In recent years, premature birth rate has increased due to the development of medical technology and the change of socioeconomic environment.In order to reduce the possibilities of extrauterine growth retardation and neural development retardation among premature infants, nutrition support should be fully paid attention to in clinical settings.Currently, nutritional intervention for premature infants mainly adopts enteral or parenteral nutrition.Parenteral nutrition is prescribed according to the recommended value in China Neonatal Nutrition Support Application Guide, individualized for premature infants.Enteral nutrition commonly uses breast milk, milk supplements, premature infant formula milk, hydrolyzed protein milk and formula milk after discharge.In this review, we summarized the clinical application of nutritional intervention in premature infants.

OBJECTIVE:To study the adsorption of disposable transfusion connective tube and infusion needle for single use only to nitroglycerin in intravenous injection via minipump.METHODS:The intravenous injection via minipump was im-itated;the concentration change of nitroglycerin during the injection process was determined by the high performance liquid chromatography(HPLC)and ultraviolet spectrophotometry.RESULTS:Disposable transfusion connective tube and infusion needle for single use only had significant adsorption to nitroglycerin with an mean adsorption rate at(73.88?2.05)%within8hours.CONCLUSION:It is unsuitable to use those disposable transfusion connective tubes and infusion needles for single use only that have strong adsorption to nitroglycerin in the intravenous injection of nitroglycerin via minipump.

BACKGROUND:Mesenchymal stem cells from human skeletal muscle exhibit multi-directional differentiation potential under the influence of osteogenic proteins such as bone morphogenetic protein 4 (BMP4). But the differentiation of a specific cell subpopulation is not yet clear.OBJECTIVE:To characterize the multi-directional differentiation potential of mesenchymal stem cells from human skeletal muscle based on the expression of different surface markers.METHODS:Four different subpopulations were isolated from the human skeletal muscle by fluorescence-activated cell sorting based on their expression of the myogenic-specific marker CD56 and the endothelial-specific markers CD34 and CD144, including CD56+, CD56+CD34+CD144+, CD34+CD144+, and unsorted groups. Osteogenic differentiation of the four groups of the cells was displayed by Von Kossa staining after the treatment with BMP4 alone or BMP4 plus transforming growth factor β3. Chondrogenic differentiation of these cells was displayed by Alcian blue staining. Bone metabolism was assessed by alkaline phosphatase staining.RESULTS AND CONCLUSION:No significant difference in the bone metabolism was found among four groups after the treatment with BMP4 (P > 0.05). Osteogenic and chondrogenic potentials of the four cell subpopulations were significantly different. Under the same osteogenic induction, the CD56+ cells exhibited strongest potential for osteogenic differentiation; and under the same chondrogenic induction, the CD56+CD34+CD144+ cells exhibited better potential for chondrogenic differentiation than the CD56+ cells. These findings indicate that the osteogenic and chondrogenic potentials are intimately associated with the type of mesenchymal stem cells from human skeletal muscle:the CD56+ cells are closely related to the osteogenic potential, while the CD56+CD34+CD144+ cells have stronger chondrogenic potential.

ObjectiveTo compare the prognosis of patiens with acute(within 72 hours) subarachnoid hemorrhage (SAH) within or without the clinical standardized pathway(CSP).Methods123 acute SAH cases were collected before CSP established meanwhile another 146 cases after CSP established from 2005 to 2009 in neurological intensive care unit of our hospital. Information such as age, gender, Hunt-Hess and CT-Fisher grade, timing and result of digital subtraction arteriography, treating time of aneurysm, and Modified Rankin Scale(MRS) at different time were recorded. Rehaemorrhagia, complications, mortality, prognosis and average stay were compared between two groups.ResultsThere was a significant difference between two groups in rehaemorrhagia, vasospasm，hydrocephaly, mortality, prognosis and average stay.ConclusionCSP is helpful to improve the prognosis of aneurysm subarachnoid hemorrhage.

Objective To investigate the expression and clinical significance of Rho GDP dissociation inhibitor 2 (Rho-GDI2) in pancreatic cancer.Methods Immunohistochemistry and RT-PCR were used to evaluate the expression of Rho-GDI2 in 60 pairs of pancreatic cancer tissues and adjacent pancreatic tissues,and its correlation with clinicopathological parameter of pancreatic cancer was also analyzed.Results The expressions of Rho-GDI2 mRNA were 0.661 ± 0.021 and 0.199 ± 0.023 in pancreatic cancer tissues and adjacent pancreatic tissues,and the positive rate of Rho-GDI2 protein expression were 73.3％ (44/60) and 41.7％ (25/60),the positive rate of Rho-GDI2 expression in pancreatic cancer tissues was higher than that of adjacent normal tissues,and the difference between the two groups was statistically significant (P ＜ 0.01).The expression of Rho-GDI2 was strongly correlated with tumor size,differentiation,staging,lymph node metastasis,vascular invasion (P＜0.05),but it was not associated with gender,age,tumor location (P ＞0.05).Conclusions Rho-GDI2 expression is up-regulated in pancreatic cancer,and is strongly correlated with the malignant biological behavior of pancreatic cancer.

