Compared with parenteral nutrition (PN) , enteral nutrition (EN) is more favorable in maintaining physiological status, protecting intestinal barrier function, liver function, immune function, and gastrointestinal function, promoting protein synthesis, reducing the stress response and insulin resistance, reducing infectious complications, and lowering healthcare costs. Successful implementation of EN depends on the good knowledge of indications, complications, and contraindications and on the proper choice of EN preparations, tube placement route, and equipment In this article, with an attempt to increase the tolerance of EN after surgery, reduce complications , and improve the therapeutic effect of nutritional support, we propose a new method of clinical application-optimization of post-operative early enteral nutrition with sequential therapy.

Objective To investigate the surgical treatment of gastrointestinal stromal tumor (GIST) based on the clinical characteristics of GIST in different locations.Methods The clinical data of 486 GIST patients who received surgical treatment at the Peking Union Hospital from January 2003 to December 2012 were retrospectively analyzed.There were 461 patients with primary GIST and 25 with secondary GIST.The clinical characteristics and surgical treatment methods were analyzed.All data were analyzed using the chi-square test.Results Of the 461 patients with esophageal stromal tumors,6 received partial esophagectomy.Of the 234 patients with gastric stromal tumors,183 received partial gastrectomy,23 received proximal gastrectomy + cardiectomy,23 received distal gastrectomy,2 received total gastrectomy and 3 received exploratory laparotomy.Of the 51 patients with duodenal stromal tumors,34 received partial duodenectomy,9 received pancreatico-duodenectomy,5 received pylorus-preserving pancreaticoduodenectomy,3 received palliative surgery.Of the 116 patients with small intestinal stromal tumors,110 received partial small intestinal resection and 6 received palliative surgery.Of the 29 patients with rectal stromal tumors,13 received posterial transsphincteric surgery of the rectum,12 received transanal local resection of rectal tumors and 4 received abdominoperineal resection; laparotomy was performed on 25 patients with GIST in other positions.Of the 25 patients with secondary GIST,10 patients with liver metastasis of GIST received hepatic segmentectomy,1 received hepatobiopsy; 6 received abdominopelvic tumor resection; 5 received portial resection of the small intestine or colon; 1 received sigmoid colostomy; 1 received splenectomy and 1 received intracranial tumor resection.Of the 461 patients with primary GIST,patients who received combined devisceration accounted for 12.58％ (58/461),and the ratio of combined cholecystectomy was the highest,which was 34.5％ (20/58).Combined devisceration was considered for patients with duodenal stromal tumors,gastric stromal tumors and small intestinal tumors.Laparoscopic surgery accounted for 20.39％ (94/461) of all the surgery,and the ratio of laparoscopic surgery which carried out in recent 5 years was 28.52％ (77/270),which was significantly higher than 8.90％ (17/191) of the earlier 5 years (x2=36.67,P ＜ 0.05).Conclusion Different surgical treatment methods including minimally invasive surgery could be adopted according to different clinical characteristics of GIST in different locations,and radical resection of GIST is the main objective.

The aim of this study is to investigate the effect of fluoxetine (FLX) on the expressions of BDNF and Bcl-2 in the hippocampus, the amygdala and the prefrontal cortex of conditioned fear (CF) model mice. Forty eight mice were randomly divided into three groups, normal control group, CF stress group and FLX-pretreated CF group. The FLX-pretreated CF group was given FLX (10 mg x kg(-1) x d(-1)) for 7 days before CF stress. After CF stress model was established, all mice were given behavioral experiments to test whether FLX impaired or improved the auditory and contextual fear conditioning. Then mice were sacrificed. The expressions of BDNF and Bcl-2 were detected by Western blotting. The results showed that the freezing time of FLX-pretreated CF group was significantly lower than that of CF group; FLX pretreatment up-regulated the expression of Bcl-2 in the hippocampus at 1 d after CF stress (P < 0.001), but no significant differences was observed at 7 d; BDNF significantly increased in the hippocampus at 7 d (P < 0.001), but no differences at 1 d; the expressions of BDNF and Bcl-2 in the amygdala and the prefrontal cortex were of no obvious differences between CF group and FLX-pretreated CF group at 1 d or 7 d after CF stress. Parallel to these changes, pretreatment with FLX could affect histopathologic changes induced by CF stress. Furthermore, the results indicated that FLX pretreatment could protect against CF stress-induced neurological damage via the activation of BDNF and Bcl-2 in hippocampus.

