Exogenous NT-3 Promotes Phenotype Switch of Resident Macrophages and Improves Sciatic Nerve Injury through AMPK/NF-κB Signaling Pathway.

Neurotrophin-3 (NT-3) is an important family of neurotrophic factors with extensive neurotrophic activity, which can maintain the survival and regeneration of nerve cells. However, the mechanism of NT-3 on macrophage phenotype transformation after sciatic nerve injury is not clear. In this study, we constructed a scientific nerve compression injury animal model and administered different doses of NT-3 treatment through osmotic minipump. 7 days after surgery, we collected sciatic nerve tissue and observed the distribution of macrophage phenotype through iNOS and CD206 immunofluorescence. During the experiment, regular postoperative observations were conducted on rats. After the experiment, sciatic nerve tissue was collected for HE staining, myelin staining, immunofluorescence staining, and Western blot analysis. To verify the role of the AMPK/NF-κB pathway, we applied the AMPK inhibitor Compound C and the NF-κB inhibitor BAY11-7082 to repeat the above experiment. Our experimental results reveal that NT-3 promotes sciatic nerve injury repair and polarization of M2 macrophage phenotype, promotes AMPK activation, and inhibits NF-κB activation. The repair effect of high concentration NT-3 on sciatic nerve injury is significantly enhanced compared to low concentration. Compound C administration can weaken the effect of NT-3, while BAY 11-7082 can enhance the effect of NT-3. In short, NT-3 significantly improves sciatic nerve injury in rats, promotes sciatic nerve function repair, accelerates M2 macrophage phenotype polarization, and improves neuroinflammatory response. The protective effects of NT-3 mentioned above are partially related to the AMPK/NF-κB signal axis.

A Rapid and Safe Minimally Invasive Procedure for Percutaneous Pedicle Screw Removal: A Case-Control Study and Technical Description.

Purpose: Percutaneous pedicle screw fixation is a common minimally invasive treatment for traumatic thoracolumbar and lumbar fractures; however, research on hardware removal after successful healing is limited. We aimed to introduce a rapid, safe, minimally invasive, and cost-effective method for percutaneous pedicle screw removal. Patients and Methods: We conducted a retrospective analysis of demographic (age, sex, body mass index, alcohol use, and current smoking), clinical (hypertension and diabetes mellitus), surgical (affected levels, number of screws, time of surgery, and blood loss), and treatment cost characteristics of 92 patients who had undergone percutaneous pedicle screw removal between May 2016 and February 2023. The first 57 patients underwent the conventional method, and the remaining 35 underwent the modified method. Independent-sample t-tests and chi-square tests were used to compare continuous and categorical variables, respectively, between the two groups. Results: No significant differences were observed in the demographic parameters, complications, or affected levels between the groups. However, the average surgical time (P=0.000) was significantly shorter, and the average blood loss volume (P=0.002) and total cost (P=0.000) were significantly lower in the modified group than in the conventional group. Conclusion: Compared with the conventional method, our modified method can shorten the surgical time, reduce blood loss, and reduce the total cost of treatment. It is a quick and safe minimally invasive method that does not require additional surgical instruments and is suitable for implementation in primary hospitals.

Evaluation of the clinical efficacy of the bilateral pedicle cement anchoring technique in percutaneous vertebroplasty for Kümmell disease.

The present study aimed to evaluate the clinical efficacy of the bilateral pedicle cement anchoring technique combined with the postural reduction in percutaneous vertebroplasty (PVP) for Kümmell disease. For this purpose, a retrospective study was performed on 18 patients with Kümmell disease who between January 2018 and June 2021 underwent bilateral pedicle cement anchoring combined with postural reduction in PVP. Pre- and post-operative bone mineral density, injected cement volume, visual analogue scale (VAS) values, Oswestry disability index (ODI) scores, Cobb angle measurements and anterior vertebral height (AVH) were recorded and assessed. The mean follow-up duration was 8.4±1.2 months. The average VAS score decreased from 8.17±0.71 pre-operatively to 1.56±0.62 post-operatively and remained at 2.00±0.91 at the final follow-up visit (P<0.05). The average ODI improved from 86.44±5.5 pre-operatively to 24.33±7.82 post-operatively. Until the last follow-up, the ODI remained at 27.11±8.76 (P<0.05). Similarly, the changes in the Cobb angle and AVH before and after surgery were also statistically significant in the radiological evaluation (P<0.05). During the follow-up, two patients experienced adjacent vertebral fractures. The loosening of cement was not found. Overall, the present study demonstrated that during the treatment of Kümmell disease with PVP, the bilateral pedicle cement anchoring technique combined with postural reduction can achieve good clinical outcomes.

