Bedside gastrointestinal ultrasound combined with acute gastrointestinal injury score to guide enteral nutrition therapy in critically patients.

BACKGROUND: To use gastric ultrasound to evaluate function and to determine the start time of enteral nutrition (EN) in patients with acute gastrointestinal injury (AGI). METHODS: We reviewed records from 105 patients who suffered AGI levels two (AGI II). We recorded several data points, including ultrasonographic transverse area of gastric antrum (CSA), left descending colonic or right ascending colonic diameter (Diam), peristatic frequency (Peri), EN start time, EN dose, prealbumin (PA), and EN complications. The recovery of intestinal function after EN treatment was judged as success. If there was EN treatment complication, this was judged as failure. We analyzed the changes in gastrointestinal function after EN treatment, to determine feeding time. RESULTS: There were 69 patients in the successful group, and 36 in the failure group. There were no significant differences between the two groups in age, intra abdominal pressure (IAP), APACHE II, PA and disease composition (p > 0.05).There were significant differences in terms of EN startup time, CSA, Diam, Peri, and PA, between the EN success and failure groups. We found IAP does not reflect gastrointestinal function;CSA ≤ 9cm2, Diam ≤ 2.9 cm, Peri > 3 bpm, indicated that the three indexes could reflect the recovery of gastrointestinal function. Receiver operating curve analysis showed that combined CSA, Diam, Peri evaluation determined the best time to start EN. CONCLUSIONS: Monitoring gastric antrum transversal area, colonic diameter, colonic peristatic frequency using ultrasound can guide the timing of initiation of enteral nutrition treatment.

The Tai Chi Flap: A Novel Design for the Radial Forearm Flap.

OBJECTIVE: Tai Chi is an ancient philosophy used to explain the universe. The Tai Chi symbol is represented by Yin/Yang fishes. The authors describe a novel radial forearm flap (RFF) design for the reconstruction of circular defects based on the Tai Chi symbol. METHODS: Eleven consecutive patients with craniofacial skin or mucus defects underwent reconstruction with a Tai Chi RFF. Patient perioperative and follow-up information was collected. RESULTS: The diameter of the Tai Chi RFF was 5 to 6 cm. All flaps healed uneventfully without ischemic problems, and all donor site defects were closed primarily without skin grafts. Remarkably, 2 patients received a tattoo to mark the Tai Chi symbol and greatly appreciate the shape of the flap. CONCLUSIONS: The Tai Chi flap is an economically friendly flap design that can be used to prevent skin grafts while providing psychological comfort to patients.

An ester extract of Cochinchina momordica seeds induces differentiation of melanoma B16 F1 cells via MAPKs signaling.

Cochinchina momordica seeds (CMS) have been widely used due to antitumor activity by Mongolian tribes of China. However, the details of the underlying mechanisms remain unknown. In the present study, we found that an EtOAc (ethyl ester) extract of CMS (CMSEE) induced differentiation and caused growth inhibition of melanoma B16 F1 cells. CMSEE at the concentration of 5-200 µg/ml exhibited strongest anti-proliferative effects on B16 F1 cells among other CMS fractions (water or petroleum ether). Moreover, CMSEE induced melanoma B16 F1 cell differentiation, characterized by dendrite-like outgrowth, increasing melanogenesis production, as well as enhancing tyrosinase activity. Western blot analysis showed that sustained phosphorylation of p38 MAP accompanied by decrease in ERK1/2 and JNK dephosphorylation were involved in CMSEE-induced B16 F1 cell differentiation. Notably, 6 compounds that were isolated and identified may be responsible for inducing differentiation of CMSEE. These results indicated that CMSEE contributes to the differentiation of B16 F1 cells through modulating MAPKs activity, which may throw some light on the development of potentially therapeutic strategies for melanoma treatment.

[Coumarins of Anemone raddeana Regel and their biological activity].

To study the coumarins of Anemone raddeana Regel, the compounds were separated by silica gel column chromatography and HPLC. Their structures were identified by their physicochemical property and spectral analysis. Two new compounds were isolated and identified as 4, 7-dimethoxyl-5-methyl-6-hydroxy coumarin (1) and 4, 7-dimethoxyl-5-formyl-6-hydroxycoumarin (2). The bioassays indicated that compounds 1 and 2 could significantly inhibit the proliferation of cancer cell, and showed the agonist effect on the transactivity of retinoic acid receptor-alpha (RARalpha). In addition, the two compounds had inhibitory effect against human leukocyte elastase (HLE).