Objective To investigate risk factors for feeding intolerance of preterm infants under the reactive scope model guidance, and provided empirical evidence for effective prevention and treatment of feeding intolerance in preterm infants. Methods Checked the cases of 242 preterm infants been treated in the neonatal department from August 2014 to January 2015 according to the order of admission. Through literature reviewing and expert consultation, the clinical observation table was designed based on the reactive scope model, and risk factors for feeding intolerance of preterm infants were investigated by single factor analysis and logistic regression analysis from the feeding intolerance (FI) group and non-FI group. Results The incidence of feeding intolerance in preterm infants was 33.8%(70/207), feeding intolerance in preterm infants often occurred during the period of being fed within 72 hours, and the clinical manifestations were gastric retention, abdominal distension and emesis. Single factor analysis showed that gestational age, birth weight, fetal distress, aminophylline application, intrauterine infection, breast milk feeding and twice stool interval were the related factors to the feeding intolerance. Logistic regression analysis showed that gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval >3 d were the risk factors of FI. Conclusions Gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval>3 d were the risk factors of FI.

Objective To investigate the clinical features and treatment of a group of patients of mitochondrial encepha-lomyopathy with actic acidosis and stroke (MELAS) with onset of status epileptics. Methods Clinical features, EEGs, image ifndings, and therapeutic data of 4 cases with onset of status epileptics patients ifnally diagnosed as MELAS were retrospectively reviewed. Results Four Patients were onset with status epileptics. The levels of serum lactic acid, ammonia, myocardial enzymes were increased, and the serum sodium level was reduced, and accompanied with metabolic acidosis. EEG found corresponding paroxysmal and interictal activities. Brain images showed basal ganglia calciifcation, brain atrophy, and acute cortex edema. Genetic detection found mtDNA3243 mutation. Conclusions The status epilepticus was commonly present in MELAS. The treatment of epileptic attack in this disease was dififcult, which needs early diagnosis. Appropriate anti-leptic drugs and relevant treatment to symptoms are important to alleviate cerebral injury.

Objective To compare the anthelmintic effect of albendazole with that of triclabendazole against Fasciola giganti-ca. Methods Two patients infected with Fasciola gigantica were investigated,and one was administered with albendazole orally (200 mg,twice per day for 5 days)and another was administered with triclabendazole[10 mg/(kg?d)for 2 days]. Their total fe-ces were collected daily during the period of whole therapy,and the eggs of the parasite were collected by using the nylon bag method,and incubated at 28℃. Results The parasite eggs were detected from the first patient’s dejecta on the 1st,2nd and 5th day after the end of the treatment,and no miracidiums hatched out as well as no eggs developed during the period of 25 days of the incubation. Meanwhile,her body temperature fluctuated between 37.4℃and 38.3℃,and she still complained bellyache. For the other invalid,the eggs were not detected on the 2nd and 5th day after the end of the treatment. However,the eggs before and dur-ing the treatment developed the miracidiums of Fasciola gigantica on the 13th day after the incubation,but the eggs collected from the 1st day after the termination of the therapy did not develop and no miracidiums hatched out. At the same time,the signs and symptoms of the patient vanished after the 4th day of the end of the therapy. Conclusions Albendazole has no obvious insecticid-al activity on adult Fasciola gigantica in the short term,but may affect the development of eggs. Triclabendazole has the anthelmin-tic effect on the adults as well as eggs of Fasciola gigantica. In addition,triclabendazole has the characteristics of well curative ef-fect,short course of treatment,and no obvious side effects.

