Objective To observe endothelin A receptor mRNA expression in gastric mucosal microvessels and to explore the mechanism by which endothelin was enrolled in the development of liver cirrhosis and portal hypertension. Methods In situ hybridization of mRNA was used to detect the location and the expression level of endothelin A receptor in gastric mucosa microvessels in Wistar rats. Results Along with the formation of liver cirrhosis and portal hypertension, peripheral and portal blood endothelin level was decreased, ETA mRNA was expressed mainly in the postcapillary venule and precapillary arteriole and enhanced remarkably with the reduction of endothelin level and elevation of portal pressure and that was dramaticlly increased in the arteriole wall. The expression was correlated positively with portal pressure(r=0.869, P

Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

Objective: To evaluate the nutritional status of gastrointestinal carcinoma patients by mini-nutritional assessment(MNA),and to compare the relationship with different tranditional evaluative methods. Methods: The nutritional state and the malnutritional incidence were analysed by MNA questionnaire in 496 gastrointestinal carcinoma patients,and the relationship among MNA score and anthropometric measurements and laboratory test was studied.Results: ①According to the scores of MNA, 16.94%(84/496) patients were of mal-nutrition and 42.54%(211/496) patients were at risk of malnutrition.② In terms of each single index,BMI,TSF,AC and AMC,the prevalence of malnutrition was 13.5%,21.9%,15.1% and 15.5% respectively.③According to laboratory test,including serum albumin,PA,TLC,the incidence of malnutrition was 14.9%,25.4% and 30.8%.④ There was a significant correlation between the MNA score and tranditional nutritional estimated markers.The correlation coefficients of MNA with BMI,ALB,AC,TSF,AMC and TLC were between 0.18 and 0.53(P

Objective To investigate the incidence of metabolic syndrome (MS) in patients with gastric cancer, and to explore the relationship between MS and the tumor site and the influence of MS on surgical procedure and short-term outcomes of patients with gastric cancer. Methods The clinical data of 639 patients with gastric cancer who were admitted to the Affiliated Hospital of Qingdao University from January 2006 to June 2008 were retrospectively analyzed. Patients with MS were in the MS group ( n= 64) and those without MS were in the control group ( n = 575 ). The surgical and postoperative complications were reviewed and the tumor site, intraoperative conditions and short-term outcomes between the two groups were analyzed. All data were analyzed using the chi-square test or t test. Results The incidence of MS in patients with gastric cancer was 10.0% (64/639).The incidence of MS in female patients was 14.4% (27/188), which was significantly higher than 8.2% (37/451)of male patients ( χ2= 6.265, P < 0.05). The operation time of the MS group was ( 185 ± 133 ) minutes, which was significantly longer than ( 168 ± 50) minutes of the control group ( t = 2. 126, P < 0. 05 ). The number of lymph nodes dissected in the MS group was 18 ± 11, which was significantly lower than 21 ± 11 of the control group ( t = 2. 125, P < 0.05 ). The postoperative period of fever of the MS group was (3.0 ± 1.4) days, which was significantly longer than (2.5 ± 1.4) days of the control group (t = 2. 433, P < 0.05 ). The incidence of postoperative complications of the MS group was 31.3% (20/64), which was significantly higher than 14.3% (82/575) of the control group ( χ2 = 12.291, P < 0.05 ). The length of hospital stay of the MS group was ( 19 ± 11 ) days,which was significantly longer than ( 16±11 ) days of the control group ( t = 2. 141, P< 0.05 ). The mortalities of MS group and control group were 0 and 0. 5% (3/575), respectively, with no significant difference ( χ2 = 0.000,P >0.05). Condusions A low prevalence of MS is found in patients with gastric cancer. However, patients with gastric cancer complicated with MS may present with prolonged surgical procedure, reduced amount of lymph nodes dissected and increased incidence of postoperative complications, hospital stay and costs. Perioperative management of patients with gastric cancer complicated with MS should be paid more attention.

ObjectivesTo evaluate the therapeutic result of various management for severe radiation injury of the bowels.MethodsThe clinical presentation, diagnostic approach, managements and therapeutic effects were analysed retrospectively in 28 severe radiation therapy caused enteric injury patients. In all intestinal stricture cases, partial ileal resection was performed in 14 patients, right hemicolectomy in 1 patient, rectosigmoid resection in 3 patients. Instestinal fistulae was treated by diseased segment resection and reanastomosis in 7 patients, sigmoidostomy was undertaken in 2 patients.ResultsThere was no inhospital mortality. One case suffered from low colonic fistula,4 died of recurrence of the primary tumor.Postoperative bowel function and nutrition status significantly improved in all patients.ConclusionSurgical management combined with nutrition support is safe and effective for the treatment of severe radiation caused enteric injury.

Objective:To observe the efficacy of contact lenses on a wide range of corneal epithelial shedding. Methods:The information has collected a wide range of corneal epithelium of thirty-six patients admitted to our hospital in the January 2010-December 2010, tracking observed in patients with epithelial wear contact lenses after the healing. Results:The patients wear contact lens immediate relief of symptoms with eye pain, foreign body sensation. Patients with continuous wear contact lenses after five to seven days, including twenty-eight patients with corneal epithelial fully restored, the remaining eight cases without contact lens continue to use eye drops of one to two days corneal epithelial fully restored in the ointment;thirty-six patients were followed up in three to six months, not fall off again. Conclusion:Therefore, use contact lenses to treat corneal epithelial shedding, the patients suffered less pain, treatment is easy to operate, low cost, the treatment effect is significant.

