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 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.

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.

Objective:To investigate the reliability of tooth color-measuring by using digital cameras.Methods: 3D-Master shade guide system was measured by Canon EOS D60,CRAIC QDI2000 micropectrophotometer and ShadeEye-NCC directly.The data collected from the three methods were analyzed statistically to evaluate the reliability of the data measured by digital cameras.Results:There was no significant difference between the data measured by digital cameras and ShadeEye-NCC statistically;while that existed between the parameters of L* collected by digital cameras and microspectrophotometer were obviously co-related(P

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 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.

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.

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.

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 observe the factors of adverse drug reactions in the nervous system.Methods:197 cases of adverse drug events in the nervous system were collected and analyzed in our hospital from January,2007 to December, 2008.Results:In the 197 cases,80 patients(about 40.61%) were above 60 years old,and 149 patients(about 75.63%) were medicated by i.v.183 cases belonged to the scope of ADRs,and the other 14 cases,to ADEs.The main drugs were anti -bacterials which caused ADR/ADE of the nervous system,and the second were traditional Chinese drug preparations. Conclusion:The ADRs in the neurological system were involved in many kinds of drugs,and had many clinical manifestations. The clinicians should pay attention to them.