The applied research on the intra-abdominal pressure monitoring in early enteral nutrition in patients with severe pneumonia.

OBJECTIVE: To explore the applied value of intra-abdominal pressure (IAP) monitoring in early enteral nutrition (EEN) in patients with severe pneumonia. METHODS: 96 patients with severe pneumonia who underwent EEN treatment in our hospital from June 2017 to June 2019 were selected. According to the random number table method, they were divided into a control group (48 patients) and an observation group (48 patients). The control group was treated using the conventional EN method, and the observation group was treated using the intra-abdominal pressure monitoring besides the conventional EN method. The incidence of EN intolerance, the acute physiology and chronic health evaluation (APECHEll) scores, the positive end expiratory pressure (PEEP) value, mechanical ventilation time, EN implementation days, length of stay in ICU, the incidence of ventilator-associated pneumonia, mortality, and the incidence of multiple organ dysfunction syndrome were compared between the two groups. RESULTS: Compared with the control group, the incidence of EEN intolerance in the observation group was significantly reduced. The results of univariate analysis showed that, in the EN intolerance group, the IAP, the PEEP value and APACHEII scores after 3 days of EEN implementation were higher than the EEN tolerance group, indicating a influencing factor of EEN intolerance (P<0.05). The results of multivariate analysis showed that IAP value was a risk factor for EEN intolerance (P<0.05). The ROC curve analysis result for IAP to predict EEN tolerance showed that the area under the curve for IAP value to predict EN tolerance was 0.856, the optimal cut-off value was 10.73 mmHg, the sensitivity was 95.10%, and the specificity was 89.60%. CONCLUSION: The intra-abdominal pressure monitoring during the EEN in patients with severe pneumonia is a preferred method to guide the patients' EEN.

Application of intra-abdominal pressure monitoring in early enteral nutrition after abdominal surgery.

OBJECTIVE: To explore the effect of intra-abdominal pressure monitoring in early enteral nutrition therapy after abdominal surgery. METHODS: 164 patients who underwent elective abdominal surgery in our hospital from January 2019 to January 2020 were selected and divided into an observation group and a control group according to the random number table method, with 82 cases in each group. On the basis of conventional enteral nutrition nursing, the control group received conventional gastric residual monitoring, and the observation group received intra-abdominal pressure monitoring. The clinical treatment effect, intra-abdominal pressure, incidence of intra-abdominal hypertension, APACHE-II score, and enteral nutrition tolerance were compared. Correlation of early enteral nutrition intolerance and intra-abdominal pressure was analyzed in the ROC curve. RESULTS: The time of abdominal pain relief, adjusted enteral nutrition, and hospitalization were significantly shorter in the observation group (P < 0.05). The intra-abdominal pressure, intra-abdominal hypertension rate, and APACHE-II scores were comparable before treatment (P > 0.05) and all were significantly reduced after treatment in the two groups (P < 0.05). After treatment, the above items were significantly lower in the observation group (P < 0.05). The enteral nutrition's tolerance level of the observation group was significantly higher than that of the control group (P < 0.05). The Pearson correlation analysis revealed that the early enteral nutrition tolerance of patients after abdominal surgery was correlated with the level of intra-abdominal pressure (P < 0.05). The ROC reveled that the baseline level of intra-abdominal pressure and the average level of intra-abdominal pressure 3 days before enteral nutrition were of diagnostic values in predicting the intolerance during enteral nutrition. CONCLUSION: Intraperitoneal pressure monitoring can significantly improve patients' symptoms, and it should be accurately measured for doctors to make timely diagnoses and provide proper treatments.

MicroRNA-30 mediates cell invasion and metastasis in breast cancer.

Despite the great progress in recent years, many aspects of the pathogenesis and progression of breast cancer remain unclear. A better understanding on the molecular mechanisms underlying metastasis and recurrence is crucial to improve the treatment of this lethal disease. MCF-7 cells were xenografted into mice until visible tumors developed, and the cells from tumor tissue and adjacent normal tissue were cultured with 3 passages as mass tumor (MT) cells and invasive tumor (IT) cells, respectively. Microarray analysis was performed to detect several viable microRNAs in these 2 types of cells. Further, miR-30 knockdown was used to investigate its role in tumor aggression. Relative levels of miR-30 were significantly higher in IT cells than MT cells. Knockdown of miR-30 in both MT and IT cells lowered cell proliferation and cell invasion abilities, and thus increased the survival time of mice xenografted with tumor cells. This study suggested that the knockdown of miR-30 decreased proliferation and invasion of carcinoma cells, giving rise to the potential of miR-30 as a tumor target or marker candidate for breast cancer therapy.