Objective: To evaluate the effect of early enteral nutrition(EEN) on gastric acid secretion in patients with severe brain injury.Methods: 168 patients with severe brain injury(GCS≤8)were divided randomly into two groups.84 patients were given EEN by naso-gastric tube as EEN group and 84 patients were treated with parenteral nutrition(PN)as PN group.Gastric juice pH and upper gastrointestinal hemorrhage were monitored on admission,the 3rd,5th and 7th day after admission.Results: The gastric juice pH was significantly lowered in EEN group.Conclusion: EEN could neutralize gastric acid and increase the gastric juice pH in patients with severe brain injury.

Objective To understand the clinical features and laboratory examination and diagnosis of Langerhas cell histio-cytosis (LCH) in newborns. Methods Retrospective analysis of the clinical data of a neonatal case of LCH was performed. Results A one-day-old girl was admitted with chief complaint of eating less, less crying and skin rash for one day. The unequal sized rash was on the head, limbs, trunk, toe and oral mucosa. The skin rashes were protruding from the skin and were partially broken and crusted. Biopsy of the skin tissue showed the expression of S-100 and CD1α, consistent with the diagnosis of LCH. Conclusions When new-borns have special rash after birth, LCH should be considered. To avoid misdiagnosis, skin biopsy should be performed.

Objective To understand the prevalence of hypertension and selenium intake of the residents in rural areas of Jilin province,and to discuss the relationship between selenium intake and the prevalence of hypertension, and to provide reference for prevention and therapy of hypertension.Methods A total of 1 380 inhabitants in rural areas of Jilin province were selected by way of cluster sampling to conduct dietary investigation,physical and blood examination.The selenium intake was categorized into three groups according to tritiles after adjusted by energy, and the relative risk for incidence of hypertension in each group was estimate by using the Logistic regression model with the first group as the reference.Results The prevalence of hypertension in the study area was 37.4%.The average for selenium intake was 35.908μg·d-1 and was lower than the standard level of selenium recommended by RNI.After adjustment for other risk factors,the relative risk for incidence of hypertension for different selenium intakes in the men was 1.00,0.471(95%CI 0.290-0.765),and 0.596(95%CI 0.373-0.951),the P values were 0.002 and 0.030. There was no significant relationship between selenium intake and the incidence of hypertension in the women,and there was also no significant relationship between Han people and Korean people in China.Conclusion The selenium intake is the influencing factor affecting the incidence of hypertension of the male rural residents in Jilin province,which reminds that the increasing selenium intake is helpful for the prevention of male hypertension.

Objective To establish characteristic spectrum of ginsenosides in Panax quinquefolium from Liuba. Methods Using C_(18) solid phase-extraction cartridges, main ginsenosides from 40% ethanol extracts of P. quinquefolium were purified. Then the samples were analyzed by HPLC-EMS. Results(From the) total ion spectrum of P. quinquefolium, 3 stronger peaks were selected. Based on them, characteristic corresponding spectrum of ginsenosides in P. quinquefolium from Liuba was established. Conclusion This method has reliable reproducibility and precision. Its simple pretreatment, easily operation, and rapidly analytic procedure show that this method is suitable for identifying P. quinquefolium.

ObjectiveTo evaluate the significance of CK19 mRNA monitoring in peripheral blood of breast cancer patients.MethodsPeripheral blood samples were collected from 137 breast cancer patients preoperatively,one day post-operation,7 days,1,3,6,12,18,and 24 months after operation.RTPCR was used to detect CK19 mRNA expression.The relationships were analyzed between CK19 mRNA expression and treatment result, between CK19 mRNA expression and clinicopathological parameters.ResultsThere was no significant difference between the level of CK19 mRNA as tested preoperatively,and 1,7 days postoperatively(P ＞ 0.05 ).From one month and thereafter,CK 19 mRNA decreased significantly when compared with that immediate perioperatives ( P ＜ 0.05 ). Postoperative peripheral CK19 mRNA expression increased in those found with recurrent or metastasized tumors ( P ＜ 0.01 ). CK19 mRNA expression does not correlate with patient's menstrual status,estrogen receptor expression,progesterone receptor expression,HER-2 expression and Ki67 proliferation expression (P ＞ 0.05 ). But there was statistically significant correlation between CK19 mRNA expression and tumour size,histology grading,pathological type,lymph node metastasis ( P ＜ 0.01 ).ConclusionsIn breast cancer patients peripheral blood CK19 mRNA expression is correlated with risk clinicopathological parameters, and increases in patients with postoperative recurrence and tumor metastasis.

