Objective To investigate the effect of early early enteral nutrition combined with parenteral nutrition support on postoperative gastrointestinal function,nutritional status and liver function of patients with obstructive jaundice.Methods Sixty-two patients with obstructive jaundice of hepatobiliary who were treated in the General Surgery Department of the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2014 were randomly divided into the control group and the observation group,31 cases in each group.The control group were treated with simple parenteral nutrition,and were injected by central venous catheter at the first day after operation,with the injection tiem of 12-15 h and continuous infusion of 7 d or more.The observation group were received enteral nutrition combined with parenteral nutrition,parenteral nutrition was given first,and the preparation method of the nutrient solution was identical with that of the control group;and then slowly dropped 250 ml physiological saline into the jejunum nutrition tube at the second day,dropped into the enteral nutrition liquid at the third day with the initial dose of 300 to 500 ml per day,slowly dropped in the speed of 20-30 ml/h.Results The first exhaust time,first defecation time and hospitalization time in the observation group were (41.37±6.85) h,(46.85±7.13) h and (12.79±3.76) d,significantly shorter than those in the control group ((57.21 ± 9.23) h,(61.43 ± 10.62) h and (16.94 ± 4.33) d;t =7.67,6.35,4.03;P＜O.05),daily hospitalization expenses was (1637.65± 138.24)yuan,significantly less than that in the control group((2121.42±112.38)yuan;t=15.12;P＜0.05).The serum albumin berofe and after the operation in the control group and observation group were (28.73±3.24) g/L and (29.21±3.31) g/L,(36.85±4.05) g/L and (47.21±4.13) g/L,respectively.The serum pre albumin berofe and after the operation in the control group and observation group were (162.81±31.27) g/L and (163.14±30.56) g/L,(248.95±58.62) g/L and(324.24±61.34) g/L,respectively.There was no difference before operation between the two groups (P＞0.05),while the serum protein levels were significantly increased in observation group than the control group (P＜0.01).There were no difference in ALT,total bilirubin and direct bilirubin levels between the two groups before operation (P ＞ 0.05),after treatment,the levels of ALT,total bilirubin and direct bilirubin in the observation group were significantly higher than those in the control group(P＜0.01).The patients in the two groups recovered well,and no serious adverse reactions occurred.Conclusion Early enteral and parenteral nutrition support in patients with obstructive jaundice has better effect and safety in the clinical treatment.

BACKGROUND: External preparations treatment of fractures in traditional Chinese medidne are mostly ordinary hard-paste, cream, ointment, which lack of modernized traditional Chinese medicine transdermal delivery systems, and the treatment has poor drug absorption and simple process. The treating procedure needs to be used repeatedly, which would affect fracture external fixation and lead to unsatisfactory therapeutic effect. In this Paler, the extemal treatment of traditional Chinese medidna was combined with advanced micro-nano-technology to develop a new medical complex functional materials-micron traditional Chinese medicine functional lining material, which is an organic combination of diaplasis, fixation and local drug remedy, which provides a better treatment for fractures. OBJECTIVE: To explore the effect of micron tradifional Chinese medicine functional lining material on the healing of fracture in rabbits, METHODS: After model preparation, rabbits were randomly divided into 4 groups: rabbits in the micron group were treated with micron traditional Chinese medicine functional lining material plus plaster external fixation; those in the traditional Chinese medidna control group were treated with ordinary Chinese medicine functional material plus plaster extemal fixation; those in the lining material control group were treated with ordinary lining material added plaster extemal fixation; those in the natural healing control group had no special treatments. The effect of fracture healing was evaluated by X-ray at 2, 4 and 6 weeks after modeling. The serum concentration of alkaline phosphatase, calcium and phosphorus was detected respectivaly before modeling and at 2, 4 and 6 weeks after modeling. RESULTS AND CONCLISION: ①X-rap examination:After 6 weeks the external was almost copletly absorbed and medullary cavity was completely recanalizad in the micron group, while fracture line disappeared and the external callus began to be absorbed and medullary cavity was not recanalized in the traditional Chinese medidne control group. Additionally, there were case of non-union stump hardening in natural healing group. ②Serum biochemistry:The activity of alkaline phosphatase reached a peak after 2 weeks in micron group, which was 2 weeks ahead of time compared with that in traditional Chinese medicine control group. And the peak concentration of alkaline phosphatase in micron group was higher than other groups. After 4 weeks serum calcium concentration started to fall significantly and phosphorus concentration started to rise significantly in micron group, as was statistically significant compared with other groups. After 6 weeks serum calcium concentration in micron group had fallen to normal level, while that in other groups was higher than normal. And phosphorus concentration in micron group increased significantly, which was statistically significant compared with natural healing group. The results demonstrated that micron feature traditional Chinese medicine lining matedat can enhance the activity of alkaline phosphatase, decrease the serum concentration of calcium and increase the serum concentration of phosphorus and the product of calcium and phosphorus, therefore, promote the healing of fracture, It shows that micron traditional Chinese medicine functional lining matedal plays a stronger effect on promoting the healing of fracture than that of ordinary Chinese medicine functional lining material.

