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.

Objective:To research the efficacy and safety of fluticasone propionate spray for allergic rhinitis children suffering with adenoidal hypertrophy. Methods:Totally 160 allergic rhinitis with adenoids growth children were in the observation group, in which 109 cases were diagnosed as adenoidal hypertrophy. Totally 157 adenoids growth children were in the control group, in which 114 cases were diagnosed as adenoidal hypertrophy. The two groups both received fluticasone propionate spray treatment for 3 months, and then the nasal endoscopic adenoidectomy volume, symptom score and adverse reactions were observed and analyzed. Results:Allergic rhi-nitis children suffering with adenoidal hypertrophy were mainly in the 3-6-year-old children. After the treatment, adenoids was shrinked in 88 patients (80. 73%) in the observation group, which was significantly higher than that in the control group [67(58. 77%), P<0. 01]. Adenoidal hypertrophy was still in 44 patients (35. 03%) of the observation group after the treatment, which was lower than that of the control group [55(68. 13%), P <0. 05]. In addition, the integral differences of nasal congestion, snoring and mouth breathing in the observation group after the treatment were higher than those in the control group, and the differences were statistically significant (P<0. 05). Conclusion:The efficacy of fluticasone propionate spray used in allergic rhinitis children suffering with adenoi-dal hypertrophy is more obvious than that in adenoid hypertrophy children, which can more significantly improve the symptoms of nasal congestion, snoring and mouth breathing.

Objective To investigate a expander placement technique for fast tissue expansion. Methods Port-free thin wall expanders with long tube were specially made and tested on 45 cases of patients with skin scar. All expanders were placed subcutanuously through intralesional perpendicular short incisions with injection tube laid out. A large amount of saline was injected to expanders intraoperatively. Three sorts of fast expansion were carried out. Results Under the local tumescent anaesthesia, subcutaneous pockets were all dissected successfully. The amount of bleeding was less and no patient received blood infusion. All of forty five cases completed fast expansion satisfactorily without incision infection and dehiscence. Conclusion The technique of intralesional perpendicular short incisions has the advantages of less invasion and better safety, and suitable for fast tissue expansion.

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.

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).