Objective To observe the clinical effectiveness of early sequential nutrition support (ESN)in the treatment of acute exacer-bation of chronic obstructive pulmonary disease (AECOPD)patients complicated with type Ⅱ respiration failure.Methods Eighty-four AE-COPD patients with type Ⅱ respiration failure were enrolled into our study and received the conventional therapies such as mechanical venti-lation,anti-infection,spasmolysis and asthma control.Patients were randomized assigned into the ESN group (n =42)and the total parenteral nutrition group (TPN,n =42)according to the nutritional care methods,and the clinical effectiveness were observed.Results Clinical symptoms were significantly improved in both of the two groups.However,the total effective rate,average length of stay,pulmonary function, triceps skinfold thickness (TSF)and serum albumin levels were significantly better in the ESN group,and the differences were ofstatistical significance (P <0.05).Conclusion The study comfirmed the necessity of ESN application on the AECOPD patients with type Ⅱ respira-tion failure,which can further improve the treatment effectiveness and nutrition status.

Objective To investigate the lens and pituitary dose impacted by additional filtration and collection field in head and neck DSA examinations. Methods All images were acquired by a Philips ALLura Xper FD 20 DSA machine. The combination of the different collection fields (48 cm, 42 cm, 31 cm, 22 cm) and additional filtrations (0.9 mmCu+1.0 mmAl, 0.4 mmCu+1.0 mmAl, 0.1 mmCu+1.0 mmAl) were adjusted when the anthropomorphic phantom filled with dosimeter was scanned in anterioposterior and lateral positions with 2D?DSA and 3D?DSA. The dose area product (DAP), air kerma (AK) and the radiation dose values of bilateral lens and pituitary were measured and recorded. The 2D and 3D?DSA regional absorption dose on lens and pituitary were analyzed using t' test, the correlations between DAP and AK parameters and different regional absorption doses were evaluated by Pearson rank correlation coefficient. Results Absorption doses of left lens, right lens and pituitary with 2D?DSA (n=12) were as following:(2.77 ± 0.68), (6.23 ± 3.54), (8.65 ± 2.62) mGy, while the parameters with 3D?DSA (n=12) were (1.78 ± 0.82), (2.18±1.15), (3.32±0.64) mGy, respectively;the results revealed a significant difference (t'=3.20, 3.76 and 6.85, P<0.01). DAP [(8 739±5 731) mGy·cm2] had a relationship with absorption dose of pituitary, left lens and right lens [(5.988 ± 3.299),( 2.258 ± 0.872),( 4.207 ± 3.303) mGy, r values were 0.766, 0.684, 0.727; P<0.01]. AK values was (31 ± 23) mGy and it had a relationship with pituitary absorption dose (r value was 0.894, P<0.01). The lens dose was reduced when the additional filtration was increased and the collection field was decreased, the radiation dose of the pituitary was reduced when both the additional filtration and the collection field were increased. Conclusions In the head and neck DSA examinations, the radiation dose of the lens and the pituitary had different changes with the different additional filters and collecting fields. The organ dose with 3D?DSA was significantly less than that with 2D?DSA.