Objective To investigate the effect of intensive insulin therapy in parenteral nutrition for patients with abdominal operation.Methods 50 patients with 1 week or more complete intestinal nutrition after abdominal surgery and parenteral nutrition stress hyperglycemia were selected and randomly divided into control group (25 cases) and treatment group (25 cases).The control group adopted conventional insulin treatment(10.0 ~11.1 mmol/L blood glucose target value),the treatment group adopted intensive insulin treatment (7.8 ~10.0 mmol/L blood glucose target).The blood glucose time,hospitalization time and cost were compared between the two groups,and the occurrence of complications was recorded.Results In the treatment group,the blood sugar control standard time was (5.16 ±1.25)d,hospitalization time was (7.69 ±2.14)d,which were shorter than those in the control group,the hospitalization expense in the treatment group was (1 045.16 ±114.17)yuan,which was lower than (2 217.18 ± 242.18)yuan of the control group,the differences were statistically significant(t =6.460,6.270,14.499,all P <0.05).The incidence rate of complications of the treatment group was 8.00%,which was significantly lower than 28.00% of the control group,the difference was statistically significant (χ2 =13.550,P <0.05).The mortality rate of the treatment group was 4.00%,which of the control group was 8.00%,the difference was not statistically signifi-cant between the two groups(χ2 =1.418,P =0.233).Conclusion Intensive insulin therapy can effectively control the blood glucose level in patients with non diabetes after abdominal operation,and can reduce the incidence of complications,it is worthy of recommending.

Objective To identify the factors related to the influence of medical research papers. Methods The influence of 1146 research papers by the hospital in the period 1996-2003 and its relationship with such factors as the backgrounds of the authors and the quality of the papers were studied u-sing regression analysis. Results Nine factors, including the impact factor, the status of the paper (being or not being one based on fund-supported research or representing research achievements), and the status of the author (being or not being chosen for talent cultivation and undertaking or not undertaking research projects), were significantly correlated with the influence of the papers. Conclusion In order to enhance the influence of medical research papers, it is necessary for research' management departments not only to encourage research personnel to publish papers in journals with high impact factors but also to step up efforts to better personnel cultivation, degree education, and project and achievement management so as to set up a quality and distinguished research contingent.

Objective To study the significance of S100A12 in patients with acute pancreatitis (AP).Methods 139 patients with AP were divided into the severe acute pancreatitis (SAP) and moderate acute pancreatitis (MAP) groups.61 patients in the SAP group were further subdivided into the infection group (n =32) and the non-infection group (n =29) based on the presence/absence of secondary infection.Serum samples of these patients were collected on the 3rd,7th and 14th day after treatment.ELISA was used to determinate the S100A12,IL-1 β and IL-6 levels in serum.The area under ROC was used to evaluate the predictive role of S100A12,IL-1β,IL-6 and CRP for infection in patients with SAP.Results The S100A12,IL-1β and IL-6 levels in SAP patients were markedly higher than those in MAP patients and normal controls on the 3rd,7th and 14th day after treatment.These levels decreased toward normal range in MAP patients.They were persistently high in SAP patients after treatment for 7 days,but decreased significantly after 14 days.The serum levels of S100A12,IL-1β,IL-6 and CRP were significantly higher in the infection subgroup(647.5 ± 300.1,155.9 ±48.5,95.7 ±25.5,166.8 ±53.0) than the non-infection subgroup(249.0 ± 176.3,108.0 ± 46.1,64.0 ±38.5,117.9 ±34.9) (P ＜0.05).The sensitivity and specificity of serum S100A12 in diagnosing secondary infection in SAP were 96.8％ and 83.3％,which were higher than those of serum IL-1β,IL-6 or CRP.Conclusion The level of S100A12 was associated with systemic inflammatory response syndrome (SIRS) in AP,and it may serve as a new marker in early diagnosis of SAP and in secondary infection in SAP.

