The incidence of malnutrition among patients with chronic kidney disease (CKD) constantly increases despite the development of health care and dialysis techniques.New nutritional targets for CKD patients upon maintenance treatment have been developed.Before dialysis,evidences have shown that a long-term nutritional care plan,with a control of protein intake,can effectively correct metabolic disorders including proteinuria and acidosis.During the maintenance dialysis,the optimal protein and energy intakes have been recently challenged.The new classification of nutritional disorders in CKD patients may help the easily identification of protein-energy wasting.

Objective If IL-2 and IFN-? are united,perhaps we may see a more significant antitumor effect.A fusion gene of IL-2 and IFN-? was designed and constructed by DNA engineering.Methods CEA promotor、IL-2cDNA and IFN-?cDNA were obtained by PCR and RT-PCR.SDS-PAGE was used to examine the results;pcDNA-IL-2、pcDNA-IFN-?、pCEA-IL-2/ IFN-?、pEGFP-IL-2/ IFN-? were transfected to CEA high expression cell line(Lovo)by use of liposome.The fusion protein expression was examined by fluorescence microscope and Western blotting.Results IL-2/ IFN-? fusion gene can be expressed in tumor cells.Its expression is more obvious in CEA high expressed cells(Lovo),and can be located in cell plasma.Conclusion The fusion gene can be expressed in plasma of CEA high expressed cell lines.It may have a new anti-tumor effects.

The initiation and development of diabetic chronic complications is associated not only with the level of blood glucose,but also with the glucose fluctuation.The damage in large artery and microvessel may be caused by glucose fluctuation.There are two causes which induce glucose fluctuation in clinical:one is postprandial hyperglyceamia with not well controlled,the other is hypoglycemia causes by unsuitable therapy.A lot of effective new types of substances were applicated in clinical,such as ?-glucosidase inhibitor,glinide-insulin secretagogus,fast-acting and long-acting insulin analogues.With these new powerful tools,there is possibility to treat diabetes more correctly and safely,and control the blood glucose in a stable and good level.

Humans ; Minimally Invasive Surgical Procedures ; Spine ; surgery

Humans ; Osteotomy ; adverse effects ; methods ; Scoliosis ; surgery

Arthroplasty, Replacement, Hip ; trends ; China ; Hip Prosthesis ; Humans ; Prosthesis Failure

ObjectiveTo develop an evidence-based guideline on the oral hygiene care for adults with dementia in aged nursing homes. MethodsUsing the keywords “oral hygiene,dementia,aged nursing homes” to search in the databases including National guideline clearinghouse,Cochrane library,and Joanna Briggs institute,etc.Only the clinical guideline,systematical review and best practice were included. ResultsOne clinical practice guideline,one systematic review,and one best practice were found mainly. ConclusionsThe scale of brief oral health status is recommended,and nurses should be trained for oral screening.Recommendations include regular using toothpaste with fluoride and mouthwash with chlorhexidine gluconate,reducing intake and frequency of sugar consumption,regular cleaning the dentures,using salvia substitutes or stimulus,and carrying out the behavior management and communication strategies for dementia patients.

Narcolepsy is a disabling sleep disorder characterized mainly by irresistible excessive daytime sleepiness.It seriously influences patient's academic,family,and social function.The etiology of narcolepsy is still elusive,but the hereditary and environmental factors have been suggested to contribute the most.It is a multi-gene regulation disease,the researches of Human Leucocyte Antigen(HLA) gene type HLA-DQB1 * 0602 and HLA-DRB1 * 1501 are most popular in recent years.Especially the HLA-DQB1 * 0602 is regard as the major HLA susceptibility allele for narcolepsy almost in all ethnic groups.And the hypocretin excreting neurons and the hypocretin's deficits would directly lead to somnolence.Some environmental factors which are newly found these years are still playing important roles,such as the contact with certain antigens,infection of beta hemolytic streptococcus,passive smoking and so on.

Objective To explore the best choice mode of repregnancy after cesarean section.Methods 312 cases with repregnancy after cesarean section were divided into the repeat cesarean section (RCS) group (210 cases),vaginal birth after cesarean(VBAC) group (102 cases),and the first time cesarean(PCS)group(210 cases).The maternity delivery mode and outcome were observed and the relevant conditions (postpartum hemorrhage,the average length of hospital stay and hospital costs,etc.) were compared among the three groups.Results The trial production was in 144 cases,and vaginal delivery in 102 cases,the success rate was 70.83％.168 cases with direct vaginal delivery,the success rate was 53.85％.The postpartum hemorrhage of RCS group[(310.5 ± 30.2)ml] was significantly higher than that of VBAC group [(143.5 ± 25.2) ml] (U =7.55,P ＜ 0.01) and PCS group [(244.2 ± 28.3) ml] (U =20.4,P ＜ 0.05).The hospital stay time of RCS group [(7.5 ± 0.2) d] was significantly more than that of VBAC group[(3.0 ±0.3)d] (U =25.50,P ＜0.01)and PCS group[(6.6 ±0.6)d] (U=16.7,P ＜0.05).The hospitalization costs of RCS group [(4 451.5 ± 62.4) yuan] was significantly higher than that of VBAC group [(1 223.6±12.3)yuan](U=71.5,P＜0.01) and PCS group[(3 756.4± 54.6)d](U=25.2,P＜0.01).Conclusion Repregnancy after cesarean section is not absolute indications for cesarean section,vaginal birth is safe and feasible as long as the medical intensive care effectively,and it can reduce the rate of cesarean section.

Objective To investigate the clinical effect and safety of microwave thermosetting joint pingyangmycin injected within the occlusion in treatment of maxillofacial hemangioma.Methods The clinical data of 102 patients with maxillofacial hemangioma were retrospectively analyzed.According to the different period of the different choice of treatment,the patients were divided into microwave thermosetting group and surgery group.The clinical effect,treatment time and hairdressing effect of the two groups were analyzed.Results Total effective rate of microwave thermosetting group was 96.30％,surgery group was 95.83％,the difference between the two groups had no statistical significance (x2 =0.153,P ＞ 0.05).The average surgical time of surgery group was obviously shorter than microwave thermosetting group(t =7.625,P ＜ 0.01),but satisfaction of hairdressing effect in microwave thermosetting group was obviously higher than that of the surgery group(90.74％ vs 75.00％,x2 =4.533,P ＜0.05),the incidence rate of adverse reaction was significantly lower than the surgery group(5.56％ vs 18.75％,x2 =4.262,P ＜ 0.05).The facial nerve injury occurred in 3 patients (6.2 5 ％) after operation in the surgery group,microwave thermosetting group had no facial nerve injury after treatment.There was no recurrence after follow-up for 6 months.Conclusion The clinical effect and hairdressing effect of microwave thermosetting joint pingyangmycin injected within the occlusion in treatment of maxillofacial hemangioma are satisfied,the incidence rate of adverse reaction and complication is relatively low.It is safe and effective,which is worth expanding in clinical practice.