Objective: To evaluate the accuracy and clinical value of fractional lfow reserve (FFR) determined by CT coronary angiography (CTA) in relevant patients. Methods: A total of 43 patients treated in our hospitals from 2013-10 to 2015-10 were retrospectively studied. There were 29 (67.40%) with male gender, the average age was (60.2±10.1) years. The patients received CTA at 1 week prior coronary angiography (CAG), the interval between CTA and CAG was (5.4±1.6) days. FFR was measured by both CAG and CTA (FFRCT) in selected target vessel which was deifned as maximal diameter reduction 50% to 70%. The imaging data were recorded and compared, FFRCT was calculated. Results: 48 vessels from 43 patients were eligible for analysis as target vessels. FFRCT vas evaluated based on the gold criteria of FFR. FFRCT had the diagnostic accuracy at 83.3%, sensitivity 75.0%, speciifcity 89.3% and positive predictive value was 83.3%, negative predictive value was 83.3% respectively. FFR and FFRCT showed obvious correlation (r=0.704,P<0.001); Bland-Altman analysis presented good concordance with 95% limits of agreement for FFRCTand FFR value ranged from -0.12 to 0.16, and 95.8% of the points (46/48) fell in the 95% limit of agreement, Receiver operating characteristic curve indicated that AUC of FFRCT was 0.871 (95% CI 0.770-0.973). Conclusion: CTA could accurately assess FFR, and FFRCT might be used in guiding the treatment for patients with intermediate coronary stenosis in clinical practice.

Objective To explore the effect of diabetes mellitus (DM) on biological behavior of epidermal keratinocyte in rats. Methods A total of 40 Sprague-Dawley rats were randomized into control group and streptozotocin (STZ) -induced diabetes group. Of each group, 10 rats were implemented with deep partial-thickness scalding. The re-epithelialization rate was observed at the 3rd, 7th, 14th and 21th post-burn day. Histological characteristics and thickness of epidermal tissue in both groups were observed. The adhesion rate, cell cycles, apoptosis rate and migration ability of keratinocyte were measured. The accumulation of advanced glycosylation end products (AGEs) of epidermal tissue was observed. Results The percentages of re-epithelialized area at the 7th, 14th and 21th post-burn day were much lower in DM group than in control group (P<0.05). In DM group, the epidermal thickness was reduced obviously with obscure multilayered epithelium and less amount of prickle cells; The adhesion rates of 12, 24 h after culturing keratinocyte and the percentage of G2/M phase cells were lower in DM group than in control group (P<0.05). However, apoptosis rate of keratinocyte was higher, the amount of migration cell was significantly less in DM group than in control group (both P<0.05). There were lots of AGEs accumulated in epidermal tissue in DM group, while there were hardly AGEs in control group. Conclusions Re-epithelization blocked exists on non-healing wound in DM rats, which is related with the impaired keratinocyte biological behavior. A large of AGEs accumulate in the epidermal tissue of DM rats, which may be a important reason to inhibit keratinocyte function in diabetic environment.

Objective:To analyze the effect of perioperative SEPT9 level in peripheral blood on long-term prognosis of patients with colorectal tumors. Methods:Retrospectively analyzed the data of 334 patients with colorectal cancer admitted to the Department of Anus & Intestine Surgery from January 2017 to December 2022, including 197 male patients and 137 female patients, aged 29 to 83 (62.8±10.7) years. Positive group was consisted of 241 patients with positive SEPT9 before surgery, while negative group was consisted of 93 patients with negative SEPT9 before surgery. Among the positive group, 169 cases turned negative for SEPT9 on the one week after surgery (transnegative group), and another 72 cases did not turn negative (non negative group). Univariate and multivariate analysis of clinical general data were carried out to screen out the risk factors affecting the long-term prognosis of colorectal cancer patients after surgery. The survival curve was calculated by Kaplan-Meier method, and the Log-rank test was used to compare the difference in survival rate between groups. Results:All patients′ overall median survival time was 67 months, and the 1, 3 and 5 years overall survival rate was 91.9%, 70.9% and 57.1%. The results of multi-factor analysis showed that whether the tumor had lymph node metastasis, TNM stage, and preoperative SEPT9 methylation status were independent risk factors affecting the long-term prognosis of colorectal cancer ( P=0.004, <0.001, 0.041), while for patients with preoperative SEPT9 positive, TNM stage of tumor and whether SEPT9 turned negative after surgery were independent risk factors for prognosis ( P=0.026, 0.001). The median survival time of patients in positive group and negative group was 63 months and 71 months, respectively. The 1, 3 and 5 year survival rates after surgery were 90.4%, 67.0%, 55.0% and 95.7%, 79.1% and 64.6%, respectively( P=0.007). The median survival time of the patients in the transnegative group and nonnegative group was 45 months and 62 months, respectively. The 1, 3 and 5-year survival rates were 83.2%, 60.5%, 48.1% and 93.5%, 72.9%, 63.5%( P<0.001). Conclusions:Perioperative SEPT9 level is correlated with long-term prognosis of CRC patients, and patients with negative SEPT9 before surgery have better prognosis than those with positive SEPT9. Preoperative positive patients who do not turn negative after surgery often indicate poor prognosis of tumor.

