ObjectiveTo explore the effects of enteral nutrition (EN) on intestinal permeability in patients with active ulcerative colitis (AUC). MethodsTwenty-four A UC patients were randomly divided into two groups:routine treatment group (n =11 ) and routine treatment plus EN group (n =13). Patients in routine treatment group were treated with mesalazine as well as low-residue diet, while patients in routine treatment plus EN group received mesalazine and short peptide EN for 14 days. The ratio of lactulose to mannitol in urine (L/M) before and after treatment was detected by high-performance liquid chromatography. ResultsThe L/M ratio was 0. 039 ± 0. 025 in routine treatment group and 0.072 ± 0.019 in routine treatment plus EN group (P =0.069). After 2 weeks of treatment, the L/M ratio of routine treatment plus EN group (0.038 ± 0.012 ) was significantly lower than the pretreatment level (P =0.043 ), while the L/M ratio of routine treatment group between before and after treatment had no significant difference (0.039 ± 0.025 vs. 0.032 ± 0.022, P =0.730). ConclusionEN can effectively improve the intestinal permeability in AUC patients.

Chemotherapy is recommended for stage Ⅲ B/ Ⅳ non-small cell lung cancer (NSCLC) treatment.The treatments for elderly patients with advanced NSCLC are mainly single-agent chemotherapy and platinum-based combination chemotherapy.However,elderly patients tolerate chemotherapy poorly because of agerelated comorbidities.Therefore,the curative effect of elderly patients is relatively poorer as compared to their younger counterparts.Targeted therapy and immune therapy have become new research directions.It is important to select an appropriate program for elderly patients according to geriatric assessments.

The abnormality of long interspersed nuclear element-1 (LINE-1) is closely related to the occurrence and development of tumor.Overexpression of LINE-1 can promote cell proliferation and affect the prognosis and metastasis of tumor.The retrotransposition and methylation status of LINE-1 have potential application value in clinical diagnosis,prognosis,disease monitoring and treatment.

Consensus ; Hirschsprung Disease ; diagnosis ; Humans

A large size tertiary comprehensive hospital designed the performance reform program not only based on RBRVS and DRGs but also combined with cost control and medical quality and safety. The hospital have implemented performance reform at 2016, with achieving the public welfare and fairness by "combination" and exploring a set of performance management methods which suit the hospital's actual condition and boost its development.

Objective:To evaluate clinical efficacy and safety of immunotherapy by retrospectively analyzing clinical medica-tion of patients with recurrent pregnancy loss(RPL)complicated with abnormal immune factors.Methods:A retrospective cohort study was conducted on RPL cases in outpatient department of Hebei Reproductive Health Hospital from January 2021 to April 2022.Efficacy and safety of immunotherapy were evaluated from pregnancy outcome,adverse reactions and birth defects of offspring.Results:According to guidelines,192 cases with abnormal autoimmunity and/or immune indicators were included.Early abortion rate was 4.16%in group of two lost pregnancies,which was lower than that in group of three lost pregnancies(16.66%).Twelve week sus-tained pregnancy rate was 89.58%in the former group,and 28 week sustained pregnancy rate was 86.45%,which were significantly higher than those in the latter group(75.00%,71.87%).RPL patients were divided into groups according to their exposure to immuno-modulatory drugs before 12 weeks of pregnancy.There was no significant difference in pregnancy outcome,adverse reaction rate and birth defect rate of their offspring(P>0.05).Conclusion:Immunotherapy can effectively reduce risk of recurrent abortion and increase rate of persistent pregnancy in patients with immune RPL.Personalized immunotherapy can make RPL patients with immune factors achieve expected effect of fetal protection.

Objective:To explore the safety and feasibility of optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation(DKT)and evaluate its effectiveness to provide more alternative protocols for kidney transplantation from extended criteria donors.Methods:DKT was performed in 10 recipients using the same protocol from June 2019 to May 2021.And retrospective reviewing was performed for clinical data, including characteristics of donors and recipients, optimized pathological evaluation system, modified surgery, treatment regimens, complications and follow-ups.Results:There were 8 male and 2 female donors with an age of(57.9±12.8)years and BMI(24.1±4.1)kg/m 2.The percentage of DCD was 70% and DBD 30%.The serum creatinine before procurement was 107.6(93.3-163.5)μmol/l.Zero-point puncture biopsy was performed for both kidneys and optimized pathological evaluation system was implemented(Banff criteria & Remuzzi score). The pathological results indicated that glomerular sclerosis for left and right kidneys were 2.0(1.5-2.0)and 1.5(1.0-2.0). And Remuzzi score for left and right kidneys were(4.4±1.2)and(3.6±1.5)points respectively.All recipients were male with an age of(43.1±9.0)years and BMI(22.2±1.9)kg/m 2.All PRAs were negative pre-operation.Modified surgery was performed in all recipients(two kidneys were implanted outside iliac vessels without patch and artery of superior kidney was anastomosed to internal iliac artery). Operative duration was(195±54.3)min and serum creatinine before discharge 125.0(102.0-199.0)μmol/L.Renal dynamic scintigraphy indicated that glomerular filtration rate was(30.0±8.2)ml/min for left kidney and(29.2±13.9)ml/min for right kidney.MRA results indicated that morphologies of renal arteries and veins were regular.The time between operation and discharge was(22.4±4.7)days.Compared with SKT, serum creatinine before discharge of DKT was lower and DGF incidence of DKT was higher without statistical significance.The time between operation and discharge was longer for DKT than that for SKT( P<0.05). The complications consisted of 20% donor derived infection(DDI)and 50% DGF.And there was no surgical complication associated with vessels and ureter.Renal function remained stable during 6-month follow-ups. Conclusions:Optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation are both safe and feasible.The postoperative function of transplanted dual kidney is successfully restored.However, long-term follow-ups are required for evaluating its effectiveness.