Objectives:To investigate the effect of early enteral nutrition after total gastrectomy and evaluate its feasibility. Methods:25 cases of postoprative patients of stomacch carcinoma after total gastrectomy were selected and is divided into two groups at random.12 cases (control group) had accepted parenteral nutrition after operation.13 cases(test group) had accepted enteral nutrition after 24 hours of the operation though jejunostomy.The study continued for 7 days. The energy was equal approximately between groups.The nutrition state was evaluated in two groups before and after operation,and the recovery of intestinal function and hospitalized charge were compared too. Results:The postoperative body weight and nutrition state in the test group were better than those in control group and the differnces were very significant( P

Proteins extracted from two varieties of Chinese roses leaves were separated by two- dimensional polyacrylamide gel electrophoresis (2-DE) with immobilized pH gradient (IPG). Many difference proteins were isolated with molecular weights ranging 10-30 kDa and pI5-6. Three proteins of high levels observed in a gel were excised and identified using peptide mass fingerprinting and MS-MS. A summary of the identified proteins and their putative functions are presented. They are identified as eIF-5A、LEA protein and Hsp17. 5. Functions of these proteins in plant tolerance to high temperature were discussed.

Objective To evaluate prognostic factors for early bronchopleural fistula after pneumonectomy with non small cell lung cancer,and establish a validated clinical model to estimate the risk of early-BPF.Methods We reviewed the medical records of 429 patients who underwent pneumonectomy for NSCLC at our institution.We used univariate and multivariate analysis to identify potential independent risk factors for early-BPF after pneumonectomy for NSCLC.A model to estimate risk of early-BPF was developed by combining independent risk factors.Results The rate of early-BPF after pneumonectomy for NSCLC was 6.5％ (28/429).Three factors were independently associated with early-BPF:neoadjuvant therapy (HR:2.406),bleeding (HR:2.171)and diabetes (HR:1.144).A scoring system for early-BPF was developed by assigning 2 points for each major risk factor (neoadjuvant therapy and bleeding) and 1 point for each minor risk factor(diabetes).Scores were grouped as low (0-1),intermediate (2-3),and high (3),yielding the rate of early-BPF was 14％,27％,and 43％,respectively.Conclusion This clinical model is established on the basis of independent risk factors.This model can be used as a predictive tool for early-BPF after pneumonectomy for NSCLC.

AIM: To investigate the efficacy, safety and localization of multilayer amniotic membrane transplantation (AMT) for the management of corneal perforation associated with ulceration.METHODS: Six eyes (6 patients) were treated with multilayer AMT for corneal perforation associated with ulceration. The perforation size was 0.5-2mm in diameter. The amniotic membrane (AM) was applied to tamp the perforation, fill the ulcer and cover the surface of ulcer. The follow-up ranged from 5-19 months.RESULTS: The anterior chamber reformed at the first postoperative day in all patients, and kept in normal depth in the follow- up time. The epithelialization of the AM grafts was observed in about 3 weeks after surgery. During the first postoperative month, the corneal thickness at the perforation site gradually increased, and the stromal inflammatory cell invasions surrounding the corneal ulcer were gradually subsided.Two months postoperatively, the ulcer healed with scar with part neovascutarization; the corneal thickness of the ulcer area was stable and recovered almost normal. The vision was not improved in all patients after operation. During-follow up,no severe complications or recurrence of ulceration was noted.CONCLUSION: Multilayer AMT is an effective and safe method for the management of small corneal perforation associated with ulceration, but the ulcer healed with scar.

AIM: To evaluate the efficacy and safety of annular bubble conjunctival excision combining with amniotic membrane transplantation(AMT) for vernal keratoconjunctivitis(VKC) with gelatinous swellings(papillae) at the limbus.METHODS: Twenty eyes(10 patients) with VKC, were characterized by gelatinous swellings(papillae) at limbus and were underwent annular bubble conjunctival excision associated with AMT. The follow up ranged 5-21months.RESULTS: After operation, the symptoms were subsided remarkably: itching,discharge and foreign body sensation were almost disappear; photophobia and tearing were obvious in the first week after surgery, but were gradually alleviated, and almost disappear after one month of postoperative.Yellow-brown or filthy red gelatinous protuberances at limbus were cleaned away by operation and did not recur during the follow up. Corneal superficial punctuate keratitis(11 eyes) and corneal ulcers(3 eyes) were healed during the first week after surgery and did not recur. Conjunctival congestion was gradually lessened after surgery, which could not be noted 1months after surgery in 19 eyes, and the conjunctiva around the limbus, where AMT was performed, was whiter than the normal. But conjunctival congestion in 1 eye lasted for about 5mon accompanying with a little of itch, and this eye was treated with eyedrops with improvement but recurrence. No severe complications had been seen during the follow up.CONCLUSION: Annular bubble conjunctival excision combining with amniotic membrane transplantation is an effective and safe method for the treatment of vernal keratoconjunctivitis with gelatinous swellings (papillae) at limbus. But the candidates must be chosen with discretion.

AIM: To investigate the efficacy and safety of annular conjunctival excision combined with amniotic membrane transplantation for the management of earlier Mooren's ulcer.METHODS: Thirty eyes (24 patients) with earlier Mooren's ulcer were treated with this method, followed-up for 5-30mo. The characteristic of these patients was localized periphery corneal ulcer: the ulcer involved 30-120° corneal limbus with depth of 1/3-1/2 cornealthickness and width of 2-5mm.RESULTS: After surgery, symptoms subsided remarkably and immediately in all patients,and almost disappeared after stitches were removed. Corneal melts were controlled. At postoperative 2-3mo, the corneal thickness of the ulcer area became almost stable, which in some patients recovered normal and in others were still thinner than normal, and the average increase was about 1/3 of the corneal thickness. Corneal transparence and vision were improved. During follow-up, no severe complications or recurrence were noted.CONCLUSION: Conjunctival peritomy combined with amniotic membrane transplantation is an effective and safe method for the treatment of earlier Mooren's ulcer.

