Objective To systematically evaluate the effectiveness of intermittent nasogastric feeding on enteral nutrition of critical patients. Methods The relevant randomized controlled trials were searched in the Cochrane Library, PubMed, EMbase, Web of Science, JBI Library and the databases of China National Knowledge Infrastructure (CNKI), China Scientific Journal Database by VIP (VIP), Wanfang Database. The studies were selected according to the inclusion and exclusion criteria by two reviewers. Meta- analysis was conducted by using RevMan 5.2. Results Nine RCTs were included involving 558 patients. The results of meta- analysis showed that intermittent nasogastric feeding was greater than continuous pump feeding in the incidence of constipation, OR=0.32, 95%CI 0.14~0.71, P<0.05, the difference was significant. However, they were alike in the incidences of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and effects of nutrition, there was no statistical difference (P>0.05). Conclusions Intermittent nasogastric feeding and continuous pump feeding did not affect the incidence of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and the effects of nutrition. However, the incidence of constipation was significantly less in patients receiving intermittent nasogastric feeding.

Objective To expatiate the ultrasonographical and pathological manifestations of breasts with juvenile macromastia.Methods Four patients with juvenile macromastia were examined by high frequency ultrasonography.The sonographical and pathological images were observed and reported.Results The sonographical characteristics of the breasts with juvenile macromastia were similar: the anatomical structures of the breasts were obscure,which were characterized by cystic formation,reticular structure,patched hypoechoic or hyperechoic regions and distorted gland structure.One patient had fibroadenoma and dermatic erythema.The results of pathological examination showed marked cystic proliferation of glands accompanied with ductal epithelial hyperplasia,irregular ductal distribution,no lobules formation or proliferation of fat tissue,fibrocyte and fibroblast.Conclusions The abnormalities of juvenile macromastia may not only be the huge volume,but also may include abnormal ultrasonographical and pathological manifestations,awaiting more follow-up studies.

Shenfu injection is a common clinical medicine. To explore the common clinical medical combinations with Shenfu injection the real world, 25 704 patients who used Shenfu injection were selected from the hospital information system (HIS) database established by Clinical and Basic Research Institute for Traditional Chinese Medicine of China Academy of Chinese Medical Sciences. The association rules were applied in a correlation analysis on common medical combinations with Shenfu injection in the patients. According to the findings, when Shenfu injection was combined with a single medicine in clinic, the ratio of using Omeprazole, Lidocaine or Furosemide were respectively 22.19%, 20.32%, 19.61%; when Shenfu injection was combined with two medicines, the top three medical combinations were respectively midazolam + omeprazole (11.01%), lidocaine + omeprazole (10.8%) and propofol + midazolam (10.76%); when Shenfu injection was combined with three medicines, the top three medical combinations were respectively propofol + fentany + midazolam (8.83%), remifentanil + propofol + midazolam (8.77% ) and propofol + midazolam + omeprazole (8.77%). According to the further analysis, the combination of Shenfu injection and Propofol + Fentany + Midazolam may reduce the incidence of hypotension and bradycardia during anesthesia, accelerate recovery after anesthesia and relieve the synergistic effect after anesthesia. The combination of Shenfu injection and furosemide may show the synergistic effect in treating the acute left ventricular failure by reducing the returned blood volume and increasing the myocardial contractile force and vitality. The combination of Shenfu injection and Omeprazole may play the synergistic effect in shortening the digestive tract ulcer healing time, reducing the ulcer recurrence and preventing hemorrhagic shock and stress ulcer caused by shock in treating ulcer hemorrhage.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Databases, Factual ; Drug Therapy, Combination ; statistics & numerical data ; Drugs, Chinese Herbal ; administration & dosage ; Electronic Health Records ; Female ; Hospital Information Systems ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the methods and therapeutic effects in reconstructing and restoring the knee stability of floating knee injury. Methods A total of 38 patients with floating knee injury combined with acute knee instability treated from January 2000 to January 2006 were retrospectively studied to evaluate the efficacy of different procedures. Results All patients were followed up for 1-4 years (mean 1.5 years), which showed fracture healing in all patients. There occurred postoperative wound infection in three, internal fixator loosening in two, anterior cruciate ligament laxity in one and osteearthritis in two. According to Score of Hospital for Special Surgery (HSS) for knee function,the knee function was excellent in 32 patients, good in five and fair in one, with excellence rate of 84%. Conclnsions During the treatment of floating knee injury, attention should not only be paid to the reconstruction of the bone continaity, but also to the restoration of ligaments, meniscus, joint capsule and muscles.

