Patients with SAP have a hypermetabolic and hypercatabolic state.Nutritional support for patients with SAP is needed.EN by the jejunal route does not stimulate pancreatic secretions and is safe.At present,the beneficeal effects of EN towards improving the nutritional condition,protecting gut barrier function,reducing translocation of bacteria and endotoxins,modulating the inflammatory response,and decreasing the cost have been observed.Therefore,the EN rather than PN should be used by the jejunal route to provide nutritional support for patients with SAP.

Acute kidney injury(AKI) is a common clinical severe emergency in children,with high morbidity,mortality and poor prognosis.The traditional indicators such as serum creatinine and urine can't diagnose early.Recently,with the deepening research of AKI,many higher specific and sensitive biomarkers have been found.But the study of biomarkers in children is behind the adult,and the etiology,pathophysiology of AKI in children have great difference from adult.So this paper will show the advances of biomarkers in children of AKI.

Objective To verify the targeting regulatory relationship between microRNA (miR)-21-5p and mitogen-activated protein kinase kinase 3 (MKK3).Methods miR-21-5p and MKK3 targeted relationship was analyzed by bioinformatics database predict.Constructing MKK3 3'UTR reporter vector (MKK3-3U) and mutation reporter vector (MKK3-3 U-M) was constructed by synthesizing miR-21-5p mimics (mimic),miR-2 1-5p inhibitor (inhibitor),nonsense miR (NC).NC (NC1 group),mimics (mimic1 group),inhibitor (inhibitor1 group) together with MKK3-3U cotransfected human embryonic kidney (HEK293) cells,respectively.Empty vector-pYr-MirTarget (NC2 group),MKK33U (Mt group),M KK3-3U-M (Mut group) together with mimic co-transfected HEK293,respectively.The fluorescence ratio was detected by dual luciferase assay.NC,mimics,inhibitor intervened human renal tubular epithelial (HK-2) cells,respectively.RT-PCR and Western blot were used to test cell MKK3 expression level in HK-2.Results 1.The fluorescence ratios of NC1 group,mimicsl group,and inhibitor1 group were 100.00％,67.99％,133.17％,and there was difference between mimic1 group and NC1 group(t =19.93,P ＜ 0.05).2.The fluorescence ratios of NC2 group,Mt group and Mut group were 100.00％,65.30％,98.48％,and there was difference between Mt group and NC2 group (t =14.39,P ＜ 0.05).There was no significant difference between NC2 and Mut group (t =0.63,P ＞ 0.05).3.MKK3 mRNA relative expression levels of the control group mimic2 group and inhibitor2 group were 1.36 ± 0.02,1.01 ± 0.04,1.43 ± 0.06 ; relative protein expression levels were 0.97 ± 0.05,0.62 ± 0.06,1.36 ± 0.32.MKK3 mRNA and protein levels of mimic2 group were significantly lower compared with the control group (F =85.98,118.26,all P ＜ 0.01).Conclusions MKK3 is the target gene of miR-21-5p.miR-21-5p can regulate the expression of MKK3 both in mRNA and protein levels.miR-21-5p may be an important regulatory molecule in p38 mitogen-activated protein kinase signaling pathway.

Objective To discuss the therapeutic effect of recombinant human CTLA-4Ig fusion protein (rhCTLA-4Ig) on rheumatoid arthritis (RA) patients and the change of T helper cells 17 (Th1 7 ) and regulatory T (Treg) cells.Methods Forty-eight active RA patients were randomly divided into the treatment group and the control group.Treatment group received 12 weeks of infusions of rhCTLA-4Ig ( 10 mg/kg),while the control group received 12 weeks of infusions of placebo.The changes of expression levels of Th17cell were detected by flow cytometry.The changes of expression level of FoxP3 in monocytes of the peripheral blood were examined by RT-PCR.T test and x2 test were used for statistical analysis.Results ① Eighteen of 24 cases in treatment group showed good ACR20 changes after 12 weeks,the effective rate (75％) was significantly higher than that of the control group ( 1/24,4％ ).After treatment,DAS28 score of the treatment group (3.0±0.7) was significantly lower than that of the control group(6.9±0.7) (t=-12.39,P＜0.01 ).② Compared with the Th17 monocytes of the peripheral blood from active RA patients of treatment group after therapy (0.22±0.20)％,the Th17 monocytes of peripheral blood from active RA patients of the control group (1.63±0.47)％ were higher (t=5.61,P＜0.05 ).③ Compared with the FoxP3 mRNA of the control group (0.24±0.05),that of the treatment group (0.88±0.18) was significantly higher after therapy (t=7.56,P＜0.01 ).Conclusion The clinical parameters of RA patients have improved significantly after the treatment,and the Th17 and Treg cells balance is also restored after rhCTLA-4Ig therapy.

