Objective To investigate the association between body mass index and postoperative complications in patients with colorectal cancer.Methods 120 patients with colorectal cancer were prospectively studied.According to the body mass index,all patients were assigned to study group (BMI ＜ 18.5kg/m2) or control group (BMI ≥ 18.5kg/m2),60 cases in each group.All patients received elective colorectal cancer resection.The operation situation,postoperative complications,postoperative recovery and postoperative stress reaction of the two groups were observed.Results There were no significant differences in the operation time,the number of lymph node dissection and the amount of bleeding between the two groups during the operation (all P ＞ 0.05).Compared with the control group,the total infection rate of the study group was significantly higher(11.67％ vs.1.67％,x2 =4.324,P =0.038);the incidence of postoperative complications was significantly increased (25.00％ vs.5.00％,x2 =7.908,P =0.005).There were no significant differences in other complications such as wound infection,anastomotic leakage,anastomotic obstruction,adverse cardiovascular events and stress ulcer (all P ＞ 0.05).Compared with the control group,the postoperative anal exhaust time of the study group was significantly prolonged [(51.48 ± 9.47) h vs.(43.73 ± 8.63) h,t =5.382,P =0.000];and the length of hospital duration was significantly prolonged [(20.35 ± 3.21) d vs.(16.28 ± 3.48) d,t =6.462,P =0.000].There were no significant differences in recurrence rate,mortality rate and progression free survival between the two groups after 1 year (all P ＞ 0.05).There were no significant differences in preoperative IL-6 and CRP levels between the two groups (all P ＞ 0.05).Compared with the control group,the IL-6 level of the study group at 7-day after operation was significantly higher[(165.56 ±45.39) ng/L vs.(122.58 ± 29.58) ng/L,t =6.459,P =0.000];CRP level was significantly higher [(23.49 ± 8.48) mg/L vs.(15.37 ±6.53)mg/L,t =4.285,P=0.002].Conclusion Body mass index less than 18.5 kg/m2 is a risk factor for postoperative infection and complications in patients with colorectal cancer,and is associated with increased stress response and prolonged hospital stay.

Objective To observe the effect and mechanism of periosteal pressure kneading plus resistance exercise in improving obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Thirty-two patients with moderate OSAHS were divided randomly into a kneading plus resistance training group and a conventional drug group,each group with 16 patients.The training group was given periosteal pressure kneading plus resistance exercise while the drug group received only conventional oral treatment with drugs.Before and after treatment,polysomnography (PSG),Thera-Band elastic bands and a PWS angle measuring instrument were used to observe PSG parameters around the neck plus the muscle strength and cervical activity of both groups.Results In the training group the following components of the PSG index had improved significantly compared with before treatment:respiratory events (AHI),sleep structure (SS),awakening number (AN),non-rapid eye movement (NREM),rapid eye movement (REM),mean oxyhemoglobin saturation (MSaO2) events,lowest oxyhemoglobin saturation (LSaO2),and the index of oxyhemoglobin saturation decrease (ODI).In the drug group only the LSaO2 and ODI had improved significantly compared with before treatment.In terms of the PSG parameters,the training group demonstrated significantly greater improvement than the drug group.After treatment,the training group's average residence time in neck load pulling was extended significantly while that of the drug group showed no significant change.The difference between the groups was statistically significant.After the treatment the training group's average activity of the cervical spine was also significantly increased,and again the drug group showed no significant improvement.Conclusion Skeletal lesions in peripheral airways may be an important factor in the formation of OSAHS.Periosteum kneading with resistance exercise has an obvious curative effect on OSAHS.

ObjectiveTo study the relationship between GDNF and ChAT Mrna and their potential role in the diabetic cognitive dysfunction by observing the change of the expression of GDNF and ChAT mRNA in brain under different blood glucose levels in STZ induced diabetic rats.MethodsForty male Wistar rats were randomly divided into diabetic group without blood glucose control( DM1 group),diabetic rats treated with insulin group( DM2 group),and normal control group( NC group).Blood glucose and body weight were detected every 4 weeks.Twelve weeks later,the hippocampus were submitted for cryostat sections which were subjected to the reverse transcription-polymerase chain reaction(RT-PCR) for GDNF and ChAT mRNA.ResultsThe expression of GDNF mRNA and ChAT mRNA in the hippocampus have negative correlation with HbAlc level( r =-0.962,-0.974,all P ＜ 0.001 );The GDNF expression had positive correlation with the ChAT mRNA expression( r =0.974,P ＜ 0.001 ).ConclusionLongterm chronic hyperglycation caused the “downregulation” of the GDNF expression in the hippocampal,which could cause the central cholinergic dysfunction symbled with the decrease of ChAT mRNA expression and the decline of learning and cognition ability.

