Objective To quantitatively detect the circulating DNA in plasma of patients with acute pancreatitis and to evaluate its potential clinical values. Methods Blood samples collected from 40 patients with mild acute pancreatitis (MAP), 20 with severe acute pancreatitis (SAP) and 50healthy controls were extracted for DNA using genomic DNA extraction kit. The DNA level was detected by real-time fluorescence quantitative PCR assay. The clinical association of DNA level with acute pancreatitis was analyzed. The receiver operating characteristic (ROC) curve was set up. Results The median concentration of plasma DNA in SAP group was 24.84 ng/ml, which was significantly higher than that in MAP group (7.60 ng/ml, P=0.006) and the healthy controls (5.23 ng/ml, P=0.000). The median concentration of plasma DNA in patients with acute pancreatitis was higher than in healthy controls (P=0.006), however, there was no significant difference between MAP group and healthy controls (P=0.322).The area under the ROC curve performed by the plasma DNA from SAP and MAP groups was 0. 881(95% CI, 0.773-0.989). With a cutoff value of 11.20 ng/ml, the overall sensitivity was 19/20% and specificity was 72.5%. Plasma DNA level was found to be associated with APACHE-Ⅱ score (P=0.001), Ranson score (P=0. 013), serum Ca2+ level (P=0.000), and c-reactive protein levels (P=0.001). Conclusions Plasma DNA is correlated with the extent of pancreatitis. It can be used in monitoring the development of acute pancreatitis and may be a potential marker for early diagnosis of SAP.

This report summarized the nursing experience of caring for twice skin grafts in a patient with enteroatmospheric fistula after trauma.Keys to nursing success including:monitoring vital signs closely to prevent septic shock,blocking enteroatmospheric fistula (EAF) and sucking overflowed intestinal juice timely,promoting the protection of the graft on abdominal wall wounds,strengthing drainage and lavage with the application of abdominal double cannula to control abdominal infection,early nutrion support with parenteral nutrition in combination with trophic enteral nutrition to improve intestinal immune function,and attaching importance to post-traumatic stress disorder.Timely blocking of EAF is the bases of skin graft healing.

A microfluidic chip with micropillar arrays for three-dimensional (3D) cell culture was designed and validated.The chip consisted of a polydimethylsiloxane (PDMS) channel plate and a glass cover plate.One cell culture chamber composed of two rows of micropillar arrays and two lateral channels for transporting the culture medium were integrated on the PDMS channel plate.The spacing between micropillars directly affects the chip performance, which is critical for the design of the chip.In this work, the spacing between micropillars was optimized by numerical simulation and experimental validation.With the optimized microfluidic chip, the mixture of cells and extracellular matrix mimics could be steadily injected into the cell culture chamber, the nutrients in the culture medium from the lateral channels could quickly diffuse into the chamber, and the cell metabolites could also timely diffuse out of the chamber.To test the stability of the microenvironment in the microfluidic chip, neural stem cells were three-dimensionally cultured.

Objective To investigate the relationship between serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and clinicopathological features and prognosis of serous ovarian cancer retrospectively. Methods A total of 73 patients with serous ovarian cancer treated in the Department of Obstetrics and Gynecology of Tianjin Medical University General Hospital from January 2000 to December 2015 were included in this study. The relationship between serum FSH, LH, PRL and clinicopathological features was analyzed by Mann-Whitney U method. Kaplan-Meier (K-M) method was used to analyze survival rates of patients with different clinical features. Multivariate Cox proportional hazards regression analysis was used to analyze prognostic factors of serous ovarian cancer patients. Results The mean concentrations of serum FSH and LH were significantly higher in the>50 year-old group than those in the<50 year-old group (P<0.05). The mean concentrations of FSH and LH were significantly higher in menopause group than those in non-menopause group (P<0.05). There were no significant differences in serum levels of FSH and LH in patients with other different clinicopathological features (P>0.05). There was no significant correlation between serum PRL concentration and clinicopathological features (P>0.05). Analysis results showed that poor prognosis of patients was related with high serum levels of FSH (>40.13 IU/L), PRL (>14.96 μg/L) and FIGO stage (Ⅲ+Ⅳ) (P<0.05). There was no significant correlation between serum LH concentration and prognosis (P>0.05). COX regression analysis showed that the serum PRL>14.96 μg/L was risk factor for prognosis of serous ovarian cancer [HR(95%CI): 3.530(1.180-10.557),P=0.024]. Conclusion The serum levels of FSH and LH are significantly increased in postmenopausal women than those in menopause women. The serum level of PRL is correlated with the prognosis of serous ovarian cancer.

