Objective: The present study is to observe and compare the different effects of electroacupuncture(EA) at acupoint Neiguan (PC 6), intravenous administration of L-arginine(L-Arg, a precursor of nitric oxide), and the drug administration combined with the EA on acute myocardial ischemia(AMI) in rats. Methods: The rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then the animals were divided randomly into 5 groups,i.e. control group, AMI group, L-Arg treatment group, EA treatment group and L-Arg plus EA treatment group, the mean arterial pressure(MAP), heart rate(HR) and the cardiac functions were observed and recorded. Results: The data showed that MAP, HR and all the indices of cardiac functions in the AMI group were significantly lower than those in control group, and the indices in each treatment group were all improved to different extents, especially in L-Arg plus EA treatment group. Conclusion: The combined use of L-Arg and EA had the better therapeutic effect on the AMI.

Objective:To investigate the mechanism of the reversal effect of acupuncture on the fall of blood pressure induced by angiotensin-(1-7)[Ang-(1-7)] in the caudal ventrolateral medulla(CVLM) of rats. Methods: Ang-(1-7) and its selective receptor antagonist (D-Ala7), Ang-(1-7) and Ang-(779) were microinjected into the CVLM respectively to induce the change of blood pressure, during which, the concentrations of amino acid neurotransmitters were detected by means of microdialysis and high performance liquid chromatography(HPLC)combined with fluorescent detector, on the other hand, the effects of electro-acupuncture (EA) on the level of blood pressure and the concentrations of amino acid neurotransmitters were also observed. Results:Unilateral microinjection of Ang-(1-7) into the CVLM could decrease the blood pressure (BP), which was accompanied by an increase in the release of Glu and a decrease in the release of Tau in the same site; Whereas microinjection of Ang-779 into the CVLM could elevate BP, which was accompanied by a decrease in the release of Glu and an increase in the release of Tau; EA at acupoint Zusanli (ST 36) for 20 min could inhibit the fall of blood pressure induced by microinjection of Ang-(1-7) into the CVLM and the elevation of blood pressure induced by microinjection of Ang-779 into the CVLM, and in the meantime, it could inhibit the changes of the release of Glu and Tau induced by microinjection of Ang-(1-7) and Ang-779 into the CVLM. Conclusion: The reversal effect of EA on the fall or elevation of blood pressure induced by microinjection of Ang-(1-7) or Ang-779 into the CVLM might be related to the changes of Glu and Tau release.

renal dysfunction.Logisitic regression showed that cardiovascular disease and hypoalbuminemia were correlated with perioperative death rate significantly. Conclusions Improving the perioperative management is very important for lowering the perioperative mortality in elderly patients with digestive tract disease.

Objective To investigate the effect of oral nutritional supplementation on the nutritional status and quality of life in patients with gastric cancer after operation.Methods In this prospective,single blind,randomized,controlled clinical study,25 postoperative patients with gastric cancer received neoadjuvant chemotherapy in outpatient clinic were enrolled.All patients received dietary guidance.In the intervention group,in addition to standard diet,oral nutritional supplements with 2 090 kJ/d of Intacted Protein Enteral Nutrition Powder were added,which lasted 90 days.The changes of body mass,body mass index(BMI),hemoglobin,prealbumin,albumin,gastrointestinal function score,and life quality score 30,60,and 90 days after discharge were recorded.Patients on standard diets were used as the control group.Results In the intervention group,the body mass increased by(0.66 ±1.47)kg 60 d after discharge and(-0.90±1.82)kg on 90 d after discharge,which were [60 d:(-5.13±1.79)kg,90 d:(-9.56±2.44)kg] in the control group,and the difference was statistically significant(P=0.027,P=0.015).The BMI of intervention group increased by(0.20 ±0.55)kg/m2 on 60 d and(-0.32±0.55)kg/m2 on 90 d after discharge,which were(-2.06±0.67)kg/m2 on 60d and(-3.21± 0.73)kg/m2 on 90 d in the control group(P=0.014,P=0.003).There was no significant difference in terms of serum albumin,prealbumin and other laboratory indicators.Intestinal functional status and quality of life also showed no significant difference between these two groups.ConclusionOral nutrition supplementation can reduce the body mass loss and improve the nutritional status in patients with gastric cancer during chemotherapy after operation.