Objective The explore regulation mechanism of specific proteins c-kit of interstitial cells of Cajal in the pathogenesis of slow transit constipation in rats.Methods Slow transit constipation in rat model was duplicated by injections of morphine (25 mg/kg,45 d).The number and weight of fecal granule were assayed.Daily average number of fecal particles,quality,and the time for first black discharge were analyzed.At the same time,the c-kit and SCF expression were detected by Real-time PCR and Western blot.The changes of inflammatory factors such as IL-1β,IL-2 and IL-10 were also detected by ELISA.Results Daily average number of fecal particles in constipation group was decreased,quality was higher,and the first time for first black discharge was prolonged,which showed significant differences (P ＜ 0.05).The expression levels of c-kit and SCF were decreased significantly,and levels of inflammatory factors IL-1β,IL-2 and IL-10 were higher in constipation rats than the controls (P ＜ 0.05).Conclusion The pathogenic progress of slow transit constipation rats are regulated,which is also related with inflammatory reactions.

Objective The explore regulation mechanism of specific proteins c-kit of interstitial cells of Cajal in the pathogenesis of slow transit constipation in rats.Methods Slow transit constipation in rat model was duplicated by injections of morphine (25 mg/kg,45 d).The number and weight of fecal granule were assayed.Daily average number of fecal particles,quality,and the time for first black discharge were analyzed.At the same time,the c-kit and SCF expression were detected by Real-time PCR and Western blot.The changes of inflammatory factors such as IL-1β,IL-2 and IL-10 were also detected by ELISA.Results Daily average number of fecal particles in constipation group was decreased,quality was higher,and the first time for first black discharge was prolonged,which showed significant differences (P ＜ 0.05).The expression levels of c-kit and SCF were decreased significantly,and levels of inflammatory factors IL-1β,IL-2 and IL-10 were higher in constipation rats than the controls (P ＜ 0.05).Conclusion The pathogenic progress of slow transit constipation rats are regulated,which is also related with inflammatory reactions.

Colorectal cancer is a common tumor of the digestive system with a high degree of malignancy. Most patients are in the advanced stages of the disease when they develop symptoms. Although the detection rate of traditional screening methods is improving with advances in imaging and the popularity of colonoscopy, the diagnosis of early, asymptomatic colon cancer is still unsatisfactory. Therefore, it is particularly important to further study the occurrence and development mechanism of colorectal cancer and obtain new ideas for the diagnosis and treatment.? In recent years, with the deepening of epigenetics research, the role of DNA methylation in the pathogenesis of colorectal cancer has gradually attracted attention. This paper will review the research progress of DNA methylation in colorectal cancer′s diagnosis and treatment.

Objective: To investigate the prevalence of bifid mandibular canals (BMC), and to measure their diameter and angle. Methods : CBCT images of 500 patients were used for this study. The incidence and types of bifid mandibular canals were recorded according to a modified classification of Naitoh: Ⅰ, retromolar canal; Ⅱ, dental canal; Ⅲ, forward canal; Ⅳ buccolingual canal. The diameter and angle between the accessory canal and the main mandibular canal were recorded. Results: Bifid mandibular canals were found in 32.2% of the 1 000 hemi- mandibles, with the incidence rate of 52.17%, 36.02%, 6.21%, 5.59% in TypeⅠ, Ⅱ, Ⅲ, Ⅳ respectively. There are 90 cases of the mandibular branch with a diameter greater than or equal to the backbone 1/2, and 100 cases that are less than 1/2 of the backbone. The angle between the mandibular branch and the trunk Ⅰ, Ⅱ and Ⅲ were 50.21° ± 22.25°、28.81° ± 11.5° and 13.50° ± 2.39° respectively. Conclusion Bifid mandibular canals were observed at a relatively high incidence using CBCT, and the most common type was the retromolar canal. It is suggested CBCT should be taken before mandibular surgery to give an accurate evaluation of bifid mandibular canals.