Objective To observe the effect of somatostatin combined with transcatheter arterial infusion chemotherapy in the treatment of malignant intestinal obstruction.Methods 60 patients with malignant intestinal obstruction were enrolled in our hospital from January 2013 to June 2015.The rats were randomly divided into 4 groups: the conventional group(n=15),the growth inhibition group(n=15),the low dose intra-arterial infusion chemotherapy group(n=15)and somatostatin plus low-dose intra-arterial infusion chemotherapy group(n=15).The clinical symptom remission time,duration of clinical symptom remission and survival time were compared between the four groups.Results The study showed that somatostatin group of gastrointestinal decompression and symptom remission time were significantly better than the conventional group.Especially the symptom remission time is significantly faster than the conventional group and chemotherapy group(P< 0.05); the duration of chemotherapy group and somatostatin+artery perfusion chemotherapy group in survival time and relieve symptoms,were significantly better than the conventional group and somatostatin group(P< 0.05).Conclusion Somatostatin is beneficial to reduce the amount of gastrointestinal decompression in the treatment of malignant intestinal obstruction.Celiac artery infusion chemotherapy can help to improve the maintenance time and prolong the survival time of patients with malignant obstruction.The combination of somatostatin and celiac artery infusion chemotherapy is beneficial to relieve the symptoms and prolong the time interval,and improve the survival time of patients.

Objective To investigate the effect of minocycline ointment in chronic periodontitis and its auxiliary efficacy on local inflammatory response.Methods From February to September 2022,88 patients with chronic periodontitis treated were randomly divided into control group(routine treatment)and study group(treated with minocycline ointment),44 cases in each group.The clinical therapeutic effects,inflammatory factors in gingival crevicular fluid,periodontal improvement and collagen indexes of the two groups were compared.Results At 2 weeks of treatment,the total clinical effective rates of the two groups were 81.82%and 63.64%respectively.The study group was slightly higher than the control group,but the difference was not statistically significant(P>0.05).At 4 weeks of treatment,the total effective rate in the study group(95.45%)was higher than that in the control group(77.27%),the difference was statistically significant(P<0.05).At 2 and 4 weeks of treatment,the levels of hypersensitive-C-reactive protein and interleukin-10 inflammatory factors in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).At 2 and 4 weeks of treatment,the levels of plaque index,gingival index and periodontal pocket depth in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).after one course of treatment and two courses of treatment,the collagen index of gingival crevicular fluid in the study group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Minocycline ointment can improve the inflammatory reaction process and microecological balance of local periodontal tissue in patients with chronic periodontitis.It has important clinical significance for promoting the recovery of periodontal tissue and is one of the ideal ways for clinical treatment of chronic periodontitis.

Objective:To observe the clinical efficacy of combining contralateral needling and tendon-bone balancing Tuina(Chinese therapeutic massage)in treating scapulohumeral periarthritis(SP). Methods:Sixty-eight eligible participants were chosen and randomized into an acupuncture group and an acupuncture plus Tuina group,with 34 cases in each group.The acupuncture group received treatment with contralateral needling,and the acupuncture plus Tuina group was treated with contralateral needling combined with tendon-bone balancing Tuina.The post-treatment changes in the Constant-Murley score for comprehensive shoulder function,visual analog scale(VAS)score for pain,and shoulder range of motion(ROM)score were compared after 2 treatment courses to estimate the clinical efficacy in the two groups. Results:After treatment,the total effective rate was 96.7%in the acupuncture plus Tuina group versus 83.9%in the acupuncture group,showing a significant difference between the two groups(P<0.05).The Constant-Murley shoulder function score increased in the acupuncture plus Tuina group after the intervention;a decreased VAS pain score and an increased shoulder ROM score were found in both groups.After 1 and 2 treatment courses,the between-group comparisons of the Constant-Murley and shoulder ROM scores showed statistical significance(P<0.05).Regarding the VAS score,the acupuncture plus Tuina group was lower than the acupuncture group after the first treatment course(P<0.05),but there was no significant difference between the two groups after 2 treatment courses(P>0.05). Conclusion:Contralateral needling plus tendon-bone balancing Tuina can produce more significant clinical efficacy and relieve pain faster than contralateral needling alone in treating SP.

