Objective To evaluate the influence of early entemal nutrition and parenteral nutrition support on gastric juice pH in patients with severe brain injury. Methods Totally 168 patients with severe brain injury ( Glasgow Coma Scale ≤ 8 ) admitted to our hospital from January 2007 to May 2009 were equally and randomly divided into early enternal nutrition (EEN) group and parenteral nutrition (PN) group. Gastric juice pH and upper gastrointestinal hemorrhage were monitored on admission and on the 3rd, 5th, and 7th day after admission. Results The gastric juice pH was significantly decreased in patients with severe brain injury. In addition, it was significantly higher in EEN group than in PN group on the 3rd, 5th, and 7th day after admission ( P ＜ 0. 001 ). The alimentary tract hemorrhage incidence showed no difference on admission between two groups but was significantly lower in the EEN group on the 3rd, 5th, and 7th day ( P ＜ 0. 05 ). Conclusions Hypersecretion of gastric acid may occur in patients with severe brain injury. EEN can neutralize gastric acid and increase gastric juice pH,which may lead to the decrease of upper gastriontestiual hemorrhage. Monitoring of the gastric juice pH also can provide a warning message of stress ulcer bleeding.

Objective To investigate the changes of leptin level in patients with intracerebral hemorrhage and the relationship between leptin level and insulin resistance(IR). Methods 57 patients with hypertensive cerebral hemorrhage (group A ), 50 patients with hypertension (group B), 41 healthy people (group C) were selected to determine the value of fasting blood-glucose ( FBG), fasting blood-insulin( FBI), leptin levels as well as insulin sensitivity index (ISI). Results The level of FNS and leptin was significantly higher (P ＜ 0.05 ) while the level of ISI was lower (P ＜ 0.05 ) in group A than those in group B and C. Correlation analysis showed that leptin level in HCH patients was negatively correlated with ISI, and positively correlated with FNS. Conclusion The results indicate that higher level of leptin and IR may play an important role in the occurrence of hypertension complicated cerebral hemorrhage.

Objective: To evaluate the effect of early enteral nutrition(EEN) on gastric acid secretion in patients with severe brain injury.Methods: 168 patients with severe brain injury(GCS≤8)were divided randomly into two groups.84 patients were given EEN by naso-gastric tube as EEN group and 84 patients were treated with parenteral nutrition(PN)as PN group.Gastric juice pH and upper gastrointestinal hemorrhage were monitored on admission,the 3rd,5th and 7th day after admission.Results: The gastric juice pH was significantly lowered in EEN group.Conclusion: EEN could neutralize gastric acid and increase the gastric juice pH in patients with severe brain injury.

Objective To improve the stability and practicability of field liquid transfusion control system.Methods SPCE062A 's high accurate AD was used to acquire the dropping speed,and a new method for weight sensor 's self proofread was applied.Results The infrared photoelectric sensor was removed,so the monitoring part could work with any appropriate sensor.Conclusion The system cost is decreased and its stability and availability are enhanced.[Chinese Medical Equipment Journal,2008,29(2):66-67]

Objective To design a more rapid and convenient infusion monitoring system.Methods Pentium series were used as its master and the MCU as its slaves.The management was based on RS232 standard.Results In the nursing station,nurses can monitor the fusion state of all patient rooms in the hospital.Conclusion It is proved that this system is simple,cheap and practical.[Chinese Medical Equipment Journal,2008,29(3):61-62,65]

Objective To examine the barbiturate infusion for intractable intracranial hypertension and its effect on brain tissue oxygen ( PbtO2 ). Method 60 patients with intractable intracranial hypertension were divided into tow groups, experimental group and control group. PbtO2 and intracranial pressure (ICP) were continuous monitored. Follow-up was more than 3 months and the prognosis was compared between two groups. Results When pentobarbital administration began, the mean PbtO2 [ 72 h: (26. 7 ±6. 7)mmHg] at 24h, 48h and 72h in experimental group were significantly higher than that of control group [ 72 h: ( 21. 1 ± 7. 2) mmHg ] ( P < 0. 05 ). The mean ICP [ 5 d: (2. 48 ± 1.11 ) kPa ] in the third and fifth day of experimental group were lower than that of control group [ 5 d: (3. 12 ± 1.09 ) kPa ]. Prognosis of pentobarbital group was better than control group( P < 0. 05 ). Conclusions Pentobarbital can effectively reduce intracranial pressure in patients with refractory intracranial hypertension and improve brain tissue oxygen. PbtO2 is an ideal monitoring marker, and it can predict prognosis to a certain extent.

