Objective To investigate unhealthy behaviors and their influence on community residents,and to evaluate the effectiveness of modified behaviors. Methods A total of 1230 community residents were randomly enrolled from 8 of 16 communities in Yantian District of Shenzhen City. The behavior information of the participants was collected through face-to-face interviews. A systematic intervention was carried out to the target residents, and the outcomes were evaluated. Results The awareness of healthy behaviors was improved and unhealthy behaviors (i. e. lack of physical activity,over-intake of salt, cigarette smoking,alcohol consumption,irregular health check-up, long-time watching TV) were significantly reduced ( P < 0. 05 ). Conclusions Systematic intervention could be an effective way to reduce unhealthy behaviors of community residents.

Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group.The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32 % and the mortality was 0 %. One hundred and sixty elderly patients,were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group (all P＜0.01). The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3%, the mortality was 4.34%. There was no significant difference in the complication rate and mortality between the 2 groups (all P＞0.05). The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0% respectively, and were 35.29% and 10.29% by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups (P＜0.01 and P＜0.05). Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.

Objective To study the effect of inosine monophosphate dehydrogenase inhibitor (IMPDHI) on chemotaxis, migration and endocytosis of human peripheral myeloid dendritic cells (MDCs). Methods Freshly isolated peripheral blood mononuclear cells(PBMC)collected from healthy volunteers (N=15) and the study group were treated with IMPDHI. CC chemokine receptors on MDCs were analyzed by flow cytometry. The study group, control group and different chemokines were added via trans-well approach for different chemokines, stained by Lin-1/CD11c/HLA-DR and counted by flow cytometry. The migration index was calculated as a percentage of MDC migrated in response to the tested chemokine. After isolation of blood dendritic cell antigen-1+ (BDCA-1+ ), mannose receptor-mediated endocytosis was measured as the cellular uptake of FITC-dextran by the flow cytometry. Results (1) Compared to the control group, the expression of CCR1 in the study group was up-regulated significantly(17.02±3.23～30.63±9.13, P＜0.05) and the expressions of CCR3(10.26±2.25～5.81±0.97 P＜0.05) and CCR7 (9.56± 1.84～5.18±0.60 P＜0.05)were downregulated significantly. MDCs in the study group showed enhanced migratory response to inflammatory chemokine CCL2, CCL3, CCL4, CCL7 and CXCL12 (P＜0.05). (2)The endocytosis capacity in the study group was significantly higher than that in control group (P ＜0.05). Conclusion IMPDHI enhances the endocytotic capacity of MDCs and impairs the migratory response of peripheral MDCs to lymphocytic tissue by up-regulating the expression of chemokine receptor in MDCs and enhancing migratory response to inflammatory chemokines.

renal dysfunction.Logisitic regression showed that cardiovascular disease and hypoalbuminemia were correlated with perioperative death rate significantly. Conclusions Improving the perioperative management is very important for lowering the perioperative mortality in elderly patients with digestive tract disease.

ObjectiveTo study the feasibility and technique in liver transplantation (LT) in an adult with situs inversus (SI) and reviewed the medical literature on this subject.MethodsA 45-year-old male with complete SI,suffered from progressive hepatic failure secondary to hepatolithiasis,obstructive jaundice,portal hypertension and liver cirrhosis.He underwent liver transplantation in July 2004.His anatomy was studied by preoperative CT scan and three-dimensional liver reconstruction imaging and angiography.LT was performed using the modified piggyback technique.The donor right liver was rotated 45 degree to the left,making the donor left liver pointing to the left paracolic sulcus and the donor right liver was in the recipient hepatic fossa.The donor suprahepatic vena cava was anastomosed end-to-side to the recipient vena cava,and the infrahepatic vena cava was closed by oversewing.ResultThe patient recovered uneventfully.His liver function was stable during a follow-up of 75 months.ConclusionLT in patients with SI is safe and feasible.Exact determination of the anatomy,comprehensive preoperative planning,and good technique in liver transplantation play important roles in LT for patients with SI.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition among hospitalized elderly abdominal surgical patients with malignant tumors.MethodsTotally 269 elderly patents ( ≥ 65 years) with malignant tumor who were hospitalized in our department of abdominal surgery from December 2009 to November 2010 were consecutively enrolled.Nutritional Risk Screening 2002 ( NRS 2002 ) was performed on the next morning after admission.Body mass index (BMI) lower than 18.5 kg/m2 was considered as malnutrition.Results The NRS 2002 was completed in all the 269 enrolled patients.The overall prevalence of malnutrition was 30.1％ (81/269) ; more specifically,37.5％ (21/56) among geriatric patients ( ≥80 years) and 17.6％ (43/245) among the other age groups (P =0.001 ).The overall rate of nutrition risk was 38.3％ (103/269) ; more specifically,57.1％ (32/56) among the geriatric patients and 29.3％ (72/245) among the other age groups (P ＜0.001 ).The rate of nutrition risk in patients with pancreas cancer was 58.3％,which was higher than other elderly patients; on the contrary,and the rate of nutrition risk in the patients with colorectal cancer was relatively lower.ConclusionThe rates of nutrition risk and malnutrition in hospitalized elderly abdominal surgical patients ( ≥ 65years) with malignant tumor are relatively higher than other age groups,especially among the geriatric patients.