Objective To determine the proportion of CD4+ CD25+ regulatory T (Treg) cells,mRNA expression of the forkhead box protein 3 (Foxp3) gene,and DNA methylation status of the Foxp3 promoter in peripheral CD4+ T cells from patients with Henoch-Sch(o)nlein purpura.Methods Totally,20 inpatients with Henoch-Sch(o)nlein purpura and 20 healthy controls were enrolled from Department of Dermatology,the Second Xiangya Hospital of Central South University between 2015 and 2016,and there were no significant differences in the gender and age between the two groups (both P ＞ 0.05).CD4+ T cells were isolated from the peripheral blood samples of these subjects.Real-time fluorescence-based quantitative PCR was performed to detect the mRNA expression of the Foxp3 gene,flow cytometry to determine the proportion of CD4 + CD25+ Treg cells,and sodium bisulfite sequencing PCR (BSP) to determine the DNA methylation status of the Foxp3 promoter.Statistical analysis was carried out with SPSS16.0 software by using two-sample t test for the comparison between the two groups,and linear correlation analysis for evaluating the correlations of the DNA methylation status of the Foxp3 promoter with clinical severity scores and the proportion of CD4+CD25+ Treg cells.Results Compared with the healthy control group,the Henoch-Sch(o)nlein purpura group showed significantly decreased mRNA expression of the Foxp3 gene in CD4+ T cells (0.380 ± 0.226 vs.1,t =9.503,P ＜ 0.01),proportion of CD4+CD25+ Treg cells (1.668％ ± 0.959％ vs.2.741％ ± 1.131％,t =2.552,P ＜ 0.05),but significantly increased DNA methylation status of the Foxp3 promoter (0.712 ± 0.164 vs.0.453 ± 0.147,t =3.610,P ＜ 0.01).In the Henoch-Sch(o)nlein purpura group,the DNA methylation status of the Foxp3 promoter was negatively correlated with the percentage of CD4+CD25+ Treg cells (r =-0.490,P ＜ 0.05),but positively correlated with the clinical severity scores (r =0.486,P ＜ 0.05).The DNA methylation level of the Foxp3 promoter was significantly higher in the patients with renal impairment than in those without renal impairment (P ＜0.05).Conclusion The patients with Henoch-Sch(o)nlein purpura showed increased DNA methylation status of the Foxp3 promoter in CD4+ T cells,decreased mRNA expression of the Foxp3 gene and proportion of CD4+CD25+ Treg cells,which may be related to the occurrence of Henoch-Sch(o)nlein purpura,and affect disease development and prognosis.

Objective? To explore the current status of feeding interruption of early enteral nutrition among critical patients and its related factors. Methods? From June 2017 to March 2018, we selected critical patients with early enteral nutrition at a ClassⅢ Grade A hospital in Nanjing by convenience sampling. We recorded the enteral nutrition intake of patients within one week. All of the patients were divided into three groups based on the total time of feeding interruption including group A (＜4 hours), group B (4 to 24 hours) and group C (＞24 hours). The general information, calorie and prognostic factors of patients in three groups were compared and the related factors of feeding interruption time were analyzed with the multiple linear regression. Results? A total of 198 patients were enrolled including 108 of them in group A, 56 in group B and 34 in group C. There was a statistical difference in the completion rate of actual calorie in three groups (P＜ 0.05). Multiple linear regression analysis showed that the feeding interruption time of enteral nutrition were positively correlated with the disease severity, hospitalization expense and target calorie (P＜0.05). Conclusions? The incidence of feeding interruption is high in critical patients with enteral nutrition. The longer the interruption time is, the higher the risk of caloric inadequacy. At present, there is no standardized feeding strategy which needs to explore the best intervention by clinical researches so as to solve the problem of feeding interruption among critical patients.

Critical ill children are generally at risk of malnutrition.Malnutrition can reduce immunity and cause a series of problems such as growth and development stagnation, increased infections and aggravation of illness. Early nutritional support is an important part of treatment and an important guarantee for successful treatment of children. This article reviews the status of early enteral nutrition, intolerance-related symptoms, tolerance monitoring and process management in critical ill children.