Objective To study the feasibility of the acute gastrointestinal injury (AGI) classification standard for evaluation of gastrointestinal function in intensive care unit (ICU) patients,and to discuss its value in administration of early enteral nutrition (EN).Methods A perspective study was conducted.85 patients with AGI admitted to ICU of Tianjin First Center Hospital from January 2013 to June 2013 were enrolled.EN was conducted after ICU admission or within 12-24 hours after high catabolic state.The patients were divided into four groups according to the AGI classification,i.e.grade Ⅰ,Ⅱ,Ⅲ,and Ⅳ,and they were treated according to the treatment procedure for AGI.The primary end points were 7-day rate of intake of standard EN,the degree of disease and nutrition,and their correlation with AGI classification.Secondary endpoint was rate of giving EN within 48 hours.Results Gastrointestinal dysfunction patients accounted for 49.42％ (85/172) of the ICU patients,and number of patients in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 29,28,19,9 respectively.On the first day of ICU stay,there were no statistical differences in age,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,serum albumin (ALB) and prealbumin (PA) among four groups,and it was demonstrated that the baseline data were comparable.APACHE Ⅱ score on the seventh day of ICU stay was significantly lower than that on the first day in grade Ⅰ,Ⅱ and Ⅲ patients (grade Ⅰ:20.48 ± 2.45 vs.22.59 ± 2.06,t=-3.120,P=0.031 ; grade Ⅱ:19.34 ± 1.80 vs.21.65 ± 2.22,t=-4.316,P=0.012; grade Ⅲ:20.63 ± 1.34 vs.23.31 ± 1.70,t=-5.640,P=0.000),and serum PA (g/L) was significantly increased (grade Ⅰ:24.37 ± 6.54 vs.10.62 ± 7.24,t=-4.866,P=0.000; grade Ⅱ:19.79± 12.48 vs.11.57±8.94,t=-2.116,P=0.031; grade Ⅲ:19.15±8.43 vs.13.78 ± 6.59,t=-3.601,P=0.000).On the seventh day ofICU stay,the APACHE Ⅱ score was higher in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (22.87 ± 3.31 vs.20.48 ± 2.45,19.34 ± 1.80,20.63 ± 1.34,P＜0.05 or P＜0.01),and PA was obviously lower in grade Ⅳ than that in grade Ⅰ,Ⅱ and Ⅲ patients (g/L:14.02 ± 8.70 vs.24.37 ± 6.54,19.79 ±12.48,19.15 ± 8.43,P＜0.05 or P＜0.01).There was no statistically significant difference among four groups in respect of serum ALB (F=0.454,P=0.722).The rate of giving EN in 24 hours in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients was 95.4％,72.1％,52.0％ and 0,respectively (x2=8.310,P=0.016),and in 48 hours it was 100.0％,83.0％,76.0％,and 0 (x2=5.470,P=0.025).7-day standard EN intake rate was 100.0％,88.7％,84.0％ and 34.0％ respectively in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ patients (x2 =0.720,P=0.017).Correlation analysis showed that there was a negative correlation between AGI classification and rate of giving EN in 1 day (r=-0.62,P=0.04) and 7-day standard EN intake rate (r=-0.76,P=0.02).Conclusions AGI classification can be used to estimate the gastrointestinal function of patients with critical illness,and it has a significant correlation with early EN support.An early goal achieving intervention based on the AGI classification can improve the nutritional status and the general state of the patients.

