肠内营养液的温度、速度对胃肠道并发症的影响

目的:探讨不同温度、速度肠内营养(enteral nutrition,EN)液输注对患者胃肠道并发症的影响.方法:将240例进行EN的患者根据使用加温营养泵与否,分为观察组与对照组,各120例.同时将观察组再根据营养泵给液速度,分为01、02、03 3组,对照组也根据以上方法,分为C1、C2、C3 3组,每组40例.01、C1组EN泵给液速度为60-70 mL/h,02、C2组EN泵给液速80-100 mL/h,03、C3组EN泵给液速度为110-120 mL/h.观察各组患者胃肠道并发症的发生情况.结果:观察组与对照组在胃肠道并发症发生率、胃潴留发生情况、EN时间方面比较差异有统计学意义;同时,不同的输注速度在上述方面比较差异有统计学意义.结论:通过使用加温营养泵,温度控制在37℃-40℃,且输注速度在80-100 mL/h时可有效减少胃肠道并发症的发生,达到临床满意的效果,值得临床推广应用.     

Antiretroviral Therapy Fails to Restore Levels of HIV-1 Restriction miRNAs in PBMCs of HIV-1-infected MSM

A number of cellular microRNAs (miRNAs) have been identified to have the ability to inhibit HIV-1 replication. In this study, we examined the impact of combination antiretroviral therapy (cART) on the expression of HIV-1 restriction miRNAs in peripheral blood mononuclear cells of HIV-1–infected men who have sex with men (MSM). Compared with male healthy donors, HIV-infected MSM had significantly lower levels of 9 HIV-1 restriction miRNAs. The treatment of HIV-1–infected MSM with cART, however, failed to restore the levels of these miRNAs in peripheral blood mononuclear cells. These observations suggest that the suppression of the cellular restriction miRNAs by HIV-1 may attribute to the virus latency during cART.     

Biomechanical behavior of brain injury caused by sticks using finite element model and Hybrid-III testing

Objective: To study the biomechanical mechanism of head injuries beaten with sticks, which is common in the battery or assaultive cases. Methods: In this study, the Hybrid-III anthropomorphic test device and finite element model (FEM) of the total human model for safety (THUMS) head were used to determine the biomechanical response of head while being beaten with different sticks. Total eight Hybrid-III tests and four finite element simulations were conducted. The contact force, resultant acceleration of head center of gravity, intracranial pressure and von Mises stress were calculated to determine the different biomechanical behavior of head with beaten by different sticks. Results: In Hybrid-III tests, the stick in each group demonstrated the similar kinematic behavior under the same loading condition. The peak values of the resultant acceleration for thick iron stick group, thin iron stick group, thick wooden stick group and thin wooden stick group were 203.4 g, 221.1 g, 170.5 g and 122.2 g respectively. In finite element simulations, positive intracranial pressure was initially observed in the frontal comparing with negative intracranial pressure in the contra-coup site. Subsequently the intracranial pressure in the coup site was decreasing toward negative value while the contra-coup intracranial pressure increasing toward positive values. Conclusions: The results illustrated that the stiffer and larger the stick was, the higher the von Mises stress, contact force and intracranial pressure were. We believed that the results in the Hybrid-III tests and THUMS head simulations for brain injury beaten with sticks could be reliable and useful for better understanding the injury mechanism.     

Pregnancy and myelodysplastic syndrome: an analysis of the clinical characteristics,maternal and fetal outcomes

Objective: To investigate the clinical characteristics, management, maternal and fetal outcomes in pregnant patients with myelodysplastic syndrome (MDS).

Methods: A retrospective analysis was conducted on 25 pregnant women with MDS between June 1998 and January 2013. The clinical data were summarized. These patients were divided into poor outcome group and control group, and regression analysis was conducted to find the risk factors for maternal and fetal outcomes.

Results: Five patients developed premature birth, five patients developed postpartum hemorrhage, one patient developed postpartum acute cardiac failure and one patient developed postpartum cerebral infarction. Twenty out of the 25 patients underwent complete follow-up and 17 newborns were normal during follow-up. The regression analysis shows anemia and gestational hypertension are the primary risk factors for poor outcomes, whereas age, first onset of hematological disease, WBC count and platelet count are not significantly associated with the outcomes.

Discussion: Anemia and gestational hypertension may be the primary risk factors for poor maternal and fetal outcomes in pregnant patients with MDS. To avoid maternal and neonatal complications, a minimum of hemoglobin level >70?g/L, platelet count >30?×?10⁹/L and WBC count >3?×?10⁹/L, are recommended. Close monitoring on blood routine, maternal complications and active supportive treatment are recommended.     

血府逐瘀汤治疗代偿期乙肝肝硬化临床治疗效果研究

目的:对血府逐瘀汤治疗代偿期乙肝肝硬化临床治疗效果进行探讨研究。方法:选取我院接收治疗的100例代偿期乙肝肝硬化患者,随机划分成研究组、对照组,每组50例,对照组接受常规内科药物治疗,研究组基于对照组接受血府逐瘀汤治疗,就两个组别临床治疗效果进行观察对比。结果:研究组总有效率96.0%相较于对照组80.0%显著更优(P0.05)。结论:血府逐瘀汤应用于治疗代偿期乙肝肝硬化临床效果满意,具备临床推广意义。