OBJECTIVE:To investigate the effects of alanyl-glutamine dipeptide-intensified early enteral nutrition (EN) sup-port on nutritional indexes,immune indexes,renal indexes and complications of sepsis patients. METHODS:A total of 112 cases of sepsis admitted into our hospital during May 2013-Jan. 2015 were selected and divided into observation group and control group according to random number table,with 56 cases in each group. Both groups received routine antibiotic therapy and early EN support(48 h)with nitrogen supplement 0.2 g/kg,calories 25 kcal/kg and nonprotein calories 19-21 kcal/kg each day. Observation group was additionally given Alanyl-glutamine for injection 0.5 g/kg with 0.9% sodium chloride injection 100 mL,continuous pump within 24 h,for 4 d. The levels of nutritional indexes (ALB,PAB,Hb),immune indexes (CRP,IgG,IgA and IgM), APACHEⅡ scores,SOFA scores,liver and renal function indexes (the levels of ALT,AST,Cr and BUN) were compared be-tween 2 groups before and after treatment. The prognosis and the occurrence of complication were also observed in 2 groups. RE-SULTS:Before treatment,there was no statistical significance in the levels of ALB,PAB,Hb,CRP,IgG,IgA,IgM,ALT, AST,Cr,BUN and APACHEⅡ scores,SOFA scores between 2 groups(P>0.05). After treatment,the levels of ALB and PAB in observation group were increased significantly compared to before treatment,and the observation groups was significantly higher than control group,with statistical significance(P<0.05). APACHEⅡ score and SOFA score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statis-tical significance(P<0.05). CRP of 2 groups were decreased significantly while IgG were increased significantly;the observa-tion group was significantly better than the control group,with statistical significance (P<0.05). Cr and BUN levels of 2 groups were decreased significantly compared to before treatment,and the level of Cr in observation group was significantly con-trol group,with statistical significance (P<0.05). The time of ICU stay,ventilator supporting time and antibiotics application time in observation group were significantly shorter than control group,and the incidence of diarrhea and gastric retention were significantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Alanyl-glutamine dipeptide-in-tensified early EN support can significantly improve immune function and liver and renal function of sepsis patients and reduce the occurrence of complications.

OBJECTIVE:To study the general pattern,characteristics and related risk of adverse drug reaction(ADR)induced by Monosialotetrahexosylganglioside sodium injection,and to provide reference for safe use of drugs in the clinic. METHODS:Us-ing“monosialotetrahexosylganglioside”and“ADR”as keywords,literautres were retrieved from CJFD,Wanfang and VIP database according to inclusion and exclusion criteria in Oct. 2014,and cases reports were extracted and analyzed statistically. RESULTS:A total of 19 literatures were included,involving 56 patients,with the ratio of male to female was 6.17∶1,and the most of patients aged 0-9 years,≥60 years,accounting for 44.64%(25 cases),30.36%(17 cases). Multiple organs or systems were involved in ADR;the most common reactions are fever (29 cases) and shiver (28 cases),etc.,and severe ADR can cause green-barry syn-drome,anaphylactic shock,etc. CONCLUSIONS:Thus,it is important to pay attention to ADR caused by Monosialotetrahexosyl-ganglioside sodium injection,to prevent the occurrence of serious ADR,to perfect drug instructions,and to ensure clinical safe ad-ministration.

Objective To investigate the roles of sphingosine kinase (SPK) on the regulation of proliferation, migration and apoptosis of gastric carcinoma cells. Methods BGC-823 cells were infected with adenoviral carriers bringing the wild type SPK gene and SPK mutant (SPK DN ), and their effect on the migration and 5-FU-induced apoptosis of BGC-823 cells was evaluated. The adenovirus-mediated expression of SPK was detected by Western blot, and cellular SPK enzyme activity was assayed. The cell migration was investigated by Transwell Migration Technology. Results The adenovirus-mediated wild type SPK gene increased the cellular SPK activity, thus leading to enhanced migration and resistance to 5-FU-induced apoptosis of BGC-823 cells. Whereas overexpression of SPK mutant (SPK DN ) decreased the cellular SPK activity, thus inhibited the migration and sensitized BGC-823 to 5-FU-induced apoptosis. Conclusion SPK plays important roles in the regulation of migration and apoptosis of gastric carcinoma cells, therefore it may be of a new target for tumor treatment.

Objective To assess the value of CT in diagnosis and clinical treatment of the traumatic rupture of spleen.Methods There were 35 cases with traumatic repture of spleen,32 cases were comfirmed by operation.Plain CT scans in all cases and contrast-enhanced scans in 4 cases were performed.Results 19 cases were subcapsular hematoma,8 cases were spleen hematoma,6 cases were rended in one place of spleen,2 cases were rended in many places of spleen.Conclusion The difinite diagnosis and classification of traumatic rupture of spleen can be made by CT.The rupture of the organs around the spleen also can be found by CT,that can provide reliable evidence for clinical treatment.

