Objectives:To compare the feasibility, complications and advantages of the nose intestine tube and the jejunostic tube in early enteral nutrition after gastrointestinal operation. Methods:55 postoprative patients were divided into three groups. The nose intestine tube group(A group, n =20) and the jejunostic tube group(B group, n =19)received the enteral nutrition(Nutrison Fibre) enterally for 7 days and the conrtrol group(C group, n =16)received intravenous isotonic glucose solution and oral liquid diet after the bowel movement recovery,The blood glucose, the function of liver and kidney, electrolytes and nutritional status were observed. The recovery of bowel movement and other digestive symptoms such as abdominal pain, distention,diarrhea,nausea and vomiting were observed during the period of study. Some complications such as acute intestinal obstruction,pnumonia and rhinolaryngitis were observed during the period of study. Results:The time for placing the jejunostic tube was faster than that for placing the nose intestine tube( P

Objective To determine the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary interstitial fibrosis (IPIF). Methods From December 2006 to January 2008, 24 consecutive patients with IPIF admitted to Beijing Chaoyang Hospital underwent 24-hour esophageal pH monitoring and esophageal manometry. Meanwhile, 23 patients with diffuse parenchymal lung disease (DPLD) (excluding IPIF) admired to the hospital in the same period served as a control group. Comparison of the prevalence of pathologic esophageal acid exposure GERD symptoms, and ineffective esophageal motility (IEM) between the two groups was made. In this study, nocturnal acid exposure is defined as acid reflux episodes occurring from 10pro to 6am. Results (1) 16 out of the 24 (66. 7%) patients with IPIF were demonstrated to have pathologic esophageal acid exposure; the prevalence of GERD in IPIF patients was significantly higher than that in other DPLD patients, whose prevalence was 26. 1% (P<0.05); (2) 87.5% patients with IPIF and GERD (GERD-IPIF) had nocturnal acid exposure episodes; (3) only 37.5% of the GERD-IPIF patients was found to have typical GERD symptoms such as heartburn and regurgitation; (4) The prevalence of IEM was similar in IPIF and other DPLD patients, being 42.9% and 39. 1% respectively (P >0. 05). Conclusions IPIF patients have higher prevalence of GERD and most of them usually do not show typical reflux symptoms. It is hereby suggested that IPIF patients should be screened with pH monitoring for GERD.

Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.

The specific fragment of Pneumococcal surface protein A(PspA)and Pneumococcal Surface Adhesin A(PsaA)gene was amplified by PCR from Streptococcus pneumonia 5 and Streptococcus pneumonia 19.The amplified fragnent of PspA and PsaA gene was ligated into pET-27b(+)vector and transformed into BL 21 E.coli for expression and obtain the expressive production of PspA and PsaA.Induced by IPTG,the expression level was as high as 75 % of the total disolube protein.The result showed that the recombinant plasmid could express a specific 75 kDa and 37 kDa fusion protein in E.coli BL 21,which showed the good immunogenicity and a broadly cross reactivity with the other serotypes.

Objective To investigate the expression and significance of ADAMDEC1 in glioma.Methods We prospectively observed the expression of ADAMDEC1 in 77 glioma patients,of which 28 cases were grade Ⅳ glioma,26 were grade Ⅲ glioma (high-grade glioma);of which 23 cases were Grade Ⅱ glioma,5 were grade Ⅰ glioma (low-grade glioma).For 10 cases in the control group,brain tissue samples were collected from internal decompression patients with heavy traumatic brain injury.The expression of ADAMDEC1 in glioma tissue was detected immunohistochemistry,RT-PCR,and Western blot.With follow-up survey we explored the relationship between the survival time and the expression of ADAMDEC1 in the patients with high-grade gliomas and low-grade gliomas.Results Compared with the low-grade glioma group and the control group,qPCR,immunohistochemistry and Western blotting all showed that the protein and mRNA levels of ADAMDEC1 in high-grade glioma group were significantly increased,while ADAMDEC1 was expressed little in low-grade glioma group and not expressed in control group (P ＜ 0.05).The survey results showed that the survival time of high-grade glioma patients was significantly shorter than low-grade glioma patients;however,the expression level of ADAMDEC1 in the highgrade glioma tissue was significantly higher than in low-grade glioma tissue (x2=5.031,P＜0.05).Conclusion The expression of ADAMDEC1 is closely related to the malignant degree of glioma cells and the prognosis of glioma patients.Therefore,ADAMDEC1 can be used as an index to evaluate the malignance degree of glioma and the prognosis of glioma.

