Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes

Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN＋PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically.

Malignant meningioma of the cerebellopontine angle in a 2-year-old girl:a case report and literature review

Meningioma is a common intracranial tumor in adults.Pediatric cases account for approximately 1.5% of all intracranial meningiomas,and very few cases show malignant histological features.Primary pediatric malignant meningioma in the cerebellopontine angle is extremely uncommon.Herein,we report a 2-yearold girl with malignant meningioma in the cerebellopontine angle.The clinical features,diagnosis,and treatment protocol are discussed.

Clinical observation of Kuntai capsule combined with Fenmotong in treatment of decline of ovarian reserve function

BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruation,amenorrhea,infertility,de-creased libido,and autonomic nervous dysfunction.Fenmatong(FMT)is a com-pound mixture of estradiol tablets and estradiol didroxyprogesterone tablets,which can improve ovarian reserve function by supplementation of exogenous estrogen.However,this treatment has also been shown to cause breast pain,gastrointestinal discomfort,irregular vaginal bleeding,and changes in sexual desire.In severe cases,FMT can promote the development of breast cancer,endometrial cancer,and venous embolic disease.AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve func-tion.METHODS Patients(130)with decreased ovarian reserve function,who were treated in our hospital from May 2018 to May 2020,were divided into two groups:The FMT group,in which patients were treated with FMT,and the observation group,in which patients were treated with Kuntai capsules.Chinese medicine symptom scores,uterine artery blood flow parameters,ovarian ultrasound test indexes,pictorial blood loss assessment chart(PBAC)scores,and hormone levels were recorded,and total effective rates were calculated for both groups.RESULTS The total effective rate in the observation group was higher than that in the FMT group(P<0.05).After treatment,primary symptoms,including low menstrual volume,delayed menstruation,red color and thick consistency of menses,di-zziness,palpitation,weakness at the waist and knee,insomnia and excessive dreaming,irritability,and dryness and astringency of the pudendal canal in the observation group decreased,and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group(P<0.05).The systolic peak flow rate(PSV),end-diastolic flow rate(EDV),ovarian diameter,sinus follicle count,and resistance index(RI)of the uterine arteries in the observation group and FMT group increased after treatment.Notably,the PSV,EDV,ovarian diameter,and antral follicle count in the observation group were higher than those in the FMT group,whereas the RI in the observation group was lower than that in the FMT group(P<0.05).The PBAC scores in the observation and FMT groups increased after treatment,with that in the ob-servation group becoming significantly higher than that in the FMT group(P<0.05).After treatment,estradiol(E2)and anti-Mullerian hormone(AMH)levels increased,whereas follicle-stimulating hormone(FSH)levels decreased in the observation group and FMT group;E2 and AMH levels became significantly higher and FSH levels became significantly lower in the observation group than in the FMT group(P<0.05).CONCLUSION Compared with FMT,Kuntai capsules promoted uterine artery blood circulation,improved menstruation,relieved symptoms,regulated endocrine function,and improved curative effects.

揿针治疗老年膝关节骨性关节炎疗效观察:随机对照试验

Objective:To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis(KOA)and compared with medication.Methods:A total of 60 patients were randomized into a thumb-tack needling group and a medication group,30 cases in each one.In the thumb-tack needling group,the therapy with the thumb-tack needle retaining and waiting for qi was adopted.The acupoints were Hèdǐng(EX-LE2鹤顶),Nèixīyǎn(内膝眼EX-LE4),Dúbí(犊鼻ST35),Xuèhái(血海SP10),Liángqiū(梁丘ST34)and Ashi points on the affected side.The needles were retained for 24 h.This therapy was given once every two days,3 times a week.The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required.In the medication group,diclofenac sodium sustained release tablets were taken orally,75 mg each time,once daily,consecutively for 4 weeks.Successively,the score of visual analogue scale(VAS)at the affected knee before treatment,after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated.The clinical therapeutic effect was observed in the patients of the two groups after treatment.Results:(1)After treatment,VAS scores were reduced as compared with those before treatment in the patients of the two groups(both P<0.05).After treatment,VAS score in the thumb-tack needling group was lower than that in the medication group(P<0.05).(2)After treatment,the scores of all the items of Lequesne indices reduced as compared with those before treatment in the patients of the both groups,indicating significance differences(all P<0.05).After treatment,compared with the medication group,the score of pain,morning stiffness and walking ability as well as the total score were all lower in the thumb-tack needling group,indicating significant differences(all P<0.05).(3)The curative and remarkably effective rate and the total effective rate were 66.7%and 93.3%in the thumb-tack needling group,higher than 56.7%and 86.7%in the medication group respectively(both P<0.05).Conclusion:The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group.Hence,this therapy deserves to be promoted in clinical practice.