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 assess the value of multi-slice spiral CT angiography (MSCTA) in diagnosis of posterior nutcracker syndrome (NCS). Methods MSCTA of 15 patients clinically diagnosed as posterior NCS (patient group) and 50 subjects with normal renal vessels (control group) were retrospectively analyzed. The anatomy, course and relationship to the adjacent structure of left renal vein (LRV) and its branches were observed. The anteroposterior diameter (d1) and cross areas (s1) of the angle of control group and posterior abdominal artery (AA), the anteroposterior diameter (d2) and cross areas (s2) at the largest lumen near the renal hilar were measured and the ratio of s2/s1 and d2/ d1 were calculated.Results All LRVs posterior AA of patient group were compressed and narrowing with dilating apparently near the renal hilar. The difference of d2 was not significant (P＞0.05), but of other values were significant (P＜0.05).Conclusion MSCTA can show anatomy and three-dimentional trend clearly of LRV for posterior NCS, and evaluate the extent of narrow and dilating lumen accurately with cross areas measuring.

Purpose To establish myocardial infarction model in rabbits and to evaluate cardiac function and pathological changes.Materials and Methods In 35 New Zealand white rabbits, the left anterior descending branch (LAD) of the coronary artery was ligated. The cardiac function was evaluated using echocardiography, and the blood serum brain natriuretic peptide (BNP) level was examined preoperatively, on postoperative day 1, and in 1 week, 2 weeks, 4 weeks and 8 weeks for comparison. Pathological sections and HE staining were performed to observe pathological changes. Results The death rate was 28.6% (10/35). There was progressive increase in left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) at 1 week, 2 weeks and 4 weeks (P<0.05). There was progressive decrease in left ventricular ejection fraction (LVEF) and left ventricular fractional shortening fraction (LVFS) at 1 day, 1 week, 2 weeks and 4 weeks (P<0.05). The BNP level started increasing in 1 day, peaked in 1 week, then gradually decreased but remained higher than preoperative level in 8 weeks (P<0.01). Pathological section showed typical myocardial cell degeneration, necrosis, ifbrosis, calciifcation and scar formation. Conclusion This myocardial infarction model is satisfactory with signiifcant decrease of cardiac function and increase of BNP level.

Objective To investigate the effects of inhalation of isoflurane at different time points on hypoxic-ischemic brain injury in neonatal rats.Methods One hundred and eighty 7-day-old Sprague-Dawley rats,weighing 12-16 g,were randomly divided into 6 groups (n =30 each):sham operation group (group Ⅰ),cerebral hypoxia/ischemia (H/I) group (group Ⅱ),and inhalation of isoflurane at different time point groups (groups Ⅲ-Ⅵ).Brain ischemia was induced by double ligation of left common carotid artery followed by inhalation of 8 ％ O2 + 92 ％ N2 for 2 h at 37 ℃.In groups Ⅲ,Ⅳ,Ⅴ and Ⅵ 1.5 ％ isoflurane was inhaled for 30 min starting from 0,3,6,12 h after H/I respectively,while the rats were exposed to 30％ O2 and 70％ N2 only in groups Ⅰ and Ⅱ.The survival rate at 7 days after H/I was recorded.The animals were sacrificed at 7 days after H/I.The brains were removed and the right and left cerebral hemispheres (CH) were weighed separately.The ratio between left/right CH was calculated.The density of normal neurons in ventral posterior inferior thalamic nucleus and posterior cingulate cortex in left and right CH were measured and the ratio of the density of normal neurons in the left to right CH was calculated.Results Compared with group Ⅰ,the weight of left cerebral hemisphere,ratio between left/right CH,and ratio of the density of normal neurons in the left to right CH were significantly decreased in other five groups (P ＜ 0.05).Compared with group Ⅱ,the weight of left cerebral hemisphere,ratio between left/right CH,and ratio of the density of normal neurons in the left to right CH were significantly increased in groups Ⅲ,Ⅳand Ⅴ (P ＜ 0.05).There were no significant differences in the indices nentioned above among groups Ⅲ,Ⅳand Ⅴ (P ＞ 0.05).There was no significant difference in the survival rate among groups Ⅱ-Ⅵ (P ＞ 0.05).Conclusion Inhalation of 1.5％ isoflurane for 30 min within 6 h after cerebral H/I can reduce the cerebral injury in neonatal rats.

BACKGROUND: Heal-all oral biofilm is a material utilized in repairing oral mucosa and soft tissues defects and characterized by degradation, easily preparation, long preserved duration, convenient transportation and good ossification, which has been widely used in dental implant as guided bone regeneration materials.OBJECTIVE: To check the clinical effective of Heal-all oral biofllm on guided bone regeneration in dental implant.METHODS: A total of 72 patients with bone defects in the implantation area were selected as subjects, who were divided into control group and experimental group at random. Bone defects around implants were repaired by guided bone regeneration technique with BME-10X medical collagen membrane and Heal-all oral biofilm respectively. X-ray and clinical examination were taken at 1 and 3 months after implantation. The amount of new.formed bone tissue was evaluated when stage Ⅱ operation was performed.RESULTS AND CONCLUSION: In stage Ⅱ operation, osseointegration was formed between implants and bone tissue in all 72 patients. The average rate of bone formation was 92% in the experimental group while 91% in the control group. All implants were successfully repaired with implant denture. Occlusal function was restored successfully with all 72 implants during the follow-up period of 3-24 months after restoration. As an alternative option of BME-10X medical collagen membrane, Heal-all oral biofilm can be used in guided bone formation clinically.