Objective To study the practicability of measurement of abdominal wall tension (AWT) for noninvasive monitoring of intra-abdominal pressure in ICU patients.Methods Patients with indwelling urethral catheter admitted to ICU from April 2011 to March 2013 were enrolled for a prospective study.Exclusion criteria were patients with muscular relaxants,abdominal operation in three months,acute peritonitis,abdominal mass,acute injury of urinary bladder,acute cystitis,neurogenic bladder,intrapelvis hematoma,and pelvic fracture.The AWT (N/mm) and urinary bladder pressure (UBP) (mm Hg) of all patients were measured.Statistical analysis was performed by SPSS 13.0 statistical software.The correlation of AWT and UBP were analyzed using linear regression analysis.The effects of respiration and body position on AWT were analyzed using the Paired-samples t test,and the effects of gender and body mass index (BMI) on basic level of AWT (IAP ＜ 12 mm Hg) were analyzed using the One-way ANOVA.Results A total of 51 patients were recruited in study.A significantly linear correlation between AWT and UBP were observed (R =0.986,P ＜ 0.01),the regression equation was Y =1.369 + 9.57X (P ＜ 0.01).Under the supine-flat positioning,the intra-abdominal pressures at the end of inspiration and the end of expiration were (1.65 ± 0.52) N/mm and (1.45 ± 0.54) N/mm,respectively,and under body straight up 30° supine positioning,the intra-abdominal pressures at the end of inspiration and the end of expiration were (1.25 ± 0.30) N/mm and (1.07 ± 0.35) N/mm,respectively.There were significant differences in intra-abdominal pressure between different respiratory phases and body positions (P ＜ 0.01).Basic levels of AWT in male and female were (1.09 ± 0.29) N/mm and (1.01 ± 0.34) N/mm.The basic levels of AWT in patients with BMI ＜ 18.5,18.5 ≤ BMI ≤25 and BMI ＞ 25 were (0.91 ± 0.30) N/mm,(1.02 ±0.35) N/mm and (1.16 ±0.28) N/mm respectively,but gender and BMI had no significant effects on basic level of AWT (P =0.457 and 0.313,respectively).Conclusions There was a significantly linear correlation between AWT and UBP,and respiratory phase and body position had significant effects on AWT,but gender and BMI had no significant impacts on basic level of AWT.AWT could be served as a simple,easy,and accurate method to monitor the IAP in critical ill patients.

The incompatibility of Chinese materia medica (CMM) has always been one of the important scientific issues of CMM safety research. Extensive researches about CMM incompatibility have been carried out represented by "eighteen-antagonisms", mainly focused on the safety evaluation, toxic effects of substances, toxicology, toxicokinetics, drug interactions, toxicity mechanisms, etc. However, due to lack of system design on research ideas, model and methods, many key issues still lacked reliable conclusions, and did not reach a consensus within the industry. We completed the toxicity-effect characterization of the anti-drugs about "Pinelliae Rhizoma, Trichosanthis Fructus, Fritillariae Cirrhosae Bulbus, Ampelopsis Radix, and Bletillae Rhizoma attack Aconiti Radix" and proposed that the serious adverse reactions caused by related anti-drug combination therapy were because of the "toxicity" of CMM incompatibility. The formation of CMM incompatibility was closely related to its composition, dose, compatibility environment, etc, wherein the disease and symptom are the key factors of incompatibility. Eventually, the research model of toxicity-effect characterization of CMM incompatibility based on the desease and symptom was formed, it was viable to provide new strategies and methods for the clinical drug safety of CMM compatibility.

