Objective: To sum up the therapeutic effect of early enteral nutrition(EN) in postoperative patients with esophageal or cardiac cancer.Methods: The clinical data of 106 postoperative patients with esophageal or cardiac cancer who had received early enteral nutrition treatment were analyzed retrospectively.Results: All the patients recovered well.The occurrence of the serious postoperative complication,such as anastomotic leak,hypoalbuminemia and so on had been decreased.Conclusion: Early EN for postoperative patients with esophageal or cardiac cancer is a physiological nutrition support way.EN can maintain gastrointestinal function and improve nutritional status.

Objective To analyze the chest CT appearance of relapsing polychondritis with severer tracheobronchial malacia and improve diagnosis veracity.Methods Five patients with relapsing polychondritis received CT examination and the CT appearances were studied.Results The characteristic appearances in CT were throat tracheal and branch stenosis.The tracheal cartilages thickened and membranous wall was normal.Conclusions Distinguishability of CT is high,which can display the area and characteristics of the pathological changes CT examination is an efficient method of diagnosis of relapsing polychondritis,and can direct selecting treating methods.[Chinese Medical Equipment Journal,2008,29(2):84-85]

Objective To explore the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the death risk evaluation in elderly patients with chronic disease in five years.Methods A total of 765 elderly patients with chronic disease[136 patients with coronary heart disease (CHD),76 patients with hypertension disease (HD),86 patients with chronic obstructive pulmonary disease (COPD),75 patients with Type 2 diabetic mellitus (T2DM),76 patients with cerebral infarction (CI),73 patients with coronary heart disease combined with hypertension,71 patients with coronary heart disease combined with chronic obstructive pulmonary disease,61 patients with coronary heart disease combined with diabetic,51 patients with coronary heart disease combined with cerebral infarction,and 60 patients with three comorbidity] were classified into the survival group (312 cases) and the death group (453 cases) according to disease prognosis.The serum NT-proBNP levels of 88 healthy controls and 765 elderly patients with chronic disease were determined by bi-directional lateral flow immunoassay.The death events were followed up and observed for an average of 5 years.The results were analyzed statistically.Results The serum NT-proBNP levels in the death group with various diseases were significantly higher than the survival group (P ＜0.01),the patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels,the patient's age and the Proportion of male in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05).The serum NT-proBNP levels in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05),and were significantly higher than the survival group (P ＜ 0.01).The patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels in the death group in the different periods had statistical significance (P ＜ 0.01),and were significantly higher than the survival group and healthy control group (P ＜ 0.01).The more shorter of the survival time was,the higher the serum NT-proBNP 1eve was.The serum NT-proBNP levels were negatively correlated with the survival time of the patients (r =-0.378,P =0.000).The receiver operator characteristic (ROC) curve indicated that the optimal cut-off values of serum NT-proBNP levels for the death risk evaluation in elder patients with chronic disease were 1 499.50 ng/L.Kaplan-Meier survival curve showed that the survival rates of serum NT-proBNP levels had significant difference (P ＜0.01).The higher the serum NT-proBNP level was,the more shorter of the Survival rates were.Conclusions The levels of serum NT-proBNP have an important prognostic value in the death risk evaluation in elderly patients with various chronic disease.It is an independent risk factor for the death occurred in eiderly patients with chronic disease.The levels of serum NT-proBNP are closely correlated with the survival rates and survival time of elderly patients,It can be used as a monitoring indicator of the elderly patients with chronic disease in risk stratification.

Objective To evaluate surgical therapy for recurrent rectovaginal fistula.Methods In this study.two patients were treated by endorectal advancement flap repair and one patient was treated by vascular pedicled segment of small bowel.Results All patients were cured and followed up from 4 to 20 months.During the period of follow-up there was no recurrence.Conclusions The procedures and timing of operation are important factors for a successful repair.Both the endorectal advancement flap and patch of intestine provide an effective methods in repairing recurrent rectovaginal fistula.

Objective To explore the relationship between hospital service culture model and the satisfaction degree of employees.Methods To build a hospital service culture model through qualitative and quantitative research and make it into the hospital service culture questionnaire and use the satisfaction scale to investigate and analyze the sample.Results The hospital service culture model conforms to the standard modeling, which consists of a sense of belonging, sense of achievement, ability development, self-reconciliation, humanization, effective communication, effective performances and win-win.These eight factors have significant positive correlations with the employee satisfaction (P<0.01).Regression analysis showed that the 8 factors on employee satisfaction prediction coefficient was between 0.062~0.241 (P<0.05 or P<0.01, P<0.001).Conclusion The sense of belonging, sense of achievement, development ability, self-congruity, humanity, effective communication, efficiency and win-win in hospital service culture have become positive predictors in different degree and range of employee satisfaction.