BACKGROUND:Glucosamine hydrochloride is considered to have the role in the treatment of knee osteoarthritis. Whether it is effective for varying degrees of osteoarthritis and whether there are efficacy differences between the combinations nonsteroidal anti-inflammatory drugs and simple glucosamine hydrochloride need further clinical research. OBJECTIVE:To compare the clinical effects between glucosamine hydrochloride capsules and combined with celecoxib for the treatment of knee osteoarthritis through prospective study. METHODS:According to Lequesne score, 152 patients with knee osteoarthritis were divided into mild, moderate and severe groups, then each group was divided into groups treated just by glucosamine hydrochloride and groups treated by glucosamine hydrochloride combined with celecoxib randomly. The Lequesne score was recorded at 2, 4 and 6 weeks after drug administration and 8 and 12 weeks after drug withdrawal, and then the adverse reactions of glucosamine hydrochloride were compared between groups and before and after treatment. RESULTS AND CONCLUSION:In the mild group, there was significant difference in Lequesne score of glucosamine hydrochloride group at 4 weeks after treatment and 12 weeks after drug withdrawal when compared with that before treatment;the Lequesne score was improved in the combined group at 2 weeks after treatment, and there was significant difference between two groups at 2 and 4 weeks after treatment, it showed that the combined group improved the score, which was more significant than the glucosamine hydrochloride group. In the moderate group, the Lequesne score in the glucosamine hydrochloride group was lower than that in the combined group at 2, 4 and 6 weeks after treatment and 8 weeks after drug withdrawal (P<0.05). It showed that the effect of glucosamine hydrochloride combined with celecoxib for the treatment of medium knee osteoarthritis was better than that of glucosamine hydrochloride. In the serious group, there was no significant difference in Lequesne score between two groups before and after treatment. The results indicate that the clinical symptoms of mild knee osteoarthritis patients can be significantly improved by a single use of glucosamine hydrochloride. To moderate osteoarthritis, combination therapy with nonsteroidal anti-inflammatory drugs is recommended to improve clinical symptoms, and both of the two methods are invalid on severe knee osteoarthritis patients.

Objective To analyze the expression of IFIT4,PRKR and investigate the clinical and immunology features of different types of liver involvement in patients with systemic lupus erythematosus (SLE).Methods Clinical data of 62 cases of SLE with liver damage and 62 cases of SLE without liver damage were collected.Peripheral venous blood samples were obtained and total RNA were extracted and transcribed into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression levels of IFIT4,PRKR in patients with SLE.Clinical parameters were analyzed by ANOVA,Chi-square test,Pearson's or Spearman's test.Results ① The increase of γ-GT or ALP was correlated with rash and oral ulcer (x2=5.625,P=0.018),lupus nephritis (x2=5.631,P=0.019),anemia,thrombocytopenia (99±21,P=0.028; 81±45,P=0.004,),CRP (33±43,P=0.004).The positive rate of nRNP (x2=4.862,P=0.027 ) and SSA (x2=8.087,P=0.004) was higher in patients with liver damage than other groups; ② The positive rate of anti-Rib antibody in SLE with liver damage was significantly higher than SLE without liver damage (x2=19.542,P=0.000); ③ There was no difference in the expression of IFIT4 among these groups,but higher expression of PRKR was detected in the group of patients with increased γ-glutamyl transpeptidase (γ-GT) or ALP(F=3.54,P=0.018).Conclusion The different types of liver damage in SLE patients have different clinical and immunology characteristics.The expression of PRKR is higher in patients with increased γ-GT or ALP.

