Objective To explore the nutrition support route of enteral nutrition (EN) and parenteral nutrition(PN) on the cellular immune function of patients after esophagectomy.Methods Sixty-two patients with esophageal surgery were randomly divided into EN group and the PN group,and each was 31 cases.Cellular immune indexes(including T lymphocyte subsets,natural killer cells,B lymphocytes) were measured at the preoperation,the postoperative 1st day and 8th day.The t test was preformed to compare the measurement data of two groups,and repeated measures analysis of variance was used to compare multiple time points of measurement data of two groups.Results The levels of CD3,CD4,CD8,CD4/CDS,NK cells and B cells in EN group at before operation were (60.46 ± 6.41) ％,(39.03 ± 5.64) ％,(25.06 ± 5.39) ％,(1.60 ± 0.24),(13.86 ±4.91)％,(13.14 ± 3.81)％ respectively,and those indices at 8th day after operation were (65.18 ±7.81)％,(40.45 ±6.82)％,(22.81 ±4.47)％,(1.78 ±0.16),(16.97 ±4.85)％,(15.69 ± 3.88)％ respectively,and the differences were statistically significant(P ＜ 0.05).The levels of CD4,CD4/CD8,NK cells and B cells in PN group at before operation were (59.78 ± 5.17) ％,(39.10 ± 5.49) ％,(24.94 ± 3.97) ％,1.57 ±0.20,(14.02 ± 4.47) ％,(12.96 ± 3.39) ％ respectively,significantly different from that of 8th days ((59.78 ±5.17)％,(39.71 ±5.63)％,(24.74 ±3.80),(1.62 ±0.15),(15.35 ±4.31)％,(14.33 ±3.43) ％ respectively),and there were significant difference compared to before operation in terms of CD4,CD4/CD8,NK cells and B cells.At the 8th day after operation,there was significant difference between in EN group and PN group in terms of CD3,CD8,CD4/CD8,NK cells and B cells(P ＜0.05).Conclusion Early EN for patients after esophageal carcinoma operation can significantly improve the cellular immune function of patients.

Objective To explore the risk factors for urinary tract infections in type 2 diabetes mellitus(T2DM )by analyzing the pathogens distribution characteristics and drug sensitivity. Methods A total of 3 ,065 T2DM patients were retrospectively analyzed for the clinical and etiological characteristics of urinary tract infections in T2DM. All patients enrolled in the study were divided into two groups :T2DM with urinary tract infection group (n= 210) and simple T2DM group (n= 132). Data harvested were analyzed by SPSS 19.0. Results Of 3 ,065 patients with T2DM the incidence of urinary tract infection was 6.85%. Compared with T2DM group ,patients in T2DM+ urinary tract infection group were older , with longer duration of diabetes ,higher levels of FPG ,urea nitrogen ,creatinine and 24 hUAlb ,and lower levels of serum albumin ( P< 0.05 ). Logistic regression analysis showed that age ,gender ,duration of diabetes and 24 hUAlb were risk factors and albumin was protective factor for urinary tract infection in T2DM. 84.2% was gram-negative bacteria among the 210 isolated strains of pathogenic bacteria. The top three pathogens were Escherichia coli (65.2% ) ,Enterococcus faecalis (6.2% ) and Klebsiella pneumoniae (5.2% ). Gram-negative bacteria had high sensitivity to Imipenem (100% ) ,Cefoperazone sulbactam (99.2% ) and Amikacin (99.2% ) but low sensitivity to cephalothin (38.1% ) ,piperacillin (35.7% ) and amoxicillin (28.2% ). Conclusion T2DM patients who have the factors including female ,advanced age , long course of diabetes and renal insufficiency are prone to suffer from urinary tract infection. Gram-negative bacteria are the most common pathogens in T 2DM patients with urinary tract infection but bacteria spectrum has changed with percentage of multiple resistant bacteria rising dramatically.

Objective To study the morbidity of Toxoplasma (TOX) and Cytomegalovirus (CMV) infection in in patient infants and their clinical character Methods The serum CMV IgG/IgM and TOX IgG/IgM ware measured by enzyme linked immunosorbant assay (ELISA) Results The positive rate of CMV IgG, CMV IgM, TOX IgG and TOX IgM were 86.7%, 5.2%,13.9% and 0.4% respectively in in patient infants. The main clinical manifestication of neonatal TOX and CMV infection were premature, small for gestational age, neonatal pneumonia, sepsis, encephalopathy, hepatitis syndrome Conclusion TOX and CMV infection were widely noticed in in patient infants, and their potential damage should be greatly considered in our clinical practice.

The urinary concentration of pseudouridine, primarily a degradation product of transfer ribonucleic acid, was determined by high-performance liquid chromatography in 84 patients with lung cancer, 22 patients with pulmonary infectious diseases and 69 healthy controls. The concentration of pseudouridine in the patient with lung cancer (33.46 ? 9.94nmol/ ?mol) was significantly higher than that in the paients with pulmonary infectious diseases (26.25 ? 4.17nmol/ ?mol, P

ObjectiveTo observe the expressions of Caspase-9,Caspase-3, cytochrome C and their relationships, and investigate apoptotic mechanisms in hippocampus of post-traumatic stress disorder(PTSD) rats. Methods Sixty male Wistar rats were used in the present study. The single-prolonged stress (SPS)-method was used to set up the rat PTSD models. There were six groups:after SPS 1 day,4 days,7 days,14 days,28 days groups and control group. The expressions of caspase-9, Caspase-3 and Cytochrome C proteins were detected with immunohistochemistry, immunofluorescence and Western blotting. Results Immunohistochemical and immunofluorescent results showed that the expression of cytochrome C peaked at 4 days and maintained higher level at 7days after SPS. Expressions of Caspase-9 and Caspase-3 were increased and peaked at 7days after SPS. Western blotting results showed that compared with control group, cytochrome C protein was up-regulated and peaked at 4 days after SPS in the cytosol. Compared with the control group, cytochrome C tended to decrease in mitochondrial fractions. The activated form of Caspase-9 and caspase-3 were not detected in control group. They were present in model groups. Cleaved- caspase-9 and cleaved-caspase-3 peaked at 7 days after SPS, and then gradually decreased at 14 days. Conclusion The neuronal apoptosis in hippocampus of PTSD rats may be one of the causes inducing hippocampus atrophy. Mitochondrial apoptotic pathway is involved in apoptosis in the hippocampus of PTSD rats.

