Objective To investigate the application value of nutritional support therapy after resection of esophageal cancer.Methods The clinical data of 125 patients with esophageal cancer who were admitted to the Shandong Provincial Hospital Affiliated to Shandong University between May and November 2013 were retrospectively analyzed.According to the Nutritional Risk Screening 2002 (NRS 2002), 58 patients with scores of NRS 2002 ≥3 were allocated to the A group including 43 receiving nutritional support therapy in the A1 group and 15 receiving no nutritional support therapy in the A2 group;67 patients with scores of NRS 2002 ＜ 3 were allocated to the B group including 29 receiving nutritional support therapy in the B1 group and 38 receiving no nutritional support therapy in the B2 group.The NRS 2002 was used as a screening tool of nutritional risk within 48 hours after admission.There was nutritional risk in patients with scores of NRS 2002 ≥ 3 and no nutritional risk in patients with scores of NRS 2002 ＜ 3.Patients and their families would choose whether or not underwent nutritional support therapy after the risks being informed.Parenteral nutritional support therapy used any 2 kinds of intravenously infusions of glucose, fat emulsion and amino acid, and enteral nutritional support therapy included tube feeding enteral nutrition or oral nutriments.The calories ≥ 10 kcal/(kg · d) were offered for more than 5 days.The incidence of malnutrition in patients with nutritional risk was calculated, and the level of serum Alb and prealbumin before operation, at postoperative day 3 and day 7, postoperative recovery time of gastrointestinal function and duration of hospital stay were detected.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as-x ± s.Comparison among groups was analyzed using the LSD-t test, and repeated measures data were analyzed by the repeated measures ANOVA.Results Of 58 patients in the A group, 51 patients were complicated with malnutrition with a incidence of 87.9％, and nutritional support therapy in 43 patients was well tolerated without abdominal pain, distension and diarrhea.The level of serum Alb before operation, at postoperative day 3 and day 7 were (29.4 ± 1.7) g/L, (29.8 ± 1.5) g/L, (32.2 ± 2.3) g/L in the A1 group, (28.5±1.9)g/L, (27.0±1.8)g/L, (28.3 ±1.7)g/L in the A2 group, (35.8±1.3)g/L, (36.0± 1.4) g/L, (37.4 ± 2.1) g/L in the B1 group and (34.5 ± 1.3) g/L, (35.3 ± 1.7) g/L, (36.3 ± 1.5) g/L in the B2 group, showing a significant difference in the changing trends between the A1 and A2 groups (F =2.541, P ＜0.05) and no significant difference between the B1 and B2 groups (F =0.734, P ＞ 0.05).The number of patients with level of prealbumin ＜2.5 g/L and ≥2.5 g/L before operation, at postoperative day 3 and day 7 were 17 and 26, 13 and 30, 10 and 33 in the A1 group, 6 and 9, 9 and 6, 10 and 5 in the A2 group, 5 and 24, 6 and 23, 7 and 22 in the B1 group and 7 and 31, 9 and 29, 13 and 25 in the B2 group, with a significant difference between the A1 and A2 groups (x2 =4.183, P ＜ 0.05) and no significant difference between the B1 and B2 groups (x2 =0.795, P ＞ 0.05).The postoperative recovery time of gastrointestinal function and duration of hospital stay were (3.2 ± 0.8) days and (11.6 ± 1.1) days in the A1 group, (3.8 ± 1.0) days and (15.5 ± 2.7) days in the A2 group, (2.7 ± 1.0) days and (10.6 ± 2.6) days in the B1 group and (3.2 ± 0.8) days and (11.3 ±1.5) days in the B2 group, with significant differences between the A1 and A2 groups (t =0.921, 3.005, P ＜0.05) and no significant difference between the B1 and B2 groups (t =0.927, 0.440, P ＞ 0.05).Conclusions Application of NRS 2002 for evaluating nutritional status and guiding nutritional support therapy in patients with esophageal cancer is accurate and trusted.The postoperative nutritional support therapy should be selectively and reasonably applied to patients with nutritional risk, and it can improve the nutritional status of patients with esophageal cancer, enhance postoperative recovery and reduce duration of hospital stay.

Mesenchymal stem cell(MSC) is a kind of tissue stem cell having a characteristics of high self-renewal and multipotency. It is tended to be separated in vitro and play an important role in hematopoietic stem cell transplantation and transplantation of other systems. This article described mesenchymal stem cell's function and mechanism on supporting hematopoiesis, enhancing implantation,adjusting immunity and alleviating graft versus host disease (GVHD) in transplantation and also give some advices and experties about its further application.