Objective To investigate the cerebral infarction patterns and pathogenesis in patients with internal carotid artery (ICA) and middle cerebral artery (MCA) severe stenosis (the degree of stenosis 70％- 99％ ) or occlusion in order to provide evidence for the individualized prevention and treatment strategies. Methods Seventy-six patients with acute cerebral infarction who showed the responsible lesions at the corresponding MCA territory on diffusion-weighted imaging (DWI) were analyzed retrospectively. The patients were divided into ICA lesion, MCA lesion and negative result on digital subtraction angiography and CT angiogaphy (NR) groups according to the vascular examinations. Their infarcts were divided into single and multiple infarctions. According to the positions, the former was divided into perforating artery infarct (PAI), pial infarct (PI), and border-zone infarct (BZ). Results The infarct morphologies in the MCA territory were divided into 9 types. The different lesions caused infarct morphologies were different (x2 =34. 000, P =0. 001). The distribution pattern of multiinfarcts accounted for 73.68％ of all patients (56/76). The distribution pattern of PAI + PI in the ICA lesion group was significantly more than that in the NR goup (17/42 vs. 1/16,x2 =6. 837, P =0. 009). There were some correlations between the degree of artery stenosis and the infarct morphology. The severe ICA lesions mostly showed PAI with PI (7/17 vs. 1/16,x2 =5. 475, P =0. 019), and the severe MCA lesions mostly showed PAI with BZ (3/8 vs. 1/17,x2 =4. 046, P =0. 040). Conclusions In patients with cerebral infarction of ICA or MCA severe stenosis or occlusion, most of them showed multiinfarct pattern. This suggested that the different mechanisms of stroke onset might be associated with the arterial-arterial embolization or hypoperfusion.

BACKGROUND: Frenulum of prepuce of penis contained many nerve terminals is an extremely sensitive region. If the frenulum is injured in circumcision or other operations, the complication, such as postoperative spontaneous pain of penis, sexual disturbance and so on, will occur. But there still is no define explanation for this up to now.OBJECTIVE: To observe the distribution of immunoreactive nerve terminal of calcitonin gene-related peptide (CGRP) in prepuce of penis and frenulum of prepuce of adult SD rats, and look for the source of CGRP immunoreactive nerve terminal in frenulum of prepuce.DESIGN: A single sample trial.SETTING:Department of Anatomy, School of Medicine, Zhejiang University.MATERIALS: The experiment was performed at Department of Anatomy,School of Medicine. Zhejiang University from September 2004 to May 2005. A total of 20 adult male SD rats were selected, and were raised in warm, quiet, photophygous environment for 1 week before the trial so as to make the rats fit for the environment and maintain their basal state.METHODS: The rats were assigned randomly into 2 groups. Ten rats in the first group were treated with the immunohistochemical method to observe the distribution of CGRP immunoreactive nerve terminal in prepuce of penis and frenulum of prepuce of adult rats. Ten rats in the second group were treated with fluorogold (FG) retrograde labeled combined with CGRP immunofluorescence labeled method to look for the source of CGRP immunoreactive nerve terminal in frenulum of prepuce of penis. MAIN OUTCOME MEASURES: ①The morphology and distribution of CGRP immunoreactive nerve terminal in prepuee of penis and frenulum of prepuce of adult SD rats were observed under light microscope. ②The distributive density and difference of CGRP immunoreactive nerve terminal in prepuce of penis and frenulum of prepuce were detected and compared (represented by A). ③Morphology and distribution of FG retrograde labeled -positive, CGRP single-labeled positive and FG/CGRP double-labeled positive neurons in dorsal root ganglion were observe under fluorescence microscope. ④Mean quantity of FG retrograde labeled positive, CGRP single abeled positive and FG/CGRP double-labeled positive neurons in dorsal root ganglion was counted.RESULTS: Totally 20 rats were involved in the analysis of results. ① Amber-coloured CGRP immunoreactive nerve terminal appeared in prepuce of penis and frenulum of prepuce of adult rats. These nerve terminal mainly occurred in basal layer of epidermis and papillary layer of dermis, distributed as twig shape or intestiniform; mostly of them were bundled, different in length, and some of them showed enlarged nodosity. ②The distributive density of CGRP immunoreactive nerve terminal in frenulum of prepuce of penis was significantly larger than that in prepuce of penis (2.15±0.32, 1.02±0.22,t =-2.03,P＜0.01). ③Combined with the FG retrograde labeled method it was found that these nerve terminal was derived from neurons of dorsal root ganglion opposed to the sixth lumbar spinal cord and the neurons of dorsal root ganglion opposed to the first acral spinal cord. FG retrograde labeled positive neurons differed in length. The cell body showed round or orbicular-ovate, without obvious prominence. Bright inaurate fine particle appeared in cytoplasm, no label in nucleus. Most cells arranged in line along nerve tract or diffusedly distributed. Most CGRP single-labeled positive neurons were middle or small cells found by CGRP immunofluorescence labeling. Dyeing was too dark.Reaction product distributed evenly in cytoplasm, which showed bright dark green (FITC labeled color). The same positive section was observed comparatively under different excitation light. It was found that FG/CGRP double-labeled positive cells were middle or small, and its amount accounted for a half of the total number of FG retrograde positive cells.CONCLUSION: CGRP may participate the transmission of sensory information in prepuce of penis and frenulum of prepuce of rats. The CGRP immunoreactive nerve terminal in frenulum of prepuce of penis of rats is sourced from neurons of dorsal root ganglion opposed to the sixth lumbar spinal cord and the neurons of dorsal root ganglion opposed to the first sacral spinal cord.

