Objective To study feasibility and effects of early enteral nutrition(EEN) after total gastrectomy in elderly patients of gastric cancer. Methods Sixty-six cases of gastric cancer underwent total gastrectomy were divided into two groups randomly. One group was treated with EEN, another with parenteral nutrition(PN). Results The difference of nutritional status and incidence of posteroprative complications between EEN and PN group had no statistical significance, but the EEN group had earlier recovery of intestinal function and shorter hospital stay when compared with PN group. Conclusions EEN is an effective way of postoperative nutritional support in elderly patients of gastric cancer, which is safe, reliable, simple and clinically valuable.

AIM:To investigate the relevance between metallothionein(MT) and matrix metalloproteinase-2 (MMP-2) expression and activity in hepatic stellate cells (HSCs). METHODS: Fifty Kunming male mice, weighing 25 g?5 g, were randomly divided into two groups: experiment group (40 mice) and control group (10 mice). CCl4 was used to induce the hepatic fibrosis model in the experiment group. Conditioned medium of HSCs (containing MMP-2) was added at different concentrations of MT, then MMP-2 activity was detected. Liver tissue microarray was used. Collagen fibers was detected by Sirius red staining. The expressions of MMP-2 and MT proteins in liver tissues were detected by immunohistochemistry staining. Gel zymography was used to confirm the activity of MMP-2 in liver tissue homogenate and in the conditioned medium. RESULTS: The expressions of both MMP-2 and MT proteins in liver tissues increased fluctuating with the process of fibrogenesis in the model mice alternately, but the proteins showed out of phase changes. The activity of MMP-2 in the liver tissues also increased gradually and fluctuated with the development of fibrosis. Apart from individual time points, the activity of MMP-2 and MT expression were negatively correlated. The activity of MMP-2 in the conditioned medium treated by MT declined in a dose-dependent manner (r=-0.9990, P

Objective To investigate the improving effect of Hedysari radix polysaccharide on the behavior and its influence on cerebral central neurotransmitters in senescence accelerated mouse prone 8 (SAMP 8).Methods The senescence accelerated mice 8 were randomly divided into a model group,a Hedysari radix polysaccharide (HRP) group and a aricept group.SAMRl were served as the control group.After intragastrical treatment for 3 months,the behavior changes and the levels of norepinephrine (NE),dopamine (DA),5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were observed respectively by applying Morris water maze and high performance liquid chromatography (HPLC).Results In the SAMP8 model group,the hidden platform test showed that the latency to find the hidden platform was remarkably prolonged,the latency range from third day to fifth day was (55.31 ±9.62) s,(58.67± 10.89) s,(58.45± 10.53) s,respectively.The level ofNE、DA、5-HT and 5-HIAA was (4.97± 1.74) mmol/L,(1.63±0.57)mmol/L,(4.29±0.94)mmol/L,(2.91±0.85)mmol/L respectively,significantly reduced (P＜0.01).Compared with model group,the latency of hidden platform test was (44.73 ± 9.83) s,(40.53±8.37)s,(44.75±9.16)s respectively,which were remarkably shortened.The expression level ofNE,DA,5-HT and 5-HIAA in the HRP treatment group was (7.58± 1.62) mmol/L,(3.25 ±0.70) mmol/L,(7.04±0.95) mmol/L,(4.62±0.79) mmol/L respectively,which obviously increased (P＜ 0.05).Conclusion HRP could improve learning and memory ability of SAMP8 and the effect may related to up-regulate the expression level of cerebral Central neurotransmitters.

The expressions of Livin and Caspase-9 were detected by immunohistochemical technique in 60 duode-nal adenocarcinoma tissues and 30 adjacent normal tissue. The positive expression rate of Livin in duodenal adeno-carcinoma tissues was significantly higher than that of adjacent normal tissue,and the expression of Caspase-9 was lower than that of adjacent normal tissue ( P<0.01 ) . The expression of Livin was negatively correlated with the ex-pression of Caspase-9 ( P<0.01 ) . The expression of Livin and Caspase-9 was closely correlated with the progress of pathological changes, degree of development,lymph nods metastasis,and clinical stages,but not with sex,age and tumor size ( P>0.05 ) . Livin and Caspase-9 were associated with occurrence and development of duodenal adeno-carcinoma,and the expression of the above two were negatively correlated. Livin and Caspase-9 may be considered as reliable markers for clinical diagnosis,therapy efficacy and the prognosis of duodenal adenocarcinoma.

ObjectiveTo investigate rational surgical therapy for patients aged at 70 and up suffering from cardiac cancer. Methods 79 cases admitted from 1991 to 2000 were treated by transabdominal total gastrectomy with a radical resection rate of 73% and palliative resection rate of 19%. Results The average age was 74 6 years with a ratio of male to female of 4 6∶1. The average course of the disease was 3 1 months, and only 1 (2%) case got early diagnosis,while the misdiagnosis rate was 54%. Postoperative complication rate was 38%, mortality rate was 3%. Conclusions With the preoperative concurrent disease properly managed and the operation appropriately performed senile patients with cardiac cancer could also be managed successfuly as young patients .