Objective To investigate the efficacy,safety and localization of multilayer amniotic membrane transplantation(AMT) for corneal perforation associated with ulceration.Design A retrospective clinical case series.Participants Nine patients(9 eyes)with corneal perforation secondary to ulceration were enrolled into this study.These were little response to medicine,including bacterial keratitis(4 eyes ),fungal keratitis(2 eyes),fungal and bacterial mixed keratitis( 1 eye),virus keratitis( 1 eye),and Mooren's ulcer ( 1 eye).Size of perforation was 0.5～3.0 mm in diameter.Methods The AMT was applied to tamp the perforation,fill the ulcer and cover the surface of ulcer.After surgery,the medicine was continued to be used to treat the original corneal ulcer.The follow-up ranged from 6～20 months.In the suffering eyes,reformation of anterior chamber,healing of ulcer,complications and recurrence of ulceration were observed.Main Outcome Measures Of the postoperative eyes,reformation of anterior chamber,healing of ulcer,complications and recurrence of ulceration.Results The anterior chamber reformed at the first postoperative day in 9 eyes,and kept in normal depth in the follow-up time.At postoperative 2 months,the ulcer healed with sear and a smooth surface.Corneal thickness of the ulcer area recovered almost to normal.During follow up,no recurrence of ulceration or severe complications was noted.Conclusions Multilayer AMT is a safe and effective method for the management of small corneal perforation associated with ulceration,but the ulcer healed with scar.(Ophthalmol CHN,2008,17:101-103)

OBJECTIVETo evaluate the applicability of immune-related response criteria (irRC) in treating non-small cell lung cancer (NSCLC) by Chinese medicine (CM).

METHODSTotally 97 stage III a-IV NSCLC patients were predominantly treated with comprehensive CM. Curative effects were evaluated by three methods such as Response Evaluation Criteria in Solid Tumors (RECIST), Oncologic Curative Effect Evaluation Criteria of Chinese Medicine in Solid Tumor (draft, abbreviated as CM criteria), and irRC. The correspondency and consistency between irRC, RECIST and CM criteria were analyzed and compared. The objectivity of irRC in evaluating curative effect of Chinese medical treatment for NSCLC was assessed.

RESULTSThe correspondency rate of irRC to RECIST was 59. 79% with Kappa value of 0. 379 (U test, P <0. 01). The two criteria had certain correspondence, but with an unsatisfactory consistency. The correspondency rate of irRC to CM criteria rate was 83. 51% with Kappa value of 0.751 (U test, P <0. 01). The two criteria had good correspondence and consistency.

CONCLUSIONSCM criteria had good consistency with CM criteria in evaluating curative effect for Chinese medical treatment of advanced NSCLC. Its results could objectively reflect features and advantages of CM for treating advanced NSCLC.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; immunology ; Medicine, Chinese Traditional ; standards ; Treatment Outcome

ObjectiveTo study the regulatory effect of Tripterygium wilfprdii polyglycoside (TWP) on the expression of EGFR and ErbB-2 induced arthritis rats.The effect of TWP on arthritis was also explored.MethodsAfter the model of CIA rats were established,the expression of EGFR and ErbB-2 in the synovium and articular cartilage were tested by immunohistochemical stain and real time PCR.ANOVA was used for statistical analysis.ResultsThe protein and mRNA expression of EGFR and ErbB-2 in the synovium (EGFR 0.268±0.059,ErbB-2 0.25±0.04,EGFR mRNA:14.2±0.55,ErbB-2 mRNA 23.46±3.64) and articular cartilage (EGFR 0.193±0.018,ErbB-2 0.217±0.033,EGFR mRNA:4.16±0.50,ErbB-2 mRNA 9.23±0.66) of the model group were significantly higher than those of the control group(P＜0.01).After being treated with TWP and MTX,the protein and mRNA expression of the EGFR and ErbB-2 decreased markedly (P＜0.01).Conclusion EGFR and ErbB-2 may play an important role in the pathogenesis of arthritis development.The molecular mechanism that TWP can treat synovitis and bone destruction of RA is related to the inhibition of EGFR and ErbB-2.

Objective: To investigate the value of positron emission tomography/computerized tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18FDG) for gastric carcinoma.Methods: Thirty-two patients(25 males,7 females,aged 31-82 years) suspected of gastric carcinoma underwent whole-body PET/CT after taking in 600 ml of water to distend the gastral cavity.The maximal standard uptake value(SUVmax) of the region of interest(ROI) in PET and the maximum width of the gastric wall in CT were analyzed.Pathological specimens were obtained from all the patients during surgery or gastroscopy.Results: 18FDG PET/CT found gastric carcinoma in 24 of the patients.The rates of positive and negative prediction and the accuracy of PET/CT in the diagnosis of the disease were 92.3%,100% and 93.8%.SUVmax was positively correlated with the maximum width of the gastric wall,but they exhibited no statistically significant differences between the patients with involved lymph nodes and those without.Based on the PET/CT findings,the 24 gastric carcinoma patients were clinically classified as follows: 9 in stage Ⅰ,1 in stage Ⅰ-Ⅱ,3 in stage Ⅱ,1 in stage Ⅲ and 10 in stage Ⅳ.Conclusion: 18FDG PET/CT is highly valuable for gastric carcinoma in its diagnosis,the evaluation of its biological behavior and determination of its treatment strategies.