ObjectiveTo explore the clinical outcome of the combined nutrition support for colorectal cancer patients.MethodsTwo research arms were obtained using a cohort sampling method.Ann A ( the study group): from 2009 to 2010,30 colorectal cancer patients were enrolled.They received nutritional risk screening (NRS) 2002 after admission.Nutritional risk was defined as NRS 2002 score ≥3 three days before operation.Patients with nutritional risk received enteral nutrition (EN) for bowel preparation without laxative drug and enema.After operation,they received EN combined with parenteral nutrition (PN) supports provided.Arm B (control group): 30 cases with historically confirmed colorectal cancer were enrolled from 2007 to 2008.They received routine bowel preparation (diet control,laxative drug,and enema) and PN supports after operation.Nutritional parameters,the rate of infectious complications,the rate of systemic inflammatory response syndrome,and the duration of hospital stay were analyzed.ResultsThere were no significant difference in body weight and plasma albumin between these two arms ( P ＞ 0.05 ). The incidence of systemic inflammatory response syndrome (13.3 ％ ),infectious complications (10.0％ ),and the duration of hospital stay [ (12.3 ± 6.5 ) d ] in arm A were significantly lowerthan those in arm B [33％,30％,and (15.0 ±7.2) d,respectively] (P =0.038,P =0.042,P =0.045).Conclusion For the colorectal cancer patients,nutritional risk screening on admission,bowel preparation with eneral nutrition before operation,and combined nutritional support after operation can improve the clinical outcome.

Objective To investigate the age-associated changes of ultrastructure,mRNA and protein expressions of H+-K+-ATPase in elderly gastric parietal cell. Methods Fifty patients with relative normal stomach without gastroduodenal diseases were enrolled,including younger group (aged 20-59 years,n=19) and elderly group (aged≥60 years,n=31).Furthermore,the elderly group was divided into 3 subgroups:60-69 years old (n =11 ),70-79 years old (n=10 ),above 80 years old (n =10).The ultrastructure of gastric parietal cell was observed under electron microscope.The expression of H+-K+-ATPase α subunit mRNA and H+-K+-ATPase β subunit protein were assessed by quantitative real-time PCR and Western-blot,respectively.The ageing-associated changes of all these data were respectively compared. Results No significant difference was showed in the morphology of gastric parietal cell and acid-secretion-associated organelles among all the groups.The average ratio Am to Ac (Am means the area of mitochondria,Ac means the area of cytoplasm) of gastric parietal cell and the average At to Ac ratio (At means the area of secretory canaliculi and tubulovesicular system )between younger group and elderly group had no significant difference[(48.4±7.5) ％ vs.(50.6±7.6) ％,t=-0.775,P=0.444; (13.8±4.1) ％ vs.(12.2±4.7) ％,t=0.984,P=0.332].Meanwhile,there were no distinctions in the expression of H+-K+ -ATPase α subunit mRNA and H+-K+-ATPase protein among all elderly subgroups(F=1.522,2.32,P=0.24,0.114).However,the mRNA expression of H+-K+-ATPase a subunit was higher in the elderly group than in the younger group(t=-3.682,P=0.001).Furthermore,the expression of H+ -K+ -ATPase protein in the elderly group was increased as compared with younger group(t=-3.389,P=0.004). Conclusions Acidsecretion-associated organelles of human gastric parietal cell have no degeneration and the expression of H + -K+-ATPase is in trend of increase with aging,indicating that healthy elderly people have the basis of ultrastructure and molecular biology to maintain well function of acid secretion.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition,and nutritional support in elderly hospitalized patients.Methods2386 elderly hospitalized patents (aged ≥65 years) in Beijing Hospital from April 2007 to June 2009 were consecutively enrolled.Nutritional Risk Screening 2002 (NRS 2002) was performed on the next morning after admission.Body mass index (BMI)lower than 18.5 kg/m2 or serum albumin lower than 35 g/L was diagnosed as malnutrition.Results Among 2517 enrolled patients,NRS 2002 was completed by 94.8％,including 466 cases in Department of Respiratory,580 cases in Department of General surgery,549 cases in Department of Neurology,180 cases in Department of Nephrology,301 cases in Department of Gastroenterology and 310 cases in Department of Thoracic Surgery in Beijing Hospital.The prevalence of nutrition risk was 28.2％ (673/2 386),and the ratioes of nutrition risk in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 27.5％,30.3％,28.5％,29.4％,25.9％ and 25.4％,respectively.The prevalence of malnutrition was 26.4％,and the ratios of malnutrition in Department of Respiratory,General surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 26.2％,29.8％,26.9 ％,28.3％,22.3％ and 22.9％,respectively.Among 48.1％ of patients with nutrition risk who received nutritional support,the proportions of nutritional support in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 30.1％,85.2％,26.1％,18.2％ 73.8％ and 64.9％,respectively.Among 15.1％ of patients without nutrition risk (NRS＜3) who received nutritional support,the proportions of nutritional support in Department of Respiratory,General Surgery,Neurology,Nephrology,Gastroenterology and Thoracic Surgery were 10.6％,25.2％,6.3％,3.8 ％,34.2％ and 17.4 ％,respectively.The ratio of parenteral nutrition (PN) over enteral nutrition(EN) was more than 4:1.ConclusionsA large proportion of elderly hospitalized patients are at nutrition risk and malnutrition.And nutritional support is somehow inappropriately applied.Evidence-based guideline of PN or EN is needed to improve this situation.

Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.