Zinc-α2-glycoprotein (ZAG), a new adipokine, plays an important role in the development of cancer cachexia by decreasing lipid content in body via promoting lipid mobilization and utilization. The lipolytic effect of ZAG is achieved by increasing the activity of hormone sensitive lipase, activating β3 adrenergic receptors,and up-regulating cyclic adenosine monophosphate. In addition, ZAG increases adiponectin expression and decreases leptin expression in adipocytes and adipose tissue. The ZAG expression is regulated by glucocorticoid, peroxisome proliferator-activated receptor gamma agonist rosiglitazone, tumor necrosis factor-α and many other factors.ZAG can potentially be applied as a tumor marker, and may become a new target in the treatment of cancer cachexia.

Objective To evaluate the safety and effect of enteral nutrition support at early period after gastroenteric operation. Methods 62 patients with gastrointestinal cancer were divided into three groups randomly: control group, TPN group, and TEN group. Patients in TPN and TEN groups received 7 days nutritional support in isonitrogenous and isocaloric. The peripheral vein blood was sampled before operation and 7 day after that to observe nutritional status and T lymphocyte subsets, NK cells, and NK cell activity. Resalts There were no significant difference in the three groups in albumin and anthropomentric measurement, visceral proteins decreased in three groups in postoperative period, but the values of control group was more seriously than TPN or TEN groups (P<0.05). Mean nitrogen balance: - 8.6 ± 3.12g/day in control group, - 4.22 ± 2.02g/day in TPN group, - 3.88 ± 2.35g/day in TEN group (P<0.05). CD3 ,CD4 ,CD4/CD8, NK cells and NK cell activity decreased in postoperative period in three groups, but there are no significant ditference in three groups. Conelasions Enteral nutrition support at early period after gastroenteric operation is safety and effective.

Objectives: To evaluate if the administration of an enteral diet supplemented with glutamine, arginine and ? 3 fatty acids modulates inflammatory and immune responses after surgery. Methods: Forty eight patients with gastrointestinal cancer randomised into two groups, one of which was given an isocaloric and isonitrogenous standard diet and the other group was fed the supplemented diet with glutamine, arginine and ? 3 fatty acids. The feeding was started within 48 hours after operation, and continued until day 8. All variables were measured before operation and on postoperative day 1 and 8. Immune response was determined by phagocytosis ability, respiratory burst of polymorphonuclear cells, total lymphocytes lymphocyte subsets, nitric oxide, cytokine concentration, and inflammatory responses by plasma levels of C reactive protein and prostaglandin E 2. Results:Tolerance of both formula diets was excellent. There were significant differences in the immunological and inflammatory responses between the two groups. In supplemented group, phagocytosis and respiratory burst after surgery were higher and C reactive protein level was lower ( P

Objective To investigate the seruln levels of solubl B7-H3(sB7-H3)in patients withbacteremia and in those with chronic hepatitis B(CHB),and its clinical significance.Methods Serumlevels of sB7-H3 from 50 bacteremia patients,78 CHB patients and 50 healthy individuals wero detected byEUSA,and its correlations with the quantities of leucocytes,neutrophils,lymphocytes and monocytes wereanalyzed.Results The average level of sB7-H3 in serum of bacteremia patients was(50.69±26.43)μg/ml which was higher than that of healthy group(P＜0.01);serum sB7-H3 level of patients with CHB was(18.07±7.28)μg/ml,and it had no significant difference compared with that in the healthy group(P＞0.05).Besides,positive correlations between the scrum sB7-H3 level in and the quantities of leucocytesand granulocytes were observed in bacteremia patients.Conclusions It suggests that sB7-H3 misht bepotentially used as a new parameter to improve the clinical diagnosis of bacteremia.