RESTRICTIVE FLUID RESUSCITATION IN SEPTIC SHOCK PATIENTS HAS LOWER MORTALITY AND ORGAN DYSFUNCTION RATES THAN STANDARD THERAPY.

ABSTRACT: Background : The influence of restrictive fluid resuscitation and the early administration of vasopressors on the clinical outcomes in patients with septic shock are not fully understood. The purpose of this study was to evaluate the effects of restrictive fluid management on mortality and organ dysfunction in patients with septic shock. Methods : This study included consecutive patients with septic shock in need of fluid resuscitation. Based on the fluid management provided in the initial resuscitation phase, a comparison was made between a restrictive group and a standard fluid management group. The primary outcome was in-hospital death, whereas secondary outcomes included organ dysfunction and other adverse events. Results : A total of 238 patients were included in this study. Restrictive fluid management was administered to 59.2% of patients, whereas 40.8% received standard fluid management. Restrictive resuscitation was associated with a lower in-hospital mortality rate (24.8% vs. 52.6%), as well as a shorter median intensive care unit stay (8.0 vs. 11.0 days). The restrictive strategy was associated with a significantly lower prevalence of new-onset acute kidney injury (25.5% vs. 51.5%) and a decrease in the incidence of renal replacement therapy (20.6% vs. 40.2%). The standard group had a higher risk of the need for mechanical ventilation and a significantly lower median number of days without a ventilator than the restrictive group. The median duration of vasopressor-free days in the restrictive group was significantly longer than that in the standard group (25.0 vs. 18.0). The administration rate of inotropes in the restrictive group was significantly lower than that in the standard group. A multivariate logistic regression model showed that restrictive fluid management (odds ratio [OR], 0.312; 95% confidence interval [CI], 0.098-0.994) and vasopressor-free days (OR, 0.807; 95% CI, 0.765-0.851) protect against in-hospital death, whereas Acute Physiology and Chronic Health Evaluation II scores (OR, 1.121; 95% CI, 1.018-1.234) were independent risk factors for in-hospital death. Conclusions : Restrictive fluid resuscitation and early vasopressor protocol in patients with septic shock are associated with better outcomes, indicating that this regimen is feasible and safe.

Diagnosis of severe Chlamydia psittaci pneumonia by metagenomic next-generation sequencing: 2 case reports.

Psittacosis is a infectious disease caused by Chlamydia psittaci (C. psittaci), which presents as pneumonia in humans. The diagnosis of psittacosis is challenging, however, Metagenomic next-generation sequencing (MNGS) is very efficient. Herein we documented the clinical characteristics of two patients with severe C. psittaci pneumonia who were admitted to the Intensive Care Unit. C. psittaci nucleic acid sequences were detected by MNGS of bronchoalveolar lavage fluid from both patients. Doxycycline was administered and the treatment was effective. Implementation of MNGS is helpful for the early identification of pathogens, shortening the diagnosis and treatment time, and improving the prognosis of patients.

Linezolid in the treatment of severe intraabdominal infection: A STROBE-compliant retrospective study.

