Objective:To investigate the role of early enteral nutrition in preventing functional delayed gastric emptying(FDGE)after radical distal subtotal gastrectomy.Methods:A retrospective review was performed in clinical data of patients with gastric cancer undergoing radical distal subtotal gastrectomy in our hospital from March 2004 to March 2008.There were 71 patients receiving early enteral nutrition (group EEN,n=71) after operation and 107 patients receiving parenteral nutrition (group PN,n=107) at the same time.The outcomes of FDGE between of two groups were compared.Results:The incidence of FDGE in group EEN was 1.4%(1/71).And the incidence of FDGE in group PN was 10.3%(11/107).There was significant difference between the group EEN and the group PN (P

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

Objective: To study the effect of the sharp marginal ridge of the abutment on the casting of the fit metal full crown in dental preparation.Methods: We established the models of the designed crown-based-teeth(American Dental Association style,No2 trail) with a sharp or smooth marginal ridge,and cast a metal crown for each model.We injected silicone into the crown and immediately fixed it onto each model.Then we took out the solidified silicone and measured its thickness between the crown and the occlusal face of each model.The thinner the thickness,the better the fitness.Results: The average silicone thickness was 250 ?m in the smooth marginal ridge group and 1 660 ?m in the sharp marginal ridge group,with significant difference in between(P

Objective To examine the sleep status and relevant psychosocial factors in patients with colorectal cancer before surgery and improve their sleep quality. Methods A cross?sectional survey method was used. Participants were 107 cases of patients with colorectal cancer from the Department of Anorectal Surgery in The First Hospital ,which is affiliated with China Medical University. The Athens insomnia scale(AIS),Ham?ilton depression scale(HAMD),Hamilton anxiety scale(HAMA),perceived social support scale(PSSS),self?esteem scale(SES),medical cop?ing questionnaire(MCMQ),memorial University of Newfoundland scale of happiness(MUNSH),Eysenck personality questionnaire(EPQ),and Wong?Baker face scale were used to assess preoperative sleep in patients with colorectal cancer and related psychosocial factors. Results Among the 107 cases,there were 24 cases of insomnia,with an insomnia incidence of 22.43%. No statistical differences were found in demographic charac?teristics and clinical characteristics(P>0.05). According to the degree of insomnia,there were significant differences between groups(P<0.05) for depression,anxiety,social support,avoidance,yield,happiness,and EPQ?N. Before the surgery,the degree of depression,anxiety,and EPQ?P had a significant positive effect on the degree of insomnia (P< 0.05). Conclusion The degree of insomnia before surgery in patients with colorectal cancer is closely associated with depression,anxiety,coping styles,social support,and personality characteristics.

Objective To explore the level of interleukin 35-producing B cells (i35-Breg) as well as its effect factors,interleukin-35 (IL-35),in peripheral blood of patients with chronic hepatitis B (CHB),and their relationship with hepatitis B virus (HBV) DNA and liver inflammatory degree.Methods A total of 35 treatment-naive CHB patients,17 interferon (IFN)-treated HBeAg-positive CHB patients and 15 healthy controls (HC) were enrolled.The levels of i35-Breg and IL-35 in peripheral blood were tested by flow cytometry and enzyme-linked immunosorption assay (ELISA).Kruskal-Wallis test,Wilcox rank sum test and two variables correlation analysis were used for statistical analysis.Results The percentage of i35-Breg cells as well as IL-35 level in peripheral blood of naive CHB patients were 3.05％ (0.89％,4.97％) and 2.81 μg/L (0.30 μg/L,12.33 μg/L),respectively,which were both significantly higher than those in HC group,which were 0.17％ (0.13％,0.45％) and 0.17 μg/L(0,1.93 μg/L),respectively.The difference were statistical significant (Z=-3.309 and-2.419,respectively,P=0.001 and 0.016,respectively).The peripheral level of i35-Breg was negatively correlated with the viral load in treatment-naive CHB patients (r=-0.529,P=0.008),while there was no correlation between the peripheral level of IL-35 and the viral load in treatment-naive CHB patients (r=0.11,P=0.54).The levels of i35-Breg and IL-35 in HBeAg positive CHB patients were 3.16％ (1.34％,5.62％) and 4.58μg/L (0.79μg/L,22.37 μg/L),respectively,which were both higher than those in HC group.The difference was statistically significant (F=3.39 and 3.37,respectively,both P＜0.01).Compared to HC group,the IL-35 levels in peripheral blood of CHB patients with ALT and AST levels less than 300 U/L were 3.03 μg/L (0.74 μg/L,22.37 μg/L) and 3.25 μg/L (0.83 μg/L,22.35 μg/L),respectively,with statistically significant difference (F=2.868 and 3.114,respectively,both P＜0.01).Compared to HC group,the peripheral level of i35-Breg in treatment-naive CHB patients with ALT levels less than 300 U/L was 3.14％ (1.03％,4.65％),with statistically significant difference (F=3.219,P=0.004).The IL-35 level showed a decreased trend in CHB who received IFN therapy,but there was no statistically significant difference (x2 =1.45,P =0.48).Furthermore,the baseline IL-35 level in patients who developed sustained viral response (SVR) was 0 (0,13.33 g/L),which was lower than that in patients who developed partial or primary no response 0.61 μg/L (0,24.72 μg/L).However,there was no statistical difference (F=0.75,P =0.68).Conclusions i35-Breg as well as its effect factor,IL-35,are involved in the progression of chronic HBV infection.The percentage of i35-Breg cells as well as IL-35 level in peripheral blood of treatment-naive CHB patients are increased.The peripheral level of i35-Breg is negatively correlated with the viral load,while there is no correlation between the peripheral level of IL-35 and the viral load.The percentage of i35-Breg cells as well as IL-35 level in CHB patients with low inflammatory degree are increased.

