Objective:To study the clinical application of X-ray assisted placement of nasojejunal feeding tube in early enteral nutrition of critical illness. Methods:The feeding tube affiliated wire guide was inserted to jejunum under X-ray observation and affirmanced by the examination with contrast medium. Results:All the feeding tubes were inserted to jejunum successfully.The time was 10-40 minutes,averagely 20 minutes.Conclusion:The placement of the nasojejunal feeding tube under X-ray is simple and safe and offer an effective route of early enteral nutrition for critical illness.

A 300 cm-long ileus tube was inserted from nasal cavity to the jejunum under the radiophotography guidance in 16 patients with recurrent adhesive small-bowel obstruction. Along with entire intestinal decompression, the ileus tube was moved forward to the terminal ileum and remained for 13 to 25 days for internal intubation plication. All the participants improved during the follow-up (range, 8 months to 2 years), and no intestinal adhesion or obstruction occurred. Non-surgical intestinal intubation plication might be a simple, safe and effective treatment for adhesive intestinal obstruction.

Objective To study the relationship of expression of nuclear factor kappab gene and MMP-2mRNA and with lymph node metastasis of pancreatic cancer.Methods The expression of NF-?B was investigated by Western blot in normal pancreatic(NP) samples of 9 cases and pancreatic cancer(PC) samples of 45 cases(lymph node metastasis 30 cases,non-lymph node metastasis 15 cases).The expression of MMP-2mRNA was detected through semiquantitative reverse transcriptase polymerase chain reaction(RT-PCR).Results Of 45 PC cases,the positive expression rate of p65 and MMP-2mRNA was 66.7%(30/45) and(57.7%)(26/45),respectively.Of 30 cases of lymph node metastasis,the positive expression rate of p65 and MMP-2mRNA was 83.3%(25/30)and 73.3 %(22/30),respectively.Of 15 cases of non-lymph node metastasis,the positive expression rate of p65 and MMP-2mRNA is 33.3%(5/15) and 26.7%(4/15),respectively,and the expression of p65 gene was positively correlated with MMP-2mRNA(expression)(r=0.743,P

This paper reviewed the development of the horseback riding exercise machine in Japan based on the theory of therapeutic riding, imitating the saddle movement by using data collected three dimensional from living horse, involving virtual reality technique, 6-axes parallel mechanism and motion capturing technique. It is effective to improve muscular strength and insulin resistance in elderly people. Mechanical horseback riding is hopeful to be used in clinical approach to improve the quality of life in elderly people in the future.

Recent years a large number of researches and studies of modern rehabilitation medicine have made great progress in various fields,such as basic theory,evaluation,treatment,institution,and network.The objective of this paper is to outline these advances,which could be benefit for medical affairs in rehabilitation of cerebrovascular diseases.

.All patients cured.Three-lumen nasogastrojejunal tube placed under X-ray monitoring proves to be a safe, convenient, highly tolerable and effective procedure.

Objective To summarize the experience in diagnosis,prention and management of right accessory hepatic duct(AHD)injury during laparoscopic cholecystectomy(LC).Method The clini-cal data of 8 patients with AHD injury during LC diagnosed and managed retrospectively analyzed. Results Of the 8 patients, 5 patients were found during LC,3 patients were found after LC.Management were ad follow:5 patients with the diameter of the AHD smaller than 3.0 mm were ligated,1 patient with the diameter of 5.0 mm were reconstructed,1 patient with the diameter of 3.0 mm,but the AHD connected with other bile duct in vicinal epaticlobes,were ligated.These 7 patients,with the injured AHD ligated or re-constructed,were followed up for 6 months to 5 years and showed good results.The another who did not be found during LC and not be managed appropriately,arose serious bile leakage and infection for a long time,underwent drainage operations for 3 times,cured after haft year.No death in all patients.Conclusions Correct operative rules should be obeyed strictly in LC,and keep the exist of AHD under close guard,if AHD injury occurred,LC should turn to open surgery immediately,early finding of the injury and managing appropriately is the key to achieve successful result.

