Objective:To investigate the correlation among prognostic nutritional index (PNI), clinical features, and adverse reac-tions after adjuvant chemotherapy of gastric cancer patients who underwent radical gastrectomy. Furthermore, this study aimed to clari-fy the predictive and prognostic significance of PNI in patients who underwent gastrectomy for gastric cancer. Methods:This study re-viewed the medical records of 148 patients with gastric cancer who underwent gastrectomy. The PNI value was calculated by serum al-bumin concentration (g/L)+5 × lymphocyte count (×109/L). The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the PNI. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. Re-sults:The mean values of the PNI in<65 years old patients (P<0.01), T1 and T2 stages of tumor (P<0.01), and negative lymph node (P=0.013) were significantly higher than those without such factors. Patients with higher PNI had significantly lower rates of postoperative complication and adjuvant chemotherapy adverse reactions than those with lower PNI (P<0.01). When the PNI value was 52.08, the Youden index was maximal, with a sensitivity of 66.7%and a specificity of 34.3%. The overall survival rate in the high PNI group was higher than that in the low PNI group (P<0.01). The univariate and multivariate analyses showed that preoperative carcinoembryonic antigen level (P=0.018), tumor depth (P=0.010), intravascular cancer embolus (P=0.010), time to initiation of chemotherapy after sur-gery (P=0.034), and the PNI value (P=0.015) were independent factors in predicting overall survival rate. Conclusion:The PNI value was a simple and useful tool to predict the prognosis and the incidence of adjuvant chemotherapy adverse reactions of gastric cancer pa-tients after radical gastrectomy.

Objective To explore the relationship between serum levels of leptin and the physieal development and the infuences of diseases on the levels of leptin in prematurities.Methods To collect the clinical data as well as weights,lengths of 40 sick premature infants(sick group)and 30 premature infants without sick diseases(control group)and to test the serum levels of leptin using radioimmunoassay(RIA)at 1d,7d and 12d of life,and to analyze the differences of serum levels of leptin and weights,lengths and body mass index(BMI)between two groups.Results In both groups the BMI and the serum levels of leptin were decreased at d7 of life and reincreased at d12 of life(P＜0.01),and the serum leptin levels were corresponding to the changes of the physical development of premature infants at ld,7d and 12d of life(P＜0.01).The serum leptin levels were lower in sick group compared with control group at 7d and 12d of life(P＜0.05).Conclusion It suggested that there was positive correlation between serum leptin level and the physieal development in prematurities and diseases had negative influences to the leptin levels.

Objective To investigate the early change of the function of hemostasis and coagulation as well as clinical significance in the full-term newborns recoveried from stifle.Methods To detect the platelet count (PLT),prothrombin time,fibrinogen and D-dimer in early stage of 50 newborns with different degrees of asphyxia recovreied from stifle,and compared with the control group.Results Compared with the control group,there were not obvious change in PLT in asphyxiated full-term newborns(P>0.05),and the differences of prothrombin time,D-dimer and fibrinogen were statistically significant(P<0.01),the more serious degree of asphyxia,the lower of the fibrinogen and higer of the D-dimer.Conclusions The function of hemostasis and coagulation can be changed in early stage of newborns recoveried from stifle.The detection of fibrinogen and D-dimer in early stage of newborns recovefied from stifle has important clinica significance.

Objective To evaluate the impact of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on patients after hepatectomy. Methods Seventy-eight patients undergoing liver resection were randomized prospectively into two groups: EEN group receiving early enteral nutrition (n=35) and PN group receiving parenteral nutrition (n=43). The patients in both groups received isocaloric and isonitrogenous nutritional formulas 24 h after operation and the formulas were stopped on postoperative day 7. The general conditions, liver function tests, clinical complications,and clinical nutritional variables at three time points that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD 8) were observed. Results No significant differences were found in length of hospital stay, liver function and clinical nutritional variables between the 2 groups. In the EEN group, the serum prealbumin level almost returned to the preoperative level on POD 8. The nutritional complication rate of the EEN group was increased significantly but it was milder than that of the PN group. The time of gut function recovery in the EEN group was shorter than that of the PN group. The costs of nutritional drugs showed a significant decrease in the EEN group.Conclusion Early enteral nutrition is safe, rational and effective in patients who have undergone hepatectomy. Early enteral nutrition is better than parenteral nutrition in promoting liver function recovery, liver protein synthesis, postoperative recovery of gut function and decreasing costs of nutritional drugs.

