Objectives:To evaluate the role of percutaneous endoscopic gastrostomy and jejunostomy in postoperative critical patients. Methods:Percutaneous endoscopic gastrostomy and jejunostomy procedures were performed in 22 postoperative critical patients.Indication, procedure-related complication, technical success and clinical outcome were reviewed. Results:The technical success was 100% and there were no death and serious complication.PEG/J feeding tubes was used for enteral nutrition for more than 30 days in 21(95%) of 22 patients. In 3 patients (14%) , local cleansing, drainage and intravenous antibiotics were used for the infection of PEG site. PEG/J tube dysfunction occurred in 6 patients (27%). Conclusions:PEG/J is a safe, minimal invasive, and effective procedure for enteral nutrition in postoperative critical patients.

Guided by the innovation theory and ideology, the authors'hospital saw to it that the main line of innovative progress ran through the entire process of its development and set up a management engineering framework for innovation in six chief aspects. It managed to achieve “three firsts”, viz. the first to put forward in the domestic medical industry the suggestion of taking strategic actions so as to promote the construction of a clean and honest administration in the hospital; the first among hospitals of the armed forces to cultivate an “experimental plot” that partook of no money earmarked for national defense; and the first among large general hospitals at home to develop into a non profit hospital without government subsidies. It also attained remarkable results in the fight against SARS.

OBJECTIVEThis research aimed to analyze the three-dimensional position of mandibular canal (MC) and man of MC and its relationship with the surrounding structures dibular morphology of normal young males and females by using data from cone beam computed tomography (CBCT), as well as to provide an anatomical basis for clinical surgery of the mandible.

METHODSNormal occlusion and CBCT scans of 29 normal young people were conducted. InVivo 5 software was used to reconstruct the mandible, anchor the points, and measure the jaw shape and three-dimensional course of MC. All measurements were analyzed with SSPS 17.0 software.

RESULTSThe MC lingual bone cortex was thinner than the MC buccal bone cortex, and the distance of the MC to the buccal bone cortex gradually increased. However, the distance of the MC to the tongue bone cortex and alveolar crest gradually decreased from proximal to distal. In addition, the distance of the MC to the mandibular lower margin was minimal at the first molar and reached the maximum at the second premolar. No significant difference was observed among the heights, widths, and thicknesses of the left and right sides of the cortical bone of the mandibular body cross sections. From the midline to the farthest point, the height and lower one-third thickness of the lingual cortical bone of the mandibular body cross sections gradually decreased, whereas the width of the upper cross section and upper one-third thickness of the buccal cortical bone gradually increased. Significant difference was observed in some measured values.

CONCLUSIONAfter MC enter into the mandibular foramen, it moved away from the lingual to the buccal bone but gradually returned to the lingual bone; its general course is closer to the lingual bone. The mandibles of males are thicker than those of females. CBCT can accurately display the course of MC and its relationship with the surrounding structures.

Alveolar Process ; Bicuspid ; Cone-Beam Computed Tomography ; methods ; Dental Pulp Cavity ; Female ; Humans ; Hyoid Bone ; Male ; Mandible ; anatomy & histology ; diagnostic imaging ; Molar ; Software ; Surveys and Questionnaires ; Tongue ; Zygoma