Objective To systematically investigate the efficacy and safety of sublingual immunotherapy( SLIT) in the treatment of a-dults with seasonal allergic rhinitis( SAR) .Methods Literature was retrieved online in CNKI,CBM,VIP,Wanfang data,PubMed,EMBase, Medline,Cochrane Library,et al.After screening literature,data collection and assessment quality,randomized controlled trials relevant to our study were selected independently based on inclusion and exclusion criteria by two researchers.Statistical analyses were conducted by RevMan 5.2 software.Results A total of 13 RCTs were enrolled.The meta-analysis revealed that SLIT provided a significant improvement in aspect of reducing Symptom Scores(SS) and Medication Scores (MS)of adults with SAR,the difference had statistical significance(P<0.000 01). Compared to placebo,SLIT could increase the rate of adverse events( AEs) in the treatment of adults with SAR compared to placebo.The fre-quently reported AEs during clinical trials were oral pruritus,tongue edema,ear pruritus,throat irritation,et al.Conclusion Sublingual im-munotherapy could improve the symptoms significantly and reduce the SS and MS in the treatment of adults with SAR.And its safety could be well tolerated.

Aim To explore the pharmacological mechanism and the effects of polysaccharide sulfat(PSS) on cardiovascular diseases induced by type 2 diabetes mellitus(DM) through observing the risk factors.Methods Type 2 diabetic animal model was established by high-sugar and high-fat diets,combined with injection of small amount streptozotocin(STZ 20 mg?kg-1,iv).Adult male wistar rats were divided into five groups: normal control group,model group,polysaccharide sulfate group,metformin group and lovastatin group.They were treated with exact medicne for 8 weeks,but control group and model group were treated with 0.9% Nacl.During this process,FBG and serum lipid concentrations were measured.22 weeks later,the rats were sacrificed.The activity of tissue-type plasminogen activator(t-PA) and plasminogen activator inhibitor type-1(PAI-1) were detected by chemical methods.The aortas were collected for histopathlogical,immunohistochemical and Western blot studies.Results FBG concentrations and serum lipid(TC,TG,LDL) levels decreased in PSS group as compared from those of model group(P

Objectives To observe the effect of continuous positive airway pressure (CPAP)for the treatment of patients with acute cerebral infarction combined with obstructive sleep apnea syndrome (OSAS)and to investigate the influence of CPAP therapy on the recovery of neurological function in patients. Methods From April 2014 to September 2015,68 consecutive patients with acute cerebral infarction combined with OSAS admitted to the Department of Neurology,General Hospital of Wanbei Coal and Electricity Group were enrolled retrospectively. According to whether received the CPAP therapy,they were divided into an observation group (n = 31)and a control group (n = 37). The control group was treated with conventional therapy,and on the basis of the treatment plan of the control group,the observation group was also treated with CPAP therapy. They were all the patients with cerebral infarction who were treated for 14 d. The oxygen desaturation index (ODI),lowest oxygen saturation (LS a O2 ),oxidized low-density lipoprotein (ox-LDL),and superoxide dismutase (SOD)concentration,National Institute of Health Stroke Scale (NIHSS)scores and Barthel index (BI)scores,and the modified Rankin scale (mRS)scores after 3 months before and after the therapy in the patients of both groups were documented. The total effective rate was assessed. Results (1)The ODI and LS a O2 in the observation group and the control group after treatment were better than those before treatment. There were significant differences between the 2 groups (ODI:16 ± 6% vs. 35 ± 21%,26 ± 15% vs. 36 ± 21 %;LS a O2:88 ± 6% vs. 75 ± 11%,80 ± 8% vs. 75 ± 11%;all P < 0. 05). (2)After treatment,ox-LDL of the observation group was lower than that of the control group. There was significant differences between the 2 groups (ox-LDL:487 ± 90 μg/ L vs. 548 ± 77 μg/ L,SOD:111 ± 10 kU/ L vs. 94 ± 15 kU/ L,all P < 0. 01). (3)After treatment,the NIHSS and BI scores of the observation group and the control group were better than those before treatment. There were significant differences (the NHISS scores:5. 2 ± 2. 2 vs. 12. 9 ± 3. 9;7. 6 ± 3. 1 vs. 12. 5 ± 4. 2;the BI scores:88 ± 10 vs. 52 ± 30;81 ± 4 vs. 58 ± 30;all P < 0. 01). The NIHSS and BI scores of observation group were better than those of the control group. There were significant differences (all P < 0. 01). They were followed up for 3 months,the mRS score (1. 3 ± 0. 4)of the observation group was lower than that of the control group (2. 0 ± 1. 1). There was significant difference between the 2 groups (t = 3. 362,P <0. 01). (4)The total effective rate of the observation group and control group was 74. 2% (23 / 31)and 48. 6% (18 / 37)respectively. There was significant difference between the 2 groups (χ2 = 4. 598,P <0. 05). Conclusion The CPAP therapy can alleviate the oxidative stress levels in patients with acute cerebral infarction combined with OSAS in short term and improve the neurological function of 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 .

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.