Objective To confirm the safety and nutritional efficacy of high branched-chain amino acids through a pragmatic study allowing its use as an alternative to 15AA in patients with liver dysfunction. Methods The study was performed as a randomized, prospective trial. Eighty two patients with liver dysfunction undergoing operation were randomly assigned to receive high branchedchain amino acids or 15AA as part of their TPN regimens for 7 days. Daily parenteral intakes of energy nitrogen and lipid were equal in the two groups. Results Efficacy analysis showed that high branched-chain amino acids were as efficient as 15AA in avoiding protein catablosim. No serious adverse event was reported in the two groups. For hematology, renal, hepatic safety criteria and for the vital signs,no significant difference was observed between the 2 groups. No significant difference was observed concerning nitrogen balance and protein catablosim. For peripheral immunoglobulin and lymphocytes, a statistically significant difference was observed between the high branched-chain amino acids and the 15AA groups. Conclusion High branched-chain amino acids is new, safe and efficient amino acids for parenteral nutrition.

Objective The article is prepared to evaluate the efficacy of Chinese acupressure and ventral massage on prevention and treatment of constipation.Methods Electronic databases such as CNKI,VIP,CBM,Wanfang,EBSCO,PubMed and the Cochrane Library were searched from their establishment to December 2013 to meet the inclusion criteria of randomized and quasi-randomized controlled trials.Meta-analysis was conducted using RevMan 5.2 and Stata 12.0 software.Results A total of 29 RCTs involving 3 084 participants were included.The Meta analysis showed that compared with the control group,the new option for prevention and treatment tended to be more effective for constipation.Compared with the control group,first defecation time,defecation difficulty rate,defecation time,dry stool rate and defecating unfinished feeling rate of the experimental group were lower.Laxative provided for the experimental group was less than that of the control group.Conclusions On the basis of available evidence,the traditional Chinese acupressure and ventral massage treatment are effective and safe in prevention and treatment of constipation.

Objectives:To evaluate if the administration of an enteral diet supplemented with glutamine,arginine and ? 3 fatty acids modulate the inflammatory and immune responses and the outcome after surgery. Methods:A prospective,randomized,double blind and clinical trial was performed.Eighty eight patients with gastrointestinal cancer were randomly divided itnto two groups.One group was given an isocaloric and isonitrogenous standard diet and the other was fed with the supplemented diet with glutamine, arginine and ? 3 fatty acids.Feedings were started within 48 hour after operation, and continued until day 8.All variables were measured before operation and on postoperative day 1,4 and 8.Blood was drawn at different time points to assess albumin, prealbumin and transferring.Immune responses was determined by phagocytosis ability,respiratory burst of polymorphonuclear cells, total lymphocytes, lymphocyte subsets, nitric oxide,cytokine concentration,immunoglobins,and inflammatory responses by plasma levels of C reactive protein and prostaglandin E 2. Results:Tolerance of both formula diets was excellent.There were significant differences in the immunological and inflammatory responses between the two groups.In supplemented group,the serum concentrations of IgA,IgG,IgM,phagocytosis and respiratory burst after surgery were higher and C reactive protein level was lower( P

Objective:To search for the optimum formula for the self emulsification of evening primrose oil. Methods: Through solubility experiment, orthogonal screen and drawing phase diagram, taking the degree of emulsifying, the volume of the rest oil and emulsion particle size as parameters,the oil, non ionic surfactant and flux for the optimum formulation were screened. Results: In the formulation of evening primrose oil, taking Tween 85 as the non ionic surfactant and propylene glycol as the co surfactant can get the best effect of emulsifying. Conclusion: The optimum formula for self emulsification of evening primrose oil is evening primrose oil, Tween 85 and propylene glycol,with their proportion being 5∶7∶3.

