The nutritional support has become an important part of the management of pa- tients with severe head injury.Fifty- two cases were supported by early nutritional supplement.The result showed that themortality and morbidity were decreased.It is experienced that early nutritional support may reduce the loss of body protein and vis- ceral proteins,increase the function of cellu- lar immune system and promote the recov- ery of impaired nerves.

Objective To study the clinical characteristics of neonatal pertussis.Method From January 2011 to December 2015,clinical data of newborns with pertussis treated in our hospital were retrospectively analyzed,including the general information,clinical manifestations,laboratory examinations,treatment and prognosis.Result A total of 68 newborns with pertussis were found during the study period,including 1 case in 2011,5 cases in 2012,1 case in 2013,18 cases in 2014 and 43 cases in 2015.The time needed for diagnosis was 7 to 35 days after onset of symptoms,and 80.9％ (55/68) in 14 days.The predominant manifestation was paroxysmal cough (68 cases,100％).Other common symptoms included flushing in 45 cases (66.2％) and cyanosis with coughing in 40 cases (58.8％).The uncommon symptoms included whooping cough (20 cases,29.4％),wheezing (10 cases,14.7％),fever (3 cases,4.4％) and apnea with decreased heart rate during cough (2 cases,2.9％).12 patients (17.6％) had elevated peripheral white blood cells or lymphocytes.The clinical manifestations didn't disappear despite erythromycin therapy,and the whooping cough continued for 12 to 42 days during the course of disease.22 cases (32.4％) had complications,including pneumonia in 12 cases,myocardial damage in 10 cases,heart failure in 2 cases,respiratory failure in 1 case,atrial tachycardia in 1 case and lung consolidation in 1 case.Conclusion Neonatal pertussis is not uncommon and has a tendency to increase year by year,and it's challenging for early diagnosis.The patients who have a whooping cough without fever should be considered of pertussis until otherwise ruled out.Leukocyte and lymphocyte count are of little value in the diagnosis of this disease.

Problems in metrology work in special hospital are elaborated,such as poor law awareness,repeated break-down of metrology equipment,etc.Improvement suggestions are put forward including emphasis on well-constituted metrology staff and adequate equipment purchase,cooperation in clinical departments,strengthening the management of metrology equipment at all levels,reinforcing the work function of the leading group in metrology management.This study is significant in supporting medical treatment and enhancing the hospital medical quality.

Maxillary sinusitis is a common condition in nose section. Traditional operations are always have more complications and easy to relapse, seriously affectting the quality of patient's life. The application of functional endoscopic sinus surgery (FESS) makes a qualitative progress on surgical treatment of maxillary sinusitis. In re- cent years, the researchs found that there are still unsatisfactories to long-term curative effect of some patients With the development of minimally invasive, people begin doubting its "functional". Recently, some new treat- merits have emerged in the world, but their safety and effectiveness needs further research. To seek for a better treatment, this article reviews the development and the existential problems of maxillary sinusitis surgery.
Endoscopy ; Humans ; Maxillary Sinusitis ; surgery ; Nose ; physiopathology ; surgery ; Recurrence

Objective To evaluate the effects of valsartan and angiotensin-converting enzyme inhibitors on the excretion rate of urinary albumm(UAER) and the clearance of endogenous creatinine(Cr-C) in elderly patients.Methods 120 elderly patients with stage of the 2～3 class hypertension were included.The patients were divided into 3 groups,the valsartan group and the benazpril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment.Results No significantly different anti-hypertensive effects were observed in valsartan,benazpril and captopril.But the effects of UAER,Cr-C in valsartan group had significant changes compared with the other groups,and the three groups had significant differentiation(P

To obtain an ideal recombinant C-terminal fragment of the merozoite surface protein of Plasmodium falciparum in the Pichia pastoris expression system, the major surface protein-119 (MSP-119) gene sequence bearing the 6-his gene was inserted into expression vector pPIC9k and the target gene was transformed to the susceptible yeast cells GS115 by using electroporation. The multiple inserts were screened and the successfully expressed MSP-119 protein with the relative molecular weight of 12kDa in the supernatants of cell cultures could be detected by SDS-PAGE. Meanwhile, Western blot analysis also demonstrated that this protein reacted with mouse anti-MSP-119 monoclonal antibody, and the expression level of MSP-119 was more than 1.0 g/L. It is concluded that this recombinant protein expressed in the Pichia pastoris expression system resembles the native proteins existed.

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.