Objective To investigate the risk factors related with postoperative complications following radical gnstrectomy for gastric cancer in cirrhotic patients. Methods In this study, 1474 cases underwent radical gastrectomy for gastric carcinoma in the past six years and the postoperative complications were retrospectively reviewed. The risk factors related with postoperative complications of cirrhotic patients were analyzed by Logistic regressive analysis. Results The postoperative morbidity rates of the 2 groups with or without liver cirrhosis were 51.22% and 23.94% (X2 = 15.955, P<0.01), and the mortality rate was 7.32% and 0.91% (P = 0.009), respectively. The main complications of the group with liver cirrhosis were postoperative aseites (5 cases), hepatic failure (4 cases), wound infection or dehiscence (4 cases), intra-abdominal infection (4 cases), etc, and three patients in the group died from extensive bleeding, jejunal fistula and hepatic failure respectively. Univariate Logistic analysis revealed that age (OR = 1.277, 95% CI:0.991 ～ 1.646), preoperative nscites (OR = 20.900,95% CI: 2.349 - 185.933), the albumin level (OR =0.160,95% CI:0.041 ～ 0.629), Child classification (OR = 9.500,95% CI: 1.046 ～ 86.261), portal hypertension (OR = 4.000,95% CI: 1.057 ～ 15.138), esophageal variees (OR = 4.400,95% CI: 1.095 ～ 17.676), transfusion (OR =3.714,95% CI: 1.021 ～ 13.511) and blood loss (OR = 1.442, 95% CI:1.023 ～ 2.034) were the main factors associated with postoperative complications of the group with liver cirrhosis. Muhivariable Logistic analysis showed that preoperative ascites (OR = 19.213,95% CI: 1.569 ～ 231.255), Child classification (OR = 12.661,95% CI: 0.721 ～ 222.458), esophageal varices (OR =6.008,95% CI:0.857 ～42.097) and blood loss (OR = 1.574,95% (7,1:0.938 ～ 2.640) were the independent risk factors. Conclusion Gastrectomy for gastric carcinoma in cirrhotic patients engenders considerably high postoperative mortality and morbidity. Preoperative ascites, Child classifation, esophageal variees and intraoperative blood loss were factors closely related with postoperative complications.

ition research with higher quality should be advocated.

Objective To study lymph node metastasis in early gastric carcinoma. Methods From July 2001 to July 2007, 177 patients with early gastric carcinoma underwent radical gastrectomy and the clinicopathologic data were analyzed by binary logistic regression. Results The overall rate of lymph node metastasis in early gastric carcinoma was 13%, involving 13% and 3% in level I (NI) and level Ⅱlymph nodes (N2), respectively. The rate of lymph node metastasis was 22%(20/89) in cases of submucosal lesion (SM), which was significantly higher than 3%(3/88) in cases of mucosal lesion (M) (X2=14. 222, P<0.01). The rate of lymph node metastasis was 3%(4/117) when the primary tumor was ≤2cmin diameter compared with 32%(19/60) when the tumor was >2cm (X2=27.992, P<0.01). The lymph node metastasis rate was 4%(3/81) and 21%(20/96) in differentiated and undifferentiated lesion (X2=11.402, P=0.001), and it was 33%(2/6)、8%(7/99) and 19% (14/92) in macroscopic type I, Ⅱ and Ⅲ (X2=8.172, P=0.014). Binarylogistic analysis found that the tumour diameter greater than 2.0cm (OR=8.408, P<0.01), infiltration of the submucosal layer (OR=5.926, P=0.009) and undifferentiated lesion (OR=4.880, P=0.020) were the independent risk factors. Conclusion Lymph node metastasis in early gastric carcinoma is significantly cantingent on the depth of infiltration, tumor size and histological type.

Objective To observe the effect of early enteral feeding on clinical outcomes and immune function in patients after colorectal cancer surgery.Methods 90 cases of colorectal cancer patients were randomly divided into early enteral feeding group (43 cases) and control group (45 cases).Patients in early feeding group were given small amount of water several times and enteral nutrition early after surgery,while patients in the control group were administrated according to conventional postoperative care protocol.Data were collected on serum IgA,IgG,IgM,CD4 +,CD4 +/CD8 + and CRP on the postoperative first,third and seventh days,postoperative length of stay,complications and quality of life.Results The postoperative fever time [(54 ±6) h vs.(65 ±6) h,t =8.688,P ＜0.01],time to flatus [(58 ±8) h vs.(72±7) h,t=8.573,P＜0.01],postoperative length of stay [(6.9±1.4) dvs.(8.5 ±1.9) d,t=4.277,P ＜ 0.01] and health care cost [(41 868 ± 3 168) RMB vs.(45 950 ± 3 714) RMB,t =5.536,P ＜ 0.01] were significantly in favour of early enteral feeding group than those in control group.Further,the score of quality of life at discharge were significantly higher in early enteral feeding group [(18.4 ± 1.7) vs.(16.4 ± 1.9),t =5.235,P ＜ 0.01],while the complication incidence showed no difference between the two groups [18.6％ (8/43) vs.22.2％ (10/45),t=0.177,P＞0.05].The CD4+,CD4+/CD8+ and IgM on the seventh postoperative day and the IgA and IgG on the third and seventh postoperative day were significantly better in early enteral feeding group while the CRP was significantly lower as compared to the control group (t =3.639,t =2.255,t =2.119,t =2.035,t =2.961,t =2.060,t =2.108,t =7.308,t =3.435,P ＜ 0.05).Conclusions Early oral enteral feeding after elective colorectal cancer surgery can improve patient's immune function,reduce the stress and accelerate rehabilitation.