Objective To study of manifestation of adenomyomatosis of gallbladder from MRI and to improve its accuracy of diagnosis .Methods MR features of 24 cases with adenomyomatosis of gallblad-der from 2006 to 2008 proved by operation and pathology were analysed retrospectively .Results Among 24 patients, 20 cases were diagnosed correctly before operation ,four were misdiagnosed as Chronic cholecysti-tis and carcinoma of gallbladder respectively; all cases of gallbladder wall increased thickness from 5 to 12mm (7mm average).Among them, the gallbladder -wall was thickened as limited type in fourteen cases , segment type in eight cases and diffuse type in two cases .And classical Rokitansky-Aschoff sinuses were clearly displayed in 20 cases by lamina T2WI from MRI .Conclusion MRI might has higher diagnostic value in diagnosing of adenomyomatosis of gallbladder .

[Abts ract] Ven tilato r-associated pneumonia ( VAP) is one fo the most common nosocomila infec-tions of mechanically ventilated children in PICU.VAP not only contributes to prolong ed hospital and PICU lengt h of stay,but asl o icn reaseds medical cost,mortality and mo rbility in critiac lly ill children.It′s an urgent task to prevent VA P in pediatrici ntensive care medicine.The aimo f the articel was to intor duce the epidemi-ology,risk factors,prevention strategya nd practice in children.The article reviewed guidelines of strategies to prevent VAP in pediatric patients.

The mi nimizign time on mechanical ventilait on is one of the great importna t issues in crit-ical ill patienst ,only limited guidance on weaing and extubation is available from the pediatric literature.T he clinical application ofni dicta ions for weaning are even less clear,and the protocol-based wae ningw ith sponta-neous breaht ing trail is a feasible way in pediatric intensive care unit.

The incidence of severe viral pneumonia increased year on year,cardiac dysfunction is one of the commonest complications in severe pneumonia.But it is still controversial whether or not the severe pneumonia is associated with heart failure.This article focuses on the mechanisms and the treatment of severe pneumonia complicated with cardiac dysfunction.

Chitinases are ubiquitous chitin-fragmenting hydrolases, however until a few years ago that chitinase like proteins have been found in mammalian. A silica-induced bronchoalveolar lavage protein (iSBLP58) with fibroblast growth promoting activity in silicotic rat, which had high sequence homology with members of the mammalian chitinase protein family has been previously purified and characterized. Bioinformatics analysis showed that several human EST clones from pooled colon, kidney or stomach matched the rat protein sequence. Thereafter clone from human kidney RNA samples with several pairs of primers was managed and a set of sequences was obtained, whose cDNA and amino acid sequences have high similarity with each other and several human chitinases in GenBank. Comparison with human genome sequence suggests that these molecules may be from variant transcripts of same a Pre-mRNA. Here the characterization of these sequences is reported.

Statin therapy has been shown to play a fundamental role in the treatment of coronary heart disease.Some studies have identified associations between genetic variants and response or toxicity in statin treatment.This review summarizes current knowledge of the pharmacogenomics of statin therapy in order to help to select the best individually adapted statin treatment for patients.

Neuropsychiatric systemic lupus erythematosus (NP-SLE) is more common in young woman but not yet in people over 75 years old.We report a case of NP-SLE in an old woman,who complained of tremor,hypermyotonia and gatism.The lab examinations showed strong positive (1∶3200) ANA,decreased levels of CH50,C3,C4,WBC,RBC,PLT,anti-ds-DNA(+),anti-Sm(+),SSA(+),PO(+),RO-52(+),urine blood (+) and protein (+).The proteins,MBPand IgGin CSF were increased.Head MRI scan showed many demyelination in bilateral intra ventricular and multiple patchy irregular long T1 and T2 signal under right parietal subcortical.The patient was immediately given methylprednisolone hormone therapy,combined with gamma globulin and hydroxychloroquine.After 4 days of treatment,most symptoms such as tremor and hypermyotonia disappeared.Laboratory tests showed that all immune markers changed better in three weeks.The patient was discharged in 4 weeks.it must be identified with cerebrovascular disease,Parkinson's disease and other common diseases in elderly people.It can be improved if the diagnosis and treatment of NP-SLE is immediately and the illness is well controlled.