Objective To establish an aortic transplantation model in the rat. Methods A thoracic aorta to abdominal aorta interposition transplant model in the rat was established. The male Lewis rats were used as donors and the female Brown Norway(BN) rats were used as recipients.Intercepted the thoracic aorta of lewis rats about one and a half centimeter. Transplanted it on the abdominal aorta of BN rats. The activity and weight change of BN rats were observed everyday until 1 week after transplantation. Then observed these index one time a week. The transplanted aortas were harvested at 8 weeks after transplantation. The intimal thickening were observed by pathological. The expression of CD3,CD68 and α-actin on transplanted aorta were observed by immunohistochemistry. Resuts All operations were finished within 2 hours. No recipients died during operation. All recipients could survival more than 8 weeks. The symptoms of bowing back, hair shedding and weight loss was appeared after transplantation. The weight of the rats were upturn at 4 or 5 days after transplantation. About 1 week after transplantation, all situations of the rats were recovery to the lever before transplantation. 8 weeks after transplantation the intimal thickening of the transplanted aortas were observed obviously by pathological. And the expressions of CD3, CD68 and α-actin on aortic allograft were observed. Conclusion The intimal thickening and the expressions of CD3, CD68 and α-actin on aortic allograft were typical expressions of chronic rejection. So this aortic transplantation model is feasible and reliable for studying chronic rejection.

Objective To observe the curative effect of nourishing the lung and strengthening the spleen and nourishing the lung to the acute exacerbation of chronic obstructive pulmonary disease with malnutrition.MethodsProspective selection 120 cases were diagnosed as AECOPD patients with malnutrition of the Department of respiratory medicine from June 2015 to August 2016,Were randomly divided into EN group and combination group, 60 cases in each group, EN group with high fat and low sugar EN liquid Omega and ω3 Yu You Zhi Fang Ru Zhu She Ye and N(2)-L-alanyl-L-glutamine for Injection, Combined group in the EN group based on the added benefits of lung spleen, compared the Nutritional status and immune function between the two groups.ResultsTwo groups of patients were successfully completed 14d treatment, After treatment, BMI, TSF, MAMC, TP, ALB, PA, HGB, TFN, NB levels were significantly higher than those before treatment (P<0.05);Combined group after treatment, the level of each index was significantly higher than the EN group (P<0.05).WBC, hs-CRP, IL-6, TNF-α levels in the two groups were significantly lower than before treatment, TLC, IgA, and IgG levels were significantly higher than before treatment (P<0.05);the combination group WBC, hs-CRP, IL-6, TNF-αlevel lower than the EN group, TLC, IgA, IgG level higher than the EN group (P<0.05).ConclusionBenefit lung and spleen strengthening traditional Chinese medicine combined with enteral nutrition can improve the nutritional status, respiratory function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease, and has high application value.

Objective To analyze the occurrence of insulin resistance ( IR ) and abnormal glucose metabolism in adolescent polycystic ovary syndrome (PCOS). Methods PCOS group included 141 patients aged 15-19 years old, who were diagnosed as PCOS according to criteria by reference to the European Society of Reproduction and Embryology/American Society for Reproductive Medicine proposed in 2003, at Rotterdam; and 266 age-matched female students,with regular menstrual cycles and no family history of diabetes, were enrolled in control group. Fasting insulin(FINS),fasting plasma glucose(FPC) ,and homeostasis model assessment for insulin resistance ( HOMA-IR) were measured in control group. 73% percentile value of control group was set as physical upper limits of FINS and HOMA-IR. PCOS patients were divided into obese ( OB-PCOS) and non-obese (NOB-PCOS) groups, and oral glucose tolerance test(OGTT) were performed. Results According to 75% percentile value of control group,the physical upper limits of FINS and HOMA-IR were 13.13 mIU/ L and 2.69, respectively. FINS and HOMA-IR values in PCOS group were higher than those in control group [ (17.68±16. 13 vs 10.40±5. 33)mIU/L,2. 64±2.01 vs 2. 01 ±1. 61,both P<0.01]. FINS and HOMA-IR values in OB-PCOS group were higher than those in the NOB-PCOS group [ (22.04± 18.01 vs 13.06± 12. 60) mIU/L,4. 62±3. 87 vs 2.38±2.26,both P<0.01]. In PCOS group,FINS of 75 cases(53.19% )and HOMA-IR of 67 patients(47.52% ) exceeded the physical upper limits. In 79 OB-PCOS patients, FINS of 56 cases (70. 89% ) and HOMA-IR of 52 patients (65.82% ) exceeded the physical upper limits while in 62 NOB-PCOS patients there were 19(30.65% ) and 15 (24. 19% )patients. In PCOS group,2(1.42% ) patients were diagnosed diabetes mellitus,and both FINS and HOMA-IR of these two cases increased. Meanwhile, 12 cases(8.51% ) were impaired glucose tolerance(ICT) ,of whom 11 patients FINS and HOMA-IR increased. Conclusion Pathological IR is prevalent in adolescent PCOS, more severe and popular in obese-PCOS, a part of them with abnormal glucose metabolism.