Acupuncture Therapy ; Adrenal Insufficiency ; therapy ; Adult ; Humans ; Male

Objective To elucidate the clinical features, diagnosis and treatment of Aspergillus necrotizing bronchitis. Methods Medical records and investigation data from 5 eases of Aspergillus necrotizing bronchitis were retrospectively analyzed, and related literatures were reviewed. Results Five patients (3 males and 2 females) with mean age of 63.6 y were enrolled in this study. All patients had histopathologically proved necrotizing aspergillosis of the large airways. Common presentations included cough, short of breath, sputum production, fever and haemoptysis. Tracheoscopy presentations included necrosis, mucous hyperemia, focal airway constriction and neoplasm. The CT findings included bronchial wall thickening, narrowing of the bronchial lumen, which was often associated with distal obstructive pneumonia. Conclusions The clinical manifestations of Aspergillus necrotizing bronchitis are nonspecific, and histopatholagical diagnosis is essential for a definite diagnosis and can be supported by tracheoscope or imaging techniques.

BACKGROUND: Nowadays, aerobic exercise has been a theme of mod ern body-building. Therefore, there are practical significance of under standing and mastering the effect of aerobic exercise on the constitution of body builder in instructing body-building practice. OBJECTIVE: To observe the effect of aerobic exercise on body composi tion, cardiore spiratory function and body figure of female college students. DESIGN: Non-randomized concurrent control experiment. SETTING: China Female College. PARTICIPANTS: The experiment was conducted from May 2003 to Oc tober 2004. 100 female college students were randomly selected from Chi na Female College and other three colleges and taken as the aerobic exer cise group. Another 100 female college students of the same age without systematic aerobic exercise were taken as the control group. METHODS: ①The course for aerobic exercise group were mainly aero bics, ballroom dancing and hexagram boxing, including 5-15 minutes of warming up, 30-45 minutes of aerobic exercise [the target heart rate in (75% maximal heart rate) exercise lasted for at least 15 minutes] and 15-20 minutes of cooling down, which were conducted for 60 minutes each time and twice a week. The exercise should be performed at 2.5 hours before supper for 1.5 years.②Subjects in the control group were not inter fered but kept in same diet and resting time as the aerobic exercise group. MAIN OUTCOME MEASURES: ①Body figure indexes: body height, body mass, chest circumference, waistline, hip circumferences.②Skinfold thickness, fat mass index and lean body mass. ③ Lung capacity, maximal breathing capacity in each minute, stroke volume, cardiac output, ejection fraction, heart rate, ejection time, mean normalized systolic ejection rate (MNSER) and left velocity of circumferential fiber shortening (LVCf). RESULTS: A total of 200 subjects, who had accomplished all tests were involved in the analysis of results. ①The waistline was smaller after exer cise in the aerobic exercise group than that in the control group, while the chest circumference and hip circumferences were bigger than those in the control group (P ＜ 0.05), and the waist-to-hip ratio was smaller than that in the control group (6.50±10.48, 70.39±11.24, P ＜ 0.05). There was no sig nificant difference in body mass index between the two groups (P ＜ 0.05). ②The skinfold thickness in rump, scapular region, thoracic region, abdom inal region as well as femoral region and region of shank were smaller after exercise in the aerobic exercise group than those in the control group (P＜0.05-0.005), and the body fat percentage was significantly smaller than that in the control group [(20.5±3.45)%, (26.5±4.58)%,P ＜ 0.005]. However, the lean body mass in the aerobic exercise group was greater than that in the control group [(41.8±9.86), (36.9±8.69) kg,P ＜ 0.01].③ After exercise, the lung capacity, maximal breathing capacity in each min utes, stroke volume, MNSER and LVCf in the aerobic exercise group were remarkably greater than those in the control group (P ＜ 0.05). CONCLUSION: ①Aerobic exercise can effectively ameliorate the body figure of female college students and coordinate three measurements with each other.②Aerobic exercise can greatly reduce the in vivo fat contents of female students and increase their lean body mass. ③Aerobic exercise can remarkably enhance the lung capacity, pulmonary ventilation volume as well as cardiac functions of blood-pumping and contraction etc. In female college students.

