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.

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.

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.

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.

Colorectal polyps are eminence lesions that protruded from mucosa into lumen,including adenomatous polyps and non-adenomatous polyps. Early detection and resection of adenoma has significance in prevention of colorectal cancer,and the surveillance afterwards is also crucial. Interval cancer is the colorectal cancer that develops between initial negative colonoscopy or all the polyps having cleared and the next colonoscopy. It is an important duty for endoscopists to reduce the incidence of interval cancer. This article reviewed the advances in studies on surveillance after resection of colorectal adenoma and the development of interval cancer.

Objective To investigate the efficacy of radiofrequency ablation assisted spleen-preservation for splenic injury.Methods The clinical data of 64 patients with splenic injury who were admitted to the Suining Central Hospital from August 2010 to May 2012 were retrospectively analyzed.Radiofrequency coagulation hemostasis devices were used for stanching bleeding directly.Results Of the 64 patients,35 received radiofrequency ablation assisted splenic bleeding stemosis,and 29 received radiofrequency ablation assisted partial splenectomy.The mean operation time and volume of intraoperative blood loss were (138 ± 48)minutes and 50-400 ml,respectively.Radiofrequency ablation assisted spleen-preservation was successfully carried out in 63 patients.One patient received reoperation (splenic resection) due to hemorrhage 24 hours after operation.Transient rise of temperature was detected in all the patients,and the temperature was back to normal after conventional management.The complication rate was 6.3％ (4/63),l patient was complicated with anastomotic leakage and was cured by reoperation; 1 was complicated with left pleural effusion; 1 was complicated with pulmonary infection,and his temperature was back to normal 4 days later; 1 was complicated with effusion in the fossa of the spleen.Celiac drainage tube drainaged out 10-120 ml liquid in the first day after operation,5-25 ml on the day 2-3,and they were removed on the third day.There was no effusion around the spleens,and the texture of the spleen was even at 2 weeks after operation.The duration of hospital stay was (14 ±4)days (range,8-40 days).The results of B sonography showed that no effusion and necrotic lesions in the spleen,and immune examinations showed that the splenic function was normal.Conclusion Radiofrequency ablation assisted spleen-preservation for splenic injury is safe and easy to manipulate.

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 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.

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.

Rheumatoid arthritis is one of the most critical diseases that impair the quality of patients' life, but its pathogenesis has not yet been fully understood. Osteopontin (OPN) is an extracellular matrix protein containing Arg-Gly-Asp (RGD) sequence and has been recently recognized as a potential inflammatory cytokine. It is discovered that OPN plays an important role in the pathogenesis of rheumatoid arthritis. It is a bridge between bone and the immune system. This paper reviewed the pivotal role that OPN plays in the pathogenesis of rheumatoid arthritis.