Objective:The objective of this study was to evaluate the relationship between the adequacy of nutritional therapy and prognosis in trauma patients.Methods:217 trauma patients were included.The nutritional therapy interventions were divided into three groups:low energy therapy (＜50％),moderate energy therapy (50％ ～ 80％),high energy therapy (＞ 80％).General data,hospitalstay,ICU stay,infectious complications and mortality were compared among groups.Results:The protein intake of high energy group was higher than the other two groups (P ＜0.01).High energy therapy was associated with reduced mortality and decreased length of hospital stay.Kaplan-Meier survival analysis indicated that high energy therapy had a significantly higher 60 days cumulative survival rate compared with other groups.Conclusion:High energy therapy is more effective and associated with improved mortality and decreased length of stay.

Objective:To study the clinical significance of examining serum pyridinoline cross-linked N-telopeptides of type I collagen(NTx) and serum bone sialoprotein(BSP) in diagnosing bone metastasis of lung cancer and breast cancer.Methods:A total of 105 patients treated in the Oncology Department of Changhai Hospital were included in this study.Patients were divided into 2 groups:bone metastasis(n=50) and non-bone metastasis groups(n=55).The levels of serum NTx and serum BSP were measured by ELISA.Results:The levels of serum NTx and serum BSP in patients with bone metastasis were significantly higher than in those without bone metastasis(P

Objective:To examine whether the existence of the donor-and-recipient-derived DNA chimerism in recipient’s plasma can be a predictive marker for the status of transplanted organ.Methods:One hundred and twenty-six female patients who had been transplanted with male kidney were enrolled in the present study.In these female recipients,the SRY1,DYZ11st and DYZ12nd genes on the Y chromosome from the plasma were prospectively examined using reverse transcription polymerase chain reaction (RT-PCR).Results:SRY1,DYZ11st and DYZ12nd sequences were detected in the cell-free blood (plasma) of 97 (77%) of 126 female patients with male kidney.The average time-span when the transplanted kidneys functioned was 8.7 years and 5.4 years among microchimerism-positive and microchimerism-negative recipients,respectively.The frequency of the patients who had acute rejection after renal transplantation was approximately 10% and 28%in microchimerism-positive and microchimerism-negative recipients,respectively.Serum creatinine levels in microchimerism-positive patients were significantly lower than those in microchimerism-negative patients.Conclusion:These results suggest that plasma DNA microchimerism is present in certain patients following renal transplantation and measurement of plasma DNA microchimerism using quantitative RT-PCR might be a useful predictor for the acceptance of transplanted kidneys.

0.05).Conclusions Laparoscopic resection of colorectal carcinoma is feasible and safe for elderly patients.The method can reduce the rate of postoperative complications.

Objective To study the feasibility of laparoscopic radical gastrectomy.Methods From August 2006 to May 2007,31 patients with gastric cancer received laparoscopic radical gastrectomy(radical distal gastrectomy in 26 cases and radical total gastrectomy in 5).Results Among the cases,1 was converted to an open surgery,2 were treated completely by laparoscopic radical gastrectomy;and in the other 28 cases,the radical gastrectomy was performed under the assistance of laparoscopy.Lymph node dissection of D1+? was performed on 2 patients and D2/D2+ was adopted in the other 29.One case was done in combination with partial liver dissection.The median operative time was 5 h(range 4.5-7 h).The median blood loss was 150 ml(range,100-600 ml).One patient received blood transfusion during the operation.Intraoperative spleen injury occurred in one case.The median number of harvested lymph nodes was 20(range,14-33).No patient died after the surgery.The median time for gastrointestinal function recovery was 4 d(range 3-6 d).One patient developed gastroparalysis after the operation and was cured by conservative therapy.One of the patients had bleeding of the jejunal pouch after total gastrectomy.And one showed subluxation of the articulatio cricothyroideus.No anastomotic leakage and lung infection occurred after the surgery.And no recurrence or metastasis was found during a 2-to 8-month follow-up(median,5).Conclusion Laparoscopic radical gastrectomy is feasible and safe.

