The enteral nutritin(EN) is the prefer- able rout of clinical nutrition support.But its septic complication,in especial,the pul- monary aspiration is serious and fatal some- times.In this report,3elderly male patients receiving EN were described;the pathogene- sis,the pathological changes,the clinical features,diagnosis,prevention and treat- ment of aspiration from EN were discussed; and itis stressed that for prevention of aspi- ration the effective method is the use of feeding tube via jejunostomy to maintain EN.

Diabetic retinopathy (DR) is a serious complication of diabetes mellitus,which leads to vision loss or even blindness.Nuclear factor erythroid 2-related factor 2 (Nrf2) is a redox-sensitive transcription factor and plays an important role in oxidative stress and tissue injury associated with inflammation.More and more evidences show that Nrf2 play an important role in the onset and development of DR.This paper reviewed the role of Nrf2 pathway in diabetes mellitus and DR,and correlation between Nrf2 pathway and vascular endothelial growth factor (VEGF) expression.

After major operation,a series of complicated pathological and physiological changes will occur during the trauma and stress state.The protein synthesis is affected,which results in negative nitrogen balance.In addition,the release of inflammatory factors can damage the capillary endothelial cells and increase the permeability of micrangium,induce vascular colloidal albumin leakage to the extravascular tissue,decrease plasma albumin,make wound edema,eventually lead to postoperative hypoproteinemia.Except for albumin supplement,it should be aimed at the mechanism to control the stress response and reduce the leakage caused by the release of inflammatory factors to solve this problem radically in clinical work.The reports about the causes and treatment of hypoproteinemia after major surgery were reviewed to provide evidence for clinical treatment.

Objective: To determine the relationship between serum omentin-1 concentration and bone mineral desity in postmenopausal women, and the adipose influence of tissue on bone mineral density (BMD). Methods: BMD values of 336 participants were measured by dual-energy-x-ray absorptiometry (DEXA) at various skeletal sites: the anteroposterior spine, femeral neck, total hip (T-hip) and total body BMD (TBMD). Body compositions including lean tissue mass (LTM) and body fat mass (FBM) were measured by DEXA. hTe plasma concentrations of adipocytokines (omentin-1, adiponectin,leptin,resistin,visfatin, andapelin) were measured by ELISA. Results: hTe overweight and obese groups had higher T-hip,femerol neck, intertrochanter BMDthan the nomal weight group. Plasma omentin-1 was negatively correlated with anteroposterior spine, femeral neck, trochanter, intertrochanter, T-hip and Ward’s BMD, after adjustment for age, BMI and fat body mass, and the correlation was not significant. Multiple stepwise regression anlysis revealed that lean body mass, menopause duration and estrogen level were the most important variables affecting the BMD and each explained 12.2%–13.7%, 6.9%–13.1%, 0.9%–1.7% of the variance. Serum adiponectin was independently associated with T-hip, lumbar spine and total BMD. Conclusion: Plasma omentin-1 is not significantly correlated with BMD in postmenopausal women. Lean body mass, menopause duration and estrogen level are the most important variables affecting the BMD. Serum adiponectin is an independent predictor of T-hip, lumbar spine and total BMD.

Apolipoprotein A-I (apoA-I) is a member of the apolipoprotein A family, which was discovered the earli-est. It has an important role in the regulation of lipid metabolism, which mainly includes cholesterol synthesis and transfer. Therefore, apoA-I is closely related to hyperlipidemia and atherosclerosis. Clinically, serum ApoA-I/ApoB has been used as one of the indexes of hyperlipidemia. This article reviewed the study progress in ApoA-I's gene polymorphism and its relationship with reverse cholesterol transport (RCT).

Medium-chain triglycerides(MCT) is one kind of saturated fat,which not only has the same characteristics to the long-chain triglycerides(LCT),but also has its special features.This article reviews the metabolism of MCT,its metabolic influences on the energy and other nutrients,and the progress in clinical use in recent ten years.

Gastric cancer is the leading cause of death of patients with malignancy and the most common malignancy in China.Stomach is also a secretory organ,thus the carcinogenesis of human stomach always accompanied neuroendocrine differentiation.There is not a explicit definition of neuroendocrine differentiation so far,and the influence of which in gastric patients prognosis is in dispute.With the deep intensive research of gastric adenocarcinoma,diagnosis and treatment in gastric adenocarcinoma with neuroendocrine differentiation becomes increasingly concerned.