BACKGROUND: The proliferation and differentiation of mesenchymal stem cells (MSCs) lack of regulatory functions. Following combining with suitable vectors, MSCs cannot highly effectively proliferate and differentiate, which are keys to prevent MSCs entering the clinic. It is of great importance to effectively regulate the differentiation of stem cells into osteoblasts using pulse electromagnetic field.OBJECTIVE: To investigate the differentiation of mouse MSCs into osteoblasts in vitro following stimulation of pulse electromagnetic field.DESIGN, TIME AND SETTING: The cytological in vitro controlled study was conducted at the Laboratory of Department of Orthopaedics, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology from May 2004 to October 2007.MATEIRALS: Totally 20 BALB/C mice were supplied by the Experimental Animal Center of Tongji Medical College. Pulse electromagnetic field deviser was designed and made by the Department of Electric Machine, Naval University of Engineering.METHODS: Mouse bilateral femur was sterilely isolated. BMSCs were harvested by the Percoll density gradient centrifugation,and purified and proliferated by the adherent method. Cells at the third passage (2×10~7/L) were incubated in a 6-well plate, and then divided into 4 groups. Cells in the blank control group were incubated in the complete medium. Cells in the pulse electromagnetic field underwent pulse electromagnetic field radiation of 50 Hz, sinusoidal wave, and 1 mT, twice a day, once 30 minutes, with an interval of 12 hours, totally 10 days. Cells in the osteogenic induction group were incubated in the complete medium, supplemented with dexamethasone, sodium glycerophosphate and VitC. Cells in the pulse electromagnetic field + osteogenic induction group were subjected to the same pulse electromagnetic field radiation and then incubated in the complete medium.MAIN OUTCOME MEASURES: The differentiation of BMSCs was measured.RESULTS: Results of alkaline phosphatase staining showed that cells were negative in the blank control group, but weakly positive in the pulse electromagnetic field group, positive in the osteogenic induction group, and strongly positive in the pulse electromagnetic field + osteogenic induction group 10 days following intervention. Compared with the blank control group,absorbance value of type I collagen immunohistochemistry was significantly greater in the osteogenic induction group, pulse electromagnetic field + osteogenic induction group (P < 0.05, P < 0.01).CONCLUSION: Pulsed electromagnetism fields of 50 Hz, waves of sine, with the intensity of 1 mT could promote alkaline phosphatase and type I collagen expression and enhance the differentiation of mouse BMSCs into osteoblasts in vitro.

Objective To investigate the effect of nerve growth factor (NGF) on the neural cells and expression of early growth response gene-1 (Egr-1 gene) in the hippocampus discharge zone of childhood intractable epileptics. Methods Acutely dissociated cell suspensions of childhood hippocampus discharge zone with non specific pathological changes (n = 16) were exposed to NGF group and control group respectively. There were three subgroups exposed to NGF at the levels of 12.5, 50, 100 ng/ml in NGF group. After 4 hr culturing, the astrocytes and neurons were lablled by Bb immunostain with the specific markers such as GFAP and MAP2. The total number of neural cells was counted under inversion fluorescence microscope and the Egr-1mRNA expression was detected by semiquantitative RT-PCR analysis. Results There were significant differences of the numbers of neural cells survived in hippoeampus region between the NGF group and the non-added NGF group (P < 0.01). Among the different levels of NGF 12.5, 50, 100 ng/ml, the number of the total cultural neurons and GFAP(+) astrocytes, MAP_2(+) neurons were increased with ascending levels of NGF (P < 0.05). At the same time, the expression of Egr-1mRNA (A_(Egr-1)/A_(β-actin)) in the NGF groups was also increased (P < 0.01). There was positive correlation between the number of the survivable neural cells and Egr-1mRNA quantity (r = 0.780, P < 0.01) among the three NGF groups. Conclusions NGF can protect the neural cells of epileptic discharge zone by promoting the expression of Egr-1 gene.

Facing the background of "team spirit"in constructing harmonious society and the development of relief medicine,the article analyzed the current situation of "team spirit education"and the dilemma of relief medical teaching,and put forward the suggestion of developing "team spirit education"in relief medical teaching.