Safety concerns over bone marrow suppression and thrombocytopenia may inhibit the use of linezolid to treat intraabdominal infection (IAI). To evaluate the effectiveness, safety, and prognosis of linezolid in the treatment of severe IAI (SIAI). Patients were divided into a linezolid group and nonlinezolid group according to whether linezolid was prescribed. Subgroup analysis (thrombocytopenia treated with linezolid group (I), and thrombocytopenia treated with nonlinezolid group (II) also was performed. We evaluated the effectiveness of linezolid by analyzing the changes in white blood cells (WBC) and procalcitonin, evaluated safety by analyzing the changes in platelet counts, and evaluated patient outcomes by analyzing the length of hospital stay, the length of ICU stay, and the rates of clinical improvement. Sixty-six adult SIAI patients were treated with anti-gram-positive (G+) bacteria drugs for more than 7 days from January 1, 2014, to December 31, 2020. The length of hospital stay, the length of ICU stay, and the rates of clinical improvement were not significantly different between the linezolid group and nonlinezolid group. On the 15th day after anti-G + bacteria treatment, the WBC of the linezolid group was significantly lower than in the nonlinezolid group (9.00 ± 4.30 vs 13.1 ± 6.19, P < .05). The time for a statistical difference in the decrease of procalcitonin in the linezolid group was earlier than in the nonlinezolid group (day 6 vs day 7, P < .05). There was no statistically significant difference in the changes of platelet counts in the subgroup I (P > .05), but compared with the baseline data (day 0), the time for the statistical difference in the increase of platelets in thrombocytopenia treated with linezolid group was earlier (day 5 vs day 6, P < .05). There was no statistical difference in the changes of platelets in subgroup II (P > .05). In the treatment of severe intraabdominal infection in a single-center, retrospective study, linezolid was not inferior to other antibiotics in patient clinical outcomes or seral WBC and procalcitonin values. Linezolid also induced no evident bone marrow suppression or thrombocytopenia. Linezolid is a good choice for treatment of SIAI.

[Discussion on a new model of holistic treatment for chronic critical illness patients by internal cross-disciplinary team in the department of intensive care unit: clinical data analysis of a case of acute exacerbation of chronic obstructive pulmonary disease].

OBJECTIVE: To explore the effect of setting up an internal-cross disciplinary team (ICDT) in the intensive care unit (ICU) on a new model of overall treatment for patients with chronic critical illness (CCI). METHODS: A 60-year-old male patient with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to ICU in the Second Affiliated Hospital of Fujian Medical University was introduced. The role of ICDT composed of physicians, nurses, respiratory therapists, physiotherapists, clinical dietitians and patients' family members in ventilator withdrawal and super-early rehabilitation was analyzed in this case. RESULTS: The patient was diagnosed as AECOPD, type II aspiration penumonia respiratory failure, septic shock. The ICDT in ICU carried out early rehabilitation treatment for the patient on the basis of traditional infection control and supportive treatment. Under the care of the ICDT, peripheral blood white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), arterial partial pressure of carbon dioxide (PaCO2), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), right excursion of diaphragm, sputum viscosity, tidal volume (VT) and respiratory rate (RR) were improved. Subsequently, the ventilator mode was gradually changed and the ventilator parameters were down-regulated. The ventilator was successfully weaned on the 10th day of treatment. After weaning, the patient's bedside pulmonary function indicators improved, and he was transferred out of ICU on the 15th day of treatment and discharged on the 20th day. The mental state of the patients was good and the quality of life was greatly improved in CCI outpatient follow-up. CONCLUSIONS: ICDT cooperation is very important for monitoring and treatment of CCI patients, which is beneficial to the super-early rehabilitation and prognosis improvement of critically ill patients.

[The application of perioperative clinical pathway for severe preeclampsia patients in intensive care unit].

OBJECTIVE: To evaluate the effect of implementation of perioperative clinical pathway (CP) for severe preeclampsia patients in intensive care unit (ICU), and to discuss variation factors in order to improve clinical quality. METHODS: Thirty-six patients treated in ICU in the Second Clinical Hospital of Fujian Medical University were divided into two groups according to time of 1 year before implementation of CP (from January to December in 2009, n=14) and 1 year after implementation of CP (from January to December in 2010, n=22). The length of stay in ICU, cost of hospitalization, occurrence of major complications and mortality, as well as the total effective rate of control of blood pressure in the first 3 days after operation were compared. RESULTS: Compared with the group of patients of 1 year before implementation of CP, in the group of patients of 1 year after implementation of CP, the length of stay in ICU (hours) was significantly shorter (65.5±24.9 vs. 86.3±28.2, t=2.321, P<0.05), the cost of hospitalization (yuan) was significantly lower (6 463.6±1 838.2 vs. 8 136.5±2 142.8, t=2.496, P<0.05), the occurrence rate of major complications was lower (36.4% vs. 42.8%, χ2=0.100, P>0.05), the total effective control rate of blood pressure was significant improved on the 1st and the 2nd postoperative day (1 day: 59.1% vs. 14.3%, 2 days: 86.4% vs. 50.0%, both P<0.05), but there was no significant change on the 3rd postoperative day (95.4% vs. 85.7%, P>0.05). One patient died before the application of CP, and none after its application. CONCLUSION: These results suggested that it was beneficial to implement the program in preeclampsia patients to improve medical quality.

