Objective To investigate the clinical efficacy ofω-3 unsaturated fatty acid enteral nutrition (EN) for treatment of elderly patients with heart failure (HF). Methods One hundred and twenty six elderly patients with HF admitted to Hangzhou Geriatric Hospital from April 2013 to April 2018 were enrolled to be the study objects, and they were divided into a TPF group and a TPF-T group (63 cases in each group) according to the difference in nutrition preparation. The nasal feeding with EN solution rich in ω-3 unsaturated fatty acid was applied in the TPF-T group; while in the TPF group, nasal feeding with common EN solution was given. According to the body mass quantity to calculate the necessary heat standard, the target energy established for the two groups was 104.6-125.5 kJ·kg-1·d-1. The changes of levels of albumin (Alb), prealbumin (PA), transferrin (TRF), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), T lymphocyte subsets such as CD3+, CD4+, CD8+, CD4+/CD8+, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF) were observed in the two groups before and after treatment, and the prognostic indexes and incidence of adverse reactions of the two groups were also observed. Results After treatment, the levels of Alb, PA, TRF, and the immune function indexes CD3+, CD4+, CD8+, CD4+/CD8+ were significantly increased in both groups (all P < 0.05), while the serum levels of IL-6, hs-CRP, TNF-α and NT-proBNP were obviously decreased in both groups (all P < 0.05), moreover, the degrees of changes in the above parameters in the TPF-T group were more significant than those in the TPF group [Alb (g/L):36.91±4.49 vs. 36.31±3.95, PA (mg/L): 190.26±15.39 vs. 188.51±17.62, TRF (g/L): 2.31±0.44 vs. 2.25±0.71, IL-6 (ng/L): 312.53±42.69 vs. 372.45±51.25, hs-CRP (mg/L): 20.43±15.72 vs. 35.81±14.28, TNF-α (ng/L):81.36±17.32 vs. 152.67±21.71, CD3+: 0.59±0.06 vs. 0.55±0.05, CD4+: 0.33±0.05 vs. 0.28±0.04, CD8+:0.23±0.03 vs. 0.21±0.04, CD4+/CD8+: 1.55±0.34 vs. 1.36±0.41, NT-proBNP (ng/L): 149.00±0.38 vs. 242.00±0.56, all P < 0.05]; the intensive care unit (ICU) length of stay, the total hospital length of stay in the TPF-T group were significantly shorter than those in the TPF group [ICU length of stay (days): 9.41±3.19 vs. 12.39±3.75, total hospital length of stay (days): 15.24±4.63 vs. 18.26±5.18, both P < 0.05], and the incidence of adverse reaction in TPF-T group was lower than that in the TPF group: [4.76%(3/63) vs. 17.46% (11/63), P < 0.05]. However, there was no statistical significant difference in left ventricular ejection fraction between the TPF-T group and TPF group (LVEF: 0.418±0.053 vs. 0.417±0.052, P > 0.05). Conclusion Early application of ω-3 unsaturated fatty acid EN may improve the immunologic function of T lymphocytes as well as prognosis, reduce the inflammatory response in elderly patients with HF, and reduce the incidence of adverse reactions.

Objective To observe the impact of multidrug resistance-related protein (MRP) 3 gene silenced by small interfering RNA (siRNA) on the drug resistance of primary liver cancer cells. Methods The drug resistance cell lines HepG2/Adriamycin(ADM) were developed by exposing parental cells to stepwise increasing concentrations of ADM and then MRP3-siRNAs were transfected in HepG2/ADM cells with lipofectamine 2000 liposomes. Three groups were assigned:HepG2 cell group (control group), HepG2/ADM cell group (resistance group) and MRP3-siRNA transfected HepG2/ADM cell group (interference group). The MRP3 mRNA contents of 3 groups were measured by real-time fluorescent quantitative polymerase chain reaction (PCR). The expression of MRP3 protein was detected by Western blot. The 50%inhibitory concentrations (IC50) of ADM, lfuorouracil (5-FU), vincristine, oxaliplatin were determined by methyl thiazolyl tetrazolium (MTT) and the drug resistance indexes (RI) were calculated. The experimental data of 3 groups were compared by one-way analysis of variance, while pairwise comparisons were conducted using LSD-t or t test. Results The mean of MRP3 mRNA content in resistance group (5.16±0.31) was signiifcantly higher than those in control group (3.08±0.27) and interference group (2.85±0.23) (LSD-t=8.765, 10.363;P<0.05). The MRP3 protein content in resistance group (21 063±274) was signiifcantly higher than those in control group (14 476±217) and interference group (6 660±153) (LSD-t=21.836, 79.578;P<0.05). The RI of ADM, 5-FU,vincristine, oxaliplatin in resistance group were 14.40±0.31, 26.68±0.22, 28.70±0.49, 20.23±0.54, and were 3.55±0.16, 9.60±0.27, 2.11±0.17, 3.15±0.13 respectively in interference group. The RI in interference group were signiifcantly lower than those in resistance group (t=53.873, 84.933, 88.811, 53.258; P<0.05). Conclusions MRP3 gene of liver cancer cells silenced by siRNA can improve the cells' sensitivity to chemotherapy drugs and reverse its chemotherapy drug resistance.

Objective To investigate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in the preoperative evaluation of patients with biliary calculus. Methods Clinical data of 70 patients with biliary calculus in Sun Yat-sen Memorial Hospital and the Third Afifliated Hospital of Sun Yat-sen University from June 2012 to June 2013 were retrospectively analyzed. There were 38 males and 32 females with age ranging from 18 to 87 years old and the median age of 52 years old. The informed consents of all patients were obtained and the ethical committee approval was received. The patients underwent ultrasound examination and MRCP before operation. The surgical procedures were cholecystectomy+bile duct exploration and the intraoperative exploration result was the gold standard of diagnosis for biliary calculus and biliary tract variations. The detectable rate of biliary calculus and biliary tract variations by two methods were compared using Chi-square test and Fisher's exact probability test. Results The detectable rate of gallstones was 93%(62/67) by ultrasound and was 79%(53/67) by MRCP, where signiifcant difference was observed (χ2=4.968, P<0.05). The detectable rate of common bile duct stones was 61%(17/28) by ultrasound and was 86%(24/28) by MRCP, where signiifcant difference was observed (χ2=4.462, P<0.05). The detectable rate of the left and right hepatic duct stones was 2/5 by ultrasound and was 4/5 by MRCP, where no signiifcant difference was observed (P>0.05). The detectable rate of intrahepatic bile duct stones was 36%(4/11) by ultrasound and was 73%(8/11) by MRCP, where no signiifcant difference was observed (P>0.05). The detectable rate of biliary tract variations was 2/8 by ultrasound and was 7/8 by MRCP, where signiifcant difference was observed (P<0.05). Conclusions MRCP is superior to ultrasound examination in the detection of common bile duct stones and biliary tract variations. It can be a common practice in the preoperative evaluation of patients with biliary calculus when circumstances allow.