Objective To study effect of clopidogrel on neck blood vessel stenosis and plasma fibrinogen ( FIB ) in patients with stroke in progression(SIP).Methods 80 cases with SIP were selected from March 2014 to March 2015, they were divided into study group and control group according to the random number table method, 40 cases in each group, the control group was received conventional treatment, the study group was given clopidogrel on the basis of conventional treatment, evaluation of neurological function and living ability of patients with Stroke Scale (NIHSS) and daily living ability score ( ADL) , carotid artery stenosis were measured by color Doppler, the levels of FIB and C reactive protein ( hs-CRP) in two groups were also measured, adverse reactions in the two groups were compared.Results Carotid artery, internal carotid artery, external carotid artery diameter before treatment between two groups were no statistical significance,which all increased after treatment, and the study group was wider than the control group, the difference was statistically significant (P <0.05);NIHSS score and ADL score before the treatment between two groups was no statistical significance.NIHSS score and ADL score after treatment between two groups were significant improved, and the study group was better than the control group, the difference was statistically significant (P<0.05); FIB and hs-CRP before the treatment between two groups was no statistical significance, FIB and hs-CRP levels after treatment between two groups were significantly reduced, the study group was significantly lower than the control group, the difference was statistically significant (P<0.05); the adverse reactions of the two groups were not statistically significant.Conclusion Clopidogrel can significantly improve the neurological function, improve the degree of cervical vascular stenosis, reduce the level of FIB for SIP patients in recovery period.

Objective To investigate the value of serum ischemia-modified protein (IMA),hypersensitivity C reaction protein (hs-CRP),myoglobin (MYO)creatine kinase MB (CK-MB)and ultra-sensitivity troponin T (hs-cTnT)in the early diagnosis of patients with acute coronary syndrome(ACS).Methods Serum levels of IMA,hs-CRP,MYO,CK-MB and hs-cTnT were meaused in 94 patients with ACS[including 40 cases of unstable angina pectoris(UAP),20 cases of non-ST segment elevation myocardial in-farction(NSTEMI),non-Q wave myocardial infarction and 34 cases of ST segment elevation myocardial infarction(STEMI),Q wave myocardial infarction]and 99 cases of controls.The efficiency,sensitivity,specificity,negative and positive predictive values in the early diagnosis of ACS were compared among 5 kinds markers by the ROC curve.Results The detection results of serum IMA,hs-CRP,MYO,CK-MB and hs-cTnT had statistically significant differences between the UAP,NSTEMI and STEMI groups with the normal control group (P <0.05),serum IMA,hs-CRP,MYO,CK-MB and hs-cTnT had statistically significant differences between the UAP group with the NSTEMI group and between the UAP group with STEMI group (P <0.05),but the difference between NSTEMI and STEMI group group was not statistically significant (P >0.05).Conclusion In the patients with ACS,the multiple indicators combined detection can achieve the early diagnostic value.

Objective To study the pharmacokinetics and bioequiavailability of Glipizide in healthy volunteers. Methods The plasma levels of Glipizide were determined at 30 min,1,2,3,4,5,6,8,10,12,14 h by HPLC after single-dose oral cross administration of 10 mg Glipizide tablets of two brands in 18 healthy male volunteers aged 23 to 25 years old,with the interval of one week. Results Glipizide tablets of the two brands were as follows,Tmax: (2.39?0.50),(2.33?0.49) h; Cmax: (675.3?151.7),(647.1?166.7)g/L; AUC_ 0-t : (3 565.4? 733.4) ,(3 304.8?588.4) ?g?h -1 ?L -1 . Conclusion The two preparations were bioequivalent.

ObjectiveTo explore the expression and significance of ER, PR,C-erbB-2,CylinDl, Rb in different precancerous lesions of breast. MethodsThe expressions of ER, PR, C-erbB-2, CylinD1, Rb in breast normal tissue,hyperplasia, atypical hyperplasia and early-stage breast cancer were examined by immunohistochemical technique. ResultsThe expressions of ER and PR were increasing time trend in the different precancerous lesions, and were related to the breast proliferative degree; the positive expression rates of ER and PR in atypical hyperplasia were 63.2% and 68. 4% respectively,significantly higher than those in normal breast tissue(31.3% and 37. 5% respectively) and in hyperplasia(37. 1% and 42.9% respectively). The positive expression rates of CylinD1 and C-erbB-2 were increasing time trend in the different precancerous lesions. The negative expression rate of Rb was the highest in early-stage breast cancer,and it was zero in normal breast tissue and hyperplasia. ConclusionThe five tumor markers are important factors in breast carcinogenesis, and the overexpression of ER, PR, C-erbB-2, CylinD1 and Rb protein low-expression may be one of the causes of breast neoplasms.

Objective To analyze the prognostic factors for patients with hepatic encephalopathy (HE) in acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed on 159 ACLF patients with HE.The hepatic encephalopathy was determined to baseline,the patients were divided into survivors(n =13) and nonsurvivors(n =146),The 32 factors affecting the prognosis were analyzed by Cox proportional hazard model with SPSS.Results One-month,three-month,and six-month survival rates were 20.13％,10.06％ and 8.18％,respectively.Cox regression analysis of prognostic factors showed that it could the stage of hepatic encephalopathy and HRS significantly improve the survival rate of the patients with HE in acute-on-chronic liver failure.The stage of hepatic encephalopathy and HRS could significantly decrease the survival rate of the patients(x2 =18.344,11.368,all P ＜ 0.05),elevated the levels of hepatic encephalopathy (relative risk (RR) =1.591) and HRS (RR =1.809) indicate worse prognosis with hepatic encephalopathy in acute-on-chronic failure.Conclusion The stage of hepatic encephalopathy and HRS were independent risk factor sof prognosis in acute-on-chronic liver failure.

OBJECTIVE　To develop an asssay for the quantitative determination of phillyrin in Shuanghuanglian tablet.METHODS　TLCS method was selected to determine the content.RESULTS　The linearity was obtained over the range of 0.31～ 1.55 μg(r=0.9996).The average recovery was 96.9% with RSD=1.49%.CONCLUSION　The results showed that this method is sensitive,simple,specific and accurate for the determination of tetrahydropalmatine in Shuang Huanglian tablet.