Objective It has been demonstrated that para-operative fasting often induce gastrointestinal mucosal atrophy, that, together with the surgically-stress effects, deteriorate the intestinal harrier structure and may further cause gut-origin infection. Parenteral nutrition has been widely employed in the patients undergone surgery or with trauma as a standard nutritional support in many hospitals. It can provide sufficient nutrients, including calories, nitrogen, and minerals for the daily and extra needs during the stress. However, numbers of investigations have proven that long term parenteral nutrition support has no effects on preventing intestinal mucosa atrophy, but indeed, consistently result in down-regulation of mucosal structure. It has been widely accepted in the clinic that enteral nutrition should be chosen as a priority mean, as to parenteral nutrition, to support the patients whenever they can tolerant. However, there are few reports concerning earlier use of enteral nutrition in post-operative patients. The purpose of this study was to evaluate the effects of postoperative earlier enteral nutrition support (24～36 hours) on the patients undergone major surgery. The cases with earlier enteral nutrition feeding during last three years were reviewed and the feeding method, the effectiveness, and the complications of earlier feeding were investigated. In five cases, with two of proximal small intestine fistula, three of pancreas, duodenal injury, the total effectiveness was satisfactory. All patients gained wight and the nutritional states were much improved. The initial disease of the patients with earlier feeding were all cured within the time periods which were significantly shorter than those who had ordinary post-operative feeding. Only one case among five had mild nausea during the feeding, and was settled after anti-nauseas medications. Two cases with proximal small intestine fistula were recovered in four weeks time. We thus conclude that earlier enteral feeding post-operatively is a safe and effective method for those who have major surgery. It benefits bowel barrier function and further improves the recovery after surgery. Besides, earlier enteral feeding is less costly compared to parenteral nutrition, and easy to operate. A more case-based, prospective controlled clinical study should be organized in the future to further evaluate the usefulness of earlier enteral feeding in the patients with surgery.

Objective To investigate the clinical effect and value of interventional therapy for post-thrombosis syndrome (PTS).Methods Clinical data of 91 patients with PTS who had received interventional therapy were retrospectively analyzed.The patients were in prone position in surgery.We selected puncture approach of popliteal vein and established a working guidewire channel, and then performed balloon dilatation and stent placement.Results The technical success rate was 98.9% (90/91), with complete recanalization of the stenosis or occluded vessel and restoration of the normal blood flow.There was 1 case of failure to traverse the left common iliac vein segment, but the collateral circulation was rich enough to compensate.The 90 patients were followed up for 6-30 months, with a mean of (18.5±2.3) months.The 6, 12, and 24-month patency rates were 93.3% (84/90), 81.3% (61/75), and 71.4%(20/28), respectively.No stent migration or ulcer recurrence occurred in the 90 patients during the follow-ups.Conclusion For the treatment of PTS, endovascular treatment has high technical success rate.With satisfactory clinical effect, this therapy is safe and effective.

To explore the central mechanisms of anger emotion and the effects of Chinese herbal medicines for regulating liver qi on the anger emotion and the expression level of 5-hydroxytryptamine 3B receptor (5-HT3BR) in rat hypothalamus.

Objective To investigate the correlation between the severity of coronary artery disease with se-rum bilirubin and left ventricular cardiac function. Methods Two hundred and six patients underwent blood bio-chemical ,color-echocardiography and angiography of coronary artery. The patients were divided into 4 ordinal groups according to the Gensini score indicating the severity of coronary artery disease. Results There were significant differences in total bilirubin(TBIL), left atrial dimension (LAD), left ventricular dimension (LVD) and left ventric-ular ejection fraction (LVEF) between the four groups(P<0.05 or P<0.01). The Spearman correlation coefficent between Gensini's scores and LAD, LVD were 0.280 (P=0.000) and 0.176 (P=0.011), respectively. The Spearman correlation coefficient between Gemini's scores and TBIL, LVEF were -0.541 (P<0.000) and -0.222 (P=0.001), respectively. The multiple linear regression between the Gensini's score and parameters showed that TBIL and LVD were independently correlated with the Gensini scores (P=0.000 and P=0.002, respec-tively). Conclusions TBIL and LVD were independently correlated with Gensini's score. LVEF was negatively cor-related with the severity of coronary disease and is a useful predictor for the severity of coronary atherosclerotic heart disease.