BACKGROUND: Previous studies have verified that under normal culture of neural stem cells (NSCs), folic acid can accelerate proliferation of NSCs by phosphorylation of mitogen activated protein kinase path activation ERK1/2. OBJECTIVE: To investigate the effect of folic acid on NSC extracellular signal regulatory protein kinase pERK1/2 under hypoxic condition. METHODS: NSCs from Neonatal rats were cultured in vitro by serum-free culture method, and incubated in a flask at 1×10~8/L. Except normal control group, self-made hypoxia equipment was used in the hypoxia model, folic acid deficiency and folic acid supplemented groups at day 3. At 37 ℃, hypoxia culture was conducted in the thermostat for 6 hours. The contents of folic acid were 4 mg/L, 4 mg/L, 0.65 mg/L, 8 mg/L in the four groups. Cells following 6 days were collected to count the density using trypan blue. RT-PCR was utilized to detect pERK1/2 mRNA expression. Western blot assay was employed to determine pERK1/2 protein expression. RESULTS AND CONCLUSION: Compared with the normal control group, the proliferation of NSCs and the expression of ERK1/2mRNA and pERK1/2 protein were decreased significantly in the hypoxia model group. Compared with the hypoxia model group, the proliferation of NSCs and the expression of ERK1/2mRNA and pERK1/2 protein were increased in the folic acid supplemented group, whereas decreased in the folic acid deficiency group. There were significant differences among groups (P < 0.001). Above-described results verified that folic acid supplementation can activate ERK1/2 phosphorylatin and accelerate proliferation of NSCs under hypoxia condition.

Objective To observe changes in relative pituitary hormones after severe traumatic brain injury (STBI) in children and to investigate the short-and long-term effects of mild hypothermia on pituitary function.Methods Included for this study were 81 children who had been admitted to the Brain Hospital of Liaocheng People's Hospital from June 2011 to January 2015 for STBI and abnormal secretion of pituitary-related hormones.They were divided by the wishes of patients and their families into 2 groups,subjected to mild hypothermia treatment (n=42) or conventional treatment (n=41).The levels were examined of growth hormone (GH),prolactin (PRL),adrenocorticotropic hormone (ACTH),free triiodothyronine (FT3),free thyroxine (FT4) and thyroid stimulating hormone (TSH) for both groups unpon admission and in the moming of 1,3,5,7 and 14 days after injury.At 6 months after injury the patients were followed up for Glasgow Outcome Score (GOS) and levels of pituitary-related hormones.Results Of the 83 patients,disturbance of one single hormone was found in 31 (30.10％) and disturbance of 2 or more hormones in 52 (50.48％).The top 3 hormones disturbed were PRL,ACTH and GH.On days 3,5 and 7 after injury,the levels of PRL and ACTH in the mild hypothermia treatment group were significantly lower than in the conventional treatment group (P＜0.05).On day 3 after injury,the level of FT3 in the mild hypothermia treatment group was significantly lower than in the conventional treatment group (P＜0.05).At 6 months after injury,the GOS score for the conventional treatment group was 3.04±0.38,significantly lower than that for the mild hypothermia treatment group (4.56±0.62) (P＜0.05).The incidence of hypopituitarism in the hypothermia treatment group (16.67％) was significantly lower than in the conventional treatment group (46.88％) (P＜0.05).Conclusions Incidence of pituitary dysfunction is high in children following severe traumatic brain injury.Mild hypothermia treatment can effectively alleviate early-stage parasecretion of pituitary hormones,and decrease the incidence of later pituitary dysfunction.

Objective To evaluate the value of 68 Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-1-Nal3-octreotide ( DOTANOC) PET/CT imaging in the diagnosis and staging of pancreatic neuroendocrine neoplasms ( pNENs) . Methods Data of 48 patients ( 18 males, 30 females, age: 23-86 (50.0±14.7) years) who underwent 68Ga-DOTANOC PET/CT imaging from June 2016 to June 2018 were retrospectively analyzed. The histopathological results were considered as the gold standard. The diagnostic efficacies of 68 Ga-DOTANOC PET/CT imaging and conventional imaging ( CI) for pNENs were analyzed and compared ( McNemar test) . Imaging characteristics of true positive lesions in 68 Ga-DOTANOC PET/CT ima-ging were analyzed. The maximum standardized uptake value ( SUVmax ) in different pathological grades of pNENs lesions were compared (Kruskal-Wallis rank sum test). Accuracy for TNM staging by 68Ga-DOTANOC PET/CT imaging and the correlations between the staging results and clinical TNM stages were analyzed (R× C contingency table). Results (1) The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 68Ga-DOTANOC PET/CT imaging were 93.8％(30/32), 14/16, 93.8％(30/32), 14/16 and 91.7％(44/48). All true positive lesions detected by PET/CT showed focal up-take of 68 Ga-DOTANOC with SUVmax of 30. 52 ± 23. 57. There were 26 patients with confirmed pathological grades of G1 (n=10;SUVmax:28.20 (17.60, 49.22)), G2 (n=13; SUVmax: 27.60 (13.05, 56.08)) and G3 (n=3;SUVmax:13.68(10.02, 27.80)), with no significant difference in SUVmax among 3 groups (H=0.495, P>0.05). (2)Of the 48 patients, 95.8％(46/48) also underwent CI concurrent with PET/CT. The sensitivity, specificity, PPV, NPV and accuracy of CI were 60.0％(18/30), 9/16, 72.0％(18/25), 9/21 and 58.7％(27/46). The diagnostic efficacy of 68Ga-DOTANOC PET/CT imaging was significantly higher than that of CI ( P=0.041) . ( 3) The accuracies of 68 Ga-DOTANOC PET/CT imaging for T, N, M staging were 93.3％(28/30), 6/6, 9/10, respectively, and the staging results were significantly correlated with clinical TNM stages (r=0.880, P<0.05). Conclusion 68Ga-DOTANOC PET/CT imaging has great values in the diagnosis and staging of pNENs.