Objective To investigate the health care workers'(HCWs) knowledge and attitude towards perioperative warming as well as patients' warming status, provide reference for warming in perioperative period and reduce surgical site infection(SSI).Methods Convenience sampling was used to select 198 HCWs in surgical department and operating room as well as 160 patients undergoing operation.HCWs were investigated by referring foreign literatures and designing questionnaires, on-site observation method was used to collect information about warming measures implemented for surgical patients.Results The median (quartile range) of scores of HCWs' knowledge and attitude towards patients' perioperative warming were 9 (2.25) and 25 (1.25) respectively.There was no statistical significance in scores of knowledge and attitude among HCWs with different age, education degree and occupation(all P>0.05).The awareness rates of hypothermia, active warming, and passive warming modes were 21.21%, 43.94%, and 30.81% respectively.80.30%, 89.90%, and 86.36% of HCWs thought that it was essential to keep warming before, during and after surgery.68.13% of surgical patients were warmed by covering cotton quilt and shoulder pad during operation.Conclusion HCWs hold positive attitude towards perioperative warming, but they lack sufficient knowledge about perioperative warming, it is necessary to improve facilities of perioperative warming.

Objective To evaluate the colon cleaning efficacy and safety of prucalopride combined with polyethylene glycol electrollytes powder in bowel preparation for colonoscopy examination and treatment under colonoscopy in elderly patients.Methods Elderly patients who prepared for colonoscopy were enrolled from October 2014 to January 2015.They were divided into group A,B and C.Patients of group A only took polyethylene glycol electrolyte powder (137.12 g dissolved in 2 000 mL warm water,stired until completely dissolved),patients of group B took polyethylene glycol electrolyte powder (same usage as group A) combined with prucalopride 2 mg/d for one day,patients of group C took polyethylene glycol electrolyte powder (same usage as group A) combined with prucalopride 2 mg/d for three days.The bowel preparation effects,especially ascending colon and ileocecal junction and cardiovascular adverse effects in all the patients and constipation patients of three groups were compared.Student t test,chisquare test and analysis of variance were performed for statistical analysis.Results A total of 124 elderly patients were divided into group A (64 cases),group B (23 cases) and group C (37 cases).Bowel preparation scores of total colon and ascending colon-ileocecal junction of group A,B,C were 8.34±0.90 and 2.56±0.56,8.96±0.21 and 2.96±0.21,8.86±0.35 and 2.86±0.35,respectively.The cleaning effects in total colon and ascending colon-ileocecal junction of group B were better than those of group A (t=5.52 and 5.15,both P＜0.05).The cleaning effects in total colon and ascending colon-ileocecal junction of groupCwere better than those of group A (t=4.69,3.65,both P＜0.05).There was no statistically significant difference between group B and group C in cleaning effects in total colon and ascending colon-ileocecal junction (both P＞0.05).There were 33,11 and 29 constipation cases in group A,B and C,respectively.The bowel preparation scores for total colon and ascending colon and ileocecal junction of group A,B,C were 7.85±0.94 and 2.24±0.56,8.91±0.30 and 2.91±0.30,8.83±0.38 and 2.83 ± 0.38,respectively.The cleaning effects in total colon and ascending colon-ileocecal junction of group B were better than those of group A (t=6.72 and 5.49,both P＜0.05).The cleaning effects in total colon and ascending colon-ileocecal junction of group C were better than those of group A (t=104.04 and 59.65,both P＜0.05).There was no significant difference between group B and group C in cleaning effects in total colon and ascending colon ileocecal junction (both P＞ 0.05).No obvious cardiovascular adverse events were observed in the patients of three groups.Conclusions The cleaning effects of prucalopride combined with polyethylene glycol electrolytes powder are good for colonoscopy examination in elderly patients,including elderly patients with constipation,especially in ascending colon and ilecocecal junction.No obvious cardiovascular adverse events are observed.

ObjectiveTo explore the effect of left move and twists of I/t curve on predicting prognosis of facial paralysis.Methods181 cases with 171 Bell's palsy and 10 Hunt's syndrome were examined with I/t curve of frontal muscle and upper orbicularis. The assessing criterion of diseases course was determined according to the recovery time of frontal muscle evaluated by raising eyebrow, the recovery time of orbicularis ascertained by House-Brackmann Ⅰ, Ⅱ grades and stable phase in partial moderate and severe facial paralysis.ResultsThe recovery time of frontal muscle and orbicularis between twist and non-twist in I/t curve and in sex was not significant. The left move of I/t curve was confined to slight, moderate and severe arranges; the recovery time was not significant also. Twist rate in I/t curve was highest in moderate facial paralysis and then second in orbicularis of slight paralysis. The left move of I/t curve had a very significant relationship with recovery time of frontal muscle and orbicualris.ConclusionThe left move of I/t curve plays a very important role in determining nerve injury degrees and predicting prognosis of facial paralysis.

