Objective To investigate the safety,feasibility and effectiveness of early oral feeding after colorectal surgery. Methods A randomized controlled trial enrolled 47 patients undergoing elective open colorectal surgery from May 2007 to November 2007. The patients were randomized into group of early oral feeding (experimental group) or group of traditional oral feeding(control group). Postoperative course, gastrointestinal function, and complications were evaluated. Results No statistically significant differences were found in clinical characteristics including age, types of procedures, times of surgery or comorbidity between the two groups. There was no perioperative mortality in the two groups. Stoma1 leak occurred and progressed to abdominal abscess in one case in the control group. Passage of flatus and defecation after operation was earlier in experimental group than in control group(1.9 ± 0. 6 d vs. 2. 8 ± 0. 9 d,P <0. 01). Length of postoperative intravenous infusion was shorter in the experimental group (3. 8 ± 0. 9 d vs. 4. 8 ± 1.2 d,P < 0. 01). Length of postoperative stay was also shorter (9.0 ± 3.2 d vs. 10. 0 ± 3. 3 d, P = 0. 27) and the rate of abdominal distension was lower in experimental group(27% vs. 44%, P = 0. 23). The rate of nausea and vomiting was higher in the experimental group(31% vs. 20% ,P =0. 35), the differences were of no significance. Reinsertion of nasogastric tube due to nausea and vomiting and reoperation was necessary in 2 patients in the experimental group and control group respectively. There were 3 patients complaining fever postoperatively in the control group. Conclusions Early oral feeding after colorectal surgery is safe and feasible, and it can promote postoperative recovery effectively.

Objective To identify the risk factors and early indicators for misplacement of subclavian vein catheter into ipsilateral internal jugular vein.Methods From August 2008 to July 2009,subclavian vein catheterization was successfully performed with Seldinger method in 167 patients in Department of General Surgery,Xuanwu Hospital of Capital Medical University.The paraeentesis side,pameentesis site,direction of puncture needle.and the perceptions of both patients and operators during catheter placement were recorded.The correlation of these factors,age,and gender with the misplacement of subclavian vein catheter into internal jugular vein was analyzed.Results Sixteen patients(9.58%)experienced misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein,which was not significantly correlated with age(P=0.375),gender(P=0.259),paraeentesis side (P=0.175),or paracentesis site(P=0.061).Misplacement of subclavian vein catheter into internal jugular vein was significantly more frequent when the direction of puncture needle was toward the midpoint of suprasternal fossa and laryngeal prominence(P=0.002).When the paracentesis site was located at a point at the junction of medial one-third and lateral two-tllirds of the clavicle.it was more frequent that the puncture needle was toward the midpoint of suprasternal fossa andlaryngeal prominence(P=0.010).There were more misplacement events when the patients feel ears pain(P=0.000)and when the operator felt resistance when inserting gnidewire during catheter placement(P=0.000).Conclusions Misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein occurs more frequently when the direction of puncture needle is towards the midpoint between suprasternal fossa and laryngeal prominence.Patients feel ears pain and operators feel resistance when inserting guidewire during catheter placement are early indicators of misplacement.

Objective To study the difference in outcomes between two treatment regimens of goal-directed fluid therapy in patients with severe acute pancreatitis. Methods From January 2000 to January 2010, 80 patients with severe acute pancreatitis were assigned into 2 groups. In group A,patients received fluid therapy aiming at the following goals in 24 hours: (1) Blood pressure >90/60 mm Hg;(2) CVP between 8-12 mm Hg;(3) Urine output >0. 5 ml · kg-1 · h-1. In group B, patients received fluid therapy aiming at the following goals in 6 hours (according to SSC guideline,2004): (1) mean arterial blood pressure >65 mm Hg;(2) CVP between 8-12 mm Hg;(3) Urine output >0. 5 ml · kg-1 · h-1 ;(4) central venous oxygen saturation >70%. After therapy for 3 days we measured the Marshall score, APACHE Ⅱ score, and the peri-pancreatic infection and mortality rates. Results The Marshall score was 6. 82±4. 69 and 4. 48±3. 78 in group A and B, respectively (P=0. 02). The APACHE Ⅱ score was 11. 35±5. 96 and 8. 22±4. 53 in group A and B, respectively (P=0. 01). The peri-pancreatic infection rate was 44% and 37% in group A and B, respectively, and there was no significant difference between the 2 groups (P = 0. 65). The mortality rate was 24% and 17% in group A and B. There was no significant difference between the 2 groups(P=0. 57). Conclusion Goal-directed fluid therapy in patients with severe acute pancreatitis according to the SSC guideline improved organ function but it did not reduce peri-pancreatic infection and mortality rates.

Objective To observe the influence of early intestinal barrier protection in patients with severe acute pancreatitis(SAP). Methods To analyze the therapeutic methods and prognosis of 56 patients with SAP. The patients were randomly divided into the conventional therapy group (A) and the intestinal barrier protection group (B). The APACHE Ⅱ score, Ranson score, Marshall score, CT severity index (CTSI), gastrointestinal functions score (GFS), the ratio of Lactulose to Mannitol (L/M), plasma Endotoxin and Diamine Oxidase (DAO), serum C-reactive protein (CRP) and TNF-α, incidence of pancreatic infection and multiorgan dysfunction syndrome (MODS), and the hospitalization mortality were compared between the two groups. Results On the 7th day after admission, the APACHE Ⅱ score, GFS, L/M, Endotoxin, DAO, CRP and TNF-α were significantly less in group B than in group A (P<0. 05). There was no significant difference in the CTSI (P>0. 05)between the two groups at 2nd week after admission. The incidence of pancreatic infection and MODS in group B were significantly lower than in group A (P<0. 05). The hospitalization mortality was not significantly different (P>0. 05) between the two groups. Conclusion Early intestinal barrier protection in SAP alleviated systemic inflammatory response, and reduced the incidences of pancreatic infection and MODS, thus improved the prognosis.

