Objective To evaluate the influence of diet structure and physical activity on the lipid level in different area of China.Methods A total of 145 people were selected by simple random sampling,including 52 residents,45 urban residents of Panzhihua and 48 rural residents of Panzhihua,each of them undergoing the laboratory examination and dietary and physical activity survey.Food frequency questionnaire and physical activity questionnaire were used.Results The blood sugar,TC and LDL-C level in Shanghai residents were higher than those of urban and rural residents of Panzhihua(P0.05)while the energy exhaust of Shanghai residents was higher than those of urban and rural residents of Panzhihua(P

Glioblastoma multiforme (GBM,WHO grade IV) contains some glioma stem cells which have unique self-renewal capacity and multilineage potency.There are numerous neural stem cells in the subventricular zone (SVZ) of adult human brain;it may also act as a storehouse of glioma stem cells that can promote the development and recurrence of a tumor.GBM involving SVZ is prone to early recurrence and intracranial metastasis after resection,so irradiation of the SVZ potentially influences the survival of GBM patients.This review provides a summary of related experimental and clinical studies,and discusses the value of irradiation of the SVZ in GBM patients and the direction of future research.

Chemoradiotherapy is a major treatment for inoperable esophageal carcinoma (EC).However, there is still controversy over the target volume for radiation, particularly nodal target volume.EC is characterized by a high rate of lymph node metastasis, and its metastatic pattern is not always predictable.Elective nodal irradiation (ENI) will increase the radiation field, which may increase the incidence of adverse events.Some investigators used involved-field irradiation (IFI) to reduce treatment-related toxicities without compromising survival.Studies have demonstrated that regional and distant micrometastases can be controlled, to some extent, by chemotherapy, incidental irradiation, and the abscopal effects of radiation.With either ENI or IFI, EC recurrence is usually found in the primary tumor and at distant sites, without survival difference.These data suggest that IFI is feasible in EC patients.

Surgery remains an important therapeutic method for localized esophageal cancer, but the 5?year survival rate of patients undergoing surgical resection alone is only 20%?25%. Early studies show that postoperative radiotherapy reduced regional recurrence rate, but did not increase the survival rate. Most recent studies show that stage Ⅲ or lymph node?positive patients can obtain survival benefit from postoperative radiotherapy, and patients in pT2?3 N0 M0 stage may also benefit from postoperative radiotherapy. The recommended radiotherapy target volumes include bilateral supraclavicular areas, superior mediastinum, subcarinal area, and tumor bed. It is recommended in most studies that regional lymph nodes in the upper abdomen should be included in patients with lower?segment lesions. The locally advanced patients may benefit more from postoperative radiotherapy combined with chemotherapy. The significance of postoperative radiotherapy for esophageal squamous cell carcinoma, target volume design, and combined chemotherapy need individualized consideration and more clinical evidence.

Objective To investigate the genetic diversity of variable number tandem repeats (VNTR) of Mycobacterium tuberculosis (M,ib) isolates and their impact factors on transmission.Methods A total of 1 310 patients with smear-positive pulmonary tuberculosis registered during 2013 from 30 counties of drug-resistance monitoring sites in Guangxi were enrolled.The VNTR genotyping technique was used to identify and analyze M.tb genotypes.Count data was analyzed by Chi-square test using descriptive statistical method,unconditioned Logistic regression was used to analyze the characteristics of gene clusters.Results A total of 1 310 strains of M.tb were classified into 964 genotypes,of which 779 strains were classified into a single gene cluster,531 strains were classified into 185 clusters.Each cluster contained 2 to 40 strains (mean 6.6).Patients aged between 41 and 60 years old had a highest gene cluster proportion (45.5％).Seven hundred and forty-six strains were Beijing genotype,while 564 were nonBeijing genotype,among which 7.4％ was original Beijing genotype.The estimated recent infection (cluster rate) was 26.41％.The cluster rate was higher in sensitive strains (24.40％) than in drugresistant strains (9.55 ％,x2 =23.621,P =0.000) and multi-drug resistant (MDR) strains (8.97 ％,x2=-9.675,P=0.002),and that was higher in Beijing genotype (28.69％) than Non-Beijing genotype (23.40％,x2 =4.610,P=0.032).The clusters proportion in sensitive strain (37.43％) was higher than drug-resistant strains (14.09％) and MDR strains (15.38％),and that was higher in Beijing genotype (40.88％) than Non-Beijing genotype (37.77％).Conclusions M.tb genetic polymorphisms display highly diversity in Guangxi region.Sensitive strains and Beijing genotype strains are the main epidemic strains.

