The disadvantages of total parenteral nutrition (TPN) in critically ill patients were increased infection rate and hepatic dysfunction.Enteral nutrition (EN) can overcome the shortcomings of TPN and cost less.However,EN may not provide enough energy and protein because of the limited gut function.The best mode of the nutritional support in the critical ill patients is PN+EN.The non protein calorie and protein needs can be decided by the measured energy expenditure and overfeeding should be avoided.To further improve the critically ill patient nutritional status,immunonutrition and ecoimmunonutrition should be considered.

Objective To investigate the efficacy of low dose thalidomide combined with chemotherapy in treatment of multiple myeloma(MM)and the clinical curative effect of the treatment method.Methods From June 2010 to June 2012,80 patients were diagnosed with multiple myeloma as the research object in Traditional Chinese Medicine Hospital of Haining,randomly divided into control group and observation group,with 40 cases in each group.The control group adopted conventional chemotherapy,the observation group were given low dose thalidomide combined with conventional chemotherapy.The clinical effect and adverse drug reactions were compared. Results The total effective rate of observation group (87.5%)was significantly higher than that of control group(65.0%)(P<0.05).The adverse reactions were 87.5%(35/40)in observation group and 100.0%(40/40)in control group,there was no significant difference between the two groups.The mean progression-free survival(PFS)and overall survival(OS)in observation group(5.5 ±1.2 months;1 1.5 ±2.4 months)were higher than those in control group(3.7 ±0.8 months;8.5 ±1.3 months)(P<0.05 ). Conclusion Low dose thalidomide combined with conventional chemotherapy in the treatment of multiple myeloma can improve clinical effect and decrease recurrence rate,with high safety and less adverse reactions.

Objective To observe and analyze the changes of prostaglandin E2 (PGE-2)and elastase (EA)levels in the pulp blood of the patients with carious tooth complicated with exposed pulp and its influence on the curative effects of direct pulp capping treatment.Methods 80 cases of the patients with carious tooth complicated with exposed pulp treated with direct pulp capping treatment were selected as the observation group and 40 cases of the patients treated with normal removal of impacted third molar were selected as the control group.The levels of PGE-2 and EA in the pulp blood of the patients in the two groups before the treatments were detected and compared.A one-year follow-up was employed for the patients in the observation group and the curative effects were evaluated and compared.Results The levels of PGE-2 and EA in the pulp blood of the patients in the observation group were 132.28±63.55 ng/ml and 114.36±19.57μg/ml respectively,and the levels of PGE-2 and EA in the pulp blood of the patients in the control group were 0.61±1.26 ng/ml and 19.38±6.34μg/ml respectively.There were statistically significant differences between the two groups (t=43.129,29.675,P<0.05). There was a positive relationship between the PGE-2 level and EA level in the pulp blood of the patients in the observation group (r=0.782,P<0.05).The levels of PGE-2 and EA in the pulp blood before the treatment of the patients with suc-cessful effects were 84.63±13.17 ng/ml and 68.25±8.16μg/ml,and the levels of PGE-2 and EA in the pulp blood before the treatment of the patients with failed effects were 177.35±41.42 ng/ml and 152.36±16.28μg/ml.There were statisti-cally significant differences between the two types of patients (t=31.578,21.556,P<0.05).Conclusion The patients with carious tooth complicated with exposed pulp show the significantly increased expression levels of PGE-2 and EA in pulp blood.The higher expression levels of PGE-2 and EA before the treatment could put adverse influence on the curative effects of direct pulp capping treatment.The clinicians should give the comprehensive consideration to the specific condition of pa-tients to choose the proper treatment methods.

BACKGROUND:Although cementation of polyethylene liner into a wel-fixed metal shel during the revision surgery has several advantages compared to total acetabular revision, there are some disputes about its clinical outcomes, especialy regarding the re-revision rate and the prosthetic survivorship. OBJECTIVE:To evaluate the clinical outcomes and safety of cementation of polyethylene liner into a wel-fixed acetabular cup in the revision after total hip arthroplasty with retained stable cup. METHODS:Between March 2012 and November 2014, nine patients underwent revision after total hip arthroplasty with cementation of polyethylene liner into a wel-fixed acetabular cup. There were 1 male and 8 females, aged 43.7 years on average. The time was 9.4 years on average from the primary total hip arthroplasty to revision. Harris Hip Score and prosthesis X-ray films were compared after revision. The effects and safety of cementation of polyethylene liner into a wel-fixed acetabular cup were further evaluated. RESULTS AND CONCLUSION:Nine patients were folowed up for 8-37 months. The Harris hip scores before revision was (49.54±18.28) points previously, and (84.82±10.59) points during final folow-up (t=6.377, P < 0.05). One patient had re-revision surgery because of recurrent dislocation. There were not complications in other patients, resulting in failure rate of 11%. These results indicated that polyethylene liner cementation technique is safe and effective when the wel-positioned and wel-fixed acetabular cup retained.