Objective: To investigate the relationship of loss of P16 expression with biologlical behaviors and prognosis of gastrointestinal stromal tumors(GISTs). Methods: The expression of P16 protein and mRNA was detected in GISTs tissues by immunohistochemistry,Western blot and RT-PCR.The prognosis was evaluated through follow up. Results: The expression rates of P16 protein and mRNA in GISTs were 53.8%(21/39，Frozen tissue)，51.3%(20/39，Frozen tissues)and 51.4%(37/72，Paraffin-embedded tissues)，respectively.The expression of P16 was significantly different among GISTs of different aggressive risk(P<0.05).With the incease of aggressive risk，the expression of P16 was deceased.The expression of P16 was negtively correlated with Ki-67 and patient survival(P<0.05). Conclusion: The loss of P16 expression has a positive correlation with the infiltration and progression of GIST.Detection of P16 protein and mRNA is helpful for the evalutaion of biological behaviors and prognosis of gastrointestinal stromal tumors.

ObjectiveTo investigate the relevant factors influencing the incidence and mortality of post cardiac arrest syndrome (PCAS), and to provide the basis of improvement of resuscitation rate.Methods A single center retrospective study of cardiopulmonary resuscitation (CPR) according to Utstein model was conducted. A clinical case report form was designed to collect clinical data. The clinical data of patients whose spontaneous circulation was restored (ROSC)> 24 hours in intensive care unit (ICU) of the First Hospital of Jilin University from January 2008 to June 2014 were collected and analyzed. The relevant risk factors of the incidence and mortality rate of PCAS were screened and analyzed by multivariate logistic regression analysis.Results① Successful CPR was achieved in 93 patients, of whom 83 patients were shown to have systemic inflammatory response syndrome (SIRS), and 75 patients suffered from PCAS (80.65%). Among them 49 died, and 18 patients who did not suffer from PCAS survived.② The age, gender, history of previous chronic disease, site of occurrence of cardiac arrest, type of rhythm when cardiac arrest occurred, and dosage of adrenaline showed no significant influence on the incidence of PCAS. The incidence of PCAS was elevated when defibrillation was done more than 3 times (χ2= 10.806,P= 0.001), SIRS occurred after ROSC (χ2= 46.687,P< 0.001), interval between collapse and first defibrillation over 5 minutes (χ2 = 6.429,P = 0.011), interval between collapse and CPR longer than 5 minutes (χ2 = 4.638,P = 0.031), interval between collapse and administration of first resuscitation medication> 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P< 0.001). Bivariate correlation showed that interval between collapse and CPR, interval between collapse and administration of first resuscitation medications, and ROSC time were all correlated (r1 = 0.677,r2 = 0.481,r3 = 0.617, allP< 0.001).③ There were no significant relations between the prognosis of PCAS patients and times of defibrillation, the amount of adrenaline used, and interval between collapse and first defibrillation. The mortality rate of PCAS was relatively elevated when interval between collapse and CRP was longer than 5 minutes (χ2 = 10.792,P = 0.001), interval between collapse and administration of first resuscitation medications was longer than 5 minutes (χ2 = 13.841,P< 0.001), ROSC time> 10 minutes (χ2 = 36.451,P< 0.001), the number of dysfunction organ≥ 4 (χ2 = 28.287,P< 0.001), arterial blood lactate levels> 2 mmol/L (χ2 = 28.926, P< 0.001), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score> 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

Objective To systematically evaluate the safety and effectiveness of interventional uterine artery embolization (UAE) in treating symptomatic uterine fibroids by comparing it with surgical therapy. Methods Computer retrieval of the Cochrane Library, PubMed, EMbase, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, etc. was conducted. The retrieval time was from the inception to July 2014. The academic papers that were related to the randomly controlled test (RCT) of UAE and surgical treatment for symptomatic uterine fibroids were collected, and the reference literatures were also searched for. Two reviewers screened the literatures according to the inclusion and exclusion criteria, the useful data were extracted and the qualities were evaluated. Meta-analysis was performed by using RevMan 5.2 software. Results A total of 6 RCTs were finally obtained, including 732 patients in total. Meta-analysis indicated that both the hospitalization time and recovery time in UAE group were shorter than those in surgery group. No significant differences in health -related quality of life, patient’s satisfaction, intra -operation complications, the recurrence rate and main complications within one year existed between UAE group and surgery group; while the differences in the incidence of minor complications within one year and the need of further intervention rate during 2 -5 years were statistically significant, the occurrence of these minor complications in UAE group being higher than that in the surgery group. The pregnancy rate and live-birth rate in UAE group were significantly lower than those in the surgery group. Conclusion Compared with surgery, UAE has many advantages, such as technically-safe, excellent therapeutic effect, simply-manipulated, easy-nursing, mini-invasive, quick-recovery and easily-accepted by patient, etc. although there is risk of receiving intervention treatment again. The influence of UAE on the fertility, the influence of different embolic agents on the therapeutic effect of UAE, and the effectiveness of UAE for multiple uterine fibroids need to be further studied.