This study was aimed to explore the clinical effect of San-Jiao (SJ) acupuncture combined with Chinese medicine and Cisapride tablets in the treatment of senile constipation. A total of 118 patients were selected according to the inclusion criteria. According to the visiting sequence, patients were randomly divided into the acupuncture with Chinese medicine group of 60 cases and drug group of 58 cases. In the acupuncture with Chinese medicine group, SJ acupuncture was combined with Huang-Di (HD) powder in the treatment. In the drug group, Cisapride tablets were applied. Both groups were treated for 20 times. The scale was used in the comprehensive evaluation of integral effect evaluation of main symptoms, psychological evaluation before and after the treatment. The results showed that there was significant difference on the integral before and after treatment in both groups (P< 0.01). The posttreatment integral showed that the acupuncture with Chinese medicine group was better than the drug group (P<0.01). There was no significant difference on total effective rate between two groups. However, comparison on good improvement rate showed that the acupuncture with Chinese medicine group was better than the drug group (χ2 =28.25, P < 0.01). It was concluded that the acupuncture with Chinese medicine group had better effect on the im-provement of clinical symptom integral, psychological integral, and comprehensive effect evaluation. SJ acupuncture combined with HD powder was a safe treatment method with good effect.

Percutaneous endoscopic gastrostomy (PEG) is an convenient, effective, and safe technique,and is especially useful for the nutritional support of patients who are unable to befedorally. PEG should be carefully arranged based on indications, ethical criteria, and contraindications. Early PEG can remarkably improve the quality of life.

Objective To investigate the CT diagnostic value of broad ligament leiomyoma.Methods CT appearances of 21 cases with broad ligament leiomyoma confirmed by operation and pathology were analyzed retrospectively.Results CT showed that the tumors were pelvic and extrauterine masses in all cases,the tumors were solid in 19 cases and was cystic-solid in one case. The tumors had clear border in 16 cases and unclear border in 3 cases. The density of tumor in 6 cases were homogeneous, which was similar to that of myometrium on precontrast scanning. There was obviously uptake on postcontrast enhancement, as in myometrium. In heterogeneous tumors, low density areas of light flakes or streaks were observed, and the density of tumor solid part was somewhat lower than that of the uterus muscles on postcontrast enhancement. The tumors grew near the uterus. The shape of tumors appeared multitudinous, which was multilobular or irregular in 11 cases, flat round in 4 cases, and round or elliptic in 6 cases. Conclusion CT is a useful tool in diagnosis of the broad ligament leiomyoma.

Objective: To explore the changes of activity of antioxidases in hippocampus of the rats with multi-infarct dementia and the intervention effects of acupuncture.Method: The multi-infarct dementia model was made by injected emboli into the internal carotid artery.The demented rats were allocated to 3 groups randomly: model,acup and sham-acup;meanwhile normal and sham-operated rats were used as control.The parameters of oxidative stress were assessed by measuring the malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT) and glutathione peroxidase(GSH-Px) levels in hippocampus after acupuncture treatment.Result: Compared to normal group,MDA levels of hippocampus in model animals increased significantly,while SOD and GSH-Px decreased much more;No significant difference was observed in CAT among groups.Interestingly,the acupuncture treatment could significantly improve all those indexes.Conclusion: SOD/GSH-Px pathway may be playing a major role in combating oxidative stress in the brain of MID rats,the CAT activity not the key enzyme.Acupuncture treatment could increase the activity of antioxidase SOD/GSH-Px,alleviate the injury of free radical and maintain the oxidant-antioxidant balance to a great extent.This may be one of the mechanisms of its therapeutic effect.

OBJECTIVE:To investigate the method for preparation and quality control of carbamide peroxide METHODS:Carbamide was mixed with hydrogen peroxide at -5℃～-10℃ to form 1∶1 molecular compound The white crystallization was obtained after drying under the condition of low temperature It was used as solidifying oxygen molecular RESULTS:The content of hydrogen peroxide in the carbamide peroxide was 34 90%,which was up to 97 00% of the label content CONCLU_SION:The preparation technology of the carbamide peroxide is simple Its quality control and clinical use are easy

Acupuncture Therapy ; Humans ; Male ; Moyamoya Disease ; therapy ; Posterior Cerebral Artery ; abnormalities ; Young Adult

Objective:To observe the efficacy of contact lenses on a wide range of corneal epithelial shedding. Methods:The information has collected a wide range of corneal epithelium of thirty-six patients admitted to our hospital in the January 2010-December 2010, tracking observed in patients with epithelial wear contact lenses after the healing. Results:The patients wear contact lens immediate relief of symptoms with eye pain, foreign body sensation. Patients with continuous wear contact lenses after five to seven days, including twenty-eight patients with corneal epithelial fully restored, the remaining eight cases without contact lens continue to use eye drops of one to two days corneal epithelial fully restored in the ointment;thirty-six patients were followed up in three to six months, not fall off again. Conclusion:Therefore, use contact lenses to treat corneal epithelial shedding, the patients suffered less pain, treatment is easy to operate, low cost, the treatment effect is significant.