Objective To investigate the levels of serum interleukin(IL)-18 in patients with chronic renal failure (CRF)and its relationship with relevant indexes. Methods Sixty patients with CRF were divided into three groups: patients with CRF (CRF group, n = 18) ,patients with bemedialysis (HD group, n = 22) and patients with peritoneal dialysis (PD group,n = 20). 20 healthy subjects were taken as controls. The levels of serum IL-18, tumor necrosis factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) were detected by means of ELISA. Serum albumin (ALB) ,total cholesterol (TC) ,triglyceride (TG) and serum creatinine (SCr) levels were detected by con-ventional means. The GFR was measured by using the abbreviated Modification of Diet in Renal Disease study (MDRD) equation. Differences in continuous variables between the three groups were evaluated. Results The lev-els of serum IL-18 were significantly increased in CRF[(497.7 ± 120.7) ng/L], HD[(538.1 ± 113.2) ng/L] and PD[(565.7 ± 122.1) ng/L] patients than those in healthy subjects[(163.9±42.2) ng/L] (P <0.01). Further-more,serum IL-18 levels in HD patients were higher than these in CRF patients (P <0.05). Serum IL-18 levels in CRF were positively related to serum TNF-α,hs-CRP and SCr(r =0. 636,0.436,0.367,P <0.01) ,and negatively related to GFR(r = -0.515 ,P <0.05). Conclusion The levels of serum IL-18 are markedly increased in patients with CRF,HD and PD,and related to the levels of TNF-α,hs-CRP and GFR,so IL-18 might be an important marker of sub-clinical inflammation in patients with chronic renal failure.

Aim To observe the effects of icariin on depressive-like behavior in prenatally stressed offsprings and explore its mechanism.Methods The model of depression was established by prenatal restraint stress on late pregnant mother, then male offspring rats were randomly divided into five groups of eight: Control, PS model, Saline group(NS), ICA(80 mg·kg-1), ICA(40 mg·kg-1).The effects of icariin on PS-induced depressive-like behaviors in male offsprings were examined by forced swimming test(FST) and open-field test(OFT).Furthermore, the protein expressions of group I metabotropic glutamate receptors(I mGluRs) and excitatory amino acid transporter 2(EAAT2) in prefrontal cortex were detected by Western blot.Results PS group exhibited depressive-like behaviors with decreased struggling time(P<0.01) and center crossing numbers(P<0.05) compared to CON, with increased protein expressions of group I mGluRs(P<0.01,P<0.05) and decreased EAAT2(P<0.05) in prefrontal cortex compared to CON.Treatment with icariin(80 mg·kg-1, 40 mg·kg-1)significantly increased struggling time(P<0.05,P<0.01) and center crossing numbers(P<0.05) in PS-exposed male offspring rats.Treatment with icariin markedly modulated the protein levels of mGluR1, mGluR5 and EAAT2 in prefrontal cortex.Conclusion Icariin has significant antidepressant effects in prenatally stressed rats, and the mechanism might be associated with the modulation of Ⅰ mGluRs.

Objective To observe the clinical effects of external application of Chinese medicine ion introduction through acupiont in the prevention and treatment of hyperamylasemia and pancreatitis following endoscopic retrograde cholangio pancreatography (ERCP). Methods Three hundred subjects were divided into treatment group and control group randomly, and treated with routine therapy after surgery, moreover, treatment group was treated with external application of Chinese medicine ion introduction through acupiont. The incidence of hyperamylasemia and pancreatitis, the time of serum amylase returned to normal in patients with hyperamylasemia and pancreatitis was observed, and the abdominal pain after ERCP was scored. Results Excluding 17 cases according to the exclusion criteria, the treatment group included 142 cases and the control group included 141 cases. The hyperamylasemia and pancreatitis happened less frequently in the treatment group than in control group, but there was no significant difference (P>0.05). The time of serum amylase returned to normal in patients with pancreatitis was (4.25±0.95)d in treatment group and (5.28±1.11)d in control group, with no significant difference (P>0.05). The time of serum amylase returned to normal in patients with hyperamylasemia was (2.88 ± 0.78)d in treatment group and (3.81±1.62)d in control group, showed a significant difference (P<0.05). The score of abdominal pain was 0.95±1.04 in treatment group and 1.21±1.12 in control group, showed a significant difference (P<0.05). Conclusion External application of Chinese medicine ion introduction through acupoint can promote the recovery of the patients postoperative ERCP combined with hyperamylasemia or pancreatitis, and can better alleviate abdominal pain.

