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.

Objective:To investigate the clinical efficacy of fluorescence in situ hybridization(FISH)in prenatal diagnosis of chromosomal aneuploidy.Methods:FISH and karyotyping analysis were done in 120 samples of amniotic fluid from pregnant women.Results:FISH analysis results were consistent with those of karyotyping,the dectecting rate can reach 100%for chromosomal aneuploidies.There was no significant difference in the preference for FISH or karyotying for prenatal diagnosis when facing high matemal age,multi-indications and other factors(P>0.05).FISH was better when biochemical datafor down's syndrome were positive (P=0.029),however karyotyping was better when there was abnormal fetal ultrasound scan(P=0.000).Conclusions:FISH can detect the chromosomal aneuploidy quickly and accurately,especially when biochemical data for down's syndrome were positive.FISH could be the first choice for prenatal diagnosis in the third trimester of high-risk pregnancy.

OBJECTIVE To study the isolation and resistance tendency of Acinetobacter calcoaceticus-baumannii to antimicrobial agents from 1998 to 2004 to provide valuable data for infection prevention and therapy. METHODS We reviewed the isolation rates,distribution in clinical specimens and wards,and the resistance rates of(A.calcoaceticus-baumannii)to 14 kinds of antimicrobial agents from 1998 to 2004. RESULTS There was an increasing tendency of isolation rates of A.calcoaceticus-baumannii every year,which was 0.18% in 1998 but 1.48% in 2004.In the seven years,there was the highest isolation rate of 70.58% in specimens from respiratory tract,the next was from the urine(9.42%),and blood(4.63%).Concerning the wards distribution,ICU had the highest rate of 47.28%.In 1998,A.calcoaceticus-baumannii had resistance rates more than 50% only to one kind of antimicrobial agents(aztreonam),but in 2004,it had increased to thirteen kinds(except cefoperazone/sulbactam).About the fourteen kinds of antimicrobial agents we inspected,that were increased in their resistance rate.The highest increasing of resistance rate was ceftazidime from 11.1% in 1998 to 88.9% in 2004,the imipenem was second for 0.0% to 64.8%,and the third was sulfamethoxazole/trimethoprim form 0.0% to 64.0%,while there still was an increasing resistance tendency to them. CONCLUSIONS The clinical isolation rate of A.calcoaceticus-baumannii is increasing,and it has higher resistance rates to many antimicrobial agents as well as an increasing resistance tendency to relatively susceptive antimicrobial agents every year.So physicians should prescribe on the basis of antimicrobial agents susceptibility tests in vitro.

Objective:To explore the clinicopathological features of end-stage lung disease complicated with neuroendocrine carcinoma after lung transplantation (LT).Methods:From April 2017 to December 2021, 5 cases of neuroendocrine cancer were diagnosed as end-stage lung disease by hematoxylin-eosin (HE) and immunohistochemical stain.Clinical follow-up data, histological characteristics and immunophenotyping were analyzed retrospectively.Results:The ratio of male-to-female in five recipients was 4: 1 and the average age 64(56-73) years.Three cases were idiopathic pulmonary fibrosis concomitant with small cell carcinoma (including 1 case of combined small cell carcinoma), bronchiectasis plus carcinoid carcinoma (n=1) and connective tissue disease-related fibrosis plus carcinoid carcinoma (n=1). HE stain indicated that morphological spectrum changed from neuroendocrine cell hyperplasia to carcinoid in transplanted lung of bronchiectasis.Immunohistochemical stain indicated that neuroendocrine markers CgA, Syn, CD56 and epithelial markers AE1/AE3, TTF-1 were positive for small cell carcinoma and carcinoid.Ki-67 index of small cell carcinoma (n=2) and combined small cell carcinoma (n=1) was 80% and Ki-67 index of carcinoid (n=2) was ≤1%.Until the last follow-up, 3/5 patients survived and the remaining 2 died of Klebsiella pneumoniae, Corynebacterium striatus and Acinetobacter baumannii infections at Days 33 and 196 post-transplantation.Conclusions:Neuroendocrine carcinoma in transplanted lung is more common in elderly males and end-stage lung disease is mostly idiopathic pulmonary fibrosis.Small cell carcinoma is a major type of neuroendocrine carcinoma.Specific neuroendocrine markers and TTF-1 aid in a definite diagnosis of neuroendocrine carcinoma.Postoperative infection is an important prognostic factor.