BACKGROUND: Studies have demonstrated that intervention material retention for a period of time in vivo causes pathogenic bacteria surface attachment, proliferation even forming biofilm to become potential source of high polymer catheter-associated infection. Inhibition of biofilm formation significantly reduces infection.OBJECTIVE: To evaluate the antimicrobial effect of anti-infective polyethylene material and its inhibiting effect to biofilm on the surface.DESIGN, TIME AND SETTING: Single sample observation was performed at the National Engineering Research Center for Engineering Plastics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences from June 2008 to May 2009, and the antimicrobial test was performed at the General Hospital of General Staff Headquarters of PLA in March 2009.MATERIALS: Organic antibacterial agent2,4,4'-trichloro-2'-hydroxydiphenyl ether; IONPURE~(R) Silver-Inorganic anti-microbialreagent; low-density polyethylene (LDPE).METHODS: LDPE was respectively blended with organic antibacterial agent and inorganic antibacterial agent, and the LDPE slice was prepared by injection molding process.MAIN OUTCOME MEASURES: The antimicrobial efficacy of anti-infective polyethylene was determined by the plate counting method. The ultrasonic-plate method and scanning electron microscopy were introduced to observe the biofilm formation.biofilm maturation. The propagation of microbe was found to be depressed remarkably on the surfaces of modified samples with organic antibacterial agent, and the formation of biofilm was prevented. The observation of SEM confirmed that no biofilm was formed on the surfaces of PE added organic antibacterial agent. The results showed that a large amount of bacteria and extracellularpolysaccharide matrix adhered on the surfaces of PE added inorganic antibacterial agent and untreated PE.CONCLUSION: Anti-infective polyethylene added organic antibacterial agent possesses excellent antimicrobial performance against S. aureus and E coli, and it can inhibit the formation of biofilm on the surfaces, which provides a promising approach to prevent catheter-related infections.

Objective:To make an empirical study on verifying whether the self-developed simple laparoscopic simulator can play a good role in the training of laparoscopic skills.Methods:Twenty-four Batch 2018 and Batch 2019 undergraduates of five-year clinical medicine of the Army Medical University were recruited in this study, and they were randomly divided into a research group and a control group for 4 weeks of simulation training, 3 times a week, 1 class hour each time. The training content was fundamental laparoscopic skills (FLSs). Before and after the training, the assessment was performed and the results and completion time were recorded. After the training, a satisfaction questionnaire was conducted among all trainees. SPSS 22.0 was used for data statistical analysis.Results:There was no statistical difference between the completion time and assessment results of the two groups before training ( P > 0.05). After four weeks of training, the completion time of the research group was shortened by 10.03% and the training performance increased by 35.17%; the completion time of the control group was shortened by 2.09%, and the training performance improved 12.34%. The comparison between groups found that the research group was superior than the control group, and the performance of the two groups were all improved after training. Most trainees recognized the simulator and were willing to promote it to other trainees according to the questionnaire feedback. Conclusion:The original laparoscopic simulator has a better training effect on simulation training than the traditional apprenticeship teaching has, which is of great significance for the promotion and optimization of laparoscopic skills teaching.

Objective To compare the dosimetric difference on organ at risk (OAR) in intensitymodulated radiotherapy (IMRT) with three-dimensional conformal radiotherapy (3D-CRT) in treatment with cervical carcinoma. Methods 36 cases of cervical cancer patients accepted radiotherapy both on IMRT and 3D-CRT in the same time,clinical target volume (CTV) focused on primary tumor and its lymphatic drainage area.Lymphatic drainage area was determined as follows:1.0 cm extension were added to the margin of pelvic vessels,the obturator lymph nodes region was extended by 1.8 cm from the pelvis inner margin.CTV does not include pelvic tissue. Data of dose distribution and irradiation volume of OAR on the basis of distributing on 45 Gy and 50 Gy were analyzed individually. The margins of planning target volume (PTV) was obtained based on CTV margins by which added 1.0 cm extension in inferior and superior directions,0.7 cm were added in all other directions. Results With the comparison of variety on irradiation volume of organs at risk (OAR) by DVH in both groups,underlying the treatment dose 45 Gy,the individual volume of D30,D40 and D45 were all lesser in IMRT plan than that of 3D-CRT plan. Even on the dose 50 Gy at pelvic wall lymph nodes regions,the volume of OAR was lesser than that in 3D-CRT plan.Conclusion In the radiotherapy of cervical cancer,IMRT should have improved protections for tumor surrounding OAR which has domestic superiority in clinical application.

From June 2007 to June 2009, 133 patients underwent esophageal resection, among them 64 cases received esophageal reconstruction with narrow gastric tube (NGT) and 69 received esophageal reconstruction with whole stomach (WS).The postoperative quality of life (QOL) in 6 months of both groups was investigated.The study found that there were 3 cases in WS group having leakage, while no one in NGT group, the weight loss, regurgitation and chest-stomach syndrome in NGT group were superior to those in WS group, there were no statistical differences in activities of daily life, emotional functions, food intake, dysphagia between two groups.The study indicates that the quality of life in NGT group is superior to that in WS group.