Objective To understand the current status of students' self-efficacy and sense of life meaning in medical college students, and explore the relationship between them, then give advice to improve the students' general self-efficacy and the sense of life meaning.Methods A random sampling method was used to select 386 undergraduates in a medical college from freshman to senior.The purpose in life test (PIL) revised by He Jiying (1994) and general self efficacy scale (GSES) revised by Wang Caikang (2001) were used in this research.Data were analyzed by SPSS 18.0 software, and the data were analyzed by t test, x2 test, Spearman correlation analysis.Inspection level of alpha=0.01 (double side).Results The score of GSES was (2.62 ± 0.40), and the score of PIL was (74.06 ± 11.09);t test showed that the PIL score of students with higher GSES score was higher than the PIL score of students with lower GSES score (t=5.054, P=0.000);The correlation analysis showed that GSES score was positively correlated with PIL score (r=0.283, P=0.000).Conclusion The general self-efficacy and sense of life meaning of medical college students are in the medium level, and the positive correlation exists between the two.A series of measures should be adopted to strengthen the students' general efficacy, so as to improve their sense of life.

Objective: To investigate the characteristics of mortality of injury among residents in Gusu District, Suzhou City, Jiangsu Province from 2013 to 2023, so as to provide the evidence for developing targeted measures of injury prevention and control. Methods: Gender, age and underlying cause of deaths due to injury in Gusu District were collected through Death Reporting Information System of Chinese Disease Prevention and Control Information System and Jiangsu Death Reporting Information System from January 1, 2013 to December 31, 2023. The crude mortality, Chinese-standardized mortality and world-standardized mortality of injury were analyzed, and the trend in mortality was analyzed using annual percent change (APC). Results: Totally 4 217 deaths due to injury were reported in Gusu District from 2013 to 2023. The crude, Chinese-standardized and world-standardized mortality rates were 51.58/105, 23.24/105 and 21.98/105, respectively, all showing a tendency towards a rise (APC=6.802%, 2.688% and 2.823%, all P<0.05). The crude mortality rate of injury was higher in women than in men (54.61/105 vs. 48.41/105, P<0.05). The five most common causes of injury included fall (32.99/105), traffic accidents (6.03/105), suicide (4.23/105), drowning (3.00/105) and asphyxia (2.16/105), accounting for 93.86% of the total number of deaths. The crude mortality rates of fall, suicide and asphyxia appeared a tendency towards a rise (APC=9.724%, 6.333% and 5.638%, all P<0.05). The crude mortality rates of injury among men, women and overall residents appeared a tendency towards a rise with age (all P<0.05). Fall was the primary cause of injury death among residents aged 65 years and above, and suicide was the primary cause of injury death among residents aged 15 to 44 years. Conclusions The crude mortality of injury appeared a tendency towards a rise in Gusu District from 2013 to 2023. The main causes of death were fall, traffic accidents, suicide, drowning and asphyxia, with the crude mortality of fall, suicide and asphyxia showing an upward trend.

Objective To compare the survival effects between using electron beams (EB) and modulated X-ray beams (XB) for boosting irradiation in breast cancer patients after breast-conserving surgery and postoperative radiotherapy.Methods This study retrospectively included 485 breast cancer patients who underwent breast-conserving surgery at Beijing Cancer Hospital.All patients underwent either EB or XB for tumor bed boost irradiation (10-16 Gy/5-8 fractions) after whole-breast irradiation of 46-50 Gy/23-25 fractions.Results Median follow-up time for the cohort was 96.04 months.Statistically significant increase of local recurrence free Survival (LRFS) was observed in XB group than in EB group.The 5-year and 10-year LRFS was both 98.4％ in XB group,as well as 94.2％ and 93.2％ in EB group,respectively (x2 =4.190,P ＜ 0.05).But there was not statistically significant difference in 5-year and 10-year overall survival (OS) between XB group(96.7％ and 95.8％) and EB group(94.9％ and 89.4％),respectively (P ＞ 0.05).The multivariate analysis showed that LRFS was significantly correlated with age≤40,positive pathological lymph nodes and positive expression of Her-2 receptor.But boost irradiation method was not independent prognostic factor for LRFS and OS (P ＞ 0.05).Conclusions For cancer patients treated with breast-conserving surgery and whole-breast postoperative radiation followed by a boost irradiation to tumor bed,XB irradiation was superior to EB irradiation in term of LRFS,yet no difference of OS was observed in both groups.