Objective To investigate the diagnostic value of 16 ku-38 ku-ESAT-6 protein in tuberculosis (TB). Methods ELISA was used for measuring the level of recombinant 16 ku-38 ku-ESAT-6 protein in 105 TB patients (TB group,26 patients with smear-positive, 79 patients with smear-negative) and 45 controls (control group, 20 healthy volunteers and 25 subjects with pulmonary diseases other than TB). The value of the antigen for diagnosis of TB in serodiagnosis was assessed, and ROC curve evaluation system was established. Results In control group, the positive rate of anti-recombinant 16 ku-38 ku-ESAT-6 protein and commercialization of TB antibody test kit had significant difference [6.67% (3/45) vs. 51.11% (23/45)](P＜0.01);but in TB group, there was no significant difference [59.05%(62/105) vs. 64.76% (68/105)](P＞0.05). The optical density value in TB group and control group was 2.22 ± 0.58 and 1.35 ± 0.24,and there was significant difference(t = 6.06,P＜ 0.01). The sensitivity, specificity, positive predictive value and negative predictive value of the test was 59.05%,93.33%,95.38%,49.41% respectively. Analyzed by ROC curve, the area under the curve was 0.751, the- value of cutoff was 2.52, and sensitivity and specificity was 65.4% and 84.8%. Conclusions Recombinant 16 ku -38 ku -ESAT-6 protein of mycobacterium tuberculosis has higher specificity, and it can significantly distinguish TB and non-TB. So it might be selected as one of diagnosis antigens of TB.

OBJECTIVETo study retrospectively the clinical efficacy on pediatric recurrent pneumonia treated with point application in summer for the prevention in winter, as well as the relationship of age, sick duration, attack frequency and skin reaction with the clinical efficacy.

METHODSOne hundred and thirty-five cases of pediatric recurrent pneumonia were divided into a one-year group, a two-year group and a three-year group, 45 cases in each one according to the duration of treatment. The acupoints for the application were Dingchuan (EX-B1), Feishu (BL 13), Gaohuang (BL 43) and Danzhong (CV 17) with the same herbal plaster (prepared with rhizome corydalis, semen brassicae, euphorbia kansui and asarum sieboldii at the ratio of 2:2:1:1) on the first day of each of the three periods of the hot season, 2 to 4 h in each treatment. The attack frequency and change rate were observed before and after treatment in the three groups. The clinical efficacy was assessed in the three groups.

RESULTS(1) After treatment, the attack frequency of pediatric pneumonia was reduced apparently in the three groups (all P < 0.01). The result in the three-year group was less than that in the one-year group and the two-year group and the change rate was the highest (all P < 0.01). (2) After treatment, the sick duration was shortened apparently in the three groups (P < 0.05, P < 0.01). The result in the three-year group was the most remarkable, statistically and significantly different as compared with the other two groups (both P < 0.01). (3) The total effective rate in the three-year group was better than that in either of the other two groups [84.4% (35/45) vs 51.1% (23/45, P < 0.01), 84.4% (35/45) vs 71.1% (32/45, P < 0.05)]. (4) The total effective rate in the children aged from 4 to 7 years was better than that in the group aged from 8 to 10 years and the group aged from 11 to 14 years [79. 7% (47/59) vs 71.7% (33/46, P < 0.05); 79.7% (47/59) vs 43.3% (13/30, P < 0.01)]. (5) The total effective rate in the children with the sick duration ≥ 4 year was lower than that in the group with the sick duration <2 years and that 2 to 4 years (both P < 0. 01). (6) The total effective rate in the children with the annual attack frequency of 2 to 4 times was better than that with the frequency ≥ 4 times (P < 0.01). (7) For the cases with skin reaction after treatment, the total effective rate was better than that in the cases without reaction (P < 0.05).

CONCLUSIONThe point application in summer for the prevention in winter reduces the attack frequency of pediatric pneumonia, shortens the sick duration and has achieved the better significant efficacy in the cases of lower age, shorter sick duration, less attack frequency and moderate skin reaction.

Acupuncture Points ; Adolescent ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Pneumonia ; drug therapy ; prevention & control ; Seasons ; Treatment Outcome

Cell-Free Nucleic Acids ; blood ; Female ; Humans ; Mosaicism ; Placenta ; Pregnancy