Objective To compare the efficiencies of enteral nutrition with nasogastric tube with that of enteral nutrition with endoscopic gastrostomy tube in ICU long-term bedridden patients. Methods A total of 6 patients who were admitted in our ICU between January 2008 and September 2009 were enrolled in this study. The expected completion of daily calorie supply, completion of total volume of nutrient fluid feeding, nutrient fluid backstreaming condition, and incidence rate of tube obstruction were compared between those supported with nasogastric tube and endoscopic gastrostomy tube. Results The completion of daily calorie supply and completion of total volume of nutrient fluid feeding were significantly superior in patients who were supported with endoscopic gastrostomy tube than those with nasogastric tube (P = 0. 002 and P = 0. 008, respectively). In addition, nutrient fluid backstreaming condition and incidence rate of tube obstruction were significantly lower than with nasogastric tube (P= 0. 011 and P = 0. 021, respectively). Conclusion Enteral nutrition with endoscopic gastrostomy tube is more efficient in reaching the nutrition support target than with nasogastric tube.

This study was aimed to explore factors related to microalbuminuria of early stage of diabetic nephropathy (DN). Through epidemiologic survey, syndrome data of patients with early stage of DN were collected. The analysis was made on relationship between MAU (strain) of early stage of DN patients and the influencing factors (variable) with logistic regression analysis. The influencing factors were investigated in the early stage of DN patients in MAU. The epidemiological study showed a close relationship between factors such as active living style, easy irritability, drinking, old age, long disease course, phlegm and dampness body constitution, qi-stagnation body constitution, purple or dark tongue, thin and rapid pulse, yin deficiency and heat pattern, qi-yin deficiency pattern, cold and dampness pattern with the incidence of early stage of DN. It was concluded that there were 114 cases of early stage of DN with MAU of 20-52 μg·mL-1. The risk factors contained easy irritability, qi-stagnation body constitution, purple or dark tongue, yin deficiency and heat pattern, qi-yin deficiency pattern, as well as cold and dampness pattern. The protective factor contained active living style. There were 95 cases of early stage of DN with MAU of 53-199 μg·mL-1. The risk factors contained drinking, old age, long disease course, phlegm and dampness body constitution, as well as thin and rapid pulse.

0.05),but for patients with mild disease,active angle reproduction

Objective To explore the potential impact of low concentration of metformin on the morphology and function of mitochondria of HepG2 cells. Methods HepG2 cells in experimental group and control group were treated with or without low concentration of metformin (1mM/L), respectively. The cells were incubated for 12h in the incubator with constant temperature and humidity as well as 1% oxygen. Orange Mitoview was used to stain the mitochondria to detect the effects of the drug on its morphology and quantity. Transmission electron microscope was utilized to observe the effect of metformin on the ultrastructure of mitochondria. The mitochondrial respiratory chain complex I activity in HepG2 cell was detected by Complex I Enzyme Activity Dipstick Assay Kit (DAK). Results Orange Mitoview staining showed that low concentration of metformin had little effect on the morphology and number of mitochondria of cells in experimental group , and the difference between control and experimental group was not statistically significant (P > 0.05). In addition, the result was further determined by transmission electron microscopy. However, DAK analysis showed that complex I activity of cells in experimental group was significantly lower than that in control group. Conclusion Under Hypoxia conditions, low concentration of metformin had no significant effect on the morphology and number of mitochondria of HepG2 cells, but it significantly reduces the activity of mitochondria of HepG2 cells.