Objective To observe clinical effect of treating glaucoma with compound trabeeuleetomy combined with activating blood circulation and promoting diuresis Chinese medicine. Methods 42 cases with glaucoma were randomly divided into two groups by means of random number table. The control group was treated with compound trabeculeetomy, and the treatment group was treated with Chinese medicine after compound trabeeuleetomy. The regular reexamination was performed, and follow-up visit was executed for an average of 12 months. Results Compared with the control group, the postoperative vision in the treatment group increased significantly (λ2=4.511, P<0.05) , and intraocular pressure decreased significantly (λ2=3.638,P< 0.05); The rate of anterior chamber in the treatment group was lower than that of the control group(λ2=4.256 P< 0.05) . Both groups had filtering bleb, and the rate of non-functional filter blebs in the treatment group was lower than that of the control group (λ2=3.054, P< 0.05 ) . Conclusion The therapy of compound trabeculectomy combined with Chinese medicine on glaucoma was better than compound trabeculeetomy only.

Objective To investigate the clinical significance of the three iodide transporters in thyroid diseases. Methods Literatures about the Na+/I-symporter (NIS), pendrin and human apical iodide transporter (hAIT) in recent years were reviewed and their expressions in different thyroid diseases were also analyzed. Results NIS proteins express at the basolateral membrane of thyrocytes in normal thyroid tissue, while pendrin and hAIT proteins are limited to the apical membrane of thyrocytes lining in the follicular lumen. In the tissues of thyroid carcinomas, it was found that the NIS proteins expressed in the cytoplasm and their expressions decreased; The mutation of NIS gene may be one of the main causes of congenital hypothyroidism. The expression of prendrin protein may be related to the function of follicles: its expression level increased significantly both in Graves diseases and toxic adenomas, but significantly decreased in differentiated thyroid carcinoma. However, the correlation between the decrease and the degrees of differentiation of carcinoma cell line are still disputable. The expression of hAIT protein does not significantly altered in hyperfunctioning tissues. It only slightly decreased occasionally in hypofunctioning adenomas, but it decreased significantly in thyroid carcinomas. Conclusion The abnormal expressions of the three iodide transporters may be related closely with the type of thyroid diseases. However, their pathogenic mechanisms and the causes of their abnormal expression are still unknown, which need to be studied further.

Objective To compare the disadvantages and advantages of open thyroid surgery when using the harmonic scalpel (HS) vs conventional hemostasis (CH). MethodsOne hundred and fifty-one patients and 70 patients underwent thyroid surgery with HS or CH respectively. The tumor diameter, incisional length, the total operative time, thyroidectomy time, intraoperative bleeding volume, postoperative drainage volume and surgical complications were compared. The incisional length and the surgical complications in and after learning curve with harmonic scalpel were compared. ResultsThere was no significant difference between the HS and CH group at baseline. Incisional length, total operative time, thyroidectomy time, intraoperative bleeding volume and postoperative drainage volume in HS group were significantly lower than those of CH group (P0.05); the incisional length after learning curve was shorter than that in learning curve in HS group (P