Objective To investigate the value of guidance and clinical significance of enteral nutritional support therapy using a joint of nutritional risk screening 2002 (NRS2002) and a screening tool for controlling nutritional status (CONUT) after radical resection of colorectal cancer.Methods The clinical data of 180 patients who underwent radical resection of colorectal cancer at the Tumor Hospital of Xinjiang Medical University between June 2012 and June 2014 were retrospectively analyzed.Seventy patients with scores of NRS 2002 ≥ 3 were allocated into the A group including 40 with enteral nutritional support therapy in the A1 group and 30 without enteral nutritional support therapy in the A2 group, 60 patients with scores of NRS 2002 ＜ 3 and negative CONUT was allocated into the B group including 30 with enteral nutritional support therapy in the B1 group and 30 without enteral nutritional support therapy in the B2 group, 50 patients with scores of NRS 2002 ＜ 3 and positive CONUT was allocated into the C group including 25 with enteral nutritional support therapy in the Cl group and 25 without enteral nutritional support therapy in the C2 group.The nutritional status of patients was evaluated using a joint of NRS 2002 and CONUT.There was nutritional risk in patients with scores of NRS 2002≥3 or scores of NRS 2002 ＜ 3 and positive CONUT and no nutritional risk in patients with scores of NRS 2002 ＜ 3 and negative CONUT.Patients and their families would choose whether or not to undergo enteral nutritional support therapy after the risks being informed.Enteral nutritional support therapy included tube feeding enteral nutrition or oral nutriments with calories ≥41.84 k J/(kg · d) for more than 3 days.Observed indicators: (l)Nutritional indicators included fasting serum albumin (Alb), prealbumin and transferrin before operation, at postoperative day 1 and day 7.(2)Postoperative recovery included time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay.Measurement data with normal distribution were presented as x ± s, comparison among groups was analyzed using the t test and repeated measures ANOVA, and count data were analyzed using the chi-square test.Results Patients in A, B and C groups had good tolerance without abdominal pain, abdominal distension and diarrhea.Comparisons of nutritional indicators: the levels of fasting serum Alb, prealbumin and transferrin in the A1 group were (29 ±4)g/L, (0.25 ±0.06)g/L and (2.0 ±0.4)g/L before operation, (27 ±4)g/L, (0.19 ± 0.07) g/L, (1.7 ± 0.4) g/L at postoperative day 1 and (33 ± 5) g/L, (0.27 ± 0.05) g/L and (1.9 ± 0.3) g/L at postoperative day 7, respectively.The levels of fasting serum Alb, prealbumin and transferrin in the A2 group were (29 ±5)g/L, (0.24 ±0.04)g/L and(2.0 ±0.4)g/L before operation, (27 ±4) g/L, (0.18 ±0.05)g/L and (1.7 ± 0.4) g/L at postoperative day 1 and (26 ± 4) g/L, (0.16 ± 0.04) g/L and (1.8 ± 0.5) g/L at postoperative day 7, respectively.There were significant differences in the changing trends of the above 3 indicators between the 2 groups (F =3.256, 6.642, 7.152, P ＜0.05).The levels of fasting serum Alb, prealbumin and transferrin in the B1 group were (37 ± 4) g/L, (0.28 ± 0.05) g/L and (2.0 ± 0.3) g/L before operation, (36 ± 4) g/L, (0.21 ± 0.06) g/L and (1.7 ± 0.5) g/L at postoperative day 1 and (38 ± 4) g/L, (0.30 ± 0.05) g/L and (1.9 ± 0.5) g/L at postoperative day 7, respectively.The levels of fasting serum Alb, prealbumin and transferrin in the B2 group were (36 ±4)g/L, (0.28 ±0.06)g/L and (2.1 ±0.4)g/L before operation, (36 ±3)g/L,(0.23 ±0.04)g/L and (1.7 ±0.4)g/L at postoperative day 1 and (37 ±4)g/L, (0.22 ±0.07)g/L and (1.8 ± 0.5) g/L at postoperative day 7, respectively.There was no significant difference in the changing trends of the above 3 indicators between the 2 groups (F =1.562, 0.625, 2.223, P ＞ 0.05).The levels of fasting serum Alb,prealbumin and transferrin in the C1 group were (28 ± 4) g/L, (0.35 ± 0.06) g/L and (2.1 ± 0.4) g/L before operation, (26 ±4)g/L, (0.17 ± 0.07)g/L and (1.7 ± 0.4)g/L at postoperative day 1 and (34 ± 5)g/L,(0.35 ±0.05)g/L and (1.8 ± 0.3)g/L at postoperative day 7, respectively.The levels of fasting serum Alb,prealbumin and transferrin in the C2 group were(28 ± 5)g/L, (0.34 ± 0.04)g/L and (2.0 ± 0.4)g/L before operation, (26 ± 4) g/L, (0.16 ± 0.05) g/L and (1.7 ± 0.4) g/L at postoperative day 1 and (25 ± 4) g/L,(0.16 ±0.04) g/L and (1.8 ±0.5)g/L at postoperative day 7, respectively.There were significant differences in the changing trends of the above 3 indicators between the 2 groups (F =5.625, 4.225, 8.221, P ＜0.05).Postoperative recovery: time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.9 ± 0.5) days, (2.3 ± 0.5) days, (8.6 ± 1.2) days, (14.7 ± 1.1) days in the A1 group and (3.0 ± 0.5) days, (4.5 ± 0.6) days, (11.4 ± 2.2) days, (17.8 ± 1.3) days in the A2 group, respectively,with significant differences between the 2 groups (t =-0.644,-12.200,-8.710,-11.650, P ＜ 0.05).Time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.2 ± 0.3)days, (3.2 ±0.7)days, (10.3 ± 1.4)days, (14.7 ±2.0)days in the B1 group and (1.5 ±0.5)days, (3.7 ± 0.6) days, (11.0 ± 1.2) days, (16.1 ± 1.5) days in the B2 group, respectively, with no significant difference between the 2 groups (t =-1.929,-1.033,-1.019,-1.171, P ＞0.05).Time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.8 ± 0.7) days, (2.1 ± 0.5) days,(7.6±1.2)days, (13.9 ±1.2)days in the C1 group and (3.1 ±0.5)days, (4.5 ±0.7)days, (11.4±2.4)days,(17.6 ± 1.3) days in the C2 group, respectively, with significant differences between the 2 groups (t =-5.934,-10.950,-10.010,-11.700, P ＜ 0.05).Conclusions A joint application of NRS2002 and CONUT after radical resection of colorectal cancer is exact and feasible for evaluating nutritional status of patients and guiding enteral nutritional support therapy.Patients should select nutritional support therapy after operation if there is nutritional risk.The proper nutritional support therapy can improve the postoperative nutritional status of patients with colorectal cancer, enhance the postoperative recovery and reduce the duration of hospital stay.