Objective To investigate whether physical training can activate the PI3K/Akt (phosphatidyli-nositol 3-kinase/Protein Kinase B) signal transduction pathway after focal brain isehemia, leading to the reduction ofendothelial cell apoptosis. Methods Twenty-four male adult Sprague-Dawley rats (2 ～ 3 month old, n = 24) weresubjected to 60-min right middle cerebral artery occlusion (MCAO). All rats were randomly assigned to one of thethree groups: physical training group, control group and sham operation group. 24 hours after MCAO ,physical train-ing group underwent 30 min treadmill training per day for 2 weeks. Results After two weeks, the phosphorylationlevel of PI3K/Akt in the physical training group was significantly higher when compared with that in the control group(P <0.05), while the expression level of Bax in physical training group was lower when compared with that in thecontrol group( P < 0.05 ). Conclusion Physical training can activate PI3K/Akt signal transduction pathway,which may be associated with the neurological recovery.

To investigate whether changes of amino acid neurotransmitter releases in the rostral ventrolateral medulla (rVLM) were related to acupuncture and to the antihypertensive effect of melatonin (Mel) microinjected into the anterior hypothalamic area (AHA) of rats with stress-induced hypertension (SIH), as well as to compare and analyze the relationship between the both antihypertensive mechanisms of acupuncture and of Mel in the AHA. Methods: Animal model of SIHR was made by electric foot shocks combined with noises. Electroacupuncture (EA) was used and Zusanli acupoint of both side was selected. The technique of drug microinjection into the brain was used to observe the change of blood pressure (BP), and synchronously, brain microdialysis was performed for collecting dialysate samples, and then the concentration of amino acid neurotransmitters in the dialysate samples was determined by high performance liquid chromatography combined with fluorescent detection (HPLC-FD). Results: After the animal received stress treatment, the BP elevated, synchronously, the release of glutamate (Glu) in the rVLM increased, and when EA was performed, the elevated BP of the rats with SIH decreased,simultaneously, the release of Glu in the rVLM decreased also. After Mel was microinjected of into the AHA of the SIHR, the elevated BP attenuated, meanwhile, the release of Glu decreased,and those of γ-aminobutyric acid (GABA) and taurine (Tau) increased in the rVLM.Administration ofbicuculline, an antagonist of GABAA receptor, into the rVLM prior to microinjection of Mel into the AHA could partially block the depressor effect of Mel in the AHA. Conclusion: The decrease in the release of Glu in the rVLM contributes to the antihypertensive effect of both acupuncture and Mel in the AHA in the rats with SIH, and the increase in the release of GABA and Tau in the rVLM is also important to Mel in the AHA.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition among hospitalized elderly abdominal surgical patients with malignant tumors.MethodsTotally 269 elderly patents ( ≥ 65 years) with malignant tumor who were hospitalized in our department of abdominal surgery from December 2009 to November 2010 were consecutively enrolled.Nutritional Risk Screening 2002 ( NRS 2002 ) was performed on the next morning after admission.Body mass index (BMI) lower than 18.5 kg/m2 was considered as malnutrition.Results The NRS 2002 was completed in all the 269 enrolled patients.The overall prevalence of malnutrition was 30.1％ (81/269) ; more specifically,37.5％ (21/56) among geriatric patients ( ≥80 years) and 17.6％ (43/245) among the other age groups (P =0.001 ).The overall rate of nutrition risk was 38.3％ (103/269) ; more specifically,57.1％ (32/56) among the geriatric patients and 29.3％ (72/245) among the other age groups (P ＜0.001 ).The rate of nutrition risk in patients with pancreas cancer was 58.3％,which was higher than other elderly patients; on the contrary,and the rate of nutrition risk in the patients with colorectal cancer was relatively lower.ConclusionThe rates of nutrition risk and malnutrition in hospitalized elderly abdominal surgical patients ( ≥ 65years) with malignant tumor are relatively higher than other age groups,especially among the geriatric patients.