Objective To investigate expression changes of nuclear receptors-glucocorticoid receptors (GR) in the locus ceruleus neurons of posttraumatic stress disorder(PTSD)like rats. Methods Sixty adult healthy male Wistar rats were enrolled in the experiment. PTSD-like rat model was established by single prolonged stress (SPS). There was no SPS stimulation in the control group and the rats of the other five groups were undisturbedly raised for 24 hours, 4 days,7 days,14 days and 28 days respectively after SPS stimulation.The expressions of glucocorticoid receptors in the locus ceruleus nucleus of all groups were detected with Nissl staining, immunohistochemistry,Western blotting and PCR, and image analysis and statistical analysis were performed. Results GR was distributed in the nucleus of coeruleus neurons, GR expression was showed after 24 hours, 4 days, 7 days treatment and gradually increased, restorative downregulation was seen after 14 days and 28 days, but still high(P<0.05). Conclusion After SPS, the GR locus ceruleus temporarily increased and then lowered, suggesting that PTSD rat locus coeruleus neurons in nuclear receptor-GR expression changes may directly involve in the continuing spirit of PTSD symptoms occurred in the development process.

Objective To observe the expression of cytochrome C (Cyt C)and apoptosis-related gene Bax in hippocampus of posttraumatic stress disorder(PTSD)rats in order to investigate their effects and relationships. Methods Sixty male Wistar rats were used in the present study. The single-prolonged stress(SPS)-method was carried out to set up the rat PTSD models. There were six groups:after SPS 1,4,7,14,28 days groups and control group. The expression of Cyt C and Bax proteins were detected with immunohistochemistry, double immunofluorescence, confocal laser scanning microscopy and Western blotting. Results The expression of Cyt C peaked at 4 days and maintained higher level at 7 days after SPS. At 7 days after SPS, strong immunoreactivity of Bax was noticed,At 14 days after SPS, the expression of Bax was down-regulated and then gradually decreased. Conclusion Bax is upregulated and promotes the releasing of Cyt C. And the releasing of Cyt C may be one of mechanisms of inducing apoptosis in the hippocampus of PTSD rats.

Objective To probe into the indication, operative skill of intrapericardial pneumonectomy, the prevention and cure in postoperative complication of intrapericardial pneumonectomy for locally advanced lung canc-er. Methods The clinical data of 43 cases of locally advanced lung cancer undergoing intrapericardial pneumonec-tomy from February 1998 to November 2007 were retrospectively analyzed. Results No surgical death occurred. The main postoperative complication was arrhythmia, acute pulmonary edema and pneumonia, with incidence as 41. 86%. The 1-,3- and 5-year postoperative survival rate was 79.1% ,30.2% and 11.6%. Conclusions The intrap-ericardial pneumonectomy skill not only can improve resection rate, reduce exploration rate, but also offer more oppor-tunity of further therapy in a part of locally advanced lung cancer.

Objective To explore the value of video-assisted thoracoscopy for the diagnosis of indeterminate solitary pulmonary nodules.Methods A total of 42 patients with indeterminate solitary pulmonary nodules(

Objective:To discuss the early diagnosis of malignant hyperthermia(MH) and its treatment regimen without dantrolene.Methods: A patient of American Society of Anesthesiologist class Ⅰhad sudden muscle spasms and masseter muscle spasm during induction of anesthesia for idiopathic scoliosis surgery,and was diagnosed as having MH.Without using dantrolene,the patient was treated promptly with removal of inducement,control of temperature,adequate oxygen supply,maintaining of pH,water and electrolyte balance,and protection of renal function.The dynamic changes of the myoglobin in the blood and urine,serum creatine kinase,the blood gas indicators,and EtCO2,together with the pathological changes of the quadriceps were observed.Our experience on diagnosis and treatment was summarized.Results: The patient fully recovered and was discharged without any complications.The myoglobin in the blood and urine,serum creatine kinase and its isoenzyme increased rapidly and reached the peak one hour after MH,and maintained for about ten hours,then returned gradually to normal level about five days later.The temperature and EtCO2 increased immediately after development of MH,arterial blood gas quickly showed hypercapnic acidosis,but pH maintained normal or partial alkali during the treatment due to sodium bicarbonate administration;the alkali maintained obviously higher.Some quadriceps muscle cell had vacuolar degeneration and lysis.Conclusion: Non-ventilation induced increase of EtCO2 is a reliable indicator for early diagnosis of MH.Anesthetics,such as succinylcholine,should be avoided in patients at high risk of MH,and EtCO2 should be monitored.Once MH is diagnosed,dantrolene is the first choice.When without dantrolene,satisfactory outcome can be achieved through early diagnosis,timely removal of incentives,control of temperature,adequate oxygen supply,maintaining of stable internal environment,control of arrhythmia and protection of renal function.