Objective:To investigate the effects of enteral nutrition support in inoperable advanced gastric cancer patients during chemotherapy.Methods:This was a prospective randomized study.A total of 62 patients with advanced gastric cancer were firsted evaluated according to the Nutritional Risk Screening 2002 (NRS 2002) scale,and were randomly divided into two groups.All patients received oxaliplatin combined with tegefur gimeracil oteraci.Patients in the control group (n =30) received chemotherapy along with nutrition consultation,and patients in the treatment group (n =32) were provided enteral nutrition-additionally.NRS 2002 assessment was conducted before and after chemotherapy,The body weight,BMI,serum albumin,and the efficacy and toxicity were collected during the study.Results:Patients in the treatment group had significantly higher serum albumin levels,body weight and BMI than those of the control group (P ＜ 0.05).No differences were found as for the efficacy and toxicity of chemotherapy between two groups.Conclusion:Enteral nutrition support therapy can improve the nutrition status of gastric cancer patients who received chemotherapy and reduce the risk of malnutrition.

Objective To investigate the relationship between the eosinophil (Eos) percentage and levels of eosinophil cationic protein (ECP) in induced sputum and the severity of late onset asthma(LOA) and differential diagnosis. Methods Fifty-four patients with LOA were selected. The percentage of eosinophil and levels of ECP were measured by Wrigbt′s stain and immuno-CAP system respectively. The lung function was also evaluated. The same indexes were measured in 25 elderly patients with chronic obstructive pulmonary disease (COPD) and 10 healthy elderly subjects as control. Results The percentage of Eos and levels of ECP in induced sputum in patients with LOA were significantly and negatively correlated with FEV_1/FVC (r=-0.68,-0.61, respectively, P

Pancreatic cancer is a highly malignancy of the digestive system, with low early diagnosis rate and poor prognosis. Cancer cachexia, muscle and adipose tissue wasting are important factors affecting surgical complications and long-term prognosis of patients with pancreatic cancer. On one hand, the occurrence and development of pancreatic cancer cachexia are associated with the decrease of food intake. On the other hand, the characteristic of tumor hypermetabolism, many inflammatory factors, fat and protein regulatory factors and many neuroendocrine pathways are also involved in pancreatic cancer cachexia. At present, the understanding of cancer cachexia and tissue wasting is not comprehensive, and the diagnostic methods are not unified. The main screening method is based on body mass index, but it is not applicable to obese patients. The detection of serum cytokines and determination of intramuscular fat content based on the abdominal computed tomography scan also play pivotal roles in the diagnosis of pancreatic cancer cachexia. Perioperative inhibition of tissue wasting can not only reduce surgical complications, but also improve the prognosis of pancreatic cancer patients. However, there is no effective method to completely reverse cancer cachexia. Multidisciplinary treatment is the routine therapy. Surgical treatment to remove the tumor is the fundamental measure to impede the development of cachexia. In addition, strengthening nutritional support, reducing inflammation and stress reaction, reducing the muscle wasting are also important in the treatment of cachexia during the perioperative period. Combined with self experience, the authors comprehensively analyze research advances, summarize the etiology, molecular mechanism, diagnosis and treatment of tissue wasting, in order to investigate tissue wasting and perioperative treatment strategies of pancreatic cancer patients.

Purpose:A comparison of the therapeutic effect studied by ?-rag,selec- tive asteriography and TAIC on advancing gastric carciomas with HM(hepatic metastasis) in 41 cases and NHM(without hepatic metastasis)the other 35 were reported.The correla- tion of primary and metastatic lesions including the efficacy of TAIC were also evaluated, Materials and Methods:Every case was undergone CAG;in addition LGA+CA were al- ways performed in cases of carcinoma of cardiac end of stomach so as CHA,either CA or LGA for gastric antrum carcinomas;while FDM(5Fu+CDDDP+MMC)were the drugs used for the majority of the patients.Results showed the number with large extent gastric carcinoma(≥one part of gastric zone)accompanied by moderate to severe deformaties in HM group were obviously greater than those of the NHM group(P

0. 05). However, the serum CYFRA21-1 level was related to the histologic classification (P

Objective To investigate the effect of liver cirrhosis on the potency of propofol for sedation in rats. Methods Fifty-eight male SD rats, aged 10-12 weeks, weighing 180-220 g, were randomly divided into 3 groups: control group (group C, n = 18), mild liver cirrhosis group (group M1, n =20) and severe liver cirrhosis group (group M2, n = 20). The model of liver cirrhosis was established using four factors described by Chen et al. After successful establishment of the model, propofol was injected intravenously. The dose of propofol was determined by up-and-down sequential method for loss of righting reflex. The dose of propofol was 5.912 mg/kg in the first rat and the ratio of the doses between the two consecutive rats was 0.85. ED50 of propofol was calculated using up-and-down sequential method. Results ED50 of propofol was significantly lower in group M1 and M2 than in group C and in group M2 than in group M1 ( P ＜ 0.05 or 0.01 ). Conclusion The liver cirrhosis can enhance the potency of propofol for sedation in rats.

