TPN can not only improve the malnutrition of organism resulted from ma- lignant tumour,but also slimulate the growth of tumour.Therefore,how to make best advantages of TPN is of great concern. From July1 994to December1 995 ,we treat- ed73patietns with malignant tumour in di- gestive tract by applying TPN,and achieved very good curative effects. We sum up our experience as following:1 perioperation and chemotherapy is a good indication oTPN which can reduce post- operation com- plication and enhance effect of chemothera- py;2 Itis contraindication of TPN to termi- nal cancer patients without operation and chemotherapy patients,TPN support is helpless;3 Operation and chemotherapy may aggravate the patients stress and cause a high matabolic rate in organism,so application of TPN should stick to the prin- ciples of metabolic support;4Taking Glu- tamine(GLN) and Se will benefit the treat- ment of tumour;5 It amy be helpful to check the growth of tumour by increasing fat emulsion,decreasing or increasing cer- tain amino acid. The questions mentioned above need futher study.

Objective:To investigate the expression of PTEN(phosphatase and tensin hmmlogy deleted on ten) in the breast cancer and the relationship with the tumor angiogenesis.Methods:The expression of PTEN and MVD were detected by immunohistochemical SP method in paraffin section from 53 women with primary breast cancer and 10 subjects of hyperplasia of mammary glands.Results:The higher lever PTEN expression in 53 case with the rate 49.1 %(26/53),which was reduced compared with the expression in benign hyperplasia of mammary glands(P

Objective To explore the change of complications and inflammatory mediators in patients at nutritional risk after intervention with fish oil after major abdominal surgery.Methods Totally 60 patients who had received extrahepatic bile duct exploration ± left lobectomy and radical surgeries for their gastrointestinal tumors in our department from September 2010 to March 2011 were enrolled in this study.Their Nutritional Risk Screening 2002 scores were ≥3 points the day after surgery.These 60 cases patients were randomly divided into fish oil group (n =30) and the control group (n =30).Both groups were treated with total parenteral nutrition isocaloric and isonitrogenous energy emulsion intralipid of 3 Ls' bags after surgery.Aslo,they were treated with electrolyte,vitamins and trace elements equally,which were adjusted according to laboratory tests.The application of parenteral nutrition was no less than 5 days,and the other treatment was provided routinely.Surgeries were performed under general anesthesia in all patients.Urinary catheter was uniformly placed preoperative,and was removed within 24 hours after surgery.The degree of surgical trauma was scored on the operative day.Fasting venous blood samples were collected for measuring the fasting interleukin (IL)-6 and tumour necrosis factor-α (TNF-α) one day before surgery and one and six days after surgery.The relevant complications were recorded.Two patients in the fish oil group withdrew from the study on the third post-operative day.Results TheIL-6 levels were (10.65 ± 4.24),(29.45 ± 9.39),and (13.37 ± 6.99) ng/Land the TNF-α levels were (2.47 ± 1.16),(23.05 ± 11.43),and (6.05 ± 2.97) ng/L in the fish oil group one day before surgery and one and six days after surgery.In the control group,in contrast,the IL-6 levels were (11.17 ± 4.67),(25.10 ± 10.13),and (17.38 ± 7.13) ng/L and the TNF-α levels were (2.70 ± 1.63),(22.11 ± 12.54),and (8.93 ± 3.61) ng/L at the corresponding time points.Comparisons of the IL-6 and TNF-α between the fish oil group and control group showed no significant difference one day before surgery and one day after surgery (P =0.787,P =0.206,P =0.983,P =0.852).Comparison of the IL-6 between the one day and six days after surgery also had no statistical significance (P =0.101).However,the decrease of IL-6 was significantly larger in the fish oil group than in the control group from day 1 to day 6 after surgery (P =0.036).The post-operative levels of TNF-α were significantly different between these two groups (P =0.024).Complications were noted in 3 cases (2 cases of infectious complications) in the fish oil group and in 6 cases in the control group (5 cases of infectious complications) (P =0.002),in which the inffectious complications were also statistically significant (P =0.001).Conclusions Patients at nutritional risks after major abdominal surgeries have higher TNF-α and IL-6 levels.Fish oil can notably reduce the TNF-α level in these patients.In addition,fish oil decreases the surgical complications,in particular the infectious complications.

Objective:To investigate the application and feasibility of the night-vision puncture technique in performing peripherally inserted central catheter(PICC).Methods:Seventy patients were randomly divided into ultrasound guided puncture group or modified blind puncture group,35 cases in each group.The puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,catheterization time and complications were recorded in two groups.Results:Two groups had no significant difference in the puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,phlebitis incidence,subcutaneous congestion (bleeding) (P ＞ 0.05).The catheterization time in modified blind puncture group was shorter than the ultrasound guided puncture group (P ＜ 0.001).In modified blind puncture group,a negative correlation (correlation coefficient:-0.475,P =0.004)between arm circumference and the puncture success rate was found.Conclusion:The puncture success rate of the modified blind puncture technique in performing peripherally inserted central catheter (PICC) is high and close to the puncture success rate of the PICC under ultrasound.Additionally,the modified blind puncture technique does not increase the incidence of complications and delay the catheter time.