Objective To monitor and compare the breathing mechanics on PC,VC and PRVC during pneumoperitoneum,and to discuss the significance of the clinic use of PRVC.Method Ninety laparoscopic cholecystectomy patients were equally divided into 3 groups (PC,VC,PRVC).Levels of PES,PAWM,PAP,PaCO2,ETCO2,TV MAP and HR were detected before pneumoperitoneum,and at 5,10,15 and 20 minutes postpneumoperitoneum.Results Pneumoperitoneum made three respiratory patterns with different levels of PAWM,PAP,and PES.PES post-pneumoperitoneum in the VC model was obviously higher than that in the PC and PRVC group.At 10 min post-pneumoperitoneum,levels of PaCO2 and ETCO2 increased obviously in the PC and VC group(P ＜ 0.05).Levels of PaCO2 and ETCO2 were increased in the PC group,but TV level post-pneumoperitoneum was significantly lower than that in the other two groups (P ＜ 0.05).Level of PaCO2 and ETCO2 were increased in the PC and VC group post-pneumoperitoneum,along with increases of MAP and HR (P ＜ 0.05).Levels of MAP and HR in the PRVC group post-pneumoperitoneum were significantly lower than those in the PC and VC group (P ＜ 0.05).Conclusion PRVC mode can effectively reduce the increases of pneumoperitoneum-induced PAWM,PAP,PES,without the unusual increase of PaCO2 and ETCO2 during surgeries,contributing to the stability of vital signs of perioperative patients.

Objective To evaluate the impact of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on patients after hepatectomy. Methods Seventy-eight patients undergoing liver resection were randomized prospectively into two groups: EEN group receiving early enteral nutrition (n=35) and PN group receiving parenteral nutrition (n=43). The patients in both groups received isocaloric and isonitrogenous nutritional formulas 24 h after operation and the formulas were stopped on postoperative day 7. The general conditions, liver function tests, clinical complications,and clinical nutritional variables at three time points that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD 8) were observed. Results No significant differences were found in length of hospital stay, liver function and clinical nutritional variables between the 2 groups. In the EEN group, the serum prealbumin level almost returned to the preoperative level on POD 8. The nutritional complication rate of the EEN group was increased significantly but it was milder than that of the PN group. The time of gut function recovery in the EEN group was shorter than that of the PN group. The costs of nutritional drugs showed a significant decrease in the EEN group.Conclusion Early enteral nutrition is safe, rational and effective in patients who have undergone hepatectomy. Early enteral nutrition is better than parenteral nutrition in promoting liver function recovery, liver protein synthesis, postoperative recovery of gut function and decreasing costs of nutritional drugs.

Objective: To analyze the information of patients with acute myocardial infarction (AMI) in a single center during last 6 years, and to distinguish the clinical differences of patients between TakoSTubo cardiomyopathy (TTC) and ST-segment elevation myocardial infarction (STEMI). Methods: A total of 1042 consecutive patients with primarily diagnosed acute anterior ST-segment elevation (STEMI) admitted in our hospital from 2008-01 to 2014-04 were retrospectively enrolled. The relevant patients were studied in 2 groups:TTC group, the patients with coronary angiography (CAG) and the contrast study of left ventricle corrected TTC diagnosis, n=10, and STEMI group, the patients received CAG within 6 hours of on set with conifrmed left anterior descending singlevessel disease at the same period of time as TTC patients,n=32. The basic clinical characteristics, levels of blood lipids, MI related biomarkers, the incidence rate of pathological Q wave, QTc interval and negative T wave in 12-lead ECG were compared between 2 groups. Results: The percentage of corrected TTC diagnosis in patients with primarily diagnosed STEMI was 1.06%. The female gender in TTC group and STEMI group was 100% vs 9%,P<0.01, TTC group had more patients with stress history before on set than that in STEMI group (70% vs 22%,P=0.02), lower levels of MI related biomarkers as CK (486 ± 249) U/L vs (716 ± 132) U/L, CK-MB (13.5 ± 17.1) mg/L vs (47.5 ± 21.9) mg/L, cTnI (22.8 ± 16.3) ng/mL vs (56.4 ± 24.0) ng/mL, allP<0.01. The age of morbidity, the ratios of hypertension, diabetes mellitus and blood lipids were similar between 2 groups. The frequency of abnormal Q-wave in ECG was similar between 2 groups, while the QTc interval was different in TTC group and STEMI group (630 ± 117) ms vs (540 ± 62) ms,P=0.001, the negative T waves in ECG leads II, III, aVF, aVR and V6 were as (100.00% vs 3.13%), (60.00% vs 6.25%), (90.00% vs 3.13%), (100.00% vs 21.88%), (100.00% vs 46.88%), allP<0.05. Conclusion: TTC patients with the main presentation as ST-segment elevation are usually having emotional or physical stress before on set, with obviously prolonged QTc interval and more frequency of negative T waves in ECG.