Objective To evaluate the prevention and treatment effect of butylphthalide injection in delayed encephalopathy after severe carbon monoxide poisoning(DESCMP).Methods One hundred and fiftyeight cases with severe carbon monoxide poisoning (SCMP) were randomly assigned to 2 groups.Observation group (n =83), butylphthalide treatment when SCMP was diagnosed;Control group (n =75), with no butylphthalide therapy.Incidence rate in 3 month, drug amount and the clinical effects of butylphthalide were observed.Results Observation group occurred 5 DEACMP, with the incidence rate of 6.58％, and control group occurred 14 cases,with the incidence rate of 18.67％ ,significant difference was observed in two groups(x2 =154.204,P＜0.05).There were also significant differences in the glasgow coma scale(14.00±1.89 vs.13.00 ±3.30,t =1.780, P＜ 0.05) and mini-mental state examination (26.20± 2.89 vs.19.57 ± 7.12, t =2.003, P＜0.05) between the two groups.Conclusion Early treatment with butylphthalide can decrease the incidence rate of DEACMP.

Objectives To evaluate the impact of virtual hepatectomy and computer-assisted risk analysis on surgical planning and intraoperative strategy for major hepatectomy.Methods Twentytwo consecutive patients (17 males and 5 females) were admitted to the hospital from January to December in 2010 for complicated major hepatectomy.CT scanning was performed with 64-MSCT.All the data of imaging were transferred to the Myrian(R) XP-Liver system (IntrasenseR,France).The following steps were undertaken by a radiologist and a surgeon majoring in liver surgery: step 1,image analysis and 3-D reconstruction; step 2,virtual resection and liver volumetry; step 3,computer-assisted risk analysis for hepatic dysfunction,followed by adjustment of the operative planning.Results The three-dimensional reconstruction models of the liver by the Myrian(R) XP-Liver system were visualized.The ideal simulation effect was achieved comparing the virtual imaging with the actual operation.Of the 22 patients who underwent complicated major hepatectomy,complete tumor removal (R0 resection) was achieved in 20 patients.There were 2 patients who received a R1 resection as microscopic tumor cells were found at the cutting margin of the right portal vein and bile duct.No patient died during the hospital stay.After computer-assisted risk analysis,the operative planning and surgical strategies were changed in 6 patients.Conclusions The application of the hepatic three-dimensional reconstruction and virtual hepatectomy using the Myrian(R) XP-Liver system provided important preoperative data for good preoperative planning and intraoperative strategy in complex hepatectomy.

Objective To over-express human trefoil factor 2 (hTFF2) by Escherichia coli system and an-alyze its activities in promoting migration and anchorage-independent growth in SW480 colonic cancer cells. Meth-ods hTFF2 gene encoding mature peptide was obtained by RT-PCR, and the recombinant expression vector pET32a-hTFF2 was constructed. Then pET32a-hTFF2 was transformed into E. coli BL21-32a and TrxA-hTFF2 fu-sion protein was induced to over-express. The expressed product was isolated by Ni-NTA affinity chromatography, purified by dialysis and identified by Western blotting. The activities of the recombinant hTFF2 in promoting SW480 cells migration and anchorage-independent growth were analyzed by MicroChemotaxis Chamber migration assay and Soft-agar assay,respectively. Results The TrxA-hTFF2 fusion protein was expressed to 220 mg/L at high purity. In vitro model demonstrated that recombinant hTFF2 obviously enhanced SW480 cell migration activity and anchor-age-independent growth. Conclusion The recombinant hTFF2 can be expressed in E. coli with high production, purity and biological activities. And its roles in cell migration and anchorage-independent growth suggest that up-regulation of TFF2 in colonic cancer might be involved in cancer invasion and metastases.

Objective To evaluate the clinical effect of treatment for deep burn wound on finger by proper digital artery flap.Methods From March 2013 to October 2016, 24 patients with deep burn wound on finger were treated by proper digital artery flap.Postoperative observation included wound repair, flap survival, complications and functional recovery of fingers.Results All the 24 flaps survived and no necrosis happened.The marginal abnormal circulation of flap occurred in only 5 cases, which cured by dress changing.All flaps kept well in contour, skin color, temperature and texture.Movement function of donor and recipient fingers was nearly normal.Conclusion Proper digital artery flap avoided the deficiencies distant pedicled flap, so it is a favorite choice for digital soft tissue defect caused by deep burn injury.

Objective To observe the occurrence and risk factors of arrhythmia in chronic kidney disease (CKD) patients in different stages of renal function. Methods A total of 405 CKD patients were enrolled in this study and none of them received renal replacement therapy.The 24 h dynamic electrocardiogram (DCG) was performed,and baseline characteristics were compared.Multivariable Logistic regression analysis was used to examine the relationship between the severe arrhythmia and the potential risk factors,such as age,gender,CKD stage,diabetes,hypertension,hyperpotassaemia,left ventricular hypertrophy (LVH),etc. Results There were 69 patients (17.04％),79 patients (19.51％),82 patients (20.25％),88 patients (21.73 ％) and 87 patients (21.48％) in CKD stage 1,2,3,4 and 5,respectively.As high as 45.68％ of all the patients had severe arrhythmia,represented by 27.54％,29.11％,42.68％,57.95％ and 65.52％ in CKD stages 1-5 respectively.The occurrence of severe arrhythmia increased as the eGFR decreased in CKD stages 2,3,4 (p＜0.05).On multivariable Logistic regression analysis,the occurrence of severe arrhythmia was related to LVH,CKD stage,diaberes hyertension and hyperpotassaemia are signidicantly assoxiated with severe arrhythmia.