Objective:To systematically evaluate the efficacy and clinical value of early enteral nutrition (EEN) combined with microecological agents in the treatment of severe acute pancreatitis (SAP).Methods:China National Knowledge Infrastructure, Chinese biomedical literature database, Wanfang Database, VIP, Cochrane Library, PubMed, Embase, and Web of Science were analyzed, and the retrieval time range is from the establishment of the datebase to November 1, 2019. To compare the clinical efficacy of EEN combined with microecological agents (experiment group) and single EEN treatment (control group) in SAP patients, and to compare the main outcome indicators: serum C-reactive protein level, incidence of multiple organ dysfunction syndrome, incidence of pancreatic infection necrosis, incidence of other complications, mortality, and length of hospital stay. And secondary outcome measures: plasma interleukin-8 (IL-8), tumor necrosis factor-α level, gastrointestinal score, and incidence of surgical intervention. The quality of the included literature was evaluated by using the Cochrane systematic evaluator's manual 5.1.0 risk of bias assessment tool, and meta-analysis was performed by using Stata16.0 software.Results:A total of 762 patients were enrolled in 9 RCTs. The results of meta-analysis showed that: among the main outcome indicators, C-reactive protein level [Mean Difference ( MD)=-7.58, 95% CI: -23.71-8.55, P>0.05], incidence of multiple organ dysfunction syndrome [Logarithm Risk Ratio (Log RR)=-0.30, 95% CI: -0.71-0.10, P>0.05], incidence of pancreatic infection and necrosis (Log RR=-0.21, 95% CI: -0.57-0.16, P>0.05) and mortality rate (Log RR=0.13, 95% CI: -0.36-0.62, P>0.05) the differences were not statistically significant. The incidence of complications in the experimental group was significantly lower than that in the control group (Log RR=-0.29, 95% CI: -0.51-0.07, P<0.05), and the length of hospital stay in the experimental group ( MD=-4.45, 95% CI: -7.47--1.43, P<0.05) was significantly shorter than that in the control group. Plasma IL-8 levels ( MD=-7.43, 95% CI: -14.28--0.57, P<0.05), TNF-α level ( MD=-38.96, 95% CI: -72.96--4.95, P<0.05)and gastrointestinal score ( MD=-0.15, 95% CI: -0.17--0.13, P<0.05)were significantly lower in the experimental group than in the control group, and the incidence of surgical intervention was significantly lower than that of the control group (Log RR=-1.63, 95% CI: -8.96-0.57, P>0.05) no statistical significance. Conclusion:EEN combined with microecological preparations can reduce the length of hospital stay in SAP patients and the incidence of complications. Therefore, EEN combined with microecological agents may be beneficial for SAP patients.

Objective To evaluate the effect of tirofiban injection in coronary artery occlusion by suction catheter on the opening time of the coronary artery occlusion , the improvement of the blood flow and the incidence of adverse events in 30 days. Methods A total of 97 patients with acute myocardial infarction in recent 4 years were included , whose culprit vessels were subtotal occlusion or total occlusion by angiography and were randomly divided into thrombus aspiration group (group A) and tirofiban injection in occlusion and thrombus aspiration group (group B). The opening time of the coronary artery, the improvement of the blood flow and the incidence of adverse events in 30 days were compared between two groups. Results The opening time of the coronary artery occlusion in group A was shortened when compared with group B but the blood flow arriving TIMI III grade in group B was shorter (P < 0.05). No-reflow incidence in group B was lower while the proportion of blood flow arriving TIMI III grade was higher than that in group A in early phase (P < 0.05). The incidence of adverse events in 30 days was decreased in group B when compared with group A ,but the difference wasn't statistically significant (P > 0.05). Conclusion Direct tirofiban injection in coronary artery occlusion could effectively shorten the opening time of the coronary artery occlusion reduce no-reflow incidence , and improve coronary perfusion but could not decrease the incidence of adverse cardiovascular events in 30 days.

Background and purpose:It was reported that many microRNAs (miRNAs) have close relation with carcinomas. miR-31 (microRNA-31) shows abnormal change in numerous cancers. China is one of the most high-risk areas of esophageal squamous cell carcinoma (ESCC). The aim of the present study was to investigate the expression of miR-31 in ESCC, and analyze the relationship of its expression with clinicopathological features and prognosis. Methods:The expression of miR-31 in KYSE410, EC1 and EC9706 cell lines, as well as 81 cases of ESCC tissues and adjacent normal esophageal tissues were detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). The result was combined with clinical and follow-up data and statistical analysis was conducted. Results: MiR-31 was up-expression in 3 cell lines and 75.31% of the ESCC tissues. miR-31 up-expression was positively related to severer lymph node metastasis (P=0.043), deeper invasion of tumors (P=0.002) and advanced pathological stage (P=0.027). There was no relationship of miR-31 with other clinicopathological features (P>0.05). Furthermore, high expression of miR-31 was associated with poor progression-free survival (PFS) in 81 ESCC patients by Kaplan-Meier analysis (P=0.014) and by multivariate Cox analysis (P=0.021). Conclusion:Our results identiifed miR-31 may be a new diagnostic criteria and prognostic biomarker for ESCC.

Cholecystectomy is currently the most important surgical treatment for gallbladder disease, however, the complications of cholecystectomy, especially the occurrence of intestinal tumors has gradually aroused attention of scholars. In recent years, scholars have found that bile acid metabolism changes significantly after cholecystectomy, which may be the main cause of colorectal cancer induction, but the specific mechanism of colorectal cancer induced by cholecystectomy has not been clarified. In this article, the changes of bile acid metabolism after cholecystectomy (the size and composition of bile acid pool) and the mechanism of colorectal cancer induction after cholecystectomy were summarized and discussed based on the research progress at home and abroad, aiming at providing theoretical basis for the exploration of the prevention and treatment of colorectal cancer.

Objective:To explore the relationship between thyroid function and cardiovascular diseases .Methods:A total of 980 patients undergoing thyroid function examination during hospitalization were selected . According to their thyroid function ,they were divided into normal thyroid function group (normal group ,n= 930) , hyperthy-roidism group (n=18) ,and hypothyroidism group (n=32) .Clinical data were analyzed ,blood lipids and coagula-tion function indexes were examined and compared among three groups . Results:Compared with normal group ,the incidence rate of atrial fibrillation significantly rose ,incidence rate of hypertension ,cardiac insufficiency signifi-cantly reduced;levels of TC、TG、 LDL-C、 HDL-C significantly reduced ,activated partial thromboplastin time significantly extended in hyperthyroidism group , P<0.01 all;incidence rate of coronary heart disease significantly rose ,levels of TG、HDL-C significantly rose ,levels of TC 、LDL-C significantly reduced in hypothyroidism group , P<0.01 all;Compared with hyperthyroidism group ,the incidence rate of hypertension ,coronary heart disease sig-nificantly rose ,atrial fibrillation significantly reduced ,P<0.05 or <0.01 ;levels of TG、LDL-C、HDL-C signifi-cantly rose ,TC level significantly reduced in hypothyroidism group , P<0. 01 all .Conclusion:Thyroid function is closely related to cardiovascular diseases .so it′s suggested that thyroid function detection should be regarded as a routine examination in patients with cardiovascular diseases and a follow-up index for those with thyroid dysfunc-tion .