Objective To examine the influence of gender difference on the reperfusion delay in patients with ST-elevation myocardial infarction (STEMI).Methods A total of consecutive 325 patients with STEMI were analyzed admitted in the 306 Hospital of PLA from Jan.2011 to Dec.2015.Patients were divided into two groups:male group (n=268) and female group (n=57).The clinical data and the time intervals including symptom onset to first medical contact (So-to-FMC),transfer delay (FMC-to-D),FMC to balloon dilatation (FMC-to-B),activation delay and door to balloon (D-to-B) time were compared between different gender groups,and the prognosis was observed.Results The overall median of pre-hospital delay was 125 minutes.The median of prehospital delay time (male 119.5min vs.female 160.0min) and So-to-FMC time (male 69.5min vs.female 100.0min) were longer in female than in male patients,but no statistical difference existed (P＞0.05) between the two groups in pre-hospital delay,So-to-FMC,FMC-to-B,D-to-B and total ischemia time.Compared with male patients,female patients were more likely to have additional comorbidities,such as hypertension and diabetes mellitus,and lower rate of smoking (P＜0.05).However,the incidence of major adverse cardiac and cerebrovascular events (MACCE) showed no significant difference between female and male patients at 30-day (male 5.22％ vs.female 5.26％) and I-year (male 10.82％ vs.female 8.77％) follow-up (P＞0.05).Conclusion The influence of gender on reperfusion delay is gradually weakening.

To investigate biological characteristics of the IVpi-189 progeny virus derived from the culture of influenza A virus as a live-attenuated vaccine candidate. Persistent infection of a cultured cell line with influenza A virus (MDCK-IVpi) was established by incubating continuously influenza virus-infected cells at a lower temperature. The infectious progeny virus derived from MDCK-IVpi cells at the 189rd subculture was designated as the IVpi-189 strain of influenza virus. The cytopathic effect induced by IVpi-189 virus was observed under different temperature conditions. The production of infectious progeny virus was examined at 38 and 32 degrees C by plaque titration of cell-associated and released virus. IVpi-189 virus showed cytopathic effect as strong as that of IVwt in infected cell line of MDCK at 32 degrees C. However, when culture temperature was raised to 38 degrees C, the cytopathic effect induced by IVpi-189 virus was delayed and less pronounced. Virus growth in IVpi-189 virus-infected cells at 38 degrees C was significantly reduced as compared with that of IVwt virus, although both viruses yielded nearly equivalent high titers of cell-associated and released virus at 32 degrees C. The reasons of the decreased proliferative ability of IVpi-189 virus at high culture temperature were unrelated with virus inactivation or the release of progeny virus, but associated with the decreased replication of infectious progeny virus in the infected cells. IVpi-189 virus derived from MDCK cells infected persistently with influenza A virus showed biological characteristics as a potential live-attenuated vaccine candidate.
Animals ; Cell Line ; Cytopathogenic Effect, Viral ; Dogs ; Humans ; Influenza A virus ; genetics ; physiology ; Temperature ; Virus Cultivation ; methods ; Virus Replication