Objective To explore the intrauterine disorders that leads to infertility and sterility in women.Methods From March 1993 to March 2008,a total of 2077 patients with infertility received hysteroscopic examination at Nanjing Drum Tower Hospital.Among the patients,531 were diagnosed with intrauterine abnormalities including primary infertility in 172(32.4%) cases,secondary infertility in 315 cases(59.3%),and sterility in 44(8.3%).The clinical data of these patients were analyzed retrospectively.Results The most common cause of infertility and sterility in the patients was intrauterine adhesion(231 cases,43.5%),followed by uterine deformities(152,28.6%) and endometrial polyps(88,16.6%).In the primary infertility group,the most common reason was endometrial polyps,which was detected in 38.4% of the cases(66/172).The rate was significantly higher than that in the secondary infertility group(6.0%,19/315) and sterility group(6.8%,3/44)(?2=80.7630,P=0.000;?2=16.0463,P=0.000).While in the secondary infertility group,intrauterine adhesion was detected in most of the patients(60.6%,191/315),that was significantly more than that in the sterility and primary groups(25.0%,11/44,?2=19.9232,P=0.000 and 16.9%,29/172,?2=86.0747,P=0.000,respectively).For the patients with sterility,the disease was caused by uterine deformities mostly(65.9%,29/44),which is significantly different from the other two groups(secondary group:25.1%,79/315,?2=30.5994,P=0.000;primary group:25.6%,44/172,?2=25.4673,P=0.000).Conclusion The major causes of primary infertility,secondary infertility,and sterility are endometrial polyp,intrauterine adhesion,and uterine deformities respectively.

Fast track surgery(FTS) is a novel surgery concept in recent years.Through using a series of perioperative optimization measures,to reduce the postoperative complications,the length of stay,and to achieve the goal of patients' rapidly rehabilitation.Nowadays,FTS protocols is widely used in general surgery,cardio-thoracic surgery,ophthalmology and orthopedics etc.This article reviewed the application of FTS in the perioperative patients which taking hip and knee arthroplasty.

Objective To evaluate the treatment effect of using preoperative embolization combined with microsurgery for the treatment of intracranial arteriovenous malformation.Methods From January 2005 to December 2015,57 consecutive patients with intracranial arteriovenous malformation (AVM ) admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. They were diagnosed by magnetic resonance imaging (MRI)and digital subtraction angiography (DSA). Glubran and/or Onyx embolization was used before the microsurgery. The clinical features,treatment, and occurrence of complications were recorded.Results In 57 patients,the Spetzler-Martin grade in 35 patients were gradeⅠ-Ⅱ,in 18 were Ⅲ,and in 4 were Ⅳ. The complications occurred in 11 patients (19. 3%),including 5 with Onyx,5 with Glubran,and 1 with Onyx+Glubran. After embilization,4 patients had hemorrhage,2 had intracranial hemorrhage,1 had postoperative intracranial infection,1 had postoperative neuro-logical dysfunction,and 3 had other systemic complications after procedure. The complication rates were 14. 3%(5/35)and 22. 2%(4/18)respectively according to the Spetzler-Martin grade Ⅰ-Ⅱ and Ⅲ. Two patients of Spetzler-Martin gradeⅣhad complications. The incidence of complications in the functional areas was 20. 0%(4/20)and that in non-functional areas was 18. 9%(7/37). One patient died. DSA revealed that 4 patients had residual lesions before discharge. The cure rate was 93. 0%. The mean modified Rankin scale (mRS)score at discharge was 1. 6 ± 1. 0. The patients of mRS 0-1 accounted for 59. 6%(34/57).The mRS scores in 7 patients at discharge were higher than before treatment.Conclusion For the high-grade AVM foci with larger volume and in the deep part of brain,the treatment with microsurgery combined with embolization can be considered.

