Objective To investigate the effect of isochlorogenic acid B(ICAB)on CCl4-induced acute liver injury(ALI)in mice. Methods The animal model of CCl4-induced ALI in mice was established and then the protective effect of ICAB was evaluated using this model. Serum levels of alanine transaminase(ALT)and aspartate aminotransferase(AST),hepatic levels of malondialdehyde (MDA)and the activities of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were measured by spectrophotometric methods. Liver cell morphology was observed by hematoxylin and eosin staining method and the effects of ICAB on the protein expres-sion of nuclear factor erythroid-2-related factor 2(Nrf2),heme oxygenase-1(HO-1)and quinone oxidoreductase 1(NQO1)in mice he-patocyte were determined by Western blot method. Results ICAB(5,10 and 20 mg/kg)significantly protected against CCl4-induced liver injury by reducing the elevated levels of serum aminotransferases and hepatic MDA and remarkably restored the impaired antioxi-dants. Meanwhile,the histopathological changes were also attenuated in mice. In addition,ICAB could induce the protein expression of Nrf2 and promote its nuclear translocation,and further increase the protein expression of HO-1 and NQO1. Conclusion ICAB has protective effect against CCl4-induced ALI in mice,which is mainly due to its ability to promote the nuclear translocation of Nrf2 and decrease the oxidative stress.

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective To investigate the efficacy of gelatin sponge particles(GSP)or polyvinyl alcohol particles (PVA) for hemoptysis secondary to bronchiectasis or pulmonary tuberculosis. Methods The clinical data on 271 patients with bronchiectasis- or tuberculosis-induced hemoptysis were retrospectively analyzed. The efficacy and rates of recurrence and complications were analyzed. Results A total 271 patients were included in this study, 176 of whom suffered from bronchiectasis and the rest 95 had tuberculosis. One-week cure rate was signifi-cantly higher in bronchiectasis group than in tuberculosis group(73.3%vs. 46.3%,P<0.05),and one-year recur-rence rate was significantly lower in bronchiectasis group(17.6%vs. 26.3%,P<0.05). One-year recurrence rate was slightly higher in patients receiving GSP than in those undergoing PVA(bronchiectasis group:22.2%vs. 10.3%, P<0.05;tuberculosis group:28.8%vs. 22.2%,P>0.05). No severe complications occurred. Conclusions In-terventional artery embolization therapy for hemoptysis secondary to bronchiectasis is better than tuberculosis-induced hemoptysis,and PVA is more effective than GSP. Recurrence of massive hemoptysis mostly occurrs within one month ,and most of the patients are complicated with blood supply and have a history of hemoptysis.

Objective To investigate the self‐management and cognitive situation of the patients with gestational diabetes melli‐tus (GDM) dietary and to discuss the influence of individualized diet intervention on patients .Methods Forty‐one pregnant women diagnosed with GDM were selected as the research objects .logistic regression analysis was used as well as questionnaire to evaluate the influence factors of comprehensive evaluation of the follow diet control ,detecting the 2 h plasma glucose(2 h PG) ,hemoglobin (HbAlc) ,total cholesterol (TC) ,three acyl glycerin (TG) change in value after individualized nutritional intervention ,which were compared with pre‐intervention index .Results (1)90 .2% of diet cognitive received diet educators ,26 .8% of the patients thought only diet and exercise therapy could effectively control blood sugar .Patients got 2 .4% correct overall about questions about food and 85 .4% patients followed diet .(2)Logistic regression analysis showed that the influencing factors of GDM patients following di‐et were age ,BMI ,cultural degree ,receiving diet education ,self monitoring of blood sugar ,regular review to the hospital regularly . (3) After the intervention(41 cases) ,the level of 2 h PG ,HbAlc ,TC ,TG of 38 cases were significantly lower than before ,and the difference was statistically significant (P<0 .01) .Conclusion Individualized diet intervention treatment in GDM patients shows obvious effect .

ObjectiveTo investigate the prevalence of nutritional risk and perioperative nutritional support status in the gastrointestinal cancer surgical patients.Methods Adult inpatients from the gastrointestinal cancer surgery department of our hospital were consecutively enrolled from May to September 2010.Nutritional Risk Screening 2002 ( NRS 2002) was performed at admission,and data of the nutritional support and complications during hospitalization were collected.The relationship between nutritional risk and postoperative complications was analyzed.ResultsA total of 195 patients were eligible.At admission,43.6％ (85/195) patients were at riskOf the patients at risk,totally 11.7％ (10/85) patients received preoperative nutritional support,and 100％ (85/85) patients received postoperative nutritional support; of the patients not at risk,no patients received preoperative nutritional support,and 84.5％ (93/110) patients received postoperative nutritional support.The overall rates of postoperative complications were 19.1％ ( 13/68 ) in the patients at risk while 7.1％ (9/127 )in the patients not at risk ( P =0.02).ConclusionsNutritional risk in gastrointestinal cancer surgical patients was high.The application of nutritional support was inappropriate in these patients.The nutritional risk is associated with higher postoperative complications.Dissemination of evidence-based guidelines should be enhanced.

Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.

Objective To evaluate the outcome of surgical treatment of tricuspid valve regurgitation after valve replacement.Methods Twenty one patients with tricuspid valve insufficiency after valve replacement were performed surgical treatment.Tricuspid valve-plasty was performed in 17 patients and tricuspid valve replacement was done in 4 patients.Three patients underwent edge-to-edge tricuspid valveplasty.DeVega procedure was performed in 5 patients.Cosgrove-Edward annuloplasty ring was used in 15 patients.Four patients' valve were replaced by SJM bileallet mechanical prostheses.Results There was 3 patients dead early after operation with a mortality of 14.3％(3/21).The causes of death including multiple organ failure,cardiac arrest and low cardiac output syndrome.The rate of early postoperative complications was 33.3％ (7/21),including pulmonary edema,arrhythmia,acute renal failure and low cardiac output syndrome.The patients were followed up 9-60 months.The rate of readmission was 23.8％ (5/21).Two patients went to hospital again for pleural effusion,1 patient for left ventricular dysfunction and 2 patients for right ventricular dysfunction.The other patients recovered well.Conclusions Surgical therapy is effective on severe tricuspid valve regurgitation after valve replacement.Preoperative aggressive treatment of heart failure,a reasonable grasp of surgical indications and timing of surgery,strict perioperative management are the keys to guarantee patients a smooth recovery.

Objective To explore the methodology of the preventing the absorption after autog-enous fat granule mammaplasty, and the main point of the operative methods.. Methods The clinical data were reviewed in 30 cases of patients with liposuction combined with fat-grafting injection for breast mammaplasty in the past four years. The tumescent technique was used in liposuction and the volume of fat tissue aspirated was between 500 ml and 3250 ml. Using appropriate way we prepared pure fat granules and then evenly injected into the layer beneath the pectoralis major muscle, submam-mary layer and subcutaneous layer of the breast, respectively. Results The effect of the method was satisfying because sucking area was significantly decreased. From six months to 10 months follow-up, grafts showed no obvious absorption. The breast looked symmetry. Conclusion Fat grafting injection is a practicable method for breast mammaplasty. The key point is to use appropriate way to get pure fat granule and to prevent infection. It deserves to be recommended.

Objective: To investigate the utilization status of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in 11 hospitals of Zhejiang province from 2009 to 2015, and to analyze the use rationality.Methods: The doctor's advice in 40 days annually was collected in 11 hospitals of Zhejiang province from 2009 to 2015, and the drug consumption, frequency of utilization (DDDs), defined daily cost (DDC) and drug utilization index (DUI) were analyzed for the patients with lung cancer treated with EGFR-TKI.Results: Icotinib, erlotinib and gefitinib were the three prevalent EGFR-TKIs used in Zhejiang province, and icotinib started to be used in clinics in 2013.The overall cost of EGFR-TKIs increased year by year during 2009 and 2015, and the total amount of sales increased by 4.67 times in 2015 when compared with that in 2009.Generally, the DDDs value of erlotinib showed a decreasing trend, however, that of icotinib and gefitinib rose year by year during 2009 and 2015.Erlotinib had the highest DDC followed by gefitinib and icotinib.The mean value of DUI of the three targeted drugs was about 1.Conclusion: The utilization of EGFR-TKI is reasonable in 11 hospitals of Zhejiang province with increasing comsuption.

OBJECTIVE:To provide reference for rational use of leucocyte increasing drugs in patients with lung cancer. METHODS:The application of drugs in lung cancer patients in 40 d each year were collected from 11 Zhejiang hospitals during 2009-2014,and then analyzed retrospectively in consumption sum,DDDs,DDC and department distribution,etc. RESULTS:The proportion of consumption sum of leucocyte increasing drugs in total consumption sum decreased generally in 11 Zhejiang hospital during 2009-2014,decreasing from 781 995.50 yuan in 2009(3.28%)to 626 792.80 yuan in 2014(1.53%). Top 3 departments in the list of consumption sum of leucocyte increasing drugs were oncology department(29.00%),radiotherapy department(27.08%) and respiratory medicine department(9.93%). Top 3 drugs in the list of consumption sum during 2009-2014 were recombinant hu-man granulocyte colony-stimulating factor,Coenzyme complex for injection and Leucogen tablets;top 3 drugs in the list of DDDs were Leucogen tablets,Berbamine tablet and recombinant human granulocyte colony-stimulating factor;Coenzyme complex for in-jection,recombinant human granulocyte colony-stimulating factor and human GM-CSF took the first three place in the list of DDC during 2009-2013,and Leucogen tablets were the top one in 2014. CONCLUSIONS:The application of leucocyte increasing drugs in lung cancer patients is decreasing year by year in 11 Zhejiang hospitals,and those with definite therapeutic efficacy and moder-ate price predominate clinical application predominate in the clinical practive.