0.05).However,there were significant differences between group C and A,group C and B,respectively(Pa

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.

Objective To investigate the accuracy of analgesia/nociception index (ANI) in assessing the severity of postoperative pain in patients.Methods Eighty patients,aged 21-77 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective operation,were admitted to the postanesthesia care unit after the patients were extubated at the end of operation,and ANI was monitored.Immediately after admission to the postanesthesia care unit (T0),numerical rating scale (NRS) score was recorded.If NRS score was 0-3,the patients received no treatment,and NRS score was recorded again 10 min later (T1).If NRS score was 4-10,fentanyl 50 μg was injected intravenously,and NRS score was recorded again 5 min later (T2).ANI value was recorded at T0,T1 and T2.NRS score was considered as the criterion for assessment of the severity of pain.The receiver operating characteristic curve was used to analyze the sensitivity and specificity of ANI in determining NRS scores,the cut-off value was determined,and the area under the curve and 95％ confidence interval were calculated.Pearson correlation was used to analyze the correlation between ANI and NRS score.Results The area under the curve (95％ confidence interval) of ANI in determining NRS scores was 0.873 (0.816-0.929),and the cut-off value was 45 with a sensitivity of 74.8％ and a specificity of 87.5％.ANI was negatively correlated with NRS score,and the correlation coefficient was-0.705 (P＜0.05).Conclusion ANI provides high accuracy in assessing the severity of postoperative pain with a cut-off value of 45 in the patients.

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

This article was aimed to explore the method of traditional Chinese medicine (TCM) health maintenance knowledge base building. TCM health maintenance knowledge classification method was studied under the guidance of TCM health maintenance classification system to construct a special literature database to store TCM health maintenance knowledge. Based on TCM literature resources, TCM health maintenance knowledge service platform was designed and developed for the static display and dynamic query support of TCM health maintenance knowledge. The content of knowledge base will be accessed to the whole society. The results showed that the construction method can be a system arrangement and modern interpretation of TCM health maintenance knowledge, in order to support TCM health maintenance knowledge base and its update and service system. It was concluded that under the guidance of TCM theories, the construction of TCM health maintenance knowledge base will realize the health maintenance knowledge-sharing and service requirement of TCM.

Objective To study the early protective effect of NADPH on human umbilical vein endothelial cells (HUVECs) and the expression of occludin and MMP9 induced by oxygen glucose deprivation and reoxygenation (OGD/R). Methods HUVECs were cultured and divided into blank control group, OGD/R group and OGD/R+NADPH 20 μmol/L group. The proliferation of HUVECs after treatment was detected by CCK-8 assay. The cytotoxicity was detected by LDH release assay. The morphological changes of HUVECs were observed by inverted microscope. Superoxide dismutase (SOD MDA) activity and malondialdehyde (MDA) were detected by commercially available kit. The expressions of occludin and MMP9 were detected by Western blot assay. Results Compared with the OGD/R, NADPH enhanced the cell viability significantly (P<0.05), reduced the release of LDH (P<0.05), promoted the maintance of HUVECs morphology, reduced MDA generation (P<0.05) and increased SOD activity (P<0.05). Following OGD/R,the treatment of NADPH can inhibit MMP9 level (P<0.05) and promote the recovery of occludin level (P<0.05). Conclusion NADPH can protect HUVECs from the damage induced by OGD/R by reducing oxidative stress and regulating the expressions of MMP9 and occludin.