BACKGROUND:Physical structure and inorganic composition of composite calcium phosphate bone implants are similar to human bone, and the implants have good bioabsorbable ability and biocompatibility. Studies have confirmed that Dipsacus powder can significantly improve the speed of bone defect repair.
OBJECTIVE:To study the effects of Dipsacus asperoides/composite calsium phosphate bone implant material in the repair of bone defects.
METHODS:Bone defects of 1.0 cm×0.5 cm×0.3 cm were made on the bilateral mandibular bodies. The right side was implanted with Dipsacus asperoides/composite calsium phosphate bone implant as experimental group and the left side implanted with calcium phosphate bone material served as control group. Samples were col ected at 4, 8, 12 weeks after implantation for gross observation, cone beam CT, scanning electron microscope observation and histological observation.
RESULTS AND CONCLUSION:(1) Gross observation:the osteogenic speed, degradation rate and hardness in the experimental group were higher than those in the control group. (2) Cone beam CT detection:the implant in the experimental group was more tightly integrated with the surrounding tissues than that in the control group, and the degradation speed in the experimental group was higher than that in the control group. (3) Scanning electron microscope observation:there were many fibrous connective tissues between the implants and the surrounding tissues in the two groups, which was more obvious in the experimental group than the control group. With time gone, the implants were combined with the surrounding tissues more tightly. (4) Histological observation:the osteogenic speed and activity in the experimental group were superior to those in the control group. These findings indicate that Dipsacus asperoides combined with composite calcium phosphate bone implant can accelerate bone repair.

Exudative erythoma multiforme is a related to the immune function of children with skin and mucosa,damage to its diversity of characteristics of acute non suppurative inflammation,one of the aller-gic diseases.The disease and its pathogenesis is complex,the body can cause multi system and multi organ damage,the cause has not yet entirely clear.In recent years,due to our understanding of the exudative erytho-ma multiforme gradually thorough,both domestic and abroad on the level of diagnosis and treatment of the disease have greatly improved,the prognosis of patients with exudative erythoma multiforme has improved significantly.The progress of the pathology,clinical manifestation,diagnosis and treatment of exudative ery-thoma multiforme were summarized.

Objective To observe the effects of autologous myoblast transplantation on endplate regeneration and neuromuscular function restoration following direct nerve implantation (DNI) in rats so as to offer experimental basis for the use of myoblasts in neural regeneration area and further lay foundation for the research using myoblasts as transgenic carriers. Methods A total of 20 male SD rats were randomly divided into experimental group and control group,with 10 rats in each group.Models of DNI in rat gastrocnemius were established.The experimental group was injected with primarily cultured autologous myoblasts to the DNI location,while the control group was injected with isometric medium without autologous myoblasts.The effects of myoblasts on the neuromuscular function recovery following DNI were studied by detecting the tibial functional index (FTI),neuro-electrophysiology and pathohistology.Results The experimental group displayed faster tibial nerve function recovery than the control group (P ＜ 0.01 ).The peak to peak value (PPV) of gastrocnemius neuro-electrophysiology,area under the curve and regenerated endplate number of the experimental group had statistical significances as compared with the control group ( P ＜ 0.01 ). Conclusion Myoblast autotransplantation accelerates the recoveryof neuromuscular function after rat DNI and increases the number of the regenerated endplates.

The Many experiments show that pH affect the growth of romastigotes of L donovani. But the control tests with Acid - base scale have not been reported on the growth of promastigotes from different genesis. This paper reports that pH has different nfluence on several kinds of promastigotes from different genesis. We obseved that the growth of promastigotes of L. doncvani is inhibited when pH is 4.6 and 8.6.

Aim To investigate the effects of ?,?-methylene ATP ( ?,?-MeATP) on the P2X1 purino-ceptor-mediated vasoconstriction by different administration ways in the rat mesenteric artery. Methods Isometric vasoconstrictive responses to ?,?-MeATP,administered in non-accumulative manner or single concentration manner,were recorded in the rat isolated mesenteric arterial rings. Results ?,?-MeATP ( 10 -7 ～ 10 -4 mol ? L -1 ) administered in both of the two manners produced concentration-dependent vasocon-strictive responses in the rat isolated mesenteric artery. The vasoconstrictive responses to ?,?-MeATP in single-concentration administration group were greater than those in non-accumulative administration group when the vasoconstriction was standardized either by tissue wet weight or by maximal response to 120 mmol ?L-1 KCl ( P