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB) in elderly men.Methods A total of 97 male BPH patients aged 80 years and over(80～98 years old,mean 87.7 years old)were enrolled in this study,who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan.2015 to July.2015.Patients were randomly divided into Tamsulosin group(n＝ 51,treated with Tamsulosin) and combination group(n＝ 46,treated with Tamsulosin and Tolterodine).Results In Tamsulosin group after treatment,the international prostate symptom score(IPSS) was reduced from (18.3 ± 2.7) to (13.3 ± 3.1) (t ＝ 14.94,P ＜ 0.05),OAB symptom score(OABSS) from (9.3 ± 2.7) to (6.8 ± 1.9) (t ＝ 3.92,P ＜ 0.05),and post void residual volume(PVRV)from(36.5±32.3)ml to(16.2±12.1)ml(t＝14.98,P＜0.01).And the daily frequency of urgency,urgency incontinence and nocturia were improved in Tamsulosin group after treatment.IPSS,OABSS and PVRV were improved more significantly in combination group after treatment than in Tamsulosin group,and the daily frequency of urgency,urgency incontinence and nocturia were reduced more significantly in combination group than in tamsulosin group(t＝-5.23,-3.98,9.01,11.5,14.8,P＜0.01).While there was no significant difference in prostate volume (PV)and PVRV between the two groups after 8 weeks of treatment(t＝ 1.22,-0.94,P＞0.05).The total incidences of adverse events (mainly mouth dryness)had no significant differences between the Tamsulosingroup and the combination group(8.7％ vs.5.9％,x2 ＝99.47,P＞0.05).No acute urinary retention was found in the two groups.Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men.

Objective To find the best time to remeasure temperature after cooling with evidence-based practice. Methods Used Johns Hopkins′ Evidence Based Practice Tool to find the best time to remeasure temperature after cooling. That tool included three steps which were establish problem, evidence synthesis and transfer evaluation. Results The best time to remeasure temperature after physical cooling was 30 minutes. The best time to remeasure temperature after drug cooling was 60 minutes. The best time to remeasure temperature after physical and drug combination cooling was 30 minutes after physical cooling and 60 minutes after using drug. Conclusion The best time to remeasure temperature after cooling was different because of the different cooling methods.

Objective To explore the effects of mouse nerve growth factor (mNGF) on expression of metallothionein I/II (MT I/II) and cytochrome C (Cyt C) in hippocampus of pentylenetetrazol (PTZ)-induced epileptic (EP) young rats. Methods Fif-ty SD rats aged 19 days were randomly divided into control group, EP group, mNGF low, medium, and high dose groups. Each group had 10 rats. Control group was injected with normal saline every day, and EP group was intraperitoneally injected with PTZ 40 mg/(kg·d) for 21 days in succession. The mNGF low, medium, and high dose groups were respectively intramuscularly injected with mNGF 500, 1 000, 2 000 AU/(kg·d) for 7 days in succession after PTZ injection. Changes of body weight, behav-ioral performance were recorded. The positive cells of MT I/II, Cyt C were examined by immunohistochemisty. The levels of MT I, Cyt C mRNA in hippocampus were measured by real-time PCR. Results The number of MT I/II, Cyt C positive cells and the levels of MT I, Cyt C mRNA in hippocampus had signiifcant differences among groups (F=15.98-105.76, P=0.000). The number of MT I/II, Cyt C positive cells and the levels of MT I, Cyt C mRNA of EP group were higher than those in control group, mNGF low, medium, and high dose groups (P<0.05). The number of MT I/II, Cyt C positive cells of mNGF low group were higher than those in mNGF high dose group (P<0.05). The levels of MT I, Cyt C mRNA of mNGF low group were higher than those in mNGF medium and high dose groups (P<0.05). The number of MT I/II, Cyt C positive cells and the levels of MT I, Cyt C mRNA had no differences between mNGF medium and high dose groups (P>0.05). Conclusions As a stress protein, metallothionein is involved in the process of chronic epilepsy along with Cyt C. mNGF has neuroprotective effects on the hippocampus of epileptic rats in dose dependent manner.