Analysis of the Impact of Medical Features and Risk Prediction of Acute Kidney Injury for Critical Patients Using Temporal Electronic Health Record Data With Attention-Based Neural Network.

Acute kidney injury (AKI) is one of the most severe consequences of kidney injury, and it will also cause or aggravate the complications by the fast decline of kidney excretory function. Accurate AKI prediction, including the AKI case, AKI stage, and AKI onset time interval, can provide adequate support for effective interventions. Besides, discovering how the medical features affect the AKI result may also provide supporting information for disease treatment. An attention-based temporal neural network approach was employed in this study for AKI prediction and for the analysis of the impact of medical features from temporal electronic health record (EHR) data of patients before AKI diagnosis. We used the publicly available dataset provided by the Medical Information Mart for Intensive Care (MIMIC) for model training, validation, and testing, and then the model was applied in clinical practice. The improvement of AKI case prediction is around 5% AUC (area under the receiver operating characteristic curve), and the AUC value of AKI stage prediction on AKI stage 3 is over 82%. We also analyzed the data by two steps: the associations between the medical features and the AKI case (positive or inverse) and the extent of the impact of medical features on AKI prediction result. It shows that features, such as lactate, glucose, creatinine, blood urea nitrogen (BUN), prothrombin time (PT), and partial thromboplastin time (PTT), are positively associated with the AKI case, while there are inverse associations between the AKI case and features such as platelet, hemoglobin, hematocrit, urine, and international normalized ratio (INR). The laboratory test features such as urine, glucose, creatinine, sodium, and blood urea nitrogen and the medication features such as nonsteroidal anti-inflammatory drugs, agents acting on the renin-angiotensin system, and lipid-lowering medication were detected to have higher weights than other features in the proposed model, which may imply that these features have a great impact on the AKI case.

Exhausting T Cells During HIV Infection May Improve the Prognosis of Patients with COVID-19.

T-cell reduction is an important characteristic of coronavirus disease 2019 (COVID-19), and its immunopathology is a subject of debate. It may be due to the direct effect of the virus on T-cell exhaustion or indirectly due to T cells redistributing to the lungs. HIV/AIDS naturally served as a T-cell exhaustion disease model for recognizing how the immune system works in the course of COVID-19. In this study, we collected the clinical charts, T-lymphocyte analysis, and chest CT of HIV patients with laboratory-confirmed COVID-19 infection who were admitted to Jin Yin-tan Hospital (Wuhan, China). The median age of the 21 patients was 47 years [interquartile range (IQR) = 40-50 years] and the median CD4 T-cell count was 183 cells/µl (IQR = 96-289 cells/µl). Eleven HIV patients were in the non-AIDS stage and 10 were in the AIDS stage. Nine patients received antiretroviral treatment (ART) and 12 patients did not receive any treatment. Compared to the reported mortality rate (nearly 4%-10%) and severity rate (up to 20%-40%) among COVID-19 patients in hospital, a benign duration with 0% severity and mortality rates was shown by 21 HIV/AIDS patients. The severity rates of COVID-19 were comparable between non-AIDS (median CD4 = 287 cells/µl) and AIDS (median CD4 = 97 cells/µl) patients, despite some of the AIDS patients having baseline lung injury stimulated by HIV: 7 patients (33%) were mild (five in the non-AIDS group and two in the AIDS group) and 14 patients (67%) were moderate (six in the non-AIDS group and eight in the AIDS group). More importantly, we found that a reduction in T-cell number positively correlates with the serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP), which is contrary to the reported findings on the immune response of COVID-19 patients (lower CD4 T-cell counts with higher levels of IL-6 and CRP). In HIV/AIDS, a compromised immune system with lower CD4 T-cell counts might waive the clinical symptoms and inflammatory responses, which suggests lymphocyte redistribution as an immunopathology leading to lymphopenia in COVID-19.

