Effect of early enteral nutrition on outcomes of trauma patients requiring intensive care / 中华创伤杂志(英文版)

PURPOSE@#To investigate the effect of early enteral nutrition on outcomes of trauma patients in the intensive care unit (ICU).@*METHODS@#Clinical data of trauma patients in the ICU of Daping Hospital, China from January 2012 to December 2017 was retrospectively analyzed, including patient age, gender, injury mechanism, injury severity score (ISS), nutritional treatment, postoperative complications (wound infection, abdominal abscess, anastomotic rupture, pneumonia), mortality, and adverse events (nausea, vomiting, abdominal distention). Only adult trauma patients who developed bloodstream infection after surgery for damage control were included. Patients were divided into early enteral nutrition group (48 h). Data of all trauma patients were collected by the same investigator. Data were expressed as frequency (percentage), mean ± standard deviation (normal distribution), or median (Q, Q) (non-normal distribution) and analyzed by Chi-square test, Student's t-test, or rank-sum test accordingly. Multiple logistic regression analysis was further adopted to investigate the significant variables with enteral nutrition.@*RESULTS@#Altogether 876 patients were assessed and 110 were eligible for this study, including 93 males and 17 females, with the mean age of (50.0 ± 15.4) years. Traffic accidents (46 cases, 41.8%) and fall from height (31 cases, 28.2%) were the dominant injury mechanism. There were 68 cases in the early enteral nutrition group and 42 cases in the control group. Comparison of general variables between early enteral nutrition group and control group revealed significant difference regarding surgeries of enterectomy (1.5% vs. 19.0%, p = 0.01), ileum/transverse colon/sigmoid colostomy (4.4% vs. 16.3%, p = 0.01) and operation time (h) (3.2 (1.9, 6.1) vs. 4.2 (1.8, 8.8), p = 0.02). Other variables like ISS (p = 0.31), acute physiology and chronic health evaluation≥20 (p = 0.79), etc. had no obvious difference. Chi-square test showed a much better result in early enteral nutrition group than in control group regarding morality (0 vs. 11.9%, p = 0.03), length of hospital stay (days) (76.8 ± 41.4 vs. 81.4 ± 44.7, p = 0.01) and wound infection (10.3% vs. 26.2%, p = 0.03). Logistic regression analysis showed that the incidence of wound infection was related to the duration required to achieve the enteral nutrition standard (OR = 1.095, p = 0.002). Seventy-six patients (69.1%) achieved the nutritional goal within a week and 105 patients (95.5%) in the end. Trauma patients unable to reach the enteral nutrition target within one week were often combined with abdominal infection, peritonitis, bowel resection, intestinal necrosis, intestinal fistula, or septic shock.@*CONCLUSION@#Early enteral nutrition for trauma patients in the ICU is correlated with less wound infection, lower mortality, and shorter hospital stay.

Evaluation of green tangerine peel processed with vinegar using HPLC fingerprint technique / 中国中药杂志

<p><b>OBJECTIVE</b>To develop an HPLC method for determination of fingerprints and evaluate green tangerine peel (GTP) processed with vinegar.</p><p><b>METHOD</b>The samples were extracted with 50% ethanol using ultrasonic bath and analyzed on a Chromasil C18 column eluted with methanol and water containing 0.2% acetic acid in a linear gradient program. The flow rate was 1.0 mL x min(-1), and detection wavelength was set at 280 nm.</p><p><b>RESULT</b>The RSD values of relative retention times and peak areas of main peaks were all less than 5%. The fingerprints of Geqingpi and Sihuaqingpi were different. The fingerprints of the processed and the unprocessed were almost same, and the fingerprint differences among the different batches processed with the same technology from the same unprocessed GTP were not obvious.</p><p><b>CONCLUSION</b>The influence of processing with vinegar on 50% ethanol extracts were not evident, and the technological pross was stable. It was found that the fingerprints of Geqingpi and Sihuaqingpi were different, but it should be study further.</p>

Significance of Determination of Argyrophilic Proteins in Nucleolar Organizer Regions of Blood T Lymphocytes before and after Complete Remission in Children with Acute Leukemia / 实用儿科临床杂志

Objective To detect the argyrophilic proteins in nucleolar organizer regions(Ag-NORs) that express rDNA and rRNA proliferation of T lymphocytes before chemotherapy and after complete remission(CR) in children with primary acute leukemia(AL).Methods The argyrophilic granules area of NOR/nuclear area(I.S%) of T lymphocytes was detected by image analysis system in peripheral blood of 42 patients before chemotherapy and after CR and 30 normal children.Results I.S% in the patients before chemotherapy(5.06%?1.36%) were significantly lower than those in the healthy donors(7.51%?1.06%)(t=8.238 P0.05).Conclusion These results suggest that decrease of Ag-NORs expresses the evidence for tumour induced suppression of immune function of T cells in children with AL prior to treatment.