Objective To evaluate the application value of denaturing high-performance liquid chromatography (DHPLC) as a rapid gene typing tool for β thalassemia. Methods 226 suspicious samples were screened with MCV, RDW, erythrocytcte agility and hemoglobin electrophoresis. The final diagnosis ofβ thalassemia genotype was made by DHPLC and PCR-reverse dot blot (PCR-RDB). Results Sixty-nine samples (30. 5% ) were eventually diagnosed as βthalassemia by PCR-RDB. The genotyping results for βthalassemia identified by DHPLC were complete agreement with genotyping results by PCR-RDB. We found 37 cases of CD41/CD42 ( - TCTT) frame shift mutation(54% ) ; 12 cases of IVS - Ⅱ - 654 (C→T) insertion mutation( 17% ) ;10 cases of TATA - 28 (A→G) transcription mutation ( 15% ) ;5 cases of CD17 (A→T)nonsense mutation ( 7% ) ; 5 cases of CD71/CD72 ( + A) frame shift mutation (7%). Conclusion The DHPLC is a rapid, sensitive , efficient and highly accurate assay in the diagnosis of β-thalassemia.

Cystectomy ; Female ; Humans ; Intrauterine Devices

Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.

Objective To analyze the clinical, radiological, pathological and microbiological features of invasive pulmonary aspergillosis (IPA) to improve clinical management.Methods Retrospective analysis of 20 pathologically and/or microbiologically confirmed IPA cases in our hospital from January 2005 to August 2008. Results Group A (with underlying diseases) included 13 patients (underlying malignancy in 9 patients, including 5 cases of hematological malignancy, COPD in 2 patients, pulmonary tuberculosis and bronchiectasis in 1 each). Group B (without underlying disease) included 7 patients (2 patients with a long time of fluffy toy contact, another 1 had exposure to moldy rice, and 3 had exposure to polluted water). All these 20 patients had pulmonary invasion revealed by CT imaging. Multiple changes were identified in 16 patients. Bilateral pulmonary infiltrates and/or consolidation were revealed in 7 patients. Multiple nodules were seen in 9 patients. Four patients had solitary lesions, including isolated nodules in 2 patients and segment consolidation in the other 2 patients. Pulmonary cavity without fluid level was found in 8 patients (40.0%). Eighteen cases received antifungal therapy. The overall efficacy rate was 55.6%. The efficacy rate in group A and B was 45.5% and 5/7 respectively. The average time to symptomatic relief was (12.0±2.8) days. The time to lung lesion improvement on CT was (17.4±2.9) days. The time to significant CT improvement was (34.3±9.9) days. The time to the resolution of active lesion was (56.4±6.2) days.Conclusions IPA may occur in immunocompetent patients without underlying disease. Most IPA patients have bilateral multiple pulmonary nodules and cavities on CT. The time to the resolution of active pulmonary lesions is about 6 weeks.

BACKGROUND: In patients with obstructive sleep apnea(OSA),the degree of severity of OSA is mostly related to the sleep time spent in the supine position. According to the apnea-hypopnea index(AHI), positional and n onpositional OSA has been distinguished.OBJECTIVE: To compare the clinical characteristics of positional and nonpositional OSA and investigatethe relationship between sleep position and respiratory function of patients with OSA.DESIGN: A comparative clinica] observation based on the OSA patients.SETTING: Center of Sleep Disorders,Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: From October 1998 to May 2002,225 patients were examined with overnight polysomnography in the Center of Sleep Disorders,Department of Respiratory Disease, Nanjing General Hospital of Nanjing Command. According to the inclusion criteria of ① AHI≥10 times/hour;② Sleep time in supine and lateral positions≥30 minutes; ③ Over 20years of age; 225 patients were selected from the total of 415 consecutive patients,including 63 with positional and 162 with nonpositional OSA.METHODS: All patients received overnight monitoring with HMS-5500polysomnography system(Respironics Inc USA) in the sleep laboratory. Queries for a detailed case history and physical examination were performed with the pulmonary functions evaluated with body p lethysmography. The clinical data and results of polysomnographic and pulmonary function tests were compared between the two groups of patients and a multiple stepwise regression analysis was employed to evaluate the determinant factors for sleep position dependence of the patients' condition.MAIN OUTCOME MEASURES: Main outcome: Comparisons of the clinical data,polysomnographic result and pulmonary function between the two groups. Secondary outcome: Correlation between classification of OSA and the clinical data.RESULTS: Totally 63 (28%) of the 225 OSA patients were identified as the positional type,who had significantly greater body mass index (BMI)then the nonpositional type patients [(43.46 ± 16.43) kg/m2 vs (23.90 ± 12.36) kg/m2,t =3. 977,P<0.01]. Except for sleeping time in lateral and supine positions, minimal SatO2 and basic SatO2 before the matching for BMI,all the other factors in polysomnograms of the two groups were significant different(P<0.05 or P<0.01). After BMI matching,all the measurements were identical to those recorded for the primary grouping with the exception of nocturnal limb movement frequency,which differed but insignificant between the two groups. The pulmonary function in the two groups was no significant difference(P>0.05) . Multiple stepwise regression analysis indicated that AHI and BMI were the two determinant factors for positional dependence of OSA with a predictive power of 26. 2%. Linear correlation analysis showed correlation of AHI and SatO2 with BMI in the whole group and nonpositional group(P<0.05 or P<0.01),but not in the positional group (P>0.05).CONCLUSION: About one-third of the OSA patients shows sleep position dependence,who may respond favorably to sleep position training. Sufficient patency can be retained in the upper airway of these patients to relieve respiratory obstruction during sleep and improve the respiratory function.