Immunotherapy which has been in practice for more than 20 years proves effective for the treatment of metastatic renal cell carcinoma (mRCC). Anti-angiogenesis-targeted therapy has recently been identified as a promising therapeutic strategy for mRCC. This study was aimed to evaluate the effectiveness of vascular endothelial growth factor (VEGF) pathway-targeted therapy for mRCC by comparing its effectiveness with that of immunotherapy. The electronic databases were searched. Randomized controlled trials (RCTs) on comparison of VEGF inhibiting drugs (sorafenib, sunitinib and bevacizumab) with interferon (IFN) or placebo for mRCC treatment were included. Data were pooled to meta-analyze. A total of 7 RCTs with 3451 patients were involved. The results showed that anti-VEGF agents improved progression-free survival (PFS) and offered substantial clinical benefits to patients with mRCC. Among them, sunitinib had a higher overall response rate (ORR) than IFN (47% versus 12%, P<0.000001). Bevacizumab plus IFN produced a superior PFS [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.76-0.97; P=0.01] and ORR (RR: 2.19; 95% CI: 1.72-2.78; P<0.00001) in patients with mRCC over IFN, but it yielded an increase by 31% in the risk of serious toxic effects (RR: 1.31; 95% CI: 1.20-1.43; P<0.00001) as compared with IFN. The overall survival (OS) was extended by sorafenib (17.8 months) and sunitinib (26.4 months) as compared with IFN (13 months). It was concluded that compared with IFN therapy, VEGF pathway-targeted therapies improved PFS and achieved significant therapeutic benefits in mRCC. However, the risk to benefit ratio of these agents needs to be further evaluated.

Objective To investigate sleep quality and it’s influencing factors of hypertensives among rural area in Hubei Province. Methods The method of stratified sampling by selecting 569 hypertensives in Xuanen county of Hubei was applied to perform the questionnaire survey, including the sociodemographic data, daily life habits and physical health data, as well as pittsburgh sleep quality index(PSQI) and compliance of hypertensive patients scale(CHPS). Results The average score of PSQI in 569 hypertensives was 7.25±3.61, of which 251(44.11%) hypertensives were poor sleep quality. The influencing factors of sleep quality for hypertensives are gender (P=0.006, OR=1.626), the number of other diseases(P=0.001, OR=1.520), regular exercise (P=0.033, OR=0.660) and the compliance of hypertensives (P=0.024, OR=1.707). Conclusions The sleep quality of rural hypertensives in Xuanen county, Hubei Province is poor, which is affected by different factors. Therefore effective measures should be taken to improve the sleep quality of hypertensives.

This study was aimed to improve the sensitivity of magnetic induction phase shift detection system for cerebral hemorrhage. In the study, a cerebral hemorrhage model with 13 rabbits was established by injection of autologous blood and the cerebral hemorrhage was detected by utilizing magnetic induction phase shift spectroscopy (MIPSS) detection method under the feature band. Sixty five groups of phase shift spectroscopy data were obtained. According to the characteristics of cerebral hemorrhage phase shift spectroscopy under the feature hand, an effective method, B-F distribution, to diagnose the severity of cerebral hemorrhage was designed. The results showed that using MIPSS detection method under feature band, the phase shift obviously growed with increase of injection volume of autologous blood, and the phase shift induced by a 3-mL injection reached -7.750 3 degrees ± 1.420 4 degrees. B-F distribution could effectively diagnose the severity of cerebral hemorrhage. It can be concluded that the sensitivity of the cerebral hemorrhage magnetic induction detection system is improved by one order of magnitude with the MIPSS detection method under the feature band.
Animals ; Cerebral Hemorrhage ; diagnosis ; Magnetic Phenomena ; Magnetics ; Rabbits ; Spectrum Analysis ; methods

Qigui Tongfeng tablet (QLTFT) is a traditional Chinese medicine with good effect for treating gout. Here, network pharmacology method and molecular similarity analysis were utilized to study the effective substance basis and molecular mechanism of the QLTFT on the gout. The similarity to the medicinal compounds is reflected in the Tanimoto coefficient that gives the structural similarity of two compounds. Operationally, similar modifiers were described as pairs of concepts with a similarity score of 0. 500. The results of the molecular similarity analysis suggested that the flavonoids in QLTFT could be new leads for gout. Furthermore, complex biological systems may be represented and analyzed as computable networks. Two important properties of a network were degree and betweenness. Nodes with high degree or high betweenness may play important roles in the overall composition of a network. And the results of network analysis showed that dongbeinine, verticinone-N-oxide, verticine N-oxide, peimine, peiminine, isobaimonidine, dongbeirine, peimisine and simi-arenol which with high degree acted on xanthine dehydrogenase/oxidase, matrix metalloproteinase-9, an arachidonate 5-lipoxygenase-activating protein, tyrosine-protein kinase and etc. Inhibition of these targets can prevent the formation of uric acid, reduce inflammation by uric acid and regulate the body's immune response. Thus, these compounds may be the main effective substance basis. The research results not only reveals its molecular mechanism, but also provide a theoretical basis for the quality control of drugs and clinical application.
Gout ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Pharmacology ; methods ; Tablets ; Technology, Pharmaceutical ; methods