Objectives:To observe the role of peri operational nutritional support in the old patients with gastrointestinal carcinoma. Methods: One hundred and seventeen cases of aged patients with gastrointestinal carcinoma were divided into two groups: nutritional support (NS) group and normal therapy(NT) group. The therapeutic effects of peri operational nutritional support were studied. Results: All patients survived. The rate of complication in group of NT was higher than that of NS group. The recovering time of the gut function after operation and average duration in the hospital of the NT group were longer than that in the NS group. The recovery of body weight, level of plasma albumen and nitrogen balance in NS group was faster than that of NT group. Conclusions:Peri operational nutritional support in the aged patients with gastroenterological carcinoma is of significance, improving the nutritional condition,enhancing the endurance from the surgical trauma and decreasing the rate of postoperative complication.

From May 2009 to February 2012, five patients with traumatic lower limb arteriovenous fistula were admitted in our department .Four patients underwent endovascular stent grafting , and one patient was given fistula indwelling , deep femoral artery-superficial femoral artery end to side anastomosis , and femoral artery-superficial femoral artery artificial vescular grafting .Four patients were cured, which were followed for 3, 5, 3, and 3 years, respectively, without recurrence.One patient with endovascular stent grafting failed to isolate the fistula effectively and a second stent grafting failed , too.Endovascular stent grafting is an effective method in the treatment of fistula, with less bleeding, small trauma, and rapid recovery.By using the technology of through the hillsto isolate limb fistula, the covered stent might not be released when the fistula is located at low position and at the same time the left iliac artery bifurcation angle is small .

Objective To investigate the effect of Bcl-2 gene expression on the proliferation and apoptosis of human pancreatic cancer SW1990 cells.Methods Bcl-2 short guide RNA (Bcl-2-sgRNA) was designed and synthesized,and it was combined with CRISPR-Cas 9.After confirmation by gene sequencing,it was transfected into human pancreatic cancer cell line SW1990,then the cells with stable Bcl-2 gene knock-out were selected,and wild type SW1990 cells were used as control.The cell growth curve was determined by CCK-8 method.The number of clone formation was measured.Flow cytometry was used to measure cell cycle and apoptosis.Results Human pancreatic cancer cell line SW1990 with Bcl-2 gene knock-out was successful constructed.Compared with wild type SW1990 cells,the growth of SW1990 cells with Bcl-2 gene knock-out was inhibited,the number of clone formation was significantly decreased [(160.7 ± 10.0) vs (285.3 ± 14.2)],the proportion of G1 cells was significandy increased [(84.51 ± 0.97) ％ vs (57.49 ± 1.08) ％],the proportion of S phase cells significantly decreased [(12.82 ± 0.99) ％ vs (27.56 ± 1.65) ％],and apoptosis rate was remarkably increased [(12.67 ± 0.59) ％ vs (0.37 ± 0.35) ％],and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions Knock-out of Bcl-2 gene can inhibit the growth of human pancreatic cancer cell line SW1990,decrease the ability of clone formation,block the cell in G1 phase and greatly increase cell apoptosis rate.

Patients with chronic thromboembolic pulmonary arterial hypertension,aged＞ 18 yr,scheduled for primary pulmonary thromboendarterectomy from May 2014 to October 2016 in our hospital,were selected.The site and degree of thrombus obstruction,pulmonary hypertension and degree of right heart insufficiency were assessed on 1 day before surgery.Anesthesia was induced with midazolam,etomidate,rocuronium or cisatracurium,and the Swan-Ganz catheter was placed.Anesthesia was maintained with Ⅳ propofol,dexmedetomidine,cisatracurium or rocuronium,and intermittent Ⅳ large boluses of sufentanil.Deep hypothermia circulatory arrest was used for cardiopulmonary bypass.The bispectral index value was maintained between 40 and 60 during surgery.The systemic blood pressure was maintained above 90/60 mmHg during the non-cardiopulmonary bypass period,and pulmonary arterial pressure was maintained not higher than the preoperative baseline level.The vasoactive drugs such as lyophilized recombinant human brain natriuretic peptide,norepinephrine and dopamine were intravenously injected after cardiopulmonary bypass.A total of 53 patients were included in the study and completed surgery successfully,vital signs were stable during surgery,and the patients returned to the recovery room safely.The mean pulmonary arterial pressure was reduced from the preoperative (38±13) mmHg to (26±12) mmHg at the end of the operation,the incidence of reperfusion pulmonary edema after surgery was 8％,incidence of pulmonary hypertensive crisis was 4％,and no patients died in the perioperative period.There were two improvements in the method of anesthetic management of pulmonary thromboendarterectomy in the perioperative period:(1) Lyophilized recombinant human brain natriuretic peptide in combination with norepinephrine was used;(2) The aortic pressure was guaranteed to ensure oxygen supply for the heart and body.This method can maintain the intraoperative circulation stable and reduce postoperative complications and is a suitable anesthetic management method for pulmonary thromboendarterectomy.

Objective To explore the effect of Src on cervical cancer cells through ERK signal transduction pathway.Methods Experimental study was carried out in vitro.Cervical cancer cell lines Hela (HPV-positive) and C33A (HPV-negative) were treated with Src kinase inhibitor PP2.Then,the cell cycle and apoptosis of each group were evaluated by using flow cytometry (FCM).Western blotting and Real-time PCR were used to detect the levels of the expression of ERK 1/2,c-Fos and c-Jun mRNA and protein respectively.The database was established and analyzed with SPSS statistical software (version 20.0).Results After down-regulating Src,the cell proliferation was inhibited and cell apoptosis was induced.The proportions of G0/G 1 stage of Hela and C33A cell in cell cycle increased while G2/M and S stages decreased.Meanwhile,the mRNA levels of ERK 1,ERK 2,c-Fos and c-Jun increased.And the expression levels of ERK 1/2,phosphorylated ERK 1/2 (p-ERK 1/2)and phosphorylated c-Fos (p-c-Fos) protein decreased,while c-Jun and phosphorylated c-Jun (p-c-Jun)protein expression increased.In addtion,the change level of Hela cell,p-ERK 1/2 and c-Fos protein were lower than that of C33A cell before and after the Src inhibition.Conclusions Src,involved in regulating the expression of key factors of the ERK signal transduction pathway including p-ERK 1/2 and p-c-Fos,might be capable of promoting the proliferation of cervical cancer cells and inhibiting their apoptosis.The infection with HPV might have adjustable effect on this process.