Objective To explore the factors related to the tolerance to enteral nutrition (EN) in gastric carcinoma patients undergoing surgical treatment and the implementation strategy of EN.Methods Fifty-four patients with gastric carcinoma undergoing surgery from November 2011 to September 2012 in the Affiliated Hospital of Medical College of Qingdao University were enrolled.EN were applied with sequential and gradual strategies.The tolerance status to EN was recorded.Factors related to the patient tolerance to EN were analyzed using single-factor and multiple-factor Logistic regression analysis.The incidences of gastrointestinal symptoms during EN application were recorded.Results Among the 54 patients,49 (90.74％) patients could tolerate EN.Single-factor analysis and multiple-factor Logistic regression analysis both showed that tumor staging (single-factor analysis:x2 =7.287,P =0.007 ; multiple-factor analysis:t =2.559,P =0.014) and surgical approach (singlefactor analysis:x2 =7.825,P =0.005 ; multiple-factor analysis:t =2.254,P =0.043) were major factors affecting patient tolerance to EN.Among the patients tolerant to EN,abdominal distension (19/49,38.8％) was the major gastrointestinal symptom of EN.Conclusion The sequential and gradual EN application strategy is suitable for the patients with gastric cancinoma after surgery,and can be widely used in clinical practice.

Objective To explore 18F-FDG PET-CT in the detection of malignant tumors of the gastrointestinal tract.Methods 39 patients with gastrointestinal tumors who was diagnosed with operation,pathological examination,clinical and imaging follow-up undertake the whole-body 18F-FDG PET-CT.Results The sensitivity and specificity were both 100.0 ％ for primary malignant tumors.Gastric metastases sensitivity,specificity and accuracy were 80.0 ％ (4/5),90.9 ％ (10/11),87.5 ％ (14/16),and the colorectal metastases sensitivity,specificity,accuracy of diagnostic results were 88.9 ％ (8/9),92.9 ％ (13/14),91.3 ％ (21/23).The gastric cancer lymph node metastasis sensitivity,specificity and accuracy were 50.0 ％ (3/6),90.0 ％ (9/10),75.0 ％ (12/16),in the diagnosis of colorectal local lymph node metastasis the sensitivity,specificity and accuracy were 71.4 ％ (5/7),93.8 ％ (15/16),87.0 ％ (20/23).Conclusion The 18F-FDG PET-CT imaging for gastrointestinal malignant tumor diagnosis and residual lesions recurrence or lesions metastases of detection is of important value and better than traditional examination methods.

Objective To investigate the changes of geometry and function of left ventricle (LV) and left atrium(LA) in hypertensive male patients with concentric remodeling.Methods Consecutive male patients were divided into two groups: normal control group(NC group,n=146) and concentric remodeling group(CR group,n=274).The whole patients were checked with echocardiogram.Echocardiographic parameters included: thickness of interventricular septum(IVST) and LV posterior wall(PWT),LV end-diastolic diameter(LVIDd),media-lateral diameter(LVID),LV length(LVL),LA anterior-posterior diameter,media-lateral diameter,superior-inferior diameter,LA area,LV end-diastolic volume,end-systolic volume,stoke volume,ejection fraction(EF),early diastolic peak velocity (E) and atrial contraction peak velocity(A) of the mitral valve flow.LV mean diameter(LVMD) and E/A were calculated.Student t test was used to compare the variables between the two groups.Results IVST,PWT,IVST/LVPWT ratio,LA diameters and LA area in CR group were larger than those in NC group.LVIDd was shorter and LVID was larger in CR group than in NC group.LVL in CR group was larger than that in NC group.LVMD/LVL ratio was smaller than that in NC group.There was no significant difference in LVEF between two groups while E/A ratio in CR group was smaller than that in NC group.Conclusions The concentric remodeling in hypertensive patients makes the LV a thin,long but thick-walled cavity.The LV diastolic function is impaired in CR group but the systolic function reserves well.

The serum contents of Cu, Fe, Zn, Pb, Cr, Mn, Ca, Mg, and K in 360 adults from different work in Nanjing were determined by atomic absorption spectrophotometry. The data were analysed by grouped statistical treatment, and the relationships among sex, age and work time were discussed. The results showed that serum Cu, Fe, Zn, Cr, Mn, Pb, Ca, Mg, K differed greatly in the different workers. There was a perfect positive correlations between Cu, Zn, Cd, Mn, Pb, Mg and age, and a negetive correlations berween Cu, Fe, Zn, Cd, Cr, Pb, Mg and work time. The serum Cu, Zn, Ca, K in women were higher than that in men.

