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 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.

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.

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 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.

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.

The differentiation and induction of neural stem cells (NSC), the most highlights in neuroscience at present is valuable application potency and great significance in theoretic study. The mechanism of the intrinsic (gene) and extrinsic factor (cytokine, microenvironment) affecting the NSC, and some progress on this field in the current years were reviewed.

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.