Objective To compare the value of transvaginal ultrasound, 3.0T magnetic resonance imaging (MRI) scanning alone and in combination for diagnosis of ectopic pregnancy, so as to provide insights into early screening of ectopic pregnancy. Methods This study enrolled a total of 130 patients with suspected ectopic pregnancy admitted to Dachuan People’s Hospital in Dazhou City, Sichuan Province, China between February 2019 and December 2022. All patients underwent transvaginal ultrasound examination and 3.0T MRI scanning. The consistency of transvaginal ultrasound and 3.0T MRI with clinical diagnostic results was evaluated with surgical pathology or clinical follow-up results as the golden standards. The sensitivity, specificity, and accuracy of transvaginal ultrasound and 3.0T MRI, alone and in combination, were compared for diagnosis of ectopic pregnancy. Results Of the 130 patients with suspected ectopic pregnancy, 108 cases were confirmed with ectopic pregnancy by surgical pathology, and 22 cases were confirmed without ectopic pregnancy by clinical follow-up. The sensitivity, specificity, and accuracy of transvaginal ultrasound were 85.19% (92/108), 54.55% (12/22), and 80.00% (104/130), respectively, with 0.358 consistency with clinical diagnostic results. The sensitivity, specificity, and accuracy of 3.0T MRI were 92.59% (100/108), 81.81% (18/22), and 90.77% (118/130), respectively, with 0.694 consistency with clinical diagnostic results. The sensitivity, specificity, and accuracy of transvaginal ultrasound combined with 3.0T MRI were 98.15% (106/108), 72.73% (16/22), and 93.85% (122/130), respectively, with 0.764 consistency with clinical diagnostic results. In addition, the sensitivity and accuracy of transvaginal ultrasound combined with 3.0T MRI were significantly higher than transvaginal ultrasound alone for diagnosis of ectopic pregnancy (χ² = 11.88 and 10.96, both P < 0.01). Conclusion Transvaginal ultrasound combined with 3.0T MRI may provide more diagnostic information for ectopic pregnancy, and is highly consistent with the clinical diagnostic results. In addition, transvaginal ultrasound combined with 3.0T MRI improves the diagnostic sensitivity and accuracy for ectopic pregnancy than transvaginal ultrasound alone.

We investigated the mechanism of human aspartyl beta-hydroxylase (HAAH) in early diagnosis of tumors. The encoding gene of HAAH was cloned from the hepatic carcinoma by RT-PCR and expressed as a fused protein in the prokaryotic vector pBV-IL1. The expressed HAAH was purified by Ni(2+)-NTA purification column and the purified protein was then used to immunize Balb/c mice. Three hybridoma cell lines (respectively designated H3/E10, E4/F12 and G4/D8) stably expressing the monoclonal antibody specific to HAAH fusion protein were obtained. The specificity and sensitivity of the monoclonal antibody were assessed by indirect enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. Finally, the monoclonal antibody expressed by H3/E10 cell line was used to detect the expression of HAAH in several tumor cell lines by indirect immuno-fluorescence, and the specific fluorescence was observed. In conclusion, this study successfully constructed the recombinant prokaryotic vector pBV-IL1-HAAH and prepared HAAH-specific monoclonal antibody for further study of the structure and function of the protein. The result may also lay solid foundation for the research of the molecular mechanism of HAAH in early diagnosis of tumors.
Animals ; Antibodies, Monoclonal ; biosynthesis ; Cell Line, Tumor ; Cloning, Molecular ; Genetic Vectors ; genetics ; Humans ; Hybridomas ; metabolism ; Immunization ; Liver Neoplasms ; pathology ; Mice ; Mice, Inbred BALB C ; Mixed Function Oxygenases ; biosynthesis ; genetics ; immunology ; Recombinant Proteins ; biosynthesis ; genetics ; immunology

The main work and achievements of clinical pathway work in China since 2009 were systematically reviewed in the paper. It analyzed the problems existing in the implementation of clinical pathway management in China, and suggested on such management in the future. The suggestions include:deeper understanding, convergence with the payment system reform, strengthened quality control, further informatization,and better performance appraisal system.

A three-dimensional feature construction method based on spectral information is presented,in which the power values of each channel are arranged into two-dimensional feature vectors based on electrode positions.The different frequency band features are arranged into a three-dimensional integral feature tensor to extract the information in frequency domain.Meanwhile,in order to reduce the influence of volume conductor effect,functional connectivity is utilized to map the temporal electroencephalogram data to the spatial brain functional network for extracting the spatial information.By analyzing the relationship between features and target classes,a 3D-CNN-Attention network model is proposed to incorporate an Attention mechanism in 3D-CNN network to enhance the electroencephalogram feature learning capability.A series of comparative experiments on publicly available datasets show that 3D-CNN-Attention network framework outperforms other methods in depression detection,obtaining an accuracy rate of up to 96.32%.The proposed method provides an effective solution for depression detection.

Facing the increasing cardiovascular disease burden and prevailing population risk factors, the cardiovascular surgery in China was also encountering challenges including imbalances in discipline development, significant divergencies in healthcare quality, lacking of clinical guidelines and domestic critical evidence. The concept of quality control and improvement has been practiced and tested in many disease specialties. Quality improvement programs are urgently needed in China to promote the universal cardiovascular surgery healthcare quality.