The curcumin prodrugs, which could be selectively activated in tumor cells, were prepared to establish a basis for the targeted chemotherapy for cancer. On the basis of the molecular structure of curcumin, the N-maleoyl-L-valine-curcumin (NVC), N-maleoyl- glycine-curcumin (NGC) were chemically synthesized and identified by IR and NMR spectroscopy. After treatment with these two prodrugs for 6 - 24 h, the rates of growth inhibition on human bladder cancer EJ cells and renal tubular epithelial (HKC) cells were detected by MTT colorimetry. Our results showed that after the treatment with 20 micromol/L - 40 micromol/L NVC and NGC for 6 - 24 h, the growth inhibitory effects on EJ cells were 6.71% - 65.13% (P < 0.05), 10.96% - 73.01% (P < 0.05), respectively, in both dose- and time-dependent manners. When compared with the curcumin of same concentrations, the growth inhibitory effects of these two prodrugs on HKC cells were significantly decreased (P < 0.01). It is concluded that activation of curcumin prodrugs via hydrolysis functions of cellular esterase could inhibit the growth activities of tumor cells, and reduce the side effects on normal diploid cells. This provided a novel strategy for further exploration of tumor-targeted chemotherapeutic drugs.
Antineoplastic Agents, Phytogenic/*pharmacology ; Curcumin/*pharmacology ; Dose-Response Relationship, Drug ; Prodrugs/*chemical synthesis ; Prodrugs/*pharmacology ; Tumor Cells, Cultured ; Urinary Bladder Neoplasms/*pathology

Objective To explore the association between genetic polymorphisms and haplotypes of tumor necrosis factor-related apoptosis inducing ligand (Trail) and ulcerative colitis (UC).Methods A total of 331 patients with UC and 832 age and sex-matched healthy controls were collected.After Trail gene was amplified by PCR,the genetic polymorphisms of three single nucleotides (G1525A/G1588A/C1595T) in 3' non coding regions of Trail gene were examined by direct sequencing.The relation between Trail haplotype and UC was analyzed.Results Compared with control group,the frequencies of variant allele A and genotype GA+ AA in Trail G1525A were significantly lower in UC group (both P＜0.01).The frequencies of variant allele A and T in Trail G1588A and C1595T were also significantly lower in UC group than that of control group,and the difference was statistically significant (both P ＜ 0.01 ).In mild and moderate UC patients,the frequencies of variant allele T and CT+TT in Trail C1595T were 49.15％ and 64.51％,in severe UC patients were 72.37％ and 84.21％,and the differences were significant between the two groups (OR=2.710 and 2.935,95％CI:1.598～4.596 and 1.188～7.249,all P ＜0.05).In severe UC patients,the frequency of variant allele A in Trail G1525A was 48.69％,which was higher than that of mild and moderate patients (35.16％,OR=1.750,95％CI:1.082～2.830,P=0.021).In UC group,the frequency of AAT haplotype was significantly lower than that of controls (43.09％ vs 58.41％,P＜0.01).The frequency of GAT haplotype was significantly higher in UC group (10.15％vs 0.18％,95％ CI:0.005 ～ 0.051,P＜ 0.01).Conclusion The genetic polymorphisms and haplotypes of Trail (G1525A/G1588A/C1595T) gene may be closely correlated with the susceptibility to UC.

Objective To analyze the association of Crohn's disease(CD)with vitamin D receptor(VDR) gene polymorphisms. Methods After collecting 326 CD patients and 464 healthy controls,the four single nucleotide polymorphisms of VDR (FokI, BsmI, ApaI and TaqI) were examined by a SNaPshot technique. Results Compared with those in controls,the frequencies of mutant allele(A)and genotype(GA+AA)of BsmI were significantly decreased in CD patients(both P=0.001). The similar conclusions were also drawn for the mutant allele(C)and genotype(TC+CC)of TaqI(both P<0.05). In further stratified analysis,compared with those in controls,the mutant alleles and genotypes of BsmI and TaqI were significantly reduced in stenotic type CD patients (all P<0.0083). The analyses of linkage disequilibrium(LD)and haplotype showed that BsmI,ApaI and TaqI were in a strong LD,and the formed haplotype AAC was significantly lower in CD patients than that in controls (P <0.05). Conclusions VDR(BsmI and TaqI)polymorphisms are significantly related with the reduced susceptibility to CD,especially for patients with stenotic CD. Moreover,the haplotype AAC might engender a reduced risk of CD.