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods Forty-one patients with Hawkins Ⅲ talus neck fracture were treated.The fractures occurred on the left side in 21 patients and on the right side in 20 patients.All patients were performed internal fixation by internal and lateral approaches.The weight bearing should be adjusted with follow-up.The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).Results The average duration of follow-up was (37.7 ± 8.2) months.All fractures gained union and the average union time was (4.1 ±0.5) months.The average AOFAS score after treatment was (79.3 ± 2.6) scores which was higher than that before treatment [(35.1 ± 8.0) scores],and there was significant difference (P =0.026).There were 11 cases in excellent,17 cases in good,11 cases in fair and 2 cases in poor.The excellent and good rate was 68.3％ (28/41).Traumatic arthritis occurred in 18 cases (43.9％,18/41),involved tibial astragaloid joint in 4 cases,involved subtalar joint in 6 cases,involved tibial astragaloid joint and subtalar joint in 8 cases.Avascular necrosis occurred in 7 cases (17.1％,7/41).Conclusions The effect of surgical treatment for Hawkins Ⅲ talus neck fracture via a bilateral approaches is satisfactory.Pay more attention to protect blood circulation intraoperative and perform anatomic reduction according to the characteristic of body of talus displacement.After operation,functional rehabilitation should be directed by the principle of early movement,later weighted.