ObjectiveTo explore the clinical outcome of the combined nutrition support for colorectal cancer patients.MethodsTwo research arms were obtained using a cohort sampling method.Ann A ( the study group): from 2009 to 2010,30 colorectal cancer patients were enrolled.They received nutritional risk screening (NRS) 2002 after admission.Nutritional risk was defined as NRS 2002 score ≥3 three days before operation.Patients with nutritional risk received enteral nutrition (EN) for bowel preparation without laxative drug and enema.After operation,they received EN combined with parenteral nutrition (PN) supports provided.Arm B (control group): 30 cases with historically confirmed colorectal cancer were enrolled from 2007 to 2008.They received routine bowel preparation (diet control,laxative drug,and enema) and PN supports after operation.Nutritional parameters,the rate of infectious complications,the rate of systemic inflammatory response syndrome,and the duration of hospital stay were analyzed.ResultsThere were no significant difference in body weight and plasma albumin between these two arms ( P ＞ 0.05 ). The incidence of systemic inflammatory response syndrome (13.3 ％ ),infectious complications (10.0％ ),and the duration of hospital stay [ (12.3 ± 6.5 ) d ] in arm A were significantly lowerthan those in arm B [33％,30％,and (15.0 ±7.2) d,respectively] (P =0.038,P =0.042,P =0.045).Conclusion For the colorectal cancer patients,nutritional risk screening on admission,bowel preparation with eneral nutrition before operation,and combined nutritional support after operation can improve the clinical outcome.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition,and nutritional support in elderly hospitalized patients.Methods2386 elderly hospitalized patents (aged ≥65 years) in Beijing Hospital from April 2007 to June 2009 were consecutively enrolled.Nutritional Risk Screening 2002 (NRS 2002) was performed on the next morning after admission.Body mass index (BMI)lower than 18.5 kg/m2 or serum albumin lower than 35 g/L was diagnosed as malnutrition.Results Among 2517 enrolled patients,NRS 2002 was completed by 94.8％,including 466 cases in Department of Respiratory,580 cases in Department of General surgery,549 cases in Department of Neurology,180 cases in Department of Nephrology,301 cases in Department of Gastroenterology and 310 cases in Department of Thoracic Surgery in Beijing Hospital.The prevalence of nutrition risk was 28.2％ (673/2 386),and the ratioes of nutrition risk in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 27.5％,30.3％,28.5％,29.4％,25.9％ and 25.4％,respectively.The prevalence of malnutrition was 26.4％,and the ratios of malnutrition in Department of Respiratory,General surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 26.2％,29.8％,26.9 ％,28.3％,22.3％ and 22.9％,respectively.Among 48.1％ of patients with nutrition risk who received nutritional support,the proportions of nutritional support in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 30.1％,85.2％,26.1％,18.2％ 73.8％ and 64.9％,respectively.Among 15.1％ of patients without nutrition risk (NRS＜3) who received nutritional support,the proportions of nutritional support in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 10.6％,25.2％,6.3％,3.8 ％,34.2％ and 17.4 ％,respectively.The ratio of parenteral nutrition (PN) over enteral nutrition(EN) was more than 4:1.ConclusionsA large proportion of elderly hospitalized patients are at nutrition risk and malnutrition.And nutritional support is somehow inappropriately applied.Evidence-based guideline of PN or EN is needed to improve this situation.

ObjectiveTo study the feasibility and technique in liver transplantation (LT) in an adult with situs inversus (SI) and reviewed the medical literature on this subject.MethodsA 45-year-old male with complete SI,suffered from progressive hepatic failure secondary to hepatolithiasis,obstructive jaundice,portal hypertension and liver cirrhosis.He underwent liver transplantation in July 2004.His anatomy was studied by preoperative CT scan and three-dimensional liver reconstruction imaging and angiography.LT was performed using the modified piggyback technique.The donor right liver was rotated 45 degree to the left,making the donor left liver pointing to the left paracolic sulcus and the donor right liver was in the recipient hepatic fossa.The donor suprahepatic vena cava was anastomosed end-to-side to the recipient vena cava,and the infrahepatic vena cava was closed by oversewing.ResultThe patient recovered uneventfully.His liver function was stable during a follow-up of 75 months.ConclusionLT in patients with SI is safe and feasible.Exact determination of the anatomy,comprehensive preoperative planning,and good technique in liver transplantation play important roles in LT for patients with SI.