Liver injury caused by various reasons can lead to the occurrence of liver fibrosis,which is the pathological process from chronic liver disease to liver cirrhosis.Liver fibrosis is caused by the increased synthesis and reduced degradation of extracellular matrix (ECM).ECM is mainly degraded by matrix metalloproteinases (MMP),and therefore,MMP play an important role in the progression and.diagnosis/treatment of liver fibrosis.This article reviews the research advances in the association between MMP and liver fibrosis.

BACKGROUND: Although considerable progress has been made in spinal tuberculosis surgery,considering the particularity of the spine position, the surgical treatment is limited by the body stress and secondary injury due to removal of the internal fixation. Tissue engineering provides a new insight into the treatment of various diseases.Ideal biomaterials instead of traditional internal fixation materials are characterized by non-toxic and non-immune rejections.OBJECTIVE: To explore the biocompatibility and mechanical properties of alginate combined with bone marrow mesenchymal stem cells for repair of spinal tuberculosis.METHODS: Forty New Zealand rabbits were divided into four groups, 10 rats in each group: control group, spinal tuberculosis group, alginate group and titanium alloy group. The control group received no treatment, and in the other groups, boreholes were drilled in the fifth lumbar intervertebral disc and filled with gelatin sponge, and Mycobacterium tuberculosis suspension 0.1 mL (the amount of bacteria, 5 g/L)was then injected to make spinal tuberculosis models.Two months after modeling, simulated L4-5 spinal tuberculosis surgery was performed in the latter two groups, and alginate combined with bone marrow mesenchymal stem cells and titanium alloy internal fixation material were implanted,respectively.RESULTS AND CONCLUSION: One rabbit in the titanium alloy group had local infection and swelling. No rabbit in the alginate group had adverse reactions, such as swelling and local infection. Anteflexion, rear protraction, lateral bending distance and maximum axial pullout force in the alginate group and titanium alloy group were superior to those in the spinal tuberculosis group (P < 0.05), which were close to normal levels (P > 0.05). The above results showed that the alginate gel combined bone marrow mesenchymal stem cells has good biocompatibility with the body after implantation,and the post-implantation spinal stability is good and close to that after implantation of the titanium alloy.

OBJECTIVE:To establish a method for determining the contents of chlorogenic acid and luteoloside in Lonicerae ja-ponicae,and to explore the shelf life of L. japonicae under ordinary temperature and sealed environment. METHODS:HPLC meth-od was adopted. The determination was performed on Agilent Zorbax SB-C18(chlorogenic acid)column and Agilent Zorbax SB-Phe-nyl(galuteolin)with mobile phase consisted of acetonitrile-0.4% phosphoric acid(13:87,V/V),acetonitrile-0.5% glacial acetic ac-id (gradient elution,galuteolin) at the flow rate of 1.0 mL/min. The detection wavelength was set at 327 nm (chlorogenic acid) and 350 nm(galuteolin). The column temperature was 30 ℃,and sample size was 10 μL. RESULTS:The linear range of chloro-genic acid and galuteolin were 10-100 μg/mL(r=0.9986),5-50 μg/mL(r=0.9993),respectively. RSDs of precision,stability and reproducibility tests were all lower than 4.0%. Recoveries were 95.78%-99.70%(RSD=1.46%,n=6)、96.30%-104.31%(RSD=2.93%,n=6). The contents of chlorogenic acid and galuteolin in roller method,baking method and natural drying method of processed L. japonicae were all decreased by 30%-40% after stored for 12 months. CONCLUSIONS:The method is simple, precise,stable and repeatable,and can be used for simultanoue determination of chlorogenic acid and luteoloside in L. japonicae. The contents of active components in L. japonicae decrease significantly after stored for 12 months. It is necessary to establish shelf life standard of L. japonicae,so as to guarantee the effectiveness of drug use in the clinic.