Objective To investigate the effects of remifentanil on lipid peroxidation druing hemorrhagic shock-induced acute lung injury (ALI) in rabbits. Methods Thirty-two healthy adult rabbits weighing 2.0-2.5 kg were randomly divided into 4 groups (n = 8 each): sham operation group (group S); ALI group; low-dose remifentanil group (group LR); high-dose remifentanil group (group HR). The left femoral artery was cannulated for blood-letting and blood sampling. The right femoral artery was cannulated for remifentanil administration. The model of hemorrhagic shock was established by modified Wigger' s methods. In group S, only cannulation was performed. In group LR and HR, remifentanil was infused intraperitoneally at 0.66 and 1.32 μg·kg-1 ·min-1 15 min before blood-letting respectively, while group ALI received equal volume of normal saline instead. Arterial blood samples were taken at 0, 20,70 and 100 min after blood-letting (T1-4) for blood gas analysis. The animals were then sacrificed and the lungs were immediately removed for histological examination with light microscope and determination of W/D lung weight ratio, MDA content and SOD activity. Results W/D ratio and MDA content were significantly increased, while SOD activity was significantly decreased in group ALI compared with group S (P ＜0.05). The pH value at T2 and PaO2 at T2-4 in group LR and the pH value and PaCO2 at T2-4 in group HR were significantly higher than those in group ALI (P ＜ 0.05). W/D ratio and MDA content were significantly lower,while SOD activity was significantly higher in group LR and HR than in group ALI, and in group HR than in group LR (P ＜ 0.05). Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil pretreatment can attenuate hemorrhagic shock-induced ALI through inhibiting lipid peroxidation in rabbits.

OBJECTIVETo investigate the regulation of leptin on insulin secretion and expression of ATP-sensitive potassium channel subunit sulfonulurea receptor 1 (SUR1) mRNA, and to determine whether the effects of leptin are mediated through known intracellular signaling transduction.

METHODSPancreatic islets were isolated by the collagenase method from male SD rats. The purified islets were incubated with different concentrations of leptin for 2 h in the presence of different concentrations of glucose. Insulin release was measured using radioimmunoassay. Expression of SUR1 mRNA was detected by RT-PCR.

RESULTSIn the presence of leptin 2 nmol/L, insulin release was significantly inhibited at either 11.1 or 16.7 mmol/L glucose concentration (both P < 0.05), but insulin release was not altered at glucose of 5.6 mmol/L physiological concentration. The dose-response experiment showed that the maximal effect of leptin on insulin secretion achieved at 2 nmol/L. Exposure of islets to 2 nmol/L leptin induced a significant increase of SUR1 transcription levels by 71% (P < 0.01) at 11.1 mmol/L glucose and by 56% (P < 0.05) at 16.7 mmol/L glucose concentration. Selective phosphatidylinositol 3-kinase (PI 3-kinase) inhibitor wortmannin significantly prevented the leptin effect on insulin secretion and SUR1 mRNA expression.

CONCLUSIONSRegulatory effects of leptin on insulin secretion could be biphasic at different concentrations of glucose and leptin. The stimulatory regulation of SUR1 transcription levels may be mediated through activation of PI 3-kinase pathway, which may be a possible mechanism of leptin in regulating insulin secretion.

Animals ; Butadienes ; pharmacology ; Cells, Cultured ; Dose-Response Relationship, Drug ; Insulin ; secretion ; Islets of Langerhans ; drug effects ; metabolism ; Leptin ; pharmacology ; Male ; Nitriles ; pharmacology ; Phosphatidylinositol 3-Kinases ; physiology ; Potassium Channels, Inwardly Rectifying ; genetics ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

Objective: To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction (AMI).
Methods: Our research included 2 groups of AMI patients who received percutaneous coronary intervention (PCI)
in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group,n=146 and Control group,n=142, in which the AMI patients without ventricular aneurysm formation. The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age, gender, hypertension, hyperlipidaemia, diabetes, smoking, family history, MI history, anterior myocardial wall infarction, angina pectoris, left main (LM) disease, the lesion at proximal left anterior descending (LAD) artery, NYHA classiifcation III/IV, chest pain time ≥ 24 hours and ST-segment elevation ≥ 4 adjacent leads in ECG.
Results: Compared with Control group, the patients in Ventricular aneurysm group had the elder age (OR=1.023, 95% CI 1.000-1.046), higher incidence rates of smoking (OR=1.819, 95% CI 1.130-2.928) and anterior MI (OR=9.162, 95% CI 4.657-18.028), more patients with ≥ 4 adjacent ST-segment elevation (OR=6.571, 95% CI 2.426-17.798), while less patients with angina pectoris (OR=0.557, 95% CI 0.335-0.927, allP<0.05. With adjusted relating factors of age, gender, hypertension, diabetes and angina pectoris, the multivariate Logistic regression analysis indicated that smoking (regression coefifcient: 0.833, OR=2.301, 95% CI 1.283-4.125), anterior MI (regression coefifcient: 1.799, OR=6.041, 95% CI 2.831-12.894) were positively related to ventricular aneurysm formation.
Conclusion: Smoking and anterior MI were strongly related to ventricular aneurysm formation in patients after AMI.

Compared with other postoperative complications following pancreatic resection, chylous leakage is rare in clinical, which could lead to serious morbidity, including malnutrition,immunosuppression and abdominal infection. The main risk factors for chylous leakage after pancreatic resection are the injury of cisterna chyli or lymphatic vessels caused by intraoperative lymph node dissection and early enteral nutrition. The clinical features of chylous leakage are not specific, and the diagnosis mainly depends on the composition analysis of the drainage fluid. The diagnostic criteria generally adopt the expert consensus of the international Study Group on Pancreatic Surgery,but it is only applicable to isolated chylous leakage and there is still no widely accepted diagnostic criteria in most complex cases. Abdominal fluid analysis and abdominal CT scan are the most applied diagnostic methods for chylous leakage after pancreatic resection,while lymphangiography can not only identify the site of leakage,but also has therapeutic value. For its treatment,the"step-up"treatment strategy is typically applied in most patients. Conservative treatments, including drainage,proper diet and applying octreotide, can benefit most patients. Surgical treatment is not commonly used,and its therapeutic value needs to be further verified. Optimizing perioperative management measures and personalized treatment strategies for different patients can effectively prevent postoperative chylous leakage and maximize the clinical benefits of patients who received pancreatic resection.