Objective To investigate the prognostic factors in patients with esophygectomy after oncologic esophagectomy by analyzing the long-term survival .Methods 104 patients underwent esophagectomy for cancer were retrospectively reviewed from 2007 to 2008 in this hospital ,and the investigation was carried on in questionnaire ,following up 3 years .Various ways ,such as Life Tables ,Kaplan-Meier and Cox regression analysis ,were used to evaluate long-term survival .Results (1)A total of 61 patients died in 3 years .The median survival time was 35 .23 months .The cumulative survival rates at 1 ,2 and 3 year after surgery were 87% , 62% ,and 48% respectively ,and death hazard in 24th month after surgery was the highest .(2)In univariate analysis :drinking ,pres-ence of lymph node metastasis and TNM staging were significant factors that influenced long-term survival .(3)Multivariate analy-sis :lymph node(RR = 2 .399 ,P= 0 .002 ,95% CI :1 .385 to 4 .154) ,drinking(RR = 0 .470 ,P = 0 .008 ,95% CI :0 .269 to 0 .882) ,di-gestive tract construction(RR= 1 .910 ,P= 0 .018 ,95% CI :1 .118 to 3 .262) were the isolated factor influencing the prognosis .Con-clusion Patients after oncologic esophagectomy generally suffer poor survival .The presence of lymph node metastasis ,drinking and different methods of reconstraction are statistically significant factors influencing long-term survival .

[Objective] To evaluate the diagnostic values of multi-detector spiral computed tomography (MDCT) in pediatric sacrococcygeal tumors (SCT) and to improve the diagnostic ability.[Methods] 54 children (22 male and 32 female,age between 1 day and 16 years old) with pathologically confirmed SCT were involved in our study.All of them received 64-row spiral Computed Tomography before surgery,CT characteristics and clinical data were retrospectively analyzed.[Results] Pediatric SCT are more common in female children under four years old,with the germ cell tumors most common,followed by neurogenic tumors.Among the 54 SCT,39cases were malignant and 15 were benign (malignant∶ benign =2.60∶1).In CT image findings,37 cases (68％) were mainly solid mass,with 31 cases confirmed malignant by pathology.8 cases (15％) were mainly cystic,with all of them confirmed benign by pathology.9 cases (17％) were cystic-solid or with obvious necrosis in solid mass,with 8 cases confirmed malignant by pathology.[Conclusion] Malignant pediatric SCT are more common than benign SCT.Most malignant SCT are mainly solid mass or cystic-solid or with obvious necrosis in solid mass,and most benign tumors are mainly cystic.Combined with clinical data,MDCT can help to correctly diagnose SCT before surgery.

Objective Learn about prevalence of depressive symptoms and to determine the relationship of depressive symptoms with social capital and social networks among migrant female adolescents.Methods A cross-sectional survey was conducted among 329 single females selected by convenience sampling who were aged from 16 to 28 years old,having worked for from one month to ten years.Center for Epidemiologic Studies Depression Scale(CES-D) was used to evaluate the status of depressive symptoms that were sentenced by total score ≥20.Self-compiled items were applied to assess social capital with six aspects involving organizational characteristics,exclusion,etc.and social networks included size and density with score ranging from 1 to 15 and from 0 to 1 respectively.Results The prevalence of depressive symptom was 52.9% in participants.Working in restaurants(OR=0.554),being younger(OR=0.506),high scores of solidarity,trust and cooperation of neighborhood(OR=0.964,0.758) were associated with low risk of depressive symptoms.Conclusions Female migrant adolescents from rural to urban should be paid more attention to in depression prevention.Improving solidarity,trust and cooperation in neighborhood in city could probably decrease risk of their depressive symptoms.