Objective:To summarize the clinical and laboratory characteristics of infectious mononucleosis (IM) in children.Methods:Clinical features and laboratory results of 270 cases with IM admitted to the Department of Pediatrics in Strategic Support Force Medical Center of People′s Liberation Army from January 2012 to December 2020 were retrospectively analyzed. χ2 test was used for comparison between groups. Results:IM mainly occurred in children aged 5 months to 18 years old in autumn and spring.The highest incidence rate (105 cases, 38.9%) was 3-<6 years old (preschoolers). There were 253 cases (93.7%) with fever, 266 cases (98.5%) with adenopharyngitis, 196 cases (72.6%) with tonsil pseudomembrane or exudation, 248 cases (91.9%) with cervical lymphadenopathy, 92 cases (34.1%) with eyelid edema, 202 cases (74.8%) with nasal obstruction, 124 cases (45.9%) with nasal obstruction and snoring, 24 cases (8.9%) with rash, and 112 cases (41.5%) with splenomegaly.A total of 225 cases (83.3%) presented with typical triplets of IM (fever, adenopharyngitis and cervical lymphadenopathy). Sixty-two IM patients were complicated with pulmonary infections and 3 cases with diarrhea.The main co-infection pathogens in children with IM were Mycoplasma pneumonia (MP) (79 cases, 29.3%), influenza A or B virus (34 cases, 12.6%), Streptococcus pneumonia (SP) (18 cases, 6.7%), adenovirus (22 cases, 8.1%) and cytomegalovirus (3 cases, 1.11%). A total of 46 cases (17.0%) had multiple infections.Laboratory test results suggested that absolute lymphocyte count ≥5.0×10 9/L was found in 199 cases (73.7%), and abnormal lymphocyte ratio >0.10 was found in 225 cases (83.3%). Some children had elevated transaminase levels.Epstein-Barr virus capsid antigen-immunoglobulin M (EBV-VCA-IgM) was positive in 249 cases (92.2%), Epstein-Barr virus capsid antigen-immunoglobulin G (EBV-VCA-IgG) was positive in 238 cases (88.1%), and Epstein-Barr virus nuclear antigen-immunoglobulin G (EBV-NA-IgG) was negative in all cases.EBV-VCA-IgG showed low affinity in all cases (<40%). EBV DNA tests of peripheral blood plasma were carried in 153 cases, of which 118 cases (77.1%) were positive. Conclusions:EBV related IM mainly attacks preschoolers.Most patients are presented with typical triplets of IM.Eyelid edema, nasal obstruction, snoring, splenomegaly and elevated transaminase levels are prevalent in IM children.Most cases have a favorable prognosis.

Objective:To construct the curriculum content system of Extreme Environmental medicine based on the trainees' competency.Methods:After analysis of Chinese doctors' post competency demand, and the characteristics of military students, qualitative and quantitative methods were used to construct the curriculum system. The consistency of expert opinions was represented by Kendall's W coefficient, using chi-square test. The hierarchy and weights of all items were analyzed by the analytic hierarchy process, using consistency ratio ( CR) , which was incorporated into this system after passing the test ( CR<0.1) . Results:The selective experts were all authoritative and positivity, the assessments were consistency. Finally, it formed 5 primary items, 15 secondary items, and 54 third items of educational materials and 13 knowledge modules and 1 comprehensive seminar.Conclusions:Based on the demand of Chinese doctors' post competency, a curriculum system of extreme environment medicine has been constructed, through combined application of qualitative and quantitative research methods.