The safety and efficacy of airway pressure release ventilation in acute respiratory distress syndrome patients: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: The acute respiratory distress syndrome (ARDS) is a critical illness with high mortality and a worse prognosis. Mechanical ventilation (MV) is currently considered to be one of the most effective methods of treating ARDS. In this meta-analysis, we discussed the efficacy of airway pressure release ventilation (APRV) in treating ARDS. METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA), Ovid Medline, Embase, and PubMed were systematically searched with the keywords of "ARDS" and "APRV". The studies containing the treatment of APRV in ARDS were included. According to the MV protocol used in the studies, the comparison was undertaken between the APRV group vs low tidal volume (LTV) group and synchronized intermittent mandatory ventilation (SIMV) group. The relative risk (RR) and the standard mean difference with 95% confidence intervals (CI) were used for the comparison between groups. RESULTS: Fourteen studies with 2096 patients were included in the meta-analysis. The average increasing rate of PaO2/FiO2 was 75.4% in the APRV group vs 44.1% in the non-APRV group. No significant differences were found in mortality and duration of ICU stay between APRV vs LTV (P = .073 and P = .404) and APRV vs SIMV (P = .370 and P = .894). CONCLUSION: The APRV protocol would have a higher increase in the PaO2/FiO2 ratio, which was a safe protocol with a compatible effect comparing to LTV and SIMV.

Integration Analysis of m6A-SNPs and eQTLs Associated With Sepsis Reveals Platelet Degranulation and Staphylococcus aureus Infection are Mediated by m6A mRNA Methylation.

Sepsis is a major threat with high mortality rate for critically ill patients. Response to pathogen infection by the host immune system is a key biological process involved in the onset and development of sepsis. Heterogeneous host genome variation, especially single nucleotide polymorphisms (SNPs), has long been suggested to contribute to differences in disease progression. However, the function of SNPs located in non-coding regions remains to be elucidated. Recently, m6A mRNA modification levels were revealed to differ at SNPs. As m6A is a crucial regulator of gene expression, these SNPs might control genes by changing the m6A level on mRNA. To investigate the potential role of m6A SNPs in sepsis, we integrated m6A-SNP and expression quantitative trait loci (eQTLs) data. Analysis revealed 15,720 m6A-cis-eQTLs and 381 m6A-trans-eQTLs associated with sepsis. We identified 1321 genes as locations of m6A-cis-eQTLs. These were enriched in platelet degranulation and Staphylococcus aureus infection pathways, which are vital for the pathophysiological process of sepsis. We conclude that m6A modification of mRNA plays a very important role in sepsis, with m6A-cis-eQTLs potentially having the most effect on individual variation in sepsis progression.

[Children with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and acute kidney injury: a case report and literature review].

OBJECTIVE: To investigate the diagnosis and treatment of children with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and acute kidney injury (AKI). METHODS: The clinical manifestations, laboratory and imaging examination results and diagnosis and treatment process of a child with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and AKI admitted to the department of intensive medicine of the Second Affiliated Hospital of Fujian Medical University on July 14th, 2014 were retrospectively analyzed to provide experience and methods for the treatment of such patients. RESULTS: The patient, a Chinese 11-year-old boy, admitted to hospital with "sore throat, fever, and double lower limb pain for 2 days". The clinical manifestations were sore throat, fever, pain in both lower extremities, fatigue, and soy sauce urine. Limb muscle tenderness, bilateral lower limb was obvious. Laboratory examination showed that blood creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), aspartate transaminase (AST), lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH) and hematuria myoglobin (Mb) were significantly elevated, and blood parainfluenza viruses (1, 2, 3 types) was positive for immunoglobulin M (IgM) antibodies. Chest X-ray shown bronchial pneumonia in the right lower lung. Pneumonia with rhabdomyolysis syndrome was considered. Anti-infection, fluid hydration, alkalized urine, diuresis and other treatment was initially prescribed. However, the condition became worse, combined with secondary epilepsy, AKI, acute heart failure, transferred to the intensive care unit (ICU). The child was put on mechanical ventilation through oral tracheal intubation, continuous hemofiltration, anti-infection and anti-virus treatment. The child's condition gradually recovered, symptoms and signs disappeared, and finally he was discharged with full recovery. CONCLUSIONS: Children with parainfluenza pneumonia can induce rhabdomyolysis. If myalgia is progressively worsened and walking is difficult, we should be highly alert to the occurrence of rhabdomyolysis. And when soy sauce urine, hematuria were noticed, and blood CK, Mb increased significantly, rhabdomyolysis syndrome can be diagnosed. Once the diagnosis is established, rehydration, alkaline urine and diuresis should be carried out in a timely manner to increase myoglobin tubular excretion. Antiviral treatment can reduce the dissolution of striated muscles. If blood purification is needed, hemofiltration and/or plasma exchange can be selected.