BACKGROUND:Interleukin-12 (IL-12) may function as an immune regulator in the pathogenesis of osteoarticular tuberculosis. OBJECTIVE:To explore the association of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with susceptibility to osteoarticular tuberculosis and serum interleukin-12 levels in Guangxi Zhuang population. METHODS:The single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms were detected by polymerase chain reaction-single base extension technique and direct DNA sequencing in 150 patients with osteoarticular tuberculosis (disease group) and 165 healthy individuals (control group) in Guangxi Zhuang population. The genotype and al ele frequencies of IL-12 and the relationship of genotypes to the susceptibility to osteoarticular tuberculosis were analyzed. In addition, the association of genotypes of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with serum IL-12 levels were analyzed. RESULTS AND CONCLUSION:There was no significant difference in the genotype and al ele frequencies of IL-12A rs568408 G/A and IL-12B rs3212227 A/C between the disease group and the control group (P>0.05). Moreover, there was no difference in four haplotypes of IL-12 gene between the disease group and the control group (P>0.05). Serum IL-12 levels in subjects with osteoarticular tuberculosis carrying the variant rs568408 GA/AA genotypes and wild-type rs568408 GG genotypes were similar (P>0.05). Similarly, there was no significant difference in serum IL-12 levels between subjects with osteoarticular tuberculosis carrying the variant rs3212227 AC/CC genotypes and wild-type rs3212227 AA genotypes (P>0.05). These findings suggest that the single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms are not associated with susceptibility to osteoarticular tuberculosis in Guangxi Zhuang population.

Background and purpose: Syndecan-1 and HPA-1 may be involved in the progression of invasion and metastasis of many malignant tumors, but there are few reports about the relationship between the two gene expressions in gastric carcinomas. This study was aimed to explore the expression of Syndecan-1 and HPA-1 mRNA in gastric carcinoma and their relationship with the invasion and metastasis of gastric carcinoma. Methods: Real-time polymerase chain reation (RT-PCR) was used to detect mRNA of Syndecan-1 and HPA-1 in 58 cases of gastric carcinoma, 58 paired adjacent gastric carcinoma (2 cm from carcinoma), and 58 surgical marginal normal gastric mucosa tissues (5 cm from carcinoma). Then we analyzed their relationship with clinico-pathological characteristics of gastric carcinoma. Results: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa (98.3%) than that in paired adjacent mucosa (25.9%) and gastric carcinoma (5.2%) (all P<0.001).The upregulation of Syndecan-1 mRNA was significantly higher in paired adjacent mucosa than that in gastric carcinoma (all P<0.05). The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma (86.2%) than that in paired adjacent gastric carcinoma (27.6%) and normal gastric mucosa (5.2%) (P<0.001). The upregulation of HPA-1 mRNA was significantly higher in paired adjacent gastric carcinoma than that in normal gastric mucosa (all the same P<0.05). The downregulation of Syndecan-1 and the upregulation of HPA-1 had relationship with the degree of differentiation, depth of infiltration, lymph node metastasis, distant metastasis and TNM staging of gastric carcinoma (P<0.05). Conclusion: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa. The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma. Also, the expression of Syndecan-1 and HPA-1 could predict the invasion and metastasis of gastric carcinoma. Determination of Syndecan-1 and HPA-1 may be of value in the treatment as well as in the prediction for prognosis of gastric cancer.

OBJECTIVETo investigate whether the angiotensin II type I receptor gene (AGTR1) A1166C polymorphism is associated with a high risk of diabetic nephropathy.

METHODSThe allele frequency and the genotype distribution of the AGTR1 A1166C polymorphism were studied in normal controls (157 cases), simple diabetes (141 cases, duration of diabetes >10 years), and diabetic nephropathy (152 cases) by means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTSPatients with diabetic nephropathy had a higher frequency of C allele of the AGTR1 A1166C polymorphism than that of normal controls and simple diabetes (P<0.05); but there was no significant difference in frequency of C allele between the normal controls and patients with simple diabetes.

CONCLUSIONThe diabetic patients with AGTR1 C allele may be more susceptible to diabetic nephropathy than diabetic patients with A allele.

Aged ; Diabetic Nephropathies ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptor, Angiotensin, Type 1 ; genetics