Objective To compare the influence of early parenteral nutrition and enteral nutrition on the nutrition,immune,and liver function state of patients with total gastrectomy.Methods A total of 90patients with total gastrectomy in our hospital from July 2010 to October 2012 were selected as research objects,and were randomly divided into group A (early parenteral nutrition group,n =45)and group B(early enteral nutrition group,n =45).The nutrition state indexes,immune state indexes,and liver function indexes of two groups before the intervention and at 3th and 10th day after the intervention were compared.Results The nutrition state indexes[3rd d:TP (68.35 ±3.02)g/L,A (38.94 ±4.69)g/L,PAB (273.54 ±29.68) mg/L,TRF (2.14 ±0.29) g/L,Hb (129.84 ±7.92) g/L;10th d:TP (72.59 ± 3.52)g/L,A (42.31 ±5.49)g/L,PAB (305.57 ±30.95)mg/L,TRF (2.78 ±0.31)g/L,Hb (135.87 ±8.95) g/L],immune state indexes [3rd d:IgA (0.94 ± 0.10) g/L,IgG (9.24 ± 0.63) g/L,IgM (1.51 ±0.14) g/L,RBC-C3bR (10.54 ± 0.52) ％,RBC-ICR (12.21 ± 1.41) ％ ; 10th d:IgA (1.23 ± 0.15) g/L,IgG (10.98 ±0.72)g/L,IgM (1.71 ±0.18) g/L,RBC-C3bR (13.74 ±0.69)％,RBC-ICR (9.27 ±1.05)％],and liver function indexes[3rd d:ALT (32.59 ±3.56)U/L,AST (33.95 ±4.03) U/L,TBIL(12.07± 1.38)μmol/L,GGT (24.03 ±2.59) U/L;10th d:ALT (22.93 ±3.18) U/L,AST (24.84 ±3.29) U/L,TBIL (10.50 ± 0.96) μmol/L,GGT (20.70 ± 2.49) U/L] in group B at 3rd and 10th day after the interventiont were all better than those in group A [3rd d:TP (64.59 ± 2.83)g/L,A (35.53 ±4.37)g/L,PAB (224.96 ±25.50)mg/L,TRF(1.63 ±0.20)g/L,Hb (121.03 ±7.18)g/L,IgA (0.68±0.07)g/L,IgG (7.32 ±0.51)g/L,IgM (1.12 ±0.10)g/L,RBC-C3bR (8.13 ±0.40)％,RBC-ICR (14.59 ±1.54)％,ALT (40.26 ±4.13)U/L,AST (40.95 ±4.26)U/L,TBIL (16.37 ± 1.75)μmol/L,GGT (31.45 ±2.97) U/L;10th d:TP (66.96 ±2.97) g/L,A (36.01 ±4.43) g/L,PAB (241.35 ±26.63) mg/L,TRF (1.86 ± 0.24) g/L,Hb (127.69 ± 7.73) g/L,IgA (0.81 ± 0.08) g/L,IgG (8.54 ±0.55) g/L,IgM (1.28 ± 0.12) g/L,RBC-C3bR (8.52 ± 0.46) ％,RBC-ICR (13.07 ± 1.46) ％,ALT(31.52 ± 3.84) U/L,AST (33.54 ± 3.90) U/L,TBIL (13.21 ± 1.41) μmol/L,GGT (25.39 ± 2.65) U/L],and these indexes in group B at 10th day after the intervention were all significantly better than those at 3rd day after the intervention (all P ＜ 0.05).Conclusions The early enteral nutrition palys an active role in improving the nutrition,immune,and liver function state of patients with total gastrectomy,and it provides the necessary premise for the postoperative rehabilitation of patients.

Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.

Objective To observe the clinical curative effect of Ⅲb~Ⅳstage non-small cell lung cancer treated by radiofrequency ablation combined with chemotherapy. Methods Forty-eight Ⅲb~Ⅳstage non-small cell lung cancer patients were divided into the study group (RFA + chemotherapy) and 74 were in control group (chemotherapy alone) by the method of non randomized controlled. Curative effect was evaluated every two cycles during the treatment. A 6 to 36 months follow-up was conducted after the treatment. Results The objective response rate of experiment group and control group was 58.3%and 41.9%respectively (P>0.05) with no significant difference and disease control rates of experiment group and control group were 91.7% and 75.7% respectively (P<0.05). MST were 14.4 months and 8.2 months respectively (P<0.01), with statistically significant differences in experiment group and control group and clinical benefit efficient were 87 . 5% and 66 . 2% respectively ( P < 0.05). Conclusion The treatment of radiofrequency ablation combined with chemotherapy for advanced non-small cell lung cancer can significantly improve the patient′s survival and the clinical curative effect.