Objective To evaluate the clinical significance of direct trocar insertion using optical trocar in the establishment of the primary port during trans-peritoneal laparoscopic surgical procedures.Methods A prospective study was conducted by collecting the data of 120 patients who should be performed abdominal laparoscopic surgery from April 2015 to December 2015.The 120 patients were randomly divided into a research group and a control group.The research group consisted of 34 male patients and 26 female patients,mean age was (52.0 ± 11.9) years and mean BMI was (24.9 ± 2.9) kg/m2.In research group,patients were positioned laterally with the flank padded and elevated.A predetermined position was drawn prior to surgery between the umbilicus and lateral rectus abdominis,for the creation of the primary laparoscopic trocar port.The predetermined point was incised,and then the method of direct trocar insertion using the optical access trocar was used for establishment of the primary port.After this maneuver was completed the surgery continued as indicated.The control group consisted of 36 male patients and 24 female patients,whose mean age was (52.9 ± 11.4) years and mean BMI was (25.2 ± 2.4) kg/m2.This group underwent the traditional method of port construction by incision into the abdomen.The time of constructing the passage,leakage rate,bleeding rate,and injury rate of abdominal organs were compared.Results In research group,the time of building primary port was clearly shorter than that in control group (2.7min vs.15.9min,P ＜ 0.05),the leakage rate was also obviously reduced compared to that in control group (0 vs.30％,P ＜ 0.05).Neither groups observed any significant bleeding nor visceral organ damage throughout the study.Conclusion Direct trocar insertion using optical trocar to establish observation port is a highly efficient and safe method in trans-peritoneal laparoscopic operation,which should be research thoroughly in clinical practice.

Objective To compare the accuracy of blood volume perfusion imaging (perfusion CT)with contrast enhanced 64-slice spiral computed tomography (CECT) in the evaluation of gross tumor volume (GTV) and clinical target volume (CTV) using rabbits with VX2 brain tumor. Methods Perfusion CT and CECT were performed in 20 rabbits with VX2 brain tumor. The GTV and CTV calculated with the maximal and minimal diameter of each tumor in the blood volume (BV) maps and CECT were measured and compared to those in pathological specimens. Results The mean value of the maximal and minimal diameter of GTV was (8.19 ± 2. 29) mm and (4.83 ± 1.31) mm in pathological specimens, (11.98 ±3.29) mmand (7.03±1.82) mm in BV maps, while (6.36±3.85) mm and (3.17±1.93) mm in CECT images, which were significantly different (pathological specimen vs. BV map, t = 7. 17,P =0. 000;pathological specimen vs. CECT, t = 8.37, P = 0. 000, respectively). The mean value of the maximal and minimal diameter of CTV in pathologic specimens was (12.87 ± 3.74) mm and (7.71 ± 2. 15) mm, which was significantly different from that of GTV and CTV in CECT (t = - 3. 18, P = 0. 005 and t = - 4. 24, P =0. 000;t= -11.59,P=0.000 and t= -9.39,P=0.000), while similar with that of GTV in BV maps (t = - 1.95,P = 0. 067; t = - 2. 06, P = 0. 054). For CECT, the margin from GTV to CTV was 81.83% ±40.33% for the maximal diameter and 276.73% ± 131.46% for the minimal. While for BV maps, the margin was 7.93% ± 17. 84% and 12.52% ± 27. 83%, which was significant different from that for CECT images (t=7.36,P=0. 000 and t= -8.78,P=0.000). Conclusions Compared with CECT, the BV map from 64-slice spiral CT peffusion imaging might have higher accuracy in target volume delineation for brain tumor.

Objective　To compare the irradiation-protective and inter-synergestic effects of E838,WR-2721, Rubia cordifolia, cystamin e hydrochloride and ethinyl estradiol on radiation and combined radiation-burn injury. Methods　Above-mentioned drugs were given to the mice i ntraperitoneally, or intragastrcally, then, the mortality and the average surviv al d for 30 d were observed before and after the administration of the drug s. Results　①When drugs were before injury , the survival rate and the average survival d of the radiation and combined radiation-burn injured mice were increased obviously with the best effect in E838 and WR-2721. ②When drugs were given after injury, E838 and R. cordifolia also kept the effect. ③Combined appling WR-2721（pre) and E838（post）displayed a significant syner gistic reaction. Conclusion　E838 and WR-2721 are more e ffective than the others in the prevention of radiation.