Objective To describe the exercise participation of residents in China,and to provide the scientific basis for developing intervention strategies.Method The data of 2002 China National Nutrition and Health Survey was used for the analysis.66 682 subjects(male 32 287,female 34 395) aged 6 years and above were involved.Results The overall rate of exercise participation of people in China was 15.7%,while that of urban residents(27.5%) was higher than that of the rural counterparts(11.1%).of all age-groups,18～years group had the lowest rate of exercise participation.8.0% people engaged in regular exercise while 7.7% people in occasional exercise.More urban residents(16.8%) engaged in regular exercise than their rural counterparts did(4.5%).The rates of regular exercise of residents in 6～years and 13～years groups were lower than those of occasional exercise,but the rates of regular exercise of people in 18～yrs,45～yrs and over 60～yrs groups were higher than those of occasional exercise.The types of exercise varied obviously among different age groups.Conclusion The rate of exercise participation of people in China is quite low.The guideline for physical activity of different target population in China should be developed in order to improve their participating rate of exercise and improve their health.

AIM: To set up population pharmacokinetics/pharmacodynamics (PPK/PD) model of valproate (VPA) in children with epilepsy in China, and promote reasonable use of antiepileptic drugs(AEDs)in clinical practice. METHODS: Sparse data of VPA serum concentrations from 246 pediatric children were collected. These patients were divided into three groups: PPK-Model group ([WTBX]n=146), to calculate PPK parameter values of VPA and set up a PPK model; PPK-Valid group ([WTBX]n=100), to valid the PPK model; and PPD group ([WTBX]n=69), to set up PPK/PD model. Based on the data of PPK-Model group and PPK-Valid group, a PPK model of VPA in children with epilepsy in China was successfully set up by using NONMEM software by ourselves. Now, using the data of 69 patients in PPD group who were on VPA monotherapy and this PPK model, we set up PPK/PD model by NONMEM software. Efficacy of epilepsy treatment was divided into 5 grades according to the percentage of seizure frequency decreased (PSFD%): grade 1: PSFD% was 100%; grade 2: PSFD% was 75%-100%; grade 3: PSFD% was 50%-75%; grade 4: PSFD% was 25%-50%; grade 5: PSFD% was less than 25%. The quantitive relationship between the VPA serum concentrations and the probability for its efficacy score was characterized by Logistic regression analysis with NONMEM. RESULTS: Logistic regression analysis showed that, VPA serum concentrations and the probability for its efficacy grades 5, 4, 3, 2, and 1 were (23 ?g?ml -1, 5, 50%), (30 ?g?ml -1, 4, 32.3%), (50 ?g?ml -1, 3, 26.3%), (65 ?g?ml -1, 2, 36.5%), (78 ?g?ml -1, 1, 50%), and (100 ?g?ml -1, 1, 84.2%)respectively. CONCLUSION: A PPK/PD model of VPA in children with epilepsy in China is successfully established by using NONMEM software, and the probability of efficacy grade for any concentration can be calculated. It will be valuable to facilitate individualized dosage regimen.

Background and purpose:Members of the NF-kappaB family of transcription factors could activate bcl-2 anti-apoptotic genes at the transcriptional level and then regulate cell apoptosis.The p53 tumor suppressor gene has a clear role!in both the regulation of cell cycle and expression of apoptosis-related bcl-2 family.There were few reports about the expression of NF-?Bp65,bcl-2,bcl-xL and their relationships with p53 and cell apoptosis in pancreatic cancer.The present study was designed to analyze the expression of the antiapoptotic molecules nuclear factor kappaB(NF-?Bp65),bcl-2 and bcl-xL in pancreatic ductal carcinoma(PC) and their correlations to the apoptosis index and p53 expression.Methods:Immunohistochemical analyses of P53 protein was performed on 25 cases of pancreatic ductal carcinoma and 9 cases of normal pancreas;Western blot was used to evaluate NF-?Bp65 protein and RT-PCR for bcl-2 mRNA and bcl-xL mRNA of 25 cases of pancreatic ductal carcinoma and 9 NP cases.The apoptosis was determined by TUNEL.Results:The positive rate of P53 protein was 56%(14/25)in PC tissues,significantly higher than that in NP tissues(P