Scheuermann's Disease as a Risk Factor for Lumbar Disc Herniation Recurrence.

OBJECTIVE: To verify whether Scheuermann's disease (SD) is a risk factor for patients with recurrent lumbar disc herniation (rLDH) than in patients without recurrence. STUDY DESIGN: Case-control study. PLACE AND DURATION OF STUDY: Department of Orthopaedics, Yantaishan Hospital, China, from December 2016 to September 2019. METHODOLOGY: The demographics (age, gender, body mass index [BMI], alcohol abuse, and current smoking), diabetes mellitus, and radiological data (affected levels, herniated side, herniation type, Pfirrmann grade, and the presence of SD) of 602 patients were retrospectively analysed, who underwent surgery for symptomatic LDH from December 2016 to August 2018. They were underwent one-year follow-up and were divided into LDH and rLDH groups. Both typical and atypical SD criteria were used to diagnose SD. Independent-sample t-test was used to analyse the role of age and BMI in both groups, and the Chi-square test was conducted to analyse other parameters. Logistic regression analysis was performed to evaluate various factors. RESULTS: There was a significant difference in age (p=0.026), BMI (p=0.007), current smoking (p=0.001), and SD (p<0.001) between the groups. When these parameters were included in the logistic regression analysis, age, current smoking status, and SD were found to be risk factors for rLDH. CONCLUSION: Age, current smoking, and SD are risk factors for rLDH. Older patients with radiological characteristics of SD should quit smoking to prevent rLDH. Key Words: Scheuermann's disease, Kyphosis, Disc herniation, Recurrence, Age, Smoking, Risk factor.

[Use of an electromagnetic device for insertion of bedside nasojejunal feeding tube in critically ill patients].

OBJECTIVE: To evaluate the efficacy of an electromagnetic device for correct bedside placement of nasojejunal feeding tube for patients in intensive care unit (ICU). METHODS: The clinical data of 109 patients in ICU who accepted bedside nasojejunal feeding tube placement from January 2010 to September 2012 were retrospectively analyzed. All the patients were divided into three groups according to the difference in type of nasojejunal feeding tube and the placement technique: control group 1 (n=48, Flocare feeding tube and bedside blind insertion group), control group 2 (n=28, Corflo(®) feeding tube and bedside blind insertion group), observation group (n=33, Corflo(®) feeding tube and electromagnetic tube placement device group). The success rate, the times of placement, duration of nasojejunal feeding, and safety were compared among three groups. RESULTS: The success rate of control group 2 and observation group were higher than control group 1 (71.43%, 90.91% vs. 33.33%), rate of partial success and failure rate were lower than those of control group 1 (partial success rate: 17.86%, 3.03% vs. 35.42%; failure rate: 10.71%, 6.06% vs. 31.25%, all P<0.05), and no differences were found between control group 2 and observation group. The average times for successful placement in observation group was lower than that of control group 1 and control group 2 (1.6±0.5 vs. 6.6±3.2, 5.8±2.3, both P<0.05), and the average time for successful placement was shorter in observation group than that of control group 1 and control group 2 (12.48±3.78 minutes vs. 25.27±3.61 minutes, 23.58±4.87 minutes, both P<0.05), but there was no difference between control group 1 and control group 2. No complications occurred in all three groups. CONCLUSION: Placement of a nasojejunal tube with the aid of an electromagnetic device is an excellent method for enteral nutrition, as it is safer, more efficient, with high successful rate, less time spending, and easier to master for beginners.