Objective To evaluate the effect of metformin in treating adolescent polycysfic ovary syndrome (PCOS).Methods Group A [ the metformin and medroxyprogesterone acetate (MPA) group ] was made of 135 adolescents with PCOS taking metformin,and MPA if no menstruation came,while group B ( the control group) consisted of 45 patients taking MPA every two months.Endocrinologic profiles and ovulation were evaluated before and after six months treatment.Results ( 1 ) All patients suffered from anovulation before treatment.( 2 ) Ovulation failure was successfully improved in 74.81％ ( 101/135 )of patients in group A after 6 months,which was significantly higher than that before treatment.In group B,no case recovered ovulation.(3) In group A,fasting serum insulin,homeostasis model assay for insulin resistance ( HOMA-IR),total testosterone,LH were significantly decreased.(4) The retrieval of ovulation was negatively correlated with fasting insulin and HOMA-IR ( both P＜0.05 ). Conclusions ( 1 ) Metformin effectively improves ovulation function and reproductive endocrine parameters in adolescent girls withPCOS.(2) Recovery of ovulation is associated with the decrease of serum insulin.

The molecular targeted therapy method using microRNAs(miRNAs)is gradually stepping into people′s vision. miRNAs affect colorectal cancer progress via abnormal expression in tumor cells or micro-environment. The high or low expressions of miRNAs in specific tissues probably have an impact on the expressions of oncogenes,tumor suppressor genes or other aspects including the surrounding environments,the metastases and the drug tolerance of tumors,thus contributing to curing the colorectal cancer. Nowadays, miRNA has entered the stage of animal experiments.

Aim To quantitatively analyze the lymphocyte proliferation using the time-series data of carboxyfluorescein diacetate succinimidyl ester(CFSE).Methods The model of immune suppression in mice was created by cyclophosphamide and CFSE dye was used for staining the lymphocyte of both control group and treatment group animals. The data were analyzed through mathematical model-fitting.Results The first generation of cell proliferation of the control group and treatment group were 27.17 h and 22.88 h; cell death rates in each division were respectively 20% and 40%; the half-life of cells before the proliferation was respectively 31.53 h and 43.32 h.Conclusions The mathematical fitting of CFSE data can quantitatively analyze the mechanism of the drugs attecting the proliferation of lymphocyte.In this experiment the mechanism of cyclophosphamide inhibiting lymphocyte proliferation may be due to the increase of cell death rate of each division caused by cyclophosphamide.

OBJECTIVE:To investigate the effect and cost of Multidimensional iron oral liquid and Polysaccharide iron com-plex capsules in the treatment of iron deficiency anemia during pregnancy. METHODS:By retrospective study,80 cases of iron de-ficiency anemia during pregnancy were divided into control group and trial group in accordance to different therapy plans,with 40 cases in each group. Control group was given Multidimensional iron oral liquid orally,10 ml each time,bid,after breakfast and supper,for consecutive 4 weeks;trial group was given Polysaccharide iron complex capsules orally,0.30 g each time,qd,for con-secutive 4 weeks. Clinical efficacy,erythrocyte related lab indexes,satisfactory rate and ADR were compared between 2 groups, and cost-effectiveness analysis was adopted for economic evaluation. RESULTS:The total effective rate of experimental group was 95.0%,which was higher than 85.0% of control group,but without statistical significance(P>0.05);hemoglobin level,erythro-cyte count and average volume of erythrocyte of trial group were significantly higher or more than control group,and satisfactory rate(95.0% vs. 65.0%)were significantly higher than control group,with statistical significance(P<0.05);no obvious ADR was found in 2 groups. Total cost of trial group and control group were 243.60 and 166.32 yuan,and cost-effective ratio was 2.56 and 1.96;incremental cost-effective ratio was 7.73. Results of sensitivity analysis were same to the result. CONCLUSIONS:Both Multi-dimensional iron oral liquid and Polysaccharide iron complex capsules can improve anemia in patients with iron deficiency anemia during pregnancy. Polysaccharide iron complex capsules show better therapeutic efficacy and satisfactory rate,but it is relatively ex-pensive. Drugs should be selected according to economic situation.

Objective The level of IL?17A in serum and gingival fluid was measured and the clinical significance was analyzed ,so as to under?stand the relationship between rheumatoid arthritis(RA)and periodontal lesions. Methods The study participants included 20 patients with RA and CP,20 patients with RA,20 patients with RA,20 patients with CP,and 20 healthy controls. All groups were balanced for age,sex,and smok?ing status. The expression levels of IL?17A in serum and gingival fluid of the four groups were determined by ELISA method. Results The level of serum IL?17A in RA+CP group,RA group,CP group and H group respectively 66.6±24.98,46.58±8.50,31.35±5.10,and 29.25±5.50 pg/mL;RA+CP group,RA group,CP group,H group of gingival fluid IL?17A levels were 25.71±5.1,19.97±4.95,18.85±5.36,and 15.38±4.36 pg/mL. The level of serum IL?17A and anti?CCP of patients in the RA+CP group had positive correlation(r=0.446,P<0.05),and the level of gingival fluid IL?17A and anti?CCP of patients in the RA+CP group had positive correlation(r=0.517,P<0.05). Compared with RA group,the visible clinical laboratory ESR,CRP,RF,anti?CCP,DAS28 and HAQ scores of RA+CP group were increased. Conclusion Rheumatoid arthritis may exacerbate the periodontal disease in patients with periodontal disease. On the other hand ,periodontal disease may also promote rheumatoid arthri?tis.