Objective To explore the CT findings of benign and malignant pancreatic neuroendocrine tumors and improve its diagnostic accuracy.Methods The clinical information and enhanced CT findings of 96 cases with pathologically-proved pancreatic neuroendocrine tumors were retrospectively reviewed.The CT findings were evaluated by several factors,which included tumor size,morphology,location,internal composition,calcification,separation,bile duct and pancreatic duct dilation and CT value.Results All cases were divided into benign or malignant according to pathological grades,and benign group involved 40 cases with 41 lesions,while malignant group involved 56 cases with 59 lesions.The size of malignant lesions was significantly larger than that of benign lesions (median size 6.0 cm vs 2.2 cm),the shape of the lesions was irregular,and was mainly cystic solid,and mottling,curve shape,clumps calcification was present,then the bile duct and pancreatic duct was mild to moderately dilated,and the difference between the two groups was statistically significant (P ＜0.05).But the difference of tumor location,separation was not significant.45.76％ (27/59) of the malignant lesions reached the peak value in arterial phase,and 44.07％ (26/59) reached the peak value in venous phase;while 68.29％ (28/41) of the benign lesions reached the peak value in arterial phase,and 31.71％ (13/41) reached the peak value in venous phase.The CT values of malignant lesions in plain CT scanning,arterial phase,venous phase,balance phase were (39.02 ±7.53),(121.20 ± 54.73),(125.25 ± 40.77),(101.41 ± 28.68) Hu,while they were (41.49 ± 8.59),(144.73 ± 53.95),(157.05 ±44.72),(121.02 ±29.80) Hu in benign group.In plain CT scanning,the difference of CT value between malignant and benign lesions was not significant;but in the enhanced phase,the CT value of malignant lesions was significantly lower than that of benign lesions,and the difference was statistically significant (P ＜ 0.05).Conclusions The lesion with its size ≥ 3.0 cm,irregnlar morphology,cystic necrosis,calcification,pancreatic and bile duct dilatation is suggestive of malignancy tumor.The average CT values of malignant group are lower than those of the benign group in arterial,venous and balance phases.

Objective To explore the remodeling modes and the plaque distribution of atherosclerotic BA at 3.0T high resolution MRI.Methods 90 symptomatic patients with atherosclerotic stenosis of BA on digital subtraction angiography (DSA) (50 ％-99 ％) were recruited consecutively.Luminal area,vessel area of maximal narrow sites and the reference sites were measured.The differences of involved imaging parameters between negative group and positive group were analyzed.Results 51 patients with required imaging quality were enrolled finally.Among the 51 patients,the rate of positive remodeling cases was 72.5％ (37/51) and negative remodeling took over 27.5％ (14/51).Compared with the negative remodeling group,the positive remodeling group had greater plaque size,larger plaque burden percentage,and higher maximal wall thickness at maximal lumen narrowing sites.The plaques were mainly located at ventral wall of the vessel.Conclusion 3.0T high-resolution MR imaging could be applied in assessing the remodeling modes and plaque distribution of BA stenosis.

Objective To investigate the application of MRI targeting contrast agent ( P-Gd-Probe) for P selectin in evaluating the severity grades of acute pancreatitis (AP).Methods L-arginine solution (100mg/100kg) were intraperitoneally injected for 3 times once an hour to establish AP model in SD rats. Control group was injected with normal saline in a equal volume .All rats were divided into acute edematous pancreatitis (AEP) group (6 h and 12 h after model establishment)and acute necrotizing pancreatitis (ANP) group (24 h and 48 h after model establishment ) based on the pathology .The rats were examined by T 1 WI plain and enhanced scanning at 6 h, 12 h, 24 h and 48 h after injection , and P-Gd-probe was as the enhanced contrast agent.The signal noise ratio ( SNR) of the pancreas were measured before and after enhancement .Then the pancreas tissues were harvested for pathological examination and P selectin expression in pancreatic tissue was detected using immunohistochemical analysis .Results Inflammation was observed in pancreatic tissue at 6h after establishment , and became more serious as the modeling time extended .P selectin expression was increased as pancreatitis inflammation became more serious .The SNR of control group was stable before and after enhancement.The SNR before and after enhancement was 17.22 ±1.35 and 37.38 ±1.66 in AEP group, and 16.29 ±1.39 and 58.18 ±1.03 in ANP group.The SNR after enhancement was higher than that before enhancement, and the differences were significantly different ( t=-49.59 and -86.09, P<0.001 ). Conclusions Monoclonal antibody MRI contrast agent targeting P selectin is helpful in evaluating the severity of AP.

Objective To observe the clinical efficacy of Zhuanyaotang Granules for the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Using a randomized double blind controlled design,104 DLSS patients were divided into an experimental group and a control group using a random number table method,with 52 patients in each group.The treatment group took oral Zhuanyaotang Granules,methylcobalamin tablets and celecoxib capsule simulants.The control group used Zhuanyaotang Granules simulants,methylcobalamin tablets and celecoxib capsules.The course of treatment was 3 weeks for both groups.The follow-ups were conducted at 1 month and 3 months after treatment.The intermittent claudication distance,visual analogue scale(VAS)score and JOA efficacy rating criteria for low back pain score were observed in both groups before treatment,1,2,3 weeks of treatment and 1 month after treatment and 3 months after treatment.Adverse reactions during treatment were recorded.Results There were 5 cases of detachment and 2 cases of exclusion in the experimental group,and 5 cases of detachment and 1 case of exclusion in the control group.Compared with before treatment,there were statistically significant differences in intermittent claudication distance,VAS score,and JOA score between the two groups of patients at various time points during treatment and follow-up(P<0.05);there was no statistically significant difference in intermittent claudication distance,VAS score,and JOA score between the experimental group and the control group before treatment and 1 and 2 weeks of treatment(P>0.05);compared with the two groups at 3 weeks of treatment and 1 and 3 months after treatment,the intermittent claudication distance and JOA score in the experimental group were lower than those in the control group(P<0.05);There was no significant difference in VAS score between the two groups and the control group after 3 weeks of treatment(P>0.05).There were 2 adverse reactions(4.4%)in the experimental group and 5 adverse reactions(10.8%)in the control group,without statistical significance(P>0.05).Conclusion Zhuanyaotang Granules can effectively relieve pain and improve lumbar function in patients with DLSS,which is more effective and safer than oral celecoxib capsules and methylcobalamin tablets.