Objective To explore the safety and effectiveness of using low molecular weight heparin (LMWH) in place of warfarin for anticoagulation in patients with a previous cardiac valve replacement. Methods We reviewed 70 patients hospitalized from Jan 2002 to Apr 2009 undergoing abdominal surgery who have had a previous cardiac valve replacement and had been on warfarin anticoagulation therapy. LMWH began to replace warfarin for anticoagulation 3 clay before the surgery in 33 cases, while the other 37 patients simply ceased to use any anticoagulant since 3 days before the surgery. Postoperative bleeding and embolism risk were compared between these two groups. Results There were 2 patients suffering from postoperative bleeding in the operative field in LMWH group, while there was no postoperative bleeding in patients on anticoagulant suspension group (χ~2=0.641, P>0.05). There was no valve embolism occurred in these two groups. Conclusions It is a safe way to stop using warfarin with LMWH taking the task for perioperative anticoagulation in patients with a history of cardiac valve replacement 3 days before an elective abdominal surgery. This protocol decreases the risk rate of valve embolism not at the expense of increasing postoperative bleeding.

Objective To evaluate the effects of nutritional support combined with human growth hormone recombinant (rhGH) in patients with mechanical ventilation. Methods One hundred and fifty cases in ICU were randomized into test group (nutritional support combined with rhGH, 80 cases) and control group (nutritional support,70 cases). Both groups received calories according to Harris-Benedict formula [N, 0.25 g/(kg· d)]. In addition, the test group received subcutaneous injections of rhGH at a dose of 0. 1 U/ (kg· d) for 7 days. The different effects on nutritional status indexes, immunological function indexes and clinical indexes were compared. Results Compared with the control group,there were significant improvement in nutritional status indexes and immunological function indexes after the treatment of 7 days. The success rate of once weaning was higher in test group than that in control group. There were significant differences in the level of transferrin, prealbumin, CD3, CD4, NK between two groups [(3.0 ± 0.6)g/L vs. ( 1.9 ± 0.4) g/L, (226.46 ± 27.02 ) mg/L vs. ( 188.68 ± 17.27 ) mg/L, (53.8 ± 3.3 ) % vs. (47.4 ±4.1 ) %, ( 0.41 ± 0.14 ) % vs. (0.25 ± 0.05 ) %, ( 16.1 ± 2.1 ) % vs. ( 10.9 ± 3.0 ) %] ( P ＜ 0.01 ). Conclusion rhGH combined with nutritional support has more effects on improving nutritional status compared with those of single nutritional support. It has significant adjustment effect on immunological function in patients with mechanical ventilation.

Objective To investigate the effect of Helicobacter pylori infection on cell proliferation and apoptosis of gastric cancer cell line SGC 7901. Method SGC 7901 cells were incubated with 1 × 108,5 × 107,1 × 107,5 × 106 cfu / ml concentration gradient of the standard HP NCTC 11637 strains in vitro. Morphological changes of cells were observed at 24, 48, 72 hour, respectively. Cell proliferation inhibition rate were detected with MTT assay. Apoptosis were observed by flow eytometry and TUNEL analysis, mRNA expression of survivin were detected by RT-PCR, and survivin expression were determined by western blot. Results Cell proliferation inhibition rate was 54.5%, 58.9%, 67.6%, 72.9% with 1 × 108,5 × 107, 1 × 107,5 × 106 cfu / ml concentration gradient of the HP bacteria on the role of SGC 7901 cells at 72h, respectively. The rate of apoptosis after 72h detected by flow cytometry and TUNEL with HP concentration gradient of different bacteria were 42.51%, 45.67%,48.57%, 49.51% and 54.61%, 51.26%, 59.41%, 62.46.% Helieobacter pylori could significantly reduce mRNA and protein expression of survivin. These effects were strengthened as the concentration of Helicobacter pylori increased and the time extended. Conclusion H. Pylori infection may be through reducing the expression of survivin to inhibit cell proliferation and pro-mote apoptosis of SGC 7901 in vitro. Moreover, this effect was positive related with time and dose.