Objective To investigate the relationship between ischemic time and thrombus types in patients with ST-segment elevation myocardial infarction (STEMI).Methods Eighty-two STEMI patients undergone emergency percutaneous coronary intervention (PCI) and coronary thrombus aspiration (CTA) from Sep.2012 to Apr.2016 were included and divided into 3 groups according to the ischemic time:≤4 hours (n=36),4-7 hours (n=30) and ＞7 hours (n=16).Visible aspirated thrombi were collected and separated into erythrocyte-rich type,platelet/fibrin-rich type and combined type thrombi by HE dying.The percentage difference of the 3 types thrombi was compared among the 3 groups.Results The percentage of platelet/fibrinrich type,erythrocyte-rich type and combined type thrombi in the 3 groups were as follows:in ≤4h group:61.1％(22/36),8.3％(3/36) and 30.6％(11/36),P=0.019;in 4-7h group:23.3％(7/30),10.0％(3/30) and 66.7％(20/30),P=0.012;and in ＞7h group:43.8％(7/16),12.5％(2/16) and 43.8％(7/16),P=0.913.For platelet/fibrin-rich type thrombi,the percentages in 3 periods were 61.1％(22/36),19.4％(7/36) and 19.4％(7/36),P=0.009;For combined type thrombi,the percentages in 3 periods were 28.9％(11/38),52.6％(20/38) and 18.4％(7/38),P=0.013;For erythrocyte-rich type thrombi,the percentages in 3 periods were 37.5％(3/8),37.5％(3/8) and 25.0％(2/8),P=0.895.Conclusions The types of intracoronary aspirated thrombi differ from various periods.Ischemia time may be an important predicted factor.

BACKGROUNDRopivacaine and levobupivacaine have been introduced into obstetric analgesic practice with the proposed advantages of causing less motor block and toxicity compared with bupivacaine. However, it is still controversial whether both anesthetics are associated with any clinical benefit relative to bupivacaine for labor analgesia. This study aimed to compare the analgesic efficacy, motor block and side effects of bupivacaine, ropivacaine and levobupivacaine at lower concentrations for patient-controlled epidural labor analgesia.

METHODSFour hundred and fifty nulliparous parturients were enrolled in this randomized clinical trial. A concentration of 0.05%, 0.075%, 0.1%, 0.125% or 0.15% of either bupivacaine (Group B), ropivacaine (Group R) or levobupivacaine (Group L) with sufentanil 0.5 microg/ml was epidurally administered by patient-controlled analgesia mode. Effective analgesia was defined as a visual analogue scale score was

RESULTSThere were no significant differences among groups in the numbers of effective analgesia, pain scores, hourly local anesthetic amount used, sensory and motor blockade, labor duration and mode of delivery, side effects and maternal satisfaction (P>0.05). The relative median potency was bupivacaine/ropivacaine: 0.828 (0.602-1.091), bupivacaine/levobupivacaine: 0.845 (0.617-1.12), ropivacaine/levobupivacaine: 1.021 (0.774-1.354), respectively. However, a significantly less number of effective analgesia and higher hourly local anesthetic use were observed in the concentration of 0.05% than those of >or=0.1% within each group (P<0.05).

CONCLUSIONSUsing patient-controlled epidural analgesia, lower concentrations of bupivacaine, ropivacaine and levobupivacaine with sufentanil produce similar analgesia and motor block and safety for labor analgesia. The analgesic efficacy mainly depends on the concentration rather than the type of anesthetics.

Adult ; Amides ; therapeutic use ; Analgesia, Epidural ; methods ; Analgesia, Obstetrical ; methods ; Analgesia, Patient-Controlled ; methods ; Anesthetics, Local ; therapeutic use ; Bupivacaine ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Labor Pain ; drug therapy ; Labor, Obstetric ; Pregnancy ; Sufentanil ; therapeutic use ; Young Adult

OBJECTIVETo observe the safety and efficacy of early oral enteral nutrition after colorectal cancer operation.

METHODSA total of 88 colorectal cancer patients in our department from March 2013 to December 2013 were prospectively enrolled in the study and randomly divided into early enteral nutrition group(43 cases, receiving early water and enteral nutrition after operation) and early fasting group(45 cases, receiving conventional postoperative care protocol) based on the random number table. The postoperative recovery, complication morbidity, nutritional status and stress were compared between the two groups.