Objective This experiment aimed to study the influence of deep sea water (DSW) on wound healing of mice .Methods 24 Mice were randomly divided into two groups :group DSW(n=12) and group sterilize tap water(STW)(n=12) ,freely feeding for 14 days respectively ,and calculated the amount of food and water .On the 15th day ,1 cm × 1 cm size of wound was established on the back area of mice ,and continued to feed with DSW and STW respectively .Tracking the wound healing rate .Specimen was taken in the edge of wound tissue on postoperative 3 ,5 ,7 days ,then observed histopathological changes .Results Compared group DSW with group STW ,there was no significant difference in the total amount of food and water .5 days after the formation of wounds ,the wound healing rate of group DSW was significantly higher than group STW .Histological observation :compared with group STW ,vascular endothelial cells and new capillaries of the group DSW was increased ,and group DSW had less inflammatory cell and more fibroblast cells proliferation .Conclusion deep sea water can promote wound healing .

Objective: To investigate the effects of trentment with hydroxythy starch(130/0.4) on the serum albumin and immunologic function in postoperative patients with obstructive jaundice.Methods: 24 patients with obstructive jaundice were randomly divided into the control group(n=12) and hydroxythy starch(130/0.4) (HS) group(n=12). The serum ALB was detected 1d, 3d, 5d, 7d after the operation,and the immunologic index were detected 1d and 7d after the operation.Results: The ALB content of control group and HS group were not significantly different in the postoperative 1d and 7 d(P>0.05) and had significant differences in the postoperative 3 d, 5 d (P<0.05).All immunologic index had no significant differences in the postoperative 1d, 7d (P>0.05).Conclusion: The ALB content of patients with obstructive jaundice may decrease postoperatively. Treatment with hydroxylthy starch(130/0.4) can alleviate the drop of the ALB content. But it has no effects on immunologic function.

Objective To probe the changes of plasma albumin concentration and its correlation with that of blood inflammatory factors at the postoperative early stage in patients undergoing intraabdominal surgery. Methods From August 2008 to March 2009, 45 patients undergoing abdominal surgery were divided into three groups according to different types of operation with 15 cases in each group, cholecystectomy group( A), chole cystectomy plus common bile duct exploration group(B) and radical resection of alimentary duct maliguance group (C). Before the surgery and 12,24,48,72 h after operation, plasma albumin contentserum IL-6 and TNF-α concentration were measured. Results Postoperatively the content of plasma albumin did not change significantly in group A ( P ＞ 0.05 ), while that decreased after operation in group B and group C(P ＜0.01 ). The postoperative concentration of serum IL-6 and TNF-α increased in group A at 12, 24 h and 48 h after operation(P ＜0.01 ). In group B and group C IL-6 and TNF-α increased at all tested time point after operation ( P ＜ 0.01 ). The postoperative alterations of IL-6 and TNF-α were statistically different between the three groups at all time points(P ＜0.01 ). The content of plasma albumin was in a negative correlation with the concentration of IL-6 and TNF-α; ( r = - 0.376, P = 0.000; r =-0.772,P = 0.000). Conclusions The content of plasma albumin decreased at the early stage after major and moderate abdominal surgery. The content of plasma albumin was in a negative correlation with the concentration of inflammatory factors at the early stage after abdominal surgery.

Objective To observe the clinical efficacy of electroacupuncture at cervical Jiaji (EX-B2) points plus behavioral intervention in treating cervical spondylosis. Method The cervical spondylosis patients were randomized into two groups at a ratio of 3:1, 90 cases in the electroacupuncture group and 30 cases in the medication group. The patients who received electroacupuncture were also given cupping and behavioral intervention (raising head for 1 min every 20-30 min and correcting sleep habits). The clinical efficacy was evaluated according to the symptoms and body signs assessment scale. Result Respectively after 4-week, 8-week, 4-month and 6-month treatments, the clinical control rate, markedly control rate and total effective rate in the electroacupuncture group were significantly higher than that in the medication group. Conclusion Electroacupuncture at Jiaji points plus behavioral intervention is an effective solution to prevent and treat cervical spondylosis.

Ghrelin and motilin (MTL) are mainly secreted by digestive tract,and they both can promote gastrointestinal motility. Disorder of gastrointestinal motility (DGIM)is a gastrointestinal motility or sensory disease mainly caused by neuroregulatory disorder,its main symptoms are nausea,vomiting,abdominal pain and abdominal distension. More and more studies have indicated that ghrelin,MTL and their receptor agonists are closely related to DGIM. This article reviewed the advances in studies on relationship between ghrelin/ GHS-R agonist,MTL/ MTL-R agonist and DGIM.

OBJECTIVETo establish a risk early warning model of human infection with avian influenza A (H7N9) virus and predict the area with high risk of the outbreak of H7N9 virus infection.

METHODSThe incidence data of human infection with H7N9 virus at prefecture level in China from February 2013 to June 2014 were collected, and the geographic and meteorological data during the same period in these areas were collected too. Spatial auto regression (SAR) model and generalized additive model (GAM) were used to estimate different risk factors. Afterwards, the risk area map was created based on the predicted value of both models.

RESULTSAll the human infections with H7N9 virus occurred in the predicted areas by the early warning model in February 2014. The early warning model successfully predicted the spatial moving trend of the disease, and this trend was verified by two outbreaks in northern China in April and May 2014.

CONCLUSIONThe established early warning model showed accuracy and precision in short-term prediction, which might be applied in the active surveillance, early warning and prevention/control of the outbreak of human infection with H7N9 virus.

China ; epidemiology ; Disease Outbreaks ; Humans ; Incidence ; Influenza A Virus, H7N9 Subtype ; Influenza, Human ; epidemiology ; virology ; Models, Statistical ; Population Surveillance ; methods ; Risk ; Risk Factors