One hundred and seventeen patients with esophageal squamous cell carcinoma were treated with radical esophagectomy from January 2011 to June 2011,among whom 63 cases received early enteral nutrition (study group) and 54 received parenteral nutrition (control group).There were no differences in serum levels of albumin (ALB),prealbumin (PAB) and transferrin (TRF) before surgery between two groups.Serum PAB and TRF levels in study group were significant higher than those in control at d8 after surgery(P ＜ 0.05),and also higher than those at d1 after surgery (P ＜ 0.05).There were no differences in immune indexes in two groups before surgery,the IgA and IgM levels were rising at d8 compared those at d1 after surgery.The total lymphocytes,CD3,CD4,CD8 and CD4/CD8 in study group at d8 were significant higher than those in control group and those at d1 after surgery.The study shows that early enteral nutrition can improve nutritional index and immune function,and to promote rapid rehabilitation in esophageal cancer patients after surgery.

Aim To study the effects of cycle arrest and molecular mechanism in human leukemia HL-60 cells induced by diallyl disulfide ( DADS ) . Methods Cell count, colony formation in soft agar experiments and flow cytometry analysis were employed to observe the DADS-induced cell growth inhibition and the effect of cycle arrest in HL-60 cells. The expressions of Chk1/2 and its downstream element in HL-60 cells were detected by Western blot. Results Cell count revealed that population doubling time increased to 35. 03 h and 71. 82 h, respectively, from 19. 14 h in HL-60 cells treated with 60 and 120 μmol·L-1 DADS ( P<0. 05 ) . Colony formation in soft agar experiments showed that colony formation inhibition rate of HL-60 cells exposed to 30, 60, 90 and 120μmol·L-1 DADS increased to 35. 06%, 62. 10%, 93. 79% and 99. 35%, respectively ( P<0. 05 ) . Flow cytometry a-nalysis exhibited that HL-60 cells treated with 60 and 120 μmol · L-1 DADS for 24 h and 48 h arrested in G2/M phase in a concentration-and time-dependent manner ( P <0. 05 ) . Western blot disclosed that the expression of p-Chk1 increased in a time-dependent manner ( P <0. 05 ); however, Chk1, Chk2 and p-Chk2 were not changed in HL-60 cells treated with 60μmol·L-1 DADS (P >0. 05). The expression of Cdc25C, CyclinB1 and CDK1 decreased after treated with 60 μmol·L-1 DADS in a time-dependent manner ( P<0. 05 ) , but the expression of 14-3-3 protein did not change ( P>0. 05 ) . Conclusion DADS can in-hibit the proliferation of HL-60 cells, and induce G2/M arrest through Chk1/Cdc25 C/CyclinB1/CDK1 path-way.

Objective To study the relationship between facial skin conditions and TCM constitutional types; To provide new means and methods for guidance of skin conservation and skin health improvement from the aspect of constitutional types. Methods Totally 2241 female volunteers in nine provincial capital cities and municipalities participated in this research, and were investigated by web questionnaire. Constitutional types were determined according to the“Classification and Judgment of TCM Constitutional Types”standard issued by China Association of Chinese Medicine. Skin color, glossiness, delicate degree, moistness, firmness, resilience, uniformity and other indicators were scored. Skin conditions were classified into three groups:1-3 score group, 4-6 score group, and 7-9 score group, and the constitutional differences among each group were compared. Results Yang-deficiency and mild constitutional types accounted for the largest proportion. Yellowish skin color accounted for the largest proportion, and the next were white, dark and reddish. Yang-deficiency constitutional type accounted for the largest proportion in 1-3 score group, and the second was Qi-stagnation; Yang-deficiency and mild constitutional types accounted for the largest proportion in 4-6 score group; mild constitutional type accounted for the largest proportion in 7-9 score group. Conclusion People with mild constitutional type got highest score in every skin index, while biased constitutional types influenced the score in varied degrees. The constitutional types which influenced Chinese urban females’ facial skin index more were Yang-deficiency and Qi-stagnation constitutional types.