for the use of the hospital management information system.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fistula ; surgery ; Humans ; Hyoid Bone ; surgery ; Infection ; Male ; Middle Aged ; Thyroglossal Cyst ; surgery ; Young Adult

Objective To investigate the effect of radix paeoniae rubra (RPR) on expressions of p38MAPK, NF-κB and iNOS in ltpopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its protective mechanism. Methods Forty Wistar rats with ALI were divided randomly into five groups: saline control group (Group A) , LPS group (Group B), RPR for treatment group (Group C), RPR for prevention group (Group D) and SB203580 group (Group E). The effects of RPR on protein content and the ratio of neutrophiles in bronchoalveolar lavage fluid (BALF), contents of malondidehyde (MDA) and serum NO in lung tissue were observed. Arterial blood was collected for blood gas analysis. Expressions of p38MAPK, NF-κB and iNOS in rat lung tissues were detected. Results Compared with Group A, expressions of p38MAPK, NF-κB and iNOS were significantly increased (P <0.01 orP< 0.05) , the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly higher (P<0.01 or P<0.05) in Groups B, C, D and E. There was a significant decrease in the level of arterial bicarbonate and partial pressure of oxygen in Groups B, C, D and E (P<0.01 or P<0.05). Compared with Group B, the expressions of p38MAPK, NF-κB and iNOS were significantly lower, and the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly decreased, while the levels of arterial bicarbonate and partial pressure of oxygen were significantly higher in Groups C, D and E (P<0.05 or P<0.01). Compared with Group B, the lunginjury of Groups C, D and E was significantly alleviated, while there was no statistical difference among Groups C, D and E in the indices of lung injury. Conclusion Protective effect of RPR on LPS-induced ALI is closely related to the inhibited expressions of p38MAPK, NF-κB and iNOS.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

Anti-Inflammatory Agents ; pharmacology ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology ; Prednisone ; pharmacology

ObjectiveTo discuss influence of Lamaze childbirth method on breast milk secretion during the course of Doula delivery. Methods106 primipara of natural childbirth were divided into the observation group(52 cases) and the control group(54 cases). Lamaze childbirth method of minus pain was applied in the observation group based upon Doula delivery, the control group only received Doula delivery. The initiating time of lactation, lactation volume were observed and the result underwent t test and χ2 test. ResultsThe initiating time of lactation was earlier and the lactation volume was increased in the observa-tion group than those in the control group. ConclusionsApplication of Lamaze childbirth method of mi-nus pain during the course of Doula delivery can promote early postpartum lactation and adequate lac-tation volume.

Objective To retrospectively analyze the clinical features,diagnostic experience and therapy of pulmonary embolism for reduction of misdiagnosis and missed diagnosis,and for improving the cure rate.Methods The data of clinical features,findings by auxiliary examination and therapeutic efficacy of 67 patients with pulmonary embolism admitted to the First Affiliated Hospital of General Hospital of PLA were summarized.The usual clinical manifestations were summarized based on the clinical symptoms of and the frequency of objective signs in the patients with the correct diagnosis.Auxiliary examinations included routine and sophisticated examinations such as CT pulmonary angiography(CTPA) and emission computed tomography(ECT),which were specially emphasized for summing up and optimizing the diagnosis.Comparisons were made of the therapeutic efficacy and complications between the treatment with thrombolysis combined with anticoagulation and simple anticoagulation.Results The primary clinical manifestations of the patients with pulmonary embolism included dyspnea,cough,chest pain,fever and hemoptysis,etc.Findings of D-Dimer assay might serve as a sensitive but not specific indicator in screening the suspected patients.For the sophisticated examinations,CTPA confirmed the diagnosis in 28 out of 31(90.32%) patients,and ECT confirmed the diagnosis in 39 out of 51(76.47%).All the patients who had undergone lung angiography received the final diagnosis,but the majority of them were reluctant to accept this examination because of potential risk of the technique.The total cure rate of thrombolysis combining anticoagulation was 90.62%(29/32),in which the administration of recombinant tissue-type plasminogen activator(rt-PA)-2h was most efficacious(with 100% of cure rate).Simple anticoagulation therapy gave a lower cure rate(68.57%,24/35) but a higher incidence of hemorrhagic complication(31.25%).After the administration of thrombolysis combined with anticoagulation therapy,both PaO2 and CTPA examinations showed significant changes for the better after the treatment compared with that before the treatment(P

BACKGROUND:Patients with spinal metastases may appear different degrees of pain and abnormal spinal stability, and can be treated with percutaneous baloon kyphoplasty combined with bone cement implantation. OBJECTIVE:To explore the effect of percutaneous baloon kyphoplasty with bone cement implantation on spinal stability and pain in patients with spinal metastases. METHODS:Twenty-three patients with metastatic spinal tumor were treated with percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement. There were 10 females and 13 males, and their age ranged from 23 to 71 years. The visual analogue scale score, anterior and posterior edge height of vertebral body, quality of life, and motor function score of patients were observed before and after treatment. RESULTS AND CONCLUSION: Compared with before treatment, the visual analogue scale score and motor function score were significantly decreased, while anterior and posterior edge height of vertebral body were significantly increased in 23 patients at 24 hours after treatment (P < 0.05). After 12 months of folow-up, no case appeared to have spinal nerve root damage, serious adverse reactions and bone cement embolism. The patient'squality of life was significantly improved, compared with before treatment (P < 0.05). Experimental findings indicate that percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement can significantly improve the spinal stability, relieve the degree of pain, and exert exact effects in treatment of spinal metastases.

Objective To investigate the significance of testing serum homocysteine for renal transplant patients .Methods 445 renal transplant patients from outpatient follow‐up(renal transplant group) and 100 healthy subjects(control group) were enrolled in the study ,whose serum homocysteine(Hcy) ,Cystatin C(CysC) ,creatinine(Cr) were tested .Then according to the eGFR(refered to the principle of NKF‐K/DOQI) patients of renal transplant group were divided into six subgroups .Serum levels of Hcy and Cr were compared among different groups ,and the relationship between serum Hcy concentration and anti‐rejection drugs were ana‐lyzed .Results In the transplant group ,concentrations of Hcy were obviously higher than that in control group(P<0 .05) .There was no significant difference in Hcy concentrations among renal transplants who had taken different anti‐rejection drugs(P>0 .05) . Concentrations of CysC and Cr were significantly associated with Hcy in renal transplant group(r=0 .481 ,0 .456 ,P<0 .05) .There was significant difference between eGFR≥90 subgroup and control group in CysC concentration(P<0 .05) .Conclusion Concen‐tration of Hcy in renal transplant group was obviously higher than that in control group .With the eGFR decreased ,Hcy increased gradually ,and in transplant group was associated with the concentration of CysC and Cr .There was significant difference between eGFR≥90 subgroup and control group in Hcy and CysC concentrations(P<0 .05) .The different anti‐rejection drugs had no effect on serum Hcy levels .