Objective To evaluate the operative techniques and the methods of the renal function protection in laparoscopic nephron sparing surgery for the treatment of renal tumors.Methods Thirty-six renal tumor patients accepted transperitoneal laparoscopic partial nephrectomy at the 70 degree lateral decubitus position.There were 17 tumors in the upper pole,13 in the lower pole and 6 in the center of kindey.The mean tumor diameter was 2.6 cm(from 0.8 to 4.0 cm).Peke forceps were used to clamp the renal artery and achieve warm ischemia.Cold scissors was used to resect tumors and Hem-o-lok was used to clamp and control the artery bleeding in surgical bed instead of ligature when suturing the kidney parenchyma.Ulinastatin was used to prevent and relieve the ischemical reperfusion injury.The operative time,estimated blood loss,warm ischemia time,intraoperative and postoperative complications and the operative efficacy were recorded.Results All operations were completed successfully,no case was converted to open surgery.The mean operative time was 128 min(95 to 186 min),mean estimated blood loss was 130 ml (40 to 600 ml),mean warm ischemia time was 21 min(16to 28 min).There was no hemorrhage and urinary leakage after surgery.The post-operative renal function was normal in all the cases.The histopathological examination showed that 36 cases were renal cell carcinoma including 31 pT1a,cases and 5 pT1b cases.There was no positive surgical margin.The mean follow-up time was 16 months (from 6 to 30 months).There was no recurrence and metastasis found and renal function was normal in all cases during the follow-up.Conclusions Laparoscopic nephron sparing surgery for renal tumors is a safe and feasible treatment option.This procedure can resect tumor safely and preserve renal function efficiently.The use of Hem-o-lok instead of ligature can significantly reduce the operative time.Ulinastatin can help reducing the ischemical reperfusion injury and thus preserve renal function.

Objective To evaluate the sensitivity and speciality of protein chip technology, and discuss its value in diagnosis or classification of autoimmune diseases, and to make its methodological evaluation. Methods The anti-dsDNA was detected with gold-colloid assay, indirect immunoflurescence(IIF) assay and protein chip technology, respectively; the other seven autoantibodies including anti-SSA, anti-SSB, anti-Sm, anti-u1RNP, anti-Rib-P, anti-Scl-70 and anti-Jo-1 were simultaneously detected with immunoblotting(IBT) assay and protein chip technology, and then all the results were delt with statistical method. Results For anti-dsDNA, the sensitivity of protein chip technology was better than that of gold-colloid assay; there was significant difference between protein chip technology and IBT assay in detecting anti-Jo-1 in DM/PM(P

Objective To investigate the clinical efficacy of combination treatment of Ambroxol,Ipratropium and Budesonide during perioperative period in elderly patients with cardiac adenocarcinoma and chronic obstructive pulmonary disease(COPD).Methods A total of 126 elderly patients aged over 65 years diagnosed as cardiac adenocarcinoma and COPD were selected,and no chemotherapy was given to them before operation.Patients were randomly divided into experimental group(n＝ 62)and control group(n＝ 64).Intravenous infusion of Ambroxol hydrochloride and atomizing inhalation of Ipratropium were given in both groups,and the experimental group received budesonide additionally.The pulmonary function,postoperative pulmonary atelectasis,pulmonary infection,antibiotics application and hospitalization after operation were compared between the two groups.Results The forced expiratory volume at the first second(FEV1),forced vital capacity(FVC)and FEV1/FVC were higher in experimental group than in control group [(1.79 ± 0.52)1 vs.(1.33 ± 0.38)L,(2.44 ±0.43)Lvs.(1.93 ± 0.36)L and(73.91 ± 8.17)％ vs.(62.87 ± 7.23)％,respectively,allP＜0.05].The postoperative pulmonary atelectasis and pulmonary infection were lower in experimental group than in control group(4.8％ vs.15.6％,6.5％ vs.18.8％,respectively,both P＜0.05).The time for antibiotics application after operation had no difference between the two groups[(4.81±1.20) days vs.(5.98 ± 1.17)days,P ＞ 0.05].There was a significant difference in postoperative hospitalization between the two groups [(8.37 ± 0.27) days vs.(11.80 ± 0.33) days,P ＜ 0.05].Conclusions The combination treatment of Ambroxol hydrochloride,Ipratropium and Budesonide during perioperative period achieves better therapeutic effects than does the combination treatment of ambroxol hydrochloride and ipratropium in elderly patients with cardiac adenocarcinoma and COPD.