Objective To investigate the effects of high energy enteral nutrition (EN) on nutritional status and immune function in patients with heart failure caused by pulmonary cardiac disease. Methods Eighty-six patients with heart failure caused by pulmonary heart disease were continuously collected from March 2017 to March 2018 in the Department of Critical Care Medicine of Taizhou First People's Hospital, and they were divided into a high-energy EN group and a standard EN group according to the different use of EN preparations, each group with 43 cases. The high-energy EN group were treated with high energy EN solution TPF-T (Ruineng), and the standard EN group were treated with standard EN solution TP (Ruisu); the initial EN infusion velocity in all the patients was 25 mL/h, the calorific calorie would reach the target to 104.6-125.5 kJ·kg-1·d-1, and the protein would target to 1.5-2 g·kg-1·d-1 within 3 days;the blood glucose was controlled within the scope of 7.8-11.1 mmol/L. The differences in rates of calorie and protein goal targeting situations, nutritional status, inflammatory response and immune function were compared between the two groups. Results From the 3rd day to 7th day after EN application, the rates of calorie and protein goal targeted in the high-energy EN group were significantly higher than those in the standard EN group [calorie targeted rate: 69.77% (30/43) vs. 41.86% (18/43), protein targeted rate: 25.58% (11/43) vs. 11.63% (5/43), all P < 0.05]. With the extension of EN application, nutritional indexes such as albumin (Alb), prealbumin (PA), transferrin (TRF), etc. and the immune indexes such as human leucocyte antigen (HLA)-DR positive rate, immunoglobulins (IgA, IgG), etc. were persistently increased in both groups, reaching the peak values on the 7th day, and the indexes in high-energy EN group were significantly higher than those in the standard EN group [Alb (g/L): 36.43±5.81 vs. 33.79±5.34, PA (mg/L): 278.83±47.56 vs. 251.67±41.92, TRF (mg/L): 3.58±0.64 vs. 3.26±0.81, HLA-RD positive rate: (53.22±6.11)% vs. (50.21±5.69)%, IgA(mg/L): 165.34±40.13 vs. 141.54±38.76, IgG (mg/L): 4 990.68±881.66 vs. 4 211.75±861.54, all P < 0.05]. However, the levels of inflammatory factors such as C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in both groups were gradually decreased, reaching the valley values on the 7th day, and the indexes in high-energy EN group were significantly lower than those in the standard EN group [TNF-α(ng/L): 14.43±8.69 vs. 20.59±9.45, CRP (mg/L): 21.33±6.35 vs. 27.36±7.83, all P < 0.05]. Conclusion High energy EN not only can improve the nutritional status in patients with pulmonary heart failure, but also can reduce patients’ inflammation response and elevate their immune function.

Objective To investigate the effects of different early enteral nutrient (EN) emulsions of TPF-T and TP on nutritional status and intestinal mucosal barrier in patients with septic shock. Methods From May 2017 to May 2018, 112 patients with septic shock were continuously enrolled in the Department of Intensive Care Unit of the First People's Hospital of Taizhou, and they were randomly divided into a TPF-T group and TP group, each group with 56 cases. After admission, the patients in both groups were all treated according to the 2016 Saving Sepsis Campaign (SSC) Guidelines for septic shock. Both groups were supported with EN, TPT-T group was given TPF-T EN emulsion rich in fish oil, while TP group was supported with standard TP EN emulsion, and the therapeutic course was consecutive 7 days in both groups. The differences in nutritional status, inflammatory response, immune function, intestinal mucosal barrier, gastrointestinal symptoms and prognosis were compared between the two groups. Results After EN, the nutrition indicators such as albumin (Alb), prealbumin (PA), transferrin (TRF) and immune indexes (IgA, IgG), human leukocyte DR antigens (HLA-DR) and D-lactic acid were increased in both groups, reaching the peaks on the 7th day after EN application, Alb, PA, TRF, IgA, IgG, HLA-DR in the TPF-T group were significantly higher than those in the TP group [Alb (g/L): 34.43±5.81 vs. 33.59±5.34, PA (mg/L): 269.83±47.56 vs. 252.67±41.92, TRF (g/L): 3.43±0.64 vs. 3.32±0.81, IgA (mg/L): 159.45±34.56 vs. 143.31±33.81, IgG (mg/L): 4 947.68±871.66 vs. 4 583.75±841.54, HLA-DR: (68.22±9.11)% vs. (62.21±9.69)%], and after EN, the D-lactic acid in the TPF-T group was significantly lower than that in the TP group (mg/L: 30.42±6.79 vs. 33.34±7.31). The inflammatory indicators of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), procalcitonin (PCT), endotoxin and diamine oxidase (DAO) were all gradually reduced in two groups, reached the lowest levels on the 7th day after EN application, and all the above-mentioned indicators in the TPF-T group were significantly lower than those in the TP group [TNF-α (ng/L):95.43±20.69 vs. 109.59±23.45, CRP (mg/L): 21.33±16.35 vs. 32.36±17.83, PCT (μg/L): 1.24±1.21 vs. 4.18±1.32, endotoxin (U/L): 10.32±2.31 vs. 11.54±2.69, DAO (g/L): 19.45±8.49 vs. 25.47±9.41]. The incidences of gastric retention, diarrhea and paralysis of lower digestive tract in TPF-T group were significantly lower than those in TP group [gastric retention: 14.29% (8/56) vs. 32.14% (18/56), diarrhea: 12.50% (7/56) vs. 35.71% (20/56), paralysis of lower digestive tract: 7.14% (4/56) vs. 23.21% (13/56)], the length of hospital stay was significantly shorter in the TPF-T group than that in the TP group (days: 18.77±5.08 vs. 21.71±6.67, P < 0.05); however, there was no significant difference in mortality between the two groups [14.29% (8/56) vs. 21.43% (12/56), P > 0.05]. Conclusion TPF-T could more effectively maintain nutritional status, reduce inflammatory reaction, improve immunity, protect intestinal mucosal barrier function, and has fewer adverse reactions, which was helpful to improve the prognosis of septic shock patients.