Objective To detect the change of cerebral perfusion in pediatric patients with Leigh's syndrome (LS)by using MR perfusion technique.Methods Twelve patients with Leigh's syndrome and thirteen normal children were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T_1 measurement (FAIREST).Their relative cerebral blood flow(rCBF)values were obtained in regions of bilateral basilar nuclei and bilateral thalami.Student t-test was used to compare them between the two groups and receiver operating characteristic(ROC)curve analysis was carried out.Results Statistical analysis revealed significant difference between two groups in the regions of bilateral basilar nuclei and right thalamus(t =3.26,P =0.002;t =2.25 ,P =0.018 ;t =2.88 ,P =0.004,respectively).The rCBF values for LS group and control group were 0.432?0.158 and 0.619?0.125 for right basilar nuclear, 0.478?0.186 and 0.621?0.123 for left basilar nuclear,0.630?0.189 and 0.833?0.160 for right thalamus,respectively.The areas under the ROC curves were 0.833 and 0.756 for the rCBF of right and left basilar nuclear,respectively.Conclusion Relative CBF maps may reveal changes of cerebral blood flow in some specific brain regions in patients with Leigh's syndrome.It can provide additional information to the clinicians in the evaluation of the disease.

Objective To investigate the value of the new method with bilateral lip mueosa flaps for central defect reconstruction of upper-lip vermilion. Methods On both sides of the central defect of upper lip vermilion, reverse triangular flaps was designed below the junction between vermilion and mucosal. These two flaps had the common pedicle of vermilion depression site. Incisions of "(λ)" shape were de-signed below the defect area and the flaps included mucosa and submucous tissue. This mueosa flaps were raised and orbicularis otis muscles under the flaps were free moderately. Bilateral orbicularis oris muscles were sutured under the common pedicle of the two mucosa flaps. Then the bilateral mucosa flaps were ro-tated down 90° and inserted into the " (λ)" shape incisions to increase the tissue volume of the middle upper lip and deepen the labiogingival sulcus. The common pediele of the bilateral mucosa flaps was formed to the vermilion tubercle and then the incisions were sutured layer by layer. Results The technique was per-formed on 26 patients including 18 cases of upper-lip vermilion defect after repair of bilateral cleft lip,4 ca-ses of upper-lip vermilion defect after repair of unilateral cleft lip and 4 cases of congenital malformation. All the lip mucosa flaps survived completely without any complications. The vermilion, tubercle and shape of the lips were satisfactory after all cases were repaired and all incision scars were concealed. Con-clusions Using the lip mucosa flaps transfer to repair vermilion defect with the same tissue can obtain satisfactory appearance. The lip mucosa flaps are ideal for repairing of the lip vermilion defect and recove-ring of the profile of labial arch and vermilion tubercle. It can be used widely in any cases with the central defect of upper lip vermilion.

Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence. Conclusion Compared with the traditional methods,this one may decrease the damage to the upper lid and frontalis area, leaving no risk of damaging the vessels or nerves. The technique is simple and the curative effect is affirmed. It can be used to treat any blepharoptosis patient with normal frontal muscle function.

Objective To reveal the relationship between a certain ratio of the length to width of a slender narrow pedicle and random flap in survival area with an experimental study. Methods 25 pigs were randomly divided into 5 groups. The ratio of length to width of slender narrow pedicle in 5 groups was different and every ratio's slender narrow pedicle was carrying 5 different sizes of random flaps. In each group, these 5 flaps were created randomly in each pigs' bilateral back. The flaps were evaluated with the general observation, fluorescence examination, blood flow ECT test, and computerized analysis of survival area. Results When the ratio of the length to width of the slender narrow pedicle was constant, along with the flap area increased, the flap survival area also increased, but when the flap reached a certain area, the distal flap would develop necrosis, the flap survival area would not reduce; when the flap size remained unchanged, along with the ratio of the length to width of the slender narrow pedicle increased, the flap survival area was not affected, but, when the ratio of the length to width of the slender narrow pedicle increased to a certain limit, distal flap would lead to necrosis, and the flap survival area would reduce. Conclusion The slender narrow pedicle flap is a new and practical random flap. The pedicle of random flap can be designed as slender shape, and the ratio of pedicle width to flap length is far less than traditional ratio. Increasing the flap size or ratio of the length to width of a slender narrow pedicle in a certain extent will not lead to flap necrosis.