Neonatal necrotizing enterocolitis (NEC)is a major cause of morbidity and mortality in premature infants.The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity.Probiotic bacteria prevent or limits disease propagation in NEC.The unique characteristics of developing intestinal epithelia focusing on gut development and colonization as well as the inflammatory propensity of immature epithelia are highlighted in this paper.Additionally, potential mechanisms of beneficial probiotic interaction with immature intestinal epithelia including immunomodulation, upregulation of cytoprotective genes, prevention and regulation of apoptosis and maintenance of barrier function are reviewed.Probiotics may restore or supply essential bacterial strains needed for gut maturation and homeostasis.Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC.

Intestinal tract is the central organ of the body's stress,and it has an important barrier function to prevent the harmful substances,such as bacteria and toxins,from the gut into the body.The main factors of intestinal barrier dysfunction are ischemia and hypoxia and endotoxin damage,and it is essential to explore the protective methods of the intestinal mucosa barrier in the early stage to prevent the organ metabolism disorder induced by intestinal derived endotoxin and bacterial translocation.Glutamine,which can effectively protect the integrity of the intestinal mucosa,maintain the normal intestinal permeability and improve the cell immunity,has been used to intensive adult patients and need further studies in the clinical application of newborns.

Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P<0. 05), while the level of TC, TG, HDL-C and LDL-C had no significant change (P>0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P<0. 05). After the treatment, the level of CRP, IL-6, IL-8 and TNF-α was reduced in the observation group (P<0.05), while the control group had no significant changes in the indices (P>0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.It is very important to correctly select a treating approach for DME.At present,the treating methods of DME include retinal laser photocoagulation,application of the glucocorticoid,intravitreous injection of anti-vascular endothelial growth factor (VEGF) drugs,administration of inhibitor of protein kinase C,vitrectomy and combined treatment etc.However,each method has its advantage and disadvantage.Retinal photocoagulation,vitrectomy,intravitreous injection and drug delivery system implantation are invasive treatment methods,and they can not rescue damaged retinal photoreceptors.Therefore,it is recommended that DME should be early diagnosed and effective treatment.The research status at home and abroad and future development trends of DME treatment were summarized.

Objective To investigate the protective effect of coenzyme Q10 (CoQ10) in the liver of preeclampsiapregnant rats and the potential etiology. Methods Fifty pregnant SD rats were equally divided into the normal pregnant (NP) group (n=10) and the preeclampsia (PE) group (n=40) randomly. The PE rats (n=40) were equally divided into four groups randomly,distilled water(DW)group,CoQ10 group, CoQ10 combined magnesium(CM) group and magnesium (Mg) group were established by treating the preeclampsia rats on day 15 to 21 of gestation with different measures. As for all the 50 rats, systolic blood pressure (SBP) of rat tail was detected on day 10, 15 and 21 of gestation respectively, 24 hours proteinuria analysis were detected on day 10, 15 and 21 of gestation respectively, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in blood andsuperoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), caspase-3, Bcl-2 and Bax protein expression in liver tissue were detected by western blot assay on day 21 of gestation. Results (1)SBP and 24 hours proteinuria analysis:there was no statistic difference among all the five groups on day 10 of gestation (P>0.05). Whereas, SBP and 24 hours proteinuria analysis were significantly higher in CoQ10 group, CoQ10 combined CM group, CM group and DW group than that in NP group on day 15, 21 of gestation (P<0.05). And SBP and 24 hours proteinuria analysis were significantly lower in CoQ10 group, CoQ10 combined CM group and CM group than that in DW group on day 21 of gestation (P<0.05). (2) Liver function: among CoQ10 group, CoQ10 combined CM group, CM group, DW group and NP group, serum levels of ALT were respectively(52±7),(34±9),(49±10), (70 ± 19),(30 ± 7)U/L;and serum levels of AST were respectively(169 ± 25),(84 ± 11),(159 ± 20),(281 ± 26)and(78±18)U/L. ALT and AST serum levels were significantly higher in CoQ10 group, CM group and DW group than that in NP group (P<0.05). ALT and AST serum levels were significant lower in CoQ10 combined CM group than those in CoQ10 group, CM group and DW group, respectively (P<0.05). ALT and AST serum levels were significant lower in CoQ10 group and CM group than that in DW group, respectively (P<0.05). (3) SOD, GSH-PX, MDA, caspase-3, Bcl-2 and Bax expression in liver tissue of rats: SOD expression was significant higher in CoQ10 group, CoQ10 combined CM group than thoes in CM group, DW group and NP group(P<0.05);SOD expression was significant lower in CM group, DW grouo than thoes in NP group(P<0.05);and SOD expression was significant higher in CM group than that in DW group(P<0.05). Compared with CoQ10 group, CoQ10 combined CM group, CW group and DW group respectively, the GSH-PX and Bcl-2 protein expressions were significant higher in NP group(P<0.05), while MDA, caspase-3 and Bax protein expressions were significant lower in NP group(P<0.05);compared with CoQ10 group, CoQ10 combined CM group and CW group respectively, the GSH-PX and Bcl-2 protein expressions were significant lower in DW group (P<0.05), while MDA, caspase-3 and Bax protein expressions were significant higher in DW group (P<0.05). Conclusions Oxidative stress and apoptosis levles were upregulated in PE pregnant liver tissues. CoQ10 could effectively protect the liver by improving the liver functions and decreasing the apoptosis of liver cells in PE pregnant rats, and markedly decrease the oxidative stress and apoptosis in the livers. The protective roles of CoQ10 in liver might through its function of anti-oxidative stress and inhibiting cell apoptosis by regulating the balance of Bcl-2/Bax.