Objective To establish an experimental model of HCV C-HBV X coexpression protein and explore its effect on tolemerase activity. Methods The HBV X gene was recovered by enzyme digestion, cloned into PBK-CMV and PBK-HCV C, and the recombinant plasmids PBK-X and PBK-X-C were obstained. The plasmids PBK-CMV, PBK-X, PBK-HCV C and PBK-X-C were transfected into HepG2 cells with liposome. After selected with G418, positive colonies were obtained. The reverse transcription PCR and Western blotting were used to detect HBV X and HCV core protein expression and PCR-ELISA for tolemerase activity. Results The recombinant plasmid PBK-X-C could express HBV X and HCV core protein efficiently. The telomerase activity of the cells coexpressed HCV C-HBV X protein was higher than that of cells expessed HBV X, HCV C and vector only. Conclusion HBV X-HCV C coexpression protein can increase the telomerase activity of HepG2 cells, which suggests that HBV and HCV can cooperate with carcinogenesis.

Objective To investigate the effect of percutaneous transluminal coronary angioplasty (PTCA) and stent implantation with intraaortic balloon pump (IABP) on immediate death rate and cardiac function of patients with acute myocardial infarction (AMI) complicated with cardiogenic shock.Methods Emergency coronary angiography was taken 0.5-32 h after the attack, and PTCA and stent implantation performed on infarction related artery (IRA), supported by IABP until patients′ complications improved. Myocardial echocardiography was taken 5 weeks after operation.Results Except for 4 patients who died of aggravated shock or cardiac failure, all the patients had IRA reperfusion. Twenty-four patients had stents implanted (85.71%). Mean time from attack to reperfusion was 8.6 h, and death rate in the period of 5 weeks was 31.25%. EF of the 22 patients who survived was 0.43～0.67.Conclusion PTCA and stent implantation supported by IABP can improve results of operation,increase reperfusion rate, decrease immediate death rate and improve cardiac function.

Objective To compare of flexible ureteroscope holmium laser lithotripsy and percutaneous nephrolithotomy in treating renal stones of ≤2cm.Methods In this retrospective study,we compared 120 patients of renal pelvic stones of ≤2cm size treated with FURS(n=62)or PCNL(n=58).Factors such as operation time,hospitalization time,stone-free rate(SFR),drop in haemoglobin level,and complications were analyzed.Results The stone burden of the FURS group and PCNL group was(1.4±0.2)cm and(1.6±0.3)cm respectively.In FURS group,The operation time was(28±12)min with postoperatlve fever in 3 cases;he hospitalization time was(3.7±1.8)days.The decrease of hemoglobin was(0.18±0.06)g/L.No major complication was recorded.The SFR was 85.5%(53/62)one week postoperatively and 95.2%(59/62)one month postoperatively.In PCNL group,the operation time was (42±15)min with postoperative fever in 2 cases and bleeding in 2 case.The hospitalization time was 6.8±1.5 days.The decrease of hemoglobin was(14.30±3.50)g/L.The SFR was 91.4%(53/58)one week postoperatively and 96.6%(56/58)one month postoperatively.Conclusion For renal stones≤2cm,FURS has the advantages of shortening operation time,reducing blood transfusion requirements,decreasing postoperative complications with a farely SFR compared with PCNL.FURS is a good alternative.

Objective To explore the influence of Hedysari radix concentrations fluid (HRCF) on learning and memory and its effect on cerebral monoamine neurotransmitters in senescence accelerated mice. Methods The senescence accelerated mice were randomly divided into the senescence accelerated mouse/resistance 1 (SAMR1) control group, senescence accelerated mouse/prone-8 (SAMP8) model group, HRCF treatment group and aricept treatment group. After 3 months of intragastrical treatment, the learning and memory ability changes and content of norepinephrine, dopamine, 5-hydroxytryptamine and 5-hydroxyindoleacetic acid were detected respectively using Morris water maze and high performance liquid chromatography. Results In the model group, the hidden platform test indicated that the latency to find the hidden platform was remarkably prolonged, and the content of norepinephrine, dopamine, 5-hydroxytryptamine as well as 5-hydroxyindoleacetic acid were significantly reduced (P<0.01). Compared with the model group, the latency of hidden platform test was remarkably shortened (P<0.05) and the content of norepinephrine, dopamine, 5-hydroxytryptamine as well as 5-hydroxyindoleacetic acid were obviously increased in HRCF treatment group (P<0.01). Conclusion HRCF could improve learning and memory ability of SAMP8 and the influence may related to increasing the content of cerebral monoamine neurotransmitters.

The PBL was adopted by the author in training medic in the department of digestion.The method has shown that it can improve the capability of independent study,spirit of team cooperation,clinical practice ability and improve comprehensive qualities.In the meanwhile,it can improve the tutor's all-around caliber.To guarantee the teaching effect,the tutor should especially comprehend the theory and skills of PBL,to design masterly clinical questions,to ensure the practice time and assistant facilities thoroughly.