Objective To investigate the effect of knockdown or overexpression of G6PD on proliferation, growth and migration of human hepatocellular carcinoma cell PLC/PRF/5. Methods Lentivirus-mediated knock-down or overexpression of G6PD was achieved in human hepatocellular carcinoma cell line PLC/PRF/5. RT-PCR and Western blotting assay were used to detect the overexpression or knockdown of G6PD.Cell proliferation and mi-gration curves were recorded by real-time cell analysis system(RTCA),the cell proportion in the DNA replication phase can be directly displayed with EDU experiment,cell growth ability was detected by colony forming assay. Results The doubling time of cells in G6PD knockdown group was longer than that of the control group,and the cell growth rate decreased significantly,the proportion of cells in proliferative phase(43.2%)was lower than that in the control group,but the rates colony formation and migration were significantly decreased(P<0.05,respective-ly),and the migration curves separated apparently.While no significant differences in proliferation,growth and mi-gration of PLC/PRF/5 cells were found between the over-expressed strain and the control group. Conclusion The reduction of G6PD expression in HCC cells inhibits the proliferation and growth of HCC,which may lay a foun-dation for the further study of the pathogenesis and treatment of HCC.

Objective To compare and analyze the primary and secondary structures and antigenic epitopes of the two allergens: Der p 2 and Der f 2. Methods The protein sequences of Der p 2 and Der f 2 were downloaded online. The primary and secondary structures of the dust mite allergens were compared and analyzed bioinformatically to determine the potential epitope and signal peptide sites. Results Both Der p 2 and Der f 2 contained 146 amino acids and 9 potential protein binding sites with a secondary structure that mainly contains [3 - sheets, and there might be signal peptides site at the 1st 17th segment of the N - terminus. B cell epitopes analysis revealed that both Der p 2 and Der f 2 have 9 potential linear B epitopes and 2 conformational B epitopes. NetMHCⅡserver prediction showed Der p 2 contains 6 high affinity sites, whereas Der f 2 0nly contains 5. Conclusion This study may lay the foundation for further research of the biochemical function of the 2 allergens and contribute to vaccine development for allergen - specific immunotherapy.

OBJECTIVETo observe the change of myeloid-derived suppressor cells (MDSCs) percentage in peripheral blood after operation in rectal cancer patients and to examine its association with the prognosis.

METHODSBlood samples of pre-operation and postoperative 21-day from 64 stage I(-III( rectal cancer patients who underwent surgery in Department of General Surgery, The Affiliated Cancer Hospital, Zhengzhou University between January and December 2009 were collected. MDSCs percentage was detected by flow cytometry. Its association with the prognosis of patients was analyzed.

RESULTSMDSCs percentage of postoperative 21-day decreased significantly compared with pre-operation (P<0.01). When local recurrence or distant metastasis presented, MDSCs percentage increased again (all P<0.01) and reached the preoperative level(P>0.05). All the patients were further divided into two groups based on median MDSCs percentage. Patients with higher MDSCs percentage before operation (>3.78%) and after operation (>2.11%) had significantly lower 5-year overall survival(OS) (58.1% and 62.1%) and 5-year disease-free survival (DFS)(54.8% and 58.6%) as compared to those with lower MDSCs percentage(5-year OS 87.9% and 84.8%; 5-year DFS 82.8% and 80.0%, all P<0.05). Multivariate analysis showed that preoperative MDSCs percentage was an independent prognostic factor of rectal cancer(HR:4.065, 95% CI:1.026 to 16.108, P=0.04).

CONCLUSIONSPreoperative increased MDSCs percentage may be an important predictor of poor OS in rectal cancer patients. Dynamic change of MDSCs percentage can reflect the disease development.