Objective:To explore and evaluate the accuracy, conformity, and clinical application value of digital surgical techniques in guiding 125I seed implantation in the brachytherapy of deep head and neck tumors. Methods:Twelve patients with deep head and neck tumors who received brachytherapy of radioactive 125I seed implantation were selected for the study.The locations of the implantation needles and seeds were designed based on CT images before the operation.A digital positioning model was built according to the treatment plan to accurately import the planned locations of implantation needles into the surgical navigation system.Meanwhile, an individualized puncture guidance template was designed and printed according to the patients′ facial profiles as well as the locations and directions of the implantation needles.During the operation, the template was put in place under the guidance of the navigation system and meanwhile, the implantation needle puncture and radioactive seed implantation were conducted under the joint guidance of the visual needle path and real-time implantation needle locations in the navigation system and template guidance holes.The locations of the implantation needle and the seeds were validated by CT scan and the dose distribution in target areas was calculated.Adverse reactions such as hematoma, pain, infection, nonunion of puncture sites, and tumor cell implantation were observed during and after the operation. Results:All 12 patients successfully received implantation needle puncture and radioactive seed implantation under the guidance of the digital surgical techniques, achieving excellent effects of real-time visualization guidance.Meanwhile, the locations and number of the implantation needles and seeds were consistent with the treatment plan and were distributed evenly.Furthermore, according to postoperative verification, D90 ranged from 83.7 Gy to 131.0 Gy, with an average of 107.5 Gy; V100 was 89.6%-99.3%, with an average of 94.6%, and V150 ranged from 40.2% to 58.9%, averaging 47.8%.No serious adverse reactions were observed during and after the operation. Conclusions:With digital surgical techniques, the surgical navigation system and 3D-printed individualized puncture guidance template jointly guided the implantation needle puncture and 125I seed implantation, improving the accuracy and conformity of the brachytherapy.Therefore, they have clinical application value in head and neck brachytherapy, especially in deep areas with complex anatomical structures.

Objective To discuss the influence of different antitumor treatments on the survival time of patients with obstructive jaundice caused by cholangiocarcinoma located at middle-low segment of common bile duct after receiving PTCD. Methods During the period from Jan. 2012 to March 2013, a total of 60 patients with pathologically-proved cholangiocarcinoma located at the middle-low segment of common bile duct were admitted to authors’ hospital. According to tumor TNM staging, stage Ⅱ was seen in 9 cases, stage Ⅲ in 39 cases and stage Ⅳ in 12 cases. Based on the degree of cell differentiation, highly differentiated cancer was observed in 9 cases, moderately differentiated cancer in 37 cases, and poorly differentiated cancer in 14 cases. The 60 patients were enrolled in this study. Drainage tube placement and stent implantation were performed in all patients so as to relieve the symptoms of jaundice. According to the antitumor treatment used, the 60 patients were randomly and equally divided into three groups with 20 patients in each group. Draining procedure with subsequent regular arterial infusion chemotherapy was employed in the patients of group A; draining procedure with subsequent particle chain placement in biliary tract was performed in the patients of group B; and draining procedure with subsequent regular arterial infusion chemotherapy together with particle chain placement in biliary tract was carried out in the patients of group C. The results were analyzed using SPSS17.0 statistical software. The death factors of patients were statistically evaluated by using multivariate Cox proportional hazards regression analysis method, P<0.05 was considered that the difference had statistical significance. Results The median survival periods of group A, B and C were (186.0±36.4) days, (183.0±26.5) days and (252.0±43.6) days respectively. The death factors of cancer patients were analyzed by using multivariate Cox proportional hazards regression analysis method, which indicated that tumor stage was a risk factor for death (HR=8.434, 95%CI 3.41-20.090);the treatment mode was a protection factor of death (HR=0.616, 95%CI 0.429-0.884); while the degree of tumor differentiation was unrelated to death(score test,字2=0.197, P=0.657>0.05). The risk of death in group B was not significantly different from that in group A (HR=1.012, 95%CI 0.558-2.179); while the treatment mode of group C was a protection factor of death (HR=0.334, 95%CI 0.148-0.075). Conclusion The TNM stage and treatment mode can influence the survival time of patients with cholangiocarcinoma located at the middle-low segment of common bile duct. Therefore, for the treatment of obstructive jaundice caused by cholangiocarcinoma, combination use of regular arterial infusion chemotherapy and particle chain placement in biliary tract should be employed immediately after draining procedure as this therapeutic mode can effectively prolong patient’s survival time.