Objective To screen the influencing factors related to prolonged mechanical ventilation (PMV). Methods Series of parameters of 154 elderly patients with pneumonia or COPD exacerbation were collected before using ventilator, after weaning of ventilator or at the 21st day of ventilating, respectively. Results By single factor analysis, PMV related to not only age, lying on bed, white blood cell, neutrophil, P (A-a)O 2, BUN, Cr, upper digestive tract bleeding, heart rate(HR), and blood pressure(BP) before using ventilator, but also related to heart function and consciousness after ventilator weaning or ventilating for 21 days. By multiple factor analysis, age, P (A-a) O 2 , heart function when ventilating for 21 days were related to PMV. Age≥82.0, P (A-a)O 2 ≥95.0 mm Hg, heart function≥grade 3 were high risk factors of PMV. Furthermore, it was found that the accuracy rate for meeting with those three parameters among 8 elderly patients with PMV was 87.5%. Conclusions Age, P (A-a)O 2 and heart function when ventilating for 21 days might be the independent factors of PMV.

Interleukin-12 can induce the production of INF-?, up-regulate the inhibitive factor of angiogenesis such as IP-10, MIG, TIMP, TNF-?, down-regulate the induced factor of angiogenesis such as VEGF, bFGF, MMP, inhibit the angiogenesis of tumor together and accelerate the regression of tumor. Interleukin-12 can inhibit the angiogenesis of tumor, which is independent of the immune system.

The choice of medicines is a key point in the treatment of hypertension.There are hundreds of antihypertensive drugs in China,including Traditional Chinese Medicines(TCM),chemical medicines and all kinds of compound preparation.But the rates of treatment and control of hypertension in China are very low,the situation of hypertension management in China is critical.In this article we compared the differences in the drug treatment among Chinese,American and European guidelines for the management of hypertension,and discussed the principles of choosing antihypertensive drugs.Chinese,American and European guidelines all mention that the specific drug classes may differ in some effect or in special groups of patients,so certain compelling indication requires certain antihypertensive drug classes.Three guidelines also emphasize the benefits obtained from the combination therapy and recommend the long-acting drugs or preparations with 24 h efficacy.The main differences among the three guidelines is whether to recommend the firstline drugs.Thiazide-type diuretics are recommended by American guideline(JNC7) in drug treatment for most patients with uncomplicated hypertension.But the European and Chinese guidelines do not recommend the first-line drugs,and the major classes of antihypertensive agents are suitable for the initiation and maintenance of therapy.Traditional Chinese medicines are invaluable resource of China,all kinds of antihypertensive TCM are widely used in the clinical,but owing to the deficiency of the high-quality evidence for TCM,the part of TCM is not included in the 2004 Chinese guideline for the management of hypertension.The choice of antihypertensive drugs is determined by its efficacy and safety.When safety and efficacy are equal,the lowest cost drug should be preferred.For the majority of patients without a compelling indication for another class of drug,a low dose of thiazides diuretic should be considered as the first choice in China.2004 Chinese guideline for the management of hypertension is based on many scientific evidences,and its publication is very important for the prevention and cure of hypertension in China.Nowadays,we must strengthen the dissemination and implementation of guideline,promote the rational use of antihypertensive drugs and improve the control rate of hypertensive in China.

Objective To explore the accuracy and the clinical significance about the diagnosis treatment to allergy rhinitis with bioresonanztherapie.Methods 22 cases who were confirmed as house dust mite,extremely sensitive to duse diagnosed by BICOM were randomly collected and examined by allergic-skin test,which were compared with the control group.Results 22 examples by BICOM bioresonanztherapie,for to the house dust mite and the dust highly sensitive patient,allergy test sets piercing experiment was the strong masculine genders.Conclusion Bioresonanztherapie is really feasible at accuracy and practicability to test allergic rhinitis.

Objective To investigate the clinical and pathological prognostic factors in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Methods The clinical and pathological factors of patients with carcinoma of ampulla of Vater who were operated from February 1994 to February 2009 at the Urumqi General Hospital of Lanzhou Military Region were retrospectively analyzed.The survival curves of these patients were also analyzed.Results The post-operative 1-,3-,5-year survival rates were 90％,63％,55％ respectively.The diameter of the majority of tumor (58.3％) was less than 2.0 cm.Of all the patients with carcinoma of ampulla of Vater,48.7％ were in T1 stage,41.7％ had high grade differentiation,73.0％ had no lymphatic metastasis.Univariate analysis showed that gender,age,tumor diameter,biopsy or not,the type of operation,the value of pre-operative serum bilirubin and the value of serum CA19-9 were not related to survival.The gross type of tumor (P =0.018),histological type (P =0.000),grade of differentiation (P =0.003),depth of infiltration (P =0.003),lymphatic metastasis (P =0.014) and TNM stage (P =0.031) were significant impact factors of survival.Multivariate analysis showed histological type and depth of infiltration were independent prognostic factors of surviva1 (P =0.002,P =0.005).Conclusion Grossly ulcerated carcinoma,mucinous adenocarcinoma on histology,low degree of differentiation,T2/T3 stage,lymphatic metastasis and clinical stage of Ⅱb were all significantly associated with poor prognosis in patients with carcinoma of ampulla of Vater treated by pancreatoduodenectomy.Histological type and the depth of infiltration were the most important risk factors of survival.