Objective To understand the clinical characters and imaging features of Mirizzi syndrome.Methods All 15 patients were confirmed by operation , including 10 females and 5 males , aged 41～82 (mean age 65.1 years old). The course ranged from 4 days to 15 years. Among them, ERCP were performed in 8 patients, PTC in 2 patients, MRCP in 4 patients and CT in 3 patients.Results Cholangiography of Mirizzi syndrome revealed a broad, curvilinear impression on the common hepatic duct in the area where the cystic duct or gallbladder was in direct apposition, hepatic bile duct dilation above the level of the cystic duct. 6 cases were diagnosed to be Mirizzi syndrome preoperatively (3 cases in ERCP , 2 cases in PTC , 1 case in MRCP), 7 cases bile duct stone, 1 case bile duct dilation, 1 case normal. Conclusion Mirizzi syndrome is a rare disease . No pathognomonic features appear in either the history or the physical examination .Diagnosis requires a combination of ultrasonography , cholangiography (ERCP,PTC), CT and MRI .

Objective:To summarize the clinical experience of surgical treatment abdominal gastrointestinal foreign body in children, thus to provide a theoretical basis for clinical decision-making.Methods:The clinical data, including age distribution, clinical manifestations, surgical treatment strategy and prognosis, from 60 children with abdominal gastrointestinal foreign body treated by operation in Children's hospital of Hu′nan Province from January 2015 to June 2020, were retrospectively analyzed. Among the 60 children, 38 males and 22 females, with a median age of 2.9 years. Observation data included the type and location of foreign bodies in the digestive tract, clinical manifestations and surgical methods, operation time, intraoperative blood loss, postoperative hospital stay. The following-up time was 6 months to 2 years by telephone or clinic. The short/long-term complications was observed.Results:Children under 3 years old accounted for 56.7%. Types of foreign bodies included magnetic foreign bodies, sharp objects[paper clips, nails, screws, fish bone and others, etc], crystal ball, jujube pit, gastric hair stone, batteries and badminton holder. The foreign bodies were mainly located in stomach and small intestine. Abdominal pain and vomiting were the most common symptoms. The patients of foreign body with long residence time had peritonitis such as fever and abdominal pain, among 21 cases were combined with gastrointestinal perforation. There were varieties kind of operaion methods, including gastrointestinal incision and foreign bodies removal( n=22), appendectomy and foreign bodies removal( n=7), repair of gastrointestinal perforation( n=6), intestinal resection and anastomosis( n=17), intestinal resection plus enterostomy( n=5)but whose fistula was closed after 3 months, lateral wall of rectum repair( n=3). Fifty-two patients underwent common open abdomen operation, 8 patients underwent laparoscopic operation. The operating time was(93.5±19.3) min. Intraoperative blood loss was(20.2±4.3) mL. The postoperative hospitalization was 13(5, 19) d. The postoperative complications occurred in 3 patients who were nonoperative treatment recovery. Conclusions:Magnetic foreign body, sharp foreign body, crystal ball, jujube nucleus and corrosive foreign body are the main causes of digestive tract obstruction and perforation in children. Individualized operation plan should be selected as soon as possible according to the number of foreign bodies, retention position and whether or not digestive tract perforation.

Objective To investigate the clinical value of human soluble endothelial protein C receptor (sEPCR) after heart valve replacement.Methods 78 cases of patients with heart valve replacement in the Second Affiliated Hospital of Nantong University from January 2005 to June 2016 were selected as the research objects,who were divided into embolic group and control group,38 cases in embolic group and 40 cases in control group,the index of two groups 1 d preoperative,while dynamic monitoring international standardization ratio (INR) and embolism,were detected,of which INR and sEPCR were examined.The INR and sEPCR oftwo groups was compared with t test.Results The INR and sEPCR of two groups 1 d preoperative had no significant difference (1.24±0.32 vs 1.23±0.19,34.91±9.14 μg/L vs 35.56±10.22 μg/L;t=0.17,P =0.868;t=0.30,P=0.768,respectively).The average value of dynamic monitoring INR in control group had no significant difference when compared with the results of embolism (1.86±0.95 vs 1.93±0.97,t=0.32,P=0.748).But the sEPCR had significant difference (101.33±27.15 μg/L vs 41.67±11.82 μg/L,t=12.69,P=0.000).Conclusion The important indexes of sEPCR could effectively guide the anticoagulant treatment,especially those who with the sEPCR value too high,the embolic threatening should be paid attention to.