Enhanced recovery after surgery (ERAS) combines various techniques used in the care of patients undergoing elective surgery,with an aim to attenuate the surgical stress response and energy loss,improve the organ function,reduce postoperative complications and the time required for full recovery.ERAS was first applied in the colorectal surgery,and gradually expanded to other surgical areas.As for ERAS in the gastric surgery,the safety and efficacy have been proved preliminarily by evidence-based medicine.However,there is still controversy about the individual items of the ERAS programs due to limited studies.Recent publications of the 2014 consensus guidelines for enhanced recovery after gastrectomy Enhanced Recovery After Surgery (ERAS@) Society recommendations that was composed by the ERAS Society indicated the developing direction of ERAS,and also updated perioperative practice to each medical unit implementing ERAS.Meanwhile,general principles (guideline or consensus) and patients' conditions should be combined closely into clinical practice.Since gastric cancer surgery is complex and patients' conditions are various,further research may focus on individualized ERAS.In the further study,more high-quality randomized clinical trials with single-component administration in fast recovery settings need to reach more definite conclusions and recommendations.Furthermore,attentions should be paid to enhance patients' compliance with the ERAS items.

This study was aimed to evaluate clinical effect and safety for diagnosis and treatment plan of Xue-tanbing (cerebral hemorrhage), and lay a foundation for further optimization of diagnosis and treatment plan. A total of 42 patients were treated with Tibetan patent medicine for one treatment course ( 28 days ) . And the pre-treatment and post-treatment clinical effects were compared through the observation on indexes such as symptoms, body signs, hepatic function, renal function, electrocardiogram (ECG), and head CT scan and so on. The results showed that indexes such as symptoms , body signs and head CT scan after treatment were obvious-ly improved with statistical significance ( P < 0 . 01 ) . There were no obvious abnormalities on the hepatic func-tion and renal function before and after treatment with no significant difference . It was concluded that the Ti-betan patent medicine diagnosis and treatment plan of X ue tanb ing has identified clinical effect and it is worth of popularization and application .

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of dendritic cells and the reticular cells. It is divided into single-system langerhans cell histiocytosis (SS-LCH) and multi-system langerhans cell system (MS-LCH). MS-LCH has a very poor prognosis. The key of survival is timely and effective treatment. The treatment protocols include chemotherapy, immunotherapy and stem cells transplantation. In this review, the new advances in the treatment of MS-LCH were systemically reviewed.

Objective To investigate the diagnostic value of antibody to group A streptococcal polysaccharide (ASP) in diagnosing atypical rheumatic fever (RF). Methods Fifty-seven cases including 33 atypical RF and 24 recurrent attack of RF with chronic rheumatic heart disease were included, and 57 patients suffered from other diseases were used as control. Nitrous acid extraction and molecular sieve chromatography was adopted to extract and purify the polysaccharide. The isolated portion of polysaccharide which possessed strongest antigenity was used to detect the level of serum ASP by enzyme-linked immunosorbent assay (ELISA). Erythrocyte sedimentation rate (ESR), antistreptolysin-O (ASO) and anti-deoxyribonuclease B (anti-DNase B) were tested with the same samples. Results The sensitivity and specificity of ASP in the diagnosis of atypical RF was 73.7% and 76.6%; while 47.4% and 46.4% for ESR respectively. As for the evaluation of streptococcal infection, the sensitivity and specificity of ASP, ASO and anti-Dnase B were 73.7%, 15.6%, 65.4% and 76.6%, 94.6%, 44.6%, respectively. ROC curve analysis and discriminant analysis were adopted to compare these laboratory measurements. The results demonstrated that ASP was superior to other methods. Conclusion ASP has a higher sensitivity together with a higher specificity than the other three methods for diagnosing the activity of RF and the infection of streptoccus. It should be a promising diagnostic test for atypical RF.

Animal models of chronic myocardial ischemia are more accordant with clinical pathological and physiological procession of ischemic cardiomyopathy, because they can be administrated more times and observed for a long time. The major methods to establish animal models include chronic coronary mechanically compressed, coronary embolismed, coronary ligated and high fat die. We should select the different kinds of animal and methods according to the different physiologicals characteristics in animal.

B-cell receptors play an important role in the mechanism of chronic lymphocytic leukemia.Distinct CLL B-cell receptors exhibit particular biological features and behaviors to specific modes of microenvironmental interactions leading to clonal evolution and adverse outcome.

Objective To observe the correlation between postmenopausal estrogen levels and diabetic retinopathy (DR) in women.Methods Thirty-nine menopause female patients with type 2 diabetes mellitus and 17 menopause subjects (control group) were enrolled in this study.Control subjects aged from 53 to 82 years,with the mean age of (69.80± 8.32) years.Diabetes mellitus patients aged from 56 to 84 years,with the mean age of (70.50±8.27) years;diabetes duration ranged from 3 to 23 years,with the average course of diabetes (11.40± 7.97) years.DR diagnosis was according to the results of fundus fluorescein angiography,and thus the 39 patients were divided into DR group (19 patients) and non-DR (NDR) group (20 patients).There was no significant difference in age and menopause duration between the three groups (t=0.347,0.485;P＞0.05).There was significant difference in diabetes course (t=2.748,P＜0.05).Compared with NDR group,fasting blood glucose (FBG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) were significantly increased (t=6.130,5.322,4.574,2.426,4.033),high density lipoprotein cholesterol (HDL-C) was significantly lower (t=3.917),the difference was statistically significant (P＜0.05).The level of estradiol (E2) was measured by radioimmunoassay.The differences of E2 levels between the three groups were compared.Logistic regression analysis was used to analyze the influencing factors of DR.Results The levels of E2 in control group,DR group and NDR group were (42.38 ±8.64),(21.49 ± 9.81) and (32.72 ± 10.51) pg/ml,respectively.The level of E2 in DR group was significantly lower than that in NDR group and control group (t=3.443,10.110;P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus [coefficients =0.166,odds ratio (OR)=1.181,P=0.016],FBG (coefficients=1.162,OR=4.014,P=0.001),TC (coefficients=3.212,OR=10.820,P=0.002),TG (coefficients=1.649,OR=5.203,P=0.030) and LDL-C(coefficients=1.605,OR=4.976,P=0.003) were the risk factors for DR;E2 (coefficients=-0.100,OR=0.904,P=0.004) and HDL-C (coefficients=-4.460,OR=0.012,P=0.002) were the protective factors for DR.Conclusion The estrogen level of postmenopausal women have a certain correlation with the development of DR,it may be one of the protective factor of DR.

Aged ; Female ; Humans ; Joint Dislocations ; etiology ; surgery ; Joints ; surgery ; Laryngeal Cartilages ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged ; Treatment Outcome

Biofilms ; Humans ; Sinusitis ; etiology ; microbiology

Adult ; Electrolysis ; Humans ; Lipid Peroxidation ; drug effects ; Male ; Middle Aged ; Nickel ; adverse effects ; blood ; pharmacokinetics ; Occupational Exposure ; adverse effects