Objective:To observe the curative effects of the combined application of domperidone, pantoprazole and hydrotalcite tablets in the treatment of bile reflux gastritis ( BRG) and explore the underlying mechanism. Methods:Totally 80 patients with BRG were randomly divided into the treatment group and the control group with 40 cases in each. The treatment group was received panto-prazole, hydrotalcite tablets and domperidone, and the control group was treated by hydrotalcite tablets and domperidone. The efficacy was observed in both groups after 4 weeks. Results:The effective rate of symptom relief in the treatment group and the control group was respectively 92. 5% and 62. 5% (P<0. 05). After the 4 week treatment, the gastritis healing rate in the treatment group was higher than that in the control group (P<0. 05). The improvement of gastric mucosal hyperemia, edema and erosion in the treatment group was better than that in the control group with significant difference (P<0. 05). Cholic acid in gastric juice and gastric acid se-cretion were significantly reduced in both groups after the treatment, while the reduction of gastric acid secretion in the treatment group was more notable than that in the control (P<0. 05). Conclusion:Pantoprazole can be used to control BRG, and the combination of the three drugs shows better efficacy in the treatment of BRG.

Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

Objective To compare effects of laparoscopic versus open anterior resection of rectal carcinoma on immune functions.Methods A total of 38 patients were given either laparoscopic(18 patients) or open(20 patients) anterior resection of rectal carcinoma from April 2004 to June 2005 in this department.The percentages of T-lymphocytes(CD_3,CD_4,and CD_8) and natural killer cells were calculated by using the flowcytometry.The levels of immunoglobins(IgG,IgA,and IgM) and complements(C_3 and C_4) were detected by using the immunonephelometry.Results In levels of T-lymphocytes,immunoglobins,and complements,there were no statistically significant differences between open and laparoscopic groups 24 and 96 hours after operation.In levels of natural killer cells,no differences were observed in laparoscopic group before and after operation(24 and 96 postoperative hours) while a significant decrease were found in open group after operation.Conclusions As compared with open surgery,laparoscopic anterior resection of rectal carcinoma has less influence on natural killer cells.

Objective To investigate the safety and feasibility of laparoscopic total/subtotal proctocolectomy. Methods Laparoscopic total/subtotal proctocolectomy was performed in 8 cases from March 2003 to November 2005, including 1 case of multiple colorectal tumors, 3 cases of ulcerative colitis, 2 cases of familial adenomatous polyposis, and 2 cases of slow transit constipation. The operation included ileal pouch-anal canal anastomosis in 3 cases, ileal pouch-rectum anastomosis in 3 cases, and cecum-rectum anastomsis in 2 cases. A prophylactic ileostomy was conducted in 5 cases. Results The operation was laparoscopically conducted in all the 8 cases, without conversions to open surgery. No fatal case was encountered. The operative time was 5.5~7.5 h (median, 6 h). The intraoperative blood loss was 150~400 ml (median, 200 ml). There was no intra- or post-operative blood transfusion. The patients began to take diet at 48 h postoperatively. Follow-up observations in 8 cases for 4~31 months (median, 25 months) showed 1 case of intraabdominal infection and 1 case of anastomsis stenosis. Conclusions Laparoscopic total/subtotal proctocolectomy is safe and feasible.

Objective To study the safety of laparoscopic total mesorectal excision for middle and lower rectal cancer.Methods A retrospective comparison was made between 52 cases of open total mesorectal excision from December 2002 to December 2005(Open Group) and 49 cases of laparoscopic mesorectal excision from January 2003 to June 2006(Laparoscopic Group).Results There was no difference in baseline parameters between the two groups.As compared with the Open Group,the Laparoscopic Group presented less blood loss [for anterior resection: 160?106 ml(n=37) vs 298?186 ml(n=36),t=-3.908,P=0.000;for abdominoperineal resection: 180?153 ml(n=10) vs 356?170 ml(n=14),t=-2.604,P=0.016].The recovery time of bowel functions was shorter in the Laparoscopic Group than in the Open Group(2.4?1.8 d vs 3.6?1.5 d;t=-3.648,P=0.000).The overall complication rate in the Laparoscopic Group(14.3%,7/49) was lower than that in the Open Group(44.2%,23/52)(?2=10.834,P=0.001).No significant difference was seen between the two groups in the number of lymph node resected(12.7?6.5 vs 13.6?7.0;t=-0.668,P=0.505),with negative margins in both groups.Follow-up observations were carried out in 45 cases in the Laparoscopic Group(91.8%) for 2～42 months and in 47 cases in the Open Group(90.4%) for 6～42 months,respectively.The local recurrence rate was respectively 4.4% in the Laparoscopic Group(2/45) and 4.3% in the Open Group(2/47). Conclusions Laparoscopic total mesorectal excision for middle and lower rectal cancer is safe and feasible.