RESULTSCompared to early fasting group, patients in early enteral nutrition group had a significantly shorter duration of postoperative fever [(53.7±5.9) h vs. (64.5±5.8) h, P<0.01], a shorter interval to flatus [(57.5±8.2) h vs. (71.8±7.2) h, P<0.01], a shorter hospital stay [(6.9±1.4) d vs. (8.5±1.9) d, P<0.01] and lower medical cost [(41 868±3168) Yuan vs. (45 950±3714) Yuan, P<0.01]. There was no significant difference in complication morbidity between the two groups [18.6%(8/43) vs. 22.2%(10/45), P>0.05]. The albumin, prealbumin, and retinol binding protein on the third and seventh postoperative days were significantly higher in early oral enteral nutrition group (P<0.05), while the rest energy expense (REE) and lnHOMA-IR were significantly lower as compared to early fasting group (all P<0.05).

CONCLUSIONEarly oral enteral nutrition after colorectal cancer operation is safe and effective, which is a natural route of nutrition and can reduce the stress response related to surgery, improve postoperative patients' nutritional status and accelerate rehabilitation.

Colorectal Neoplasms ; surgery ; Digestive System Surgical Procedures ; Enteral Nutrition ; Humans ; Nutritional Status ; Postoperative Care ; Postoperative Period

OBJECTIVETo study the immuno-tolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells (BMSCs) in the allogeneic transplantation.

METHODSForty female C57BL/6 mice and forty male BALB/C mice were respectively used as donors and recipients in skin allogenic graft model. Forty male BALB/C mice were divided randomly into 4 groups: blank control group, CP group, BMSCs group , CP + BMSCs group, with 10 mice in each group. Before skin graft, high-dose abdominal injection of cyclophosphamide (200 mg/kg, 2 d, q. d.) was performed in recipient mice in CP and CP + BMSCs groups. On the transplantation day, a bonus of 2 x 10(6) BMSCs from the SD rat (SD-BMSCs) were injected through the tail vein in the BMSCs and CP + BMSCs groups. The observation and HE staining of skin grafts were used. The expressions of CD29, CD34, CD45 and CD90 of cells were analyzed by using flow cytometry in order to identify BMSCs. The CD4+, CD25+, Foxp3 and Treg cells of spleen were detected by flow cytometry. Cytokine in peripheral blood of recipient mice were measured by ELISA, including TGF-beta, IL-10 and IFN-gamma. T cells were co-cultured with 60Co-irradiated bone marrow MSCs from different individuals. The proliferative activity of T cells were evaluated with MTT assay.

RESULTSThe skin graft survival time was significantly prolonged in the CP + BMSCs group, as compared with that in the blank control group, the CP group, the BMSCs group, respectively. Cells cultured by whole bone marrow adherent cultivation showed CD29 (99.7%), CD44+ (96.7%), CD34- (1.6%), CD45- (1.3%). Compared with the control group and CP group, the ratio of the CD4+, CD25+, Foxp3+ and Treg cells significantly increased in the SD-BMSCs group and CP + BMSCs group (P < 0.05). Analysis of peripheral blood by ELISA showed significant high level of TGF-beta, IL-10 and low level of IFN-gamma in BMSCs group and CP group,compared with that in control group. When co-cultured with BMSCs from different individuals, T- lymphocytes proliferation decreased apparently in SD-BMSCs group and C57-BMSCs group (P < 0.05), but there was no significant difference between SD-BMSCs group and C57-BMSCs group (P > 0.05).

CONCLUSIONSThe immunotolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells in the allogeneic transplantation might be associated with its effect on the proliferation of Treg cells and increasing expression of TGF-beta and IL-10, decreasing expression of IFN-gamma.

Animals ; Bone Marrow Cells ; immunology ; Female ; Immune Tolerance ; Interferon-gamma ; immunology ; Interleukin-10 ; immunology ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; immunology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Rats ; Rats, Sprague-Dawley ; Skin Transplantation ; T-Lymphocytes, Regulatory ; immunology ; Transforming Growth Factor beta ; immunology ; Transplantation, Homologous