The aim of this study was to investigate whether shear stress could promote function of endothelial progenitor cells (EPCs) with Shexiang Baoxin Pill (SBP) treatment in vitro, and to study whether shear stress contributed to vascular injury repair by EPCs. EPCs were isolated and characterized; EPCs' proliferation, migration, adhesion, tube formation and eNOS protein level in vitro were investigated by culturing confluent EPCs in 4 mg/mL SBP under physiological shear stress (15 dyne/cm2) for up to 24 hours. Afterwards, EPCs were transfused into rats after wire-induced carotid artery injury augmented re-endothelialization. The results showed that, compared to the SBP group, the shear stress+SBP group obviously enhanced EPCs proliferation, migration, adhesion, tube formation and eNOS protein expression in vitro (P<0.01). After one week, immunofluorescence staining showed that endothelial regeneration rate obviously enhanced in shear stress+SBP group (P<0.01). The present study demonstrates that shear stress can promote function of endothelial progenitor cells treated with SBP, which improves the vascular injury repair potentials of EPCs.
Animals ; Cell Adhesion ; Cell Movement ; Cell Proliferation ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Progenitor Cells ; cytology ; drug effects ; Endothelium, Vascular ; Nitric Oxide Synthase Type III ; metabolism ; Rats ; Regeneration ; Stress, Mechanical

Objective:To explore the application effect of small private online course (SPOC) teaching mode in clinical practice teaching of thoracic surgery.Methods:A total of 56 undergraduate students who were internships from May to July 2018 were selected as subjects. They were randomly divided into experimental group and control group. SPOC teaching mode and traditional teaching mode were respectively adopted in the practice teaching, and the teaching effect was evaluated by questionnaires and written examinations. SPSS 22.0 was used for statistical analysis, ttest for independent-sample test, and chi-square test for counting data. There were significant differences when P<0.05. Results:The questionnaire showed that the six teaching effect evaluation indicators of the experimental group were higher than those of the control group ( P<0.01). In terms of written test assessment, the average score of the experimental group was significantly higher than that of the control group, with significant differences ( P<0.05). Conclusion:The SPOC teaching mode can improve the teaching effect of clinical practice in thoracic surgery and improve students' self-learning ability.

Objective To study the best combination of respiratory parameters that can maintain good ventilation with a low airway pressure under general anesthesia and CO2 pneumoperitoneum (12 mm Hg) during laparoscopy, which is important for lung protections. Methods Basic respiratory parameters of anesthesia machine, respiratory frequency (f), tidal volume (VT), and respiration ratio (I∶E), were used as three factors A, B, and C. The there levels were set as f=15, 12, and 9 bpm; VT =8, 10, and 12 ml/kg body weight; and I∶E =1∶2.5, 1∶2.0, and 1∶1.5. L9(34) K=3 was adopted for repeated orthogonal experimental design. The effect of different combinations of respiratory parameters on peak inspiratory pressure (PIP), mean airway pressure (Pmean),and end-tidal carbon dioxide partial pressure (PETCO2), were analyzed statistically. Results During the laparoscopy, the vital signs of 27 patients were stable under general anesthesia with 9 combinations of the respiratory parameters, the SpO2 was maintained at 100%, and the PEEP was kept at 1 hPa. The effect of the three levels of VT (factor B) on PIP was not significant (P=0.074). While the effects of f (factor A) on PETCO2 and I∶E on Pmean were significantly different among the three levels (P=0.002 and P=0.017, respectively). Conclusion The best combination of three factors-levels respiratory parameters is not small tidal volume with fast frequency or large tidal volume with slow frequency, but is A2B2C2 (f=12 bpm, VT=10 ml/kg body weight, and I∶E=1∶2.0).

Objective To study the correlation of replication efficiency and antigen expression of hepatitis B virus (HBV) strains in patient sera and transfected cells. Methods Quantification of five maternal serum HBV DNA was carried out using dot hybridization and polymerase chain reaction-enzyme linked immunosorbent assay (PCR-ELISA), hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) levels in the sera were determined by ELISA. Full-length genomes of HBV strains cloned from five pregnant women were separately used to transfect HepG2 cells. The levels of HBsAg and HBeAg in the supernatant of transfected cells were determined with Abbott EIA kits, the replication efficiency of intracelluar replicative intermediates and extracellular HBV DNA of viral particles was analyzed by Southern blot and hybridization. Results Intracellular and extracellular HBV replication and antigen expression of cloned HBV strains showed positive correlation tendency with the HBV DNA and antigen levels in serum samples. Conclusions Virus replication efficiency and expression of HBsAg and HBeAg by full-length HBV clones are in relative coincidence with the biological characteristics of HBV strains in patients. Cell transfection can be used to study the biological characteristics of individual isolates.